A 3-phase model of psychotherapy outcome is proposed that entails progressive improvement subjectively experienced well-being, reduction in symptomatology, and enhancement life functioning. The also predicts movement into a later phase treatment depends on whether progress has been made an earlier phase. Thus, clinical subjective well-being potentiates symptomatic improvement, distress life-functioning improvement. large sample patients provided self-reports distress, functioning before...

Evidence suggests that a moderate amount of variance in patient outcomes is attributable to therapist differences. However, explained estimates vary widely, perhaps because some therapists achieve greater success with certain kinds patients. This study assessed the across-session change symptom intensity scores by differences large naturalistic data set (1,198 patients and 60 therapists, who each treated 10–77 patients). Results indicated approximately 8% total 17% rates improvement could be...

The dosage model provides a normative estimate of the overall pattern patient improvement in psychotherapy. phase further specifies patterns change domains subjective well-being, symptom remediation, and functioning. expected treatment response (ETR) approach uses characteristics to predict an path progress for each patient. With repeated measures mental health status, individual can be assessed against patient's ETR support decisions that would enhance quality clinical service while it is...

Abstract Recent psychotherapy research literature has stressed the importance of therapist effects (i.e., impact individual on treatment outcome). The authors report an analysis in National Institute Mental Health Treatment Depression Collaborative Research Program using hierarchical linear modeling. In addition to studying overall effects, they investigate possible interaction therapists with initial patient severity and difficulty levels. There were virtually no significant findings regard...

Abstract Background Genesis of persistent gastro‐esophageal reflux symptoms despite proton pump inhibitor ( PPI ) therapy is not fully understood. We aimed at determining patterns on 24‐h pH‐impedance monitoring performed and correlating impedance symptom occurrence in non‐responders. Methods Seventy‐eight non‐responder patients underwent . Reflux characterization included gastric supragastric belches proximal extent reflux. Symptoms were considered associated with if occurring within 5 min...

Abstract Objective : To date, no studies have examined dietary intake, physical activity, and body image in a large sample of Latin‐American black women recruited using the same methodology. The aim this study was to examine three potential correlates obesity (dietary image, activity) across weight spectrum. Research Methods Procedures Participants were ( n = 271) 234) adult who completed 24‐hour recall activity questionnaires. Results After controlling for BMI, education, marital status,...

Adaptive treatment planning is a dynamic process that dependent on valid, systematic assessments. The dosage and phase models provide theoretical bases for the development of such "patient-focused" information. Given an underlying mathematical regularity to recovery process, growth modeling techniques can be used determine expected response every patient. By mapping patient's actual status against change trajectory, it possible address most clinically relevant question, "Is this working?"

ObjectivesTo characterize the initial management of patients with sickle cell disease and an acute pain episode, to compare these practices American Pain Society Guideline for Management Acute Chronic in Sickle-Cell Disease emergency department, identify factors associated a delay receiving analgesic. MethodsThis was multicenter retrospective design. Consecutive department visit 2004 episode related were included. Exclusion criteria included age younger than 18 years. A structured medical...

Objectives To characterize the initial management of patients with sickle cell disease and an acute pain episode, to compare these practices American Pain Society Guideline for Management Acute Chronic in Sickle‐Cell Disease emergency department, identify factors associated a delay receiving analgesic. Methods This was multicenter retrospective design. Consecutive department visit 2004 episode related were included. Exclusion criteria included age younger than 18 years. A structured medical...

Despite recent attempts to define acute injury characteristics of mild traumatic brain (MTBI), neuropsychological outcome is often unpredictable. One hundred MTBI cases were prospectively collected, which consecutive referrals a concussion clinic, and the roles various neurologic variables examined in relation status vocational outcome. Significant differences found between subgroups patients classified by (1) mechanism (i.e. acceleration/deceleration trauma head strikes an object (HSO)...

The strategies for extending clinical significance (CS) methodology, suggested by Tingey et al., have considerable merit. They also serve to highlight the difficulties encountered with CS methodology in general. Problems original may be compounded, not solved, such extensions. For example, problems around lack of agreement about appropriateness certain measures, and questionable psychometric properties are likely exacerbated, lessened, when attempting measure social impact. Similarly,...

Objectives: The Emergency Severity Index (ESI) version 3 is a five-level triage acuity scale with demonstrated reliability and validity. Patients are rated from ESI level 1 (highest acuity) to 5 (lowest acuity). Clinical experience has two levels of 2 patients: those who require immediate intervention stable wait for at least ten minutes. Studies have found that few patients 1, it been suggested revisions the might result in appropriate reclassification some sickest as 1. purpose this study...

To determine whether there is a difference in time to initial analgesic for patients with acute pain from sickle cell disease (SCD) versus renal colic (RC) and identify factors contributing variance analgesic.A retrospective cohort study of the adult emergency department (ED) SCD RC an urban ED (final discharge ICD-9 diagnosis codes were included). A structured medical record review abstracted demographics, arrival shift, triage level, score, time, dose. Data compared Kaplan-Meier plots both...

The aims of this study were to 1) estimate differences in pain management process and patient-reported outcomes, pre- postimplementation analgesic protocols for adults with sickle cell disease (SCD), 2) examine the effects site visit frequency on changes scores time analgesic.

OBJECTIVE: The aim of this study is to explore the relationship between reported sleep, perceived fatigue and sleepiness, cognitive performance. BACKGROUND: Although evidence suggests that sleepiness affect provision care in inpatient units, there a lack research on sleep patterns emergency nurses effects disturbed their abilities susceptibility medical errors. METHODS: A quantitative correlational design was used study; each 7 different statistical models, zero-order relationships...

In the delivery of clinical services, outcomes monitoring (i.e., repeated assessments a patient's response to treatment) can be used support decision making recurrent revisions outcome expectations on basis that response). Outcomes particularly useful in context established practice research networks. This article presents strategy disaggregate patients into homogeneous subgroups generate optimal expected treatment profiles, which predict and track progress different modalities. The study...