Extra Care (extra + care)

Distribution by Scientific Domains

Selected Abstracts

A comparison of drug overdose deaths involving methadone and other opioid analgesics in West Virginia

ADDICTION, Issue 9 2009
Leonard J. Paulozzi
ABSTRACT Aims To describe all people dying from unintentional overdoses of methadone or other opioid analgesics (OOA) in West Virginia in 2006. Design We analyzed medical examiner data supplemented by data from the state prescription drug monitoring program. We compared people whose deaths involved methadone with those whose deaths involved OOA. Findings The methadone group included 87 decedents, and the OOA group included 163 decedents. Most were male. Decedents in the methadone group were significantly younger than those in the OOA group: more than a quarter were 18,24 years of age. For both groups, approximately 50% had a history of pain, and 80% had a history of substance abuse. There was no intergroup difference in the prevalence of benzodiazepines at post-mortem. Methadone was significantly less likely to have ever been prescribed than OOA. Among those with prescriptions, the proportion prescribed within 30 days of death was significantly greater for methadone than for hydrocodone, but not for oxycodone. Ten (11.5%) of the methadone decedents were enrolled in an opiate treatment program (OTP) at the time of death. Conclusions The high prevalence of a substance abuse history and lack of prescriptions suggest that most of the deaths in both groups are related to substance abuse. There was no indication of a harmful effect from methadone's metabolic interaction with benzodiazepines, but provider or patient unfamiliarity with methadone may have been a risk factor. Prescribing methadone, especially to young males, requires extra care. Providers, OTPs and coroners/medical examiners should use state prescription drug monitoring programs to monitor the use of controlled substances by their patients. [source]

Tape Casting and Dielectric Properties of Zn2Te3O8 -Based Ceramics with an Ultra-Low Sintering Temperature

Johanna Honkamo
The suitability of dielectric ceramics made of zinc tellurate (Zn2Te3O8) and titanium dioxide (TiO2) with an ultra-low sintering temperature (650C) for tape casting and thus for the multimodule technique with Al electrodes was investigated. The properties of the tape before and after sintering as well as the amount of organic additives for the casting process and a thermal analysis of the tape up to 1000C are reported. In addition, electrodes on a multilayer module made on stacked tapes were prepared using Al paste and postfiring, followed by relative permittivity and loss tangent measurements to verify the electrical performance of the whole structure. The dielectric properties of the stacked module without any electrodes were also measured. The results show that the composition is well suited for the tape process but extra care should be taken especially with the proper sintering temperature for optimized electrical performance. [source]

Nursing home care: whodunit?

Aggie TG Paulus PhD
Aims and objectives., (1) To analyse and compare (changes and differences in) activity profiles of various types of nursing home care. (2) To assess the impact of integrated care on these activity profiles. Background., Because of an ongoing introduction of integrated nursing home care, caregivers increasingly have to co-ordinate their activities, engage into interprofessional relationships and take over each other's tasks. Consequently, activity profiles [i.e. combinations of (contributions to) care activities and the roles that perform them] are expected to change. Design/methods., At three measurement points in the period 1999,2003, caregivers (in 18 different roles) recorded and listed direct and indirect care activities. A total of 41 335 lists were analysed to derive activity profiles of traditional, transitional and integrated nursing home care in the Netherlands. Results., Traditional, transitional and integrated care shared some comparable activity profiles. Integrated care differed from the other types with respect to the contribution of the geriatric nurse, recreational activities supervisor, nutrition assistant, household assistant and nursing assistant to activities such as extra care, handling food and club activities. Contrary to the other roles, the licensed practical nurse contributed to (almost) all activities in all types of care. Conclusions., Nursing home care has several recurring activity profiles. These profiles are the same in all types of nursing home care. The introduction of integrated care implies that particular profiles have to be added to these profiles. As a generalist, the licensed practical nurse seems to play a key role in all activity profiles. Relevance to clinical practice., Because of demographic and financial pressures, integrated care for older people becomes increasingly important. By addressing the impact of integrated care on activity profiles, this paper provides information on how new types of care can be delivered in the most effective manner. [source]

Bounded Choices: Somali Women Constructing Difference in Minnesota Housing

Tasoulla Hadjiyanni
ABSTRACT Coming to Minnesota to escape a devastating war, Somali refugees found themselves living in rental units that had little resemblance to the dwellings they left behind. Interviews with eight Somali women in their Minnesota homes reveal the difficult choices they had to make in order to preserve Somali cultural traditions and practices amidst strong American influences. As a way to construct the Somali sense of difference, women appropriated their living environments by relying on all five senses and various forms of cultural expressions that range from burning unsi to adorning the walls with Somali handicrafts. Unwilling to let go of valued Somali institutions, many had to make bounded choices like cooking while veiled in open kitchens, limiting children's play to accommodate formal impromptu visits, and restraining their social gatherings to the bedrooms to continue the tradition of gender separation. By proposing design solutions to the housing problems revealed through the study, this paper hopes to alert those who work with refugees and other immigrant groups that, with a little extra care, a house can be transformed into a home that fosters a sense of belonging and eases the stresses of adjusting to new life circumstances. [source]

Potential bias caused by control selection in secondary data analysis: Nonaspirin nonsteroidal anti-inflammatory drugs and hemorrhagic stroke,

Nam-Kyong Choi PhD
Abstract Background This study investigated the potential for bias introduction when selecting controls for secondary analysis of case-control study data. Methods We used a data set previously collected for an acute brain bleeding analysis (ABBA) study, which was designed to investigate the risk of hemorrhagic stroke (HS) resulting from the use of phenylpropanolamine in Korea. Cases in that study had experienced an HS. Each HS case was matched with age- and gender-based hospital and community controls. Information was obtained on drug exposures including nonaspirin nonsteroidal anti-inflammatory drugs (NANSAIDs). Odds ratios (OR) for, and 95% confidence intervals (CI) of, experiencing an HS were calculated using conditional logistic regressions for each control group. Results A total of 940 patients were matched with 1880 controls. The OR of HS occurring in NANSAID users was 1.18 (95%CI, 0.80,1.73) in community controls and 0.67 (95%CI, 0.45,0.98) in hospital controls. The majority of the hospital controls were selected from patients who had visited neurology, neurosurgery, or orthopedic departments. Conclusion The difference between OR values estimated from hospital and community controls could be the result of selection bias. The study data were originally obtained for a different purpose than this study, and NANSAID use was not considered when the hospital controls were selected. When performing secondary analyses, extra care is needed to note whether the results are consistent across control groups and whether there are indications of bias related to the selection of those controls. Copyright 2010 John Wiley & Sons, Ltd. [source]