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1.
PLoS One ; 18(1): e0280045, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36649277

RESUMO

BACKGROUND: Disclosure of Human Immunodeficiency Virus (HIV) status to sexual partners plays a significant role in the successful prevention and care of HIV infection. Pregnant women who did not reveal their HIV status to their sexual partners make the prevention and control efforts challenging. Therefore, this study was aimed to assess HIV status disclosure to sexual partners and associated factors among pregnant women living with HIV attending prenatal care in Amhara Regional state referral Hospitals, Ethiopia in 2021. METHODS: An institution-based cross-sectional study was conducted from October 17th, 2020 to March 1st, 2021. A total of 423 pregnant women living with HIV were participated in this study. A systematic random sampling technique was used to select all eligible women. Data was collected using a semi-structured, pretested, and interviewer-administered questionnaire. EPI INFO version 7 and SPSS version 21 were used for data entry and analysis, respectively. Both univariable and multivariable logistic regression analyses were performed to find factors associated with women's disclosure status to a sexual partner. Statistical association was decided based on the adjusted odds ratio (AOR) with its 95% Confidence Interval (CI) and p-value of ≤ 0.05. RESULTS: The prevalence of disclosure of their HIV status to their sexual partners was 73% (95% CI: 68.9%, 77.3%). Being an urban resident (AOR = 5.04, 95% CI: 2.14, 11.81), diagnosed HIV before pregnancy (AOR = 7.77, 95% CI: 3.09, 19.52), disclosing their HIV status to others (AOR = 7.01, 95% CI: 3.78, 13.25), planned pregnancy (AOR = 2.46, 95% CI: 1.32, 4.57), and having good knowledge on HIV/AIDS prevention (AOR = 2.19, 95% CI:1.22, 3.94) were found to be statistically significant with women's disclosure of their HIV status to their sexual partner. CONCLUSION: In this study, nearly three-fourth of pregnant women disclosed their HIV status to their sexual partner. Thus, setting strategies in preventing unplanned pregnancy, HIV diagnosed before pregnancy, and increasing knowledge of HIV prevention will have significant role in escalating women's disclosure status.


Assuntos
Infecções por HIV , Parceiros Sexuais , Humanos , Feminino , Gravidez , Gestantes , Cuidado Pré-Natal , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Etiópia/epidemiologia , Estudos Transversais , Hospitais Estaduais , Revelação da Verdade , Gravidez não Planejada
2.
Sci Rep ; 12(1): 20121, 2022 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-36418456

RESUMO

Unplanned postoperative critical care admission poses a potential risk to patients and places unanticipated pressure on clinical services and it has become an important parameter to assess patient safety in perioperative services. This study was aimed to determine the incidence of unplanned intensive care unit admission following surgery and the associated factors. A multi-center cross-sectional study was conducted on postoperative patients admitted to the ICU of three hospitals located in the Amhara region. Data were collected via a structured survey tool and analyzed using SPSS version 23 software with binary logistic regression analysis. The statistical significance to identify patient, anesthetic and surgical related factors in the preoperative, intraoperative, and postoperative period was < 0.05 for multivariable regression with a 95% confidence interval. Predominantly patients were admitted to the ICU in an unplanned manner. ASA status, preoperative hemoglobin (Hgb) level, intraoperative estimated blood loss, and adverse events occurring in the operating room were significantly associated with intensive care unit admission following surgery. Patients who had a low preoperative Hgb value were 35.1 times more likely to be admitted to the intensive care unit in an unplanned manner compared with their counterparts [(Adjust odds ratio (AOR) 35.16; CI 12.82, 96.44)]. Patients with ASA II and III were 19.4 and 16.2 times more likely to be admitted to ICU in an unplanned way compared to patients who had ASA I physical status [(AOR 51.79; CI 8.28, 323.94) (AOR 67.8 CI 14.68, 313.53)]. Unplanned ICU admission after surgery was high in this study, suggesting poor perioperative planning, risk stratification, and optimization of patients.


Assuntos
Hospitais Estaduais , Unidades de Terapia Intensiva , Humanos , Incidência , Estudos Transversais , Etiópia
3.
JAMA Health Forum ; 3(9): e222919, 2022 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-36218926

RESUMO

Importance: Given higher reimbursement rates, hospitals primarily serving privately insured patients may invest more in intensive coding than hospitals serving publicly insured patients. This may lead these hospitals to code more diagnoses for all patients. Objective: To estimate whether, for the same Medicaid enrollee with multiple hospitalizations, a hospital's share of privately insured patients is associated with the number of diagnoses on claims. Design, Setting, and Participants: This cross-sectional study used patient-level fixed effects regression models on inpatient Medicaid claims from Medicaid enrollees with at least 2 admissions in at least 2 different hospitals in New York State between 2010 and 2017. Analyses were conducted from 2019 to 2021. Exposures: The annual share of privately insured patients at the admitting hospital. Main Outcomes and Measures: Number of diagnostic codes per admission. Probability of diagnoses being from a list of conditions shown to be intensely coded in response to payment incentives. Results: This analysis included 1 614 630 hospitalizations for Medicaid-insured patients (mean [SD] age, 48.2 [20.1] years; 829 684 [51.4%] women and 784 946 [48.6%] men). Overall, 74 998 were Asian (4.6%), 462 259 Black (28.6%), 375 591 Hispanic (23.3%), 486 313 White (30.1%), 128 896 unknown (8.0%), and 86 573 other (5.4%). When the same patient was seen in a hospital with a higher share of privately insured patients, more diagnoses were recorded (0.03 diagnoses per percentage point [pp] increase in share of privately insured; 95% CI, 0.02-0.05; P < .001). Patients discharged from hospitals in the bottom quartile of privately insured patient share received 1.37 more diagnoses when they were subsequently discharged from hospitals in the top quartile, relative to patients whose admissions were both in the bottom quartile (95% CI, 1.21-1.53; P < .001). Those going from hospitals in the top quartile to the bottom had 1.67 fewer diagnoses (95% CI, -1.84 to -1.50; P < .001). Diagnoses in hospitals with a higher private payer share were more likely to be for conditions sensitive to payment incentives (0.08 pp increase for each pp increase in private share; 95% CI, 0.06-0.10; P < .001). These findings were replicated in 2016 to 2017 data. Conclusions and Relevance: In this cross-sectional study of Medicaid enrollees, admission to a hospital with a higher private payer share was associated with more diagnoses on Medicaid claims. This suggests payment policy may drive differential investments in infrastructure to document diagnoses. This may create a feedback loop that exacerbates resource inequity.


Assuntos
Hospitais Estaduais , Seguro , Codificação Clínica , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New York/epidemiologia , Estados Unidos
4.
PLoS One ; 17(7): e0271072, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35797273

RESUMO

INTRODUCTION: Sleep plays an essential role in every individual's life since it contributes greatly to their well-being and health. Poor sleep quality is one of the most common consequences of hypertension (HTN), which is a leading public health problem. In Ethiopia, it is the main health concern among hypertension patients. Thus, in the study area, there is limited information regarding the investigation of sleep quality among hypertension patients. Therefore, this study aimed to assess sleep quality and associated factors among adult hypertensive patients attending a chronic follow up care clinic in northwest Amhara regional state referral hospitals, Northwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted among adult HTN patients from March 15/2021 to May 15/2021 in Northwest Amhara Regional State Referral Hospitals. A systematic random sampling method was used to select the study participants. A face-to-face interviewer-administered questionnaire with chart review was used. The Pittsburgh Sleep Quality Index (PSQI) for assessing sleep quality was used in this study. A binary logistic regression was used to see the association between dependent and independent variables. Variables having a p-value < 0.05 with a 95% CI were considered statistically significant in the multivariable logistic regression analysis. RESULTS: In this study, 563 hypertensive patients were included, with a response rate of 96.9%. The overall prevalence of poor sleep quality was 37.7% (95% CI: 33.4%-41.6%). Female gender (AOR = 2.55, 95% CI: 1.55-4.18), age ≥ 65 years (AOR = 4.07, 95% CI: 2.07-7.97), overweight (BMI) ≥ 25 kg/m2 (AOR = 1.68, 95% CI: 1.06-2.65), WHO stage II hypertension (AOR = 1.78, 95% CI:1.01-3.12), poor physical activity (AOR = 2.39, 95% CI:1.41-4.05), participants who had depression (AOR = 2.03,95% CI:1.24-3.34) and participants who had anxiety (AOR = 1.89, 95% CI: 1.16-3.03) were factors associated with poor sleep quality. CONCLUSIONS: In this study, more than one-third of the study participants had poor sleep quality. Female gender, age ≥ 65 years, overweight (BMI) ≥ 25 kg/m2, stage II hypertension, physical inactivity, depression, and anxiety were all associated with poor sleep quality. Managing depression and anxiety disorders, encouraging physical activity, and providing health education about weight loss are all necessary for HTN patients.


Assuntos
Hipertensão , Distúrbios do Início e da Manutenção do Sono , Adulto , Assistência ao Convalescente , Idoso , Estudos Transversais , Etiópia/epidemiologia , Feminino , Hospitais Estaduais , Humanos , Hipertensão/epidemiologia , Sobrepeso/complicações , Sobrepeso/epidemiologia , Prevalência , Encaminhamento e Consulta , Qualidade do Sono
5.
Psychol Serv ; 19(2): 201-205, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35575705

RESUMO

Over the past several years, individuals with serious mental illness (SMI) have become involved with the legal system at an increasing rate. State psychiatric hospitals and community mental health programs have seen a high number of referrals and admissions at a time when resources and staffing have been challenges. Individuals with SMI continue to be highly represented among those incarcerated in jails and prisons, often for minor charges. This article serves as an introduction to a special section of Psychological Services on innovations in assessment and treatment of legally involved patients in state hospitals and community mental health settings. Data are presented on the prevalence of legal involvement among individuals with serious mental illness, including the exponential growth in individuals evaluated and found incompetent to stand trial. A brief summary of the articles in the special section is presented, broken down by themes of assessment, treatment, and policy. We hope that the studies described in this issue will lead to further exploration of problems, barriers, and potential solutions for individuals with SMI who become involved with the legal system. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Hospitais Estaduais , Transtornos Mentais , Hospitais Psiquiátricos , Humanos , Transtornos Mentais/psicologia , Saúde Mental , Prisões
6.
Hist Psychiatry ; 33(2): 163-179, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35588212

RESUMO

Graduates from foreign medical schools (FMGs) began to staff US state psychiatric hospitals after World War II, and became increasingly associated with the poor quality of those institutions. Public and professional commentary on FMGs criticized their skills and suitability for the US healthcare system in the 1970s, at the same time that state hospitals were under increasing attack. By the 1980s and 1990s, the association between international medical graduates (as they became known) and underserved populations became an argument in favour of easing restrictions on these graduates. The role of foreign-trained psychiatrists in the US public sector became a way for American psychiatry leaders to manage the problems of the seriously mentally ill, first with blame and then with neglect.


Assuntos
Médicos Graduados Estrangeiros , Psiquiatria , Hospitais Psiquiátricos , Hospitais Estaduais , Humanos , Estados Unidos
7.
Stud Health Technol Inform ; 294: 701-702, 2022 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-35612181

RESUMO

In this study we examined the correlation of COVID-19 positivity with area deprivation index (ADI), social determinants of health (SDOH) factors based on a consumer and electronic medical record (EMR) data and population density in a patient population from a tertiary healthcare system in Arkansas. COVID-19 positivity was significantly associated with population density, age, race, and household size. Understanding health disparities and SDOH data can add value to health and the creation of trustable AI.


Assuntos
COVID-19 , COVID-19/epidemiologia , Atenção à Saúde , Hospitais Estaduais , Humanos , Densidade Demográfica , População Rural , Determinantes Sociais da Saúde
8.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48746

RESUMO

Hospital Estadual da Mulher Heloneida Studart (HEMulher), em São João do Meriti (RJ), agora se soma a outras 307 unidades de Saúde com a certificação na Iniciativa Hospital Amigo da Criança (IHAC). O título de qualidade é conferido pelo Ministério da Saúde às unidades que cumprem critérios destinados à garantia do aleitamento materno e o cuidado humanizado à mulher e à criança no pré-parto, parto e pós-parto.


Assuntos
Aleitamento Materno , Controle de Qualidade , Parto Humanizado , Cuidado Pré-Natal , Cuidado Pós-Natal , Hospitais Estaduais , Atenção Primária à Saúde , Promoção da Saúde , Maternidades , Brasil
9.
ABCS health sci ; 47: e022207, 06 abr. 2022. ilus, tab
Artigo em Inglês | LILACS | ID: biblio-1372363

RESUMO

INTRODUCTION: Several studies have shown that early mobilization is safe and beneficial for patients admitted to the intensive care units (ICUs), especially for those with mechanical ventilation (MV). OBJECTIVE: To investigate the benefits of early mobilization physiotherapeutic techniques applied to patients who suffered craniocerebral trauma (CCT). METHODS: This is an experimental study that evaluated clinical data from 27 patients. In sedated patients, mobilization and passive stretching were performed on the upper and lower limbs; in those without sedation, active-assisted, free and resisted exercises were included. RESULTS: The experimental group was composed of 51.8% of the participants and the control group by 48.2%, the majority being male (81.5%) with a median age of 43 years. The patients in the experimental group had an average of 9.5 days (2.2-14.7) of mechanical ventilation (MV), and those belonging to the control group, of 17 days (7-21.7) with MV (p=0.154). The patients in the experimental group had an average of 13.5 days in the ICU, against an average of 17 days in the control group (p=0.331), and an average of 20.5 days in hospital against 24 days in the control group (p=0.356). CONCLUSION: Early mobilization should be applied to critically ill patients as it can decrease the length of stay in the ICU and the hospital.


INTRODUÇÃO: Diversos estudos têm mostrado que a mobilização precoce é segura e benéfica para pacientes internados em unidades de terapia intensiva (UTIs), especialmente para aqueles com ventilação mecânica (VM). OBJETIVO: Investigar os benefícios das técnicas fisioterapêuticas de mobilização precoce aplicada aos pacientes que sofreram traumatismo cranioencefálico (TCE). MÉTODOS: Trata-se de um estudo quasi-randomizado, que incluiu 27 com TCE divididos em dois grupos: controle (n=13) e experimental (n=14) pacientes. No grupo experimental, os pacientes sedados foram submetidos à mobilização e alongamentos passivos nos membros superiores e inferiores; naqueles sem sedação, foram incluídos exercícios ativo-assistidos, livres e resistidos. RESULTADOS: O grupo experimental foi composto por 51,8% dos participantes da pesquisa e o grupo controle por 48,2%, sendo a maioria do sexo masculino (81,5%) com mediana de idade de 43 anos. Os pacientes do grupo experimental apresentaram média de 9,5 dias (2,2-14,7) de ventilação mecânica, e os pertencentes ao grupo controle, de 17 dias (7-21,7) com de VM (p=0,154). Os pacientes do grupo experimental apresentaram média de 13,5 dias de internação em UTI, contra média de 17 dias do grupo controle (p=0,331), e média de 20,5 dias de internação hospitalar contra 24 dias do grupo controle (p=0,356). CONCLUSÃO: A mobilização precoce é uma técnica que deve ser aplicada em pacientes críticos dentro das UTIs, pois pode diminuir o tempo de internação na UTI e hospitalar.


Assuntos
Humanos , Masculino , Feminino , Serviço Hospitalar de Fisioterapia , Deambulação Precoce , Lesões Encefálicas Traumáticas/terapia , Unidades de Terapia Intensiva , Hospitais Estaduais
10.
Sex Abuse ; 34(3): 319-340, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34154482

RESUMO

We examined the recidivism rates and the predictive validity of the Static-99R in 335 men who were detained or civilly committed and released from California State Hospitals pursuant to the Sexually Violent Predator (SVP) Act, and followed up for approximately 21 years from date of hospital admission. In all, 8.7% were arrested or convicted for a new sexual offense during the total follow-up (N = 335) and 7.8% over a fixed 5-year follow-up (n = 205). The Static-99R demonstrated small in magnitude discrimination for sexual, violent, and general recidivism (area under the curve [AUC]/C = .56 to .63). Calibration analyses, conducted through expected/observed (E/O) index, demonstrated that the Static-99R overpredicted sexual recidivism, irrespective of whether the Routine or High Risk/Need norms were used. Observed recidivism rates were lower than predicted by Static-99R scores and may be the result of the sample's older age at release, lengthy hospitalization, or other factors.


Assuntos
Reincidência , Delitos Sexuais , California , Hospitais Estaduais , Humanos , Masculino , Alta do Paciente , Medição de Risco
11.
Psychol Serv ; 19(2): 243-251, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34110868

RESUMO

Olmstead v. L.C. ex rel Zimring (1999) was a landmark U.S. Supreme Court decision holding that unjustified segregation of people with disabilities is impermissible discrimination; specifically, if the clinician and client believe community integration to be appropriate, the state must have reasonable accommodations in place for the client to be in the community. Enforcement of the Olmstead decision for people with serious mental illness (SMI) has taken many shapes, from the U.S. Department of Justice's (DOJ) settlement agreements requiring substantive development of community mental health services and aggressive community integration protocols, to the Third Circuit approach which requires only lower census numbers in the state psychiatric hospital (SPH). The question of whether Olmstead is being differentially enforced is addressed in an empirical, qualitative analysis of legal documents, including court opinions and settlement agreements. Through legal research spanning all U.S. jurisdictions, five distinct Olmstead enforcement approaches in ten different states were identified. The enforcement approaches are described, and limitations and future directions are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Serviços Comunitários de Saúde Mental , Pessoas com Deficiência , Hospitais Psiquiátricos , Hospitais Estaduais , Humanos , Decisões da Suprema Corte , Estados Unidos
12.
Psychol Serv ; 19(2): 234-242, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34043383

RESUMO

The present study examines the extent to which clients with serious mental illnesses (SMI) enrolled in a social-learning program (SLP) within a maximum-security state hospital were able to achieve discharge to less restrictive settings without requiring a return to maximum security. Retrospective analyses were undertaken to examine several time periods of the SLP's operation within maximum security. From 1988 to 2019, 248 clients were discharged from the SLP. Only 20 were readmitted to maximum security, primarily for violence in less restrictive facilities. The proportion of clients who were discharged from one 19-bed ward offering the SLP differed significantly from the proportion of clients who were discharged from an identical 19-bed ward offering treatment as usual within maximum security from 1988 to 1995. The rate of readmission to maximum security was also significantly lower for clients treated on the SLP than for clients treated on other long-term treatment programs within maximum security from 2010 to 2019. Violence in a less restrictive facility was the most common reason for readmission, which typically occurred more than 1 year after discharge. The results of the present study demonstrate the SLP's success in discharging clients with SMI from a maximum-security state hospital. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Hospitais Estaduais , Alta do Paciente , Humanos , Assistência de Longa Duração , Readmissão do Paciente , Estudos Retrospectivos , Violência
13.
Psychiatr Serv ; 73(3): 346-348, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-34320832

RESUMO

This study assessed the cost savings to the local health care system from using a 16-bed crisis residential facility (the Inn) in Austin, Texas, instead of hospitalization, for individuals with acute psychiatric illness (N=1,364) during FY2017-FY2019. Health service utilization data were obtained from the provider and Central Texas's regional health information exchange. Unit cost data were obtained from the provider, Austin State Hospital, the Healthcare Cost and Utilization Project, and the Medical Expenditure Panel Survey. Results indicated that the Inn saved the health care system up to $2.8 million annually. Future work can use these findings to improve the efficiency and effectiveness of the mental health care system.


Assuntos
Serviços Comunitários de Saúde Mental , Transtornos Mentais , Análise Custo-Benefício , Custos de Cuidados de Saúde , Hospitais Estaduais , Humanos , Transtornos Mentais/psicologia
14.
J Am Acad Psychiatry Law ; 50(1): 67-73, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34880078

RESUMO

This article examines the explosive growth of individuals referred for competency to stand trial evaluation and restoration services in the state of Oregon and at Oregon State Hospital between the years 2000 and 2020. This paper also examines the links between competency to stand trial and civil commitment statutes. As yearly civil commitments rates have decreased in Oregon, competency to stand trial commitments to Oregon State Hospital have increased, suggesting an inverse relationship between these two important statutes. There is an overlap in the jurisdiction of these statutes, with both needing to function harmoniously for the civil and the criminal justice processes to each work for the benefit of the individuals involved in the criminal justice and mental health systems.


Assuntos
Hospitais Estaduais , Transtornos Mentais , Internação Compulsória de Doente Mental , Direito Penal , Humanos , Competência Mental , Transtornos Mentais/psicologia , Oregon
16.
Rev. medica electron ; 43(6): 1770-1778, dic. 2021.
Artigo em Espanhol | LILACS-Express | LILACS, CUMED | ID: biblio-1409685

RESUMO

RESUMEN Con el crecimiento económico, cultural y demográfico de Matanzas, alcanzado entre 1818 y 1839, se sentaron las bases para el surgimiento de edificaciones imprescindibles como el antiguo Hospital de Santa Isabel. Esta institución fue inaugurada el 24 de julio de 1838. Durante la Colonia fue usado con fines civiles y militares, y entregado al gobierno norteamericano en agosto de 1899. En la Neocolonia brindó atención ininterrumpida a la población matancera. Fue remodelado en 1947, y en el período revolucionario se instituyó como hospital general, civil y docente hasta 2016, en que se reacondiciona para convertirse en el actual Hospital Provincial Docente Ginecobstétrico José Ramón López Tabrane. Es el hospital más longevo en funciones de la Isla (AU).


ABSTRACT With the economic, cultural and demographic growth of Matanzas, reached between 1818 and 1839, the grounds were laid for the emergence of indispensable buildings such as the old Hospital de Santa Isabel. This institution was inaugurated on July 24, 1838. During the colonial period it was used for civilian and military purposes, and handed over to the American government in August 1899. In the neocolonial period, it provided uninterrupted attention to the population of Matanzas. It was remodeled in 1947, and in the revolutionary period it was instituted as a general, civil and teaching hospital until 2016, in which it was re-conditioned to become the current Provincial Teaching Gyneco-obstetric Hospital José Ramón López Tabrane. It is the longest functioning hospital on the Island (AU).


Assuntos
Humanos , Masculino , Feminino , Hospitais Gerais/história , Hospitais Estaduais/história , História da Medicina , Maternidades/história , Hospitais de Ensino/história
17.
Aust Health Rev ; 45(6): 704-717, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34743785

RESUMO

Objective The provision of medicines through state public hospitals is comparatively restrictive compared with the federally funded Pharmaceutical Benefits Scheme (PBS). Individual states are progressively moving towards statewide medicines formularies. Although a statewide formulary has existed in Queensland for some time. The effects of hospital formularies on medicines utilisation and policy in Australia has not been quantified. Thus, the aim of the present study was to quantify the effects of the Queensland Health List of Approved Medicines (LAM) on medicines utilisation in Queensland at a state and PBS-purchasing level and describe the implications for medicines policy. Methods This study used a quasi-experimental design with an interrupted time series (with control for PBS) examining utilisation effects of medicines within the therapeutic classes of proton pump inhibitors and non-vitamin K oral anticoagulants with LAM listing or delisting. Results The LAM was demonstrated to be highly effective at controlling utilisation within Queensland Health purchasing. Effects on PBS utilisation were evident, resulting in increases in generic utilisation (where available) and associated reduced total costs both within Queensland Health and to the PBS. The full benefit is likely underestimated due to limitations in the PBS datasets. Conclusion The LAM is a highly effective state medicines policy tool with demonstrable effects on PBS utilisation. With increased use of statewide medicines formularies, this will be an increasingly relevant aspect of Australia's overall medicines policy. What is known about the topic? State medicines policy is comparatively restrictive compared with the federal PBS. Most Australian states have, or are developing, statewide medicines formularies. What does this paper add? By examining several classes of medicines, a substantial quantitative effect of the Queensland state formulary on both state and PBS medicines utilisation can be demonstrated. Increased use of generic medicines and reduced costs are seen. What are the implications for practitioners? With increased use of state medicines formularies, state medicines formularies will become increasingly relevant to medicines policy makers and advocates at both the state and federal level.


Assuntos
Hospitais Estaduais , Medicina Estatal , Austrália , Custos e Análise de Custo , Humanos , Queensland
18.
J Am Acad Psychiatry Law ; 49(4): 526-529, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34750190

RESUMO

The criminalization of mental illness is a national tragedy. Over the past three decades there have been numerous programs and initiatives designed to reduce the number of people with mental illness incarcerated in jails and prisons. Despite such efforts, incarceration rates have not fallen and have actually climbed in many jurisdictions. One major consequence of the criminalization of mental illness has been a large increase in referrals for evaluation for competency to stand trial and, consequently, in the need for competency restoration services. Many states have been unable to keep up with the demand for such services, causing patients to languish in jails with their criminal proceedings suspended, awaiting transfer to a state hospital. Expedited Diversion to Court-Ordered Treatment (EDCOT) is a new model for diversion that has great potential to drastically improve the diversion process, bypass the competency restoration system, and reduce the criminalization of mental illness. Successful implementation of EDCOT would result in more humane treatment of people with mental illness, without jeopardizing public safety; furthermore, it would pay for itself with the savings from reductions in the use of competency restoration services.


Assuntos
Criminosos , Transtornos Mentais , Hospitais Estaduais , Humanos , Transtornos Mentais/terapia , Saúde Mental , Prisões
19.
Turkiye Parazitol Derg ; 45(3): 176-180, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34346872

RESUMO

Objective: This study aimed to retrospectively reveal the seroprevalence of Toxoplasma gondii (T. gondii) in pregnant women with routine pregnancy follow-up. Methods: Anti-T. gondii IgM-IgG antibody values of pregnant women aged 16-49 years, who had routine pregnancy follow-up in January-December 2019 were analysed retrospectively. RESULTSResults: Of the 1.832 serum samples, in which the anti-T. gondii IgG test was studied, 28.7% were found to be positive, 70.4% were negative and 0.9% was found to be suspicious. For anti-T. gondii IgM, 0.7% of the 1.844 serum samples were evaluated as positive, 99.5% as negative and 0.1% as suspicious. The positivity rates was observed to increase as age decreases in anti-Toxoplasma IgM (r=0.144, p=0.001), and the positivity rates increase as the age increases in the anti-Toxoplasma IgG (r=0.061, p=0.001). In the nationality evaluation, the anti-T. gondii IgM and IgG positivity rates were observed to be higher in Syrian pregnant women compared to Turkish pregnant women. Conclusion: In our study, a significant portion of pregnant women were observed to be non-immune to the agent, and therefore informing these people about the protection methods from the parasite in order to prevent infection occurrence is important.


Assuntos
Toxoplasma , Toxoplasmose , Anticorpos Antiprotozoários , Feminino , Hospitais Estaduais , Humanos , Imunoglobulina M , Gravidez , Gestantes , Estudos Retrospectivos , Fatores de Risco , Estudos Soroepidemiológicos , Toxoplasmose/epidemiologia
20.
Brain Behav ; 11(8): e2318, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34333876

RESUMO

BACKGROUND: The 2019 novel coronavirus (COVID-19) is highly contagious and can spread a pandemic, so it is related to serious health issues and major public concerns, and is considered by the medical community to be the greatest concern because it is the greatest risk of infection. OBJECTIVE: To identify and assess the psychological effects of the COVID-19 pandemic on healthcare professionals in Khartoum state hospitals 2021. MATERIALS AND METHODS: Generalized Anxiety Scale (GAD-7), Perceived Stress Scale (PSS-10), and Work-Family Balance Measure Scale were used to assess the psychological impact of doctors and nurses working in four big hospitals in Sudan, by an online questionnaire, analyzed by the statistical package for social science (SPSS) during February. RESULTS: Most of the participants had minimal to mild anxiety according to GAD-7 score, 121 (35.2%) and 103 (29.9%), respectively. Using PSS-10, the cutoff point was determined as 19 as the mean for total score was 19.2 ± 6.2, accordingly, more than half had high levels of stress (scored 19 and above) 189 (54.9%). For the Work-Family Balance Scale, 10 was regarded as the cutoff point. There was a significant association between specialty and stress level p-value .032. No significant correlations were found between age and stress level, neither between age and anxiety level (r -.100, p-value .064 and r = -.022, p-value .683, respectively). CONCLUSION: More than half of healthcare professionals (54.9%) showed high levels of stress. Most of the healthcare professionals had poor work-family balance (60.2%).


Assuntos
COVID-19 , Pandemias , Adaptação Psicológica , Ansiedade/epidemiologia , Estudos Transversais , Atenção à Saúde , Hospitais Estaduais , Humanos , SARS-CoV-2 , Estresse Psicológico/epidemiologia , Sudão/epidemiologia
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