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At least 703 records · Page 39Linked to original sources
PubMed1999

Infant feeding practices in a deprived environment: a concern for early introduction of water and glucose D water to neonates.

The main objective of this study was to inquire from lactating mothers whether they were fully or partially practising exclusive breastfeeding in the first six months postnatally. Time of initiation of breast and complementary feedings, types of feeds and reasons for giving other feeds to infants apart from breast milk were also examined. The data were collected by structured pretested questionnaire. Of the 200 nursing mothers interviewed, 103 (51.5%) and 77 (38.5%) reported to have given water and glucose D water to neonates respectively within the first week of life. Sieved cornpap was the popular weaning diet. Time of introducing complementary feeding to infants, and nursing mothers' educational levels, were highly significantly related (P = 0.005). Surprisingly, none of the nursing mothers listed infant formula as one of the complementary feeds. It is concluded that there is a strong need to correct this unnecessary practice of giving water and glucose D water to neonates to prevent thirst and Jaundice respectively. The correction should commence with health workers and then the nursing mothers.

Adult↗
PubMed2004

Thermal Responses in Football and Cross-Country Athletes During Their Respective Practices in a Hot Environment.

OBJECTIVE: To determine if football (FB) players and cross-country (CC) runners had different thermal responses to their respective training sessions. DESIGN AND SETTING: On days 4 and 8 of preseason training, we assessed core (T(c)) and skin (T(sk)) temperatures. SUBJECTS: Fifteen collegiate athletes volunteered: 10 FB players (age = 21.2 +/- 1.14 years, height = 193.5 +/- 4.8 cm, mass = 116.6 +/- 16.3 kg, and V(2max) = 44.7 +/- 9.4 mLkg(-1)min(-1)) and 5 CC runners (age = 22.8 +/- 2.77 years, height = 176.3 +/- 8.9 cm, mass = 71.16 +/- 8.9 kg, and V(2max) = 71.3 +/- 6.18 mLkg(-1)min(-1)). MEASUREMENTS: We measured T(c) using ingestible sensors before, during, and immediately after exercise. The T(sk) was measured at the calf, forearm, back, chest, and forehead sites. Level of dehydration was assessed by urine specific gravity. RESULTS: Mean wet-bulb temperature was 74 degrees F (23.33 degrees C). Resting T(c) in shorts and T-shirts was higher in the FB group. The T(c) midway through practices and runs was higher in the CC and FB subjects when active, compared with the FB subjects when inactive. Postexercise T(c) was higher in the CC group than the FB group with pads, and postconditioning T(c) was higher in the FB subjects with pads versus no pads. Forehead, chest, back, and mean weighted T(sk) were higher in the FB group. The T(c) and urine specific gravity were not correlated. CONCLUSIONS: The T(c) fluctuated in the FB subjects during practice depending on exercise intensity, whereas T(c) increased steadily in the CC subjects during continuous running. Thus, CC athletes may have to decrease intensity to maintain thermoregulation. Our FB players seemed to dissipate heat adequately during rest periods.

Journal Article↗
PubMedDate not supplied

Rural child welfare practice from an organization-in-environment perspective.

An "organization-in-environment" perspective can help researchers understand how rurality influences child welfare practice. Drawing from theoretical perspectives on environment and organizations, researchers find rural/urban differences in practice at the level of the organization, which is the immediate environment of child welfare practice, and also in the relationship between organization and environment. Results challenge previous findings of few differences between rural and urban practice and offer particular implications for rural child welfare practice.

Child↗
PubMed1989

Medical practice sales in a changing environment.

In reality, the present climate for the sale of your practice is probably not quite as good as reported in many practice management articles. That is, contrary to the accounts of some authors, relatively few practices receive net selling prices that equal or exceed one year's revenue. However, the future of practice transfer is not likely to be as dismal as suggested in the initial accounts of the new federal rules and tax codes. Physicians who are considering the purchase or sale of a medical practice must carefully plan the transaction and take care to avoid violation of any law. Health care is big business and the physician should be able to share in the financial rewards of the industry. The carefully executed transfer of a medical practice should produce monetary gains while permitting the physician to attain nonfinancial personal goals. It also will produce continuity of medical services for area residents.

Humans↗
PubMed2001

[Evaluation of sphygmomanometers used by family physicians practicing outside the hospital environment in Bas-Saint-Laurent].

OBJECTIVE: To assess the precision and integrity of all aneroid and mercury sphygmomanometers regularly used by family physicians practising outside hospitals. DESIGN: Cross-sectional study. SETTING: Private medical clinics and local community health centres in Bas-Saint-Laurent, Qué. PARTICIPANTS: A total of 151 of the 166 physicians in this administrative region. MAIN OUTCOME MEASURES: Precision of the mercury sphygmomanometers was measured using the difference between a reading in the absence of pressure and level 0. Precision of the aneroid sphygmomanometers was measured using variations at pressures of 140 mm Hg and 90 mm Hg compared with those on a calibrated mercury sphygmomanometer. Integrity of sphygmomanometers, arm cuffs, and inflating bulbs was also assessed. RESULTS: In all, 258 sphygmomanometers met the inclusion criteria (111 mercury sphygmomanometers and 147 aneroid sphygmomanometers). Discrepancies of > or = 4 mm Hg were found in 15.5% of these instruments (12.6% and 17.7% of the mercury and aneroid sphygmomanometers, respectively). In 31.0% of the instruments (52.3% and 15.0% of the mercury and aneroid sphygmomanometers, respectively), one component was malfunctioning. CONCLUSION: Sphygmomanometers that measure patients' blood pressure inaccurately could result in an incorrect diagnosis of hypertension or in a normal blood pressure reading in a hypertensive patient.

Blood Pressure↗
PubMed1986

Mercury in dental practice. I. The working environment of dental personnel and their exposure to mercury vapor.

Eighty-two dental clinics in the county of Västerbotten, Sweden, were examined. The dentists answered questionnaires concerning working routines, consumption of mercury and the amount of amalgam therapy. Measurings of mercury vapor were performed in 109 operatories and in 35 sterilizing rooms in Public Dental Care (Ftv) and in 59 operatories and 48 sterilizing rooms in Private Dental Care (Ptv). In order to trace the sources of mercury exposure measurings were made at predetermined places. Peak values exceeding 150 micrograms/m3 were found in the operatories in Ftv in 2 places of measuring and in Ptv at 5 places and also at 2 places in the sterilizing rooms. The average amount of mercury vapor in the breathing zone (Hg-index) never exceeded 25 micrograms/m3. The exposure was higher in the operatories than in the sterilizing rooms and was higher in Ptv than in Ftv. Hg-index could be effected, though not in a statistically significant way, by the design of the clinic, the equipment and the routines. Peak readings of mercury vapor at floor level had the greatest influence on Hg-index, which indicates that spillage of mercury is the most important contributor to the dental personnel's exposure to mercury vapor.

Air Pollutants, Occupational↗
PubMed2003

Collaboration among nurse executives in complex environments: fostering administrative best practice.

In the past decade, many healthcare institutions have formed new partnerships, alliances, and networks. Collaboration among chief nursing officers and other leaders from affiliating institutions is essential to the success of these new organizational structures. The authors explore the nature of the collaboration among chief nursing officers and senior nurse leaders at 5 Harvard-affiliated teaching hospitals that provide cancer care. In particular, this article examines how collaborative relationships have been fostered and highlights the challenges, benefits, and outcomes of successful cross-institutional collaboration.

Benchmarking↗
PubMed1995

Establishing a community health focus in perinatal nursing practice within a capitated environment.

In this article, a model of care delivery is proposed that establishes a framework for meeting the health care needs of urban-dwelling women and children by organizing nursing care providers in a variety of delivery systems to balance access, quality, and cost. The program, intended as a component of an integrated health care network, illustrates the potential for nursing to assume a dominant role in providing health care services to a high-risk, high-cost population within a capitated environment.

Capitation Fee↗
PubMed1998

The nighttime environment and incontinence care practices in nursing homes.

OBJECTIVES: To determine the variability in noise, light, and incontinence care practices between nursing homes (NHs) and the association between these factors and residents' nighttime sleep. DESIGN: Prospective descriptive study of a sample of incontinent NH residents. SETTING: Ten nursing homes. SUBJECTS: Two hundred twenty-five incontinent NH residents. MAIN OUTCOME MEASURES: Measurements of residents' sleep by wrist actigraphs, bed mobility by pressure sensitive Kynar strips, and environmental noise and light changes were recorded by bedside monitors in consecutive 2-minute intervals for two 10-hour nighttime data collection periods (7 PM to 5 AM). RESULTS: Forty-two percent of waking episodes lasting 4 minutes or longer were associated with noise, light, or incontinence care events. Twenty-two percent of waking episodes of 4 minutes or longer were associated with noise alone, 10% with light or light + noise, and 10% with incontinence care routines. Seventy-six percent of all incontinence care practices resulted in awakenings. There was variability between the 10 NHs, with the percentage of waking episodes associated with environmental events (noise, light, or incontinence care events) ranging from 23.6 to 66.0%. CONCLUSION: Noise and incidents of incontinence care practices were associated with a substantial amount of sleep disruption in residents in all 10 nursing homes, even though there was variability between homes. Interventions minimizing such environmental events are needed to promote better sleep in incontinent NH residents.

Aged↗
PubMed1999

Virtual endoscopic environments in modern neurosurgical practice.

Modern radiographic techniques have allowed the creation of high-definition planar images that can provide important anatomical as well as physiological data. Planar imaging sets can be reformatted into three-dimensional (3-D) data sets that can then be manipulated to demonstrate important anatomical or gross pathological features. Three-dimensional data sets have been used with success in modern image-guided or frameless stereotactic surgery. Another potential application is so-called "virtual endoscopy" or "scopeless endoscopy," in which a 3-D anatomical data set is reformatted into a volume-rendered image that can then be viewed. By reformatting images in this way, a "surgeon's-eye" view can be obtained, which can aid in presurgical planning and diagnosis. The use of virtual endoscopy has the potential to increase our understanding of the appropriate anatomy and the anatomical relationships most apparent during neurosurgical approaches. In so doing, virtual endoscopy may serve as an important means of planning for therapeutic interventions. On the other hand, one must always be cognizant of the technical limitations of these studies regardless of the quality of the reconstructed images. Prospective, correlative, clinical studies in which the anatomical advantages of virtual-based endoscopy are evaluated in large cadaver or patient series must be performed. Until then, the only potential ways to compensate for errors that exist in the algorithms and reconstructions of 3-D endoscopic images are based on the surgeon's understanding of the clinical state of the patient and prior experience with the anatomy in the region of question.

Journal Article↗
PubMed1998

The changing environment of community health practice and education: perceptions of staff nurses, administrators, and educators.

Historically, baccalaureate nursing programs in Canada have prepared graduates to practice in the community. Two recent trends-the move to prepare all registered nurses in degree programs and the changing climate in which community nursing is practiced-made it timely to explore the educational preparation required for community health practice. This article reports on one part of the study, i.e., on findings that explicate the nature of community health nursing practice in a western Canadian province, as it has changed during the past decade, as it is currently practiced, and as it is expected to develop in the future. What, in other words, is the nature of the community practice for which nursing students should be prepared? An action research design guided the study. Participants were recruited from all major urban, rural, and northern settings in which baccalaureate nurses practice throughout the province. The perspective of relevant people was considered important, i.e., nurses practicing in the community, administrators, and educators of future community nurses. One hundred eighteen (118) participants were interviewed in 27 focus groups. Data were tape recorded, transcribed, and analyzed for content. Among the themes identified were those that captured changes community health nurses experienced in their nursing practice. Nurses also described how they thought practice would evolve in the years to come. These themes are discussed within a primary health care framework in which nurses can be expected to play a more active role in shaping community health nursing practice.

Canada↗
PubMed1992

Purchasing practices in a hospital environment: an ethical analysis.

The critical state of the hospital industry, as previously described, generates a difficult decision environment for the materiel manager and those in the purchasing function. The unique life- and death circumstances of hospitals impose a further onus on those who manage them. In the name of saving lives, they can find a convenient excuse to disregard all moral principles, forgetting the Socratic dictum "it is not enough that one lives, but that one lives well." Without the moral "right stuff," they can easily give in to the seductions of momentary gains and glory through ethical short-cuts. There is wisdom and consolation in the words that "nice guys may appear to finish last, but usually they're running in a different race." Studies have established a direct relationship between corporate excellence and ethical values. The reality of competition in the hospital industry dictates that the integration of ethics into the life of the organization should happen by design and not by accident. This is what is meant by strategy. If hospitals would strive for excellence to survive and grow, they should have a strategy with a mission statement that also embodies its moral values and moral agenda. Such an approach does not guarantee that an organization will become immune to moral contamination, but it does provide an antidote.

Civil Rights↗
PubMed2002

[Cancer networks].

The complexity of legislation and the obstacle race run by all promoters in search of approval and funding for their projects could have greatly hindered the development of healthcare networks in France, or at least discouraged many promoter. Yet social and health professionals, along with certain healthcare service staff, considered these networks highly useful for decompartmentalising the French healthcare system. They would favour patient-oriented projects. It is not a surprise that the number of networks in the field of oncology is expanding rapidly, with more than 60 projects registered by public authorities by the end of 1999. Cancers are chronic diseases which often bring into play the patient's vital prognosis, as well as psychological and social consequences - sometimes dreadful - for patients and their relatives. Cancer patient management calls for a multidisciplinary approach in elaborating the therapeutic project and providing psychological support. Continuity and consistency of care require a partnership between different care providers from different specialities, with different medical practice and environments - hospital or home care, public or private practice. Though so much information has become available in the medical literature, quality of care demands that each healthcare professional keeps fully aware of the latest diagnostic or therapeutic findings and techniques in his/her field. Certain cancer networks have become a place where care providers and establishments can share methods and medical practice. Network promoters and members have thus been able to regain control over the functioning and the future of their profession. Patients have also obtained a place in decisions concerning their own health. Setting up healthcare networks will certainly shake up the tranquil system which the WHO has reported as the world's best health care system at the dawn of this century. However, this will also probably contribute to maintaining this excellence.

Ethics↗