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Biomedical subjects

P Solomon

Publications and source records attributed to P Solomon.

At least 19 recordsLinked to original sources
PubMed1992

Service needs of youths released from a state psychiatric facility as perceived by service providers and families.

The following article reports on the results of service needs assessments of a cohort of youths released from a state psychiatric facility as perceived by service providers and families/caregivers. Families as well as service providers consistently agreed on three service areas of high need--psychotherapy for the child, family therapy and parent skill training. However, families perceived a need for a number of other services that are not traditionally provided by the mental health system such as after school recreation activities and self-help and support groups for the child. The discrepancies between service providers and families' perceptions of assessed needs may lead to families dropping out of service due to the unresponsiveness of the services in meeting their perceived needs. Steps that service providers need to take to be more responsive to the needs of families are discussed.

Adolescent↗
PubMed1992

The efficacy of case management services for severely mentally disabled clients.

A comprehensive review of published and unpublished research studies of case management for severely mentally disabled adults was undertaken. This yielded 20 studies of four models of case management, Full Support, Personal Strengths, Rehabilitation and Expanded Broker Models. This article reviews these models, the research studies, the outcomes of these studies and conclusions that can be drawn regarding the efficacy of case management services for severely mentally disabled adults. Future directions for research in this area are recommended.

Adaptation, Psychological↗
PubMed1992

Assessment of therapeutic relationship of community-agency workers.

This article reports on the ratings of the personal and professional characteristics of community-based workers for children and adolescents who had recently been released from a psychiatric inpatient service. The child/adolescent's family members/caregivers and the community workers both responded to the same items of a questionnaire. Families/caregivers rated the community workers with whom they were the most and the least satisfied. Community workers rated themselves in relation to these study children and/or their families. Findings indicate that both family members/caregivers and the community workers themselves saw community workers performing relatively well in the areas of providing information and offering support to families. Likewise, both assessed the service providers as having the greatest deficits in the area of teaching skills for child/adolescent home management. Suggestions for meeting the needs of the families and for ensuring that a system of care for child/adolescents is child-centered and family-focused are discussed.

Adolescent↗
PubMed1992

The closing of a state hospital: what is the quality of patients' lives one year post-release?

The closing of a state psychiatric facility afforded an opportunity to assess the quality of life of a cohort of patients who were released. Patients were interviewed a month after release and again a year later. Patients spent about half their time in mental health programs, but few were engaged in community activities or in employment. Cohort members mainly turned to mental health workers and case managers for support and problem resolution, as they had limited supports to turn to otherwise. Patients desired assistance in such areas as money management. In a number of areas of daily living, cohort members desired assistance a year after discharge, more so than upon release. Despite this, a year after release patients appeared to be quite positive toward themselves and their quality of life.

Activities of Daily Living↗
PubMed1992

Learning contracts in clinical education: evaluation by clinical supervisors.

Learning contracts can be a useful learning and evaluation tool within a clinical setting provided the supervisor shifts their role from one of imparter of knowledge to facilitator of learning. If this role is not assumed then a student's learning experience could be jeopardized. In a survey of 59 student supervisors, 90 percent found the learning contract to be a useful evaluation and teaching tool. Advantages stated suggest that the learning contract promotes negotiation between student and teacher, provides a flexible learning environment and promotes acquisition of self-directed learning skills. These qualities are important in a clinical or practical setting where learning experiences cannot be standardized.

Canada↗
PubMed1991

The role of litigation in predicting disability outcomes in chronic pain patients.

This study examined the extent to which being involved in civil and industrial litigation predicted outcome in an population of chronic pain patients. Data were collected in a structured telephone interview for a litigant group of 80 patients and a nonlitigant group of 47 patients. There were no significant differences in the amount of medication used, the number of hours spent resting per day, or the number of individuals who were able to return to work. Litigants showed significantly higher levels of depression. Multiple regression analyses indicated that litigation was not the primary predictor of downtime or medication use. Litigation was found to be the primary predictor of Zung depression scores. Discriminant function analyses indicated that litigation was not the most important variable in distinguishing between those working and not working. Results lend support to previous studies that suggest that the suspicion and disbelief with which litigating patients are often treated is unfounded.

Adult↗
PubMed1991

Experience with colposcopy in a family practice center.

The experience of a family practice center that performed colposcopy for one year was reviewed to provide insight into the appropriateness of this procedure to a family practice clinic. Almost three thousand Papanicolaou smears were performed, which prompted 97 colposcopy clinic appointments involving 68 patients. Dysplastic Pap smears accounted for 1.82% of the total. Atypical Pap smears occurred in 3.91% of the tests, and 16.1% of a sample of these demonstrated dysplasia. Controversy concerning the atypical Pap smear is discussed. The colposcopy service was convenient for the patients and was at least revenue neutral while providing a new professional opportunity for selected family practitioners. A referral base of at least 1,000 Pap smears might justify a colposcopy program, depending on referral strategies.

Ambulatory Care↗
PubMed1991

Advanced actinomycotic pelvic inflammatory disease simulating gynecologic malignancy. A report of two cases.

Two women had large, solid, fixed pelvic masses simulating advanced ovarian cancer in one case and advanced cervical cancer in the other. Both patients had had plastic intrauterine contraceptive devices in situ for 7 and 17 years, respectively. Both patients required laparotomy to make the diagnosis. In both the surgery was markedly difficult because of the total absence of tissue planes. Both had obvious actinomycotic disease on routine histologic examination of the ovary and were treated with prolonged penicillin, with some, but not total, resolution of the pelvic fibrosis. The diagnosis of advanced actinomycotic pelvic inflammatory disease should be entertained in patients with a large, solid pelvic mass and an intrauterine device in situ or a recent history of intrauterine device use.

Actinomycosis↗
PubMed1990

Effect of station examination item sampling on generalizability of student performance.

This article may be of interest to physical therapy educators who are responsible for structuring station or practical examinations used to evaluate physical therapy students. The global intent of the article is to provide information that may be useful in selecting test items. Specifically, the purposes of this study were 1) to examine how two item-sampling strategies (one based on different diagnostic concepts, or diagnostic probes, and the other based on different anatomical sites) influenced the generalizability of a station examination, 2) to determine the interrater reliability during the station examination, and 3) to determine whether the status of the rater (that of observer or simulated patient) influenced the rating. Using a nested study design, 24 physical therapy students were assessed by eight raters. The raters were randomly and equally assigned to four teams. Each team assessed six students. One rater acted as the simulated patient for the first three students in each group, and the other rater acted as observer. This order was reversed for the last three students. Each student performed nine mini-diagnostic patient cases consisting of three diagnostic probes reproduced at three different anatomical sites. The results demonstrate that 1) similar diagnostic concepts can be generalized across anatomical sites, although different concepts or skills cannot be generalized at a given anatomical site or across sites; 2) interrater reliability was excellent; and 3) the status of the raters (ie, simulated patient or observer) did not bias the ratings.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Competence↗
PubMed1989

Patients' perceived service needs when seen in a psychiatric emergency room.

Patients who came to a psychiatric emergency room and were assessed as not needing psychiatric hospitalization were interviewed regarding their service needs for the month prior to their index visit. The highest expressed needs were for information and advice, financial assistance, counseling and assistance in controlling emotions, while leisure-time activities, meeting people, budgeting, medications, and getting along with others were the lowest areas of expressed need. Those who sought help generally went to appropriate community resources rather than informal supports. For some, coming to the psychiatric emergency room was their way of addressing their needs. For a number, their methods of coping were to escape from their problems through the use of drugs and alcohol or sleep. Implications for programming in the psychiatric emergency room are discussed.

Adolescent↗
PubMed1989

Treatment of recurrent and metastatic endometrial cancer with cisplatin, doxorubicin, cyclophosphamide, and megestrol acetate.

The combination of cisplatin, doxorubicin, cyclophosphamide, and megestrol acetate was used to treat 15 patients with recurrent and metastatic endometrial cancer. Four patients had a complete response and one patient had a partial response, yielding a total response rate of 33%. Five patients had stable disease. The median survival for the whole group was 38 weeks. The median survival for responders was 60 weeks, and that for nonresponders was 21 weeks. The median progression-free survival for the whole group was 17 weeks. The median progression-free survival for responders was 32 weeks, and that for patients with stable disease was 25 weeks. The toxic reactions noted were primarily nausea, vomiting, and myelosuppression. The combination of cisplatin, doxorubicin, cyclophosphamide, and megestrol acetate has modest effectiveness in the treatment of metastatic or recurrent carcinoma of the endometrium.

Aclarubicin↗
PubMed1988

Family members' perspectives on psychiatric hospitalization and discharge.

Families of currently hospitalized patients in an extended-care psychiatric facility were interviewed concerning their views of hospitalization and discharge. Although most were sad that their relative was hospitalized, only a third felt that they would rather be caring for their relative at home. Families felt communication with hospital staff was poor and many of their needs were unmet. Families indicated a number of concerns around discharge. If clients were to be discharged soon, most families felt the clients needed a highly structured supervised living arrangement.

Adult↗
PubMed1988

Comparison of outpatient care of discharged state hospital and non-hospitalized psychiatric emergency room patients.

The present article compares a cohort discharged from two state hospitals in a large urban area with a cohort referred for outpatient services from a psychiatric emergency room. Both cohorts were referred into the same community mental health system of services. The two cohorts are examined in terms of clinical and social demographic characteristics, in part to consider how distinct the two populations appear to be. In addition, patterns of initial contact and the nature and amounts of community services received by each group are compared. Based on these comparisons, some conclusions are drawn regarding the way in which these two groups are served by the community system.

Adolescent↗
PubMed1988

Outpatient compliance of psychiatric emergency room patients by presenting problems.

In the present study, a cohort of patients who came to a psychiatric emergency room in a general hospital, and were not referred for hospitalization, were analyzed in regard to the amount and rate of subsequent contact with community mental health and substance abuse agencies. Patterns of service receipt and the differential impact of service use on hospitalization and/or return visits were analyzed by three major problem types: (1) psychiatric; (2) psychiatric/substance abuse; and (3) substance abuse. The analysis of these subgroups yielded valuable information about how the service system and/or different groups of patients in crisis respond to the system.

Adolescent↗
PubMed1987

Follow-up of outpatient referrals from a psychiatric emergency room.

This article reports on the findings of a follow-up study of a cohort of 114 patients who were evaluated at a psychiatric emergency room and were referred to community mental health and substance abuse agencies. Two-thirds subsequently made contact with these agencies, but fewer made contact with the agency to which they were specifically referred. Few kept their scheduled appointment. Prior experience with an agency, as was a client's diagnosis, were related to agency contact. Considerations for social workers to increase patients' ability to complete referrals for treatment are addressed.

Adult↗
PubMed1987

Response of tardive and L-dopa-induced dyskinesias to antidepressants.

We report two patients with dyskinesia responding to antidepressants. The first is a 70-year-old man with depression, Parkinsonism and neuroleptic-induced tardive dyskinesia who presented with hysterical mutism. After recovery from the mutism, he was started on desipramine for depression. One week later the dyskinesia improved markedly. The second patient is a 61-year-old man with Parkinson's disease, dementia, depression and L-dopa-induced oro-lingual-facial dyskinesias. He was taking levodopa, trihexyphenydil and bromocriptine. The depression was treated first with desipramine and later with trazodone. The dyskinesia improved significantly on both drugs. The response of the dyskinesias to antidepressant medication may be due to the fact that antidepressants decrease beta-adrenoreceptor sensitivity and density which in turn may result in a diminished release of dopamine since beta-adrenoceptors mediate the noradrenaline-stimulated release of dopamine.

Aged↗