Articles: health.
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The ELAN Ecuadorian Study of Hospital Malnutrition returned a malnutrition rate of 37.1% in public hospitals of Ecuador [Gallegos Espinosa S, Nicolalde Cifuentes M, Santana Porbén S; para el Grupo Ecuatoriano de Estudio de la Desnutrición Hospitalaria. State of malnutrition in hospitals of Ecuador. Nutr Hosp (España) 2014;30:425-35]. Hospital malnutrition could be the result of institutional cultural practices affecting the patient's nutritional status. ⋯ Currently, nutritional status of hospitalized patient is not included within therapeutic goals, nutritional assessment exercises are incomplete, and Artificial nutrition is not considered a therapeutic option. From these findings it can only be concluded that the nutritionist still has no place within medical care teams. Adoption of required measures in order to introduce "Food and Nutrition Good Practices" into the medical care in public hospitals of Ecuador is urgently needed.
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The Internet has become a primary and ubiquitous information source for patient education material (PEM); however, the information provided may not be appropriate for the average patient to comprehend. Various national healthcare organizations have recommended that PEM be written at or below the sixth-grade level. The purpose of this study was to assess the readability of pituitary tumor-related PEMs available on the Internet. ⋯ These findings suggest that online pituitary tumor-related material may be too difficult for comprehension by the majority of the targeted patient population. Keeping the reading level of PEMs at or below the sixth grade may improve understanding of this disease and its management for pituitary tumor patients.
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A close and complex relationship between smoking and mental health problems was found. Different hypotheses have been proposed to explain these associations: 1) smoking and poor mental health may share common causes (genetic factors or environmental mechanisms); 2) for people with poor mental health smoking is a coping strategy to regulate psychiatric symptoms; 3) smokings worsen mental health. Moreover, smokers with psychiatric disorders may have more difficulty quitting and patients with mental diseases who received mental health treatment within the previous year were more likely to stop smoking than those not receiving treatment. ⋯ The study results provided enough evidence to assure that quitting smoking is associated with a reduction of depression, anxiety, and stress, with an improvement of psychological quality of life and positive affect compared with continuing to smoke. The strength of association was similar for both the general population and study enrolled populations, including those with mental health disorders. The results of this meta-analysis have direct clinical implications: the benefits for mental health could motivate physicians and patients to take into account the possibility of smoking cessation.
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Published reports of massive or emergency transfusion protocols (MTP/ETPs) focus primarily on large trauma centers. There is little guidance available in the literature to assist nontrauma, hospital-based blood banks in the development of an MTP/ETP for occasional bleeding emergencies. Here, we describe the design of an MTP/ETP at the Veterans Affairs Connecticut Healthcare System in West Haven. ⋯ Four of the five patients who underwent MTP/ETP survived at least 21 days following the event. A total of 2 units of FFP and 4 units of RBCs issued as a part of the MTP/ETP were wasted. The development of an MTP/ETP at our Veterans Affairs hospital helped to ensure that patients requiring massive transfusion received RBCs, FFP, and PLTs in a protocolized fashion as part of their resuscitation with relatively little product wastage.
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In recent years, protracted crises and fragile post-conflict settings have challenged the co-existence, and even the linear continuum, of relief and development aid. Forced migration has tested humanitarian and development paradigms where sudden-onset emergencies, violence and displacement arise alongside ongoing development work. Drawing on Médecins Sans Frontières interventions in the region from December 2010 to May 2011, this paper examines aid and healthcare responses to displacement in Côte d'Ivoire and Liberia; it focuses on challenges to the maintenance of preparedness for such foreseeable emergencies and to adaptation in response to changing situations of displacement and insecurity. This 'backsliding' from development to emergency remains a substantial challenge to aid; yet, in exactly such cases, it also presents the opportunity to ensure access to medical care that is much more urgently needed in times of crisis, including the suspension of user fees for medical care.