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At least 433 records · Page 24Linked to original sources
PubMed2006

A comparison of shoulder joint forces during ambulation with crutches versus a walker in persons with incomplete spinal cord injury.

OBJECTIVE: To compare 3-dimensional (3D) shoulder joint reaction forces and stride characteristics during bilateral forearm crutches and front-wheeled walker ambulation in persons with incomplete spinal cord injury (SCI). DESIGN: Cross-sectional cohort study. SETTING: Biomechanics laboratory. PARTICIPANTS: Fourteen adult volunteers with incomplete SCI recruited from outpatient rehabilitation hospital services. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Peak force, rate of loading, and force-time integral were compared for each component of the net 3D shoulder joint reaction force during ambulation with crutches and a walker. Stride characteristics were also compared between assistive device conditions. RESULTS: The largest weight-bearing force was superiorly directed, followed by the posterior force. The superior joint force demonstrated a significantly higher peak and rate of loading during crutch walking (48.9N and 311.6N/s, respectively, vs 45.3N and 199.8N/s, respectively). The largest non-weight-bearing force was inferiorly directed with a significantly greater peak occurring during crutch ambulation (43.2N vs 23.6N during walker gait). Walking velocity and cadence were similar; however, stride length was significantly greater during crutch walking (62% vs 58% of normal). CONCLUSIONS: Shoulder joint forces during assisted ambulation were large. Crutch use increased the superior force but did not increase walking velocity.

Adult↗
PubMed1975

Day-transfusion centre for patients with thalassaemia major.

In August, 1973, the Royal Children's Hospital in Melbourne, Australia, established a day-transfusion centre for treatment of children with thalassemia major. The centre is described, and the results of the first 4 months of operation were compared with a similar period before the centre opened, for the same fifty children. A significant decrease in total number of nights spent in hospital, hours spent at hospital for each blood-transfusion, days lost from school or unusual activity, and travel cost was noted. The transfusion-rate rose, but this probably reflected a change of policy rather than an effect of the centre.

Adolescent↗
PubMed2001

Reduced utilisation of specialist care among elderly cancer patients: a randomised study of a primary healthcare intervention.

The aim of this study was to evaluate the effect of an individual support (IS) intervention including intensified primary healthcare on the utilisation of specialist care among cancer patients, and to investigate if such an effect was modified by the patient's age (less than 70 years or 70 years and more). Newly diagnosed cancer patients (n=416) were randomised between the intervention and a control condition, and data were collected on the utilisation of specialist care within 3 months from inclusion. Intensified primary healthcare comprised extended information from the specialist clinics, and education and supervision in cancer care for general practitioners (GPs) and home-care nurses. The support given also included interventions designed to diminish problems of weight loss and psychological distress. The intervention reduced the number of admissions (NoA) and the days of hospitalisation (DoH) after adjustment for weight loss and psychological distress, but only for older patients. Older patients randomised to the intervention (n=82) experienced 393 fewer DoH than the older control patients (n=79). In addition, the proportion of older patients in the IS group who utilised acute specialist care was smaller compared with older control patients group. The conclusion is that older cancer patients' utilisation of specialist care may be reduced by intensified primary healthcare services.

Age Factors↗
PubMed2006

An outbreak of pertussis in a hematology-oncology care unit: implications for adult vaccination policy.

A pertussis outbreak in a hematology-oncology care unit involved 10 (8.5%) of 117 employees. The source was an employee who contracted pertussis via a family contact. No screened patients contracted pertussis, likely because of isolation measures. Hospitals should consider employee immunization with acellular vaccine in healthcare settings where pertussis has high rates of morbidity and mortality.

Academic Medical Centers↗
PubMed2002

Improving adverse-drug-reaction reporting in ambulatory care clinics at a Veterans Affairs hospital.

The detection of adverse drug reactions (ADRs) by a traditional passive reporting system and by a method involving patient and provider interviews was studied. The study sample consisted of randomly selected outpatients seen by their primary care provider during scheduled appointments in January and February 2001 at a Veterans Affairs medical center. After ambulatory care clinic sessions, patients and providers were asked (by telephone and in person, respectively) to identify potential ADRs. Also obtained were demographic data, information about drug regimens, and the severity and management of each ADR. A standardized ADR-assessment tool was used to determine the severity of each reported reaction and its causal relationship with the medication. A total of 198 patients were included. Of these, 51 (26%) had one or more ADRs. The patient and provider interviews identified a total of 83 ADRs, compared with 1 ADR identified by the passive reporting system. When providers were made aware of the ADRs they had not identified, changes were made to the patient's medication regimen in 34% of cases. The risk of an ADR was not associated with age, number of medications, or provider type. Direct patient and provider interviews yielded a significantly higher rate of ADR detection in an ambulatory care setting than did a passive ADR-reporting system.

Adverse Drug Reaction Reporting Systems↗
PubMed1993

Developing actual costs of patient services: the University of Alberta Hospitals.

Analysis of the costs of diagnostic and therapeutic services provided to patients yields a multitude of useful results: a sophisticated tool to assist in streamlining the underlying processes of patient care; an improved understanding of the nature and extent of case-based resource requirements; maximization of existing patient information collected through various feeder systems; a key step in the direction of measuring quality and the cost of quality, when linked to patient outcomes realization of the strategic significance of information management in today's complex, data-intensive health industry.

Alberta↗
PubMed1995

The effect of ambulatory oncology nursing practice models on health resource utilization. Part 2, Different practice models--different use of health resources?

The continuous rise in healthcare expenditures concerns providers, recipients, and payers alike, all of whom seek to explain, justify, or contain these costs. Although nurses are major healthcare providers in ambulatory oncology settings, the efficiency or productivity of nursing, expressed as frequency and cost of services (resource utilization), has not been addressed. Part 1 presented findings from a retrospective comparative study that delineated two different models of oncology nursing practice, the Nurse Complement Model and the Nurse Substitute Model of practice. Part 2 discusses these differences in the economic effectiveness of ambulatory oncology nursing in terms of health resource utilization.

Breast Neoplasms↗