Journal articles: 'Occasional care'

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Hast, AS, M. Naser-Knapik, and CJ Fasnacht-Allison. "Orienting occasional staff to critical care." Critical Care Nurse 9, no. 5 (June 1, 1989): 86–92. http://dx.doi.org/10.4037/ccn1989.9.5.86.

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Ascari, A., S. Ferrari, M. Andreoli, M. Peggi, and M. Rigatelli. "Frequent attenders at a primary care clinic: Occasional or regular abusers?" European Psychiatry 26, S2 (March 2011): 1699. http://dx.doi.org/10.1016/s0924-9338(11)73403-4.

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BackgroundFrequent attendance in general practice is known for being associated with certain socio-demographical characteristics (female sex and middle-old age) and with important medical-psychiatric morbidity. Moreover, it has a high impact on workload of GPs. However, we have poor literature about long-term studies on Frequent Attenders (FAs) and persistent FAs.ObjectivesTo re-evaluate a group of patients of FAs after nine years since first assessment; to determine the existence of others FAs and possible differences between persistent and occasional FAs.MethodsConsultation of computerized data on 168 patients between 2001 and 2009; interwiew to the GP and the assistant.SettingA primary health care center in Fiorano Modenese (Modena, Northern Italy).Patients56 persistent FAs, 56 occasional FAs, 56 non FAs.Main outcome results: Twenty-eight of 40 patients (70%) evaluated in 2001 were found to be persistent FAs, most frequently older women. Medical morbidity was frequent among persistent FAs, and intermediate among occasional FAs, while psychiatric morbidity does not show important differences between the two groups; however, depression was present in 46% of persistent FAs and in 41% of occasional FAs, while somatization only in occasional FAs (10%), and not among persistent FAs. Persistent FAs received more prescriptions for all types of drugs, while among the occasional FAs the requests for a psychiatric treatment were higher.ConclusionsThe phenomenon of frequent attendance has a large amount and claims for further studies. Psychiatric morbidity between persistent and occasional FAs might have different expressions, requiring different clinical approaches to be specifically tailored.

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Teculescu, Dan, Bernard Hannhart, Catherine Aubry, Bettina Montaut-Verient, Jean-Marc Virion, Jean-Pierre Michaely, and René Gueguen. "Who Are the “Occasional” Snorers?" Chest 122, no. 2 (August 2002): 562–68. http://dx.doi.org/10.1378/chest.122.2.562.

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Reho, Tiia T. M., Salla A. Atkins, Nina Talola, Markku P. T. Sumanen, Mervi Viljamaa, and Jukka Uitti. "Occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in Finland." BMJ Open 9, no. 2 (February 2019): e024980. http://dx.doi.org/10.1136/bmjopen-2018-024980.

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ObjectivesFrequent attenders (FAs) create a substantial portion of primary care workload but little is known about FAs’ sickness absences. The aim of the study is to investigate how occasional and persistent frequent attendance is associated with sickness absences among the working population in occupational health (OH) primary care.Setting and participantsThis is a longitudinal study using medical record data (2014–2016) from an OH care provider in Finland. In total, 59 676 patients were included and categorised into occasional and persistent FAs or non-FAs. Sick-leave episodes and their lengths were collected along with associated diagnostic codes. Logistic regression was used to analyse associations between FA status and sick leaves of different lengths (1–3, 4–14 and ≥15 days).ResultsBoth occasional and persistent FA had more and longer duration of sick leave than non-FA through the study years. Persistent FAs had consistently high absence rates. Occasional FAs had elevated absence rates even 2 years after their frequent attendance period. Persistent FAs (OR=11 95% CI 7.54 to 16.06 in 2016) and occasional FAs (OR=2.95 95% CI 2.50 to 3.49 in 2016) were associated with long (≥15 days) sickness absence when compared with non-FAs. Both groups of FAs had an increased risk of long-term sick leaves indicating a risk of disability pension.ConclusionBoth occasional and persistent FAs should be identified in primary care units caring for working-age patients. As frequent attendance is associated with long sickness absences and possibly disability pensions, rehabilitation should be directed at this group to prevent work disability.

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Lamers, William M. "Book Review: Palliative Care in the Hospital Setting. Occasional Paper #10." Journal of Palliative Care 14, no. 1 (March 1998): 61. http://dx.doi.org/10.1177/082585979801400116.

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Gillam, Steve. "Evidence into action: changing practice in primary care. Occasional Paper 84." Family Practice 20, no. 3 (June 2003): 353–54. http://dx.doi.org/10.1093/oxfordjournals.fampra.a001511.

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Batt, Murray D., Charles E. Edmiston, and John Heggers. "Occasional Surveys: Varicella Immunization for Healthcare Workers in Acute-Care Facilities." Infection Control & Hospital Epidemiology 17, no. 4 (April 1996): 268. http://dx.doi.org/10.1017/s019594170000391x.

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Lee, Y. "PREVALENCE AND PROFILE OF GRANDPARENTS PROVIDING OCCASIONAL GRANDCHILD CARE IN THE U.S." Innovation in Aging 1, suppl_1 (June 30, 2017): 376–77. http://dx.doi.org/10.1093/geroni/igx004.1368.

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Merenstein, Gerald, and Sandra Gardner. "Handbook of Neonatal Intensive Care (6th Edition)." Neonatal Network 26, no. 2 (March 2007): 136. http://dx.doi.org/10.1891/0730-0832.26.2.136.

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Handbook of Neonatal Intensive Care (6th Edition) is a comprehensive, well-written clinical reference book that remains a cornerstone reference for the neonatal nurse. The sixth edition continues to provide an inclusive reference for the neonatal intensive multidisciplinary care team, from staff nurses to house staff and entry-level neonatal nurse practitioners. There are a few distractions in this professional and quality reference book, including some figures that are dated, if not antiquated, and the occasional noteworthy spelling error.

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Li, Yan, Kefeng Zhou, Jinghong Dai, Haijian Fan, Le Cheng, Xuebin Zhang, and Hourong Cai. "Isolated Peripheral Pulmonary Artery Hypoplasia in Adulthood Presented with Occasional Hemoptysis." American Journal of Respiratory and Critical Care Medicine 196, no. 9 (November 2017): e52-e53. http://dx.doi.org/10.1164/rccm.201704-0726im.

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Clarkson, Douglas. "Robotics in ophthalmic surgery." Optician 2017, no. 10 (October 2017): 6779–1. http://dx.doi.org/10.12968/opti.2017.10.6779.

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SELF, DONNIE J., NANCY S. JECKER, and DeWITT C. BALDWIN. "The Moral Orientations of Justice and Care among Young Physicians." Cambridge Quarterly of Healthcare Ethics 12, no. 1 (January 2003): 54–60. http://dx.doi.org/10.1017/s0963180103121068.

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High moral standards and adherence to a moral code have long been strong tenets of the profession of medicine, even though there have been occasional lapses that have led to renewed calls for a revitalization of moral integrity in medicine. Certainly, a moral component has generally been held to be an important aspect of the concept of a physician.

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Watson, Alan R. "Home Health and Respite Care." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 16, no. 1_suppl (January 1996): 551–53. http://dx.doi.org/10.1177/089686089601601s113.

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Families with a child on chronic peritoneal dialysis have to assume a significant burden of care, which can result in stress and potential complications. Adequate preparation of the child and family with appropriate information in many forms is essential. We describe a homevisiting strategy using the named nurse, dietitian, and social worker, which also includes liaison with nurseries, schools, community nurses, and primary care physicians. Respite care is provided by an occasional evening babysitting service and increasing use of daytime support from a home care nurse. The holiday support strategy includes a holiday caravan for families in addition to an organized holiday for children alone. A parents’ support group has provided valuable feedback on quality-of care issues.

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Dharmshaktu, Ganesh Singh, and Tanuja Pangtey. "How much can a small bursa stretch? A curious case of massive superficial infrapatellar bursitis in the emergency department." Journal of Emergency Practice and Trauma 7, no. 2 (June 1, 2021): 146–48. http://dx.doi.org/10.34172/jept.2021.23.

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Introduction: Inflammation of the infrapatellar bursa results from various causes like trauma, infection and overuse. Superficial skin or soft tissue infection can also lead to occasional septic bursitis. Infrapatellar bursa has two parts, superficial and deep bursae. Superficial bursa inflammation reactive to adjacent superficial skin infection may occasionally lead to secondary bursitis. Case Presentation: We report a rare finding of acute right knee pain with extraordinary amount of fluid collection within superficial part of infrapatellar bursa in an elderly male patient. A secondary, septic and massive superficial infrapatellar bursitis was unusual in its appearance mimicking neoplastic lesion. Judicious use of clinical assessment and imaging helped to diagnose the condition. Conclusion: Early diagnosis and treatment of bursitis can ensure optimal outcome and it can be used to check further complications. Atypical presentation of any bursitis should be acknowledged and the judicious use of clinical assessment and imaging is critical for prompt diagnosis and treatment.

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Lakhey, Shishir, M. Lakhey, and B. P. Shrestha. "SQUAMOUS CELL CARCINOMA AS A LATE COMPLICATION OF CHRONIC OSTEOMYELITIS." Journal of Nepal Medical Association 42, no. 146 (March 1, 2003): 104–6. http://dx.doi.org/10.31729/jnma.803.

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ABSTRACTSquamous cell carcinoma is a rare but well documented complication of chronic osteomyelitis. With theadvent of antibiotics, better health care delivery to the people and improving socioeconomic conditions, theincidence of squamous cell carcinoma arising as a late complication of acute haematogenous osteomyelitishas become increasingly less. Occasional difficulty in the differential diagnosis of a pseudoepitheliomatoushyperplasia and well differentiated squamous cell carcinoma can be troublesome. These two cases arepresented to remind the clinician of this now increasingly rare complication of chronic osteomyelitis andthe occasional diagnostic dilemma involved in its histopathological diagnosis.Key Words: Squamous Cell Carcinoma, Chronic Osteomyelitis.

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Singh, Sangeeta, Devi Prasad Shukla, Basant Joshi, and Ashok Kumar. "A study of effect of alcohol consumption on cardiovascular biomarkers in a tertiary care centre in the Kumaon Region." Panacea Journal of Medical Sciences 12, no. 3 (November 15, 2022): 514–19. http://dx.doi.org/10.18231/j.pjms.2022.097.

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An important mechanism responsible for increased cardiovascular risks in chronic excessive alcohol use is the pro-oxidant effects of alcohol. There are some emerging risk factors like :- (i) lipoprotein(a) {Lp[a]}, (ii) High‑sensitivity C‑reactive protein (hs‑CRP), (iii) Lipid profile, (iv) Prothrombotic and proinflammatory factors that play an important role in the pathogenesis of atherosclerosis. So we investigated the relation between the levels of cardiovascular biomarkers & the degree of alcohol intake in alcoholic subjects. The present study was carried out in the Department of Biochemistry, in association with the Department of Medicine, Government Medical College, Haldwani. Estimation of Serum Level of hs-CRP & Lp (a) byturbidimetric immunoassay. Serum Cholesterol by CHOD-POD & Triglycerides by enzymatic colorimetric method. LDL cholesterol was calculated by Friedwald equation.The mean total cholesterol, TG, LDLc, hs-CRP, Lp(a) & including HDLc levels were significantly raised (p < 0.05) in cases as compared to controls. The mean serum total cholesterol & Lp (a) levels showed no significant association across different alcohol drinking groups (p>0.05). The mean TG & LDLc levels were significantly (p<0.05) higher in occasional drinkers and heavy drinkers than that of low-moderate & moderate drinkers. The mean serum HDL cholesterol levels in the occasional drinkers were significantly elevated in comparison to the low-moderate drinkers, moderate drinkers and heavy drinkers. The mean serum hs-CRP level in the mediocre and heavy drinkers was significantly low (p<0.05) as compared occasional drinkers and low-moderate drinkers. Our study suggests heavy drinking (>30drinks/week) must be strongly discouraged as it may lead to changes in cardiovascular markers and dyslipidemia. Our study also showed a beneficial effect of occasional drinking on HDLc and moderate drinking on hs-CRP.

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Briggs, Freda, and Susan Hunt. "Foster Care from a Historical Perspective." Children Australia 40, no. 4 (October 19, 2015): 316–26. http://dx.doi.org/10.1017/cha.2015.36.

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Foster care has been available in Australia for almost 150 years. Carers have long been recognised as “the ultimate volunteers” who care for the most traumatised, emotionally disturbed children in the nation. Given that they provide the foundation stone of the child protection system, one might expect carers to be supported and valued. Numerous studies have shown otherwise. Warning signs over the years have been ignored by child welfare authorities resulting in carers leaving the service faster than they could be recruited and the most needy young children being placed in caravan parks, cheap motels and group homes supervised by occasional, inadequately trained, generalist carers employed on seven hour contracts by agencies.

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Ettun, Rachel, Michael Schultz, and Gil Bar-Sela. "Transforming Pain into Beauty: On Art, Healing, and Care for the Spirit." Evidence-Based Complementary and Alternative Medicine 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/789852.

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From drawing to sculpture, poetry to journaling, and dance to music and song, the arts can have a major impact on patients’ spiritual well-being and health. The arts empower patients to fulfill the basic human drive to create and give patients a sense of possibility. Through creative expression, patients regain a feeling of wholeness, individually and as part of the larger world. Although spiritual caregivers have made occasional use of the arts, it would be better for the arts to be seen as a pillar of spiritual care provision. This paper provides a model for arts-based spiritual care (chaplaincy) in oncology/hematology and elsewhere. We discuss how to match the art form intervention to the individual patient and give examples of many kinds of uniquely spiritual arts-based interventions. In life, there are occasional “caseuras,” or ruptures. Using a theoretical foundation drawn from theologian Michael Fishbane, our model of arts-based spiritual care bridges the experience of the caesura to a renewed sense of meaning, or spiritual reorientation, that can be discovered within the reality of illness. Additionally, the ambiguity and playfulness inherent to creative expression strengthen the patient’s flexibility and resilience.

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Corbo, G. M., N. Agabiti, F. Forastiere, V. Dell'Orco, R. Pistelli, D. Kriebel, R. Pacifici, P. Zuccaro, G. Ciappi, and C. A. Perucci. "Lung function in children and adolescents with occasional exposure to environmental tobacco smoke." American Journal of Respiratory and Critical Care Medicine 154, no. 3 (September 1996): 695–700. http://dx.doi.org/10.1164/ajrccm.154.3.8810607.

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Ashton, Carol M., Jeroan J. Allison, and Catarina Kiefe. "Announcing a New Occasional Feature of Medical Care: The Annals of Health Services Research." Medical Care 45, no. 8 (August 2007): 697–98. http://dx.doi.org/10.1097/mlr.0b013e318074cebd.

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Telesca, Mariassunta, Francesco Santini, and Alessandro Mazzucco. "Adenoma related pituitary apoplexy disclosed by ptosis after routine cardiac surgery: occasional reappearance of a dismal complication." Intensive Care Medicine 35, no. 1 (September 12, 2008): 185–86. http://dx.doi.org/10.1007/s00134-008-1285-3.

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Miguel, Lucía García San, Javier Cobo, Enrique Otheo, Aurora Sánchez-Sousa, Victor Abraira, and Santiago Moreno. "Secular Trends of Candidemia in a Large Tertiary-Care Hospital From 1988 to 2000: Emergence ofCandida parapsilosis." Infection Control & Hospital Epidemiology 26, no. 6 (June 2005): 548–52. http://dx.doi.org/10.1086/502582.

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AbstractObjective:To analyze the secular trends of candidemia in a large tertiary-care hospital to determine the overall incidence, as well as the incidence by ward and by species, and to detect the occurrence of outbreaks.Design:Retrospective descriptive analysis. Secular trends were calculated using the Mantel-Haenszel test.Setting:A large tertiary-care referral center in Spain with a pediatric intensive care unit (ICU) to which more than 500 children with congenital cardiac disease are admitted annually.Patients:All patients with candidemia occurring from 1988 to 2000 were included. Cases were identified from laboratory records of blood cultures.Results:There were 331 episodes of candidemia. The overall incidence of nosocomial candidemia was 0.6 episode per 1,000 admissions and remained stable throughout the study period (P= .925). The species most frequently isolated wasCandida albicans, but the incidence ofC. parapsilosiscandidemia increased (P= .035). In the pediatric ICU, the incidence ofC. parapsilosiswas 5.6 episodes per 1,000 admissions and it was the predominant species. Outbreaks occurred occasionally in the pediatric ICU, suggesting nosocomial transmission.Conclusions:During this 13-year period, the incidence of candidemia remained stable in this hospital, butC. parapsilosisincreased in frequency. Occasional outbreaks of candidemia suggested nosocomial transmission ofCandidaspecies (Infect Control Hosp Epidemiol2005;26:548-552).

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Hemani, Sunita, and Premlata Mital. "Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital." Journal of South Asian Federation of Obstetrics and Gynaecology 5, no. 3 (2013): 129–31. http://dx.doi.org/10.5005/jp-journals-10006-1244.

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ABSTRACT Medical healthcare providers are an important link with the general public to impart knowledge regarding contraception. However, their own attitude and practice of contraception is often lacking. Objective This study was conducted to assess the attitude and practice of contraception over the last 5 years of the gynecologists themselves in a tertiary care hospital in Jaipur. Materials and methods The study was conducted on 125 female gynecologists in a tertiary care hospital in Jaipur. All were given a questionnaire which was duly filled by them and data obtained was analyzed. Results All the doctors used some form of contraception. The mean age was 29.32 years. The commonest was the barrier method (38.4%) followed by OC pills (27.2%). Twenty-one percent of the barrier users used them occasionally. Emergency contraception was used by either those using natural methods of contraception or who were occasional users of OC pills or condoms. Fifty percent of the couples relying on natural methods conceived. Conclusion Gynecologists have complete knowledge regarding contraception, yet fail to use it regularly. Proper attitude and practice is essential to prevent unintended pregnancies. How to cite this article Hemani S, Hooja N, Mital P. Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital. J South Asian Feder Obst Gynae 2013;5(3): 129-131.

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Cumming, M., F. Boreland, and D. Perkins. "Do rural primary health care nurses feel equipped for palliative care?" Australian Journal of Primary Health 18, no. 4 (2012): 274. http://dx.doi.org/10.1071/py11150.

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Community primary health care nurses in rural and remote settings are required to provide palliative care as part of their generalist role. They have limited access to specialist medical and nursing support and sometimes there are no resident GPs. A study consisting of a mailed survey and follow-up interviews was conducted to explore the experiences of these nurses and to determine how personally and professionally equipped they felt for palliative care service provision. Most participants were registered nurses experienced in nursing and in rural and remote settings, who juggled multiple generalist work roles. They had only occasional palliative care patients, and more than half had provided palliative care for a friend or family member. Some nurses found palliative care rewarding, others preferred not to have to do it. However, even those who did not enjoy working with palliative care patients often went beyond the ‘call of duty’ to support a home death if that was what the patient wanted. Three-quarters had attended palliative care education in the last 2 years but 88% wanted more education. Barriers to education included competing work roles, work load, geographical isolation and lack of backfill. Support from managers and peers was considered important, as was accessing timely and relevant clinical support.

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Oberoi, G. S., and N. Yaubihi. "An Occasional Segment Presenting Reports of Clinical Investigation and Experience in the Pacific Island Region." Anaesthesia and Intensive Care 17, no. 3 (August 1989): 332–35. http://dx.doi.org/10.1177/0310057x8901700315.

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In order to introduce the technique of epidural narcotics for pain relief in Papua New Guinea, fifty patients were given low doses of epidural morphine and thereupon the quality of analgesia and morbidity evaluated. The lowest effective epidural morphine dose was determined by considering the patient's characteristics and height of surgical incision. Pain relief was provided for three postoperative days in the surgical or gynaecological wards. The quality of analgesia thus provided was excellent in all the patients with no incidence of clinically significant respiratory depression or hypotension. Minor complications such as nausea, vomiting, pruritis and retention of urine were also relatively uncommon.

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Reeves, M. D., M. W. Skinner, and C. J. Ginifer. "Evaluation of the Intubating Laryngeal Mask Airway™ Used by Occasional Intubators in Simulated Trauma." Anaesthesia and Intensive Care 32, no. 1 (February 2004): 73–76. http://dx.doi.org/10.1177/0310057x0403200111.

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Cudak, Henryk, and Sławomir Cudak. "DEVELOPING THE PEDAGOGICAL CULTURE OF PARENTS AS A CHALLENGE OF CONTEMPORARY TIMES." Zeszyty Naukowe Wyższej Szkoły Humanitas w Sosnowcu. Pedagogika 22 (December 12, 2020): 27–42. http://dx.doi.org/10.5604/01.3001.0014.5704.

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Interactions of parental care, family education and socialisation take place in two ways. The first track of interactions is spontaneous, occasional. The other one is purposeful and aware. This second path of interaction is related to the level of parents’ pedagogical education. The aim of this paper is to diagnose pedagogical culture, and to develop a system of pedagogical education for parents. Familiologists’ studies indicate a low level of parents’ educational awareness. Parental pedagogical education through parallel education is occasional and inefficient. Therefore, primary school can successfully complete tasks in the field of shaping parents’ pedagogical culture. The implementation of the actions taken by the school will be based on the universality of education and the purposeful, planned and systematic organization of parents’ pedagogical training.

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Lease, John G. "Office Care of Wounds." Pediatrics In Review 13, no. 7 (July 1, 1992): 257–61. http://dx.doi.org/10.1542/pir.13.7.257.

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All children experience a variety of minor injuries, the vast majority of which can be cared for easily by a competent parent. Wounds of a larger scope, wounds of a complex nature, or wounds with secondary complications require consultation with the pediatrician. Knowledge of the principles of treatment is essential and must be tailored to individual parental abilities, home environment, and emotional concerns. The purpose of this article is to outline common problems and to give suggestions for efficient office management. Tetanus Prophylaxis All wounds, regardless of etiology or size, should be considered as potential sources of tetanus. Therefore, it is incumbent upon the primary provider to ensure adequacy of tetanus prophylaxis (Table). Lacerations Pediatricians see a variety of lacerations. Those which do not come to medical attention through the emergency department are usually within the scope of the primary provider. Occasional surgical referral may be necessary because of the nature of location of the wound. If bleeding has not ceased by the time of initial presentation, a small gauze dressing should be applied with direct, constant pressure for 15 min. Large, bulky dressings are inefficient for applying pressure at the exact bleeding site. Careful documentation should include location, orientation, depth, and exact length of the laceration.

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Tsai, Meng-Han, Sudha Xirasagar, Scott Carroll, Charles S. Bryan, Pamela J. Gallagher, Kim Davis, and Edward C. Jauch. "Reducing High-Users’ Visits to the Emergency Department by a Primary Care Intervention for the Uninsured: A Retrospective Study." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 55 (January 1, 2018): 004695801876391. http://dx.doi.org/10.1177/0046958018763917.

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Reducing avoidable emergency department (ED) visits is an important health system goal. This is a retrospective cohort study of the impact of a primary care intervention including an in-hospital, free, adult clinic for poor uninsured patients on ED visit rates and emergency severity at a nonprofit hospital. We studied adult ED visits during August 16, 2009-August 15, 2011 (preintervention) and August 16, 2011-August 15, 2014 (postintervention). We compared pre- versus post-mean annual visit rates and discharge emergency severity index (ESI; triage and resource use–based, calculated Agency for Healthcare Research and Quality categories) among high-users (≥3 ED visits in 12 months) and occasional users. Annual adult ED visit volumes were 16 372 preintervention (47.5% by high-users), versus 18 496 postintervention. High-users’ mean annual visit rates were 5.43 (top quartile) and 0.94 (bottom quartile) preintervention, versus 3.21 and 1.11, respectively, for returning high-users, postintervention (all P < .001). Postintervention, the visit rates of new high-users were lower (lowest and top quartile rates, 0.6 and 3.23) than preintervention high-users’ rates in the preintervention period. Visit rates of the top quartile of occasional users also declined. Subgroup analysis of medically uninsured high-users showed similar results. Upon classifying preintervention high-users by emergency severity, postintervention mean ESI increased 24.5% among the lowest ESI quartile, and decreased 12.2% among the top quartile. Pre- and post-intervention sample demographics and comorbidities were similar. The observed reductions in overall ED visit rates, particularly low-severity visits; highest reductions observed among high-users and the top quartile of occasional users; and the pattern of changes in emergency severity support a positive impact of the primary care intervention.

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Khan, Dalia, Rohan Sajeev Wijesurendra, Melanie Orchard, Pru Evans, and Richard William Smith. "Picture Quiz: All in the head?" Acute Medicine Journal 9, no. 2 (April 1, 2010): 97. http://dx.doi.org/10.52964/amja.0393.

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A 40 year old previously fit bank executive of Cypriot origin presented to the acute medical take with insidious onset frontal and vertex headaches with features suggesting raised intracranial pressure. He had been under investigation in the outpatient department after developing multiple erythematous lesions on his legs, associated with malaise, occasional mouth ulcers and episodic sweats.

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Williamson, Iain. "Developing Interprofessional Education in Health and Social Care Courses in the United Kingdom, Occasional Paper 12." Journal of Interprofessional Care 26, no. 2 (January 3, 2012): 161–62. http://dx.doi.org/10.3109/13561820.2012.636965.

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Cydulka, Rita K. "Characteristics of occasional and frequent emergency department users: Do insurance coverage and access to care matter?" Annals of Emergency Medicine 44, no. 5 (November 2004): 554. http://dx.doi.org/10.1016/j.annemergmed.2004.08.031.

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Guelmann, Marcio, and Joseph Katz. "Macroglossia combined with lymphangioma: a case report." Journal of Clinical Pediatric Dentistry 27, no. 2 (January 1, 2004): 167–69. http://dx.doi.org/10.17796/jcpd.27.2.a466020r10440121.

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A four year old white female with a clinical presentation of macroglossia is described. Speech disturbances and occasional episodes of traumatic injury to the tongue with severe bleeding brought the patient to seek dental care. Lymphangioma was diagnosed after incisional biopsy. The differential diagnosis of tongue enlargement in children is discussed including review of the literature relevant to the diagnosis and treatment of lymphangioma.

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Cox, John, and Alison Gray. "The College reply to Francis misses the big question: a commentary on OP92." Psychiatric Bulletin 38, no. 4 (August 2014): 152–53. http://dx.doi.org/10.1192/pb.bp.114.047514.

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SummaryThe College has recently published an occasional paper in response to the Francis inquiry into the care at Mid Staffordshire NHS Foundation Trust. We consider that it overlooks one key question implicit in the inquiry's recommendations: ‘Is the business model of care fit for purpose?’ We question whether the business model in its present form is appropriate for the delivery of healthcare. We suggest there is a need for greater conceptual clarity with regard to the nature of compassionate care and the meaning of person-centred medicine. We recommend that a broader moral and ethical framework is considered not only for psychiatry, but for all healthcare provision which would transcend specialty and Royal College boundaries.

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Yandell, Margaret, and Lesley Hewitt. "Confirming common sense: How relief daycare assists parents of preschool children." Children Australia 21, no. 4 (1996): 11–16. http://dx.doi.org/10.1017/s1035077200007252.

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A small project explored how occasional daycare assisted families perceived by referring agents as needing relief from the pressures of constant child care. The results suggested that ‘common sense’ was confirmed and the underlying practice wisdom behind referrals for relief daycare was validated. Respite daycare does assist families with preschool children by acting as a ‘circuit-breaker’, reducing tension and giving breathing space for both parents and children.

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Chukmaitov, Askar S., Anqi Tang, Henry J. Carretta, Nir Menachemi, and Robert G. Brooks. "Characteristics of All, Occasional, and Frequent Emergency Department Visits Due to Ambulatory Care–Sensitive Conditions in Florida." Journal of Ambulatory Care Management 35, no. 2 (2012): 149–58. http://dx.doi.org/10.1097/jac.0b013e318244d222.

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Gungam, Praveena, Y. Sunil Kumar Yadav, and Sunil Junapudi. "ANTIBIOTIC USE IN PEDIATRIC INFECTIONS; A STUDY IN TERTIARY CARE HOSPITAL." International Journal of Clinical and Biomedical Research 4, no. 4 (October 30, 2018): 26–32. http://dx.doi.org/10.31878/ijcbr.2018.44.06.

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Objectives: Antibiotics are frequently used in tertiary care hospitals. We conducted an observational study on children admitted to a teaching hospital in south India, to make a profile of antibiotics use and suspected adverse drug reactions (ADRs) owing to them. Methods: Hospitalized children of either sex, aged between 1 month and 12 years, were inspected. Baseline demographic and clinical features, duration of hospital stay, antibiotics received in hospital along with dosing and indications and interest of suspected ADRs attributable to their use were recorded. Every patient was followed up till discharge, admission to the Pediatric Intensive Care Unit, or passing. Results: Over the year and a half report period 364 confirmations were screened. The prevalence of Antibiotics use was 80.22%. The majority of the 292 children who received Antibiotics were males (63.35%). Median age was 35 months, five children died. In most instances, either two (41%) or a single antibiotic (37.32%) was used. Ceftriaxone, co-amoxiclav, amikacin, vancomycin, and ampicillin were predominantly used. Antimalarials, antivirals and antiprotozoals were used occasionally. Average number of Antibiotics per patient was 2.2± 1.1 the majority (81.15%) were by parenteral route and initial choice was usually empirical. Prescriptions were usually in generic name. The antibiotic treatment went somewhere in the range of 1 and 32days, with a middle of 8 days. Five ADRs were noted of which half were skin rash and the rest loose stools. Conclusions: The profile of Antibiotic utilize is comprehensively like prior Indian investigations. Apparent overuse of multiple Antibiotics per prescription and the parenteral route requires exploration. Antibiotics are being used empirically in the absence of policy. ADRs to Antibiotics are occasional and usually mild. The benchmark information can serve in situation analysis for antibiotic prescribing guidelines.Keywords: Antibiotic; Pediatric infections; Adverse drug reactions; Tertiary care hospital.

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Chakraborty, Arup, Arti Bhimjiyani, and Richard William Smith. "An Unusual cause of ‘Troponinaemia’." Acute Medicine Journal 8, no. 3 (July 1, 2009): 131. http://dx.doi.org/10.52964/amja.0253.

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58 year old policeman presented with a 4 week history of cough, haemoptysis, exertional dyspnoea, ear discomfort and sore throat. He was previously healthy and taking no regular medications. He was a non-smoker and had no risk factors for coronary artery disease. He had recently completed two courses of antibiotics for a presumed ear infection. He had also experienced occasional minor epistaxis with constitutional symptoms of weight loss and night sweats over recent months. Clinical examination was unremarkable.

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Binu, Jeffy, and Sonia Raichel Thomas. "A cross sectional study on the precocious puberty among girls in the age group of 11-15 years, in two schools in Kollam." International Journal Of Community Medicine And Public Health 4, no. 5 (April 24, 2017): 1603. http://dx.doi.org/10.18203/2394-6040.ijcmph20171771.

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Background: Puberty is the period during which human development progresses, from the first pubertal sign to full sexual maturation. Precocious puberty is a common problem affecting up to 29 per 100 000 girls per year. The objective of this study is to find out the prevalence of precocious puberty among school going girls and to find out relation with various risk factors.Methods: A cross sectional study was conducted by enrolling 250 school going girls by selecting one school each from urban and rural setup. Prevalence of precocious puberty was expressed in percentage and Chi square test was applied to check association. P value for statistical significance was fixed at P<0.05.Results: The prevalence of precocious puberty was found to be 10.4%. In urban it was found to be 12.35% and in rural it was 8.43%. Girls whose fathers have primary education are risky to have precocious puberty (P<0.049). Those students who take fish occasionally, that is once or thrice in a week were more prone to have precocious puberty (P<0.000). Prevalence of Precocious puberty is more in rural area when compared to urban area. Parents, especially fathers who were less educated should take of care of their daughter’s health by not giving them dried and junk foods. It is better to take fish daily, rather than once or thrice in a week, occasional consumption of fish is found to be a reason for precocious puberty.Conclusions: Prevalence of Precocious puberty was 10.4%. Fathers of the girls, who are not well educated and occasional fish consumption of girls was found to be the significant reason for Precocious puberty.

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Young, James Harvey. "Health Fraud: A Hardy Perennial." Journal of Policy History 9, no. 1 (January 1997): 117–40. http://dx.doi.org/10.1017/s0898030600005856.

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Quackery forms a gaudy thread in the fabric of health care through the course of American history. In the colonial years, the American market for commercial self-dosage was dominated by “patent medicines”—some of them actually patented—shipped overseas from the mother country. Packed in containers of distinctive shape, sealed in wrappers printed with boastful therapeutic claims, advertised in the slender newborn press, these British nostrums far overshadowed occasional American imitators.

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Crossland, Nicholas A., Peter M. DiGeronimo, Yulia Sokolova, April L. Childress, James F. X. Wellehan, Javier Nevarez, and Daniel Paulsen. "Pneumonia in a Captive Central Bearded Dragon With Concurrent Detection of Helodermatid Adenovirus 2 and a Novel Mycoplasma Species." Veterinary Pathology 55, no. 6 (June 25, 2018): 900–904. http://dx.doi.org/10.1177/0300985818780451.

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A 4-year-old captive male central bearded dragon ( Pogona vitticeps) was presented for recurrent episodic dyspnea and anorexia with occasional expulsion of oral mucoid discharge. Despite empirical antimicrobial therapy and supportive care, the animal died and was submitted for autopsy. Defining histologic features included heterophilic and lymphocytic interstitial pneumonia, with occasional amphophilic intranuclear inclusions and prominent type II pneumocyte hyperplasia. Transmission electron microscopy revealed intranuclear 80-nm, nonenveloped, hexagonal viral particles within pneumocytes. Helodermatid adenovirus 2 (HeAdV2) was determined as the etiologic agent through pan-adenoviral consensus polymerase (PCR) chain reaction and sequencing. Nucleic acid from a novel Mycoplasma sp. (provisionally called Mycoplasma pogonae) was identified by pan-generic PCR targeting the mycoplasma 16S ribosomal RNA gene with sequencing and phylogenetic analysis. As bacteria morphologically consistent with Mycoplasma sp. were not observed by special stains and transmission electron microscopy, the detection of M. pogonae nucleic acid is of indeterminate significance; however, M. pogonae and HeAdV2 coinfection may have exacerbated disease.

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MACHADO, Raphaela Corrêa Monteiro, Mirian Ribeiro BAIÃO, Beatriz Della LÍBERA, Cláudia SAUNDERS, and Marta Maria Antonieta de Souza SANTOS. "The symbolic dimension of prenatal nutrition care in diabetes Mellitus." Revista de Nutrição 30, no. 6 (December 2017): 703–11. http://dx.doi.org/10.1590/1678-98652017000600003.

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ABSTRACT Objective Aimed at analysing the symbolic dimension of prenatal nutritional care in diabetes. Methods Participants were 17 puerperal adults diagnosed with previous or gestational diabetes. Participant observation and semi-structured interviews were conducted to collect data. The data were interpreted according to an adaptation of Bardin’s Thematic Content Analysis. Results The main meaning of diabetes was the need for changing eating habits. Nutritional care based on the Traditional Method or the Carbohydrate Counting Method was understood as an opportunity for dietary re-education. Weight loss was considered desirable by some participants, albeit against the advice of nutritionists. Pregnant women adopted the standard meal plan, rarely used the food substitution list, and reported occasional dietary transgressions, self-allowed in small portions. Foods containing sucrose were perceived as less harmful to health than added sugars. Conclusion Each pregnant woman experienced prenatal nutritional care in diabetes not as a dietary method, but as part of her lifestyle.

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Naiim, I., F. Tubach, S. Guillo, A. Ajrouche, V. Houdouin, Y. De Rycke, and F. Kaguelidou. "P48 Prescribing patterns of antiasthma medication in children and adolescents in primary care in france." Archives of Disease in Childhood 104, no. 6 (May 17, 2019): e37.1-e37. http://dx.doi.org/10.1136/archdischild-2019-esdppp.86.

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BackgroundLittle is known about the short and long-term therapeutic management of asthmatic children. The aim of this study was to assess the prescribing patterns of antiasthma drugs in primary care.MethodsThis is a retrospective cohort study performed between January 2011 and December 2017 using the EGB (Echantillon Généraliste de Bénéficiaires) database, a 1/97th sample of the French national healthcare insurance system. Claims data for all individuals aged from 5 to 18 years‘ old who had received at least one antiasthma drug in the study period without any delivery in the previous 24 months and with 24 months of follow-up after first delivery, were analysed.ResultsA total of 7,680 children and adolescents (68.6% aged 5–11, 31.4% aged 12–18 years) were delivered at least one antiasthma drug (ATC code R03) during study period. The majority (66%) did not redeem another prescription in the following year (occasional users), when 18.4% redeemed prescriptions twice (low users) and 15.6% ≥3 times (high users). Most users (67%) were delivered only one class of R03 per dispensing in the first year and short-acting β2-agonists (SABAs) were the most frequently dispensed drugs. However, 33.4% of users were not prescribed SABAs. During the second year, only 27% of first-year users redeemed R03 prescriptions: 15.8% among occasional users, 35.5% of low users and 64.7% of high users. Among low and high first-year users who redeemed R03 drugs during the second year, 39.7% did not use inhaled corticoids alone or in association to LABAs.ConclusionsA high proportion of children and adolescents that used antiasthmatic drugs, even on a regular basis, were not prescribed these drugs in the long term. This finding may correspond either to the widespread use of antiasthmatic drugs in indications other than asthma or to an important undertreatment of asthmatic children and adolescents.Disclosure(s)Nothing to disclose

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Huda, Anwar Ul, Amjad Mehboob, and Abdul Saboor Memon. "Critical care management of COVID–19 infection in previously vaccinated patients – a case series." Anaesthesia, Pain & Intensive Care 25, no. 6 (December 12, 2021): 793–97. http://dx.doi.org/10.35975/apic.v25i6.1711.

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Vaccination against COVID–19 has made significant contribution in reducing the severity of the disease and the mortality worldwide. Although most of the vaccinations have been reported to be safe and without serious side effects other than mild to moderate pain at the vaccination site, occasional reports of developing overt viral disease after the vaccination have emerged. We report a case series of four cases, who developed symptomatic COVID–19 following vaccination. We describe the clinical features and intensive care management of these patients. Key words: COVID–19 infection; Vaccine; Critical care management; High flow nasal oxygen Citation: Huda AU, Mehboob A, Memon AS. Critical care management of COVID–19 infection in previously vaccinated patients – a case series. Anaesth. pain intensive care 2021;25(6):793–797; DOI: 10.35975/apic.v25i6.1711 Received: September 08, 2021, Reviewed: September 19, 2021, Accepted: October 05, 2021

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Ball, C. "Unravelling the Mystery of Malignant Hyperthermia." Anaesthesia and Intensive Care 35, no. 1_suppl (June 2007): 26–31. http://dx.doi.org/10.1177/0310057x0703501s05.

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Malignant hyperthermia was an unknown condition in 1960 although there had always been occasional patients who died mysteriously under anaesthesia. The nature of the disease became apparent when a young Melbourne man presented that year with a compound fracture and a family history of deaths under anaesthesia. He survived his anaesthetic due to the combined efforts of the anaesthetist and the surgeon. His family history was then investigated by the physicians. Over the next 20 years the cause of the disease was discovered and eventually a treatment was found. This article is based around a series of interviews with many of the participants in this story.

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Wilsford, David. "Path Dependency, or Why History Makes It Difficult but Not Impossible to Reform Health Care Systems in a Big Way." Journal of Public Policy 14, no. 3 (July 1994): 251–83. http://dx.doi.org/10.1017/s0143814x00007285.

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ABSTRACTThe idea of path-dependency is applied to an examination of health policy reform in Germany, France, Great Britain and the United States. In the path-dependent model, actors are hemmed in by existing institutions and structures that channel them along established policy paths. Therefore, in any system, big (non-incremental) change is unlikely. However, sometimes we do observe big change. Why? By developing the interplay of structure with conjuncture, the occasional accomplishment of big change - in spite of path dependency - can be systematically understood.

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Vehko, Tuulikki, Outi Jolanki, Anna-Mari Aalto, and Timo Sinervo. "How do health care workers manage a patient with multiple care needs from both health and social care services? – A vignette study." International Journal of Care Coordination 21, no. 1-2 (November 21, 2017): 5–14. http://dx.doi.org/10.1177/2053434517744070.

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Introduction To assess how health care professionals outline the management of care and explore which health or social care professionals were involved in the patient's treatment. Methods A survey with a patient vignette for general practitioners (n = 31) and registered nurses (n = 31) working daily in Finnish health centres located in four cities. Respondents answered structural questions and explained in detail the care process that they tailored for the patient. The care process was examined using content analysis. Results A physician–nurse working pair was declared to be in charge of the care process by 27% of respondents, a registered nurse by 9% and a general practitioner by 11%. However, 53% reported that no single person or working pair was in charge of the care process (response rate 72%). The concluding result of the analyses of the presented process was that both treatment practices and the professionals participating in the patient's treatment varied. Collaboration with social services was occasional, and few care processes included referrals to social services. Conclusion For the patient who needs both health and social care services, the management of care is a challenge. To improve the chances of patients being actively involved in making treatment plans at least three factors need to be addressed. Firstly, a written treatment plan should explicate the care process. Second, collaboration and interaction between health and social care services should be strengthened, and third, a contact person should be named to avoid care gaps in primary health care. Next-step data from patients need to be collected to get their views on care management and compare these with those from general practitioners and registered nurses.

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Szmukler, George I., Til Wykes, and Sue Parkman. "Care-giving and the impact on carers of a community mental health service." British Journal of Psychiatry 173, no. 5 (November 1998): 399–403. http://dx.doi.org/10.1192/bjp.173.5.399.

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BackgroundWe examined: care-giving activities in a population-based sample of carers of sufferers from psychotic disorders; putative determinants of care-giving; and changes in care-giving in an intensive community psychiatric service.MethodsIn the PRiSM interview sample 170 people had a carer; 124 were interviewed. Care-giving activities, dissatisfaction with these, and carers General Health Questionnaire (GHQ) scores were measured. Patient and illness characteristics were examined as predictors of the carer measures. The carer measures were reassessed for 62 carers after two years in two service sectors, one with an intensive community service, the other with a standard service.ResultsOverall, 36% of carers were engaged in no, or only occasional care-giving activities. Fifty per cent expressed no dissatisfaction with their care-giving role. Patient and illness characteristics predicted care-giving poorly. Carers in the intensive community treatment sector did not experience significantly different care-giving demands or distress than those in the standard sector.ConclusionsA significant proportion of carers of sufferers from psychosis do not engage in common care-giving activities, and are not dissatisfied with their role. An intensive community service did not affect the impact of the illness on carers.

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Naessens, Veronique, Richard Ward, and Kevin H. M. Kuo. "Treatment Patterns and Outcomes Of Sickle Cell Patients With Frequent ER Visits: A Single Center Experience." Blood 122, no. 21 (November 15, 2013): 1010. http://dx.doi.org/10.1182/blood.v122.21.1010.1010.

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Abstract Background Painful vaso-occlusive crisis (VOC) is the most frequent complication of sickle cell disease (SCD) and is the primary reason for these patients to present to the emergency room (ER). However, a small proportion of SCD patients account for the majority of ER resources through repeated attendances. Objectives To describe characteristics and outcomes of SCD patients that frequently present to the ER for treatment of painful VOC, as opposed to the occasional ER SCD visitors. Methods A retrospective observational study was conducted on all ER visits in a Canadian adult sickle cell comprehensive care center with a presenting diagnosis of painful VOC between 2009 and 2012. Patients were identified as frequent ER visitors when they had at least 9 visits during the 3-year study period. Baseline characteristics were collected and analyzed via Chi-Squared test. Subgroup analysis was conducted on the occasional and frequent ER visitors, using multivariable logistic regression on hospitalization and multiple regression on length of stay in ER. Results A total of 116 patients were included in the study, comprising of 61 females and 55 males, for a total of 602 visits. There were 12 frequent ER visitors, who accounted for more than half the total visits (346 visits, 57%), with 104 occasional visitors accounting for the remaining 256 visits. Median age was 27 years, and the most prevalent SCD genotype was sickle cell anemia (Hb SS or S/β0). 49 patients (42%) were on disease-modifying therapy (hydroxyurea, chronic transfusion, phlebotomy or combination). There was no statistical difference in these baseline characteristics between the frequent and occasional ER visitors. However, frequent ER visitors had a longer time to first opioid administration (101 vs. 74 minutes, p < 0.001) though their total length of stay in ER was shorter (6.24 hours vs. 8.03 hours, p < 0.001), and were more likely to be discharged home than to be admitted (OR 1.95, p < 0.001). The total amount of opiate use while in ER was not significantly different between the two groups. The use of disease-modifying therapy in frequent ER visitors was associated with a reduced need for hospitalization (p = 0.019) and shorter length of ER stay (p = 0.001). Conclusion There appears to be management and outcome disparities between frequent and occasional ER visitors. The use of disease-modifying therapy may have contributed to the reduction in the need for hospitalization and length of stay in ER, suggesting that disease-modifying therapy may play a role in the treatment of frequent painful VOC even though it may not reduce the frequency of ER admission. Management of SCD patients with frequent ER visits for painful VOC remains a challenge for ER physicians and healthcare resource utilization. Specific strategies that target this group of patients should be deployed to improve their overall care. Whether the frequent attendance in ER is the cause or consequence of the disparities in management remains undefined and needs to be further examined. Disclosures: No relevant conflicts of interest to declare.

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Manterola, Carlos. "Gastroesophageal Reflux Disease." International Journal of Medical and Surgical Sciences 3, no. 1 (October 26, 2018): 795–809. http://dx.doi.org/10.32457/ijmss.2016.010.

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Gastroesophageal reflux disease (GERD) is one of the most frequent causes of consultation in primary care and gastroenterology. Over 40 % of the general population experiences occasional heartburn and regurgitation due to GERD. It is a complex disease and physiology and pathogenesis are not yet completely defined. However, abnormalities in the lower esophageal sphincter, esophageal motility or gastric emptying can cause or worsen GERD. There are various diagnostic and therapeutic approaches; however, the use of proton-pump inhibitor fundoplication permanence and (antireflux surgery), are the most effective options.

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Journal articles on the topic 'Occasional care'

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