A frontier nursing service

The type of cases which come to the service of Cook County Hospital makes “a follow-up” exceedingly difficult for a period sufficiently long. Frequency of syphilis makes the possibility of pregnancy rather remote. Of sixteen cases of transplantation all resumed menstrual function from three weeks to three months after the operation. Slight dysmenorrhea was the only complication noted in some of the cases. Out of a group of five cases of transplantation with preservation of the pedicle, all menstruated and one became pregnant six months later, but aborted at two months. The effect of operation upon the health and the psychic states of the women was most gratifying. My experience coincides with that of Estes and Tuffier. Preservation of ovarian function in these cases is a distinct advance over the older castrating procedures.     

Ambulance utilization in metropolitan and rural areas in Taiwan.

BACKGROUND AND PURPOSE: Emergency medical services (EMS) have expanded rapidly in the Asian developing countries recently. However, the patterns of ambulance utilization in the rural and urban areas of these countries have not been thoroughly described. This study investigated the patterns of ambulance utilization in two urban areas and the larger rural area of Taiwan formerly designated Taiwan Province. METHODS: We studied a total of 304,368 ambulance missions during 1997 in Taiwan. We analyzed the differences in the characteristics of emergency calls and the interventions performed on the scene in two urban areas, Taipei City and Kaohsiung City, and in the rural area formerly designated Taiwan Province. RESULTS: The call volume and percentage of non-transport calls were higher in the more developed of the two urban areas, Taipei City, than in Kaohsiung (p < 0.01). The incidence of calls with trauma-related causes was higher in both urban areas. However, the percentage of calls placed for trauma-related reasons was higher in the rural area (p < 0.01). More calls for acute medical illness were placed in Taipei City (p < 0.01) than in the rural area. The number of interventions performed by ambulance staff was higher in Taipei City and Kaohsiung City than in the rural area (p < 0.01). The availability of acute illness management was generally lower than needed in all areas. CONCLUSIONS: Call volume and the number of interventions performed were higher in the urban area, whereas the percentage of trauma-related calls was higher in the rural area. These findings suggest that EMS use patterns in Taiwan are transitioning towards a pattern characteristic of a more developed country. The differences in ambulance utilization patterns must be considered in plans to further develop EMS services in these areas.     

Tubectomies in rural areas of Jaipur district

In Jaipur district, 1065 cases of tubectomies were performed from 1974-1975, of which 1000 were performed vaginally and 65 through the abdomen using the Pomeroy and Viennese Method. The majority of patients were between 25-34 years old and had 4 or more children. Post-operative side effects included menstrual disturbance (25% of the patients), backache (25%), leucorrhea (18%), low abdominal pain (20%), and sexual dyspareunia (2.1%). Complications included: 1) rectal injury; 2) ruptured cystic ovary; 3) bleeding; 4) spinal headache; 5) febrile convalescence; and 6) distension of abdomen. 2 deaths from peritonitis and paralytic ileus occurred because the patients did not seek help soon enough. There are no sterilization failures at present.     

Family planning by nurse-midwives in a rural area

Graduate nurse-midwives in rural Kentucky, where the physician to population ratio is 1:5000, make significant contributions to both oral contraceptive programs and IUCD programs. Nurse-midwives assumed follow-ups since the patients had confidence in their judgement. Starting in 1964, nurse midwives were trained in the insertion of IUCDs. Retention rate of 244 IUCDs inserted by nurse-midwives compared favorably with those inserted by physicians.     

Determinants of institutional childbirth service utilisation among women of childbearing age in urban and rural areas of Tsegedie district,Ethiopia

Background

despite receiving greater attention, optimal maternal health remains a challenge in developing countries such as Ethiopia. Evidence from various studies shows that skilled attendance during childbirth is among the key strategies to reduce maternal mortality. However, in Ethiopia, the use of institutional childbirth services is very low. In Ethiopia, studies dealing with factors affecting women?s use of institutional childbirth services are scarce and generally focus on urban settings. As such, this study aimed to explore the determinants of institutional childbirth service utilisation among urban and rural women who gave birth in the previous two years in Tsegedie district, Ethiopia.

Methods

a community-based cross-sectional study was performed from 20 November 2012 to 30 June 2013 on 485 mothers. The participants were selected systematically using a multistage sampling technique. A pre-tested structured questionnaire, administered by an interviewer, was used to collect quantitative data. Focus group discussions and in-depth interviews were used to triangulate the evidence from the quantitative study. Bivariate and multivariate data analysis was performed using Statistical Package for the Social Sciences Version 17.0.

Finding

this study found that 31.5% of the respondents used institutional childbirth services. The main reason for home birth was close attention from family (47%). Women?s educational status [adjusted odds ratio (AOR) 5.3, 95% confidence interval (CI) 1.59–17.87], time taken to reach the nearest health facility (AOR 3.3, 95% CI 1.15–9.52), ultimate decision maker regarding the place of childbirth (AOR 3.7, 95% CI 1.08–12.63) and receipt of maternal and child health care information (AOR 9.4, 95% CI 2.4–36.38) were significantly associated with the use of institutional childbirth services.

Conclusion

the proportion of births attended in health facilities was low in the study district. Women?s educational status, distance to the nearest health facility, women?s decision-making power and receipt of maternal and child health care information were important predictors of institutional childbirth service utilisation. This implies that women still lack physical and effective access to maternal health care services. Thus, improving community awareness about skilled providers and institutional childbirth, targeting women who prefer to give birth at home, is encouraged. Safe motherhood education using communication networks in rural and urban communities is crucial. Furthermore, it is recommended that essential obstetric care facilities (health centres) should be established within a reasonable distance of homes, women should be empowered and community midwives should be deployed.     

Nutrition of pregnant women in rural and urban areas

The purpose of the study was to gain information on the present state of nutrition of pregnant women in rural areas and towns, and on the level of their knowledge of adequate nutrition. The study covered 300 women in villages and 258 in towns. The selection of women was done randomly, the method of the study was interviewing of the women. The questions concerned consumption of milk, cheese, meat and its products, eggs, vegetables and fruit during the whole pregnancy, and separately the data on potato consumption were obtained. The women were questioned also about the read publications on rational nutrition of pregnant women. The answers were obtained from mothers aged 18-42 years in labour rooms, clinics for children or in homes. The answers were noted during interviews by experienced interviewers. It was found that 26.6% of pregnant women in towns and 16.2% in villages were not consuming daily milk or cheese, while 6.2% of these women in towns and 4.3% in villages consumed no milk at all. Only 41.1% of these women in towns and 19% in villages took meat and processed pork everyday. Most frequently the women consumed meat and processed pork 4 times weekly (39.6% in towns and 60.3% in villages). Eggs were consumed daily by only 13% of women in towns and villages, and they were eaten most frequently 4 times weekly (30.2% in towns and 45.7% in villages). In a week meat, processed pork and eggs were eaten 5 to 7 times by only 43.8% of pregnant women in towns and 21.3% in villages.(ABSTRACT TRUNCATED AT 250 WORDS)     

小儿支气管哮喘的家庭护理分析

目的:对患有支气管哮喘的患儿进行家庭护理的具体措施和相应的护理体会进行总结。方法:抽取80例在我院就诊的患有支气管哮喘的临床确诊患儿病例,在其治疗结束出院时,根据患儿的各自特点,为患儿制定有针对性的家庭护理方案,并对家长进行一定的培训,采用定期电话或上门随访的方式,对患儿的家庭护理效果进行了解,总结护理的具体措施和相应的体会。结果:分析结果表明,家长们都能在患儿出院后按照医院所制定的家庭护理方案对患儿进行护理,所有患儿的病情都得到了完全的康复,没有一例患儿出现复发再住院的情况。结论:对患有支气管哮喘的小儿患者,在其结束治疗出院后,对其进行正确且有针对性的家庭护理,对患儿的病情完全康复,防止由于病情反复导致出现再住院现象,有着积极的促进作用,在今后的临床工作中应给予充分的重视。