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Medical Care System (medical + care_system)
Selected AbstractsOlder Persons in the Emergency Medical Care SystemJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2002Jane McCusker No abstract is available for this article. [source] Surge Capacity for Health Care Systems: Early Detection, Methodologies, and ProcessACADEMIC EMERGENCY MEDICINE, Issue 11 2006Peter L. Estacio PhD Excessive demand on hospital services from large-scale emergencies is something that every emergency department health care provider and hospital administrator knows could happen at any time. Nowhere in this country have we recently faced a disaster of the magnitude of concern we now face involving agents of mass destruction or social disruption, especially those in the area of infectious diseases and radiological materials. The war on terrorism is not a conventional war, and terrorists may use any means of convenience to carry out their objectives in an unpredictable time line. Have we adequately prepared for the potentially excessive surge in demand for medical services that a large-scale event could bring to our medical care system? Are our emergency departments ready for such events? Surveillance systems, such as BioWatch, BioSense, the National Biosurveillance Integration System, and the countermeasure program BioShield, offer hope that we will be able to meet these new challenges. [source] Alcohol, Tobacco, and Other Drugs: Future Directions for Screening and Intervention in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 11 2009Rebecca M. Cunningham MD Abstract This article is a product of a breakout session on injury prevention from the 2009 Academic Emergency Medicine consensus conference on "Public Health in the ED: Screening, Surveillance, and Intervention." The emergency department (ED) is an important entry portal into the medical care system. Given the epidemiology of substance use among ED patients, the delivery of effective brief interventions (BIs) for alcohol, drug, and tobacco use in the ED has the potential to have a large public health impact. To date, the results of randomized controlled trials of interventional studies in the ED setting for substance use have been mixed in regard to alcohol and understudied in the area of tobacco and other drugs. As a result, there are more questions remaining than answered. The work group developed the following research recommendations that are essential for the field of screening and BI for alcohol, tobacco, and other drugs in the ED. 1) Screening,develop and validate brief and practical screening instruments for ED patients and determine the optimal method for the administration of screening instruments. 2) Key components and delivery methods for intervention,conduct research on the effectiveness of screening, brief intervention, and referral to treatment (SBIRT) in the ED on outcomes (e.g., consumption, associated risk behaviors, and medical psychosocial consequences) including minimum dose needed, key components, optimal delivery method, interventions focused on multiple risk behaviors and tailored based on assessment, and strategies for addressing polysubstance use. 3) Effectiveness among patient subgroups,conduct research to determine which patients are most likely to benefit from a BI for substance use, including research on moderators and mediators of intervention effectiveness, and examine special populations using culturally and developmentally appropriate interventions. 4) Referral strategies,a) promote prospective effectiveness trials to test best strategies to facilitate referrals and access from the ED to preventive services, community resources, and substance abuse and mental health treatment; b) examine impact of available community services; c) examine the role of stigma of referral and follow-up; and d) examine alternatives to specialized treatment referral. 5) Translation,conduct translational and cost-effectiveness research of proven efficacious interventions, with attention to fidelity, to move ED SBIRT from research to practice. [source] Cancer screening practices of adult survivors of retinoblastoma at risk of second cancersCANCER, Issue 2 2008Victoria Sheen BA Abstract BACKGROUND. The aim of the current study was to investigate the pattern of cancer screening behavior in adult retinoblastoma survivors, who are at high risk of developing second cancers. METHODS. Self-reported cancer screening practices were investigated in a cohort of retinoblastoma survivors to evaluate whether they were receiving adequate screening for specific cancers and compare these rates with those of other adult survivors of childhood cancer and the general population. The prevalence of breast self-examination, clinical breast examination, mammography, Papanicolaou (Pap) test, testicular self-examination, and magnetic resonance imaging (MRI) or computed tomography (CT) scanning was determined from computer-aided telephone interviews with 836 retinoblastoma survivors aged >18 years. RESULTS. Among female survivors, 87% had a Pap test within the past 2 years, and 76% of females age >40 years reported having a mammogram within the past 2 years; 17.4% of male survivors had performed monthly testicular self-examinations. A significantly higher proportion of hereditary compared with nonhereditary survivors reported having undergone an MRI or CT scan in the past 5 years. Higher education, greater contact with the medical care system, and having a second cancer were found to be associated positively with most screening practices. Cancer screening practices reported by retinoblastoma survivors were similar to national screening rates for breast, cervical, and testicular cancer. CONCLUSIONS. To the authors' knowledge, the current study provides the first report of cancer screening practices of retinoblastoma survivors. Survivors of hereditary retinoblastoma should be encouraged to maintain, if not increase, their current screening practices to ensure early detection of second cancers in this high-risk population. Cancer 2008. © 2008 American Cancer Society. [source] Patients' perceptions of drug dispensing in a rheumatological in-patient unitMUSCULOSKELETAL CARE, Issue 4 2005Barbro Arvidsson RNT Abstract Introduction: The dispensing of drugs in medical care systems is, in most countries, strictly regulated, and nurses are responsible for distributing drugs to in-patients. Aim: To describe the perceptions of patients with rheumatic diseases regarding traditional drug dispensing during in-patient care and rehabilitation in a specialized rheumatological care unit. Method: Twenty in-patients who stayed in the Spenshult Hospital unit for 3,4 weeks and who were on continuous medication were chosen for the study. The phenomenographic approach was used for the collection and analysis of data. Findings: Three descriptive categories emerged , Relief, Active Participation and Dependence. These descriptive categories comprised: three perceptions for Relief (to experience security, to be ,served', to dare to bother), two for Active Participation (to rely on one's own ability, to search for knowledge) and two for Dependence (lack of independence, lack of information). Conclusion: The patients experienced relief due to the nurse assuming responsibility for the medication and its dispensation. Patients expressed a wish to be more active in the management of their medication, as they trusted their own ability. The patients articulated that they were dependent on the nurse to give them the correct medication and they also asked for more information about their medication. Copyright © 2005 John Wiley & Sons, Ltd. [source] | ||||||||||