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Selected AbstractsEffectiveness of planning hospital discharge and follow-up in primary care for patients with chronic obstructive pulmonary disease: research protocolJOURNAL OF ADVANCED NURSING, Issue 6 2010Eva Abad-Corpa abad-corpa e., carrillo-alcaraz a., royo-morales t., pérez-garcía m.c., rodríguez-mondejar j.j., sáez-soto a. & iniesta-sánchez j. (2010) Effectiveness of planning hospital discharge and follow-up in primary care for patients with chronic obstructive pulmonary disease: research protocol. Journal of Advanced Nursing,66(6), 1365,1370. Abstract Title.,Effectiveness of planning hospital discharge and follow-up in primary care for patients with chronic obstructive pulmonary disease: research protocol. Aim., To evaluate the effectiveness of a protocolized intervention for hospital discharge and follow-up planning for primary care patients with chronic obstructive pulmonary disease. Background., Chronic obstructive pulmonary disease is one of the main causes of morbidity and mortality internationally. These patients suffer from high rates of exacerbation and hospital readmission due to active problems at the time of hospital discharge. Methods., A quasi-experimental design will be adopted, with a control group and pseudo-randomized by services (protocol approved in 2006). Patients with pulmonary disease admitted to two tertiary-level public hospitals in Spain and their local healthcare centres will be recruited. The outcome variables will be readmission rate and patient satisfaction with nursing care provided. 48 hours after admission, both groups will be evaluated by specialist coordinating nurses, using validated scales. At the hospital, a coordinating nurse will visit each patient in the experimental group every 24 hours to identify the main caregiver, provide information about the disease, and explain treatment. In addition, the visits will be used to identify care problems and needs, and to facilitate communication between professionals. 24 hours after discharge, the coordinating nurses will inform the primary care nurses about patient discharge and nursing care planning. The two nurses will make the first home visit together. There will be follow-up phone calls at 2, 6, 12 and 24 weeks after discharge. Discussion., The characteristics of patients with this pulmonary disease make it necessary to include them in hospital discharge planning programmes using coordinating nurses. [source] General health in Timor-Leste: self-assessed health in a large household surveyAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2009Jaya Earnest Abstract Objective: Timor-Leste is one of the world's newest nations and became a democracy in 2002. Ranked 150 out of 177 in the 2007 UNDP Human Development Index, the country has the worst health indicators in the Asia-Pacific region. The objective of this study was to collect and analyse data on subjectively assessed general health, health service use, migration and mobility patterns. Methods: The data collection involved recording self-reported status of general health using a structured questionnaire. The survey was administered to 1,213 Timorese households in six districts using a multi-stage random cluster sampling procedure. Basic descriptive statistical analyses were performed on all variables with SPSS version 13. Results: More than a quarter (27%) of respondents reported a health problem at the time of the survey. Only approximately half of respondents assessed their health to be good (53%) or average (38%). Barriers reported in the uptake of healthcare services were no felt needed; difficulty in accessing services and unavailability of service. Conclusions: Results reveal that Timor-Leste needs a more decentralised provision of healthcare through primary healthcare centres or integrated health services. Trained traditional healers, who are familiar with the difficult terrain and understand cultural contexts and barriers, can be used to improve uptake of public health services. An adult literacy and community health education program is needed to further improve the extremely poor health indicators in the country. Implications: Key lessons that emerged were the importance of understanding cultural mechanisms in areas of protracted conflict and the need for integrated health services in communities. [source] Non-hospital delivery and permanent congenital and early-onset hearing loss in a developing countryBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 11 2008BO Olusanya Objective, The objective of this study was to determine the role of non-hospital delivery and other risk factors for permanent congenital and early-onset hearing loss (PCEHL) in a developing country. Design, Matched case,control study. Setting, Four primary healthcare centres in inner-city Lagos, Nigeria. Population, Fifty-six infants with PCEHL and 280 normal hearing controls matched for age and sex from a population of infants not older than 3 months attending Bacille de Calmette-Guérin immunisation clinics. Methods, Conditional logistic regression analyses of infant and maternal characteristics associated with PCEHL, and the evaluation of population exposure to each risk factor. Main outcome measures, Adjusted matched odds ratios and population attributable risk percent (PAR%). Results, Children with PCEHL were significantly more likely to be first born (OR 1.9, 95% CI 1.1,3.6) without skilled attendants at birth (OR 2.4, 95% CI 1.3,4.5) and have a history of neonatal jaundice requiring exchange blood transfusion (NNJ/EBT) (OR 9.6, 95% CI 2.4,38.2) but less likely to be small for gestational age (SGA) (OR 0.1, 95% CI 0.0,0.5). After controlling for other covariates, the absence of skilled attendants at birth (OR 4.2, 95% CI 2.0,8.6) and NNJ/EBT (OR 19.1, 95% CI 4.3,85.5) emerged as predictors of PCEHL, while SGA (OR 0.1, 95% CI 0.0,0.2) retained its inverse relationship with PCEHL. The PAR% was 35.9% for the lack of skilled attendants at birth and 10.6% for having NNJ/EBT. About 23% of children with PCEHL did not exhibit any risk factors. Conclusions, NNJ/EBT and the absence of skilled attendant at birth rather than the place of delivery are significant predictors of PCEHL in this study population. Targeted hearing screening using these risk factors would facilitate the detection of about 77% of children with PCEHL. [source] Antibiotic susceptibility and molecular epidemiology of nasopharyngeal pneumococci from Spanish childrenCLINICAL MICROBIOLOGY AND INFECTION, Issue 8 2008D. Sánchez-Tatay Abstract Nasopharyngeal pneumococci were collected from 635 Spanish children aged 6 months to 6 years attending four primary healthcare centres (n = 276) or two hospital emergency rooms (n = 359); 36% of the children had received ,1 dose of pneumococcal conjugate vaccine (PCV7). Overall, the carriage rate of Streptococcus pneumoniae was 31%, with no significant differences in carriage rates according to setting. Colonization with vaccine serotypes was significantly associated with the absence of PCV7 immunization (29.4% vs. 5.9%, p <0.001). Forty-seven per cent of all isolates were penicillin- and/or erythromycin-non-susceptible; 13 international antibiotic-resistant clones were represented among non-susceptible pneumococci and were similarly distributed among vaccine and non-vaccine serotypes. [source] |