RESUMO
The 5th Army Medical Corps Caribbean campaigns provided valuable lessons on the noncombat hazards to troops and the challenges to the provision of care in a tropical theater of operations. The Army quickly adapted the lessons learnt for the invasion in Puerto Rico and future overseas expeditions.
Assuntos
Militares , Política Antifumo , Abandono do Hábito de Fumar , Fumar , Meio Social , Adulto , Feminino , Humanos , Masculino , Militares/psicologia , Militares/estatística & dados numéricos , Formulação de Políticas , Fumar/epidemiologia , Fumar/psicologia , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/estatística & dados numéricos , Prevenção do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos/epidemiologiaRESUMO
Colonel (Col.) Bailey K. Ashford was a turn of the 19th century Army medical corps officer who made great contributions to military medicine in the areas of infectious disease, public health, and education. His service period spans from the Spanish American War to the early 1920s. Although not as well-known as some of his contemporaries, he is an important figure, contributing to the diagnosis and treatment of "new world hookworm" in the tropics, training medical units in World War I, and the creation of the Institute of Tropical Medicine.
Assuntos
Medicina Militar/história , Medicina Tropical/história , Lesões Relacionadas à Guerra/história , História do Século XIX , História do Século XX , Porto Rico , Guerra Hispano-Norte-Americana 1898 , Estados Unidos , Lesões Relacionadas à Guerra/terapia , I Guerra MundialRESUMO
We present a case of combat-related post-traumatic stress disorder that made and unusual initial clinical presentation with anorexia nervosa restrictive type.
Assuntos
Anorexia Nervosa/etiologia , Militares/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Humanos , Masculino , Transtornos de Estresse Pós-Traumáticos/complicaçõesAssuntos
Serviços Comunitários de Saúde Mental , Acessibilidade aos Serviços de Saúde , Hispânico ou Latino/psicologia , Transtornos Mentais/terapia , Psiquiatria , Consulta Remota , Doença Crônica , Comunicação , Características Culturais , Humanos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Satisfação do Paciente , Estados Unidos , Comunicação por VideoconferênciaAssuntos
Antipsicóticos/efeitos adversos , Transtornos de Deglutição/induzido quimicamente , Discinesia Induzida por Medicamentos/diagnóstico , Esquizofrenia/tratamento farmacológico , Anticonvulsivantes/efeitos adversos , Anticonvulsivantes/uso terapêutico , Antipsicóticos/uso terapêutico , Clonazepam/efeitos adversos , Clonazepam/uso terapêutico , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/tratamento farmacológico , Discinesia Induzida por Medicamentos/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Exame Neurológico/efeitos dos fármacos , Síndrome de Abstinência a Substâncias/diagnóstico , Síndrome de Abstinência a Substâncias/tratamento farmacológicoRESUMO
When visiting patients with serious mental illness at their homes, case managers carried a portable videophone. This was used to access the hospital clinical team via the home telephone line, when an acute clinical need arose in addressing questions related to medication management and treatment planning; travel was therefore avoided. In an acceptability study lasting 12 months, 24 patients received the supplemental videophone mental health service and 19 of them completed a satisfaction survey. Only one patient was not satisfied with the videophone treatment, while 74% of them were very satisfied. Specific areas of satisfaction concerned the savings of time and travel, assistance with medication questions and increased involvement in treatment. No patient reported any difficulty in using the equipment. Staff members were enthusiastic about the decrease in travel time and there were no complaints about the videophone process or encounters. During the study, 135 h of the case manager's time was saved by using the videophone for urgent access visits, equivalent to a saving of $4000 in salary costs. In addition, the patients saved 135 h in travel time. We believe that there are other potential uses of videophones for seriously mentally ill patients, including discharge planning, intensive post-discharge monitoring and transition to community life.
Assuntos
Serviços Hospitalares de Assistência Domiciliar/organização & administração , Transtornos Mentais/terapia , Telemedicina , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Satisfação do Paciente , Telefone/instrumentação , Fatores de TempoRESUMO
OBJECTIVE: : To develop and evaluate an educational strategy to increase motivation to quit smoking and improve attendance at antismoking classes in a residential substance abuse treatment program. METHODS: : The 241 patients admitted in 2004 who smoked reported the number of cigarettes smoked daily at the time of admission. Attendance at the antismoking classes was noted to determine if there was a relationship between attending the classes and a change in the number of cigarettes smoked at discharge. The 193 patients admitted in 2005 additionally attended four 1-hour motivational classes to encourage quitting smoking. Rates of attendance at the antismoking classes and smoking rates at discharge were again noted. RESULTS: : Smoking rates in 2004 (n = 194; 81%) and 2005 (n = 161, 83%), P = 0.43, were similar. Voluntary participation in antismoking classes increased from 40% to 64% (P < 0.001). There was a greater reduction in the number of cigarettes smoked between admission and discharge in the quality improvement period compared with the reference period (P = 0.025). In both years, attendance at antismoking classes was strongly associated with quitting, P < 0.001. Of those who attended antismoking classes, 133 (74%) reported a reduction in smoking compared with only 27 (15%) of those who declined to attend, P < 0.001. Among smokers, nonattendance of antismoking classes was associated with increased likelihood of having an irregular discharge, P < 0.001. CONCLUSION: : This study suggests the benefit of relatively brief, specific educational efforts to increase motivation to quit smoking in this high-use population.