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Practice Situations (practice + situation)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

The Efficacy of Metered-Dose Inhalers with a Spacer Device in the Pediatric Setting

JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 9 2002
APRN, Lance J. Buxton MSN
Purpose To systematically review the published research and report on the efficacy of using a metereddose inhaler with a spacer (MDI-S) device in a pediatric setting to treat acute exacerbations of asthma. Data sources A literature search was conducted on the CINAHL, Medline, and Cochrane databases; additional searches were made by hand from the reference lists in each study retrieved from databases and from review articles written on the same topic. Conclusion This critical appraisal of the research demonstrates the MDI-S is as effective as the nebulizer, faster in the delivery of medication, and cost-effective. Implications for Practice No significant difference between the MDI-S and nebulizer in delivering medication in an acute exacerbation of asthma was found in this analysis. The practitioner's choice of delivery methods should reflect the family's preference, the practice situation, and economic considerations. [source]

Which Patients Benefit the Most from a Geriatrician's Care?

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2008
Consensus Among Directors of Geriatrics Academic Programs
Given the anticipated limited availability of geriatricians for the foreseeable future, how should the geriatrician's specialized clinical skills be deployed to optimally benefit the health of our aging population? Directors of geriatrics academic programs (DGAPs) at all 145 U.S. allopathic and osteopathic medical schools were asked this question as part of a winter 2007 on-line survey. The DGAPs were to indicate the types of patients who would most benefit from a geriatrician's services in three practice situations: primary care, consultations, and care in the hospital. The survey response rate was 74.5%. There was high consensus among the DGAPs on the benefits of having a geriatrician care for the most complex and vulnerable older adults in primary care and hospital settings. There was slightly less consensus as to when geriatrics consultations are beneficial. The patient subsets that were viewed as benefiting the most from geriatrician care were aged 85 and older, frailty, geriatric syndromes, severe functional impairment, and complexity. The results of this survey suggest that, because of the predicted shortage of geriatricians, the DGAPs would target geriatricians to work with the most vulnerable older adults. These findings offer the beginning of a consensus statement as to the role of geriatricians in the continuum of American medical care. [source]

Nurses' views on current and future systems for classification of psychiatric disorders

ASIA-PACIFIC PSYCHIATRY, Issue 2 2010
Rachael Aitchison MSC
Abstract Introduction: This study aimed to document experiences and views of practicing mental health nurses on the official psychiatric diagnostic systems and their current usage. Methods: A questionnaire and research design were established by a nursing reference group and resulted in a survey sent to 600 nurses of whom 150 responded. Respondents represented a wide range of clinical practice situations, age, years of experience and both genders. Results: Only 20% of respondents routinely used the World Health Organization (WHO) system of International Classification of Diseases (ICD) 10. The American Diagnostic and Statistical Manual (DSM)-IV was a more popular diagnostic system. Discussion: This study highlights the importance of the classificatory system to treatment planning and to intra-team communication. However, nurses indicated a number of reservations about its utility and appropriateness for their daily work and specified areas they consider for improvement in the development of next versions of the international classificatory systems. [source]

Assessing the current Brazilian sugarcane industry and directing developments for maximum fossil fuel mitigation for the international petrochemical market

BIOFUELS, BIOPRODUCTS AND BIOREFINING, Issue 3 2009
Ben Brehmer
Abstract The EU proposes that 5.75% of the transportation fuels market consist of biofuels by 2010 and the USA proposes that all gasoline be blended with 10% bioethanol by 2012. While these targets have not yet been reached, an aura of critique is emerging, arguing that biofuel mandates are not sustainable. One of the major ensuing topics surrounding biofuel sustainability is the food versus fuel debate in reference to first-generation (or food-based) technology. This article will reveal that for the specific case of sugarcane in Brazil, first-generation bioethanol is more sustainable than expansion to include second-generation (non-food-based) technology. Two life cycle assessments are conducted. First, a cradle-to-factory gate analysis with focus on fossil fuel reduction potential. Fertile land is consumed and occupied by all biomass crops; the biomass option with the highest mitigation potential per land can be considered the most sustainable and least intrusive to food production. Ethanol, on average, can mitigate 104GJ/ha/a, which is equivalent to 17 barrels of oil annually. This can increase to 353GJ/ha/a for the foreseeable best practice situations, higher than the second-generation option. A first-step chemical biorefinery producing ethylene achieves 509GJ/ha/a. Second, the BASF-developed eco-efficiency model, which links both environmental impacts and economic profitability in one, easy-to-interpret graph, is used as validation. Overall it is calculated that a best practice first-generation ethanol and its later dehydration to ethylene are the most eco-efficient options. The biobased economy deserves highly specific assessments. © 2009 Society of Chemical Industry and John Wiley & Sons, Ltd [source]