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At least 19 recordsLinked to original sources
PubMed2006

Glaucoma admissions and surgery in public sector tertiary care hospitals in pakistan: results of a national study.

PURPOSE: To assess the annual number of glaucoma operations and admissions in the public sector tertiary care hospitals in Pakistan. METHODS: Eye departments in all 18 public tertiary care centers in the country were requested to provide data on the number of glaucoma operations and admissions during 1998. Of these, 13 hospitals agreed to participate. Eye departments' log books or patients' records were used to collect data retrospectively on the total number of eye admissions, the total number of glaucoma admissions, the type of glaucoma, and the total number and type of glaucoma operations. RESULTS: Glaucoma accounted for 8.1% (1,942/23,931) of all eye admissions. Open-angle glaucoma was responsible for 37.6% or 731 glaucoma admissions followed by secondary glaucoma (35.0%) and angle-closure glaucoma (18.2%). During 1998, 1,407 glaucoma-related operations were performed in the selected hospitals. The mean (+/-SD) and the median number of operations performed were 108.2 (+/-59.6) and 112 (range: 17-206), respectively. Trabeculectomies accounted for 1,043 (74.1 %) of all procedures. Their number ranged from 16 to 170 (median: 84) in the selected hospitals. CONCLUSIONS: We believe that the annual number of glaucoma operations performed in the public tertiary care hospitals in Pakistan is far less than required. In-depth research is therefore needed to explain if this is because of gaps in service provision or a genuine shift to medical management of glaucoma on an outpatient basis.

Filtering Surgery↗
PubMedDate not supplied

[Indoor air quality and occupational health, past and present].

The expression "indoor pollution" of residential, office and public buildings appeared for the first time in western societies toward the end of the '60s to indicate a complex phenomenon as important to public health as that of the "outdoor air pollution" or even more so. The demonstration of the toxic effects of passive smoking, radon, and other chemical and biological pollutants present in office and residential environments has prompted a wide spectrum of research into health risks, has led to position-taking by national and international authorities, and has given rise to a new scientific multi-disciplinary field of research, with respective international associations, scientific journals, and international conferences attended by thousands of participants. In Italy, since 1988, several scientific conferences have been organised and these have led to institutional initiatives such as the Commission set up in 1990 by the Italian Environment Ministry and the Commission set up in 1998 by the Italian Ministry of Health. The latter produced a Prevention Plan for Health Protection and Promotion in Indoor Environments which, for the first time, tackles indoor air pollution in a systematic way and provides an overall picture of the health and economic impact of the main illnesses related to indoor pollution on society. Decree 626/94 has also been affected, in some way, by these new scientific findings and in art. 33 has produced an update of the old art. 9 of the Decree 303/56. The attention to the subject of indoor air quality, in addition to that of offices and commercial buildings, has turned in more recent years to special environments such as schools and hospitals, resulting in the production of important publications. The modern frontier of research on indoor and outdoor air hazards is represented by fine air particulate matter. A large number of worldwide epidemiological studies have revealed that the daily variation in fine and ultra-fine particle air concentration in urban areas is associated with the simultaneous daily variation in the morbidity and mortality of the general population. The particle-linked increase in mortality has been attributed to respiratory and cardiovascular toxic effects, but the mechanisms by which urban air particles (indoor and outdoor) induce worsening of respiratory and cardio-vascular diseases are so far unknown and are the subject of intense investigation. Workers employed in the tertiary sector (offices, trade, banking, hospitals, schools, etc.) now account for 80% of the Italian labour force and the occupational physician is increasingly requested to assess the risk and monitor the health status of tertiary sector workers. These working environments are believed to be healthy and lacking in specific health risk factors, but such a belief is often only the result of the limited knowledge that employers, workers and the physicians themselves have about these environments and the results of international research studies over the last forty years. This issue is surely at the centre of the interest of our discipline and of public health throughout the developed western world and represents an ongoing challenge for the occupational physician, with new research topics and new problems to deal with. Recent issues include SARS and the defence of buildings and the air of working environments against terrorism attacks, such as the use of anthrax dust.

Air Pollution, Indoor↗
PubMed1995

[The new configuration of migratory exchanges between Mexico and the United States: the case of mid-sized cities in the state of Jalisco].

"Migration between the urban areas of the State of Jalisco and the United States has undergone profound transformations in the last twenty years. These are apparent in the recent decrease of the flow of first time migrants and the migration balance; the growing participation of women in this flow; and in the diversity of activities carried out by the migrants, both in their place of origin and in the United States.... Migration is translated by an important transfer of currency, mostly used for the support of the families of the migrants; by a shift in the activities of the migrants, from wages towards different forms of self-employment; and by the sway of the primary and secondary sectors of economy towards the tertiary sector, once the migrants reinstall themselves in their cities of origin." (SUMMARY IN ENG AND SPA)

Americas↗
PubMed1982

[Cancer mortality, according to social indicators].

The age-standardized annual mortality rates for 1969/72 are analyzed for each of 183 districts which have been characterized socio-economically and demographically on the basis of the 1970 census. Discriminant analysis for several malignant tumours shows increased mortality in regions of greater population density (lung cancer) and, independently of this finding, in regions with a higher proportion of persons working in the "tertiary sector" (other malignant tumours).

Adult↗
PubMedDate not supplied

[Changes in factors associated with the nutrition transition in Mexico].

OBJECTIVES: To describe the demographic and socioeconomic changes, food availability and food expense in Mexico during 1980-2000. METHODS: From official statistics (Population Census, FAO Food Balance Sheets, Family Income and Expense National Survey and Economic Census) we estimated the evolution of population distribution according to locality size, occupational structure, woman participation in the wage-earning labor force, minimum wage, availability of food establishments and expense in food. RESULTS: The percentage of the population that lives in urban areas has increased, they are employed in the tertiary sector, womens participation in the labor market has increased but real minimum wages have decreased. Vegetables, oleaginous, oils, fish and seafood availability have decreased whereas animal fat, vegetables, fruits, softdrinks, meats and egg availability have increased. The number of inexpensive restaurants (cocinas económicas and fondas) has also increased. Food expenses have decreased while amount of money spent in food consumed away from home has increased. CONCLUSIONS: In Mexico, the growth in urban areas and the tertiary job sector shows a parallel growth in the availability of high fat and protein food, a greater diet variety and more opportunities to consume food not prepared in the home. On the other hand, the sale of equipment and places designed for recreational physical activity have increased. By reducing employment in the primary sector it is foreseeable that labor intensive physical activity will become less important overtime.

Female↗
PubMed1992

[Foreign migrants in the labor force. The case of Lombardy].

"The article examines...the integration of immigrant workers into the regular labour force [in Italy]. The analysis concentrates its attention upon Lombardy, one of the regions in which the integration is more relevant. The author compares the situation in Milan, a metropolis where the tertiary sector is highly developed and job opportunities are very diversified, with the one in Brescia where immigrants are mainly employed as factory workers." (SUMMARY IN ENG AND FRE)

Acculturation↗
PubMed1996

Tertiary psychiatric nursing graduates: something different or more of the same?

Nursing education was transferred to the tertiary sector as the result of perceived inadequacies of the hospital-based system. The degree to which tertiary-based psychiatric nursing education has, in Victoria, redressed these deficiencies is considered. This paper focuses upon research conducted with registered psychiatric nurses to ascertain their perception of the difference between tertiary and hospital-based psychiatric nursing graduates. The graduates were interviewed during their third year of study and again at the end of their first post-graduate year. The data collected from these interviews were supported by interviews with educators from the tertiary and hospital-based courses. The interview data as a whole emphasized characteristic differences between hospital and tertiary graduates and underlined the potential advantages of the tertiary course.

Clinical Competence↗
PubMed1998

Examination of the preclinical visit in a bachelor of nursing program.

When nursing entered the tertiary sector in 1985 the preclinical visit was introduced and became accepted practice. The initial purpose of the preclinical visit was to inform and prepare Clinical Facilitators and Nursing Unit Managers for undergraduate nursing students' clinical experience. The preclinical visit was perceived as a significant factor which potentially impacts on the quality of student learning within the clinical environment. Initial planning of the preclinical visit shapes and determines the outcomes of the clinical experience for all participants. Students personal and professional development often depend upon how well they are received in the ward area. Despite the emphasis placed on the significance of the preclinical visit, its effectiveness has not been evaluated. Ten years after the introduction of nursing to tertiary education, the preclinical visit was evaluated by a group of academics and clinicians who perceived that the preclinical visit was not achieving the desired outcomes. A survey using a convenience sample of Nursing Unit Managers and Clinical Facilitators was conducted at a major metropolitan teaching hospital in New South Wales. This paper reviews the findings of the study evaluating the preclinical visit. From the results of the study it is evident that a structured, clear format is required for the preclinical visit to be effective.

Attitude of Health Personnel↗
PubMed1993

A follow-up study of early onset psychosis: comparison between outcome diagnoses of schizophrenia, mood disorders, and personality disorders.

This study examined the outcome of youth previously diagnosed with psychotic disorders at a public-sector tertiary care hospital. Of 95 children and adolescents retrospectively identified, follow-up information (mean interval 3.9 years) was obtained on 24 subjects with an outcome diagnosis of schizophrenia, 9 with psychotic mood disorders, 5 with personality disorders (antisocial or borderline), and 1 with schizo-affective disorder. The schizophrenic group was more often odd premorbidly and functioned worse at outcome, while the mood-disordered group had a shorter follow-up period and was more often anxious or dysthymic premorbidly. The personality-disordered group resembled the schizophrenics in their degree of impairment and chronicity. All three groups had high rates of family disruption, low SES, substance abuse, and chronicity, and were similar in their degree of premorbid impairment, length of prodrome, age of onset, initial diagnosis, and family psychiatric history. Misdiagnosis at onset was quite common and highlights the need for systematic longitudinal assessment of early onset psychotic disorders.

Adolescent↗
PubMed2001

Perceptions, preferences, and reactions of local inhabitants in Vikos-Aoos National Park, Greece.

Local inhabitants' perceptions, preferences, and reactions were investigated in Vikos-Aoos National Park, 25 years after its designation. Knowledge of aims of the park and source of information about them, necessity for infrastructure, reactions to certain policies, and effectiveness of administration and management scheme were studied by means of a questionnaire survey. Personal interviews were performed by systematic sampling, which resulted in 203 cases for analysis. Most respondents said that they had knowledge of the aims of the national park, and this was positively associated with education; protection of flora and fauna was identified by most as the main aim, and the management authority (the Forest Service) ranked first in order as source of information. Tourism development of the area was seen as a positive change, and recreation facilities and improvement in accessibility were considered of high priority for development. The investigation into peoples' reactions to several possible alternative management policies revealed willingness to accept certain restrictions on their agricultural use of the land. A policy of non-intensive agriculture with compensation for loss of income, if the ecosystems of the park were in danger, seems the most acceptable. Long-term leasing of farms by the Forest Service was another policy with a high degree of acceptance, especially for certain occupational groups; those working in the secondary and tertiary sectors of economy would accept such a policy more easily than those working in the primary sector. Finally, a very large majority of the respondents expressed a preference for a new administration and management scheme with the participation of local communities in the decision-making process.

Age Factors↗
PubMed1989

Changing times changing paradigm (1): From hospital training and college education in Australia.

In 1985, nurse education in New South Wales (NSW), Australia changed from hospital based nursing courses to preparation for comprehensive registration within the tertiary sector. The Nightingale apprenticeship system with an emphasis on the service needs of the institution had persisted for almost a century. The early 1970's however saw the emergence in Australia of a new paradigm in nurse education challenging the traditional training perspective. The student nurse in NSW has now assumed the role of learner and is supernumerary to the health care team when practising in a wide range of health care settings. This article has two parts, the first of which discusses the background to the development of a new paradigm in nurse education and the implications of the change process. In particular, the reaction of the medical profession to the greater degree of autonomy demonstrated by nurses in relation to their preparation for practice, is discussed.

Education, Nursing, Baccalaureate↗
PubMed2004

Private sector hospital response to the 2003 dengue outbreak in the Indian capital metropolis of Delhi.

During 2003, the Indian capital metropolis of Delhi was afflicted with an outbreak of dengue. A private-sector tertiary care hospital responded instantly to the sudden influx of 162 patients during an 8-week interval. That was an unusual challenge because, until 1997, the hospital had exclusively managed patients with ophthalmic disorders. Dengue patients received fiscal concessions and several free services. A multidisciplinary cell was commissioned for case management. Apart from a diagnosis of patients with dengue and their clinical management, suspected or confirmed dengue episodes were instantly reported to health authorities. Anti-mosquito measures in the hospital premises including residential areas for the nursing personnel prevented any local virus transmission. The integrated therapeutic and public health response was associated with a 1.23% case fatality rate. The protocol developed during the dengue outbreak would address every locally reportable disease in the future.

Adolescent↗
PubMed1998

Learning on clinical placement: the experience of six Australian student nurses.

Concerns about the adequacy of clinical education in nursing courses in Australia have escalated since the transfer of pre-registration nursing education into the tertiary sector. This descriptive, interpretative study, informed by the tradition of critical social science, sought to understand the clinical learning experiences of undergraduate nursing students. At the same time, it fostered an active participation of students in their own learning. Daily post-clinical conferences with the students were taped and transcribed verbatim to provide data for the study. Additional data was collected from informal discussions and observations of the students during the placement. Analysis revealed three main categories, which reflected the students' experiences. These included: (1) I don't belong; (2) doing and practising: progress at last; and (3) transitions in thinking. Feeling part of the team was closely linked to the opportunity to learn, emphasizing the important role not only of educators but also clinicians in undergraduate learning on clinical placement. Though the findings reflect age-long problems associated with student learning in the clinical field, it serves to remind all nurses of the importance they play in the learning process. This study reflects the importance of effective communication between the health and education sectors and the need to concentrate on strategies which will strengthen this bond.

Clinical Competence↗
PubMed1995

Education in critical care nursing: a new beginning.

The movement of nurse education to the tertiary sector is all but complete in Australia. Trends are changing as new partnerships are being forged and the focus of education is now reponsive to economic and political factors. These factors have resulted in the regionalisation of health care facilities and the de-institutionalisation of health services in Queensland. Moreover, de-institutionalisation of services coupled with economic rationalism has pre-empted the offering of post-graduate clinical courses by university nursing faculties. This paper addresses the process of developing the content of new courses under the umbrella of the Graduate Diploma/Masters in Critical Care Nursing offered at Griffith University Gold Coast. This initiative is the first in Queensland and has provided new vision in education for critical care nursing. This course includes a tapestry of theoretical knowledge enhancing clinical and factual subjects presented by experienced clinicians teaching with academics. The collaborative nature of nursing practice is reflected in academics and clinicians working jointly in course development, teaching and clinical placement. Strategies which were developed collaboratively addressed course content including logistics, time management, the critical selective selection of appropriate content, assessment critera, 'registerbility' within Queensland and other states, and clinical competence will be addressed. Moreover, this process of developing the course content utilised Australian National Registering Authority (ANRAC 1990) Competencies and Benners' (1984) use of the Dreyfus model to guide the expected knowledge level of the clinician at course completion. In particular this paper will not only address the blending of theory and practice to consolidate the relationship inherent between the clinician and education, but will establish the fact that no gap exists.

Critical Care↗
PubMed1996

Education in emergency nursing: a new beginning. Part I.

The movement of nurse education to the tertiary sector is all but complete in Australia. Trends are changing as new partnerships are being forged and the focus of education is now responsive to economic and political factors. These factors have resulted in the regionalisation of health care facilities and the de-institutionalisation of health services in Queensland, Australia. Moreover, de-institutionalisation of services coupled with economic rationalism has pre-empted the offering of post-graduate clinical courses by university nursing facilities. This paper addresses the process of developing the content of new courses under the umbrella of the Graduate Diploma/Masters in Emergency Care Nursing offered at Griffith University Gold Coast, Australia. This initiative is the first in Queensland and has revisioned the education of emergency care nursing. This course includes a tapestry of knowledge enhancing, clinical and factual subjects presented by experienced clinicians teaching with academics, recognising the collaborative nature of nursing practice with academics and clinicians working jointly in course development, teaching and clinical placement. Strategies developed collaboratively addressed course content including logistics, time management, the critical selective selection of appropriate content, assessment criteria, registerability within Queensland and other states and clinical competence. Moreover, this process of developing the course utilised the Australian National Registering Authorities' Competencies and Benner's use of the Dreyfus model to guide the knowledge level of the clinician at course completion. In particular this paper will not only address the blending of theory and practice to consolidate the relationship inherent between the clinician and education, but will establish the fact that no gap exists.

Clinical Competence↗
PubMed2002

From apprentices to academics: are nurses catching up?

In comparison to other disciplines, Australian nursing has only come relatively lately to academia. Traditionally, academic qualifications were not viewed as necessary for nurses. The movement of nursing education to the tertiary sector has seen many changes from the traditional apprenticeship model and the characteristics of nurse-academics reflect these. The researchers identified changes that have occurred in the last five years in nurse-academics' qualifications, academic rank and links between them. It is clear that the goalposts for nurse academics have moved, with a master's degree now standard for Lecturer Level B and a doctorate for Level D. Other findings show a strong link between movement (transfer), increased qualifications and promotion. Females were more likely than males to have increased their qualifications and to be promoted. In terms of academic qualifications in the whole system, female nurse-academics have caught up with their counterparts in the former CAE sector. Male nurse-academics have parity with female nurse-academics but not with males in the system generally. The study shows the great strides that Australian nurse-academics have made in the five years preceding the end of the old millenium but illustrates that they and female academics generally have not yet caught up to their male colleagues.

Academic Medical Centers↗