1,062 research outputs found
Implementasi Mvc Pada Situs Portal Pencarian Universitas Di Daerah Istimewa YOGYAKARTA
Daerah Istimewa Yogyakarta merupakan kota pelajar dan memiliki banyak perguruan tinggi. Karena begitu banyaknya perguruan tinggi, akan menyebabkan para calon mahasiswa baru mengalami kesulitan dalam mencari informasi seputar perguruan tinggi di Daerah Istimewa Yogyakarta. Selain itu, setiap perguruan tinggi memiliki program studi yang berbeda-beda. Oleh karena itu, penulis menerapkan implementasi MVC (Model-View-Controller) pada situs portal pencarian universitas di Daerah Istimewa Yogyakarta. MVC merupakan suatu metode yang digunakan penulis untuk merancang sistem berbasis website. Tampilan (view) website dihasilkan dari pengolahan database yang terdapat dalam model. Proses pengolahan tersebut dengan menggunakan query SQL (Structured Query Language). Agar hasil dari pengolahan database tersebut dapat ditampilkan, maka diperlukan controller untuk menghubungkan model dengan view. Hasil dari implementasi MVC (Model-View-Controller) pada situs portal ini ternyata dapat membantu calon mahasiswa baru untuk mengetahui perguruan tinggi apa saja yang tersedia di Daerah Istimewa Yogyakarta dan dapat melakukan pencarian perguruan tinggi yang diinginkan beserta peta lokasinya. Sehingga dapat disimpulkan bahwa penggunaan MVC sangat berperan penting dalam pembuatan situs portal pencarian universitas di Daerah Istimewa Yogyakarta
Sistem Pakar Untuk Mendiagnosa Penyakit Babi Dengan Metode Backward Chaining
Proses diagnosa suatu penyakit baik pada manusia maupun hewan seharusnya dilakukan oleh seorang dokter yang ahli dibidang tersebut. Namun keterbatasan jumlah dokter khususnya dokter hewan dan kesulitan mengakses tenaga medis tersebut menyebabkan sebagian peternak melakukan pengobatan sendiri terhadap ternak mereka yang sedang sakit. Kurangnya pengetahuan para peternak terhadap penyakit hewan dan cara penangannya sering kali mengakibatkan kesalahan diagnosis dan pemberian obat kepada ternak mereka yang sedang sakit. Untuk itulah dibutuhkan sebuah sistem yang dapat membantu para peternak untuk melakukan diagnosis awal terhadap penyakit yang mungkin diderita oleh hewan ternak mereka. Pada penelitian ini penulis membangun sebuah sistem pakar yang dapat membantu melakukan diagnosa terhadap penyakit pada babi. Sistem pakar merupakan sebuah aplikasi yang berisi fakta, pengetahuan, dan penalaran yang dapat digunakan untuk menyelesaikan sebuah permasalahan yang membutuhkan keahlian khusus. Teknik penalaran yang digunakan dalam sistem ini adalah penalaran runut Balik/backward chaining. Fakta dan pengetahuan sistem diperoleh dari seorang dokter hewan yang memiliki keahlian dalam mendiagnosis penyakit pada babi. Sistem memiliki kemampuan memberikan diagnosis terhadap satu atau lebih penyakit yang diderita oleh seekor babi. Berdasarkan uji beta, ketepatan diagnosis yang diberikan sistem cukup baik (87%)
Outpatient costs in pharmaceutically treated diabetes patients with and without a diagnosis of depression in a Dutch primary care setting
<p>Abstract</p> <p>Background</p> <p>To assess differences in outpatient costs among pharmaceutically treated diabetes patients with and without a diagnosis of depression in a Dutch primary care setting.</p> <p>Methods</p> <p>A retrospective case control study over 3 years (2002-2004). Data on 7128 depressed patients and 23772 non-depressed matched controls were available from the electronic medical record system of 20 general practices organized in one large primary care organization in the Netherlands. A total of 393 depressed patients with diabetes and 494 non-depressed patients with diabetes were identified in these records. The data that were extracted from the medical record system concerned only outpatient costs, which included GP care, referrals, and medication.</p> <p>Results</p> <p>Mean total outpatient costs per year in depressed diabetes patients were €1039 (SD 743) in the period 2002-2004, which was more than two times as high as in non-depressed diabetes patients (€492, SD 434). After correction for age, sex, type of insurance, diabetes treatment, and comorbidity, the difference in total annual costs between depressed and non-depressed diabetes patients changed from €408 (uncorrected) to €463 (corrected) in multilevel analyses. Correction for comorbidity had the largest impact on the difference in costs between both groups.</p> <p>Conclusions</p> <p>Outpatient costs in depressed patients with diabetes are substantially higher than in non-depressed patients with diabetes even after adjusting for confounders. Future research should investigate whether effective treatment of depression among diabetes patients can reduce health care costs in the long term.</p
A study of the effectiveness of telepsychiatry-based culturally sensitive collaborative treatment of depressed Chinese Americans
<p>Abstract</p> <p>Background</p> <p>Chinese American patients with Major Depressive Disorder (MDD) tend to underutilize mental health services and are more likely to seek help in primary care settings than from mental health specialists. Our team has reported that Culturally Sensitive Collaborative Treatment (CSCT) is effective in improving recognition and treatment engagement of depressed Chinese Americans in primary care. The current study builds on this prior research by incorporating telemedicine technology into the CSCT model.</p> <p>Methods/Design</p> <p>We propose a randomized controlled trial to evaluate the acceptability and effectiveness of a telepsychiatry-based culturally sensitive collaborative treatment (T-CSCT) intervention targeted toward Chinese Americans. Patients meeting the study's eligibility criteria will receive either treatment as usual or the intervention under investigation. The six-month intervention involves: 1) an initial psychiatric interview using a culturally sensitive protocol via videoconference; 2) eight scheduled phone visits with a care manager assigned to the patient, who will monitor the patient's progress, as well as medication side effects and dosage if applicable; and 3) collaboration between the patient's PCP, psychiatrist, and care manager. Outcome measures include depressive symptom severity as well as patient and PCP satisfaction with the telepsychiatry-based care management service.</p> <p>Discussion</p> <p>The study investigates the T-CSCT model, which we believe will increase the feasibility and practicality of the CSCT model by adopting telemedicine technology. We anticipate that this model will expand access to culturally competent psychiatrists fluent in patients' native languages to improve treatment of depressed minority patients in primary care settings.</p> <p>Trial Registration</p> <p><a href="http://www.clinicaltrials.gov/ct2/show/NCT00854542">NCT00854542</a></p
Generalist care managers for the treatment of depressed medicaid patients in North Carolina: A pilot study
BACKGROUND: In most states, mental illness costs are an increasing share of Medicaid expenditures. Specialized depression care managers (CM) have consistently demonstrated improvements in patient outcomes relative to usual primary care (UC), but are costly and may not be fully utilized in smaller practices. A generalist care manager (GCM) could manage multiple chronic conditions and be more accepted and cost-effective than the specialist depression CM. We designed a pilot program to demonstrate the feasibility of training/deploying GCMs into primary care settings. METHODS: We randomized depressed adult Medicaid patients in 2 primary care practices in Western North Carolina to a GCM intervention or to UC. GCMs, already providing services in diabetes and asthma in both study arms, were further trained to provide depression services including self-management, decision support, use of information systems, and care management. The following data were analyzed: baseline, 3- and 6-month Patient Health Questionnaire (PHQ9) scores; baseline and 6-month Short Form (SF) 12 scores; Medicaid claims data; questionnaire on patients' perceptions of treatment; GCM case notes; physician and office staff time study; and physician and office staff focus group discussions. RESULTS: Forty-five patients were enrolled, the majority with preexisting depression. Both groups improved; the GCM group did not demonstrate better clinical and functional outcomes than the UC group. Patients in the GCM group were more likely to have prescriptions of correct dosing by chart data. GCMs most often addressed comorbid conditions (36%), then social issues (27%) and appointment reminders (14%). GCMs recorded an average of 46 interactions per patient in the GCM arm. Focus group data demonstrated that physicians valued using GCMs. A time study documented that staff required no more time interacting with GCMs, whereas physicians spent an average of 4 minutes more per week. CONCLUSION: GCMs can be trained in care of depression and other chronic illnesses, are acceptable to practices and patients, and result in physicians prescribing guideline concordant care. GCMs appear to be a feasible intervention for community medical practices and to warrant a larger scale trial to test their appropriateness for Medicaid programs nationally
Cost-effectiveness of a stepped-care intervention to prevent major depression in patients with type 2 diabetes mellitus and/or coronary heart disease and subthreshold depression: design of a cluster-randomized controlled trial
Background: Co-morbid major depression is a significant problem among patients with type 2 diabetes mellitus and/or coronary heart disease and this negatively impacts quality of life. Subthreshold depression is the most important risk factor for the development of major depression. Given the highly significant association between depression and adverse health outcomes and the limited capacity for depression treatment in primary care, there is an urgent need for interventions that successfully prevent the transition from subthreshold depression into a major depressive disorder. Nurse led stepped-care is a promising way to accomplish this. The aim of this study is to evaluate the cost-effectiveness of a nurse-led indicated stepped-care program to prevent major depression among patients with type 2 diabetes mellitus and/or coronary heart disease in primary care who also have subthreshold depressive symptoms.Methods/design: An economic evaluation will be conducted alongside a cluster-randomized controlled trial in approximately thirty general practices in the Netherlands. Randomization takes place at the level of participating practice nurses. We aim to include 236 participants who will either receive a nurse-led indicated stepped-care program for depressive symptoms or care as usual. The stepped-care program consists of four sequential but flexible treatment steps: 1) watchful waiting, 2) guided self-help treatment, 3) problem solving treatment and 4) referral to the general practitioner. The primary clinical outcome measure is the cumulative incidence of major depressive disorder as measured with the Mini International Neuropsychiatric Interview. Secondary outcomes include severity of depressive symptoms, quality of life, anxiety and physical outcomes. Costs will be measured from a societal perspective and include health care utilization, medication and lost productivity costs. Measurements will be performed at baseline and 3, 6, 9 and 12 months.Discussion: The intervention being investigated is expected to prevent new cases of depression among people with type 2 diabetes mellitus and/or coronary heart disease and subthreshold depression, with subsequent beneficial effects on quality of life, clinical outcomes and health care costs. When proven cost-effective, the program provides a viable treatment option in the Dutch primary care system.Trial registration: Dutch Trial Register NTR3715. © 2013 van Dijk et al.; licensee BioMed Central Ltd
The Economics of Integrated Depression Care: The University of Michigan Study
A goal of the Robert Wood Johnson Depression and Primary Care Initiative at the University of Michigan is to create and implement the clinical care and financial systems necessary to enable links between primary care and mental health specialty depression care. This paper describes the economic issues related to resources required, the mechanisms to distribute those resources, and the support that must be garnered from stakeholders. By systematic measurement and application, we assess the cost, price and selected consequences of these efforts. The study illustrates the need for both centralized and distributed capacity and support for innovative models of care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44096/1/10488_2005_Article_4231.pd
Racial Disparities in the Treatment of Depression in Low-Income Persons With Diabetes
Individuals with diabetes are at higher risk for depression than the general population. Although depression can be treated with antidepressant medications, patients with diabetes and comorbid depression often go untreated. The goal of this study was to examine racial disparities in the treatment of depression with antidepressant medication in the southeastern U.S
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