Changes in experience and behavior of schizophrenic patients in therapy groups improve functioning and symptoms. RCT with 154 outpatients in CR-group compared to TAU

For the treatment of schizophrenia patients, some evidence-based group therapy approaches with different treatment goals are available today, also in cognitive remediation. However, there is little to no data on how the group factor, as an unspecific mechanism of change, affects the treatment outcome in schizophrenia patients. Does participation in goal-directed groups per se affect treatment outcome? Methods: To address this gap, a group approach to cognitive remediation developed in our laboratory (Integrated Neurocognitive Therapy, INT) was compared with control patients who did not participate in therapy groups (Treatment As Usual, TAU). 154 outpatients with schizophrenia were randomly assigned to INT (N=79) or TAU (n=75). INT was administered twice a week for a therapy duration of 15 weeks. A comprehensive test battery was assessed before and after therapy, as well as at the 1-year follow-up in both comparison groups. The group factor was assessed with the newly developed short questionnaire "Experience and Behavior in Therapy Groups EBIT", which comprises 11 items. Results: The therapy group showed significantly better effects in EBIT outcome compared to controls regarding the global score (mean of all EBIT items) (GLM: F=5.42, p <.01) as well as the empirical 2-factor solution using factor analysis: factor 1 (inactivity and fear) (GLM: F=5.05; p <.01) and factor 2 (eye contact and attention during communication) (F=4.02, p=.02). Additionally, EBIT scores are significantly associated with improvement in cognition, negative and general symptoms after treatment. Furthermore, EBIT scores are also significantly correlated with treatment motivation and therapy attendance rate but not with positive symptoms and medication. Conclusion: The group factor can be identified and measured using a brief questionnaire. Additionally, the experience and behavior in groups have a supplement positive effect on various group outcome variables

Computing in medical practice

OBJECTIVE: currently, information technology is part of several aspects of our daily life. The objective of this paper is to analyze and discuss the use of information technology in both medical education and/or medical practice. SOURCES OF DATA: information was gathered through nonsystematic bibliographic review, including articles, official regulations, book chapters and annals. Direct search and search of electronic databanks in Medline and Lilacs databases were also performed. SUMMARY OF THE FINDINGS: this paper was structured in topics. First, there is a discussion on the electronic medical record. The following aspects are presented: history, functions, costs, benefits, ethical and legal issues, and positive and negative characteristics. Medical decision-support systems are also evaluated in view of the huge amount of information produced every year regarding healthcare. The impact of the Internet on the production and diffusion of knowledge is also analyzed. Telemedicine is assessed, since it presents new challenges to medical practice, and raises important ethical issues such as virtual medical consultation. Finally, a practical experience of modernization of a pediatric outpatient center by the introduction of computers and telecommunication tools is described. CONCLUSIONS: medical computing offers tools and instruments that support the administrative organization of medical visits, gather, store and process patient's data, generate diagnoses, provide therapeutical advice and access to information in order to improve medical knowledge and to make it available whenever and wherever adequate decision-making is required.OBJETIVO: a informática hoje participa em vários aspectos de nossa vida cotidiana. Os autores, através deste artigo de revisão, analisam e discutem sua inserção nos consultórios médicos assistenciais e/ou de ensino. FONTES DE DADOS: foram utilizadas informações obtidas através de revisão bibliográfica, não sistemática, abrangendo artigos, normas oficiais, capítulos de livros e anais, realizada, também, por busca direta e de bancos eletrônicos nas bases de dados Medline e Lilacs. SÍNTESE DOS DADOS: o artigo foi estruturado em tópicos, apresentando, inicialmente, uma discussão sobre o prontuário eletrônico, sua história, funções, custos e benefícios, aspectos éticos e legais e suas vantagens e desvantagens. Avalia-se, também, os sistemas de apoio à decisão em medicina frente à quantidade enorme de informações que surgem, a cada ano, na área da saúde. Foi analisado o impacto do uso da Internet na universalização e na democratização do conhecimento e avaliada a telemedicina, que cria novos desafios à prática médica, bem como levanta aspectos éticos importantes como os da consulta virtual e, finalizando, descreve-se uma experiência prática de modernização de um ambulatório de ensino em Pediatria, com a introdução das ferramentas de informática e telecomunicação. CONCLUSÕES: a área de informática médica hoje dispõe de ferramentas e instrumentos que podem apoiar a organização administrativa da consulta médica, a captura, o armazenamento e o processamento das informações do paciente, a geração do diagnóstico, a orientação terapêutica e o acesso às informações, visando a melhora do conhecimento médico e a disponibilidade deste conhecimento onde e quando ele for necessário, para uma adequada tomada da decisão.UNIFESP-EPM Departamento de PediatriaUNIFESP-EPM Departamento de Informática em SaúdeUNIFESP, EPM, Depto. de PediatriaUNIFESP, EPM Depto. de Informática em SaúdeSciEL

Effect of dietary alpine butter rich in conjugated linoleic acid on milk fat composition of lactating sows

Multiparous sows (n 17) were included in a controlled cross-over-study in order to investigate the influence of a natural source of conjugated linoleic acid (CLA) (alpine butter) on the milk fatty acid composition of lactating sows (as an animal model for lactating women) and on the growth performance of their progeny. The usual fat source of a standard lactation diet was replaced by either CLA-rich alpine butter or margarine (control diet). Compared with the margarine diet, feeding the alpine butter-supplemented diet increased (P0·05) affected. Growth performance of the progeny was similar for both dietary treatments. In summary, the findings show that adding alpine butter to the diet does not provoke a milk fat depression and does not alter the composition of total SFA, MUFA and PUFA in sow milk but increases its CLA concentratio

Early diagnosis remains the most reliable way to cure chidren with melanoma: Response

No Abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/48703/1/20398_ftp.pd