Community treatment orders (CTOs) require individuals with a mental illness to accept treatment from mental health services. CTO legislation in South Australia states that treatment and care should be recovery-focused, although justification for use is predominantly risk-based, and care often coercive. Although CTOs are contested, individuals, families, and clinicians frequently engage in care planning within this context. This paper examines how the concepts of risk and risk management impact care planning from the perspectives of individuals on CTOs, their families, and clinicians. Ethnographic methods of observation and interview provided a detailed account of the perspectives of each group over an 18-month period from two community mental health teams in South Australia. Findings show that care planning occurred within a culture of practice dominated by risk. Risk, however, was understood differently by each participant group, with the dominant narrative informed by biogenetic understandings of mental illness. This dominance impacted on the positioning of participant groups in care planning, focus of care contacts, and care options available. To improve care experiences and outcomes for individuals on CTOs, narrow conceptualizations of risk and recovery need to broaden to include an understanding of personal and social adversities individuals face. A broader understanding should reposition participants in the care planning context and rebalance care discussions, from a focus on clinical recovery to recovering citizenship.
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http://dx.doi.org/10.1111/inm.12877 | DOI Listing |
Importance: Little is known about the spatial accessibility to dental clinics across the US.
Objective: To map the spatial accessibility of dental clinics nationally and to examine the characteristics of counties and US Census block groups with dental care shortage areas.
Design, Setting, And Participants: Cross-sectional study of US dental clinics in 2023 using data from the IQVIA national practitioners' database, which includes 205 762 active dentists.
Support Care Cancer
December 2024
Physical Therapy Program, Medical Science Campus, University of Puerto Rico, P.O. Box 365967, San Juan, Puerto Rico, 00936-5067, USA.
Purpose: Compare the effects of low-intensity and moderate-intensity exercise on physical functioning in breast cancer survivors.
Methods: Women aged 50 + years and post-primary treatment for stage 0 to III breast cancer were randomly assigned to a 6-month low-intensity (LIG) or moderate-intensity (MIG) exercise group. Participants were instructed to walk (low- or moderate-intensity) for 30 min five days a week, followed by flexibility exercises, and do strengthening and balance exercises twice weekly.
Eur Child Adolesc Psychiatry
December 2024
Department of Neurodevelopmental Disorders, Bethesda Children's Hospital, Budapest, Hungary.
Tourette syndrome and other tic disorders are prevalent neurodevelopmental disorders typically treated with behavioral techniques or pharmacological interventions, primarily antipsychotics. However, many patients do not achieve sufficient response to conventional treatments, underscoring the need for further research in this area. To provide a comprehensive overview of ongoing research activities, we systematically searched the clinical registries of the World Health Organization (WHO) and of the United States National Institutes of Health (NIH) for currently planned or ongoing registered clinical studies.
View Article and Find Full Text PDFJ Med Internet Res
December 2024
Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Background: Structured and standardized documentation is critical for accurately recording diagnostic findings, treatment plans, and patient progress in health care. Manual documentation can be labor-intensive and error-prone, especially under time constraints, prompting interest in the potential of artificial intelligence (AI) to automate and optimize these processes, particularly in medical documentation.
Objective: This study aimed to assess the effectiveness of ChatGPT (OpenAI) in generating radiology reports from dental panoramic radiographs, comparing the performance of AI-generated reports with those manually created by dental students.
Alzheimers Dement
December 2024
Medical & Scientific Relations Division, Alzheimer's Association, Chicago, Illinois, USA.
US clinical practice guidelines for the diagnostic evaluation of cognitive impairment due to Alzheimer's disease (AD) or a related dementia (ADRD) are two decades old. This evidence-based guideline was developed to empower all clinicians to implement a structured approach for evaluating a patient with symptoms that may represent clinical AD/ADRD. An expert workgroup conducted a review of 7374 publications (133 met inclusion criteria) and developed recommendations as steps in an evaluation process.
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