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Biomedical subjects

E Segest

Publications and source records attributed to E Segest.

At least 19 recordsLinked to original sources
PubMed1992

Appeals from disciplinary rulings of patients' complaints regarding physicians' conduct.

In 1984 and 1985 the Danish National Board of Health received a total of 1,062 complaints from patients regarding alleged physician negligence. The board has disciplinary powers over physicians in cases of negligence, and advises the Attorney General in cases of gross negligence which are referred to the court. The investigation found that 17% of the board's rulings were taken on appeal, of these 9% were either wholly or partly upheld. Physicians did not appeal frequently (2%), but their appeals were more often upheld (32%) than was the case in respect of patients' appeals (15% and 4.4% respectively). Evaluation of the cases taken on appeal did not provide support for extending the right to appeal. The consequences of such an extension are, however, discussed in the light of subsequent limitations imposed on the right to appeal and the more well-established and comprehensive provisions for appealing that exist in some neighbouring countries.

Child, Preschool↗
PubMed1992

Patients' complaints: some aspects of the evaluation of physicians' conduct by the Danish National Board of Health.

This study comprises all complaints made by patients to the Danish National Board of Health in 1984-1985. All disciplinary cases regarding physicians' conduct are evaluated by the board. A quantitative evaluation was carried out of the 1,062 complaints received by the board in the period under study. Special attention was given to some topics. It is emphasized that adverse outcome termed fortuitous has been narrowed over time, but more investigation is needed, in order to have a more objective foundation from which to determine whether an adverse outcome really is fortuitous or whether it is due to negligence. A central registration of cases of adverse outcome is suggested. The problem of allocating responsibility is very much open to debate, but more adequate case journal keeping is also mentioned. It was surprising that violations of information and consent requirements are often sanctioned very mildly, and more attention to this sphere is appropriate in order to ensure patients' rights. In this connection regular inquiries into patient satisfaction should be considered as a feedback mechanism.

Adult↗
PubMed1991

[Contribution of the Medico Legal Council to the National Board of Health's handling of patient complaints about physicians' conduct].

In 1984 and 1985 the National Board of Health received a total of 1,062 complaints from patients regarding alleged malpractice. The Medico Legal Council submitted an opinion in 100 (9.4%) of these cases. There were only very few cases where there was a real and significant difference between the ruling of the National Board of Health and the opinion of the Medico Legal Council. However, the National Board of Health was clearly more critical in general in assessment of the complaints. It is considered of value, both with regard to the extent of the assessment and also the legal aspects, that it is possible, in some cases, to obtain an assessment of the case by a "second-opinion" from the Medico Legal Council.

Adult↗
PubMed1991

The correlation between general disease prevention and prevention of HIV-contagion among adolescents.

A representative group of young persons (N = 745), who used the youth clubs in Copenhagen were asked to fill in a structured questionnaire. A large group of the young had had their sexual debut (N = 367). In respect of this group we found no correlation between prevention regarding general health risk factors vs. prevention against HIV contraction. It is discussed as to whether this difference can be accepted as an expression of the fact that adolescents do not consider the risk of AIDS as something that can affect them. Similarly, current problems in the chain of knowledge, attitude and behaviour in relation to intervention programmes are also discussed, including ethical aspects.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Standardized treatment].

Treatment protocols have not been well-defined, and may comprise anything from mere instructions regarding simple procedures to guide-lines for the treatment of the whole course of a disease. The discussion about treatment protocols has continued on since the 70's, and the system has been introduced into the Health Service of a number of countries. Those in favour of the programmes have focused, in particular, on the economic advantages and the advantage of achieving a certain quality of treatment, while those opposing the programmes insist that clinical freedom is at stake. We have found, especially via literature studies, that little knowledge is available as to what extent treatment protocols or case management protocols are employed, e.g., in Sweden and the USA where there have been a number of advocates of these systems. We have only been able to find two evaluation studies of more comprehensive programmes. In these two studies, the total expenditure for treatment was not clearly reduced, and as there were no well-defined parameters for quality of care, it has not been possible to demonstrate any improvement in the quality itself. It is, of course, possible that the discussion in respect of treatment protocols has indirectly had an effect on clinical thought, including those countries where these systems have not been introduced.

Clinical Protocols↗
PubMed1990

Free condoms in youth clubs in Copenhagen.

As a step to limit the spread of AIDS, condoms were supplied free of charge in Copenhagen in youth clubs in connection with personal advice. A representative group of young people (N = 745) and of social workers in these clubs (N = 130) were asked to complete a structured questionnaire. The investigation revealed that the young were well informed about AIDS and its prevention, but despite this, they comprise a relative risk group with regard to the spread of AIDS due to high numbers of partners and poor habits with regard to the use of condoms. The campaign was well received by both the young and the young club social workers. There was an obvious need for a continuation of such a campaign. It is concluded that youth clubs are a good forum for AIDS information.

Acquired Immunodeficiency Syndrome↗
PubMed1990

The influence of prolonged stable methadone maintenance treatment on mortality and employment: an 8-year follow-up.

A cohort of 169 opiate drug addicts was followed for 8 years. The mortality rate was 3.3 per year. The average lethality per observation year was found to be higher than in other studies. The treatment with methadone was unstable and only 11% had received stable prolonged maintenance treatment. It is not possible to reject a model that described increasing mortality rates neither as a function of falling methadone maintenance treatment nor as a function of socially unstable addicts contra stable addicts. Unemployment was high in the cohort (87%), and no relationship could be demonstrated between methadone maintenance treatment and employment.

Adult↗
PubMed1990

Prevention of AIDS: free condoms to drug abusers in the Municipality of Copenhagen.

The slogan "safer sex" was presented in a questionnaire investigation carried out over an interval of 6 months among intravenous drug addicts (N = 116) attending three different outpatient clinics in Copenhagen. Despite this, many of the patients, who were mainly heterosexual and many of whom were HIV positive, continued to practice sexual and injection behaviors which exposed both them and others to HIV infection. Free condoms and advice have been offered as a part of the campaign against AIDS. The initiative was well accepted by the drug addicts and within a period of 6 months there was an increase of 19% in the group which employed condoms. It is concluded that there is still a need for initiatives and research to support the changes achieved in the behavioral pattern of the population.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[The problem of proof in the processing of complaints about alleged medical errors].

The processing of patients complaints of alleged medical errors comprises two main elements: the definition of the medical standard and general legal aspects, particularly the submission of evidence. On the basis of laws, chiefly the Health Act, several judicial theories are presented together with empirical studies and usage pertinent to the problem of evidence. It is concluded that there are very few empirical studies but that the instruments of law give wide scope for judgement on issues of alleged medical error.

Adult↗
PubMed1989

Free condoms in the schools of Copenhagen, Denmark.

Attitudes of ninth grade students and their classroom teachers toward using condoms as a preventive measure against contracting AIDS were studied. Students (N = 438) and their teachers (N = 28) in the council schools of the Municipality of Copenhagen were surveyed using a structured questionnaire. Overall, results demonstrated that the message regarding "safe sex" had been well understood. However, 42% of pupils reported not using a condom during their last sexual intercourse. Many pupils indicated difficulty in using condoms. A continuing need exists for advice to the young. An information campaign, with distribution of free condoms, was well accepted by pupils and teachers. Almost all (94%) pupils indicated they will use condoms more frequently in the future. This campaign differed from other efforts that focused more on general information. The importance of other strategies designed to alter behavior to reduce the risk of contracting AIDS is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The allocation of drug addicts to different types of treatment. An evaluation and a two-year follow-up.

In Denmark the official aim has been to reduce methadone treatment, even though no effort is made to directly forbid this therapy. A multiprofessional committee was established to regulate and limit methadone treatment. There were no specific guidelines for what type of drug addict should be treated with methadone. We found that allocation for the Regional Narcotic Committee of the Municipality of Copenhagen during 1982-1984 did not serve the desires of the addicts because only 41% followed it. Allocation also did not follow the principles of research in this field. In a 2-year follow-up investigation we found that drug addicts had a mortality rate of 6.3/year, rising criminality (significant), and falling availability to the labor market (nonsignificant). We therefore came to the conclusion that the efforts of the committee did not improve the conditions of drug addicts. Only those drug addicts who had been under almost constant methadone treatment had a low lethality and a falling number of criminal convictions (significant). Finally, it is concluded that limited research within this field prevents more specific treatment and improved use of financial resources.

Adult↗