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Assessment of referrals to an OT consultation-liaison service: a retrospective and comparative study

Gomes, Maria Gabriela J. B.; De Morais, Luciene V.; Osorio, Flavia De L.; Cabrera, Catalina Camas; Bertuso-Pela, Elaine C.; De Carlo, Marysia M. R.; Hallak, Jaime E. C.; Contel, Jose Onildo B.; Loureiro, Sonia Regina; Chagas, Marcos Hortes N.; Crippa, Jos
Fonte: INFORMA HEALTHCARE; LONDON Publicador: INFORMA HEALTHCARE; LONDON
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
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The objective was to conduct a retrospective and comparative study of the requests for consultation-liaison (RCLs), during a period of six years, sent to the Occupational Therapy (OT) team that acts as the Consultation-liaison Service in Mental Health. During the studied period 709 RCLs were made and 633 patients received OT consultations. The comparison group was extended to 1 129 consecutive referrals to the psychiatric CL service, within the same period and that were also retrospectively reviewed. Regarding to RCLs to the OT team, most of the subjects were women with incomplete elementary schooling, with a mean age of 39.2 years, and were self-employed or retired. Internal Medicine was responsible for most of the RCLs. The mean length of hospitalization was 51 days and the mean rate of referral was 0.5%, with the most frequent reason for the request being related to the emotional aspects and the most frequent psychiatric diagnosis was mood disorder. It is concluded that there is a clear demand for the development of consultation-liaison in OT, particularly with regard to the promotion of mental health in general hospitals.; Fundacao de Ensino e Pesquisa do Hospital das Clinicas da Faculdade de Medicina de Ribeirao PretoUniversidade de Sao Paulo (FAEPA); Fundacao de Ensino e Pesquisa do Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto-Universidade de Sao Paulo (FAEPA); CNPq (CNPq...

Caracterização clínica e sócio-demográfica da população atendida por um serviço de interconsulta de terapia ocupacional em um hospital geral universitário; Clinical characterization and socio-demographic of the population served by a Consultation-Liaison Service Occupational Therapy in a University General Hospital

Gomes, Maria Gabriela Junqueira Pernambuco Barboza
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 28/07/2008 Português
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A Interconsulta Psiquiátrica é considerada uma área da Psiquiatria, que trabalha no Hospital Geral compondo uma equipe (Psiquiatria de Ligação) ou prestando seus serviços a uma equipe solicitante (Consultoria Psiquiátrica). O Serviço de Interconsulta em Psiquiatria (SIP) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP-USP) teve início em março de 1978 e a Terapia Ocupacional passou a integrar esta equipe em 1999. O cotidiano hospitalar tem uma marca própria com obrigações como usar vestimentas, ter horários previamente estabelecidos para se alimentar, para cuidar de sua higiene e para receber visitas, inclusive dos familiares. Os terapeutas ocupacionais, como profissionais que lidam com o cotidiano do indivíduo, têm sido inseridos nas equipes multiprofissionais do Hospital Geral, contribuindo com seus conhecimentos teóricos e técnicos específicos para cuidar de pessoas hospitalizadas. Apesar das várias funções que a Terapia Ocupacional (TO) pode exercer no Serviço de Interconsulta, existe escassez de estudos publicados sobre o perfil sócio-demográfico dos pacientes atendidos, o que prejudica o planejamento de ações e o levantamento da necessidade de recursos humanos para aquele Serviço. O objetivo deste trabalho foi realizar um estudo retrospectivo dos Pedidos de Interconsulta (PIs) para a TO do Serviço de Interconsulta em Saúde Mental (SISMen) do HCFMRP - USP no período de janeiro de 2000 a dezembro de 2005. Os sujeitos foram os indivíduos que estiveram internados nas enfermarias do campus do hospital universitário e para quem foi solicitada a assistência do Serviço de TO naquele período...

Consulta terapêutica com pais de crianças autistas: a interface entre a parentalidade e a conjugalidade; Therapeutic consultation with parents of autistic children: the interface between parenthood and the conjugal relationship

Nunes, Maria Angela Favero
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 11/06/2010 Português
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A presente tese teve por objetivo compreender as repercussões da condição da criança autista, na vida familiar e conjugal dos pais. Interrogamo-nos, ainda, acerca da utilização da entrevista clínica não-dirigida, seguindo o modelo da consulta terapêutica. Utilizamos também dados de prontuário como recurso auxiliar para obtenção de informações da criança e de seus pais. Participaram deste estudo cinco casais (dez participantes), pais de crianças autistas, cujo filho tinha sido diagnosticado recentemente, tendo iniciado as atividades em uma instituição para tratamento educacional especializado, localizada em um município do interior do Estado de São Paulo. O critério de inclusão empregado foi a participação de ambos os membros do casal nas entrevistas. Tratou-se de uma pesquisa de metodologia clínico-qualitativa, em que a Psicanálise foi a teoria de referência, especialmente a abordagem de Donald W. Winnicott. Além disso, apoiamo-nos nos estudos da Psicanálise familiar e de casal, para a análise do material clínico. O estudo pormenorizado das entrevistas estimulou reflexões a partir de três núcleos temáticos levantados: parentalidade e o lugar ocupado pela criança na dinâmica familiar; interface entre parentalidade e conjugalidade; a entrevista como um espaço de holding aos pais...

Caracterização do padrão de solicitações psiquiátricas em um hospital geral: estabilidade e mudanças em um período de 30 anos de um serviço de Interconsulta; Referral pattern of requests in a general hospital: stability and change over a period of 30 years of consultation-liaison service

Nakabayashi, Tatiana Iuriko Kawasaki
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 17/10/2012 Português
Relevância na Pesquisa
36.99%
A Interconsulta Psiquiátrica é considerada por muitos pesquisadores como sendo a área prática e aplicada da Medicina Psicossomática, de conhecimento concernente à investigação da interação entre fatores biológicos e psicossociais no desenvolvi-mento, curso e resultado de todas as doenças. A prevalência de transtornos psiqui-átricos em hospitais gerais pode variar de 20 a 40% entre pacientes internados, po-rém uma reduzida parcela é assistida pela Interconsulta e consequentemente recebe tratamento psiquiátrico. Sendo assim, o presente estudo teve por objetivos: a) obter informações dos dados sociodemográficos dos pacientes e seus históricos em sa¬úde mental (tratamentos anteriores e tentativa de suicídio); b) analisar o uso do ser¬viço de Interconsulta Psiquiátrica, tais como as clínicas solicitantes, função dos pro¬fissionais solicitantes, motivos de solicitação, tempo de internação dos pacientes assistidos, tempo de solicitação do PI e de sua resposta, e o número de atendimen-tos realizados; c) descrever os diagnósticos clínicos e psiquiátricos dos pacientes avaliados através dos critérios estabelecidos pela CID-10; d) analisar intervenções farmacoterapêuticas e não medicamentosas, tais como as condutas sugeridas pelo interconsultor...

Implantação da consultoria de enfermagem psiquiátrica em um hospital geral; Implementation of a psychiatric nursing consultation program in a general hospital

Thomas, Juciléia; Santos, Luciane Beatriz Marks; Wetzel, Christine; Barbisan, Regina Beatriz Kirsten
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
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36.72%
A consultoria em enfermagem psiquiátrica se configura como um dispositivo voltado para a qualificação do atendimento a pacientes com transtornos psiquiátricos ou outras formas de sofrimento mental internados em um hospital geral. O principal objetivo é apoiar e instrumentalizar as equipes de enfermagem no cuidado integral desses pacientes quando internados em unidades não-psiquiátricas. Este artigo apresenta um relato da implantação do Programa de Consultoria de Enfermagem Psiquiátrica no Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS.; Psychiatric nursing consultation is a tool for qualifying the treatment of patients hospitalized at a general hospital with psychiatric disorders or other forms of mental suffering. The main objective is to support and provide operational guidance to nursing teams concerning full health care of these patients when hospitalized in non-psychiatric units. The present article is a report on the implementation of the Psychiatric Nursing Consultation Program at Hospital de Clínicas de Porto Alegre (HCPA), in Porto Alegre, Brazil.

Early nephrology consultation can have an impact on outcome of acute kidney injury patients

Ponce, Daniela; Franco Zorzenon, Caroline de Pietro; dos Santos, Nara Yamane; Balbi, André Luís
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica Formato: 3202-3206
Português
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Background. Patients who develop acute kidney injury (AKI) in the intensive care unit (ICU) have extremely high rates of mortality and morbidity. The objectives of this study were to compare clinical and laboratory characteristics of AKI patients evaluated and not evaluated by nephrologists in ICU and generate the hypothesis of the relationship between timing of nephrology consultation and outcome.Methods. We explored associations among presence and timing of nephrology consultation with ICU stay and in-ICU mortality in 148 ICU patients with AKI at a Brazilian teaching hospital from July 2008 to May 2010. Multivariable logistic regression was used to adjust confounding and selection bias.Results. AKI incidence was 30% and 52% of these AKI patients were evaluated by nephrologists. At multivariable analysis, AKI patients evaluated by nephrologists showed higher Acute Tubular Necrosis-Index Specific Score and creatinine level, more dialysis indications, lower urine output and longer ICU stay. The mortality rate was similar to AKI patients who were not evaluated. Nephrology consultation was delayed (>= 48 h) in 62.3% (median time to consultation, 4.7 days). Lower serum creatinine levels (P - 0.009) and higher urine output (P = 0.002) were associated with delayed consultation. Delayed consultation was associated with increased ICU mortality (65.4 versus 88.2%...

Psychiatric disorders and psychiatric consultation in a general hospital: A case- control study

Smaira, Sumaia Inaty; Kerr-Corrêa, Florence; Contel, José Onildo B.
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 18-25
Português
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Introduction: Psychiatric consultation (PC) has been considered an efficient tool to develop research, to track and to give assistance benefiting patients, health professionals and the institution. However, it has not been much used in Brazil. Although 30 to 50% of general hospital (GH) inpatients may present a psychiatric disorder, only 1 to 12% of them are referred to assessment. The aims of this study were: to assess mental disorders in a GH; to identify which of these patients are sent to psychiatric care; to verify alleged reasons for referral to psychiatric consultation, and to examine the relationship between PC and psychiatric learning (during medical school and residence). Methods: A case-control patient study was conducted (47 cases and 94 controls) to analyze in detail the following variables: socio-demographic; clinical; degree of information (about the disease and diagnostic/therapeutic procedures), and relationship between patient and health team. Psychiatric diagnoses were made according to the ICD- 10 criteria. The Self Report Questionnaire (SRQ), the CAGE and Brief Psychiatric Rating Scale (BPRS) were used as well as a specifically designed questionnaire to collect clinical and demographic data. Results: Behavioral alterations...

Consultation-Liaison psychiatric service delivery: results from a European study

Huyse, F; Herzog, T; Lobo, A; Malt, U; Opmeer, B; Stein, B; Jonge, P; Dijck, R; Creed, F; Crespo, MD; Cardoso, G
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Publicado em //2001 Português
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The reported findings of the European Consultation-Liaison Workgroup (ECLW) Collaborative Study describe consultation-liaison service delivery by 56 services from 11 European countries aggregated on a C-L service level. During the period of 1 year (1991), the participants applied a standardized, reliability tested method of patient data collection, and data were collected describing pertinent characteristics of the hospital, the C-L service, and the participating consultants. The consultation rate of 1% (median; 1.4% mean) underscores the discrepancy between epidemiology and the services delivered. The core function of C-L services in general hospitals is a quick, comprehensive emergency psychiatric function. Reasons to see patients were the following. deliberate self-harm (17%), substance abuse (7.2%), current psychiatric symptoms (38.6%), and unexplained physical complaints (18.6%) (all means). A significant number of patients are old and seriously ill. Mood disorders and organic mental disorders are most predominant (17.7%). Somatoform and dissociative disorders together constitute 7.5%. C-L services in European countries are mainly emergency psychiatric services and perform an important bridge function between primary, general health...

European guidelines for training in consultation-liaison psychiatry and psychosomatics: report of the EACLPP Workgroup on Training in Consultation-Liaison Psychiatry and Psychosomatics

Sollner, W; Creed, F; European Association of Consultation–Liaison Psychiatry; Psychosomatics Workgroup on Training in Consultation–Liaison; Cardoso, G
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
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OBJECTIVE: The European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) has organized a workgroup to establish consensus on the contents and organization of training in consultation-liaison (C-L) for psychiatric and psychosomatic residents. METHODS: Initially, a survey among experts has been conducted to assess the status quo of training in C-L in different European countries. In several consensus meetings, the workgroup discussed aims, core contents, and organizational issues of standards of training in C-L. Twenty C-L specialists in 14 European countries participated in a Delphi procedure answering a detailed consensus checklist, which included different topics under discussion. RESULTS: Consensus on the following issues has been obtained: (1) all residents in psychiatry or psychosomatics should be exposed to C-L work as part of their clinical experience; (2) a minimum of 6 months of full-time (or equivalent part-time) rotation to a C-L department should take place on the second part of residency; (3) advanced training should last for at least 12 months; (4) supervision of trainees should be clearly defined and organized; and (5) trainees should acquire knowledge and skills on the following: (a) assessment and management of psychiatric and psychosomatic disorders or situations (e.g....

A prospective evaluation of indications for neurological consultation in the emergency department

Hansen, Christopher K; Fisher, Jonathan; Joyce, Nina R; Edlow, Jonathan A
Fonte: Springer Berlin Heidelberg Publicador: Springer Berlin Heidelberg
Tipo: Artigo de Revista Científica
Português
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Background: Recognizing the diverse presentation of neurological conditions that emergency physicians encounter can be challenging, and management of these patients often requires consultation with a neurologist. Accurate diagnosis is critical in neurological emergencies because patient outcomes are often dependent on timely treatment. Our primary objective was to ascertain whether consultant neurologists understood the reason for consultation in the emergency department. Methods: The authors conducted a prospective study of a non-consecutive sample of 94 patients seen in an academic tertiary care emergency department (ED) who underwent consultation by neurologist over 4 consecutive months. At the time a consult was requested, we independently surveyed the treating ED physician for their differential diagnosis. Neurologists were also queried as to whether there was a clear indication for consultation. We then followed the patients to determine their final diagnosis and outcome. Results: The median age was 57 years (interquartile range 45–78). 45.7 % were male. The clinical reasons for all the consults were 61 % focal symptom, 12 % concern about a specific diagnosis, 9 % radiological finding, 9 % diagnostic ambiguity, and 11 % other. There was no significant difference in the rate of a final neurological diagnosis based on the clinical reason for consult (p = 0.13). In the 17 % of patients for whom the treating neurologist reported a lack of a clear indication for the consultation...

Use of Public Consultation in the Nam Theun 2 Hydroelectric Project

McPhail, Kathryn; Callieri, Christian
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
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The purpose of this note is to describe the public consultation program to date for the Nam Theun 2 (NT2) hydroelectric project and share lessons learned regarding the process and methodologies that were used. The Lao PDR is a large, sparsely populated country with rugged terrain, limited infrastructure, and a weak manufacturing base. Poverty is widespread with nearly 50 percent of the population living below the poverty line. The options available to provide substantial export earnings to help fuel long-term economic growth are limited to the export of natural resources - particularly hydroelectricity and tropical hardwoods. The objectives of public consultation in NT2 are to ensure that stakeholders are identified, key social and environmental impacts are established, and a process of stakeholder consultation and involvement in project design and implementation is put in place. The added transparency, resulting from the process of public consultation, is expected to help meet important social and environmental quality assurance objectives...

Public sector restructuring and community consultation in the Australian Capital Territory: can old and new public policy trends work together?

Enfield, Samantha
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Working/Technical Paper Formato: 68003 bytes; 351 bytes; text/html; application/octet-stream
Português
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The aim and the reality of community consultation in the public policy process are often at odds. Simple mechanical remedies of consultative models and practices will not in themselves include the citizen beyond the ballot box. This Discussion Paper discusses the findings of a study conducted as part of PhD work in progress that examines two current public institutional trends in the ACT, purchaser-provider public sector arrangements and community consultation. The Australian Capital Territory offers the academic and practicing public policy community a unique opportunity to observe the interaction of old and new trends in OECD public policy best practice. Internationally, ideas about purchaser-provider models have been in place for some time. Current OECD activity is now emphasising community consultation to "strengthen government-citizen connections" in OECD countries and notes that there is now a strong trend towards renewal and expansion of public consultation in regulatory development which is underway in OECD countries (PUMA 1999). The ACT has both purchaser provider arrangements and significant investment in community consultation and provides a practical insight into the interaction of past ideas and current preoccupations in public policy. The Discussion Paper's study has found indications in the ACT that public institutional and reported service delivery arrangements have conditionally resulted in greater government control over the policy process; elected representatives have greater determination of public services...

Public Consultation in Environmental Assessments 1997-2000 : Findings from the Third Environmental Assessment Review

Rukuba-Ngaiza, Nightingale; Lubis, Rusdian; Cullen, Michelle; Zongmin Li; Mausolff, Christopher
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper; Publications & Research
Português
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36.8%
According to internal and external reviews of the public consultation process, public consultations have increasingly become a standard part of the environmental assessment process in Bank operations. However, the current challenge for Bank operations focuses on the quality of public consultations and the extent to which they influence project design and effect project impact. In an attempt to evaluate how projects were meeting this challenge, the Third Review assessed whether qualitative and quantitative improvements in EA public consultations had taken place for Category A and B Bank-financed projects (A project is classified as Category A if it is "likely to have significant adverse environmental impacts that are sensitive, diverse or unprecedented." On the other hand, a project is classified as Category B if it will not have significantly adverse impacts on human populations or environmentally important areas including wetlands, forests, grasslands, and other natural habitats.) In order to provide guidance for improving public consultation in future EA processes...

Meaningful Consultation in Environmental Assessments

Davis, Shelton H.; Rukuba-Ngaiza, Nightingale
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Brief; Publications & Research
Português
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36.86%
The World Bank's Operational Directive 4.01 on Environmental Assessments (EA) calls for consulting the public on environmental impacts in Bank-financed projects. The operational directive (OD) requires borrowers to prepare environmental assessments in those categories of projects that have potential significant impact on the environment. The Bank requires that at designated stages of the EA cycle, borrowers conduct meaningful consultations with affected groups and local NGOs. The criteria for assessing meaningful consultation is based on the Borrower's or EA preparer's capacity to identify the affected groups and obtain information. Meaningful consultation will be deemed to have taken place if the final EA document reflects the views of affected groups, local nongovernmental organizations, and those traditionally excluded from the consultative and planning processes, as well as those of the project's sponsor and other relevant government agencies.

Public Consultation in Environmental Assessment : Lessons from East and South Asia

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Publications & Research :: Brief; Publications & Research
Português
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36.8%
Consultation is a two-way communication process by which the knowledge and views of affected peoples, NGOs, the private sector and other interested parties are taken into account in development decision-making. In the case of EAs, the assumption is often made that such involvement is not necessary because of the often complex and highly technical nature of environmental impacts. Nevertheless, it is becoming increasingly clear that the knowledge of affected communities and NGOs can contribute to the quality of EAs, as well as provide a better understanding of the social impacts which accompany development interventions. The Bank and other development agencies have learned that if public consultation does not take place early in the project preparation process, it often leads to public misunderstandings, and unnecessary delays in project processing and implementation. The Bank's Operational Directive on EA (OD 4.01) distinguishes between various types of projects based upon the potential significance of their environmental impacts. Category A projects are usually large (e.g....

Integrating corpus consultation in language studies

Chambers, Angela
Fonte: University of Hawaii * National Foreign Language Resource Center Publicador: University of Hawaii * National Foreign Language Resource Center
Tipo: info:eu-repo/semantics/article; all_ul_research; ul_published_reviewed
Português
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peer-reviewed; Alongside developments in language research, the potential of corpora as a resource in language learning and teaching has been evident to researchers and teachers since the late 1960s. Despite publications which emphasise the benefits of corpus consultation for language learners (Bernardini, 2002; Kennedy & Miceli, 2001), there is little evidence to suggest that direct corpus consultation is coming to be seen as a complement or alternative to consultation of a dictionary, course book, or grammar by the majority of learners. There is thus a need for research to underpin the integration of corpora and concordancing in the language-learning environment. This study begins with an account of published research relating to course design and structure in the area of corpus consultation by language learners. The focus then narrows to the initial training of learners in corpus consultation, using as an example a course involving undergraduate students on several language degree programmes. The results of the students' consultation of the corpora are examined, including choice of search word(s), analytical skills, the problems encountered, and their evaluation of the activity. The results reveal how corpus consultation can complement traditional language-learning resources...

Élaboration et validation empirique d'un modèle de consultation individuelle auprès des enseignants afin de favoriser l'inclusion scolaire des enfants ayant un TDAH

Nadeau, Marie-France
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
Português
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Les interventions proactives ou comportementales en classe sont reconnues empiriquement pour leur efficacité à améliorer le comportement ou le rendement scolaire des enfants ayant un TDAH (DuPaul & Eckert, 1997; Hoza, Kaiser, & Hurt, 2008; Pelham & Fabiano, 2008; Zentall, 2005). Or, l’écart entre les interventions probantes et celles retrouvées dans le milieu général de l’éducation souligne l’importance de répliquer les résultats d’études obtenus dans un environnement contrôlé dans un format de livraison réaliste. L’objectif principal de cette thèse est d’élaborer et d’évaluer un programme de consultation individuelle (PCI) fondé sur une démarche de résolution de problème et d’évaluation fonctionnelle, pour soutenir les enseignants du primaire dans la planification et la mise en œuvre cohérente des interventions privilégiées pour aider les enfants ayant un TDAH. D’abord, une recension des principales modalités d’intervention auprès des enfants ayant un TDAH est effectuée afin d’identifier les interventions à inclure lors du développement du programme. Par la suite, des solutions favorisant le transfert des interventions probantes à la classe ordinaire sont détaillées par la proposition du PCI ayant lieu entre un intervenant psychosocial et l’enseignant. Enfin...

Clinical and demographic profile of cancer patients in a consultation-liaison psychiatric service

Citero,Vanessa de Albuquerque; Nogueira-Martins,Luiz Antonio; Lourenço,Maria Teresa; Andreoli,Sergio Baxter
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2003 Português
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ABSTRACT CONTEXT: An almost 50% prevalence of psychiatric disorders among cancer patients has prompted a series of studies on consultation-liaison psychiatry. Nonetheless, there are few reports on the epidemiological factors involving comorbidity between cancer and psychiatric disorders. OBJECTIVE: To evaluate the epidemiological profile of cancer inpatients referred to the consultation-liaison psychiatric service in an oncology hospital during its first year of activity. TYPE OF STUDY: Descriptive study. SETTING: Tertiary-care teaching hospital. PARTICIPANTS: 319 patients referred 412 times to the consultation-liaison psychiatry service. PROCEDURES: From August 97 to July 98, an appraisal was made of data on all admissions registered at the Hospital do Câncer, and also all referrals registered at the consultation-liaison psychiatry service. MAIN MEASUREMENTS: The demographics and patients' clinical data, the type and flow of the request, and the evaluation conducted by the service were analyzed and comparisons with the hospital data were made. The distribution of the number of referrals was used to construct a profile of patients who had repeatedly used the service. RESULTS: Psychiatric diagnoses were found in 59% of the cases. Forty-three percent of these required medication...

De la consultation des peuples autochtones : structure institutionnelle d'un dialogue appelé à renouveler la notion des droits ancestraux : essai fondé sur la jurisprudence de la Cour suprême du Canada (1984-2004) et la théorie du droit

Boisselle, Andrée
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation Formato: 7584480 bytes; application/pdf
Português
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Le présent mémoire est consacré à l'étude de l'obligation faite à l'État canadien de consulter les autochtones lorsqu'il envisage de prendre des mesures portant atteinte à leurs droits et intérêts. On s'y interroge sur le sens que peut avoir cette obligation, si elle n'inclut pas celle de s'entendre avec les autochtones. Notre étude retrace d'abord l'évolution de l'obligation de consulter dans la jurisprudence de la Cour suprême du Canada, pour se pencher ensuite sur l'élaboration d'un modèle théorique du processus consultatif. En observant la manière dont la jurisprudence relative aux droits ancestraux a donné naissance à l'obligation de consulter, on constate que c'est en s'approchant au plus près de l'idée d'autonomie gouvernementale autochtone - soit en définissant le titre ancestral, droit autochtone à la terre elle-même - que la Cour a senti le besoin de développer la consultation en tant que véritable outil de dialogue entre l'État et les Premières nations. Or, pour assurer la participation réelle des parties au processus de consultation, la Cour a ensuite dû balancer leur rapport de forces, ce qu'elle a fait en admettant le manque de légitimité du pouvoir étatique sur les autochtones. C'est ainsi qu'après avoir donné naissance au processus de consultation...

Perception of consultation length in cardiology and its ethical implications

Doval,Hernan C.; Borracci,Raul Alfredo; Darú,Victor D.; Giorgi,Mariano A.; Samarelli,Marisa
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/2008 Português
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36.94%
OBJECTIVES: This study considered whether the time employers allotted to medical consultations in many working environments in Argentina might be inadequate to carry out an interview. The objective was to conduct a survey to gather information on the length of cardiologic medical consultations in Argentina. METHODS: During 2007, a survey was carried out that included 816 cardiologists. RESULTS: Seventy-six percent of participants said they needed 20 to 30 minutes, and 14% considered that 15 minutes was sufficient, for an adequate consultation. On the other hand, 64% reported that their employer required that consultations be done in 10 to 15 minutes, and 86% cited limits of less than 20 minutes (P < 0.0001). This time was inadequate for 60% of physicians. With regard to ethics, 89% answered affirmatively that requiring that patients be attended in such a short time could be considered an ethical flaw of the employer; 75% acknowledged their own ethical flaw when agreeing to conduct the consultation in an inadequate amount of time. When opinions were grouped, 22% considered that an adequate consultation length was fundamental for a correct patient-physician relationship, 27% reported that this time depended on "pressures" of the system...