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Selected AbstractsAcupuncture for the induction of labour: a double-blind randomised controlled studyBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2010J Modlock Please cite this paper as: Modlock J, Nielsen B, Uldbjerg N. Acupuncture for the induction of labour: a double-blind randomised controlled study. BJOG 2010;117:1255,1261. Objective, To investigate whether acupuncture is effective for the induction of labour in post-term pregnancies. Design, A double-blind multicentre randomised controlled study. Settings, Aarhus University Hospital and Herning Regional Hospital, Denmark. Population, One hundred and twenty-five healthy women with uneventful pregnancies at gestational week 41+6 were randomised into two groups. Methods, The intervention group was given acupuncture twice on the same day at acupuncture point GV20 and bilaterally at points BL67, LI4 and SP6. The control group received sham acupuncture at the same points. Main outcome measures, At effect evaluation, which was carried out 24 hours after randomisation, the primary endpoint was labour or delivery. Results, The primary endpoint was achieved in seven women (12%) in the acupuncture group and eight women (14%) in the control group (P = 0.79). Stratification for parity and fetal gender did not alter the results. Conclusion, Under the treatment regimen investigated in this study, acupuncture for the induction of labour in post-term women at gestational age 41+6 weeks may not be effective. [source] Do family members interfere in the delivery of care when present during invasive paediatric procedures in the emergency department?EMERGENCY MEDICINE AUSTRALASIA, Issue 3 2007Glenn Ryan Abstract Objective:, To determine whether family members interfere with patient care when present during invasive procedures performed on their children in the ED. Methods:, A prospective observational study of consecutive cases of procedural sedation of children aged between 12 months and 16 years was conducted between March 2002 and March 2006 in the ED of a secondary-level regional hospital in south-east Queensland. Procedures performed included laceration repair, fracture reduction, foreign body removal and abscess incision and drainage. Parents/primary caregivers were encouraged to stay with their child. A stepwise explanation of the procedure and sedation to be used was undertaken, informed consent obtained and telephone follow up attempted 5,14 days post procedure. Results:, Six hundred and fifty-two patient encounters with parents or primary caregivers present for the procedure were included for a total of 656 procedures: 234 laceration repairs, 250 fracture reductions, 85 foreign body removals, 33 abscess incision and drainages, 14 dislocation reductions and 40 other procedures. Telephone follow up was successful in 65% (424) of cases. The mean age was 6.5 years. Family member interference occurred in one case (0.15%, 95% confidence interval 0,0.73%). In 17 cases (2.68%, 95% confidence interval 2.1,5.9%) family members present expressed concerns about the procedure during the telephone follow up but had not interfered at the time of the procedure. There were no significant differences between the concerned parents at follow up and the study group across key patient variables such as child's age (P = 0.369), weight (P = 0.379), respiratory rate (P = 0.477), sex (P = 0.308), procedure indication (P = 0.308) and airway manoeuvres (P = 0.153). Conclusion:, When family members are encouraged to stay for invasive procedures performed on their child, and careful explanation of the procedure, sedation, possible complications, choice of medication for sedation and possible side-effects is undertaken, family member interference is extremely rare. [source] Witnessing invasive paediatric procedures, including resuscitation, in the emergency department: A parental perspectiveEMERGENCY MEDICINE AUSTRALASIA, Issue 3 2005Jonathon Isoardi Abstract Objective:, To determine whether parents prefer to be present during invasive procedures performed on their children in the ED. Methods:, A prospective study using a written survey was carried out in the ED of a secondary level regional hospital in south-east Queensland. The survey conducted between August 2003 and November 2003 consisted of parental demographics, seven theoretical paediatric procedural scenarios with increasing level of procedural invasiveness (including resuscitation) and reasons for the decisions of parents to either stay with the child or leave the room. Parents of children with Australasian Triage Scale (ATS) triage category 3, 4 and 5 were surveyed. Results:, Of 573 surveys collected, 553 (96.5%) were completed correctly. The number of parents expressing a desire to be present during a procedure performed on their child was 519 (93.9%) for phlebotomy or i.v. cannulation of an extremity, 485 (87.7%) for nasogastric tube insertion, 461 (83.4%) for lumbar puncture, 464 (83.9%) for urinary catheter insertion, 430 (77.8%) for suprapubic bladder aspiration, 519 (93.4%) during procedural sedation and 470 (85%) during a resuscitation where the possibility existed that their child may die. The most common reason for wanting to be present was to provide comfort to their child (542/98%). The most common reason for not wanting to be present was a parental concern of getting in the way (181/33%). Conclusion:, Most parents surveyed would want to be present when invasive procedures are performed on their children in the ED. With increasing invasiveness, parental desire to be present decreased. However, the overwhelming majority of parents would want to be in attendance during procedural sedation or resuscitation. [source] Medical thoracoscopy in an Australian regional hospitalINTERNAL MEDICINE JOURNAL, Issue 4 2007G Simpson Abstract Medical thoracoscopy is not widely available in Australia. A medical thoracoscopy service has been set up in a regional hospital using no specialized equipment and at minimal cost. Of the first 100 procedures carried out, 89 were for investigation of pleural effusion, 6 for pneumothorax and 6 for empyema. Of the 89 pleural effusions, 73 were diagnosed as malignant (43 carcinoma, 24 mesothelioma, 3 lymphoma, 2 melanoma and 1 sarcoma). The sensitivity for a malignant diagnosis was 94.5%, with 100% specificity. Four patients had unsuspected tuberculous effusions. Pleurodesis was carried out with instillation of dry sterile talc in 67 cases. In 92.5% of these, no further drainage procedure was needed. There was one fatality caused by pre-existing sepsis in a debilitated patient with disseminated carcinoma. Medical thoracoscopy is a simple, safe and cost-effective technique for diagnosing and treating pleural effusions and provides a useful service in the setting of a regional hospital. [source] Mechanical Heart Valves in SeptuagenariansJOURNAL OF CARDIAC SURGERY, Issue 1 2008Ch.M., F.E.T.C.S., F.R.C.S., R. Ascione M.D. Methods: The study was carried out in a tertiary regional hospital in South-West England. Study 1: Consecutive series of 567 patients undergoing Sorin Bileaflet (SB) mechanical valve implant (437 patients < 70 years; 130 patients , 70 years). Study 2: 113 septuagenarians undergoing biological implant matched on age, valve type, concomitant coronary surgery, and operative priority to the SB septuagenarian group. Main outcome measures included in-hospital mortality and morbidity and mid-term valve-related outcome. Results: Study 1: Septuagenarians were more likely to present with coronary disease, and to undergo coronary surgery (p < 0.01). In-hospital mortality was 2.8% and 2.3% (p = 0.79) and neurological complications 1.4% versus 3.8% (p = 0.026) in the younger and older groups, respectively. Valve-related mortality at two years was 1.8% (95%CI, 0.8% to 3.6%) and 4.8% (95% CI, 2.0% to 9.7%); cumulative three- year incidence of thromboembolic or major hemorrhagic event was 8.3% (95% CI, 5.7% to 12.0%) and 4.6% (95% CI, 1.7% to 12.4%) in the younger and older groups, respectively. Study 2: In-hospital mortality was 1.8% and 7.1% in the SB and biological groups, respectively (ratio 0.25; 95% CI, 0.05 to 1.18, p = 0.058). The incidence of acute renal failure was greater in the biological group (risk ratio 0.30; 95% CI, 0.09 to 0.98, p = 0.035). There was no difference in mid-term valve-related mortality between groups (hazard ratio 0.53; 95% CI, 0.18 to 1.52, p = 0.24). Conclusion: The performance of SB valve in septuagenarians seems to be effective with no increased risk of in-hospital mortality, bleeding, or thromboembolic events. [source] A comparison of mothers' and fathers' experiences of the attachment process in a neonatal intensive care unitJOURNAL OF CLINICAL NURSING, Issue 6 2008Liv Fegran RN Aim., To compare mothers' and fathers' individual views and experiences of the attachment process in a neonatal intensive care unit within the first week after a premature birth. Background., The attachment between parents and children is a precursor to the consolidation of parenting skills, the growth and development of the infant and the establishment of a bond between parent and child. Premature birth and the resultant hospitalization disrupt the normal attachment process between parent and child. Most of the litteraure on attachment theory focuses on the mother,child connection and is being criticised for regarding the father's role as supportive and peripheral. Methods., The design of this study was descriptive with a hermeneutic approach. Twelve parents (six mothers and six fathers) in a 13-bed neonatal intensive care unit in a Norwegian regional hospital participated in a field study addressing the encounter between parents and nurses. This paper is based on the semi-structured interviews with the parents at discharge. Results., The interview analysis revealed two main categories. (a) Taken by surprise: For mothers, the premature birth created a feeling of powerlessness and they experienced the immediate postnatal period as surreal and strange. The fathers experienced the birth as a shock, but were ready to be involved immediately. (b) Building a relationship: Mothers experienced a need to regain the temporarily lost relationship with their child, whereas the fathers experienced the beginning of a new relationship. Conclusion., Comparing parents' experiences of the attachment process within the first days after a premature birth reveals a striking contrast between the mother's experience of surrealism and the father's ability to be involved immediately after birth. Relevance to clinical practice., Parents' of premature children's different starting points should be acknowledged as professionals encourage parents to have early skin-to-skin contact with their premature infant. [source] Nurse discharge planning in the emergency department: a Toowoomba, Australia, studyJOURNAL OF CLINICAL NURSING, Issue 8 2006Desley Hegney BA Aim., This study aimed to ascertain whether a model of risk screening carried out by an experienced community nurse was effective in decreasing re-presentations and readmissions and the length of stay of older people presenting to an Australian emergency department. Objectives., The objectives of the study were to (i) identify all older people who presented to the emergency department of an Australian regional hospital; (ii) identify the proportion of re-presentations and readmissions within this cohort of patients; and (iii) risk-screen all older patients and provide referrals when necessary to community services. Design., The study involved the application of a risk screening tool to 2139 men and women over 70 years of age from October 2002 to June 2003. Of these, 1102 (51·5%) were admitted and 246 (11·5%) were re-presentations with the same illness. Patients presenting from Monday to Friday from 08:00 to 16:00 hours were risk-screened face to face in the emergency department. Outside of these hours, but within 72 hours of presentation, risk screening was carried out by telephone if the patient was discharged or within the ward if the patient had been admitted. Results., There was a 16% decrease in the re-presentation rate of people over 70 years of age to the emergency department. Additionally during this time there was a 5·5% decrease in the readmission rate (this decrease did not reach significance). There was a decrease in the average length of stay in hospital from 6·17 days per patient in October 2002 to 5·37 days per patient in June 2003. An unexpected finding was the decrease in re-presentations in people who represented to the emergency department three or more times per month (known as ,frequent flyers'). Conclusions., Risk screening of older people in the emergency department by a specialist community nurse resulted in a decrease of re-presentations to the emergency department. There was some evidence of a decreased length of stay. It is suggested that the decrease in re-presentations was the result of increased referral and use of community services. It appears that the use of a specialist community nurse to undertake risk screening rather than the triage nurse may impact on service utilization. Relevance to clinical practice., It is apparent that older people presenting to the emergency department have complex care needs. Undertaking risk screening using an experienced community nurse to ascertain the correct level of community assistance required and ensuring speedy referral to appropriate community services has positive outcomes for both the hospital and the patient. [source] Relationship between organizational climate and empowerment of nurses in Hong KongJOURNAL OF NURSING MANAGEMENT, Issue 3 2002Esther Mok RN Aims,The authors explore the relationship between organizational climate and empowerment among the nursing staff of a regional hospital in Hong Kong. The main purpose of the study was to apply the modified Spreitzer measure of empowerment in a hospital and to examine the relationship of organizational climate to perceptions of empowerment. Methods,From 658 questionnaires sent out, 331 nurses participated in the study with a response rate of 50.3%. Survey measures administered included the modified Litwin and Stringer Organizational Climate Questionnaire (LSOCQ) and the modified Spreitzer empowerment instrument. The relationships between organizational climate and empowerment were examined in a series of bivariate correlational analyses. The final section of the questionnaire asked the respondents to list three elements in the organizational climate that they perceived would further increase their feelings of empowerment. Findings,Exploratory factor analysis of the modified LSOCQ resulted in six factors: leadership, working harmony, challenge, recognition, teamwork and decision making. There was a positive correlation between organizational climate and psychological empowerment. Using multiple regression analysis, all the six derived climate factors significantly accounted for 44% of the variance. Among the six predicting factors, leadership and teamwork showed the most positive relationship with psychological empowerment. Responses from the open questions on perception of organizational climate that further enhance nurses' feelings of empowerment were categorized into eight areas. They include leadership, communication, working relationship, recognition, structure, training, teamwork and stress management. Conclusion,The study echoes previous studies in finding that organizational climate and, in particular, supportive leadership and teamwork are related to empowerment. The findings also suggest that the nurses in the study did not put much emphasis on the importance of participative decision making. [source] Parents' Experiences, Reactions and Needs Regarding a Nonviable Fetus Diagnosed at a Second Trimester Routine UltrasoundJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2008Maria Ekelin ABSTRACT Objective: To conceptualize women's and their partners' experiences and ways of handling the situation before, during, and after second trimester ultrasound examination with the diagnosis of a nonviable fetus. Design: A grounded theory study. Setting: A Swedish regional hospital. Participants: Nine women and 6 men (n=15) were interviewed within a year of the event. Results: The core category was Unexpected change in life. Four categories that were encompassed by the core category emerged: (a) Deceived by a false sense of security; (b) Confronting reality; (c) Grieving; and (d) Reorientation. Conclusion: These parents were unprepared for the diagnosis of a nonviable fetus. In addition to the crisis reaction, they realized that the sense of security they had experienced was false. As different care givers were involved, the need for a care plan was evident. Support from care givers was a very important factor. [source] Medical practice, procedure manuals and the standardisation of hospital deathNURSING INQUIRY, Issue 1 2009Hans Hadders This paper examines how death is managed in a larger regional hospital within the Norwegian health-care. The central focus of my paper concerns variations in how healthcare personnel enact death and handle the dead patient. Over several decades, modern standardised hospital death has come under critique in the western world. Such critique has resulted in changes in the standardisation of hospital deaths within Norwegian health-care. In the wake of the hospice movement and with greater focus on palliative care, doors have gradually been opened and relatives of the deceased are now more often invited to participate. I explore how the medical practice around death along with the procedure manual of post-mortem care at Trondheim University Hospital has changed. I argue that in the late-modern context, standardisation of hospital death is a multidimensional affair, embedded in a far more comprehensive framework than the depersonalised medico-legal. In the late-modern Norwegian hospital, interdisciplinary negotiation and co-operation has allowed a number of different agendas to co-exist, without any ensuing loss of the medical power holder's authority to broker death. I follow Mol's notion of praxiographic orientation of the actor,network approach while exploring this medical practice. [source] Modeling the Emergency Ambulance Pass-By of Small Rural Hospitals in Victoria, AustraliaTHE JOURNAL OF RURAL HEALTH, Issue 4 2005Patrick Gleeson MBA ABSTRACT: Context: Many small rural hospitals struggle to attract sufficient numbers of suitable patients. Inadequate patient throughput threatens the viability of these hospitals and, consequently, the financial, physical, and social well-being of the whole community. Anecdotal evidence suggests that many emergency ambulance patients are routinely taken past their local small rural hospital to the area's major receiving hospital. Purpose: To quantify the ambulance pass-by of local small rural hospitals and identify the factors that influence its occurrence. Methods: Data were collected from the ambulance and hospital records of 3 small rural centers in central Victoria, Australia. Results: Ambulances transport a significant number of patients past their local small rural hospitals to the area's major receiving hospital. This takes less time for paramedics than bringing a patient to the local hospital first if the patient is then redirected by that hospital to the larger hospital. There is an inverse relationship between the rate of cases in which the local hospital redirects ambulances to the regional hospital and the rate of ambulance crew decisions to use the local hospital. Conclusions: If some patients are being transported directly to the major receiving hospital because paramedics are considering their own time commitments when making patient transport decisions, this could have revenue implications for rural hospitals. Attracting appropriate local ambulance patients to the smaller hospitals may provide an income source that is currently lost to the crowded major receiving hospital's emergency department. [source] Maternal and neonatal outcomes in the Torres Strait Islands with a sixfold increase in type 2 diabetes in pregnancy over six yearsAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2010Henrik FALHAMMAR Background:, Torres Strait Islander population has a high prevalence of type 2 diabetes (T2DM). Aims:, To review pregnancy data of women and their newborns living in the Torres Strait area. Methods:, All medical charts of mothers and their neonates delivered in two one-year periods (1999 and 2005/2006) were reviewed. The initial screening test for diabetes in pregnancy (DIP) was a random blood glucose level followed by an oral glucose challenge test in 1999 and from 2000 an oral glucose tolerance test. Results:, Diabetes in pregnancy increased by 4.3,13.3% and T2DM by 0.8,4.6%. During the two periods, 258 and 196 mothers delivered respectively 84,92% by midwives/general practitioners at the local hospital and 7,16% by midwives/obstetricians at the regional hospital; in 2005/2006, 58% of women with DIP delivered at the regional hospital. Screening increased from 89.2 to 99.5%. DIP mothers were older and heavier with more hypertension and previous miscarriages. Parity decreased in the DIP mother during the two periods. Caesarean section was five times more common for DIP in 2005/2006 versus non-DIP, while in 1999, there was no difference. In 1999, the DIP infants were heavier, longer (P = 0.053) and had a larger head circumference not seen 2005/2006. There was more neonatal trauma, hypoglycaemia and IV dextrose in the DIP infants. Breastfeeding numbers increased in DIP. In 2005/2006, follow-up of gestational diabetes occurred in 47% (all normal). Conclusion:, A massive increase in DIP was seen. The neonatal outcomes improved slightly. There is need for improvement in follow-up of gestational diabetes. [source] Analysis of recording and coding of smoking history for patients admitted to a regional hospitalAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2007Sharafat Malek No abstract is available for this article. [source] Evaluation of emergency medicine trainees' ability to use transport equipmentEMERGENCY MEDICINE AUSTRALASIA, Issue 3 2009Manoj Samuel Abstract Objective: To assess the skills of advanced emergency medicine trainees in the use of commonly used transport equipment and to determine what teaching has been undertaken and what level of confidence trainees have in their ability to use the equipment tested. Methods: This is a prospective multicentre observational study examining equipment use. Three pieces of equipment were examined: the infusion pump, defibrillator-monitor and transport ventilator. A questionnaire and a series of practical tasks were used. Advanced trainees from Victorian ED were enrolled as participants. Outcomes included proportion of participants able to perform all tasks successfully, subjective registrar confidence with use of equipment and departmental training practices. Eleven ED were represented, covering metropolitan tertiary, metropolitan peripheral and regional hospitals. Results: There were 47 participants enrolled in the study. The range of advanced training years of participants was 1,5+. Of the 47 participants, 39 (83%; 95% CI 72.2,93.7%) had been involved as medical escorts. Eighteen participants (38.3%; 95% CI 24.4,52.2%) described some form of teaching for equipment use. The median level of confidence of participants (on a 5-point scale) was 4 (25,75% interquartile range 3,4), which correlates with a moderate degree of confidence. Of 47 participants, 7 (14.9%; 95% CI 4.7,25.1%) rated themselves as not confident or somewhat under-confident (i.e. 1 or 2 on the scale). Of 47, 12 passed overall (25.5%; 95% CI 13.1,38%) and 8 completely failed (17.0%; 95% CI 6.3,27.8%) the skill testing. Conclusion: When tested in isolation, there appears to be deficits in the equipment skills of advanced ED trainees who are expected to be proficient in transport medicine. [source] Hyperhomocysteinemia in Children Treated with Antiepileptic Drugs Is Normalized by Folic Acid SupplementationEPILEPSIA, Issue 10 2005Martina Huemer Summary:,Purpose: To assess the prevalence of hyperhomocysteinemia in pediatric patients treated with antiepileptic drugs (AEDs) and to evaluate the effect of folic acid supplementation on plasma total homocysteine (tHcy) concentrations in hyperhomocysteinemic patients. Methods: 123 patients from three regional hospitals participated in the study. Patients with hyperhomocysteinemia were included in a 3-month double-blind randomized trial testing oral folic acid supplementation (1 mg/day) versus placebo. Results: Hyperhomocysteinemia (tHcy >10.4 ,mol/L) was present in 19 of 123 patients. Patients with hyperhomocysteinemia were older (13.7 ± 4 vs. 11.0 ± 3.9 years) and had significantly lower folate and cobalamin concentrations. Multidrug (two or more) AED treatment and duration of therapy correlated significantly with elevated total homocysteine (tHcy) and low folate. In contrast, polymorphisms in the methylene tetrahydrofolate reductase gene (MTHFR 677 C,T, 1298 A,C, 1793 G,A) had no significant impact on tHcy. Nine of 19 patients with hyperhomocysteinemia were randomized to placebo, whereas the remaining 10 patients received folic acid supplementation. Folic acid supplementation resulted in a significant increase of folate and decrease of tHcy, whereas both parameters remained unchanged in the placebo group. Conclusions: Hyperhomocysteinemia is present in 15.5% of children receiving long-term AED treatment. Multidrug treatment and long duration of therapy enhance the risk for hyperhomocysteinemia. Folic acid supplementation significantly reduces tHcy. We recommend assessment of serum folate and plasma tHcy in children receiving AEDs. [source] Organisational climate, organisational commitment and intention to leave amongst hospital nurses in TaiwanJOURNAL OF CLINICAL NURSING, Issue 11-12 2010Shwu-Ru Liou Aims and objectives., To examine: (1) Taiwanese nurses' perceptions of organisational climate, levels of organisational commitment and intention to leave, as well as relationships between these three variables; (2) demographic differences in the levels of these variables; and (3) mediating effects of organisational commitment on the relationship between organisational climate and intention to leave. Background., Organisational climate is related to organisational commitment and affects nurses' performances and attitudes towards an organisation. Design., A cross-sectional, descriptive design. Method., Registered nurses working in eight hospitals in southern Taiwan for more than six months were recruited. Data were collected using the Litwin and Stringer's Organisational Climate Questionnaire, Organizational Commitment Questionnaire and a five-item scale measuring intention to leave. Questionnaires were distributed to 612 potential participants; 486 valid returned questionnaires were analysed. Results., The study's participants were generally satisfied with their hospital's climate and yet claimed low commitment to their organisation and, nevertheless, reported low intention to leave their job. Single nurses were more satisfied with their hospital's climate and were more committed to their hospital and had a lower intention to leave their job compared to married nurses. Nurses working in district hospitals perceived a better hospital climate and had a lower intention to leave than nurses working in teaching or regional hospitals. Staff nurses perceived a better organisational climate than did nurse managers. Organisational climate, organisational commitment and intention to leave were intercorrelated. Organisational climate had almost 60% indirect effect on organisational commitment related to intention to leave. Conclusions., Creating a good organisational climate may increase nurses' organisational commitment and, in turn, decrease their intention to leave. Relevance to clinical practice., To motivate nurses' positive organisational behaviours and to address their diverse needs, hospital administrators are encouraged to understand nurses' work-climate perceptions and to address nurses' varied demographic factors. [source] Family involvement in perioperative nursing of adult patients undergoing emergency surgeryJOURNAL OF CLINICAL NURSING, Issue 2 2001Eija Paavilainen PhD ,,The purpose of this study was to describe how adult patients undergoing emergency surgery experience family centredness in perioperative nursing practice. The central aim was to generate knowledge to be used while developing the practice, education and management of perioperative nursing. ,,Data were collected using a questionnaire with emergency surgical patients in five regional hospitals in Southern Finland. The number of distributed questionnaires was 132. The response rate was 85% (n=112). ,,The results were mainly described as frequencies and percentages. The open-ended sections of the answers were analysed using qualitative content analysis. The findings from the open-ended questions were used for deepening and complementing the quantitative description of the results. ,,In the preoperative phase, ascertaining the family situation and informing the family member chosen by the patient were not achieved systematically. Family situation was also rarely examined in the intraoperative and postoperative phases, although it is central to coping after surgery, especially in home care. ,,The results support the view of earlier research about the importance of individuality of patients and their families during the perioperative care process and hence enhance the endeavour to develop nursing based on families' real needs. [source] Relationships among conflict, conflict management, job satisfaction, intent to stay, and turnover of professional nurses in Thailand*NURSING & HEALTH SCIENCES, Issue 1 2000DSN , Wipada Kunaviktikul RN Abstract This study was conducted to describe level of conflict, conflict management styles, level of job satisfaction, and intent to stay, and to ascertain relationships among conflict, conflict management styles, level of job satisfaction, intent to stay, and turnover of professional nurses in Thailand. The sample was 354 professional nurses employed in four regional hospitals in Thailand. The findings showed that the overall level of conflict was at a moderate level. The majority of subjects used accommodation most frequently to manage conflict. Subjects were dissatisfied with pay but were neither satisfied nor dissatisfied with work, supervision, opportunities for promotion, co-workers and the job in general facets of job satisfaction. Most subjects had a high intent to stay in their present jobs for 1 year (97.1%) but intent to stay for the next 5 years decreased (78.5%). The result showed some relationships among these variables, but no relationship between intent to stay and turnover of professional nurses. [source] Pragmatic indicators for remote Aboriginal maternal and infant health care: why it matters and where to startAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Malinda Steenkamp Abstract Objective: There are challenges in delivering maternal and infant health (MIH) care to remote Northern Territory (NT) communities. These include fragmented care with birthing in regional hospitals resulting in cultural and geographical dislocation for Aboriginal women. Many NT initiatives are aimed at improving care. Indicators for evaluating these for remote Aboriginal mothers and infants need to be clearer. We reviewed existing indicators to inform a set of pragmatic indicators for reporting improvement in remote MIH care. Methods: Scientific databases and grey literature (organisational websites and Google Scholar) were searched using the terms ,Aboriginal/maternal/infant/remote health/monitoring performance'. Key stakeholders identified omitted indicators sets. Relevant sets were reviewed and organised by indicator type, stage of patient journey, topic and theme. Results: Forty-two indicators sets were found. Seven focused on Aboriginal health, 23 on reproductive/maternal health, eight on child/infant health and four on other aspects, e.g. remote health. We identified more than 1,000 individual indicators. Of these, 656 were relevant for our purpose and were subsequently organised into 300 topics and 16 themes for antenatal, birth and postpartum, and infant care by indicator type. Conclusion: There are many measures for monitoring health care delivery to mothers and infants. Few are framed around remote MIH services, despite poorer health outcomes of remote mothers and infants and the specific challenges with providing care in this setting. Establishing relevant indicators is vital to support relevant data collection and the development of appropriate policy for remote Aboriginal maternal and infant care. [source] Double-bundle reconstruction of the anterior cruciate ligamentAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2007Thomas Nau Abstract Injuries of the anterior cruciate ligament often present in rural practices and rural regional hospitals. Surgical reconstruction is the treatment of choice in the young and active patient. Better biomechanical understanding has led to a further improvement of the surgical technique. The double-bundle reconstruction, which aims to address both functional bundles of the anterior cruciate ligament, represents the latest development in this field. In this review article the basic biomechanical principles as well as a new surgical technique are presented for practitioners in rural practice and rural regional hospitals. [source] REMOVING THE ROADBLOCKS TO MEDICAL AND HEALTH STUDENT TRAINING IN RURAL HOSPITALS IN VICTORIAAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 5 2003Graeme I. Jones ABSTRACT Objective: To assess the extent of undergraduate health student placements in regional hospitals in northern Victoria in 1999, prior to substantial changes in rural undergraduate medical education in Australia. Method: Cross sectional postal survey with telephone follow-up in north-east Victoria. Subjects were all 17 regional and rural hospitals involved in health student teaching in North-east Victoria. Main outcome measures were the numbers, duration and discipline of health students placements and reported barriers to such placements. Results: Large regional hospitals accounted for two-thirds of all undergraduate health student placements. Smaller sites placed few allied health students. Barriers to a larger, more sustainable system of rural placements and rotations included accommodation shortages and funding constraints, particularly in smaller rural hospitals. Conclusions: Adequate resourcing of placements of a meaningful duration, stronger institutional support, and improved resourcing of regional accommodation is required to facilitate a larger, more systematic and sustainable system of medical and health student placements in rural areas. [source] | |||||||||||||||||||||||||