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Web-Based Patient Education

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53721. Community-based home-care program for the management of pre-eclampsia: an alternative. (Full text)

Community-based home-care program for the management of pre-eclampsia: an alternative. To evaluate the safety, acceptability and cost of a community-based home-care program for the management of mild pre-eclampsia.A descriptive study of outcomes between Apr. 1, 1985, and Dec. 31, 1989.St. Boniface General Hospital, Winnipeg.Urban Winnipeg residents between 27 and 40 weeks' gestation with mild pre-eclampsia who demonstrated acceptance and compliance with home-care management; 321 patients (...) of 1330 were enrolled in the program.Bed rest at home with daily biochemical and biophysical follow-up protocol and weekly clinic visits; patient education; hospital admission for labour, induction, worsening pre-eclampsia or noncompliance with rest at home.Patterns of referral to the program; clinical, biochemical and biophysical profiles; incidence of severe complications; reduction in total hospital stay and cost analysis.As many women were referred from physicians' offices as were referred from

1993 CMAJ: Canadian Medical Association Journal

53722. The academic base for general practice: the case for change. (Full text)

development, allow human and other resources to be used more flexibly and effectively, and provide a strong base for undergraduate education, vocational training, higher professional training, and continuing education. It could encourage collaborative ventures with other disciplines and also lead to higher standards of patient care. (...) The academic base for general practice: the case for change. University departments of general practice and the postgraduate education system for general practice have developed separately over the past 30 years. This separation is now impeding the academic development of the discipline and causes difficulties with recruitment and career progression. These problems could be eased by the creation of integrated departments. This would establish a critical mass for research and educational

1993 BMJ : British Medical Journal

53723. Support for hospital-based HIV testing and counseling: a national survey of hospital marketing executives. (Full text)

. These include hospital support for voluntary HIV testing and AIDS education and the impact that treating AIDS patients has on the hospital's image. Also tested is the hypothesis that certain hospitals, such as for-profit institutions and those outside the AIDS epicenters, would be less supportive of hospital-based AIDS intervention strategies. To assess these issues, a national random sample of 193 executives in charge of hospital marketing and public relations were surveyed between December 1992 (...) Support for hospital-based HIV testing and counseling: a national survey of hospital marketing executives. Today, hospitals are involved extensively in social marketing and promotional activities. Recently, investigators from the Centers for Disease Control and Prevention (CDC) estimated that routine testing of hospital patients for human immunodeficiency virus (HIV) could identify more than 100,000 patients with previously unrecognized HIV infections. Several issues are assessed in this paper

1995 Public Health Reports

53724. Toward a Multidimensional Model for Psychotherapy Supervision Based on Developmental Stages (Full text)

Toward a Multidimensional Model for Psychotherapy Supervision Based on Developmental Stages The need for a systematic approach to psychotherapy training in psychiatric education is greater than ever. Most models of psychotherapy supervision focus on supervisee development and ignore developmental issues concerning the other participants in the supervisory triangle. The author reviews theories of psychotherapy supervision and identifies factors that contribute to the dynamic interrelationships (...) among psychiatrists who are supervising psychotherapy, the psychiatry resident supervisees, and their patients as each party progresses through stages of development. A dynamic formulation of psychotherapy supervision based on developmental stages can result in a better understanding of the instructional process, its greater effectiveness, and associated changes in program structure. Further development of a comprehensive dynamic model depends on additional research.

1994 The Journal of psychotherapy practice and research

53725. Identification of design features to enhance utilization and acceptance of systems for Internet-based decision support at the point of care. (Full text)

Identification of design features to enhance utilization and acceptance of systems for Internet-based decision support at the point of care. Extensive utilization of point-of-care decision support systems will be largely dependent on the development of user interaction capabilities that make them effective clinical tools in patient care settings. This research identified critical design features of point-of-care decision support systems that are preferred by physicians, through a multi-method (...) . Users also preferred features that enhance usefulness and motivate use, such as an encounter documentation tool and the availability of physician instruction and patient education materials. In addition to identifying design features that are relevant to efforts to develop clinical systems for point-of-care decision support, this study demonstrates the value of combining quantitative and qualitative methods of formative evaluation with an iterative system development strategy to implement new

1998 Proceedings of the AMIA Symposium

53726. General practitioner's perceptions of the route to evidence based medicine: a questionnaire survey. (Full text)

General practitioner's perceptions of the route to evidence based medicine: a questionnaire survey. To determine the attitude of general practitioners towards evidence based medicine and their related educational needs.A questionnaire study of general practitioners.General practice in the former Wessex region, England.Randomly selected sample of 25% of all general practitioners (452), of whom 302 replied.Respondents' attitude towards evidence based medicine, ability to access and interpret (...) evidence, perceived barriers to practising evidence based medicine, and best method of moving from opinion based to evidence based medicine.Respondents mainly welcomed evidence based medicine and agreed that its practice improves patient care. They had a low level of awareness of extracting journals, review publications, and databases (only 40% knew of the Cochrane Database of Systematic Reviews), and, even if aware, many did not use them. In their surgeries 20% had access to bibliographic databases

1998 BMJ : British Medical Journal

53727. Normative models and healthcare planning: network-based simulations within a geographic information system environment. (Full text)

Normative models and healthcare planning: network-based simulations within a geographic information system environment. Network analysis to integrate patient, transportation and hospital characteristics for healthcare planning in order to assess the role of geographic information systems (GIS). A normative model of base-level responses of patient flows to hospitals, based on estimated travel times, was developed for this purpose.A GIS database developed to include patient discharge data (...) that was implemented within a GIS. Scenarios were developed and tested that involved patient discharge data geocoded to the five-digit zip code, hospital locations geocoded to their individual addresses, and a transportation network of varying road types and corresponding estimated travel speeds to examine both patient discharge levels and a doubling of discharge levels associated with total discharges and DRG 391 (Normal Newborns). The Network analysis used location/allocation modeling to optimize for travel time

1997 Health Services Research

53728. Unequal access to cadaveric kidney transplantation in California based on insurance status. (Full text)

Unequal access to cadaveric kidney transplantation in California based on insurance status. To assess the impact of insurance status on access to kidney transplantation among California dialysis patients.California Medicare and Medicaid dialysis populations.All California ESRD dialysis patients under age 65 eligible for Medicare or Medicaid in 1991 (n = 9,102) took part in this cohort analytic study.Medicare and California Medicaid Program data were matched to the Organ Procurement (...) , CI 1.24, 1.91). Once on the waiting list, however, Medicare enrollment did not influence the adjusted median waiting time to acquire a first cadaveric transplant (p > .05).California dialysis patients excluded from Medicare coverage, who are disproportionately minority, female, and poor, are much less likely to enter the U.S. transplant system. We hypothesize that patient concerns with potential subsequent loss of insurance coverage as well as cultural and educational barriers are possible

1999 Health Services Research

53729. Is Internet-based disease management on the way? (Full text)

& administration Microcomputers Patient Education as Topic organization & administration Remote Consultation organization & administration 1999 4 20 1999 4 20 0 1 1999 4 20 0 0 ppublish 10207346 PMC1230204 (...) Is Internet-based disease management on the way? 10207346 1999 04 30 2008 11 20 0820-3946 160 7 1999 Apr 06 CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne CMAJ Is Internet-based disease management on the way? 1039 OReilly M M eng Clinical Trial Controlled Clinical Trial Journal Article Canada CMAJ 9711805 0820-3946 AIM IM N Aged Aged, 80 and over Chronic Disease Disease Management Heart Failure therapy Humans Information Services Internet organization

1999 CMAJ: Canadian Medical Association Journal

53730. Morbidity from asthma in relation to regular treatment: a community based study (Full text)

Morbidity from asthma in relation to regular treatment: a community based study The extent to which asthma morbidity in the community occurs in patients who are having relatively little treatment or in those on step 3 or above of the British asthma management guidelines is uncertain. We have looked at this in a community population in southern Nottinghamshire.A cross sectional review of treatment in all patients over the age of four with diagnosed asthma was carried out in five large general (...) half the patients requiring high doses of inhaled beta agonists or a course of oral prednisolone came from those taking low dose or no regular inhaled corticosteroid.Evidence of morbidity from asthma was found in many patients taking little or no prophylactic medication and this should be amenable to improved education. A different approach may be needed for patients with continuing morbidity who are already taking higher doses of prophylactic medication.

1999 Thorax

53731. Towards content-based image retrieval in a HIS-integrated PACS. (Full text)

Towards content-based image retrieval in a HIS-integrated PACS. Development of a Picture Archiving and Communications System (PACS) with a large and diverse set of medical images will lead to large digital libraries that can be accessed to provide improved support for patient care, research and education. New representational and retrieval models for clinical images are required to address these issues. The PACS at the Georges Pompidou Hospital (GPH) is integrated in the hospital information (...) system (HIS), and several modalities from medical imaging departments have been attached to it. The two main axes of the GPH PACS project were 1) HIS-integration to allow hospital-wide access to the images based on demographic and procedure-type information and 2) the development of content-based image retrieval to enhance the medical impact of image retrieval in daily practice.

2000 Proceedings of the AMIA Symposium

53732. Implementing evidence based medicine in general practice: audit and qualitative study of antithrombotic treatment for atrial fibrillation (Full text)

Implementing evidence based medicine in general practice: audit and qualitative study of antithrombotic treatment for atrial fibrillation To determine the extent to which implementation of an evidence based treatment, antithrombotic treatment in atrial fibrillation, is possible in general practice.Audit and qualitative study of patients with atrial fibrillation and an educational intervention for patients judged eligible for antithrombotic treatment.South east England.56 patients with a history (...) of atrial fibrillation.Assessment and interview to ascertain patients' views on antithrombotic treatment.Number of patients receiving antithrombotic treatment.Out of 13 239 patients, 132 had a history of atrial fibrillation of which 100 were at risk of thromboembolism. After the study, 52 patients were taking warfarin. Of the remaining 48 patients (of whom 41 were taking aspirin), eight were too ill to participate, 16 were unable to consent, four refused the interview, and 20 declined warfarin. Patients

1999 BMJ : British Medical Journal

53733. Evidence and belief in ADHD : Informed decisions on stimulants must be based on studies with good methodology (Full text)

drug therapy psychology Behavior Therapy Central Nervous System Stimulants therapeutic use Child Child Behavior Child, Preschool Diagnosis, Differential Humans Parents Patient Education as Topic Randomized Controlled Trials as Topic Research Design 2000 10 20 11 0 2001 2 28 10 1 2000 10 20 11 0 ppublish 11039942 PMC1118810 Can J Psychiatry. 1999 Dec;44(10):991-8 10637678 J Am Acad Child Adolesc Psychiatry. 1997 Oct;36(10 Suppl):85S-121S 9334567 Arch Gen Psychiatry. 1999 Dec;56(12):1073-86 10591283 (...) Evidence and belief in ADHD : Informed decisions on stimulants must be based on studies with good methodology 11039942 2000 11 22 2018 11 13 0959-8138 321 7267 2000 Oct 21 BMJ (Clinical research ed.) BMJ Evidence and belief in ADHD. 975-6 Zwi M M Ramchandani P P Joughin C C eng Editorial England BMJ 8900488 0959-8138 0 Central Nervous System Stimulants AIM IM BMJ. 2001 Mar 3;322(7285):555-6 11263457 BMJ. 2001 Mar 3;322(7285):556 11263458 Attention Deficit Disorder with Hyperactivity diagnosis

2000 BMJ : British Medical Journal

53734. Raising concerns about family history of breast cancer in primary care consultations: prospective, population based study (Full text)

M M Mackay J J eng Journal Article Multicenter Study Research Support, Non-U.S. Gov't England BMJ 8900488 0959-8138 AIM IM Breast Neoplasms genetics psychology Family Practice Female Genetic Counseling Humans Patient Education as Topic Prospective Studies 2001 1 5 11 0 2001 4 6 10 1 2001 1 5 11 0 ppublish 11141150 PMC26605 BMJ. 1998 Mar 7;316(7133):767-70 9529418 Fam Pract. 1997 Feb;14(1):40-3 9061343 Fam Pract. 1999 Aug;16(4):426-45 10493716 BMJ. 1999 Jul 3;319(7201):32-6 10390458 (...) Raising concerns about family history of breast cancer in primary care consultations: prospective, population based study 11141150 2001 04 05 2018 11 13 0959-8138 322 7277 2001 Jan 06 BMJ (Clinical research ed.) BMJ Raising concerns about family history of breast cancer in primary care consultations: prospective, population based study. Women's Concerns Study Group. 27-8 Hyland F F Kinmonth A L AL Marteau T M TM Griffin S S Murrell P P Spiegelhalter D D Todd C C Walter F F Berrington B B Bobrow

2001 BMJ : British Medical Journal

53735. A Study of Primary Care Teaching Comparing Academic and Community-Based Settings (Full text)

found in the frequency of clinical problem exposure between the 2 settings. The frequency and focus of teaching interventions did not differ by practice type. Teaching by community-based preceptors tended to decrease with increased patient care workload, but increased in academically based practices.Although several differences exist between educational experiences in community- and academically based primary care practices, they appear to be minor and of minimal educational significance. (...) evaluated.Student-preceptor pairs collected a convenience sample of data from shared patient encounters. Preceptors recorded the content of teaching interventions, and students independently documented learning points received for each clinical encounter.Comparison of problem exposure, frequency and content of teaching interventions, and the effect of patient complexity and patient care workload on teaching frequency was made between the academic and community-based practices. Several small differences were

2001 Journal of General Internal Medicine

53736. Seventeen years' experience of a voluntarily based drug rationalisation programme in hospital. (Full text)

Seventeen years' experience of a voluntarily based drug rationalisation programme in hospital. A study was carried out analysing the operation of a drug rationalisation programme in a central London teaching district that had evolved from experience over 17 years. Creation of a limited list of about 700 drugs had been achieved by local consensus. Drug selection was based on appraisal of efficacy, safety, and cost and was undertaken by means of collaborative participation of most consultant (...) specialists in the district. Educative and other non-restrictive strategies for reinforcing the rationalisation policy had achieved a consistently high rate of compliance in prescribing recommended drugs. The concept of selectivity in drug use and its continuous local reappraisal had a beneficial impact on the prescribing habits of doctors at all levels of seniority as well as on the training of medical undergraduates and nurses in the therapeutic use of medicines. Peer review and self audit were

1988 BMJ : British Medical Journal

53737. Community-based, community-oriented maternity care. (Full text)

organization & administration Patient Education as Topic Prenatal Care 1989 7 1 1989 7 1 0 1 1989 7 1 0 0 ppublish 2735485 PMC1349680 (...) Community-based, community-oriented maternity care. 2735485 1989 07 20 2008 11 20 0090-0036 79 7 1989 Jul American journal of public health Am J Public Health Community-based, community-oriented maternity care. 897-8 Sakala C C eng News United States Am J Public Health 1254074 0090-0036 AIM IM Adolescent African Americans Breast Feeding Community Health Services economics methods organization & administration Female Home Care Services Humans Maternal Health Services economics methods

1989 American Journal of Public Health

53738. Establishing criterion validity of a computer-based clinical simulation. (Full text)

Establishing criterion validity of a computer-based clinical simulation. Clinical simulations, depictions of real-life patient care situations, have been used extensively in medical education. This study determined the criterion validity of a computer-based simulation which permits natural language interface and runs interactively with videotape to be fair to good (K = .61).

1991 Proceedings of the Annual Symposium on Computer Application in Medical Care

53739. Socioeconomic status and survival from soft-tissue sarcomas: a population-based study in northern Italy. (Full text)

Socioeconomic status and survival from soft-tissue sarcomas: a population-based study in northern Italy. Differential prognosis among cancer patients according to socioeconomic status (SES) has been reported. We analyzed survival from soft tissue sarcomas (STS) according to different SES indicators.We followed up all the adult patients with a new diagnosis of STS occurring between 1.1.1981 and 31.12.1983 in an area of Northern Italy (N = 86).The overall three-year survival rate was 57 percent (...) . After adjustment for confounders, both low education and blue collar jobs were negatively associated with survival.The results suggest that patients of low SES have a poorer prognosis for STS.

1991 American Journal of Public Health

53740. A community-based study of the use of chiropractic services. (Full text)

A community-based study of the use of chiropractic services. Little population-based information is available on the use of chiropractic services.We analyzed data from the RAND Health Insurance Experiment (HIE), a community-based study of the use of health services. Insurance claim forms for all fee-for-service patients who completed the study were examined for all visits coded as being seen by a chiropractor. Services provided and patient-specified symptoms were taken from these forms (...) . Population-based use rates were calculated for each HIE site. Use rates and services were calculated separately for first visits and repeat visits.There were 5,279 persons who contributed 19,021 person-years of exposure during the study; 395 different persons used 7,873 chiropractic services for a visit rate of 41 per 100 person-years and rate of use of 7.5 percent. Forty-two percent of all visits were for pain in the back. Spinal manipulation accounted for 61 percent of all services provided. Compared

1991 American Journal of Public Health

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