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Dental conditions in inpatients with schizophrenia: A large-scale multi-site survey  [cached]
Tani Hideaki,Uchida Hiroyuki,Suzuki Takefumi,Shibuya Yumi
BMC Oral Health , 2012, DOI: 10.1186/1472-6831-12-32
Abstract: Background Clinical relevance of dental caries is often underestimated in patients with schizophrenia. The objective of this study was to examine dental caries and to identify clinical and demographic variables associated with poor dental condition in patients with schizophrenia. Methods Inpatients with schizophrenia received a visual oral examination of their dental caries, using the decayed-missing-filled teeth (DMFT) index. This study was conducted in multiple sites in Japan, between October and December, 2010. A univariate general linear model was used to examine the effects of the following variables on the DMFT score: age, sex, smoking status, daily intake of sweets, dry mouth, frequency of daily tooth brushing, tremor, the Clinical Global Impression-Schizophrenia Overall severity score, and the Cumulative Illness Rating Scale for Geriatrics score. Results 523 patients were included in this study (mean ± SD age = 55.6 ± 13.4 years; 297 men). A univariate general linear model showed significant effects of age group, smoking, frequency of daily tooth brushing, and tremor (all p’s < 0.001) on the DMFT score (Corrected Model: F(23, 483) = 3.55, p < 0.001, R2 = 0.42) . In other words, older age, smoking, tremor burden, and less frequent tooth brushing were associated with a greater DMFT score. Conclusions Given that poor dental condition has been related with an increased risk of physical co-morbidities, physicians should be aware of patients’ dental status, especially for aged smoking patients with schizophrenia. Furthermore, for schizophrenia patients who do not regularly brush their teeth or who exhibit tremor, it may be advisable for caregivers to encourage and help them to perform tooth brushing more frequently.
Clinical Correlates Associated with Basic Ability of Social Life in Schizophrenia Inpatients  [PDF]
Shinichi Chiba, Masahito Tomotake, Masatomo Aono, Hidefumi Toshimitsu, Tetsuro Ohmori
Open Journal of Psychiatry (OJPsych) , 2016, DOI: 10.4236/ojpsych.2016.61008
Abstract: Objective: The aim of the present study is to explore clinical factors associated with basic ability of social life in schizophrenia inpatients. Methods: The subjects were 50 inpatients with schizophrenia (DSM-IV). Their mean age was 53.08 (SD = 12.08) years. Social life functioning was evaluated using the Rehabilitation Evaluation of Hall and Baker (REHAB). Cognitive function was assessed with the Brief Assessment of Cognition in Schizophrenia (BACS) and clinical symptoms with the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia and the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS). Results: The REHAB deviant behavior score showed a significant correlation with the PANSS positive syndrome score (r = 0.55, p< 0.01) and the REHAB general behavior score had significant correlations with the PANSS positive syndrome score (r = 0.28, p < 0.05), the PANSS negative syndrome score (r = 0.53, p < 0.01), and the DIEPSS score (r = 0.43, p < 0.01). However, there was no significant correlation between the scores of the REHAB and the BACS. Conclusion: These results suggest that negative and drug-induced extrapyramidal symptoms are much more important factors related to lowered basic ability of social life of schizophrenia inpatients than cognitive function.
The needs of members of the families of general hospital inpatients
Lucchese, Ana Cecília;Citero, Vanessa de Albuquerque;De Marco, Mario Alfredo;Andreoli, Sergio Baxter;Nogueira-Martins, Luiz Antonio;
Sao Paulo Medical Journal , 2008, DOI: 10.1590/S1516-31802008000200013
Abstract: context and objective: the needs of members of the families of intensive care unit patients have been studied, but little is known about the needs of members of the families of general hospital inpatients, especially patients with chronic diseases. the aim of this study was to identify the needs of members of the families of general hospital inpatients and investigate associations between these needs and the patients' clinical and psychiatric profiles. design and setting: descriptive study, in a public teaching hospital. methods: a random sample of 47 patients and members of their families was studied. family members' needs were investigated using the critical care family needs inventory and the patients' clinical profiles were investigated using the hospital anxiety and depression scale, confusion assessment method and karnofsky performance status. the frequencies of family members' needs were described and the patients' clinical and psychiatric characteristics were correlated with the needs using the chi-squared test. results: chronic patients predominated and the needs for reassurance and information were indicated as the most important by all members of their families. no associations were found between the patients' characteristics and the needs of members of their families during the hospitalization. conclusions: the needs indicated by members of the families of general hospital inpatients were similar to those of members of the families of patients in intensive care units: they considered it very important to be reassured and kept informed throughout the hospitalization.
Factors associated with dental caries among institutionalized residents with schizophrenia in Taiwan: a cross-sectional study
Kuan-Yu Chu, Nan-Ping Yang, Pesus Chou, Hsien-Jane Chiu, Lin-Yang Chi
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-482
Abstract: An oral health survey of institutionalized residents with schizophrenia in the largest public psychiatric hospital was conducted in Taiwan in 2006. Based on this data, multiple logistic analyses were used to determine the relationship between some explanatory variables and the outcome variables of dental caries among subjects with schizophrenia.Among the 1,108 subjects with schizophrenia, age was the only variable independently associated with DMFT > 8 (OR = 7.74, 95% CI = 3.86-15.55, p < 0.001 in comparison to residents aged 65 + years vs. 20-44 years; OR = 3.06, 95% CI = 2.03-4.61, p < 0.001 in comparison to residents aged 55-64 years vs. 20-44 years) after making adjustments for other explanatory variables. In addition, those with an education of only elementary school (OR = 1.67, 95% CI = 1.08-2.56, p = 0.021), low income (OR = 1.58, 95% CI = 1.02-2.44, p = 0.039), and length of stay (LOS) of > 10 years (OR = 2.09, 95% CI = 1.30-3.37, p = 0.002) were associated with a care index < 54.7%. Older age, lower educational level, and longer hospital stays were associated with number of remaining teeth being < 24.Aging was the most important factor related to a high level of dental caries. Low educational level, low income, and LOS were also associated with the indicators of dental caries among institutionalized subjects with schizophrenia. It is necessary to address the treatment factors such as prolonged stay in institutions when decision-makers are planning for preventive strategies of oral health for institutionalized residents with schizophrenia.Factors such as age and the length of stay (LOS) in institutions seem to be associated with the dental caries of psychiatric patients [1-4]. Schizophrenia is the most complex psychiatric disorder that affects mankind; treatment of institutionalized residents, especially those with schizophrenia, takes up a significant part of the health care resource, compared to other psychiatric inpatient groups [5,6]. However, to date, t
Needs and demands of prosthetic treatment among two groups of individuals  [cached]
Mukatash Gadeer,Al-Rousan Medyan,Al-Sakarna Basma
Indian Journal of Dental Research , 2010,
Abstract: Objectives: The level of knowledge, awareness, and attitude about teeth-replacement options among a group of medical and paramedical subjects and to compare them with the general population. Materials and Methods: A self-administered questionnaires using simple Arabic language were distributed to two groups of subjects. Questions focused on the willingness to replace the missing teeth, the preferable methods of choice for replacement, and the reasons for these choices. The first group (G-I) was from the medical and paramedical staff who work in a military hospital at Jordan Royal medical services, the dental staff was excluded from the study. The other group (G-II) was from the general population who attended the dental department in the same hospital with comparable level of education. All the participants were partially edentulous excluding the third molars. Clinical examination was done by qualified prosthodontist to evaluate the possible prosthetic treatment options for replacement. A total of 612 questionnaires were distributed, of which 533 questionnaires were returned (response rate 87.09%). The results were analyzed and comparison was made between the two groups. Results: Responses to questions about awareness and attitude about prosthetic management of missing teeth revealed that G-I have more awareness than G-II to the probable causes for tooth/teeth replacement and limitation of the preferable method for replacement (P<0.05). More than 80% of the participants believed that replacement of anterior teeth is more important than the posterior teeth. Implants and fixed partial denture (FPD), respectively, were more preferable than removable prosthesis, although clinically was not indicated in cases (P<0.05). There was no clinical benefit from replacement of missing teeth in 33.4% while only 6% believe this. Conclusions: This study showed that the awareness and attitude between the medical and paramedical staff to prosthetic needs is better than between general populations. The demands for dental replacement by patients were significantly different when compared with the actual needs.
Prosthetic status and prosthetic needs in relation to socio-economic factors among the Municipal employees of Mysore city.  [PDF]
Chandra Shekar
Indian Journal of Dental Advancements , 2010,
Abstract: Objective: To assess the Prosthetic status and prosthetic needs in relation to socio-economic among the Municipal employees of Mysore city. Settings and Design: The study was cross sectional and conducted on the employees of Reader1 Mysore City Corporation. Materials and methods: All the available employees (1187) of Mysore city Corporation during the study period were considered for the study. WHO Oral Health Assessment form (1997) and a preformed questionnaire were used to collect the required data. Modified Kuppuswamy scale with readjustment of the per capita income was used for classifying the individuals into different Socioeconomic status (SES) categories. Data was collected by a single, trained and calibrated examiner (dentist) using mouth mirror and CPI probe under natural day light. Data analysis was done using SPSS windows version 10. Comparison of the prosthetic status and needs between different SES categories was done using cross tabs and contingency co-efficient. Results: 6.1% of the subjects in the study had prosthesis of some kind. Prosthesis of some kind was present in 24.7% of the subjects in the upper middle SES category and none of the subjects in the lower SES category had prosthesis. The prosthetic need in the study population was 45.7%. About 67.9% of the subjects in the lower SES category needed prosthesis of some kind. The prosthetic need was 52.9% in the upper lower and 6% in the upper SES category. Conclusion: The study found a direct relationship between socio-economic status and prosthetic status and inverse relation between socio-economic status and prosthetic need.
Prevalence and Correlates of Cigarette Smoking among Chinese Schizophrenia Inpatients Receiving Antipsychotic Mono-Therapy  [PDF]
Yan-Min Xu, Hong-Hui Chen, Fu Li, Fang Deng, Xiao-Bo Liu, Hai-Chen Yang, Li-Guo Qi, Jin-Hong Guo, Tie-Bang Liu
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0088478
Abstract: Objective To investigate the prevalence rate of cigarette smoking and its socio-demographic and clinical correlates in Chinese schizophrenia inpatients receiving antipsychotic mono-therapy. Methods This study was a cross-sectional, two-site, hospital-based survey. Four hundred and twenty-nine schizophrenia patients (male/female: 66.9% vs. 33.1%) were consecutively recruited from psychosis inpatient wards of two large specialty psychiatric hospitals in mainland China. Patients were assessed using a cigarette smoking questionnaire, the Positive and Negative Symptom Scale, the Simpson Angus Scale, the Barnes Akathisia Rating Scale, and the Abnormal Involuntary Movement Scale. Socio-demographic and other clinical data were also collected. We calculated the prevalence of current smoking in our sample as well as its indirectly standardized prevalence ratio (ISPR) using data from the 2010 Global Adult Tobacco Survey in China. Results The prevalence rate of current smoking was 40.6% in our sample, and 57.5% in males and 6.3% in females. The ISPRs of all patients, men and women were 1.11(95%CI: 0.95~1.29), 1.07(95%CI = 0.91~1.24) and 4.64(95%CI = 2.12~8.82), respectively. The overall and male-specific prevalence of current smoking did not differ significantly between patients and the general population. In multiple logistic regression analysis, male sex, older age, poor marital status, alcohol use, use of first-generation antipsychotics, longer duration of illness, more frequent hospitalizations, and more severe negative symptoms were independently associated with current smoking. Conclusion Male Chinese inpatients with schizophrenia who received a mono-therapy of antipsychotics were not more likely to smoke than the general population. Cigarette smoking is more common in schizophrenia patients with more severe illness.
Prosthetic education: Are occupational therapy students’ needs being met?  [PDF]
Marilyn Mitchell, Mark Gorelick, David I. Anderson, Diane J. Atkins
Open Journal of Therapy and Rehabilitation (OJTR) , 2014, DOI: 10.4236/ojtr.2014.21002
Abstract: Based on a previous survey on prosthetics and orthotics training in occupational therapy (OT) [1], we developed a 14-question online questionnaire that was made available to the directors of 167 occupational therapy programs (Masters and Ph.D.) in the US and Canada. Fifty- two surveys were completed for a response rate of 31%. Overall, the results indicated that since the previous survey, little has changed in the amount of time and emphasis OT faculty assign to providing training in prosthetics and orthotics, or in the training experiences, OT students receive. Notably, only a few hours of the total OT curriculum is devoted to training in prosthetics. For the majority of programs (62%) the content was embedded within related classes. Only 32% of programs had a required lecture in prosthetics/orthotics. Despite the lack of time given in the curriculum, 85% of program directors thought that training in prosthetics/orthotics was important or very important. The use of prosthetic simulators was reported as the single most desirable training tool. However, lack of time and overcrowding in the curriculum were cited as the greatest barriers to providing more training to students. We elaborate on these findings, discuss their implications for OT students and practitioners, and provide specific recommendations about how to overcome the barriers and enhance upper limb amputee exposure and knowledge through the prosthetic training experience.
Parenting Confidence and Needs for Parents of Newborns in Taiwan
Ching-Pyng Kuo,Hsiao-Ling Chuang,Shu-Hsin Lee,Wen-Chun Liao
Iranian Journal of Pediatrics , 2012,
Abstract: Objective: Parenting confidence with regards to caring for their infants is crucial for the healthy adaptation to parenthood and the development of positive parent-infant relationships. The postpartum period is a tremendous transitional time for parents, so their unique needs should be considered. This study explored parenting confidence and needs in parents when their newborns are discharged from hospital, and explored the best predictors of parenting confidence and needs.Methods: A cross-sectional design with a questionnaire survey was used in this study. The questionnaire included three parts: Demographic, Parenting Needs and Parenting Confidence Questionnaire. We survey a convenience sample of 96 parents from a postnatal ward and a neonatal intermediate care unit of the medical central hospital in Taichung, Taiwan.Findings: The mean age of the subjects was 32 years and 67.7% of the subjects’ education level was college or above. Approximately one half of the subjects was multiparous, vaginal delivery and had planned pregnancy.The mean gestational age and birth weight of the newborns was 37.7 weeks and 2902 g, respectively. Parentswho had a planned pregnancy (t=2.1, P=0.04) or preterm infants (t=2.0, P=0.046) and those whose infants were delivered by cesarean section (t=2.2, P=0.03) had higher parenting needs. In addition, parents of low birth weight infants had higher parenting needs (r=-0.23, P=0.02). Regarding parenting confidence, multiparaparents perceived higher confidence than primipara parents (t=2.9, P=0.005). Needs in psychosocial support were significantly correlated with parenting confidence (r=0.21, P<0.05). The stepwise multiple regression analysis showed that parity and needs in psychosocial support predict parenting confidence of 13.8%variance.Conclusion: The findings of this study help care providers to identify parents with low parenting confidence at an early postpartum stage. Health care teams should provide appropriate psychosocial support and health education based on parents needs.
The effect of ethnicity on prescribing practice and treatment outcome in inpatients suffering from schizophrenia in Greece
Athanassios Douzenis, Athanassios Apostolopoulos, Dionisios Seretis, Emmanouil N Rizos, Christos Christodoulou, Lefteris Lykouras
BMC Psychiatry , 2011, DOI: 10.1186/1471-244x-11-66
Abstract: In this retrospective study, the prescribing of medication was compared between 90 Greek and 63 non-Greek inpatients which were consecutively admitted into the emergency department of a hospital covering Athens, the capital of Greece. Participants suferred from schizophrenia and other psychotic disorders. Overall, groups were compared with regard to 12 outcomes, six related to prescribing and six related to treatment outcome as assesed by standardised psychometric tools.No difference between the two ethnic groups was found in terms of improvement in treatment as measured by GAF and BPRS-E. Polypharmacy, use of first generation antipsychotics, second generation antipsychotics and use of mood stabilizers were not found to be associated with ethnicity. However, non-Greeks were less likely to receive SSRIs-SNRIs and more likely to receive benzodiazepines.Our study found limited evidence for ethnic bias. The stronger indication for racial bias was found in benzodiazepine prescribing. We discuss alternative explanations and give arguments calling for future research that will focus on disorders other than schizophrenia and studying non-inpatient populations.Ethnicity as a form of clinical bias in psychiatric contexts has long been debated and researched. The effect of ethnicity in clinical practice has been investigated in reference to diagnosis [1] and treatment (i.e. prescribing practices [2], psychotherapy outcome [3]) - for both in-patients as well as outpatients. More recently several studies have identified clinical bias and heightened concern has been raised, calling for more extensive research on institutional racism, and the training of staff to address disparities in both admission and use of mental health services. It has been shown, for example, that ethnic minority group members tend to be perceived as having more psychopathological traits compared to other population groups and are more likely to be admitted to psychiatric wards [4].However, findings are rel
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