Permanent care: 24 hours nursing care, our way to take care

Theoretical-reflexive study motivated by the epistemology of Gaston Bachelard and by the project "Thousand and one ways to take care in Nursing" by Maria José Coelho. We had as objective to trace new ways to take care in dialysis nursing, creating a system of cares offered to chronic kidney patients. Seven nursing cares that involve care of people in dialysis treatment were described: reception; bonding; specialized techniques; support to self-care; assessment of the treatment, facing the unstimulating routine; and citizenship rescue. Permanent care emerged, understood as an articulate and complementary relation between the scientific knowledge present in nursing care and the valorization of the other's essence, as a complex being in its whole.     

New perspectives on our national health care dilemma

Continued debate over who should pay for the increasingly unaffordable U.S. health care system has failed to yield a consensus solution. Shifting attention to how to reduce health care costs may be more productive. Strategies for achieving this goal include drastically reducing costly quality deficiencies, eliminating higher cost care options that add no demonstrated value, recognizing that responsibility for clinical and cost consequences cannot be divided, and acknowledging that rationing available resources is superior to other allocation alternatives.     

我院药剂工作向药学服务转型的探讨

目的改变药学人员的旧观念,推动医院药学服务工作的发展。方法利用归纳总结的方法,汇总近期颁布的药学政策法规,分析本院药学工作现况并提出讨论。结果本院药学人员的意识和综合能力得到提升、窗口服务得到改善、处方质量得到了较大提高但药物正确选择、抗菌药物应用规范等方面的缺陷改善不明显。结论医院药学人员应以促进合理用药为目标,努力做好药学技术服务。     

Hospital missions and the education of our future health care workforce

Today's U.S. health care industry is facing unprecedented shortages of health personnel in a great variety of disciplines and locations. An adequate supply of well-educated and trained health professionals is imperative to ensure sufficient access to health care for our citizenry. Hospital mission statements reflect the character, strategic direction, and priorities of the organization; thus, we might expect these statements to address the position and strategy of the organizations in regard to education of future health professionals. To investigate hospitals' publicly stated attention and commitment to the education of health professionals, we analyzed publicly available mission statements from a random stratified sample of 402 hospitals. The hospitals were stratified on the basis of teaching status, rural or urban, and profit status. The percentage of hospitals mentioning an education-related keyword was estimated using a 95% confidence interval with a finite population correction factor on the proportion within each stratum. As expected, teaching hospitals were significantly more likely to include language about education in their mission statements than nonteaching hospitals, with 74% of teaching hospitals mentioning education at least once. We found no significant difference in the use of education language among the mission statements of nonteaching hospitals, where 20% mentioned education at least once. From these findings, we conclude that despite the key importance of health professionals, strategies and policy regarding the education of future health personnel have not yet become "mission level" in importance to hospitals.     

Putting people first: health care our families can afford

With U.S. health care costs expected to reach 16.4 percent of the gross national product by the year 2000, the nation can no longer afford not to have a national health care plan. The reciprocal problems of cost control and access to health insurance can be addressed by implementing health expenditures targets and market reform guaranteeing coverage, reforming health care insurance, improving our primary care delivery system, and improving health education. Such a program will enable America to have the confidence and productivity necessary to achieve global economic leadership.     

Diagnosis and therapy of myotonic dystrophy in our practice of neuromuscular care

INTRODUCTION: Myotonic dystrophy is the most frequent, autosomal dominantly inherited muscular dystrophy. The typical neurological picture (facial myopathy, myotonia, muscle atrophy) may be associated with cardial, endocrine and ocular symptoms. METHODS: The diagnosis is based on electromyography, muscle biopsy and genetical tests. Muscle histology is characterized by high frequency of central nuclei. Genetical tests detect CTG repeat expansion of the involved gene. AIMS: Authors summarize 9 cases found in the Neurology Clinic of Pecs University in the last three years. RESULTS: The prevalence is lower than expected, therefore some cases might be unrecognized. After recognizing the typical clinical picture, electrophysiological, muscle biopsy, brain MRI, psychologic and molecular genetic studies were performed. Six patients belonged to 3 families and 3 sporadic cases were found. In all except one patient mild neurocognitive deficit was detected. Three patients had cataract and cardiac involvement. CONCLUSIONS: The authors emphasize that in cases of cardial, endocrine and central nervous system involvement myotonic dystrophy must be considered and detailed examinations are necessary for early detection of the specific organ manifestations.