Association between vaginal bacterial microbiota and the presence and clinical presentation of vulvovaginal candidiasis

Thesis (Master's)--University of Washington, 2016-08

Interprofessional collaboration in nursing homes (interprof): A grounded theory study of general practitioner experiences and strategies to perform nursing home visits

Background: Interprofessionalism, considered as collaboration between medical professionals, has gained prominence over recent decades and evidence for its impact has grown. The steadily increasing number of residents in nursing homes will challenge medical care and the interaction across professions, especially nurses and general practitioners (GPS). The nursing home visit, a key element of medical care, has been underrepresented in research. This study explores GP perspectives on interprofessional collaboration with a focus on their visits to nursing homes in order to understand their experiences and expectations. This research represents an aspect of the interprof study, which explores medical care needs as well as the perceived collaboration and communication by nursing home residents, their families, GPS and nurses. This paper focusses on GPS' views, investigating in particular their visits to nursing homes in order to understand their experiences. Methods: Open guideline-interviews covering interprofessional collaboration and the visit process were conducted with 30 GPS in three study centers and analyzed with grounded theory methodology. GPS were recruited via postal request and existing networks of the research partners. Results: Four different types of nursing home visits were found: visits on demand, periodical visits, nursing home rounds and ad-hoc-decision based visits. We identified the core category "productive performance" of home visits in nursing homes which stands for the balance of GPŚ individual efforts and rewards. GPS used different strategies to perform a productive home visit: preparing strategies, on-site strategies and investing strategies. Conclusion: We compiled a theory of GPS home visits in nursing homes in Germany. The findings will be useful for research, and scientific and management purposes to generate a deeper understanding of GP perspectives and thereby improve interprofessional collaboration to ensure a high quality of care.

Abordagem do paciente com Cardiopatia Isquémica em consulta de Medicina Dentária

Nos últimos anos com a evolução dos sistemas de saúde tem-se verificado uma melhoria na qualidade dos serviços médicos prestados, conduzindo a uma esperança média de vida mais longa. Muitas patologias, apesar de patentes, são tratadas e/ou controladas de modo a permitir que a população possa adquirir um estilo de vida normal. As doenças cardiovasculares com o seu carácter multidimensional, têm consequências graves para o cidadão comum, para a sociedade e para o sistema de saúde, o que determina que sejam encaradas como um dos mais importantes problemas de saúde pública, problema este que urge minorar. Dentro das doenças cardiovasculares, a cardiopatia isquémica tem um significado relevante, uma vez que, engloba condições que necessitam de cuidados médicos especiais, em situações de emergência, como o enfarte agudo do miocárdio e a angina de peito (estável e instável). O médico dentista deve estar atento ao doente com cardiopatia isquémica, tendo em conta os cuidados especiais em consultório dentário que o mesmo necessita. A recolha de uma anamnese detalhada e história clínica atualizada, são fundamentais para o sucesso do tratamento dentário. O médico dentista deverá estar habilitado para atuar em situações de emergência e ter o consultório devidamente equipado, de forma a agir em conformidade com estes possíveis eventos.

Emergências médicas na prática clínica de Medicina Dentária

Durante a prática clínica de medicina dentária, os médicos dentistas atendem todo o tipo de pacientes. No consultório ou clínica dentária, durante a consulta, podem surgir situações inesperadas, que poderão colocar a vida do paciente em risco. Devido a isso, para além de uma completa anamnese do paciente de forma e prevenir essas situações, e a minimizar o risco, ao permitir antever a ocorrência de algumas delas, o médico dentista deverá estar preparado para atuar em caso de emergência médica, garantindo ainda que o consultório está provido dos equipamentos e fármacos de emergência necessários e adequados e que a sua equipa está preparada para o auxiliar em qualquer situação. Esta revisão bibliográfica visa elucidar os médicos dentistas e futuros médicos dentistas para a existência de situações de emergência na prática clínica de medicina dentária, assim como da importância da formação em suporte básico de vida e métodos de atuação em contextos de emergência.

State of malnutrition in hospitals of Ecuador

Rationale: Hospital malnutrition is a global health problem affecting 30-50% of hospitalized patients. There are no estimates of the size of this problem in Ecuadorian hospitals. Hospital malnutrition might influence the quality of medical assistance provided to hospitalized populations. Objectives: To estimate the current frequency of malnutrition among patients admitted to Ecuadorian public hospitals. Materials and methods: The Ecuadorian Hospital Malnutrition Study was conducted between November 2011 and June 2012 with 5,355 patients (Women. 37.5%; Ages ≥ 60 years. 35.1%; Length of stay ≤ 15 days. 91.2%) admitted to 36 public hospitals located in the prominent cities of 22 out of the 24 provinces of the country. Malnutrition frequency was estimated by means of the Subjective Global Assessment survey. Results: Malnutrition affected 37.1% of the surveyed patients. Malnutrition was dependent upon patient's age and education level; as well as the presence of cancer, sepsis, and chronic organic failure. Hospital areas showed different frequencies of hospital malnutrition. Health condition leading to hospital admission influenced negatively upon nutritional status. Malnutrition frequency increased as length of stay prolonged. Conclusions: Malnutrition currently affects an important proportion of patients hospitalized in public health institutions of Ecuador. Policies and actions are urgently required in order to successfully deal with this health problem and thus to ameliorate its negative impact upon quality of medical care

Annual report 1985-1986

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 85-86, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and financial Statement for FY85-86.

Annual report 1986-1987

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 85-86, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, organizational chart, and financial Statement for FY86-87.

Une analyse des limites inhérentes au nouveau régime des directives médicales anticipées face à l'essor du droit à l'autonomie décisionnelle du patient

Résumé : La Loi concernant les soins de fin de vie ainsi que la mise en place du régime des directives médicales anticipées sont le résultat d’une profonde transformation sociétale, guidée par l’importance grandissante du respect de l’autonomie décisionnelle des personnes et à leur droit à l’autodétermination. Au regard de ce contexte, cet essai décrit en première partie l’état du droit actuel en matière de volontés exprimées de manière anticipée, il analyse les enjeux qui s’y rapportent tout en soulevant les pistes de réflexion déjà amorcées en droit québécois. Il existe effectivement de nombreux outils qui permettent à un individu d’exprimer ses volontés en prévision de son inaptitude, mais les directives médicales anticipées se distinguent d’une façon bien précise : elles possèdent un caractère contraignant qui reconnaît la primauté des volontés relatives aux soins. Or, parallèlement à cela, le régime des directives médicales anticipées impose des limites à ce droit. Dans ce contexte d’essor du droit à l’autonomie, cet essai étudie, en seconde partie, les limites inhérentes au régime des directives médicales anticipées puis propose une analyse critique des défis liés à l’opérationnalisation clinique de ces directives.

Annual report 1987-1988

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 87-88, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and financial Statement for FY87-88.

Annual report 1988-1989

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 88-89, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and year-end expenditure report.

Annual report 1989-1990

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 89-90, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and financial Statement for FY 89-90.

Annual report 1990-1991

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 90-91, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and expenditure report.

Annual report 1991-1992

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 91-92, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and expenditure report.

Annual report 1992-1993

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 92-93, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and expenditure report.

Annual report 1993-1994

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 93-94, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and expenditure report.