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At least 55 records · Page 3Linked to original sources

Diagnostic practices of evaluators of drunken drivers.

This study was designed to evaluate the impact of driving under the influence (DUI) arrest history on the diagnostic decisions of DUI evaluators and the reported bases on which alcohol-related diagnostic decisions are made in DUI cases. Subjects were 70 (out of a potential 140) Illinois certified DUI evaluators who responded by mail to one of four case summaries containing different information about a "client's" drinking history and arrest history. Results indicated a significant difference in the frequency with which these DUI evaluators noted whether the "client" had an alcohol problem, with zero, one and two DUI arrests yielding approximately 30%, 15%, and 50% alcohol diagnoses in the absence of DSM-III criteria supporting such a diagnosis. Collaborative reports by significant others and alcohol-related tests (e.g., Michigan Alcoholism Screening Test) were the two most frequently reported bases. The costs of such diagnostic unreliability and the disadvantages of collaborative reports and screening tests are discussed.

Alcohol Drinking↗

Influence of measurement accuracy on the application of the 1991 NIOSH equation.

A relatively neglected topic in manual materials handling (MMH) research is the impact of the accuracy of task parameter measurements on the application of various assessment methods. A laboratory experiment was conducted to investigate the accuracy of NIOSH equation parameter measurements made by eight subjects following a 4-h training session. Five individual tasks were measured; two were single tasks and three were part of a multiple-component simulated palletizing operation. Significant differences between reference parameter measurements and average measurements made by subjects were found. The sensitivity analysis showed that frequency and horizontal location are the most important parameters. These parameters also tended to have the highest measurement errors. Recommendations for increasing the effectiveness of training programs for NIOSH equation users based on the results of the study are presented.

Ergonomics↗

Effective treatment of scalp psoriasis using the excimer (308 nm) laser.

BACKGROUND: Psoriasis of the scalp can be a major therapeutic challenge as response to topical medication is often inadequate. The excimer laser has potential for providing local phototherapy as its high irradiance makes treatment at this site a practical option. OBJECTIVES: To analyze retrospectively results of treating scalp psoriasis with the excimer (308 nm) laser. METHODS: Thirty-five patients were treated and all had failed intensive topical therapy. Manual separation of hair was used to provide access to the treatment site. Starting doses ranged from 300 mJ/cm(2) (type I) to 1000 mJ/cm(2) (type IV) with treatment twice weekly. RESULTS: All patients improved. Seventeen/35 (49%) of patients cleared>95% (mean: 21 treatments; range: 6-52) and 16/35 (45%) cleared 50-95%. Phototoxicity in the form of erythema and blistering occurred in all patients, particularly around the ears and nape of neck. CONCLUSION: The excimer laser is a successful approach to treatment of psoriasis of the scalp being a simple treatment that can be performed in a short period of time and which has a high rate of effectiveness.

Adolescent↗

DSM-III field trials: I. Initial interrater diagnostic reliability.

The interrater agreement for major diagnostic categories in studies using DSM-I and DSM-II was usually only fair or poor. In phase one of the DSM-III field trials the overall kappa coefficient of agreement for axis I diagnoses of 281 adult patients was .78 for joint interviews and .66 for diagnoses made after separate interviews; for axis II--personality disorders and specific developmental disorders--the coefficients of agreement were .61 and .54. The interrater reliability of DSM--III is, in general, higher than that previously achieved and may be due to changes in the classification itself, the separation of axis I from axis II conditions, the systematic description of the various disorders, and the inclusion of diagnostic criteria.

Adolescent↗

DSM-III field trials: II. Initial experience with the multiaxial system.

The multiaxial system of DSM-III includes nondiagnostic data that are valuable in understanding possible etiological factors and in treatment planning and prognosis. The authors describe the reliability of axis IV--severity of psychosocial stressors--and axis V--highest level of adaptive functioning in the past year--for 281 adult patients interviewed in phase one of the DSM-III field trials. The kappa coefficient of agreement for axis IV was .62 for joint interviews and .58 for separate interviews, which the authors consider at least fair. Reliability for axis V was quite good, .80 for joint interviews and .69 for separate interviews. Eighty-one percent of the participating clinicians judged the multiaxial system to be a useful addition to traditional diagnostic evaluation, although many indicated that they had difficulty quantifying severity of psychosocial stressors.

Adolescent↗

Accuracy of DSM-III diagnoses following a training program.

The authors describe a 2 1/2-day training program designed to teach mental health professionals how to use a new DSM-III classification scheme. The 251 participants had previous clinical training but no prior exposure to DSM-III. They were asked to diagnose three cases from a series of five videotapes case vignettes; the authors then compared the participants' diagnoses with the expert opinion of clinical faculty. The degree of agreement among the participants with the expert opinion varied across the five cases, but the overall level of agreement was high (74.2%). These results indicate that with adequate training the new DSM-III classification scheme can be accurately applied to diagnostic situations.

Clinical Competence↗

A debate on DSM-III.

Explore the source record for details and available documents.

Diagnosis, Differential↗

Developing, implementing, and evaluating a handbook for parents of pediatric hematology/oncology patients.

This article details the development of a parent handbook for pediatric hematology and oncology patients. The planning and content development are discussed. Adult learning principles were incorporated throughout the handbook. Use of the handbook in a pediatric cancer center is described. Both subjective and objective methods were used to evaluate the handbook. Results from the evaluation verify the value of the handbook to parents and give direction for future revisions of the handbook.

Child↗

Special feature: theory and treatment development and evaluation: reflections on Benjamin's "models for treatment".

To make the final point of this commentary clear at the outset, I could not agree with Dr. L. S. Benjamin's comments more, on the one hand, and could not disagree more, on the other hand. I will first review the points that I not only agree with but also think are extremely important. I will then beg to differ with some of her conclusions (at least as I interpret then), and with her analysis of the outcomes of the one cognitive-behavioral treatment of a personality disorder she reviewed in some detail.

Clinical Protocols↗

National Practitioner Data Bank: more guidelines, more problems.

The complex reporting requirements under the National Practitioner Data Bank are further complicated by numerous exceptions and conflicting interpretations. Even after two years of operation, many physicians and reporting entities are unfamiliar with the system and its problems. In an apparent attempt to clarify the requirements, the Department of Health and Human Services, in 1992, issued a supplement to its 1990 guidebook for users. Unfortunately, this supplement causes even greater confusion and fails to correct existing inconsistencies with respect to such critical issues as summary suspension and medical malpractice settlement reporting.

Documentation↗