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At least 307 records · Page 17Linked to original sources
PubMed2003

Prevalence of Chlamydia trachomatis infections and specimen collection preference among women, using self-collected vaginal swabs in community settings.

BACKGROUND: Chlamydia trachomatis is a common, often asymptomatic sexually transmitted infection. GOAL: The goal was to estimate the prevalence and predictors of C. trachomatis among young women using self-collected vaginal swabs, and the preferences of women and physicians for self-testing. STUDY DESIGN: A total of 514 attendees of university/college health clinics, adolescent birth control clinics, centers providing health services to homeless youth and adults (street health centers), a sexually transmitted diseases clinic, and family practices were tested by ligase chain reaction. Preference for self- versus provider-testing was examined. RESULTS: Prevalence was 6.0% and was highest (18.2%) in the street health centers. In multivariate analysis, only recent contact with someone with C. trachomatis infection was significantly associated with infection (odds ratio, 7.1; 95% confidence interval, 2.5-20.0). Most women (54.2%; 256 of 472) preferred self-sampling compared with physician sampling (15.9%; 75 of 472). The majority of physicians (75.0%; 9 of 12) reported at the start and end of the study that they would use vaginal swab self-sampling if available. CONCLUSIONS: Prevalence of infection in young women attending homeless youth organizations was high. Self-sampling was acceptable and could facilitate screening in high-risk women who do not regularly access health services.

Adolescent↗
PubMed1994

Effective coping with stroke disability in a community setting: the development of a causal model.

A proposed causal model based upon Lazarus' theory of psychological stress and coping was tested in a sample of 75 persons disabled by stroke. Coping constraints such as demographic and stroke factors were hypothesized to affect resources (perceived availability of social support, perceived effectiveness of social support, social contact), stress appraisal, coping behavior and coping effectiveness. Although the model did not fit the data, several path coefficients within the model were statistically significant. Functional status was positively related to resources and negatively related to the stressor. Resources were negatively related to the stressor and positively related to coping effectiveness. It was noted that the buffering effect of social support was related to the level of disability of the stroke person. Persons with functional disability following stroke also had decreased social contact, perceived less availability of social resources and increased threat to physical well-being, and had reduced coping effectiveness.

Activities of Daily Living↗
PubMed2005

Injuries to the head, face, mouth and neck in physically abused children in a community setting.

OBJECTIVES: The aims of the present study were to identify the incidence of orofacial injuries found within a cohort of physically abused children, and examine demographic data surrounding the alleged perpetrator, the location in which the alleged assault occurred, the mechanism of injury and the actual orofacial injury incurred. METHODS: The research took the form of a retrospective study of clinical case records of children with suspected physical abuse from 1 June 1998 to 31 May 2003. Seven hundred and fifty case records were identified and 390 (46.7%) were available for data extraction. RESULTS: Fifty-nine per cent (n = 230) of children had signs of abuse on the head, face or neck. The alleged perpetrator was the mother in 104 cases (26.7%), the father in 100 (25.6%) and mother's partner in 49 other cases (12.6%). More than half (53.3%) of the alleged abuse occurred in the child's home; in 32.3% of cases, the location was not recorded. Other locations included outside in a public place, school and at the home of the alleged abuser. Some 23.4% (n = 54) had been punched or slapped around the head, neck or face, 17.4% (n = 40) had been struck by an object, and 15.2% (n = 35) had allegedly sustained multiple modes of injury. Bruising to the head, neck or face was seen in 95.2% (n = 219) of children, and 32.6% (n = 75) had abrasions; 65.2% (n = 150) of the bruises and 22.9% (n = 53) of the abrasions were on the face. CONCLUSIONS: Fifty-nine per cent of physically abused children in the present cohort had orofacial signs of abuse which would be easily visible to a dental practitioner. The commonest injuries were bruises and abrasions. This concurs with previous reports in the literature and highlights the important role of dental practitioners in the recognition of children who have been abused.

Adolescent↗
PubMed2007

Risk factors for adverse drug events in older adults with mobility limitations in the community setting.

OBJECTIVES: To investigate risk factors for self-reported adverse drug events (ADEs) in a cohort of annually surveyed Iowa Medicare beneficiaries with mobility limitations. DESIGN: Prospective cohort study with baseline and two annual follow-up questionnaires. SETTING: Population-based sample of Iowa Medicare beneficiaries with mobility limitations. PARTICIPANTS: Members of the cohort with complete follow-up questionnaires and prescription dispensing data (N=689). MEASUREMENTS: The questionnaires asked about self-reported ADEs in the previous 12 months, sociodemographic data, smoking, alcohol use, number of mobility limitations, and history of chronic disease. Pharmacy dispensing records were the source of number and classes of prescription drug use. Linked Medicare claims provided additional comorbidity data. RESULTS: Of the 689 subjects, 151 (21.9%) reported an ADE, 83% of which resulted in physician contact and 56% of which resulted in discontinuing the medication. Number of different medications dispensed during the prior year was an independent predictor of a self-reported ADE. Neither age, extent of mobility limitation, nor number of chronic conditions was independently associated with reporting an ADE. CONCLUSION: Excess ADE risk observed with increasing mobility limitations is mediated through greater medication use.

Age Factors↗
PubMed1989

Evaluation of suicide risk among youths in community settings.

Identifying youths in imminent danger of suicide and in need of emergency psychiatric services is a difficult task. Although clinicians have often described the psychiatric profile of youths at risk for suicide, there is little empirical evidence of successful strategies for identifying suicidal risk. Researchers are faced with a number of problems when attempting to validate risk evaluation procedures: Suicide risk profiles vary with age and developmental stage; there appear to be several patterns or subtypes of suicidal patterns; suicidality depends on one's current emotional state; evaluators are likely to be biased in the direction of over-estimating risk and are not likely to have extensive clinical training; imminent danger for suicide is time-limited; and a youth's risk will depend on surrounding environmental stressors and supports. These considerations force researchers to assume a strategic approach in defining levels of suicide risk and imminent danger of suicide. An example of a potential strategy for identifying risk among youths is outlined in this chapter. Although this strategic approach appears useful, researchers continue to be faced with major problems in validating such procedures. Determining the predictive validity of potential suicide screening procedures requires researchers to evaluate and to follow longitudinally a large sample of youths, while deliberately refraining from intervening to help those youths who appear to be in crisis.

Adolescent↗
PubMed1991

Mycobacterium avium complex pulmonary disease. Incidence, presentation, and response to therapy in a community setting.

The experience with pulmonary disease caused by Mycobacterium avium complex (MAC-PD) was examined over a 12-yr period in a nonreferral setting. The 29 patients with the disease constituted 30% of all pleuropulmonary mycobacterioses. The mean annual incidence rate was 1/100,000. Sixty-two percent of patients were female, the majority of whom had no discernible preexisting pulmonary disorder to account for their susceptibility. A short- and long-term favorable response to therapy was observed in more than 90% of the 16 patients treated with intent to cure. Suggested as plausible explanations for the favorable response rate compared with previous studies originating in referral settings were: absence of adverse selection as shown by a smaller proportion of patients with far-advanced cavitary disease or with previous treatment failure, and a larger proportion of female patients. A previously unreported pattern of MAC-PD was observed: disease limited to the lingula or middle lobe occurred in 21% of the patients, all female. A rarely identified pattern, primary disease in a 3-yr-old exposed to pet birds, is reported.

Adult↗
PubMed1998

Antiseptics: a forgotten weapon in the control of antibiotic resistant bacteria in hospital and community settings?

The aim of this study was to ascertain the activity of a selection of widely-used antiseptic/disinfectant agents against antibiotic resistant bacteria and strains isolated from patients infected with clinically significant species. Four antiseptic agents (Dettol, Dettol Hospital Concentrate, Savlon and Betadine) were tested against Staphylococcus aureus, Methicillin Resistant S. aureus (MRSA), Enterococcus hirae, Vancomicin Resistant Enterococcus sp (VRE), Escherichia coli and E. coli 0157. The antiseptics were applied at recommended use dilutions and at a half and a quarter of those concentrations in a standard suspension test (EST). Organic material was added to mimic the presence of blood, protein and other such contaminants to be found in the clinical situation. All antiseptics tested were effective against both the antibiotic sensitive and antibiotic resistant strains of S. aureus and E. hirae as well as normal and clinical strains of E. coli at recommended concentrations. All but Betadine were also effective against the antibiotic resistant bacteria at a half and a quarter of normal concentration. The iodine containing antiseptic, however, failed the test against MRSA at a half normal concentration and showed virtually no activity against MRSA at a quarter normal concentration.

Anti-Infective Agents, Local↗
PubMed2002

Guidelines for international training in mental health and psychosocial interventions for trauma exposed populations in clinical and community settings.

OBJECTIVE: To develop consensus-based guidelines for training in mental health and psychosocial interventions for trauma-exposed populations in the international arena. PARTICIPANTS: The Task Force on International Trauma Training of the International Society for Traumatic Stress Studies. EVIDENCE: The Task Force engaged in a 1-year dialogue on the practice of international training, drawing upon field experience, literature review, and consultation with key informants. CONSENSUS PROCESS: This statement was prepared on the basis of shared dialogue, consensus decision making, and a writing process involving all Task Force members. It was then disseminated for review to more than 200 professionals of more than 60 service and academic organizations. Written and oral suggestions from over 80 persons were incorporated and revisions made on the basis of consensus. CONCLUSIONS: The generated guidelines addresses four dimensions: (1) values, (2) contextual challenges in societies during or after conflicts, (3) core curricular elements, and (4) monitoring and evaluation. The guidelines can improve international training.

Crisis Intervention↗