Ecosystem health as a clinical rotation for senior students in Canadian veterinary schools

A research nurse interviewed 55 practice staff in 11 general practices to ascertain their views about their needs for occupational health care. In a second parallel study, a specialist in occupational medicine undertook an in-depth audit of occupational health provision in five other general practices with respect to the organization, the health and safety process, the services and the working environment. In the first study, the majority of practice staff reported the need for various aspects of occupational health care, particularly stress at work. In the second study, general practitioners and practice managers possessed a basic awareness of occupational health matters such as Health and Safety legislation, but their limited knowledge was not translated into effective management. General practice staff did not know where to obtain occupational health advice; most practices had no policies or procedures in place to manage health and safety. Both studies illustrate the need for expert occupational health advice in primary care.     

Transgene expression kinetics after transfection with cationic phosphonolipids in hematopoietic non adherent cells

Persons with chronic mental illnesses have a higher prevalence of medical illnesses and higher mortality rates than the general population. Those living in the community are usually linked with mental health services but are expected to manage their own medical care. The ability to manage their health care and the ability of "surrogate families" to assist them were measured among residents and staff of supervised community residences. In its surrogate role, the agency promoted routine health examinations and follow-up care. Its staff was a central resource for the residents, who sought out staff members for assistance with their health problems. However, residents and staff alike lack knowledge about health problems, medications, and approaches to modifying unhealthy lifestyle practices. Although residents identified lack of knowledge about sexually transmitted diseases as a major concern, staff indicated discomfort with this topic. These findings suggest the importance of supporting chronically mentally ill persons and residential staff in managing residents' health care functions.     

Fatal pulmonary fat embolism after dorsal spinal fusion

OBJECTIVE: To determine whether health shop staff give specific therapeutic recommendations to someone who describes symptoms associated with serious pathology and to determine whether they refer this person to conventional medical care. DESIGN: Quantitative survey using participant observation. SETTING: Health food shops selling herbal, homeopathic or nutritional remedies in inner London. METHOD: A researcher visited 29 health food shops and claimed to be suffering from severe, daily headaches of recent onset. The researcher recorded on tape whether the health shop staff took diagnostic information; recommended any therapeutic intervention; asked about or recommended seeing a general practitioner (GP); asked about use of conventional drugs. Coding of the interactions was carried out independently by two researchers. RESULTS: Whereas all but two shops recommended a specific therapeutic intervention, less than one in four advised a GP consultation. Forty-two different interventions were recommended. There was little consistency in the advice given. CONCLUSION: Health food shops need to review the circumstances in which they should venture to provide advice and the basis on which they make any therapeutic recommendations. Shops selling over-the-counter herbal, homeopathic and health food products are a common feature of UK high streets. Such shops could be a useful source of health information and advice to their customers, but could also lead to harm, for example by delaying treatment of known benefit, if their recommendations were to be inaccurate or inappropriate.     

Health education via interactive television

Providing health education in rural areas is a challenge because of the time and cost involved in travel to serve small groups of clients in their own towns. Baccalaureate nursing students provided health education to faculty and staff members in five rural high schools simultaneously through the use of interactive television.     

Prostate surgery: a communication challenge

Many patients requiring prostate surgery experience a lack of interest from health-care staff in relation to their views and opinions. Information offered to patients who have undergone prostate surgery is often inadequate as a result of poor communication by health staff. Nurses need to understand the priorities of their patients and use this information to inform the way in which advice is given.     

Flow-injection analysis of cobalt(II) utilizing enhanced lophine chemiluminescence with hydroxylammonium chloride

This study was designed to look at General Practitioner's knowledge of and attitudes to the use of seat belts in pregnancy. It has been shown that correct seat belt use does significantly reduce both maternal and fetal morbidity and mortality following RTAs. However, seat belts are infrequently and often incorrectly utilised by women during pregnancy. Passenger safety education is essential. General Practitioners in Ireland are in a prime position to provide this education in early pregnancy. A postal questionnaire was sent to all members of ICGP (n = 1,780). The results show that 70% of GPs are aware that women are obliged by law to use a seat belt while pregnant, and a similar number felt the subject of passenger safety education is an important medical issue. 75% feel women should wear seat belts in third trimester. However, only 30% provide regular advice and less than 50% indicated that they are aware of the correct advice to give. Also GPs are not asked by their pregnant patients for advice. There is no statistically significant difference between male and female GPs. GPs have the opportunity to and so should provide passenger safety advice. This advice must be accurate and safe.     

构建冶金企业自主型员工队伍的建设实践

当前钢铁工业面临资源价格高涨,需求增速趋缓、环境压力增大的严峻挑战,针对具有大专文化比例高达65%以上、平均年龄不足30岁的职工队伍,塑造自己的企业文化,对每一位新入厂的员工不仅进行三级安全教育,还进行入厂文化教育,通过加强员工的培训与教育、充分发挥员工的自主独立性、给员工足够的关爱、强调以人为本,实行分散化管理、实施正确的激励等管理措施,构建一支自主型员工队伍体系,最大限度地利用其拥有的知识,形成有效的合力,促进企业目标的实现。     

Preceptorship: a model to empower nurses in rural health settings

Continuing education and staff development help nurses meet new needs and demands caused by rapid changes in society, demography, technology, politicoeconomic structure, and disease patterns. Rural nurses have a unique, generalist role within their practice but are disadvantaged in accessing professional development because of geographical and professional isolation. A preceptorship program was developed to empower individual nurses in rural health units in South Australia. This program equipped them with the knowledge, skills, and attitudes necessary to make changes in their health units. At the same time, it enabled participants to act as mentors to colleagues in collaborative partnerships designed to meet the complex health needs of their rural clients.     

Predictors of brief smoking intervention in a midwifery setting

The aims of this study were: to assess current practice in smoking cessation interventions by midwives and to examine the relationship between the use of smoking intervention, practitioner characteristics and organizational factors. A mail-out survey was sent to a random sample of 500 midwives. The response rate was 85% (n = 425). The results indicated that most midwives used minimal interventions (advice and education) for at least some of their clients. However, the more skilled and more time-intensive forms of intervention such as counselling about methods to quit, negotiating a quit date and follow-up were infrequently utilized. Moreover, participants estimated that half their smoking clients were not offered any advice about smoking. Organizational factors such as: hospital policy for smoking intervention, type of hospital, size of hospital, cohesion of staff and work pressure predicted the use of smoking interventions. Self-reported ability to intervene for smoking and the level of assessment undertaken were practitioner characteristics which predicted the use of smoking interventions. The barriers that inhibit the use of smoking intervention by midwives are discussed and methods for change canvassed.     

Use of complaint procedures in cases of therapist–patient sexual contact.

Clients' use of complaint procedures after sexual involvement with psychotherapists is examined, and the effectiveness of these procedures is evaluated. In California, the system chosen for study, between 12 and 16 therapists were disciplined for sexual contact with clients in 1982. Representatives of state licensing boards and therapists' professional organizations attributed this acknowledged underreporting to clients' refusal to lodge complaints. However, interviews with 21 women who had been sexually involved with their male therapists contradicted this assumption. For most of the women, it was lack of knowledge rather than lack of motivation that kept them from taking action on their own behalf. Those who did file complaints found that taking action was healing, even though the results were often minimal. Data from interviews suggest guidelines for the kind of consumer education needed and some pitfalls to be avoided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of biotinylated cells as a source of antigens for characterization of their molecular profile

BACKGROUND: Childbirth by emergency cesarean section can be a traumatic experience, but since the result is often a healthy mother and baby, its seriousness is open to doubt. METHOD: Fifty-three women were interviewed approximately two days after emergency cesarean section to ascertain whether or not the trauma met the stressor criterion of posttraumatic stress disorder. A time-spatial model from disaster psychiatry was used to chart the women's thoughts and feelings during consecutive phases of the delivery process. The women's causal attributions of the event were also assessed. RESULTS: Generally speaking, the feeling of the women after they had arrived at the delivery ward changed from one of confidence and safety to one of fear. The decision to undertake a cesarean section brought a feeling of relief, but this was again replaced by fear as the operation approached. The women's thoughts centered around the impending delivery and operation until after the event, when the newborn baby occupied their attention and happiness predominated. In retrospect, 55 percent of the women experienced intense fear for their own life or that of their baby. Eight percent felt very badly treated by the delivery staff and were angry. Almost all the women had adequate knowledge of the reasons for the emergency cesarean section. One in four blamed themselves to some extent for the event. CONCLUSIONS: The stressor criterion of DSM IV is applicable to the trauma of emergency cesarean section. Even if and when a new mother is happy to meet her baby, negative feelings, such as fear, guilt, or anger, may dominate her memories of the birth.     

A study of the services provided by the women's health nurses in a Sydney Area Health Service

OBJECTIVES: To describe the client characteristics and nature of services provided by women's health nurses and to examine whether the goals set for the service are being met. DESIGN: A retrospective study of women's health nurse (WHN) records from 1987 to 1991. SETTING AND SUBJECTS: All women attending the women's health nurse in the Southern Sydney Area Health Service, 1987 to 1991. Older women and women of non English-speaking background are specific targets for this service. OUTCOME MEASURES: Pap test and breast self-examination practices were examined in relation to age and ethnic background. Use of general practitioner services was examined for all women attending the women's health nurse in 1991. RESULTS: Forty-five per cent of clients were aged over 50, and 29 per cent were from a non English-speaking background. Older women were more likely to return for subsequent visits to the women's health nurse. The practice of breast self-examination increased significantly between visits among all women. Forty-one per cent of women had not had a Pap test for at least three years, 93 per cent of these women were screened at their first visit. Eighty-seven per cent of women on their first visit and 86 per cent of women revisiting the women's health nurse had seen their general practitioner within the previous year. CONCLUSION: Women's health nurses are meeting the goals set for their service in relation to health promotion and the screening of women. Their services are perceived by their clients as complementary to those provided by their general practitioners.     

An analysis of telephone health counseling for Japanese employees and their families abroad, "Japan health Care Line (overseas)"

In the past 6 years, the "Japan Health Care Line" has accumulated over 2,000 cases of telephone counseling calls, mainly on health problems, by Japanese living abroad on business, and their families, in 55 countries. The characteristics of these Japanese from medical aspects (physical and psychological), life style, and education were determined; and factors that influence their life abroad as well as some of their problems were analyzed. The role that telephone counseling can play in alleviating their anxiety, in helping them adapt, and in maintaining their health was also examined. The clients were Japanese employees and their families whose health insurance associations had joined this service. Data were recorded on a card for 14 items-the caller, the person needing the advice, age, sex, area of residence, length of stay, hour of call, number of calls etc. The data and main complaints were categorized in three ways: 1) by medical fields for business reports; 2) by coding the complaints; and 3) by the ICD-10 classification. Of the callers, 80% were in their 20's and 30's, meanwhile, as to the persons who need the advice, 30% of them were under 10, and 30% were in their 30's. There were many cases in obstetrics-gynecology, pediatrics, and general medical information. In the contents of the counseling, conditions or symptoms of the client were foremost, and together with advice on treatment, comprised half the calls. A study was made on the correlation between the clients' length of stay/location and the main complaints. Clients living abroad less than 1 year tended to call more, especially for vaccination, translation, mental problems, and medical systems, but did not call much in fields of obstetrics-gynecology, dentistry-oral surgery, examination data and treatments. Location did not make much difference in the fields of consultations, except for obstetrics-gynecology and dermatology. Middle and Near East countries had special characteristics to their consultations. There were differences in fields of counseling in calls from developing countries and developed countries. In the former countries, calls on orthopedics, urology, tropical diseases, and infectious diseases were numerous, while in the latter, pediatrics and mental problems were.     

Unconventional therapies for cancer: 3. Iscador. Task Force on Alternative Therapies of the Canadian Breast Cancer Research Initiative

Unconventional therapies (UTs) are therapies not usually provided by Canadian physicians or other conventionally trained health care providers. Examples of common UTs available in Canada are herbal preparations, reflexology, acupuncture and traditional Chinese medicine. UTs may be used along with conventional therapies (complementary) or instead of conventional therapies (alternative). Surveys have shown that many Canadians use UTs, usually as complementary therapies, for a wide range of diseases and conditions. Reliable information about UTs is often difficult to find. Your doctor may be unable to give you specific advice or recommendations, since UTs are often not in a physician's area of expertise. However, he or she will usually be able to provide some general advice and help supervise your progress. For your own health and safety, it is important to keep your doctor informed of the choices you make. This document is intended to (a) provide you with questions to consider when making your treatment choices, (b) help you find information about UTs, (c) help you decide whether a specific UT is right for you, and (d) provide tips to help you evaluate the information you find.     

Forced opiate withdrawal under anaesthesia augments and prolongs the occurrence of withdrawal signs in rats

This study examined the impact of the introduction of lecturer-practitioner (LP) roles in four Nuffield Hospitals over a period of two years. A series of interviews was conducted with the practitioners themselves, the staff and the managers. LPs also maintained structured diaries. Nursing practice in the independent sector is influenced by a number of factors, including caring for patients in individual rooms and working directly with consultants because there are no junior medical staff. Nurses encountered patients with very diverse problems, and accordingly needed help to maintain a wide professional knowledge base. Nursing staff benefited from the presence of an LP in terms of linking theory to practice, role modelling, obtaining career advice and introducing change. Non-nursing staff also benefited from the LPs' adoption of an interdisciplinary approach to certain care situations. LPs were valued as a resource for staff and seen as important in enabling the company to maintain its image as a provider of high-quality care. The LP was also well placed to raise the profile of nursing in the independent sector through research activities. LPs themselves benefited from their experiences and were able to develop their own skills.     

The effect of physician advice on exercise behavior

BACKGROUND: Although sedentariness, a prevalent lifestyle, is recognized as a significant risk factor for coronary artery disease and other conditions, little is known about the effectiveness of prevention strategies in the primary care setting. This study examines the impact of brief, exercise advice-giving by family physicians. METHODS: During a 2-month baseline period, patients visiting their family physician and who were age 18 or older were queried about their exercise habits and attitudes and whether their physician had discussed exercise. During the following 2-month experimental phase, the same data were gathered, and half the physicians were trained to give brief exercise advice. All patients were followed for 1 month. Changes in exercise duration and frequency were the primary outcome measures. RESULTS: During baseline, a sizable portion of patients were given exercise advice. This was true also of control group patients during the experimental phase, although trained physicians gave advice almost twice as often. A comparison of the patients receiving advice with those not receiving advice revealed significant increases in exercise duration, but not frequency. Patient attitudes were responsive to exercise advice. CONCLUSION: Members of primary care, adult patient population will increase their duration of physical activity in response to physician advice to exercise.     

Grapefruit juice increases oral nimodipine bioavailability

OBJECTIVE: To study the cost-effectiveness of simple anti-smoking advice in Primary health care. METHODS: We accomplish a cost-effectiveness analysis in the area of the Primary health care. As efficiency of the advice we use own results. To evaluate the smoking cessation we base on vital tables of the "25-State Cancer Prevention Study", discounted to the 5%. The costs have been calculated as of the tariffs used for services billing lent in primary health centers to not beneficiary of the social security. It was accomplished a sensibility analysis on different aspects with possible influence on the result. RESULTS: The cost-effectiveness oscillated between 67,621 and 89,619 pesetas by year of life saved for the men and between 116,225 and 137,748 pesetas for the women, in function of the age. The relationship most favorable, for both sexes, it is between 45 and 54 years. In the group of 35 to 39 years, for the physicians, was of 89,419 and 163,934 pesetas for men and women respectively, and for the nursing personnel was oscillating between 43,955 and 81,523, for men; and between 80,584 and 149,460 pesetas for women in function of the considered salary. CONCLUSIONS: It is an intervention with a very favorable relationship cost-effectiveness, at least, comparable to that of other customarily accepted preventive measures. The nursing advice is less effective that the physician advice, but it is, at least, equal of efficient in terms of cost by year of life saved.     

Understanding NHS indemnity

The NHS indemnity scheme began in January 1990 and covers all NHS hospital and community health service staff (but not general practitioners). However, some doctors continue their membership with medical defence organizations for continuing advice and assistance regarding medicolegal issues.