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Chronic disease management requires a clear vision, collaboration, and continuing program development to be successful. The patient benefits from an approach that is patient-centered and goal directed. Our challenge in this environment of declining healthcare reimbursement is to stay the course and continue measurement of our outcomes to determine our success in meeting our goals.
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PURPOSE: To provide the physician and registered professional nurse with an overview of education strategies for patients with wounds. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in learning more about strategies for educating patients with wounds. OBJECTIVES: After reading the article and taking the test, the participant should be able to: 1. Describe the educational needs of the adult learner. 2. Discuss strategies for educating the adult learner in wound care.
Health literacy--the "ability to read, understand and use health information to make appropriate healthcare decisions"--was brought to national attention in April 2004 when the Institute of Medicine and the Agency for Healthcare Quality and Research published reports linking low health literacy with negative patient outcomes. Harvey Fineberg commented in the Institute of Medicine report, "Health Literacy, a Prescription to End Confusion": "Health literacy, enabling patients to understand and to act in their own interest remains a neglected final path to high quality healthcare." This article defines health literacy, describes the scope of the problem, identifies affected patient groups, and offers interventions to maximize patient understanding during the teaching process.
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Follow these steps to keep your patient breathing easy.
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Complete and accurate reporting of diagnostic research are essential to assess the validity of its results. To improve the quality of reporting of diagnostic accuracy studies, the Standards for Reporting of Diagnostic Accuracy (STARD) steering committee has developed a checklist of 25 items. We asked whether the quality of reporting of diagnostic accuracy studies published in three major orthopaedic journals (Clinical Orthopaedics and Related Research, Journal of Bone and Joint Surgery British Volume, and Journal of Bone and Joint Surgery American Volume) would be similar across levels of study, journals, and years of publication, and would be similar to other subspecialty journals. We identified 37 articles from 2002-2004 diagnostic accuracy studies and applied the STARD checklist and scoring system. The scores ranged from 6.6 to 21.4 with a mean of 15 +/- 3.3. Only 38% of the articles (14 of 37) reported more than 2/3 of the items, and the majority failed to report nine specific items. The mean STARD scores were similar between the studies with different levels of evidence, across the three journals, and across the three years of publication. They were similar to scores for other subspecialty journals. The current standards of reporting of diagnostic accuracy studies in orthopaedic journals are suboptimal.
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This study identified preparatory information appropriate for patients undergoing myelogram. Twenty-eight patients (16 lumbar and 12 cervical) described the sensations they experienced as they were having a myelogram. Sensations reported by 40% or more of the participants having both kinds of myelograms included hard, cold examining table; wet and cold cleansing of site; stick with injection of local anesthetic; sharp stick with spinal needle insertion; and burning (cervical) or sharp, tingling (lumbar) with contrast medium injection. These sensations, linked with the temporal elements of the procedure, yield a preparatory information intervention appropriate for those scheduled for myelogram. When preparatory information is used for the same myelogram procedure as described in this study, patients should experience reduced anxiety before and during the procedure.
The ICSB Subcommittee on the taxonomy of Campylobacter and related bacteria has discussed several contemporaneous issues and makes the following recommendations. (i) The reported synonymy between Campylobacter coli and Campylobacter hyoilei was based on valid taxonomic arguments. The subcommittee therefore discourages the use of the name C. hyoilei. (ii) The revised infrasubspecific nomenclature of Campylobacter sputorum is endorsed. C sputorum is subdivided into C. sputorum biovar sputorum (characterized by the absence of catalase and urease activity); C. sputorum biovar faecalis (characterized by catalase but not urease activity); and C. sputorum biovar paraureolyticus (characterized by urease, but not catalase activity). (iii) The subcommittee points out that 'Flexispira rappini' is a taxon that is circumscribed by means of morphological criteria. It encompasses multiple Helicobacter species, including Helicobacter billis and Helicobacter trogontum. (iv) Finally, the subcommittee wishes to point out that the etymology of several specific or subspecific epithets of Campylobacter taxa has been corrected and that the spelling of the epithet 'fecalis' was corrected to 'faecalis'.
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