HubMed - holistic Health
Gambling problems in young people: experience from the Asian region.
Curr Opin Psychiatry. 2013 May 20;
Liu L, Luo T, Hao W
PURPOSE OF REVIEW: To introduce the existing research conducted into gambling problems among young people in the Asian region. RECENT FINDINGS: The prevalence rates of gambling-related problems of young people ranged from 32 to 60% for participation, from 1.5 to 5.0% for problem gambling and from 0.07 to 2.66% for pathological gambling in Asia; social gambling and lottery were the most popular gambling types. Psychiatric comorbidity is common among pathological gamblers, but the causal mechanisms are unclear. The psychological theories on youth gambling in Asia included diathesis, motivation, stress, coping, cognitive and positive youth development. The Positive Adolescent Training through Holistic Social Programmers has been developed; this aims to intervene and help those young people experiencing gambling problems in Hong Kong. SUMMARY: Published gambling studies on young people in Asia are limited and have different definitions, research tools and diagnostic criteria. Therefore, the results vary and are incomparable. More work needs to be done in the near future, on comorbidity mechanisms, the neuropsychological and neurobiological mechanisms of youth gambling and, importantly, an increase in early intervention programmes.
HubMed - Acupuncture
Integrative medicine at academic health centers: a survey of clinicians' educational backgrounds and practices.
Fam Med. 2013 May; 45(5): 330-4
Ehrlich G, Callender T, Gaster B
Integrative medicine is a relatively new field that seeks to combine conventional and nonconventional approaches to patient care. Many academic health centers have now established integrative medicine clinics, yet little is known about the clinicians who practice at them. We used a nationwide survey to characterize the backgrounds, clinical practices, and involvement in research and education of clinicians who practice integrative medicine at academic health centers.Participants included clinicians (MDs, DOs, PAs, and nurse practitioners) who practice at 30 different integrative medicine clinics that are affiliated with academic health centers.Completed surveys from 136 of 162 clinicians were received (84% response rate). The integrative therapies that clinicians most often reported providing themselves were breathing exercises (66%), herbal medicine prescribing (61%), meditation (44%), and functional medicine (34%). The integrative therapies that clinicians most often referred their patients for were acupuncture (96%), massage (92%), yoga (85%), and meditation (79%). Respondents reported spending a mean of 20% of their time training medical students, and 63% had participated in research in the past year.This survey provides the first national assessment of clinicians practicing integrative medicine at academic health centers. These clinicians use a wide variety of complementary and alternative therapies and appear involved in the research and education missions of their academic health centers.
HubMed - Alternative Health
Inefficiencies and vulnerabilities of telephone-based communication between U. S. poison control centers and emergency departments.
Clin Toxicol (Phila). 2013 May 23;
Cummins MR, Crouch B, Gesteland P, Wyckoff A, Allen T, Muthukutty A, Palmer R, Peelay J, Repko K
Context. Poison control centers (PCCs) and emergency departments (EDs) rely upon telephone communication to collaborate. PCCs and EDs each create electronic records for the same patient during the course of collaboration, but those electronic records are not shared. Objective. The purpose of this study was to describe the current, telephone based process of PCC-ED communication as the basis for potential process improvement. Materials and methods. This study was conducted at one PCC and two tertiary care EDs. We developed workflow diagrams to depict clinician descriptions of the current process, descriptions obtained through interviews of key informants. We also analyzed transcripts of phone calls between emergency departments and the poison control center, corresponding to a random sample of 120 PCC cases occurring January 1-December 31, 2011. Results. Collaboration between the ED and PCC takes place during multiple telephone calls, and the process is unsupported by shared documentation. The process occurs in three phases: notification, collaborative care, and ongoing consultation. In the ED, multiple care providers may communicate with the PCC, but only one ED care provider communicates with the poison control center specialist at a time. Handoffs occur for both ED and PCC. Collaborative care planning is common and most cases involve some type of request for information, whether vital signs, laboratory results, or verification that a treatment was administered. We found evidence of inefficiencies and safety vulnerabilities, including the inability of PCC specialists to reach ED care providers, telephone calls routed through multiple ED staff members in an attempt to reach the appropriate care provider, and exchange of clinical information with non-clinical staff. In 55% of cases, the patient was discharged prior to any synchronous telephone communication between the ED care provider and a PCC specialist. Ambiguous communication of information was observed in 22% of cases. In 12% of cases, a PCC specialist was unable to obtain requested information from the ED. Discussion and conclusion. Inefficiencies and vulnerabilities occur in telephone-based PCC-ED communication. Prudence begs consideration of alternative processes and models of ED-PCC communication and information sharing, including a process that supports collaboration with health information exchange.
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