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PubMed2007

The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) prisons project pilot study: protocol for a randomised controlled trial comparing dihydrocodeine and buprenorphine for opiate detoxification.

BACKGROUND: In the United Kingdom (UK), there is an extensive market for the class 'A' drug heroin. Many heroin users spend time in prison. People addicted to heroin often require prescribed medication when attempting to cease their drug use. The most commonly used detoxification agents in UK prisons are buprenorphine, dihydrocodeine and methadone. However, national guidelines do not state a detoxification drug of choice. Indeed, there is a paucity of research evaluating the most effective treatment for opiate detoxification in prisons. This study seeks to address the paucity by evaluating routinely used interventions amongst drug using prisoners within UK prisons. METHODS/DESIGN: The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) Prisons Pilot Study will use randomised controlled trial methodology to compare the open use of buprenorphine and dihydrocodeine for opiate detoxification, given in the context of routine care, within HMP Leeds. Prisoners who are eligible and give informed consent will be entered into the trial. The primary outcome measure will be abstinence status at five days post detoxification, as determined by a urine test. Secondary outcomes during the detoxification and then at one, three and six months post detoxification will be recorded.

Journal Article↗
PubMed1998

Telepsychiatry: an island pilot project.

A telemedicine link was established in 1996 between the island of Inishmore and the department of psychiatry in University College Hospital, Galway. The link was mainly used to facilitate emergency consultations between patients on the island and the duty psychiatrist, always at the request of the island's general practitioner. Nine patients were referred for assessment in this manner over eight months. Three patients had their first psychiatric contact and assessment through the video-link, and were followed up as outpatients via the link to eventual resolution of the episode of illness and discharge at the outpatient clinic. Our experience has been that videoconferencing systems are acceptable and satisfactory for patients and staff alike.

Adult↗
PubMed1980

Acute phase of drug withdrawal management by clothiapine (Entumin): a pilot project.

Fifty-nine drug addicts and alcoholics were treated with clothiapine for a period up to 2 months for alleviation of their withdrawal symptoms. Most of the patients cooperated with the treatment, and this was due to the very few side effects that were experienced by them. The patients were completely withdrawn from physical dependence on drugs and we were able to discharge them without an irresistible impulse for the drug.

Adolescent↗
PubMed1991

Mental dysfunction: a clinical pilot project in the elderly.

In recognizing that there will be an increase in the number of individuals with dementing illnesses well into the next century, the authors show how one institution is coping with this problem today. The authors outline an innovative approach to admission and discharge planning and monitoring of patients with irreversible dementias and behavioral problems. Nurses and other team members need a mechanism (ie, a flow chart) to monitor behavior and plot progress within an individualized program designed to meet the needs of dementia patients.

Aged↗
PubMed1999

A single-visit cervical carcinoma prevention program offered at an inner city church: A pilot project.

BACKGROUND: A single-visit cervical carcinoma prevention program was implemented, integrating screening, diagnosis, treatment, and health education in the familiar environment of the community church. METHODS: Nonpregnant women age 18 years or older, who had not received cervical carcinoma screening in the preceding year were eligible. Subjects provided information on personal demographics, health, and knowledge regarding cervical carcinoma prevention. Thereafter, cervical cytology was collected, processed, and interpreted on site. Participants attended small-group instruction on cervical carcinoma prevention. Screening results were given to each subject individually. Patients with abnormal cytology underwent immediate colposcopy with biopsies or loop electrosurgical excision procedure as indicated. Participant satisfaction and educational impact were evaluated. RESULTS: Ninety of the 98 participants reported that Spanish was their native language; 59 did not speak English. Fifty-four had had fewer than 6 years of education and 55 were unemployed. Seventy-eight did not have a regular physician or health insurance. Twenty-four either had never undergone cervical carcinoma screening or had let more than 5 years elapse since their previous examination. None of nine potential barriers assessed correlated with past compliance with cervical carcinoma screening. The mean time for processing and on-site interpretation of cervical cytology smears was 22.6 +/- 5.3 minutes. The median time patients spent in the program was 75 minutes. There was a significant improvement in the subjects' knowledge regarding cervical carcinoma prevention. All participants were highly satisfied. CONCLUSIONS: This parish-based, integrated, single-visit program for the prevention of cervical carcinoma was easily implemented and provided care to a substantial proportion of underserved patients.

Adult↗
PubMed1999

[Depression and suicidal behavior more effectively controlled by a team approach. Pilot project to optimize diagnosis and therapy].

The aim of the competition (Specialist-field Networks in Medicine "MedNet") announced by the Federal Ministry for Education and Research (BMBF) is to stimulate the creation of supraregional networks for specific diseases, in order, in this way, to improve cooperation and the transfer of knowledge between research institutions and various levels of medical care. The MedNet "Depression, Suicidal tendency" is one of the winners of this BMBF competition". In view of the central role played by the family doctor in the care given to patients with depressive disorders, permanent improvement in cooperation between physicians in private practice and the research institutions is a central aspect of the planned MedNet activities.

Depressive Disorder↗
PubMed2000

A cost analysis of community screening for diabetes in the central Wisconsin Medicare population (results from the MetaStar pilot project in Wausau).

CONTEXT: Type 2 diabetes mellitus is often undiagnosed and untreated. OBJECTIVE: To estimate the costs and possible savings of screening for Type 2 diabetes mellitus in the Wisconsin Medicare population from a population health perspective. DESIGN: The costs and benefits of community screening were analyzed using various primary and secondary data sources. Data on the community screening were obtained by MetaStar, collaborators at the screening site, and published material. Results from a Monte Carlo simulation model, developed by the CDC Diabetes Cost-Effectiveness Study Group, and recent developments in diabetes research were used to estimate the incidence levels of major complications for Type 2 diabetes. SETTING AND PARTICIPANTS: Medicare beneficiaries in central Wisconsin residing in the Wausau Hospital Service Area, which is composed of 14 zip codes. RESULTS: Of 826 Medicare patients screened, 32 were diagnosed as having diabetes. If we use the same assumptions offered by the CDC Study Group, we find that the excess lifetime costs from screening and early treatment ($4850) exceed costs saved from preventing complications ($378), costing an average of $4471 per diabetic. However, if we alter assumptions on cardiovascular disease reduction risk and routine care costs, we find that screening could save an average of $619 per diabetic detected. CONCLUSIONS: The costs of community screening, using the CDC Study Group's assumptions, are greater than the costs of diabetes without screening in this population. However, recent evidence on cardiovascular disease risk and routine care costs could alter the results, leading to lower costs and greater benefits in the future. More research is necessary, particularly in the area of quality of life measures, to more accurately reflect the benefits of screening.

Aged↗
PubMed2000

[Benzene exposure among urban traffic wardens in the City of Rome: preliminary results of a pilot project].

In the framework of a research project on short-term effects of human exposure to atmospheric pollutants, a survey on personal exposure to benzene and related aromatic hydrocarbons in traffic wardens has been carried out. Approximately two-hundred subjects, namely 143 policemen involved in traffic control and 63 office clerks, have been enrolled in the study. Spot measurement of personal exposure to volatile aromatic hydrocarbons have been performed along the period December 1998-June 1999 using passive dosimeters. In addition, blood benzene and urinary trans-muconic acid and phenyl mercapturic acid have been determined at the beginning and at the end of workshift. The results so far obtained suggest average levels of exposure to benzene around 10 micrograms/m3 (7 h time weighted average) for traffic wardens, and about three fold lower levels for indoor workers. Average values of benzene exposure recorded for policemen are basically comparable to background levels measured in the urban area. Nevertheless, some outlier values indicate that distinct higher exposure values may be occasionally experienced by traffic wardens. Internal exposure biomarkers were not significantly different between policemen and office workers. Yet, both urinary trans-muconic and phenyl mercapturic acids were significantly increased in smokers compared to non smokers, irrespective of their job.

Acetylcysteine↗