169 research outputs found

    What do patients want from their psychiatrist? A cross- sectional questionnaire based exploratory study from Karachi

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    <p>Abstract</p> <p>Background</p> <p>The aspects of consultation that are important for psychiatric patients have always remained a less acknowledged area. The aim of this study was to identify these aspects.</p> <p>Methods</p> <p>A Cross-sectional, questionnaire based study was carried out in a psychiatry outpatient clinic of two tertiary care hospitals in a developing country. The patients were asked to fill out the questionnaire containing a total of 11 close-ended questions plus 1 open-ended question. They graded them as not important, important, very important or do not know. Non-psychotic patients aged 18 and above, visiting the clinic were recruited into the study before they went in for their first consultation.</p> <p>Results</p> <p>The response rate of patients was 84%. More than 90% wanted the doctor to tell them the cause of their illness, talk to them about their condition, provide symptomatic relief, let them know that how long their illness would last and make the final decision about their treatment plan. Less than 20% wanted to be part of a support network. A significant 82% wanted talking therapy as part of their treatment plan.</p> <p>Conclusion</p> <p>The three issues, most important for patients were: the doctor should listen to them, make the final decision about treatment and provide symptomatic relief. Only 20% wanted to be a part of patients' support group.</p

    Pretransplant Serum Uromodulin and Its Association with Delayed Graft Function Following Kidney Transplantation—A Prospective Cohort Study

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    Delayed graft function (DGF) following kidney transplantation is associated with increased risk of graft failure, but biomarkers to predict DGF are scarce. We evaluated serum uromodulin (sUMOD), a potential marker for tubular integrity with immunomodulatory capacities, in kidney transplant recipients and its association with DGF. We included 239 kidney transplant recipients and measured sUMOD pretransplant and on postoperative Day 1 (POD1) as independent variables. The primary outcome was DGF, defined as need for dialysis within one week after transplantation. In total, 64 patients (27%) experienced DGF. In multivariable logistic regression analysis adjusting for recipient, donor and transplant associated risk factors each 10 ng/mL higher pretransplant sUMOD was associated with 47% lower odds for DGF (odds ratio (OR) 0.53, 95% confidence interval (95%-CI) 0.30–0.82). When categorizing pretransplant sUMOD into quartiles, the quartile with the lowest values had 4.4-fold higher odds for DGF compared to the highest quartile (OR 4.41, 95%-CI 1.54–13.93). Adding pretransplant sUMOD to a model containing established risk factors for DGF in multivariable receiver-operating-characteristics (ROC) curve analysis, the area-under-the-curve improved from 0.786 [95%-CI 0.723–0.848] to 0.813 [95%-CI 0.755–0.871, p = 0.05]. SUMOD on POD1 was not associated with DGF. In conclusion, higher pretransplant sUMOD was independently associated with lower odds for DGF, potentially serving as a non-invasive marker to stratify patients according to their risk for developing DGF early in the setting of kidney transplantation

    Evaluation of the efficacy and safety of olanzapine as an adjunctive treatment for anorexia nervosa in adolescent females: a randomized, double-blind, placebo-controlled trial

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    <p>Abstract</p> <p>Background</p> <p>Anorexia Nervosa (AN) is a serious, debilitating condition that causes significant physical, emotional, and functional impairment. The condition is characterized by destructive weight loss behaviours and a refusal to maintain body weight at or above a minimally normal weight for age and height. AN often develops in adolescence and is a predominantly female disorder. Treatment for AN typically involves medical, nutritional and psychological interventions. Pharmacotherapy is also often used; however, the literature on the effectiveness of these drugs in a pediatric population is very limited. Olanzapine, which is an 'atypical' antipsychotic, is becoming more widespread in the treatment of AN. Olanzapine is hypothesized to facilitate weight gain, while decreasing levels of agitation and decreasing resistance to treatment in young women with AN. This randomized, double-blind placebo-controlled trial seeks to examine the effectiveness and safety of olanzapine in female youth with AN.</p> <p>Methods/Design</p> <p>Adolescent females between the ages of 12 and 17 diagnosed with AN (either restricting or binge/purge type) or Eating Disorder Not Otherwise Specified with a Body Mass Index of less than or equal to 17.5, will be offered inclusion in the study. Patients will be randomly assigned to receive either olanzapine or placebo. Patients assigned to receive olanzapine will start at a low dose of 1.25 mg/day for three days, followed by 2.5 mg/day for four days, 5 mg/day for one week, then 7.5 mg/day (the target dose chosen) for 10 weeks. After 10 weeks at 7.5 mg the medication will be tapered and discontinued over a period of two weeks. The effectiveness of olanzapine versus placebo will be determined by investigating the change from baseline on measures of eating attitudes and behaviors, depression and anxiety, and change in Body Mass Index at week 12, and after a follow-up period at week 40. It is anticipated that 67 participants will be recruited over two years to complete enrollment.</p> <p>Discussion</p> <p>Randomized controlled trials designed to measure the safety and effectiveness of olanzapine in comparison to placebo are desperately needed, particularly in the adolescent population.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN23032339</p

    Sexual dysfunction during treatment with serotonergic and noradrenergic antidepressants: Clinical description and the role of the 5-HTTLPR

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    Objectives. Sexual dysfunction (SD) is a frequently reported side-effect of antidepressant treatment, particularly of selective serotonin reuptake inhibitors (SSRIs). In the multicentre clinical and pharmacogenetic GENDEP study (Genome-based Therapeutic Drugs for Depression), the effect of the serotonin transporter gene promoter polymorphism 5-HTTLPR on sexual function was investigated during treatment with escitalopram (SSRI) and nortriptyline (tricyclic antidepressant). Methods. A total of 494 subjects with an episode of DSM-IV major depression were randomly assigned to treatment with escitalopram or nortriptyline. Over 12 weeks, depressive symptoms and SD were measured weekly with the Montgomery-Asberg Depression Rating Scale, the Antidepressant Side-Effect Checklist, the UKU Side Effect Rating Scale, and the Sexual Functioning Questionnaire. Results. The incidence of reported SD after 12 weeks of treatment was relatively low, and did not differ significantly between antidepressants (14.9% escitalopram, 19.7% nortriptyline). There was no significant interaction between the 5-HTTLPR and antidepressant on SD. Improvement in depressive symptoms and younger age were both associated with lower SD. The effect of age on SD may have been moderated by the 5-HTTLPR. Conclusions. In GENDEP, rates of reported SD during treatment were lower than those described in previous reports. There was no apparent effect of the 5-HTTLPR on the observed decline in SD. © 2011 Informa Healthcare.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

    Zum Nutzen von Forschungsergebnissen fĂŒr die schulische Praxis aus der Perspektive von Lehramtsstudierenden in Österreich - Eine qualitative, explorative Studie

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    This paper investigates how Austrian undergraduate preservice student teachers evaluate (1) the importance of educational research for teachers in general and for themselves in particular and (2) the impact of different aspects of utility value of research evidence on educational practice. In order to achieve this, a theoretical framework proposing five aspects of utility value (Rossi & Freeman, 1993; Visscher & Coe, 2002; Weiss, 1979, 1998) was transferred to the pedagogical context and served as a basis for the development of an interview guideline and of content-analytical rules for qualitative text analysis. To answer the research questions, 30 guideline-based qualitative interviews with Austrian undergraduate preservice student teachers in their second or third year of study were analyzed using various techniques of Qualitative Content Analysis, in particular, inductive category formation and deductive category assignment (Mayring, 2014). Results of the analysis suggest that the interviewed undergraduate preservice student teachers tend to primarily refer to study-orientated topics (e.g. bachelor theses) when evaluating the importance of educational research for teachers and address the conceptual and instrumental value of research evidence for educational practice. The paper concludes with a critical discussion and derives implications for further research projects. (DIPF/Orig.)Im vorliegenden Beitrag wird untersucht, wie österreichische Lehramts studierende (1) den Nutzen von Forschungsergebnissen fĂŒr Lehrer/innen im Allgemeinen und fĂŒr sich selbst und (2) den Einfluss verschiedener Nutzenaspekte fĂŒr schulische Praxis einschĂ€tzen. HierfĂŒr wurde ein theoretisches Rahmenmodell bestehend aus fĂŒnf Nutzenaspekten (Rossi & Freeman, 1993; Visscher & Coe, 2002; Weiss, 1979, 1998) abgeleitet, welches zunĂ€chst in den pĂ€dagogischen Kontext transferiert wurde. Diese Nutzenaspekte bildeten die Grundlage fĂŒr die Entwicklung eines Interviewleitfadens und fĂŒr die Erstellung von inhaltsanalytischen Regeln zur qualitativen Textanalyse. Zur Beantwortung der Forschungsfrage wurden 30 Leitfadeninterviews mit österreichischen Lehramtsstudierenden in ihrem zweiten Ausbildungsjahr gefĂŒhrt. Die Transkripte der Interviews wurden mit verschiedenen Techniken der qualitativen Inhaltsanalyse, insbesondere der induktiven Kategorienbildung und der deduktiven Kategorienanwendung (Mayring, 2014), ausgewertet. Die Ergebnisse legen nahe, dass die befragten Lehramtsstudierenden ĂŒberwiegend studienbezogene Themen (z.B. Verfassen der Bachelorarbeit) nennen, wenn sie den Nutzen von Forschungsergebnissen fĂŒr Lehrer/innen angeben sollen. FĂŒr die schulische Praxis sehen sie insbesondere den konzeptuellen und instrumentellen Nutzen von Forschungsergebnissen. Der Beitrag endet mit einer kritischen Diskussion der Ergebnisse und der Ableitung von Implikationen fĂŒr zukĂŒnftige Forschungsprojekte. (DIPF/Orig.
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