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Objective
To compare estimated versus measured blood loss at the time of dilation and evacuation (D&E).Study design
We measured blood loss for all D&E procedures between 16 and 24 weeks at one abortion clinic over 9 months. We weighed all blood-containing items and measured blood captured in the D&E tray. Providers recorded estimated blood loss before weighing or measuring blood. We compared median measured blood loss (MBL) and estimated blood loss (EBL) for each gestational week.Results
We measured blood loss in 371 of the 534 D&Es in the study period; we excluded 163 procedures because of failure to measure blood loss or contamination with amniotic fluid. Included and excluded procedures had similar median EBLs. Median EBL differed significantly from MBL for each week gestation from 16 to 24 weeks (p≤.001 for all comparisons); MBL was approximately twice as high as EBL for each gestational week. EBL and MBL increased with increasing gestation, as did the difference between EBL and MBL.Conclusion
Providers consistently and significantly underestimate blood loss at the time of D&E. D&E providers may want to consider using a new heuristic for estimating blood loss.Implications
Providers significantly underestimate blood loss at the time of D&E. Future research should confirm these findings (particularly at 22–24 weeks gestation), evaluate the efficacy of interventions to improve estimations of blood loss, and determine best practices for decreasing blood loss. 相似文献Background
Knowledge about frailty among patients seen by general practitioners (GP) is currently limited.Patients and methods
Frailty assessment by the criteria of Fried and additional documentation was performed at a GP??s office.Results
Out of 119?participating patients, 14.3% were classified as frail, 52.1% as prefrail, and 33.6% as not frail. Frailty was associated with comorbidity, the number of drugs prescribed, depressive symptoms, cognitive function, and frequency of falls.Conclusion
The prevalence of frailty is high among the cohort of elderly persons seen by a GP. Routine frailty assessment will help to direct preventive and therapeutic interventions. 相似文献Background: Stigma is one of the most frequently cited barriers to seeking treatment and many women with perinatal mental illness fail to get the treatment they need. However, there is no psychometric scale that measures how women may experience the unique aspects of perinatal mental illness stigma.
Method: A draft scale of 30 items was developed from a literature review. Women with perinatal mental illness (n = 279) were recruited to complete the City Mental Illness Stigma Scale. Concurrent validity was measured using the Internalised Stigma of Mental Illness Scale. Factor analysis was used to create the final scale.
Results: The final 15-item City Mental Illness Stigma Scale has a three-factor structure: perceived external stigma, internal stigma and disclosure stigma. The scale accounted for 54% of the variance and had good internal reliability and concurrent validity.
Conclusion: The City Mental Illness Stigma Scale appears to be a valid measure which provides a potentially useful tool for clinical practice and research in stigma and perinatal mental illness, including assessing the prevalence and characteristics of stigma. This research can be used to inform interventions to reduce or address the stigma experienced by some women with perinatal mental illness. 相似文献