RESUMO
1. Self-esteem affects motivation, achievement, and job satisfaction. 2. Access to a clinical ladder for milieu counselors rewards their achievements in a visible and tangible way, thereby increasing their self-esteem with positive effects on their job satisfaction and quality of patient care. 3. Since the implementation of the clinical ladder program for milieu counselors, there has been documented evidence of increased retention and higher levels of job performance on work evaluations.
Assuntos
Mobilidade Ocupacional , Competência Clínica/normas , Aconselhamento , Pessoal de Saúde/normas , Terapia Ambiental , Autoimagem , Pessoal de Saúde/psicologia , Humanos , Satisfação no Emprego , Motivação , Avaliação de Programas e Projetos de Saúde , Recursos HumanosRESUMO
Open access to a physiotherapy outpatient department of a district general hospital was offered to general practitioners to whom domiciliary physiotherapy was already available. The effects of the new service have been monitored. Delays are reduced and consultants economise on time spent in merely confirming need for physiotherapy. Policies determining treatment, placing emphasis on prevention and self-help rather than prolonged treatment, are adhered to equally well by physiotherapists whether patients are referred directly or indirectly. It had proved unnecessary to restrict access to physiotherapy by insisting that general practitioners refer all patients first to consultant clinics. General practitioners have been sufficiently selective in referral and physiotherapists sufficiently economical in selecting treatment and determining its duration for the service to remain within the limits of available resources.
Assuntos
Medicina de Família e Comunidade , Acessibilidade aos Serviços de Saúde , Departamentos Hospitalares/organização & administração , Serviço Hospitalar de Fisioterapia/organização & administração , Encaminhamento e Consulta/estatística & dados numéricos , Dor nas Costas/terapia , Inglaterra , Humanos , Fatores de TempoRESUMO
Under inpatient controlled conditions 4 patients with gout and hypertension were treated with varying doses of tienilic acid, a new uricosuric diuretic. Plasma urate levels were reduced by an average of 50% in association with significantly increased urinary urate excretion. A twice-daily regimen was considerably more effective than a single morning dosage in reduction of plasma urate, though both regimens were equally effective in antihypertensive potency. The single daily regimen produced greater diurnal fluctuations in plasma urate and was more frequently associated with the development of acute gout attacks.
Assuntos
Glicolatos/uso terapêutico , Gota/tratamento farmacológico , Hipertensão/tratamento farmacológico , Ticrinafeno/uso terapêutico , Pressão Sanguínea , Esquema de Medicação , Gota/complicações , Humanos , Hipertensão/complicações , Ticrinafeno/administração & dosagem , Ácido Úrico/metabolismo , Equilíbrio HidroeletrolíticoRESUMO
A double-blind trial was carried out in 24 patients with acute gout to compare the efficacy and tolerance of feprazone, a non-steroidal anti-inflammatory drug, with that of phenylbutazone. Patients received 800 mg of either drug daily for 2 days and then 600 mg daily for up to 8 days. The results of patient assessment showed there was no significant difference between the two groups in time taken either to significant improvement or to final resolution of the gout attack. No side-effects were reported with either drug.