No description available.

Thesis (M.S.)--Boston University / Broadly, the purpose of this study is to examiner some aspects of the relationship between the practice of social casework and the treatment of mental illness in the mental hospital setting. It has long been acknowledged that the sociaal worker has a recognized role in the treatment of the mentally ill, since mental illness reflects some failure in social as well as personal adaptation. Social work in mental hospital settings, however, has expanded the concept of its role and undergone modifications. This evolution has been the result of new knowledge and new experiences. "The truth is that casework concepts are dynamic--they change, grow and develop..." This statement apolies as well to casework oriented to a specific setting as to the generic casework processes.

No description available.

The purpose of the study was to investigate the activity of Nursing and supportive care hospitals in the city of Kaunas and to define patients’ needs for post-hospitalization. Methods. Analysis of statistical data on hospital activity for 2001-2003 was done. A questionnaire was given to 163 patients in the study hospitals to complete anonymously and the results of medical tests were analyzed. The results: The number of nursing beds (275) in the city of Kaunas remains unchanged since 2001 and it is out of phase with the prognosis of 386-407 beds in the Reorganization plan of health care institutions in the Kaunas region. According to an evaluation of patients’ independence in performing everyday activities (Barthel scale) and mental status evaluation using the Mini-Mental Status Examination, a higher percentage (76,7%) of patients in nursing and supportive care institutions in the city of Kaunas are dependent or sub-dependent and/or with severe or moderate cognitive disorders. The others (23,3%) are slightly dependent and independent with slight or no cognitive disorders. Half of the respondents stated the necessity or wish for post-hospitalization. 58,3% respondents are alone, 42% living unsupported, 72,4% have minimal income and 12,3% have even lower income, 12,3% have no one to help them apply for help and support, and 5,5% have no place to stay after discharge. These results indicate a social need for continuity of care. It was concluded that the activity of Nursing and... [to full text]

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2018-04-30T12:32:37Z No. of bitstreams: 2 Dissertação - Railda Aparecida Barbosa Barreto - 2018.pdf: 3263329 bytes, checksum: 0f13b79f73e0d36b8ba0e1852746f311 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2018-04-30T12:34:41Z (GMT) No. of bitstreams: 2 Dissertação - Railda Aparecida Barbosa Barreto - 2018.pdf: 3263329 bytes, checksum: 0f13b79f73e0d36b8ba0e1852746f311 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-04-30T12:34:41Z (GMT). No. of bitstreams: 2 Dissertação - Railda Aparecida Barbosa Barreto - 2018.pdf: 3263329 bytes, checksum: 0f13b79f73e0d36b8ba0e1852746f311 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-03-29 / This dissertation seeks to analyze, from the historical genealogical perspective of Michel Foucault, the discourses and practices of psychiatry applied to the family of people who undergo the psychiatry in Goiás. In order to reach our objective, we stablished a historical cut from the year of 1954, with the construction of the Psychiatric Hospital Adauto Botelho - Goiânia, until 1995, when, through the psychiatric reform movement, that hospital was closed. From the research sources, such as medical journals, journals, psychiatric records, dissertations and thesis, we highlight the emergence of two ruptures that indicate the place occupied by the family in the context of hospitalization and psychiatric de-hospitalization. In the first rupture, we mapped out that psychiatry assumed the custody of its subjected personand the family, when it appeared, it was to answer some of the functions made from psychiatry. In the second rupture, we show that, under the initiatives of psychiatric reform, the family was considered strategic in psychiatric custody in Goiás. However, it was up to psychiatry to use varied tactics to trigger the family and make it responsible in the treatment of the person subjected to the psychiatric power, especially as an active participant in the de-hospitalization policy. In both ruptures, we discussed the formation of statements acredited as truths about the family and the construction of alliances of the family and of psychiatry with other knowledge, to establish their speeches, etc. We believe that there is no single way of telling history and others will be necessary, but we hope that this work can contribute to the debate about the place attributed to the family in psychiatric care in Goiás. In addition, we want to contribute to preserve the documentary collection in the history of mental health in the State of Goiás, making it accessible to other people interested in this field of research. / O objetivo desta dissertação foi o de analisar, partindo da perspectiva histórica genealógica de Michel Foucault, os discursos e práticas da psiquiatria que se dirigiram à família do psiquiatrizado em Goiás. Para o alcance do objetivo tivemos como recorte histórico o ano de 1954, com a construção do Hospital Psiquiátrico Adauto Botelho - Goiânia, até o ano de 1995, quando, através do movimento da reforma psiquiátrica, houve a sua desativação. A partir das fontes pesquisadas, como revistas médicas, jornais, prontuários psiquiátricos, dissertações e teses, destacamos a emergência de duas rupturas que assinalam o lugar ocupado pela família no contexto da hospitalização e da desospitalização psiquiátrica. Na primeira ruptura mapeamos que a psiquiatria assumia a tutela do familiar psiquiatrizado e a família, quando se apresentava, era para responder algumas funções colocadas pela psiquiatria. Na segunda ruptura, evidenciamos que, já sob as iniciativas da reforma psiquiátrica, a família passou a ser considerada estratégica na assistência psiquiátrica em Goiás. No entanto, coube à psiquiatria se utilizar de táticas variadas para acionar a família e torná-la participante ativa na política de desospitalização. Em ambas as rupturas, discutimos sobre a formação de verdades a respeito da família e a construção de alianças da família e da psiquiatria com outros saberes, para firmar seus discursos, etc. Consideramos que não existe uma única maneira de contar história e que outras serão necessárias, porém, esperamos que esta escrita possa contribuir no debate a respeito do lugar atribuído à família na assistência psiquiátrica em Goiás, como também na preservação do acervo documental sobre a história da saúde mental no Estado, tornando-o acessível aos demais interessados na área.

Avoidable hospitalizations of hospice patients cost Medicare $3 billion a year. When hospice nurses are able to identify early signs and symptoms of acute illness and provide appropriate interventions to prevent such admissions, 20-60% of the hospitalizations are preventable. The practice problem addressed in this quality improvement doctor of nursing project was the 30% hospital admission rate of hospice patients as evidenced by chart review, admission data, and revocation data. The first purpose of the project was to identify evidence-based nursing care paths in the literature for the top 5 medical diagnoses related to avoidable hospital admissions. The second purpose was to develop an educational curriculum to educate the staff on the care paths with a pretest/posttest to assess knowledge gained from the education. Rosswurm and Larrabee's conceptual model was used to frame the project. Three content experts evaluated the curriculum plan using a 4 item dichotomous rating of 1 (not met) and 2 (met). An average score of 2 revealed that the curriculum content met the course objectives. Content experts validated each of the 16 pretest/posttest items using a Likert scale ranging from 1 (not relevant) to 4 (highly relevant). The content validation index score was .94, indicating that the pretest/posttest reflected the course objectives and content. Recommendations were made for structuring the pretest/posttest. The project promotes social change by assessing, intervening, and treating patients in the outpatient hospice setting to prevent avoidable hospitalizations, thus promoting patient well-being and fiscal responsibility of healthcare dollars.

Globally, in both developed and developing countries, the twinning rates have increased since the early 70’s. A large proportion of twins are born preterm and/or small-for-gestational-age (SGA) and/or with a low birth weight. Several studies have been performed on the long-term effect of these non-optimal birth characteristics on future reproductive performance and morbidity. Yet, most studies exclude twins or higher order pregnancies and thus the findings are based on singleton pregnancies only. The aim of the present thesis was therefore to investigate the impact of non-optimal birth characteristics in terms of preterm birth, small-for-gestational age, and low birth weight, on the reproductive pattern and morbidity among twins and singletons Furthermore, the present thesis attempted to establish whether twins and singletons were affected in the same manner. The studies included in this thesis are prospective population-based register studies, including all men and women, alive and living in Sweden at age 13, who were born between 1973 and 1983 (1,000,037 singletons and 16,561 twins) for the first three studies with follow-up till the end of 2006 and 2009. The last study included all men and women, alive and living in Sweden at age 13, who were born between 1973 and 1993 (2,051,479 singletons and 39,726 twins) with follow-up till the end of 2012. In general, twins were found less likely to reproduce between 13 and 33 years of age compared with singletons. Stratifying data by different birth characteristics, it was found that twins had a lower likelihood of reproducing on several different birth characteristics (appropriate-for-gestational-age, normal birth weight, low birth weight, term birth, preterm birth). However, twins born very preterm had an increased likelihood of reproducing compared with singletons born very preterm. Not taking birth characteristics into account, twinning was associated with a higher degree of hospitalization. However, accounting for the diverging birth characteristics this difference diminished and for some diagnoses the relationship was reversed such that twins were actually less likely to be hospitalized compared with singletons. In terms of the heritability of non-optimal birth characteristics singleton mothers born preterm were more predisposed to give birth to a child that was preterm while singleton mothers born SGA more often gave birth to a child either born preterm or SGA. Among twins this heritability was not as evident. The only difference observed was among twin mothers born SGA who were more likely to give birth to a child born SGA. In the extended cohort comprising those born between 1973 and 1993, male and female twins were found to be less likely to become parents compared with singletons. No difference was found among women in terms of having a second child, while male twins were more likely to have a second child compared with male singletons. It was also found that the likelihood of becoming a first-time parent and second-time parent was positively associated with the number of siblings.

Seasonal influenza epidemics are a major public health concern, causing three to five million cases of severe illness and about 250,000 to 500,000 deaths worldwide. Given the unpredictability of these epidemics, hospitals and health authorities are often left unprepared to handle the sudden surge in demand. Hence early detection of disease activity is fundamental to reduce the burden on the healthcare system, to provide the most effective care for infected patients and to optimize the timing of control efforts. Early detection requires reliable forecasting methods that make efficient use of surveillance data. We developed a dynamic Bayesian estimator to predict weekly hospitalizations due to influenza related illnesses in the state of Texas. The prediction of peak hospitalizations using our model is accurate both in terms of number of hospitalizations and the time at which the peak occurs. For 1-to 8 week predictions, the predicted number of hospitalizations was within 8% of actual value and the predicted time of occurrence was within a week of actual peak. / text

Hemodializuojamų ligonių skaičius pasaulyje kasmet auga, dializuojama vis daugiau vyresnio amžiaus ligonių, turinčių sunkią gretutinę patologiją. Todėl tenka dažniau juos stacionarizuoti, didėja finansinė šių ligonių gydymo našta visuomenei. Daugelis pasaulyje atliekamų hemodializuojamų ligonių stacionarizavimą vertinančių tyrimų apima atskiras būkles, kaip anemijos, kaulų ir mineralų metabolizmo sutrikimų reikšmę, gretutines ligas ir kitus veiksnius. Mes savo tyrime sujungėme dažniausias hemodializuojamiems ligoniams aprašomas komplikacijas, kad įvertintume bendrą suminę jų reikšmę stacionarizavimui. Tai pirmasis tyrimas, nagrinėjantis Lietuvos hemodializuojamų ligonių stacionarizavimo priežastis ir sąlygojančius veiksnius. Taip pat pirmą kartą nustatytos Lietuvos hemodializuojamų ligonių gydymo išlaidos. Perspektyvusis tyrimas atliktas Kauno Medicinos universiteto Nefrologijos klinikoje. Į tyrimą įtraukti visi galutinės stadijos inkstų nepakankamumu sergantys ligoniai, kurie buvo hemodializuoti visuose Kauno krašto hemodializės centruose 5 metų laikotarpiu (2002-2006 metais). Nustatėme, kad hospitalizavimui svarbūs tiek demografiniai veiksniai, tiek gretutinės ligos, tiek kai kurių laboratorinių rodiklių pokyčiai, tiek ir režimo pažeidimai. / Increasing numbers of hemodialysis patients is influenced by growing life expectancy. increasing burden of diabetes and hypertension. Dialysis population becomes older with heavy comorbidities and high risk for hospitalization. Treatment of those patients is a big financial burden for society. So it is necessary to evaluate the predisposing factors for hospitalization and to assess possibilities of ambulatory treatment optimization and reduction of hospitalization rates in hemodialysis patients. Most of the studies in hemodialysis patients investigate hospitalization risk according to separate conditions, like influence of anemia, bone-mineral metabolism, comorbidities and other factors. In our study we tested together most common complications of end stage renal disease in order to evaluate a combined value of various different factors on hospitalization risk and to discriminate the most important ones. This is the first study which examined hospitalizations rates and factors related to hospitalization in Lithuanian hemodialysis population. Also for the first time treatment expenditures of Lithuanian hemodialysis patients were estimated. Prospective study was performed in the Nephrology department of Kaunas University of Medicine. We enrolled all end stage renal disease patients dialysed in the years 2002-2006 in all centers in Kaunas region. In order to reduce hospitalization risk, a contribution of the doctor and the patient is needed as both treatment failure and... [to full text]

Background: How nurses treats the patients is always important, especially when caring for children. With this aspect in mind good communication and information are key aspects for trust and cooperation with families. Children have the right to participate and get information about their care and they are dependent on their parents, why it’s important that the environment and treatment from nurses accommodate the needs of the whole family. Aim: To examine and illustrate how children and parents experience hospitalization and the treatment from nurses during the hospital stay. Method: A literature review based on 11 qualitative articles was performed. The articles were found through four searches in PubMed and CINAHL. Results: Both children and parents felt that participation in and information during the care was important while hospitalized. Although some children reported being ignored and excluded from the caregiving process most children were satisfied with the treatment from nurses. Parents also experienced the treatment from nurses as mainly positive. The hospital environment was perceived as both frightening and foreign to the children, but it could also be exciting. Boredom and loneliness was reported by some children. As for parents, they perceived that the hospital environment was poorly adapted to families and induced feelings of stress and anxiety related to both environment and role changes. Conclusion: The conclusion of this study is that hospitalization and the nurses treatment needs further improvement and adjustment to fit the family’s needs.