Preparation Of Discharge Research Articles

Identifying changes in vaginal fluid using SERS: Advancing diagnosis of vulvovaginal candidiasis

Vaginal infections, medically termed vaginitis, encompass a spectrum of symptomatic presentations arising from disturbances within the vaginal microflora. The conventional diagnostic approach relies on microscopic examination of wet preparation of vaginal discharge, considered the ‘gold standard’ in clinical practice. Complementary to this, culture-based methodologies are often employed to reinforce diagnostic accuracy. However, challenges such as subjectivity in result interpretation, resource-intensive requirements regarding skilled personnel, and reagent utilization underscore the need for alternative diagnostic strategies.In this article, we demonstrate surface-enhanced Raman spectroscopy (SERS) and partial least squares regression (PLSR) techniques to elucidate the molecular signatures present in vaginal fluids, accounting for various influencing factors, including disruptions in the natural microflora, vaginal irrigation practices, and contraceptive usage. Furthermore, we investigated the spectral manifestations associated with vulvovaginal candidiasis (VVC) relative to control samples. Each clinical specimen underwent meticulous characterization encompassing microbial composition, pH levels, purity, and other pertinent parameters.Our findings unveil significant associations between extraneous inflammatory factors such as vaginal irrigation and diminished sample purity with alterations in SERS signals. Conversely, the day of the menstrual cycle phase exhibits negligible influence on spectral profiles. Notably, VVC samples demonstrated diverse spectral responses correlating with the abundance of pathogenic bacteria. These explorations hold promise in paving the path towards developing a novel intrinsic framework for the diagnosis of vaginitis.

Prevalence of Trichomonas vaginalis Infection among Women of Reproductive Age in Anambra State, South Eastern, Nigeria

Aim: This study was undertaken to determine the prevalence of Trichomonas vaginalis infection among women of reproductive age in some selected hospitals in Awka, Anambra State, Nigeria.
 Methods: This study, conducted from October to December 2021, involved 200 women aged 20 years and above as participants. Prior to specimen collection, informed consent was obtained from each woman by qualified medical personnel. High vaginal swab sticks, labeled and sterile, were used to meticulously and aseptically collect specimens from the high vaginal area. A few drops of normal saline were added to each swab stick, and within 30 minutes of collection, a wet mount examination was performed to ensure optimal results. For the wet preparation of vaginal discharge, a drop from the sample was applied to a clean glass slide with a cover slip, avoiding the trapping of air bubbles. The wet smear was then examined under a microscope using a low-power objective (x10) followed by a high-power objective (x40) to detect motile T. vaginalis. The vaginal secretion was characterized by the presence of epithelial cells, white blood cells, and red blood cells. The T. vaginalis trophozoite was identified based on its oval shape, flagellation, and distinct jerky movement.
 Results: The study area had an overall prevalence rate of 11.0% for T. vaginalis infection. Among the selected hospitals, COOUTH had the highest prevalence at 13.24%, while Rock Foundation Hospital had the lowest at 6.67%. Prevalence varied across age groups, with the highest rate of 16.42% found in the 30-39 years age group, and the lowest rate of 5.0% in the 20-29 years age group. Divorced women had the highest prevalence at 60.0%, while singles had the lowest at 4.7% among the marital groups. Among different occupations, traders had the highest prevalence at 12.24%, whereas students and civil servants had the lowest rates at 4.0% and 7.72%, respectively. T. vaginalis infection was only observed in non-pregnant women, with a prevalence rate of 13.3%.
 Conclusion: T. vaginalis infection is prevalent among sexually active women of reproductive age in the study area. The findings highlight the importance of practicing good personal hygiene and being faithful to a single sexual partner. It is recommended to raise public awareness regarding the prevention and control of T. vaginalis in order to reduce its prevalence among women in the study area.

Prevalenţa infecţiei cu Trichomonas vaginalis la femeile de vârstă reproductivă din Kosovo

Aim. This study was undertaken to determine the prevalence of Trichomonas vaginalis infection in women of reproductive age from Kosovo. Methodology. The study was carried out in the Obstetrics and Gynecology Clinic of the Faculty of Medicine, University of Pristine, Kosovo, between April and July 2022. The study population consisted of a total of 207 women. Sexually active women aged at least 20 years old were included in the study. A semi-structured questionnaire was distributed to the participants to seek for information such as age, marital status, occupation and pregnancy status. Every woman’s informed consent was sought before the collection of specimens by qualified medical personnel. The specimens were carefully and aseptically collected from the high vaginal area using well-labeled, sterile, non-abrasive high vaginal swab sticks. A few drops of normal saline were added to each swab stick, and a wet mount examination was performed within less than half an hour of collection in order to get optimal results. The wet preparation of the vaginal discharge was made by applying a drop from the sample to a small area of a clean glass slide with a cover slip in order not to trap air bubbles. The wet smear was examined microscopically for motile T. vaginalis with a low-power objective (x10) and then with a high-power objective (x40). The vaginal secretion was characterized by the presence of epithelial cells, white blood cells and red blood cells. The T. vaginalis trophozoite was identified by its oval, flagellated and distinctive motility (jerky movement). Results. An overall prevalence rate of 12.56% was found in Kosovo. The prevalence of T. vaginalis infection differed from place to place. It varied as well among age groups, showing the highest prevalence in the age group of 30-39 years old (13.63%), and the lowest in the age group of 20-29 years old (5.70%). The prevalence varied with marital groups, being the highest in divorced women (30.76%) and the lowest among singles (6.74%). The prevalence rate was also observed to be highest among the employed (19.71%) and lowest among students (14.81%) and unemployed (7.33%). T. vaginalis infection was observed in non-pregnant women in a prevalence rate of 15.20%. Conclusions. T. vaginalis infection is prevalent in women of reproductive age, as evident in our country. The infection is common in sexually active female participants, especially in those with multiple sex partners. Proper personal hygiene, faithfulness to one sexual partner, and massive public awareness on the prevention and control of T. vaginalis are advised to reduce its prevalence among women of reproductive age in our country.

Successful discharge from a mental health halfway house: A personalized process with integrated approaches

IntroductionIn Taiwan, residents of mental health halfway houses (MHHH) receive psychiatric rehabilitation services, aiming for independent living and community integration. Research is yet to investigate how MHHH may effectively assist residents’ discharge in this cultural context.ObjectivesTo examine the processes of assessment, preparation, assistance, and appraisal of discharge from MHHH staff’s perspectives.MethodsSemi-structured in-depth interviews were conducted with 11 halfway house staff members. Verbatim transcripts were analyzed with dimensional analysis procedures of the grounded theory methodology.ResultsSuccessful discharge is a personalized process with integrated approaches addressing three essential factors: (a) regular community involvement, (b) the residents’ capacity to work, and (c) the family’s acceptance and support. Staff supported individual residents’ community involvement by attending to residents’ personal interests, resource availability, financial concerns, and transportation. Moreover, staff provided rehabilitation trainings to develop work capacity. However, residents’ motivation and functioning as well as job opportunities might affect their employment. Finally, in Taiwan, residents were rarely discharged without their family members’ consent because residents tended to co-reside with their family after discharge or rely on family support while living separately. Staff worked to engage families, which was influenced by family relationship quality, past traumatic events, financial concerns, capacity to assist the resident, and/or the resident’s ability to assist with family affairs.ConclusionsTo achieve successful discharges, MHHH staff need to assist each resident by developing an integrated plan to enhance conditions of the aforementioned factors, including strategies for different familial situations to garner family support in this cultural context.

Involvement of informal carers in discharge planning and transition between hospital and community mental health care: A systematic review.

Family members and friends (informal carers) are very important for providing support to people with mental health difficulties. When these carers are included to care planning patients seem to benefit, as they are less likely to relapse. There are three types of interventions including carers in the patients'transition 1) programmes that offer education in hospital; 2) programmes that involve carers in planning the patients discharge; and 3) programmes that involve carers in hospital care, discharge planning and also follow-up in the community. Interventions including carers that take place both in the hospital and the community have the clearest evidence for benefit on relapse reduction. Comprehensive interventions have the best evidence for effectiveness but challenges in their implementation and resourcing should be considered. It might worth trying to identify and test simpler interventions focusing on discharge planning that can be used in busy services and require more limited resources whilst providing opportunities for the participation of carers. INTRODUCTION: Involving informal carers (family and friends of patients) in mental health interventions can lead to positive clinical and psychosocial outcomes such as relapse prevention or treatment adherence. To explore the evidence on the effectiveness of different models that involve carers in the transition between hospital and community mental health care. Five electronic databases (PsycINFO, CINAHL, MEDLINE, Embase and Scopus) and Grey literature (Open Grey and Grey Literature report) were systematically searched. The results were analysed using a narrative synthesis. Fourteen papers were identified. They described twelve interventions that were categorized into three groups: 1) purely educational programmes in preparation of discharge; 2) programmes that involved carers in planning the transition from the mental health inpatient treatment to community mental health services; and 3) programmes that bridged into the aftercare involving carers in community follow-up. The most comprehensive interventions, i.e. those including psychoeducation, care planning and aftercare follow-up were better evaluated and showed a clearer benefit in improving long-term outcomes and, in particular, reduce re-hospitalization. Comprehensive interventions showed the clearest benefit in improving long-term clinical outcomes of patients. Future research should explore implementation, costs and cost-effectiveness, as comprehensive interventions delivered across different settings are likely to require wide-ranging organizational changes and significant resources.

PCN97 ANALYSIS OF THE OPERATING COSTS FROM THE CHEMOTHERAPY SERVICES IN THE COSTA RICAN SOCIAL SECURITY (CCSS) RELATED TO THE ADMINISTRATION OF MEDICINES INTRAVENOUS COMPARED TO SUBCUTANEOUS: VALIDATION IN THE CASE OF TRASTUZUMAB

To estimate the average operating cost per minute (AOCM) of one unit for administration of chemotherapy (UAC) in the CCSS, assess the existing installed capacity (IC), and its use, in order to use this data as input in the cost minimization study of two preparations of the monoclonal antibody trastuzumab for the adjuvant treatment of HER 2+ breast cancer, one to be administered intravenously and other one subcutaneously. We used the building, maintenance and equipment costs registered in the UAC from one national reference hospital, recently built, assessed its IC and from that information determined the AOCM; then, we described all the process from the arrival of patient, the preparation of medication, administration and discharge, for each route of administration, and then, compared each other, estimating its cost. We determined the AOCM in $0,44 US dollars per minute, 87% of it is defined by human resources. The current demand on UAC has an annual growth of 6,3%, IC is insufficient to attend this demand in normal working hours, so it is required extraordinary shifts. The time needed to administer one treatment with intravenous trastuzumab is five times greater than with the subcutaneous preparation. The use of subcutaneous preparation of trastuzumab offers an advantage to CCSS in terms of opportunity and financial costs, derived from a diminished time required to prepare and administer medication, which is critical considering that IC has been surpassed.

Neonatal family integrated care: Ensuring a positive parental experience

ObjectivesThe Quality Improvement Project (QIP) aims to implement Family Integrated Care (FiCare) in our Neonatal Unit ensuring that a positive parental experience is provided. The principle objective was to gain feedback from previous parents in order to identify barriers and facilitators to a positive parental experience, areas for improvement and to consider specific changes in practice to implement. MethodData were collected in our tertiary level Unit using the following mixed methods:1) Questionnaires posted to parents who had a baby admitted to the Neonatal Unit in the preceding two years.2) One open-ended question.3) A focus group inclusive of staff and parents.Quantitative data were analysed to identify areas of both success and for improvement. Qualitative data were analysed using framework analysis to identify common themes. ResultsFrom 37 completed questionnaires parents felt:•Involved in their baby's care.•Staff were trustworthy.•Good feeding support was provided.Areas for improvement included providing more information about a baby's condition and about support groups.Seven emerging themes from the analysis, including communication and staff support, identified a number of facilitators and barriers to a positive parental experience. ConclusionThe data analysis suggested key areas for improvement include communication, providing more information about support groups and better preparation of discharge. Based on these findings, changes in our Neonatal Unit have been implemented to improve parental experience. Regular committee groups will continue and subsequently feedback will be re-assessed.

A Review on Carbon Nanotubes: As a Nano carrier Drug Delivery System

Carbon nanotubes were discovered in 1991, Sumio Iijima gives the theory of carbon nanotubes which is made up of carbon allotrope graphene having brilliant electrical, mechanical, optical and synthetic properties, pulling in extensive enthusiasm for their application in different fields including drug conveyance and malignancy treatment. Malignancy is one of the most testing sicknesses of present day times since its treatment includes recognizing ordinary sound cells from influenced cells. Here, carbon nanotubes assume a significant job since marvels, for example, electronic paramagnetic resonance, permit carbon nanotubes to recognize typical cells from influenced ones, the Holy Grail in malignancy treatment. Significant work has been done on carbon nanotubes as medication conveyance frameworks throughout the most recent 20 y. Not with standing, worries over specific issues, for example, biocompatibility and poisonousness have been raised and warrant broad exploration in this field. For the preparation of Single-walled carbon nanotubes and Multi-walled carbon nanotubes arc discharge, laser ablation and chemical vapor deposition method of preparation are used. By the process of acid treatment, magnetic purification and size exclusion chromatography carbon nanotubes impurities are removed out. Because of hydrophobic nature of carbon nanotubes, Covalent and non-covalent functionalization are done for the surface modification. Cytotoxic of carbon nanotubes have a beneficial effect in cancer treatment. Drug released from carbon nanotubes by using various stimulants such as electric, magnetic field and changes in pH.

Intervenções de enfermagem na transição de cuidados em adultos com acidente vascular cerebral: uma scoping review

Introduction: A stroke is an event that in an acute way changes the life of a person and their family members. Scientific evidence points towards a need in the health system to establish interventions which favour continuity of care after the acute phase, with emphasis on the rehabilitation period and social and community reintegration. Taking into account the fundamental intervention of the nurse in the transition of care, this scoping review becomes relevant. Aim: To identify nursing interventions in the transition of care, particularly in adults with a diagnostic of stroke who usually present with problems after their hospital discharge. Materials and Methods: The Joanna Briggs Institute protocol was used for this revision. Results: In agreement with the defined criteria, 5 articles were analysed. The articles of the processes of transition of care, which were analysed, were mostly developed or generated by nurses or multidisciplinary teams in which the nurse assumes the primary role. Conclusion: Nursing interventions which should be developed in key moments, were identified, which show the effective transition of care of the person with a diagnosis of a stroke, namely in the preparation of discharge, the moment of discharge and the accompanying of the patient in the weeks following the hospital discharge.

Hospital Discharge Day Management: Are You Coding Correctly?

CPT provides codes for reporting discharge day management services for inpatient and observation stays. These codes take into account work such as final examination of the patient, review and discussion of the hospital stay, coordination and instruction for ongoing care with caregiving agencies, preparation of final discharge records, prescriptions, and referral forms.

ENCONTRO EDUCATIVO DA ENFERMAGEM E DA FAMÍLIA DE CRIANÇAS COM NECESSIDADES ESPECIAIS DE SAÚDE

RESUMO Objetivo: conhecer as dúvidas dos familiares de crianças com necessidades especiais de saúde quanto aos cuidados domiciliares relacionados aos dispositivos tecnológicos; e analisar o uso da roda de conversa como estratégia de educação em saúde no preparo de alta hospitalar dos familiares de crianças com dispositivos tecnológicos. Método: pesquisa descritiva e exploratória, com abordagem qualitativa, realizada no setor de internação pediátrica de um hospital federal no Rio de Janeiro entre maio e junho de 2014. Seis familiares participaram de entrevistas semiestruturadas e rodas de conversa. Os dados foram submetidos à análise temática. Resultados: os familiares destacaram dúvidas no aprendizado e na adaptação à tecnologia durante a transição do hospital para o domicílio e em possíveis situações de emergência após a alta hospitalar. Essas dúvidas versaram, principalmente, sobre os cuidados procedimentais com a traqueostomia e a gastrostomia. Entretanto, a estratégia da roda de conversa com uso de um boneco com dispositivos tecnológicos acoplados foi bem aceita pelos familiares, pois favoreceu o diálogo e a troca de conhecimentos e experiências entre os participantes, além da promoção da segurança no cuidado. Conclusão: a roda de conversa é uma estratégia de educação em saúde, que pode ser utilizada pela Enfermagem no preparo de alta hospitalar de crianças com necessidades especiais de saúde, dependentes de tecnologia. Todavia, esse preparo deve acontecer de forma processual durante a hospitalização.

Liquid-Based Medium Used to Prepare Cytological Breast Nipple Fluid Improves the Quality of Cellular Samples Automatic Collection

BackgroundBreast cancer is the second cause of death in women worldwide. The spontaneous breast nipple discharge may contain cells that can be analyzed for malignancy. Halo® Mamo Cyto Test (HMCT) was recently developed as an automated system indicated to aspirate cells from the breast ducts. The objective of this study was to standardize the methodology of sampling and sample preparation of nipple discharge obtained by the automated method Halo breast test and perform cytological evaluation in samples preserved in liquid medium (SurePath™).MethodsWe analyzed 564 nipple fluid samples, from women between 20 and 85 years old, without history of breast disease and neoplasia, no pregnancy, and without gynecologic medical history, collected by HMCT method and preserved in two different vials with solutions for transport.ResultsFrom 306 nipple fluid samples from method 1, 199 (65%) were classified as unsatisfactory (class 0), 104 (34%) samples were classified as benign findings (class II), and three (1%) were classified as undetermined to neoplastic cells (class III). From 258 samples analyzed in method 2, 127 (49%) were classified as class 0, 124 (48%) were classified as class II, and seven (2%) were classified as class III.ConclusionOur study suggests an improvement in the quality and quantity of cellular samples when the association of the two methodologies is performed, Halo breast test and the method in liquid medium.

English

INTRODUCTION- Sub clinical ascending infections through the lower female genital tract are predominant worldwide. Important morbidities related to poor perinatal outcome both for the mother and for the fetus and new born comprise preterm birth, prelabor rupture of membranes, post partum sepsis and maternal anaemia. In the fetus, sepsis and intrauterine growth retardation are suspected to be the consequences of ascending maternal infection. Both the direct effect of the infection and the maternal immune response contribute to these eventualities. This study was done to identify antenatal women with various genital infections and to know the outcome of pregnancy in presence of these infections. OBJECTIVES- Diagnosis treatment and preventive measures in genital infections in Antenatal period to improve the pregnancy out come . MATERIAL AND METHODS- One thousand women were studied for lower genital tract infection by ELISA KITS for chlamydia trachomatis, hanging drop preparation of vaginal discharge for trichomoniasis and mycelia of candida albicans can be seen by wet mount of vaginal dischage in 10% KOH. Gardnerella vaginal infection was diagnosed by Amsel's criteria . RESULT-out of thousand women 53% were positive for single or multiple infections (gp-1), 47% women had no infection (gp-11) . Labour outcome was studied in 415 antenatal women of gp -1 &395 antenatal women of gp -11 . In gp-1 51.80% had no effect ,7.71% had abortions and 40.48% had pre term labour and/or PROM .Which was significantly higher than in non infected group . IN INFECTED GROUP-41.92% neonates had no effect others had some effect in terms of LBW, birth asphyxia, neonatal death & IUD. Which was significantly higher than in non infected group. P=0.00 CONCLUSION- The study showed significantly higher incidence of obstetrical morbidities in women with lower genital tract infection,since genital infections are the root cause of these obstetrical morbidities so early detection and treatment of these infections is very important to

PROGRAMA DE ALTA HOSPITALARIA PROGRAMADA PARA PREPARAR EL EGRESO DEL PACIENTE Y FAMILIA

Este artículo describe la implementación y desarrollo del Programa del Alta Hospitalaria Programada (PAH), específicamente en el área de cirugía del Hospital Rafael Angel Calderón Guardia, con la finalidad de mostrar un modelo a implementar para otras instituciones hospitalarias nacionales e internacionales, ya que proporciona herramientas a los pacientes y a sus familiares para llevar a cabo el autocuidado y su posterior reincorporación a la comunidad de la cual forman parte, partiendo de las necesidades mostradas durante su hospitalización y al momento del alta hospitalaria. Se trata de un estudio cuantitativo y descriptivo, con una población conformada por el total de egresos registrados, durante el año 2010, en el alta programada del área de Cirugías, del Hospital Rafael Ángel Calderón Guardia, seleccionando una muestra de 1224 pacientes, quienes requirieron, por parte del profesional de Enfermería responsable , valoración e intervención en la preparación del egreso. En este programa se realiza una valoración de las necesidades del paciente, tanto al momento del ingreso como la condición de egreso. La información recopilada se registra en el Instrumento de Valoración de Necesidades del paciente, el cual constituye la base para elaborar el plan de intervención para el usuario y su familia durante el internamiento y el día del egreso, orientado hacia la preparación del alta por parte del profesional en enfermería. Dicha intervención queda documentada en el Instrumento de registro de la condición de egreso de los usuarios de cirugía y en la nota de enfermería. El paciente y la familia logran, de acuerdo a la intervención del profesional de enfermería encargado del programa y con la colaboración de otros miembros del equipo de salud, adquirir conocimientos y técnicas de acuerdo al grado de dependencia o condición de salud para lograr el autocuidado al egresar del centro hospitalario. Conclusión. Los beneficios que se evidencian en la implementación del PHA giran en torno a: una preparación oportuna, según sea el grado de dependencia y de acuerdo a la condición de salud, para el autocuidado del paciente por parte de la familia al momento de egresar del centro hospitalario, una coordinación con la red externa de salud y la reubicación oportuna de los usuarios con problemas sociales, así como una agilización de los trámites administrativos.

Effects of interprofessional education on patient perceived quality of care

Background: Active patient-based learning by working together at an interprofessional clinical education ward (CEW) increases collaborative and professional competence among students.Aim: To assess the patients’ perceptions of collaborative and communicative aspects of care when treated by interprofessional student teams as compared to usual care.Method: Patients treated by student teams (medical, nurse, physiotherapy and occupational therapy students) at a CEW comprised the intervention group. Patients treated at a regular ward were taken as controls. The patients answered a questionnaire representing collaborative and communicative aspects of care. Questionnaires from CEW (n = 84) and control (n = 62) patients were obtained (82% vs 73% response rates).Results: CEW patients rated a significantly higher grade of own participation in decisions regarding treatment as compared to controls (p = 0.006). They did further rate a higher grade of satisfaction with information regarding need of help at home (p = 0.003) and perceived that the CEW staff had taken their home situation into account at a higher grade in the preparation of discharge (p = 0.0002). Finally, CEW patients felt better informed (p = 0.02).Conclusion: Patients perceived a higher grade of quality of care as compared to controls with no signs of disadvantages when treated and informed by supervised interprofessional student teams.

A comprehensive model of care for rehabilitation of children with acquired brain injuries

Acquired brain injury (ABI) is a leading cause of death and lifelong acquired disability in children and remains a significant public health issue. Deficits may only become fully apparent when developmental demands increase and once cognitive processes are expected to be fully developed. It is therefore necessary to provide organized long-term follow-up for children post ABI. Despite these recommendations, it has been shown that only a small proportion of children received specialized rehabilitation and adequate follow-up after ABI. The aims are: (i) to describe a comprehensive model of care devoted to children with acquired brain injuries; and (ii) to provide descriptive data analysing the characteristics of children followed up, the type/amount of services provided and general outcomes. The programme features an in- and outpatient rehabilitation facility, where multidisciplinary rehabilitation and specialized schooling are provided. The ultimate goal of the programme is to promote each child's successful reintegration in school and in the community. Adequate preparation of discharge is essential, long-term follow-up is organized, and an outreach programme has been developed to deal with the complex delayed psychosocial issues. Overall outcome, as measured by the Glasgow Outcome Scale, improved dramatically between admission (3.3; SD = 0.45) and discharge (2.15; SD = 0.74). Most of the children were discharged home with an adequate personalized plan for ongoing rehabilitation and school adaptations. Analysis of the outreach programme underlines the more challenging issues arising in late adolescence-early adulthood. Given the specificities of childhood ABI, long-term specific care must be organized and co-ordinated, regardless of injury severity.

Discharge planning in mental health care: a systematic review of the recent literature

To determine and estimate the efficacy of discharge planning interventions in mental health care from in-patient to out-patient treatment on improving patient outcome, ensuring community tenure, and saving costs. A systematic review and meta-analysis identified studies through an electronic search on the basis of defined inclusion and exclusion criteria and extracted data. Of eleven studies included, six were randomised controlled trials, three were controlled clinical trials, and two were cohort studies. The discharge planning strategies used varied widely, most were limited to preparation of discharge during in-patient treatment. Pooled risk ratios were 0.66 (95% CI = 0.51 to 0.84; P < 0.001) for hospital readmission rate, and 1.25 (1.07 to 1.47; P < 0.001) for adherence to out-patient treatment. Effect sizes (Hedge's g) were -0.25 (-0.45 to -0.05; P = 0.02) for mental health outcome, and 0.11(-0.05 to 0.28; NS) for quality of life. Discharge planning interventions are effective in reducing rehospitalisation and in improving adherence to aftercare among people with mental disorders.

Enterobius Vermicularis Infection of Female Genital Tract

We report the case of female genital tract enterobiasis. The patient is a pediatrician at a large general hospital and was suffering from nocturia, dysuria and vaginal itching. Vaginal examination showed mild inflammation and normal hematogram. The midstream urine and the culture of vaginal discharge were negative. The Gram-stained microscopic examination of the vaginal discharge showed normal numbers of galactobacilli and absence of fungus, but the microscopic examination of fresh preparation of vaginal discharge revealed 3–4 leukocytes/mm3 and E. vermicularis of about 4 mm. The patient was treated with mebendazole 100 mg PO bid for 3 days and all the symptoms disappeared. In order to prevent possible re-infection, the treatment was repeated with a further two courses. After three months the cellotape test was negative.

A family caregiver‐oriented discharge planning program for older stroke patients and their family caregivers

To test the effectiveness of a discharge planning program for dyads of older stroke survivors and their family caregivers in Taiwan. Family caregivers of stroke survivors often feel inadequately prepared to deal with the physical, cognitive and emotional needs of the stroke survivors. However, little information could be found on discharge planning programs for caregivers of stroke survivors in Asian families. A randomised experimental design was used to explore the effects of a discharge planning program for 158 dyads of older stroke patients and their family caregivers. The control group (n = 86 dyads) received only routine hospital discharge planning services and the experimental group (n = 72 dyads) received routine hospital discharge planning services plus the caregiver-oriented discharge planning program. Outcome variables were measured at baseline, before discharge and one month after hospital discharge. Variables were measured by the Nurse Evaluation of Caregiver Preparation Scale, Preparedness for Caregiving Scale, Caregiver Discharge Needs Satisfaction Scale and Perception of Balance between Competing Needs Scale. Caregivers in the experimental group had significantly better nurse evaluation and self-evaluation of preparation after the program than before, and greater satisfaction of discharge needs one month after discharge than before discharge. Caregivers in the experimental group had significantly better nurse evaluations and self-evaluations of preparation and better satisfaction of discharge needs after the program compared with the control group. However, no significant difference was found between caregiver groups in perceived balance of competing needs. This discharge planning program benefited family caregivers of older stroke patients during the transition from hospitalisation to one month after discharge. This caregiver-oriented discharge planning program, with its emphasis on individualised health education and home visits following discharge may improve caregivers' preparation and the satisfaction of their needs during the discharge transition.

Percepção de cuidadores familiares sobre um programa de alta hospitalar

O preparo de alta hospitalar, enquanto uma estratégia de Educação em Saúde, pode contribuir para a família dar continuidade aos cuidados no contexto domiciliar, após a alta hospitalar. Este estudo descritivo com abordagem qualitativa objetiva analisar a percepção do cuidador familiar de idosos com Acidente Vascular Cerebral (AVC) em relação a um programa de preparo de alta em um hospital universitário, para isso 12 cuidadores familiares foram entrevistados. Os dados foram analisados conforme a técnica de Análise de Conteúdo emergindo quatro categorias: opinião sobre o programa, adequação das orientações às demandas de cuidados, pontos de melhoria e repercussões do ser cuidador. Sugere-se a implantação de programas similares nos serviços de saúde que contemplem o idoso com AVC e sua família.