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Orientador: Maria Salete Machado Cândido / Banca: Renato Luiz Terence / Banca: Luiz Antônio Borelli Barros / Banca: Alberto Magno Gonçalves / Banca: Denise Pedrini / Resumo: Foram analisados 176 prontuários gerais da Clínica Integrada da Faculdade de Odontologia de Araraquara - UNESP, referentes aos pacientes atendidos no período de 1999 e 2000, assim como, os planejamentos realizados pelos alunos, através do odontograma para plano de tratamento e sequência dos trabalhos a realizar e confrontados os dados com o tratamento realizado no odontograma de trabalho executado, a fim de determinar a eficácia da disciplina quanto ao cumprimento das necessidades dos seus pacientes. Foram realizadas tabelas e gráficos utilizando o software EPIINFO 6.0 e aplicada a estatística Kappa para conhecer a concordância das atividades realizadas e planejadas. Conclue-se neste periódo de estudo que o grupo etário 25-34 anos foi o mais significativo e o sexo feminino (62,5%) procurou mais atendimento; com relação as necessidades odontológicas encontrou-se que 97,6% de pacientes que necessitaram exodontia; 78% raspagem e polimento dental, 67% restaurações estéticas, 59,5% próteses parciais removíveis, 53,4% próteses unitárias, 46,1% endodontias; 44% próteses fixas; 43% cirurgias periodontais; 22% restaurações de amálgama e 5,7% próteses totais. Para os tratamentos realizados foram encontrados respectivamente: 98,7%; 68,7%; 62,6%; 24,5%; 31%; 44,3%; 8,9%; 38%; 20% e 4,2%. Ressaltando que a disciplina de clínica integrada foi eficaz quanto ao cumprimento do seu objetivo de ensino, voltado para a formação do clínico geral em odontologia apesar de possuir deficiências quanto a satisfação integral das necessidades dos seus pacientes através dos tratamentos evidenciados nos planejamentos globais. / Abstract: The 176 patients who received treatment from 1999 to 2000 in the Integrated Clinics of the Araraquara Dental School - UNESP, wher choused for this study. The treatment register for the treatment plan and clinical sequence of treatment was confronted the data with the treatment accomplished in the plan of the executed treatments, in order determine the effectiveness of the discipline with relationship to the execution of your patient's needs. Table and graphics were accomplished using EPIINFO 6.0 software and to applied the statistics type Kappa (k). It was concluded that during this period of study the groups aged from 25-34 years was the most significant and the women looked more for attendance; in relation to the dental needs it was observed that 97,6% of the patient's need extraction; 78% scaling and dental polishment; 67% esthetic restorations; 59,5% partial removable dentures; 53,4% unitary fixed prosthesis; 46,1% endodontics; 43% periodontal surgery; 22% amalgam restorations and 5,7% total dentures. For the accomplished treatments they were observed respectively: 98,7%; 68,7%; 62,6%, 24,5%; 31%; 44,3%; 8,9%, 38%; 20% and 4,2%. The integrated clinics discipline was effective with the relationship to the execution of your teaching objective, general clinicians formation in dentistry, in spite of deficiencies as the total satisfaction of your patient's needs through the treatments evidenced in the global planning. / Doutor

This thesis explores the perspectives of people on psychogenic non-epileptic seizures (PNES). It is presented in three separate papers: a systematic literature review; an empirical research paper and a critical reflection of the research process as a whole. The systematic literature review aimed to provide a detailed understanding of stakeholder perspectives on PNES. A systematic search identified relevant studies that were subsequently synthesised using thematic analysis and the broader principles of narrative synthesis. Three broad themes relating to stakeholder perspectives were identified: the nature of PNES as a condition; diagnosis; and management and treatment issues. It was found that both patients and professionals experienced uncertainties in relation to understanding and managing the condition. This highlighted the need for further information and awareness of PNES and the development of clear treatment guidelines. Important differences in opinion were also identified between patients and professionals and consideration was given to how these may disrupt the development of effective partnerships in care. The research into patients' and families' perspectives was found to be lacking and further research was identified as being needed in this area. The empirical paper reports an exploratory qualitative study that aimed to provide an in-depth understanding of the perceived treatment needs of patients with PNES. Semi-structured interviews were conducted and findings were analysed inductively using the principles of thematic analysis. Four key themes were identified: return to normality; post-diagnostic limbo; uncertainty and apprehension about therapy; and need for validation. Patients with PNES described clear goals for their recovery and clear ideas about their treatment needs. However, following their diagnosis, many felt caught in 'limbo' due to uncertainties about their diagnosis and as a result of a lack of post-diagnostic support. Being in 'limbo' also linked to patients' uncertainties about psychology meeting their needs and for some there was apprehension about the potential negative consequences of therapy. The clinical implications of the research are discussed and recommendations for future research are made. The third paper is a critical reflection of the research process as a whole. It provides an overview and evaluation of the first two papers and personal reflections of the lead researcher are offered throughout. Implications for further research and clinical practice are offered and a summary of the research as a whole is offered.

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Pathological gambling brings serious impacts on an individual, his or her surroundings and the society in the areas of economics, intellectual, physical and social health. In the Czech Republic about 40,000 - 80,000 adults are threatened by pathological gambling, however the actual amount of treated adults is only about 2.5 - 5% of the total year estimate. The reason behind this number can be the fact that in the Czech Repulic pathological gambling is treated together with substance addiction in most of the therapy centers. In the beginning of the theoretical part the concept of 'pathological gambling' is defined and the prevalence and the number of treated patients with the diagnosis of pathological gambling is shown along with the availability of electronic gaming devices in the Czech Republic and abroad. Furthermore, etiological context, pathogenesis, and some diagnostic aspects of pathological gambling are described. The theoretical part further compares pathological gambling with substance addiction and the treatments of pathological gambling and introduces the treatments of other addictions in the healthcare system in the Czech Republic. The goal of the empirical part of the thesis is to find out and describe different and similar features of patients with the diagnosis of pathological...

Made available in DSpace on 2014-06-11T19:31:27Z (GMT). No. of bitstreams: 0 Previous issue date: 2002-08-13Bitstream added on 2014-06-13T19:41:17Z : No. of bitstreams: 1 munozchaves_ofm_dr_arafo.pdf: 4621531 bytes, checksum: b37b9cea1f3ddfa1a7a0e6b4fbf70506 (MD5) / Foram analisados 176 prontuários gerais da Clínica Integrada da Faculdade de Odontologia de Araraquara - UNESP, referentes aos pacientes atendidos no período de 1999 e 2000, assim como, os planejamentos realizados pelos alunos, através do odontograma para plano de tratamento e sequência dos trabalhos a realizar e confrontados os dados com o tratamento realizado no odontograma de trabalho executado, a fim de determinar a eficácia da disciplina quanto ao cumprimento das necessidades dos seus pacientes. Foram realizadas tabelas e gráficos utilizando o software EPIINFO 6.0 e aplicada a estatística Kappa para conhecer a concordância das atividades realizadas e planejadas. Conclue-se neste periódo de estudo que o grupo etário 25-34 anos foi o mais significativo e o sexo feminino (62,5%) procurou mais atendimento; com relação as necessidades odontológicas encontrou-se que 97,6% de pacientes que necessitaram exodontia; 78% raspagem e polimento dental, 67% restaurações estéticas, 59,5% próteses parciais removíveis, 53,4% próteses unitárias, 46,1% endodontias; 44% próteses fixas; 43% cirurgias periodontais; 22% restaurações de amálgama e 5,7% próteses totais. Para os tratamentos realizados foram encontrados respectivamente: 98,7%; 68,7%; 62,6%; 24,5%; 31%; 44,3%; 8,9%; 38%; 20% e 4,2%. Ressaltando que a disciplina de clínica integrada foi eficaz quanto ao cumprimento do seu objetivo de ensino, voltado para a formação do clínico geral em odontologia apesar de possuir deficiências quanto a satisfação integral das necessidades dos seus pacientes através dos tratamentos evidenciados nos planejamentos globais. / The 176 patients who received treatment from 1999 to 2000 in the Integrated Clinics of the Araraquara Dental School - UNESP, wher choused for this study. The treatment register for the treatment plan and clinical sequence of treatment was confronted the data with the treatment accomplished in the plan of the executed treatments, in order determine the effectiveness of the discipline with relationship to the execution of your patient's needs. Table and graphics were accomplished using EPIINFO 6.0 software and to applied the statistics type Kappa (k). It was concluded that during this period of study the groups aged from 25-34 years was the most significant and the women looked more for attendance; in relation to the dental needs it was observed that 97,6% of the patient's need extraction; 78% scaling and dental polishment; 67% esthetic restorations; 59,5% partial removable dentures; 53,4% unitary fixed prosthesis; 46,1% endodontics; 43% periodontal surgery; 22% amalgam restorations and 5,7% total dentures. For the accomplished treatments they were observed respectively: 98,7%; 68,7%; 62,6%, 24,5%; 31%; 44,3%; 8,9%, 38%; 20% and 4,2%. The integrated clinics discipline was effective with the relationship to the execution of your teaching objective, general clinicians formation in dentistry, in spite of deficiencies as the total satisfaction of your patient's needs through the treatments evidenced in the global planning.

The goal of this study was to determine the bio-psychosocial treatment needs of dual diagnosis patients with depressive episodes and alcohol misuse. In order to achieve this goal, a qualitative research approach was adopted to gain a holistic understanding of dual diagnosis, as well as to explore and to describe the bio-psychosocial treatment needs of these individuals. This research study aimed to contribute towards solving a practical problem in practice by offering recommendations for a multidisciplinary team approach with regard to the treatment of patients diagnosed with depressive episodes and alcohol misuse in South African treatment centres. To this end, the collective case study design guided the research study. A two-stage sampling strategy was implemented in the study. Firstly, purposive sampling was used to identify potential participants, and it was followed up with, secondly, volunteer sampling to recruit 10 individuals with co-occurring depressive episodes and alcohol misuse from a private psychiatric clinic in Pretoria, which formed the research sample. Furthermore, a semi-structured one-on-one interview, guided by questions contained in an interview schedule, was used as a data collection method. The researcher implemented the qualitative data analysis process of Creswell (1998, in Schurink, Fouché & De Vos, 2011) to extrapolate themes and sub-themes from the raw data through thematic analysis. The trustworthiness of the data interpretation was confirmed through peer debriefing, member checking, as well as the assurance of confidentiality. An analysis of two different sources of data, namely the literature review and interviews, was used to answer the following research question: What are the bio-psychosocial treatment needs of dual diagnosis patients suffering from depressive episodes and alcohol misuse? The key findings indicated that persons suffering from a dual diagnosis of depressive episodes and alcohol misuse have idiosyncratic biological, psychological and social treatment needs. On a biological level it was found that patients with a dual diagnosis lead a less active and an unhealthy lifestyle and are therefore more prone to the development of chronic illnesses, such as hypertension and cardiovascular disease. It was also found that these individuals exhibit addictive behaviours apart from the alcohol misuse. With regard to psychological needs, the research found that dual diagnosis patients experience difficulties in expressing their needs and emotions to others. In this regard the research indicated that these individuals have poorly developed coping mechanisms and limited resources for gaining an improved sense of well-being. Identified areas in which these individuals may need assistance on a psychological level include: general coping mechanisms, communication skills, problem solving skills, and conflict management. With regard to violent and aggressive behaviour, it was found that these individuals are more likely to internalise their frustration and aggress towards themselves. On a social level it was found that individuals with a dual diagnosis of depressive episodes and alcohol misuse experience more relationship breakdown and less social support. Additionally, on a social level these individuals experience difficulties in coping in the workplace, as well as having problems with financial management. It is recommended that the multidisciplinary team participate in the development of psycho-educational groups that focus on the education of dual diagnosis patients regarding their needs on each level of functioning. Furthermore, it is recommended that effective clinical communication patterns are in place to prevent fragmented service delivery to individuals with a dual diagnosis. It is recommended that service delivery takes place in all forms of service delivery, including individual therapy, psycho-educational groups, group work activities, as well as family counselling. Further research could focus on the following: 1) Extending the research population to areas outside the Gauteng Province, or even South Africa, in order to determine if these findings can be generalised to all patients with a dual diagnosis of depressive episodes and alcohol misuse; 2) Conducting the research in public health care centres to determine if the findings of this study are also prevalent in lower socio-economic classes (taking into consideration that the present study was conducted at a private psychiatric clinic); 3) Repeating the study with different combinations of psychiatric illnesses, as well as substances of abuse, to determine if the conclusions drawn from this study can be made applicable to dual diagnosis in general, or only to dual diagnosis with depressive episodes and alcohol misuse in particular. / Dissertation (MSW)--University of Pretoria, 2014. / tm2015 / Social Work and Criminology / MSW / Unrestricted

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Oral Health Status and Treatment Needs of the Institutionalized Chronic Psychiatric Patients in two Ontario Psychiatric Care Centres Neyaz Farrahi-Avval Master of Science Graduate Department of Dentistry University of Toronto 2008 Abstract Purpose: To examine the oral health status of psychiatric in-patients at two long-term psychiatric health centres, with one operating a full-time dental care facility. Methods: Data were gathered from clinical examinations, a structured interview and hospital records from 120 participants. Periodontal (CPI) and dental (DMFT) indices, subjectively reported oral health status, and oral health behaviour were subsequently analyzed. Results: Referrals for dental problems were made for 62.9% of participants. Bivariate analyses revealed positive correlations between DMFT scores, age and length of stay. Multiple regression analyses demonstrated correlations between DMFT scores and infrequent dental visits, frequent snacking and age. Patients at the psychiatric hospital without a full-time dental care facility were more likely to have had higher DMFT scores, and infrequent dental visits. Conclusions: Psychiatric patients have poor oral health and significant oral health treatment needs. This study underlines the need for on-site dental care facilities at long-term psychiatric care centres.

Aim: To describe and analyze the demographic profile and the dental treatment needs, workload and costs of the 2007 and 2008 CF recruit population (N=10,641). Method: Treatment procedures and costs were aggregated and calculated, beginning from the date of a member’s enrolment, over a period that ranged between 13 to 36 months. Associations between treatment services and the demographic variables were tested using one-way ANOVA and chi-square tests. Independent samples T-test was used to compare means. Linear regression models were used to determine the influence of demographic variables on treatment cost. Results: Treatment needs and costs varied with recruit age, gender, rank, first language (French/English), birthplace (Canada/Foreign), tobacco use, province and census tract. The cost of treatment for the entire population was $13.9M. Mean cost per recruit was $1224 over an average period of 26 months. Outsource costs ($2.9M) were driven by referrals for restorative, endodontic and oral surgery procedures.