RESUMO
This paper presents the conceptual framework, activities and outcomes of the Allied Health BONE (Best Orthopaedic New Enterprise) Team, an early discharge incentive at the Gold Coast Hospital. The clinical team of a physiotherapist, occupational therapist and social worker provided services within an interdisciplinary model of care with the aim of reducing the length of stay of acute adult orthopaedic patients. The team provided intervention in the community, the accident and emergency department, pre-admission clinic and orthopaedic wards to patients with hip and knee replacements, back pain and upper femoral fractures. This paper reports data from the first six months of the project, demonstrating success in improving the continuity of care provided to orthopaedic patients and reducing the length of stay in target groups by 24%.
Assuntos
Artroplastia de Quadril/reabilitação , Artroplastia do Joelho/reabilitação , Equipe de Assistência ao Paciente , Alta do Paciente , Adulto , Assistência ao Convalescente , Idoso , Continuidade da Assistência ao Paciente/organização & administração , Continuidade da Assistência ao Paciente/normas , Hospitais com mais de 500 Leitos , Visita Domiciliar , Humanos , Tempo de Internação , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Readmissão do Paciente , Avaliação de Programas e Projetos de Saúde , Queensland , Encaminhamento e ConsultaRESUMO
Peripheral blood mononuclear cell fractions from 15 patients in continuous clinical remission from follicular lymphoma for longer than 10 years were examined for cells carrying the t(14;18) translocation using the polymerase chain reaction (PCR). The assay used was able to detect one positive cell in approximately 5 x 10(5) cells (a single 14q+ molecule in 2.5 micrograms DNA). Cells positive for t(14;18) were found in six of eight patients initially presenting with stage III or IV disease, compared with zero of seven of those with stage I or II disease (P less than .05). In two cases 14q+ junction regions were also successfully amplified from formalin-fixed biopsy material obtained at presentation 12 and 17 years previously. In both, sequence analysis demonstrated that the cells circulating in remission belonged to the original clone. These results indicate that cells bearing t(14;18) frequently persist in the peripheral blood in long remission of advanced follicular lymphoma and question the value of their presence as a predictor of relapse.
Assuntos
Cromossomos Humanos Par 14/fisiologia , Cromossomos Humanos Par 18/fisiologia , Leucócitos Mononucleares/fisiologia , Linfoma Folicular/genética , Translocação Genética/genética , Adulto , Idoso , Sequência de Bases , DNA de Neoplasias/genética , Feminino , Humanos , Linfoma Folicular/sangue , Linfoma Folicular/terapia , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , Valor Preditivo dos Testes , Indução de RemissãoRESUMO
A six-month prospective study of violent incidents was carried out in a Special Hospital (Rampton). Comparisons were made with results from earlier studies in general psychiatric hospitals. As might be expected, incidents occurred more frequently in the Special Hospital. These incidents were also more serious in nature and resulted in greater injury. Although more patients in the Special Hospital were involved in incidents, only a small number of patients accounted for the majority of these. Female patients, who comprised 25% of the Special Hospital population, were involved in 75% of the incidents. Nursing staff were three times as likely to be assaulted as patients.