ABSTRACT
The study aims to describe the experiences of a hospital-based home care programme in the families of children with cancer. Fourteen parents, representing 10 families, were interviewed about their experiences of a hospital-based home care programme during a 4-month period in 2009 at a university hospital in Denmark. Five children participated in all or part of the interview. The interviews were transcribed verbatim and analysed using qualitative content analysis. The findings indicate that hospital-based home care enabled the families to remain intact throughout the course of treatment, as it decreased the strain on the family and the ill child, maintained normality and an ordinary everyday life and fulfilled the need for safety and security. According to family members of children with cancer, hospital-based home care support enhanced their quality of life during the child's cancer trajectory. Our study highlights the importance of providing hospital-based home care with consideration for the family members' need for the sense of security achieved by home care by experienced paediatric oncology nurses and regular contact with the doctor. In future studies, interviews with children and siblings could be an important source of information for planning and delivering care suited to the families' perceived needs.
Subject(s)
Child Health Services/standards , Family/psychology , Home Care Services, Hospital-Based/standards , Neoplasms/therapy , Quality of Health Care/standards , Adolescent , Adult , Child , Child Health Services/organization & administration , Child, Preschool , Denmark , Female , Humans , Infant , Male , Middle Aged , Neoplasms/psychology , Surveys and QuestionnairesABSTRACT
The rising incidence of caesarean section (CS), including emergency caesarean section (ECS) in nulliparas is of concern. Previous CS may have implications for future pregnancies and deliveries. This article describes the prevalence and indications for ECS in a cohort of low risk nulliparas and identifies maternal and fetal risk factors associated with ECS. We included 2,748 low-risk women and 8.7% had ECS. Failure-to-progress (FTP) accounted for 68.3% of the ECS and 30.4% were performed due to suspected fetal distress (SFD). Multivariate logistic regression analyses were done to estimate the association between risk factors and indications for ECS. Smoking during pregnancy (OR 2.33; CI 1.18-4.61) and BMI ≥ 30 (OR 2.87, CI 1.34-6.16) were associated with increased risk of ECS due to SFD. Birth weight (BW) ≥ 4,000 (OR 2.95; CI 1.92-4.53) and smoking cessation during pregnancy (OR 2.02; CI 1.26-3.20) were associated with increased risk of ECS due to FTP.
Subject(s)
Cesarean Section/statistics & numerical data , Parity , Denmark/epidemiology , Female , Fetal Distress/epidemiology , Humans , Pregnancy , Prevalence , Risk FactorsABSTRACT
OBJECTIVES: The primary aim of this study was to assess pregnant women's knowledge of first-trimester combined Down syndrome screening in a setting of required informed consent. As the secondary aim, we wanted to identify relevant differences in knowledge level among subgroups of pregnant women, including those informed in different ways about prenatal examinations. METHODS: Data stem from a population-based cross-sectional questionnaire study including 15 multiple-choice questions assessing knowledge of different aspects of screening. Included were 6427 first-trimester pregnant women from three Danish obstetric departments offering prenatal screening free of charge. Both participants and non-participants in the screening program were included. The results are based on 4095 responders (64%). Differences between subgroups were examined using chi-squared tests and logistic regression analysis. Estimates are stated with 95% CI. RESULTS: The majority of the participants (87.6 (86.6-88.6)% to 92.6 (91.7-93.3)%) correctly identified the test concept and the main condition being screened for. Fewer participants (16.4 (15.3-17.6)% to 43.3 (41.8-44.8)%) correctly recognized test accuracy and the potential risk of adverse findings other than Down syndrome. Knowledge level was positively associated with length of education (adjusted ORs 1.0 (0.8-1.4) to 3.9 (2.4-6.4)) and participation in the screening program (adjusted OR 0.9 (0.6-1.3) to 5.9 (3.9-8.8)). Participation in an individual information session was weakly associated with more knowledge. CONCLUSION: The majority of the pregnant women correctly identified the test concept and the main condition being screened for. The pregnant women were found less knowledgeable on test accuracy and drawbacks.
Subject(s)
Down Syndrome/diagnosis , Health Knowledge, Attitudes, Practice , Mothers/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Adolescent , Adult , Chi-Square Distribution , Cross-Sectional Studies , Decision Making , Denmark/epidemiology , Down Syndrome/epidemiology , Down Syndrome/psychology , Educational Status , Female , Humans , Informed Consent/statistics & numerical data , Logistic Models , Mothers/psychology , Nuchal Translucency Measurement , Odds Ratio , Patient Acceptance of Health Care/psychology , Pregnancy , Pregnancy Trimester, First , Prenatal Diagnosis , Surveys and Questionnaires , Young AdultABSTRACT
We examined background information and course of labour from a cohort of 2,810 low-risk nulliparas to identify possible lifestyle and anthropometrical risk indicators for dystocia. Criteria for dystocia: cervical dilatation <2 cm over 4 h during labour's active phase, or no descent during 2 h (3 h with epidural) in the descending phase, or no progress for 1 h during the expulsive phase. After adjustments, athletics or heavy gardening > or =4 h per week appeared protective for dystocia (OR 0.63, CI 0.45-0.89), contrary to a non-significant finding of intensive physical training (OR 1.57, CI 0.84-2.93). Caffeine intake of 200-299 mg/day was associated with dystocia (OR 1.37, CI 1.04-1.80); also high maternal age (OR 2.25, CI 1.58-3.22), small stature (OR 2.18, CI 1.51-3.15) and pre-pregnancy overweight (OR 1.28, CI 1.02-1.61). No association was found between dystocia and alcohol intake, smoking, night sleep and options for resting during the day.
Subject(s)
Dystocia/epidemiology , Adult , Anthropometry , Denmark/epidemiology , Female , Humans , Life Style , Parity , Pregnancy , Risk FactorsABSTRACT
Aerococci are only occasionally isolated from urinary tract specimens. A 4-month' survey revealed 29 patients suspected of urinary tract infection (UTI), from whom an Aerococcus-like organism (ALO) was isolated in significant numbers from urinary tract specimens and singly in 11 cases. Approximately 0.8% of all urinary tract specimens examined during the period yielded growth of ALO. The median age of patients was 75 years. Half of the patients were found to have conditions predisposing to UTI. 9 of 11 patients without indwelling catheter, having ALO isolated in pure culture from the urine, showed one or more typical signs of UTI (fever, dysuria and/or pollakisuria and pyuria). A phenotypic comparison was made between 29 strains of ALO and 6 related organisms, including Aerococcus viridans, Streptococcus faecium, Streptococcus sanguis, Streptococcus bovis, Streptococcus Group Q and Streptococcus Group R. ALO and A. viridans showed many similarities, but, owing to characteristic differences with regard to colony morphology, biochemical reactions and antibiotic susceptibility pattern, the strains were easily separated.
Subject(s)
Streptococcaceae/isolation & purification , Urinary Tract Infections/microbiology , Catheterization , Humans , Streptococcaceae/pathogenicity , Urinary Tract Infections/pathologyABSTRACT
There are some discrepancies in both the vibrational assignments and in the metal-ligand (M-L) bond strengths predicted in the previous studies on the copper (II) chelated complex of dibenzoylmethane, Cu(dbm)2. Also, there is a lack of theoretical structure, Raman spectrum and full vibrational assignment for Cu(dbm)2 in the literatures. Density functional theory (DFT) at the B3LYP level and also MP2 calculations using different basis sets, besides Natural Bond Orbital (NBO) and Atoms-in-Molecules (AIM) analyses, have been employed to investigate the effect of methyl substitution with the phenyl group on the stabilities of bis(acetylacetonate) copper (II), Cu(acac)2, and Cu(dbm)2 complexes and the electron delocalization in their chelated rings. Measured solid phase infrared and Raman bands for Cu(dbm)2 complex have been interpreted in terms of the calculated vibrational modes and detailed assignment has been presented. We concluded that, theoretically, the results of charge transfer studies, and experimentally, in-phase symmetric O-Cu-O stretching mode of these complexes are very useful measures for M-L bond strength. The electron delocalization in the chelated rings and the M-L bond strength in Cu(dbm)2 are concluded to be higher than those in Cu(acac)2. The calculated geometries and vibrational results are in good agreement with the experimental data.
Subject(s)
Chalcones/chemistry , Copper/chemistry , Models, Chemical , Models, Molecular , Spectrum Analysis, RamanSubject(s)
Colonic Polyps/diagnostic imaging , Adolescent , Adult , Aged , Colonoscopy , Female , Humans , Male , Middle Aged , Radiation Dosage , Radiography , RiskABSTRACT
The number of iatrogenic perforations of the oesophagus has increased during the last decade and the condition still carries a high morbidity and mortality. The mortality increases considerably if treatment is delayed for more than 24 hours. In our department all patients with iatrogenic perforation of the thoracic oesophagus are treated in the same way: antibiotics and gastric decompression followed by thoracotomy with cleavage of the mediastinum and closure of the defect if it can be visualized and if the oesophageal wall is vital. During the last decade we have treated 15 patients in whom treatment was delayed for more than 24 hours. Two of the patients (13%) died during the postoperative course. We find that our strategy is associated with a low mortality.
Subject(s)
Esophageal Perforation/surgery , Adult , Aged , Aged, 80 and over , Esophageal Perforation/diagnosis , Esophageal Perforation/mortality , Female , Humans , Iatrogenic Disease , Intubation, Gastrointestinal/instrumentation , Male , Middle Aged , Postoperative Complications/mortality , Reoperation , ThoracotomyABSTRACT
Atmospheric field measurements and models of the stratospheric sulfate aerosol layer led to the suggestion that sulfuric acid (H2SO4) must photolyze at high altitudes. We propose that excitation of vibrational overtones of H2SO4 and its hydrate in the near-infrared and visible leads to photolysis, forming sulfur trioxide (SO3) and water. On the basis of absorption cross sections calculated with ab initio methods calibrated to experimental measurements, we estimated J values that are sufficient to explain stratospheric and mesospheric sulfur dioxide (SO2) concentrations and the observation of the sulfate layer.
ABSTRACT
A unique case of foreign body perforation of the stomach directly into the liver with formation of a liver abscess is presented. The literature concerning foreign body perforation of the gastrointestinal tract complicated by liver abscess is reviewed.