...depression in primary health care: a case–control study Lena Flyckta1 c1, Ejda Hasslera2, Louise Lotfia2, Ingvar Krakaua2 and Gunnar H. Nilssona2 a1 Department of Clinical Neuroscience, Stockholm Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden a2 Department of Neurobiology, Care Science and Society, Centre for Family and Community Medicine, Karolinska Institutet, Stockholm, Sweden Abstract Aim To identify clinical cues indicative of depression in medical records of cases in primary care with undetected depression. Background Depressive disorders are common; the lifetime risk for men and women is 27% and 45%, respectively. Despite effective treatment methods such as antidepressants and cognitive behavioural therapy, depression often remains undiscovered in primary care, with great implications both on the individual and societal level. Methods Clinical cues indicating depression were sought in medical records the year before an opportunistic screening for depression in primary care. In a previous study of 221 patients in the waiting room of a primary care centre during 10 randomly selected days, 45 (20%) showed signs of depression (MADRS-S ≥ 12) and 60% of these were verified as having depressive disorders (Prime-MD). These 45 patients constitute the cases in the present study. Age- and gender-matched controls were selected among those who scored below the chosen cut-off level. Findings Seventeen (38%) of the 45 cases compared with eight (18%) of the...
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...This case study ([38] Yin, 2003) concerns the introduction and application of organization-wide process management between 1997 and 2001 at Huddinge University Hospital, an 800-bed tertiary care centre with salaried staff in the Stockholm County Council healthcare system, Sweden (which subsequently merged to form the Karolinska University Hospital). The QI program involved identifying hospital processes and assembling multi-professional and management teams to conduct QI projects - aimed, typically, at reducing waiting times for patients or otherwise streamlining clinical operations - to enhance organizational performance ( Thor 2010) Statement of problem In the health care field in the United States there are going to be major health care reform issues that come in the coming years. The government will be putting certain mandates down and health care will have to try to hold it together at all costs. During the uncertain times in health care there will need to be some improvement programs put in place. In a study in Swedish hospital they went thru change and had a quality improvement program enduring uncertainty regarding the effectiveness of such programs and how evaluate it. They were able to use design, methodology and approach.( Thor 2010) Literatuare Review Goal achievement was assessed based on baseline levels, the goal set at the start of each QI project and the QI indicator level at project conclusion. Goal achievement was (arbitrarily) categorized into more or...
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...that appendicitis was related to an obstruction of the appendix, therefore it was logical to use contrast enema and fluoroscopy to diagnose. Later on, contrast enema and oral contrast was continued in combination with computed tomography (CT) to diagnose appendicitis and this method has been continuously explored with published studies. After the development of high-resolution multidetector, researchers have suggested that the use of enteral contrast was unnecessary. The objective of this study was to evaluate the accuracy of the multidetector CT for diagnosing appendicitis in relation to enteral contrast. Protection of Human Participants The participants in the study were all fifteen years or older. The local ethical committee approved the study. Informed consent was not needed because the study was retrospective and did not violate patient privacy in Sweden. There were no risks noted because of the study since the CT scan was a routine test that was done prior to the data being collected. Data Management and Analysis Two hundred and forty six examinations were retrospectively selected for this study that took place at Karolinska University Hospital, Solna, Sweden, during 2005-2006. The patients were divided into four groups based on the use of the enteral contrast agents. Group X consisted of patients examined without any contrast. Group O consisted of patients examined with oral contrast agents. Group R consisted of patients examined with contrast enema. Group B consisted...
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...individualised attention in order to be effectively treated. This requires large resources in terms of labour, knowledge, skill, and time which is why in the past, improving productivity has been difficult. Information and communications technology, ICT, has been seen to have potential to improve productivity in e.g. diagnosing, devising treatment plans, communicating with patients and clinical staff, and record-keeping if applied correctly. During mainly the 1990s, the banking sector changed its distribution channel strategy to focus increasingly on Internet banking rather than local branches. If parallels are drawn between the two, such as comparing local branches to clinics, what can a rheumatology department learn? A case study was conducted at Karolinska University Hospital's Department of Rheumatology. Existing communication pathways associated with the clinic-patient communication were identified, theory and knowledge of the banking sector change was compiled and some current efforts...
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...Agoo Technical & Vocational Education Training Center Sta. Barbara Agoo, La Union DISEASES (REPORT by GROUP 3) Submitted by: Michelle Manzano Alvin Viduya Jane Foronda Rhodora Gagaoin Arlene Heruela Jo-ann Eballar Marlon Catalan Submitted to: Mr. Jose Eric Rivera THROMBOANGIITIS OBLITERANS What is Thromboangiitis Obliterans? * Also known as Buerger’s Disease * A rare disease of the arteries and veins in the arms and legs. In buerger’s disease your blood vessels become inflamed, swell and can become blocked with blood clots. This eventually damages or destroy skin tissues and lead to infection usually first shows in the hands and feet and may eventually affect larger areas of your arms and legs SYMPTOMS * Pain in your lower legs or feet when walking * Pain in your hands or forearms * Blood clots * Ulcers on your toes and fingers * Raynaud’s syndrome, a narrowing of blood vessels in your hands and sometimes your toes TREATMENT * Stopping all smoking and other forms of tobacco use * Having surgery to bring blood to the affected tissues (people who have smoked for more than 20 years are more likely to need surgery COMPLICATIONS * Changes in the way you walk or move due to pain * Ulcers * Tissue damage or tissue death * Gangrene * Amputation ASTHMA What is Asthma? * Asthma existed in ancient egyptian times and there’s some evidence that asthma has been around even before that. The...
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...------------------------------------------------- Peptic ulcer A peptic ulcer, also known as PUD or peptic ulcer disease,[1] is the most common ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. It is defined as mucosal erosions equal to or greater than 0.5 cm. As many as 70–90% of such ulcers are associated with Helicobacter pylori, a spiral-shaped bacterium that lives in the acidic environment of the stomach; however, only 40% of those cases go to a doctor. Ulcers can also be caused or worsened by drugs such as aspirin, ibuprofen, and other NSAIDs.[2] Four times as many peptic ulcers arise in the duodenum—the first part of the small intestine, just after the stomach—as in the stomach itself. About 4% of gastric ulcers are caused by a malignant tumor, so multiple biopsies are needed to exclude cancer. Duodenal ulcers are generally benign. ------------------------------------------------- ------------------------------------------------- [edit]Classification By Region/Location * Duodenum (called duodenal ulcer) * Oesophagus (called esophageal ulcer) * Stomach (called gastric ulcer) * Meckel's diverticulum (called Meckel's diverticulum ulcer; is very tender with palpation) Modified Johnson Classification of peptic ulcers: * Type I: Ulcer along the body of the stomach, most often along the lesser curve at incisura angularis along the locus minoris resistantiae. * Type II: Ulcer in the body in combination...
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...association (or its equivalent) or the local licensing authorities. NOTE: Medical service in Germany is of a high standard. Charges for private patients can be approximately the same as those assessed in the United States but vary from physician to physician. University professors are likely to charge higher fees than other doctors on the list. These fees, however, in view of the physicians’ standing in the medical community are not considered excessive. Tourists should be prepared to pay in cash when they visit a doctor. For hospital admittance, except in emergency cases, a deposit is usually required to cover a five day stay. All cities, town and rural areas in Bavaria will have University, City or County Hospitals. You will generally find physicians with basic English knowledge. Any hotel manager will assist you, in case of illness, in finding appropriate doctors or medical care. As a general rule, patients are admitted into hospitals through their physicians, except in emergencies. 1|Page Contents Anesthesiologists: 3 Chiropractors: 3 Dentists/Dental...
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...TOTAL QUALITY MANAGEMENT AND SIX SIGMA Edited by Tauseef Aized Total Quality Management and Six Sigma http://dx.doi.org/10.5772/2559 Edited by Tauseef Aized Contributors Aleksandar Vujovic, Zdravko Krivokapic, Jelena Jovanovic, Svante Lifvergren, Bo Bergman, Adela-Eliza Dumitrascu, Anisor Nedelcu, Erika Alves dos Santos, Mithat Zeydan, Gülhan Toğa, Johnson Olabode Adeoti, Andrey Kostogryzov, George Nistratov, Andrey Nistratov, Vidoje Moracanin, Ching-Chow Yang, Ayon Chakraborty, Kay Chuan Tan, Graham Cartwright, John Oakland Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained...
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...without reading it." R. Buckminster Fuller: "Cogent ... brilliant ... I hope vast numbers will read Toffler's book." Betty Friedan: "Brilliant and true ... Should be read by anyone with the responsibility of leading or participating in movements for change in America today." Marshall McLuhan: "FUTURE SHOCK ... is 'where it's at.'" Robert Rimmer, author of The Harrad Experiment: "A magnificent job ... Must reading." John Diebold: "For those who want to understand the social and psychological implications of the technological revolution, this is an incomparable book." WALL STREET JOURNAL: "Explosive ... Brilliantly formulated." LONDON DAILY EXPRESS: "Alvin Toffler has sent something of a shock-wave through Western society." LE FIGARO: "The best study of our times that I know ... Of all the books that I have read in the last 20 years, it is by far the one that has taught me the most." THE TIMES OF INDIA: "To the elite ... who often get committed to age-old institutions or material goals alone, let Toffler's FUTURE SHOCK be a lesson and a warning." MANCHESTER GUARDIAN: "An American book that will ... reshape our thinking even more radically than Galbraith's did in the 1950s ... The book is more than a book, and it will do more than send reviewers raving ... It is a spectacular outcrop of a formidable, organized intellectual effort ... For the first time in history scientists are marrying the insights of artists, poets, dramatists, and novelists to statistical analysis and operational research...
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...TE AM FL Y Strategic Planning for Information Systems Third Edition JOHN WARD and JOE PEPPARD Cranfield School of Management, Cranfield, Bedfordshire, UK Copyright # 2002 by John Wiley & Sons Ltd, Baffins Lane, Chichester, West Sussex PO19 1UD, England National 01243 779777 International (þ44) 1243 779777 e-mail (for orders and customer service enquiries): cs-books@wiley.co.uk Visit our Home Page on http://www.wiley.co.uk or http://www.wiley.co.uk All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except under the terms of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London, UK W1P 9HE without the permission in writing of the publisher. Other Wiley Editorial Offices John Wiley & Sons, Inc., 605 Third Avenue, New York, NY 10158-0012, USA Wiley-VCH Verlag GmbH, Pappelallee 3, D-69469 Weinheim, Germany John Wiley Australia Ltd, 33 Park Road, Milton, Queensland 4064, Australia John Wiley & Sons (Asia) Pte Ltd, 2 Clementi Loop #02-01. Jin Xing Distripark, Singapore 129809 John Wiley & Sons (Canada) Ltd, 22 Worcester Road, Rexdale, Ontario M9W 1L1, Canada British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 0-470-84147-8 Project management by Originator...
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