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At least 1,027 records · Page 57Linked to original sources
PubMed1981

Location of community-based treatment centers.

Neighborhood opposition to community-based treatment centers (CBTCs) has prompted fears that these centers will become concentrated in inner city, "transitional neighborhoods." These neighborhoods are thought to lack the willingness and/or resources to oppose CBTCs. This paper examines the distribution of CBTCs in a northern metropolitan county. The findings suggests that the fears of "ghettoization" may be real only for certain types of centers. Most centers were located in higher-status city and suburban neighborhoods. However, these centers were physically or visually isolated from the surrounding housing, making them less likely to attract attention and therefore less likely to arouse neighborhood opposition.

Attitude to Health↗
PubMed1982

Balancing required resources and neighborhood opposition in community-based treatment center neighborhoods.

This paper analyzes the compatibility of two characteristics of neighborhoods containing community-based treatment centers (CBTCs): the availability of resources that can be used in treatment and the likelihood of neighborhood opposition. Do CBTC neighborhoods having high levels of geographically based resources also have characteristics associated with low opposition to these centers? The findings suggest that among neighborhoods with centers serving adults, inner-city transitional neighborhoods where low opposition would be expected have significantly higher levels of treatment resources than do more affluent, suburban neighborhoods. The implications of these findings for selecting sites for community-based treatment centers are discussed.

Adolescent↗
PubMed2004

Distribution of streptogramin resistance determinants among Enterococcus faecium from a poultry production environment of the USA.

OBJECTIVES: The impact of agricultural use of antimicrobials on the present and future efficacy of therapeutic drugs in human medicine is a growing public concern. Quinupristin/dalfopristin has been approved to treat human disease caused by vancomycin-resistant Enterococcus faecium and is related to virginiamycin, a streptogramin complex that has long been used in USA agriculture poultry production. METHODS: Streptogramin-resistant isolates of E. faecium from poultry production environments on the eastern seaboard were recovered without selection for streptogramin resistance and examined using ribotyping to evaluate clonal bias. Colony PCR screening for the previously described streptogramin resistance determinants erm(A), erm(B), msr(C), vgb(A), vat(D) and vat(E) was performed to determine the prevalence of streptogramin resistance mechanisms from these environments. RESULTS: The collection of E. faecium isolates was unevenly distributed among 28 ribogroups and did not cluster geographically. The most prevalent ribogroups was composed of isolates that possessed diverse antimicrobial resistance profiles. Of the 127 isolates examined, 63% were resistant to quinupristin/dalfopristin. The resistance determinants erm(A) and erm(B) were observed among 6% and 10%, respectively, of streptogramin-resistant isolates. msr(C) was detected in a single isolate that was resistant to macrolide and lincosamide antimicrobials. The streptogramin B hydrolase vgb(A) and the streptogramin A acetyltransferases genes vat(D) and vat(E) were not detected in any of the E. faecium isolates. CONCLUSIONS: These results indicate that there is widespread resistance to streptogramin antimicrobials among E. faecium throughout the poultry production region in this study and that the mechanisms of resistance to streptogramin antimicrobials within this population remain largely uncharacterized.

Animal Husbandry↗
PubMed1999

Improving patient care through implementation of nurse-driven restraint protocols.

Nationally, much attention has been placed on the indiscriminate application and abuse of restraint usage. This was the impetus for health care institutions across the country to relook at the policy, practices, and procedures regarding restraints. Our health care system made changes to our restraint policy, practice guidelines, and procedures in an effort to assure protection of the patients' health and safety while preserving their dignity, rights, and well-being. The mission was to pursue a restraint-appropriate environment by restraining only those patients who were assessed as being at risk of harming self and to protect the patient or others from injury. Our overall goal was to reduce restraint usage. This article describes the current policies, practice guidelines, and procedures for identifying clinically appropriate and adequately justified situations for restraint usage. The focus is on implementation of nurse-driven restraint protocols to improve patient care. All efforts directed at improvements in restraint usage and management of a patient in restraints has reduced our overall numbers of patients in restraints as well as significantly reduced risk of incidence for patients in restraints.

Clinical Competence↗
PubMed1978

Educational costs to hospitalized patients.

One of the less obvious costs of educational programs is the increased volume of work-ups and treatment for hospitalized patients that are ordered by residents. In a hospital which has both private teaching and private nonteaching floors, a comparison of these costs shows that service charges on teaching floors are 60 percent higher than on nonteaching floors. The sicker the patients are, the greater is the disparity.

Costs and Cost Analysis↗
PubMed2000

Young women with physical disabilities: risk factors for symptoms of eating disorders.

Women with disabilities are at risk for poor psychological adjustment and unhealthy weight-control practices. This study was conducted to determine the prevalence of symptoms of eating disorders in a clinic-based sample of women who had two disabling conditions and to identify condition-related risk factors that were linked to these symptoms. A cross-sectional survey of 71 women (mean age = 23 yr) with spina bifida or rheumatologically related illnesses was conducted to assess the symptoms of eating disorders, condition-related characteristics, and weight-control practices. Symptoms of eating disorders were measured by the Eating Disorders Inventory (EDI). Eight percent of the respondents reported a sufficient number of symptoms of eating disorders to indicate a possible clinical disorder. More than 20% of the respondents scored at or above the clinical cut-point on at least one of the eight EDI subscales. Selected condition-related characteristics (multiple conditions, condition-affected driving, and uncertainty of illness course) were associated with EDI scores after adjusting for demographic variables, family factors, and weight-control practices.

Adolescent↗
PubMed1995

Flipping assumptions and revisioning perioperative services.

As we approach a fully capitated healthcare environment, total revisioning and restructuring of hospitals as a whole, and perioperative services in particular, will be necessary to maintain the financial viability of our healthcare institutions. Nurse executives will be in pivotal roles in leading and influencing these hospital initiatives. The authors present a vision of the new hospital and discuss methods of responding to change within the healthcare environment, with an emphasis on perioperative services. An analysis of the findings of an operating room survey conducted with nurse executives is included in the discussion.

Capitation Fee↗