Mit der Diagnose "chronisch psychisch krank" ins Pflegeheim?

Eine Erhebung des Berliner Senats in Pflegeheimen ergab, dass dort zum Stichtag (1999) rund 6.700 psychisch kranke Menschen lebten, wobei die Diagnosekategorien sehr unspezifisch waren und Doppeldiagnosen nicht ausgeschlossen wurden (Gerontopsychiatrische Fachplanung, 2001). Über die Unterbringungsprozesse psychisch kranker Menschen in Pflegeheime war wenig bekannt. Wie und aus welchen Gründen werden psychisch kranke Menschen in Heime vermittelt und ist die Betreuung in einem Heim für diese Menschen wirklich die adäquate Betreuungsform? Diese Fragen standen im Fokus der hier beschriebenen Studie, die die Steuerungsprozesse und die Unterbringungsqualität in einem Zeitraum von über eineinhalb Jahren (2004 – 2005) in Berlin untersuchte (Vock, Zaumseil, Zimmermann & Manderla)

Enhancing development outcomes for smallholder farmers through closer collaboration between ACIAR’s landcare and other projects

Improving development outcomes for smallholder farmers through closer collaboration between landcare and other ACIAR projects

CT dose reduction in children

World wide, the number of CT studies in children and the radiation exposure by CT increases. The same energy dose has a greater biological impact in children than in adults, and scan parameters have to be adapted to the smaller diameter of the juvenile body. Based on seven rules, a practical approach to paediatric CT is shown: Justification and patient preparation are important steps before scanning, and they differ from the preparation of adult patients. The subsequent choice of scan parameters aims at obtaining the minimal signal-to-noise ratio and volume coverage needed in a specific medical situation; exposure can be divided in two aspects: the CT dose index determining energy deposition per rotation and the dose-length product (DLP) determining the volume dose. DLP closely parallels the effective dose, the best parameter of the biological impact. Modern scanners offer dose modulation to locally minimise exposure while maintaining image quality. Beyond the selection of the physical parameters, the dose can be kept low by scanning the minimal length of the body and by avoiding any non-qualified repeated scanning of parts of the body. Following these rules, paediatric CT examinations of good quality can be obtained at a reasonable cost of radiation exposur

Ziele, Inhalte und Struktur

In den letzten Jahren hat der Gedanke des Open Access vermehrt Einzug in den Bereich des wissenschaftlichen Publizierens erhalten. Viele namhafte Wissenschaftsorganisationen und renommierte Wissenschaftler/innen haben sich öffentlich zu diesem Prinzip positioniert und fordern den kostenlosen und barrierefreien Zugang zu wissenschaftlichen Informationen. Trotz dieser positiven Einstellung gegenüber Open Access veröffentlichen viele Autor/innen nur selten ihre wissenschaftlichen Arbeiten nach diesem Prinzip. Laut verschiedener Studien liegt dies unter anderem auch an dem geringen Bekanntheitsgrad des Open Access unter Wissenschaftler/innen. Um diesem Informationsdefizit entgegenzuwirken förderte die Deutsche Forschungsgemeinschaft den Aufbau der Informationsplattform open-access.net, die im Mai 2007 an den Start ging. Ziel der Plattform ist es, die vielen im Internet verstreuten Informationen zu Open Access zu sammeln, zu systematisieren und an einem Ort allen Interessierten zur Verfügung zu stellen

Image quality of supine chest radiographs: intra-individual comparison of computed radiography and low-dose linear-slit digital radiography

The purpose of this retrospective study was to intra-individually compare the image quality of computed radiography (CR) and low-dose linear-slit digital radiography (LSDR) for supine chest radiographs. A total of 90 patients (28 female, 62 male; mean age, 55.1years) imaged with CR and LSDR within a mean time interval of 2.8days ± 3.0 were included in this study. Two independent readers evaluated the image quality of CR and LSDR based on modified European Guidelines for Quality Criteria for chest X-ray. The Wilcoxon test was used to analyse differences between the techniques. The overall image quality of LSDR was significantly better than the quality of CR (9.75 vs 8.16 of a maximum score of 10; p < 0.001). LSDR performed significantly better than CR for delineation of anatomical structures in the mediastinum and the retrocardiac lung (p < 0.001). CR was superior to LSDR for visually sharp delineation of the lung vessels and the thin linear structures in the lungs. We conclude that LSDR yields better image quality and may be more suitable for excluding significant pathological features of the chest in areas with high attenuation compared with C

The Impact of Full Practice Authority of Nurse Practitioners and Resulting Patient Satisfaction

The purpose of this study is to assess the current understanding about the roles and abilities of nurse practitioners (NP) with full practice authority (FPA), and to evaluate the level of patient awareness and satisfaction related to having NP as their primary care provider (PCP). The study was a quantitative, non-experimental design including 76 participants ages 18 and older receiving care from Appletree Bay Primary Care in Burlington, VT. Participants completed anonymous surveys and identified themselves into one of four age groups (18-49, 50-64, 65-75, 76+). Over 97 percent of participants were aware that they were seeing an NP-PCP versus a medical doctor (MD). The questions addressing patient understanding revealed a statistically significant difference between age groups (p=0.05) when asked if they understood that the NP could perform a list of tasks without MD supervision. Participants reported high levels of satisfaction with averages ranging from 3.8-3.91 out of 4. This study showed a high level of support and satisfaction with FPA NP-PCPs at Appletree Bay, suggesting a need for continuing research on NPs with FPA to allow for findings to be generalized, supporting FPA NPs. With projected demands for PCPs to grow faster than MD workforce growth, continued research may help support endorsing NP-PCPs to be incorporated into workforce to help alleviate projected PCP shortages

Beyond California: States in Fiscal Peril

Analyzes the causes of fiscal stress in nine states facing issues similar to California's: high foreclosure rates, increasing joblessness, loss of state revenues, large budget gaps, legal obstacles to balanced budgets, and poor money management practices