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1
Vermont. Dept. of Health. Mobile screening clinics: Report to the Legislature on Act 27 - 10. Burlington, Vt: Vermont Dept. of Health, 2007.
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2
Clinical Standards Board for Scotland. Diabetic retinopathy screening: Clinical standards - March 2004. Edinburgh: Clinical Standards Board for Scotland, 2004.
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3
Law, J. Screening for speech and language delay: A systematic review of the literature. Alton (GB): Core Research, 1998.
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4
Bartu, Anne. Evaluation of a preventative intervention strategy in a non-clinical setting using computerised screening. [Perth, W.A.]: Western Australian Alcohol & Drug Authority, 1991.
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5
Medical Tests Sourcebook: Basic Consumer Health Information about Medical Tests, Including Age-Specific Health Tests, Important Health Screenings and Exams, ... Reference Series) (Health Reference Series). 2nd ed. Detroit, Mich.: Omnigraphics, Inc., 2004.
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6
Offit, Kenneth. Clinical cancer genetics: Risk counseling and management. New York: Wiley-Liss, 1998.
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7
United States. Congress. Senate. Committee on Health, Education, Labor, and Pensions. Severe acute respiratory syndrome threat (SARS): Hearing before the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Eighth Congress, first session on examining the severe acute respiratory syndrome threat, focusing on the issues of vaccine development, drug screening, and clinical research, April 7, 2003. Washington: U.S. G.P.O., 2003.
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8
Adsul, Prajakta, and Purnima Madhivanan. Assessing the Community Context When Implementing Cervical Cancer Screening Programs. Edited by David A. Chambers, Wynne E. Norton, and Cynthia A. Vinson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190647421.003.0032.
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This case study demonstrates the use of qualitative, community-based, participatory research to understand the context in which cervical cancer screening programs are implemented in rural India, thereby enabling not just successful implementation but also future sustainability of the program in the community. A series of studies were undertaken to understand the cervical cancer screening program in its current state and provide information for the implementation of future programs. These studies included (1) qualitative interviews with physicians delivering cervical cancer care in the private and public sector, (2) focus group discussions with health workers in primary health care clinics, and (3) photovoice study with women residing in the communities. Study findings helped identify elements of the social and cultural context of rural communities, thereby providing a rich understanding of factors influencing of cervical cancer screening that can be integrated into pre-intervention capacity development in the future.
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How to Integrate Pharmacotherapy for Substance Use Disorders at Your Mental Health Clinic: A Step-By-Step Guide for Screening and Treating Adults with Co-Occurring Mental Illness and Alcohol and/or Opioid Use Disorders with Pharmacotherapy in Mental Health Clinics. RAND Corporation, 2021. http://dx.doi.org/10.7249/tl-a928-1.
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Maloney, Michael P., Joel Dvoskin, and Jeffrey L. Metzner. Mental health screening and brief assessments. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0011.
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Screening and assessment are a core component of psychiatric care in any setting. In jails and prisons, the process, structure, content and timing of screenings and assessments are vital parts of the healthcare system. While the number of incarcerated persons is clear, the actual number of incarcerated prisoners who suffer from a mental disorder or independent psychiatric symptoms is difficult to determine because of methodological issues (e.g., different definitions of mental illness, different thresholds of severity, etc.) as well as wide variation in the nature (e.g. prison, jail, police lockup), size, and mental health service delivery systems of various settings. However, despite differences in methodology, geographic area, and other issues (e.g., types of facility, when studies were conducted, etc.), virtually every relevant study has concluded that a significant number of prisoners have serious mental illnesses and that the numbers of mentally ill prisoners are increasing. Because people with mental illnesses are at risk of suicide and exacerbations of their mental illnesses, correctional institutions need to identify such persons in a timely manner and provide appropriate clinical interventions. This chapter addresses the initial mental health screening of persons entering prisons and jails, with a special emphasis on suicide risk screening and follow-up clinical assessments of prisoners whose receiving or intake screening results suggest the likelihood that treatment or suicide prevention efforts will be necessary.
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Mitchell, MRCPsych, Alex J., and James C. Coyne, PhD. Screening for Depression in Clinical Practice. Oxford University Press, 2009. http://dx.doi.org/10.1093/oso/9780195380194.001.0001.
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Mood disorders are a global health issue. National guidance for their detection and management have been published in the US and in Europe. Despite this, the rate at which depression is recognized and managed in primary and secondary care settings remains low and suggests that many clinicians are still unsure how to screen people for mood disorders. Against the backdrop of this problem, the editors of this volume have designed a book with a dynamic two-fold purpose: to provide an evidence-based overview of screening methods for mood disorders, and to synthesize the evidence into a practical guide for clinicians in a variety of settings--from cardiologists and oncologists, to primary care physicians and neurologists, among others. The volume considers all important aspects of depression screening, from the overview of specific scales, to considerations of technological approaches to screening, and to the examination of screening with neurological disorders, prenatal care, cardiovascular conditions, and diabetes and cancer care, among others. This book is sure to capture the attention of any clinician with a stake in depression screening.
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Davis's Clinical Guide to Health Assessment. 2nd ed. F. A. Davis Company, 1995.
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Soule, Michael, and Hilary S. Connery. Co-occurring Substance Use Disorders. Edited by Hunter L. McQuistion. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190610999.003.0020.
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Substance use disorders are frequently comorbid with mood, anxiety, and psychotic disorders, and they commonly present in tandem in both primary care and psychiatric settings. Unfortunately, in the past, individuals with co-occurring substance use and mental health disorders would receive treatment in community mental health clinics only after their substance use disorder was “stabilized.” There has been increasing recognition that integrated treatment is necessary for these individuals to fully succeed and achieve recovery. This chapter uses a common presentation to illustrate up-to-date screening and treatment recommendations. Motivational interviewing, contingency management, cognitive–behavioral therapy, and medication-assisted treatment are explored. A discussion of the continuum of community-based services and systems challenges follows.
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Smedley, Julia, Finlay Dick, and Steven Sadhra. Clinical tasks and procedures. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199651627.003.0037.
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Recording an occupational health consultation 748Assessing mental health: tools 750Psychological therapies 752Chronic pain management 754Night worker health assessment 756Methods for alcohol and drug screening 758Lung function testing 760Serial peak flow testing 762Screening audiometry 764Colour vision testing ...
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Montgomery, Paul, Nicole Thurston, Michelle Betts, and C. Scott Smith. Implementing Distress Screening in a Community and Veteran’s Administration Oncology Clinic. Edited by David A. Chambers, Wynne E. Norton, and Cynthia A. Vinson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190647421.003.0023.
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The complexities of cancer treatment present a myriad of life-altering impacts for patients. These impacts can be addressed only if health care systems have been designed to detect and address all of these challenges. One significant, but often hidden, challenge is distress. This reaction to the myriad obstacles that cancer presents can impact the quality of life, and influence outcomes, of patients with cancer. Health systems have been slow to address these problems, and a prime example is the implementation of a distress screening and management system. This case study summarizes distress screening in a community oncology clinic compared to a Department of Veterans Affairs (VA) oncology clinic. The community clinic responded to accreditation and grant-driven initiatives, whereas the VA responded to mental health and integrated primary care initiatives. This case study explores the history and the ongoing challenges of distress screening in these community-based health care systems.
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Shedler, Jonathan. Automated Mental Health Assessment for Integrated Care. Edited by Robert E. Feinstein, Joseph V. Connelly, and Marilyn S. Feinstein. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190276201.003.0010.
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Mental health conditions are prevalent in primary care and general medical settings. Health care policy organizations recommend routine mental health screening, but the screening tools most often used in medical settings do not meet medical providers’ clinical needs and have had little impact on patient outcomes. The Quick PsychoDiagnostics Panel (QPD Panel) is a computerized, fully automated mental health assessment test designed to meet the specific real-world needs of busy medical providers. It screens for 11 common mental health conditions and provides actionable information for treatment decisions. The QPD Panel is self-administered by patients, typically in the clinic waiting room using a tablet device. Providers immediately receive a computer-generated, chart-ready assessment report. The QPD Panel achieves high physician and patient acceptance in real-world clinical use. This chapter describes the benefits of the QPD Panel in primary and integrated care medical settings and discusses its rationale and development.
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Riegelman, Richard K. Putting Prevention into Practice: Problem Solving in Clinical Prevention. Little Brown & Co, 1988.
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Putting prevention into practice: Problem solving in clinical prevention. Boston: Little, Brown, 1988.
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Scheuner, Maren T., Marcia Russell, Jane Peredo, Alison B. Hamilton, and Elizabeth M. Yano. Implementing Lynch Syndrome Screening in the Veterans Health Administration. Edited by David A. Chambers, Wynne E. Norton, and Cynthia A. Vinson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190647421.003.0024.
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Lynch syndrome (LS) is the most common hereditary colorectal cancer (CRC) syndrome. Diagnosis of LS has important clinical implications for CRC patients and their family members. LS screening in tumor tissue is possible, and screen-positive cases are referred for diagnostic testing. This case study describes how implementation science informed a population-based LS screening program in the Veterans Health Administration (VHA), the largest integrated health care delivery system in the United States. Successful implementation strategies relied on the organizational structures and processes characteristic of integrated health care systems, including data warehousing methods that leverage the electronic health record, case management, and centralized technical assistance. Challenges to sustainability of the population-based program include low prevalence of LS among veterans, limited expertise, organizational changes, and the rapidly evolving field of precision oncology. LS screening is an exemplar case study for implementation science in integrated health care delivery systems.
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Medforth, Janet, Linda Ball, Angela Walker, Sue Battersby, and Sarah Stables. Sexual health. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198754787.003.0003.
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This chapter is mainly concerned with sexually transmitted infections and covers a range of issues, including Chlamydia, gonorrhoea, hepatitis B and C, herpes, syphilis, and other vaginal infections such as Candida, Trichomonas vaginalis, and bacterial vaginitis. Each of these is taken separately with reference to a screening programme, if appropriate, clinical symptoms and appearance, diagnosis, the latest guidance on treatment, and considerations for pregnancy. Fetal and neonatal infections, congenital transmission, treatment, and surveillance options for the neonate, along with specific advice for the mother are also given.
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Kenneth, Gohagan John, Kramer Barnett S. 1948-, and Prorok P. C, eds. Cancer screening: Theory and practice. New York: Marcel Dekker, 1999.
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(Editor), Khalid Aziz, and George Y. Wu (Editor), eds. Cancer Screening: A Practical Guide for Physicians (Current Clinical Practice). Humana Press, 2002.
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(Editor), Barnett S. Kramer, John K. Gohagan (Editor), and Philip C. Prorok (Editor), eds. Cancer Screening: Theory and Practice (Basic and Clinical Oncology, 18). CRC, 1999.
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24
Banerjee, Amitava, and Kaleab Asrress. Screening for cardiovascular disease. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0351.
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Screening involves testing asymptomatic individuals who have risk factors, or individuals who are in the early stages of a disease, in order to decide whether further investigation, clinical intervention, or treatment is warranted. Therefore, screening is classically a primary prevention strategy which aims to capture disease early in its course, but it can also involve secondary prevention in individuals with established disease. In the words of Geoffrey Rose, screening is a ‘population’ strategy. Examples of screening programmes are blood pressure monitoring in primary care to screen for hypertension, and ultrasound examination to screen for abdominal aortic aneurysm. The effectiveness and feasibility of screening are influenced by several factors. First, the diagnostic accuracy of the screening test in question is crucial. For example, exercise ECG testing, although widely used, is not recommended in investigation of chest pain in current National Institute for Health and Care Excellence guidelines, due to its low sensitivity and specificity in the detection of coronary artery disease. Moreover, exercise ECG testing has even lower diagnostic accuracy in asymptomatic patients with coronary artery disease. Second, physical and financial resources influence the decision to screen. For example, the cost and the effectiveness of CT coronary angiography and other new imaging modalities to assess coronary vasculature must be weighed against the cost of existing investigations (e.g. coronary angiography) and the need for new equipment and staff training and recruitment. Finally, the safety of the investigation is an important factor, and patient preferences and physician preferences should be taken into consideration. However, while non-invasive screening examinations are preferable from the point of view of patients and clinicians, sometimes invasive screening tests may be required at a later stage in order to give a definitive diagnosis (e.g. pressure wire studies to measure fractional flow reserve in a coronary artery). The WHO’s principles of screening, first formulated in 1968, are still very relevant today. Decision analysis has led to ‘pathways’ which guide investigation and treatment within screening programmes. There is increasing recognition that there are shared risk factors and shared preventive and treatment strategies for vascular disease, regardless of arterial territory. The concept of ‘vascular medicine’ has gained credence, leading to opportunistic screening in other vascular territories if an individual presents with disease in one territory. For example, post-myocardial infarction patients have higher incidence of cerebrovascular and peripheral arterial disease, so carotid duplex scanning and measurement of the ankle–brachial pressure index may be valid screening approaches for arterial disease in other territories.
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Behavioral and clinical indicators of Chlamydia trachomatis in women. 1989.
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Behavioral and clinical indicators of Chlamydia trachomatis in women. 1987.
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27
Gupta, Sunanda, Debra Holloway, and Ali Kubba, eds. Oxford Handbook of Women's Health Nursing. 2nd ed. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198842248.001.0001.
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This handbook covers the role of the nurse in the context of women’s health in primary care and hospital and community settings. It explains the role of the multidisciplinary team, and covers the basic anatomy and physiology required for good care of women, alongside techniques for examination, record-keeping, and clinical governance. The handbook discusses paediatric and adolescent gynaecology, menstrual and bleeding disorders, hormone and endocrine disorders, and other issues with women’s health. Management and care during the menopause are detailed, as is a full spectrum of contraceptive methods. Fertility and subfertility are included, alongside assisted conception and management of pregnancy. Various screening programmes and techniques for investigations are included.
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Phillips, Katharine A. Assessment of Body Dysmorphic Disorder : Screening, Diagnosis, Severity, and Insight. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0017.
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This chapter discusses assessment of body dysmorphic disorder (BDD), including diagnosis and screening as well as potential diagnostic pitfalls and how to avoid them. Measures used to screen for BDD, diagnose BDD, and assess BDD severity and BDD-related insight are reviewed, and guidelines for their use are provided. This chapter also discusses assessment of BDD in children and adolescents and assessment of patients who seek cosmetic procedures (such as surgery or dermatologic treatment) for appearance concerns. Because BDD is common, often severe, and usually missed in clinical settings, clinicians and researchers should routinely screen for BDD. Screening is especially recommended in mental health, substance abuse, dermatology, cosmetic surgery, and other cosmetic treatment settings. It is also important to screen for BDD when patients manifest clues suggesting a possible diagnosis of BDD (e.g., BDD rituals, camouflaging of disliked body areas, and social anxiety or avoidance).
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Lal, Mira. Women’s psychosomatic health promotion and the biopsychosociocultural nexus. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198749547.003.0008.
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Chapter 8 discusses the promotion of women's psychosomatic health by prevention or early treatment of cancer and obesity. Health providers have to consider the biological, psychological, social, and cultural factors that alter psychosomatic interactions to generate these health conditions. Primary/secondary prevention need more emphasis than tertiary prevention or treatment. The transition of normal cervical epithelium to cervical-intraepithelial neoplasia (CIN), and the progression of CIN 2/3 to cancer is preventable. Two-thirds of patients with CIN have HPV infection. Cervical screening allows astute clinical decision-making as CIN could revert back to normal epithelium. Colposcopically-directed early treatment of CIN 2/3 is a secondary preventive measure. Cervical screening has reduced cervical cancer in the West but organised screening is unavailable in low-middle income countries where cervical cancer is common. Sociocultural practices promote unsafe sex, such as when minors in these countries acquire HPV infection through marriage to an older infected male or when women/adolescents are war victims. Inebriated party-goers may acquire HPV infection through unsafe sex. HPV vaccines protect against 70% of carcinogenic HPV strains only. Serious adverse effects after vaccination are uncommon. Barrier contraception prevents HPV, and other sexually transmitted diseases. Obesity increases the risk of endometrial cancer. Type-1 endometrial cancer relates to obesity and starts at a younger age, unlike type-2. Obesity also affects fertility. Transgenerational changes in the fetus of the obese gravida can promote obese offspring. Bariatric surgery for obesity is however expensive, with a potential for complications. WHO directives thus advise on prevention of obesity, and the overweight habitus. Primary prevention of obesity through lifestyle changes should start in childhood.
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Fisher, Martin M., Elizabeth M. Alderman, Richard E. Kreipe, and Walter D. Rosenfeld, eds. AAP Textbook of Adolescent Health Care. American Academy of Pediatrics, 2011. http://dx.doi.org/10.1542/9781581105650.
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Trustworthy guidance spanning every aspect of adolescent health care. Unlike other adolescent medicine references, the all-new AAP Textbook of Adolescent Care is an action-oriented working tool expressly built for efficient, on-target clinical problem-solving. Broad scope - Nearly 200 chapters cover physical growth and development, examination and laboratory screening, sexual development, puberty, obesity, sleep disorders, adolescent dermatology and much more. Clear management guidelines - Provides step-by-step recommendations: What to do, How to do it; When to admit, When to treat, When to refer. Evidence-based approach - Treat patients and counsel parents with high confidence. Excellent study reference - for the pediatric or internal medicine boards. Integrated companion resources - Use with complementary AAP resources: AAP Textbook of Pediatric Care, Tools for Practice, and Pediatric Care Online.
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Shannon, Joyce Brennfleck. Medical Tests Sourcebook: Basic Consumer Health Information About Medical Tests, Including Periodic Health Exams, General Screening Tests, Tests You Can ... Home, Findings of (Health Reference Series). Omnigraphics, 1999.
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Jandial, Sharmila, and Helen Foster. Principles of clinical examination in children. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0005.
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The clinical examination of children and adolescents is an essential component of assessment, facilitates appropriate interpretation of investigations and is integral to the process of making a diagnosis. The clinical assessment of children and young people differs from that of adults, requiring greater reliance on physical examination as the history may be vague and illocalized and requires knowledge of normal musculoskeletal development, normal motor milestones and different patterns of clinical presentations across the ages. The interpretation of clinical findings needs to be in the context of the whole child and the clinical presentation. The degree of expertise required in clinical skills varies with the clinical practice of the examiner and ranges from the basic screening assessment to a more detailed examination of joints, muscles and anatomical regions. The evidence base for clinical assessment in children and young people is accruing and undoubtedly, competent clinical skills requires learning to be embedded in core child health teaching and assessment starting at medical school and reinforced in postgraduate training.
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Jandial, Sharmila, and Helen Foster. Principles of clinical examination in children. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642489.003.0005_update_002.
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The clinical examination of children and adolescents is an essential component of assessment, facilitates appropriate interpretation of investigations and is integral to the process of making a diagnosis. The clinical assessment of children and young people differs from that of adults, requiring greater reliance on physical examination as the history may be vague and illocalized and requires knowledge of normal musculoskeletal development, normal motor milestones and different patterns of clinical presentations across the ages. The interpretation of clinical findings needs to be in the context of the whole child and the clinical presentation. The degree of expertise required in clinical skills varies with the clinical practice of the examiner and ranges from the basic screening assessment to a more detailed examination of joints, muscles and anatomical regions. The evidence base for clinical assessment in children and young people is accruing and undoubtedly, competent clinical skills requires learning to be embedded in core child health teaching and assessment starting at medical school and reinforced in postgraduate training.
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Clinical Cancer Genetics: Risk Counseling and Management. Not Avail, 2008.
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Sundgot-Borgen, Christine, and Jorunn Sundgot-Borgen. Nutrition and eating disorders. Edited by Neil Armstrong and Willem van Mechelen. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198757672.003.0047.
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This chapter covers the energy and nutrient requirements and the continuum of disordered eating in adolescent athletes. Studies focusing on nutrition and adolescent athletes are limited, but there is potential for nutritional improvement, especially among female adolescent athletes. Additionally for young athletes, the risk of inadequate micronutrient intake is associated with energy restriction. Abnormal vitamin-D status is reported for both genders, with lack of exposure to sunlight likely to produce the greatest risk. There is a continuum of normal to abnormal eating that ranges from a healthy body image, body weight, body composition, and energy balance to abnormal eating, including clinical eating disorders. Prevention of disordered eating should integrate education and screening for early identification. Education should target not only athletes, but also parents, volunteers, coaches, officials, and health care providers.
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Darcy, Alison, and Shiri Sadeh-Sharvit. Mobile Device Applications for the Assessment and Treatment of Eating Disorders. Edited by W. Stewart Agras and Athena Robinson. Oxford University Press, 2017. http://dx.doi.org/10.1093/oxfordhb/9780190620998.013.27.
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Mobile devices and applications (apps) are increasingly used in clinical practice, offering reconceptualization of and novel avenues to tracking symptoms and delivery of more personalized interventions. This chapter reviews the burgeoning approaches to the integration of mobile in screening and treating individuals with eating disorders. Promising methods of data collection such as ecological momentary assessments enhance the capabilities of detecting symptoms and recognizing patterns—both are fundamental to the screening, evaluation, and monitoring of eating disorders and lay the foundations for better treatment design. More recent advances in machine learning allow ecological momentary interventions to be delivered and continuously optimized at the individual level in real time. This chapter explores what this means for the future of personalized treatment for eating disorders, referring to apps that integrate these mechanisms. Finally, the chapter provides a framework for evaluating mobile device mental health apps in clinical care.
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Gilroy, Mark N., and Juan C. Salazar. Syphilis (Treponema pallidum). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190604813.003.0021.
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Syphilis, a chronic, sexually transmitted disease caused by the extracellular spirochete Treponema pallidum, has exhibited a remarkable resurgence in recent years. Despite the existence of inexpensive, easily administered, and highly effective antibiotic treatments, maternal and neonatal syphilis infections continue to be a major global public health problem. In addition to its potential to cause morbidity in the mother, untreated gestational syphilis (GS) can lead to serious adverse outcomes in the offspring, including stillbirth, prematurity, low birth weight, and neonatal death. Congenital syphilis (CS) is regarded as a missed opportunity during the antenatal care of the mother, resulting from socioeconomic, demographic, and behavioral factors that promote mother-to-child transmission (MTCT) of syphilis. This chapter emphasizes emerging concepts about screening aimed at controlling the ongoing epidemic, including serological screening of mother and infant, newer paradigms of “reverse screening,” clinical presentation, therapy, and long-term neurodevelopmental disabilities that must be a component of follow-up care.
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Sokas, Rosemary K., Barry S. Levy, David H. Wegman, and Sherry L. Baron. Recognizing and Preventing Occupational and Environmental Disease and Injury. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190662677.003.0004.
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This chapter describes various approaches to recognizing and preventing occupational and environmental disease and injury from primarily a clinical perspective. It describes in detail the occupational and environmental health history, including what questions to ask and when to ask them. It also describes recognizing occupational or environmental disease clusters or outbreaks. The chapter describes in detail the options that health and safety professionals have for implementing and facilitating preventive measures, including substitution of hazardous substances, installation of engineering controls, changes in job design and work practices and organization, education and training, use of personal protective equipment, and screening surveillance. Prevention options are discussed both at the individual and organizational levels.
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McGlasson, Timothy J., Michael K. Champion, and Joseph V. Penn. Geriatric Offenders. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199374656.003.0027.
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Globally there is an increasing older patient population in jails, prisons, and other correctional settings. Effective and federally determined access to medical and mental health services for older offenders requires recognition of numerous challenges related to correctional custody, healthcare, and policymakers. Basic issues such as housing, appropriate supervision, ensuring safety, access to health care, communication and mobility issues, and living and recreational accommodations are examples of challenges encountered by correctional systems. This chapter presents an overview of the epidemiology, phenomenology, and clinical presentation of the older inmate. It addresses intake health screening, medical and mental health evaluations, chronic health issues within this vulnerable population, and challenges facing the geriatric offender, such as dementia. The chapter also discusses how healthcare services are provided to older offenders within correctional settings and how correctional systems have developed processes and services to ensure a continuum of care, from assessment to hospice, for the geriatric offender.
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Ourada, Jason D., and Kenneth L. Appelbaum. Intoxication and drugs in facilities. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0024.
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Active abuse of substances by inmates poses a challenge for correctional psychiatrists. Substance use disorders (SUD) are common among inmates, with higher prevalence usually found in those with general psychiatric conditions. Knowledge about substance use in correctional facilities fosters competent clinical intervention and enhances management at all levels. Psychiatrists working in jails and prisons have the challenging task of maintaining therapeutic alliances with patients who have co-occurring SUDs and also may be actively using substances. Patients might not spontaneously report use during incarceration because they fear retribution by correctional staff or not receiving needed treatment for medical and mental health problems. Psychiatrists need to remain aware of this and to screen for SUD and active substance use as part of comprehensive treatment planning. The clinical challenges in jails and prisons differ, and the substances found in facilities vary geographically. Active substance abuse by inmates presents clinical and systemic challenges for correctional psychiatrists. The interplay among mental health, medical, and custody staff regarding screening, detection, triage, management, and treatment lies at the heart of these challenges. Correctional psychiatrists make important contributions by providing direct assessment and treatment to inmates, and by offering educational, clinical, and policy consultations to other staff. These contributions help prevent potentially life-threatening complications of intoxication and withdrawal, ensure integrated and evidence-based care, and avoid misguided or ill-informed disciplinary or other institutional practices. This chapter highlights these differences, outlines clinical management, and describes an interdisciplinary approach to intervention.
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Freeman, Harold P., and Melissa A. Simon. Patient Navigation and Cancer Care Delivery. Edited by David A. Chambers, Wynne E. Norton, and Cynthia A. Vinson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190647421.003.0022.
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Although the US health care system offers the very best care to many, the poor and uninsured typically face challenges in accessing timely health care, even when faced with a life-threatening disease such as cancer. Spurred by unmet patient needs and the growing complexity of health care delivery systems, patient navigation seeks to diminish social, economic, cultural, and medical system barriers to timely quality care. This case study discusses the emergence of patient navigation as a strategy for improving cancer outcomes, especially among vulnerable populations. It explores challenges and opportunities related to advancing successful implementation of patient navigation across the cancer care continuum. It seeks to harness and apply the power and energy of patient navigators with the goal of guiding individuals across the health care continuum—from the communities where they live all the way through screening, diagnosis, and treatment at clinical care sites.
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Sinagra, Gianfranco, Marco Merlo, and Davide Stolfo. Dilated cardiomyopathy: clinical diagnosis and medical management. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0356.
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Dilated cardiomyopathy (DCM) is a relatively rare primary heart muscle disease with genetic or post-inflammatory aetiology that affects relatively young patients with a low-risk co-morbidity profile. Therefore, DCM represents a particular heart failure model with specific characteristics and long-term evolution. The progressively earlier diagnosis derived from systematic familial screening programmes and the current therapeutic strategies have greatly modified the prognosis of DCM with a dramatic reduction of mortality over recent decades. A significant number of DCM patients present an impressive response to pharmacological and non-pharmacological evidence-based therapy in terms of haemodynamic improvement with subsequent left ventricular reverse remodelling, which confer a favourable long-term prognosis. However, in some DCM patients the outcome is still severe. This prognostic heterogeneity is possibly related to the aetiological variety of this disease. Maximal effort towards an early aetiological diagnosis of DCM, by using all diagnostic available tools (including cardiovascular magnetic resonance imaging, endomyocardial biopsy, and genetic testing when indicated), as well as the individualized long-term follow-up appear crucial in improving the prognostic stratification and the clinical management of these patients.
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Williams, Joah L., Melba Hernandez, and Ron Acierno. Elder Abuse. Edited by Phillip M. Kleespies. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199352722.013.27.
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Elder abuse and neglect are serious problems affecting tens of thousands of older adults each year. In this chapter, we discuss elder abuse in its various forms (including emotional, physical, and sexual abuse, financial maltreatment, and neglect) and provide recommendations for screening and prevention relevant to health-care providers working with geriatric populations. We further highlight clinical and contextual issues pertinent to screening for elder abuse and to its prevention, followed by a review of information regarding emergency management and care in cases of suspected or confirmed elder abuse. We conclude with a discussion about mandated reporting laws and community-based intervention strategies. We hope that this chapter will improve providers’ knowledge of the prevalence and consequences of elder abuse and strengthen the willingness to screen for and intervene in situations where an older adult may be the victim of elder abuse or neglect.
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Cetin, Derrick. Medical Evaluation of the Bariatric Surgery Patient. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0002.
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Evaluation of the obese patient requires identification of all comorbidities and health conditions, including underlying cardiac and pulmonary conditions that could have a negative outcome on noncardiac surgery. Once comorbidities have been recognized, aggressive optimization of these medical conditions can provide improved outcomes after bariatric surgery. Estimating medical risk can be performed by several validated classification systems. The preoperative checklist and clinical practice guidelines (CPG) were updated in 2013. The CPG recommendations for preoperative evaluation of the bariatric surgery patient include lab testing, nutritional screening, endocrine assessment, and cardiopulmonary assessment, including sleep apnea screening. The CPG suggest an extensive multidisciplinary team approach to the preoperative bariatric surgery patient. Finally, the medical evaluation includes an algorithm for a seven-step approach to the preoperative visit. Also recommended for evaluation of the morbidly obese patient is an algorithm that uses a five-step approach after a comprehensive history and physical exam and lab testing.
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McInerny, Thomas K., Henry M. Adam, Deborah E. Campbell, and Deepak M. Kamat, eds. American Academy of Pediatrics Textbook of Pediatric Care. American Academy of Pediatrics, 2008. http://dx.doi.org/10.1542/9781581106411.
Full textAbstract:
For more than 75 years, the American Academy of Pediatrics has been the nation’s leading and most trusted child health expert. The all-new full color AAP Textbook continues the tradition by providing a wealth of expert guidance spanning every aspect of current clinical practice and sets a new standard for one-stop pediatric references! Directed by a distinguished editorial team, and featuring contributions from experienced clinicians nationwide, the new AAP Textbook of Pediatric Care is a resource you’ll use with complete confidence. Look here for expert guidance spanning every aspect of current clinical practice. Comprehensive scope: Covers screening, pathophysiology, diagnosis, treatment, management, prevention, critical care, practice management, ethical and legal concerns and much more. Practical focus: Directly addresses day-to-day practice concerns for efficient patient problem-solving. Essential clinical guidance: Step-by-step recommendations on what to do, when and how to do it, when to admit, and when to refer. Evidence-based approach: State-of-the-art approach includes the evidence base for recommendations and lists detailed references within each chapter. Topical coverage: Highlights new priorities for 21st century practice: evidence-based medicine, environmental concerns, electronic health records, quality improvement, community-wide health approaches, confidentiality, cultural issues, and psychosocial issues.
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Breitbart, William, Phyllis Butow, Paul Jacobsen, Wendy Lam, Mark Lazenby, and Matthew Loscalzo, eds. Psycho-Oncology. 4th ed. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780190097653.001.0001.
Full textAbstract:
Psycho-Oncology, 4th edition, follows the publication of Psycho-Oncology, 3rd edition in 2015. This is the latest in the series of textbooks which have defined the field of psycho-oncology. William Breitbart, MD, serves as the new senior editor along with associate editors Phyllis N. Butow, PhD, MPH, of the University of Sydney; Paul B. Jacobsen, PhD, of the U.S. National Cancer Institute; Wendy W. T. Lam, RN, PhD, of the University of Hong Kong; Mark Lazenby, APRN, PhD, of the University of Connecticut School of Nursing; and Matthew J. Loscalzo, MSW, of the City of Hope. In this 4th edition of Psycho-Oncology, we feel we have accomplished the delicate task of having this “Official Textbook of our Field” serve both as the source textbook providing the broadest and most multidisciplinary essential science and practice of the field of psycho-oncology, as well as the newest and latest innovations and cutting-edge research and clinical practice that would equip our readers with the knowledge and resources to participate in the “new frontiers of psycho-oncology.” Several new sections and areas of update include: 1. Evidence-Based Interventions; 2. Digital Health Intervention; 3. Biobehavioral Psycho-Oncology; 4. Geriatric Oncology; 5. Pediatric Psycho-Oncology; 6. Survivorship; 7. Palliative Care and Advanced Planning; 8. Diversities in the Experience of Cancer; 9. Behavioral and Psychological Factors in Cancer Risk; Screening for Cancer in Normal and At-Risk Populations; 10. Screening and Testing for Germ Line and Somatic Mutations; 11. Screening and Assessment in Psychosocial Oncology; 12. Building Supportive Care Teams; 13. Psycho-Oncology in Health Policy.
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DelCarmen-Wiggins, Rebecca, and Alice S. Carter, eds. The Oxford Handbook of Infant, Toddler, and Preschool Mental Health Assessment. Oxford University Press, 2019. http://dx.doi.org/10.1093/oxfordhb/9780199837182.001.0001.
Full textAbstract:
The fully revised and updated Handbook of Infant, Toddler, and Preschool Mental Health Assessment remains the first clinically-informative, research-based reference for those seeking to understand and assess mental health in infants and young children. It describes the latest empirical research on measures and methods of infant and young child assessment and provides clinically applicable information for those seeking to stay apprised of the latest empirical research on measures and procedures in early assessment. Through authoritative examination by leading developmental and clinical scholars, this handbook takes a closer look at current developmentally based conceptualizations of mental health function and dysfunction in infants and young children as well as current and new diagnostic criteria in such as specific disorders as sensory modulation dysfunction, autism spectrum disorders, affective disorders, and post-traumatic stress disorder. Translation and application to a variety of settings is also discussed. The chapters are presented in four sections corresponding to four broad themes: (1) contextual factors in early assessment; (2) temperament and regulation in assessment of young children; (3) early problems and disorders; and (4) translation and varied applied settings for assessment. Each chapter presents state of the science information on valid, developmentally based clinical assessment and makes recommendations based on developmental theory, empirical findings, and clinical experience. Chapters have been revised and updated, and new chapters have been added to cover family assessment, early care and educational environments, new approaches to distinguish temperament from psychopathology, assess language, and implement second stage screening and referral. The volume recognizes and highlights the important role of developmental, social, and cultural contexts in approaching the challenge of assessing early problems and disorders. This new, updated volume will be an ideal resource for teachers, researchers, and wide variety of clinicians and trainees including child psychologists and psychologists, early interventionists, and early special educators.
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Bhopal, Raj S. Concepts of Epidemiology. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198739685.001.0001.
Full textAbstract:
Epidemiology is a population science that underpins health improvement and health care, and is concerned with the pattern, frequency, trends, and causes of disease. This book teaches its applications to population health research, policy-making, health service planning, health promotion, and clinical care. The book emphasizes concepts and principles. In 10 chapters, the book explains what epidemiology is; illustrates the basis of epidemiology in populations; provides a framework for analysing diseases by time, place, and person; introduces error, bias, and confounding; explains how we move from association to causation; considers the natural history, spectrum, and iceberg of disease in relation to medical screening; discusses the acquisition and analysis of data on incidence and prevalence of risk factors and diseases; shows the ways in which epidemiological data are presented, including relative and absolute risks; provides an integrated overview of study designs and the principles of data analysis; and considers the theoretical and ethical basis of epidemiology both in the past and the future. The emphasis is on interactive learning, with each chapter including learning objectives, theoretical and numerical exercises, questions and answers, and a summary. The text is illustrated, with detailed material in tables. The book is written in plain English, and the necessary technical and specialized terminology is explained and defined in a glossary. The book is for postgraduate courses in epidemiology, public health, and health policy. It is also suitable for clinicians, undergraduate students in medicine, nursing and other health disciplines, and researchers.
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Sullivan, Maria, and Frances Levin, eds. Addiction in the Older Patient. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199392063.001.0001.
Full textAbstract:
Addictive disorders in older adults are underdiagnosed and undertreated. An important reason for this lack of recognition of a serious health problem is a paucity of clinical knowledge about how such disorders present in this population. The presentation for alcohol and substance use disorders in the elderly can be confusing, given the metabolic changes and concurrent conditions associated with aging, together with interactions between alcohol and prescribed psychoactive drugs. Further, screening instruments have not been validated for this population. Brief interventions may be effective but should take into account contextual needs such as medical conditions, cognitive decline, and mobility limitations. Treatment strategies, including detoxification regimens, need to be modified for older patients and - in the case of opioid dependence - must address the management of chronic pain in this population. Ironically, benzodiazepines are the most frequently prescribed psychoactive medication in the elderly, despite older individuals' greater sensitivity to side effects and toxicity. Older women are at particularly heightened vulnerability for iatrogenic dependence on sedatives and hypnotics. More clinical research data are needed to inform screening and referral strategies, behavioral therapies, and pharmacological treatment. At the same time, emerging technologies such as communication tools and monitoring devices offer important opportunities to advance addiction treatment and recovery management in older adults. Although research to date has been limited in this population, recent data suggest that treatment outcomes are equal or better to those seen in younger cohorts.
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Cardim, Nuno, Denis Pellerin, and Filipa Xavier Valente. Hypertrophic cardiomyopathy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0042.
Full textAbstract:
Hypertrophic cardiomyopathy is a common inherited heart disease caused by genetic mutations in cardiac sarcomeric proteins. Although most patients are asymptomatic and many remain undiagnosed, the clinical presentation and natural history include sudden cardiac death, heart failure, and atrial fibrillation. Echocardiography plays an essential role in the diagnosis, serial monitoring, prognostic stratification, and family screening. Advances in Doppler myocardial imaging and deformation analysis have improved preclinical diagnosis as well as the differential diagnosis of left ventricular hypertrophy. Finally, echocardiography is closely involved in patient selection and in intraoperative guidance and monitoring of septal reduction procedures. This chapter describes the pathophysiology, clinical presentation, role of echocardiography, morphological features, differential diagnosis, diagnostic criteria in first-degree relatives, echo guidance for the treatment of symptomatic left ventricular outflow tract obstruction, and follow-up and monitoring of patients with hypertrophic cardiomyopathy.