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Immediate Needs (immediate + need)
Selected AbstractsClinical approach to the patient with unexpected bleedingINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 2000J. M. Teitel Bleeding can be considered unexpected if it is disproportionate to the intensity of the haemostatic stress in a patient with no known haemorrhagic disorder or if it occurs in a patient in whom a bleeding disorder has been characterized but is adequately treated. A thorough history usually allows the clinician to predict reasonably accurately whether the patient is likely to have a systemic haemostatic defect (and if so whether it is congenital or acquired), or whether the bleeding likely has a purely anatomical basis. The nature of bleeding is instructive with respect to preliminary categorization. Thus, mucocutaneous bleeding suggests defects of primary haemostasis (disordered platelet,vascular interactions). Bleeding into deeper structures is more suggestive of coagulation defects leading to impaired fibrin clot formation, and delayed bleeding after primary haemostasis is characteristic of hyperfibrinolysis. Localized bleeding suggests an anatomical cause, although an underlying haemostatic defect may coexist. Where bleeding is so acutely threatening as to require urgent intervention, diagnosis and treatment must proceed simultaneously. In the case of minor haemorrhage (not threatening to life or limb) it may be preferable to defer therapy while the nature of the bleeding disorder is methodically investigated. Initial laboratory evaluation is guided by the preliminary clinical impression. The amount of blood loss can be inferred from the haematocrit or haemoglobin concentration, and the platelet count will quickly identify cases in which thrombocytopenia is the likely cause of bleeding. In the latter instance, examination of the red cell morphology, leucocyte differential, and mean platelet volume may allow the aetiological mechanism to be presumptively identified as hypoproliferative or consumptive. With regard to coagulation testing, the activated PTT, prothrombin time, and thrombin time usually constitute an adequate battery of screening tests, unless the clinical picture is sufficiently distinctive to indicate the immediate need for more focused testing. In any event, sufficient blood should be taken to allow more detailed studies to be done based on the results of these screening tests. These results will direct the need for further assays, such as specific clotting factor activity levels, von Willebrand factor assays, tests for coagulation inhibitors, platelet function assays, and markers of primary or secondary fibrinolytic activity. [source] Are Banks Still Special?JOURNAL OF APPLIED CORPORATE FINANCE, Issue 1 2000New Evidence on Their Role in the Corporate Capital-Raising Process Bankers appear to play a special role in providing commitment-based financing to corporations. This type of lending is important not only for small firms that lack access to public debt markets but for large and medium-size companies as well. For such companies, commitment-based financing provides access to debt capital that becomes valuable when the firm has an immediate need for funding but interest rates in public debt markets are prohibitively high, or the firm is undervalued by the market. A good example of this was provided by the Asian crisis in the last quarter of 1998, when $10 billion of commercial paper was retired and $20 billion of net new commercial loans were booked. The authors also suggest that the fact that commitment-based financing is used by larger companies when they believe themselves to be undervalued in the market is probably the best explanation of why announcements of these types of loans elicit a positive stock price reaction. [source] Masseter muscle thickness as a predictive variable in treatment outcome of the twin-block appliance and masseteric thickness changes during treatmentORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 4 2010S Kiliaridis To cite this article: Kiliaridis S, Mills CM, Antonarakis GS: Masseter muscle thickness as a predictive variable in treatment outcome of the twin-block appliance and masseteric thickness changes during treatment Orthod Craniofac Res 2010;13:203,213 Structured Abstract Authors,,, Kiliaridis S, Mills CM, Antonarakis GS Objectives,,, To estimate the association of initial masseter muscle thickness with treatment outcomes using functional appliances and the effect of treatment on masseter muscle thickness. Material and Methods,,, Twenty-two children, aged 8,12, with skeletal and dental class II relationships and increased overjet were treated with twin-block appliances for 9,17 months, until a class I molar relationship and decreased overjet was achieved. Dental casts, lateral cephalograms, and ultrasonographic measurements of the masseter muscle were performed before and after treatment. Twenty-two children, aged 8,12, without immediate need for orthodontic treatment, served as controls. They were observed for 11,17 months, and ultrasonographic masseter muscle measurements were taken before and after the observation period. Results,,, Masseter muscles in treated children were thinner at the end of treatment, while untreated controls showed an increase in thickness. Treated children with thinner pre-treatment muscles showed greater mandibular incisor proclination, distalisation of maxillary molars, and posterior displacement of the cephalometric A point during treatment. Conclusion,,, Treatment of a dental class II relationship with functional appliances leads to mild atrophy of the masticatory muscles, possibly because of their decreased functional activity. The initial condition of the muscles may be associated with mandibular incisor proclination, and the position of maxillary first molars and A point. [source] Care for the Adult Family Members of Victims of Unexpected Cardiac DeathACADEMIC EMERGENCY MEDICINE, Issue 12 2006Robert Zalenski MD Abstract More than 300,000 sudden coronary deaths occur annually in the United States, despite declining cardiovascular death rates. In 2000, deaths from heart disease left an estimated 190,156 new widows and 68,493 new widowers. A major unanswered question for emergency providers is whether the immediate care of the loved ones left behind by the deceased should be a therapeutic task for the staff of the emergency department in the aftermath of a fatal cardiac arrest. Based on a review of the literature, the authors suggest that more research is needed to answer this question, to assess the current immediate needs and care of survivors, and to find ways to improve care of the surviving family of unexpected cardiac death victims. This would include improving quality of death disclosure, improving care for relatives during cardiopulmonary resuscitation of their family member, and improved methods of referral for services for prevention of psychological and cardiovascular morbidity during bereavement. [source] Safety Nets and Opportunity Ladders: Addressing Vulnerability and Enhancing Productivity in South AsiaDEVELOPMENT POLICY REVIEW, Issue 5 2002Naila Kabeer As patterns of poverty and vulnerability in South Asia change, households have to balance immediate needs and long,term goals. For the poor, these choices, and the costs of precautionary measures, are particularly acute and call for suitable government policies. While policy,makers face a number of trade,offs between promotion, prevention and protection goals, careful design can maximise the potential to reconcile these objectives. A review of experience suggests a number of lessons regarding the relative benefits of targeted and universal programmes; the need to differentiate microfinance products for different groups amongst the poor; ways of basing the self,targeting of public works on rights rather than stigma; and the influence of political processes (such as decentralisation) for the overall effectiveness of social protection. [source] East Timor Emerging from Conflict: The Role of Local NGOs and International AssistanceDISASTERS, Issue 1 2001Ian Patrick International assistance efforts have represented a conundrum for East Timorese seeking to assert their new independence and autonomy. While urgent needs have been met, local participation, involvement and capacity building have not been given adequate attention. This outcome is aptly demonstrated in the case of local non-government organisations (LNGOs). This paper specifically examines the role of LNGOs in the recovery of East Timor within the international assistance programme. It examines the challenges of rehabilitation efforts in East Timor with a particular focus on capacity building of East Timorese NGOs as part of a broader effort to strengthen civil society. The initial crisis response in East Timor highlighted tension between meeting immediate needs while simultaneously incorporating civil society actors such as NGOs and communities. It has been argued that local NGOs and the community at large were not sufficiently incorporated into the process. While it is acknowledged that many local NGOs had limited capacity to respond, a greater emphasis on collaboration, inclusion and capacity building was desirable, with a view to supporting medium and longer term objectives that promote a vibrant civil society, sustainability and self-management. [source] Rapid assessment of a helpdesk service supporting severe acute respiratory syndrome patients and their relativesJOURNAL OF CLINICAL NURSING, Issue 6 2004Joanne WY Chung PhD Background., To contain severe acute respiratory syndrome, the Hong Kong Hospital Authority set a policy that stipulated there should be no visitors to hospital wards. A helpdesk service was established with the goal of providing immediate emotional and communication support to relatives while severe acute respiratory syndrome patients were isolated during the acute phase of the illness. Aim., This study describes the results of a rapid assessment of the effectiveness of a helpdesk service designed to meet the immediate needs of relatives of severe acute respiratory syndrome patients in Hong Kong. Design., Survey. Method., Eighty-three respondents, representing about 46.3% of relatives (179), attending the helpdesk on the day of the study were recruited. Service evaluation data was collected using a self-administered questionnaire completed by respondents. Results., Nearly 100% of respondents who used the service found the delivery service with on-site counselling useful for alleviating their anxiety. However, about half of these relatives complained of insufficient information regarding the patient's condition and progress. The majority of respondents were satisfied with the service. In describing the most important traits of the service providers, caring and enthusiasm were mentioned most frequently by respondents who stated that they were very satisfied with the service. Conclusion., The results support the value of the service, and demonstrate that the service is effective in meeting relatives' immediate needs. These needs include information, aid in fulfilling their role as caretaker for the patient (delivering prepared soup) and psychological support. The results suggest that facilitation of visitation of patients by relatives via video conferencing and education of the public on the nature and course of severe acute respiratory syndrome to reduce the social stigma of having a potentially life-threatening disease should be introduced in Hong Kong. Relevance to clinical practice., The results highlight important attributes that helpers (nurses) should have in order to alleviate the suffering of severe acute respiratory syndrome patients and their relatives. [source] Plugging the Prisoner Finance Gap: A Critical Analysis of Financial Support for Newly-Released PrisonersTHE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 1 2010YVETTE HARTFREE Senior Research Associate Abstract: The prison discharge grant is intended to meet prisoners' immediate needs on release and assist with living costs prior to their receiving their first benefit payment. It has been widely criticised for providing inadequate financial support, leaving prisoners with a gap in their finances on release. This article discusses the extent to which recent policy developments have been effective in closing this gap. The analysis is based on data from a longitudinal qualitative study of 40 prisoners who were tracked over a six-month period following their release from prison. This research shows that despite new policy initiatives the prisoner finance gap remains. [source] Health reform and the immediate needs of rural and remote communitiesAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2010Gordon Gregory No abstract is available for this article. [source] | |||||||||||||