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Biomedical subjects

Lorraine E Ferris

Publications and source records attributed to Lorraine E Ferris.

16 recordsLinked to original sources
PubMed2005

Predictors of completion status in a remedial program for male convicted drinking drivers.

OBJECTIVE: Rates of attrition in alcohol and drug treatment programs are often greater than 50%, and completion of treatment has been shown to be a potent predictor of posttreatment outcome. The current study examined both rates and predictors of completion among male participants in a remedial measures program for convicted drinking drivers. METHOD: Male individuals (n = 5,409) convicted of a drinking driving offense in Ontario between October 2000 and December 2002 who did and did not complete a mandatory rehabilitation program were described in terms of demographic, drug use and legal variables collected at time of assessment. RESULTS: The program completion rate was extremely high (97.3%). In multivariate analyses, noncompleters-relative to completers-were younger; drank more frequently; were less likely to own a home; and were more likely to live in urban centers, have two or more lifetime impaired driving convictions and have experienced more than one adverse consequence of substance use. CONCLUSIONS: Ontario's remedial measures program for convicted drinking drivers, in which the return of a suspended license after the period of mandatory suspension is contingent on the completion of the program, demonstrates a very low level of client attrition. Individuals who do not complete the program bear many similarities to those at high risk for persistent drink-drive behavior and its associated negative health consequences.

Adult↗
PubMed2004

Randomized controlled trial of misoprostol for second-trimester pregnancy termination associated with fetal malformation.

OBJECTIVE: Our purpose was to compare the effectiveness, women's views of the termination procedure, and success of umbilical cord culture for vaginal and oral misoprostol versus intra-amniotic prostaglandin PGF(2alpha) for second-trimester pregnancy termination (STPT). STUDY DESIGN: We randomized 217 women, 15 to 24 weeks' gestation, into 3 groups. Oral (OM) and vaginal (VM) misoprostol groups received 400 microg of misoprostol every 4 hours for 24 hours. The intra-amniotic PGF(2alpha) (IAPG) group received 40 mg of PGF(2alpha) followed by oxytocin infusion. Women completed self-administered questionnaires 3 weeks after the termination procedure. Umbilical cord samples were collected at delivery for karyotype analysis. The primary outcome was the time from start of the procedure to placental delivery. Secondary outcomes were maternal complications, women's acceptance of the termination procedure, and success rates of umbilical cord culture. RESULTS: The time was longer for the OM group (30.5+/-14.4 hours) compared with the VM group (18.3+/-8.2 hours) and the IAPG group (21.1+/-10.2 hours), P<.001 for both comparisons. Women in the VM group reported being more willing to repeat the termination method in the future and reported fewer side effects than those in the other groups, P<.001. Failure rates for umbilical cord cultures were 9.6%, 17.0%, and 45.6% for the VM, OM, and IAPG groups, respectively. CONCLUSION: Oral misoprostol is less effective than intra-amniotic PGF(2alpha) or vaginal misoprostol for STPT. Women report vaginal misoprostol more acceptable than other methods. Umbilical cord culture failure rate is highest in the IAPG group.

Abortifacient Agents, Nonsteroidal↗
PubMed2004

Psychological responses to prenatal NTS counseling and the uptake of invasive testing in women of advanced maternal age.

This study examines women's psychological responses to prenatal group genetic counseling, and to subsequent individualized risk counseling. All women (N=123) aged 35 and older underwent nuchal translucency screening (NTS), a prenatal ultrasound screening test. After group counseling, decisional conflict decreased significantly among those reporting at baseline having made a decision about invasive testing (t(222)=2.0, P=0.014) and for those who were uncertain (t(222)=5.74, P <0.0005). After receiving NT-adjusted risks, decisional conflict decreased further for those uncertain about testing at baseline (t(222)=4.64, P <0.0005). There was no change in risk perception and anxiety after group counseling. After NT-adjusted risks were communicated, risk perception decreased significantly (t(230)=5.02, P <0.0005), as did anxiety (t(115)=7.91, P <0.005). Despite reassuring NTS results, the uptake rate for prenatal invasive testing was 78.4%. Risk perception, anxiety, and decisional conflict decreased after individual counseling for reassuring NTS results, but the uptake of invasive testing remained high.

Adult↗
PubMed2004

To tell or not to tell? Professional and lay perspectives on the disclosure of personal health information in community-based dementia care.

Developments in information technology and the ongoing restructuring of health services to increase provision in community settings militate in favour of a streamlining of communications and the exchange of information about patients among health and social care providers. Yet the principles of confidentiality and privacy appear to inhibit this process. In order to explore the practical, ethical, and legal imperatives attendant upon personal health information exchange, we conducted a series of interviews with professional care providers, persons with early-stage dementia, and their family caregivers. The findings indicate some degree of discordance. Professionals reported valuing disclosure both to colleagues and family caregivers on the basis of its being in the patients' best interests. Patients also valued inter-professional exchange, but sought strong control over disclosure to family members. Family caregivers valued being kept informed of the patient's condition, even without the latter's consent. Implications for research and policy are discussed.

Aged↗
PubMed2004

Using therapeutic jurisprudence and preventive law to examine disputants' best interests in mediating cases about physicians' practices: a guide for medical regulators.

Therapeutic jurisprudence (TJ) and preventive law (PL) are used as two theoretical perspectives from which to examine the best interests of parties in mediation because of a dispute about a physician's practice. The focus is mediation provided by and/or for the medical regulator. The paper reviews the literature on TJ and PL, and their relationship to mediation, and demonstrates how medical regulators could benefit by working within a framework reflecting both these perspectives providing it does not involve an egregious matter. A TJ and PL framework would be of particular value in identifying cases for mediation and in evaluating resolutions to mediated disputes.

Humans↗
PubMed2002

The effects of prenatal group genetic counselling on knowledge, anxiety and decisional conflict: issues for nuchal translucency screening.

This study evaluates the effects of prenatal genetic group counselling on women's anxiety, decisional conflict and levels of knowledge. Participants (N=271) were aged 35 years and older. ANOVA results indicated that pre/postcounselling scores for anxiety did not change significantly, while decisional conflict decreased significantly (P<0.001). Pre/postcounselling scores on two different knowledge measures were analysed using 2x3 mixed ANOVAs for time by highest level of education and by having discussed prenatal diagnosis with one's health care provider. No potential interactions were statistically significant; time alone had a strong significant effect for both knowledge measures (P<0.01); P<0.01, respectively), suggesting that the effects of the counselling intervention were robust. Group genetic counselling is an effective method for education and decision support in the prenatal context, and may serve as a model for other clinical populations facing genetic screening decisions.

Adult↗
PubMed2002

A challenge and an opportunity for medical regulators--considering the public's interests in cases using ADR to resolve disputes about physicians' practices: a Canadian analysis.

Disputes between patients or their families and the patient's treating physician are not uncommon. While many of these disputes are resolved by the disputants alone or informally with others, many are resolved through formal adjudication processes of court litigation or through processes of medical regulators. Alternative dispute resolution (ADR) options either within the courts or within regulatory bodies are becoming more popular as decision-makers realize the benefits to using these options in appropriate cases. ADR offers both opportunities for advancing our appropriate dealings of these disputes and challenges in terms of ensuring that the public's interests are met. This article examines the public's interests in cases using mediation to resolve disputes about physician's practices from a Canadian perspective. The article concludes with recommendations to protect the public interests and to respect the rights of disputants.

Canada↗
PubMedDate not supplied

A descriptive analysis of two mobile crisis programs for clients with severe mental illness.

PURPOSE: To describe cases seen by two Mobile Crisis Programs (MCPs) for individuals with severe mental illnesses. Focus is on client characteristics, mental health status, interventions, referrals, and immediate outcomes. METHODS: Data were collected retrospectively through a chart review of clinical record forms and accompanying progress notes for cases seen by the MCPs over a one-year period. A total of 981 cases were included in the study. Data were analyzed using descriptive and bivariate statistics. RESULTS: Most cases involved clients who were female (60.2%), single (55.8%), living at home (56.8%), unemployed (85.6%), and between 20 and 44 years of age (44.5%). The two programs varied on a number of factors related to the demographic profile and mental health needs of the different geographical regions in which they are located. CONCLUSIONS: Findings highlight the need for further research into how MCPs can be integrated with related mental health services in offering clients the least intrusive and most efficient services.

Adult↗