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PubMedDate not supplied

Understanding the obstacles to consistent intravenous catheter-related infection reporting by home health providers.

A variety of formulae have been used by home health providers to obtain consistent and accurate reporting of intravenous catheter-related infections. This article describes the most widely used statistical formulae, their advantages and disadvantages, and their relevance to the home health setting. However, because of the numerous and complex intervening variables that influence these statistical applications, epidemiological measurement in nonhospital settings remains an unresolved dilemma for most providers.

Community Health Nursing↗
PubMed2000

Working women identify influences and obstacles to breast health practices.

PURPOSE/OBJECTIVES: To identify factors contributing to participation in breast screening in working women to drive health education planning and implementation. DESIGN: Survey. SETTING: Automotive plants in southern Canada. SAMPLE: Union and nonunion women working in the plants. METHODS: Survey using "Health Care Practices: A Worksite Survey," modified for Canadian population. MAIN RESEARCH VARIABLES: Age, education, breast health practices, influences on decision to participate in breast screening, and physician gender. FINDINGS: Differences were noted among three age groups (under 30 years, 30-49 years, 50 years or older) in terms of influences and perceived barriers to the different modalities of breast screening. For clinical breast exams, women preferred an expert in breast health, regardless of whether the professional was a physician or a nurse. In all groups, the physician was noted as being very influential; however, perceptions of encouragement from the physician varied across the age groups. Perceptions of barriers to breast screening differed among the age groups and between women with male physicians and those with female physicians. Coworkers were identified as being a strong influence in the older group, whereas friends and family were identified as being more influential in the younger groups. CONCLUSIONS: Health promotion and education strategies may need to be stratified for different age groups. IMPLICATIONS FOR NURSING PRACTICE: Breast health education may need to be seen as an ongoing educational process, with the target groups being both the women and the primary healthcare professionals. The worksite has strong potential as a setting for health promotion activities.

Adolescent↗
PubMed2000

HIV-1 can be recovered from a variety of cells including peripheral blood monocytes of patients receiving highly active antiretroviral therapy: a further obstacle to eradication.

During highly active antiretroviral therapy (HAART), HIV-1 can still persist in circulating, resting CD4+ T lymphocytes, lymph node mononuclear cells, and seminal cells of patients despite sustained suppression of plasma viremia to undetectable levels. Sanctuary sites where antiretroviral drug penetration is not optimal may allow local HIV-1 infection of cells within and passing through these tissues. Factors such as imperfect drug adherence due to complicated drug regimens may also result in tissue compartments with suboptimal drug concentrations allowing viral replication. We have examined blood monocytes from HIV-1-infected subjects being effectively treated with HAART to determine virus carriage in these cells. Monocytes were purified from peripheral blood of patients with plasma HIV-1 RNA below 50 copies/mL and who had maintained levels of plasma RNA below detection for 3 months or more. Replication-competent virus could be recovered from the majority of monocyte populations by co-culture with CD8-depleted, PHA-activated, peripheral blood mononuclear cells. Sequencing of the reverse transcriptase and protease genes of the recovered viruses did not reveal resistance to both reverse transcriptase and protease inhibitors. Continued new infection of this transitory, circulating population of cells even during prolonged, effective HAART most likely reflects ongoing, low-level HIV-1 replication within cellular reservoirs and sanctuary sites in the body.

Anti-HIV Agents↗
PubMed2000

Inner obstacles to psychoanalysts' retirement: personal, clinical, and theoretical perspectives.

To live, age, and retire successfully, life must have meaning. The aged Freud bestowed passionate commitment exclusively on psychoanalysis. Therefore life lost meaning when he stopped analyzing, and so Freud sought death. Identified with this exclusive commitment, successor generations of analysts also aspired to die in harness. Successful retirement requires the conviction that there is life after analysis, with the actualizing of multiple antecedent or new passions. The reactions of three patients to the retirement announcement are discussed.

Anecdotes as Topic↗
PubMed2001

Is your job description a certification obstacle?

For case managers in the hospital setting, eligibility for the Commission for Case Manager Certification's CCM credential can be difficult to prove. Kathryn Bennett, RN, case manager coordinator at Bloomington (IN) Medical Center, found out that her official job description did not meet the requirements, even though her duties include case management across the continuum.

Administrative Personnel↗
PubMed2000

Integrating specialized application systems into hospital information systems--obstacles and factors for success.

Hospital information systems are often huge and heterogeneous systems. To support physicians with their daily clinical work, application systems are developed which are dedicated to particular medical fields or tasks and which have to be integrated into the hospital information system. The integration process is quite complicated, because it makes the information system's infrastructure even more heterogeneous. We developed an application system for documentation and therapy planning in pediatric oncology (DOSPO) and we started to introduce it into the Department of Pediatric Oncology of Heidelberg University Hospital. The fact that DOSPO is developed as a universal system for nationwide use made the integration process more difficult. In any case, the introduction of specialized application systems has to be planned systematically in advance, regarding the prevailing information system's infrastructure, available resources and established processes. To simplify the integration process comprehensive electronic patient records for the future should be designed in a way that they can be enhanced easily by new clinical functions.

Child↗
PubMedDate not supplied

"Dr. P. C. Sen Memorial Best Paper Presentation Award on rural health practice". Physical and mental community health: what are the obstacles!

The present work aims to study the cultural concepts of the health in general and mental health in particular from six villages of Sundarban region, West Bengal, India, by using field research methodology, viz, participants observation, focus group discussion and in depth interview. A qualitative data was collected from the field. Analysis of the data shows that there is a clear difference of conception among the people of the region according to their socio-economic status. Poor and non-educated segment stressed much more on the physical ability and lack of economic resources in relation to health, whereas educated and comparatively economically stable segment with some urban influence, stressed more on both physical and emotional stability as a measure of good health. The pattern of help seeking also reflects different preferences towards traditional and modern treatment facilities available in the region. Results on the study promoted to take intensive community awareness programme for effective health coverage of the population.

Adult↗
PubMed2000

Obstacles and advances in non-viral gene delivery.

This review focuses on recent progress and novel strategies to improve the efficiency of in vivo non-viral gene delivery. Examples of the most promising attempts to overcome specific barriers are presented in fuller detail. Current research into several of the most difficult steps in the gene delivery pathway is discussed including particle stabilization, targeting, cytoplasmic entry and access to the nucleus. The impact of recent reports on our current understanding of the true limitations to in vivo delivery is also discussed. The importance of preclinical animal models for the development of clinical applications of gene therapy is noted.

Animals↗