Care Being (care + being)

Distribution by Scientific Domains

Selected Abstracts

Chronic lung disease: oxygen dogma revisited

O D Saugstad
Since the discovery of retrolental fibroplasia, and the role of oxygen in its development, oxygen has been considered a double-edged sword in neonatal medicine, the utmost care being exercised in order not to give too much oxygen (1). However, the important observation that hypoxaemia might induce pulmonary vasoconstriction (2) and airway constriction (3) in infants at risk for bronchopulmonary dysplasia has resulted in only a minor upward adjustment of oxygen supplementation in many neonatal units. Since oxygen toxicity has long been linked not only to retinopathy of prematurity but also to bronchopulmonary dysplasia (4), it is relevant to ask whether an increased FiO2 might have any detrimental effects on babies. [source]

The stress dependent elastic properties of thermally induced microfractures in aeolian Rotliegend sandstone

Colin MacBeth
ABSTRACT The impact of thermally induced microfractures on the stress-sensitive elastic wave properties of aeolian Rotliegend sandstone samples is analysed. It is found that to identify the effects of the microfracture contribution accurately, a correction must first be made to account for water loss (representing a mass loss of 4,6%) from the pore throats and clays due to the heating process, despite care being taken to ensure that the thermally fractured samples re-adsorb room moisture. Both the original and thermally fractured rocks are stress-sensitive at the ultrasonic wave frequencies of the laboratory. However, a distinct shift in the estimated distribution of internal rock compliance indicates that the population of thermal microfractures differs in nature from that caused solely by core-plug extraction damage. In particular, the ratio of normal to tangential compliance is observed to be higher for the thermally generated microfractures than for the broken grain-grain contacts created by extraction unloading. This can be explained by the intragranular thermal-fracture surfaces being smoother when compared to the intergranular boundaries. Mechanical hysteresis is observed between the up- and downgoing test cycles for both the original and, to a greater extent, the thermally fractured rock. This indicates that there is compaction-induced movement of the fractures in the samples during application of stress in the laboratory. [source]

Hospital care of people living in residential care facilities: Profile, utilization patterns and factors impacting on quality and safety of care

Sanjay Jayasinghe
Background: Residents in residential care facilities (RCF) are frequent users of acute hospital services. However, the interface between the two sectors remains relatively unexplored. Our objective was to determine the patterns of utilization, characteristics and experiences of RCF residents accessing a tertiary referral center (TRC). Methods: An observational study of RCF residents presenting to the TRC emergency department (ED). The experiences of acute care services were explored for more than one-quarter of this group 2,3 days postdischarge. The carer within the RCF acted as the proxy respondent. Results: During the study period, RCF residents accounted for 2.3% of all ED presentations. These presentations involved 526 residents. The dimension "continuity of care" for the Picker Patient Experience questionnaire had the highest proportion (53.1%) reporting a problem. The likelihood of reporting a problem for "continuity of care" (odds ratio [OR], 3.58; confidence interval [CI], 1.72,7.45) and "information and education" (OR, 2.62; CI, 1.14,3.01) were higher if the resident was admitted to a ward compared to ED only. If the resident had a low level care status the likelihood of reporting a problem for "continuity of care" (OR, 2.8; CI, 1.02,7.72) also increased. The odds of RCF staff reporting a problem for "ambulance service" were significantly higher if the resident's presentation was related to a fall. (OR, 3.35; CI, 1.28,8.8). Conclusion: The utilization rates for acute hospital care in our study were similar to the two previous Australian studies. Factors at the patient and organizational level impacted significantly on problems relating to the quality and safety of care being reported. [source]

,Care': Moral concept or merely an organisational suffix?

J. Clapton
Abstract Background Over recent decades, a couple of interesting trends have occurred in regard to human services practices in Australia. First, there has been a significant shift from practices that previously have intentionally responded to emerging and continuing human need within communities to practices that are now managed within a context of managerialism and influenced by market forces. Second, in such a changing context, increasingly, organisations have added the suffix ,care' to their organisational name. One is therefore left to consider why this latter change has occurred, and how is care being considered, particularly in organisations supporting people with intellectual disability (ID). Method A conceptual-theoretical analysis is undertaken to explore the characteristics of human services that embrace managerialism. The moral constructions of personhood in regard to people with ID within this service context are investigated; and the implications of how care is practised are considered. Results An immoral-amoral binary of personhood within an underpinning neo-liberal context is identified and analysed. Further analysis reveals a more insidious independent,dependent binary for people with an ID linked to a dominating Ethic of Normalcy. This latter binary suggests that care seemingly becomes neither ethically relevant nor legitimate for people with ID in managerialist service contexts. Conclusions Ethical transformation in regard to care is needed for contemporary human services practice for people with ID. The underpinning Ethic of Normalcy is challenged for an Ethic of Engagement; whereby a deep understanding of care as a moral concept needs to be at the core of practice, rather than merely attached in an organisational name. [source]

Quality Improvement and Changes in Diabetic Patient Outcomes in an Academic Nurse Practitioner Primary Care Practice

FAANP, Thomas A. Mackey PhD
Purpose To examine a set of system interventions in the management of patients with diabetes and the outcomes of their care. Data sources Preintervention and postintervention data collected from electronic medical records. Conclusions The sample size was smaller than expected, contributing to a lack of statistical significance from preintervention to postintervention in the patient outcome measures. The systems-level variables that were under the direct control of the clinic staff (e.g., pneumococcal vaccine given) showed great improvement. In the preintervention period, the percentage of "yes" responses to the system-level variables ranged from 8 to 24 and jumped to 16 to 95 after the intervention. Implications for practice Unequivocally, this project demonstrated that systems-level changes result in improved care being provided to patients; however, these had minimal impact on the patient outcome variables. Promoting change in patient behavior is difficult, which may have contributed to the lack of significance in this area, while the variables under the direct control of the clinic staff were more easily changed. [source]