Escort Service Research Articles

Incidence and seasonality of falls amongst old people receiving home help services in a municipality in northern Sweden

Objectives. Falls among old people is a well-documented phenomenon; however, falls among people living in the community and receiving home help services have been under-researched. The aim of this study was to investigate the incidence, including possible seasonal variation, circumstances and injuries related to falls among community living home help receivers, and to investigate whether fall incidence is associated with the type and amount of home help services received.Study design. Prospective cohort study.Methods. All 614 persons aged 65 and over who were living in a particular northern Swedish community and receiving municipality home help were included. Data on age, sex and home help service use were collected from home help service records, and falls were reported by staff on report forms specifically designed for the study.Results. A total number of 264 falls were recorded among 122 participants. The overall fall incidence was 626 per 1,000 PY, and incidence rate ratios were significantly correlated to the total amount of services used (p&0.001), as well as to the degree of help for I-ADL needs (p&0.001), P-ADL needs (p&0.001) and escort service (p=0.007). The proportion of falls reported as resulting in injury was 33%. The monthly fall incidence was significantly associated to daylight photoperiod, however it was not associated to temperature. Conclusions. Fall incidence among home help receivers aged 65 and over seems correlated to the amount of services they receive. This is probably explained by the fact that impairments connected to ADL limitations and home help needs also are connected to an increased risk of falls. This implies that fall prevention should be considered when planning home help care for old people with ADL limitations. Further research on the connection between daylight photoperiod and fall incidence in populations at different latitudes is needed.

Participação do acompanhante na humanização do parto e sua relação com a equipe de saúde

A humanização é entendida como responsabilização mútua entre serviços de saúde e a comunidade e consiste em acolhimento e resolutividade. O objetivo deste artigo foi refletir sobre a participação do acompanhante na humanização do parto e nascimento e sobre a sua interface com a equipe de saúde. Reflexão baseada na experiência dos pesquisadores e na literatura atualizada. Organizou-se o texto com abordagem nas temáticas: a participação do acompanhante na humanização do parto e nascimento e o acompanhante no processo de parturição e sua interface com a equipe de saúde. O atendimento humanizado é importante para que o parto seja uma experiência satisfatória e segura para a mulher e seu filho. Entre as medidas do parto humanizado destaca-se o direito da mulher decidir pelo parto natural e de ser acompanhada durante o processo de parturição. A relação entre o acompanhante e a equipe de saúde é complexa, dada a limitação de sua participação no contexto do parto. Trata-se de processo em construção, envolvendo aspectos físico-ambientais das instituições de saúde, qualificação dos profissionais de saúde e da própria cultura das usuárias, que mantém muito arraigada a atitude submissa diante de seus direitos como cidadãs. Descritores: Parto humanizado; Humanização da assistência; Acompanhantes de pacientes; Enfermagem obstétrica.

Contribuições do acompanhamento terapêutico na assistência ao portador de transtorno mental

The psychiatric reform allowed for transformations in mental health care and therapeutic accompaniment (TA) is part of these transformations. Its theoretical bases are increasingly solid and its practice accepted because it fills the gaps left by traditional psychiatric treatments. This study aimed to point and to discuss the contribution of TA in psychosocial care and rehabilitation of patients with mental disorders. Therefore, a multi-professional team from a Psychosocial Care Center of Ribeirão Preto-SP, in 2007, chose one female user, with whom sixteen TA meetings were held. The contents of these meetings were analyzed by means of the qualitative method. Results showed a very positive contribution of TA, such as: recovery of self esteem and daily activities; healthier experiences in family and social life and the creation of moments of confrontation between the mental state and reality, which allowed behavioral modification and improved quality of life. Thus, it could be considered that TA is another treatment mode to contribute to psychosocial care and rehabilitation of patients with mental disorder and can be included in therapeutic planning of mental health services and care, inserted in the psychiatric reform context. Descriptors: Patiente escort service; Alternative therapies; Psychiatric nursing.

Factors affecting recovery and discharge following ambulatory surgery

Recovery and discharge following ambulatory surgery are important components of the ambulatory surgery experience. This review provides contemporary perspectives on the issues of discharge criteria, fast-tracking, patient escort requirements, and driving after ambulatory anesthesia. A search was performed in the Cochrane Central Register for Controlled Trials, MEDLINE(R), EMBASE(R), CINAHL, and PsycINFO, to review factors delaying discharge following ambulatory surgery. The following subject headings were used: "ambulatory surgery, discharge, recovery, car driving, escort, transport, fast tracking, patient discharge, recovery, transportation of patients, hospital discharge, recovery room, patient transport, hospital discharge, recovery room, anesthetic recovery, patient transport, ambulatory surgical procedures, patient discharge, recovery of function, automobile driving, patient escort service, recovery room". Using the same search engines, the following keywords were used: "fast tracking, recovery, and discharge". The current literature supports that discharge scoring systems may be useful to guide discharge following ambulatory surgery. While fast-tracking has become common in some centres, further studies are required to justify more routine implementation of this practice in the management of patients undergoing ambulatory surgery. Patients at low risk for urinary retention can be discharged home without voiding. Patients should not drive until at least 24 hr postoperatively. Ensuring rapid postoperative recovery and safe discharge following ambulatory surgery are important components of the ambulatory surgical program. A clearly defined process should be established for each ambulatory surgical unit to ensure the safe and timely discharge of patients after anesthesia, in accordance with current best evidence.

Escort service for cross-priming

Cross-priming of cytotoxic T cells requires the transfer of antigens to dendritic cells from other cells. Careful analysis indicates that the antigens are peptides in association with chaperone proteins.

«Rompiendo Distancias»: un programa integral para prevenir y atender la dependencia de las personas mayores en el medio rural

Introduction and objectives elderly individuals living in rural areas have specific needs derived from their environment and the scarcity of resources available in these locations. A large part of Asturias, in Spain, is rural and its orographic characteristics hamper social participation and access to services. The present article presents the results of evaluation of an integral programme for rural areas in Asturias that aims to promote active ageing, the creation of new and nearby services to prevent and manage dependency and to increase social participation. Population and method breaking barriers, an innovative pilot project, was implemented in three rural areas with 9427 individuals aged more than 65 years old. The methodology was inspired in Research, Action and Participation (RAP). Work in the community was defined as the axis of the project and a design combining qualitative techniques (technical review committees, evaluation protocols, strengths, weaknesses, opportunities and threats [SWOT] analysis) with quantitative techniques (surveys of users, families and health professionals, with the application of 684 questionnaires and analysis of the results using the SPSS statistical programme) was used to evaluate the results. Results in all territories new services were created (accessible transport, provision of technical supports, escort service, home meals service, mobile library, podology, newspaper delivery, etc.), which represented highly innovative initiatives. New associations with their respective community centres were created. Cultural activities, meetings, intergenerational programmes and voluntary initiatives were established. A total of 3219 elderly individuals, 169 families and 219 volunteers participated in the programme. All participants showed a high degree of satisfaction with the various initiatives implemented and with the development of the programme as a whole. The model of the intervention, based on community work guided by the principles of a cross-sector approach, coordination and flexibility has worked satisfactorily and has led to significant intersectorial involvement. Conclusions the utility of the network system established and the community focus of the intervention, to which we recommend that municipal social services return, has been demonstrated. The intervention has also achieved its objective: social participation has been fomented among a group of elderly, physically and socially isolated individuals and channels to ensure the continuity of participation have been established. New, accessible services have been created and existing services have been improved to maintain the autonomy of many individuals and to support caretaking families. Social capital has improved through associations, altruism and intergenerational interchange.

The Winning Edge: Naval Technology in Action, 1939-1945

Reviewed by: The Winning Edge: Naval Technology in Action, 1939–1945* Russell I. Fries (bio) The Winning Edge: Naval Technology in Action, 1939–1945. By Kenneth Poolman. Annapolis, Md.: Naval Institute Press, 1997. Pp. xii+235; illustrations, maps, figures, notes, bibliography, index. $32.95. This book is an interesting one, drawing together as it does the course of technological change and its interplay with weapons and tactics. It provides a long overdue look at specific naval technology, though many other books have covered the same general area with an emphasis on strategy and tactics. Written by a British historian and former naval officer (1943–46) on escort service, The Winning Edge is interesting for its emphasis on European naval technology and evolution, normally less emphasized than the American technology that won the war. In Europe the Germans mastered the art of building the new advanced submarines as a way of interdicting the flow of life-giving commerce to Great Britain from her colonies and the United States, though similarly advanced surface craft such as the Bismarck and the Graf von Spee had less impact because they could not become invisible like the submarine. Kenneth Poolman ties the war in the Pacific to the initial air power struggles in the European theater as well. The advanced Kate torpedo [End Page 692] bomber was ironically the product of lessons learned by Japan from Britain’s Blackburn 2 bomber of the 1920s and the torpedo tactics shown them by the British in 1922 (pp. 147–48). Similarly, the British aerial torpedo attack on the Italian naval base at Taranto in September 1940 was carefully reported to Admiral Isoroku Yamamoto by none other than aviator Minoru Genda, leader of the Pearl Harbor raid, then assistant air attaché in London (p. 102). Poolman’s discussion of similar events, such as Britain’s lack of carrier success in Europe and the British overconfidence about ASDIC submarine detection, enhanced my appreciation of the European operations. He also attributes many of the American carrier losses in the Pacific to design flaws that were avoided in the British carriers. However, he is certainly not alone in pointing to other early weaknesses of the American naval operations in the Pacific—flawed torpedoes and igniters, slow, underpowered, if rugged aircraft, and vulnerable torpedo and dive bombers. Poolman misses or slights at least some American technologies—notably the proximity fuse, which helped to blunt the Japanese assault by kamikazes as American naval forces approached the home islands. Nor does he mention the intelligence gained from the capture of an almost-intact Japanese Zero fighter, found upside down after a crash landing in the Aleutians. Similarly, I missed any emphasis on the development of operations research or the scientific use of technology, such as the advanced theoretical analyses of search tactics by American patrol and attack aircraft during the Battle of the Atlantic. The Winning Edge contains too little discussion of the interaction between the scientists and engineers who designed weapons and the sailors or aviators who used them. Weapons or technologies seem to emerge in this narrative without much real interaction with engineers or scientists. Yet in actuality it was the report of what sailors lacked that led to significant weapon upgrades. Poolman also mentions many individual users of the weapons, but these names contribute little to our understanding of their use, though they do help to give personal and human dimensions to the enormous conflict. I also felt that the organization of the book could have been better; technologies were picked up, then dropped, then picked up again in the narrative, making it difficult to follow even the heavily covered Battle of the Atlantic from start to finish, for example. A more unified focus on either describing all the weapons used in a particular campaign or all the campaigns depending on a single weapon would have worked better than the composite approach used. But the insights gained on use of technology more than outweighed any organization problems, and I would add this book to my library unreservedly. Russell I. Fries Dr. Fries, of the Institute for Defense Analyses, is a former private pilot and Vietnam-era officer at the Springfield Armory...

E-Z-Roll

E-Z-ROLL/ Willoughby Johnson JUST NOW, FARRIS is in the computer room showing off a glamour shot of his daughter. She looks like an ad for an escort service, a ponderous wonderbra-ed décolletage welling up around her feather boa. There is a stamped foU signature in one corner of the picture. She is thirteen, and Farris is a proud papa. He is showing the picture to Ruby, who has been fighting the fax machine, and he says, 'Ta know, I can remember when she was just a little girl. Idn that something?" Farris shakes his head in wonderment and lights up his most sincere smile. I look over at Ruby. She widens her eyes for just a moment and I can teU we are thinking the same thing, which is that Farris would like nothing better than to bang the heck out of his glamour-shots daughter in the back of his El Dorado. Ruby grew up in west Texas, and from the Anglos there she learned to say sweet things like "She's beautiful, Farris! Oh my, I think I'm going to have to find out about getting some of those done of my nieces!" while maintaining a dripping contempt for the object of her sweetness. Farris is just under six feet tall, wears a gold chain and crisply laundered clothes. The smell of his menthols mingles with his cologne and hair goo to create an unmistakable odor of rot. He is the sales manager of E-Z-RoIl, Inc., which is to say he is my boss. Farris pauses, as if he's thinking, and looks up. "Say, did you get the quote on that 3543 to Moline?" Ruby hands the photo back to Farris. "Yeah, it's eighty nine bucks." "Eighty nine?" "Yepper." "D'ja get a look?" Farris says to me as he walks out, holding the picture to me. Ruby or someone has left a big thumbprint on the girl's chest. Without really meaning to, I grunt back at him, a sort of prelinguistic "yes." Farris holds his precious photo closer to him and scurries down the hall toward the old man's office, his smell lingering for a moment. "Farris sell something?" I ask. "A 3543?" "No, just a quote." Ruby sits down at a terminal. "I can't believe you grunted at him like that. You can't just go around grunting at pictures of your boss's kids." The Missouri Review · 53 "You're fawning all over him and I'm . . . just a Uttle grunt," I say lamely. I hit the buttons on the Coke machine to see if anything wiU come out. "But fawning comes off good," she says. "He's happy, I get to feel like he's a pornographer. That's ok." Ruby gets paged and picks up the phone. She hates Farris' guts, but this hasn't prevented her from taking a few turns in the back of the El Dorado. I walk downstairs to my office. Don, in his office, has his feet up. He's laughing his extra-loud Kappa Sig laugh, no doubt talking to some girl he met eight years ago at a mixer. Jeff's voice comes from Tim's office, "Fucking Elway, man, fucking Elway. The thing is, the motherfucker can pass, you know?" I sit down at my desk and start a new section of this graph-paper mosaic I've been working on. Today, Ruby and I are going out for lunch. This is a bigger deal than it sounds like, because the company is very much a sack-lunch sort of place. Usually the only person who goes out for a sit-down lunch is the old man, when he's meeting with a lawyer or accountant or something . We're going out because I asked her to because there's been this wall that's grown up between us in the last month. Like me grunting at Farris. Two months ago Ruby wouldn't have scolded me, she would have been, like, sweet grunt there bad boy. But she has this new skepticism about me, as if she thinks I am in fact...

The influence of reference price on the acceptance of new healthcare services among the elderly.

Reference price has been postulated in the consumer behavior literature to be an important determinant of new product acceptance in the marketplace. This study was undertaken to assess the influence of reference price on the acceptance of new healthcare transportation services among the elderly. Over five hundred elderly, chosen at random, were studied in a major metropolitan area. The proposed new healthcare transportation services were: a shuttle service (from the hospital to a satellite healthcare center) and an escort service (from the hospital to the patient's home). The results show that reference price is the main influence on the acceptance of the shuttle service superseding the effects of the traditional demographic variables of gender and marital status. However, reference price was not found to be an influence on the acceptance of the escort service. It appears that the use of reference price as a guide in the acceptance of a new product is not universal but rather contingent on the product being offered.

Designing healthcare transportation for the elderly: an empirical study.

The growing elderly market in the United States has spawned a number of studies examining different aspects of the elderly market such as their expenditure patterns, healthcare needs, attitudinal types, etc. One of the least studied areas in this field is the transportation of the elderly to their primary health care facilities. This study was undertaken to assess the likelihood of adoption by the elderly of two proposed transportation alternatives by a hospital in a major metropolitan area: a shuttle service and an escort service. The receptivity to the proposed new service was hypothesized to differ across age subsegments among the elderly. Five-hundred and fifty-three elderly, selected at random, were studied in telephone interviews. The results show that the escort service was received more favorably than the shuttle service and the 75+ age group was the most receptive to the two services. The 71-75 age group appeared to be the least receptive to the proposed services.

Group Tour Management: Does Good Service Produce Satisfied Customers?

A modified version of the expectation/performance paradigm was applied in a specific group tour situation to measure the relative importance of tourism services and attractions to satisfaction with a weekend motorcoach tour to Niagara Falls. It was determined that the experience level of the traveler did not significantly affect expectations norperformance ratings. Utilizing repeated measures ANOVA, two service features (tour escort service and convenience of departurepoints) and one attraction (sightseeing) were singled out as being the attributes which contributed significantly to satisfaction with the trip and to intention to book another tour. These three variables were not rated as most important in the travelers' tour selection processes.

Winnipeg's Escort Service

Winnipeg's Escort Service

Time for Nursing Care

An escort service to transport patients to off-ward therapy appointments saved nurses' time. A central scheduling system reduced the confusion of demands for the same patient at the same time from many departments in the hospital. But the benefits of these two innovations were offset by their deleterious effects on the quality of nursing care. A third innovation scheduling patients' therapy appointments on the basis of the time needed for nursing caresolved the problem.