Interventions, comprehensive

More recently, thrombolytic therapy was reported in 106 patients as part of the TEMPiS system in Bavaria, Germany. The network consists of two comprehensive and 12 regional centers connected by around-the-clock telemedicine support for stroke care. In the first year following intervention, the number of patients treated with rt-PA increased to 86 patients (2% of all patients admitted with stroke), compared to 10 patients treated in the year preceding intervention. The rate of symptomatic hemorrhage was 8.5%, similar to the NINDS trial. " ... 

Access to health care can be defined in many ways, including by insurance status, number of physician visits in the last year, and treatment interventions once an individual is in the health care system. Furthermore, access can relate to whether the patient s health care is satisfactory, comprehensive, and meeting the overall needs of the patient from a social, cultural, spiritual, or other perspective. 

The voluntary consent of the human subject is essential. This means that the person involved should have legal capacity to give consent should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, over-reaching, or other ulterior form of constraint or coercion and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an rmderstanding and enlightened decision. This latter element requires that, before the acceptance of an affirmative decision by the experimental subject, there should be made known to him the nature, duration, and purpose of the experiment the method and means by which it is to be conducted all inconveniences and hazards reasonably to be expected and the effects upon his health or person, which may possibly come from his participation in the experiment. 

The course of training for music therapists is comprehensive. In addition to formal musical and therapy training, music therapists are taught to discern what kinds of interventions will be most beneficial for each individual patient. 

Table 2.8. Typical issues addressed when designing a clinical trial protocol. The trial objectives should clearly define what questions the trial should answer. The study design section should contain comprehensive information detailing trial size, criteria used to choose the study population, and enrolment procedures. Description of intervention section should give the background to the intervention itself, its therapeutic rationale and how it is to be administered. Measurement of response should detail the data to be collected, how it will be collected and analysed. The organization and administration section should give full details of all the investigators, where the trial is being run, and its project management details...

Consideration of the use of medications in children requires a careful discussion with the child and the child s family of the risks and benefits potentially associated with the treatment. The AACAP Practice Parameters address the issue of informed consent, and how children, parents, and clinicians might reach a consensus on the use of medications (King, 1997). Children should have the opportunity to assent to the use of medications at a developmentally appropriate level. In general, pharmacotherapy should not be used as the sole intervention for a child s disorder but should be integrated into a comprehensive treatment plan. 

Al-Razi (Rhazes, 854-925) was a Persian who studied in Baghdad. Al-Razi wrote extensively on medicine, philosophy, astronomy, and alchemy, but he was primarily a physician. Al-Razi was less mystical than his contemporary alchemists and classified chemicals by their origin. According to Al-Razi, chemicals came from either animals, plants, and minerals or were derived from other chemicals. Al-Razi wrote The Comprehensive Book, which was an enormous medical encyclopedia that synthesized medical practices of ancient Greeks, Syrians, Arabs, and Persians. Al-Razi was the first person known to describe the disease smallpox. Most of his alchemical writings have been lost, but Al-Razi believed in the atomic nature of matter. Al-Razi took a systematic approach to science and rejected the idea of divine intervention. His rational methods and descriptions were more consistent with modern science than most individuals of his time. Ali al Husayn ibn Sina (Avicenna, 980-1037) was another Persian physician whose voluminous works, including The... 

Having established the primary role of antipsychotics, evidence indicates that psychosocial therapies, when administered with these agents, improve long-term prognosis. Because chronically psychotic patients have difficulties with social adjustment, reason dictates that they and their families could benefit from such interventions. Regardless of theoretical orientation, it is clear that practitioners should provide psychosocial therapy as part of a comprehensive treatment strategy. 

Consequently, botulinum toxin represents a strategy for dealing with spasticity that is especially problematic in specific muscles or groups of muscles. Despite the rather ominous prospect of injecting a potentially lethal toxin into skeletal muscles, this intervention has a remarkably small incidence of severe adverse effects when administered at therapeutic doses.5,44 Botulinum toxin can therefore be used as part of a comprehensive rehabilitation program to provide optimal benefits in certain patients with severe spasticity. 

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