Another look at religious objections to obstetric anaesthesia

Starting with the earliest biographies of James Young Simpson, the topic of religious opposition to obstetric anaesthesia in 1847 was gradually embellished in historical articles. Objective data are lacking and it has been suggested that this is a myth of recent medical history. A search for more information led to a contemporaneous case-book of the maternity hospital in Edinburgh, which was examined. The provision of anaesthesia in the 11 months before publication of Simpson’s pamphlet Answer to the Religious Objections was compared with that in the 11 months after. This revealed a marked increase (P<0.01) in the provision of anaesthesia for childbirth after the publication of Simpson’s pamphlet in December 1847. This analysis supports the existence of opposition to obstetric anaesthesia and the success of Simpson’s pamphlet in overcoming it, but the introduction of chloroform about six weeks earlier, may also have contributed.     

PRACTICE GUIDELINES IN PEDIATRIC HEMATOONCOLOGY: Implementation and Survey. A Possible Way for Medical Quality Assurance

The Hungarian Pediatric Oncology Working Group intended to change the practice of prescribing diagnostic tests as well as to examine the possibility of introducing indicators about the time factors of medical care. A nationwide accepted protocol was established for these tests. The examined time factors were the length of elapsed time from admittance to treatment and the length of hospital stay for different reasons (diagnosis, treatment, complications). Included in to this study are the new cases of 5 common groups of malignancies (acute lymphoblastic leukemia and non-Hodgkin lymphoma, osteosarcoma, soft tissue sarcoma, Wilms tumor, neuroblastoma) for a study period of 1 year. The follow-up data of 152 patients were examined; the length of survey was 1-12 months, depending on when the patients entered the study. As a continuous clinical audit, a system of survey was set up for each follow-up test, using a questionnaire about the conformity of physicians to the protocol, evaluating the principal reasons of deviation from the protocol. Using the data provided by this questionnaire, a renewal of the protocols for each disease was made three times during the whole study period. The principal reasons of nonconformity to the protocol were (1) complications, (2) the nonuse of the protocol, (3) nonacceptance of the protocol, and (4) technical problems. The authors intended to use their time indicators for benchmarking, to make a comparison possible between centers concerning the length of treatment, occurrence of complications, and delays in chemotherapy. However, the examination of the time indicators in the most frequent disease (acute lymphoblastic leukemia, n = 73) showed inverse correlation between the numberof admissions per year per center and the length of time elapsed up to the beginning of treatment. This points to a need for better cooperation in small centers at the initial phase of the diagnosis. The main result of this study is the successful elaboration and implementation of practice guidelines by information linked to performance (the feedback) in daily practice: Compliance during the first 3 months of the study was 28%, and compliance during the last 3 months was 61%.     

What Can Health Communication Science Offer for ACA Implementation? Five Evidence-Informed Strategies for Expanding Medicaid Enrollment

Context: Implementing the Affordable Care Act (ACA) in 2014 will require effective enrollment and outreach efforts to previously uninsured individuals now eligible for coverage.Methods: From 1996 to 2013, the Health Communication Research Laboratory conducted more than 40 original studies with more than 30,000 participants to learn how to improve the reach to and effectiveness of health information for low-income and racial/ethnic minority populations. We synthesized the findings from this body of research and used them to inform current challenges in implementing the ACA.Findings: We found empirical support for 5 recommendations regarding partnerships, outreach, messages and messengers, life priorities of low-income individuals and families, and the information environment. We translated these into 12 action steps.Conclusions: Health communication science can inform the development and execution of strategies to increase the public''s understanding of the ACA and to support the enrollment of eligible individuals into Medicaid or the Health Insurance Marketplace.     

Touch,the essence of caring for people with end-stage dementia: A mental health perspective in Namaste Care

This article presents the mental health aspects of ‘touch’ associated with a funded research project: Avoiding ‘high tech’ through ‘high touch’ in end-stage dementia: Protocol for care at the end-of-life. These mental health aspects highlight the human need for touch that continues up until and inclusive of the final stages of life. This study was informed by Simard's (2007) ‘high touch’ protocol based on the End-of-Life Namaste Care programme for people with dementia. The article is situated in relation to the research project which used a three-phase mixed methods approach. Data explored in this article are derived from focus groups conducted at three residential aged care facilities located in metropolitan and regional areas of NSW, Australia. The exploration of touch vis-a-vis mental health fell under two broad themes: touch by others and touch by the person. Sub-elements of these themes comprised touch towards a physical objective, touch towards an emotional objective, touch of objects and touch of others. The overarching outcome of interconnectedness embraced environmental awareness and human and life awareness. These two broad themes, with their accompanying elements, express the essential nature of mental health as a reciprocal connectedness, with reciprocal impacts on both those people with advanced dementia and their carers.     

胃、十二指肠溃疡出血的临床观察及护理体会

目的探讨胃、十二指肠溃疡出血的有效护理措施,为临床护理提供切实的参考依据。方法将我院近年来收治的108例胃、十二指肠溃疡出血患者随机平均分为对照组和实验组,对照组的患者采取常规护理措施,实验组的患者在常规对症护理的基础上加上护理干预。结果实验组的患者比对照组的患者住院时间短,并发症发生率低,溃疡愈合状况良好。两组的各项指标有显著差异,p<0.05,有统计学意义。结论精心的治疗和科学有效的护理干预能促进患者的痊愈,对患者的早日康复有着重要的意义。     

护理对轮状病毒性肠炎患儿预后的影响

目的为了进一步研究和探讨有效改善轮状病毒性肠炎患儿预后的相关临床护理干预措施和方法 ,从而为轮状病毒性肠炎患儿的护理实践提供参考和依据。方法入选该次研究的病例均为2010年12月—2013年12月期间该院收治的轮状病毒性肠炎患儿,全部患儿共计156例,随机对患儿进行分组,分成了护理干预组和常规护理组,每组患儿78例。分别实施护理干预措施和常规护理措施,对实施不同的临床护理措施的两组患者的家长关于护理工作的满意程度和提供护理干预措施之后患者的大便情况分别进行观察和比较。结果 1对临床护理总满意度组间作比较,护理干预组明显比常规护理组的高,而且组间数据的比较差异有统计学意义（χ2=13.650 0,P=0.000 2）;2大便平均次数组间比较,得到的结果是护理干预组明显低于常规护理组,而且组间数据的比较差异有统计学意义（t=51.390 7,P=0.000 0）。结论针对患有轮状病毒性肠炎的患儿在临床实施护理实践的过程中,若采用该院所提出的临床护理干预措施的临床,则效果显著,可以显著的改善患儿预后并提高临床护理满意度水平,是临床针对轮状病毒性肠炎患儿实施护理的理想选择。