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Sample records for alcoholics attending outpatient

  1. A demographic study to profile non-attenders at a gynaecology outpatient clinic.

    PubMed

    Pillai, R; Bhangu, N; Narayanan, M; Yoong, W

    2012-02-01

    Missed outpatient appointments result in the inefficient utilisation of resources and have secondary effects on the health of the non-attenders, as well as on other patients who have to wait longer for their appointments. The first part of the study involved retrospective analysis of trends of non-attendance based on a computerised database of all gynaecology appointments over 12 months. The second comprised a prospective case-control study in which women who missed their gynaecology outpatient appointments (index cases) over 2 months were compared with patients who attended the same clinics matched for indication for referral (control cases). The overall non-attendance rate over 12 months was 16.1%, of whom 42% were recurrent non-attenders. Data from 105 defaulters were compared with 105 non-defaulters who attended the same clinics. Defaulters were significantly younger, single or separated and were more likely to be 'follow-ups' rather than new cases (all p < 0.05). Longer intervals between the appointment letter and actual appointment date was significantly related to non-attendance (p = 0.01) and there was a trend to a greater degree of smoking and alcohol ingestion in the defaulter group (p = 0.059). Comparison of other variables such as severity of symptoms, parity, source of referral and fluency of English did not reach statistical significance (p > 0.05). This prospective study has demonstrated certain profiles which are common to defaulters and which can be used to develop strategies to minimise non-attendance. Examples include reducing the time interval between sending the appointment letter and actual appointment date and selectively over-booking younger, single women who smoke.

  2. Outpatient management of alcohol withdrawal syndrome.

    PubMed

    Muncie, Herbert L; Yasinian, Yasmin; Oge', Linda

    2013-11-01

    Approximately 2% to 9% of patients seen in a family physician's office have alcohol dependence. These patients are at risk of developing alcohol withdrawal syndrome if they abruptly abstain from alcohol use. Alcohol withdrawal syndrome begins six to 24 hours after the last intake of alcohol, and the signs and symptoms include tremors, agitation, nausea, sweating, vomiting, hallucinations, insomnia, tachycardia, hypertension, delirium, and seizures. Treatment aims to minimize symptoms, prevent complications, and facilitate continued abstinence from alcohol. Patients with mild or moderate alcohol withdrawal syndrome can be treated as outpatients, which minimizes expense and allows for less interruption of work and family life. Patients with severe symptoms or who are at high risk of complications should receive inpatient treatment. In addition to supportive therapy, benzodiazepines, either in a fixed-dose or symptom-triggered schedule, are recommended. Medication should be given at the onset of symptoms and continued until symptoms subside. Other medications, including carbamazepine, oxcarbazepine, valproic acid, and gabapentin, have less abuse potential but do not prevent seizures. Typically, physicians should see these patients daily until symptoms subside. Although effective treatment is an initial step in recovery, long-term success depends on facilitating the patient's entry into ongoing treatment.

  3. Correlates of depressive symptoms in individuals attending outpatient stroke clinics.

    PubMed

    Vermeer, Julianne; Rice, Danielle; McIntyre, Amanda; Viana, Ricardo; Macaluso, Steven; Teasell, Robert

    2017-01-01

    Background and purpose Depressive symptoms are common post-stroke. We examined stroke deficits and lifestyle factors that are independent predictors for depressive symptomology. Methods A retrospective chart review was performed for patients' post-stroke who attended outpatient clinics at a hospital in Southwestern Ontario between 1 January 2014 and 30 September 2014. Demographic variables, stroke deficits, secondary stroke risk factors and disability study measures [Patient Health Questionnaire-9 (PHQ-9) and Montreal Cognitive Assessment (MoCA)] were analyzed. Results Of the 221 outpatients who attended the stroke clinics (53% male; mean age = 65.2 ± 14.9 years; mean time post-stroke 14.6 ± 20.1 months), 202 patients were used in the final analysis. About 36% of patients (mean = 5.17 ± 5.96) reported mild to severe depressive symptoms (PHQ-9 ≥ 5). Cognitive impairment (CI), smoking, pain and therapy enrollment (p < 0.01) were significantly associated with depressive symptoms. Patients reporting CI were 4 times more likely to score highly on the PHQ-9 than those who did not report CI (OR = 4.72). While controlling for age, MoCA scores negatively related to depressive symptoms with higher PHQ-9 scores associated with lower MoCA scores (r= -0.39, p < 0.005). Conclusions High levels of depressive symptoms are common in the chronic phase post-stroke and were partially related to cognition, pain, therapy enrollment and lifestyle factors. Implications for Rehabilitation Stroke patients who report cognitive deficits, pain, tobacco use or being enrolled in therapy may experience increased depressive symptoms. A holistic perspective of disease and lifestyle factors should be considered while assessing risk of depressive symptoms in stroke patients. Patients at risk for depressive symptoms should be monitored at subsequent outpatient visits.

  4. The accelerated intake: a method for increasing initial attendance to outpatient cocaine treatment.

    PubMed

    Festinger, D S; Lamb, R J; Kirby, K C; Marlowe, D B

    1996-01-01

    We examined whether offering an accelerated (same-day) versus a standard (1- to 7-day delay) intake appointment increased initial attendance at an outpatient cocaine treatment program. Significantly more of the subjects who were offered an accelerated intake (59%) attended than those who were given a standard intake (33%), chi 2 (2, N = 78) = 4.198, p < .05. The accelerated intake procedure appears to be useful for enhancing enrollment in outpatient addiction treatment.

  5. The Accelerated Intake: A Method for Increasing Initial Attendance to Outpatient Cocaine Treatment.

    ERIC Educational Resources Information Center

    Festinger, David S.; And Others

    1996-01-01

    The effectiveness of offering same day appointments at an outpatient cocaine treatment program to increase intake attendance was examined. Seventy-eight clients were given standard or accelerated intake appointments. Significantly more clients who were given accelerated appointments attended the program. An accelerated intake procedure appears to…

  6. Treatment choices and subsequent attendance by substance-dependent patients who disengage from intensive outpatient treatment

    PubMed Central

    Van Horn, Deborah H. A.; Drapkin, Michelle; Lynch, Kevin G.; Rennert, Lior; Goodman, Jessica D.; Thomas, Tyrone; Ivey, Megan; McKay, James R.

    2016-01-01

    In an effort to increase engagement in effective treatment, we offered a choice of alternate evidence-based treatments to 137 alcohol- or cocaine-dependent adults (110 males, 27 females) who entered an intensive outpatient program (IOP) but disengaged within the first 8 weeks. We hypothesized that disengaged patients would choose and subsequently attend alternatives to IOP when given the chance, that their choices would be consistent with their previously-stated preferences, and that demographic and clinical characteristics would be predictive of alternatives chosen. Of 96 participants reached by phone, 19% chose no treatment; 49% chose to return to IOP; 24% chose individual psychotherapy; 6% chose telephone counseling; 2% chose naltrexone with medication management. There were few relationships between participant characteristics and choices made upon disengagement. Participants who chose alternative treatments were equally likely to attend their chosen treatment as those who chose IOP. Limited interest in alternative treatments may reflect allegiance to IOP, which was initially chosen by all participants. Implications for implementation of patient-centered adaptive treatment are discussed. PMID:27667970

  7. Age, Gender, and Treatment Attendance among Forensic Psychiatric Outpatients.

    ERIC Educational Resources Information Center

    Hadley, Dianne C.; Reddon, John R.; Reddick, Robert D.

    2001-01-01

    Uses the records of forensic psychiatry outpatients (N=6,299) to evaluate absenteeism from treatment in relation to age and gender. Results reveal that females had a significantly higher absentee rate than males in all age groups. For both males and females, missed appointments declined significantly with age. (Contains 34 references and 1 table.)…

  8. Do referral-management schemes reduce hospital outpatient attendances? Time-series evaluation of primary care referral management

    PubMed Central

    Cox, Jonathan MS; Steel, Nicholas; Clark, Allan B; Kumaravel, Bharathy; Bachmann, Max O

    2013-01-01

    Background Ninety-one per cent of primary care trusts were using some form of referral management in 2009, although evidence for its effectiveness is limited. Aim To assess the impact of three referral-management centres (RMCs) and two internal peer-review approaches to referral management on hospital outpatient attendance rates. Design and setting A retrospective time-series analysis of 376 000 outpatient attendances over 3 years from 85 practices divided into five groups, with 714 000 registered patients in one English primary care trust. Method The age-standardised GP-referred first outpatient monthly attendance rate was calculated for each group from April 2009 to March 2012. This was divided by the equivalent monthly England rate, to derive a rate ratio. Linear regression tested for association between the introduction of referral management and change in the outpatient attendance rate and rate ratio. Annual group budgets for referral management were obtained. Results Referral management was not associated with a reduction in the outpatient attendance rate in any group. There was a statistically significant increase in attendance rate in one group (a RMC), which had an increase of 1.05 attendances per 1000 persons per month (95% confidence interval = 0.46 to 1.64; attendance rate ratio increase of 0.07) after adjustment for autocorrelation. Mean annual budgets ranged from £0.55 to £6.23 per registered patient in 2011/2012. RMCs were more expensive (mean annual budget £5.18 per registered patient) than internal peer-review approaches (mean annual budget £0.97 per registered patient). Conclusion Referral-management schemes did not reduce outpatient attendance rates. RMCs were more expensive than internal peer review. PMID:23735409

  9. Changes in hospital and out-patient events and costs following implant naltrexone treatment for problematic alcohol use.

    PubMed

    Kelty, Erin; Hayes, Lesleigh; O'Neil, Graeme; Kyle, Sarah; Jeffrey, Gary P; O'Neil, George; Hendrie, Delia; Mukhtar, Aqif; Hulse, Gary

    2014-08-01

    The harmful use of alcohol places a considerable burden on the community, both socially and financially. The aim of this study was to determine if the use of implant naltrexone is associated with a reduction in health care events and costs in patients treated for problematic alcohol use. Ninety four patients (60.6% male) treated between 2002 and 2007 were matched against state hospital, emergency department (ED), mental health out-patients and mortality data sets for 6 months prior to and 6 months post treatment. The number of patients, events, and costs associated with each health event were compared before and after treatment. Overall health care events and costs were reduced from $509033 prior to treatment to $270001 following treatment. Costs associated with hospital admission showed the most significant reduction, falling from $424605 (82 admissions/36 patients) before treatment to $203462 (43 admission/24 patients) after. While costs associated with ED attendances also fell ($74885 to $54712), costs associated with mental health out-patient attendances increased ($9543 to $11827). The use of implant naltrexone was associated with a reduction health events and costs in patients with problematic alcohol use in the first 6 months following treatment.

  10. Malaria in rural Mozambique. Part I: Children attending the outpatient clinic

    PubMed Central

    Guinovart, Caterina; Bassat, Quique; Sigaúque, Betuel; Aide, Pedro; Sacarlal, Jahit; Nhampossa, Tacilta; Bardají, Azucena; Nhacolo, Ariel; Macete, Eusébio; Mandomando, Inácio; Aponte, John J; Menéndez, Clara; Alonso, Pedro L

    2008-01-01

    Background Malaria represents a huge burden for the health care services across Africa. Describing malaria attending health services contributes to quantify the burden and describe the epidemiology and clinical presentation. Methods Retrospective analysis of data collected through the Manhiça morbidity surveillance system (Mozambique) on all paediatric visits (<15 years) to the outpatient clinic from June 2003 to May 2005. Age-specific minimum community-based incidence rates (MCBIRs) of malaria were calculated using demographic surveillance system data. Malaria was defined as fever or history of fever in the preceding 24 hours with asexual Plasmodium falciparum parasitaemia of any density in the blood smear. Results A total of 94,941 outpatient visits were seen during the study period, of which 30.5% had malaria. Children younger than three years accounted for almost half of the total malaria cases and children aged ≥ 5 years represented 36.4% of the cases. Among children who presented with malaria, 56.7% had fever and among children who presented with fever or a history of fever only 37.2% had malaria. The geometric mean parasitaemia in malaria cases was 8582.2 parasites/μL, peaking in children aged two to three years. 13% of malaria cases had a PCV<25% and the mean PCV in malaria cases increased gradually with age, ranging from 27.8% in children aged 2–12 months to 34.4% in ≥ 5 years. The percentage of cases admitted or transferred showed a clear decreasing trend with age. MCBIRs of outpatient malaria per 1,000 child years at risk for the whole study period were of 394 in infants, 630 in children aged 1 to <5 years and 237 in children aged five years or more. A clustering of the cases was observed, whereby most children never had malaria, some had a few episodes and very few had many episodes. Conclusion Preventive measures should be targeted at children younger than three years, as they carry the highest burden of malaria. Children aged 5–15 years

  11. Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in western Kenya.

    PubMed

    Papas, Rebecca K; Sidle, John E; Martino, Steve; Baliddawa, Joyce B; Songole, Rogers; Omolo, Otieno E; Gakinya, Benson N; Mwaniki, Michael M; Adina, Japheth O; Nafula, Tobista; Owino-Ong'or, Willis D; Bryant, Kendall J; Carroll, Kathleen M; Goulet, Joseph L; Justice, Amy C; Maisto, Stephen A

    2010-06-01

    Two-thirds of those with HIV worldwide live in sub-Saharan Africa. Alcohol use is associated with the HIV epidemic through risky sex and suboptimal ARV adherence. In western Kenya, hazardous drinking was reported by HIV (53%) and general medicine (68%) outpatients. Cognitive behavioral treatment (CBT) has demonstrated strong efficacy to reduce alcohol use. This article reports on a systematic cultural adaptation and pilot feasibility study of group paraprofessional-delivered CBT to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. Following adaptation and counselor training, five pilot groups were run (n = 27). Overall attendance was 77%. Percent days abstinent from alcohol (PDA) before session 1 was 52-100% (women) and 21-36% (men), and by session 6 was 96-100% (women) and 89-100% (men). PDA effect sizes (Cohen's d) between first and last CBT session were 2.32 (women) and 2.64 (men). Participants reported treatment satisfaction. Results indicate feasibility, acceptability and preliminary efficacy for CBT in Kenya.

  12. Chlamydia trachomatis in women attending a gynaecological outpatient clinic with lower genital tract infection.

    PubMed

    Svensson, L; Weström, L; Mårdh, P A

    1981-08-01

    In a study of 3794 consecutive women attending a gynaecological outpatient clinic with symptoms of lower genital tract infection (LGTI) 350 (9.2%) harboured Chlamydia trachomatis and 83 (2.2%) Neisseria gonorrhoeae. One hundred and ninety-five patients who were later found to have acute salpingitis and 109 other women in whom the chlamydial cultures were spoiled were excluded from the series. Of the remaining 3490 women, 281 were infected with C trachomatis, 42 with N gonorrhoeae, and 17 with both. Of the 3150 women who were infected with neither organism, 146 were randomly selected as controls. The chlamydia-positive patients were younger (P less than 0.001), did not complain of pelvic discomfort or pain (P less than 0.01), and used oral contraceptives (P less than 0.001) more frequently than did the controls; intrauterine devices were used more often (P less than 0.01) by the controls. Increased vaginal discharge was reported significantly more often in chlamydia-positive patients than in the controls (P less than 0.05). Of 266 women harbouring C trachomatis the organism was still present in 22 (8.3%) when they were followed up from two to more than eight weeks after finishing treatment with doxycycline. Of 91 male consorts of chlamydia-positive women, 53 (58.2%) were infected with C trachomatis.

  13. The use of complementary medications by cancer patients attending an outpatient pain and symptom clinic.

    PubMed

    Oneschuk, D; Fennell, L; Hanson, J; Bruera, E

    1998-01-01

    Complementary medications appear to be gaining popularity among cancer patients. When we surveyed 143 advanced cancer patients attending an outpatient pain and symptom clinic at a regional cancer centre as to their use of complementary medications and nutritional supplements, we found 37% (53/143) to be making use of complementary medications. Users tended to be younger (mean age 53.3 years) and have a preference for purchase from health stores, with 61% of complementary medications being bought there. Health store staff were the primary recommenders for both men and women and especially for those over 60 years of age. Of the 197 complementary medications purchased, 78 (39.6%) were herbs, 67 (32.5%) were vitamins, 13 (6.6%) were minerals, 21 (10.7%) were other medications including shark cartilage, and 21 (10.7%) could not be identified. Both anticancer effect and the promotion of well-being were prominent among the stated reasons for using these medications.

  14. DUI/DWAI Offenders Compared to Clients Seen in an Outpatient Alcohol-Treatment Facility.

    ERIC Educational Resources Information Center

    Packard, Michele A.

    1987-01-01

    Examined client records to compare 50 subjects admitted to a drinking-driver program and 50 subjects admitted to an outpatient alcohol treatment clinic. Highly significant differences were found between groups on 10 of 12 drinking indices, suggesting that clients referred for alcohol-related traffic offenses represent a population different from…

  15. Drinking Game Participation among Undergraduate Students Attending National Alcohol Screening Day

    ERIC Educational Resources Information Center

    Cameron, Jennifer M.; Heidelberg, Natalie; Simmons, Lisa; Lyle, Sarah B.; Mitra-Varma, Kathakali; Correia, Chris

    2010-01-01

    Objectives, Participants, Methods: Drinking game participation has increased in popularity among college students and is associated with increased alcohol consumption and alcohol-related problems. The current study investigated drinking game participation among 133 undergraduates attending National Alcohol Screening Day (NASD) in April of 2007.…

  16. Patterns of Technology Use in Patients Attending a Cardiopulmonary Outpatient Clinic: A Self-Report Survey

    PubMed Central

    2015-01-01

    Background Self-management education for cardiopulmonary diseases is primarily provided through time-limited, face-to-face programs, with access limited to a small percentage of patients. Telecommunication tools will increasingly be an important component of future health care delivery. Objective The purpose of this study was to describe the patterns of technology use in patients attending a cardiopulmonary clinic in an academic medical center. Methods A prevalence survey was developed to collect data on participant demographics (age in years, sex, and socioeconomic status); access to computers, Internet, and mobile phones; and use of current online health support sites or programs. Surveys were offered by reception staff to all patients attending the outpatient clinic. Results A total of 123 surveys were collected between March and April 2014. Technological devices were a pervasive part of everyday life with respondents engaged in regular computer (102/123, 82.9%), mobile telephone (115/117, 98.3%), and Internet (104/121, 86.0%) use. Emailing (101/121, 83.4%), researching and reading news articles (93/121, 76.9%), social media (71/121, 58.7%), and day-to-day activities (65/121, 53.7%) were the most common telecommunication activities. The majority of respondents reported that access to health support programs and assistance through the Internet (82/111, 73.9%) would be of use, with benefits reported as better understanding of health information (16/111, 22.5%), avoidance of difficult travel requirements and time-consuming face-to-face appointments (13/111, 18.3%), convenient and easily accessible help and information (12/111, 16.9%), and access to peer support and sharing (9/111, 12.7%). The majority of patients did not have concerns over participating in the online environment (87/111, 78.4%); the few concerns noted related to privacy and security (10/15), information accuracy (2/15), and computer literacy and access (2/15). Conclusions Chronic disease burden and

  17. Alcohol Consumption among Urban, Suburban, and Rural Veterans Affairs Outpatients

    ERIC Educational Resources Information Center

    Williams, Emily C.; McFarland, Lynne V.; Nelson, Karin M.

    2012-01-01

    Purpose: United States rural residents tend toward poorer health than urban residents. Although alcohol use is associated with multiple medical conditions and can be reduced via brief primary care-based interventions, it is unknown whether alcohol consumption differs by rurality among primary care patients. We sought to describe alcohol…

  18. Using "Bud World Party" Attendance to Predict Adolescent Alcohol Use and Beliefs about Drinking

    ERIC Educational Resources Information Center

    Thomsen, Steven R.; Rekve, Dag; Lindsay, Gordon B.

    2004-01-01

    This study explored the association between attendance at the "Bud World Party," a family entertainment venue created by Anheuser-Busch for the 2002 Winter Olympics, and alcohol-related beliefs and current drinking behaviors for a group of 7th and 8th graders who attend a middle school in close proximity to the downtown Salt Lake City plaza where…

  19. Adolescent Substance-Use Frequency following Self-Help Group Attendance and Outpatient Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Gangi, Jennifer; Darling, Carol A.

    2012-01-01

    Despite the heterogeneity of posttreatment outcomes, the likelihood of relapse is often dependent on several factors, including participation in continuing care services such as self-help groups. However, few studies have examined the use of self-help groups among adolescent outpatients. Therefore, in this study, investigators examined self-help…

  20. Awareness and Practices of Oral Hygiene and its Relation to Sociodemographic Factors among Patients attending the General Outpatient Department in a Tertiary Care Hospital of Kolkata, India

    PubMed Central

    Paul, Bobby; Basu, Mausumi; Dutta, Sinjita; Chattopadhyay, Sita; Sinha, Debasis; Misra, Raghunath

    2014-01-01

    Background: Periodontal diseases, dental caries, malocclusion, and oral cancer are the most prevalent dental diseases affecting people in the Indian community. Objective: The study was conducted to assess the awareness and practices on oral hygiene and its association with the sociodemographic factors among patients attending the general Outpatient Department (OPD). Materials and Methods: A cross-sectional study was conducted among 224 patients attending the general OPD of the SSKM Hospital, Kolkata, India, from 1 April to 30 April, 2013. The study tool was a pre-designed and pre-tested semi-structured schedule. Results: About 69.20% of the participants used a toothbrush with toothpaste as a method of cleaning their teeth; 35.71% brushed twice in a day; 33.03% brushed both in the morning and at bedtime; and 8.93% used mouthwash. About 40.62% visited the dentist during the last six months; among them 61.18% attended because of pain. Almost three-fourth of the participants knew that tooth decay and bad breath were the effects of not cleaning the teeth. It was known to 71.42, 63.39, 70.53, and 73.21% of the respondents, respectively, that excess sweet, cold drink, alcohol, and smoking/pan chewing were bad for dental health. Television was the source of knowledge to 57.14% of the participants and 35.71% acquired their knowledge from a dentist. Females, literates, urban residents, users of mouthwash, and regular visitors to the dentist had good oral hygiene practices. Conclusion: Oral health awareness and practices among the study population are poor and need to improve. PMID:25161965

  1. 38 CFR 17.82 - Contracts for outpatient services for veterans with alcohol or drug dependence or abuse...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... services for veterans with alcohol or drug dependence or abuse disabilities. 17.82 Section 17.82 Pensions... Agencies § 17.82 Contracts for outpatient services for veterans with alcohol or drug dependence or abuse... requirements of the “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and...

  2. 38 CFR 17.82 - Contracts for outpatient services for veterans with alcohol or drug dependence or abuse...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... services for veterans with alcohol or drug dependence or abuse disabilities. 17.82 Section 17.82 Pensions... Agencies § 17.82 Contracts for outpatient services for veterans with alcohol or drug dependence or abuse... requirements of the “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and...

  3. Erectile dysfunction in a sample of patients attending a psychiatric outpatient department.

    PubMed

    Mosaku, K S; Ukpong, D I

    2009-01-01

    To assess the prevalence of erectile dysfunction among a sample of patients attending a psychiatric clinic, we administered the International Index of Erectile Function on 108 male patients attending the clinic. We also obtained sociodemographic and clinical variables from the patients. The mean age of the patients studied was 39.6 (s.d.=11.6), with a mean duration of illness of 10.24 (s.d.=8.2) years. There were 46.8% schizophrenics; other diagnoses include bipolar affective disorder, recurrent depressive disorder and substance use disorder. The prevalence of erectile dysfunction was 83%. Age, marital status, current medications and the presence of comorbid medical conditions were significantly associated with erectile dysfunction; however, only age and marital status significantly predicted erectile dysfunction. We concluded that erectile dysfunction is highly prevalent among patients attending the psychiatric clinic, as such inquiries about sexual function should be routinely carried out by clinicians.

  4. Non-attendance and effective equity of access at four public specialist outpatient centers in Hong Kong.

    PubMed

    Johnston, Janice M; Leung, Gabriel; Saing, Hnin; Kwok, Kin-On; Ho, Lai-Ming; Wong, Irene O L; Tin, Keith Y K

    2006-05-01

    This study tests whether socio-economic status (SES), at either the individual or ecologic levels, exerts a direct impact on non-attendance or an indirect impact on attendance through longer waiting time for appointments and/or doctor-shopping behavior at four public specialist outpatient centers in Hong Kong. We collected information through three main sources, namely patients' referral letters, telephone interviews with both open- and closed-ended questions (e.g. doctor-shopping data) and hospital administrative databases from a total of 6495 attenders and non-attenders enrolled from July 2000 through October 2001. Individual-level SES was measured by education, occupation and monthly household income. Tertiary planning unit (TPU)-level SES data consisted of proportion unemployed, proportion with tertiary education, median income and Gini coefficient. Direct effects of SES on non-attendance were examined by logistic regression. Indirect contributions mediated through waiting time and doctor-shopping were analyzed by structural equation modeling. We found that SES, at the individual or ecologic level, did not exert a direct effect on non-attendance. Instead, TPU-level SES contributed positively to waiting time (beta=0.06+/-0.03, p=0.048), i.e. worse-off neighborhoods (and those with greater income inequality) had a shorter waiting time. Individual-level SES was also directly associated with the likelihood of doctor-shopping (beta=0.16+/-0.02, p<0.001), i.e. the poor were less likely to doctor-shop. Both waiting time (beta=0.12+/-0.02, p<0.001) and doctor-shopping (beta=0.37+/-0.02, p<0.001) were significantly related to non-attendance. Our findings suggest a highly equitable specialist ambulatory care public system in Hong Kong. Health care resources are appropriately targeted at the socially indigent, and the poor are not discriminated against and pushed to seek alternative sources of care by the system. These results should be confirmed using a prospective

  5. Self-Reported Alcohol and Drug Problems Among Internal Medicine Outpatients: Relationships With Criminal Behavior

    PubMed Central

    Lam, Charlene; Wiederman, Michael W.

    2011-01-01

    Objective: Previous research indicates relationships between alcohol/substance misuse and criminal behavior, but past studies have restricted investigations to atypical samples and/or utilized limited assessments of illegal behavior. In the present study, we explored relationships between alcohol/drug problems and charges for 27 criminal behaviors in a primary care sample. Method: Participants were a cross-sectional sample of 376 consecutive men and women, aged 18 years or older, being seen for nonemergent medical care at an outpatient internal medicine clinic staffed predominantly by residents and located in a midsized, midwestern city in October 2010. Using a self-report survey methodology, we examined relationships between alcohol and drug problems (“Have you ever had a problem with alcohol?” and “Have you ever had a problem with drugs?”) and 27 illegal behaviors as delineated by the categories used by the US Federal Bureau of Investigation. Results: Men with alcohol or drug problems statistically exhibited the greatest number of charges for different forms of illegal behavior (P < .001). These charges were directly related to alcohol/drug misuse (eg, driving under the influence of alcohol or drugs) and otherwise (eg, aggravated assault, simple assault, gambling, larceny-theft). Conclusions: In primary care settings, men with alcohol/drug problems may also have a history of illegal behaviors—a finding that is relevant in terms of social and legal implications. PMID:22454803

  6. Prevalence and predictors of Lymphogranuloma venereum in a high risk population attending a STD outpatients clinic in Italy

    PubMed Central

    2014-01-01

    Background We evaluated LGV prevalence and predictors in a high risk population attending a STI Outpatients Clinic in the North of Italy. Methods A total of 108 patients (99 MSM and 9 women), with a history of unsafe anal sexual intercourses, were enrolled. Anorectal swabs and urine samples were tested for Chlamydia trachomatis (CT) DNA detection by Versant CT/GC DNA 1.0 Assay (Siemens Healthcare Diagnostics Terrytown, USA). RFLP analysis was used for CT molecular typing. Results L2 CT genotype was identified in 13/108 (12%) rectal swabs. All LGV cases were from MSM, declaring high-risk sexual behaviour and complaining anorectal symptoms. Patients first attending the STI Outpatient Clinic received a significant earlier LGV diagnosis than those first seeking care from general practitioners or gastroenterologists (P = 0.0046). LGV prevalence and characteristics found in our population are in agreement with international reports. Statistical analysis showed that LGV positive patients were older (P = 0.0008) and presented more STIs (P = 0.0023) than LGV negative ones, in particular due to syphilis (P < 0.001), HIV (P < 0.001) and HBV (P = 0.001). Multivariate logistic regression analysis revealed that HIV and syphilis infections are strong risk factors for LGV presence (respectively, P = 0.001 and P = 0.010). Conclusions Even if our results do not provide sufficient evidence to recommend routine screening of anorectal swabs in high-risk population, they strongly suggest to perform CT NAAT tests and genotyping on rectal specimens in presence of ulcerative proctitis in HIV and/or syphilis-positive MSM. In this context, CT DNA detection by Versant CT/GC DNA 1.0 Assay, followed by RFLP analysis for molecular typing demonstrated to be an excellent diagnostic algorithm for LGV identification. PMID:24716676

  7. Reasons for attending a general emergency outpatient clinic versus a regular general practitioner – a survey among immigrant and native walk-in patients in Oslo, Norway

    PubMed Central

    2017-01-01

    Objective To explore reasons for attending a general emergency outpatient clinic versus a regular general practitioner (RGP). Design Cross-sectional study using a multilingual anonymous questionnaire. Setting Native and immigrant walk-in patients attending a general emergency outpatient clinic in Oslo (Monday–Friday, 08:00–23:00) during 2 weeks in September 2009. Subjects We included 1022 walk-in patients: 565 native Norwegians (55%) and 457 immigrants (45%). Main outcome measures Patients’ reasons for attending an emergency outpatient clinic versus their RGP. Results Among patients reporting an RGP affiliation, 49% tried to contact their RGP before this emergency encounter: 44% of native Norwegian and 58% of immigrant respondents. Immigrants from Africa [odds ratio (OR) = 2.55 (95% confidence interval [CI]: 1.46–4.46)] and Asia [OR = 2.32 (95% CI: 1.42–3.78)] were more likely to contact their RGP before attending the general emergency outpatient clinic compared with native Norwegians. The most frequent reason for attending the emergency clinic was difficulty making an immediate appointment with their RGP. A frequent reason for not contacting an RGP was lack of access: 21% of the native Norwegians versus 4% of the immigrants claimed their RGP was in another district/municipality, and 31% of the immigrants reported a lack of affiliation with the RGP scheme. Conclusions and implications Access to primary care provided by an RGP affects patients’ use of emergency health care services. To facilitate continuity of health care, policymakers should emphasize initiatives to improve access to primary health care services. Key points Access to immediate primary health care provided by a regular general practitioner (RGP) can reduce patients’ use of emergency health care services. The main reason for attending a general emergency outpatient clinic was difficulty obtaining an immediate appointment with an RGP. A frequent reason for native Norwegians

  8. Syphilis and HIV co-infection in patients who attend an AIDS outpatient clinic in Vitoria, Brazil

    PubMed Central

    Callegari, Fabiola Mesquita; Pinto-Neto, Lauro Ferreira da Silva; Medeiros, Charlla Jezus; Scopel, Camila Binsi; Page, Kimberly; Miranda

    2013-01-01

    Our goal was to determine the prevalence of, and risk factors associated with, syphilis in HIV-infected patients who attend an AIDS outpatient clinic in Vitoria, Brazil. We conducted a cross-sectional study—including interviews for demographic, behavioral, and clinical characteristics—and blood collection (venipuncture and fingerstick) for VDRL and treponemal tests (rapid test) in a total of 438 patients. The mean age was 43.0 years (SD = 11), and mean years of school was 8.1 (SD = 4.2). The prevalence of syphilis was 5.3% (95% CI, 3.3%–7.3%). The treponemal test was positive in 18.9% of participants. In multivariate analysis, prevalent syphilis infection was independently associated with male gender (AOR 4.6, 95% CI, 1.1–20.0), a history of male-male sex (AOR 1.8, 95% CI, 1.6–4.1), current use of antiretroviral therapy (AOR 5.5, 95% CI, 1.7–16.7), and history of treated syphilis infection (AOR 5.5, 95% CI, 2.0–15.8). Syphilis prevalence was high in patients living with HIV/AIDS who attend an AIDS clinic; therefore, routine STI counseling and screening should be included in their care. PMID:23732958

  9. 38 CFR 17.82 - Contracts for outpatient services for veterans with alcohol or drug dependence or abuse...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... services for veterans with alcohol or drug dependence or abuse disabilities. 17.82 Section 17.82 Pensions... Agencies § 17.82 Contracts for outpatient services for veterans with alcohol or drug dependence or abuse disabilities. (a) Contracts for treatment services authorized under § 17.80 may be awarded in accordance...

  10. Affect and alcohol use: an ecological momentary assessment study of outpatients with borderline personality disorder.

    PubMed

    Jahng, Seungmin; Solhan, Marika B; Tomko, Rachel L; Wood, Phillip K; Piasecki, Thomas M; Trull, Timothy J

    2011-08-01

    Alcohol use may be viewed as an attempt (albeit maladaptive) to regulate negative emotional states. We examined associations between both negative and positive affects and alcohol use in outpatient women diagnosed with borderline personality disorder (BPD; n=74), a prototype of emotional dysregulation, as well as a psychiatric control group of women with current depressive disorder (major depressive disorder/dysthymic disorder [MDD\\DYS]; n=50). Participants completed randomly prompted reports of mood and alcohol use up to six times a day over a 28-day period using electronic diaries. Mean levels of either positive or negative affects did not distinguish between drinkers and nondrinkers in either diagnostic group. However, levels of both negative and positive affects were positively associated with alcohol use at the momentary level in BPD drinkers. More robust findings were obtained with respect to within-person affective variability, which was related to alcohol use in multiple ways. BPD drinkers showed higher within-person variability for most negative affects than BPD nondrinkers; MDD\\DYS drinkers in general showed less within-person variability than MDD\\DYS nondrinkers for negative affects. Multilevel lagged analyses for BPD drinkers indicated that alcohol use was positively related to variability in all affects, concurrently, but fewer significant effects of affect variability on the next day's drinking or significant effects of alcohol use on the next day's affect variability were observed. Among MDD\\DYS drinkers, we observed more significant associations between affect variability on next day's alcohol use and of alcohol use on next day's affect variability. We discuss theoretical and methodological issues relevant to these findings as well as implications for future research.

  11. Prevalence of unrecognized depression and associated factors among patients attending medical outpatient department in Adare Hospital, Hawassa, Ethiopia

    PubMed Central

    Tilahune, Asres Bedaso; Bekele, Gezahegn; Mekonnen, Nibretie; Tamiru, Eyerusalem

    2016-01-01

    Depression is an illness that involves the body, mood, and thoughts and that affects the way a person eats, sleeps, feels about him or herself and thinks about things. Depression is one of the most common mental disorders affecting 121 million people in the world, and it frequently goes unrecognized among patients. It is estimated that 5%–10% of the population at any given time is suffering from identifiable depression needing psychiatric or psychosocial intervention. An institution-based cross-sectional study design was implemented to determine the magnitude and associated factors of unrecognized depression among patients attending the adult medical outpatient department in Adare Hospital, Hawassa, Southern Nations, Nationalities, and Peoples’ Region, Ethiopia, among 326 patients selected using systematic random sampling technique. Data were collected using the interviewer-administered technique. A structured questionnaire was used to collect data on sociodemographic characteristics and other independent variables. Depression was assessed using the Patient Health Questionnaire 9. Data were entered and ana-lyzed using SPSS 20. The level of significance was determined at P<0.05. About 326 patients were interviewed, of whom 186 (57.1%) were males. The mean age of participant was 34 with standard deviation of ±13.1 years. Current substance users accounted for 106 (32.5%) of the total participants. Of 326 respondents, 80 (24.5%) had significant depressive symptoms, while the detection rate of depression by the clinician was 0%. Depression was associated with female sex (adjusted odds ratio [AOR] =1.63 [1.14–2.34]), age >60 years (AOR =4.14 [1.87–9.14]), being divorced (AOR =3.13 [1.70–5.76]), and having an average monthly income <750 ETB (AOR =1.92 [1.119–3.195]). The findings of this study revealed that the prevalence of depression among patients attending general medical outpatient department was highly underrecognized and unmanaged. On the basis of

  12. Age of onset as a discriminator between alcoholic subtypes in a treatment-seeking outpatient population.

    PubMed

    Johnson, B A; Cloninger, C R; Roache, J D; Bordnick, P S; Ruiz, P

    2000-01-01

    Subtyping alcoholics may provide a more accurate guide as to the course and character of the disease. Classifications of different ages of onset of problem drinking have so far resulted in categorical inconsistencies. In the past, hospital-based alcoholics have over-represented those most severely ill, and comprehensive evaluations of psychopathology for discriminating between alcoholic subtypes have been infrequent. In a heterogeneous treatment-seeking, outpatient, alcoholic population, we tested the hypothesis that age of onset represents a continuum of disease, and that greater severity of psychopathology is associated with lower ages of onset. Using a standard questionnaire, 253 male and female treatment-seeking alcoholics were stratified according to specific ages of onset: a) < 20 years; b) 20-25 years, and c) > 25 years. These age of onset groups were compared on alcohol severity and craving, family history, childhood behavior, personality, hostility, overt aggression, mood, and social functioning. Symptom severity and age of onset were negatively correlated, and the 20-25-year onset group usually had intermediate scores. The < 20 year onset group was characterized by greater severity of alcohol-related problems, family history, childhood behavioral problems, craving, hostility, antisocial traits, mood disturbance, and poor social functioning. Alcoholics with an earlier age of onset have relatively greater psychopathology than those of later onset. While the preponderance of psychopathology among those in the < 20-year onset group could be conceptualized as a clinical "subtype," such a characterization would not define an entirely homogeneous category. Yet, this clinical characterization would be clinically important if specific age of onset levels were found to be differentially sensitive to pharmacological and/or psychological treatments.

  13. An Open Pilot Study of Gabapentin vs. Trazodone to Treat Insomnia in Alcoholic Outpatients

    PubMed Central

    Karam-Hage, Maher; Brower, Kirk J.

    2009-01-01

    Alcohol-dependent outpatients with persisting insomnia were treated with either gabapentin or trazodone. Patients were assessed at baseline and after 4 to 6 weeks on medication using the Sleep Problems Questionnaire (SPQ). Of 55 cases initially treated, 9% dropped out due to morning drowsiness. Of the remaining 50 cases, 34 were treated with gabapentin (mean dose ± SD = 888 ± 418 mg) at bedtime and 16 were treated with trazodone (105 ± 57 mg) at bedtime. Both groups improved significantly on the SPQ, however, the gabapentin group improved significantly more than the trazodone group. Controlled studies are warranted to replicate these findings. PMID:12950711

  14. Efficacy of Automated Telephone Continuing Care following Outpatient Therapy for Alcohol Dependence

    PubMed Central

    Rose, Gail L.; Skelly, Joan M.; Badger, Gary J.; Ferraro, Tonya A.; Helzer, John E.

    2014-01-01

    Background Relapse rates following cognitive behavioral therapy (CBT) for alcohol dependence are high. Continuing care programs can prolong therapeutic effects but are underutilized. Thus there is need to explore options having greater accessibility. Methods This randomized controlled trial tested the efficacy of a novel, fully automated continuing care program, Alcohol Therapeutic Interactive Voice Response (ATIVR). ATIVR enables daily monitoring of alcohol consumption and associated variables, offers targeted feedback, and facilitates use of coping skills. Upon completing 12 weeks of group CBT for alcohol dependence, participants were randomly assigned to either four months of ATIVR (n=81) or usual care (n=77). Drinking behavior was assessed pre- and post-CBT, then at 2 weeks, 2 months, 4 months, and 12 months post-randomization. Results Drinking days per week increased over time for the control group but not the intervention group. There were no significant differences between groups on the other alcohol-related outcome measures. Comparisons on the subset of participants abstinent at the end of CBT (n=72) showed higher rates of continuous abstinence in the experimental group. Effect sizes for the other outcome variables were moderate but not significant in this subgroup. Conclusions For continuing care, ATIVR shows some promise as a tool that may help clients maintain gains achieved during outpatient treatment. However, ATIVR may not be adequate for clients who have not achieved treatment goals at the time of discharge. PMID:25452069

  15. Prevalence of and Factors Associated with Nephropathy in Diabetic Patients Attending an Outpatient Clinic in Harare, Zimbabwe

    PubMed Central

    Machingura, Pasipanodya Ian; Chikwasha, Vasco; Okwanga, Parmenas Nelson; Gomo, Exnevia

    2017-01-01

    There is limited information on the burden of diabetic nephropathy in developing countries. This study aimed to determine the prevalence of and factors associated with nephropathy among diabetic patients attending an outpatient clinic in Harare, Zimbabwe. In an analytical cross-sectional study, diabetic patients were consecutively enrolled and a questionnaire administered, clinical assessment conducted, and blood samples collected for human immunodeficiency virus testing and measurement of lipids, creatinine, fructosamine, and glycosylated hemoglobin levels. Urine samples were collected for determination of albumin and creatinine levels, which were used to categorize albuminuria. A total of 344 diabetic patients were enrolled. Overall, just over a third (35.8%) of patients had moderately increased albuminuria and 9.0% had severely increased albuminuria giving an overall prevalence of nephropathy of 44.8%. Prevalence of moderately increased albuminuria was slightly higher (36.5% versus 33.3%) and severely increased albuminuria slightly lower (8.8% versus 9.5%) in type 2 than type 1 diabetes patients, but the difference was not statistically significant (P = 0.866). Higher fructosamine and retinopathy were associated with nephropathy in both univariate and multivariate analysis {higher fructosamine (odds ratio [OR] = 1.00, confidence interval [CI] = 1.00–1.01), and retinopathy (OR = 2.80, CI = 1.64–4.97)}. We report a higher prevalence of moderately increased albuminuria and a lower prevalence of severely increased albuminuria compared with findings reported a decade ago among type 1 and type 2 diabetes mellitus patients attending the same clinic. High fructosamine and retinopathy were independent predictors of nephropathy. PMID:27994108

  16. Alcohol Consumption and Risky Sexual Behavior Among Persons Attending Alcohol Consumption Venues in Gaborone, Botswana.

    PubMed

    Lama, Tsering Pema; Kumoji, E 'Kuor; Ketlogetswe, Ditsotlhe; Anderson, Marina; Brahmbhatt, Heena

    2016-02-01

    Alcohol use is a known key risk factor associated with risky sexual behavior that contributes to HIV transmission. This cross-sectional study used time location sampling to investigate alcohol use and risky sexual behaviors that occurred after ingesting alcohol among 609 patrons of alcohol venues in Gaborone, Botswana. Alcohol Use Disorders Identification Test (AUDIT) scores were categorized as low (1-7), medium (8-15), and high (16+) for analysis. Logistic regression models stratified by gender assessed the association between alcohol use and condom use at last sex after drinking alcohol. Among females, the odds of condom use during last sex after drinking alcohol were significantly lower for high compared to low AUDIT scores (AOR = 0.17, 95% CI 0.06-0.54). Among males, factors significantly associated with condom use at last sex after alcohol use were low levels of education (primary level compared to university and above AOR = 0.13; 95% CI 0.03-0.55) and beliefs that alcohol use did not increase risky sexual behaviors (AOR = 0.26; 95% CI 0.11-0.62). HIV prevention interventions should target females and emphasize sexual risks associated with alcohol use.

  17. Study of H. pylori infection in children with recurrent abdominal pain attending the pediatrics outpatient clinic of Zagazig University Hospitals.

    PubMed

    Badr, M A; El-Saadany, Hosam F; Ali, Adel S A; Abdelrahman, D

    2012-12-01

    This study assessed the prevalence of H. pylori infection in children with recurrent abdominal pain attending the Outpatient Pediatric Clinic of Zagazig University Hospitals. The study was conducted on 100 children suffering from different GIT symptoms mainly recurrent abdominal pain, they were categorized into 3 categories according to their ages. First category below 5 years, second category between 5 and 10 years and last category above 10 years. All subjects underwent full history taking, clinical examination and laboratory investigations. Protozoa infection was in 29% of patients, helminthes 10%, chronic constipation 4% and UTI 4%. The patients with apparent etiology were excluded. The data do not support the hypothesis that there is a direct role for H. pylori infection as a causative agent for Recurrent Abdominal Pain (RAP) in children. The mean +/- SD of age of patients were 5.7 +/- 3.7, with range of 1:18 years. Male to female ratio was 1:1.1. H. pylori serum IgG antibodies were in 26 patients (43.3%) and 24 controls (p = 0.71), and H. pylori stool Ag in stool of 22 cases and 20 controls (p = 0.7).

  18. Trends of HIV-1, HIV-2 and dual infection in women attending outpatient clinics in Senegal, 1990–2009

    PubMed Central

    Heitzinger, K; Sow, P S; Badiane, N M Dia; Gottlieb, G S; N’Doye, I; Toure, M; Kiviat, N B; Hawes, S E

    2013-01-01

    Summary We assessed trends in the relative prevalences of HIV-1, HIV-2 and dual HIV-1/HIV-2 infection in 10,321 women attending outpatient clinics in Senegal between 1990 and 2009. The relative prevalence of HIV-1 (defined as the proportion of seropositive subjects having HIV-1) rose sharply from 38% in 1990 until 1993 (P < 0.001), whereupon it continued to rise, but at a slower rate, reaching 72% of HIV infections in 2009. As compared with HIV-1, the relative prevalence of HIV-2 decreased sharply from 54% in 1990 until 1993 (P < 0.001) and continued to decrease at a slower rate through 2009. The relative prevalence of dual infection, as compared with HIV-1, was stable from 1990 to 1993, but decreased slightly thereafter (P < 0.001). These study findings indicate that during the early 1990s, the relative prevalence of HIV-1 increased markedly, while the relative prevalence of HIV-2 decreased and the relative prevalence of dual infection remained stable in Senegal. From 1993 to 2009, the relative prevalence of HIV-1 increased at a slower rate, while the relative prevalences of HIV-2 and dual infection decreased. These results confirm trends in HIV prevalence observed in other West African populations and provide a critical update on HIV transmission risk among women in Senegal. PMID:23104745

  19. Pneumococcal carriage in children attending a hospital outpatient clinic in the era of pneumococcal conjugate vaccines in Barcelona.

    PubMed

    Hernandez-Bou, Susanna; Garcia-Garcia, Juan Jose; Gene, Amadeu; Esteva, Cristina; del Amo, Eva; Muñoz-Almagro, Carmen

    2012-11-01

    Between April 2004 and March 2006 an oropharyngeal swab was obtained from 502 asymptomatic children, aged 6 months to 6 years, at a tertiary children's hospital outpatient department to assess the pneumococcal colonisation rate, risk factors, serotype distribution and antimicrobial susceptibility. Only 126 (25.3%) children had received ≥ 1 dose of PCV7. The pneumococcal carriage rate was 23.5%. Carrier rates were significantly higher in children aged ≥ 24 months and children attending daycare center. Thirty six (31.0%) of the isolates were contained in PCV7, 39 (33.6%) in PCV10 and 62 (53.4%) in PCV13. Forty-four strains (37.9%) were resistant to penicillin. Vaccine serotype (VT) strains were more likely to be penicillin-nonsusceptible S. pneumoniae than non-PCV7 serotype (NVT) strains (66.7% vs. 21.6%; P < 0.001). In our pediatric population, NVT were predominant among pneumococcal carriers whereas antibiotic resistance was significantly associated with VT. PCV13 can substantially increase the serotype coverage of S.pneumoniae in healthy carriers.

  20. Sex-Related Alcohol Expectancies among African American Women Attending an Urban STI Clinic

    PubMed Central

    Hutton, Heidi E.; McCaul, Mary E.; Norris, Jeanette; Valliant, Julia D.; Abrefa-Gyan, Tina; Chander, Geetanjali

    2014-01-01

    African American women are disproportionately affected by HIV/AIDS and sexually transmitted infections (STIs). Alcohol use is a significant risk factor for HIV/STI acquisition. Sex related alcohol expectancies (SRAE) may partially account for alcohol related risky sexual behaviors. Using qualitative interviews we explored the link between alcohol use and risky sex among 20 African American women attending an STI clinic who had consumed ≥4 alcoholic drinks per drinking day (binge drinking) and/or reported vaginal or anal sex while under the influence of alcohol. Four SRAE emerged which we named: drink for sexual desire, drink for sexual power, drink for sexual excuse, and drink for anal sex. While the desire SRAE has been documented, this study identified three additional SRAEs not currently assessed by expectancy questionnaires. These SRAEs may contribute to high-risk sex when under the influence of alcohol, and suggests the importance of developing integrated alcohol-sexual risk reduction interventions for high-risk women. PMID:25110958

  1. Gender Comparison in Referrals and Treatment Completion to Residential and Outpatient Alcohol Treatment

    PubMed Central

    Bazargan-Hejazi, Shahrzad; De Lucia, Valory; Pan, Deyu; Mojtahedzadeh, Mona; Rahmani, Elham; Jabori, Sinan; Zahmatkesh, Golara; Bazargan, Mohsen

    2016-01-01

    BACKGROUND Residential treatment for alcoholism is associated with high completion rates for clients, yet there appear to be gender disparities in patient referrals and treatment completion rates. We studied whether (A) gender is associated with differential patient placement to outpatient vs. residential treatment facilities and (B) completion rates differ by gender. METHODS In this cross-sectional study, we analyzed the admission and discharge data from 185 publicly funded substance abuse treatment facilities across Los Angeles County between 2005 and 2010. RESULTS Among the 33,745 studied cases, women were referred to residential treatment facilities less frequently than men (75% vs. 66%). The adjusted results derived from logistic regression models confirmed that females were more likely to be referred to outpatient treatment than to residential treatment facilities (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.05–1.26). In addition, we observed that compared to White/Caucasian patients, all other races were associated with more referral to outpatient facilities (ie, less referral to residential facilities), indicating a racial disparity on the top of the observed gender disparity. However, there was no significant link between gender and treatment completion rates (OR: 0.93, 95% CI: 0.86–1.00). CONCLUSIONS Women seem to have treatment completion rates comparable to men, yet they are less likely to be referred to residential treatment facilities. Hence, there still remains a gender disparity in alcoholic patient referrals. Further studies should delineate which specific therapeutic aspects and programmatic components of women-focused treatments are essential to augment positive treatment outcomes. PMID:28008266

  2. Use of short message service reminders to improve attendance at an internal medicine outpatient clinic in Saudi Arabia: a randomized controlled trial.

    PubMed

    Youssef, A

    2014-06-09

    Non-attendance at outpatient appointments is a major problem. This study aimed to evaluate the efficacy of sending short message service (SMS) reminders to patients' mobile phones in reducing non-attendance at scheduled appointments. A randomized clinical trial was conducted in 2011 in an internal medicine outpatient clinic at a hospital in Eastern Province, Saudi Arabia. Eligible patients (n = 502) were randomly allocated to receive an SMS reminder of their appointment (intervention group) or no reminder (control group). The non-attendance rate was significantly lower in the reminder group (26.3%) than the non-reminder group (39.8%). In multivariate logistic regression, age, sex and nationality did not affect attendance rates but having their first contact with the hospital (OR = 7.40) and not receiving an SMS reminder (OR = 0.56) were significant factors in non-attendance. All patients surveyed about their perceptions of the SMS reminder (n = 76) reported they would like to continue to receive SMS reminders in the future.

  3. Patterns of Alcohol and Other Drug Use Associated with Major Depression among Gay Men Attending General Practices in Australia

    ERIC Educational Resources Information Center

    Holt, Martin; Bryant, Joanne; Newman, Christy E.; Paquette, Dana M.; Mao, Limin; Kidd, Michael R.; Saltman, Deborah C.; Kippax, Susan C.

    2012-01-01

    Our aim was to clarify the role of alcohol and other drug (AOD) use in major depression among gay men attending general medical practices. A secondary analysis was conducted on survey data collected from 531 gay men attending high-HIV-caseload general practices in Adelaide and Sydney, Australia. The survey contained demographic, social,…

  4. Using Ethyl Glucuronide in Urine to Detect Light and Heavy Drinking in Alcohol Dependent Outpatients

    PubMed Central

    McDonell, Michael G.; Skalisky, Jordan; Leickly, Emily; McPherson, Sterling; Battalio, Samuel; Nepom, Jenny R.; Srebnik, Debra; Roll, John; Ries, Richard K.

    2015-01-01

    Aims This study investigated which ethyl glucuronide immunoassay (EtG-I) cutoff best detects heavy versus light drinking over five days in alcohol dependent outpatients. Methods A total of 121 adults with alcohol use disorders and co-occurring psychiatric disorders taking part in an alcohol treatment study. Participants provided self-reported drinking data and urine samples three time per week for 16-weeks (total samples = 2761). Agreement between low (100 ng/mL, 200 ng/mL), and moderate (500 ng/mL) EtG-I cutoffs and light (women ≤3 standard drinks, men ≤ 4 standard drinks) and heavy drinking (women >3, men >4 standard drinks) were calculated over one to five days. Results The 100 ng/mL cutoff detected >76% of light drinking for two days, and 66% at five days. The 100 ng/mL cutoff detected 84% (1 day) to 79% (5 days) of heavy drinking. The 200 ng/mL cutoff detected >55% of light drinking across five days and >66% of heavy drinking across five days. A 500 ng/mL cutoff identified 68% of light drinking and 78% of heavy drinking for one day, with detection of light (2–5 days <58%) and heavy drinking (2–5 days <71%) decreasing thereafter. Relative to 100 ng/mL, the 200 ng/mL and 500 ng/mL cutoffs were less likely to result in false positives. Conclusions An EtG-I cutoff of 100 ng/mL is most likely to detect heavy drinking for up to five days and any drinking during the previous two days. Cutoffs of ≥ 500 ng/mL are likely to only detect heavy drinking during the previous day. PMID:26475403

  5. Personality and alcohol/substance-use disorder patient relapse and attendance at self-help group meetings.

    PubMed

    Janowsky, D S; Boone, A; Morter, S; Howe, L

    1999-01-01

    This study evaluated the role of personality in the short-term outcome of alcohol/substance-use disorder patients. Detoxifying alcohol/substance-use disorder patients were administered the Myers-Briggs Type Indicator (MBTI), the Tridimensional Personality Questionnaire (TPQ), the Michigan Alcohol Screening Test (MAST), the CAGE Questionnaire, and the Beck Depression Inventory (BDI). These patients were subsequently evaluated over a 1-month period for relapse and attendance at self-help group meetings. High TPQ Persistence scale scores predicted abstinence. When the Thinking and Feeling groups were considered separately, and when these two groups were combined into a single group, high scores for the individual groups and the combined group (i.e. Thinking and Feeling types together) predicted abstinence. High TPQ Persistence scale scores and low Shyness with Strangers and Fear of Uncertainty subscale scores predicted attendance at self-help group meetings. High MBTI Extroversion and high MBTI Thinking scores also predicted attendance at self-help group meetings. When the Extroverted and Introverted types and the Thinking and Feeling types respectively were combined, as with abstinence, high scores predicted attendance at self-help group meetings. Age, gender, CAGE, MAST, and BDI scores did not predict outcome. The above information suggests that specific personality variables may predict abstinence and attendance at self-help group meetings in recently detoxified alcoholics, and this may have prognostic and therapeutic significance.

  6. Mental health problems and post-migration stress among multi-traumatized refugees attending outpatient clinics upon resettlement to Norway.

    PubMed

    Teodorescu, Dinu-Stefan; Heir, Trond; Hauff, Edvard; Wentzel-Larsen, Tore; Lien, Lars

    2012-08-01

    Refugees have often been exposed to multiple traumas making them prone to mental health problems later. The aim of this study is to describe the prevalence and symptom load of psychiatric disorders in refugees admitted to psychiatric outpatient clinics and to investigate the relationship between multiple exposure to traumatic events, the severity of traumatic symptoms and post-migration stressors. A clinical sample of 61 refugee outpatients from psychiatric clinics in Southern Norway was cross-sectionally examined using three structured clinical interviews (SCID-PTSD, SIDES and MINI) and self-report psychometric instruments (HSCL-25, IES-R). Post-traumatic Stress Disorder (PTSD) was diagnosed in 82% of the patients, while Disorders of Extreme Stress Not Otherwise Specified (DESNOS) was present in 16% of them. Comorbidity was considerable; 64% of the patients had both PTSD and major depression disorder (MDD) and 80% of those who had PTSD had three or more additional diagnoses. Multi-traumatized refugees in outpatient clinics have high prevalence of PTSD, DESNOS, comorbid depression and anxiety disorders. A more severe symptomatology was found in patients diagnosed with both PTSD and DESNOS, than in those diagnosed with only PTSD. Higher rates of unemployment, weak social network and weak social integration were also prevalent in these outpatients, and related to increased psychiatric comorbidity and severity of symptoms. Further research may clarify the existence of a cumulative relationship between pre-resettlement traumas and post-resettlement stressors in the mental health of refugees, which in turn may help to improve therapeutic interventions.

  7. Reinforcement of counseling attendance and alcohol abstinence in a community-based dual-diagnosis treatment program: a feasibility study.

    PubMed

    Helmus, Todd C; Saules, Karen K; Schoener, Eugene P; Roll, John M

    2003-09-01

    This study evaluated the effectiveness of a community-based contingency management (CM) protocol reinforcing punctual dual-diagnosis group counseling attendance and negative breath alcohol levels. Participants were 20 dual-diagnosis patients. The A-B-A within-subjects reversal design included a 4-week baseline phase (BL), a 12-week CM intervention, and a 4-week return-to-baseline phase (R-BL). Group counseling was provided twice weekly, with breath tests before each session. CM attendance rates were significantly higher (65%+-28%) than BL (45%+-32%, p<.05) and remained elevated in the R-BL phase (68%+-29%). Despite clinical reports of frequent intoxication, during the study all breath test results were negative, regardless of study phase. Thus, no contingency effect on alcohol use could be determined. Results suggest that CM interventions can be effective in increasing attendance in a community treatment program for the dually diagnosed.

  8. If You Feed Them, Will They Come? The Use of Social Marketing to Increase Interest in Attending a College Alcohol Program

    PubMed Central

    Palmer, Rebekka S.; Kilmer, Jason R.; Larimer, Mary E.

    2010-01-01

    The authors used social marketing to design and test advertisement components aimed at increasing students’ interest in attending an alcohol program focused on reaching students who drink heavily, although the authors offered no such program. Participants were undergraduate students in introductory psychology courses (N = 551). Questionnaires included measures assessing demographic information, alcohol use and negative consequences, and interest in attending an alcohol program in response to exposure to 1 of 12 systematically varied advertisements. The authors found that approximately 20% of participants across all ad types indicated some level of interest in attending the alcohol program. Students who use alcohol reported more interest in attending when an informational message was used. Of the participants offered food, 41.9% indicated the food offered in the advertisement impacted their interest in attending. Results suggest market segmentation plays a role in developing effective advertisements to recruit different groups of students based on their reported drinking behavior. PMID:16889315

  9. If you feed them, will they come? The use of social marketing to increase interest in attending a college alcohol program.

    PubMed

    Palmer, Rebekka S; Kilmer, Jason R; Larimer, Mary E

    2006-01-01

    The authors used social marketing to design and test advertisement components aimed at increasing students' interest in attending an alcohol program focused on reaching students who drink heavily, although the authors offered no such program. Participants were undergraduate students in introductory psychology courses (N = 551). Questionnaires included measures assessing demographic information, alcohol use and negative consequences, and interest in attending an alcohol program in response to exposure to 1 of 12 systematically varied advertisements. The authors found that approximately 20% of participants across all ad types indicated some level of interest in attending the alcohol program. Students who use alcohol reported more interest in attending when an informational message was used. Of the participants offered food, 41.9% indicated the food offered in the advertisement impacted their interest in attending. Results suggest market segmentation plays a role in developing effective advertisements to recruit different groups of students based on their reported drinking behavior.

  10. Staphylococcus aureus nasal carriage among outpatients attending primary health care centers: a comparative study of two cities in Saudi Arabia and Egypt.

    PubMed

    Abou Shady, Hala M; Bakr, Alaa Eldin A; Hashad, Mahmoud E; Alzohairy, Mohammad A

    2015-01-01

    Epidemiological and molecular data on community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) are still scarce in both Egypt and Saudi Arabia. There is almost no data regarding methicillin resistant Staphylococcus aureus (MRSA) prevalence in both countries. This study was conducted to investigate the prevalence and molecular epidemiology of S. aureus and MRSA nasal carriage among outpatients attending primary health care centers in two big cities in both countries. A total of 206 nasal swabs were obtained, 103 swabs from each country. S. aureus isolates were characterized by antibiotic susceptibility, presence of mecA and PVL genes, SCCmec-typing and spa typing, the corresponding Multi locus sequence typing clonal complex was assigned for each spa type based on Ridom StaphType database. MRSA was detected in 32% of the Egyptian outpatients while it was found in 25% of the Saudi Arabian outpatients. All MRSA isolates belonged to SCCmec type V and IVa, where some isolates in Saudi Arabia remained nontypeable. Surprisingly PVL(+) isolates were low in frequency: 15% of MRSA Egyptian isolates and 12% of MRSA isolates in Saudi Arabia. Two novel spa types were detected t11839 in Egypt, and t11841 in Saudi Arabia. We found 8 spa types among 20 isolates from Egypt, and 12 spa types out of 15 isolates from Saudi Arabia. Only two spa types t008 and t223 coexisted in both countries. Four clonal complexes (CC5, CC8, CC22, and CC80) were identified in both Egypt and Saudi Arabia. However, the data collected lacked a representation of isolates from different parts of each country as only one health center from each country was included, it still partially illustrates the CA-MRSA situation in both countries. In conclusion a set of control measures is required to prevent further increase in MRSA prevalence.

  11. Brief intervention for alcohol misuse in people attending sexual health clinics: study protocol for a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Over the last 30 years the number of people who drink alcohol at harmful levels has increased in many countries. There have also been large increases in rates of sexually transmitted infections. Available evidence suggests that excessive alcohol consumption and poor sexual health may be linked. The prevalence of harmful alcohol use is higher among people attending sexual health clinics than in the general population, and a third of those attending clinics state that alcohol use affects whether they have unprotected sex. Previous research has demonstrated that brief intervention for alcohol misuse in other medical settings can lead to behavioral change, but the clinical- and cost-effectiveness of this intervention on sexual behavior have not been examined. Methods We will conduct a two parallel-arm, randomized trial. A consecutive sample of people attending three sexual health clinics in London and willing to participate in the study will be screened for excessive alcohol consumption. Participants identified as drinking excessively will then be allocated to either active treatment (Brief Advice and referral for Brief Intervention) or control treatment (a leaflet on healthy living). Randomization will be via an independent and remote telephone randomization service and will be stratified by study clinic. Brief Advice will comprise feedback on the possible health consequences of excessive alcohol consumption, written information about alcohol and the offer of an appointment for further assessment and Brief Intervention. Follow-up data on alcohol use, sexual behavior, health related quality of life and service use will be collected by a researcher masked to allocation status six months later. The primary outcome for the study is mean weekly alcohol consumption during the previous three months, and the main secondary outcome is the proportion of participants who report unprotected sex during this period. Discussion Opportunistic intervention for excessive

  12. Psychiatric comorbidity and plasma levels of 2-acyl-glycerols in outpatient treatment alcohol users. Analysis of gender differences.

    PubMed

    García Marchena, Nuria; Araos, Pedro; Pavón, Francisco Javier; Ponce, Guillermo; Pedraz, María; Serrano, Antonia; Arias, Francisco; Romero-Sanchiz, Pablo; Suárez, Juan; Pastor, Antoni; De la Torre, Rafael; Torrens, Marta; Rubio, Gabriel; Rodríguez de Fonseca, Fernando

    2016-09-29

    Alcohol addiction is associated with high psychiatric comorbidity. Objective stratification of patients is necessary to optimize care and improve prognosis. The present study is designed to gain insights into this challenge by addressing the following objectives: a) to estimate the prevalence of psychiatric comorbidities in a sample of outpatients seeking treatment for alcohol use disorder, b) to describe the existence of gender differences and c) to validate 2-acyl-glycerols as biomarkers of alcohol use disorder and/or psychiatric comorbidity. One hundred and sixty-two patients were recruited and evaluated with the semi-structured interview PRISM. The presence of psychopathology was associated with a greater number of criteria for alcohol abuse and dependence according to DSM-IV-TR. We found gender differences in psychiatric comorbidity, e.g., mood disorder, as well as in comorbid substance use disorders. The prevalence of lifetime psychiatric comorbidity was 68.5%, with mood disorders the most frequent (37%), followed by attention deficit disorder (24.7%) and anxiety disorders (17.9%). Substance-induced disorders were more frequent in mood and psychotic disorders, whereas the primary disorders were more prevalent in patients with comorbid anxiety disorders. We found that 2-acyl-glycerols were significantly decreased in comorbid anxiety disorders in alcohol dependent patients in the last year, which makes them a potential biomarker for this psychopathological condition.

  13. Prevalence of Antipsychotic Polypharmacy and Associated Factors among Outpatients with Schizophrenia Attending Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

    PubMed Central

    Tesfaye, Siranesh; Debencho, Nigussie; Kisi, Teresa; Tareke, Minale

    2016-01-01

    Background. Despite recommendations by guidelines to avoid combinations of antipsychotics unless after multiple trials of antipsychotic monotherapy, it is quite a common practice to use combinations. This practice leads to unnecessary expenses and exposes the patient to severe drug adverse effects. Methods. An institution based cross-sectional study was conducted from April to May 2014. Systematic random sampling technique was used to select 423 study subjects. Logistic regression analysis was conducted to identify associated factors of antipsychotic polypharmacy among schizophrenia outpatients. Result. The overall prevalence of antipsychotic polypharmacy was found to be 28.2%. Extra pyramidal side effects (AOR = 2.80; 95% CI: 1.38, 5.71), repeated psychiatric hospitalization (AOR = 2.83; 95% CI: 1.45, 5.50), history of substance use (AOR = 2.82; 95% CI: 1.36, 5.88), longer duration of treatment (AOR = 2.10; 95% CI: 1.14, 3.87), and drug nonadherence (AOR = 1.84; 95% CI: 1.14, 2.98) were found to be significantly associated with antipsychotic polypharmacy. Conclusion. Prevalence of antipsychotic polypharmacy was found to be high among the current study participants. Individuals who had extra pyramidal side effects, admission, substance use, duration of treatment, and drug nonadherence were associated with antipsychotic polypharmacy. PMID:26904586

  14. Alcohol Use and Antisocial Behavior in Late Adolescence: Characteristics of a Sample Attending a GED Program

    ERIC Educational Resources Information Center

    Owens, Meredith Reesman; Bergman, Andrea

    2010-01-01

    This study examined peer deviance, disinhibition, and ADHD symptoms as differential predictors of alcohol use, alcohol use disorder symptoms, and antisocial behavior. It was hypothesized that peer deviance would most strongly predict alcohol use while disinhibition and ADHD would predict alcohol use disorder symptoms and antisocial behavior.…

  15. Clinical utility of PKD2 mutation testing in a polycystic kidney disease cohort attending a specialist nephrology out-patient clinic

    PubMed Central

    2012-01-01

    Background ADPKD affects approximately 1:1000 of the worldwide population. It is caused by mutations in two genes, PKD1 and PKD2. Although allelic variation has some influence on disease severity, genic effects are strong, with PKD2 mutations predicting later onset of ESRF by up to 20 years. We therefore screened a cohort of ADPKD patients attending a nephrology out-patient clinic for PKD2 mutations, to identify factors that can be used to offer targeted gene testing and to provide patients with improved prognostic information. Methods 142 consecutive individuals presenting to a hospital nephrology out-patient service with a diagnosis of ADPKD and CKD stage 4 or less were screened for mutations in PKD2, following clinical evaluation and provision of a detailed family history (FH). Results PKD2 mutations were identified in one fifth of cases. 12% of non-PKD2 patients progressed to ESRF during this study whilst none with a PKD2 mutation did (median 38.5 months of follow-up, range 16–88 months, p < 0.03). A significant difference was found in age at ESRF of affected family members (non-PKD2 vs. PKD2, 54 yrs vs. 65 yrs; p < 0.0001). No PKD2 mutations were identified in patients with a FH of ESRF occurring before age 50 yrs, whereas a PKD2 mutation was predicted by a positive FH without ESRF. Conclusions PKD2 testing has a clinically significant detection rate in the pre-ESRF population. It did not accurately distinguish those individuals with milder renal disease defined by stage of CKD but did identify a group less likely to progress to ESRF. When used with detailed FH, it offers useful prognostic information for individuals and their families. It can therefore be offered to all but those whose relatives have developed ESRF before age 50. PMID:22863349

  16. Cost-effectiveness study of oral hypoglycemic agents in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City

    PubMed Central

    de León-Castañeda, Christian Díaz; Altagracia-Martínez, Marina; Kravzov-Jinich, Jaime; Cárdenas-Elizalde, Ma del Rosario; Moreno-Bonett, Consuelo; Martínez-Núñez, Juan Manuel

    2012-01-01

    Introduction Worldwide, diabetes mellitus presents a high burden for individuals and society. In Latin America, many people with diabetes have limited access to health care, which means that indirect costs may exceed direct health care cost. Diabetes is Mexico’s leading cause of death. Purpose To evaluate the cost-effectiveness ratios of the most used oral hypoglycemic agents (OHA) in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City. Design A cross-sectional and analytic study was conducted in Mexico City. Methodology Twenty-seven adult outpatients with type 2 diabetes who were treated either with metformin or glibenclamide were included. Acarbose was used as an alternative strategy. The study was carried out from the perspective of Mexican society. Direct medical and nonmedical costs as well as indirect costs were evaluated using a structured questionnaire. Efficacies of all drug treatments were evaluated retrospectively. A systematic search was conducted to select published randomized clinical trials based on predetermined inclusion criteria, and treatment success was defined as glycosylated hemoglobin factor ≤ 7%. Efficacy data of each drug and/or combination were analyzed using meta-analysis. The Monte Carlo Markov model was used. Quality-adjusted life-years (QALY) were used as the unit of effectiveness; incremental and sensitive analyses were performed and a 5% discount rate was calculated. A hypothetical cohort of 10,000 patients was modeled. Results The odds ratios of the success of each drug treatment were obtained from the meta-analyses, and were the following: 5.82 (glibenclamide), 3.86 (metformin), 3.5 (acarbose), and 6.76 (metformin–glibenclamide). The cost-effectiveness ratios found were US$272.63/QALY (glibenclamide), US$296.48/QALY (metformin), and US$409.86/QALY (acarbose). Sensitivity analysis did not show changes for the most cost-effective therapy when the effectiveness probabilities or

  17. Office versus Home-Based Family Therapy for Runaway, Alcohol Abusing Adolescents: Examination of Factors Associated with Treatment Attendance

    PubMed Central

    Slesnick, Natasha; Prestopnik, Jillian L.

    2008-01-01

    There is a dearth of research examining treatment engagement and attendance among runaway youth and their families. Such research is needed in order to inform treatment providers on factors associated with engagement and maintenance of these difficult to engage families into counseling. This study examined differential treatment attendance for alcohol abusing runaway youth residing at a local shelter. A traditional office-based family systems approach, Functional Family Therapy (FFT), was compared to a non-traditional, home-based, multi-systemic family therapy approach, Ecologically Based Family Therapy (EBFT). As expected, treatment engagement and attendance was significantly higher for those assigned to EBFT (N = 37) compared to FFT (N = 40). Predictors of treatment attendance (income, family chaos, externalization problems and level of youth substance use) were examined within each treatment modality. Findings suggest that home-based (compared to office-based) treatment modalities may significantly increase treatment attendance and engagement of runaway youth and their families. Non-traditional forms of treatment may need to be considered in order to best meet the needs of highly chaotic and disorganized family systems. PMID:18607515

  18. Study of the prevalence and association of ocular chlamydial conjunctivitis in women with genital infection by Chlamydia trachomatis, Mycoplasma genitalium and Candida albicans attending outpatient clinic

    PubMed Central

    Khattab, Rania Abdelmonem; Abdelfattah, Maha Mohssen

    2016-01-01

    AIM To determine the association between chlamydial conjunctivitis and genital infection by Chlamydia trachomatis, Mycoplasma genitalium and Candida albicans, in addition to the possible relationship between cultured bacterial pathogens and oculogenital chlamydial infection. METHODS This study was performed on 100 (50 symptomatic and 50 asymptomatic) women attending the Gynecological and Obstetric outpatient clinic of Alzahra hospital, Alazhar University. Simultaneously a conjunctival swab was taken from these patients. Polymerase chain reaction (PCR) was done on DNA extracted from both vaginal and conjunctival swab samples. Culture for both vaginal and conjunctival swabs was also done. RESULTS Candida albicans was the predominant organism isolated by culture in 20% and 40% of conjunctival and vaginal swabs respectively. By the PCR method, ocular Chlamydia trachomatis was present in 60% of symptomatic women, while genital Chlamydia trachomatis infection was present in 30% of symptomatic women. The results of this method also indicated that 25/50 (50%) vaginal swabs were positive with PCR for Candida albicans versus 15/50 (30%) were PCR positive in conjunctival swab. Mycoplasma genitalium was present in only 10% of vaginal swabs. Concomitant oculogenital PCR positive results for Chlamydia trachomatis and Candida albicans were 30% and 28% respectively. CONCLUSION Ocular Chlamydia trachomatis was associated with genital Chlamydia trachomatis in a high percentage of women followed by Candida albicans. Cultured bacterial organisms do not play a role in enhancement of Chlamydia trachomatis infection. PMID:27588273

  19. Perception of personal risk of acquiring human immunodeficiency viral infection/acquired immune deficiency syndrome among people attending outpatient clinics in a teaching hospital of Nigeria.

    PubMed

    Adegun, P T; Adegoke, S A; Solomon, O S; Ade-Ojo, I P

    2013-01-01

    The Human Immunodeficiency Virus (HIV) pandemic is on the increase with the highest burden in sub-Saharan Africa. This descriptive cross-sectional study was carried out in 2008 to assess the knowledge, self-perception of risk of contracting HIV infection and risky sexual practices among patients attending some out-patient clinics at the University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria. The knowledge on the modes of transmission and methods of prevention of HIV was high. Although, 53.0% of the study participants perceived themselves not to be at risk of contracting HIV infection, 80.6% were engaged in risky sexual practices within a year preceding the study. Significantly more participants with multiple sexual partners, past and present history of Sexually Transmitted Infections (STI) perceived themselves not to be at risk (P= 0.001, 0.008 and 0.001 respectively). Effective strategies must therefore be developed, to enhance risk-perception since poor risk-perception is known to mitigate behavioral change.

  20. A randomized trial of combined citalopram and naltrexone for nonabstinent outpatients with co-occurring alcohol dependence and major depression.

    PubMed

    Adamson, Simon J; Sellman, J Douglas; Foulds, James A; Frampton, Christopher M A; Deering, Daryle; Dunn, Alistair; Berks, John; Nixon, Lee; Cape, Gavin

    2015-04-01

    Despite the high rate of co-occurrence of major depression and alcohol dependence, the role of pharmacotherapy in their treatment remains unclear. In the new era of naltrexone for alcohol dependence, it is notable that only 1 study to date has examined the efficacy of antidepressant medication prescribed concurrently with naltrexone. We aimed to determine whether combining naltrexone with citalopram produced better treatment outcomes than naltrexone alone in patients with co-occurring alcohol dependence and depression, and to investigate whether either sex or depression type (independent or substance-induced depression) moderated treatment response. Participants were 138 depressed alcohol-dependent adults who were not required to be abstinent at the commencement of the trial. They were randomized to 12 weeks of citalopram or placebo, plus naltrexone and clinical case management. Treatment was well attended, and medications were reasonably well tolerated with high adherence rates. Substantial improvements in both mood and drinking occurred in both groups, with no significant differences between groups on any of the mood or drinking outcome measures, whether or not other variables were controlled for. No interaction effect was found for independent/substance-induced depression status, whereas there was a marginal effect found by sex, with greater improvement in 1 drinking outcome measure (percent days abstinent) in women taking citalopram. These findings suggest that citalopram is not a clinically useful addition to naltrexone and clinical case management in this treatment population. Independent/substance-induced depression status did not predict treatment response. Findings for sex were equivocal.

  1. Feasibility, Acceptability, and Impact of a Web-based Gratitude Exercise among Individuals in Outpatient Treatment for Alcohol Use Disorder

    PubMed Central

    Krentzman, Amy R.; Mannella, Kristin A.; Hassett, Afton L.; Barnett, Nancy P.; Cranford, James A.; Brower, Kirk J.; Higgins, Margaret M.; Meyer, Piper S.

    2015-01-01

    This mixed-methods pilot study examined the feasibility, acceptability, and impact of a web-based gratitude exercise (the ‘Three Good Things’ exercise (TGT)) among 23 adults in outpatient treatment for alcohol use disorder (AUD). Participants were randomized to TGT or a placebo condition. The intervention was feasible with high rates of completion. Participants found TGT acceptable and welcomed the structure of daily emails; however, they found it difficult at times and discontinued TGT when the study ended. Participants associated TGT with gratitude, although there were no observed changes in grateful disposition over time. TGT had a significant effect on decreasing negative affect and increasing unactivated (e.g., feeling calm, at ease) positive affect, although there were no differences between groups at the 8 week follow up. Qualitative results converged on quantitative findings that TGT was convenient, feasible, and acceptable, and additionally suggested that TGT was beneficial for engendering positive cognitions and reinforcing recovery. PMID:27076837

  2. Alcoholics Anonymous Attendance, Aftercare, and Outcome: A Secondary Analysis of Two Years Posthospitalization Data

    DTIC Science & Technology

    1988-01-01

    dependency treatment, they are encouraged to attend both aftercare and AA meetings.’ 6 This study attempted to look at the relationships between the subjects...Moos, and Mewborn, 1980; PettInati, et al., 1982; and Ornstein and Cherepon, 1985). In contrast to the above, this study looks at aftercare and AA...questions of this study look at the relationship between aftercare and AA attendance, and whether, as test variables, they correlated with selected outcome

  3. Do Drug-Dependent Patients Attending Alcoholics Anonymous Rather than Narcotics Anonymous Do As Well? A Prospective, Lagged, Matching Analysis

    PubMed Central

    Kelly, John F.; Greene, M. Claire; Bergman, Brandon G.

    2014-01-01

    Aims: Alcoholics Anonymous (AA) is the most prevalent 12-step mutual-help organization (MHO), yet debate has persisted clinically regarding whether patients whose primary substance is not alcohol should be referred to AA. Narcotics Anonymous (NA) was created as a more specific fit to enhance recovery from drug addiction; however, compared with AA, NA meetings are not as ubiquitous. Little is known about the effects of a mismatch between individuals' primary substance and MHOs, and whether any incongruence might result in a lower likelihood of continuation and benefit. More research would inform clinical recommendations. Method: Young adults (N = 279, M age 20.4, SD 1.6, 27% female; 95% White) in a treatment effectiveness study completed assessments at intake, and 3, 6, and 12 months post-treatment. A matching variable was created for ‘primary drug’ patients (i.e. those reporting cannabis, opiates or stimulants as primary substance; n = 198/279), reflecting the proportion of total 12-step meetings attended that were AA. Hierarchical linear models (HLMs) tested this variable's effects on future 12-step participation and percent days abstinent (PDA). Results: The majority of meetings attended by both alcohol and drug patients was AA. Drug patients attending proportionately more AA than NA meetings (i.e. mismatched) were no different than those who were better matched to NA with respect to future 12-step participation or PDA. Conclusion: Drug patients may be at no greater risk of discontinuation or diminished recovery benefit from participation in AA relative to NA. Findings may boost clinical confidence in making AA referrals for drug patients when NA is less available. PMID:25294352

  4. Effects of long-term AA attendance and spirituality on the course of depressive symptoms in individuals with alcohol use disorder.

    PubMed

    Wilcox, Claire E; Pearson, Matthew R; Tonigan, J Scott

    2015-06-01

    Alcohol use disorder (AUD) is associated with depression. Although attendance at Alcoholics Anonymous (AA) meetings predicts reductions in drinking, results have been mixed about the salutary effects of AA on reducing depressive symptoms. In this single-group study, early AA affiliates (n = 253) were recruited, consented, and assessed at baseline, 3, 6, 9, 12, 18, and 24 months. Lagged growth models were used to investigate the predictive effect of AA attendance on depression, controlling for concurrent drinking and treatment attendance. Depression was measured using the Beck Depression Inventory (BDI) and was administered at baseline 3, 6, 12, 18, and 24 months. Additional predictors of depression tested included spiritual gains (Religious Background and Behavior questionnaire [RBB]) and completion of 12-step work (Alcoholics Anonymous Inventory [AAI]). Eighty-five percent of the original sample provided follow-up data at 24 months. Overall, depression decreased over the 24 month follow-up period. AA attendance predicted later reductions in depression (slope = -3.40, p = .01) even after controlling for concurrent drinking and formal treatment attendance. Finally, increased spiritual gains (RBB) also predicted later reductions in depression (slope = -0.10, p = .02) after controlling for concurrent drinking, treatment, and AA attendance. In summary, reductions in alcohol consumption partially explained decreases in depression in this sample of early AA affiliates, and other factors such as AA attendance and increased spiritual practices also accounted for reductions in depression beyond that explained by drinking. (PsycINFO Database Record

  5. Effects of Long-Term AA Attendance and Spirituality on the Course of Depressive Symptoms in Individuals with Alcohol Use Disorder

    PubMed Central

    Wilcox, Claire E.; Pearson, Matthew R.; Tonigan, J. Scott

    2016-01-01

    Alcohol use disorder (AUD) is associated with depression. Although attendance at Alcoholics Anonymous (AA) meetings predicts reductions in drinking, results have been mixed about the salutary effects of AA on reducing depressive symptoms. In this single-group study, early AA affiliates (n=253) were recruited, consented, and assessed at baseline, 3, 6, 9, 12, 18 and 24 months. Lagged growth models were used to investigate the predictive effect of AA attendance on depression, controlling for concurrent drinking and treatment attendance. Depression was measured using the Beck Depression Inventory (BDI) and was administered at baseline 3, 6, 12, 18 and 24 months. Additional predictors of depression tested included spiritual gains, [Religious Background and Behavior questionnaire (RBB)] and completion of 12-step work [(Alcoholics Anonymous Inventory (AAI)]. Eighty-five percent of the original sample provided follow-up data at 24 months. Overall, depression decreased over the 24 month follow-up period. AA attendance predicted later reductions in depression (slope=−3.40, p= 0.01) even after controlling for concurrent drinking and formal treatment attendance. Finally, increased spiritual gains (RBB) also predicted later reductions in depression (slope=−0.10, p=0.02) after controlling for concurrent drinking, treatment, and AA attendance. In sum, reductions in alcohol consumption partially explained decreases in depression in this sample of early AA affiliates, and other factors such as AA attendance and increased spiritual practices also accounted for reductions in depression beyond that explained by drinking. PMID:26076099

  6. Alcohol Use and Mental Health Conditions Among Black College Males: Do Those Attending Postsecondary Minority Institutions Fare Better Than Those at Primarily White Institutions?

    PubMed

    Barry, Adam E; Jackson, Zachary; Watkins, Daphne C; Goodwill, Janelle R; Hunte, Haslyn E R

    2016-11-02

    While there is a sizeable body of research examining the association between alcohol use and mental health conditions among college students, there are sparse investigations specifically focusing on these associations among Black college students. This is concerning given Black college students face different stressors compared with their non-Black peers. Black males appear especially at risk, exhibiting increased susceptibility to mental health issues and drinking in greater quantities and more frequently than Black females. This investigation examined the association between alcohol consumption and mental health conditions among Black men attending institutions of higher education in the United States and sought to determine differences between Black men attending predominantly White institutions (PWIs) compared with those attending postsecondary minority institutions. Final sample included 416 Black men, 323 of which attended a PWI. Data were from the National College Health Assessment. Black men attending a PWI reported significantly greater levels of alcohol consumption and significantly more mental health conditions. Attendance at a minority-serving institution was associated with fewer mental health conditions among Black men. Future studies should seek to replicate these findings and conduct culturally sensitive and gender-specific research examining why Black men at PWIs report greater alcohol consumption and more mental health conditions than their peers attending postsecondary minority institutions.

  7. Prevalence of alcohol use disorders and associated factors among people with epilepsy attending Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

    PubMed Central

    Waja, Tsegereda; Ebrahim, Jemal; Yohannis, Zegeye; Bedaso, Asres

    2016-01-01

    Introduction Alcohol use disorders represent one of the leading causes of preventable death, illness, and injury in many societies throughout the world. Heavy alcohol consumption has multiple negative consequences for people with epilepsy such as precipitation of seizure, exacerbation of seizure, poor seizure control, increased side effects of antiepileptic drugs, noncompliance to antiepileptic drugs, alcohol withdrawal seizures, long-term hospital admission, status epilepticus, sudden unexpected death, and premature mortality. Methods An institution-based cross sectional study was conducted from April 15, 2014 to May 15, 2014 with the aim of assessing prevalence of alcohol use disorders and associated factors among people with epilepsy attending Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. A total of 413 randomly selected epileptic patients were included in this study. Data were structured using the 10-item Alcohol Use Disorders Identification questionnaire. Data were analyzed using SPSS Version 20. Bivariate and multivariate logistic regression analyses were performed to study the association, and variables with P-value <0.05 were considered as having a statistically significant association at 95% confidence interval. Results A total of 423 study participants were selected, of whom 413 completely filled the questionnaire making the response rate 97.6%. The mean age of the respondents was 31.9 years with standard deviation of ±10.97, and 248 (60%) were males. The prevalence of alcohol use disorder was 17.4%. Educational status (grade 9–12) (adjusted odds ratio [AOR] =3.25, [1.21, 8.69]), not living with family members (AOR =1.89, [1.06, 3.39]), availability of house (AOR =2.04, [1.10, 3.78]), taking carbamazepine (AOR =2.38, [1.13, 5.01]), and drinking alcohol to find relief from stress (AOR =4.28, [1.89, 9.67]) were significantly associated with alcohol use disorder among people with epilepsy. Conclusion and recommendation The findings of this

  8. Lifetime Alcoholics Anonymous attendance as a predictor of spiritual gains in the Relapse Replication and Extension Project (RREP).

    PubMed

    Tonigan, J Scott; McCallion, Elizabeth A; Frohe, Tessa; Pearson, Matthew R

    2017-02-01

    This study investigated the association between extent of lifetime attendance in Alcoholics Anonymous (AA) and spiritual gains among treatment seeking adults for alcohol use disorder. Participants included 246 individuals from 2 of the 3 sites in the Relapse Replication and Extension Project (Lowman, Allen, Stout, & The Relapse Research Group, 1996). Baseline characteristics included 63% male, 39.9% single, and the average age was 34 years (SD = 8.2). The Alcoholics Anonymous Involvement questionnaire (Tonigan, Connors, & Miller, 1996) was used to assess lifetime AA attendance. The Religious Beliefs & Behaviors Questionnaire (Connors, Tonigan, & Miller, 1996) was used to assess spirituality. Percent days abstinent (PDA) and drinks per drinking day (DPDD) were measured using the Form 90. At baseline, adults with more extensive AA histories were more severely alcohol impaired although they were no older relative to adults with less past AA exposure. Clear patterns of AA engagement were found between the high-low AA history groups over follow-up, with adults with less AA experience reporting less AA participation across a swath of AA-specific measures. Gains in spiritual practices significantly mediated AA-related benefit as measured by PDA and DPDD. Tests for moderated-mediation indicated that the magnitude of the mediational effect of spiritual gains did not differ between high-low AA history groups. Having an extensive AA history did not advantage (or disadvantage) adults in mobilizing future spiritual practices that are prescribed in AA. Clinical assessment of client AA history is important, however, because it predicts both the nature and extent that clients may participate in AA. (PsycINFO Database Record

  9. Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcoholic fathers’ treatment involvement and their children’s externalizing problems

    PubMed Central

    Andreas, Jasmina Burdzovic; O'Farrell, Timothy J

    2008-01-01

    We investigated longitudinal associations between alcoholic fathers’ 12-step treatment involvement and their children’s internalizing and externalizing problems (N=125, Mage=9.8±3.1), testing the hypotheses that fathers’ greater treatment involvement would benefit later child behavior, and that this effect would be mediated by fathers’ post-treatment behaviors. The initial association was established between fathers’ treatment involvement and children’s externalizing problems only, while structural equation (SEM) results supported mediating hypotheses. Fathers’ greater treatment involvement predicted children’s lower externalizing problems 12 months later, and fathers’ post-treatment behaviors mediated this association: greater treatment involvement predicted greater post-treatment Alcoholics Anonymous (AA) attendance, which in turn predicted greater abstinence. Finally, fathers’ abstinence was associated with lower externalizing problems in children. Theoretical and practical implications of these findings are discussed. PMID:18715745

  10. Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcohol-dependent fathers' treatment involvement and their children's externalizing problems.

    PubMed

    Andreas, Jasmina Burdzovic; O'Farrell, Timothy J

    2009-01-01

    We investigated longitudinal associations between alcohol-dependent fathers' 12-step treatment involvement and their children's internalizing and externalizing problems (N = 125, M(age) = 9.8 +/- 3.1), testing the hypotheses that fathers' greater treatment involvement would benefit later child behavior and that this effect would be mediated by fathers' posttreatment behaviors. The initial association was established between fathers' treatment involvement and children's externalizing problems only, whereas Structural Equation Modeling (SEM) results supported mediating hypotheses. Fathers' greater treatment involvement predicted children's lower externalizing problems 12 months later, and fathers' posttreatment behaviors mediated this association: Greater treatment involvement predicted greater posttreatment Alcoholics Anonymous attendance, which in turn predicted greater abstinence. Finally, fathers' abstinence was associated with lower externalizing problems in children. Theoretical and practical implications of these findings are discussed.

  11. Risk factors associated with tobacco, alcohol and drug use among adolescents attending secondary school in three cities from Argentina.

    PubMed

    Morello, Paola; Pérez, Adriana; Peña, Lorena; Braun, Sandra N; Kollath-Cattano, Christy; Thrasher, James F; Sargent, James; Mejía, Raúl

    2017-04-01

    Tobacco, alcohol and drug use starts at an early age. It is important to identify risk factors associated with initiation. In 2014, a survey was conducted among students attending first year of secondary schools in Buenos Aires, Córdoba, and Tucumán. A total of 3172 students completed the survey (42% were girls); their mean age was 12.8 years old. Findings showed that 10% had smoked; 32% had consumed alcohol; 17% had a heavy drinking episode in the past month; and 8% had used at least one illegal drug once in their lifetime. A high sensation seeking index was associated with the use of tobacco (odds ratio [OR]: 4.25, 95% confidence interval [CI]: 2.2-8.1), alcohol (OR: 5.56, 95% CI: 3.73-8.31), and marijuana, coca paste or cocaine, (OR: 11.73, 95% CI: 5.81-23.69). Having friends who smoke or drink was associated with tobacco (OR: 12.6, 95% CI: 7.8-20.5) and alcohol use (OR: 5.17, 95% CI: 4.15-6.40). Having permissive parents in terms of media use was associated with tobacco use (OR: 3.7, 95% CI: 2.1-6.5), and perceiving a low parental support and control (OR: 3.02, 95% CI: 1.40-6.52) was associated with marijuana, coca paste and cocaine use.

  12. Alcohol and Drug Use among Gang Members: Experiences of Adolescents Who Attend School

    ERIC Educational Resources Information Center

    Swahn, Monica H.; Bossarte, Robert M.; West, Bethany; Topalli, Volkan

    2010-01-01

    Background: Problems related to gangs have been noted in large cities and in many schools across the United States. This study examined the patterns of alcohol, drug use, and related exposures among male and female high school students who were gang members. Methods: Analyses were based on the Youth Violence Survey, conducted in 2004, and…

  13. Ethical issues in a stage 1 cognitive-behavioral therapy feasibility study and trial to reduce alcohol use among HIV-infected outpatients in western Kenya.

    PubMed

    Papas, Rebecca K; Gakinya, Benson N; Baliddawa, Joyce B; Martino, Steve; Bryant, Kendall J; Meslin, Eric M; Sidle, John E

    2012-07-01

    Epidemics of both HIV/AIDS and alcohol abuse in sub-Saharan Africa have spurred the conduct of local behavioral therapy trials for these problems, but the ethical issues involved in these trials have not been fully examined. In this paper, we discuss ethical issues that emerged during the conduct of a behavioral intervention adaptation and trial using cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. The study was performed within our multinational collaboration, the USAID-Academic Model Providing Access to Healthcare Partnership. We discuss relevant ethical considerations and how we addressed them.

  14. Ethical Issues in a Stage 1 Cognitive-Behavioral Therapy Feasibility Study and Trial to Reduce Alcohol Use Among HIV-Infected Outpatients in Western Kenya

    PubMed Central

    Papas, Rebecca K.; Gakinya, Benson N.; Baliddawa, Joyce B.; Martino, Steve; Bryant, Kendall J.; Meslin, Eric M.; Sidle, John E.

    2013-01-01

    Epidemics of both HIV/AIDS and alcohol abuse in sub-Saharan Africa have spurred the conduct of local behavioral therapy trials for these problems, but the ethical issues involved in these trials have not been fully examined. In this paper, we discuss ethical issues that emerged during the conduct of a behavioral intervention adaptation and trial using cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. The study was performed within our multinational collaboration, the USAID-Academic Model Providing Access to Healthcare Partnership. We discuss relevant ethical considerations and how we addressed them. PMID:22850141

  15. [Preliminary study on detox in outpatient care units with 18 alcoholic patients in Directly Observed Treatment].

    PubMed

    Lloréns Martínez, Ramón; Calatayud Francés, María; Morales Gallús, Esperanza; Añó Cervera, Consol; Adriá Caballero, Librada

    2008-01-01

    Directly Observed Treatment (TOD-DOT) has been tested in different conditions. The objective of this work is to check whether a UCA-CAB (Centre for Addictive Behaviour) can achieve detox and reduce the risk of early relapse (up to 12 weeks) in alcoholic patients. All patients had an established organic addiction and serious withdrawal syndrome, and had undergone multiple previous treatments. Furthermore, they had not managed to abstain for a 3-month consecutive period over the previous 2 years. The aim of the Directly Observed Treatment was to attain detox and reduce relapse by following a multi-method approach: medical, psychological and personal care, based on a brief daily consultation and pharmacological supervision. The results were as follows: Of the 18 patients included in the study, after 12 weeks, 13 (72 %) were still abstinent and 4 (22 %) had relapsed. Thus, 17 (94 %) were still following the treatment, with just one drop-out. We analysed the profiles of the patients abstaining, of those who relapsed (4) and of the one who dropped out. The average CIWA-Ar was 27.05 (21-36). Any value over 20 is considered to indicate serious withdrawal syndrome, though there were no negative events leading to hospitalization. Level of adherence to the treatment (94 %) meant that the most seriously affected patients and those with fewest financial resources could benefit, not only from any auxiliary social schemes, but also from basic health services, permitting them to improve the quality of their everyday life.

  16. If You Feed Them, Will They Come? The Use of Social Marketing to Increase Interest in Attending a College Alcohol Program

    ERIC Educational Resources Information Center

    Palmer, Rebekka S.; Kilmer, Jason R.; Larimer, Mary E.

    2006-01-01

    The authors used social marketing to design and test advertisement components aimed at increasing students' interest in attending an alcohol program focused on reaching students who drink heavily, although the authors offered no such program. Participants were undergraduate students in introductory psychology courses (N = 551). Questionnaires…

  17. The clinical and cost-effectiveness of brief advice for excessive alcohol consumption among people attending sexual health clinics: a randomised controlled trial

    PubMed Central

    Crawford, Mike J; Sanatinia, Rahil; Barrett, Barbara; Byford, Sarah; Dean, Madeleine; Green, John; Jones, Rachael; Leurent, Baptiste; Sweeting, Michael J; Touquet, Robin; Greene, Linda; Tyrer, Peter; Ward, Helen; Lingford-Hughes, Anne

    2015-01-01

    Objectives To examine the clinical and cost-effectiveness of brief advice for excessive alcohol consumption among people who attend sexual health clinics. Methods Two-arm, parallel group, assessor blind, pragmatic, randomised controlled trial. 802 people aged 19 years or over who attended one of three sexual health clinics and were drinking excessively were randomised to either brief advice or control treatment. Brief advice consisted of feedback on alcohol and health, written information and an offer of an appointment with an Alcohol Health Worker. Control participants received a leaflet on health and lifestyle. The primary outcome was mean weekly alcohol consumption during the previous 90 days measured 6 months after randomisation. The main secondary outcome was unprotected sex during this period. Results Among the 402 randomised to brief advice, 397 (99%) received it. The adjusted mean difference in alcohol consumption at 6 months was −2.33 units per week (95% CI −4.69 to 0.03, p=0.053) among those in the active compared to the control arm of the trial. Unprotected sex was reported by 154 (53%) of those who received brief advice, and 178 (59%) controls (adjusted OR=0.89, 95% CI 0.63 to 1.25, p=0.496). There were no significant differences in costs between study groups at 6 months. Conclusions Introduction of universal screening and brief advice for excessive alcohol use among people attending sexual health clinics does not result in clinically important reductions in alcohol consumption or provide a cost-effective use of resources. Trial registration number Current Controlled Trials ISRCTN 99963322. PMID:24936090

  18. Relationship between depressive symptoms, alcohol use, and antiretroviral therapy adherence among HIV-infected, clinic-attending patients in South Africa.

    PubMed

    Magidson, Jessica F; Saal, Wylene; Nel, Adriaan; Remmert, Jocelyn E; Kagee, Ashraf

    2016-02-15

    Despite the prevalence of depression and alcohol use among HIV-infected individuals, few studies have examined their association together in relation to nonadherence to antiretroviral therapy in sub-Saharan Africa. This study examined depressive symptoms, alcohol use, and other psychosocial factors (stigma, demographic characteristics) in relation to nonadherence to antiretroviral therapy among clinic-attending, HIV-infected individuals in South Africa (n = 101). Nonadherence was assessed using event-level measurement (missed doses over the past weekend). Multivariable logistic regression analyses revealed that only alcohol use, over and above depressive symptoms and education level, was associated with antiretroviral therapy nonadherence(AOR = 1.15; 95%CI = 1.02-1.29; p < .05). Findings point to the independent association of alcohol use and nonadherence to antiretroviral therapy above and beyond depressive symptoms.

  19. Traumatic stress and the mediating role of alcohol use on HIV-related sexual risk behavior: Results from a longitudinal cohort of South African women who attend alcohol-serving venues

    PubMed Central

    Abler, Laurie; Sikkema, Kathleen J.; Watt, Melissa H.; Pitpitan, Eileen V.; Kalichman, Seth C.; Skinner, Donald; Pieterse, Desiree

    2014-01-01

    Background In South Africa, alcohol contributes to the HIV epidemic, in part, by influencing sexual behaviors. For some, high levels of alcohol consumption may be driven by previous traumatic experiences that result in traumatic stress. The purpose of this study was to quantify the longitudinal association between traumatic stress and unprotected sex among women who attend drinking venues and to assess whether this association was explained by mediation through alcohol use. Methods Data were collected in four waves over a year from a prospective cohort of 560 women who regularly attended alcohol-serving venues in a Cape Town township. Longitudinal mixed models examined: 1) the relationship between traumatic stress and counts of unprotected sex, and 2) whether alcohol use mediated the association between traumatic stress and unprotected sex. Results Most women reported elevated traumatic stress (80%) and hazardous alcohol use (88%) at least once during the study period. In models adjusted for covariates, traumatic stress was associated with unprotected sex (b=0.28, SE=0.06, t=4.82, p<.001). In addition, traumatic stress was associated with alcohol use (b=0.27, SE=0.02, t=14.25, p<.001), and was also associated with unprotected sex (b=0.20, SE=0.06, t=3.27, p<.01) while controlling for alcohol use (b=0.28, SE=0.07, t=4.25, p<.001). The test for the mediated effect established that alcohol use was a significant mediator, accounting for 27% of the total effect of traumatic stress on unprotected sex. Conclusions These results highlight the need to address traumatic stress among female venue patrons as an important precursor of HIV risk due to alcohol use. PMID:25394191

  20. Emergency department outpatient treatment of alcohol-intoxicated bicyclists increases the cost of medical care in Japan

    PubMed Central

    Yamauchi, Sunao; Mizobe, Michiko; Nakashima, Yoshiyuki; Takahashi, Jin; Funakoshi, Hiraku; Urayama, Kevin Y.; Ohde, Sachiko; Takahashi, Osamu; Shiga, Takashi

    2017-01-01

    Riding a bicycle under the influence of alcohol is illegal in Japan. Nevertheless, intoxicated bicyclists are frequently treated at hospital emergency departments for bicycle-related injuries. This patient population usually requires more hospital resources, even for relatively minor injuries. Therefore, we hypothesized that bicycle-related crashes involving bicyclists under the influence of alcohol cost more to treat than those that do not involve alcohol intoxication. The aim of the present study was to examine the costs associated with bicycle-related minor injuries and alcohol intoxication of the bicyclist. The study was conducted at the Tokyo Bay Urayasu Ichikawa Medical Center Emergency Department, Japan. All minor bicycle crashes involving 217 individuals aged ≥20 years treated from September 1, 2012 to August 31, 2013 were included in the analysis of data obtained from medical records. Variables included alcohol intoxication, sex, age, collision with a motor vehicle, Glasgow Coma Scale, injury severity score (ISS), laboratory tests, treatment of wounds, number of X-ray images, number of computed tomography scans, and medical costs. Multiple linear regression analysis was performed to evaluate the association between alcohol intoxication and medical costs. Seventy (32%) patients consumed alcohol, and the median medical cost was 253 USD (interquartile range [IQR], 164–330). Multivariable analysis showed that alcohol intoxication was independently associated with higher medical costs (p = 0.030, adjusted R-square value = 0.55). These findings support our hypothesis and should encourage authorities to implement comprehensive measures to prohibit bicycling under the influence of alcohol to prevent injuries and to reduce medical costs. PMID:28329002

  1. A Study on the Prevalence of Genital Trichomoniasis among Female Outpatients Attending Sexually Transmitted Infection Clinic in a Tertiary Care Hospital

    PubMed Central

    Muthusamy, Swapna; Elangovan, Selvi

    2017-01-01

    Introduction: Women with high-risk sexual behavior accounts for more than half of the sexually transmitted infection (STI) clinic attendees. The prevalence of trichomoniasis is as low as 5% in the general population to as high as 60% in high-risk population. This infection can pave the way to the acquisition of human immunodeficiency virus and other STIs, vice versa and is even associated with cancer. Objectives: To identify, isolate and study the prevalence of Trichomonas vaginalis in genital specimens of female outpatients. Materials and Methods: Total number of subjects involved in the study was 130, among them 85 belonged to high-risk group and 45 belonged to low-risk group. Two high vaginal swabs were collected from each patient. Saline wet mount, Giemsa stain, and culture in modified cysteine peptone liver infusion maltose medium were performed. Results were tabulated and analyzed. Results: Saline wet mount was positive for trichomoniasis in seven individuals, Giemsa detected trichomoniasis in five patients, and culture was positive in eight patients. Of these eight culture positive cases, one was wet mount negative and four were Giemsa stain negative. Conclusion: Culture is more sensitive than wet mount and Giemsa stain. PMID:28042211

  2. Bacterial Isolates and Their Antimicrobial Susceptibility Patterns of Wound Infections among Inpatients and Outpatients Attending the University of Gondar Referral Hospital, Northwest Ethiopia

    PubMed Central

    Mohammed, Aynalem; Tiruneh, Moges

    2017-01-01

    Background. The widespread uses of antibiotics, together with the length of time over which they have been available, have led to the emergence of resistant bacterial pathogens contributing to morbidity and mortality. This study was aimed to assess bacterial isolates and their drug susceptibility patterns from inpatients and outpatients with pus and/or wound discharge. Methods. A cross-sectional study was conducted at the University of Gondar Referral Hospital from March to May, 2014. Wound swab samples were collected from each study participant and inoculated into appropriate media. The bacterial pathogens were identified using standard microbiological methods. Antimicrobial susceptibility tests were performed using disk diffusion technique following Kirby-Bauer method. Results. A total of 137 study subjects were included in the study with bacterial isolation rate of 115 (83.9%). Of all, 81 (59.1%) were males. Seventy-seven (57%) of the isolates were Gram-negative and 59 (43%) were Gram-positive. From the total isolates, Staphylococcus aureus was the most predominant isolate 39/115 (34%) followed by Klebsiella species (13%), coagulase negative staphylococci spp. (12%) and Pseudomonas aeruginosa. Gram-positive isolates were resistant to ampicillin (86.4%), amoxicillin (83%), penicillin (81.3%), oxacillin (74.6%), and tetracycline (59.4%), while Gram-negative isolates were resistant to amoxicillin (97.4%), ampicillin (94.8%), tetracycline (72.7%), trimethoprim/sulfamethoxazole (66%), and chloramphenicol (54.5%). Conclusion. High prevalence of bacterial isolates was found, Staphylococcus aureus being the most dominant. High rates of multiple drug resistance pathogens to the commonly used antimicrobial agents were isolated. Therefore, concerned bodies should properly monitor the choice of antibiotics to be used as prophylaxis and empiric treatment in the study area. PMID:28386280

  3. Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa

    PubMed Central

    Naidoo, Mergan

    2016-01-01

    Background Diabetic foot disease (DFD) is a major challenge for the healthcare system, with enormous economic consequences for people living with diabetes, their families, and society, affecting both quality of life and quality of care. The study aim was to assess the level of awareness of DFD amongst patients with type 2 diabetes mellitus (T2DM). Methods An observational descriptive cross-sectional study was conducted at the chronic outpatients department of a regional hospital in Durban, South Africa. Results Two hundred participants with T2DM participated in the study. Ninety-one per cent of participants were either overweight or obese. Ninety-two per cent of participants had concomitant hypertension (57.5%), dyslipidaemia (26.7%) and eye disease (7.2%). Seventy-six per cent reported altered sensation in their lower limbs, and 90% reported having no previous DFD education. Only 22.2% of participants reported having examined their feet, but only when they experienced a problem. Participants achieved mediocre scores for knowledge (mean 4.45, standard deviation (s.d.) 2.201, confidence interval (CI) 4.2–4.7) and practice (mean 11.09, s.d. 2.233, CI 10.8–11.5) on diabetic foot care (DFC). Those who had a higher level of education and who were less than 65 years old had a significantly better score for previous foot care education (p <0.05). Conclusion The study demonstrated that awareness of DFD was suboptimal, based on current DFC guidelines. To minimise the burden of DFD, improved screening and prevention programmes as well as patient education should be provided to T2DM patients, whilst maintaining an aggressive approach to risk factor modifications, footwear and identifying the at-risk foot. PMID:28155315

  4. Outpatient Surgery

    MedlinePlus

    ... Outpatient Surgery Share this Page Preparing For Surgery Effects of Anesthesia Children and Anesthesia Pregnancy and Anesthesia Seniors and Anesthesia Surgery Risks Anesthesia Awareness Obesity and Anesthesia Sleep Apnea and Anesthesia Smoking and Anesthesia Outpatient Surgery ...

  5. Prazosin Augmentation of Outpatient Treatment of Alcohol Use Disorders in Active Duty Soldiers with and without PTSD

    DTIC Science & Technology

    2015-10-01

    Substance Abuse Program (ASAP) at Madigan Health Care System/Joint Base Lewis McChord. The aims of this trial are 1) to determine prazosin’s efficacy... Abuse Program (ASAP) at Madigan HCS/Joint Base Lewis McChord. The aims of this trial are 1) to determine prazosin’s efficacy for AUD in OIF/OEF soldiers...Augmentation of Outpatient Treatment of AUD in Active Duty Soldiers with and without PTSD. Presented at Joint Army/NIH Substance Abuse IP – September 29

  6. A Pilot Study of Alcohol and Cigarette Consumption among Adolescent and Young Adult Females Attending Health Clinics.

    ERIC Educational Resources Information Center

    Werch, Chudley E.; Dunn, Michael; Woods, Robert

    1997-01-01

    Examines the alcohol and cigarette use patterns of adolescent and young adult female patients (N=246). Results indicate that smoking differences between Whites and Blacks was inversely related to education: less-educated Whites and more-educated Blacks had a greater smoking risk. Conclusions show females' differential needs regarding alcohol and…

  7. The clinical effectiveness and cost-effectiveness of brief intervention for excessive alcohol consumption among people attending sexual health clinics: a randomised controlled trial (SHEAR).

    PubMed Central

    Crawford, Mike J; Sanatinia, Rahil; Barrett, Barbara; Byford, Sarah; Dean, Madeleine; Green, John; Jones, Rachael; Leurent, Baptiste; Lingford-Hughes, Anne; Sweeting, Michael; Touquet, Robin; Tyrer, Peter; Ward, Helen

    2014-01-01

    BACKGROUND Excessive use of alcohol is associated with poor sexual health, but the clinical effectiveness and cost-effectiveness of brief alcohol intervention in this setting has not been investigated. OBJECTIVE To examine the effects and cost-effectiveness of brief intervention for excessive alcohol consumption among people who attend sexual health clinics. DESIGN A two-arm, parallel-group, single-blind, pragmatic, randomised controlled trial. Participants were randomised via an independent and remote telephone randomisation service using permuted blocks, stratified by clinic. SETTING Study participants were recruited from three sexual health clinics in central and west London. PARTICIPANTS For inclusion, potential participants had to be aged ≥ 19 years, drink excessive alcohol according to the Modified-Single Alcohol Screening Question, and be willing to provide written informed consent. We excluded those who were unable to communicate in English sufficiently well to complete the baseline assessment and those who could not provide contact details for the follow-up assessment. INTERVENTIONS Brief advice was delivered by the treating clinician and comprised feedback on the possible health consequences of excessive drinking, a discussion of whether the participant's clinic attendance was linked to current alcohol use, written information on alcohol and health and an offer of an appointment with an alcohol health worker (AHW). Appointments with AHWs took place either in person or by telephone, lasted up to 30 minutes, and used the 'FRAMES' (Feedback about the adverse effects of alcohol, an emphasis on personal Responsibility for changing drinking behaviour, Advice about alcohol consumption, a Menu of options for further help and advice, an Empathic stance towards the patient and an emphasis on Self-efficacy) approach. Those in the control arm of the trial were offered a copy of a leaflet providing general information on health and lifestyle. MAIN OUTCOME MEASURES

  8. A Novel Integration Effort to Reduce the Risk for Alcohol-Exposed Pregnancy Among Women Attending Urban STD Clinics

    PubMed Central

    Hutton, Heidi E.; Chander, Geetanjali; Green, Patricia P.; Hutsell, Catherine A.; Weingarten, Kimberly

    2014-01-01

    Alcohol-exposed pregnancy (AEP) is a significant public health problem in the United States. Sexually transmitted disease (STD) clinics serve female clients with a high prevalence of heavy alcohol consumption coupled with ineffective contraceptive use. Project CHOICES (Changing High-Risk AlcOhol Use and Increasing Contraception Effectiveness) is an evidence-based, brief intervention to lower risk of AEP by targeting alcohol and contraceptive behaviors through motivational interviewing and individualized feedback. We describe our experience integrating and implementing CHOICES in STD clinics. This endeavor aligns with CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's program collaboration and service integration strategic priority to strengthen collaborative work across disease areas and integrate services provided by related programs at the client level. PMID:24385650

  9. Alcohol

    MedlinePlus

    ... that's how many accidents occur. continue What Is Alcoholism? What can be confusing about alcohol is that ... develop a problem with it. Sometimes, that's called alcoholism (say: al-kuh-HOL - ism) or being an ...

  10. Alcohol

    MedlinePlus

    If you are like many Americans, you drink alcohol at least occasionally. For many people, moderate drinking ... risky. Heavy drinking can lead to alcoholism and alcohol abuse, as well as injuries, liver disease, heart ...

  11. The Effect of Social Desirability on Reported Motivation, Substance Use Severity, and Treatment Attendance

    PubMed Central

    Zemore, Sarah E.

    2011-01-01

    Research has not consistently supported an association between stage of change and substance abuse treatment retention. The current study examined whether social desirability response bias could help explain why. Participants (N=200), recruited from an outpatient program, completed the URICA, TREAT, Marlowe-Crowne Social Desirability Scale (MC-SDS), and other measures. Number of treatment groups attended was collected from program records. In bivariate analyses, neither the URICA nor the TREAT was related to attendance. However, higher social desirability was strongly associated with lower URICA (but not TREAT) total scores, and in a multivariate path model, a moderately strong association emerged between higher URICA scores and greater treatment attendance when accounting for social desirability. Higher social desirability was also an independent predictor of greater treatment attendance, and was strongly associated with lower ASI Alcohol, Drug, and Psychiatric severity. Results underline a critical problem in measuring motivation and problem severity that has been largely neglected. PMID:22119180

  12. Alcohol

    MedlinePlus

    ... de los dientes Video: Getting an X-ray Alcohol KidsHealth > For Kids > Alcohol Print A A A What's in this article? ... What Is Alcoholism? Say No en español El alcohol Getting the Right Message "Hey, who wants a ...

  13. Outpatient Pain Rehabilitation Programs

    PubMed Central

    Chen, Joseph J

    2006-01-01

    Outpatient pain rehabilitation programs that include an interdisciplinary approach have been shown to be effective treatments for patients with chronic pain. The objectives of this article are to describe the common interdisciplinary pain rehabilitation programs available, the appropriate indications for use, the components of typical pain rehabilitation programs, the short-term and long-term success rates, the costs of attending these programs, and the significant societal costs of those patients who do not complete these programs and do not return to work. PMID:16789457

  14. Alcohol

    MedlinePlus

    ... parents and other adults use alcohol socially — having beer or wine with dinner, for example — alcohol seems ... besides just hanging out in someone's basement drinking beer all night. Plan a trip to the movies, ...

  15. Are the Twelve Steps more acceptable to drug users than to drinkers? A comparison of experiences of and attitudes to Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) among 200 substance misusers attending inpatient detoxification.

    PubMed

    Best, D W; Harris, J C; Gossop, M; Manning, V C; Man, L H; Marshall, J; Bearn, J; Strang, J

    2001-07-01

    The present study is a cross-sectional interview-based investigation comparing experiences of and attitudes towards Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) in a sample of 200 patients attending inpatient substance misuse detoxification services. Two hundred consecutive admissions were recruited; 100 each from one drug and one alcohol in-patient treatment service in which attendance at AA/NA was a voluntary adjunct to a generic treatment programme. Although there were no differences in the history of AA/NA attendance, the drug users (who were on average younger) reported significantly more positive attitudes towards AA/NA, more willingness to attend during their in-patient treatment and greater intention to attend following completion of their detoxification. In particular, despite no differences in spiritual/religious orientation, the drug users reported more positive views of the Twelve Steps. As AA/NA remain popular and accessible forms of substance misuse support, it is critical that we develop a clearer understanding of their impact and of the scope for their integration with generic forms of substance misuse treatment.

  16. Alcoholism.

    ERIC Educational Resources Information Center

    Caliguri, Joseph P., Ed.

    This extensive annotated bibliography provides a compilation of documents retreived from a computerized search of the ERIC, Social Science Citation Index, and Med-Line databases on the topic of alcoholism. The materials address the following areas of concern: (1) attitudes toward alcohol users and abusers; (2) characteristics of alcoholics and…

  17. [Outpatient emergencies].

    PubMed

    Rivallan, Armel; Le Nagard, Philippe

    2014-01-01

    The outpatient monitoring of patients sometimes involves emergency situations. In their practice, the nurses who visit the patient's home are confronted with the limits of their intervention. Faced with these delicate situations team coordination is a strength and the reactivity of the caregivers often contributes to a satisfactory outcome for the patient.

  18. School characteristics among children of alcoholic parents.

    PubMed

    Casas-Gil, Maria J; Navarro-Guzman, Jose I

    2002-02-01

    Studies show that children of alcoholics constitute a population at-risk commonly for poor performance, skipping school days, and school drop out. The focus of the present study was to examine a variety of direct outcome variables measuring academic performance among a sample of 226 children, 108 of them from parents who misused alcohol in Cadiz. Parents were outpatients of a Health Service and received treatment for the drinking problem; 118 students were children of nonalcoholic parents attending the same schools as the children of alcoholic parents. Both groups were compared on age, sex, school grade, and social environment. The study identified five variables on which performance by children of alcoholic parents was poorer: intelligence, repeating a grade, low academic performance, skipping school days, and dropping out of school.

  19. Relationship between Methyl Tertiary Butyl Ether Exposure and Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study among Petrol Station Attendants in Southern China

    PubMed Central

    Yang, Jianping; Wei, Qinzhi; Peng, Xiaochun; Peng, Xiaowu; Yuan, Jianhui; Hu, Dalin

    2016-01-01

    Methyl tertiary butyl ether (MTBE)—A well known gasoline additive substituting for lead alkyls—causes lipid disorders and liver dysfunctions in animal models. However, whether MTBE exposure is a risk factor for non-alcoholic fatty liver disease (NAFLD) remains uncertain. We evaluate the possible relationship between MTBE exposure and the prevalence of NAFLD among 71 petrol station attendants in southern China. The personal exposure concentrations of MTBE were analyzed by Head Space Solid Phase Microextraction GC/MS. NAFLD was diagnosed by using abdominal ultrasonography according to the guidelines for the diagnosis and treatment of NAFLD suggested by the Chinese Hepatology Association. Demographic and clinical characteristics potentially associated with NAFLD were investigated. Mutivariate logistic regression analysis was applied to measure odds ratios and 95% confidence intervals (CI). The result showed that the total prevalence of NAFLD was 15.49% (11/71) among the study subjects. The average exposure concentrations of MTBE were 292.98 ± 154.90 μg/m3 and 286.64 ± 122.28 μg/m3 in NAFLD and non-NAFLD groups, respectively, and there was no statistically significant difference between them (p > 0.05). After adjusting for age, gender, physical exercise, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), alanine aminotransferase (ALT), white blood cell (WBC), total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), the odds ratios were 1.31 (95% CI: 0.85–1.54; p > 0.05), 1.14 (95% CI: 0.81–1.32; p > 0.05), 1.52 (95% CI: 0.93–1.61; p > 0.05) in the groups (including men and women) with exposure concentrations of MTBE of 100–200 μg/m3, 200–300 μg/m3, and ≥300 μg/m3, respectively, as compared to the group (including men and women) ≤100 μg/m3. Our investigation indicates that exposure to MTBE does not seem to be a significant risk factor for the prevalence of

  20. Alcohol

    MedlinePlus

    ... created when grains, fruits, or vegetables are fermented . Fermentation is a process that uses yeast or bacteria ... change the sugars in the food into alcohol. Fermentation is used to produce many necessary items — everything ...

  1. Alcohol.

    ERIC Educational Resources Information Center

    Schibeci, Renato

    1996-01-01

    Describes the manufacturing of ethanol, the effects of ethanol on the body, the composition of alcoholic drinks, and some properties of ethanol. Presents some classroom experiments using ethanol. (JRH)

  2. The 10 Year Course of AA Participation and Long-Term Outcomes: A Follow-up Study of Outpatient Subjects in Project MATCH

    PubMed Central

    White, William L.; Kelly, John F.; Stout, Robert L.; Carter, Rebecca R.; Tonigan, J. Scott

    2012-01-01

    This study investigates the 10-year course and impact of AA-related helping (AAH), step-work, and meeting attendance on long-term outcomes. Data were derived from 226 treatment-seeking alcoholics recruited from an outpatient site in Project MATCH and followed for 10 years post-treatment. Alcohol consumption, AA participation, and other-oriented behavior were assessed at baseline, end of the 3-month treatment period, and one year, three years, and 10 years post-treatment. Controlling for explanatory baseline and time-varying variables, results showed significant direct effects of AAH and meeting attendance on reduced alcohol outcomes and a direct effect of AAH on improved other-oriented interest. PMID:23327504

  3. Do Alcohol Misuse, Service Utilisation, and Demographic Characteristics Differ between UK Veterans and Members of the General Public Attending an NHS General Hospital?

    PubMed Central

    Murphy, Dominic; Palmer, Emily; Westwood, Greta; Busuttil, Walter; Greenberg, Neil

    2016-01-01

    The aim of this paper was to provide insights into alcohol misuse within UK veterans to inform as to whether their presentations differ from the general public. This was done by exploring differences in the severity of alcohol misuse between UK veterans and the general public admitted to a general NHS hospital over an 18 month period using retrospective data. All patients admitted to the hospital were screened for alcohol misuse. Those deemed as experiencing problems were referred for specialist nurse-led support. A total of 2331 individuals were referred for this supported and administered with a standardised assessment that included measures of the severity of alcohol difficulties (AUDIT), dependency levels (LDQ), and assessed for the presence of withdrawal symptoms (CIWA-Ar). In addition, information was collected on service utilisation, referral category (medical or mental health), other substance misuse, and demographic characteristics. No differences were found between the severity of reported alcohol difficulties between veterans and non-veterans. Evidence was found to suggest that veterans were more likely to be referred for support with alcohol difficulties at an older age and to be admitted to hospital for longer periods of time. This could have considerable cost implications for the NHS. It was more common for veterans to present at hospital with physical health difficulties prior to being referred for support for alcohol. PMID:27827830

  4. "It's better for me to drink, at least the stress is going away": perspectives on alcohol use during pregnancy among South African women attending drinking establishments.

    PubMed

    Watt, Melissa H; Eaton, Lisa A; Choi, Karmel W; Velloza, Jennifer; Kalichman, Seth C; Skinner, Donald; Sikkema, Kathleen J

    2014-09-01

    The Western Cape of South Africa has one of the highest rates of fetal alcohol spectrum disorders (FASD) globally. Reducing alcohol use during pregnancy is a pressing public health priority for this region, but insight into the experiences of women who drink during pregnancy is lacking. Convenience sampling in alcohol-serving venues was used to identify women who were currently pregnant (n = 12) or recently post-partum (n = 12) and reported drinking during the pregnancy period. In-depth qualitative interviews were conducted between April and August 2013. Interviews explored drinking narratives, with textual data analyzed for themes related to factors that contributed to drinking during pregnancy. All but one woman reported her pregnancy as unplanned. The majority sustained or increased drinking after pregnancy recognition, with patterns typically including multiple days of binge drinking per week. Analysis of the textual data revealed five primary factors that contributed to drinking during pregnancy: 1) women used alcohol as a strategy to cope with stressors and negative emotions, including those associated with pregnancy; 2) women drank as a way to retain social connection, often during a difficult period of life transition; 3) social norms in women's peer groups supported drinking during pregnancy; 4) women lacked attachment to the pregnancy or were resistant to motherhood; and 5) women were driven physiologically by alcohol addiction. Our data suggest that alcohol-serving settings are important sites to identify and target women at risk of drinking during pregnancy. Intervention approaches to reduce alcohol use during pregnancy should include counseling and contraception to prevent unwanted pregnancies, mental health and coping interventions targeting pregnant women, peer-based interventions to change norms around perinatal drinking, and treatment for alcohol dependence during pregnancy. Our findings suggest that innovative interventions that go beyond the

  5. A Proposal for a Prevalence Study of the Use of Alcohol among Women Attending Selected United States Air Force Prenatal Clinics.

    DTIC Science & Technology

    1985-06-01

    and ptosis 7. epicanthal folds 8. cleft lip or cleft palate 9. hirsuitism APPENDIX 2 PROCESSION PLAN Stage Activit Time Required Phase I step 1 Select...thin upper lip , and/or flattening of the maxillary area II. FETAL ALCOHOL EFFECTS: Any congenital abnormality seen in children as a result of maternal

  6. Factors Associated with Deliberate Self-Harm Behaviour among Depressed Adolescent Outpatients

    ERIC Educational Resources Information Center

    Tuisku, Virpi; Pelkonen, Mirjami; Kiviruusu, Olli; Karlsson, Linnea; Ruuttu, Titta; Marttunen, Mauri

    2009-01-01

    This study examined whether depressed adolescent outpatients with deliberate self-harm behaviour (DSH) differed from non-suicidal depressed adolescent outpatients in depressive and anxiety symptoms, alcohol use, perceived social support and number of negative life-events. Depressed adolescent outpatients (n = 155) aged 13-19 years were interviewed…

  7. Treatment Attendance among Veterans with Depression, Substance Use Disorder, and Trauma

    PubMed Central

    Cui, Ruifeng; Haller, Moira; Skidmore, Jessica R.; Goldsteinholm, Kelly; Norman, Sonya; Tate, Susan R.

    2016-01-01

    Objective Low attendance in psychotherapy, particularly among individuals with comorbid disorders, is a pervasive challenge. The present study examined predictors of treatment attendance in a sample of veterans with depression, substance use disorder, and trauma. Methods This is an analysis of data collected as part of a larger clinical trial involving outpatients at a Veterans Administration dual diagnosis clinic. Individuals were excluded if they had significant memory deficits, schizophrenia, bipolar disorder, or substantial travel constraints. Participants (N = 146) received 12 weeks of group-delivered Integrated Cognitive Behavioral Therapy for depression and substance use, followed by randomization to 12 additional weeks of individually-delivered Cognitive Behavioral Therapy (n = 62) or Cognitive Processing Therapy (n = 61) modified to address substance use and trauma. Participants, therapists, and researchers were not blinded to group assignment. For this study, we included only the 123 participants who were randomized into the second phase, analyzing predictors of treatment attendance categorized into predisposing factors, enabling factors, and need factors. Results Participants were primarily male (89%), Caucasian (76%), and averaged 47 years old (SD = 12). Forty-four percent had alcohol use disorder, 16% had drug use disorder, and 40% had polysubstance use disorder. Most met criteria for PTSD (82%), with 44% having combat-related trauma, 33% sexual trauma, and 28% other trauma. Treatment attendance did not differ between groups. More education was associated with increased group (r = .19, p = .04) and individual session attendance (r = .28, p = .002). Individuals with chronic housing problems attended fewer group sessions (r = -.19, p = .04), while individuals with sexual trauma, compared to those with other traumas, attended more individual sessions (r = .23, p = .01). Number of group sessions attended was positively associated with individual session

  8. Alcohol-adapted Anger Management Treatment: A Randomized Controlled Trial of an Innovative Therapy for Alcohol Dependence

    PubMed Central

    Walitzer, Kimberly S.; Deffenbacher, Jerry L.; Shyhalla, Kathleen

    2015-01-01

    A randomized controlled trial for an innovative alcohol-adapted anger management treatment (AM) for outpatient alcohol dependent individuals scoring moderate or above on anger is described. AM treatment outcomes were compared to those of an empirically-supported intervention, Alcoholics Anonymous Facilitation treatment (AAF). Clients in AM, relative to clients in AAF, were hypothesized to have greater improvement in anger and anger-related cognitions and lesser AA involvement during the six-month follow-up. Anger-related variables were hypothesized to be stronger predictors of improved alcohol outcomes in the AM treatment condition and AA involvement was hypothesized to be a stronger predictor of alcohol outcomes in the AAF treatment group. Seventy-six alcohol dependent men and women were randomly assigned to treatment condition and followed for six months after treatment end. Both AM and AAF treatments were followed by significant reductions in heavy drinking days, alcohol consequences, anger, and maladaptive anger-related thoughts and increases in abstinence and self-confidence regarding not drinking to anger-related triggers. Treatment with AAF was associated with greater AA involvement relative to treatment with AM. Changes in anger and AA involvement were predictive of posttreatment alcohol outcomes for both treatments. Change in trait anger was a stronger predictor of posttreatment alcohol consequences for AM than for AAF clients; during-treatment AA meeting attendance was a stronger predictor of posttreatment heavy drinking and alcohol consequences for AAF than for AM clients. Anger-related constructs and drinking triggers should be foci in treatment of alcohol dependence for anger-involved clients. PMID:26387049

  9. Maternal religious attendance and low birth weight.

    PubMed

    Burdette, Amy M; Weeks, Janet; Hill, Terrence D; Eberstein, Isaac W

    2012-06-01

    We use data from the U.S. Fragile Families and Child Wellbeing study to test whether maternal religious attendance is protective against low birth weight. Building on previous research, we also consider the mediating influence of mental health, cigarette use, alcohol use, illicit drug use, poor nutrition, and prenatal care. Our results indicate that maternal religious attendance is protective against low birth weight. In fact, each unit increase in the frequency of religious attendance reduces the odds of low birth weight by 15%. Religious attendance is also associated with lower odds of cigarette use and poor nutrition, but is unrelated to mental health, alcohol use, illicit drug use, and prenatal care. Although lower rates of cigarette use help to mediate or explain 11% of the association between maternal religious attendance and low birth weight, we find no evidence to substantiate the mediating influence of mental health, alcohol use, illicit drug use, poor nutrition, or prenatal care. Our results suggest that the health benefits of religious involvement may extend across generations (from mother to child); however, additional research is needed to fully explain the association between maternal religious attendance and low birth weight. It is also important for future research to consider the extent to which the apparent health advantages of religious adults might be attributed to health advantages in early life, especially those related to healthy birth weight.

  10. The Attendance Nightmare.

    ERIC Educational Resources Information Center

    Phillips, John A., Jr.

    This paper describes a program intended to increase student attendance in a Savannah, Georgia, inner city high school. The author maintains that shifting the accountability for attendance to the students through peer pressure was perhaps the most significant reason for gains in attendance. He believes that a successful attendance increase program…

  11. Socio-Demographic, Clinical and Behavioral Characteristics Associated with a History of Suicide Attempts among Psychiatric Outpatients: A Case Control Study in a Northern Mexican City

    PubMed Central

    Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Arnaud-Gil, Carlos Alberto; Hernández-Tinoco, Jesús; Molina-Espinoza, Luis Fernando; Rábago-Sánchez, Elizabeth

    2014-01-01

    Background: Little is known about the epidemiology of suicide attempts among psychiatric outpatients in Mexico. This study was aimed to determine the socio-demographic, clinical and behavioral characteristics associated with suicide attempts in psychiatric outpatients in two public hospitals in Durango, Mexico. Methods: Two hundred seventy six psychiatric outpatients (154 suicide attempters and 122 patients without suicide attempt history) attended the two public hospitals in Durango City, Mexico were included in this study. Socio-demographic, clinical and behavioral characteristics were obtained retrospectively from all outpatients and compared in relation to the presence or absence of suicide attempt history. Results: Increased prevalence of suicide attempts was associated with mental and behavioral disorders due to psychoactive substance use (F10-19) (P=0.01), schizophrenia, schizotypal and delusional disorders (F20-29) (P=0.02), mood (affective) disorders (F30-39) (P<0.001), and disorders of adult personality and behavior (F60-69) (P<0.001). Multivariate analysis showed that suicide attempts were associated with young age (OR=1.21, 95% CI: 1.06-1.39; P=0.003), female gender (OR=2.98, 95% CI: 1.55-5.73; P=0.001), urban residence (OR=2.31, 95% CI: 1.17-4.57; P=0.01), memory impairment (OR=1.91, 95% CI: 1.07-3.40; P=0.02), alcohol consumption (OR=2.39, 95% CI: 1.21-4.70; P=0.01), and sexual promiscuity (OR=3.90, 95% CI: 1.74-8.77; P<0.001). Conclusions: We report the association of suicide attempts with socio-demographic, clinical and behavioral characteristics in psychiatric outpatients in Mexico. Results may be useful for an optimal planning of preventive measures against suicide attempts in psychiatric outpatients. PMID:24711751

  12. Alcoholism and Alcohol Abuse

    MedlinePlus

    ... their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that causes ... groups. NIH: National Institute on Alcohol Abuse and Alcoholism

  13. A Comparison between Locus of Control in Inpatient Alcoholics and Children of Alcoholics.

    ERIC Educational Resources Information Center

    Mills, Jon K.

    1991-01-01

    Administered Internal-External Control Scale to 22 male alcoholics in residential treatment and 8 adult male children of alcoholics (COAs) in outpatient counseling. Contrary to prediction, alcoholics demonstrated external control orientation. COAs also exhibited external locus of control. Alcoholics in first residential treatment demonstrated more…

  14. Student Admission and Attendance.

    ERIC Educational Resources Information Center

    Majestic, Ann L.

    1988-01-01

    Considers the North Carolina statutes that define the process for admitting students to public schools and ensuring their attendance. Examines cases relating to issues of school admission and compulsory attendance. (MLF)

  15. Effect of Motivational Interviewing on Reduction of Alcohol Use

    PubMed Central

    Nyamathi, Adeline; Shoptaw, Steven; Cohen, Allan; Greengold, Barbara; Nyamathi, Kamala; Marfisee, Mary; de Castro, Viviane; Khalilifard, Farinaz; George, Daniel; Leake, Barbara

    2009-01-01

    Background Methadone-Maintained (MM) clients who engage in excessive alcohol use are at high risk for HIV and Hepatitis B virus (HBV) infection. Nurse-led Hepatitis Health Promotion (HHP) may be one strategy to decrease alcohol use in this population. Objective To evaluate the impact of nurse-led HHP, delivered by nurses compared to Motivational Interviewing (MI), delivered by trained therapists in group sessions or one-on-one on reduction of alcohol use. Methods A three-arm randomized, controlled trial, conducted with 256 MM adults attending one of five MM outpatient clinics in the Los Angeles area. Within each site, moderate-to-heavy alcohol-using MM participants were randomized into one of three conditions: 1) nurse-led hepatitis health promotion group sessions (n=87); 2) MI delivered in group sessions (MI-group; n=90), or 3) MI delivered one-on-one sessions (MI-single, n=79). Results Self-reported alcohol use was reduced from a median of 90 drinks/month at baseline to 60 drinks/month at six month follow-up. A Wilcoxon sign-rank test indicated a significant reduction in alcohol use in the total sample (p < .05). In multiple logistic regression analysis controlling for alcohol consumption at baseline and other covariates, no differences by condition were found. Discussion As compared to two programs delivered by MI specialists, a culturally-sensitive and easy to implement nurse-led HHP program produced similar reductions in alcohol use over six months. Employing nurse-led programs may allow cost savings for treatment programs as well as a greater integration of alcohol reduction counseling along with a more comprehensive focus on general health-related issues than previously conducted. PMID:19836904

  16. 75 FR 47819 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... Alcoholism. The meeting will be open to the public as indicated below, with attendance limited to space... on Alcohol Abuse and Alcoholism. Date: September 22-23, 2010. Closed: September 22, 2010, 5:30...

  17. Outpatient therapeutic nuclear oncology.

    PubMed

    Turner, J Harvey

    2012-05-01

    In the beginning, nuclear medicine was radionuclide therapy, which has evolved into molecular tumour-targeted control of metastatic cancer. Safe, efficacious, clinical practice of therapeutic nuclear oncology may now be based upon accurate personalised dosimetry by quantitative gamma SPECT/CT imaging to prescribe tumoricidal activities without critical organ toxicity. Preferred therapy radionuclides possess gamma emission of modest energy and abundance to enable quantitative SPECT/CT imaging for calculation of the beta therapy dosimetry, without radiation exposure risk to hospital personnel, carers, family or members of the public. The safety of outpatient radiopharmaceutical therapy of cancer with Iodine-131, Samarium-153, Holmium-166, Rhenium-186, Rhenium-188, Lutetium-177 and Indium-111 is reviewed. Measured activity release rates and radiation exposure to carers and the public are all within recommendations and guidelines of international regulatory agencies and, when permitted by local regulatory authorities allow cost-effective, safe, outpatient radionuclide therapy of cancer without isolation in hospital.

  18. Process evaluation of an out-patient detoxification service.

    PubMed

    Sannibale, Claudia; Fucito, Lisa; O'Connor, Danny; Curry, Kenneth

    2005-11-01

    This paper describes the process evaluation of an out-patient detoxification service (ODS) established by Drug Health Services (DHS) to increase the supervised withdrawal options for substance users in a Sydney metropolitan Area Health Service. The ODS aimed to provide a safe and effective supervised withdrawal to substance users who were at low risk of severe withdrawal, engage those with severe dependence in further treatment and increase the involvement of general practitioners (GPs) in the medical care of ODS clients. During its first 10 months of operation, the ODS received 199 inquiries, assessed 82 individuals and admitted 76 clients for detoxification. Withdrawal treatment proceeded without complications and within the expected time frames. Fifty-four clients completed withdrawal, 10 ceased treatment, 10 remained in treatment without completing withdrawal and two were transferred elsewhere. Clients who injected substances (mainly heroin) daily at admission, compared to others, were less likely to complete withdrawal and more likely to use a range of non-prescribed substances during withdrawal. One-fifth of clients went on to further treatment with DHS, attending at least once. Overall, the ODS met its goals, providing a safe and effective supervised withdrawal to local residents, especially women, young people and those withdrawing from benzodiazepines who had significant substance dependence, impairment and previous alcohol and other drug (AOD) treatment. Non-injecting substance users benefited most from the ODS in terms of withdrawal completion and ongoing treatment. The level of GP involvement in the conjoint care of ODS clients remained constant over time. The development and expansion of the ODS are discussed.

  19. Pattern and Predictors of Alcohol Use Disorders in a Family Practice in Nigeria

    PubMed Central

    Obadeji, Adetunji; Oluwole, Lateef O.; Dada, Mobolaji U.; Ajiboye, Adedotun S.

    2015-01-01

    Background: Primary care has been identified as a key setting for the reduction of alcohol-related harm, while general practitioners are expected to play a significant role. The study aimed at identifying pattern of, and factors that are associated with alcohol use disorders (AUDs) among patients attending Family Medicine unit of State University Teaching Hospital. Materials and Methods: Sample was selected through a random sampling from a population of patients, aged 18-65 years, attending the general medical out-patients unit of the hospital from January to April 2013. A pretested, semi-structured questionnaire was administered, incorporating sociodemographics and the diagnoses made by the attending Physician. The participants also completed the alcohol use disorders identification test (AUDIT) questionnaire and the patient health questionnaire-9. Results: The prevalence of AUDs among the population of general out-patients was 9.7%. The AUDIT scores of the participants range from 0 to 29 with a mean of 1.3 (standard deviation = 4.08). AUDs were significantly associated with gender, level of education, occupational class, and the presence of significant depressive symptoms (P < 0.05). There was no statistically significant association found for age, employment status, marital status, and religion. Conclusion: The prevalence of AUDs among population studied was lower compared with a similar study in similar setting, but however, significant. AUDs were predicted by gender, lower education level, occupational group, and the presence of significant depressive symptoms mostly in the mild to moderate form. Identifying the group at risk in clinical setting may go a long way in reducing the adverse effect of AUDs in our society. PMID:25722517

  20. 38 CFR 18.453 - Drug and alcohol addicts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Drug and alcohol addicts... Social Services § 18.453 Drug and alcohol addicts. A recipient that operates a general hospital or outpatient facility may not discriminate, with regard to a drug or alcohol abuser or alcoholic who...

  1. 38 CFR 18.453 - Drug and alcohol addicts.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Drug and alcohol addicts... Social Services § 18.453 Drug and alcohol addicts. A recipient that operates a general hospital or outpatient facility may not discriminate, with regard to a drug or alcohol abuser or alcoholic who...

  2. 38 CFR 18.453 - Drug and alcohol addicts.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Drug and alcohol addicts... Social Services § 18.453 Drug and alcohol addicts. A recipient that operates a general hospital or outpatient facility may not discriminate, with regard to a drug or alcohol abuser or alcoholic who...

  3. 38 CFR 18.453 - Drug and alcohol addicts.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Drug and alcohol addicts... Social Services § 18.453 Drug and alcohol addicts. A recipient that operates a general hospital or outpatient facility may not discriminate, with regard to a drug or alcohol abuser or alcoholic who...

  4. 38 CFR 18.453 - Drug and alcohol addicts.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Drug and alcohol addicts... Social Services § 18.453 Drug and alcohol addicts. A recipient that operates a general hospital or outpatient facility may not discriminate, with regard to a drug or alcohol abuser or alcoholic who...

  5. Prenatal alcohol consumption and knowledge about alcohol consumption and fetal alcohol syndrome in Korean women.

    PubMed

    Kim, Oksoo; Park, Kyungil

    2011-09-01

    The study investigated prenatal alcohol consumption and knowledge of alcohol risks and fetal alcohol syndrome among Korean women. The participants were 221 Korean women who attended the post-partum care centers in Seoul, Korea. The data included the participants' background characteristics, quantity-frequency typology, Student Alcohol Questionnaire, and a scale on the participants' knowledge of fetal alcohol syndrome. Alcohol was consumed during pregnancy by 12.7% of the participants. Of these, 60.7% drank alcohol with their spouse. A few participants reported that nurses identified their drinking habits and gave them information on alcohol consumption and fetal alcohol syndrome. Most of the participants did not have the opportunity for prenatal counseling about fetal alcohol syndrome. The knowledge level regarding alcohol risks and fetal alcohol syndrome among the participants was poor. Alcohol consumption before pregnancy was significantly related to prenatal alcohol consumption. Prenatal alcohol consumption was not related to knowledge about alcohol consumption and fetal alcohol syndrome. The assessment of alcohol consumption and counseling about alcohol are needed for pregnant women in order to prevent fetal alcohol syndrome.

  6. Self-reported expected emotional changes as a function of alcohol intoxication by alcoholic men and women.

    PubMed

    Gustafson, R

    1989-08-01

    80 alcoholic men and women registered for counseling at different Swedish outpatient units volunteered to complete semantic differential scales related to emotional expected effects of alcohol intoxication. Analyses indicated that alcoholics expect large doses of alcohol to increase pleasure, dominance, and arousal. These results were discussed in comparison with the results from previous related studies with nonalcoholic samples.

  7. Treatment Outcome in Male Gambling Disorder Patients Associated with Alcohol Use

    PubMed Central

    Jiménez-Murcia, Susana; Del Pino-Gutiérrez, Amparo; Fernández-Aranda, Fernando; Granero, Roser; Hakänsson, Anders; Tárrega, Salomé; Valdepérez, Ana; Aymamí, Neus; Gómez-Peña, Mónica; Moragas, Laura; Baño, Marta; Sauvaget, Anne; Romeu, Maria; Steward, Trevor; Menchón, José M.

    2016-01-01

    Aims: The primary objective of this study was to analyze the association between alcohol consumption and short-term response to treatment (post intervention) in male patients with gambling disorder enrolled in a group cognitive behavioral therapy (CBT) program. Methods: The sample consisted of 111 male individuals with a diagnosis of Gambling Disorder, with a mean age of 45 years (SD = 12.2). All participants were evaluated by a comprehensive assessment battery and assigned to CBT groups of 10–14 patients attending 16 weekly outpatient sessions lasting 90 min each. Results: The highest mean pre- and post-therapy differences were recorded for the alcohol risk/dependence group on the obsessive/compulsive and anxiety dimensions of the SCL-90-R. As regards the presence of relapses and dropouts over the course of the CBT sessions, the results show a significant association with moderate effect size: patients with risk consumption or alcohol dependence were more likely to present poor treatment outcomes. Conclusions: Alcohol abuse was frequent in GD, especially in patients with low family income and high accumulated debts. High levels of somatization and high overall psychopathology (measured by the SCL-90-R) were associated with increased risk of alcohol abuse. Alcohol abuse was also associated with poor response to treatment. PMID:27065113

  8. The Incidence of Heavy Drinking in a Community Mental Health Center's Outpatient Population.

    ERIC Educational Resources Information Center

    Stark, Michael J.

    Research has shown that many psychiatric inpatients are alcoholics and that a significant number of these alcoholics are not being diagnosed or treated for their drinking problems. The incidence of heavy drinking among psychiatric outpatients and the extent to which psychotherapists are aware of their drinking behaviors were assessed. A…

  9. Design and Outcome of a Certification Preparation Program for Outpatient Nurses.

    PubMed

    Johnson, Theresa; Ferguson, Susan; McKenzie, Jennifer; Brassil, Kelly J

    2015-10-01

    This article presents the design, implementation, and outcomes of a certification preparation program for nurses working in an outpatient clinic. A nurse educator designed curriculum using the Certified Breast Care Nurse test blueprint. Nurse administrators provided the resources and the staff coverage to allow all staff members to attend the sessions without disruption to patient care. This outpatient center has achieved and sustained 100% certification among eligible nurses over the past 5 years.

  10. Miscarriage Among Flight Attendants

    PubMed Central

    Grajewski, Barbara; Whelan, Elizabeth A.; Lawson, Christina C.; Hein, Misty J.; Waters, Martha A.; Anderson, Jeri L.; MacDonald, Leslie A.; Mertens, Christopher J.; Tseng, Chih-Yu; Cassinelli, Rick T.; Luo, Lian

    2015-01-01

    Background Cosmic radiation and circadian disruption are potential reproductive hazards for flight attendants. Methods Flight attendants from 3 US airlines in 3 cities were interviewed for pregnancy histories and lifestyle, medical, and occupational covariates. We assessed cosmic radiation and circadian disruption from company records of 2 million individual flights. Using Cox regression models, we compared respondents (1) by levels of flight exposures and (2) to teachers from the same cities, to evaluate whether these exposures were associated with miscarriage. Results Of 2654 women interviewed (2273 flight attendants and 381 teachers), 958 pregnancies among 764 women met study criteria. A hypothetical pregnant flight attendant with median firsttrimester exposures flew 130 hours in 53 flight segments, crossed 34 time zones, and flew 15 hours during her home-base sleep hours (10 pm–8 am), incurring 0.13 mGy absorbed dose (0.36 mSv effective dose) of cosmic radiation. About 2% of flight attendant pregnancies were likely exposed to a solar particle event, but doses varied widely. Analyses suggested that cosmic radiation exposure of 0.1 mGy or more may be associated with increased risk of miscarriage in weeks 9–13 (odds ratio = 1.7 [95% confidence interval = 0.95–3.2]). Risk of a first-trimester miscarriage with 15 hours or more of flying during home-base sleep hours was increased (1.5 [1.1–2.2]), as was risk with high physical job demands (2.5 [1.5–4.2]). Miscarriage risk was not increased among flight attendants compared with teachers. Conclusions Miscarriage was associated with flight attendant work during sleep hours and high physical job demands and may be associated with cosmic radiation exposure. PMID:25563432

  11. [Outpatient care for urological patients].

    PubMed

    Kul'chitskiĭ, V V

    1999-01-01

    The presence of adequately equipped surgical unit in outpatient clinics provides surgical aid to more patients with urological diseases. Preoperative preparation, aseptic and antiseptic measures, local anesthesia were routine. 64 operations for phimosis, condylomatous growth of the foreskin, hydrocele, cyst of the epididymis and spermatic cord, chronic epididymitis, short frenulum of the prepuce were performed in outpatient setting. Recovery lasted as usual.

  12. Making Connections: Attending Professional Conferences

    ERIC Educational Resources Information Center

    Cherrstrom, Catherine A.

    2012-01-01

    Attending a professional conference is an effective way to explore and advance knowledge, skills, and careers. For graduate students, attending a conference is an effective way to explore academic fields and new professions. However, attending a professional conference requires precious resources--time and money--so the decision to attend, or not,…

  13. DEVELOP students attend conference

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Last month, Madeline Brozen and Jason Jones of the DEVELOP Program at John C. Stennis Space Center joined members from the program's national office at Langley Research Center to attend the Southern Growth Policies Board annual conference in Biloxi. Pictured are (l to r): Karen Allsbrook, Jonathan Gleason, Gov. Haley Barbour, Madeline Brozen, Lindsay Rogers and Tracey Silcox.

  14. School Counselors Improving Attendance

    ERIC Educational Resources Information Center

    Edwards, LaWanda

    2013-01-01

    This study examined the outcomes of interventions used to address attendance issues at a middle school located in the Southern United States. School-wide interventions were implemented to address absenteeism of all students and individual interventions were implemented to address absenteeism with targeted students. An explanation of each…

  15. Student Attendance Accounting Manual.

    ERIC Educational Resources Information Center

    Freitas, Joseph M.

    In response to state legislation authorizing procedures for changes in academic calendars and measurement of student workload in California community colleges, this manual from the Chancellor's Office provides guidelines for student attendance accounting. Chapter 1 explains general items such as the academic calendar, admissions policies, student…

  16. Pulmonary Embolism Following Outpatient Vasectomy

    PubMed Central

    Mott, Frank E.; Farooqi, Bilal; Moore, Harry

    2016-01-01

    Venous thromboembolic events have several known major risk factors such as prolonged immobilization or major surgery. Pulmonary embolism has rarely been reported after an outpatient vasectomy was completed. We present the rare case of a healthy 32-year-old Caucasian male with no known risk factors who presented with pleuritic chest pain 26 days after his outpatient vasectomy was performed. Subsequently, he was found to have a pulmonary embolism as per radiological imaging. We explore the association between outpatient vasectomies and venous thromboembolic events. A review of the literature is also included. PMID:26989373

  17. Outpatient clinic referrals and their outcome.

    PubMed

    Sullivan, F M; Hoare, T; Gilmour, H

    1992-03-01

    A cohort of 392 patients referred to six outpatient clinics by general practitioners during 1987 with diagnoses of rheumatoid arthritis, osteoarthritis, peripheral vascular disease, psoriasis or eczema, were studied from the time of their first attendance until up to two years later. Six consultant clinics were studied in the three specialties: rheumatology, vascular surgery and dermatology. For each specialty a clinic in both a teaching hospital and a district general hospital were included. The cohort members were predominantly middle-aged or elderly people, with a greater proportion of women, except at the vascular surgery clinic where 65% of patients were men. The 392 patients made a total of 936 visits (median two, range one-eight) during the study period; 91 patients were still attending up to two years after the first visit. Patients referred by their general practitioner for therapy were less likely to be discharged than those referred for other reasons. The principal reason for continuing attendance as perceived by patients, general practitioners and hospital doctors was the necessity for consultant supervision, although agreement was far from complete in individual cases. Junior staff tended to see a higher proportion of patients at follow-up visits than did consultants, and were found to have lower discharge rates than consultants. Analyses of data showed that at the first visit, diagnosis, disease severity and the grade of doctor seeing the patient in the clinic was significantly associated with patient discharge at the P < 0.05 level of significance. Patients considered that their visits had produced improvement in their condition in 38% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Monitoring Outpatient Care

    NASA Technical Reports Server (NTRS)

    2003-01-01

    Each year, health care costs for managing chronically ill patients increase as the life expectancy of Americans continues to grow. To handle this situation, many hospitals, doctors practices, and home care providers are turning to disease management, a system of coordinated health care interventions and communications, to improve outpatient care. By participating in daily monitoring programs, patients with congestive heart failure, chronic obstructive pulmonary disease, diabetes, and other chronic conditions requiring significant self-care are facing fewer emergency situations and hospitalizations. Cybernet Medical, a division of Ann Arbor, Michigan-based Cybernet Systems Corporation, is using the latest communications technology to augment the ways health care professionals monitor and assess patients with chronic diseases, while at the same time simplifying the patients interaction with technology. Cybernet s newest commercial product for this purpose evolved from research funded by NASA, the National Institute of Mental Health, and the Advanced Research Projects Agency. The research focused on the physiological assessment of astronauts and soldiers, human performance evaluation, and human-computer interaction. Cybernet Medical's MedStar Disease Management Data Collection System is an affordable, widely deployable solution for improving in-home-patient chronic disease management. The system's battery-powered and portable interface device collects physiological data from off-the-shelf instruments.

  19. Use of Outpatient Endometrial Biopsy in a Population with Intellectual Disability

    ERIC Educational Resources Information Center

    Jaffe, Joshua S.

    2008-01-01

    Background: To demonstrate the feasibility of outpatient endometrial sampling to evaluate abnormal uterine bleeding in a population of women with intellectual disability. Method: Retrospective chart review was completed of all endometrial biopsies performed on women attending a dedicated gynaecology clinic for women with intellectual disability…

  20. 43 CFR 17.251 - Drug and alcohol addicts.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Drug and alcohol addicts. 17.251 Section... Drug and alcohol addicts. A recipient that operates a general hospital or outpatient facility may not discriminate in admission or treatment against a drug or alcohol abuser or addict who is suffering from...

  1. 43 CFR 17.251 - Drug and alcohol addicts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Drug and alcohol addicts. 17.251 Section 17... Drug and alcohol addicts. A recipient that operates a general hospital or outpatient facility may not discriminate in admission or treatment against a drug or alcohol abuser or addict who is suffering from...

  2. 43 CFR 17.251 - Drug and alcohol addicts.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Drug and alcohol addicts. 17.251 Section... Drug and alcohol addicts. A recipient that operates a general hospital or outpatient facility may not discriminate in admission or treatment against a drug or alcohol abuser or addict who is suffering from...

  3. 43 CFR 17.251 - Drug and alcohol addicts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Drug and alcohol addicts. 17.251 Section... Drug and alcohol addicts. A recipient that operates a general hospital or outpatient facility may not discriminate in admission or treatment against a drug or alcohol abuser or addict who is suffering from...

  4. 43 CFR 17.251 - Drug and alcohol addicts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Drug and alcohol addicts. 17.251 Section... Drug and alcohol addicts. A recipient that operates a general hospital or outpatient facility may not discriminate in admission or treatment against a drug or alcohol abuser or addict who is suffering from...

  5. Unintentional Injuries among Psychiatric Outpatients with Major Depressive Disorder

    PubMed Central

    Hung, Ching-I; Liu, Chia-Yih; Yang, Ching-Hui

    2016-01-01

    Background No study has investigated the percentages of and factors related to unintentional injuries among psychiatric outpatients with major depressive disorder (MDD). This study aimed to investigate these issues. Methods One-hundred and forty-one outpatients with MDD at baseline were enrolled from psychiatric outpatients by systematic sampling, and 119 subjects attended a one-year follow-up. Self-reported unintentional injuries in the past one year were recorded. Psychiatric disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. The severity of depression was evaluated by the Hamilton Depression Rating Scale. Other data, including body weight and height, cigarette smoking, headaches, and medications, were collected. Generalized Estimating Equations were used to investigate independent factors related to unintentional injuries. Results At baseline and follow-up, 40.4% and 27.7% of subjects had experienced at least one unintentional injury in the past one year, respectively. About half of subjects with unintentional injuries needed medical treatment for injuries and had functional impairment due to injuries. A greater severity of depression, cigarette smoking, a higher body mass index, and an older age were independent risk factors related to unintentional injuries. Conclusion Unintentional injuries that increased the medical burden and functional impairment were common among outpatients with MDD and should not be neglected. Treatment of depression, control of body weight, and quitting cigarettes might be helpful to prevent unintentional injuries. PMID:27992483

  6. Alcoholics Anonymous and Relapse Prevention as Maintenance Strategies After Conjoint Behavioral Alcohol Treatment for Men: 18-Month Outcomes

    ERIC Educational Resources Information Center

    McCrady, Barbara S.; Epstein, Elizabeth E.; Kahler, Christopher W.

    2004-01-01

    Ninety men with alcohol problems and their female partners were randomly assigned to 1 of 3 outpatient conjoint treatments: alcohol behavioral couples therapy (ABCT), ABCT with relapse prevention techniques (RP/ABCT), or ABCT with interventions encouraging Alcoholics Anonymous (AA) involvement (AA/ABCT). Couples were followed for 18 months after…

  7. Patient satisfaction with services of the outpatient department

    PubMed Central

    Mohd, Athar; Chakravarty, Abhijit

    2014-01-01

    Background Patients' satisfaction is a useful measure to provide an indicator of quality in healthcare and thus needs to be measured frequently. The aim of the study was to analyse and compare the level of satisfaction of patients attending the Outpatient Department of a Hospital. Methods Study was conducted by using a pre-structured questionnaire with 120 samples. Samples were further stratified into sub-populations of Officers, Junior Commissioned Officers (JCOs) and Other Ranks (ORs) including dependents as study population. Results JCOs predominantly expressed lower satisfaction judgement with several attributes. Overall satisfaction judgement with Outpatient Department services were rated lower by JCOs (2.56) when compared with Officers and ORs (3.10), the difference being statistically significant. Conclusion Statistically significant differences have been identified by this study against various study attributes as well as overall impression towards OPD services among the study groups, which need to be addressed by the hospital leadership to achieve consumer delight. PMID:25378776

  8. Clinical pathology of alcohol.

    PubMed Central

    Marks, V

    1983-01-01

    There is good though not conclusive evidence that a small to modest average daily intake of alcohol--that is, 20-30 g/day is associated with increased longevity due mainly to a reduction in death from cardiovascular disease. Larger average daily alcohol intakes--especially those in excess of 60 g/day for men and 40 g/day for women--are associated with gradually increasing morbidity and mortality rates from a variety of diseases. Alcohol may be unrecognised as the cause of somatic disease, which can occur without overt psychosocial evidence of alcohol abuse, unless the index of suspicion is high and a thorough drink history obtained. Laboratory tests for the detection and/or confirmation of alcohol abuse are useful but subject to serious limitations being neither as sensitive nor specific as sometimes believed. The value of random blood and/or breath alcohol measurements, in outpatients, as an aid to diagnosis of alcohol-induced organic disease is probably not sufficiently appreciated and, though relatively insensitive, is highly specific. PMID:6339563

  9. Attendance and Substance Use Outcomes for the Seeking Safety Program: Sometimes Less Is More

    ERIC Educational Resources Information Center

    Hien, Denise A.; Morgan-Lopez, Antonio A.; Campbell, Aimee N. C.; Saavedra, Lissette M.; Wu, Elwin; Cohen, Lisa; Ruglass, Lesia; Nunes, Edward V.

    2012-01-01

    Objective: This study uses data from the largest effectiveness trial to date on treatment of co-occurring posttraumatic stress and substance use disorders, using advances in statistical methodology for modeling treatment attendance and membership turnover in rolling groups. Method: Women receiving outpatient substance abuse treatment (N = 353)…

  10. Alcoholism, Alcohol, and Drugs

    ERIC Educational Resources Information Center

    Rubin, Emanuel; Lieber, Charles S.

    1971-01-01

    Describes research on synergistic effects of alcohol and other drugs, particularly barbiturates. Proposes biochemical mechanisms to explain alcoholics' tolerance of other drugs when sober, and increased sensitivity when drunk. (AL)

  11. Client Incentives versus Contracting and Staff Incentives: How Care Continuity Interventions in Substance Abuse Treatment can improve Residential to Outpatient Transition

    PubMed Central

    Acquavita, Shauna P.; Stershic, Sandra; Sharma, Rajni; Stitzer, Maxine

    2013-01-01

    Interventions for improving transition from short-term residential to outpatient treatment were examined. Usual care (UC; N = 114) was referral to a preferred outpatient program with advance appointment optional. Client Incentive (CI; N = 97) offered up to $100 in gift cards for intake and attendance during the first 30 days of treatment. Contracting with staff incentives (CSI; N = 49) consisted of meeting with an outpatient counselor prior to residential discharge, signing an attendance contract, receiving an appointment and payment to staff if clients attended. CSI significantly improved rates of successful transition (84%) and admission (74%) compared to UC (64% contact; 49% admitted). CI did not result in significantly improved outcomes (74%; 60%). CSI was likely mediated by the reliability (92% vs 52% in UC) and immediacy (1.0 vs 3.9 days) of appointment scheduling. This study supports use of CSI for improving rates of transition between residential and outpatient continuing care treatment. PMID:23375361

  12. Assessing the Need for Higher Levels of Care Among Problem Gambling Outpatients.

    PubMed

    Ledgerwood, David M; Arfken, Cynthia L

    2017-03-02

    Most treatment for gambling disorder is provided on an outpatient basis. Only a small number of jurisdictions in North America provide higher levels of gambling treatment, such as residential or intensive outpatient (IOP) care, despite the potential need for these services. Further, there appear to be few guidelines for determining appropriate level of gambling treatment. The aim of the present study was to assess the appropriateness of higher levels of problem gambling care among clients receiving outpatient treatment. Problem gamblers and their therapists independently completed questionnaires that assessed the need and desire for residential and IOP treatment. About 42% of problem gambling outpatients noted that they would be "probably" or "definitely" willing to attend residential treatment, and about half indicated they would be equally likely to attend IOP. Therapists recommended about a third of their clients as appropriate for higher levels of care. For both client and therapist assessments, there was a significant association between desire or recommendation for level of treatment and severity of gambling and co-occurring problems. Further, therapist recommendations for level of care were significantly associated with client willingness to attend higher levels of treatment. Our data reveal the potential need for higher levels of care for problem gambling, as evaluated by clients and their therapists. Policy implications for the funding of residential and IOP treatment are discussed.

  13. Compliance to Cell Phone-Based EMA Among Latino Youth in Outpatient Treatment.

    PubMed

    Comulada, W Scott; Lightfoot, Marguerita; Swendeman, Dallas; Grella, Christine; Wu, Nancy

    2015-01-01

    Outpatient treatment practices for adolescent substance users utilize retrospective self-report to monitor drug use. Cell phone-based ecological momentary assessment (CEMA) overcomes retrospective self-report biases and can enhance outpatient treatment, particularly among Latino adolescents, who have been understudied with regard to CEMA. This study explores compliance to text message-based CEMA with youth (n = 28; 93% Latino) in outpatient treatment. Participants were rotated through daily, random, and event-based CEMA strategies for 1-month periods. Overall compliance was high (>80%). Compliance decreased slightly over the study period and was less during random versus daily strategies and on days when alcohol use was retrospectively reported. Findings suggest that CEMA is a viable monitoring tool for Latino youth in outpatient treatment, but further study is needed to determine optimal CEMA strategies, monitoring time periods, and the appropriateness of CEMA for differing levels of substance use.

  14. Chlamydia trachomatis cervicitis in gynecologic outpatients.

    PubMed

    Ripa, K T; Svensson, L; Mårdh, P A; Weström, L

    1978-12-01

    Symptoms suggestive of a lower genital tract infection (LGTI) are common complaints in women who consult gynecologists. Sexually transmitted microorganisms, such as Chlamydia trachomatis. Neisseria gonorrhoeae, and Trichomonas vaginalis, are responsible for a substantial proportion of LGTI. This study was performed to establish the frequency of LGTI caused by C trachomatis in women attending a gynecologic outpatient clinic. Of 170 women with LGTI, 32.9% harbored one or more of these organisms: C trachomatis was found in 19.3%, N gonorrhoeae in 4.7%, and T vaginalis in 25.9%. The results of the isolation studies were correlated with clinical signs and symptoms. In women under 25 years of age, chlamydial cervicitis was found significantly more often in users of oral contraceptives than in nonusers. In women not taking such drugs, cervical erosion was found more often in Chlamydia-positive than Chlamydia-negative women. Since clinical examination failed to reveal any characteristic signs in cases of chlamydial infection, it was not possible to distinguish a chlamydial from a gonococcal infection. This study also reports the successful treatment of 15 women affected by chlamydial cervicitis with doxycycline or trimethoprim sulphamethoxazole.

  15. Alcohol Alert

    MedlinePlus

    ... Us You are here Home » Alcohol Alert Alcohol Alert The NIAAA Alcohol Alert is a quarterly bulletin that disseminates important research ... text. To order single copies of select Alcohol Alerts, see ordering Information . To view publications in PDF ...

  16. Alcoholic neuropathy

    MedlinePlus

    Neuropathy - alcoholic; Alcoholic polyneuropathy ... The exact cause of alcoholic neuropathy is unknown. It likely includes both a direct poisoning of the nerve by the alcohol and the effect of poor nutrition ...

  17. Alcoholism - resources

    MedlinePlus

    Resources - alcoholism ... The following organizations are good resources for information on alcoholism : Alcoholics Anonymous -- www.aa.org Al-Anon Family Groups www.al-anon.org National Institute on Alcohol ...

  18. An audit of travel and waiting times for outpatient radiotherapy.

    PubMed

    Junor, E J; Macbeth, F R; Barrett, A

    1992-05-01

    The object of this study was to assess the non-medical factors which detract from the quality of outpatient receiving service to a population of 2.7 million in a wide geographical area. We conducted a survey by patient questionnaire of all outpatients receiving radiotherapy in the West of Scotland on a single day in 1990. A total of 216 outpatients attended for radiotherapy with a 92% response rate to the questionnaire being achieved. Median values (and ranges) were: age 58 (4-85) years, number of daily treatments 20 (4-33), distance travelled in one direction 10 (1-60) miles, travelling time 45 (5-130) minutes, waiting time in the unit for treatment 60 (0-200) minutes, and a time away from home of 2 hours 50 minutes (35 minutes-7 hours). Sixteen per cent of patients had a relative who lost time from work by transporting the patient and only 12 of 60 patients who were away from home over a meal time were offered a hospital meal. Sixteen per cent of patients came by ambulance and 73% by motor car. Of 146 travelling by car 27% used a charity service and 20% a volunteer driver ambulance service car. It is concluded that long travelling distances, travelling times and treatment waiting times for many patients require revision of transport provision, a strict appointment system, more treatment machines and hostel accommodation.

  19. Attendance Policies, Student Attendance, and Instructor Verbal Aggressiveness

    ERIC Educational Resources Information Center

    Snyder, Jason; Forbus, Robert; Cistulli, Mark

    2012-01-01

    The authors utilized an experimental design across six sections of a managerial communications course (N = 173) to test the impact of instructor verbal aggressiveness and class attendance policies on student class attendance. The experimental group received a policy based on the principle of social proof (R. B. Cialdini, 2001), which indicated…

  20. Alcohol Alert: Genetics of Alcoholism

    MedlinePlus

    ... 84 Alcohol Alert Number 84 Print Version The Genetics of Alcoholism Why can some people have a ... to an increased risk of alcoholism. Cutting-Edge Genetic Research in Alcoholism Although researchers already have made ...

  1. Simulation analysis of an outpatient services facility.

    PubMed

    Levy, J L; Watford, B A; Owen, V T

    1989-11-01

    Anderson Memorial Hospital in Anderson, South Carolina is in the process of constructing a new Outpatient Services Center. The Outpatient Services Center will combine existing outpatient services within the hospital and offsite services at the Outpatient Diagnostic Center. A simulation model of the proposed facility has been developed based on historical data. The information obtained from the simulation model includes the analysis of outpatient services utilization, patient waiting and flow times, and service area queue sizes. This information has been used to determine minimum facility design requirements, such as waiting room size, based on the expected demands.

  2. Student Attendance Accounting Manual, 1996.

    ERIC Educational Resources Information Center

    California Community Colleges, Sacramento. Office of the Chancellor.

    This report documents student attendance in California's community colleges. It begins by outlining the requirements for academic calendars as they relate to student attendance. It then defines who is admissible to community colleges in California and classifies all of the possible enrollment statuses one may take. The first chapter defines which…

  3. The development of outpatient milestones.

    PubMed

    Rosen, Donald E

    2014-06-01

    The Milestones work group sought to establish a baseline of expected competence development across the six core competencies. The subcompetencies and milestones reflect the committee's work with input from ABPN, AADPRT, and AAP. They are intended to serve not only as consistent markers of progress nationwide but also as a basis by which individual programs can build their own milestones that reflect unique qualities of any given learning environment. The Milestones work group anticipates that iterative changes will be made as the milestones are broadly implemented. In anticipating the implementation of outpatient milestones, the committee will be particularly interested to how effectively psychotherapy milestones will be captured through the combination of outpatient evaluations and other data points captured in the program director's semiannual evaluation.

  4. Dissociative disorders and suicidality in psychiatric outpatients.

    PubMed

    Foote, Brad; Smolin, Yvette; Neft, Deborah I; Lipschitz, Deborah

    2008-01-01

    Although it is common for patients with dissociative disorders to report a history of suicide attempts, there is very little data systematically comparing suicidality in patients with dissociative disorders versus patients without these disorders. The subjects in our study were 231 patients consecutively admitted to an inner-city, hospital-based outpatient psychiatric clinic. Eighty-two of these patients completed structured interviews for dissociative disorders, borderline personality disorder, and trauma history (dissociative disorders interview schedule) and for posttraumatic stress disorder and substance abuse (Structured Clinical Interview for DSM-IV). Patients receiving a dissociative disorder diagnosis were compared with nondissociative patients on measures of self-harm and suicidality. Presence of a dissociative disorder was strongly associated with all measures of self-harm and suicidality. When we focused on patients with a history of multiple suicide attempts, significant associations were found between several diagnoses (dissociative disorder; borderline personality disorder; posttraumatic stress disorder; alcohol abuse/dependence) and multiple suicide attempter status. When these diagnoses were entered in a logistic regression, a highly significant association remained for dissociative diagnosis and multiple suicide attempter status (odds ratio, 15.09; 95% confidence interval, 2.67-85.32; p = 0.002). Dissociative disorders are commonly overlooked in studies of suicidality, but in this population they were the strongest predictor of multiple suicide attempter status.

  5. [Outpatient rheumatologic treatment in Germany].

    PubMed

    Edelmann, E

    2014-03-01

    Outpatient rheumatologic treatment in Germany is managed by rheumatologists in private practice (n = 557), by authorized rheumatism outpatient centers (n = 116), by rheumatism centers according to §116b (n = 43) and by university outpatient departments. A total number of 975 rheumatologists were registered by the end of 2012 of whom approximately 830 were active in outpatient care. With this number of rheumatologists Germany is in the middle range in comparison to eight industrial nations including the USA. This number is not sufficient to provide adequate medical care and the consequences are too long waiting times for an appointment with a rheumatologist. Statistical data of the Kassenärztliche Bundesvereinigung (KBV, National Association of Statutory Health Insurance Physicians) showed 688,000 general insurance patients with rheumatoid arthritis (RA). As some 68.9 % of the population are in this insurance scheme there are some 770,000 RA patients in Germany (almost 1 % of the population). One way to improve rheumatology care in spite of the lack of rheumatologists could be special agreements with the general health insurance providers to improve cooperation and division of responsibilities between rheumatologists and general practitioners, to implement patient education, tighter control and treat to target in rheumatology care. Another way could be a new treatment level called "ambulant specialist care", with no budget for medical care and no budget for the number of patients treated and therefore the chance for rheumatologists to treat more patients and have a better income. To achieve that more young doctors receive approval as a specialist in rheumatology, more chairs of rheumatology at universities and a nationwide stipendium for training assistants are needed.

  6. Understanding and Counseling Elderly Alcohol Abusers.

    ERIC Educational Resources Information Center

    Kelly, Shirley; Remley, Theodore P., Jr.

    1987-01-01

    Investigated cause of abusive drinking among the elderly and treatment practices and counseling strategies used by professionals who serve them. Structured interviews with six practitioners who were knowledgeable about alcohol abuse among the elderly revealed consensus that alcoholism is a physiological disorder with attendant psychological and…

  7. Violence against women: prevalence and associated factors in patients attending a public healthcare service in the Northeast of Brazil.

    PubMed

    Silva, Maria Arleide da; Falbo Neto, Gilliatt Hanois; Figueiroa, José Natal; Cabral Filho, José Eulálio

    2010-02-01

    The prevalence of and factors associated with violence against women attended as outpatients between October 2005 and January 2006 by the Instituto Materno Infantil Professor Fernando Figueira (IMIP), Recife, Pernambuco State, Brazil, were investigated using a cross-sectional type study. 619 women over the age of 18 were included in a systematic probabilistic sample. The modified Abuse Assessment Screen (AAS) was applied and the data were evaluated statistically by way of univariate and bivariate analyses, using the chi2 or Fischer's exact test and an adjusted multivariate logistic regression model. The prevalence of violence against women was 27.5% (95%CI: 24.0%-31.2%) in the twelve-month period prior to the consultation. The associated factors were low level of schooling (OR = 2.34), a history of domestic violence (OR = 2.21) the woman being mentally disturbed (OR = 2.35), and the partner's consumption of alcohol (OR = 1.77). The prevalence of violence was high in the group of women studied, indicating the need to broaden preventive measures and all-round health care for women.

  8. Self-Determination Theory and Outpatient Follow-Up After Psychiatric Hospitalization.

    PubMed

    Sripada, Rebecca K; Bowersox, Nicholas W; Ganoczy, Dara; Valenstein, Marcia; Pfeiffer, Paul N

    2016-08-01

    The objective of this study was to assess whether the constructs of self-determination theory-autonomy, competence, and relatedness-are associated with adherence to outpatient follow-up appointments after psychiatric hospitalization. 242 individuals discharged from inpatient psychiatric treatment within the Veterans Health Administration completed surveys assessing self-determination theory constructs as well as measures of depression and barriers to treatment. Medical records were used to count the number of mental health visits and no-shows in the 14 weeks following discharge. Logistic regression models assessed the association between survey items assessing theory constructs and attendance at mental healthcare visits. In multivariate models, none of the self-determination theory factors predicted outpatient follow-up attendance. The constructs of self-determination theory as measured by a single self-report survey may not reliably predict adherence to post-hospital care. Need factors such as depression may be more strongly predictive of treatment adherence.

  9. 22 CFR 142.63 - Drug and alcohol addicts.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Drug and alcohol addicts. 142.63 Section 142.63... § 142.63 Drug and alcohol addicts. A recipient to which this subpart applies that operates a general hospital or outpatient facility may not discriminate in admission or treatment against a drug or...

  10. 22 CFR 142.63 - Drug and alcohol addicts.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Drug and alcohol addicts. 142.63 Section 142.63... § 142.63 Drug and alcohol addicts. A recipient to which this subpart applies that operates a general hospital or outpatient facility may not discriminate in admission or treatment against a drug or...

  11. 22 CFR 142.63 - Drug and alcohol addicts.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Drug and alcohol addicts. 142.63 Section 142.63... § 142.63 Drug and alcohol addicts. A recipient to which this subpart applies that operates a general hospital or outpatient facility may not discriminate in admission or treatment against a drug or...

  12. 22 CFR 142.63 - Drug and alcohol addicts.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Drug and alcohol addicts. 142.63 Section 142.63... § 142.63 Drug and alcohol addicts. A recipient to which this subpart applies that operates a general hospital or outpatient facility may not discriminate in admission or treatment against a drug or...

  13. 22 CFR 142.63 - Drug and alcohol addicts.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Drug and alcohol addicts. 142.63 Section 142.63... § 142.63 Drug and alcohol addicts. A recipient to which this subpart applies that operates a general hospital or outpatient facility may not discriminate in admission or treatment against a drug or...

  14. Validation of the French version of the alcohol, smoking and substance involvement screening test (ASSIST) in the elderly

    PubMed Central

    2012-01-01

    Background Substance use disorders seem to be an under considered health problem amongst the elderly. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), was developed by the World Health Organization to detect substance use disorders. The present study evaluates the psychometric properties of the French version of ASSIST in a sample of elderly people attending geriatric outpatient facilities (primary care or psychiatric facilities). Methods One hundred persons older than 65 years were recruited from clients attending a geriatric policlinic day care centre and from geriatric psychiatric facilities. Measures included ASSIST, Addiction Severity Index (ASI), Mini-International Neuropsychiatric Interview (MINI-Plus), Alcohol Use Disorders Identification Test (AUDIT), Revised Fagerstrom Tolerance Questionnaire-Smoking (RTQ) and MiniMental State(MMS). Results Concurrent validity was established with significant correlations between ASSIST scores, scores from ASI, AUDIT, RTQ, and significantly higher ASSIST scores for patients with a MINI-Plus diagnosis of abuse or dependence. The ASSIST questionnaire was found to have high internal consistency for the total substance involvement along with specific substance involvement as assessed by Cronbach’s α, ranging from 0.66, to 0.89 . Conclusions The findings demonstrate that ASSIST is a valid screening test for identifying substance use disorders in elderly. PMID:22538114

  15. From telephone to office: intake attendance as a function of appointment delay.

    PubMed

    Festinger, David S; Lamb, R J; Marlowe, Douglas B; Kirby, Kimberly C

    2002-01-01

    In the present study, 116 clients calling an outpatient cocaine treatment clinic were randomly assigned to intake appointments scheduled either the same day, 1 day, 3 days, or 7 days later. Significantly more subjects scheduled 1 day later attended their intake appointments (72%), compared to those scheduled 3 days (41%) or 7 days (38%) later. Odds ratios indicate that subjects offered intake appointments approximately 24 h following their initial contact are more than four times as likely to attend their intakes as those scheduled later. This accelerated intake procedure allows clinics to reach more patients in need of services.

  16. Using Attendance Worksheets to Improve Student Attendance, Participation, and Learning

    NASA Astrophysics Data System (ADS)

    Rhoads, Edward

    2013-06-01

    As science instructors we are faced with two main barriers with respect to student learning. The first is motivating our students to attend class and the second is to make them active participants in the learning process once we have gotten them to class. As we head further into the internet age this problem only gets exacerbated as students have replaced newspapers with cell phones which can surf the web, check their emails, and play games. Quizzes can motivated the students to attend class but do not necessarily motivate them to pay attention. Active learning techniques work but we as instructors have been bombarded by the active learning message to the point that we either do it already or refuse to. I present another option which in my classroom has doubled the rate at which students learn my material. By using attendance worksheets instead of end of class quizzes I hold students accountable for not just their attendance but for when they show up and when they leave the class. In addition it makes the students an active participant in the class even without using active learning techniques as they are writing notes and answering the questions you have posed while the class is in progress. Therefore using attendance worksheets is an effective tool to use in order to guide student learning.

  17. Outpatient management of pediatric burns.

    PubMed

    Kassira, Wrood; Namias, Nicholas

    2008-07-01

    The leading etiologies of pediatric burns are scald, thermal, and electrical injuries. The initial management of burns involves assessment of burn depth and total body surface area (TBSA) affected, a history, and physical examination. Calculation of percent of TBSA affected is an important determinant of the necessity for hospitalization versus outpatient management. Only second- and third-degree burns are included in the calculation. The criteria for outpatient management vary based on the center experience and resources. One such set of criteria in an experienced burn center includes burn affecting less than 15% TBSA, therefore not requiring fluid resuscitation; the ability to take in oral fluids, excluding serious perioral burns; no airway involvement or aspiration of hot liquid; no abuse; and dependable family able to transport the patient for clinic appointments. Once the child is ready to reenter school, the physician must discuss with the family and school staff any needs and expectations for the child, including wound care. Social reintegration can be difficult. Educating the teachers and staff of the child's appearance may help prepare the students.

  18. Mental Health and Substance Use Characteristics of Flight Attendants Enrolled in an In-Patient Substance Abuse Treatment Program

    ERIC Educational Resources Information Center

    Horton, Gail; Diaz, Naelys; McIlveen, John; Weiner, Michael; Mullaney, Donald

    2011-01-01

    The purpose of this study was to explore the prevalence rates of co-occurring mental health problems among 70 flight attendants in substance abuse treatment. Results indicated that flight attendants in treatment were more likely to experience alcohol dependency than drug dependency. A high proportion of participants reported clinical levels of…

  19. 29 CFR 785.28 - Involuntary attendance.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS HOURS WORKED Application of Principles Lectures, Meetings and Training Programs § 785.28 Involuntary attendance. Attendance is not voluntary,...

  20. 29 CFR 785.28 - Involuntary attendance.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS HOURS WORKED Application of Principles Lectures, Meetings and Training Programs § 785.28 Involuntary attendance. Attendance is not voluntary,...

  1. 29 CFR 785.28 - Involuntary attendance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS HOURS WORKED Application of Principles Lectures, Meetings and Training Programs § 785.28 Involuntary attendance. Attendance is not voluntary,...

  2. 29 CFR 785.28 - Involuntary attendance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS HOURS WORKED Application of Principles Lectures, Meetings and Training Programs § 785.28 Involuntary attendance. Attendance is not voluntary,...

  3. 29 CFR 785.28 - Involuntary attendance.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS HOURS WORKED Application of Principles Lectures, Meetings and Training Programs § 785.28 Involuntary attendance. Attendance is not voluntary,...

  4. Dermatophytoses in outpatients attending the Dermatology Center of Avicenna Hospital in Qazvin, Iran.

    PubMed

    Aghamirian, Mohammad Reza; Ghiasian, Seyed Amir

    2008-03-01

    Dermatophytosis is still being considered as one of the major public health problems in many parts of the world. To identify the prevalence and etiological agents of dermatophytoses, a study was carried out between 2004 and 2006. Out of 1023 subjects suspected to have cutaneous mycoses, 348 (34%) patients were affected with dermatophytoses. The causative agents were identified macroscopically and microscopically after the clinical samples were subjected to potassium hydroxide examination and culture isolation. Epidermophyton floccosum was the most frequently isolated species representing 32.8% of isolates, followed by T. rubrum (18.1%), T. verrucosum (17.2%), T. mentagrophytes var. interdigitale (15.8%), T. mentagrophytes var. mentagrophytes (6.6%) and T. violaceum, T. schoenleinii and Microsporum canis (0.9%). The most common type of infection was tinea cruris (31.9%) affecting in particular male patients. Some other most prevalent tinea types were tinea corporis (20.7%), tinea pedis (19%), and tinea unguium (11.2%). To the best of our knowledge, this is the first report on dermatophytoses in Qazvin and the first study that shows tinea cruris as a major type of superficial fungal infection in Iran. The frequency of tinea was higher in males and tinea cruris showed a remarkably increasing tendency and was an important public health issue in Qazvin.

  5. Prevalence and Risk Factors of Obesity among Elderly Attending Geriatric Outpatient Clinics in Mansoura City

    ERIC Educational Resources Information Center

    Shebl, Amany Mohamed; Hatata, El Sayed Zaki; Boughdady, Aziza Mahmoud; El-Sayed, Sally Mohammed

    2015-01-01

    Obesity is a major public health problem affecting all ages in both developed and developing countries. It is considered the fifth leading risk factor for deaths all over the world as about 2.8 million people die due to obesity each year directly or indirectly. Obesity in elderly is considered one of the most serious public health challenges for…

  6. Strategies for boosting outpatient care profitability.

    PubMed

    Baptist, A J; Lameka, R B

    1990-02-01

    With outpatient charges approaching one-fourth of hospital revenues nationwide, healthcare providers are pressed to handle this care more efficiently and profitably. Five steps toward healthier profit margins for outpatient services involve finding ways to expand volume and market share; setting and meeting strict quality standards; studying operational efficiency; working with physicians to improve productivity; and monitoring price-cost relationships.

  7. Driving While Intoxicated Among Individuals Initially Untreated for Alcohol Use Disorders: One- and Sixteen-Year Follow-Ups*

    PubMed Central

    Timko, Christine; Desai, Akash; Blonigen, Daniel M.; Moos, Bernice S.; Moos, Rudolf H.

    2011-01-01

    Objective: This study examined associations between frequency of driving while intoxicated (DWI) at baseline and obtaining alcohol-related help at follow-up, and between obtaining help and subsequent reductions in DWI. It also examined improvements on personal functioning and life context indices as mediators between obtaining help and reduced occurrences of DWI. Method: A total of 628 individuals who were initially untreated for alcohol use problems completed a baseline inventory; follow-ups were 1, 3, and 16 years later. Results: More extended participation in outpatient treatment and Alcoholics Anonymous (AA) during Year 1 was associated with a lower likelihood of DWI at the 1-year follow-up. More extended participation in AA through Year 3 was associated with a lower likelihood of DWI at the 16-year follow-up. Improvement on personal functioning and life context indices was associated with reduced risk of subsequent occurrences of DWI. Decreases in drinking-related problems, impulsivity, and drinking to reduce tension mediated associations between more AA participation and reductions in DWI at 1 year. Conclusions: Among initially untreated individuals, sustained mutual help may be associated with a reduced number of occurrences of DWI via fewer drinking consequences and improved psychological functioning and coping. Treatment providers should attend to these concomitants of DWI and consider actively referring individuals to AA to ensure ongoing AA affiliation. PMID:21388590

  8. Heart Failure Update: Outpatient Management.

    PubMed

    Wojnowich, Katherine; Korabathina, Ravi

    2016-03-01

    Outpatient management of heart failure (HF) is aimed at treating symptoms and preventing hospitalizations and readmissions. Management is initiated in a stepwise approach. Blockade of the renin-angiotensin system is a cornerstone of therapy and should be started, along with beta blockers, as soon as the diagnosis of HF is made. Other drugs, including diuretics, aldosterone antagonists, hydralazine, and nitrates, may be added based on symptoms and American College of Cardiology/American Heart Association stage. Despite a great interest in and theoretical benefit of naturoceutical products in the mitigation of oxidative stress and HF progression, none has been proven to be beneficial, and concerns exist regarding their interactions with standard HF drugs. Other nonpharmacologic interventions, including sodium restriction, regular exercise, and/or cardiac rehabilitation, should be initiated at diagnosis. HF often is progressive, and clinicians should be aware of late stage management options, including implantable devices, cardiac transplantation, and hospice care.

  9. Outpatient treatment of adult asthma.

    PubMed Central

    Kleerup, E C; Tashkin, D P

    1995-01-01

    As a chronic disease with intermittent exacerbations, asthma is treated primarily in the outpatient setting by primary care physicians. Asthma is the result of complex and only partially understood interactions of respiratory, inflammatory, and neural cells and their mediators. The goals of asthma therapy are to prevent and relieve symptoms, allow normal activities of daily living, restore and maintain normal pulmonary function, avoid adverse effects from interventions, and minimize inconvenience and cost. These goals can be achieved through educating patients, assessing and monitoring asthma severity, avoiding or controlling asthma triggers, establishing an intervention plan for routine self-management and the management of exacerbations, and providing regular follow-up care. We present a stepped approach to asthma pharmacotherapy, emphasizing anti-inflammatory therapy--inhaled corticosteroids, cromolyn sodium, or nedocromil sodium--as a summary of recent national and international recommendations. PMID:7667983

  10. Spirituality and alcoholics anonymous.

    PubMed

    Tonigan, J Scott

    2007-04-01

    What can be confidently said about AA in general and about the role of spirituality in AA in particular? First, there is convincing evidence that alcoholism severity predicts later AA attendance. Second, atheists are less likely to attend AA, relative to individuals who already hold spiritual and/or religious beliefs. However, belief in God before AA attendance does not offer any advantage in AA-related benefits, and atheists, once involved, are at no apparent disadvantage in deriving AA-related benefits. Third, the spiritually-based principles of AA appear to be endorsed in AA meetings regardless of the perceived social dynamics or climate of a particular meeting, eg, highly cohesive or aggressive. Fourth, significant increases in spiritual and religious beliefs and practices seem to occur among AA-exposed individuals. Fifth, in spite of much discussion to the contrary there is little evidence that spirituality directly accounts for later abstinence. We are finding, however, that spirituality has an important indirect effect in predicting later drinking reductions. Specifically, in the past 20 years a number of effective methods have been developed to facilitate initial AA attendance (AA dropout is high, with some estimates ranging as high as 80%). Interventions that lead to initial increases in spirituality appear to lead to sustained AA affiliation, which, in turn, produces sustained recovery over time.

  11. Use of Legal Drugs by Psychiatric Outpatients: Benefits, Costs, and Change

    PubMed Central

    Carey, Kate B.; Maisto, Stephen A.; Carey, Michael P.; Gordon, Christopher M.; Correia, Christopher J.

    2008-01-01

    Caffeine, nicotine, and alcohol use by persons with a severe mental illness occurs frequently but is poorly understood. We used qualitative methods to elicit information regarding the functional relationships between legal substance use and its antecedents and consequences. This report summarizes responses provided by 37 psychiatric outpatients who participated in focus groups and key informant interviews regarding the use and functions of alcohol, caffeine, and nicotine. We describe major themes regarding positive and negative consequences, triggers for use, change efforts, and offer observations regarding substance use in this under-served population. PMID:18545676

  12. Birthday Effects and Preschool Attendance

    ERIC Educational Resources Information Center

    Huang, Francis L.; Invernizzi, Marcia A.

    2013-01-01

    Young-for-grade students have been shown to receive lower grades and have a higher likelihood of retention compared to their oldest peers upon kindergarten entry. Our study of 1474 economically disadvantaged first-time kindergarteners investigates if preschool attendance may ameliorate some of the risks potentially associated with being…

  13. Survey of satisfaction with care in a rheumatology outpatient clinic.

    PubMed Central

    Hill, J; Bird, H A; Hopkins, R; Lawton, C; Wright, V

    1992-01-01

    Consumer satisfaction is increasingly recognised by hospital administrators and health care providers as an important aspect of health care. A study was undertaken to investigate the satisfaction with care among patients with rheumatoid arthritis (RA) attending a rheumatology outpatient clinic at Leeds General Infirmary. The Leeds satisfaction questionnaire was developed and rigorously tested for reliability (Cronbachs alpha) and stability (test/retest). The Leeds satisfaction questionnaire was then completed by 70 patients with RA who had attended the Leeds General Infirmary on at least three previous occasions. The results showed that patients were, in general, satisfied with the care they received. The highest satisfaction scores were obtained on the scale for technical quality and competence of health professionals. The least satisfaction was accredited to the difficulty of unscheduled access to the clinic and the lack of continuity with the providers of care. The time spent in the waiting area before consultation was highlighted as the one aspect which caused the greatest dissatisfaction. PMID:1550403

  14. The prevalence of diabetic peripheral neuropathy in an outpatient setting.

    PubMed

    Mimi, O; Teng, C L; Chia, Y C

    2003-10-01

    This study was undertaken to clinically estimate the prevalence of diabetic peripheral neuropathy amongst patients attending an outpatient clinic and to evaluate their risk factors for developing peripheral neuropathy. It was a cross-sectional study of 134 diabetes mellitus patients who attended the Primary Care Clinic, University Hospital, Kuala Lumpur. The patients were interviewed for their demographic data, past and present medical/surgical history, social history, personal habits and symptoms of peripheral neuropathy. Foot examination and clinical neurological tests were conducted and the presence of peripheral neuropathy was assessed. The main outcome measures were the Neuropathy Symptom Score and the Neuropathy Disability Score. The prevalence of diabetic peripheral neuropathy was found to be 50.7%. Peripheral neuropathy was related to the age of the patient and the duration of diabetes but did not seem to be significantly related to diabetic control. To conclude, there was a high prevalence of peripheral neuropathy amongst the diabetics in this study. These patients developed peripheral neuropathy at a younger age and shorter duration of diabetes compared to a similar study that was done in the UK.

  15. Alcohol Calorie Calculator

    MedlinePlus

    ... Alcohol Calorie Calculator Weekly Total 0 Calories Alcohol Calorie Calculator Find out the number of beer and ... Calories College Alcohol Policies Interactive Body Calculators Alcohol Calorie Calculator Alcohol Cost Calculator Alcohol BAC Calculator Alcohol ...

  16. Anticonvulsants for the treatment of alcohol withdrawal syndrome and alcohol use disorders.

    PubMed

    Hammond, Christopher J; Niciu, Mark J; Drew, Shannon; Arias, Albert J

    2015-04-01

    Alcoholic patients suffer from harmful allostatic neuroplastic changes in the brain causing an acute withdrawal syndrome upon cessation of drinking followed by a protracted abstinence syndrome and an increased risk of relapse to heavy drinking. Benzodiazepines have long been the treatment of choice for detoxifying patients and managing alcohol withdrawal syndrome (AWS). Non-benzodiazepine anticonvulsants (NBACs) are increasingly being used both for alcohol withdrawal management and for ongoing outpatient treatment of alcohol dependence, with the goal of either abstinence or harm reduction. This expert narrative review summarizes the scientific basis and clinical evidence supporting the use of NBACs in treating AWS and for reducing harmful drinking patterns. There is less evidence in support of NBAC therapy for AWS, with few placebo-controlled trials. Carbamazepine and gabapentin appear to be the most promising adjunctive treatments for AWS, and they may be useful as monotherapy in select cases, especially in outpatient settings and for the treatment of mild-to-moderate low-risk patients with the AWS. The body of evidence supporting the use of the NBACs for reducing harmful drinking in the outpatient setting is stronger. Topiramate appears to have a robust effect on reducing harmful drinking in alcoholics. Gabapentin is a potentially efficacious treatment for reducing the risk of relapse to harmful drinking patterns in outpatient management of alcoholism. Gabapentin's ease of use, rapid titration, good tolerability, and efficacy in both the withdrawal and chronic phases of treatment make it particularly appealing. In summary, several NBACs appear to be beneficial in treating AWS and alcohol use disorders.

  17. Motivational Enhancement for 12-Step Involvement among Patients Undergoing Alcohol Detoxification

    ERIC Educational Resources Information Center

    Kahler, Christopher W.; Read, Jennifer P.; Ramsey, Susan E.; Stuart, Gregory L.; McCrady, Barbara S.; Brown, Richard A.

    2004-01-01

    Forty-eight patients undergoing inpatient detoxification for alcohol dependence were assigned to either brief advice (BA) to attend Alcoholics Anonymous or a motivational enhancement for 12-step involvement (ME-12) intervention that focused on increasing involvement in 12-step self-help groups. Attendance at 12-step groups did not differ…

  18. Integrating Mailed Personalized Feedback and Alcohol Screening Events: A Feasibility Study

    ERIC Educational Resources Information Center

    Benson, Trisha A.; Ambrose, Carrie; Mulfinger, Amanda M. M.; Correia, Christopher J.

    2004-01-01

    This study characterized a sample of college students attending National Alcohol Screening Day (NASD), and tested the feasibility of using NASD as a platform for initiating the delivery of mailed personalized feedback forms. Participants (N = 153, 65% female) attended NASD and completed the Alcohol Use Disorders Identification Test (AUDIT [1]). A…

  19. Anesthesia for outpatient female sterilization.

    PubMed

    Fishburne, J I

    1983-04-01

    This issue of the Bulletin deals with the principles of anesthesia for outpatient female sterilization with emphasis on techniques for laparoscopy and minilaparotomy. General anesthesia techniques provide analgesia, amnesia, and muscle relaxation and are particularly useful for managing the anxious patient. Disadvantages include increased expense, need for specialized equipment, and highly trained personnel, and delayed recovery. Complications, though relatively rare, can be life-threatening and include aspiration of stomach contents, hypoxia, hypercarbia, hypotension, hypertension, cardiac arrhythmias, cardiorespiratory arrest, and death. There is no single preferred technique of general anesthesia, athough most anesthetists employ methods that allow rapid recovery of faculties, enabling the patient to be discharged soon after surgery. To accomplish this end, light anesthesia with sodium thiopental induction and nitrous oxide maintenance is often used. Short duration muscle relaxation with an agent such as succinylcholine supplements this technique. Other techniques include light anesthesia with inhalational anesthetic agents and the use of intravenous ketamine. Local anesthesia augmented by systemic and/or inhalational analgesia is supplanting general anesthesia techniques for laparoscopy in many locales. This approach is also particularly well-suited for minilaparotomy in developing countries, where it has achieved its greatest popularity. The local technique carries with it reduced morbidity and mortality but may not entirely relieve discomfort. The primary danger of local anesthesia is respiratory depression due to excessive narcosis and sedation. The operator must be alert to the action of the drugs and should always use the minimal effective dose. Although toxicity due to overdosage with local anesthetic drugs is occasionally experienced, allergic reactions to the amide-linkage drugs such as lidocaine or bupivacaine are exceedingly rare. For outpatient

  20. Triage of Patients in the Child and Adolescent Psychiatry Outpatient Clinic

    PubMed Central

    ARAS, Şahbal; VAROL TAŞ, Fatma; BAYKARA, Burak

    2014-01-01

    Introduction The aim of this study was to evaluate and describe the three-stage triage method used in a child and adolescent psychiatry outpatient clinic. Method The study investigated the new allocation process of 1482 children and adolescents who were assessed using this triage system for the duration of one year, in the year 2005. Data of 1423 children and adolescents who presented in 2003 regarding the waiting time for the first appointment and the rate of nonattendance at the first appointment were used for the comparison. In triage system, new patients presenting to the outpatient clinic in the morning four days a week were assessed by a three-stage procedure: An initial Strengths and Difficulties Questionnaire screening and a structured interview administered by an intern was then followed by a clinical interview. Results Of the 1482 children and adolescents who presented to the outpatient clinic during the study period, 1291 were given further appointments. Among patients who presented in 2005, the 207 non-attendant patients were significantly more likely to have longer waiting times than the 1084 attendant patients. When compared to year 2003, it was found that there was a significant decrease in the median waiting time for the first appointment and the rate of nonattendance at the first appointment among patients who presented in 2005. Conclusion The triage procedure used in this study may constitute a model for developing countries with limited health care resources.

  1. [Treatment processes of pre-alcoholism and alcohol dependence targeted towards drinking reduction].

    PubMed

    Yoshimura, Atsushi; Maesato, Hitoshi; Hisatomi, Nobuko; Higuchi, Susumu

    2013-02-01

    Since the 1990s, we have suggested the concept of pre-alcoholism which encompasses patients who have drunk a great deal of alcohol leading to alcohol related problems such as health issues, domestic violence, drunken driving and black-outs. Pre-alcoholism excludes alcohol-dependent patients who have experienced continuous drinking or withdrawal symptoms. We have treated many outpatients with pre-alcoholism for several years. Our regimen demands that the patients must be abstinent for half a year at the beginning of their treatment. After half a year they can choose whether they will continue to be abstinent or they will resume drinking with the aim of reducing their total alcohol consumption. The study clarified the character of pre-alcoholism by investigation of the patients' background and re-diagnosis of the patients based on the International Classification of Diseases, 10th Revision (ICD-10). A remarkable ratio of pre-alcoholic patients was diagnosed with alcohol dependence under ICD-10. We classified pre-alcoholic patients into two groups, one diagnosed as having ICD-10-classed alcohol dependence and the other which did not fulfill the ICD-10 diagnostic criteria of alcohol dependence, and examined the therapeutic processes of the two groups. It was shown that most pre-alcoholic patients could finally take required courses of treatment by themselves without regard to diagnosis under ICD-10, even if they chose any treatment and made alcohol related mistakes on the way. Our findings suggested that pre-alcoholic patients, a portion of whom may have exhibited mild alcohol dependence, could select drinking reduction as a primary goal of treatment after a certain period of abstinence.

  2. Outpatient Myelography: A Prospective Trial Comparing Complications after Myelography between Outpatients and Inpatients in Japan

    PubMed Central

    Matsumoto, Tomohiro; Inoue, Hidenori; Aoki, Takaaki; Ishiguro, Naoki; Osawa, Yoshimitsu

    2015-01-01

    Study Design Prospective comparative study. Purpose To compare the incidence and severity of adverse reactions associated with myelography performed in outpatients vs. in inpatients and report the safety and usefulness of outpatient myelography in Japanese patients. Overview of Literature Myelography is normally performed as an inpatient procedure in most hospitals in Japan. No studies have reported the usefulness and adverse effects of outpatient myelography in Japanese patients. Methods We performed 221 myelography procedures. Eighty-five of the 221 patients underwent outpatient myelography using our new protocol. The incidence and severity of adverse reactions were compared with the other 136 patients, who underwent conventional inpatient myelography. We further compared the cost of outpatient and inpatient myelography. Results The overall rate of adverse effects was 9.4% in outpatients, as compared with 7.4% in inpatients. Overall, 1.2% of outpatients and 0.74% inpatients experienced "severe" adverse effects (requiring hospitalization). There were no significant differences between the 2 groups in either the overall rate of adverse effects or the rate of "severe" adverse effects. Moreover, the average outpatient procedure cost was only one-third to one-half that of the inpatient procedure. Conclusions This was the first study to address the safety and usefulness of outpatient myelography in Japanese patients. If selected according to proper inclusion criteria for outpatient procedure, no significant differences were observed in the adverse effects between inpatients and outpatients. The outpatient procedure is more economical and has the added benefit of being more convenient and time-efficient for the patient. PMID:26713127

  3. An Analysis of the Last Clinical Encounter before Outpatient Mortality among Children with HIV Infection and Exposure in Lilongwe, Malawi

    PubMed Central

    Rees, Chris A.; Flick, Robert J.; Sullivan, David; Bvumbwe, Menard; Mhango, Joseph; Hosseinipour, Mina C.; Kazembe, Peter N.

    2017-01-01

    Background Human immunodeficiency virus (HIV) contributes to nearly 20% of all deaths in children under five years of age in Malawi. Expanded coverage of antiretroviral therapy has allowed children to access treatment on an outpatient basis. Little is known about characteristics of the final outpatient encounter prior to mortality in the outpatient setting. Methods This retrospective cohort study assessed clinical factors associated with mortality among HIV-exposed infants and HIV-infected children less than 18 years of age at the Baylor College of Medicine Abbott Fund Children’s Center of Excellence in Lilongwe, Malawi. We compared clinical indicators documented from the final outpatient encounter for patients who died in the outpatient setting versus those who were alive after their penultimate clinical encounter. Results Of the 8,546 patients who were attended to over a 10-year period at the Baylor Center of Excellence, 851 had died (10%). Of children who died, 392 (46%) were directly admitted to the hospital after their last clinical encounter and died as inpatients. Of the remaining 459 who died as outpatients after their last visit, 53.5% had a World Health Organization (WHO) stage IV condition at their last visit, and 25% had a WHO stage III condition. Multivariate regression analysis demonstrated that poor nutritional status, female gender, shorter time as a patient, more clinical encounters in the prior month, if last visit was an unscheduled sick visit, and if the patient had lost weight since their prior visit independently predicted increased mortality in the outpatient setting after the final clinical encounter. Conclusion Clinical indicators may assist in identifying children with HIV who have increased risk of mortality in the outpatient setting. Recognizing these indicators may aid in identifying HIV-infected children who require a higher level of care or closer follow-up. PMID:28099432

  4. National Institute on Alcohol Abuse and Alcoholism

    MedlinePlus

    ... Alcohol Awareness Month April is Alcohol Awareness Month Biosensor Challenge Learn more College Drinking Learn More Alcohol Dependence Get the facts Alcohol Awareness Month Biosensor Challenge College Drinking Alcohol Dependence Latest News New & ...

  5. Alcohols toxicology

    SciTech Connect

    Wimer, W.W.; Russell, J.A.; Kaplan, H.L.

    1984-01-01

    A comprehensive reference volume which summarizes literature reports of the known consequences of human and animal contact with alcohols and alcohol-derived substances is presented. Following a discussion of alcohol nomenclature and a brief history of alcohols, the authors have provided detailed chapters on the toxicology of methanol, ethanol, normal and isopropanol, and the butanols. Properties of these alcohols are compared; industrial hygiene and exposure limits are discussed. Additional sections are included covering processing and production technology and exhaust emissions studies. Of particular interest are the section containing abstracts and synopses of principal works and the extensive bibliography of studies dating from the 1800s. 331 references, 26 figures, 56 tables

  6. Antecedents of gregarious alcoholism: an a priori model.

    PubMed

    Thurber, S; Snow, M; Thurber, J

    1989-01-01

    Path analysis procedures were used to test a causal model that concerns possible antecedent conditions in relation to gregarious drinking patterns. Selected scales from The California Psychological Inventory (CPI) and The Alcohol Use Inventory (AUI) constituted the assessments. The model was partially corroborated with reference to a group of 40 alcoholics (32 males; 8 females; M age = 33) in an outpatient treatment setting. The presumed causal variables accounted for 26% of the variance in self-reported gregarious drinking. Support was obtained for the assumption that certain interpersonal deficiencies may combine with beliefs in social benefits via alcohol usage to produce gregarious alcoholism.

  7. 28 CFR 0.152 - Approval of funds for attendance at meetings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Approval of funds for attendance at meetings. The Director of the Federal Bureau of Investigation, the Director of the Bureau of Prisons, the Commissioner of Immigration and Naturalization, the Administrator of the Drug Enforcement Administration, the Director of the Bureau of Alcohol, Tobacco, Firearms,...

  8. Perceptions of Problem Drinkers Attending a Voluntary Organization in a Scottish Community

    ERIC Educational Resources Information Center

    Collins, Stewart Anthony; Elefteriades, Amanda

    2012-01-01

    Twelve clients attending a voluntary agency, a local Council on Alcohol in a Scottish Community, were interviewed individually over a period of up to 1 year. The aims of this study were to explore clients' perceptions of their experiences during the year and their perceptions of help received from the agency. A qualitative approach was used.…

  9. A Comparison of DWI Repeaters and Non-repeaters Who Attended a Level I Rehabilitation Program.

    ERIC Educational Resources Information Center

    Landrum, James W.; Windham, Gerald O.

    1981-01-01

    Compares behavioral and demographic characteristics of drunk drivers with repeated arrests and drivers not having repeated arrests, after attending an alcohol education program. Previous public drunkeness and previous drunk driving arrests were strong predictors of repeat arrests and were judged useful in screening offenders for rehabilitation…

  10. Youth Risk Behavior Survey of High School Students Attending Bureau Funded Schools, 2001.

    ERIC Educational Resources Information Center

    Shaughnessy, Lana; Branum, Cheryl; Everett-Jones, Sherry

    In spring 2001, 5,654 American Indian high school students attending schools funded by the Bureau of Indian Affairs (BIA) completed the Youth Risk Behavior Survey. The survey examined youth behaviors in the areas of motor vehicle safety, weapons, violence, suicide, current and lifetime tobacco use, current and lifetime drug and alcohol use,…

  11. Attendance, Achievement and Participation: Young Carers' Experiences of School in Australia

    ERIC Educational Resources Information Center

    Moore, Tim; McArthur, Morag; Morrow, Ros

    2009-01-01

    Schools play an important part in the lives of children and young people who have caring responsibilities for a family member with an illness, disability, alcohol or other drug problem or mental health condition but many of these "young carers" report difficulty in attending, achieving and participating in education. This qualitative…

  12. An Exploration of the Effect of On-Site 12-Step Meetings on Post-Treatment Outcomes among Polysubstance-Dependent Outpatient Clients

    ERIC Educational Resources Information Center

    Laudet, Alexandre; Stanick, Virginia; Sands, Brian

    2007-01-01

    Rates of return to active substance use after addiction treatment tend to be high; participation in 12-step fellowships (e.g., Alcoholics Anonymous) reduces relapse rates but many clients do not attend or attend for a short period only. This quasi-experimental study uses repeated measurement to explore the role of presence/absence of on-site…

  13. Advice for Administrators: Writing the Attendance Policy.

    ERIC Educational Resources Information Center

    Rood, Robert E.

    1989-01-01

    Since the 1990s, truancy has become administrators' most persistent problem. This article examines student absenteeism trends, characteristics of nonattenders, and current attendance policies. While schools can encourage attendance, final responsibility rests with students and parents. Includes four references. (MLH)

  14. Unexpected deaths in cardiology outpatients – what can we learn from case review?

    PubMed Central

    Kitz, Thomas Michael; Burnand, Nikki; Ortner, Astrid; Rudd, Ian G; Sampson, Rod; Rushworth, Gordon F

    2016-01-01

    Objectives A proportion of cardiac patients managed at a cardiology outpatient clinic will die between clinic visits. This study aimed to identify the cause of death, to determine if case review occurred and if a formal review of such cases might be useful. Design Single-centre retrospective cohort study. Setting A remote regional centre in the North of Scotland. Participants All patients who had been removed from the cardiology outpatient clinic due to death in the community. Main outcome measures Cause of death, comorbidities and treatments were collected from hospital records and the national register of deaths. Chi-squared test and Student’s t-test were used with significance taken at the 5% level. Results Of 10,606 patients who attended the cardiology outpatient clinic, 75 (0.7%) patients died in the community. The majority (57.0%) died from a non-cardiac cause. Eleven patients (14.9%) died due to an unexpected cardiac death. A detailed case note review was undertaken. In only two (18.2%) cases was any note made as to the cause of death in the hospital records and in only one was there details of post mortem discussion between primary and secondary care. Conclusions A small proportion of patients attending a cardiology outpatient clinic died in the community. Documentation of the death in the hospital notes was very poor and evidence of post mortem communication between primary and secondary care was absent in all but one case. Better documentation and communication between primary and secondary care would seem desirable. PMID:27928509

  15. Alcohol Use Disorders

    MedlinePlus

    ... Search Alcohol & Your Health Overview of Alcohol Consumption Alcohol's Effects on the Body Alcohol Use Disorder Fetal Alcohol ... less effect than before? Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such ...

  16. Attendance and Attainment in a Calculus Course

    ERIC Educational Resources Information Center

    Meulenbroek, Bernard; van den Bogaard, Maartje

    2013-01-01

    In this paper the relationship between attendance and attainment in a standard calculus course is investigated. Calculus could in principle be studied without attending lectures due to the wealth of material available (in hardcopy and online). However, in this study we will show that the pass rate of students attending classes regularly (>75%…

  17. Association between autoimmune thyroiditis and depressive disorder in psychiatric outpatients.

    PubMed

    Degner, Detlef; Haust, Merle; Meller, Johannes; Rüther, Eckart; Reulbach, Udo

    2015-02-01

    Thyroid diseases are often associated with psychiatric disorders. The prevalence of autoimmune thyroiditis in the general population is estimated to be at about 5-14 %. A clinical study was conducted to evaluate the association between autoimmune thyroiditis and depression in psychiatric outpatients. Fifty-two patients with depression and nineteen patients with schizophrenia (serving as control group), attending a psychiatric outpatient unit, were included. In addition to the measurement of thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, antithyroid peroxidase (anti-TPO) antibodies, and anti-thyroglobulin antibodies, ultrasound examination of the thyroid gland was performed. The proportion of pathologically increased anti-TPO levels in patients with depression was high. Furthermore, the distribution of pathologically increased anti-TPO levels was significantly (χ (2) = 5.5; p = 0.019) different between patients with depression (32.7 %) and patients with schizophrenia (5.3 %). In a gender- and age-adjusted logistic regression, the odds ratio of uni- or bipolar patients with depression for an autoimmune thyroiditis was ten times higher (95 % CI = 1.2-85.3) when compared with schizophrenia patients. TSH basal level did not differ between patients with depression and patients with schizophrenia. Our study demonstrates a strong association between anti-TPO levels, which are considered to be of diagnostic value for autoimmune thyroiditis (in combination with a hypoechoic thyroid in ultrasonography) with uni- or bipolar depression. It should be noted that the routinely measured TSH level is not sufficient in itself to diagnose this relevant autoimmune comorbidity.

  18. The Effectiveness of Alcohol Policies in 4-Year Public Universities

    ERIC Educational Resources Information Center

    Walter, Gayle T.

    2010-01-01

    A problem facing American universities is heavy drinking by the student body which results in unintentional injuries and deaths, illegal offenses, sexual assault, altercations, and academic demise. The relationship between the type of alcohol policy enacted on campus and alcohol consumption among undergraduate students attending 4-year public…

  19. Incoming Students' Alcohol Use and Intent to Join Greek Organizations

    ERIC Educational Resources Information Center

    Oswalt, Sara B.; Shutt, Michael D.; Cooper, Diane L.

    2006-01-01

    Incoming first-time, first-year students attending summer orientation (N = 1,710) at a large public university in the Southeast completed an instrument that assessed their use of alcohol and other drugs during the previous year, their perceptions of use by current students on campus, their intended alcohol use, and their intent to join a Greek…

  20. Swaziland's Traditional Birth Attendants Survey.

    PubMed

    Lech, M M; Mngadi, T P

    2005-12-01

    The Traditional Birth Attendants (TBAs) Survey in Swaziland was undertaken between March 27th 1996 and April 8th 1996. The objective of the survey was to generate reliable information regarding activities of TBAs in Swaziland. The survey was conducted in 25 Chiefdoms sampled out of a total of 206 Chiefdoms registered in Swaziland. The total number of sampled respondents in the 25 Chiefdoms was 721. From the survey, it is estimated that there were probably 3000 TBAs in the country, and in the majority of cases such TBAs would be a 51-year old woman who herself had delivered six children and had worked as a TBA for at least 10 years. Between 9,000 and 12,000 deliveries are estimated to take place out of health facilities. Of these many, nearly 43.5% are assisted by "TBAs"; 16.3% of woman interviewed deliver relative/family member and 15.1% are assisted by friends/neighbours, etc. Some of TBAs carry out procedures which are considered to be potentially harmful. Nearly 30% of TBAs have administered herbs; 45% attend to abnormal deliveries (breech and multiple pregnancies); 26.7% re-use their cord cutting tools and in the case of haemorrhage 23.4% do manual procedures within reproductive tract of delivering women.

  1. Differential mortality among alcoholics by sample site.

    PubMed Central

    Combs-Orme, T; Taylor, J R; Robins, L N; Holmes, S J

    1983-01-01

    In a sample of 1,289 alcoholics from four clinical sites, the overall mortality rate after five to eight years of observation was 22.0 per cent, 3.1 times the expected rate. Patients from the medical and surgical services of a general hospital suffered 4.0 times the rate of expected mortality and died most often of medical causes associated with alcoholism. Patients of the public alcoholism ward had a mortality rate 3.3 times the expected rate and died of causes often associated with low social class. Private psychiatric patients had a mortality rate 2.3 times the expected rate, and psychiatric outpatients had an excess mortality ratio of 2.1. Sample site must be considered as a variable in the study of mortality among alcoholics. PMID:6869642

  2. Alcoholic Liver Disease and Malnutrition

    PubMed Central

    McClain, Craig J.; Barve, Shirish S.; Barve, Ashutosh; Marsano, Luis

    2013-01-01

    Malnutrition, both protein energy malnutrition (PEM) and deficiencies in individual nutrients, is a frequent complication of alcoholic liver disease (ALD). Severity of malnutrition correlates with severity of ALD. Malnutrition also occurs in patients with cirrhosis due to etiologies other than alcohol. The mechanisms for malnutrition are multifactorial, and malnutrition frequently worsens in the hospital due to fasting for procedures and metabolic complications of liver disease, such as hepatic encephalopathy. Aggressive nutritional support is indicated in inpatients with ALD, and patients often need to be fed through an enteral feeding tube to achieve protein and calorie goals. Enteral nutritional support clearly improves nutrition status and may improve clinical outcome. Moreover, late-night snacks in outpatient cirrhotics improve nutritional status and lean body mass. Thus, with no FDA-approved therapy for ALD, careful nutritional intervention should be considered as frontline therapy. PMID:21284673

  3. Mixing an Energy Drink with an Alcoholic Beverage Increases Motivation for More Alcohol in College Students

    PubMed Central

    Marczinski, Cecile A.; Fillmore, Mark T.; Henges, Amy L.; Ramsey, Meagan A.; Young, Chelsea R.

    2012-01-01

    Background There has been a dramatic rise in the consumption of alcohol mixed with energy drinks (AmED) in social drinkers. It has been suggested that AmED beverages might lead individuals to drink greater quantities of alcohol. This experiment was designed to investigate if the consumption of AmED would alter alcohol priming (i.e., increasing ratings of wanting another drink) compared with alcohol alone. Methods Participants (n = 80) of equal gender attended one session where they were randomly assigned to receive one of 4 doses (0.91 ml/kg vodka, 1.82 ml/kg energy drink, 0.91 ml/kg vodka mixed with 1.82 ml/kg energy drink (AmED), or a placebo beverage). Alcohol-induced priming of the motivation to drink was assessed by self-reported ratings on the Desire-for-Drug questionnaire. Results The priming dose of alcohol increased the subjective ratings of “desire” for more alcohol, consistent with previous research that small doses of alcohol can increase the motivation to drink. Furthermore, higher desire ratings over time were observed with AmED compared to alcohol alone. Finally, ratings of liking the drink were similar for the alcohol and AmED conditions. Conclusions An energy drink may elicit increased alcohol priming. This study provides laboratory evidence that AmED beverages may lead to greater motivation to drink versus the same amount of alcohol consumed alone. PMID:22724427

  4. Alcohol Consumption and Injury among Canadian Adolescents: Variations by Urban-Rural Geographic Status

    ERIC Educational Resources Information Center

    Jiang, Xuran; Li, Dongguang; Boyce, William; Pickett, William

    2008-01-01

    Context: The impact of alcohol consumption on risks for injury among rural adolescents is an important and understudied public health issue. Little is known about whether relationships between alcohol consumption and injury vary between rural and urban adolescents. Purpose: To examine associations between alcohol and medically attended injuries by…

  5. Success and safety in outpatient microlumbar discectomy.

    PubMed

    Best, Natalie M; Sasso, Rick C

    2006-07-01

    Currently, many spine surgeons perform microlumbar discectomies on an outpatient basis. Yet, it is often customary for patients to have a 1-night stay in the hospital. Many studies have shown the efficacy of microlumbar discectomy (MLD) and its preference among surgeons for the treatment of lumbar disc herniation. It has also been shown to be safe, successful, and cost-effective. However, a large comprehensive study of this magnitude, gauging safety, success, and patient satisfaction for these procedures on an outpatient basis has not yet been done. One thousand three hundred seventy-seven MLD procedures have been done from 1992 to 2001 by 1 surgeon. A retrospective chart review was done on all procedures. Patients were then contacted by either telephone or mail to complete an outcome questionnaire. Seven hundred thirteen patients (53.9%) completed the questionnaire. Follow-up questionnaires were not completed due to deaths, incorrect contact information, and refused responses. Out of all MLD procedures, 55 (4.0%) were done with a hospital stay-only 24 of these (1.7%) were originally intended outpatient procedures. Of those that were done on an outpatient basis, 8.6% had a complication, including 6.4% who had a recurrent disc herniation. When asked, 81.6% said they would undergo the procedure again as an outpatient. In 82.1% the surgery's outcome was good, very good, or excellent. MLD is a routine procedure that can be performed on an outpatient basis safely, successfully, and with high patient satisfaction.

  6. Continuous Intravenous Milrinone Therapy in Pediatric Outpatients

    PubMed Central

    Curley, Michelle; Liebers, Jill

    2017-01-01

    Milrinone is a phosphodiesterase 3 inhibitor with both positive inotropic and vasodilator properties. Administered as a continuous infusion, milrinone is indicated for the short-term treatment of patients with acute decompensated heart failure. Despite limited data supporting long-term milrinone therapy in adults with congestive heart failure, children managed as outpatients may benefit from continuous milrinone as a treatment for cardiac dysfunction, as a destination therapy for cardiac transplant, or as palliative therapy for cardiomyopathy. The aim of this article is to review the medical literature and describe a home infusion company's experience with pediatric outpatient milrinone therapy. PMID:28248808

  7. Social persuasion in rheumatology: a randomized trial of testimonials on television in the rheumatology clinic waiting room to increase attendance for multidisciplinary education.

    PubMed

    Tingey, Paul; Khanafer, Mohamed; Singh, Kulraj; Thompson, Andy; Le Riche, Nicole; Barra, Lillian; Haig, Sara; Rohekar, Gina; Rohekar, Sherry; Nielson, Warren; Pope, Janet E

    2014-07-01

    Multidisciplinary self-management programs are important in inflammatory arthritis as adjunctive treatment. Patients often have excuses as to why they do not attend these programs. The purpose of this study was to determine whether an intervention of televised testimonials from rheumatologists and allied health professionals increases attendance at a multidisciplinary education day for rheumatology patients seen in a large university hospital clinic. This was an RCT of intervention: playing televised interviews in the waiting room where rheumatology patients were seen versus no TV. There was a total of 6 months (3 months with and 3 without the televised interview playing). All eligible patients who attended the rheumatology outpatient clinic were then tracked to determine whether they attended a subsequent education day over the next 10 months. The sample size was calculated to have a 15% increase in attendance at the education days. There was a 20% increase in attendees at the multidisciplinary education days for patients who saw the televised testimonials. Sixty-three patients who viewed the testimonials (2.17% of 2,908) attended the education day compared to 39 who did not receive the intervention (1.80% of 2,168); however, the increase was not statistically significant (p = 0.36). Attendance of eligible patients increased using televised testimonials; however, the increase was not significant as the rates of attendance were still very low in both groups. Many eligible patients did not attend the program. Other interventions are necessary to encourage attendance in a multidisciplinary program.

  8. Who attends family planning clinics?

    PubMed

    Chick, P; Nixon, J

    1984-08-01

    Data were obtained from 1,810 consecutive women who attended a central metropolitan (Brisbane) Family Planning Clinic during a 5 week period in 1982. Young women in particular formed the major client group with 32% being under 20 years of age. The client population was skewed towards women of upper socioeconomic status (SES). There was no SES disproportion in the use of oral contraceptives or IUD's. However, diaphragm use occurred disproportionately in women of upper SES groups; postcoital contraception was sought by and limited to, women of SES classes A and B only. The clinic satisfied a need for women with a history of failed or absent contraception and 15% had already had a termination of pregnancy by the time they first presented at the clinic.

  9. Evaluation of Flight Attendant Technical Knowledge

    NASA Technical Reports Server (NTRS)

    Dunbar, Melisa G.; Chute, Rebecca D.; Rosekind, Mark (Technical Monitor)

    1997-01-01

    Accident and incident reports have indicated that flight attendants have numerous opportunities to provide the flight-deck crew with operational information that may prevent or lessen the severity of a potential problem. Additionally, as carrier fleets transition from three person to two person flight-deck crews, the reliance upon the cabin crew for the transfer of this information may increase further. Recent research indicates that flight attendants do not feel confident in their ability to describe mechanical parts or malfunctions of the aircraft, and the lack of flight attendant technical training has been referenced in a number of recent reports. Chute and Wiener describe five factors which may produce communication barriers between cockpit and cabin crews: the historical background of aviation, the physical separation of the two crews, psychosocial issues, regulatory factors, and organizational factors. By examining these areas of division we can identify possible bridges and address the implications of deficient cockpit/cabin communication on flight safety. Flight attendant operational knowledge may provide some mitigation of these barriers. The present study explored both flight attendant technical knowledge and flight attendant and pilot expectations of flight attendant technical knowledge. To assess the technical knowledge of cabin crewmembers, 177 current flight attendants from two U.S. carriers voluntarily completed a 13-item technical quiz. To investigate expectations of flight attendant technical knowledge, 181 pilots and a second sample of 96 flight attendants, from the same two airlines, completed surveys designed to capture each group's expectations of operational knowledge required of flight attendants. Analyses revealed several discrepancies between the present level of flight attendant operational knowledge and pilots' and flight attendants' expected and desired levels of technical knowledge. Implications for training will be discussed.

  10. Alcohol project

    SciTech Connect

    Not Available

    1980-12-01

    It is reported that Savannah Foods and Industries, in a joint venture with United States Sugar Corporation have applied for a loan guarantee for the production of alcohol from agricultural commodities. The two phase program calls for research and development, before a prototype plant will be built for the conversion of cellulosic compounds found in bagasse into alcohol for use as a fuel.

  11. Alcohol Facts

    MedlinePlus

    ... Families? Why Is It So Hard to Quit Drugs? Effects of Drugs Drug Use Hurts Other People Drug Use Hurts ... This Section Signs of Alcohol Abuse and Addiction Effects of Alcohol on Brains and Bodies Previous ... Treatment Work? Treatment and Rehab Resources About the ...

  12. Alcoholism & depression.

    PubMed

    Hall, Mellisa

    2012-10-01

    One out of 2 Americans report drinking on a routine basis, making the excessive consumption of alcohol the third leading cause of preventable death in America (). Alcoholism and depression are common comorbidities that home healthcare professionals frequently encounter. To achieve the best patient outcomes, alcoholism should be addressed initially. Although all age groups are at risk, alcoholism and depression occur in more than 8 percent of older adults. Prevention through identifying alcohol use early in adolescence is vital to reduce the likelihood of alcohol dependence. This article provides an overview of the long-term effects of alcohol abuse, including alcoholic cirrhosis and hepatic encephalopathy. The diagnostic criteria for substance dependence and ideas for nonthreatening screening questions to use with patients who are adolescent or older are discussed. While providing patient care, home healthcare nurses share the patient's intimate home environment. This environment is perceived as a safe haven by the patient and home care nurses can take advantage of counseling and treatment opportunities in this nonthreatening environment.

  13. [Alcohol-related injuries--an emergency department study in the Lausanne University Hospital].

    PubMed

    Gmel, Gerhard; Kuendig, Hervé; Gaume, Jacques; Daeppen, Jean-Bernard

    2007-09-05

    Alcohol-related injuries are responsible for a large share of the global mortality and morbidity burden. Scant information existed, however, for Switzerland. Based on 3653 injured patients and 3519 patients attending the emergency department of the Lausanne University Hospital for other reasons, alcohol attributable fractions with regard to the alcohol consumption in the 6 hours before the injury were estimated. Among men 17% of all injures were alcohol attributable, and 12% among women. Relative risks increased in dose-response relationship with alcohol intake. Leisure time related injuries were most likely to be alcohol attributable. Most of the alcohol-related injuries occurred at already small ethanol quantities ingested.

  14. Extending computer-based critiquing to a new domain: ATTENDING, ESSENTIAL-ATTENDING, and VQ-ATTENDING.

    PubMed

    Miller, P L

    1986-01-01

    The paper describes a research project which is developing expert computer systems to critique a physician's plan of medical management. In particular, the paper outlines the evolution of three computer systems: ATTENDING, a system designed to critique anesthetic management, ESSENTIAL-ATTENDING, a domain-independent system-building system, and VQ-ATTENDING, a prototype system implemented using ESSENTIAL-ATTENDING to critique aspects of ventilator management. The goals of the research project are to explore the critiquing approach in several different medical domains, to understand the design problems involved in implementing such systems, and to help other researchers build critiquing systems in further domains.

  15. Assessing Whether Religious Behaviors and Positive and Negative Affect are Associated with Alcohol Use and Abuse Among a Sample of College Students Living in the Midwest.

    PubMed

    Carmack, Chakema C; Lewis, Rhonda K

    2016-06-01

    Alcohol use and abuse are a problem on college campuses. Religious behaviors (religious attendance, prayer, and importance) have been shown to be a protective factor against alcohol use among college students. This study examined the role religious behaviors and positive and negative affect had on drinking (alcohol use and alcohol to intoxication). College students (765) completed an online survey. The results showed that college students who attended religious services were less likely to use alcohol than those who did not attend religious services. The results have important implications for college administrators and policy makers. Limitations and future research will be discussed.

  16. Dental Outpatients: Health Locus of Control Correlates.

    ERIC Educational Resources Information Center

    Ludenia, Krista; Donham, Greg W.

    1983-01-01

    Examined relationships among specific personality variables, the Multidimensional Health Locus of Control Scales, and criterion-based ratings by staff dentists with dental outpatients (N=101). Found a consistent relationship between the perception that health is maintained by engaging in health-related behaviors and individual difference measures…

  17. Tobacco Smoking in Adolescent Psychiatric Outpatients

    ERIC Educational Resources Information Center

    Ditchburn, K. Marie; Sellman, J. Douglas

    2013-01-01

    Three main aims of this study were to ascertain the prevalence rate of smoking among adolescent psychiatric outpatients; estimate smokers' degree of nicotine dependence; and investigate the relationship between smoking and common mental health disorders. Face-to-face interviews were conducted on 93 patients ages 13-18 presenting to an adolescent…

  18. Outpatient coronary angioplasty: feasible and safe.

    PubMed

    Slagboom, Ton; Kiemeneij, Ferdinand; Laarman, Gert Jan; van der Wieken, Ron

    2005-04-01

    This study tested the safety and feasibility of coronary angioplasty on an outpatient basis. The purpose of this approach includes cost-effectiveness and patient comfort. Six hundred forty-four patients were randomized to either transradial or transfemoral PTCA using 6 Fr equipment. Patients were triaged to outpatient management based on a predefined set of predictors of an adverse outcome in the first 24 hr after initially successful coronary angioplasty. Three hundred seventy-five patients (58%) were discharged 4-6 hr after PTCA; 42% stayed in hospital overnight. In the outpatient group, one adverse event occurred (subacute stent thrombosis 7 hr postdischarge, nonfatal myocardial infarction). There were no major vascular complications. In the hospital group, 19 patients (7%) sustained an adverse cardiac even in the first 24 hr; 1 patient died. Patients treated via the femoral route had more (minor) bleeding complications (19 patients; 6%); in 17 of these, this was the sole reason that discharge was delayed. PTCA on an outpatient basis, performed via the radial or the femoral artery with low-profile equipment, is safe and feasible in a considerable part of a routine PTCA population. A larger proportion of transradial patients can be discharged due to a reduction in (minor) bleeding complications.

  19. [Dimensional modeling analysis for outpatient payments].

    PubMed

    Guo, Yi-zhong; Guo, Yi-min

    2008-09-01

    This paper introduces a data warehouse model for outpatient payments, which is designed according to the requirements of the hospital financial management while dimensional modeling technique is combined with the analysis on the requirements. This data warehouse model can not only improve the accuracy of financial management requirements, but also greatly increase the efficiency and quality of the hospital management.

  20. Flight Attendant Injuries: 1971-1976

    DTIC Science & Technology

    1982-01-01

    fighting in- flight fires, and evacuating passengers from disabled aircraft. Any injury to a flight attendant may adversely influence the safety of the other...the aircraft was responsible for the injury is the second largest event followed by the category in which the flight attendants were injured because...Report No. 2. Government Accession Ne. 3. Recipientlo Catalog No. FAA-AM-82-8 ]A___________ 4. Title and Subtitle 5. Report Dote FLIGHT ATTENDANT

  1. Alcohol Energy Drinks

    MedlinePlus

    ... Home / About Addiction / Alcohol / Alcohol Energy Drinks Alcohol Energy Drinks Read 24059 times font size decrease font size increase font size Print Email Alcohol energy drinks (AEDs) or Caffeinated alcoholic beverages (CABs) are ...

  2. Alcohol during Pregnancy

    MedlinePlus

    ... Home > Pregnancy > Is it safe? > Alcohol during pregnancy Alcohol during pregnancy E-mail to a friend Please ... and fetal alcohol spectrum disorders. How does drinking alcohol during pregnancy affect your baby's health? Drinking alcohol ...

  3. Prevalence and associated factors of polypharmacy among adult Saudi medical outpatients at a tertiary care center

    PubMed Central

    Salih, Salih Bin; Yousuf, Muhammad; Durihim, Huda; Almodaimegh, Hind; Tamim, Hani

    2013-01-01

    Objective: The objective of this study was to assess the prevalence of polypharmacy (PP) and the associated factors in medical outpatients. Materials and Methods: A cross-sectional, observational, descriptive study was carried out in adult medical outpatients attending internal medicine clinics at King Abdulaziz Medical City, Riyadh, Saudi Arabia from 1 March 2009 to 31 December 2009. PP was defined as the concomitant use of ≥5 medications daily. The number of medications being currently taken by patient was recorded. Effect of patients’ age, gender, educational level, number of prescribers, disease load and disease type on PP was assessed by multivariate analysis using Statistical Package for Social Sciences Incorporated (SPSS Inc) Version 18. Results: Out of 766 patients included in the study, 683 (89%) had PP. The mean number of prescribed medications, oral pills and doses was 8.8, 9.6 and 12.1, respectively. Factors significantly associated with PP included age (≥61 years), disease load and the number of prescribers. Gender had no impact on PP while education beyond primary education significantly decreased PP. Hypertension, diabetes mellitus and dyslipidemia alone and as a cluster increased PP. Conclusion: We found an extremely high level of PP in medical outpatients at our tertiary care center. The impact of PP on medication compliance and control of underlying diseases in Saudi Arabia is unknown and needs to be studied at different levels of care. PMID:24672273

  4. Prevalence of Internet use amongst an elective spinal surgery outpatient population.

    PubMed

    Baker, Joseph F; Devitt, Brian M; Kiely, Paul D; Green, James; Mulhall, Kevin J; Synnott, Keith A; Poynton, Ashley R

    2010-10-01

    Nationally 62% of individuals in Ireland have internet access. Previous published work has suggested that internet use is higher among those with low back pain. We aimed to determine the levels of internet access and use amongst an elective spinal outpatient population and determine what characteristics influence these. We distributed a self-designed questionnaire to patients attending elective spinal outpatient clinics. Data including demographics, history of surgery, number of visits, level of satisfaction with previous consultations, access to the internet, possession of health insurance, and details regarding use of the internet to research one's spinal complaint were collected. 213 patients completed the questionnaire. 159 (75%) had access to the internet. Of this group 48 (23%) used the internet to research their spinal condition. Increasing age, higher education level, and possession of health insurance were all significantly associated with access to the internet (p < 0.05). A higher education level predicted greater internet use while possession of insurance weakly predicted non-use (p < 0.05). In our practice, internet access is consistent with national statistics and use is comparable to previous reports. Approximately, one quarter of outpatients will use the internet to research their spinal condition. Should we use this medium to disseminate information we need to be aware some groups may not have access.

  5. One-year treatment patterns and change trajectories for adolescents participating in outpatient treatment for the first time.

    PubMed

    Godley, Susan H; Passetti, Lora L; Funk, Rodney R; Garner, Bryan R; Godley, Mark D

    2008-03-01

    The American Society on Addiction Medicine's Patient Placement criteria are commonly used in adolescent treatment. However, the use of these criteria and how they affect the course of treatment and interact with adolescent change has not been examined. Twelve-month treatment patterns were examined for 176 adolescents who entered their first ever episode in a treatment system using these criteria. Forty-one percent of the adolescents received additional treatment after their initial outpatient episode with over 30 unique treatment sequences (i.e., various combinations of outpatient, intensive outpatient, and residential treatment). Significant differences in treatment patterns were found between the change trajectory groups. For example, adolescents who participated in only one outpatient treatment episode were more likely to be in the low alcohol and drug use (AOD) group and less likely to have high rates of time in a controlled environment or to report moderate AOD use. Over one-third of the adolescents participated in additional treatment and almost one-quarter of those who only participated in outpatient treatment had problematic use. These findings suggest the need for clinical monitoring protocols that can be used to identify adolescents needing additional treatment or recovery services.

  6. 77 FR 5317 - Medicaid Program; Covered Outpatient Drugs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-02

    ... 42 CFR Part 447 Medicaid Program; Covered Outpatient Drugs; Proposed Rule #0;#0;Federal Register... Outpatient Drugs AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed rule. SUMMARY... outpatient drugs to implement provisions of the Patient Protection and Affordable Care Act of 2010,...

  7. 42 CFR 410.60 - Outpatient physical therapy services: Conditions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of this section, Medicare Part B pays for outpatient physical therapy services only...

  8. 42 CFR 410.60 - Outpatient physical therapy services: Conditions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of this section, Medicare Part B pays for outpatient physical therapy services only...

  9. Alcohol conversion

    DOEpatents

    Wachs, Israel E.; Cai, Yeping

    2002-01-01

    Preparing an aldehyde from an alcohol by contacting the alcohol in the presence of oxygen with a catalyst prepared by contacting an intimate mixture containing metal oxide support particles and particles of a catalytically active metal oxide from Groups VA, VIA, or VIIA, with a gaseous stream containing an alcohol to cause metal oxide from the discrete catalytically active metal oxide particles to migrate to the metal oxide support particles and to form a monolayer of catalytically active metal oxide on said metal oxide support particles.

  10. Contingency Management for Attendance to Group Substance Abuse Treatment Administered by Clinicians in Community Clinics

    PubMed Central

    Ledgerwood, David M; Alessi, Sheila M; Hanson, Tressa; Godley, Mark D; Petry, Nancy M

    2008-01-01

    Contingency management (CM) is effective in enhancing retention in therapy. After an 8-week baseline, four community-based substance abuse treatment clinics were exposed in random order to 16 weeks of standard care with CM followed by 16 weeks of standard care without CM or vice versa. In total, 75 outpatients participated. Patients who were enrolled in the clinics when the CM treatment phase was in effect attended a significantly greater percentage of therapy sessions than patients who were enrolled in treatment when CM was not in effect. This study is one of the first to investigate CM in community settings implemented entirely by community clinicians, and results suggest that CM is effective in improving therapy attendance. PMID:19192856

  11. Factors Influencing Likelihood of Voice Therapy Attendance.

    PubMed

    Misono, Stephanie; Marmor, Schelomo; Roy, Nelson; Mau, Ted; Cohen, Seth M

    2017-03-01

    Objective To identify factors associated with the likelihood of attending voice therapy among patients referred for it in the CHEER (Creating Healthcare Excellence through Education and Research) practice-based research network infrastructure. Study Design Prospectively enrolled cross-sectional study. Setting CHEER network of community and academic sites. Methods Data were collected on patient-reported demographics, voice-related diagnoses, voice-related handicap (Voice Handicap Index-10), likelihood of attending voice therapy (VT), and opinions on factors influencing likelihood of attending VT. The relationships between patient characteristics/opinions and likelihood of attending VT were investigated. Results A total of 170 patients with various voice-related diagnoses reported receiving a recommendation for VT. Of those, 85% indicated that they were likely to attend it, regardless of voice-related handicap severity. The most common factors influencing likelihood of VT attendance were insurance/copay, relief that it was not cancer, and travel. Those who were not likely to attend VT identified, as important factors, unclear potential improvement, not understanding the purpose of therapy, and concern that it would be too hard. In multivariate analysis, factors associated with greater likelihood of attending VT included shorter travel distance, age (40-59 years), and being seen in an academic practice. Conclusions Most patients reported plans to attend VT as recommended. Patients who intended to attend VT reported different considerations in their decision making from those who did not plan to attend. These findings may inform patient counseling and efforts to increase access to voice care.

  12. Neurodynamics of relapse prevention: a neuronutrient approach to outpatient DUI offenders.

    PubMed

    Brown, R J; Blum, K; Trachtenberg, M C

    1990-01-01

    The central nervous system rewarding properties of ethanol, cocaine, and heroin may activate a common catecholaminergic reward system in the mesolimbic circuitry of the brain. Driving-under-the-influence (DUI) offenders with either alcohol- or cocaine-related problems were studied. The neuronutrients SAAVE and Tropamine significantly reduced relapse rates and enhanced recovery in these DUI outpatient offenders over a 10-week period. Follow-up on both the SAAVE and Tropamine groups after 10 months revealed a 73% and a 53% overall recovery rate, respectively. These clinical results favor the use of these neuronutrients as adjuncts to psychological therapeutic modalities.

  13. Alcoholics Anonymous

    MedlinePlus

    ... Help What's New Read Daily Reflections Make a Contribution Go to Online Bookstore Welcome to Alcoholics Anonymous ® ... and Twelve & Twelve | 75th Anniversary Edition | Make a contribution | Self-Support Press/Media | Archives & History | A.A. ...

  14. Alcohol Intolerance

    MedlinePlus

    ... or other preservatives Chemicals, grains or other ingredients Histamine, a byproduct of fermentation or brewing In some ... in some people, possibly as a result of histamines contained in some alcoholic beverages. Your immune system ...

  15. Alcoholic ketoacidosis

    MedlinePlus

    Tests may include: Arterial blood gases (measure the acid/base balance and oxygen level in blood) Blood alcohol ... PA: Elsevier Saunders; 2013:chap 161. Seifter JL. Acid-Base disorders. In: Goldman L, Schafer AI, eds. Goldman's ...

  16. Alcohol withdrawal

    MedlinePlus

    ... Seeing or feeling things that aren't there (hallucinations) Seizures Severe confusion ... alcohol withdrawal. You will be watched closely for hallucinations and other signs of delirium tremens. Treatment may ...

  17. Legal Challenges to Compulsory Attendance Laws.

    ERIC Educational Resources Information Center

    Beckham, Joseph C.

    Legal challenges to state compulsory attendance laws have emphasized four interrelated constitutional claims. Under provisions of the free exercise clause of the First Amendment, parents have challenged the state's authority to require public school attendance in lieu of home instruction and private, religious organizations have refused to comply…

  18. Does Mandatory Attendance Improve Student Performance?

    ERIC Educational Resources Information Center

    Marburger, Daniel R.

    2006-01-01

    Previous empirical literature indicates that student performance is inversely correlated with absenteeism. The author investigates the impact of enforcing an attendance policy on absenteeism and student performance. The evidence suggests that an enforced mandatory attendance policy significantly reduces absenteeism and improves exam performance.

  19. 42 CFR 35.22 - Attendants.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Transfer of Patients § 35.22 Attendants. Patients shall be transferred by such means... nursing attendants shall be qualified to care for persons suffering from the type of disease or...

  20. 42 CFR 35.22 - Attendants.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Transfer of Patients § 35.22 Attendants. Patients shall be transferred by such means... nursing attendants shall be qualified to care for persons suffering from the type of disease or...

  1. 42 CFR 35.22 - Attendants.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Transfer of Patients § 35.22 Attendants. Patients shall be transferred by such means... nursing attendants shall be qualified to care for persons suffering from the type of disease or...

  2. Substance Abuse Intensive Outpatient Programs: Assessing the Evidence

    PubMed Central

    McCarty, Dennis; Braude, Lisa; Dougherty, Richard H.; Daniels, Allen S.; Ghose, Sushmita Shoma; Delphin-Rittmon, Miriam E.

    2014-01-01

    Objective Substance abuse intensive outpatient programs (IOPs) are direct services for people with substance use disorders or co-occurring mental and substance use disorders who do not require medical detoxification or 24-hour supervision. IOPs are alternatives to inpatient and residential treatment. They are designed to establish psychosocial supports and facilitate relapse management and coping strategies. This article assesses their evidence base. Methods Authors searched major databases: PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. They identified 12 individual studies and one review published between 1995 and 2012. They chose from three levels of research evidence (high, moderate, and low) based on benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness. Results Based on the quality of trials, diversity of settings, and consistency of outcomes, the level of evidence for IOP research was considered high. Multiple randomized trials and naturalistic analyses compared IOPs with inpatient or residential care; these types of services had comparable outcomes. All studies reported substantial reductions in alcohol and drug use between baseline and follow-up. However, substantial variability in the operationalization of IOPs and outcome measures was apparent. Conclusions IOPs are an important part of the continuum of care for alcohol and drug use disorders. They are as effective as inpatient treatment for most individuals seeking care. Public and commercial health plans should consider IOP treatment as a covered health benefit. Standardization of the elements included in IOPs may improve their quality and effectiveness. PMID:24445620

  3. Brief Alcohol Interventions With Mandated or Adjudicated College Students

    PubMed Central

    Barnett, Nancy P.; Tevyaw, Tracy O’Leary; Fromme, Kim; Borsari, Brian; Carey, Kate B.; Corbin, William R.; Colby, Suzanne M.; Monti, Peter M.

    2009-01-01

    This article summarizes the proceedings of a symposium presented at the 2003 RSA Meeting in Ft. Lauderdale, Florida, organized and chaired by Nancy Barnett. The purpose of the symposium was to present information and efficacy data about approaches to brief intervention with students who get into trouble on their campuses for alcohol and as a result are required to attend alcohol education or counseling. Presentations were (1) Differences Between Mandated College Students and Their Peers on Alcohol Use and Readiness to Change, by Tracy O’Leary Tevyaw; (2) An Effective Alcohol Prevention Program for Mandated College Students, by Kim Fromme; (3) Two Brief Alcohol Interventions for a Referred College Population, by Kate Carey; and (4) Brief Motivational Intervention With College Students Following Medical Treatment or Discipline for Alcohol, by Nancy Barnett. The data presented in this symposium indicated that students who are evaluated or disciplined for alcohol use are on average heavy drinkers who drink more heavily than their closest peers. Brief intervention approaches described by the speakers included group classroom sessions, individual motivational intervention, individual alcohol education, and computerized alcohol education. Reductions in consumption and problems were noted across the various intervention groups. Brief motivational intervention as a general approach with mandated students shows promise in that it reduced alcohol problems in a group of mandated students who were screened for being at risk (in the Borsari and Carey study) and increased the likelihood that students would attend further counseling (in the Barnett study). PMID:15218881

  4. Attending Behavior of Children Near a Child Who is Reinforced for Attending

    ERIC Educational Resources Information Center

    Okovita, Hymie Wolf; Bucher, Bradley

    1976-01-01

    The present study investigated effects of a token program for one child on the attending behavior of other children sitting near him. Results show the rewarded child's attending increased in the reinforcement conditions and the unrewarded children's attending increased when they were sitting on either side of the rewarded child. (Author)

  5. Comparison of health-risk behaviors among students attending alternative and traditional high schools in Minnesota.

    PubMed

    Johnson, Karen E; McMorris, Barbara J; Kubik, Martha Y

    2013-10-01

    Previous research, over a decade old, suggests students attending alternative high schools (AHS) engage in high levels of health-risk behaviors. Data from the 2007 Minnesota Student Survey for students attending AHS (n = 2,847) and traditional high schools (THS; n = 87,468) were used for this cross-sectional analysis to compare prevalence estimates, adjusted for age, race/ethnicity, and free and reduced lunch, for 28 health-risk behaviors. Students attending AHS were significantly more likely than students attending THS to report engaging in all behaviors related to unintentional injury and violence, tobacco use, alcohol and other drug use, and sexual activity, and were significantly less likely to report participating in physical activity, including sports teams. Students attending AHS continue to engage in high levels of health-risk behaviors as compared to their peers in THS. Updated national prevalence data were needed, as well as studies examining the role of protective factors in the lives of students attending AHS.

  6. Review of 212 individuals attending a city centre genitourinary medicine clinic following acute sexual assault.

    PubMed

    Thompson, C

    2006-05-01

    A retrospective case note review of 212 individuals (190 women) attending a city-centre Genitourinary Medicine clinic between 1/4/2002 and 31/3/2004 following an acute sexual assault. Direct referral by the Forensic Medical Examiner to the dedicated weekly clinic for victims of sexual assault facilitated the attendance of 55/113 attending the dedicated clinic. The 99 individuals who did not disclose a recent assault as the reason for attendance were seen at routine clinics. One third of individuals attending the dedicated clinic were less than 16 years old, reflecting the facilitated referral pathway. Those attending the dedicated clinic were more likely to be offered the extended service outlined in the departmental protocol. Twenty four sexually transmitted infections were detected in 23 (11%) individuals but 23/24 could have been acquired during other recent consensual sexual activity. Overall, the assailant was known to the victim in 53% cases, there was an allegation of violence associated with the assault in 20%, suspicion of a drug facilitated ('spiked drink') assault in 24% and admission of alcohol intoxication in 11% cases. The 22/212 (10%) who were male were more likely to present to a routine clinic.

  7. Lifestyle, harassment at work and self-assessed health of female flight attendants, nurses and teachers.

    PubMed

    Gunnarsdottir, Holmfridur K; Sveinsdottir, Herdis; Bernburg, Jon Gunnar; Fridriksdottir, Hildur; Tomasson, Kristinn

    2006-01-01

    Health-related lifestyle, harassment at work, and self-assessed health of female flight attendants in comparison to that of female nurses and female primary school teachers were surveyed. A higher proportion of flight attendants than nurses or teachers were smokers, 26% vs. 15% and 17% respectively; and consumed alcohol at least once a week, 40% vs. 21% and 16%. Repeated sexual harassment at work was more common among the flight attendants, 31% vs. 8% and 4%; whereas bullying, physical violence and threats were less prevalent among the flight attendants (12%) than among nurses (19%). Flight attendants were on average somewhat taller, but weighed on average less, 63.8 kg vs. 72.4 kg and 72.7 kg respectively. Repeated exposure to sexual harassment, bullying, violence and threats was related to less physical and psychological well-being in all the groups. Teachers scored on average significantly lower than did the flight attendants on general health and physical well-being, while nurses did not.

  8. Regular clinic attendance in two large San Francisco HIV primary care settings.

    PubMed

    Cohen, Jenny K; Santos, Glenn-Milo; Moss, Nicholas J; Coffin, Phillip O; Block, Nikolas; Klausner, Jeffrey D

    2016-01-01

    Although poor clinic attendance is associated with increased morbidity and mortality among HIV-infected individuals, less is known about predictors of retention and the acceptability of targeted interventions to increase regular clinic attendance. To better understand which patients are at risk for irregular clinic attendance and to explore interventions to aid in retention to care, we surveyed patients attending two outpatient HIV clinics affiliated with the University of California, San Francisco. A total of 606 participants were surveyed, and the analysis was restricted to the 523 male respondents. Of this group, 45% (N = 299) reported missing at least one visit a year. Missing a clinic visit was associated with being African American (aOR = 1.99; 95%CI 1.12-3.52), being a man who has sex with both men and women (aOR=2.72; 95%CI 1.16-6.37), and reporting at least weekly methamphetamine use (aOR=5.79; 95%CI 2.47-13.57). Participants who reported a monthly income greater than $2000 were less likely to miss an appointment (aOR = 0.56; 95%CI 0.34-0.93). Regarding possible retention interventions, most patients preferred phone calls over other forms of support. These findings support the need for ongoing engagement support with particular attention to at-risk sub-groups.

  9. Predictive validity of the ASAM Patient Placement Criteria for naturalistically matched vs. mismatched alcoholism patients.

    PubMed

    Magura, Stephen; Staines, Graham; Kosanke, Nicole; Rosenblum, Andrew; Foote, Jeffrey; DeLuca, Alexander; Bali, Priti

    2003-01-01

    This study examined the predictive validity of the ASAM Patient Placement Criteria for matching alcoholism patients to recommended levels of care. A cohort of 248 patients newly admitted to inpatient rehabilitation, intensive outpatient, or regular outpatient care was evaluated using both a computerized algorithm and a clinical evaluation protocol to determine whether they were naturalistically matched or mismatched to care. Outcomes were assessed three months after intake. One common type of undertreatment (ie, receiving regular outpatient care when intensive outpatient care was recommended) predicted poorer drinking outcomes as compared with matched treatment, independent of actual level of care received. Overtreatment did not improve outcomes. There also was a trend for better outcomes with residential vs. intensive outpatient treatment, independent of matching. Results were robust for both methods of assessment. Corroboration by more research is needed, but the ASAM Criteria show promise for reducing both detrimental undertreatment and cost-inefficient overtreatment.

  10. Brief Report: Excessive Alcohol Use Negatively Affects the Course of Adolescent Depression--One Year Naturalistic Follow-Up Study

    ERIC Educational Resources Information Center

    Meririnne, Esa; Kiviruusu, Olli; Karlsson, Linnea; Pelkonen, Mirjami; Ruuttu, Titta; Tuisku, Virpi; Marttunen, Mauri

    2010-01-01

    The impact of alcohol use on the course of adolescent depression over one-year was investigated by following 197 consecutive adolescent outpatients with unipolar depression in a naturalistic treatment setting. Their baseline alcohol consumption was categorized in three groups: excessive use (defined as weekly drunkenness), regular use (monthly…

  11. DBT in an outpatient forensic setting.

    PubMed

    van den Bosch, L M C; Hysaj, M; Jacobs, P

    2012-01-01

    Literature shows that effective treatment of borderline personality disorder (BPD) has become possible. However, borderline patients in forensic psychiatry do not seem to benefit from this development. In forensic psychiatry, prevention of criminal recidivism is the main focus of treatment, not core borderline problems like parasuicidal and self-destructive behavior. A dialectical behavioral treatment program for BPD was implemented in an outpatient forensic clinic in The Netherlands. Sociodemographic, clinical, and treatment data were collected from ten male, and nineteen female forensic BPD patients, and compared with corresponding data from fifty-eight non-forensic BPD patients. The results show that it is possible to implement dialectical behavior therapy in an outpatient forensic clinic. The data indicate that the exclusion of forensic patients, and especially female forensic patients, from evidence-based treatment is unjustified given the highly comparable clinical and etiological characteristics they share with female BPD patients from general mental health settings.

  12. Outpatient commitment and procedural due process.

    PubMed

    Player, Candice Teri-Lowe

    2015-01-01

    A large empirical literature on Kendra's Law has assessed the impact of court ordered outpatient treatment on outcomes such as treatment adherence, psychiatric hospitalization, quality of life, and treatment costs. Missing from the empirical literature, however, is a better understanding of procedural due process under Kendra's Law. Procedural due process concerns the safeguards that must be in place when governments deprive persons of their liberties, for example--notice, the right to a hearing and the right to appeal. This article reports the findings from a qualitative study of procedural due process and assisted outpatient treatment hearings under Kendra's Law. Attorneys reported significant barriers to effective advocacy on behalf of their clients. Further, despite the shift from a medical model of civil commitment to a judicial model in the 1970s, by and large judges continue to accord great deference to clinical testimony.

  13. Technology and outpatient review: a preliminary evaluation.

    PubMed

    Bergman, A; Henderson, M; Cline, J L

    1990-06-01

    Most health care utilization and cost control programs focus on inpatient care or on high-cost, catastrophic illnesses or injuries. Recently, however, Parkside Health Management Corporation has developed a utilization review program that targets treatments and high-technology procedures performed primarily in an outpatient setting, as well as specific inpatient procedures not included in other review programs. These include chiropractic, podiatric, and physical therapy treatments; cesarean section; and endoscopy, ultrasound in pregnancy, and lithotripsy. The treatments/procedures examined in this program, called Technology and Outpatient Review (TOR), account for approximately 6% of claims expenses. Bigel Institute for Health Policy researchers are evaluating a pilot test to determine TOR's effect on health care costs and utilization, appropriateness, and patient satisfaction.

  14. Psychiatric monitoring of not guilty by reason of insanity outpatients.

    PubMed

    Almeida, Fernando; Moreira, Diana; Moura, Helena; Mota, Victor

    2016-02-01

    Individuals deemed Not Guilty by Reason of Insanity (NGRI) by the courts, under Article 20 of the Portuguese Criminal Code, have often committed very serious crimes. It is unreasonable to consider that these patients were usually kept without adequate supervision after the security measure had been declared extinct. They often decompensated after leaving the institution where they complied with the security measure, and/or relapsed to alcohol and drug abuse. Very often, severe repeated crime erupted again. Considering this, there was an urgent need to keep a follow-up assessment of these patients in order to prevent them from relapsing in crime. This work presents the results of a psychiatric follow-up project with NGRI outpatients. The main goals of the project were: ensuring follow-up and appropriate therapeutic responses for these patients, maintaining all individuals in a care network, and preventing them from decompensating. The team consisted of a psychiatrist, a nurse, and a psychologist. Seventy-two patients were monitored during two years. Results demonstrated the unequivocal need to follow up decompensated patients after the court order is extinguished. Suggestions are presented for a better framing and psychiatric follow-up of these patients.

  15. Factors associated with problematic drug use among psychiatric outpatients 1

    PubMed Central

    Corradi-Webster, Clarissa Mendonça; Gherardi-Donato, Edilaine Cristina da Silva

    2016-01-01

    ABSTRACT Objective: to examine the factors associated with problematic drug use among psychiatric outpatients. Method: a cross-sectional study was carried out in two mental health services. Eligible individuals were patients of these mental health services, who used them within the data collection period. Instruments: standardized questionnaire with sociodemographic, social network, social harm, and clinical information; Alcohol, Smoking and Substance Involvement Screening Test; Barratt Impulsiveness Scale; Holmes and Rahe Stress Scale. Statistical analysis was performed using parametric statistics considering a significance level of p ≤ 0.05. Study participants were 243 patients, with 53.9% of these presenting problematic drug use. Results: the most important independent predictors of problematic drug use were marital status (OR = 0.491), religious practice (OR = 0.449), satisfaction with financial situation (OR = 0.469), having suffered discrimination (OR = 3.821) and practicing sports activities in previous 12 months (OR = 2.25). Conclusion: the variables found to be predictors were those related to the social context of the patient, there, it is recommended that mental health services valorize psychosocial actions, seeking to know the social support network of patients, their modes of socialization, their financial needs, and their experiences of life and suffering. PMID:27901217

  16. Drug dreams in outpatients with bipolar disorder and cocaine dependence.

    PubMed

    Yee, Tonia; Perantie, Dana C; Dhanani, Nafisa; Brown, E Sherwood

    2004-03-01

    Patients with substance abuse or dependence often have dreams about alcohol or drugs during early recovery. However, the literature on drug dreams in rehabilitating patients with drug-related disorders remains limited. No data are available on drug dreams in people with substance-related disorders and other major mental illness. As part of a large study on the use of lamotrigine in patients with bipolar disorder and cocaine dependence, the frequency and nature of drug dreams, triggers for dreams, and response to the dreams during study participation were assessed in 37 outpatients for as long as 36 weeks. Altogether, 74% of participants experienced at least one drug dream during the study. Furthermore, drug dreams rapidly decreased during study participation. The presence of drug dreams at baseline did not predict mood, cocaine craving, or drug use at exit. No clear risk factors for drug dreams were identified. However, drug dreams were related to survival in the study by a negative U-shaped curve relationship in which those participants with the highest and lowest frequency of drug dreams discontinued from the study the earliest. Content of the dreams frequently included drug use or refusing to use the drug. Dreams of drug use tended to occur during the first few weeks of study participation. Most dreams were associated with triggers for drug use. The findings suggest that drug dreams are common in patients with bipolar disorder and cocaine dependence and are similar in nature to those previously reported in people with pure substance abuse.

  17. Outpatient laser tonsillar ablation under local anaesthetic.

    PubMed

    Andrews, Peter J; Latif, Abdul

    2004-11-01

    Outpatient laser ablation of the palatine tonsils under local anaesthetic is an alternative technique to capsular tonsillectomy for recurrent tonsillitis under general anaesthetic. Laser tonsillotomy ablates up to 70% of the tonsillar tissue and is performed when patients choose not to have a conventional tonsillectomy, or are unfit for a general anaesthetic. The technique described here is an adaptation of Krespis' laser-assisted serial tonsillectomy (LAST) whereby only one sitting is required. Krespis' technique effectively eliminates recurrent tonsillitis in 96% of the cases over a 4-year follow-up period and represents the only substantial study looking at treating recurrent tonsillitis with outpatient laser ablation. This study is a retrospective postal survey of 19 patients who underwent laser tonsillar ablation under local anaesthetic for recurrent chronic tonsillitis from 1997 to 2001 and was performed in liaison with the clinical audit department at Basildon Hospital. We had a response rate of 74% and an admission rate of 0%, which compares favourably with day case tonsillectomy surgery. Of the patients, 75% did not experience further episodes of tonsillitis 12 months after the procedure and 77% of the patients were glad they had the operation. Although this technique does not completely eliminate tonsillitis, it offers an alternative for those patients who prefer a procedure that is done quickly in an outpatient setting without the additional problems of general anaesthesia, overnight hospital admission and long waiting lists.

  18. Disparities in internet use among orthopedic outpatients.

    PubMed

    Walsh, Kenneth P; Rehman, Saqib; Goldhirsh, Jessie

    2014-02-01

    Internet access has lagged behind for patients with lower incomes and from certain ethnic groups. This study investigated the possible improvement of access to health-related information on the Internet for all patients in an urban outpatient setting, regardless of socioeconomic background. A 28-question survey was completed by 100 orthopedic outpatients evaluating associations between their age, ethnicity, income, or education level and their access to the Internet. The survey also examined how patients used the Internet to obtain information about their medical condition, their privacy concerns when conducting online research, and their use of mobile phones as a primary means of Internet access. The Internet was used by 57% of orthopedic outpatients in this urban setting. Internet access decreased with advancing age but increased with increasing income and education, findings consistent with similar studies. Despite the inability to identify an association between ethnicity and Internet access in this patient population, fewer Latinos (33%) than whites (67%) or African Americans (77%) sought information about their medical condition. Among patients who used a mobile phone as the primary method for online access, 74% were African American or Latino and 26% were white. This difference in mobile phone use for online access suggests that mobile phones have provided ethnic minorities with greater Internet access and thus may have narrowed the digital divide among the races.

  19. Deciding to quit drinking alcohol

    MedlinePlus

    ... Alcohol abuse - quitting drinking; Quitting drinking; Quitting alcohol; Alcoholism - deciding to quit ... pubmed/23698791 . National Institute on Alcohol Abuse and Alcoholism. Alcohol and health. www.niaaa.nih.gov/alcohol- ...

  20. Cancer morbidity in alcohol abusers.

    PubMed Central

    Tønnesen, H.; Møller, H.; Andersen, J. R.; Jensen, E.; Juel, K.

    1994-01-01

    Data on the association between alcohol abuse and cancer morbidity are scarce in large cohorts of non-hospitalised alcoholic men and women. Of 18,368 alcohol abusers who entered an outpatient clinic in Copenhagen during 1954-87, 18,307 were followed and their cancer incidence was compared with that of the total Danish population. On average the 15,214 men were observed for 12.9 years and the 3,093 women for 9.4 years. The overall morbidity of cancer was increased significantly. Of the men, 1,441 developed cancer [relative risk (RR) = 1.6; 95% confidence interval (CI) = 1.5-1.7], while 182 women did (RR = 1.5; 95% CI 1.3-1.8). Significantly increased incidences were found of cancer in the tongue, mouth, pharynx, oesophagus, liver, larynx, lung and pleura and secondary cancer. The women had significantly increased risk of cervical cancer (RR = 2.0; 95% CI 1.2-3.0). The men developed prostatic cancer significantly more frequently than expected (RR = 1.4; 95% CI 1.2-1.8). The risk of melanomas (RR = 0.5; 95% CI 0.2-0.8) was significantly lower than expected. The relative risks of cancer of the stomach, pancreas, kidney and endocrine system were only slightly increased. The study group did not develop more colonic (RR = 1.0; 95% CI 0.8-1.3) or rectal cancer (RR = 1.0; CI 0.7-1.3) than expected. The risk of breast cancer in women was slightly increased (RR = 1.3; 95% CI 0.9-1.7), but not statistically significant. Thus, the associations between alcohol and cancer of the upper digestive and respiratory tract and the liver are confirmed. In addition, this study indicates an increased occurrence of cancer of the prostate gland, pleura and uterine cervix in alcohol abusers. PMID:8297729

  1. Flight Attendant Fatigue, Part 1: National Duty, Rest, and Fatigue Survey

    DTIC Science & Technology

    2009-12-01

    counter medications, 20% indicated they used alcohol, and 9% used melatonin to help them sleep . Flight attendants were asked to rate 22 factors and an...rhythms for managing sleep and alertness. In fact, acute sleep loss, sustained periods of wakefulness, and circadian factors resulting from this...and duty time, sleep , health, fatigue, work environment, and general demographics. Participants were 9,180 cabin crewmembers who voluntarily and

  2. Alcohol consumption among rural African American and White adolescents: The role of religion, parents, and peers.

    PubMed

    Dickens, Danielle D; Jackman, Danielle M; Stanley, Linda R; Swaim, Randall C; Chavez, Ernest L

    2016-05-31

    Although studies have examined ethnic differences in psychosocial factors and adolescent alcohol use, most have not examined these relationships for rural adolescents. The Community Drug and Alcohol Survey (CDAS) was completed by 23,163 rural adolescents attending African American secondary schools. Multilevel analysis tested the hypothesis of stronger relationships of peer use and religiosity with alcohol use and a weaker relationship for parental permissiveness and alcohol use for White compared to African American adolescents. Results suggested that peer use, religiosity, and parental permissiveness were more strongly associated with changes in alcohol use for White adolescents. Findings provide insight for alcohol prevention among rural adolescents.

  3. Variables Associated with Therapy Attendance in Runaway Substance Abusing Youth: Preliminary Findings

    PubMed Central

    SLESNICK, NATASHA

    2008-01-01

    Service providers and researchers note that youth with substance abuse problems are difficult to engage in treatment and, when engaged, often drop out early. Estimates of the alcohol and drug abuse rate of runaway youth range from 70% to 95%. This study evaluated predictors of therapy attendance in a sample of substance abusing youth recruited through two southwestern runaway shelters. Runaway youth and their families (N = 36) were engaged into a 15-session ecologically-based family therapy (EBFT) intervention. Fewer days between the pretreatment assessment and the first therapy session, as well as less perceived parental care, predicted more therapy sessions attended. No relationship was found between level of substance use and treatment attendance. The findings highlight the importance of engaging families in therapy soon after the youth’s arrival to the shelter, as treatment motivation may decrease as the crisis lessens. PMID:18596885

  4. School attendance, health-risk behaviors, and self-esteem in adolescents applying for working papers.

    PubMed Central

    Suss, A. L.; Tinkelman, B. K.; Freeman, K.; Friedman, S. B.

    1996-01-01

    Since health-risk behaviors are often encountered in clusters among adolescents, it was hypothesized that adolescents with poor school attendance would be associated with more health-risk behaviors (e.g., substance use, violence) than those who attend school regularly. This study assessed the relationship between poor school attendance and health-risk behaviors, and described health-risk behaviors and self-esteem among adolescents seeking employment. In this cross-sectional study, school attendance (poor vs. regular attendance) was related to health-risk behaviors by asking 122 subjects seen at a New York City Working Papers Clinic to complete both a 72-item questionnaire about their health-risk behaviors and the 58-item Coopersmith Self-Esteem School Form Inventory. Chi-square and Fisher's Exact Tests were performed. The poor and regular attenders of school differed significantly in only 5 out of 44 items pertaining to health-risk behaviors. Self-esteem measures for the two groups did not differ from one another or from national norms. In this sample, depression "in general" (global) and "at home," but not "at school," were associated significantly with suicidal thoughts/attempts and serious past life events (e.g. family conflict, sexual abuse). There were no significant associations between depression or self-esteem and illicit substance or alcohol use. We found few associations between poor school attendance and health-risk behaviors in this sample of employment-seeking adolescents. The poor and regular attenders of school were similar in most aspects of their health-risk behaviors and self-esteem. PMID:8982520

  5. The Influence of Religious Attendance on Smoking

    PubMed Central

    Brown, Qiana L.; Linton, Sabriya L.; Harrell, Paul T.; Mancha, Brent Edward; Alexandre, Pierre K.; Chen, Kuan-Fu; Eaton, William W.

    2014-01-01

    Generalized linear models were used to assess the relationship between religious attendance and lifetime smoking status among middle-aged adults (n = 666) sampled from waves three (1993 to 1996) and four (2004 to 2005) of the Baltimore Epidemiologic Catchment Area (ECA) study. Religious attendance once per week or greater as compared to never was inversely associated with smoking status. Future research should explore potential mediating factors of the association between religious attendance and smoking among middle-aged adults in order to gain a greater understanding of the mechanisms underlying this relationship. Funding: NIMH grant DA026652; NIDA grant T32DA007292. PMID:24827865

  6. Academic Success Groups for Middle-School Children with ADHD in the Outpatient Mental Health Setting – An Open Trial

    PubMed Central

    Ciesielski, Heather; Tamm, Leanne; Vaughn, Aaron; Cyran, Jessica; Epstein, Jeff

    2015-01-01

    Objective To conduct an open trial assessing the initial efficacy of an intervention focusing on increasing skills related to academic performance (planning, organization, studying, homework behaviors) for middle-school children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). The intervention is modeled on evidence-based interventions but designed for administration in the outpatient setting. Method Parents and their children diagnosed with ADHD attended 7 weekly group sessions targeting academic, organizational, and homework skills. Parents completed the Homework Problem Checklist and Impairment Rating Scale pre- and post-treatment. Results Following intervention, significant improvements in homework completion and management, as well as reductions in academic impairment and improvements in parent confidence and family relations were reported. Conclusion Despite limitations including small sample size and lack of a control group, our results demonstrate initial efficacy of an academic skills intervention designed for use in the outpatient setting with middle-school children diagnosed with ADHD on clinically relevant outcome measures. PMID:25926629

  7. The current situation of treatment systems for alcoholism in Korea.

    PubMed

    Kim, Jee Wook; Lee, Boung Chul; Kang, Tae-Cheon; Choi, Ihn-Geun

    2013-02-01

    Alcoholism is becoming one of the most serious issues in Korea. The purpose of this review article was to understand the present status of the treatment system for alcoholism in Korea compared to the United States and to suggest its developmental direction in Korea. Current modalities of alcoholism treatment in Korea including withdrawal treatment, pharmacotherapy, and psychosocial treatment are available according to Korean evidence-based treatment guidelines. Benzodiazepines and supportive care including vitamin and nutritional support are mainly used to treat alcohol withdrawal in Korea. Naltrexone and acamprosate are the drugs of first choice to treat chronic alcoholism. Psychosocial treatment methods such as individual psychotherapy, group psychotherapy, family therapy, cognitive behavior therapy, cue exposure therapy, 12-step facilitation therapy, self-help group therapy, and community-based treatment have been carried out to treat chronic alcoholism in Korea. However, current alcohol treatment system in Korea is not integrative compared to that in the United States. To establish the treatment system, it is important to set up an independent governmental administration on alcohol abuse, to secure experts on alcoholism, and to conduct outpatient alcoholism treatment programs and facilities in an open system including some form of continuing care.

  8. The Ties That Bind: Bonding Versus Bridging Social Capital and College Student Party Attendance

    PubMed Central

    Buettner, Cynthia K.; Debies-Carl, Jeffrey S.

    2012-01-01

    Objective: This study explored the relationship between bonding and bridging social capital and college student attendance at alcohol-present parties, a common method for building informal social networks. Method: A random sample of students (n = 6,291; 52% female) from a large public midwestern university completed a survey regarding their alcohol use and party-related behaviors on targeted weekends. The survey also included questions regarding students’ living arrangements, romantic relationships, and membership in student and community organizations. Results: Based on a dichotomous logistic regression analysis, we concluded that the act of attending parties largely serves as a complement to, rather than a substitute for, more conventional and formal social capital. Membership in bonding groups is associated with increased odds of party attendance, and bridging exerts no direct effect on party attendance. However, bridging capital does mitigate the effect of bonding capital, reducing its apparent tendency to promote or contribute to partying. Conclusions: Off-campus parties may offer an informal supplement to more conventional social capital as students establish themselves in their new context. These findings may have implications for structural decisions (e.g., number of roommates) as well as the design of context-based prevention programs that address students’ need to quickly build social capital without exposing both themselves and the students around them to the harms associated with high-risk drinking. PMID:22630799

  9. Alcoholic sialosis.

    PubMed

    Kastin, B; Mandel, L

    2000-01-01

    Sialosis (sialadenosis) is a term used to describe a disorder that involves both secretory and parenchymal changes of the major salivary glands, most commonly the parotid. Seen often in a dental office, it is recognized as an indolent, bilateral, non-inflammatory, non-neoplastic, soft, symmetrical, painless and persistent enlargement of the parotid glands. Four major entities have commonly been associated with this disorder. They are alcoholism, endocrinopathy (particularly diabetes mellitus), maLnutrition and idiopathic. We are reporting a case of alcoholic sialosis with its clinical and diagnostic aspects. It is important for the dental practitioner to recognize sialosis, because it often indicates the existence of an unsuspected systemic disease.

  10. Illness perception of dropout patients followed up at bipolar outpatient clinic, Turkey.

    PubMed

    Oflaz, Serap; Guveli, Hulya; Kalelioglu, Tevfik; Akyazı, Senem; Yıldızhan, Eren; Kılıc, Kasım Candas; Basyigit, Sehnaz; Ozdemiroglu, Filiz; Akyuz, Fatma; Gokce, Esra; Bag, Sevda; Kurt, Erhan; Oral, Esat Timucin

    2015-06-01

    Dropout is a common problem in the treatment of psychiatric illnesses including bipolar disorders (BD). The aim of the present study is to investigate illness perceptions of dropout patients with BD. A cross sectional study was done on the participants who attended the Mood Disorder Outpatient Clinic at least 3 times from January 2003 through June 2008, and then failed to attend clinic till to the last one year, 2009, determined as dropout. Thirty-nine dropout patients and 39 attendent patients with BD were recruited for this study. A sociodemographic form and brief illness perception questionnaire were used to capture data. The main reasons of patients with BD for dropout were difficulties of transport (31%), to visit another doctor (26%), giving up drugs (13%) and low education level (59%) is significant for dropout patients. The dropout patients reported that their illness did not critically influence their lives, their treatment had failed to control their illnesses, they had no symptoms, and that their illness did not emotionally affect them. In conclusion, the nonattendance of patients with serious mental illness can result in non-compliance of therapeutic drug regimens, and a recurrence of the appearance symptoms. The perception of illness in dropout patients with BD may be important for understanding and preventing nonattendance.

  11. Comorbid Illness, Bowel Preparation, and Logistical Constraints Are Key Reasons for Outpatient Colonoscopy Nonattendance

    PubMed Central

    Chopra, Deepti

    2016-01-01

    Background. Colonoscopy nonattendance is a challenge for outpatient clinics globally. Absenteeism results in a potential delay in disease diagnosis and loss of hospital resources. This study aims to determine reasons for colonoscopy nonattendance from a Canadian perspective. Design. Demographic data, reasons for nonattendance, and patient suggestions for improving compliance were elicited from 49 out of 144 eligible study participants via telephone questionnaire. The 49 nonattenders were compared to age and sex matched controls for several potential contributing factors. Results. Nonattendance rates were significantly higher in winter months; the OR of nonattendance was 5.2 (95% CI, 1.6 to 17.0, p < 0.001) in winter versus other months. Being married was positively associated with attendance. There was no significant association between nonattendance and any of the other variables examined. The top 3 reasons for nonattendance were being too unwell to attend the procedure, being unable to complete bowel preparation, or experiencing logistical challenges. Conclusions. Colonoscopy attendance rates appear to vary significantly by season and it may be beneficial to book more colonoscopies in the summer or overbook in the winter. Targets for intervention include more tailored teaching sessions, reminders, taxi chits, and developing a hospital specific colonoscopy video regarding procedure and bowel preparation requirements. PMID:27478818

  12. Alcohol and pregnancy

    MedlinePlus

    Drinking alcohol during pregnancy; Fetal alcohol syndrome - pregnancy; FAS - fetal alcohol syndrome ... group of defects in the baby known as fetal alcohol syndrome. Symptoms can include: Behavior and attention problems Heart ...

  13. Alcohol and Hepatitis

    MedlinePlus

    ... Home » Living with Hepatitis » Daily Living: Alcohol Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... Alcohol for Veterans and the Public Alcohol and Hepatitis: Entire Lesson Overview Alcohol is one of the ...

  14. Alcohol and Hepatitis

    MedlinePlus

    ... code here Enter ZIP code here Daily Living: Alcohol for Veterans and the Public Alcohol and Hepatitis: Entire Lesson Overview Alcohol is one ... related to choices you make about your lifestyle . Alcohol and fibrosis Fibrosis is the medical term for ...

  15. Is alcohol more dangerous than heroin? The physical, social and financial costs of alcohol.

    PubMed

    Lee, Geraldine A; Forsythe, Marcus

    2011-07-01

    A recent paper claimed in its classification of harmful substances, that alcohol is more dangerous than heroin. This paper aims to weigh up some of the evidence in the literature on the physical, social and financial effects of alcohol and the associated disease burden. We will also explore alcohol within the context of emergency department (ED) presentations. Reasons for ED attendance can be overtly and directly alcohol related such as alcohol intoxication, assaults, injuries and falls and indirectly such as child neglect, psychological problems and chronic diseases. Alcohol is often viewed as an isolated incident or factor for ED presentations but there are data that refute this perception. In ED, the priority is to treat the patient and their primary complaint, however it may be appropriate to screen for alcohol use, give advice and potentially offer an intervention to the patient. With the recent UK and Australian guidelines on reducing health risks from drinking alcohol, the ED has the ability to play an active role in reducing the harmful effects of alcohol through screening, advising and undertaking intervention as appropriate. However this cannot be achieved in isolation but within the broader political and health policy framework. There is now a growing body of literature supporting the need to make alcohol less affordable, less easy to buy and reducing alcohol advertising. Although alcohol is a legal substance, this paper concludes that examining the wider effects in physical, social and financial terms, alcohol is more dangerous than heroin. It has become an endemic problem in society affecting the individual and the whole community.

  16. Training traditional birth attendants in southern Sudan.

    PubMed

    Haarsager, Mary

    2008-01-01

    Traditional birth attendants are currently the principal service providers to pregnant women in southern Sudan. A training program provides education to promote maternal and newborn health as well as birth preparedness and establishes mechanisms for supportive supervision.

  17. Evaluation of the Alcohol Education Discipline Program (AEDP) for the 1986-87 Academic Year. Alcohol Abuse Intervention and Prevention Program.

    ERIC Educational Resources Information Center

    Rapaport, Ross J.; Look, Sherri

    The Alcohol Education Discipline Program (AEDP) is a program offered as a service to the Office of Student Life at Central Michigan University. Students are required to attend the program's five 50-minute sessions as a condition of disciplinary probation for alcohol-related infractions of the Student Code of Conduct. This paper reports reactions…

  18. Thai men’s experiences of alcohol addiction and treatment

    PubMed Central

    Hanpatchaiyakul, Kulnaree; Eriksson, Henrik; Kijsompon, Jureerat; Östlund, Gunnel

    2014-01-01

    Background Men are overrepresented with regard to alcohol addiction and in terms of alcohol treatment worldwide. In Thailand, alcohol consumption continues to rise, but few of those afflicted with alcohol addiction attend alcohol treatment programs, even though there is universal care for all. No comprehensive studies have been done on men’s experiences with addiction and alcohol treatment programs in Thailand. Objective The aim of this study was to explore men’s experiences in terms of the ‘pros and cons of alcohol consumption’ in order to identify the barriers that exist for Thai men with regard to alcohol addiction and the decision to stop drinking. Design Purposive sampling was applied in the process of recruiting participants at an alcohol clinic in a hospital in Thailand. Thirteen men with alcohol addiction (aged 32–49 years) were willing to participate and were interviewed in thematic interviews. The analysis of the data was done with descriptive phenomenology. Results Through men’s descriptions, three clusters of experiences were found that were ‘mending the body’, ‘drinking as payoff and doping related to work’, and ‘alcohol becoming a best friend’ as ways of describing the development of addiction. Conclusions The results highlight the importance of addressing concepts of masculinity and related hegemonic ideas in order to decrease the influence of the barriers that exist for Thai men with alcohol addiction with regard to entering treatment and to stop drinking. PMID:24845212

  19. Optimizing pain care delivery in outpatient facilities: experience in NCI, Cairo, Egypt.

    PubMed

    Hameed, Khaled Abdel

    2011-04-01

    As a result of increasing waiting lists of patients attending National Cancer Institute of Cairo, we are faced to provide high-quality pain care service through our outpatient pain clinic. The program description presented here shows the capacity of a 24 hours/7 days outpatient cancer pain management service to provide rapidly accessible, high-quality care to patients with complex pain and palliative care symptom burdens. In addition, this model avoids inpatient hospital admissions. Pain clinics of cancer are committed to helping patients and families identify and implement the treatments necessary to achieve optimum functional ability and the best possible quality of life. These clinics also help to communicate and work with the family physician, surgeon, and other physicians associated with patient treatment. Cancer pain is complex in its causes, and affects all parts of the body. It involves the tissues, body systems , and the mind. Being multidimensional, it is never adequately addressed with unidimensional treatment. Pain management must extend beyond physical approaches to include the psychological, social, and even spiritual aspects of the patient. Effective integrated treatment fosters self awareness and teaches appropriate and effective self care. With time, complex issues are managed, pain is reduced, and the patient moves toward peak physical and psychological functioning. These goals can be achieved by providing the highest quality pain management services. Patients attending the clinic get treated medically for their physical ailments. Their emotional and psychological problems also need to be attended with an atmosphere of love and care. The mission of the highest quality service is to obtain customer satisfaction with reduction of cost in a multidisciplinary (or better interdisciplinary) approach. This can be reached by proper identification of the customers either internal or external, assessing their needs, and implementing plans for their

  20. Alcoholism and Minority Populations.

    ERIC Educational Resources Information Center

    Watts, Thomas D.; Wright, Roosevelt, Jr.

    1991-01-01

    Briefly discusses some aspects of the role of the state and the position of minorities in respect to alcoholism policies and services. Includes case study of a Black alcoholic. Refers readers to studies on Black alcoholism, Native American alcoholism, Hispanic alcoholism, and Asian-American alcoholism. (Author/NB)

  1. Propargyl alcohol

    Integrated Risk Information System (IRIS)

    Propargyl alcohol ; CASRN 107 - 19 - 7 Human health assessment information on a chemical substance is included in the IRIS database only after a comprehensive review of toxicity data , as outlined in the IRIS assessment development process . Sections I ( Health Hazard Assessments for Noncarcinogenic

  2. Allyl alcohol

    Integrated Risk Information System (IRIS)

    Allyl alcohol ; CASRN 107 - 18 - 6 Human health assessment information on a chemical substance is included in the IRIS database only after a comprehensive review of toxicity data , as outlined in the IRIS assessment development process . Sections I ( Health Hazard Assessments for Noncarcinogenic Eff

  3. Isobutyl alcohol

    Integrated Risk Information System (IRIS)

    Isobutyl alcohol ; CASRN 78 - 83 - 1 Human health assessment information on a chemical substance is included in the IRIS database only after a comprehensive review of toxicity data , as outlined in the IRIS assessment development process . Sections I ( Health Hazard Assessments for Noncarcinogenic E

  4. Antiplatelet resistance in outpatients with monitored adherence.

    PubMed

    Walter, Philipp N; Tsakiris, Dimitrios A; Romanens, Michel; Arnet, Isabelle; Hersberger, Kurt E

    2014-01-01

    Antiplatelet resistance with aspirin and clopidogrel has been associated with clinical, cellular and pharmacogenetic factors; and non-adherence has been considered as a major contributor to resistance in outpatients. We aimed at assessing factors to resistance when adherence to the antiplatelet drugs and all other oral solid drugs was controlled for. In a pilot study, we tested arachidonic acid and/or ADP-induced in vitro platelet aggregation of 82 outpatients with chronic aspirin and/or clopidogrel treatment before and after a one-week period of measuring the patient's adherence with the polymedication electronic monitoring system (POEMS). Resistance was found in 20% (aspirin; n = 69) and 25% (clopidogrel; n = 32) of the patients after monitored adherence. Mean platelet aggregation was not (aspirin) or non-significantly (clopidogrel) lowered when compared to baseline. Diabetes mellitus and inflammation were consistently associated with resistance to both drugs, but CYP2C19 polymorphisms could not be confirmed as predictors of clopidogrel response. Electronically compiled multidrug dosing histories allowed the concomitant intake of high-dose lipophilic statins to be identified as a risk factor of impaired response to clopidogrel and revealed that exposure to further potential drug-drug interactions (DDIs) was too low for analysis. Multidrug adherence monitoring allowed thus dismissing non-adherence as a major contributor to resistance and inter-individual response variability in an outpatient setting. Additionally, it allowed analysing the impact of DDIs according to the actual exposure to the potentially interfering drugs. Further studies based on this methodology are essential to prevent misleading results due to incomplete adherence and gain additional insight into the impact of timing adherence on antiplatelet drug response.

  5. Involuntary outpatient treatment (IOT) in Spain.

    PubMed

    Hernández-Viadel, M; Cañete-Nicolás, C; Bellido-Rodriguez, C; Asensio-Pascual, P; Lera-Calatayud, G; Calabuig-Crespo, R; Leal-Cercós, C

    2015-01-01

    In recent decades there have been significant legislative changes in Spain. Society develops faster than laws, however, and new challenges have emerged. In 2004, the Spanish Association of Relatives of the Mentally Ill (FEAFES) proposed amending the existing legislation to allow for the implementation of involuntary outpatient treatment (IOT) for patients with severe mental illness. Currently, and after having made several attempts at change, there is no specific legislation governing the application of this measure. Although IOT may be implemented in local programmes, we consider legal regulation to be needed in this matter.

  6. Management of hypertension in the outpatient setting.

    PubMed

    Sica, Domenic A

    2008-09-01

    The treatment of hypertension on an outpatient basis should be approached in a systematic manner. The diagnosis of hypertension should always be verified first before treatment is initiated and, where indicated, a workup should be done. Lifestyle modifications should be considered in all patients with hypertension. Blood pressure can be brought to goal in the majority of patients if antihypertensive medications are correctly dosed or combined. As blood pressure is brought to goal in the patient with hypertension, ongoing attention should be directed to long-term adherence to therapy.

  7. Evaluation of a rapid assay for detection of Chlamydia trachomatis infections in outpatient clinics in South Kalimantan, Indonesia.

    PubMed

    Widjaja, S; Cohen, S; Brady, W E; O'reilly, K; Susanto; Wibowo, A; Cahyono; Graham, R R; Porter, K R

    1999-12-01

    A multicenter cross-sectional survey was conducted comparing a commercially available chlamydial optical immunoassay (OIA) to the chlamydial ligase chain reaction (LCR). Endocervical samples from 415 outpatients visiting clinics from three hospitals in South Kalimantan, Indonesia, were evaluated. Relative to the LCR, the overall sensitivity and specificity of the OIA were 31.6 and 98.9%, respectively. The sensitivity of the OIA varied among the three hospital laboratories, ranging from 20 to 50%. The OIA performance was slightly lower on samples from patients attending dermatovenereology clinics than on samples from nondermatovenereology clinic patients. The results indicate that the OIA did not perform well compared to LCR.

  8. Evaluation of a Rapid Assay for Detection of Chlamydia trachomatis Infections in Outpatient Clinics in South Kalimantan, Indonesia

    PubMed Central

    Widjaja, Susana; Cohen, Surekha; Brady, William E.; O'reilly, Kevin; Susanto; Wibowo, Ajar; Cahyono; Graham, Robert R.; Porter, Kevin R.

    1999-01-01

    A multicenter cross-sectional survey was conducted comparing a commercially available chlamydial optical immunoassay (OIA) to the chlamydial ligase chain reaction (LCR). Endocervical samples from 415 outpatients visiting clinics from three hospitals in South Kalimantan, Indonesia, were evaluated. Relative to the LCR, the overall sensitivity and specificity of the OIA were 31.6 and 98.9%, respectively. The sensitivity of the OIA varied among the three hospital laboratories, ranging from 20 to 50%. The OIA performance was slightly lower on samples from patients attending dermatovenereology clinics than on samples from nondermatovenereology clinic patients. The results indicate that the OIA did not perform well compared to LCR. PMID:10565960

  9. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... hospice benefit: (1) Antigens. (2) Splints and casts. (3) Hepatitis B vaccine. (e) Effective January 1... prospective payment system for the following: (a) Medicare Part B services furnished to hospital outpatients designated by the Secretary under this part. (b) Services designated by the Secretary that are covered...

  10. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... hospice benefit: (1) Antigens. (2) Splints and casts. (3) Hepatitis B vaccine. (e)(1) Effective January 1... prospective payment system for the following: (a) Medicare Part B services furnished to hospital outpatients designated by the Secretary under this part. (b) Services designated by the Secretary that are covered...

  11. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... hospice benefit: (1) Antigens. (2) Splints and casts. (3) Hepatitis B vaccine. (e)(1) Effective January 1... prospective payment system for the following: (a) Medicare Part B services furnished to hospital outpatients designated by the Secretary under this part. (b) Services designated by the Secretary that are covered...

  12. Core components of clinical education: a qualitative study with attending physicians and their residents

    PubMed Central

    ESTEGHAMATI, ALIREZA; BARADARAN, HAMIDREZA; MONAJEMI, ALIREZA; KHANKEH, HAMID REZA; GERANMAYEH, MEHRNAZ

    2016-01-01

    Introduction In medical education, particularly in residency courses, most of the training occurs in real clinical environments. Workplace-based learning profoundly affects students’ knowledge, attitudes, and practice; therefore, it should be properly planned.  Due to the extensiveness   of the clinical   environment   and   its   importance in training residents, investigating how residents learn in these environments and detecting factors that influence effectiveness will help curriculum designers to promote residents’ learning by improving their learning environment.  Therefore, our qualitative content analysis study, aimed  to  examine  the experiences and perspectives of internal and surgical residents and their attending physicians about learning in clinical settings. Methods This qualitative content analysis study was conducted through purposeful sampling.  Semi-structured interviews were conducted with 15 internal and surgical residents and 15 of their attending physicians at educational hospitals of Tehran University of Medical Sciences. Results The main categories explored in this study were hidden curriculum, learning resources, and learning conditions. In the context of clinical environment and under its individual culture, residents learn professionalism and learn to improve their communication skills with patients and colleagues. Because of clinical obligations such as priority of treating the patients for education or workload of the attending physicians, residents acquire most of their practical knowledge from colleagues, fellows, or follow-up patients in different learning conditions (such as: educational rounds, morning reports and outpatient clinics). They see some of their attending physicians as role models. Conclusion Changing cultural and contextual factors is of prime importance to promote a learning-oriented environment in a clinical setting. The present findings will help curriculum planners and attending physicians to

  13. Residential treatment following outpatient treatment for children with mild to borderline intellectual disabilities: a study of child and family characteristics.

    PubMed

    Embregts, Petri J C M

    2009-01-01

    In this study, the question was explored whether children with a mild intellectual disability (MID) who were placed in residential treatment following outpatient treatment differ significantly on child and family characteristics from children with MID and not placed in residential treatment following outpatient treatment. The records of the children were examined with respect to various child and family characteristics. Retrospective case analyses were thus undertaken. The results showed those children placed in residential treatment to have experienced significantly more often a traumatic event than the other children. Those children placed in residential treatment had received significantly fewer months of outpatient treatment than those not placed in residential treatment. Finally, there were significantly more children placed in residential treatment having educationally incapable parents or parents with alcohol/drug problems and/or psychiatric problems than in the other group. The findings are discussed in light of a disturbed balance between the support needs and means of the family which can lead to placement of a child in a residential treatment. The possibilities of a multisystemic model for outpatient treatment are discussed.

  14. The skilled attendance index: proposal for a new measure of skilled attendance at delivery.

    PubMed

    Hussein, Julia; Bell, Jacqueline; Nazzar, Alex; Abbey, Mercy; Adjei, Sam; Graham, Wendy

    2004-11-01

    Increasing the proportion of deliveries with skilled attendance is widely regarded as key to reducing maternal mortality and morbidity in developing countries. The percentage of deliveries with a health professional is commonly used to assess skilled attendance, but measures only the presence of an attendant, not the skills used or the enabling environment To supplement currently available information on the presence of an attendant at delivery, a method to measure the extent of skilled attendance at delivery through use of clinical records was devised. Data were collected from 416 delivery records in hospitals, government health centres and private non-hospital maternity facilities servicing Kintampo District, Ghana, using a case extraction form. Based on the defined criteria, summary measures of skilled attendance were calculated. Between 32.6% and 93.0% of the criteria for skilled attendance were met in the sample, with a mean of 65.5%. No delivery met all the criteria. A Skilled Attendance Index (SAI) was developed as a composite measure of delivery care. The SAI revealed that 26.9% of delivery records met at least three-quarters of the criteria for skilled attendance. Documentation of haemoglobin, current pregnancy complications, post-partum vital signs and completed partographs were amongst the criteria most poorly recorded. The purpose of applying these measures should be seen not as an end in itself but to advance improvements in delivery care.

  15. Fluoxetine attenuates alcohol intake and desire to drink.

    PubMed

    Naranjo, C A; Poulos, C X; Bremner, K E; Lanctot, K L

    1994-09-01

    Several serotonin uptake inhibitors, including the long-acting fluoxetine, have been found to decrease alcohol intake in moderately dependent alcoholics. While the mechanism of their effect is not fully elucidated, a previous study with citalopram indicated that decreased desire to drink may be an important factor. Therefore, we tested fluoxetine effects on alcohol intake and desire to drink in a placebo-controlled study. Subjects, recruited by advertisement, were mildly/moderately dependent alcoholics (12 male, four female, aged 19-59 years, healthy, non-depressed) who did not believe they had a drinking problem and were not requesting treatment. After a 1 week baseline they received, single-blind, 2 weeks placebo followed by 2 weeks fluoxetine 60 mg/day. As out-patients, subjects recorded daily standard drinks (13.6 g ethanol) and rated interest, desire, craving and liking for alcohol biweekly. Each out-patient period was immediately followed by a double-blind experimental drinking session. Out-patient daily drinks slightly decreased during fluoxetine to 6.6 +/- 0.9 (mean +/- S.E.M.) compared with during placebo (7.16 +/- 0.95, p = 0.07, N.S.) and baseline (7.18 +/- 1.0, p > 0.1, N.S.). Desire, interest and craving for alcohol decreased during fluoxetine vs placebo baseline (p < 0.05), but not vs placebo. Appetite loss and decrease in food intake (p < 0.01, fluoxetine vs placebo) correlated with each other (r = 0.91, p < 0.01) but neither correlated with decrease in alcohol intake (appetite: r = 0.26, N.S.; food intake: r = 0.22, N.S.). Weight loss occurred during fluoxetine (p < 0.05 vs placebo) but did not correlate with decrease in alcohol intake (r = 0.1, N.S.). In the experimental drinking sessions after placebo and fluoxetine treatments subjects rated their desire for each of 18 mini-drinks (each one-third of a standard drink) offered at 5 min intervals. Fluoxetine decreased desire to drink throughout the sessions; both mean and maximum desire ratings were

  16. Influenza vaccine effectiveness in preventing inpatient and outpatient cases in a season dominated by vaccine-matched influenza B virus

    PubMed Central

    Martínez-Baz, Iván; Navascués, Ana; Pozo, Francisco; Chamorro, Judith; Albeniz, Esther; Casado, Itziar; Reina, Gabriel; Cenoz, Manuel García; Ezpeleta, Carmen; Castilla, Jesús

    2015-01-01

    Studies that have evaluated the influenza vaccine effectiveness (VE) to prevent laboratory-confirmed influenza B cases are uncommon, and few have analyzed the effect in preventing hospitalized cases. We have evaluated the influenza VE in preventing outpatient and hospitalized cases with laboratory-confirmed influenza in the 2012–2013 season, which was dominated by a vaccine-matched influenza B virus. In the population covered by the Navarra Health Service, all hospitalized patients with influenza-like illness (ILI) and all ILI patients attended by a sentinel network of general practitioners were swabbed for influenza testing, and all were included in a test-negative case-control analysis. VE was calculated as (1-odds ratio)×100. Among 744 patients tested, 382 (51%) were positive for influenza virus: 70% for influenza B, 24% for A(H1N1)pdm09, and 5% for A(H3N2). The overall estimate of VE in preventing laboratory-confirmed influenza was 63% (95% confidence interval (CI): 34 to 79), 55% (1 to 80) in outpatients and 74% (33 to 90) in hospitalized patients. The VE was 70% (41 to 85) against influenza B and 43% (−45 to 78) against influenza A. The VE against virus B was 87% (52 to 96) in hospitalized patients and 56% in outpatients (−5 to 81). Adjusted comparison of vaccination status between inpatient and outpatient cases with influenza B did not show statistically significant differences (odds ratio: 1.13; p = 0.878). These results suggest a high protective effect of the vaccine in the 2012–2013 season, with no differences found for the effect between outpatient and hospitalized cases. PMID:25996366

  17. Alcohol use and safe drinking

    MedlinePlus

    ... to alcohol use Get into trouble with the law, family members, friends, school, or dates because of alcohol THE EFFECTS OF ALCOHOL Alcoholic drinks have different amounts of alcohol in them. Beer is about 5% alcohol, although some beers can ...

  18. Interstellar Alcohols

    NASA Technical Reports Server (NTRS)

    Charnley, S. B.; Kress, M. E.; Tielens, A. G. G. M.; Millar, T. J.

    1995-01-01

    We have investigated the gas-phase chemistry in dense cores where ice mantles containing ethanol and other alcohols have been evaporated. Model calculations show that methanol, ethanol, propanol, and butanol drive a chemistry leading to the formation of several large ethers and esters. Of these molecules, methyl ethyl ether (CH3OC2H5) and diethyl ether (C2H5)2O attain the highest abundances and should be present in detectable quantities within cores rich in ethanol and methanol. Gas-phase reactions act to destroy evaporated ethanol and a low observed abundance of gas-phase C,H,OH does not rule out a high solid-phase abundance. Grain surface formation mechanisms and other possible gas-phase reactions driven by alcohols are discussed, as are observing strategies for the detection of these large interstellar molecules.

  19. Recurring alcohol-related care between 1998 and 2007 among people treated for an alcohol-related disorder in 1997: A register study in Stockholm County

    PubMed Central

    2011-01-01

    Background Inpatient care for alcohol intoxication is increasing in Sweden, especially among young women. Since it is well known that alcohol disorder is a chronic relapsing illness, this study examines the extent to which people return for more care. Method All inpatients with alcohol-related diagnoses in Stockholm County during 1997 were followed prospectively to 2007 through registers. The proportion reappearing for the same diagnosis, other alcohol-related inpatient, or outpatient care each year after baseline, as well as the number of years the inpatients reappeared were calculated (n = 2735). Three diagnoses were examined separately; alcohol dependence, harmful use of alcohol, and alcohol intoxication. Results Three out of five inpatients with an alcohol diagnoses reappeared for more alcohol-related inpatient care during the following decade. The proportion returning was largest the year after baseline and then decreased curvilinearly over time. The inclusion of outpatient care increased proportions, but did not change patterns. Of those with an alcohol dependence diagnosis at baseline 42 percent returned for more alcohol-related inpatient care the first, 28 percent the fifth, and 25 percent the tenth year. Corresponding proportions for harmful use and intoxication were smaller. One in five among those with an alcohol dependence returned for more than five of the ten years. Ordered logistic regressions confirmed that besides diagnosis, age and gender were independently related to the number of years returning to care. Conclusions While middle-aged males with alcohol dependence were in a revolving door, young female inpatients with intoxication diagnosis returned to a comparably lower degree. PMID:21771291

  20. Father attendance in nurse home visitation.

    PubMed

    Holmberg, John R; Olds, David L

    2015-01-01

    Our aim was to examine the rates and predictors of father attendance at nurse home visits in replication sites of the Nurse-Family Partnership (NFP). Early childhood programs can facilitate father involvement in the lives of their children, but program improvements require an understanding of factors that predict father involvement. The sample consisted of 29,109 low-income, first-time mothers who received services from 694 nurses from 80 sites. We conducted mixed-model multiple regression analyses to identify population, implementation, site, and nurse influences on father attendance. Predictors of father attendance included a count of maternal visits (B = 0.12, SE = 0.01, F = 3101.77), frequent contact between parents (B = 0.61, SE = 0.02, F = 708.02), cohabitation (B = 1.41, SE = 0.07, F = 631.51), White maternal race (B = 0.77, SE = 0.06, F = 190.12), and marriage (B = 0.42, SE = 0.08, F = 30.08). Random effects for sites and nurses predicted father-visit participation (2.7 & 6.7% of the variance, respectively), even after controlling for population sociodemographic characteristics. These findings suggest that factors operating at the levels of sites and nurses influence father attendance at home visits, even after controlling for differences in populations served. Further inquiry about these influences on father visit attendance is likely to inform program-improvement efforts.

  1. Text Messaging for Psychiatric Outpatients: Effect on Help-Seeking and Self-Harming Behaviors.

    PubMed

    Kodama, Toyohiko; Syouji, Hiroko; Takaki, Sachiko; Fujimoto, Hirokazu; Ishikawa, Shinichi; Fukutake, Masaaki; Taira, Masaru; Hashimoto, Takeshi

    2016-04-01

    A mobile phone intervention was developed and tested with 30 psychiatric outpatients with mental illness, who had high ideation for suicide. The intervention involved promoting help-seeking behaviors by sending text messages, including information about social welfare services and reminders about medical appointments, for 6 months. After the intervention period, the number of participants who used social services significantly increased, and more than 80% of participants reported that the text messaging service was helpful and useful. Compared to baseline, participants' self-harming behaviors decreased and the attending psychiatrists rated their suicide ideation as weaker. This is the first intervention study to promote psychiatric patients' help-seeking using text messaging, and although it was not a randomized controlled trial, this intervention has practical value and may lead to the prevention of suicide.

  2. Day treatment for cocaine dependence: incremental utility over outpatient counseling and voucher incentives.

    PubMed

    Marlowe, Douglas B; Kirby, Kimberly C; Festinger, David S; Merikle, Elizabeth P; Tran, Giao Q; Platt, Jerome J

    2003-03-01

    Urban, poor, crack cocaine-dependent clients were randomly assigned to outpatient addiction counseling (n=39) or day treatment (n=40). Participants in both conditions received equivalent individual cognitive-behavioral counseling and earned equivalent payment vouchers for providing cocaine-negative urine samples. However, day treatment participants attended significantly more psychoeducational and recreational groups and received two meals per day. Prior to random assignment, more participants expressed a preference for day treatment and participants were more likely to return for an initial appointment following assignment to day treatment. However, no significant between-groups differences in tenure or abstinence were detected during the 3-month course of treatment. These null findings were attributable to an absence of a dose-response effect for the group interventions in the day treatment condition. In addition, there may have been a ceiling effect from the vouchers, which masked the influence of the additional day treatment components.

  3. Risk and Protective Factors for Recent Alcohol Use among African-American Youth

    ERIC Educational Resources Information Center

    Vidourek, Rebecca A.; King, Keith A.

    2010-01-01

    A total of 7488 7th-12th grade African-American students completed a survey assessing factors associated with recent alcohol use. Results indicated that 13.6% used alcohol in the past month. A series of odds ratios revealed that making good grades, participating in school activities, attending church, and having parents/teachers talk about the…

  4. Dieting Behavior and Alcohol Use Behaviors among National Eating Disorders Screening Program Participants

    ERIC Educational Resources Information Center

    Heidelberg, Natalie F.; Correia, Christopher J.

    2009-01-01

    Objective: Research has shown that college students have elevated rates of alcohol use and problematic eating behaviors. The current study focused on the relationships between dieting behaviors and alcohol use among a sample of undergraduates attending National Eating Disorder Screening Program. Method: All participants (n=70, 100% female, average…

  5. Development of a Questionnaire to Assess University Students' Intentions to Use Behavioral Alcohol-Reduction Strategies

    ERIC Educational Resources Information Center

    Bonar, Erin E.; Hoffmann, Erica; Rosenberg, Harold; Kryszak, Elizabeth; Young, Kathleen M.; Ashrafioun, Lisham; Kraus, Shane W.; Bannon, Erin E.

    2012-01-01

    Objective: To evaluate the psychometric properties of a new self-report questionnaire designed to assess college students' intentions to employ 31 specific alcohol-reduction strategies. Method: Students attending a large public university were recruited to complete alcohol-reduction, drinking history, and personality questionnaires online.…

  6. Did It Work? Examining the Impact of an Alcohol Intervention on Sanctioned College Students

    ERIC Educational Resources Information Center

    Oswalt, Sara B.; Shutt, Michael D.; English, Erin; Little, Shay Davis

    2007-01-01

    Universities often conduct alcohol interventions for individuals who have violated institutional, local, or state laws. Few of these programs have been evaluated thoroughly. This study examined the impact of a 10-hour alcohol education course on 400 college students whose attendance was required as part of a judicial sanction. The…

  7. Reducing Alcohol Risk in Adjudicated Male College Students: Further Validation of a Group Motivational Enhancement Intervention

    ERIC Educational Resources Information Center

    LaBrie, Joseph W.; Cail, Jessica; Pedersen, Eric R.; Migliuri, Savannah

    2011-01-01

    This study examined the effectiveness of a single-session group motivational enhancement alcohol intervention on adjudicated male college students. Over two sequential academic years, 230 students sanctioned by the university for alcohol-related infractions attended a 60- to 75-minute group intervention. The intervention consisted of a timeline…

  8. Drinking and Driving among College Students: The Influence of Alcohol-Control Policies

    ERIC Educational Resources Information Center

    Journal of American College Health, 2005

    2005-01-01

    Randomly selected full-time college students attending four-year colleges in 39 states completed a questionnaire about alcohol consumption and driving. The results revealed that 29 percent of the students drove after drinking some amount of alcohol 10 percent drove after drinking five or more drinks, and 23 percent rode with a driver who was high…

  9. The Effectiveness of an Alcohol and Drug Awareness Program on Emotionally Disturbed Children.

    ERIC Educational Resources Information Center

    Gately, Susan E.

    This study investigated the incidence of alcohol and/or drug abuse within families of emotionally disturbed/behaviorally disordered children, and the effectiveness of an alcohol and drug awareness curriculum for these children. Subjects were 116 children, aged 6-15, attending a residential and day treatment center. While 35.3% of the children were…

  10. Predicting Post Treatment-Initiation Alcohol Use Among Patients With Severe Mental Illness and Alcohol Use Disorders

    PubMed Central

    Bradizza, Clara M.; Maisto, Stephen A.; Vincent, Paula C.; Stasiewicz, Paul R.; Connors, Gerard J.; Mercer, Nicole D.

    2010-01-01

    Few studies examining alcohol abuse among individuals with a severe mental illness (SMI) have examined predictors of post-treatment alcohol outcomes. The present study uses a multivariate approach based on a theoretical model to study the relationship between psychosocial factors and post treatment-initiation alcohol use. Predictors of alcohol use outcomes were examined in 278 individuals diagnosed with a current DSM-IV schizophrenia-spectrum or bipolar disorder and an alcohol use disorder (AUD). At 6-months follow-up after initiating treatment, 144 of 228 available participants (63%) had good clinical outcomes. The results of structural equation modeling indicated that type of pretreatment residential setting was directly related to treatment with participants living in supervised settings (41%) reporting significantly more days of treatment (β = .34, p < .001). In addition, participants with more psychiatric symptoms, assessed by the Brief Symptom Inventory and Structured Clinical Interview for the Positive and Negative Syndrome Scale, reported significantly fewer treatment days (β = −.20, p < .001). Number of days participants attended treatment was indirectly associated with alcohol use outcomes and was mediated by use of alcohol coping skills, such that more frequent use of alcohol-specific coping skills was associated with less post treatment-initiation alcohol use (β = −.34, p < .001). This study emphasizes the favorable prognosis for alcohol outcomes among treated individuals with a SMI and AUD and the importance of psychosocial interventions, particularly those that result in better alcohol-specific coping skills. PMID:19968390

  11. Prevalence of Attention Deficit Hyperactivity among Children Attending Outpatient Clinic in Psychiatric Teaching Hospital in Erbil City

    ERIC Educational Resources Information Center

    Shakir, Lana Nabeel; Sulaiman, Karwan Hawez

    2016-01-01

    Background and objectives: Attention deficit hyperactivity disorder is one of the common psychiatric disorder in childhood and it affects on children socially and academically. The aim of this study is to find out the prevalence of Attention deficit hyperactivity disorder among the studied population, describe its association with certain…

  12. SYMPTOMATOLOGY AND COMORBIDITY OF SOMATIZATION DISORDER AMONGST GENERAL OUTPATIENTS ATTENDING A FAMILY MEDICINE CLINIC IN SOUTH WEST NIGERIA

    PubMed Central

    Obimakinde1, A.M.; Ladipo, M.M.; A.E. Irabor

    2014-01-01

    Background: Individuals with somatization may be the most difficult to manage because of the diverse and frequent complaints across many organ systems. They often use impressionistic language to describe circumstantial symptoms which though bizarre, may resemble genuine diseases. The disorder is best understood in the context "illness" behaviour, masking underlying mental disorder, manifesting solely as somatic symptoms or with comorbidity. Objective: To evaluate somatization symptoms and explore its comorbidity in order to improve the management of these patients. Methods: A cross-sectional survey of 60 somatizing patients who were part of a case-control study, selected by consecutive sampling of 2668 patients who presented at the Family Medicine Clinic of University College Hospital Ibadan, Nigeria between May-August 2009. Data was collected using the ICPC-2, WHO- Screener and Diagnostic Schedule and analysed with SPSS 16. Results: There were at least 5 symptoms of somatization in 93.3% of the patients who were mostly females. Majority had crawling sensation, "headache", unexplained limb ache, pounding heart, lump in the throat and insomnia. The mean age at onset was 35yrs with 90% having recurrence of at least 10yrs.Approximately 54% had comorbidity with cardiovascular disease being the most prevalent. Conclusions: The study revealed that somatization is not a specific disease but one with a spectrum of expression. This supports proposition that features for the diagnosis of somatization could be presence of three or more vague symptoms and a chronic course lasting over two years. It is important to be conversant with pattern of symptoms and possible comorbidity for effective management of these patients. PMID:26069465

  13. Generic versus branded medicines: An observational study among patients with chronic diseases attending a public hospital outpatient department

    PubMed Central

    Das, Manisha; Choudhury, Supriyo; Maity, Somnath; Hazra, Avijit; Pradhan, Tirthankar; Pal, Aishee; Roy, Ranendra Kumar

    2017-01-01

    Background: The concept of generic prescription is widely accepted in various parts of the world. Nevertheless, it has failed to gain popularity in India due to factors such as nonavailability and distrust on the product quality. However, since 2012, the Government of West Bengal, India, has initiated exclusive generic drug outlets called “fair price medicine shop” (FPMS) inside the government hospital premises in a “public-private-partnership” model. This study was undertaken to evaluate the experience and attitude of patients who were consuming generic drugs purchased from these FPMS. Materials and Methods: It was a questionnaire-based cross-sectional study where we have interviewed 100 patients each consuming generic and branded drugs, respectively. The perceived effectiveness, reported safety, medication adherence, cost of therapy, and availability of drugs was compared between two mentioned groups. Medication adherence was estimated through Drug Attitude Inventory-10. Results: 93% of generic and 87% branded drug users believed that their drugs were effective (P = 0.238) in controlling their ailments. No significant difference (9% generic, 10% branded drug users, P = 1.000) was observed in reported adverse effects between generic and branded drug users. 82% and 77% of patients were adherent generic and branded drugs, respectively (P = 0.289). As expected, a significantly lower cost of generic drugs was observed compared to its branded counterpart. Conclusion: The policy of FPMS implemented by the Government of West Bengal, India appeared to be promising in terms of perceived effectiveness, safety, and adherence of generic drugs from FPMS compared to drugs purchased from open market retailers. Therefore, this study might act as an impetus for the policy-makers to initiate similar models across the country. PMID:28250671

  14. A Guide for the Personal Care Attendant: Independent Living with Attendant Care.

    ERIC Educational Resources Information Center

    Board, Mary Ann; And Others

    The first of three booklets on attendant care of severely disabled persons is addressed to the personal care attendants (PCAs). An introductory section reviews the basic concepts of independent living, noting the role of PCAs in promoting independence. Discussions of congenital and acquired disability are followed by information on equipment and…

  15. An Analysis of Florida's School Districts' Attendance Policies and their Relationship to High School Attendance Rates

    ERIC Educational Resources Information Center

    Reardon, Ryan Turner

    2008-01-01

    The purpose of this non-experimental correlational study was to determine the relationship between the type of attendance policies in the high schools of the 67 Florida school districts, the size of the school district (number of high school students), the socioeconomic status SES) of the school district, and the average daily attendance rate of…

  16. School Attendance and Attainment: Poor Attenders' Perceptions of Schoolwork and Parental Involvement in Their Education

    ERIC Educational Resources Information Center

    Sheppard, Anne

    2009-01-01

    Because of established links with attainment, the UK government has, over the last ten years, developed policies to improve school attendance. Legislation now makes school attendance a parental responsibility. In the small-scale study reported in this article, Anne Sheppard, manager of an Education Welfare Service Team in North Yorkshire,…

  17. Dynamic association between negative affect and alcohol lapses following alcohol treatment.

    PubMed

    Witkiewitz, Katie; Villarroel, Nadia Aracelliz

    2009-08-01

    Clinical research has found a strong association between negative affect and returning to alcohol use after a period of abstinence. Yet little is known about the probability of a lapse given a particular level of negative affect or whether there is a reciprocal relationship between negative affect and alcohol use across time. The goal of the current study was to examine the association between negative affect and drinking behavior in the 1st year following alcohol treatment. The authors applied an associative latent transition analysis to the Project MATCH outpatient data (n = 952) and then replicated the model in the Project MATCH aftercare data (n = 774). Changes in drinking following treatment were significantly associated with current and prior changes in negative affect, and changes in negative affect were related to prior changes in drinking (effect size range = 0.13-0.33). The results supported the hypothesis that negative affect and alcohol lapses are dynamically linked and suggest that targeting the relationship between negative affect and alcohol use could greatly decrease the probability of lapses and improve alcohol treatment outcomes.

  18. Sending parents outpatient letters about their children: parents' and general practitioners' views.

    PubMed Central

    Waterston, T; San Lazaro, C

    1994-01-01

    Parents' cooperation is essential to ensuring implementation of effective healthcare management of children, and complete openness should exist between paediatricians and parents. One method of achieving this is to send parents a copy of the outpatient letter to the general practitioner (GP) after the child's outpatient consultation. To determine the views of parents and GPs a pilot survey was conducted in two general children's outpatient clinics in hospitals in Newcastle upon Tyne. In March and April 1991 a postal questionnaire was sent to 57 parents of children attending the clinics, and a similar questionnaire to their GPs to elicit, respectively, parents' understanding of the letter and perception of its helpfulness, and GPs' views on the value of sending the letters to parents. Completed questionnaires were received from 34(60%) parents and 47(82%) GPs; 26(45%) respondents were matched pairs. 27(79%) parents said they understood all of the letter, 19(56%) that it helped their understanding, 32(94%) felt it was a good idea, and 31(91%) made positive comments. In all, 29(61%) GPs favoured the idea and six (13%) did not. Eleven (23%) said they would be concerned if this became routine practice, and 20(74%) of the 27 providing comments were doubtful or negative; several considered that they should communicate information to parents. The views in the matched pairs were dissimilar: parents were universally in favour whereas many GPs had reservations. The authors concluded that sending the letters improved parents' satisfaction with communication, and they recommend that paediatricians consider adopting this practice. PMID:10139411

  19. Use of the Alcohol Use Disorders Identification Test (AUDIT) to determine the prevalence of alcohol misuse among HIV-infected individuals.

    PubMed

    Surah, S; Kieran, J; O'Dea, S; Shiel, C; Raffee, S; Mulcahy, F; Keenan, E; Lyons, F

    2013-07-01

    The aim of the paper is to evaluate alcohol misuse among an inner city adult HIV clinic population with AUDIT (Alcohol Use Disorders Identification Test). A cross-sectional HIV outpatient clinic analysis between 28 February 2011 and 11 March 2011 was carried out. AUDIT, demographic and clinical data were collected. Univariate analysis was performed to look for the associations between variables. Backward stepwise multivariate analyses were performed on significant variables from the univariate analysis to assess for predictors of alcohol dependence. In total, 111 patients were included (60% uptake of clinic attendees); 66% were men and 26% were hepatitis C virus (HCV) co-infected. The median AUDIT score was 5 (within normal range). Thirty-four 'AUDIT positive' cases were identified: five (4.5%) indicated consumption of hazardous levels of alcohol; 21 (19%) indicated harmful levels of alcohol; and eight (7%) were likely alcohol dependent. Younger age (<40 years old) was significantly associated with AUDIT positivity (P = 0.006). On multivariate analysis younger age (P = 0.045, odds ratio 13.8) and lower level of education (P = 0.006, odds ratio 6.7) were predictive of scores indicative of alcohol dependence (AUDIT ≥20). In conclusion, younger age and lower educational levels were associated with scores consistent with alcohol dependence. AUDIT was well tolerated and easy to administer in this outpatient HIV clinic population.

  20. No-show at a forensic psychiatric outpatient clinic: risk factors and reasons.

    PubMed

    Feitsma, W Nathalie; Popping, Roel; Jansen, Daniëlle E M C

    2012-02-01

    Nonattendance for and late cancellations of scheduled appointments, that is no-show, is a well-known phenomenon in psychiatric outpatient clinics. Research on the topic of no-show for initial and consecutive appointments in the field of forensic psychiatry is scarce. This study therefore aims to determine the prevalence and causes of no-show and to explore reasons for nonattendance. The study was carried out in an outpatient clinic in northern Netherlands. Telephone interviews were administered to 27 no-show clients, 84 follow-up no-show clients, and 41 attendees of 18 years and older. A no-show rate of 24.9% and a follow-up no-show rate of 9.8% was found. The majority of appointments missed were in the beginning phase of clinic contact. No-show clients were younger than their attending counterparts and more often dropped out from clinic contact. Also, less family social support was experienced by nonattendees. Reasons for nonattendance were having forgotten about appointment and work commitments.

  1. [Satisfaction with life and functionality among elderly patients in a geriatric outpatient clinic].

    PubMed

    Sposito, Giovana; D'Elboux, Maria José; Neri, Anita Liberalesso; Guariento, Maria Elena

    2013-12-01

    Aging is often accompanied by functional limitations that affect self esteem, lowering the level of satisfaction with life. Studies highlight satisfaction with life as a predictor of quality of life and has a marked correlation with a decrease in functionality. Therefore, this study sought to examine the relationship between satisfaction with life and functional independence and performance of the lower limbs (muscle strength, gait speed and balance) among the elderly in outpatient care with respect to age groups and genders. A total of 125 elderly men and women aged 60 years and above, attending a geriatric outpatient clinic. The instruments used were: 1) Functional Independence Measure (FIM) to evaluate functional dependence; 2) Short Physical Performance Battery (SPPB) to measure physical performance; 3) Satisfaction with life. The sample was random, with a predominance of females, in which the older participants had greater functional impairment. In univariate logistic regression analysis and multivariate analysis, overall self reported and comparative satisfaction with life was more satisfactory among the oldest elderly. The results suggest that older individuals have better satisfaction with life even though they have greater functional impairment.

  2. Transmission of MRSA between companion animals and infected human patients presenting to outpatient medical care facilities.

    PubMed

    Ferreira, Jorge Pinto; Anderson, Kevin L; Correa, Maria T; Lyman, Roberta; Ruffin, Felicia; Reller, L Barth; Fowler, Vance G

    2011-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in both human and veterinary medicine. The importance of companion animals as reservoirs of human infections is currently unknown. The companion animals of 49 MRSA-infected outpatients (cases) were screened for MRSA carriage, and their bacterial isolates were compared with those of the infected patients using Pulsed-Field Gel Electrophoresis (PFGE). Rates of MRSA among the companion animals of MRSA-infected patients were compared to rates of MRSA among companion animals of pet guardians attending a "veterinary wellness clinic" (controls). MRSA was isolated from at least one companion animal in 4/49 (8.2%) households of MRSA-infected outpatients vs. none of the pets of the 50 uninfected human controls. Using PFGE, patient-pets MRSA isolates were identical for three pairs and discordant for one pair (suggested MRSA inter-specie transmission p-value = 0.1175). These results suggest that companion animals of MRSA-infected patients can be culture-positive for MRSA, representing a potential source of infection or re-infection for humans. Further studies are required to better understand the epidemiology of MRSA human-animal inter-specie transmission.

  3. Evidence-Based Practices in Outpatient Treatment for Eating Disorders

    ERIC Educational Resources Information Center

    Schaffner, Angela D.; Buchanan, Linda Paulk

    2010-01-01

    This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…

  4. Creative Art Therapy Groups: A Treatment Modality for Psychiatric Outpatients

    ERIC Educational Resources Information Center

    Drapeau, Marie-Celine; Kronish, Neomi

    2007-01-01

    This brief report examines the benefits of a creative art therapy group program for outpatients suffering from psychiatric disorders. Included is a review of relevant treatment outcomes literature on the effectiveness of group art therapy. The authors describe the Creative Art Therapy Group Program offered to adult psychiatric outpatients that is…

  5. Bypassing the Local Rural Hospital for Outpatient Procedures

    ERIC Educational Resources Information Center

    Saunders, Charles; Bellamy, Gail R.; Menachemi, Nir; Chukmaitov, Askar S.; Brooks, Robert G.

    2009-01-01

    Purpose: To assess the amount of local rural hospital outpatient department (HOPD) bypass for outpatient procedures. Methods: We analyzed data on colonoscopies and upper gastrointestinal endoscopies performed in the state of Florida over the period 1997-2004. Findings: Approximately, 53% of colonoscopy and 45% of upper gastrointestinal endoscopy…

  6. 42 CFR 482.54 - Condition of participation: Outpatient services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... nonprofessional personnel available at each location where outpatient services are offered, based on the scope and... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Outpatient services. 482.54 Section 482.54 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...

  7. 42 CFR 482.54 - Condition of participation: Outpatient services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... nonprofessional personnel available at each location where outpatient services are offered, based on the scope and... 42 Public Health 5 2013-10-01 2013-10-01 false Condition of participation: Outpatient services. 482.54 Section 482.54 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...

  8. 38 CFR 17.92 - Outpatient care for research purposes.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... research purposes. 17.92 Section 17.92 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Outpatient Treatment § 17.92 Outpatient care for research purposes. Subject to the... the treatment to be rendered is part of an approved Department of Veterans Affairs research...

  9. 38 CFR 17.92 - Outpatient care for research purposes.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... research purposes. 17.92 Section 17.92 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Outpatient Treatment § 17.92 Outpatient care for research purposes. Subject to the... the treatment to be rendered is part of an approved Department of Veterans Affairs research...

  10. 38 CFR 17.92 - Outpatient care for research purposes.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... research purposes. 17.92 Section 17.92 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Outpatient Treatment § 17.92 Outpatient care for research purposes. Subject to the... the treatment to be rendered is part of an approved Department of Veterans Affairs research...

  11. 38 CFR 17.92 - Outpatient care for research purposes.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... research purposes. 17.92 Section 17.92 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Outpatient Treatment § 17.92 Outpatient care for research purposes. Subject to the... the treatment to be rendered is part of an approved Department of Veterans Affairs research...

  12. 42 CFR 410.59 - Outpatient occupational therapy services: Conditions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Outpatient occupational therapy services... Other Health Services § 410.59 Outpatient occupational therapy services: Conditions. (a) Basic rule... occupational therapy services only if they are furnished by an individual meeting the qualifications in...

  13. 42 CFR 410.59 - Outpatient occupational therapy services: Conditions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Outpatient occupational therapy services... Other Health Services § 410.59 Outpatient occupational therapy services: Conditions. (a) Basic rule... occupational therapy services only if they are furnished by an individual meeting the qualifications in...

  14. 42 CFR 410.59 - Outpatient occupational therapy services: Conditions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Outpatient occupational therapy services... Other Health Services § 410.59 Outpatient occupational therapy services: Conditions. (a) Basic rule... occupational therapy services only if they are furnished by an individual meeting the qualifications in...

  15. [Out of addictions: Alcohol, or alcohol to alcohol].

    PubMed

    Simmat-Durand, L; Vellut, N; Lejeune, C; Jauffret-Roustide, M; Mougel, S; Michel, L; Planche, M

    2016-06-29

    Pathways from alcoholism to recovery are documented; less often are those from drug addiction to alcoholism. Biographical approaches allow analyzing how people change their uses and talk about their trajectories of recovery.

  16. The dimensionality of alcohol use disorders and alcohol consumption in a cross-national perspective

    PubMed Central

    Borges, Guilherme; Ye, Yu; Bond, Jason; Cherpitel, Cheryl J.; Cremonte, Mariana; Moskalewicz, Jacek; Swiatkiewicz, Grazyna; Rubio-Stipec, Maritza

    2009-01-01

    Aims To replicate the finding that there is a single dimension trait in alcohol use disorders and to test whether usual 5+ drinks for men and/4+ drinks for women and other measures of alcohol consumption help to improve alcohol use disorder criteria in a series of diverse patients from Emergency Departments (EDs) in four countries. Design Cross-sectional surveys of patient 18 and older that reflected consecutive arrival at the ED. The Composite International Diagnostic Interview Core was used to obtain a diagnosis of DSM-IV alcohol dependence and alcohol abuse. Quantity and frequency of drinking and drunkenness as well as usual number of drinks consumed during the last year. Setting Participants were 5,195 injured and non-injured patients attending 7 EDs in 4 countries, Argentina, Mexico, Poland the U.S., (between 1995-2001). Findings Using exploratory factor analyses alcohol use disorders can be described as a single, unidimensional continuum without any clear cut distinction between the criterions for dependence and abuse in all sites. Results from item response theory analyses showed that the current DSM-IV criterions tap people in the middle-upper end of the alcohol use disorder continuum. Alcohol consumption (amount and frequency of use) can be used in all EDs with the current DSM-IV diagnostic criterions to help tap the middle-lower part of this continuum. Even though some specific diagnostic criterions and some alcohol consumption variables showed differential item function across sites, test response curves were invariant for ED sites and their inclusion would not impact the final (total) performance of the diagnostic system. Conclusions DSM-IV abuse and dependence form a unidimensional continuum in ED patients regardless of country of survey. Alcohol consumption variables, if added, would help to tap patients with more moderate severity. DSM diagnostic system for alcohol use disorders showed invariance and performed extremely well in these samples. PMID

  17. Evaluation of outpatient experience with vitreoretinal surgery.

    PubMed Central

    Cannon, C S; Gross, J G; Abramson, I; Mazzei, W J; Freeman, W R

    1992-01-01

    The experience of 55 consecutive individuals undergoing outpatient vitreoretinal surgery was evaluated. Objective variables, including preoperative and intraoperative information, subjective postoperative pain, and discomfort were measured with a previously validated 100 mm visual analogue scale. Patients also ranked the overall experience. Average pain and discomfort scores in the recovery room were 21.8 and 22.6 and overnight were 26.7 and 30.4 (scale 0 to 100), respectively. Eighty eight per cent of subjects were satisfied with the experience. Elevated pain and discomfort scores were statistically correlated with scleral buckling, prolonged surgical or recovery room time, requirement for parenteral pain medications, and high intraocular pressure on the first postoperative visit. None of the patients needed further hospital treatment. This study suggests that vitreoretinal surgery in an appropriately selected population does not require routine inpatient care. PMID:1739718

  18. A decision-supported outpatient practice system.

    PubMed Central

    Barrows, R. C.; Allen, B. A.; Smith, K. C.; Arni, V. V.; Sherman, E.

    1996-01-01

    We describe a Decision-supported Outpatient Practice (DOP) system developed and now in use at the Columbia-Presbyterian Medical Center. DOP is an automated ambulatory medical record system that integrates in-patient and ambulatory care data, and incorporates active and passive decision support mechanisms with a view towards improving the quality of primary care. Active decision support occurs in the form of event-driven reminders created within a remote clinical information system with its central data repository and decision support system (DSS). Novel features of DOP include patient specific health maintenance task lists calculated by the remote DSS. uses of a semantically structured controlled medical vocabulary to support clinical results review and provider data entry, and exploitation of an underlying ambulatory data model that provides for an explicit record of evolution of insight regarding patient management. Benefits, challenges, and plans are discussed. PMID:8947774

  19. Problems in outpatients with laryngeal hyperplastic lesions.

    PubMed

    Goldman, N C

    1997-01-01

    The care of outpatients with epithelial hyperplastic lesions of the larynx presents problems of classification, treatment, continued surveillance and prognosis. One hundred patients who underwent microlaryngoscopy and vocal cord stripping from 1990 through 1995 were studied retrospectively with a follow-up period of 8-156 months. Twenty-eight patients with biopsy proven epithelial hyperplastic lesions were given 21 different pathological diagnoses exclusive of invasive carcinoma following 52 operative microlaryngoscopies. Prognosis was inferred and treatment commenced primarily on the basis of the pathology report. Microlaryngoscopy and stripping with and without the carbon dioxide laser, "watchful waiting," radiation therapy, and partial laryngectomy were all used as treatment modalities. Controversy remains as of choice of treatment. Encouraging the patient to discontinue smoking is an integral part of treatment; however, most patients continue to smoke. Recent changes in the United States health care delivery system present additional problems in surveillance of the patient.

  20. Outpatient management of the suicidal child.

    PubMed

    Robinson, L H

    1984-07-01

    Susceptible children may become depressed and suicidal in response to stressful social factors including loss or separation from parents, parental abuse, neglect, rejection, pressure, or a chaotic, disorganized family environment. Psychological factors that predispose children to suicidal behavior include inadequate ego-defenses to cope with feelings engendered by the adverse environmental circumstances. Often these children relate poorly to others and are excessively dependent. Outpatient management is possible if the parents are able to be appropriately supportive and protective. Intensive psychotherapy is often necessary to modify a basic depressive outlook on life and to resolve inner conflict about self-worth. The suicidal child must be helped to give up perfectionistic attitudes and to alter aggressive responses to loss and disappointment. Work with parents is important, particularly when the child's suicidal state is reactive to inappropriate parental behavior. Antidepressant drugs may prove to be a useful adjunct.

  1. Comparison of Sexual Experience and Behavior between Bipolar Outpatients and Outpatients without Mood Disorders

    PubMed Central

    Downey, Jennifer; Friedman, Richard C.; Haase, Elizabeth; Goldenberg, David; Bell, Robinette; Edsall, Sidney

    2016-01-01

    Sexual behavior over the past year of 32 outpatients with Bipolar disorder is compared to that of 44 Comparison patients that had never had an episode of affective illness. Subjects were outpatients treated with drugs and psychotherapy in routine office practice. Differences in sexual behavior between the two groups as a whole were minimal, but meaningful differences emerged when subgroups were compared. Compared to control men, Bipolar men had had more partners in the last year and were more likely to have had sex without condoms. Compared to Bipolar females, Bipolar males had more sex partners, had more sex with strangers, and were more likely to have engaged in homosexual behavior. Even so, some patients in the Comparison group also had engaged in risky sexual behavior. They had failed to use condoms and had had sex with strangers and prostitutes during the previous year. PMID:27190984

  2. Errors associated with outpatient computerized prescribing systems

    PubMed Central

    Rothschild, Jeffrey M; Salzberg, Claudia; Keohane, Carol A; Zigmont, Katherine; Devita, Jim; Gandhi, Tejal K; Dalal, Anuj K; Bates, David W; Poon, Eric G

    2011-01-01

    Objective To report the frequency, types, and causes of errors associated with outpatient computer-generated prescriptions, and to develop a framework to classify these errors to determine which strategies have greatest potential for preventing them. Materials and methods This is a retrospective cohort study of 3850 computer-generated prescriptions received by a commercial outpatient pharmacy chain across three states over 4 weeks in 2008. A clinician panel reviewed the prescriptions using a previously described method to identify and classify medication errors. Primary outcomes were the incidence of medication errors; potential adverse drug events, defined as errors with potential for harm; and rate of prescribing errors by error type and by prescribing system. Results Of 3850 prescriptions, 452 (11.7%) contained 466 total errors, of which 163 (35.0%) were considered potential adverse drug events. Error rates varied by computerized prescribing system, from 5.1% to 37.5%. The most common error was omitted information (60.7% of all errors). Discussion About one in 10 computer-generated prescriptions included at least one error, of which a third had potential for harm. This is consistent with the literature on manual handwritten prescription error rates. The number, type, and severity of errors varied by computerized prescribing system, suggesting that some systems may be better at preventing errors than others. Conclusions Implementing a computerized prescribing system without comprehensive functionality and processes in place to ensure meaningful system use does not decrease medication errors. The authors offer targeted recommendations on improving computerized prescribing systems to prevent errors. PMID:21715428

  3. Proceedings of Management Workshop for Alcohol Safety Action Project Leaders.

    ERIC Educational Resources Information Center

    Human Resources Research Organization, Alexandria, VA.

    The workshop for Alcohol Safety Action Project administrators was held to help prepare project directors in the management of their projects and to identify their responsibilities and job tasks. It was also attended by National Highway Traffic Safety Administration (NHTSA) representatives to help in the orientation of the ASAP program. The full…

  4. Differences between Alcoholics and Cocaine Addicts Seeking Treatment.

    PubMed

    López-Goñi, José J; Fernández-Montalvo, Javier; Arteaga, Alfonso

    2015-03-03

    This study explored the characteristics of a representative sample of patients who were addicted to either alcohol or cocaine, comparing the profiles of both types of drug users. A sample of 234 addicted patients (109 alcoholics and 125 cocaine addicts) who sought outpatient treatment in a Spanish clinical centre was assessed. Data on socio-demographic, consumption, psychopathological and maladjustment characteristics were collected using the European Addiction Severity Index (EuropASI), the Symptom Checklist-90-Revised (SCL-90-R) and the Millon Clinical Multiaxial Inventory (MCMI-II). Demographically, differences were observed with regard to age (alcoholics were older than cocaine addicts; t = 12.2, p = .001), employment (the alcoholic group had more labor problems; χ 2 = 6.2, p = .045) and family consequences (worse in alcoholics; t = 2.3, p = .025). The EuropASI results showed statistically significant differences in addiction severity, with alcoholics showing a greater severity than cocaine addicts. In terms of psychopathology, alcoholics presented more associated symptomatology than cocaine addicts. According to these results, patients with alcohol dependence have a different profile from patients with cocaine dependence, resulting in different repercussions for important areas of their lives. These differences should be taken into account when standard treatments for addiction are implemented.

  5. 38 CFR 3.667 - School attendance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... institution and a claim for such benefits is filed within 1 year from the child's 18th birthday. (2) Pension... child's 18th birthday, and if a claim for benefits is filed within 1 year from the child's 18th birthday... evidence of such school attendance is filed within 1 year from that date. (b) Vacation periods. A child...

  6. Does Attendance Enhance Political Science Grades?

    ERIC Educational Resources Information Center

    Tiruneh, Gizachew

    2007-01-01

    This article tests a relationship between class attendance and final grades in several political science courses that I taught at the University of Georgia, University of Vermont, and University of Central Arkansas between the Fall 2000 and Spring 2006 semesters. The study employs ordinary least square estimators to test the foregoing hypothesis.…

  7. Encouraging Faculty Attendance at Professional Development Events

    ERIC Educational Resources Information Center

    Burdick, Dakin; Doherty, Tim; Schoenfeld, Naomi

    2015-01-01

    For faculty development events to have the greatest impact on campus practice, faculty developers need to attract and include as many faculty members as possible at their events. This article describes the testing of a checklist regarding faculty attendance at professional development events through a survey of 238 faculty members at small…

  8. Service Station Attendant. Performance Objectives. Basic Course.

    ERIC Educational Resources Information Center

    Davis, John

    Several intermediate performance objectives and corresponding criterion measures are listed for each of 24 terminal objectives for a basic secondary level service station attendant course. The materials were developed for a two-semester course (2 and 3 hours daily). The specialized classroom and shop experiences are designed to enable the student…

  9. Attendance and Truancy Programs. Research Brief

    ERIC Educational Resources Information Center

    Walker, Karen

    2007-01-01

    According to the 2000 census, high school dropouts had a 52% employment rate, compared to 71% for high school graduates and 83% for college graduates. According to NCSE, the national dropout rate is 30% of which 80% had been chronically absent from school ("School attendance tracking: Challenges and effective practices"), which puts the…

  10. International Determinants of Private School Attendance

    ERIC Educational Resources Information Center

    Rutkowski, Leslie; Rutkowski, David; Plucker, Jonathan

    2012-01-01

    The current study uses Programme for International Student Assessment (PISA) 2006 data to investigate international determinants of private school attendance. In particular, we seek to understand whether student achievement and home background factors such as socioeconomic status (SES) or motivational and goal-oriented factors are more predictive…

  11. Automated Attendance Accounting System; Patent Application.

    ERIC Educational Resources Information Center

    Chapman, Carl P.; And Others

    An automated accounting system, useful for applying data to a computer from a multiplicity of terminals, has the potential of replacing the manual attendance accounting system now employed in schools. The inventors claim that such a sophisticated system with terminals in the classrooms would enable school administrators not only to monitor simple…

  12. Medical specialist attendance in nursing homes

    PubMed Central

    Balzer, Katrin; Butz, Stefanie; Bentzel, Jenny; Boulkhemair, Dalila; Lühmann, Dagmar

    2013-01-01

    The care in nursing homes was examined based on scientific studies. The analysis focuses on dementia and type II diabetes. There is evidence for deficits in the supply of medical specialist attendance to nursing home residents with these diseases in Germany. Compared with corresponding guidelines the medical care for nursing home residents may be too low or inadequate. PMID:23755088

  13. The Effects of Attending a Diverse College

    ERIC Educational Resources Information Center

    Hinrichs, Peter

    2011-01-01

    The question of whether there are benefits to be obtained from having a diverse student body is a key issue in the debate over affirmative action. This paper estimates the effects of college racial diversity on post-college earnings, civic behavior, and satisfaction with the college attended. I use the Beginning Postsecondary Students survey,…

  14. Earning and Learning: Reasons Students Attend College

    ERIC Educational Resources Information Center

    Arboleda, Ana; Chen, JingJing; Shelley, Mack C., II; Whalen, Donald F.

    2004-01-01

    Linear models of two of the most salient motivations for undergraduates to attend college--learning (intrinsic) and enhanced post-graduation earnings (extrinsic)--are estimated from a sample of 2,199 respondents to the 2000 Cooperative Institutional Research Program (CIRP) survey of first-year students, supplemented by institutional records. Model…

  15. 45 CFR 1305.8 - Attendance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Attendance. 1305.8 Section 1305.8 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM...

  16. 45 CFR 1305.8 - Attendance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Attendance. 1305.8 Section 1305.8 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM...

  17. 45 CFR 1305.8 - Attendance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Attendance. 1305.8 Section 1305.8 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM...

  18. 45 CFR 1305.8 - Attendance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Attendance. 1305.8 Section 1305.8 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM...

  19. 45 CFR 1305.8 - Attendance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Attendance. 1305.8 Section 1305.8 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM...

  20. 38 CFR 3.667 - School attendance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    .... (a) General. (1) Pension or compensation may be paid from a child's 18th birthday based upon school attendance if the child was at that time pursing a course of instruction at an approved educational institution and a claim for such benefits is filed within 1 year from the child's 18th birthday. (2)...

  1. 38 CFR 3.667 - School attendance.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    .... (a) General. (1) Pension or compensation may be paid from a child's 18th birthday based upon school attendance if the child was at that time pursing a course of instruction at an approved educational institution and a claim for such benefits is filed within 1 year from the child's 18th birthday. (2)...

  2. 38 CFR 3.667 - School attendance.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    .... (a) General. (1) Pension or compensation may be paid from a child's 18th birthday based upon school attendance if the child was at that time pursing a course of instruction at an approved educational institution and a claim for such benefits is filed within 1 year from the child's 18th birthday. (2)...

  3. Alcoholics Anonymous and 12-step alcoholism treatment programs.

    PubMed

    Humphreys, Keith

    2003-01-01

    Alcoholics Anonymous (AA) self-help groups are the most commonly accessed component of the de facto system of care for alcohol problems in the United States. Further, AA's concepts and approach have strongly influenced a significant number of professional treatment programs. Nevertheless, only a modest number of longitudinal, comparative outcome studies on AA and on professional 12-step treatment programs have been conducted, which has limited both the certainty and scope of conclusions that can be drawn about these interventions. Research indicates that participation in Alcoholics Anonymous and in 12-step treatment are associated with significant reductions in substance abuse and psychiatric problems. Further, such interventions, it has been found, reduce health care costs over time in naturalistic, quasi-experimental, and experimental studies. Evaluation studies have also begun to illuminate the processes through which self-help groups and 12-step treatment programs exert their effects. To build on this knowledge base, future research should (1) be methodologically flexible and well-matched to its phenomenon of interest, (2) include evaluation of the unique features of self-help organizations, (3) increase representation of African-Americans and women in research samples, and (4) increase statistical power through larger sample sizes and more reliable measurement. Key content areas for future enquiry include further longitudinal evaluation of the outcomes of participation in AA and 12-step treatment (particularly in outpatient samples); better specification of the aspects of AA that influence outcome; and individual-, community-, and health organization-level controlled studies of the health care cost consequences of 12-step interventions.

  4. An audit of waiting times in the diabetic outpatient clinic: role of patients' punctuality and level of medical staffing.

    PubMed

    Perros, P; Frier, B M

    1996-07-01

    A survey of patients' waiting times was performed in the follow-up clinics of a large hospital outpatient diabetic department (approximately 6500 patients). Over a period of 1 week, 138 patients attended 5 review outpatient clinics. The overall patient:doctor ratio was 11.1:1. Only 18.8% of patients were seen by the doctor, and 86% by the nurse within 30 min of their appointment time. A policy of strict adherence to the formal appointment times was implemented but had no effect on the waiting time (20% of patients were seen by the doctor, and 82.2% by the nurse within 30 min of their appointment time). The combined effects of adherence to actual appointment times and increasing the number of doctors (lowering the patient:doctor ratio to 7.7:1), reduced the total waiting times, and increased the proportion of patients seen by the doctor or nurse within 30 min of their appointment time, to 31% and 100%, respectively. Strict adherence to appointment times was difficult to implement and ineffective but the patient:doctor ratio was important in determining waiting times in the diabetic clinic. Inadequate medical staffing of diabetic outpatient clinics is a major cause of prolonged waiting time for patients. This approach may be useful in assessing and improving the organizational efficiency of a diabetes service.

  5. Cancer-related neuropathic pain in out-patient oncology clinics: a European survey

    PubMed Central

    2013-01-01

    Background Although pain is frequently experienced by patients with cancer, it remains under-treated. The primary aim of this study was to estimate the prevalence of cancer-related neuropathic pain (CRNP) in patients with chronic pain who attended an outpatient clinic for standard care in Europe (irrespective of the reason or stage of the cancer). The secondary aims of this study were to characterise pain and cancer in patients with CRNP (including treatment) and to evaluate the usefulness of the painDETECT (PD-Q) screening tool to help physicians identify a potential neuropathic component of cancer-related pain. Methods An observational, non-interventional, cross-sectional, multi-centre study of adult patients with cancer using patient and physician case report forms (CRFs). Patients with CRNP were identified by physicians’ clinical assessments after examining the completed PD-Q. Results A total of 951 patients visiting outpatient clinics across Europe were enrolled in this study between August 2010 and July 2011. Of these, 310 patients (32.60%; 95% confidence interval 29.62, 35.58) were identified as having CRNP. Twenty-nine of 39 (74.4%) physicians who completed the CRF relating to the PD-Q considered it a useful tool to help detect CRNP in daily practice and 28 of 39 (71.8%) indicated that they would use this tool in the future for most or some of their patients. Data from physicians before and after review of the completed PD-Qs showed a shift in clinical opinion (either to positive CRNP diagnosis [yes] or negative CRNP diagnosis [no]) in respect of 142 patients; about half of which (74) were categorised with an initial diagnosis of unknown. Opinions also shifted from a no to a yes diagnosis in 10 patients and from a yes to a no diagnosis in 51 patients. Conclusions Approximately one-third of adults with cancer experiencing chronic pain attending outpatient clinics as part of routine care were considered to have CRNP in the opinion of the physicians after

  6. Do Negative Emotions Predict Alcohol Consumption, Saturated Fat Intake, and Physical Activity in Older Adults?

    ERIC Educational Resources Information Center

    Anton, Stephen D.; Miller, Peter M.

    2005-01-01

    This study examined anger, depression, and stress as related to alcohol consumption, saturated fat intake, and physical activity. Participants were 23 older adults enrolled in either an outpatient or in-residence executive health program. Participants completed (a) a health-risk appraisal assessing medical history and current health habits, (b)…

  7. Older Adults and Alcohol

    MedlinePlus

    ... Alcohol Exposure Support & Treatment Alcohol Policy Special Populations & Co-occurring Disorders Publications & Multimedia Brochures & Fact Sheets NIAAA ... are here Home » Alcohol & Your Health » Special Populations & Co-occurring Disorders » Older Adults In this Section Underage ...

  8. Fetal Alcohol Syndrome

    MedlinePlus

    ... The diagnosis of fetal alcohol syndrome. Deutsches Arztebaltt International. 2013;110:703. Ungerer M, et al. In utero alcohol exposure, epigenetic changes and their consequences. Alcohol Research: Current Reviews. 2013;35:37. Coriale G, et al. ...

  9. Fetal Alcohol Syndrome

    MedlinePlus

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Fetal Alcohol Syndrome Read in Chinese What is Fetal Alcohol Syndrome (FAS)? Fetal Alcohol Syndrome (FAS) describes changes in ...

  10. Alcoholic liver disease

    MedlinePlus

    Liver disease due to alcohol; Cirrhosis or hepatitis - alcoholic; Laennec's cirrhosis ... Alcoholic liver disease occurs after years of heavy drinking. Over time, scarring and cirrhosis can occur. Cirrhosis is the ...

  11. Clinical utility of the Hospital Anxiety and Depression Scale (HADS) for an outpatient fibromyalgia education program.

    PubMed

    Nam, Seungree; Tin, Diane; Bain, Lorna; Thorne, J Carter; Ginsburg, Liane

    2014-05-01

    This paper examines the clinical utility of the Hospital Anxiety and Depression Scale (HADS) in the context of evaluating the Fibromyalgia Outpatient Education Program at Southlake Regional Health Centre (Newmarket, Canada). A pre-test/post-test design was implemented for data analysis. A total of 232 patients' data were obtained through retrospective patient chart review. Complete pre-post data were available for 70 patients and qualitative analysis was done for 12 patients. Main outcome measures included HADS and Arthritis Self-Efficacy (ASE) scores. At the end of the education program, subgroups of patients (high attendance, high exercise habit, low medication) experienced significant improvement on HADS-depression and ASE scores. Linear regression analysis found that HADS pre-program scores explain far more variance in HADS post-test scores than ASE pre-program scores explain in ASE post-program scores; more variance in ASE post-program scores was explained by other variables. In contrast to the quantitative analysis of the Anxiety subscale of HADS, patients in the focus group indicated that their anxiety level decreased through attending the education program. These findings suggest that HADS is an appropriate tool for evaluating fibromyalgia and related patient education programs. Moreover, patient education programs have positive effects on enhancing patients' psychological well-being and self-confidence in controlling fibromyalgia-related symptoms.

  12. Domestic sexual violence and sexual problems among gynecology outpatients: an example from Turkey.

    PubMed

    Ipekten Alaman, Mehtap; Yıldız, Hatice

    2014-01-01

    Domestic violence is a universal problem, and sexual violence in marriage, in particular, is a hidden form of it. This descriptive, cross-sectional study was conducted to determine to the prevalence of domestic sexual violence by husbands, the prevalence of sexual problems, and the relation of these among married women attending a gynecology outpatient clinic. This study was performed in a university hospital in Turkey and data were collected February-April 2009. The study sample consisted of 200 married women, 53% of whom reported having been exposed to at least one type of domestic sexual violence behaviors by their husbands. Among those behaviors, the rate of marital rape was 33%. The frequency of experiencing any sexual problem was 82%. Women expressed that they mostly had orgasmic problems, and their husbands had premature ejaculation problems. The majority of women who reported sexual violence reported experiencing sexual problems; the frequency of sexual problems was higher in the participants who did (94.3%) than in those who did not report (68.1%) sexual violence (p < .001). Bad sexual harmony (Odds ratio [OR] = 13.50, 95% confidence interval [CI] = 3.87-47.01) and experiencing sexual problems (OR = 12.67, 95% CI = 3.78-42.35) were strongly related to sexual violence in marriage. The results also revealed that the prevalence of sexual violence and sexual problems among those married women who attended gynecology clinics was considerable, even though they did not report this to the health care provider as a problem.

  13. Evaluation of an ongoing psychoeducational inflammatory bowel disease support group in an adult outpatient setting.

    PubMed

    McMaster, Kristin; Aguinaldo, Laika; Parekh, Nimisha K

    2012-01-01

    Previous studies assessing efficacy of support groups for patients with inflammatory bowel disease showed mixed results in terms of attendance and overall effectiveness. In this study, researchers evaluated the use of an ongoing open psychoeducational support group for adult patients with inflammatory bowel disease in an outpatient tertiary setting. The sample consisted of 18 adults who have attended more than 2 meetings of the support group. Topics addressed in the support group include complementary medicine, diet and nutrition, the psychological impact of inflammatory bowel disease, medication and side effects, and insurance/disability. Participants were asked to complete the Client Satisfaction Questionnaire, Multidimensional Support Scale, 11 general demographic questions, and a brief open-ended qualitative questionnaire developed by the researchers. Results demonstrated that participants reported very high satisfaction with the support group and rated the adequacy of peer support from others with inflammatory bowel disease higher than support from family/friends and professionals. A majority of group members reported joining the group for mutual support and education; this expectation was met through the psychoeducational structure of the group. This study demonstrates the potential for success of an ongoing psychoeducational inflammatory bowel disease support group for adult patients and their caregivers.

  14. Outpatient provider contact prior to unintentional opioid overdose

    PubMed Central

    Lin, Lewei (Allison); Bohnert, Amy; Ilgen, Mark; Pfeiffer, Paul Nelson; Ganoczy, Dara; Blow, Fred

    2015-01-01

    Objectives Prescribed opioid medications are the most commonly implicated substances in unintentional overdoses. Outpatient health care encounters represent a potential opportunity to intervene to reduce opioid overdose risk. This study assessed the timing and type of outpatient provider contacts prior to overdose. Methods This study examined all adult patients nationally in the Veterans Health Administration (VHA) who died from unintentional prescription opioid overdose in fiscal years 2004–2007 and used VHA services anytime within two years of their deaths (n=1,813). For those whose last treatment contact was in an outpatient setting (n=1,457), demographic, clinical and treatment characteristics were compared among patients categorized by the location of their last contact. Results 33% (N=479) of those last seen in outpatient settings were seen within one week and 62% (N=910) within one month of their overdose. A substantial proportion of patients were last seen within one month of death in mental health or substance disorder outpatient settings (30% N=438). The majority of patients did not fill an opioid prescription on their last outpatient visit prior to unintentional opioid overdose. Conclusions The majority of patients who died by unintentional overdose on prescription opioids were seen within a month of their overdose in outpatient settings. These settings may provide an opportunity to prevent patients from dying from prescription opioid overdoses, and interventions to reduce risk should not be limited to visits that resulted in an opioid prescription. PMID:26129993

  15. A brief cognitive-behavioural group therapy programme for the treatment of depression in adolescent outpatients: a pilot study

    PubMed Central

    2014-01-01

    Background The goal of this pilot study was to examine the feasibility and clinical outcomes of a brief (6-session) group therapy programme in adolescent outpatients with depression. The programme had previously been assessed in in-patients, with positive results. Methods A total of 15 outpatients aged 13 to 18 years took part in the programme between October 2010 and May 2011, in 3 separate groups of 4–6 participants each. The outcomes measured were feasibility of the programme, as assessed by attendance rate, user feedback, fidelity of implementation, and response to treatment, as assessed by pre- and post-intervention measurement of depressive symptoms, quality of life, and suicidal ideation. Results The programme demonstrated good feasibility, with a mean attendance rate of 5.33 out of 6 sessions, a mean rating by participants on overall satisfaction with the programme of 7.21 out of 10 (SD = 1.89), and a 93% concurrence between the contents of the sessions and the contents of the treatment manual. Compared to baseline scores, depressive symptoms at follow-up test were significantly reduced, as assessed by the Children’s Depression Rating Scale Revised (F(1, 12) = 11.76, p < .01) and the Beck Depression Inventory Revision (F(1, 32) = 11.19, p < .01); quality of life improved, as assessed by the Inventory of Quality of Life (F(1, 31) = 5.27, p < .05); and suicidal ideation was reduced. No significant changes were seen on the measures of the Parent Rating Scale for Depression and the Clinical Global Impression scale. Conclusions Based on the results of this pilot study, it is feasible to further assess this brief outpatient treatment programme in a randomized controlled trial without further modifications. PMID:24655595

  16. Safety of Outpatient Closed-Loop Control: First Randomized Crossover Trials of a Wearable Artificial Pancreas

    PubMed Central

    Renard, Eric; Cobelli, Claudio; Zisser, Howard C.; Keith-Hynes, Patrick; Anderson, Stacey M.; Brown, Sue A.; Chernavvsky, Daniel R.; Breton, Marc D.; Mize, Lloyd B.; Farret, Anne; Place, Jérôme; Bruttomesso, Daniela; Del Favero, Simone; Boscari, Federico; Galasso, Silvia; Avogaro, Angelo; Magni, Lalo; Di Palma, Federico; Toffanin, Chiara; Messori, Mirko; Dassau, Eyal; Doyle, Francis J.

    2014-01-01

    OBJECTIVE We estimate the effect size of hypoglycemia risk reduction on closed-loop control (CLC) versus open-loop (OL) sensor-augmented insulin pump therapy in supervised outpatient setting. RESEARCH DESIGN AND METHODS Twenty patients with type 1 diabetes initiated the study at the Universities of Virginia, Padova, and Montpellier and Sansum Diabetes Research Institute; 18 completed the entire protocol. Each patient participated in two 40-h outpatient sessions, CLC versus OL, in randomized order. Sensor (Dexcom G4) and insulin pump (Tandem t:slim) were connected to Diabetes Assistant (DiAs)—a smartphone artificial pancreas platform. The patient operated the system through the DiAs user interface during both CLC and OL; study personnel supervised on site and monitored DiAs remotely. There were no dietary restrictions; 45-min walks in town and restaurant dinners were included in both CLC and OL; alcohol was permitted. RESULTS The primary outcome—reduction in risk for hypoglycemia as measured by the low blood glucose (BG) index (LGBI)—resulted in an effect size of 0.64, P = 0.003, with a twofold reduction of hypoglycemia requiring carbohydrate treatment: 1.2 vs. 2.4 episodes/session on CLC versus OL (P = 0.02). This was accompanied by a slight decrease in percentage of time in the target range of 3.9–10 mmol/L (66.1 vs. 70.7%) and increase in mean BG (8.9 vs. 8.4 mmol/L; P = 0.04) on CLC versus OL. CONCLUSIONS CLC running on a smartphone (DiAs) in outpatient conditions reduced hypoglycemia and hypoglycemia treatments when compared with sensor-augmented pump therapy. This was accompanied by marginal increase in average glycemia resulting from a possible overemphasis on hypoglycemia safety. PMID:24929429

  17. Faster self-paced rate of drinking for alcohol mixed with energy drinks versus alcohol alone.

    PubMed

    Marczinski, Cecile A; Fillmore, Mark T; Maloney, Sarah F; Stamates, Amy L

    2017-03-01

    The consumption of alcohol mixed with energy drinks (AmED) has been associated with higher rates of binge drinking and impaired driving when compared with alcohol alone. However, it remains unclear why the risks of use of AmED are heightened compared with alcohol alone even when the doses of alcohol consumed are similar. Therefore, the purpose of this laboratory study was to investigate if the rate of self-paced beverage consumption was faster for a dose of AmED versus alcohol alone using a double-blind, within-subjects, placebo-controlled study design. Participants (n = 16) of equal gender who were social drinkers attended 4 separate test sessions that involved consumption of alcohol (1.97 ml/kg vodka) and energy drinks, alone and in combination. On each test day, the dose assigned was divided into 10 cups. Participants were informed that they would have a 2-h period to consume the 10 drinks. After the self-paced drinking period, participants completed a cued go/no-go reaction time (RT) task and subjective ratings of stimulation and sedation. The results indicated that participants consumed the AmED dose significantly faster (by ∼16 min) than the alcohol dose. For the performance task, participants' mean RTs were slower in the alcohol conditions and faster in the energy-drink conditions. In conclusion, alcohol consumers should be made aware that rapid drinking might occur for AmED beverages, thus heightening alcohol-related safety risks. The fast rate of drinking may be related to the generalized speeding of responses after energy-drink consumption. (PsycINFO Database Record

  18. Outpatient competence restoration: A model and outcomes

    PubMed Central

    Johnson, Nicole R; Candilis, Philip J

    2015-01-01

    AIM: To describe a model outpatient competence restoration program (OCRP) and provide data on time to restoration of adjudicative competence. METHODS: The authors tracked the process by which individuals are referred for outpatient competence restoration (OCR) by courts in the United States capital, describing the unique requirements of American law, and the avenues available for compelling adherence. Competence to stand trial is a critical gate-keeping function of the judicial and forensic communities and assures that defendants understand courtroom procedures. OCR is therefore an effort to assure fairness and protection of important legal rights. Multi-media efforts are described that educate patients and restore competence to stand trial. These include resources such as group training, use of licensed clinicians, visual aids, structured instruments, and cinema. Aggregate data from the OCRP’s previous 4 years of OCR efforts were reviewed for demographic characteristics, restoration rate, and time to restoration. Poisson regression modeling identified the differences in restoration between sequential 45-d periods after entrance into the program. RESULTS: In the past 4 years, the DC OCRP has been successful in restoring 55 of 170 participants (32%), with an average referral rate of 35 persons per year. 76% are restored after the initial 45 d in the program. Demographics of the group indicate a predominance of African-American men with a mean age of 42. Thought disorders predominate and individuals in care face misdemeanor charges 78% of the time. Poisson regression modeling of the number attaining competence during four successive 45-d periods showed a substantial difference among the time periods for the rate of attaining competence (P = 0.0011). The three time periods after 45 d each showed a significant decrease in the restoration rate when compared to the initial 0 to 45 d period - their relative rates were only 22% to 33% as high as the rate for 0-45 d (all

  19. Vulnerability of Rural Hospitals to Medicare Outpatient Payment Reform

    PubMed Central

    Mohr, Penny E.; Franco, Sheila J.; Blanchfield, Bonnie B.; Cheng, C. Michael; Evans, William N.

    1999-01-01

    Because the Balanced Budget Act (BBA) of 1997 requires implementation of a Medicare prospective payment system (PPS) for hospital outpatient services, the authors evaluated the potential impact of outpatient PPS on rural hospitals. Areas examined include: (1) How dependent are rural hospitals on outpatient revenue? (2) Are they more likely than urban hospitals to be vulnerable to payment reform? (3) What types of rural hospitals will be most vulnerable to reform? Using Medicare cost report data, the authors found that small size and government ownership are more common among rural than urban hospitals and are the most important determinants of vulnerability to payment reform. PMID:11481724

  20. Physician Use of Outpatient Electronic Health Records to Improve Care

    PubMed Central

    Wilcox, Adam; Bowes, Watson A.; Thornton, Sidney N.; Narus, Scott P.

    2008-01-01

    We applied a model of usage categories of electronic health records for outpatient physicians to a large population of physicians, using an established electronic health record. This model categorizes physician users according to how extensively they adopt the various capabilities of electronic health records. We identified representative indicators from usage statistics for outpatient physician use of the HELP-2 outpatient electronic medical record, in use at Intermountain Healthcare. Using these indicators, we calculated the relative proportion of users in each category. These proportions are useful for predicting the expected benefits of electronic health record adoption. PMID:18999307

  1. Achieving cost control in the hospital outpatient department.

    PubMed

    Sulvetta, M B

    1991-01-01

    The rapid growth in outpatient expenditures and the congressional mandate for development of a prospective payment system (PPS) for these expenditures are discussed. Extension of diagnosis-related groups to outpatient care is shown to be infeasible. Alternative patient classification schemes and options for defining the unit of payment and establishing weights and rates are discussed. A PPS primarily controls price and can only address volume by defining a broad unit of payment, such as an episode of care. Therefore, adoption of a volume performance standard approach could be effective. Outpatient payment policies must be integrated with those of other ambulatory care providers.

  2. The pros and cons of outpatient breast biopsy.

    PubMed

    Lou, M A; Mandal, A K; Alexander, J L

    1976-06-01

    A review of the 130 breast biopsies performed on women during the past three years at the Martin Luther King, Jr, General Hospital showed that 90 were performed on outpatients and 40 on inpatients. Of the 90 outpatient procedures, 61 were under local anesthesia and 29 under general. Only three outpatient biopsy specimens were malignant and required subsequent patient admission to the hospital for mastectomy at an interval of 9 to 14 days. In all three, the axillary nodes were uninvolved. In two, no residual tumor was found in the mastectomy specimen.

  3. Patterns in admission delays to outpatient methadone treatment in the United States.

    PubMed

    Gryczynski, Jan; Schwartz, Robert P; Salkever, David S; Mitchell, Shannon Gwin; Jaffe, Jerome H

    2011-12-01

    Waiting lists for methadone treatment have existed in many U.S. communities, but little is known nationally about what patient and service system factors are related to admission delays that stem from program capacity shortfalls. Using a combination of national data sources, this study examined patterns in capacity-related admission delays to outpatient methadone treatment in 40 U.S. metropolitan areas (N = 28,920). Patient characteristics associated with admission delays included racial/ethnic minority status, lower education, criminal justice referral, prior treatment experience, secondary cocaine or alcohol use, and co-occurring psychiatric problems. Injection drug users experienced fewer delays, as did self-pay patients and referrals from health care and addiction treatment providers. Higher community-level utilization of methadone treatment was associated with delay, whereas delays were less common in communities with higher utilization of alternative modalities. These findings highlight potential disparities in timely admission to outpatient methadone treatment. Implications for improving treatment access and service system monitoring are discussed.

  4. Comparing the BDI-II and the PHQ-9 with outpatient substance abusers.

    PubMed

    Dum, Mariam; Pickren, Jason; Sobell, Linda Carter; Sobell, Mark B

    2008-02-01

    Because of the high co-occurrence of Axis-I mood disorders with primary substance use disorders (SUD), it is important to routinely assess substance abusers for evidence of a mood disorder. The primary goal of the present study was to examine the psychometric characteristics of two widely used self-report measures of depression (Beck Depression Inventory-II; Patient Health Questionnaire PRIME MD) with substance abusers (N=108) in an outpatient treatment setting. Using Cronbach's alpha, the reliabilities of the BDI-II and the PHQ-9 were 0.95 and 0.91, respectively. Principal component factor analyses of both measures were conducted to evaluate the relationship between a 3-factor solution (cognitive, affective, and somatic) for the BDI-II and a 1-factor solution for the PHQ-9 (depression). Both measures were correlated with severity levels of alcohol and drug use. Advantages and disadvantages of using both measures with substance abusers are discussed.

  5. Non-attendance at a difficult-asthma clinic.

    PubMed

    McDonough, Beverley; Mault, Susan

    Increasing demand for our weekly difficult-asthma clinic means routine appointments are at a premium. This led us to explore the reasons why patients failed to attend for appointments and whether contacting them by telephone within a week of their missed scheduled appointment increased attendance. Memory lapses were the most common reason for non-attendance. Telephoning non-attenders led to a two-fold increase in attendance at subsequent clinics. Non-attendance may be a reflection of poor concordance, which, in itself, may contribute to a patient's difficult asthma.

  6. Assessing anxious features in depressed outpatients

    PubMed Central

    McClintock, Shawn M.; Husain, Mustafa M.; Bernstein, Ira H.; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Morris, David; Alpert, Jonathan; Warden, Diane; Luther, James F.; Kornstein, Susan G.; Biggs, Melanie M.; Fava, Maurizio; Rush, A. John

    2013-01-01

    Both the 17-item Hamilton Rating Scale for Depression (HRSD17) and 30-item Inventory of Depressive Symptomatology – Clinician-rated (IDS-C30) contain a subscale that assesses anxious symptoms. We used classical test theory and item response theory methods to assess and compare the psychometric properties of the two anxiety subscales (HRSDANX and IDS-CANX) in a large sample (N = 3453) of outpatients with non-psychotic major depressive disorder in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Approximately 48% of evaluable participants had at least one concurrent anxiety disorder by the self-report Psychiatric Diagnostic Screening Questionnaire (PDSQ). The HRSDANX and IDS-CANX were highly correlated (r = 0.75) and both had moderate internal consistency given their limited number of items (HRSDANX Cronbach’s alpha = 0.48; IDS-CANX Cronbach’s alpha = 0.58). The optimal threshold for ascribing the presence/absence of anxious features was found at a total score of eight or nine for the HRSDANX and seven or eight for the IDS-CANX. It would seem beneficial to delete item 17 (loss of insight) from the HRSDANX as it negatively correlated with the scale’s total score. Both the HRSDANX and IDS-CANX subscales have acceptable psychometric properties and can be used to identify anxious features for clinical or research purposes. PMID:22057975

  7. Outpatient Management of Pediatric Type 1 Diabetes

    PubMed Central

    Cogen, Fran R.

    2015-01-01

    The incidence of both type 1 and type 2 diabetes (T1DM and T2DM) continues to rise within the pediatric population. However, T1DM remains the most prevalent form diagnosed in children. It is critical that health-care professionals understand the types of diabetes diagnosed in pediatrics, especially the distinguishing features between T1DM and T2DM, to ensure proper treatment. Similar to all individuals with T1DM, lifelong administration of exogenous insulin is necessary for survival. However, children have very distinct needs and challenges compared to those in the adult diabetes population. Accordingly, treatment, goals, and age-appropriate requirements must be individually addressed. The main objectives for the treatment of pediatric T1DM include maintaining glucose levels as close to normal as possible, avoiding acute complications, and preventing long-term complications. In addition, unique to pediatrics, facilitating normal growth and development is important to comprehensive care. To achieve these goals, a careful balance of insulin therapy, medical nutrition therapy, and exercise or activity is necessary. Pharmacological treatment options consist of various insulin products aimed at mimicking prior endogenous insulin secretion while minimizing adverse effects. This review focuses on the management of pediatric T1DM in the outpatient environment, highlighting pharmacotherapy management strategies. PMID:26472948

  8. Outpatient Management of Pediatric Type 1 Diabetes.

    PubMed

    Beck, Joni K; Cogen, Fran R

    2015-01-01

    The incidence of both type 1 and type 2 diabetes (T1DM and T2DM) continues to rise within the pediatric population. However, T1DM remains the most prevalent form diagnosed in children. It is critical that health-care professionals understand the types of diabetes diagnosed in pediatrics, especially the distinguishing features between T1DM and T2DM, to ensure proper treatment. Similar to all individuals with T1DM, lifelong administration of exogenous insulin is necessary for survival. However, children have very distinct needs and challenges compared to those in the adult diabetes population. Accordingly, treatment, goals, and age-appropriate requirements must be individually addressed. The main objectives for the treatment of pediatric T1DM include maintaining glucose levels as close to normal as possible, avoiding acute complications, and preventing long-term complications. In addition, unique to pediatrics, facilitating normal growth and development is important to comprehensive care. To achieve these goals, a careful balance of insulin therapy, medical nutrition therapy, and exercise or activity is necessary. Pharmacological treatment options consist of various insulin products aimed at mimicking prior endogenous insulin secretion while minimizing adverse effects. This review focuses on the management of pediatric T1DM in the outpatient environment, highlighting pharmacotherapy management strategies.

  9. Laboratory tests and compliance of dermatologic outpatients

    PubMed Central

    Kim, Jaehwan

    2013-01-01

    Laboratory tests, including blood tests and urine analysis, are frequently performed in the dermatology outpatient clinic, but doctors often do not consider the cognitive or psychological effect of the examinations. Based on terror management theory, we hypothesized that performing laboratory tests increases the patient’s fear of mortality, and therefore has a positive effect on the patient’s attitude toward the doctor’s recommendations and willingness to accept them. The study employed a single factor between-subjects design, using a questionnaire completed by the patients. One group consisted of patients who had undergone laboratory tests 1 week before the survey, and the other group consisted of patients who had not undergone a laboratory test. Although the differences between two groups were not statistically significant, the patients who had laboratory tests had tendency to show even lower positive attitude toward the doctor’s recommendations and less intention to follow the recommendations. In contrast to our hypothesis, performing laboratory tests does not subliminally increase patients’ fears or anxieties about their disease or their compliance with doctors’ recommendations. PMID:24555101

  10. Household Income and Preschool Attendance in China

    ERIC Educational Resources Information Center

    Gong, Xin; Xu, Di; Han, Wen-Jui

    2015-01-01

    This article draws upon the literature showing the benefits of high-quality preschools on child well-being to explore the role of household income on preschool attendance for a cohort of 3-to 6-year-olds in China using data from the China Health and Nutrition Survey, 1991-2006. Analyses are conducted separately for rural (N = 1,791) and urban…

  11. Narcissism and relational representations among psychiatric outpatients.

    PubMed

    Kealy, David; Ogrodniczuk, John S; Joyce, Anthony S; Steinberg, Paul I; Piper, William E

    2015-06-01

    Pathological narcissism is associated with maladaptive interpersonal behavior, although less is known regarding the internal relational representations of narcissistic patients. The authors examined the relationship between pathological narcissism and two constructs that reflect internal representations of relational patterns: quality of object relations and attachment style. Patients attending a psychiatric day treatment program (N = 218) completed measures of narcissism, general psychiatric distress, and attachment style in terms of attachment avoidance and anxiety. A semistructured interview was used to assess quality of object relations. Multiple regression analysis was conducted, controlling for general psychiatric distress. Pathological narcissism was associated with anxious attachment, but not with avoidant attachment. Narcissism was also associated with lower levels of quality of object relations. The implications of these results are discussed in terms of internal representations of self-other relations.

  12. Outpatient follow-up for critical limb ischemia.

    PubMed

    Watch, Libby

    2014-09-01

    Outpatient follow-Up for critical limb ischemia offers the clinician the opportunity to monitor the patient for risk factor modification and wound healing. Routine surveillance following intervention will improve long-term patency.

  13. 76 FR 49458 - TRICARE; Hospital Outpatient Radiology Discretionary Appeal Adjustments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ... of the Secretary TRICARE; Hospital Outpatient Radiology Discretionary Appeal Adjustments AGENCY... hospitals of an opportunity for net adjusted payments for radiology services for which TRICARE payments were... radiology services specified in the regulation as being reimbursed under the allowable charge...

  14. Outpatient angioplasty: 4-year experience in one practice.

    PubMed Central

    Payne, S. P.; Stanton, A.; Travers, P.; Glenn, D.; Hanel, K. C.

    1997-01-01

    Angioplasty is often performed as an inpatient procedure after preliminary angiography. In order to increase efficiency and patient comfort we introduced a policy of performing angioplasty for chronic leg ischaemia as an outpatient whenever possible, using duplex scanning to select suitable lesions. This paper examines the safety and feasibility of this policy over a 4-year period. We prospectively assessed 168 consecutive cases which were planned for outpatient angioplasty from a total of 190 cases undergoing angioplasty and found full agreement between duplex scanning and angiography in 92%. Six patients (4%) developed complications of angioplasty requiring admission and another five were admitted for unexpected organisational reasons. Thus, the complication rate of outpatient angioplasty was 4%. All complications were noted at the time of angioplasty with no unexpected readmissions. Angioplasty for leg ischaemia is feasible and safe to perform as an outpatient using duplex scanning to select appropriate cases. PMID:9326123

  15. Barriers and Facilitators in Implementing “Prevention for Positives” Alcohol Reduction Support: The Perspectives of Directors and Providers in Hospital-Based HIV Care Centers

    PubMed Central

    Strauss, Shiela M.; Munoz-Plaza, Corrine E.; Tiburcio, Nelson J.; Gwadz, Marya

    2011-01-01

    HIV-infected patients have considerable need for alcohol reduction support, and HIV care providers are strategically placed to implement a “prevention for positives” alcohol reduction approach through alcohol screening and brief interventions (SBIs). To facilitate this approach, we provided alcohol SBI education and training to HIV care providers in four hospital-based, New York City HIV Care Centers in 2007. Interviews with the medical directors and 14 of the HIV care providers who attended the training identified barriers to implementing alcohol SBIs. These included limited time for alcohol screening, patients’ incomplete disclosure of alcohol use, providers’ perceptions that alcohol use is not a major problem for their patients, and provider specialization that assigns patients with problematic alcohol use to specifically designated providers. Identified facilitators for alcohol SBI implementation included adequate time to conduct the SBI; availability of information, tools, and key points to emphasize with HIV-infected patients; and use of a brief alcohol screening tool. PMID:21570321

  16. Impact of alcohol consumption on clinical aspects of gambling disorder.

    PubMed

    Del Pino-Gutiérrez, Amparo; Fernández-Aranda, Fernando; Granero, Roser; Tárrega, Salomé; Valdepérez, Ana; Agüera, Zaida; Håkansson, Anders; Sauvaget, Anne; Aymamí, Neus; Gómez-Peña, Mónica; Moragas, Laura; Baño, Marta; Honrubia, María; Menchón, José M; Jiménez-Murcia, Susana

    2017-04-01

    Similarities between gambling disorder and substance use disorders have been extensively described. To date, however, few studies using large clinical samples have been carried out that reliably assess the relationship between different levels of alcohol consumption and gambling disorders. The present study aimed to assess the impact of baseline alcohol consumption levels on the clinical profile in a large sample of treatment-seeking individuals. Nine hundred and fifty-one consecutive outpatients diagnosed with gambling disorder according to DSM-IV criteria were compared after being included in three alcohol consumption groups (low risk, abuse and risk of dependence) based on their total raw scores on the AUDIT questionnaire. Results showed a high prevalence of risk of alcohol dependence in GD patients who were immigrants, unemployed, and had a low level of education. A positive linear trend was also found between alcohol consumption level and the prevalence of other current and life-time comorbid mental disorders, and for the presence of drug abuse. Statistically significant differences were found between the three alcohol consumption groups in terms of the evolution and severity of the gambling disorder, self-directedness personality trait, and levels of general psychopathology, hostility and paranoid ideation. In conclusion, the results showed an association between increased alcohol consumption and greater dysfunction.

  17. Ethnic Differences in Presentation and Severity of Alcoholic Liver Disease

    PubMed Central

    Durbin-Johnson, Blythe; Halsted, Charles H.; Medici, Valentina

    2015-01-01

    Background The frequency of alcoholic liver disease (ALD), including alcoholic steatosis, hepatitis and cirrhosis, varies significantly by ethnicity. Methods With the goal to assess the role of ethnicity in determining the age of onset and severity of ALD and to compare the risk factors for its progression among ethnic groups, we conducted a retrospective chart review of all patients with ALD who were admitted or were followed as outpatients at University of California Davis Medical Center between 2002 and 2010. After excluding HBsAg and HIV positive subjects, we reviewed the charts of 791 ALD patients including 130 with alcoholic fatty liver, 154 with alcoholic hepatitis, and 507 with alcoholic cirrhosis. Results When controlling for all variables in the model, Hispanic patients presented at significantly 4-10 years younger ages than White/Caucasian patients, in each of the three disease severity categories and the results were confirmed after excluding HCV Ab/RNA positive subjects. There were more obese Hispanic patients than White/Caucasian patients, whereas the proportion of patients with hepatitis C was significantly greater in African/American subjects with alcoholic hepatitis and the proportion of patients with diabetes mellitus was significantly lower in White/Caucasian subjects than in Hispanic subjects with cirrhosis. The proportion of subjects with severe alcoholic hepatitis was similar in Hispanic and White/Caucasian patients, but lower in African/American subjects. Conclusion Ethnicity is a major factor affecting the age and severity of presentation of different subtypes of ALD. PMID:25702770

  18. Alcoholic metabolic emergencies.

    PubMed

    Allison, Michael G; McCurdy, Michael T

    2014-05-01

    Ethanol intoxication and ethanol use are associated with a variety of metabolic derangements encountered in the Emergency Department. In this article, the authors discuss alcohol intoxication and its treatment, dispel the myth that alcohol intoxication is associated with hypoglycemia, comment on electrolyte derangements and their management, review alcoholic ketoacidosis, and end with a section on alcoholic encephalopathy.

  19. Fetal Alcohol Exposure

    MedlinePlus

    ... of the National Academies (IOM) diagnostic categories: 4 » Fetal Alcohol Syndrome (FAS) » Partial FAS (pFAS) » Alcohol-Related Neurodevelopmental Disorder ( ... 301.443.3860 Relevant Clinical Diagnoses IOM Diagnoses Fetal Alcohol Syndrome (FAS) Fetal Alcohol Syndrome (FAS) was the first ...

  20. Nurses' Attitudes towards Alcoholics.

    ERIC Educational Resources Information Center

    Speer, Rita D.

    Nurses' attitudes toward the alcoholic can have a profound impact on the person suffering from alcoholism. These attitudes can affect the alcoholic's care and even whether the alcoholic chooses to recover. This study investigated attitudes of approximately 68 nurses employed in hospitals, 49 nurses in treatment facilities, 58 nursing students, and…

  1. Children of Alcoholics.

    ERIC Educational Resources Information Center

    Krois, Deborah Helen

    Although alcoholism has long been considered a serious problem, the impact of parental alcoholism on children has only recently begun to receive attention from researchers and clinicians. A review of the empirical literature on children of alcoholics was conducted and it was concluded that children raised in an alcoholic family are at increased…

  2. Overview of Alcohol Consumption

    MedlinePlus

    ... Work Our Funding Our Staff Jobs & Training Our Location Contact Us You are here Home » Alcohol & Your Health » Overview of Alcohol Consumption In this Section Alcohol Facts & Statistics What Is A Standard Drink? Drinking Levels Defined Overview of Alcohol Consumption ...

  3. Relationship Between Service Utilization and Runaway Youths' Alcohol and Other Drug Use.

    PubMed

    Slesnick, Natasha; Meade, Melissa; Tonigan, J Scott

    2001-01-01

    Runaway youths represent a vulnerable, high-risk population that has received little societal attention. Studies show that youths at greatest need are the least likely to access mental health, medical, and other social services. This study evaluated service utilization, including medical visits, psychological, alcohol and drug counseling and 12-step attendance, and substance use. Runaway youths (n = 51) between the ages of 12 and 17 with a diagnosis of alcohol abuse or dependence were recruited from two southwestern runaway shelters. Results showed that psychological counseling and medical visits were associated with less alcohol use while 12-step attendance was associated with more alcohol use at pretreatment. Service utilization was not associated with illicit drug use. The findings suggest that alcohol and other drug use are affected differently by service utilization in this sample of youths. More research is required to evaluate and develop treatments which can effectively intervene with this high-risk group.

  4. Move to outpatient settings may boost medical hotels.

    PubMed

    Burns, J

    1992-06-08

    The shift of surgeries to outpatient settings could be healthy for medical hotels, those amenity-equipped facilities originally developed to ease patients out of costly acute-care beds. Because fewer hospitals have a pressing need to use such alternative lodging, some medical hotels are hoping to hitch their fortunes to the outpatient trade, keeping patients overnight after surgeries that don't require hospital admission.

  5. Internet Alcohol Marketing and Underage Alcohol Use

    PubMed Central

    McClure, Auden C.; Tanski, Susanne E.; Li, Zhigang; Jackson, Kristina; Morgenstern, Matthis; Li, Zhongze; Sargent, James D.

    2016-01-01

    BACKGROUND AND OBJECTIVE Internet alcohol marketing is not well studied despite its prevalence and potential accessibility and attractiveness to youth. The objective was to examine longitudinal associations between self-reported engagement with Internet alcohol marketing and alcohol use transitions in youth. METHODS A US sample of 2012 youths aged 15 to 20 was surveyed in 2011. An Internet alcohol marketing receptivity score was developed, based on number of positive responses to seeing alcohol advertising on the Internet, visiting alcohol brand Web sites, being an online alcohol brand fan, and cued recall of alcohol brand home page images. We assessed the association between baseline marketing receptivity and both ever drinking and binge drinking (≥6 drinks per occasion) at 1-year follow-up with multiple logistic regression, controlling for baseline drinking status, Internet use, sociodemographics, personality characteristics, and peer or parent drinking. RESULTS At baseline, ever-drinking and binge-drinking prevalence was 55% and 27%, respectively. Many (59%) reported seeing Internet alcohol advertising, but few reported going to an alcohol Web site (6%) or being an online fan (3%). Higher Internet use, sensation seeking, having family or peers who drank, and past alcohol use were associated with Internet alcohol marketing receptivity, and a score of 1 or 2 was independently associated with greater adjusted odds of initiating binge drinking (odds ratio 1.77; 95% confidence interval, 1.13–2.78 and odds ratio 2.15; 95% confidence interval, 1.06–4.37 respectively) but not with initiation of ever drinking. CONCLUSIONS Although high levels of engagement with Internet alcohol marketing were uncommon, most underage youths reported seeing it, and we found a prospective association between receptivity to this type of alcohol marketing and future problem drinking, making additional research and ongoing surveillance important. PMID:26738886

  6. Demographic and clinical characteristics of UK military veterans attending a psychological therapies service

    PubMed Central

    Giebel, Clarissa M.; Clarkson, Paul; Challis, David

    2014-01-01

    Aims and method To investigate the demographic and clinical characteristics of subgroups of UK veterans attending a dedicated psychological therapies service following the Improving Access to Psychological Therapies (IAPT) treatment model. Veterans accessing a newly established service in the north-west were categorised into three groups: early service leavers, those with a physical disability, and substance and/or alcohol misusers. Anxiety, depression and social functioning were measured pre- and post-treatment. Results Veterans vary in their demographic and clinical characteristics as well as in treatment efficacy, as measured by the post-treatment scores on probable depression and anxiety. Therapy appears to be most effective in early service leavers, whereas veterans with a physical disability or a substance or alcohol misuse problem tend not to do as well in terms of symptoms of depression or anxiety. Clinical implications This study highlights the importance of targeting different veteran subgroups for dedicated psychological therapy. PMID:25505626

  7. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Definitions § 440.20 Outpatient hospital services and rural health clinic services. (a) Outpatient hospital... agency may exclude from the definition of “outpatient hospital services” those types of items and... 42 Public Health 4 2010-10-01 2010-10-01 false Outpatient hospital services and rural...

  8. The role of alcohol perceptions as mediators between personality and alcohol-related outcomes among incoming college-student drinkers.

    PubMed

    Hustad, John T P; Pearson, Matthew R; Neighbors, Clayton; Borsari, Brian

    2014-06-01

    After high school, college students escalate their drinking at a faster rate than their noncollege-attending peers, and alcohol use in high school is one of the strongest predictors of alcohol use in college. Therefore, an improved understanding of the role of predictors of alcohol use during the critical developmental period when individuals transition to college has direct clinical implications to reduce alcohol-related harms. We used path analysis in the present study to examine the predictive effects of personality (e.g., impulsivity, sensation seeking, hopelessness, and anxiety sensitivity) and three measures of alcohol perception: descriptive norms, injunctive norms, and perceptions regarding the perceived role of drinking in college on alcohol-related outcomes. Participants were 490 incoming freshmen college students. Results indicated that descriptive norms, injunctive norms, and the role of drinking largely mediated the effects of personality on alcohol outcomes. In contrast, both impulsivity and hopelessness exhibited direct effects on alcohol-related problems. The perceived role of drinking was a particularly robust predictor of outcomes and mediator of the effects of personality traits, including sensation seeking and impulsivity on alcohol outcomes. The intertwined relationships observed in this study between personality factors, descriptive norms, injunctive norms, and the role of drinking highlight the importance of investigating these predictors simultaneously. Findings support the implementation of interventions that target these specific perceptions about the role of drinking in college.

  9. The Role of Alcohol Perceptions as Mediators Between Personality and Alcohol-Related Outcomes Among Incoming College-Student Drinkers

    PubMed Central

    Hustad, John T. P.; Pearson, Matthew R.; Neighbors, Clayton; Borsari, Brian

    2014-01-01

    After high school, college students escalate their drinking at a faster rate than their noncollege-attending peers, and alcohol use in high school is one of the strongest predictors of alcohol use in college. Therefore, an improved understanding of the role of predictors of alcohol use during the critical developmental period when individuals transition to college has direct clinical implications to reduce alcohol-related harms. We used path analysis in the present study to examine the predictive effects of personality (e.g., impulsivity, sensation seeking, hopelessness, and anxiety sensitivity) and three measures of alcohol perception: descriptive norms, injunctive norms, and perceptions regarding the perceived role of drinking in college on alcohol-related outcomes. Participants were 490 incoming freshmen college students. Results indicated that descriptive norms, injunctive norms, and the role of drinking largely mediated the effects of personality on alcohol outcomes. In contrast, both impulsivity and hopelessness exhibited direct effects on alcohol-related problems. The perceived role of drinking was a particularly robust predictor of outcomes and mediator of the effects of personality traits, including sensation seeking and impulsivity on alcohol outcomes. The intertwined relationships observed in this study between personality factors, descriptive norms, injunctive norms, and the role of drinking highlight the importance of investigating these predictors simultaneously. Findings support the implementation of interventions that target these specific perceptions about the role of drinking in college. PMID:24467197

  10. Alcohol and bone.

    PubMed

    Mikosch, Peter

    2014-01-01

    Alcohol is widely consumed across the world in different cultural and social settings. Types of alcohol consumption differ between (a) light, only occasional consumption, (b) heavy chronic alcohol consumption, and (c) binge drinking as seen as a new pattern of alcohol consumption among teenagers and young adults. Heavy alcohol consumption is detrimental to many organs and tissues, including bones. Osteoporosis is regularly mentioned as a secondary consequence of alcoholism, and chronic alcohol abuse is established as an independent risk factor for osteoporosis. The review will present the different mechanisms and effects of alcohol intake on bone mass, bone metabolism, and bone strength, including alcoholism-related "life-style factors" such as malnutrition, lack of exercise, and hormonal changes as additional causative factors, which also contribute to the development of osteoporosis due to alcohol abuse.

  11. Alcoholism and the Hispanic: A Mutual Concern = El Alcoholismo y Los Hispanos Una Preocupacion Nacional. Proceedings of the National Hispanic Conference on Alcoholism (San Antonio, Texas, September 7-10, 1981).

    ERIC Educational Resources Information Center

    AVANTE International Systems Corp., San Antonio, TX.

    Written in Spanish and English, the proceedings include 6 papers and the recommendations presented at the conference on alcoholism and alcohol-related problems among Hispanics attended by approximately 400 participants, representing 29 states, Puerto Rico, and Mexico. "The Challenge of the 1980's: Action Through Unity" discusses the need for unity…

  12. Alcohol dependence and driving: knowledge of DVLA regulations

    PubMed Central

    Collier, Andrew; Watts, Maggie; Ghosh, Sujoy; Rice, Peter; Dewhurst, Neil

    2015-01-01

    Aims and Methods The UK’s Driver Vehicle Licensing Authority (DVLA) requires individuals to report if they have a medical condition such as alcohol dependence. General Medical Council guidance indicates that medical practitioners should ensure patients are aware of their impairment and requirement to notify the DVLA. Results In a survey of 246 people with known alcohol dependence, none were aware of advice on driving given by medical practitioners and none had self-reported. In addition, 362 doctors, either attending a college symposium or visiting a college website, were asked about their knowledge of DVLA regulations regarding alcohol dependence: 73% of those attending the symposium and 63% of those visiting the website answered incorrectly. In Scotland, over 20 000 people have alcohol dependence (over 1 million people with alcohol abuse), yet only 2548 people with alcohol problems self-reported to the DVLA in 2011. Clinical implications If the DVLA regulations were implemented, it could make an enormous difference to the behaviours of the driving public. PMID:26191423

  13. Alcohol fuels

    SciTech Connect

    Not Available

    1990-07-01

    Ethanol is an alcohol made from grain that can be blended with gasoline to extend petroleum supplies and to increase gasoline octane levels. Congressional proposals to encourage greater use of alternative fuels could increase the demand for ethanol. This report evaluates the growth potential of the ethanol industry to meet future demand increases and the impacts increased production would have on American agriculture and the federal budget. It is found that ethanol production could double or triple in the next eight years, and that American farmers could provide the corn for this production increase. While corn growers would benefit, other agricultural segments would not; soybean producers, for example could suffer for increased corn oil production (an ethanol byproduct) and cattle ranchers would be faced with higher feed costs because of higher corn prices. Poultry farmers might benefit from lower priced feed. Overall, net farm cash income should increase, and consumers would see slightly higher food prices. Federal budget impacts would include a reduction in federal farm program outlays by an annual average of between $930 million (for double current production of ethanol) to $1.421 billion (for triple production) during the eight-year growth period. However, due to an partial tax exemption for ethanol blended fuels, federal fuel tax revenues could decrease by between $442 million and $813 million.

  14. Dental caries prevalence among type II diabetic and nondiabetic adults attending a hospital

    PubMed Central

    Malvania, Ekta A.; Sheth, Sona A.; Sharma, Ashish S.; Mansuri, Saloni; Shaikh, Faizan; Sahani, Saloni

    2016-01-01

    Objectives: Diabetes mellitus (DM) is a common chronic metabolic disorder which affects millions of people. At present, India has the highest incidence of diabetes worldwide. Several oral lesions and conditions are associated with diabetes. However, there is a lack of consensus among researchers regarding the relationship between DM and dental caries. Hence, the present study was carried out to assess the dental caries prevalence among type II diabetic and nondiabetic adults attending a hospital in Ahmedabad city. Materials and Methods: A hospital-based cross-sectional study was conducted. One hundred and twenty diabetics individuals attending the diabetic Outpatient Department (OPD) and age and sex-matched 120 nondiabetic individuals from general OPD were included in the study. The data were gathered through semi-close-ended questionnaire and clinical examination. Dental caries was assessed by using the World Health Organization's 2013 proforma. Data was analyzed by applying Student's independent t-test or one-way analysis of variance. Results: Dental caries prevalence among the diabetic group was 73.33% and 33.33% among the nondiabetic group. Dental caries prevalence and mean dental caries was significantly higher among uncontrolled diabetic individuals than that among controlled diabetic individuals. Duration of the disease and dental caries prevalence did not show any significant difference. Conclusion: Dental caries prevalence was significantly high among diabetic individuals compared with nondiabetic individuals. Close collaboration between the patients, healthcare units, and oral health professionals could be a way of improving diabetic patients' general and oral health. PMID:28217542

  15. Effectiveness of the Brief Alcohol and Screening Intervention for College Students (BASICS) Program with a Mandated Population

    ERIC Educational Resources Information Center

    DiFulvio, Gloria T.; Linowski, Sally A.; Mazziotti, Janet S.; Puleo, Elaine

    2012-01-01

    Objective: This study evaluated the effectiveness of a large-scale intervention designed to reduce alcohol abuse among adjudicated college students. Participants: Participants were college students mandated to attend a Brief Alcohol Screening and Intervention for College Students (BASICS) program and a randomly selected comparison group of…

  16. Alcohol Increases Impulsivity and Abuse Liability in Heavy Drinking Women

    PubMed Central

    Reed, Stephanie Collins; Levin, Frances R.; Evans, Suzette M.

    2013-01-01

    Heavy drinking has increased in recent years and has been linked to numerous health-related risks, particularly in women. A number of factors may play a role in exacerbating the risks linked to heavy drinking, such as impulsivity, which itself is related to a number of risky behaviors. The present study investigated the effects of alcohol (0, 0.5, 0.75 g/kg) on impulsivity in female heavy drinkers (n = 23) and female light drinkers (n = 23) using a double-blind, placebo-controlled outpatient design; all women were tested during follicular phase of the menstrual cycle. Each session, participants completed a range of tasks including subjective measures of abuse liability, cognitive performance tasks, three behavioral impulsivity tasks, and a risk-taking task. Alcohol increased impulsivity on the Immediate and Delayed Memory Task (IMT and DMT) and Delay Discounting task. Heavy drinkers scored higher on impulsivity self-reports and were more impulsive on the IMT and the GoStop task than light drinkers. The high dose of alcohol further increased impulsive performance on the IMT and DMT in heavy drinkers. There were no group differences or alcohol effects on the Balloon Analogue Risk Task. Alcohol increased sedative-like effects more in light drinkers and increased stimulant-like effects and alcohol liking more in heavy drinkers. In summary, female heavy drinkers are less sensitive to the negative effects of alcohol, report more positive effects of alcohol, and are more impulsive than female light drinkers. Moreover, impulsive responding was exacerbated by alcohol drinking among female heavy drinkers, indicating that women who drink at this level are at increased risk for developing alcohol use disorders and engaging in other risky behaviors, particularly after drinking. PMID:23066857

  17. Should We Bother Improving Students' Attendance at Seminars?

    ERIC Educational Resources Information Center

    Gbadamosi, Gbolahan

    2015-01-01

    This study uses action research intervention to improve students' attendance at seminars. Specifically, the study asks the question: will students' attendance improve if they drive their own learning by running their own seminars? Records of lecture and seminar attendance at a module and comparative ones were used. Focus group interviews provided…

  18. 38 CFR 21.374 - Authorization for travel of attendants.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Authorization for travel... 38 U.S.C. Chapter 31 Interregional and Intraregional Travel of Veterans § 21.374 Authorization for travel of attendants. (a) Travel for attendants. The services of an attendant to accompany a...

  19. 38 CFR 21.374 - Authorization for travel of attendants.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Authorization for travel... 38 U.S.C. Chapter 31 Interregional and Intraregional Travel of Veterans § 21.374 Authorization for travel of attendants. (a) Travel for attendants. The services of an attendant to accompany a...

  20. 38 CFR 21.374 - Authorization for travel of attendants.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Authorization for travel... 38 U.S.C. Chapter 31 Interregional and Intraregional Travel of Veterans § 21.374 Authorization for travel of attendants. (a) Travel for attendants. The services of an attendant to accompany a...

  1. 38 CFR 21.374 - Authorization for travel of attendants.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Authorization for travel... 38 U.S.C. Chapter 31 Interregional and Intraregional Travel of Veterans § 21.374 Authorization for travel of attendants. (a) Travel for attendants. The services of an attendant to accompany a...

  2. 38 CFR 21.374 - Authorization for travel of attendants.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Authorization for travel... 38 U.S.C. Chapter 31 Interregional and Intraregional Travel of Veterans § 21.374 Authorization for travel of attendants. (a) Travel for attendants. The services of an attendant to accompany a...

  3. Interpreting the Influence of Community College Attendance upon Baccalaureate Attainment

    ERIC Educational Resources Information Center

    Townsend, Barbara K.

    2007-01-01

    National quantitative studies examining the impact of community college attendance upon educational attainment conclude that initial attendance at a community college (as opposed to a 4-year institution) reduces the likelihood of attaining a bachelor's degree. Yet these studies, which suggest that initial attendance at a community college is not a…

  4. Efficacy of the alcohol use disorders identification test as a screening tool for hazardous alcohol intake and related disorders in primary care: a validity study.

    PubMed Central

    Piccinelli, M.; Tessari, E.; Bortolomasi, M.; Piasere, O.; Semenzin, M.; Garzotto, N.; Tansella, M.

    1997-01-01

    OBJECTIVE: To determine the properties of the alcohol use disorders identification test in screening primary care attenders for alcohol problems. DESIGN: A validity study among consecutive primary care attenders aged 18-65 years. Every third subject completed the alcohol use disorders identification test (a 10 item self report questionnaire on alcohol intake and related problems) and was interviewed by an investigator with the composite international diagnostic interview alcohol use module (a standardised interview for the independent assessment of alcohol intake and related disorders). SETTING: 10 primary care clinics in Verona, north eastern Italy. PATIENTS: 500 subjects were approached and 482 (96.4%) completed evaluation. RESULTS: When the alcohol use disorders identification test was used to detect subjects with alcohol problems the area under the receiver operating characteristic curve was 0.95. The cut off score of 5 was associated with a sensitivity of 0.84, a specificity of 0.90, and a positive predictive value of 0.60. The screening ability of the total score derived from summing the responses to the five items minimising the probability of misclassification between subjects with and without alcohol problems provided an area under the receiver operating characteristic curve of 0.93. A score of 5 or more on the five items was associated with a sensitivity of 0.79, a specificity of 0.95, and a positive predictive value of 0.73. CONCLUSIONS: The alcohol use disorders identification test performs well in detecting subjects with formal alcohol disorders and those with hazardous alcohol intake. Using five of the 10 items on the questionnaire gives reasonable accuracy, and these are recommended as questions of choice to screen patients for alcohol problems. PMID:9040389

  5. Alcohol misuse Y91 coding in ICD-11: rational terminology and logical coding specifically to encourage early identification and advice.

    PubMed

    Touquet, Robin; Harris, Dan

    2012-01-01

    Alcohol misuse is a common presentation to the Emergency Department (ED). The International Classification of Diseases ICD-10 for alcohol misuse, both under F10 and Y90/Y91, is not straightforward. The practicalities of coding ED attendances reveal an increasing detachment from ICD-10 (currently under review). Early identification [sometimes using blood alcohol concentrations (BACs)] and brief advice (IBA) can reduce unscheduled alcohol-related ED re-attendance. The UK Government Department of Health has implemented use of the terms 'Hazardous Drinking', 'Harmful Drinking' and 'Dependent Drinking' in its Public Service Agreements aimed at reducing harm by alcohol. Simplifying coding might increase IBA usage. We suggest that coding improvements in ICD-11 should update Y91 (currently 'clinical assessment')-with ICD-10 Y90 remaining for BAC to classify a patient's 'alcohol status'. Y90 and Y91 together would indicate the urgency for early IBA and/or speciality referral, aiming to reduce the prevalence of 'Dependent Drinking'.

  6. Positively essential: traditional birth attendants in Malawi.

    PubMed

    Stronge, Shirley

    2011-06-01

    One of the biggest challenges for healthcare professionals working in developing countries is the lack of trained personnel to carry out much needed health care provision. Shirley Stronge worked as a nurse/midwife tutor in a rural area in the north of Malawi. Millennium Development Goals four and five have focused our attention on the care required by mothers and newborns. Shirley has chosen to reflect on the role of Traditional Birth Attendants in the north of Malawi and their positive impact on maternity services in this area.

  7. The temporal association between energy drink and alcohol use among adolescents: A short communication

    PubMed Central

    Choi, Hye Jeong; Wolford-Clevenger, Caitlin; Brem, Meagan J.; Elmquist, JoAnna; Stuart, Gregory L.; Pasch, Keryn E.; Temple, Jeff R.

    2015-01-01

    Purpose To investigate the temporal relation between energy drink and alcohol use among adolescents. Methods Data were collected from adolescents attending public high schools in two waves (n = 894). Results Path analysis indicated that energy drink use at baseline was positively associated with the number of drinking days but not binge drinking or average drinks per drinking day over the past 30 days at follow-up. This relation remained while controlling for race, age, gender, previous alcohol use, and impulsivity. Conclusions Alcohol use prevention efforts should consider energy drink use as risk factors for adolescent alcohol use. PMID:26632245

  8. Alcoholism and alcohol drinking habits predicted from alcohol dehydrogenase genes.

    PubMed

    Tolstrup, Janne Schurmann; Nordestgaard, Børge Grønne; Rasmussen, Søren; Tybjaerg-Hansen, Anne; Grønbaek, Morten

    2008-06-01

    Alcohol drinking habits and alcoholism are partly genetically determined. Alcohol is degraded primarily by alcohol dehydrogenase (ADH) wherein genetic variation that affects the rate of alcohol degradation is found in ADH1B and ADH1C. It is biologically plausible that these variations may be associated with alcohol drinking habits and alcoholism. By genotyping 9080 white men and women from the general population, we found that men and women with ADH1B slow vs fast alcohol degradation drank more alcohol and had a higher risk of everyday drinking, heavy drinking, excessive drinking and of alcoholism. For example, the weekly alcohol intake was 9.8 drinks (95% confidence interval (CI): 9.1-11) among men with the ADH1B.1/1 genotype compared to 7.5 drinks (95% CI: 6.4-8.7) among men with the ADH1B.1/2 genotype, and the odds ratio (OR) for heavy drinking was 3.1 (95% CI: 1.7-5.7) among men with the ADH1B.1/1 genotype compared to men with the ADH1B.1/2 genotype. Furthermore, individuals with ADH1C slow vs fast alcohol degradation had a higher risk of heavy and excessive drinking. For example, the OR for heavy drinking was 1.4 (95% CI: 1.1-1.8) among men with the ADH1C.1/2 genotype and 1.4 (95% CI: 1.0-1.9) among men with the ADH1B.2/2 genotype, compared with men with the ADH1C.1/1 genotype. Results for ADH1B and ADH1C genotypes among men and women were similar. Finally, because slow ADH1B alcohol degradation is found in more than 90% of the white population compared to less than 10% of East Asians, the population attributable risk of heavy drinking and alcoholism by ADH1B.1/1 genotype was 67 and 62% among the white population compared with 9 and 24% among the East Asian population.

  9. Profile of Vitamin D in patients attending at general hospital Mahad India

    PubMed Central

    Bawaskar, Parag Himatrao; Bawaskar, Himmatrao Saluba; Bawaskar, Pramodini Himmatrao; Pakhare, Abhijit Patilbuwa

    2017-01-01

    Background: Despite abundant sunshine, Vitamin D deficiency is prevalent in urban India. However, reports on analyzing Vitamin D status from rural Indian population are scanty. Here, we have evaluated Vitamin D status in patients attending outpatient department (OPD) in a rural Indian hospital setting. Methods: A hospital-based cross-sectional study was conducted at a secondary level rural hospital in patients attending medicine OPD. After obtaining informed consent, demographic information was collected from consecutive adult patients along with 3 ml blood sample for Vitamin D analysis using electro chemiluminescene on cobas elecys E411 fully automated system. Vitamin D levels were compared across various groups by using Mann–Whitney or Kruskal–Wallis tests, and multiple linear regression analysis was performed to identify the predictors of Vitamin D level. Results: A total of 640 patients were enrolled in the study, and the prevalence of Vitamin D deficiency (<20 ng/ml) was found to be 65.4% with 95% confidence interval of 61.7–69.1%. On univariate analysis, Vitamin D levels were statistically significantly lower among younger age group, those who have dark complexion, wearing Burkha (veil), and those who were not adequately exposed to sunlight. After multiple linear regressions, dark complexion, wearing Burkha, inadequate exposure to sunlight, and presence of diabetes were identified as statistically significant predictors of Vitamin D deficiency. Conclusion: We report a high prevalence of Vitamin-D deficiency in patients attending medicine OPD. Thus, patients with generalized complaints may be evaluated for serum Vitamin D levels. PMID:28217511

  10. Prevalence and correlates of cannabis use in an outpatient VA posttraumatic stress disorder clinic.

    PubMed

    Gentes, Emily L; Schry, Amie R; Hicks, Terrell A; Clancy, Carolina P; Collie, Claire F; Kirby, Angela C; Dennis, Michelle F; Hertzberg, Michael A; Beckham, Jean C; Calhoun, Patrick S

    2016-05-01

    Recent research has documented high rates of comorbidity between cannabis use disorders and posttraumatic stress disorder (PTSD) in veterans. However, despite possible links between PTSD and cannabis use, relatively little is known about cannabis use in veterans who present for PTSD treatment, particularly among samples not diagnosed with a substance use disorder. This study examined the prevalence of cannabis use and the psychological and functional correlates of cannabis use among a large sample of veterans seeking treatment at a Veterans Affairs (VA) PTSD specialty clinic. Male veterans (N = 719) who presented at a VA specialty outpatient PTSD clinic completed measures of demographic variables, combat exposure, alcohol, cannabis and other drug use, and PTSD and depressive symptoms. The associations among demographic, psychological, and functional variables were estimated using logistic regressions. Overall, 14.6% of participants reported using cannabis in the past 6 months. After controlling for age, race, service era, and combat exposure, past 6-month cannabis use was associated with unmarried status, use of tobacco products, other drug use, hazardous alcohol use, PTSD severity, depressive symptom severity, and suicidality. The present findings show that cannabis use is quite prevalent among veterans seeking PTSD specialty treatment and is associated with poorer mental health and use of other substances. It may be possible to identify and treat individuals who use cannabis in specialty clinics (e.g., PTSD clinics) where they are likely to present for treatment of associated mental health issues. (PsycINFO Database Record

  11. A Comparison of Sexual Minority Youth Who Attend Religiously Affiliated Schools and Their Nonreligious-School-Attending Counterparts

    ERIC Educational Resources Information Center

    Stewart, Brandon T.; Heck, Nicholas C.; Cochran, Bryan N.

    2015-01-01

    Sexual minority youth are an at-risk group for negative health outcomes. The present study compares descriptive characteristics and outness of sexual minority youth who attend religious schools to sexual minorities who do not attend religious schools, and also investigates if attending religiously affiliated schools is associated with levels of…

  12. Class Attendance in College: A Meta-Analytic Review of the Relationship of Class Attendance with Grades and Student Characteristics

    ERIC Educational Resources Information Center

    Crede, Marcus; Roch, Sylvia G.; Kieszczynka, Urszula M.

    2010-01-01

    A meta-analysis of the relationship between class attendance in college and college grades reveals that attendance has strong relationships with both class grades (k = 69, N = 21,195, p = 0.44) and GPA (k = 33, N = 9,243, p = 0.41). These relationships make class attendance a better predictor of college grades than any other known predictor of…

  13. Increasing Attendance for Psychotherapy: Implementation Intentions and the Self-Regulation of Attendance-Related Negative Affect

    ERIC Educational Resources Information Center

    Sheeran, Paschal; Aubrey, Richard; Kellett, Stephen

    2007-01-01

    The present study evaluated an implementation intention intervention that aimed to increase attendance at scheduled, initial appointments for psychotherapy by helping clients to manage negative feelings about attendance. Participants received a postal questionnaire that measured their views about attending psychotherapy. One half of the sample was…

  14. Alcoholism and reproduction.

    PubMed

    Heine, M W

    1981-01-01

    A brief overview of the reproductive capacities of both men and women in alcoholism is presented. A historical evaluation indicates a resurgence of interest in this area. The effect of chronic alcohol consumption on both male fertility and potency is reported in conjunction with alcohol-mediated effects on the female subject. Emphasis is placed on pharmacokinetics, metabolism and drinking behavior of the alcoholic female. The adverse actions of some therapeutic drugs and chronic alcohol consumption is discussed in relationship to fetal alcohol syndrome and the accompanied mental and somatic abnormalities.

  15. Alcohol and fuel production

    SciTech Connect

    Roth, E.R.

    1984-01-10

    Alcohol/water mixtures, such as those produced by fermentation of biomass material, are separated by extraction of alcohol with a solvent, comprising a higher aliphatic alcohol in major amount and an aliphatic hydrocarbon in minor amount, especially suited to such extraction and to subsequent removal. The solvent alcohol desirably has a branched chain, or the hydrocarbon an unsaturated bond, or both. Conventional distillation steps to concentrate alcohol and eliminate water are rendered unnecessary at a considerable reduction in heat energy requirement (usually met with fossil fuel). Optional addition of gasoline between the solvent extraction and solvent recovery steps not only aids the latter separation but produces alcohol already denatured for fuel use.

  16. Neurologic effects of alcoholism.

    PubMed Central

    Diamond, I; Messing, R O

    1994-01-01

    Alcoholism, a worldwide disorder, is the cause of a variety of neurologic disorders. In this article we discuss the cellular pathophysiology of ethanol addition and abuse as well as evidence supporting and refuting the role of inheritance in alcoholism. A genetic marker for alcoholism has not been identified, but neurophysiologic studies may be promising. Some neurologic disorders related to longterm alcoholism are due predominantly to inadequate nutrition (the thiamine deficiency that causes Wernicke's encephalopathy), but others appear to involve the neurotoxicity of ethanol on brain (alcohol withdrawal syndrome and dementia) and peripheral nerves (alcoholic neuropathy and myopathy). Images PMID:7975567

  17. Fetal Alcohol Spectrum Disorders (FASDs): Alcohol Use Quiz

    MedlinePlus

    ... this page: About CDC.gov . FASD Homepage Facts Secondary Conditions Videos Alcohol Use in Pregnancy Questions & Answers Quiz Alcohol Screening & Brief Intervention Diagnosis Treatments Data & Statistics Alcohol Consumption Rates Research & Tracking Monitoring Alcohol ...

  18. Change in alcohol outlet density and alcohol-related harm to population health (CHALICE)

    PubMed Central

    2012-01-01

    Background Excess alcohol consumption has serious adverse effects on health and violence-related harm. In the UK around 37% of men and 29% of women drink to excess and 20% and 13% report binge drinking. The potential impact on population health from a reduction in consumption is considerable. One proposed method to reduce consumption is to reduce availability through controls on alcohol outlet density. In this study we investigate the impact of a change in the density of alcohol outlets on alcohol consumption and alcohol-related harms to health in the community. Methods/Design A natural experiment of the effect of change in outlet density between 2005–09, in Wales, UK; population 2.4 million aged 16 years and over. Data on outlets are held by the 22 local authorities in Wales under The Licensing Act 2003. The study outcomes are change in (1) alcohol consumption using data from annual Welsh Health Surveys, (2) alcohol-related hospital admissions using the Patient Episode Database for Wales, (3) Accident & Emergency department attendances between midnight–6am, and (4) alcohol-related violent crime against the person, using Police data. The data will be anonymously record-linked within the Secure Anonymised Information Linkage Databank at individual and 2001 Census Lower Super Output Area levels. New methods of network analysis will be used to estimate outlet density. Longitudinal statistical analysis will use (1) multilevel ordinal models of consumption and logistic models of admissions and Accident & Emergency attendance as a function of change in individual outlet exposure, adjusting for confounding variables, and (2) spatial models of the change in counts/rates of each outcome measure and outlet density. We will assess the impact on health inequalities and will correct for population migration. Discussion This inter-disciplinary study requires expertise in epidemiology and public health, health informatics, medical statistics, geographical information science

  19. Nurse Manager Safety Practices in Outpatient Hemodialysis Units.

    PubMed

    Thomas-Hawkins, Charlotte; Flynn, Linda; Lindgren, Teri G; Weaver, Susan

    2015-01-01

    Little is known regarding the specific managerial activities or best practices that nurse managers in outpatient hemodialysis settings use to achieve positive safety outcomes. The purpose of this study was to identify and describe specific managerial practices used by nurse managers in outpatient hemodialysis units to enhance patient safety and quality of care. A descriptive qualitative design was used. Seventeen nurse managers in outpatient hemodialysis units comprised the study sample. Telephone interviews were conducted, and qualitative content analysis was used to encode the data. Nurse managers identified patients, staff, the dialysis unit environment, and the dialysis organization as sources of safety risks. Nurse manager safety practices illuminated from the data were complex and multifaceted, and were aimed at reducing patient, staff environmental, and organization risks. The findings from this study offer a description and a better understanding of the practices in which nurse managers in outpatient hemodialysis units engage to keep patients safe in their units, and they underscore the critical role of nurse managers in creating and maintaining patient safety within outpatient hemodialysis settings.

  20. Lifestyle of Hemodialysis Patients in Comparison with Outpatients

    PubMed Central

    Moghadasian, Sima; Sahebi Hagh, Mohammad Hasan; Aghaallah Hokmabadi, Leila

    2012-01-01

    Introduction: Nowadays, the chronic diseases are known to be associated with lifestyle risk factors. Hemodialysis patients encounter considerable amount of physical, mental and social pressure. Lifestyle is important because it affects quality of life and has important role in prevention. This study aimed to compare the lifestyle of hemodialysis patients and outpatients in health clinics of Tabriz. Methods: This was a case-control study on 155 hemodialysis patients and 155 outpatients referring to five dialysis centers and clinics, who met the inclusion criteria. Demographic data and some questions about lifestyle in nutrition, stress, physical activity and smoking were asked. Results: The history of hypertension among hemodialysis patients was 34.6% greater than outpatients. High daily salt consumption (more than two tablespoons a day) was 40.5% higher among hemodialysis patients than outpatients. In terms of saturated oil intake, it was 30.8%higher among hemodialysis patients. Problem in communicating with family members was 69.8% higher in hemodialysis patients. In terms of physical activity, 46.4% of outpatients had higher physical activity like walking. Conclusion: Lifestyle in different dimensions was associated with chronic kidney disease (CKD); therefore, the officials of health system are recommended to develop a program to combat chronic diseases and integrate it with providing the first-level health services. It seems that public education can have a major role in life-style modification and in chronic kidney diseases prevention. PMID:25276683

  1. Patterns of Psychiatric Outpatient Practice in Taiwan: A Nationwide Survey

    PubMed Central

    Dai, Ying-Xiu; Chen, Mu-Hong; Chen, Tzeng-Ji; Lin, Ming-Hwai

    2016-01-01

    (1) Background: Limited studies have utilized nationwide data to assess the patterns of psychiatric practice in other countries. In this study, data from the National Health Insurance Research Database in Taiwan (NHIRD-TW) for 2012 was analyzed to determine the patterns of psychiatric outpatient practice in Taiwan; (2) Methods: To determine the patterns of psychiatric outpatient practice in Taiwan, the data were drawn from the datasets of Taiwan’s National Health Insurance Research Database for 2012, with 619,760 records of outpatient visits representing 1/500 of all the claims in Taiwan for that year. The analysis of psychiatric outpatient visits included patient demographics, diagnoses, and prescribed medications; (3) Results: Neurotic disorders were the most prevalent diagnoses (43.1%, n = 5714). Hypnotics-sedatives and anxiolytics were prescribed in 51.7% (n = 6850) and 39.1% (n = 5181) of psychiatric visits, respectively, with zolpidem being the most commonly prescribed drug (22.6%, n = 2998); and (4) Conclusion: Hypnotics and sedatives were widely prescribed for the outpatient population, and zolpidem had the highest annual prevalence of use. These findings deserve the attention of clinicians and policy makers for monitoring the abuse and dependence of these agents and subsequent adverse events. PMID:27690067

  2. Comparison of Antibiograms Developed for Inpatients and Primary Care Outpatients

    PubMed Central

    McGregor, Jessina C.; Bearden, David T.; Townes, John M.; Sharp, Susan E.; Gorman, Paul N.; Elman, Miriam R.; Mori, Motomi; Smith, David H.

    2013-01-01

    To support antimicrobial stewardship, some healthcare systems have begun creating outpatient antibiograms. We developed inpatient and primary care outpatient antibiograms for a regional health maintenance organization (HMO) and academic healthcare system (AHS). Antimicrobial susceptibilities from 16,428 Enterococcus, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa cultures from 2010 were summarized and compared. Methicillin susceptibility among S. aureus was similar in inpatients and primary care outpatients (HMO: 61.2% vs. 61.9%, p=0.951; AHS: 62.9% vs. 63.3%, p>0.999). E. coli susceptibility to trimethoprim/sulfamethoxazole was also similar (HMO: 81.8% vs. 83.6%, p=0.328; AHS: 77.2% vs. 80.9%, p=0.192), but ciprofloxacin susceptibility differed (HMO: 88.9% vs. 94.6%, p<0.001; AHS: 81.2% vs. 90.6%, p<0.001). In the HMO, ciprofloxacin-susceptible P. aeruginosa were more frequent in primary care outpatients than inpatients (91.4% vs. 79.0%, p=0.007). Comparison of cumulative susceptibilities across settings yielded no consistent patterns; therefore, outpatient primary care antibiograms may more accurately inform prudent empiric antibiotic prescribing. PMID:23541690

  3. Alcohol affects goal commitment by explicitly and implicitly induced myopia.

    PubMed

    Sevincer, A Timur; Oettingen, Gabriele; Lerner, Tobias

    2012-05-01

    Alcohol commits people to personally important goals even if expectations of reaching the goals are low. To illuminate this effect, we used alcohol myopia theory, stating that alcohol intoxicated people disproportionally attend to the most salient aspects of a situation and ignore peripheral aspects. When low expectations of reaching an important goal were activated students who consumed alcohol were less committed than students who consumed a placebo. We observed less commitment regardless of whether low expectations were explicitly activated in a questionnaire (Study 1) or implicitly activated through subliminal priming (Study 2). The results imply that, intoxicated people commit to goals according to what aspects of a goal are activated either explicitly or implicitly.

  4. Effects of Depression on Treatment Motivation in Male Alcohol Dependence

    PubMed Central

    CENGİSİZ, Cengiz; DEVECİ, Artuner; YAPICI, Aslıhan

    2015-01-01

    Introduction Treatment motivation in alcohol dependents is usually viewed as a strong predictor of seeking treatment and treatment success. The conditions affecting motivation in alcohol dependence, however, has not been clarified. In this study, it is aimed to determine the effects of depression on treatment motivation in male alcohol dependence. Methods The present study included 34 male alcohol dependents presenting to outpatient clinics in Manisa Hospital of Mental Disorders and Hospital of Celal Bayar University. The patients underwent evaluation using the socio-demographic and clinical information form, DSM-IV SCID-I Clinical Version, Treatment Motivation Questionnaire (TMQ), and Hamilton Depression Rating Scale (HDRS). Results A significant relationship was found between the total score of TMQ and HDRS (p=.039). Conclusion We believe that the present study, in which we examined the relationship between treatment motivation in male alcohol dependence and depression, would provide a significant contribution to literature. It is also important to investigate other factors that may affect treatment motivation in male alcohol dependence. Studies with larger samples are needed on this topic.

  5. An Exploration of Quality of Life and Its Predictors in Patients with Addictive Disorders: Gambling, Alcohol and Drugs

    ERIC Educational Resources Information Center

    Manning, Victoria; Gomez, Brenda; Guo, Song; Low, Yee Deng; Koh, Puay Kee; Wong, Kim Eng

    2012-01-01

    The study set out to examine Quality of Life (QoL), specifically subjective well being in three different addiction populations (260 alcohol-dependent, 282 drug-dependent, and 132 pathological gambling outpatients) at their first visit to treatment, using the Personal Well being Index (PWI). The mean PWI score for all patients was significantly…

  6. A Post-Treatment Examination of Adolescents' Reasons for Starting, Quitting, and Continuing the Use of Drugs and Alcohol

    ERIC Educational Resources Information Center

    Titus, Janet C.; Godley, Susan H.; White, Michelle K.

    2007-01-01

    Qualitative data from 923 adolescents treated in outpatient and residential settings were used to create taxonomies of their reasons for starting, continuing, and quitting use of drugs and alcohol. Three raters independently categorized reasons by dominant theme. The final sets of taxonomies were defined within several iterations and the raters'…

  7. A Randomized Trial of Extended Telephone-Based Continuing Care for Alcohol Dependence: Within-Treatment Substance Use Outcomes

    ERIC Educational Resources Information Center

    McKay, James R.; Van Horn, Deborah H. A.; Oslin, David W.; Lynch, Kevin G.; Ivey, Megan; Ward, Kathleen; Drapkin, Michelle L.; Becher, Julie R.; Coviello, Donna M.

    2010-01-01

    Objective: The study tested whether adding up to 18 months of telephone continuing care, either as monitoring and feedback (TM) or longer contacts that included counseling (TMC), to intensive outpatient programs (IOPs) improved outcomes for alcohol-dependent patients. Method: Participants (N = 252) who completed 3 weeks of IOP were randomized to…

  8. Fetal Alcohol Spectrum Disorders.

    PubMed

    Williams, Janet F; Smith, Vincent C

    2015-11-01

    Prenatal exposure to alcohol can damage the developing fetus and is the leading preventable cause of birth defects and intellectual and neurodevelopmental disabilities. In 1973, fetal alcohol syndrome was first described as a specific cluster of birth defects resulting from alcohol exposure in utero. Subsequently, research unequivocally revealed that prenatal alcohol exposure causes a broad range of adverse developmental effects. Fetal alcohol spectrum disorder (FASD) is the general term that encompasses the range of adverse effects associated with prenatal alcohol exposure. The diagnostic criteria for fetal alcohol syndrome are specific, and comprehensive efforts are ongoing to establish definitive criteria for diagnosing the other FASDs. A large and growing body of research has led to evidence-based FASD education of professionals and the public, broader prevention initiatives, and recommended treatment approaches based on the following premises:▪ Alcohol-related birth defects and developmental disabilities are completely preventable when pregnant women abstain from alcohol use.▪ Neurocognitive and behavioral problems resulting from prenatal alcohol exposure are lifelong.▪ Early recognition, diagnosis, and therapy for any condition along the FASD continuum can result in improved outcomes.▪ During pregnancy:◦no amount of alcohol intake should be considered safe;◦there is no safe trimester to drink alcohol;◦all forms of alcohol, such as beer, wine, and liquor, pose similar risk; and◦binge drinking poses dose-related risk to the developing fetus.

  9. To Attend or Not To Attend: Guiding All Students in the Right Direction.

    ERIC Educational Resources Information Center

    Smith, Irving; Johnson, Robert E.

    2003-01-01

    Argues that a perpetual cycle of education deprivation is embedded in our educational system that forces some of the best students into a vocational education path that may not include attending college. Proposes that students must be educated early about the value of a college education and must be aware that they are making decisions with…

  10. Alcohol abusive use increases facial trauma?

    PubMed Central

    Soares-Carneiro, Suzana-Célia-de-Aguiar; Matos da-Silva, Gessyca-Suielly-Melo; de-Barros-Caldas, Luciano-Cruz; Porto, Gabriela-Granja; Leal, Jefferson-Figueiredo; Catunda, Ivson

    2016-01-01

    Background Trauma is among the main death causes and morbidity in the world and is often related to the use of alcohol and its abuse has reached massive proportions, no matter if the country is developed or not, being considered as public health problem. Since there are very few randomized and prospective studies in literature about the association of facial trauma and the use of alcohol, this study aims to investigate the impact of alcohol use in facial trauma. Material and Methods This was a prospective and cross sectional study, involving facial trauma patients attended at Oral Maxillofacial Surgery Division of a State Hospital. Variables included patient´s profile, trauma etiology, facial region involved, type of injury and treatment and days of hospitalization. AUDIT test was applied to identify risks and damages of alcohol use and chemical dependence. Absolute distribution, uni and mutilvaried percentages were made for data evaluation. Pearson´s qui-squared and Fisher´s Exact tests were also used. Results One hundred patients were evaluated. The patient´s mean age was 33.50 years-old, 48% had between 17 and 29 years old, 28% had 30 to 39, and 24% 40 or more. Most of them were male (86%). The most frequent etiology was traffic accident (57%), the extraoral area was most committed (62%), the most frequent type of injury was fractures (78%) and the most affected bone was the mandible (36%). More than half of the patients (53%) had surgical treatment. 38% had their discharge from hospital right after the first attendance. The AUDIT most frequent answer was “moderate use” (46%) and use at risk (39%). There was significant difference between the use of alcohol (AUDIT) and hematoma (0.003) and number of days of hospitalization (p=0.005). Conclusions In this study it was not observed association between alcohol consumption using the AUDIT and trauma etiology, but patient victims of traffic accidents were classified as with risk in the scale. Most of the

  11. Characteristics of motorcyclists involved in road traffic accidents attended at public urgent and emergency services.

    PubMed

    Mascarenhas, Márcio Dênis Medeiros; Souto, Rayone Moreira Costa Veloso; Malta, Deborah Carvalho; Silva, Marta Maria Alves da; Lima, Cheila Marina de; Montenegro, Marli de Mesquita Silva

    2016-12-01

    Injuries resulting from motorcycle road traffic accidents are an important public health issue in Brazil. This study aimed to describe the characteristics of motorcyclists involved in traffic accidents attended in public urgent and emergency services in the state capitals and the Federal District. This is a cross-sectional study based on data from the Violence and Accident Surveillance System (VIVA Survey) in 2014. Data were analyzed according to sociodemographic, event and attendance characteristics. Proportional differences between genders were analyzed by chi-square test (Rao-Scott) with 5% significance level. Motorcyclist-related attendances (n = 9,673) reported a prevalence of men (gender ratio = 3.2), young people aged 20-39 years (65.7%), black / brown (73.6%), paid work (76.4%). Helmet use was reported by 79.1% of the victims, 13.3% had consumed alcohol in the six hours prior to the accident, 41.4% of the events were related to the victim's work. Accidents were more frequent on weekends, in the morning and late afternoon. These characteristics can support the development of public accident prevention policies and health promotion.

  12. Alcohol Use and Older Adults

    MedlinePlus

    ... version of this page please turn Javascript on. Alcohol Use and Older Adults Alcohol and Aging Adults of any age can have ... Escape (Esc) button on your keyboard.) What Is Alcohol? Alcohol, also known as ethanol, is a chemical ...

  13. Fetal Alcohol Spectrum Disorders

    MedlinePlus

    ... Daily life skills, such as feeding and bathing Fetal alcohol syndrome is the most serious type of FASD. People with fetal alcohol syndrome have facial abnormalities, including wide-set and narrow ...

  14. Children of Alcoholics.

    ERIC Educational Resources Information Center

    Chafetz, Morris E.

    1979-01-01

    It is estimated that 29 million American children have alcoholic parents. The author documents the unstable environment and psychological consequences suffered by these children, who are at great risk to become alcoholics themselves. (Editor)

  15. Fetal alcohol syndrome

    MedlinePlus

    ... resources for information on alcoholism: Alcoholics Anonymous -- www.aa.org Al-Anon Family Groups -- www.al-anon. ... exposures to the fetus. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal ...

  16. Alcohol Use Screening

    MedlinePlus

    ... Centers Mental Health Medical Library Alcohol Use Screening (AUDIT-C) - Instructions The following questions are a screening ... is also text-only version . Alcohol Use Screening (AUDIT-C) - Manual Instructions The following questions are a ...

  17. Epidemiology of Alcoholism.

    ERIC Educational Resources Information Center

    Helzer, John E.

    1987-01-01

    Reviews the application of epidemiology to alcoholism. Discusses measurement and diagnostic issues and reviews studies of the prevalence of alcoholism, its risk factors, and the contributions of epidemiology to our knowledge of treatment and prevention. (Author/KS)

  18. Women and Alcohol

    MedlinePlus

    ... turn JavaScript on. Feature: Rethinking Drinking Women and Alcohol Past Issues / Spring 2014 Table of Contents Women react differently than men to alcohol and face higher risks from it. Pound for ...

  19. Myths about drinking alcohol

    MedlinePlus

    ... gov/ency/patientinstructions/000856.htm Myths about drinking alcohol To use the sharing features on this page, ... We know much more about the effects of alcohol today than in the past. Yet, myths remain ...

  20. Benzyl Alcohol Topical

    MedlinePlus

    Benzyl alcohol lotion is used to treat head lice (small insects that attach themselves to the skin) in adults ... children less than 6 months of age. Benzyl alcohol is in a class of medications called pediculicides. ...

  1. Translational Studies of Alcoholism

    PubMed Central

    Zahr, Natalie M.; Sullivan, Edith V.

    2008-01-01

    Human studies are necessary to identify and classify the brain systems predisposing individuals to develop alcohol use disorders and those modified by alcohol, while animal models of alcoholism are essential for a mechanistic understanding of how chronic voluntary alcohol consumption becomes compulsive, how brain systems become damaged, and how damage resolves. Our current knowledge of the neuroscience of alcohol dependence has evolved from the interchange of information gathered from both human alcoholics and animal models of alcoholism. Together, studies in humans and animal models have provided support for the involvement of specific brain structures over the course of alcohol addiction, including the prefrontal cortex, basal ganglia, cerebellum, amygdala, hippocampus, and the hypothalamic–pituitary–adrenal axis. PMID:20041042

  2. Alcohol advertising and alcohol consumption by adolescents.

    PubMed

    Saffer, Henry; Dave, Dhaval

    2006-06-01

    This study investigates the effects of alcohol advertising on adolescent alcohol consumption. The theory of an industry response function and evidence from prior studies indicate the importance of maximizing the variance in advertising measures. Monitoring the Future (MTF) and National Longitudinal Survey of Youth 1997 (NLSY97) data are augmented with alcohol advertising, originating on the market level, for five media. The large sample of the MTF allows estimation of race and gender-specific models. The longitudinal nature of the NLSY97 allows controls for unobserved heterogeneity with state-level and individual fixed effects. Price and advertising effects are generally larger for females relative to males. Controls for individual heterogeneity yield larger advertising effects, implying that the MTF results may understate the effects of alcohol advertising. Results from the NLSY97 suggest that a 28% reduction in alcohol advertising would reduce adolescent monthly alcohol participation from 25% to between 24 and 21%. For binge participation, the reduction would be from 12% to between 11 and 8%. The past month price-participation elasticity is estimated at -0.26, consistent with prior studies. The results show that reduction of alcohol advertising can produce a modest decline in adolescent alcohol consumption, though effects may vary by race and gender.

  3. Assessing Nutrient Intake and Nutrient Status of HIV Seropositive Patients Attending Clinic at Chulaimbo Sub-District Hospital, Kenya

    PubMed Central

    Onyango, Agatha Christine; Walingo, Mary Khakoni; Mbagaya, Grace; Kakai, Rose

    2012-01-01

    Background. Nutritional status is an important determinant of HIV outcomes. Objective. To assess the nutrient intake and nutrient status of HIV seropositive patients attending an AIDS outpatient clinic, to improve the nutritional management of HIV-infected patients. Design. Prospective cohort study. Setting. Comprehensive care clinic in Chulaimbo Sub-District Hospital, Kenya. Subjects. 497 HIV sero-positive adults attending the clinic. Main Outcome Measures. Evaluation of nutrient intake using 24-hour recall, food frequency checklist, and nutrient status using biochemical assessment indicators (haemoglobin, creatinine, serum glutamate pyruvate (SGPT) and mean corpuscular volume (MCV)). Results. Among the 497 patients recruited (M : F sex ratio: 1.4, mean age: 39 years ± 10.5 y), Generally there was inadequate nutrient intake reported among the HIV patients, except iron (10.49 ± 3.49 mg). All the biochemical assessment indicators were within normal range except for haemoglobin 11.2 g/dL (11.4 ± 2.60 male and 11.2 ± 4.25 female). Conclusions. Given its high frequency, malnutrition should be prevented, detected, monitored, and treated from the early stages of HIV infection among patients attending AIDS clinics in order to improve survival and quality of life. PMID:22997571

  4. Why the evidence for outpatient commitment is good enough.

    PubMed

    Swanson, Jeffrey W; Swartz, Marvin S

    2014-06-01

    After nearly three decades of studies evaluating the legal practice of involuntary outpatient commitment, there is yet little consensus about its effectiveness and only limited implementation. Debate continues over how best to assist adults with serious mental illnesses who are unable or unwilling to participate in prescribed community treatment and as a result experience repeated involuntary hospitalizations or involvement with the criminal justice system. The authors comment on the Oxford Community Treatment Order Evaluation Trial (OCTET), a recently conducted randomized trial of outpatient commitment, and discuss the limitations of the study's design for resolving the persistent question of whether compulsory treatment is more effective than purely voluntary treatment for this difficult-to-reach target population. The authors conclude that the search for a definitive and generalizable randomized trial of outpatient commitment may be a quixotic quest; the field should, rather, welcome the results of well-conducted, large-scale, quasi-experimental and naturalistic studies with rigorous multivariable statistical controls.

  5. [Outpatient anesthesia--the office-based anesthetist].

    PubMed

    Fischer, Guntram

    2013-03-01

    The aim of the present article is to describe the field of activity and prevailing conditions for office-based anesthetists in Germany. From the introduction of outpatient operations on the basis of actual numbers, data and facts, we present the project profile and the structures of the different fields of activity and practice constellations for office-based anesthesiology. Particular emphasis is placed on the requirements for room space and technical facilities, the criteria for patient selection, and the structural and procedural quality as well as quality management of outpatient anesthesia. With the aid of current numerical data the anesthetic procedures performed in the outpatient field through to the possibilities for development of continuous regional anesthetic procedures in catheter technique are illustrated. In conclusion, we discuss the economic conditions and the health-care economic significance together with a description of the current health-care quality of ambulant anesthesiology and the possibilities for participation in an error-reporting system.

  6. Distillation for alcohol

    SciTech Connect

    Kawase, T.; Sawai, K.

    1983-02-22

    A new distillation equipment for alcohol which consists mainly of a brief concentrating column a, a concentrating column b, a compressor C to compress alcohol vapor generated in column B and water evaporator D heated by the compressed alcohol vapor is developed and this especially fits for a distillation source of a glue like solution obtained by alcohol fermentation because steam generated in the water evaporator D is directly blown into the solution in the concentrating column A.

  7. Alcohol and fuel production

    SciTech Connect

    Roth, E.R.

    1981-12-22

    Alcohol/water mixtures, such as those produced by fermentation of biomass material, are separated by extraction of alcohol with a solvent especially suited to such extraction and to subsequent removal. Conventional distillation steps to concentrate alcohol and eliminate water are rendered unnecessary at a considerable reduction in heat energy requirement (Usually met with fossil fuel). Addition of gasoline between the solvent extraction and solvent recovery steps not only aids the latter separation but produces alcohol already denatured for fuel use.

  8. Modelling the distance impedance of protest attendance

    NASA Astrophysics Data System (ADS)

    Traag, V. A.; Quax, R.; Sloot, P. M. A.

    2017-02-01

    Protesters are usually young, relatively well educated, middle class people that are politically engaged. But where do protesters come from? We here show, based on mobile phone data, that distance is an important impedance to protest attendance. Most protesters come from nearby regions, suggesting distance forms an obstacle to participation. Although this effect can be partly explained by social network effects, which show similar spatial dependencies, an effect of distance remains. This suggests distance still acts as an obstacle to participation, although it may also be that long-range contacts are less effective for recruitment. Face-to-face contacts seem more important in spreading protests through earlier participants, whereas central recruitment works better by telephone. Our results are important for understanding processes of recruitment.

  9. Attending to music decreases inattentional blindness.

    PubMed

    Beanland, Vanessa; Allen, Rosemary A; Pammer, Kristen

    2011-12-01

    This article investigates how auditory attention affects inattentional blindness (IB), a failure of conscious awareness in which an observer does not notice an unexpected event because their attention is engaged elsewhere. Previous research using the attentional blink paradigm has indicated that listening to music can reduce failures of conscious awareness. It was proposed that listening to music would decrease IB by reducing observers' frequency of task-unrelated thoughts (TUTs). Observers completed an IB task that varied both visual and auditory demands. Listening to music was associated with significantly lower IB, but only when observers actively attended to the music. Follow-up experiments suggest this was due to the distracting qualities of the audio task. The results also suggest a complex relationship between IB and TUTs: during demanding tasks, as predicted, noticers of the unexpected stimulus reported fewer TUTs than non-noticers. During less demanding tasks, however, noticers reported more TUTs than non-noticers.

  10. Lipoid Pneumonia in a Gas Station Attendant

    PubMed Central

    Yampara Guarachi, Gladis Isabel; Barbosa Moreira, Valeria; Santos Ferreira, Angela; Sias, Selma M. De A.; Rodrigues, Cristovão C.; Teixeira, Graça Helena M. do C.

    2014-01-01

    The exogenous lipoid pneumonia, uncommon in adults, is the result of the inhalation and/or aspiration of lipid material into the tracheobronchial tree. This is often confused with bacterial pneumonia and pulmonary tuberculosis due to a nonspecific clinical and radiologic picture. It presents acutely or chronically and may result in pulmonary fibrosis. We describe here a case of lipoid pneumonia in a gas station attendant who siphoned gasoline to fill motorcycles; he was hospitalized due to presenting with a respiratory infection that was hard to resolve. The patient underwent bronchoscopy with bronchoalveolar lavage, which, on cytochemical (oil red O) evaluation, was slightly positive for lipid material in the foamy cytoplasm of alveolar macrophages. Due to his occupational history and radiographic abnormalities suggestive of lipoid pneumonia, a lung biopsy was performed to confirm the diagnosis. The patient was serially treated with segmental lung lavage and showed clinical, functional, and radiological improvement. PMID:25374742

  11. Continuity of outpatient and inpatient care for hospitalized older adults

    PubMed Central

    Sharma, Gulshan; Fletcher, Kathlyn E.; Zhang, Dong; Kuo, Yong-Fang; Freeman, Jean L.; Goodwin, James S.

    2009-01-01

    Context Little is known about the extent of continuity of care across the transition from outpatient care to hospitalization. Objective To describe continuity of care in older hospitalized patients, its change over time, and factors associated with discontinuity. Design, Setting and Participants Retrospective cohort study of hospital admissions from a 5% national sample of Medicare patients between1996 and 2006 (n=3,020,770). Main Outcome Measures Percent of hospitalized patients who were seen while hospitalized by any outpatient physician they had seen in the year prior to hospitalization (Continuity with any outpatient physician) or by their primary care physician (Continuity with a PCP). Results In 1996, 50.5% (95% CI: 50.3% – 50.7%, n=125,789) of hospitalized patients saw at least one physician that they had seen in an outpatient setting in the prior year, whereas 44.3% (95% CI: 44.1% – 44.6%, n=58,046) of patients with an identifiable PCP saw that physician while hospitalized. These percentages had dropped to 39.8% (95% CI: 39.6%–40.0%, n=99,463) and 31.9% (95% CI: 31.6%–32.1%, n=47,761), respectively, by 2006. Greater absolute declines in continuity with any outpatient physician from 1996 to 2006 occurred in patients admitted on weekends (13.9%, 95% CI: 12.9%– 14.7%), those living in large metropolitan areas (11.7%, 95% CI: 11.1% – 12.3%) and in New England (16.2%, 95% CI: 14.4% – 18.0%). In multivariable, multilevel models, increasing involvement of hospitalists was associated with approximately one third of the decrease in continuity of care from 1996 to 2006. Conclusion Between 1996 and 2006, physician continuity from outpatient to inpatient settings declined in the Medicare population. PMID:19383958

  12. GABA receptors, alcohol dependence and criminal behavior.

    PubMed

    Terranova, Claudio; Tucci, Marianna; Sartore, Daniela; Cavarzeran, Fabiano; Di Pietra, Laura; Barzon, Luisa; Palù, Giorgio; Ferrara, Santo D

    2013-09-01

    The aim of this study was to analyze the connection between alcohol dependence and criminal behavior by an integrated genetic-environmental approach. The research, structured as a case-control study, examined 186 alcohol-dependent males; group 1 (N = 47 convicted subjects) was compared with group 2 (N = 139 no previous criminal records). Genetic results were innovative, highlighting differences in genotype distribution (p = 0.0067) in group 1 for single-nucleotide polymorphism rs 3780428, located in the intronic region of subunit 2 of the GABA B receptor gene (GABBR2). Some environmental factors (e.g., grade repetition) were associated with criminal behavior; others (e.g., attendance at Alcoholics Anonymous) were inversely related to convictions. The concomitant presence of the genetic and environmental factors found to be associated with the condition of alcohol-dependent inmate showed a 4-fold increase in the risk of antisocial behavior. The results need to be replicated on a larger population to develop new preventive and therapeutic proposals.

  13. Television: Alcohol's Vast Adland.

    ERIC Educational Resources Information Center

    2002

    Concern about how much television alcohol advertising reaches underage youth and how the advertising influences their attitudes and decisions about alcohol use has been widespread for many years. Lacking in the policy debate has been solid, reliable information about the extent of youth exposure to television alcohol advertising. To address this…

  14. Alcohol and the law.

    PubMed

    Karasov, Ariela O; Ostacher, Michael J

    2014-01-01

    Society has had an interest in controlling the production, distribution, and use of alcohol for millennia. The use of alcohol has always had consequences, be they positive or negative, and the role of government in the regulation of alcohol is now universal. This is accomplished at several levels, first through controls on production, importation, distribution, and use of alcoholic beverages, and second, through criminal laws, the aim of which is to address the behavior of users themselves. A number of interventions and policies reduce alcohol-related consequences to society by regulating alcohol pricing, targeting alcohol-impaired driving, and limiting alcohol availability. The legal system defines criminal responsibility in the context of alcohol use, as an enormous percentage of violent crime and motor death is associated with alcohol intoxication. In recent years, recovery-oriented policies have aimed to expand social supports for recovery and to improve access to treatment for substance use disorders within the criminal justice system. The Affordable Care Act, also know as "ObamaCare," made substantial changes to access to substance abuse treatment by mandating that health insurance include services for substance use disorders comparable to coverage for medical and surgical treatments. Rather than a simplified "war on drugs" approach, there appears to be an increasing emphasis on evidence-based policy development that approaches alcohol use disorders with hope for treatment and prevention. This chapter focuses on alcohol and the law in the United States.

  15. Alcohol and Family Violence.

    ERIC Educational Resources Information Center

    Covington, Stephanie S.

    There is growing acknowledgement of the association between family violence and alcohol use. A study was conducted to examine the role that abuse plays in the lives of women and to investigate the relationship between alcohol and violence. Data were collected from 35 recovering female alcoholics and 35 nonalcoholic women on their sexual experience…

  16. Alcoholism's Hidden Curriculum.

    ERIC Educational Resources Information Center

    Gress, James R.

    1988-01-01

    Discusses children of alcoholics as victims of fetal alcohol syndrome, family violence, retarded social development, and severe emotional scars. These children bring family roles to school that allow survival in the alcoholic home but are dysfunctional outside it. Educators can take certain steps to address these students' problems. Includes six…

  17. Biological Vulnerability to Alcoholism.

    ERIC Educational Resources Information Center

    Schuckit, Marc A.

    1987-01-01

    Reviews the role of biological factors in the risk for alcoholism. Notes the importance of the definition of primary alcoholism and highlights data indicating that this disorder is genetically influenced. In studies of men at high risk for the future development of alcoholism, vulnerability shows up in reactions to ethanol brain wave amplitude and…

  18. Drugs, Alcohol and HIV

    MedlinePlus

    ... and drugs can do to your overall health. Drugs and Alcohol: Effects on your immune system Drinking too much alcohol ... getting help and finding the treatment you need. Drugs and Alcohol: ... on short- and long-term effects of drinking, with specific information on people who ...

  19. Alcohol and Aggression.

    ERIC Educational Resources Information Center

    Gustafson, Roland

    1994-01-01

    Reviews the acute effects of alcohol on aggressive responding. From experimental studies that use human subjects, it is concluded that a moderate dose of alcohol does not increase aggression if subjects are unprovoked. Under provocative situations, aggression is increased as a function of alcohol intoxication, provided that subjects are restricted…

  20. Alcoholism and Lesbians

    ERIC Educational Resources Information Center

    Gedro, Julie

    2014-01-01

    This chapter explores the issues involved in the relationship between lesbianism and alcoholism. It examines the constellation of health and related problems created by alcoholism, and it critically interrogates the societal factors that contribute to the disproportionately high rates of alcoholism among lesbians by exploring the antecedents and…