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A M Worning

Publications and source records attributed to A M Worning.

17 recordsLinked to original sources
PubMed1994

Drug consumption among elderly--a four-year study.

The aim of the study was to analyse whether a radical structural change in the provision of care for the elderly, including changes in the pattern of drug administration, might influence drug consumption among residents in a Danish nursing home. A comprehensive reorganization of the care of the residents took place in the mid-1980s. The general approach to self-care, with greater autonomy and influence over one's own life was also disseminated to the area of administration of medication. Previously the nurses had been responsible for this area but a new model was introduced in 1986 in principle permitting all residents to be in charge of their own medication. The study was carried out as a survey over four consecutive years from 1985 to 1988, and included 48 residents in a nursing home of whom 24 participated in all four surveys. A minimum of drugs were administered immediately after the change in regimen. Although a slight increase was recorded in the subsequent years, the level of drug consumption did not reach pre-intervention levels. The total number of regularly administered drugs per day in survey 1 averaged 4.6 drugs/person. In survey 2 this had decreased to average 3.6 (p < 0.05).

Aged↗
PubMed1993

Prevalence of infections and use of antibiotics among hospitalized patients in Mauritius. A nationwide survey for the planning of a national infection control programme.

As part of a programme for improving hospital infection control in Mauritius a nationwide survey, including a prevalence study, was carried out in order to identify characteristics of the hospitals, the population, and the infections. Community-acquired infections were three times more prevalent than nosocomial infections: 15.0% and 4.9%, respectively. Surgical wound infection was by far the most common nosocomial infection, with a prevalence rate of 8.2 per 100 operations, followed by urinary tract infection with a low rate of 0.8 per 100 admissions. The survey showed that these hospitals in Mauritius housed mainly a young population (mean of 36.8 years for females and 39.4 years for males) with few risk factors for acquiring nosocomial infection. Although diabetes mellitus is prevalent in Mauritius the diagnosis of diabetes was not associated with nosocomial infection. The spectrum of operations offered was limited, and Caesarean section was the most prevalent operation. The amount and types of antibiotics used in hospitalized patients were recorded. More than one third of the patients received antibiotic treatment at the time of the survey, which is comparable to figures reported from large teaching hospitals in Western Europe. The information gathered from the survey, the interviews and the inspection were used to establish priorities for a collaborative programme for improved infection control. It included the draft of a set of custom-made guidelines, which were eventually studied by staff members from hospitals in Mauritius during a training period in Denmark. We believe that a prevalence survey is useful for initiating infection control programmes in hospitals in developing countries.

Adult↗
PubMed1992

[Quality assessment, quality assurance and quality improvement in health care. Concepts and terminology].

At present the topic "quality of health care" takes up a central position in the Danish debate, both among health professionals and politicians. In the present review the terms quality, quality assessment, and quality assurance are attempted defined and described. To assess the quality of health care deliveries it is necessary to establish indicators, criteria and standards. Indicators are defined variables which reflect deviations in quality. Criteria are established determinants of the optimal level of care while standards represent the degree of fulfillment of these. The relationship between indicators, criteria, and standards are illustrated. Quality assurance is a continuous process based on identifying quality problems for a given health delivery, and determining criteria and standards in relation to this. Quality assessment is the data collection and analysis through which the degree of conformity to predetermined standards and criteria are exemplified. If the quality, through this process is found to be unsatisfactory, attempts are made to discover the reason for this. On the basis of this, remedial actions are instituted and the quality reevaluated after a suitable time period. This stepwise process makes quality assurance a dynamic activity where criteria and standards are revised continuously with the overall purpose of improving the quality of health care services. Quality assessment and assurance should be incorporated as routine activities for health professionals. However, development, testing, and validation of the tools and methodologies for this new discipline are research activities.

Denmark↗
PubMed1987

The prognostic significance of virus-associated changes in grade 1 cervical intra-epithelial neoplasia.

Virus-associated changes of the cervix uteri were assessed in patients treated for grade 1 cervical intra-epithelial neoplasia (CIN). Of 106 patients evaluated, 67 (63%) had virus-associated changes. The patients were treated without regard to the presence/absence of virus-associated changes. In 26 patients the treatment was unsuccessful (persistence, recurrence, or progression of the neoplasia). The frequency of treatment failure was 33% in patients with, and 10% in patients without virus-associated changes (p less than 0.025). It is recommended that patients with CIN 1 and virus-associated changes should, after initial treatment, be followed-up with increased attention.

Adolescent↗
PubMed1987

Acute appendicitis in the rabbit. An experimental study.

With the purpose of devising an experimental model of acute appendicitis, the vermiform appendix in five rabbits was lightly compressed with a specially designed metal clamp, and in five others it was firmly ligated proximally. Based on these experiments, a final model was evolved, with a firm ligature midway on the vermiform process. This model was tested in 15 rabbits and proved to be reliable in provoking acute inflammation in one part, while the rest of the appendix remained unaffected. The literature is reviewed.

Acute Disease↗
PubMed1986

Antibiotic prophylaxis in vascular reconstructive surgery: a double-blind placebo-controlled study.

In a prospective randomized double-blind study of 141 patients referred for reconstructive vascular surgery on the abdominal aorta and the lower extremities, placebo was compared to antibiotic prophylaxis. The prophylaxis group received three doses of a combination of methicillin, 2 g and netilmicin, 200 mg. Antibiotic prophylaxis reduced postoperative wound infections as compared to placebo, i.e. 4/69 (5.8%) vs. 12/72, (16.7%) respectively (P = 0.04). No graft infections occurred. Two cases of postoperative septicaemia were seen in the placebo group, none in the antibiotic group. Among different procedures aortic-femoral bypass operations showed the highest wound infection rates. The two treatment groups were comparable with regard to all other postoperative complications registered, including nephro- and ototoxicity. The antibiotic regimen was considered safe, but had only marginal value as prophylaxis in vascular reconstructive surgery on the abdominal aorta and the lower extremities.

Adolescent↗
PubMed1985

Conservative surgical treatment of splenic cysts.

The common treatment of splenic cysts is splenectomy, but with today's knowledge of the important position of the spleen in the infection defense, it is advisable to preserve the spleen whenever this is possible, especially in younger individuals. A large non-parasitic, benign splenic cyst is excised. Postoperative ultrasound control presents a normal appearance of the spleen.

Adult↗
PubMed1984

Urethral cancer in females. A case history.

A case of female urethral cancer with late diagnosis on account of concomitant complaints is presented. When persistent urethral symptoms or localized pain are found the diagnostic procedure should include urethrocystoscopy .

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Report of a symposium on use and abuse of antibiotics worldwide.

A collaborative symposium of the Quality of Care and Technologies Programme of the World Health Organization's Regional Office for Europe and the Department of Hospital Epidemiology of the University Hospital, Freiburg, was held in Freiburg, FRG, in September 1988 to consider the use and abuse of antibiotics worldwide. Participants from developing countries provided estimates of use of antibiotics and problems of resistance in their countries. Because much of the information either is anecdotal or may not be representative of the vast, heterogenous populations in these countries, it is difficult to provide exact guidelines for the use of antibiotics. There is a need for better etiologic definition of the causes of acute respiratory tract infection and diarrheal disease and for surveillance of resistant bacterial strains. Because of the difficulty of making an etiologic diagnosis, a set of empiric guidelines has been developed for diagnosis and management of common conditions. Recommendations for the use of antibiotics must take into account the economics, medical manpower, social constraints, and emergence of resistant bacteria in both developed and developing countries. There is a need to establish a coordinated, worldwide network to obtain representative data and to organize clinical trials pertinent to the conditions of both developed and developing countries to define the best antimicrobial agent(s), the dosage, and duration of treatment for specific conditions.

Anti-Bacterial Agents↗