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General Improvement (general + improvement)
Selected AbstractsInfluence of psychotherapist density and antidepressant sales on suicide ratesACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2009N. D. Kapusta Objective:, Antidepressant sales and suicide rates have been shown to be correlated in industrialized countries. The aim was to study the possible effects of psychotherapy utilization on suicide rates. Method:, We assessed the impact of antidepressant sales and psychotherapist density on suicide rates between 1991 and 2005. To adjust for serial correlation in time series, three first-order autoregressive models adjusted for per capita alcohol consumption and unemployment rates were employed. Results:, Antidepressant sales and the density of psychotherapists in the population were negatively associated with suicide rates. Conclusion:, This study provides evidence that decreasing suicide rates were associated with both increasing antidepressant sales and an increasing density of psychotherapists. The decrease of suicide rates could reflect a general improvement in mental health care rather than being caused by antidepressant sales or psychotherapist density alone. [source] Description and evaluation of an education and communication skills training course in HIV and AIDS for dental consultantsEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2000D. A. Lewis A 2-day course was organised for dental hospital consultants as part of a project on raising awareness of dental staff about HIV and AIDS. The course comprised an information update, practical experience in the diagnosis of oral conditions and a ,hands-on' exercise in infection control. The 2nd day of the course consisted of experiential communication skills training using rôle-play with actors and video feedback. Evaluation of the course showed that the consultants perceived the course to be valuable. There was a general improvement in dentists' confidence in their knowledge, ability to communicate with HIV-positive patients and in talking to staff who are unwilling to provide treatment. These changes are statistically significant and these skills are still being utilized and maintained 2 years later. Information and training packs prepared by multidisciplinary groups using a variety of teaching methods should be made available to those involved in training dental staff. [source] The Regulation of Telecommunications in the Czech RepublicEUROPEAN LAW JOURNAL, Issue 3 2003Andrew Skudder The rapid development of the telecommunications sector was to act as a catalyst for the general improvement of the entire national economy, whilst at the same time helping the country to meet its policy goal of creating the conditions precedent to its successful integration into the European Union. The purpose of this article is to trace the progress of the Czech telecommunications market to date and to assess the regulatory framework adopted by the Czech government in light of its stated policy goals. After giving a brief history of the development of the market and the corresponding development of a regulatory régime this article shall turn to examine the current legal position after the adoption of the recent Law on which came into force on 1 July 2000. As well as suggesting necessary modifications and amendments due to certain flaws or omissions in the Act, modifications arising from the adoption by the EU of its new regulatory framework for communications shall also be suggested. [source] State-of-the-Art in Longitudinal Studies on Aging: An Overview of the SupplementJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2010Ruth M. Tappen RN The articles in this supplement are based on a conference held in January 2008 sponsored by a grant from the Robert Wood Johnson Foundation. The purpose of the conference was to summarize major findings and methodological issues in previous and ongoing longitudinal studies on aging and to identify potentially fruitful areas for future research. This article is a review and synthesis of the articles in this supplement. Each of the articles makes important contributions to summarizing existing research, identifying challenging methodological issues, or proposing areas that should be explored in future research. Three themes were identified: general improvement in the health status of the population aged 65 and older in the United States, a shift in longitudinal research on aging from a focus on the endpoints of disease to a focus on the preclinical stage and underlying mechanisms of these diseases, and contemporary developments in longitudinal research methodology. A number of practical suggestions were also drawn from the articles reviewed. [source] A Mitochondrial view of aging, reactive oxygen species and metastatic cancerAGING CELL, Issue 4 2010Warren Ladiges Summary This perspective article highlights the growing evidence placing mitochondria and mitochondrial function at the center of cancer as an age-related disease. The discussion starts from the mitochondrial free radical hypothesis that predicts the involvement of endogenous mitochondrial reactive oxygen species (ROS) in cancer development and summarizes studies demonstrating the impact of the modulation of ROS levels on cancer development and metastasis. Cancer is fundamentally a complex interplay of cell growth, division, metastasis and death- processes connected to mitochondria through energy metabolism. Based on this evidence, therapeutics focused on mitochondrial function and mitochondrial ROS production are an attractive approach to modulating the progression of metastatic cancer and the general improvement of human health span. [source] A retrospective analysis of two independent prospective cartilage repair studies: autogenous perichondrial grafting versus subchondral drilling 10 years post-surgeryJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2002Phianne S. J. M. Bouwmeester Background: Experimental data indicate that perichondrial grafting to restore articular cartilage defects will result in repair with hyaline-like cartilage. In contrast, debridement and drilling results in repair with fibro-cartilage. In this retrospective study the longterm clinical results of both procedures were compared to evaluate the theoretical benefit of repair with hyaline-like tissue. Methods: From two independent studies patients were selected with a cartilage defect in their knee. The selection was performed using strict inclusion criteria published elsewhere [Bouwmeester et al. Int. Orthop. 21 (1997) 313]. The patients were treated with either a perichondrium transplantation (PT group, n = 14) or with an ,open' debridement and drilling procedure (DD group, n = 11). The results of both procedures after 10,11 years were evaluated using the Hospital for Special Surgery Knee Score (HSSS), X-ray examination, clinical examination and visual analogue scales (VAS) for pain during walking and at rest. Results: Both procedures resulted in a general improvement compared to the situation before the operation. After an average of 10 years in the PT group there were three failures, in the DD group none, success rates were 78% and 100%, respectively. When comparing the successful PT patients with the DD patients, there were no differences in HSSS and VAS data. Both groups showed an equal number of irregular operation surface sites on X-ray (PT 9/11 versus DD 8/10). Conclusions: This study shows that clinically at 10 years follow-up no difference was observed between debridement and drilling and perichondrium transplantation for treatment of an isolated cartilage defect. This raises questions about ongoing research to develop methods in order to improve the results of debridement and drilling as therapy for an isolated cartilage defect in a young patient (, 40 years). © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source] Integrating education into primary care quality and cost improvement at an academic medical centerTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2006R. Van Harrison PhD Abstract Introduction: In 1996 the University of Michigan Health System created the Guidelines Utilization, Implementation, Development, and Evaluation Studies (GUIDES) unit to improve the quality and cost-effectiveness of primary care for common medical problems. GUIDES's primary functions are to oversee the development of evidence-based, practical clinical guidelines for common medical conditions; measure and provide feedback on physicians' performance; and facilitate systemic changes to support appropriate care. Various methods are used to improve care, including evidence reviews, formal education, informal clinical "opinion leaders," feedback, reminders, and procedure changes. Twenty-four common medical conditions have been addressed through this process. More than 30 measures of clinical performance have been developed and reported. Methods: This case study describes a systematic, multifaceted program to improve the quality and cost-effectiveness of primary care. Results: Illustrative results for clinical performance are presented for 2 measures of chronic care, 2 measures of preventive care, and 2 measures of acute care. All 6 measures show general improvement in performance across years, with performance near or above the National Committee for Quality Assurance's 90th percentile for Health Plan Employer Data and Information Set measures. Discussion: A systematic approach involving all relevant components of a health system integrates the synthesis of information, education about the information and how to implement it, and addressing operational barriers. Benefits include a curriculum that is shared across faculty, residents, and medical students and more uniform quality of care that faculty model for physicians-in-training. [source] Short-term variation in the ecological status of a Mediterranean coastal lagoon (NE Iberian Peninsula) after a man-made change of hydrological regimeAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 7 2008Anna Badosa Abstract 1.The Ter Vell (NE Iberian Peninsula) is a eutrophic coastal lagoon that has been mostly flooded by excessive irrigation water during recent decades. During 2001 and 2002 the lagoon was subject to several water management actions, the main consequence of which was a change in the hydrological regime due to drastically reduced irrigation water inputs to the lagoon. 2.In order to comply with the Water Framework Directive, all the management actions in an ecosystem should be focused on protecting and, where necessary, improving its ecological status. 3.The aims of this study were (1) to analyse whether the hydrological change caused by management actions have affected the ecological status of the lagoon, and (2) to discuss the suitability of several physicochemical and biological indicators for the assessment of the ecological status in this kind of coastal ecosystem. 4.After the change in the hydrological regime, a general improvement of the ecological status was observed mainly as a result of the significant decrease in the nitrogen Trophic State Index and in the abundance of rotifer indicative of eutrophy, and in turn by the significant increase in the water quality index QAELS, based on crustaceans and insect assemblages. 5.Contradictory results emerged with regard to some of the indicators used. After the hydrological change, the increase in the phosphorus Trophic State Index was related with the fact that Mediterranean confined coastal ecosystems are typically P-enriched. In contrast with general assumptions, low diversity and richness of the zooplankton and the dominance of a few species have been related with an improvement of the ecological status after the hydrological change, when freshwater inputs were reduced and the lagoon became more confined. Copyright © 2008 John Wiley & Sons, Ltd. [source] Do Integrated Children's Services Improve Children's Outcomes?: Evidence From England's Children's Trust PathfindersCHILDREN & SOCIETY, Issue 5 2009Margaret O'Brien Thirty-five children's trust pathfinders, local cross-sector partnerships, were introduced across England in 2003 to promote greater integration in children's services. Using administrative performance data, this paper tracks yearly trends in child service outputs and child well-being outcomes from 1997 to 2004 in these local areas, including the period before their introduction. Professional perceptions of change in child outcomes are also presented. Time series regression analysis shows there was a general improvement in England in these selected performance indicators prior to the introduction of children's trusts pathfinders. Children's trust pathfinder areas initially focusing on ,all children' in their local area, rather than selected groups of children, showed the most progress. There was no consistent quantitative evidence for better outcomes in more integrated areas, however, 25 of the 35 survey respondents provided locally specific examples of children's trust pathfinder arrangements improving outcomes for children and young people. [source] The impact of a motivational assessment interview on initial response to treatment in adolescent anorexia nervosaEUROPEAN EATING DISORDERS REVIEW, Issue 2 2004S. G. Gowers Abstract This study was a pilot for a larger study to evaluate a time-limited outpatient programme for adolescent anorexia nervosa, to explore the ability of an assessment interview to change self-reported motivation and ascertain the extent to which this predicted engagement with treatment and early behavioural change. Forty-two adolescents with anorexia nervosa rated their motivation for change before and after attending a new-style assessment interview. Initial (6 week) effectiveness of the programme was evaluated by measuring engagement with treatment, weight change, clinician (HoNOSCA) and self-rated (EDI, MFQ, HoNOSCA-SR) outcome measures, overall and in relation to motivational status. The assessment interview significantly improved motivation. Motivational category after interview was unrelated to physical status, cognition or general functioning but predicted engagement with treatment. Whilst for the whole sample, treatment produced physical, cognitive and general improvements at 6 weeks, motivational status was a powerful predictor of weight gain. A client-centred assessment interview engaged 80% in an outpatient programme based on CBT. Motivational enhancement may improve engagement and specifically result in behavioural change and early weight gain. Copyright © 2004 John Wiley & Sons, Ltd and Eating Disorders Association. [source] | |||||||||||||