			Home About us Contact

Outpatient Therapy (outpatient + therapy)

Distribution by Scientific Domains

Psychology	50%
Medical Sciences	50%

Selected Abstracts

Developing a Comprehensive Mechanical Support Program

JOURNAL OF CARDIAC SURGERY, Issue 3 2001
David N. Helman M.D.
As cardiac surgery centers appreciate that ventricular assist devices (VAD) can dramatically impact patient survival as a bridge to transplant or recovery, and possibly permanent therapy, increasing numbers will desire to establish mechanical support programs. A number of vital elements must be put in place in order to operate a successful mechanical support program. Of utmost importance is the assembly of a dedicated team focused on comprehensive care of critically ill patients in need of circulatory support. An ongoing commitment from anesthesiologists, cardiologists, nephrologists, and other support staff is essential. Selection of complementary assist devices should be made to cover the spectrum of required support scenarios, both short- and long-term. Outpatient therapy has become increasingly important in mechanical cardiac assistance and establishment of an office where "LVAD coordinators" see outpatients facilitates this aspect of the program. Critically ill patients in need of cardiac assistance may benefit from specialized medical therapies such as: (1) intravenous arginine vasopressin for vasodilatory hypotonsion; (2) inhaled nitric oxide for right heart failure; (3) aprotinin to reduce hemorrhage; and (4) early enteral feeding in an effort to reduce infectious complications and improve rehabilitation following VAD implantation. A regional network with spoke hospitals centered around a hub hospital with long-term VAD and heart transplant programs can improve survival of patients with postcardiotomy cardiogenic shock via early transfer to the hub hospital. In this article, we describe the components of our mechanical support program that have allowed us to successfully support patients with heart failure in need of circulatory support. [source]

Aftercare intervention through text messaging in the treatment of bulimia nervosa,Feasibility pilot

INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 8 2006
Sarah Robinson BSc
Abstract Objective: Even with the best available treatment, most bulimia nervosa (BN) sufferers are not symptom free at the end of therapy and, for those who have achieved remission, risk of relapse is high. Thus, there is a need for aftercare or relapse prevention interventions after therapy. It is not yet known what type of intervention should be delivered, and how to suit patient needs while being mindful of cost and time constraints of service providers. This pilot study was conducted to explore the feasibility, acceptability, and efficacy of a text messaging (short messaging service [SMS])-based intervention in the aftercare of BN patients who had received outpatient psychotherapy. Method: A total of 21 patients with BN participated in the 6-month SMS-based intervention as a step-down treatment AFTER outpatient therapy. Results: Levels of use of the program were relatively low and attrition high, indicating limited acceptance of the intervention. Conclusion: This study suggests that the SMS-based intervention would benefit from further adaptation to make it a more useful tool for the aftercare of patients after outpatient treatment for bulimia nervosa. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006; 39:633,638 [source]

A survival analysis of clinically significant change in outpatient psychotherapy

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 7 2001
Edward M. Anderson
The number of sessions required to produce meaningful change has not been assessed adequately, in spite of its relevance to current clinical practice. Seventy-five clients attending outpatient therapy at a university-affiliated clinic were tracked on a weekly basis using the Outcome Questionnaire (Lambert et al., 1996) in order to determine the number of sessions required to attain clinically significant change (CS). Survival analysis indicated that the median time required to attain CS was 11 sessions. When current data were combined with those from an earlier investigation (Kadera, Lambert, and Andrews, 1996), it was found that clients with higher levels of distress took 8 more sessions to reach a 50% CS recovery level than clients entering with lower levels of distress. At a six-month follow-up, CS gains appeared to have been maintained. Other indices of change also were examined (reliable change, average change per session). The implications of these results for allocating mental-health benefits, such as the number of sessions provided through insurance, are discussed. © 2001 John Wiley & Sons, Inc. J Clin Psychol 57: 875,888, 2001. [source]

Emergency Physicians' Risk Attitudes in Acute Decompensated Heart Failure Patients

ACADEMIC EMERGENCY MEDICINE, Issue 1 2010
Julie B. McCausland MD
Abstract Objectives:, Despite the existence of various clinical prediction rules, no data exist defining what frequency of death or serious nonfatal outcomes comprises a realistic "low-risk" group for clinicians. This exploratory study sought to identify emergency physicians' (EPs) definition of low-risk acute decompensated heart failure (ADHF) emergency department (ED) patients. Methods:, Surveys were mailed to full-time physicians (n = 88) in a multihospital EP group in southwestern Pennsylvania between December 2004 and February 2005. Participation was voluntary, and each EP was asked to define low risk (low risk of all-cause 30-day death and low risk of either hospital death or other serious medical complications) and choose a risk threshold at which they might consider outpatient management for those with ADHF. A range of choices was offered (<0.5, <1, <2, <3, <4, and <5%), and demographic data were collected. Results:, The response rate was 80%. Physicians defined low risk both for all-cause 30-day death and for hospital death or other serious complications, at <1% (38.8 and 40.3%, respectively). The decision threshold to consider outpatient therapy was <0.5% risk both for all-cause 30-day death (44.6%) and for hospital death or serious medical complications (44.4%). Conclusions:, Emergency physicians in this exploratory study define low-risk ADHF patients as having less than a 1% risk of 30-day death or inpatient death or complications. They state a desire to have and use an ADHF clinical prediction rule that can identify low-risk ADHF patients who have less than a 0.5% risk of 30-day death or inpatient death or complications. ACADEMIC EMERGENCY MEDICINE 2010; 17:108,110 © 2010 by the Society for Academic Emergency Medicine [source]