bluuebunny/crossref_metadata_2025_split huggingface dataset:
Panic Disorder in Primary Care: Patients' Attributions of Illness Causes and Willingness to Accept Psychiatric Treatment
Authors: Johnson Michael R. , Gold Paul B. , Siemion Laura , Magruder Kathryn M. , Frueh B. Christopher , Santos Alberto B. 
Published: May 2005

Objective: This study assessed the causes that primary care patients with panic disorder (PD) attribute to their panic symptoms, and their acceptance of various psychiatric treatment options. Methods: In a cross-sectional assessment of 306 patients treated at two primary care clinics, 42 met criteria for DSM-IV PD in the past year. The authors classified these 42 PD-positive patients to one of two groups: those receiving both primary and specialty mental health care (PC+MH; n = 19) and those receiving only primary care (PC-only; n = 23). Patients rated the probability of four possible causes of their panic symptoms, and level of acceptability of three psychiatric and two medical treatments for PD. To place primary care patients' ratings into a broader context, a third contrast group of PD-positive patients, recruited from clinical trials of investigational PD pharmacotherapies ( n = 31), also rated causes and treatment acceptability. Results: Participants of the three treatment groups attributed psychiatric causes for their panic symptoms in approximately the same proportion (78 percent to 90 percent; p = ns). PC-only participants attributed medical causes for panic symptoms more frequently than PC+MH and PD Clinical Trials participants (48 percent vs. 5 percent and 32 percent; p = .01). Remarkably, the great majority of patients across all groups expressed willingness to see psychiatrists (84 percent to 94 percent) and psychotherapists (95 percent to 100 percent), and to take psychotropic medications (87 percent to 100 percent). Conclusions: In this study most patients attributed a psychiatric cause for panic symptoms and communicated strong acceptance of psychiatric treatment. Thus, we recommend that primary care clinicians more assertively inform their patients of PD diagnoses and recommend psychiatric treatments with less fear about stigmatizing and alienating them.
Learner-Controlled Computing: A Description and Rationale
Authors: Milner Stuart D. 
Published: May 2005

This paper discusses a use of technology in which the student controls the computer (e.g., computer programming) instead of it controlling the student (e.g., drill-and-practice). A description of the nature of this mode of computer use is provided, and some examples are given. A rationale for learner control is discussed in terms of cognitive and affective outcomes of computing. The cognitive outcomes include relatively specific learning and thinking skills and more general systematic methods of problem solving. Affective outcomes include self-confidence, curiosity and exploratory behaviors, and motivation.
Small Group Interactive Techniques Utilizing Videofeedback
Authors: Gask Linda 
Published: May 2005

Objective: Development and evaluation of a method of training primary care providers in psychiatric skills which utilizes videofeedback of real and roleplayed consultations in a group setting. Method: The development of the basic training approach and additional material for teaching specific skills is described. Evaluation has addressed the impact of training on 1) clinician behavior and 2) measures of outcome. Results: Research over a number of years has demonstrated an impact on clinician behavior with some evidence of impact on clinical and economic measures and patient satisfaction. Conclusions: Videofeedback training appears to be most effective when it is provided with a clear model for the professional-patient interaction. Its effectiveness can be further enhanced by delineating sets of component microskills that can be learned using a combination of videotape modeling, role-play, and feedback. Challenges for future research include investment in randomized controlled trials for outcome, developing the training approach for a range of primary care workers, training sufficient group facilitators, and achieving widespread dissemination without subsequent dilution of effectiveness.
The “New Economics” and Industrial Health: A Reply
Authors: Chasse John Dennis , LeSourd David A. 
Published: May 2005

Our article called attention to two logical conclusions from the “rational worker” model: first, that firm safety investments can induce such carelessness that accidents will actually increase; second, that increased compensation payments can also induce such an increase. This leads directly to the conclusion that accidents can be reduced by reducing firm safety investments and by reducing compensation payments. Our contention was that this model, when used to draw policy conclusions, is conceptually flawed, empirically flimsy and dangerous in the sense in which the “accident prone” hypothesis has been called dangerous. If we understand James Chelius's reply (1), it serves to strengthen our contention. Chelius offers no empirical evidence for the first conclusion that firm safety investments can induce an increase in accidents. He ducks conceptual issues, and, in particular, ethical questions. When he comes to the second conclusion, he shifts his ground, ignores considerable direct evidence that contradicts what he is trying to prove and relies again on regression coefficients from aggregate statistics. He then draws the same type of “blame the victim” policy conclusions that earned for the “accident prone” hypothesis its label of dangerous. He has responded in three areas: 1. The theoretical model and methodology; 2. The empirical evidence; 3. Policy implications.
The Psychiatric Profile of Patients with Chronic Diseases Who Do Not Receive Regular Medical Care
Authors: Cooper-Patrick Lisa , Crum Rosa M. , Pratt Laura A. , Eaton William W. , Ford Daniel E. 
Published: May 2005

Objective: To assess the relationship between psychiatric disorders and lack of regular medical care in individuals with chronic medical diseases. Methods: Nine hundred sixty-three respondents to the household-based Baltimore Epidemiologic Catchment Area (ECA) Follow-Up Study were interviewed in 1981, 1982, and 1993–1996. The main outcome measures were: 1) not receiving regular care from a health professional for an active chronic medical condition in 1981, 2) persistent lack of regular medical care, and 3) leaving regular medical care. Results: In cross-sectional analyses, having a psychiatric disorder (OR 1.70, 95% CI 1.17–2.48) was associated with not receiving regular medical care. This was mostly due to individuals with phobic disorder (OR 1.57, 95% CI 1.02–2.43). In prospective analyses, depression (RR 2.4, p < 0.04) and alcohol abuse (RR 2.9, p < 0.001) predicted leaving regular medical care one year later. Phobic disorder (RR 2.8, p < 0.001) predicted leaving care thirteen years later. Conclusions: Psychiatric disorders appear to place an individual at risk for irregular medical care. Studies of the quality and continuity of care for patients with chronic medical conditions should include measures of common psychiatric conditions.
Preventing Tractor-Related Injuries and Deaths in Rural Populations: Using a Persuasive Health Message Framework in Formative Evaluation Research
Authors: Witte Kim , Peterson Tarla Rai , Vallabhan Shalini , Stephenson Michael T. , Plugge Carol D. , Givens Vonda K. , Todd Jay D. , Becktold Melissa G. , Hyde Mary Kay , Jarrett Robin 
Published: May 2005

Though agriculture is the most dangerous occupation in the United States, two key issues impede the effectiveness of farm safety interventions. First, little is known about what farmers think about farm equipment accidents and safety procedures. Second, current safety interventions are typically atheoretical and focus on information exchange, instead of persuasion. Formative evaluation is desperately needed, but rarely used in farm safety campaigns. The study reported here represents a formative evaluation based on a theoretically-grounded persuasive health message framework. The goal of this formative evaluation was to discover farmers' safety practices, as well as their beliefs about farm equipment accidents and safety. Methodological triangulation was achieved by assessing farmers' beliefs, attitudes, and behaviors via face-to-face interviews ( N = 46), telephone interviews ( N = 48), and mailed surveys ( N = 177). The formative evaluation revealed that farmers believe farm equipment accidents to be severe and dangerous, yet believe themselves to be invulnerable to these accidents. East Texas Farmer, Fall 1992 [My neighbor's wife] was running the big old tractor to shredding. And she hit a stump and it throwed her off and it run over her. Them big old tires run right over her and that shredder still running just chopped her all to pieces. Killed her just real quick.
The Economics of Pharmaceutical Policy in Ghana
Authors: Barnett Andrew , Creese Andrew Lacey , Ayivor Eddie C. K. 
Published: May 2005

Pharmaceutical expenditure in Ghana accounts for about one-third of the total recurrent costs of the Ministry of Health, but in isolation this figure is a misleading indicator of economic importance. In the primary care sector up to 75–80 percent of the running cost of a health center may be accounted for by pharmaceuticals, and because the Ghanaian currency is heavily overvalued, even these proportions understate the true value of resources used on imported drugs. An apparent lack of central control of drugs expenditure led to a study of the existing allocation procedures and prescribing practices. The results suggest large-scale wastage through overprescribing, often in response to patients' preferences for more costly medication. Approaches to improved planning of drug use, including the setting of expenditure norms based on recommended prescribing routines, are detailed, and it is concluded that the resultant savings could allow a sizable extension of the coverage given to rural populations by the primary health care system.
Screening for Psychiatric Morbidity in a Medical Outpatient Clinic for HIV Infection: The Need for a Psychiatric Presence
Authors: Lyketsos Constantine G. , Hanson Anne , Fishman Marc , McHugh Paul R. , Treisman Glenn J. 
Published: May 2005

Objective: To ascertain the prevalence and type of psychiatric morbidity present in HIV infected patients presenting for the first time to a specialty HIV medical clinic. Also, to develop a way of screening for psychiatric cases in this setting using established self-report questionnaires. Method: Fifty patients who presented consecutively for medical care at the Johns Hopkins Hospital General HIV Clinic participated in this study. These patients were first screened using the General Health Questionnaire and the Beck Depression Inventory and subsequently underwent a comprehensive neuropsychiatric evaluation. Results: Fifty-four percent were found to suffer from a psychiatric disorder with an additional 22 percent from an active substance use disorder. These rates are one-and-one-half to two times higher than those reported from other medical clinics. The GHQ and BDI used together as screens could identify psychiatric “cases” with a sensitivity of 81 percent and a specificity of 61 percent, an efficacy similar to that found in other clinics. Conclusions: Given the high prevalence of psychiatric disorders in HIV infected patients presenting for medical care, screening, evaluating, and treating for these disorders is crucial and should be pursued systematically. This is best done through the presence of a psychiatric team within HIV medical clinics rather than in affiliation with such clinics.
Pediatric Mood and Anxiety Syndromes in Primary Care: Who Gets Identified?
Authors: Wren Frances J. , Scholle Sarah H. , Heo Jungeun , Comer Diane M. 
Published: May 2005

Objective: To seek clues to the enhancement of primary care management by (i) Determining how often and in whom primary care clinicians in the United States, Puerto Rico, and Canada identify pediatric mood or anxiety syndromes; (ii) Determining which clinical and demographic features predict higher rates of identification; (iii) Describing assessment methods used. Methods: This report uses the database of the multi-site Child Behavior Study. This cross-sectional study involved 206 primary care practices in the United States, Puerto Rico, and Canada; 395 clinicians and 20,861 primary care attenders aged 4–15 years. Clinicians completed a visit questionnaire addressing presence and type of psychosocial problems and how assessed. Parents completed a questionnaire addressing family demographics, child symptoms (Pediatric Symptom Checklist) and functioning, and child service use. Results: Clinicians identified psychosocial problems on 17.9% of visits, but mood or anxiety syndromes on only 3.3%, most commonly in children judged to have co-morbid behavioral syndromes, of whom the majority (66.7%) already had contact with specialized mental health. Neither parental concerns about mood and anxiety symptoms nor clinician familiarity with the patient were major predictors of identification. When making a diagnosis of a pure internalizing syndrome (i.e., without a co-morbid behavioral syndrome) clinicians rarely used standardized tools or school reports. Conclusions: Neither screening for nor diagnosis of mood and anxiety syndromes is a routine part of primary care of children and adolescents. Efforts to improve care must include practical, validated screening procedures to enhance assessment for mood and anxiety syndromes, particularly among children in whom primary care clinicians identify psychosocial problems.
Depressive Symptoms in Hospitalized Patients: A Cross-Sectional Survey
Authors: Soskolne Varda , Bonne Omer , Denour Atara Kaplan , Shalev Arieh Y. 
Published: May 2005

Objective: To evaluate the level of depressive symptoms among medical inpatients, and to examine the associations with sociodemographic, medical, and psychosocial characteristics. Method: A point prevalence study (1 day) of all adult medical patients hospitalized at Hadassah University Hospital. Patients who were too incapacitated to be interviewed were excluded. The questionnaire included sociodemographic data, social supports (MOS Social Support Scale), Multidimensional Health Locus of Control (MHLC), and depressive symptoms (CES-D scale). Medical data were collected from the patients' charts. Of the 331 eligible patients, 256 (77%) were interviewed. Results: The level of depressive symptoms was high (mean = 21, s.d. = 12). About 60 percent of the patients had scores above 16, which is the suggested cut-off point for psychopathology. A multifactorial analysis of covariance showed that higher scores of depression were significantly ( p < 0.01) associated with being a female, with lower scores of internal and higher scores of external health locus of control and only marginally ( p = .08) with medical diagnosis (multiple R2 = .33, multiple R = .58). Depressive symptoms were not associated with age, education, marital status, social supports, type of admission, ward, or length of stay prior to evaluation. Conclusions: The high levels of depressive symptoms found across medical and most of the personal and social characteristics in this first survey of its kind in Israel may reflect a reaction to the event of hospitalization; sex and locus of control may be suggested as risk markers of elevated depression to be used for screening and prompt psychiatric consultation in this population.
Nurses and Trade Unions in Britain
Authors: Lewis Susan Scott 
Published: May 2005

The nature of the negotiating body for pay and conditions of nurses in Britain and some of the reasons for the body's past failure to negotiate a substantial pay increase for nurses are described in this article. A description is given of a series of events, including strike action by nurses during 1974, which led to a substantial pay raise. The pay award, however, represented only a partial success for the trade unions and the negotiating body. Methods of nurses' organization and the roles of their representative unions and professional body indicate some of the reasons for only a partial success. The lack of unity between the National Health Service trade unions and the reactionary role of the professional body were notable. However, many important political and organizational lessons were learned by nurses in this struggle. We are now facing savage cuts in National Health Service expenditure, leading to a reduction in the number of nurses employed. These lessons are clearly useful for the nurses and their organization with the labor movement in fighting these cuts in National Health Service expenditure.
Reducing Substance Abuse Risk Factors among Children through a Teacher as Facilitator Program
Authors: McLaughlin Robert J. , McClanahan Kimberly K. , Holcomb J. David , Gibbins Ann D. , Smith Quentin W. , Vlasak Jerry W. , Kingery Paul M. 
Published: May 2005

A Teachers as Facilitators (TAF) Program used classroom teachers as leaders of small groups that promoted social, emotional, and academic development of children at high risk of adopting potentially destructive substance abuse patterns. The program was intended to increase participating students' positive socialization experiences and academic achievement by successfully integrating these students into the school's social system. A longer-range goal was to increase students' sense of worth as it affects their attitudes toward relationships with other people and academic demands. Program results were: 1) school personnel were found capable of accurately identifying and referring to the TAF Program children who were at risk of substance usage and in need of assistance; 2) the TAF Program was effective in improving at-risk students' perceived academic self-concept, but was less effective in increasing students' perceived sense of social support; and 3) the program was endorsed by participating teachers, counselors, and administrators.
The Future of Educational Telecommunication
Authors: Suchy John T. 
Published: May 2005

Twelve years have gone by since federal funding of educational television began in the United States; seven years since the goal of a national service that is also responsible to local needs was set by the Public Broadcasting Act of 1967. Today there is a working national system which encompasses both educational and cultural purposes. But many of the original ambitious objectives have not yet been attained and much of the system has grown in response to day to day problems. In an effort to clarify the policy issues and identify future needs for educational telecommunications, the Communication Research Laboratory of Battelle Memorial Institute conducted a planning study for the U.S. Office of Education in 1973. This study was based on evaluations of published information, tempered by in-depth interviews of policy makers, site visits, and lengthy discussions with more than sixty educational broadcast licensees. This paper is based on highlights of the Battelle study.
The Mini Mental State Exam as a Predictor of Neuropsychological Functioning after Cardiac Surgery
Authors: Burker Eileen J. , Blumenthal James A. , Feldman Michelle , Thyrum Elizabeth , Mahanna Elizabeth , White William , Smith L. Richard , Lewis Judy , Croughwell Narda , Schell Randy , Newman Mark , Reves J. G. 
Published: May 2005

Objective: The present longitudinal study was designed to: 1) determine the ability of the Mini Mental State Exam (MMSE) to predict neuropsychologic impairment based on neuropsychologic testing five to seven days and six weeks after cardiac surgery; and 2) to determine whether the traditional or the education-related MMSE norms are more appropriate to use for this purpose. Method: The day before surgery (T1), before hospital discharge (T2), and six weeks after surgery (T3), 247 subjects completed a battery of five neuropsychologic tests. Subjects also completed the Center for Epidemiological Studies Depression Scale and the Speilberger State-Trait Anxiety Inventory. Subjects completed the MMSE two to three days after surgery. Results: Stepwise regression analyses revealed that the MMSE significantly predicted only a small portion of the variance in neuropsychologic test performance at T2, and to an even lesser extent at T3, over and above the demographic variables. In assessing the association between an impairment score (derived from the neuropsychologic test battery) and the MMSE, we found that the traditional MMSE cut-off score maximized specificity (number of true negatives) while the education-adjusted MMSE cut-off scores maximized sensitivity (number of true positives). Conclusions: These results suggest that although the MMSE is widely used to assess cognitive mental status, it may have limited value in identifying patients with cognitive impairment post-cardiac surgery, and special attention must be paid to the cut-off scores used in interpreting the MMSE.
The Doctor-Patient Relationship as a Diagnostic Tool
Authors: Clyne Max B. 
Published: May 2005

Diagnosis is possible on a number of levels. Traditional, overall, and interrelationship types of diagnosis are differentiated. The effectiveness of the traditional diagnosis, which is used to indicate etiology of disease, to assess the effect of the disorder on structure and function, and to classify the illness, is questioned, since it usually leads to a general prognosis based on statistical probability rather than to a unique prognosis indicating specific predictions and treatments for the individual patient. The doctor, when making this kind of diagnosis, acts as an objective observer and assesses an abstract concept, the illness rather than a person, so that the traditional diagnosis is illness-centered. By including features of the patient's personality and his relationships with others, the overall diagnosis provides a more embracing overview of the individual's physical and emotional conditions. It has greater ongoing validity in description and of usefulness for treatment by centering upon the patient as an individual whose conflicts and sufferings are felt and understood. It may require lengthy interviewing, but this may be shortened in practice by focusing upon the particular aspect of the patient's world which seems central to the pathology. This focal area is often determined spontaneously through a “flash,” the mutual intuitive recognition of an important understanding between doctor and patient, leading to further diagnostic and therapeutic work. The flash establishes a climate of high emotional charge and involves both patient and doctor intrinsically in the diagnostic process and its outcome. It is one of the means by which an interrelationship diagnosis, centered on the doctor-patient relationship, may be arrived at. Truly successful treatment in general practice, and perhaps in most branches of medicine, is probably based on some form of interrelationship diagnosis, even though this diagnosis may not have been verbalized or properly conceptualized by the doctor. Case material illustrates the effectiveness of each type of diagnosis for the physician and for his patient.