Update in Gynecology and Obstetrics: reviews and databases

There is a considerable body of new information on Gynecology and Obstetrics. To aid in keeping gynecologists updated, renowned periodicals publish review articles. Review articles enable the reader to obtain the best evidence for clinical or research issues from several individual articles. This enables the professional to make clinical decisions in the light of current knowledge. The different types of reviews and database that may be used for the elaboration of reviews are discussed in the present article. It is suggested that future reviews on Gynecology and Obstetrics include articles published in other idioms apart from English and that a larger number of database is researched. Thus, reviews will be not only more inclusive but more representative of the international literature.

Multidisciplinary case conference reviews: Improving outcomes for nursing home residents, carers and health professionals

Aim of study: This study sought to determine whether multidisciplinary case conference reviews improved outcomes for nursing home residents, and the effects of this team approach to resident care on carers, including the hands-on carers employed by the nursing home, and health professionals. Method: 245 residents of three Canberra nursing homes were enrolled in this non-randomised controlled trial. The intervention consisted of sessions of three case conference reviews held between 10/4/96 and 4/12/96. These sessions were attended by the General Practitioners (GPs) of the residents discussed, the GP project officer from the ACT Division of General Practice, a clinical pharmacist, senior nursing staff, other health professionals eg physiotherapist, and occasionally the resident concerned or their representative. At each review, a case presentation by the resident's GP was followed by a multidisciplinary discussion of all aspects, medical and non-medical, of the resident's care. The review concluded with a management plan for the resident. In total 75 residents were reviewed. Main outcome measures: Medication use and cost, and mortality. Results: One month after the reviews were completed comparisons between those who were reviewed and those who were not showed non-significant reductions in medication orders, medication cost, and mortality in the reviewed group. Many of the 92 recommendations in the management plans that were carried out benefited the residents (n=37) and/or carers (n=24). The responses of the GPs and the Directors of Nursing to the reviews were overwhelmingly positive. Conclusion: Recommendations arising from multidisciplinary case conferences were carried out to the benefit of patients and carers. Given the support shown by key stakeholders, multidisciplinary conferences should be used more.

Sa??de materno infantil no Brasil: evolu????o e programas desenvolvidos pelo Minist??rio da Sa??de

Trata-se de uma revis??o de literatura com o objetivo de descrever a evolu????o da aten????o ?? sa??de materno infantil no Brasil desde o Estado Novo at?? os dias atuais. O levantamento de dados foi realizado em livros, sites do Minist??rio da Sa??de, Legisla????es do Di??rio Oficial e artigos das bases de dados Biblioteca Virtual em Sa??de (BVS/Bireme), Medline e Scientific Eletronic Library (Scielo). As pol??ticas p??blicas de sa??de materno infantil foram definidas seguindo desde os princ??pios meramente reprodutivos at?? aqueles mais amplos, voltados para garantir uma melhor condi????o de sa??de e de vida. Nas ??ltimas d??cadas, com o aux??lio do governo e da sociedade, houve uma progress??o no atendimento da sa??de da mulher e da crian??a. No entanto, conclui-se que, apesar da evolu????o observada, o grande desafio ainda se encontra na redu????o da morbimortalidade materna, neonatal e infantil.