PubMed Health⌕ Search

Biomedical subjects

D P Mueller

Publications and source records attributed to D P Mueller.

16 recordsLinked to original sources
PubMed1991

Older volunteers: a discussion of the Minnesota Senior Study.

We used findings from the Minnesota Senior Study to examine the theoretical and methodological difficulties of defining, coding, and analyzing data on older volunteers. This study, the first statewide survey of the needs and resources of the elderly in Minnesota in almost 20 years, found that over half (52%) of older Minnesotans do volunteer work for organizations--considerably higher than has been found in national surveys. Problems in definition and methodology, however, have confounded analyses. This paper proposes a new conceptual model for classifying volunteer roles, based on three dimensions: whether the voluntary service is "formal" or "informal"; whether the activity entails a regular or an occasional time commitment; and the nature of the service activity (person-to-community, person-to-object, or person-to-person).

Aged↗
PubMed1989

Temporal bone computed tomography in the preoperative evaluation for cochlear implantation.

High resolution computed tomography of the temporal bone is performed routinely in the preoperative evaluation for cochlear implantation. A retrospective review was performed to determine the effect of these studies. The clinical significance was determined through consultation with the referring otolaryngologist and review of the operative reports. Twelve examinations were reviewed. Abnormalities were identified in 12 of the 24 ears examined (eight of 12 patients studied). In two patients the CT examination strongly influenced the selection of the ear to be implanted. In four additional cases information felt to be useful in preoperative planning was provided. Useful information related to potential complications with the mechanical insertion of the electrode apparatus. We conclude that temporal bone abnormalities are common in the population undergoing cochlear implantation and that high resolution temporal bone CT is essential in preoperative evaluation. The CT scan should be interpreted with adequate knowledge of the operative procedure to evaluate any possible barriers to the mechanical insertion of the internal components of the system.

Cochlear Implants↗
PubMed1988

Therapists' perceptions of difficult psychiatric patients.

Psychotherapists often describe patients who present management problems as "difficult patients." This article describes a 5-factor scale to measure how therapists perceive difficult psychiatric patients. Reliability and validity evidence is presented for scales labeled Demanding, Help Rejecting, Unreachable, Dangerous, and Poor Fit. Fifty-four psychiatric outpatients identified as difficult to treat by two or more therapists were compared with 54 control psychiatric outpatients matched on age, sex, marital status, and diagnosis. Therapists rated difficult patients higher on each scale. Patients rated higher on the Demanding, Help Rejecting, and Poor Fit scales were heavier and more varied users of the treatment system than were those rated lower on these scales. The scale helps identify causes of staff dissatisfaction and inappropriate organization of services and suggests how to meet the special needs of difficult patients. Problem patients can be seen as denying the competence and authority of the mental health professional but also as central to the unique mandate of psychiatry. The reward system should more adequately support those therapists who care for the patients often avoided by others.

Ambulatory Care↗
PubMed1978

Stressful life events and community mental health center patients.

This paper reports on the occurrence of stressful life events prior to treatment and at a follow-up timepoint in a general sample of community mental health center patients. Life events scores from the patients, at both timepoints, are compared with scores from a nonpatient sample drawn from the community. Results indicate that patients before entering treatment tend to experience more events (particularly undesirable ones that could be confounded with psychological condition) than nonpatients. The result is no longer true at the follow-up time point. Findings regarding life events and patienthood are basically the same whether all events are used (i.e., the change score) or undesirable events alone. If, however, only events judged to be unconfounded with psychological condition are considered, we find no difference between patients and nonpatients at either timepoint. Implications of the study's results for the direction-of-effect issue with respect to the stress-psychological disorder relationship are discussed.

Adolescent↗
PubMed1978

Does patient satisfaction correlate with succes?

The authors studied the relationship between patient satisfaction and success of treatment in a group of out-patients consecutively admitted to two community mental health centers in California in 1975. The study is based on patient ratings of the satisfaction with treatment and the success of treatment at the second visit, the last visit, and follow-up, as well as on therapists' ratings of treatment success at the second visit and the last visit. At both time points the therapists' mean ratings of treatment success were significantly lower than the patients'. Significant but low correlations between satisfaction and success indicate that satisfaction ratings cannot replace success ratings or other outcome indicators in assessments of quality of care.

Adult↗
PubMedDate not supplied

MRI spectrum of medulloblastoma.

Medulloblastomas have been characterized as solid, homogeneously enhancing, midline masses of the posterior fossa. To evaluate atypical MRI characteristics, we retrospectively reviewed 13 histologically proven medulloblastomas. MRI examinations were correlated with pathologic specimens and operative reports. Atypical features included cyst formation (77%), irregular enhancement (19%), extension through fourth ventricle foramina (15%), and presentation as a cerebellopontine angle mass (8%). We conclude that "atypical" characteristics are common. In the child or young adult, medulloblastomas must be included in the differential diagnosis of any posterior fissa mass.

Adult↗
PubMedDate not supplied

Gadolinium-enhanced MR of the postoperative internal auditory canal following acoustic neuroma resection via the middle fossa approach.

PURPOSE: To evaluate the ability of gadolinium-enhanced MR in detecting recurrent tumor in patients whose acoustic neuromas were surgically removed via the middle cranial fossa approach. PATIENTS AND METHODS: Postoperative gadolinium-enhanced exams of 13 of 44 patients who underwent excision of acoustic neuromas via the middle cranial fossa approach were reviewed. RESULTS: Postoperative enhancement was seen in 12 of the 13 patients; two patients underwent serial exams without significant change. On the basis of a single exam, we were unable to conclusively differentiate postoperative enhancement from residual or recurrent tumor. CONCLUSIONS: A single exam is of limited value. Serial studies are recommended to identify changes that would indicate tumor growth. A proposed MR follow-up schedule is an initial baseline exam within 2 months of surgery and a repeat exam during the second postoperative year.

Contrast Media↗