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991.
Julie Considine RN RM BN GDipNurs GCertHigherEd MNurs PhD FRCNA Mari Botti RN BA GDCAP PhD Shane Thomas BA DipPubPol PhD 《Australasian emergency nursing journal : AENJ》2011,14(3):180-188
Background
Streamlining emergency department (ED) care of patients with chronic obstructive pulmonary disease (COPD) may be an important strategy in managing the increasing burden of this disease.Study objectives
The aim of this study was to identify factors predictive of hospital admission in ED patients with COPD, specifically factors that can be used early in the ED episode of care.Methods
Using retrospective regression analysis, case data from 321 randomly selected medical records from five Australian EDs were analysed. Patient characteristics, triage and ED system features, physiological status, and ED treatment during the first four hours of ED care were compared between discharged and admitted patients.Results
Factors available on ED arrival associated with increased likelihood of admission were: age (OR = 1.04, p = 0.008) respiratory symptoms affecting activities of daily living (OR = 1.8, p = 0.043) and signs of respiratory dysfunction (OR = 2.5, p = 0.005). Factors available from the first four hours of ED care associated with increased likelihood of admission were: age (OR = 1.04, p = 0.021), oxygen use at four hours (OR = 3.5, p = 0.002) and IV antibiotic administration (OR = 2.6, p = 0.026). There were conflicting findings regarding the association between ambulance transport and admission.Conclusion
There were significant differences in the characteristics of patients who were admitted or not admitted to hospital. Knowledge of these differences may be used to tailor care directed at anticipated outcome (home or hospital admission). 相似文献992.
993.
994.
van den Berg Jolice P Westerbeek Elisabeth AM Berbers Guy AM van der Klis Fiona RM Lafeber Harrie N van Elburg Ruurd M 《Tijdschrift voor kindergeneeskunde》2013,81(1):23-24
Tijdschrift voor Kindergeneeskunde - 相似文献
995.
Yvonne L. Hauck BScN RM MSc PhD Professor Catherine Graham-Smith RN RM BNsg Staff Development Educator Justine McInerney BN PG Dip PG Dip Coordinator Performance Analysis & Clinical Midwife Sue Kay RN RM Clinical Midwife 《Midwifery》2011,27(5):486
Objective
to explore women’s perceptions of conflicting advice around breast feeding from formal support networks, specifically health professionals involved in postnatal support.Design, setting and participants
a qualitative exploratory design was employed using the critical incident technique. Data were obtained from 62 Western Australian women who responded to an invitation to share incidents of receiving conflicting advice. Women who had breast fed a child within the past 12 months shared their experience through a telephone interview (n=50) or completing a brief questionnaire (n=12) addressing the following questions: Describe a situation in detail where you felt you received conflicting advice about breast feeding from a health professional. How did this situation affect you and/or your breast feeding?Findings
a modified constant comparison method was used to analyse the critical incidents revealing commonalities under who offered conflicting advice; what contributed to advice being perceived as conflicting; topic areas more inclined to being regarded as conflicting; what protected against advice being perceived as conflicting; the consequences of receiving conflicting advice; and strategies that women used to manage these incidents.Key conclusions and implications for practice
advice that was viewed as conflicting extended beyond the provision of information that was inconsistent or directly contradictory, and included issues around information overload and disparities between the mother’s and health professional’s expectations. The manner of presenting information or advice, the skills of using effective communication, demonstration of a caring attitude with an empathic approach and focusing upon the woman as an individual were seen to be important to minimise these incidents. Attention to women’s perceptions and the consequences of conflicting advice must be addressed, otherwise the credibility and confidence in health professionals’ knowledge and ability to support breast feeding is questioned, resulting in a valuable support network being selectively ignored. 相似文献996.
Jane Warland RN RM Dip Appl Sc PhD Lecturer in Nursing Midwifery Joann O’Leary MPH MS PhD Field faculty Helen McCutcheon RN RM BA MPH PhD Professor Head of School 《Midwifery》2011,27(5):628-633
Objective
to gain an in-depth understanding of subsequent children’s experiences of being born into and raised in a family following an infant death.Design
an exploratory qualitative study.Setting
semi-structured interview in the participants’ homes. Data were collected over a five-month period in 2009 and analysed using thematic analysis.Participants
a purposive sample of 10 subsequent children (five boys and five girls) was used. Children whose parents had accessed the support services offered by two bereavement support agencies were recruited. Participants were asked to describe their experiences of being a subsequent child. Interviews were conducted when the subsequent child was at least 13 years of age.Findings
all participants spent time describing how they felt about being a subsequent child. They described how they had experienced life as a subsequent child, how they considered others felt about them (especially their mother), and finally how they felt about their deceased sibling.Key conclusions and implications for practice
all participants in this study provided a picture of emotional well-being. They were aware of their family history, and all appreciated the grief and loss which their parents had suffered. However, they did not believe that this had impacted negatively on them; rather, most talked about positive effects including feeling loved and special because of the circumstances resulting in their birth. Even those who recognised that they may not have been born had their sibling lived accepted this and appeared to be emotionally secure and well adjusted. These findings suggest that intervention with bereaved parents at the time of the perinatal/infant death and soon after is beneficial to the experiences of the subsequent child. Further research to determine the nature and extent of this benefit is warranted. 相似文献997.
Destructive deformation of the digits with auto-amputation: a review of pseudo-ainhum 总被引:1,自引:0,他引:1
RM Rashid† E Cowan† SA Abbasi‡ J Brieva§ M Alam§ 《Journal of the European Academy of Dermatology and Venereology》2007,21(6):732-737
Pseudo-ainhum is an auto-amputation of the digits. Although extremely rare, it is a traumatic and painful experience that can be alleviated with early recognition and intervention. The scientific literature is filled with reports of this interesting but unfortunate phenomenon. To date, a firm causative aetiology has not yet been established. Although reports on this phenomenon have attempted to further our understanding of pseudo-ainhum, a clear understanding has been complicated by the interchangeable use of terms describing this auto-amputation. In this review, we discuss the current understanding, diagnostic criteria, and management of pseudo-ainhum. Furthermore, the nomenclature of pseudo-ainhum is clarified. Ideally, this will allow for more efficient exploration of pseudo-ainhum, its causes, and therapeutic approaches. 相似文献
998.
M Akhyani AH Ehsani RM Robati AM Robati 《Journal of the European Academy of Dermatology and Venereology》2007,21(10):1330-1332
BACKGROUND: Psoriasis is an inflammatory dermatosis that is characterized with hyperproliferation of keratinocytes and inflammatory infiltration in the epidermis and dermis. The high prevalence of atherosclerosis has been reported in psoriatic patients. High serum lipid level has been suggested in the pathogenesis of this phenomenon. In this study, our purpose was to compare the lipid profile in psoriatic patients with non-affected persons. METHODS: This study was designed and conducted as a case-control assay with 50 cases in the patient and control groups, respectively. The lipid profile, including serum level of triglyceride, cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL), were assessed in both groups. RESULTS: The patient and control groups each consisted of 50 cases (39 male and 11 female). The serum triglyceride, cholesterol, and LDL was significantly higher in psoriatic patients (P < 0.05) but not for HDL (P = 0.29). CONCLUSION: This study, like previous assays, shows that high serum lipid level is significantly more common in psoriasis. This fact may be responsible for higher prevalence of cardiovascular accident in psoriatic patients. It may be useful to do early screening and treatment of hyperlipidaemia in psoriasis to prevent the atherosclerosis and its complications. 相似文献
999.
1000.
Naehrig S Lang S Schiffl H Huber RM Fischer R 《European journal of medical research》2011,16(2):63-66