scholarly journals Predicting Inpatient Detoxification Outcome of Alcohol and Drug Dependent Patients: The Influence of Sociodemographic Environment, Motivation, Impulsivity, and Medical Comorbidities

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Yvonne Sofin ◽  
Heidi Danker-Hopfe ◽  
Tina Gooren ◽  
Peter Neu

Aims. This prospective study aims to identify patient characteristics as predictors for treatment outcome during inpatient detoxification treatment for drug and alcohol dependent patients.Methods. A mixed gender sample of 832 consecutively admitted drug and alcohol dependent patients were interviewed by an experienced physician. The impact of a variety of factors concerning social environment, therapy motivation, impulsivity related variables, medical history, and addiction severity on treatment outcome was examined.Results. 525 (63.1%) of the patients completed detoxification treatment whereas 307 (36.9%) dropped out prematurely. Being female, living in a partnership, having children, being employed, and having good education were predictive for a positive outcome. Family, health, the fear of losing the job, prosecution, and emergency admission were significant motivational predictors for treatment outcome. Being younger, history of imprisonment, and the number of previous drop-outs were predictive for a negative outcome.Conclusions. Variables concerning social environment and the number of previous drop-outs have been identified as best predictors for treatment outcome. Socially stable patients benefit from the current treatment setting and treatment shall be adapted for patients with negative predictors. Treatment may consequently be tailored with respect to intervention type, duration, and intensity to improve the outcome for those patients that fulfil criteria with negative impact on treatment retention.

2010 ◽  
Author(s):  
Berch Berberoglu

The post-Soviet transformation of Eurasian economies over the past two decades has taken place within the context of the globalization process that has affected many countries around the world. Globalization of capital and transformation of these countries in a market-oriented direction through privatization and joint-ventures with foreign capital has had varied effects in growth and development of Eurasian economies. These developments have taken place at various rates and at varying speeds, depending on the country, especially when one contrasts those in Central Asia with other countries in more developed regions of Eurasia, such as Turkey. In Turkey, a hybrid model of development has evolved over several decades -- one that is built on a strong economic base inherited from the past, where heavy state intervention in the economy has led to the development of a viable industrial infrastructure upon which private capital has expanded and benefited immensely. Thus, the Turkish economy can serve as a model for other Eurasian economies that lack the necessary industrial and financial base, but are able to address the region’s economic problems through a partnership with Turkey. Although a common characteristic of Eurasian economies is the adoption of neoliberal economic policies and integration into the global economy, which often has a negative impact on national economies, a careful approach in engaging with the global economy with heavy state support to guide through the process (as in China) could result in a positive outcome that fosters growth and development of the Eurasian region in the twenty-first century.


2020 ◽  
Vol 22 (2) ◽  
pp. 52-55
Author(s):  
Irina V. Poddubnaya ◽  
Elena A. Baryakh ◽  
Vladimir I. Vorobyev ◽  
E. A. Demina ◽  
Nikolay V. Zhukov ◽  
...  

Relevance. COVID-19 pandemic currently has a significant negative impact on the treatment of patients with oncological pathology, including patients with classic Hodgkin lymphoma. Generalized data on publications on the impact of concomitant pathology on the severity of infection show a significant increase in the risk of death from infection in male patients, aged 60 years, with the presence of 3 concomitant diseases, among which particularly negative role is played by diseases of the cardiovascular system, diabetes, oncology, chronic lung disease, immunodeficiency conditions. Particularly dangerous is the development of COVID-19 infection in an interval of less than 14 days from the course of antitumor therapy. At the same time, patients with Hodgkin lymphoma require immediate treatment, often associated with toxic, immunosuppressive therapy, frequent visits to the clinic, hospitalizations. International communities have not yet developed clear guidelines for the management of patients with Hodgkins lymphoma. Taking into account the understanding that the circulation of coronoviral infection will continue in the population, the Advisory board on the Problems of Hodgkin Lymphoma Therapy in the COVID-19 Pandemic is highly relevant. Aim. To change and adapt current treatment approaches in the current epidemiological environment. Results. The main directions of the impact of the COVID-19 pandemic on the treatment of patients with cancer pathology, including patients with classical Hodgkin lymphoma, were determined, key problems in the treatment of LC during the COVID-19 pandemic were identified, and measures aimed at reducing the risk for patients were developed. Existing approaches to first-line, relapse/refracturing cHL therapy, including salvage therapy, and auto/allo SCT during the COVID-19 pandemic, have been adapted.


2020 ◽  
Vol 3 (1) ◽  
pp. 18-23
Author(s):  
Florica Șandru ◽  
Adelina Popa ◽  
Adina Nenciu ◽  
C. G. Nenciu ◽  
R. Petca ◽  
...  

Psoriasis is an inflammatory chronic, common skin disease that represents a great burden affecting people of all ages. It has no clear cause and although there are treatments none of them can guaranty remission. This pathology has a significant negative impact on people in all countries, affecting between 0.09% and 11.43%, which means at least 100 million people worldwide. A particular category is represented by pregnant women. Although it is reported that 55% of the patients have improved symptomatology during pregnancy, 21% reported no change and 23% suffered worsening of the illness. Psoriasis can be difficult to manage due to fluctuations in hormone levels.  Even if patients can experience improvements during pregnancy, most of the women report worsening in the post-partum period (4-6 weeks). Pregnancy and lactation can also interfere with specific treatment for psoriasis. Psoriasis can increase the risk of gestational, diabetes, pre-eclampsia and hypertension in pregnancy, increased risk of preterm birth, low birth weight and emergency caesarean section. In order to have a positive outcome for the mother and the baby, careful multidisciplinary management is needed. The aim of this review is to summarize the notions in the literature regarding pregnancy with psoriasis and the current treatment trend in this group of patients.


2016 ◽  
Vol 30 (6) ◽  
pp. 939-949 ◽  
Author(s):  
Sandra G. Leggat ◽  
Richard Gough ◽  
Timothy Bartram ◽  
Pauline Stanton ◽  
Greg J. Bamber ◽  
...  

Purpose Hospitals have used process redesign to increase the efficiency of the emergency department (ED) to cope with increasing demand. While there are published studies suggesting a positive outcome, recent reviews have reported that it is difficult to conclude that these approaches are effective as a result of substandard research methodology. The purpose of this paper is to explore the perceptions of hospital staff on the impact of a process redesign initiative on quality of care. Design/methodology/approach A retrospective qualitative case study examining a Lean Six Sigma (LSS) initiative in a large metropolitan hospital from 2009 to 2010. Non-probability sampling identified interview subjects who, through their participation in the redesign initiative, had a detailed understanding of the implementation and outcomes of the initiative. Between April 2012 and January 2013 26 in-depth semi-structured interviews were conducted and analysed with thematic content analysis. Findings There were four important findings. First, when asked to comment on the impact of the LSS implementation, without prompting the staff spoke of quality of care. Second, there was little agreement among the participants as to whether the project had been successful. Third, despite the recognition of the need for a coordinated effort across the hospital to improve ED access, the redesign process was not successful in reducing existing divides among clinicians and among managers and clinicians. Finally, staff expressed tension between production processes to move patients more quickly and their duty of care to their patients as individuals. Originality/value One of the first studies to explore the impact of process redesign through in-depth interviews with participating staff, this study adds further evidence that organisations implementing process redesign must ensure the supporting management practices are in place.


2020 ◽  
Vol 3 (1) ◽  
pp. 36-45
Author(s):  
Ilma Sholeha ◽  
Ayu Sholina

This study was motivated by low motivation of students This study aims to find out the impact of port lane as social environment  so that it has impact on education in SDN 03 Sintete because most of students live around the port. The study used qualitative approach and data collection techniques used were observation, interview and documentation. Sampling technique used is sampling purposive that determination of the sample based on certain consideration. The result showed that port lane had positive impact  on the socio-economic society in Sintete. However, port lane also had negative impact for student’s education in SDN 03 Sintete. 


2012 ◽  
Vol 23 (9) ◽  
pp. e1-e4 ◽  
Author(s):  
P Tabarsi ◽  
E Chitsaz ◽  
A Moradi ◽  
P Baghaei ◽  
P Farnia ◽  
...  

The risk of death is significantly higher in HIV-infected patients with tuberculosis (TB). This study aims to evaluate the impact of demographic, clinical and laboratory characteristics on the treatment outcome and mortality of TB/HIV co-infected patients in a tertiary TB centre in Iran. In total, 111 patients were recruited from 2004 to 2007. Mycobacteriological studies and demographic, clinical, and laboratory data from all patients were analysed and predictors of unsuccessful outcomes as well as mortality were determined. The mean age for all 111 TB-HIV patients was 38 ± 9 years (range 22–70) and 107 (96.3%) were men; 104 (93.7%) had a history of drug abuse and 96 (86.4%) had a history of imprisonment. The method of HIV transmission was intravenous drug use in 88 (79.3%). Twenty-three (20.7%) had a history of Category 1 (CAT I) TB treatment and six (5.4%) Category 2 (CAT II) treatment. Combination antiretroviral therapy (cART) was given to 48 (43.2%). No significant associations were found between treatment outcomes or mortality and gender, smoking, drug and alcohol abuse, imprisonment, method of transmission, history of CAT I and CAT II treatments, CD4 counts or adverse effects ( P > 0.05). Administration of cART led to significantly better outcomes ( P < 0.001). Lower serum albumin levels and low body weight were significantly associated with mortality.


2015 ◽  
Vol 26 (3-4) ◽  
pp. 116-123
Author(s):  
A. P. Korzh ◽  
T. V. Zahovalko

Recently, the number of published works devoted to the processes of synanthropization of fauna, is growing like an avalanche, which indicates the extreme urgency of this theme. In our view, the process of forming devices to coexist with human and the results of his life reflects the general tandency of the modern nature evolution. Urbanization is characteristic for such a specific group of animals like amphibians, the evidence of which are numerous literature data. Many researchers use this group to assess the bioindicative quality of the environment. For this aim a variety of indicators are used: from the cellular level of life of organization up to the species composition of the group in different territories. At the same time, the interpretation of the results is not always comparable for different areas and often have significantly different interpretations by experts. Urban environment, primarily due to the contamination is extremely aggressive to amphibians. As a consequence, the urban populations of amphibians may be a change in the demographic structure, affecting the reproductive ability of the population, the disappearance of the most sensitive species or individuals, resizing animals, the appearance of abnormalities in the development, etc. At the same time play an important amphibians in the ecosystems of cities, and some species in these conditions even feel relatively comfortable. Therefore, it is interesting to understand the mechanisms of self-sustaining populations of amphibians in urban environments. To assess the impact of natural and anthropogenic factors on the development of amphibian populations were used cognitive modeling using the program Vensim PLE. Cognitive map of the model for urban and suburban habitat conditions were the same. The differences concerned the strength of connections between individual factors (migration, fertility, pollution) and their orientation. In general, factors like pollution, parasites, predators had negative impact on the population, reducing its number. The birth rate, food and migration contributed to raising number of individuals. Some of the factors affected on the strength to of each other as well: the majority of the factors affected the structure of the population, had an influence on the fertility. Thanks to it the model reflects the additive effect of complex of factors on the subsequent status of the population. Proposed and analyzed four scenarios differing strength and duration of exposure. In the first scenario, a one-time contamination occurs and not subsequently repeated. The second and third scenario assumes half board contamination, 1 year (2 scenario) and two years (scenario 3). In the fourth scenario, the pollution affected the population of amphibians constantly. In accordance with the results of simulation, much weaker than the natural populations respond to pollution - have them as an intensive population growth and its disappearance at constant pollution is slow. Changes to other parameters of the model showed that this pollution is the decisive factor -only the constant action leads to a lethal outcome for the populations. All other components of the model have a corrective effect on the population dynamics, without changing its underlying trand. In urban areas due to the heavy impact of pollution maintaining the population is only possible thanks to the migration process – the constant replenishment of diminishing micropopulations of natural reserves. This confirms the assumption that the form of existence metapopulations lake frog in the city. In order to maintain the number of amphibians in urban areas at a high level it is necessary to maintain existing migration routes and the creation of new ones. Insular nature of the placement of suitable habitats in urban areas causes the metapopulation structure of the types of urbanists. Therefore, the process of urbanization is much easier for those species whicht are capable of migration in conditions of city. In the initial stages of settling the city micropopulationis formed by selective mortality of the most susceptible individuals to adverse effects. In future, maintaining the categories of individuals is provided mainly due to migration processes metapopulisation form of the species of existence is supported). It should be noted that the changes in the previous levels are always saved in future. In the case of reorganizations of individuals we of morphology can assume the existence of extremely adverse environmental conditions that threaten the extinction of the micropopulations. 


2020 ◽  
Vol 8 (3) ◽  
pp. 3-17
Author(s):  
Elena Blagoeva

The impact of the last global economic crisis (2008) on the European economy put a strain on higher education (HE), yet it also pushed the sector towards intensive reforms and improvements. This paper focuses on the “Strategy for the Development of Higher Education in the Republic of Bulgaria 2014-2020”. With a case study methodology, we explore the strategic endeavours of the Bulgarian government to comply with the European directions and to secure sustainable growth for the HE sector. Our research question is ‘How capable is the Bulgarian HE Strategy to overcome the economic and systemic restraints of Bulgarian higher education?’. Because the development of strategies for HE within the EU is highly contextual, a single qualitative case study was chosen as the research approach. HE institutions are not ivory towers, but subjects to a variety of external and internal forces. Within the EU, this is obviated by the fact that Universities obtain their funds from institutions such as governments, students and their families, donors, as well as EU-level programmes. Therefore, to explore how these pressures interact to affect strategic action on national level, the case method is well suited as it enabled us to study the phenomena thoroughly and deeply. The paper suggests the actions proposed within the Strategy have the potential to overcome the delay, the regional isolation and the negative impact of the economic crisis on the country. Nevertheless, the key elements on which the success or failure of this Strategy hinges are the control mechanisms and the approach to implementation. Shortcomings in these two aspects of strategic actions in HE seem to mark the difference between gaining long-term benefits and merely saving face in front of international institutions.


1997 ◽  
Vol 36 (4II) ◽  
pp. 947-957 ◽  
Author(s):  
Shahrukh Rafi Khan

This paper has a two-fold objective: first, to examine the terms on which Pakistan receives aid and whether its debt situation is sustainable, and second, to examine the impact of aid and debt on economic growth. It is found that there is little encouraging that can be said about how the terms on which Pakistan has received aid over time have changed, and its current debt situation is not sustainable. Also reported is the analysis done elsewhere which shows that aid has a negative (Granger) causal impact on GDP, and aid has a robust negative impact on economic growth after controlling for supplyside shocks. We provide various reasons for this negative association.


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