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Selected AbstractsPressure Ulcers in Elderly Patients with Hip Fracture Across the Continuum of CareJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2009Mona Baumgarten PhD OBJECTIVES: To identify care settings associated with greater pressure ulcer risk in elderly patients with hip fracture in the postfracture period. DESIGN: Prospective cohort study. SETTING: Nine hospitals that participate in the Baltimore Hip Studies network and 105 postacute facilities to which patients from these hospitals were discharged. PARTICIPANTS: Hip fracture patients aged 65 and older who underwent surgery for hip fracture. MEASUREMENTS: A full-body skin examination was conducted at baseline (as soon as possible after hospital admission) and repeated on alternating days for 21 days. Patients were deemed to have an acquired pressure ulcer (APU) if they developed one or more new stage 2 or higher pressure ulcers after hospital admission. RESULTS: In 658 study participants, the APU cumulative incidence at 32 days after initial hospital admission was 36.1% (standard error 2.5%). The adjusted APU incidence rate was highest during the initial acute hospital stay (relative risk (RR)=2.2, 95% confidence interval (CI)=1.3,3.7) and during re-admission to the acute hospital (RR=2.2, 95% CI=1.1,4.2). The relative risks in rehabilitation and nursing home settings were 1.4 (95% CI=0.8,2.3) and 1.3 (95% CI=0.8,2.1), respectively. CONCLUSION: Approximately one-third of hip fracture patients developed an APU during the study period. The rate was highest in the acute setting, a finding that is significant in light of Medicare's policy of not reimbursing hospitals for the treatment of hospital-APUs. Hip fracture patients constitute an important group to target for pressure ulcer prevention in hospitals. [source] Behavioral Symptoms in Residential Care/Assisted Living Facilities: Prevalence, Risk Factors, and Medication ManagementJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2004Ann L. Gruber-Baldini PhD Objectives: To examine the prevalence, correlates, and medication management of behavioral symptoms in elderly people living in residential care/assisted living (RC/AL) facilities. Design: Cross-sectional study. Settings: A stratified random sample of 193 RC/AL facilities in four states (Florida, Maryland, New Jersey, North Carolina). Participants: A total of 2,078 RC/AL residents aged 65 and older. Measurement: Behavioral symptoms were classified using a modified version of the Cohen-Mansfield Agitation Inventory. Additional items on resistance to care were also examined. Results: Approximately one-third (34%) of RC/AL residents exhibited one or more behavioral symptoms at least once a week. Thirteen percent exhibited aggressive behavioral symptoms, 20% demonstrated physically nonaggressive behavioral symptoms, 22% expressed verbal behavioral symptoms, and 13% resisted taking medications or activities of daily living care. Behavioral symptoms were associated with the presence of depression, psychosis, dementia, cognitive impairment, and functional dependency, and these relationships persisted across subtypes of behavioral symptoms. Overall, behavioral symptoms were more prevalent in smaller facilities. More than 50% of RC/AL residents were taking a psychotropic medication, and two-thirds had some mental health problem indicator (dementia, depression, psychosis, or other psychiatric illness). Conclusion: Integrating mental health services within the process of care in RC/AL is needed to manage and accommodate the high prevalence of behavioral symptoms in this evolving long-term setting. [source] Herbal product use in a sample of Turkish patients undergoing haemodialysisJOURNAL OF CLINICAL NURSING, Issue 15 2009Belgüzar Kara Aim., To examine herbal product use among patients with end-stage renal disease undergoing haemodialysis. Background., Herbal therapy is a very popular choice for many patients. However, little information is available about herbal product use in renal patients. Design., The study was designed as a cross-sectional survey. The data were obtained from 114 end-stage renal disease patients in two haemodialysis centres in Ankara, Turkey between June,August 2007. Methods., Data were collected through face-to-face structured interviews. Descriptive statistics and the chi-square test were conducted. Results., Approximately one-third of the patients (28·1%) used a herbal product after the diagnosis of chronic kidney disease. Of these, 13·2% reported currently taking herbal products. A minority of participants (12·5%) informed their physician of herbal product use. Marital status was the only variable significantly associated with herbal product use. Conclusions., The results of this study showed that many patients used herbal products, but most did not disclose this use to their physician. Herbal product use was more prevalent among the participants who were married. Relevance to clinical practice., Understanding the patterns and reasons of herbal use is beneficial in efforts to improve the care of patients with end-stage renal disease. Nurses should be aware of the potential health risks caused by herbal products and should educate the patient and the family. [source] How and why do college students use Wikipedia?JOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 11 2009Sook Lim The purposes of this study were to explore college students' perceptions, uses of, and motivations for using Wikipedia, and to understand their information behavior concerning Wikipedia based on social cognitive theory (SCT). A Web survey was used to collect data in the spring of 2008. The study sample consisted of students from an introductory undergraduate course at a large public university in the midwestern United States. A total of 134 students participated in the study, resulting in a 32.8% response rate. The major findings of the study include the following: Approximately one-third of the students reported using Wikipedia for academic purposes. The students tended to use Wikipedia for quickly checking facts and finding background information. They had positive past experiences with Wikipedia; however, interestingly, their perceptions of its information quality were not correspondingly high. The level of their confidence in evaluating Wikipedia's information quality was, at most, moderate. Respondents' past experience with Wikipedia, their positive emotional state, their disposition to believe information in Wikipedia, and information utility were positively related to their outcome expectations of Wikipedia. However, among the factors affecting outcome expectations, only information utility and respondents' positive emotions toward Wikipedia were related to their use of it. Further, when all of the independent variables, including the mediator, outcome expectations, were considered, only the variable information utility was related to Wikipedia use, which may imply a limited applicability of SCT to understanding Wikipedia use. However, more empirical evidence is needed to determine the applicability of this theory to Wikipedia use. Finally, this study supports the knowledge value of Wikipedia (Fallis, 2008), despite students' cautious attitudes toward Wikipedia. The study suggests that educators and librarians need to provide better guidelines for using Wikipedia, rather than prohibiting Wikipedia use altogether. [source] Management of Pain in Addicted/Illicit and Legal Substance Abusing PatientsPAIN PRACTICE, Issue 1 2005Aaron B. Rosenblatt MD Abstract: Approximately one-third of the American population experiences chronic pain. This varies in origin and severity. It also has been documented that billions of dollars are lost yearly because of health care expenses and missed workdays for chronic pain. Addiction is a primary, chronic, neurobiological disease with genetic, psychological and environmental factors influencing its development and manifestations. Addictive disorders occur in 3% to 26% of the general population, 19% to 255 of hospitalized patients and 40% to 60% in patients who sustained major trauma. More specifically 13.9 million of people living in USA over the age of 12 years are currently using illicit drugs. Although patients with chronic pain may be at an increased risk for addiction, the general population has demonstrated similar addiction rates. Unfortunately, patients who have chronic pain and addition will only have one of these aspects addressed. The purpose of this article is to clarify specific definition of substance use, abuse and addiction. As well as examining the role of pain physicians in evaluating and treating the chronic pain patients who have a history of substance abuse, and lastly outline strategy for assessing patients at risks and evaluating the most practical way of dealing with their chronic pain issues. [source] Complementary medicine use by Australian women with gynaecological cancerPSYCHO-ONCOLOGY, Issue 3 2006Milica Markovic Abstract Aims and objectives: Social and cultural factors are identified that impact on complementary therapy use among Australia-born and immigrant women diagnosed with gynaecological cancer. Methods: A qualitative study design including in-depth interviews with women diagnosed with gynaecological cancer (N=53) and participant observation was conducted. Results: Approximately one-third of women utilized complementary and alternative medicine, with this being determined by current health concerns and health beliefs related to the efficacy of different modalities. Four types of complementary therapy users emerged: consequential, therapeutic, informed and exploratory. Conclusion: There was a relatively low uptake of complementary treatments. Choice was influenced by women's socio-demographic background, clinical and personal history, lack of personal experiences of gynaecological cancer among study participants' kin and friends, and lack of popular alternative literature on such cancer. Copyright © 2005 John Wiley & Sons, Ltd. [source] Cessation in the use of tobacco , pharmacologic and non-pharmacologic routines in patientsTHE CLINICAL RESPIRATORY JOURNAL, Issue 1 2008Petter Quist-Paulsen Abstract Introduction:, Approximately one-third of the adult population in industrial countries and 70% in several Asian countries are daily smokers. Tobacco is now regarded as the world's leading cause of death. Approximately two-thirds of lifelong smokers eventually die because of smoking. Smoking cessation is the most effective action to reduce mortality in patients with chronic obstructive pulmonary disease (COPD) and coronary heart disease. Objective:, The aim of this study was to determine the effectiveness of smoking cessation programmes in patients with smoking-related disorders. Methods:, Medline was searched for studies of interventions for smoking cessation in patients. Results:, In patients with cardiovascular diseases and COPD, smoking cessation programmes with behavioural support over several months significantly increase quit rates. The intensity of the programmes seems to be proportional to the effect. A long follow-up period is probably the most important element in the programmes. Even the most intensive programmes are very cost-effective in terms of cost per life-year gained. Effective programmes can be delivered by personnel without special education in smoking cessation using simple intervention principles. Conclusions:, In patients with smoking-related disorders, smoking cessation interventions with several months of follow-up are effective and easily applicable in clinical practice. Wider implementation of such programmes would be a cost-effective way of saving lives. Please cite this paper as: Quist-Paulsen P. Cessation in the use of tobacco , pharmacologic and non-pharmacologic routines in patients. The Clinical Respiratory Journal 2008; 2: 4,10. [source] | ||||||||||