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High Users (high + user)
Selected AbstractsDifferences in Trait Anger Among Children with Varying Levels of Anger Expression PatternsJOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 2 2006Marti Rice PhD PROBLEM:,Little research has been done with children to determine effects of using various patterns of anger expression on trait anger. The purpose was to examine differences in trait anger of children who indicated high, moderate, or low use of three patterns of anger expression. METHODS:,A convenience sample of 1,060 third through sixth graders completed trait anger and patterns of expressing anger instruments. FINDINGS:,High users of anger-out (anger expressed outwardly) had the highest trait anger for every grade while high users of anger-reflection/control had the lowest. CONCLUSIONS:,Anger-reflection/control may be more effective than anger-out in reducing trait anger in school-age children. [source] Children, admitted to high security (special) hospitalCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2003Adolescent Forensic Psychiatry, Claire Dimond Consultant in Child Introduction The Special Hospitals in England provide psychiatric treatment in high security. The aim of this study was to examine the demographics and background characteristics of children admitted to high security hospitals in England, using the special hospital case register. Method Forty-six children (the subject group) were admitted to a high security hospital under the MHA (1983) classification of disorder of mental illness and/or psychopathic disorder between 1983 and 1999, 33 (72%) of whom were male. A comparison group of adults was matched on sex, legal classification of detention and MHA 1983 classification of disorder. Results The children were admitted for a similar range of offences to those of the comparison group. However, the children had received convictions for criminal damage and violence at a significantly earlier age, they were more likely to have experienced a change in carer during their childhood, been placed in a children's home and were less likely to be living with a family member on their 16th birthday. Children admitted to special hospital experience a lot of disruption in their childhood and are extremely high users of multi-agency services as they grow up. Discussion Issues are raised regarding how to provide a developmentally sensitive service for children who require high security care. Copyright © 2003 Whurr Publishers Ltd. [source] Application of Regression-Discontinuity Analysis in Pharmaceutical Health Services ResearchHEALTH SERVICES RESEARCH, Issue 2 2006Ilene H. Zuckerman Objective. To demonstrate how a relatively underused design, regression-discontinuity (RD), can provide robust estimates of intervention effects when stronger designs are impossible to implement. Data Sources/Study Setting. Administrative claims from a Mid-Atlantic state Medicaid program were used to evaluate the effectiveness of an educational drug utilization review intervention. Study Design. Quasi-experimental design. Data Collection/Extraction Methods. A drug utilization review study was conducted to evaluate a letter intervention to physicians treating Medicaid children with potentially excessive use of short-acting ,2 -agonist inhalers (SAB). The outcome measure is change in seasonally-adjusted SAB use 5 months pre- and postintervention. To determine if the intervention reduced monthly SAB utilization, results from an RD analysis are compared to findings from a pretest,posttest design using repeated-measure ANOVA. Principal Findings. Both analyses indicated that the intervention significantly reduced SAB use among the high users. Average monthly SAB use declined by 0.9 canisters per month (p<.001) according to the repeated-measure ANOVA and by 0.2 canisters per month (p<.001) from RD analysis. Conclusions. Regression-discontinuity design is a useful quasi-experimental methodology that has significant advantages in internal validity compared to other pre,post designs when assessing interventions in which subjects' assignment is based on cutoff scores for a critical variable. [source] The effect of daily caffeine use on cerebral blood flow: How much caffeine can we tolerate?HUMAN BRAIN MAPPING, Issue 10 2009Merideth A. Addicott Abstract Caffeine is a commonly used neurostimulant that also produces cerebral vasoconstriction by antagonizing adenosine receptors. Chronic caffeine use results in an adaptation of the vascular adenosine receptor system presumably to compensate for the vasoconstrictive effects of caffeine. We investigated the effects of caffeine on cerebral blood flow (CBF) in increasing levels of chronic caffeine use. Low (mean = 45 mg/day), moderate (mean = 405 mg/day), and high (mean = 950 mg/day) caffeine users underwent quantitative perfusion magnetic resonance imaging on four separate occasions: twice in a caffeine abstinent state (abstained state) and twice in a caffeinated state following their normal caffeine use (native state). In each state, there were two drug conditions: participants received either caffeine (250 mg) or placebo. Gray matter CBF was tested with repeated-measures analysis of variance using caffeine use as a between-subjects factor, and correlational analyses were conducted between CBF and caffeine use. Caffeine reduced CBF by an average of 27% across both caffeine states. In the abstained placebo condition, moderate and high users had similarly greater CBF than low users; but in the native placebo condition, the high users had a trend towards less CBF than the low and moderate users. Our results suggest a limited ability of the cerebrovascular adenosine system to compensate for high amounts of daily caffeine use. Hum Brain Mapp 2009. © 2009 Wiley-Liss, Inc. [source] Differences in Trait Anger Among Children with Varying Levels of Anger Expression PatternsJOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 2 2006Marti Rice PhD PROBLEM:,Little research has been done with children to determine effects of using various patterns of anger expression on trait anger. The purpose was to examine differences in trait anger of children who indicated high, moderate, or low use of three patterns of anger expression. METHODS:,A convenience sample of 1,060 third through sixth graders completed trait anger and patterns of expressing anger instruments. FINDINGS:,High users of anger-out (anger expressed outwardly) had the highest trait anger for every grade while high users of anger-reflection/control had the lowest. CONCLUSIONS:,Anger-reflection/control may be more effective than anger-out in reducing trait anger in school-age children. [source] A population-based cohort study of ambulatory care service utilization among older adultsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2010Jason X. Nie BSc (Hons) Abstract Rationale, aims and objectives, Age-related effects on ambulatory care service utilization are not well understood. We aim to measure the utilization patterns of ambulatory health care services (i.e. family physician visits, specialist physician visits and emergency room visits) in the late life course (65 years and older). Methods, A population-based retrospective cohort study was conducted for the period 1 April 2005 to 31 March 2006. All Ontario, Canada, residents aged 65+ and eligible for government health insurance were included in the analysis. Results, This population-based cohort study demonstrates considerable increase in utilization rates and variability of ambulatory services as age increases. Variations in utilization were observed by gender as overall women were more likely to consult a family physician, and men more likely to visit specialists and the emergency room. A small group of high users, constituting 5.5% of the total population, accounted for 18.7% of total ambulatory visits. Finally, we report socio-economic status (SES) based disparity for specialist services in which high users were more likely to have higher SES. Conclusions, There is increasing utilization and variability in ambulatory service utilization with increase in age. Further research is required to explain the gender and SES differences reported in this study. [source] Frail older people's experiences and use of health and social care servicesJOURNAL OF NURSING MANAGEMENT, Issue 2 2007MARKUS THEMESSL-HUBER PhD Aims, To highlight older people's experiences and expectations of services and the consequences for service provision, service development and research. Rationale, A large amount of resources have been invested in providing services for frail older people who experienced multiple hospital admissions. However, their own views are under-reported. Method, Semi-structured interviews with frail older people were conducted in four Scottish Health Board areas to explore the context of emergency admissions and the use of extramural services. Outcomes, Frail older people are high users of services but claim that services are not responsive to their main concerns: meeting individual needs, maximizing independence and helping to live fulfilled lives. Services not catering for these needs are often cancelled or left in abeyance. Conclusion, The same people who are targeted by care services are reluctant to engage with them. Care providers need to adopt older people's priorities to provide them with responsive patient-centred care. [source] | ||||||||||