Treatment Efforts (treatment + effort)

Distribution by Scientific Domains

Selected Abstracts

Ethnic Differences in Pain Among Outpatients with Terminal and End-Stage Chronic Illness

PAIN MEDICINE, Issue 3 2005
Michael W. Rabow MD
ABSTRACT Objective., To explore ethnic and country of origin differences in pain among outpatients with terminal and end-stage chronic illness. Design., Cohort study within a year-long trial of a palliative care consultation. Setting., Outpatient general medicine practice in an academic medical center. Patients., Ninety patients with advanced congestive heart failure, chronic obstructive pulmonary disease, or cancer, and with a prognosis between 1 and 5 years. Outcome Measures., Patients' report of pain using the Brief Pain Inventory and analgesic medications prescribed by primary care physicians. Differences in pain report and treatment were assessed at study entry, at 6 and 12 months. Results., The overall burden of pain was high. Patients of color reported more pain than white patients, including measures of least pain (P = 0.02), average pain (P = 0.05), and current pain (P = 0.03). No significant ethnic group differences in pain were found comparing Asian, black, and Latino patients. Although nearly all patients who were offered opioid analgesics reported using them, opioids were rarely prescribed to any patient. There were no differences in pain between patients born in the U.S. and immigrants. Conclusions., Pain is common among outpatients with both terminal and end-stage chronic illness. There do not appear to be any differences in pain with regard to country of origin, but patients of color report more pain than white patients. Patients of all ethnicities are inadequately treated for their pain, and further study is warranted to explore the relative patient and physician contributions to the finding of unequal symptom burden and inadequate treatment effort. [source]

Context-Oriented Model Development in Psychotherapy Planning (,COMEPP'): a useful adjunct to diagnosis and therapy of severe personality disorders

M. Fischer-Kern
Objective:, Pathogenous interpersonal (e.g. interfamilial) relationships and reference styles can compromise treatment efforts in severely disturbed (i.e. psychotic or borderline) patients. The integration of family- and individual-centred starting points may be useful in establishing interdisciplinary treatment concepts in these patients. Context-Oriented Model Development in Psychotherapy Planning (COMEPP) represents a diagnostic and therapy planning process, integrating both systemic and psychoanalytic conceptualizations. Method:, COMEPP is exemplified by the case of a young man with psychotic personality disorder who had previously been unresponsive to pharmacological and psychological treatment. Results:, After psycho-dynamical conflicts (i.e. primitive projective processes from the patient's mother to her son) had been elucidated during the COMEPP process, a sufficient treatment setting could be established. Conclusion:, COMEPP provides a psychotherapeutical approach to treatment planning on case-specific premises and may serve as an adjunct to concomitant pharmacological and psychological treatment strategies in so-called ,therapy refractory' patients. [source]

Smokers with financial stress are more likely to want to quit but less likely to try or succeed: findings from the International Tobacco Control (ITC) Four Country Survey

ADDICTION, Issue 8 2009
Mohammad Siahpush
ABSTRACT Objective To examine the association of financial stress with interest in quitting smoking, making a quit attempt and quit success. Design and participants The analysis used data from 4984 smokers who participated in waves 4 and 5 (2005,07) of the International Tobacco Control (ITC) Four Country Survey, a prospective study of a cohort of smokers in the United States, Canada, the United Kingdom and Australia. Measurement The outcomes were interest in quitting at wave 4, making a quit attempt and quit success at wave 5. The main predictor was financial stress at wave 4: ,. . . because of a shortage of money, were you unable to pay any important bills on time, such as electricity, telephone or rent bills?'. Additional socio-demographic and smoking-related covariates were also examined. Findings Smokers with financial stress were more likely than others to have an interest in quitting at baseline [odds ratio (OR): 1.63; 95% confidence interval (CI): 1.22,2.19], but were less likely to have made a quit attempt at follow-up (OR: 0.74; 95% CI: 0.57,0.96). Among those who made a quit attempt, financial stress was associated with a lower probability of abstinence at follow-up (OR: 0.53; 95% CI: 0.33,0.87). Conclusions Cessation treatment efforts should consider assessing routinely the financial stress of their clients and providing additional counseling and resources for smokers who experience financial stress. Social policies that provide a safety net for people who might otherwise face severe financial problems, such as not being able to pay for rent or food, may have a favorable impact on cessation rates. [source]

Epithelioid osteosarcoma presenting as a rapidly expanding maxillary mass,

Joseph Rinaggio DDS
Abstract Background. Osteosarcomas of the jaws account for less than 10% of reported neoplasms of this type. Patients with osteosarcoma in this region tend to be in the late-third to mid-fourth decades of life. The osteoblastic, chondroblastic, and fibroblastic variants constitute the majority of lesions. Methods. A mass was observed in the maxilla of a 50-year-old male who presented for a complete odontectomy. Over the ensuing weeks, the mass substantially increased in size, despite multimodality treatment efforts. Results. Radiographic findings revealed a mixed density mass of the left maxilla. Histologic, immunohistochemical, and electron microscopy examination of the tumor showed a malignant mesenchymal neoplasm consisting of sheets of epithelioid and spindle cells exhibiting focal osteoid formation. Conclusions. We report a rare and aggressive case of epithelioid osteosarcoma arising in the maxillofacial complex. 2007 Wiley Periodicals, Inc. Head Neck, 2007 [source]

Enhancing the effectiveness of residential treatment for substance abusing pregnant and parenting women: Focus on maternal reflective functioning and mother-child relationship

Marjukka Pajulo
Substance abuse during early motherhood has become a significant problem and has led to accelerated efforts to develop specific treatment facilities for these mothers and children. Despite the often intensive treatment efforts in residential settings, there is surprisingly little evidence of their efficacy for enhancing the quality of caregiving. The situation of these mother-child pairs is exceptionally complex and multilevel, and has to be taken into account in the content and structuring of treatment. Intensive work in the "here and now" focusing on the mother-child relationship from pregnancy onwards in an effort to enhance maternal reflective capacity and mindedness is considered a key element for better treatment prognosis, in terms of both abstinence and quality of parenting. Pioneering work with such a focus is described in this article. [source]

Cytomegalovirus Infection: Perinatal Implications

Elizabeth G. Damato RN
Cytomegalovirus (CMV), a member of the herpes virus family, is the most common cause of congenital infection in humans, affecting 0.5,3% of all newborns worldwide. Congenital cytomegalovirus infection is the leading infectious cause of deafness, learning disabilities, and mental retardation in children. The high prevalence of cytomegalovirus in the general population, unpredictability of transmission, and asymptomatic nature of the disease in otherwise healthy women challenge prevention and treatment efforts. [source]

Mental Health Problems Among Single Mothers: Implications for Work and Welfare Reform

Rukmalie Jayakody
Welfare reform's emphasis on work and self-sufficiency assumes that poor single mothers are similar in their status and functioning to the rest of the population. However, we find that their status is quite distinct. Logistic regression results reveal that the likelihood of working is 25% lower for those with a psychiatric disorder. Mental health problems may prevent women from undertaking the tasks necessary to find employment, or women with these problems may lack the self-confidence needed to take on new challenges. Our findings suggest that mental health problems among single mothers deserve greater attention as a barrier to self-sufficiency and highlight the need for more effective intervention and treatment efforts to improve economic and social outcomes. [source]

The rising prevalence of comorbid obesity and eating disorder behaviors from 1995 to 2005

Anita Darby BSc (Nutrition & Dietetics)
Abstract Objective: To measure the cooccurrence of obesity and eating disorder (ED) behaviors in the South Australian population and assess the change in level from 1995 to 2005. Method: Two independent cross-sectional single stage interview based population surveys were conducted a decade apart. Self-reported height, weight, ED behaviors, and sociodemographics were assessed. Changes between the two time points were analyzed. Results: From 1995 to 2005 the population prevalence of comorbid obesity and ED behaviors increased from 1 to 3.5%. Comorbid obesity and ED behaviors increased more (prevalence odds ratio (POR) = 4.5; 95% confidence interval (CI) = 95% CI = [2.8, 7.4]; p < .001) than either obesity (POR = 1.6; 95% CI = [1.3, 2.0]; p < .001) or ED behaviors (POR = 3.1; 95% CI = [2.3, 4.1]; p < .001) alone. Discussion: Comorbid obesity and ED behaviors are an increasing problem in our society. Prevention and treatments efforts for obesity and EDs must consider and address this increasing comorbidity. 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2009 [source]