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Hospital Treatment (hospital + treatment)
Selected AbstractsMisclassification and the use of register-based indicators for depressionACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2009K. Thielen Objective:, To study the degree to which depression indicators based on register data on hospital and antidepressant treatment suffer from differential misclassification with respect to gender, age and social group. Method:, Data on 7378 persons were obtained by linking a cross-sectional survey of Danish adults aged 40 and 50 years with population-based registers. Misclassification was analysed by comparing survey data to register data on major depression using the method proposed by Rothman and Greenland. Results:, Differential misclassification was found. Adjustment for misclassification reduced women's odds ratios from 2.18 to 1.00 for hospital treatment and from 1.70 to 1.10 for antidepressants. For the lower social group, the corresponding odds ratios increased from 1.18 to 3.52, and from 1.35 to 2.32 respectively, whereas odds ratios with respect to age remained almost unchanged. Conclusion:, Differential misclassification should be considered when register-based information about hospital and antidepressant treatment are used as depression indicators. [source] Allogeneic bone marrow transplantation with reduced conditioning (RC-BMT)EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 2 2001Lars Vindeløv Abstract: Allogeneic bone marrow transplantation with conventional conditioning (CC-BMT) has the potential of curing various malignant and non-malignant diseases. The curative mechanisms encompass 1) stem cell support for myeloablative radio-chemotherapy, 2) the graft-versus-tumor (GVT) effect, 3) gene replacement for genetic diseases and 4) immunoablation for autoimmune diseases. CC-BMT is characterized by high intensity conditioning, the requirement of prolonged and expensive hospital treatment and a treatment related mortality (TRM) of 10,50% depending on diagnosis, disease stage, patient age and donor type. Recent preclinical and clinical progress has resulted in the emergence of new concepts and procedures that allow replacement of patient bone marrow and immune system with that of the donor by a transplant procedure with markedly reduced conditioning (RC-BMT). This type of transplant, sometimes referred to as mini-BMT, activates curative mechanisms 2,4, which for a number of diseases seems sufficient for cure. It avoids the severe organ toxicity of myeloablative radio-chemotherapy and the complications of profound neutropenia. Patients beyond the age limit of conventional BMT (50,60 yr) may therefore be candidates for this type of transplant as well as patients which because of other medical conditions or the type of disease for which the transplant is needed are poor candidates for CC-BMT. The procedure can be performed in an outpatient setting. The resulting cost reduction should contribute to making allogenic BMT more readily available. This review describes basic concepts and procedures involved in RC-BMT and summarizes preliminary results obtained with RC-BMT in different transplant centers. [source] Critical appraisal of the management of severe malnutrition: 1.JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 10 2006Epidemiology, treatment guidelines Abstract: Hospital case-fatality rates for severe malnutrition in the developing world remain high, particularly in Africa where they have not changed much over recent decades. In an effort to improve case management, WHO has developed treatment guidelines. The aim of this review is to critically appraise the evidence for the guidelines and review important recent advances in the management of severe malnutrition. We conclude that not only is the evidence base deficient, but also the external generalisability of even good-quality studies is seriously compromised by the great variability in clinical practice between regions and types of health facilities in the developing world, which is much greater than between developed countries. The diagnosis of severe wasting is complicated by the dramatic change in reference standards (from CDC/WHO 1978 to CDC 2000 in EpiNut) and also by difficulties in accurate measurement of length. Although following treatment guidelines has resulted in improved outcomes, there is evidence against the statement that case-fatality rates (particularly in African hospitals) can be reduced below 5% and that higher rates are proof of poor practice, because there is wide variation in severity of illness factors. The practice of prolonged hospital treatment of severe malnutrition until wasting and/or oedema has resolved is being replaced by shorter hospital stays combined with outpatient or community follow-up because of advances in dietary management outside of hospital. [source] Mental health crisis and respite services: service user and carer aspirationsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2009C. LYONS phd msc pg cert rnt dpsn rmn teacher's cert There is emerging evidence that crisis resolution services can provide alternatives to hospital admission, reducing demand on inpatient beds. Following a public consultation exercise in Lancashire (England), a team of nurses undertook a study, using interactive research methodology, to gain an understanding of how users and carers define a crisis and what range of crisis services, resources and interventions service users and carers thought would help avoid unnecessary hospital admission. Data collection comprised postal questionnaires and 24 group meetings with service users and carers, which were held during 2006. Data were analysed, and seven themes were identified: (1) definitions of a crisis; (2) access to services; (3) interventions; (4) range of services required (before, during and after crisis); (5) place of treatment; (6) recovery and rehabilitation; and (7) community support. We conclude that expressed preferences of service users and carers for pre-emptive services that are delivered flexibly will present a challenge for service commissioners and providers, particularly where stringent access criteria are used. Home-based pre-emptive services that reduce the need for unnecessary hospital treatment may avoid progression to social exclusion of service users. [source] Inhaled corticosteroids during and after respiratory syncytial virus-bronchiolitis may decrease subsequent asthmaPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 3 2000Merja Kajosaari Respiratory syncytial virus (RSV) bronchiolitis in infancy can lead to bronchial hyper-reactivity or recurrent obstructive bronchitis. The aim of the present study was to determine whether the type of treatment has an influence on respiratory status after RSV bronchiolitis. The study involved 117 infants (mean age 2.6 months), who needed hospital treatment because of RSV bronchiolitis. The patients were divided randomly into three groups. All received the same symptomatic treatment. Group I children received symptomatic treatment only, group II children were treated for 7 days with inhaled budesonide, 500 µg three times per day, administered via a nebulizer. Group III children received nebulized budesonide, 500 µg twice per day for two months. Follow-up consisted of out-patient check-ups 2 and 6 months after the infection, and telephone contact two years after the infection. Statistically significant differences were seen between the groups. In group I 37% of the children had asthma, in group II 18%, and in group III 12%. According to the present study it seems that inhaled corticosteroid treatment during and after the acute phase of infant RSV bronchiolitis may have a beneficial effect on subsequent bronchial wheezing tendency. [source] PRIMARY PERITONITIS IN ADULTS: IS IT TIME TO LOOK FOR A BETTER DIAGNOSTIC CLASSIFICATION?ANZ JOURNAL OF SURGERY, Issue 3 2006John Jarvis Background: The occurrence of primary peritonitis is rare. The experience of a single institution and the definition of this disease are reviewed. Methods: A retrospective audit of primary peritonitis at a single institution was undertaken. Age, sex, clinical presentation, initial diagnosis, imaging and blood tests, comorbidities, recent medical intervention, surgical treatment and operative findings, antibiosis, bacterial isolates, the course of hospital treatment and follow up, including later diagnoses, were reviewed. Results: The audit was carried out at Christchurch Hospital between January 1998 and March 2005. A total of 115 patients were identified with a diagnosis of non-specific peritonitis, of which five patients were identified with a diagnosis of primary peritonitis. All were women aged 22,38 years. Three had undergone a caesarean section in the last 3 months. The details of these cases are presented in detail. Conclusion: Five cases of primary peritonitis are reported, and from a review of published work, a classification of primary peritonitis is suggested, which more clearly identifies the cause of the disease. [source] Five years later: children's memory for medical emergenciesAPPLIED COGNITIVE PSYCHOLOGY, Issue 7 2001Carole Peterson Children who had been 2,13 years of age at the time of a medical emergency (an injury serious enough to require hospital ER treatment) were re-interviewed about their injury and treatment five years after injury, and three years after a previous interview. The children showed excellent recall of the central components of their injury experience, although their recall of hospital treatment was more incomplete. Thus, both the nature of the event being recalled (the injury versus the hospital treatment) and the centrality of information (central versus peripheral) were important. The recall of 2-year-olds, although not as good as that of children just a year older, did not fit with predictions of infantile amnesia since they recalled a considerable amount about their injury. High stress levels at the time of the target experiences had little effect on the highly memorable injury event, but seemed to facilitate children's recall of central components of the hospital event,the event that they had a harder time remembering. Implications for eyewitness testimony are discussed. Copyright © 2001 John Wiley & Sons, Ltd. [source] Childhood risk factors for offending before first psychiatric admission for people with schizophrenia: a case,control study of high security hospital admissionsBEHAVIORAL SCIENCES & THE LAW, Issue 3 2010B.Sc., Ch.B., M.Sc., Roland M. Jones M.B. Background People with schizophrenia who offend do not constitute a homogenous population. Pre-illness characteristics may distinguish groups. Aims To test for differences in prevalence of childhood risk factors for offending between serious offenders with schizophrenia who had started offending before their first ever psychiatric admission (pre-admission offenders) and those who had started after it (post-admission offenders). Our hypothesis was that such adverse childhood factors would be more prevalent in the pre-admission offenders. Method Retrospective interview and records case,control study of all first high security hospital admissions diagnosed with schizophrenia in England 1972,2000. Risk factors were identified by multivariate logistic regression. Results 853 patients were pre- and 741 post-admission offenders. Our hypothesis was confirmed in that factors associated with pre-admission offending were paternal criminal convictions, larger family size, and younger age at first use of illicit drugs, on first smoking cigarettes, and at maternal separation. There were differences too in pre-high security hospital treatment: pre-admission offenders had been younger at first court appearance and had more criminal justice system disposals, post-admission offenders were younger at first ever psychiatric hospital admission and more often hospitalized. Conclusions While early offending among people with schizophrenia may delay treatment, making the distinction between pre-admission and post-admission offending may be useful in understanding the aetiology of the offending, and establishment of such a history may help in targeting interventions supplementary to treatment specific for the psychosis. Copyright © 2009 John Wiley & Sons, Ltd. [source] | |||||||||||||