Articles: outcome.
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ABSTRACTObjective:To determine whether a nursing intervention delivered at emergency department (ED) discharge would reduce ED revisits. Method:A randomized study was conducted in the ED of a tertiary cardiac hospital in Montreal, Quebec. Between November 2006 and March 2010, 3,795 patients were assessed for eligibility based on two risk factors for ED revisits (≥ 1 ED visit in the past year and ≥ 6 medications); 132 were randomized to the experimental group (EG) and 133 to the control group (CG). ⋯ The only difference identified was a lower hospitalization proportion at 180 days in the EG group (13.6% v. 24.1%; p = 0.038). Conclusions:These findings are consistent with previous research showing that few ED-based interventions are successful in reducing ED returns. Factors other than those targeted by the intervention, including an improvement in usual care, may explain the findings.
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The purpose of this study was to determine if marital status, including specific types of single status categories, is associated with length of survival in lung cancer patients. ⋯ Our study demonstrated that married or widowed lung cancer patients have better survival compared to patients who were never married or separated/divorced. Research to understand the mechanism of this effect, and how the beneficial effect can be extended to those who have never married or have had the marital relationship severed through divorce or separation is needed.
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ABSTRACTObjective:To define the range of clinical conditions Canadian emergency pediatricians consider appropriate for management by physician assistants (PAs) and the degree of autonomy PAs should have in the pediatric emergency department (PED). Methods:We conducted a cross-sectional, pan-Canadian survey using electronic questionnaire technology: the Active Campaign Survey tool. We targeted PED physicians using the Pediatric Emergency Research Canada (PERC) network database (N = 297). ⋯ For the remaining 33 clinical conditions, more than 85% of respondents felt that PA could appropriately manage but were divided between requiring direct and only indirect physician supervision. Respondents' selection of the number of conditions felt to be appropriate for PA involvement varied between the size of the emergency department (ED) in which they work (larger EDs 87.7-89.1% v. smaller EDs 74.2%) and familiarity with the clinical work of PAs in the ED (90.5-91.5% v. 82.2-84.7%). Conclusion:This national survey of Canadian PED physicians suggests that they feel PAs could help care for a large number of nonemergent clinical cases coming to the PED, but these clinical encounters would have to be directly supervised by a physician.
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Journal of intensive care · Jan 2013
Prevalence of vitamin D deficiency in critically ill patients and its influence on outcome: experience from a tertiary care centre in North India (an observational study).
Limited studies are available on prevalence and severity of vitamin D deficiency in a critically ill population. To the best of our knowledge, this the first study of its kind in an Indian intensive care set-up. ⋯ Vitamin D deficiency is highly prevalent in critically ill patients. A causal association between vitamin D deficiency and mortality was not found in our study. Larger studies are needed to understand the relationship between vitamin D deficiency and ICU outcome.