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Selected AbstractsAssessment for crisis interventionJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2006Rick A. Myer This article describes the triage assessment system (TAS) for crisis intervention. The TAS assesses affective, behavioral, and cognitive reactions of individuals to crisis events. This assessment model offers clinicians an understanding of the type of reactions clients are experiencing as well as the intensity of these reactions. The TAS provides a quick, accurate, and easy-to- use method that is directly usable in the intervention process. The system can also be used to monitor clients' progress during the intervention process. Two case illustrations are presented to demonstrate the use of the model. In addition, the Triage Assessment Form: Crisis Intervention is included as an Appendix. © 2006 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 959,970, 2006. [source] A standardized and reliable method to apply the Global Assessment of Functioning (GAF) scale to psychiatric case recordsINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 2 2000Dr M. Mirandola Abstract The Global Assessment of Functioning (GAF) scale is widely used both in routine clinical practice and in research. However, its reliability has never been assessed when used to rate information in clinical records. The present study focuses on the development of a standardized method (an ongoing modelling process between raters) for establishing desired levels of inter-rater reliability (IRR) in the application of the GAF to psychiatric case records. Fifty-one patients at first-ever contact with mental health services were included in the study. They were selected from a total sample of 662 first-ever patients by using a systematic sampling. Three raters (resident psychiatrists at their third year of training) took part in a 12-hour training programme, during which they were asked to assess the global psychological functioning of patients, taking into account information recorded in case records. The extent of agreement between raters was estimated by applying the ,limits of agreement' method and the ,concordance correlation coefficient'. The training programme proved to be feasible, easy to administer and acceptable to psychiatrists in training with limited previous experience of using rating scales. Very high levels of concordance (all greater than 0.95) emerged between the three raters. The GAF, completed using information from case records included in the initial assessment form, appeared to be a reliable instrument, even when used by clinical psychiatrists in training. Copyright © 2000 Whurr Publishers Ltd. [source] Comparison of treatment modalities in burning mouth syndromeAUSTRALIAN DENTAL JOURNAL, Issue 4 2009KE Barker Abstract Background:, Burning mouth syndrome (BMS) is characterized by a spontaneous burning pain in the oral mucosa without known organic cause or standardized treatment. The aims of this study were to assess and compare the efficacy of clonazepam and diazepam in relieving the symptoms associated with BMS and evaluate for which patients this treatment might be effective by correlating treatment efficacy with underlying psychological status. Methods:, The medical records of BMS patients attending an oral medicine private practice (1999,2004) were reviewed. The patients were then contacted and asked to complete a short questionnaire regarding their response to diazepam/clonazepam drug therapies. A second group of patients attending the above clinic (n = 30) were asked to fill out a hospital anxiety and depression assessment form in an attempt to correlate treatment success with underlying psychological status. Results: A total of 71.4 per cent of patients treated with clonazepam had partial or complete resolution of their oral symptoms, while 55.1 per cent of patients treated with diazepam had improvement of their oral symptoms. There was no correlation between underlying anxiety or depression and efficacy of benzodiazepine medication. Conclusions:, A greater percentage of patients taking clonazepam reported either partial or complete relief of symptoms compared to diazepam. However, the differences were not statistically significant. There was no correlation found between underlying psychopathology and treatment success with benzodiazepines. [source] Objective assessment of surgical competency , ENT traineesCLINICAL OTOLARYNGOLOGY, Issue 6 2007A.P. Bath Key points ,,The objective assessment of the progression of surgical competence throughout the career of a trainee surgeon is complicated. ,,An operative competence assessment form was introduced into the RITA process for ENT trainees in 2004 in the Eastern Deanery. ,,Analysis of the data has shown that there is a clear improvement in their surgical ability with ,minor' procedures being mastered much earlier in their career than ,major' procedures. ,,The value of such an assessment tool is that it has the potential to identify the trainee that has poor surgical ability early and it also provides evidence that senior trainees at the end of their training are surgically competent to meet the demands of a consultant post. [source] The influence of bladder filling on anorectal functionCOLORECTAL DISEASE, Issue 3 2003J. J. Crosbie Abstract Objective The aim of this study was to develop a technique to simultaneously evaluate bladder and anorectal function. In particular, this study was designed to determine if anal sphincter resting pressure, anal sphincter squeeze pressure and rectal sensation change with bladder filling. Patient and methods A pilot study of ten female patients who presented to the pelvic physiology unit for assessment of urinary symptoms was performed. All patients completed a symptom questionnaire and quality of life assessment form. Following informed consent a baseline urodynamic test was performed with the bladder empty and subsequently followed by an anorectal manometric test. Changes in anal sphincter resting pressure, squeeze pressure and rectal pressure were recorded over a ten-minute period. With the patient lying in the left lateral position, the bladder was then filled with isotonic saline at room temperature at a constant rate of 30ml/min. A continuous assessment of changes in anal sphincter resting pressure during bladder filling was made. Anal sphincter squeeze pressure and rectal sensation were measured at fixed intervals during bladder filling (50, 100, 150 ml etc.) and at fixed intervals relative to bladder capacity (25, 50, 75 and 100% capacity) by stopping bladder filling at the appropriate level. Results , There was no significant change in anal sphincter resting pressure (Mean difference(s.d.) between bladder full and empty = 2.7(5.6) P = 0.92*), squeeze pressure (Mean(s.d.) difference = 9.5(26.3) P = 0.86*) and rectal sensation (Mean difference(s.d.) first sensation 10(15.2) P = 0.958; Mean difference(s.d.) urgency = 10(17.8) P = 0.07*) on bladder filling. Conclusion , Under normal physiological circumstances, bladder filling does not influence anorectal function. *Stastistical analysis: Wilcoxon signed rank sum test. P < 0.05 considered significant. Units = mmHg [source] Using Assessing Care of Vulnerable Elders Quality Indicators to Measure Quality of Hospital Care for Vulnerable EldersJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2007Vineet M. Arora MD OBJECTIVES: To assess the quality of care for hospitalized vulnerable elders using measures based on Assessing Care of Vulnerable Elders (ACOVE) quality indicators (QIs). DESIGN: Prospective cohort study. SETTING: Single academic medical center. PARTICIPANTS: Subjects aged 65 and older hospitalized on the University of Chicago general medicine inpatient service who were defined as vulnerable using the Vulnerable Elder Survey-13 (VES-13), a validated tool based on age, self-reported health, and functional status. MEASUREMENTS: Inpatient interview and chart review using ACOVE-based process-of-care measures referring to 16 QIs in general hospital care and geriatric-prevalent conditions (e.g., pressure ulcers, dementia, and delirium); adherence rates calculated for type of care process (screening, diagnosis, and treatment) and type of provider (doctor, nurse). RESULTS: Six hundred of 845 (71%) older patients participated. Of these, 349 (58%) were deemed vulnerable based on VES-13 score. Three hundred twenty-eight (94%) charts were available for review. QIs for general medical care were met at a significantly higher rate than for pressure ulcer care (81.5%, 95% confidence interval (CI)=79.3,83.7% vs 75.8%, 95% CI=70.5,81.1%, P=.04) and for delirium and dementia care (81.5%, 95% CI=79.3,83.7 vs 31.4% 95% CI=27.5,35.2%, P<.01). According to standard nursing assessment forms, nurses were responsible for high rates of adherence to certain screening indicators (pain, nutrition, functional status, pressure ulcer risk; P<.001 when compared with physicians), although in patients with functional limitations, nurse admission assessments of functional limitations often did not agree with reports of limitations by patients on admission. CONCLUSION: Adherence to geriatric-specific QIs is lower than adherence to general hospital care QIs. Hospital care QIs that focus on screening may overestimate performance by detecting standard nursing or protocol-driven care. [source] Treatment outcome of immediate, early and conventional single-tooth implants in the aesthetic zone: a systematic review to survival, bone level, soft-tissue, aesthetics and patient satisfactionJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2008Laurens Den Hartog Abstract Aim: This study evaluated, through a systematic review of the literature, the outcome of single-implant restorations in the aesthetic zone with natural adjacent teeth, thereby addressing immediate, early and conventional implant approaches. Material and Methods: MEDLINE (1950,2008), EMBASE (1966,2008), and CENTRAL (1800,2008) were searched to identify eligible studies. Two reviewers independently assessed the methodological quality using specific study-design-related assessment forms. Results: Out of 86 primarily selected articles, 19 studies fulfilled the inclusion criteria. A meta-analysis showed an overall survival rate of 95.5% [95% confidence interval: (93.0,97.1)] after 1 year. A stratified meta-analysis revealed no differences in survival between immediate, early and conventional implant strategies. Little marginal peri-implant bone resorption was found together with low incidence of biological and technical complications. No significant differences in outcome measures were reported in clinical trials comparing immediate, early or conventional implant strategies. Conclusion: The included literature suggested that promising short-term results could be achieved for immediate, early and conventional single-implants in the aesthetic zone. However, important parameters as aesthetic outcome, soft-tissue aspects, and patient satisfaction were clearly underexposed. The question whether immediate and early single-implant therapies would result in better treatment outcomes remained inconclusive due to lack of well-designed controlled clinical studies. [source] |