Presence Of Family Members Research Articles

A household survey of medicine storage practices in Gondar town, northwestern Ethiopia

BackgroundHousehold surveys are crucial to get accurate information on how medicines are acquired, and used by consumers, as they provide the best evidence in the area. The objective of this study was to document household medicine storage practices in Gondar town, northwestern Ethiopia.MethodsA cross-sectional household survey was conducted from April 5 to May 6, 2015. In the study, 809 households were surveyed from four sub-cities in the town selected through multistage sampling with 771 included in the final analysis. Data on the extent of storage, storage conditions, sources of medicines and their current status among others were collected through structured interviews and observations. The data were entered in to Epidata version 3.1, exported to and analyzed using Statistical Packages for Social Sciences (SPSS) version 21.ResultsOf the 771 households in the study, 44.2% stored medicines. Presence of family members with chronic illness(es) and higher levels of household incomes predicted higher likelihood of medicine storage. In the households which allowed observation of stored medicines (n = 299), a mean of 1.85 [SD = 1.09] medicines per household were found. By category, anti-infectives for systemic use (23.9%), medicines for alimentary tract and metabolism (19.2%) and those for cardiovascular system (17.7%) ranked top. Among individual medicines stored, diclofenac (10.7%), paracetamol (9.9%) and amoxicillin (8.0%) were on top of the list. Dispensaries (97.8%) and physicians (83.5%) were almost exclusive sources of medicines and advices/orders for medicines respectively. Nearly two-thirds of the medicines found were on use and a vast majority (76.5%) were stored in chests of drawers. Proportion of expired medicines was very low (3.14%).ConclusionsThe use of physicians’ and pharmacists’ advice to get medicines; use of dispensaries as principal sources, large proportion of medicines being in use and very low proportion of expiry showed good practices. However, storage places of medicines were not purpose built. Encouraging good practices through continued medicine use education and advocating appropriate medicine storage in medicine cabinets is required to improve storage conditions and consequent use of medicines.

First molecular epidemiology of Entamoeba histolytica, E. dispar and E. moshkovskii infections in Yemen: different species-specific associated risk factors.

To investigate the molecular epidemiology of Entamoeba histolytica, E. dispar and E. moshkovskii infections among rural communities in Yemen. In a community-based study, faecal samples were collected from 605 participants and examined by wet mount, formalin-ether sedimentation, trichrome staining and nested multiplex PCR techniques. Demographic, socio-economic and environmental information was collected using a pre-tested questionnaire. Overall, 324 (53.6%) of the samples were positive for Entamoeba cysts and/or trophozoites by microscopic examination. Molecular analysis revealed that 20.2%, 15.7% and 18.2% of the samples were positive for E. histolytica, E. dispar and E. moshkovskii, respectively. Multivariate analysis showed different sets of species-specific risk factors among these communities. Educational level was identified as the significant risk factor for E. histolytica; age and gender were the significant risk factors for E. moshkovskii; and sources of drinking water and consumption of unwashed vegetables were the significant risk factors for E. dispar. Moreover, living in coastal/foothill areas and presence of other infected family members were risk factors for both E. histolytica and E. moshkovskii infections. The study reveals that Entamoeba spp. infection is highly prevalent among rural communities in Yemen, with E. histolytica, E. dispar and E. moshkovskii differentiated for the first time. Identifying and treating infected family members, providing health education pertinent to good personal and food hygiene practices and providing clean drinking water should be considered in developing a strategy to control intestinal parasitic infections in these communities, particularly in the coastal/foothill areas of the country.

Counseling patients and family members in out-of-hospital emergency situations: a survey for emergency staff

BackgroundNot much is known about emergency care delivered in patients’ homes or other out-of-hospital settings. This study aims to describe out-of-hospital emergency staff’s experiences of encountering and counseling patients and their family members.MethodsA descriptive cross-sectional design was applied. Data were collected from a hospital district in Finland from emergency care staff via an electronic survey questionnaire specifically developed for this purpose (N = 142 reponse rate 59%) and analyzed using descriptive statistics.ResultsRespondents succeeded in encountering (up to 3.88/4) and counseling (up to 3.89/4) patients and family members. Challenges were related to introducing themselves to family members (3.20/4), to interacting with patients from different cultures (3.38/4) and to allowing family members to be present in care situations (2.29/4). Providing emotional support (2.56/4), especially to family members, and confirming (3.16/4) and ensuring continuity of care instructions (3.00/4) were found to be challenging.ConclusionsHigh-level counseling in acute out-of-hospital situations demands that care providers can put themselves into the patient’s and family’s situation, ensure follow-up care and provide care instructions to both patients and families. The presence and participation of family members is essential in acute care situations outside hospital contexts. Ensuring that these contents are included and practiced during basic and continuing emergency care education for nurses and other emergency staff is crucial for developing counseling practices.

The Effect of Family Presence on Rounding Duration in the PICU.

The incorporation of family-centered rounds has become standard in PICUs across the United States. We compared rounding times in our institution, with and without family members present, to determine the effect on total rounding time and work flow. This observational study of a convenience sample was conducted over a 17-month period (May 2014-October 2015), accounting for typical seasonal variation in the PICU. The individual patient rounding times for 2657 encounters were recorded. The presence of family members, intubation status, physician assistant participation, interruptions during rounds, attending physician's full- or part-time status, and patient census were documented. The effect of family presence on per-patient rounding time was analyzed, while controlling for influential variables. Family members were present during 1743 of 2657 (66%) rounding encounters. The average per-patient rounding time with and without family members present was 8.6 minutes and 7.3 minutes, respectively, a difference of 1.3 minutes per patient. In statistical models that accounted for other influential variables, the presence of family members was associated with a highly significant (20.4%, P < .001) increase in the per-patient rounding time. The presence of family members increases per-patient rounding times in the PICU. Family presence on rounds may have benefits that outweigh the additional time required to complete each patient interaction.

196: THE EFFECT OF FAMILY PRESENCE DURING PEDIATRIC INTENSIVE CARE UNIT BEDSIDE ON FAMILY GENERAL HEALTH: A CLINICAL TRIAL STUDY

Background and aims:A child's hospitalization in intensive care units causes stress and worry in other family members. This study aimed to determine the effect of family presence during pediatric ICU...

Incorporation of the time aspect into the liability-threshold model for case-control-family data.

Familial aggregation and the role of genetic and environmental factors can be investigated through family studies analysed using the liability-threshold model. The liability-threshold model ignores the timing of events including the age of disease onset and right censoring, which can lead to estimates that are difficult to interpret and are potentially biased. We incorporate the time aspect into the liability-threshold model for case-control-family data following the same approach that has been applied in the twin setting. Thus, the data are considered as arising from a competing risks setting and inverse probability of censoring weights are used to adjust for right censoring. In the case-control-family setting, recognising the existence of competing events is highly relevant to the sampling of control probands. Because of the presence of multiple family members who may be censored at different ages, the estimation of inverse probability of censoring weights is not as straightforward as in the twin setting but requires consideration. We propose to employ a composite likelihood conditioning on proband status that markedly simplifies adjustment for right censoring. We assess the proposed approach using simulation studies and apply it in the analysis of two Danish register-based case-control-family studies: one on cancer diagnosed in childhood and adolescence, and one on early-onset breast cancer. Copyright © 2017 John Wiley & Sons, Ltd.

An Investigation of Nursing Students’ Views about the Presence of Family Members and Parents During Painful Procedures and Cardiopulmonary Resuscitation

An Investigation of Nursing Students’ Views about the Presence of Family Members and Parents During Painful Procedures and Cardiopulmonary Resuscitation

Who should sit there? Effects of family-oriented objectives on board composition

The aim of this article is to shed new light on the antecedent of board composition in family firms. By integrating socioemotional wealth and stewardship theory, we hypothesise that family-oriented objectives not only affect the traditional dichotomous classification (family vs. non-family board members) but also the inner composition among family board members (e.g., family board members working in the firm vs. family board members not working in the firm). Our main findings suggest that the stronger the importance of family-oriented objectives, the greater the presence of family members on boards of directors. Furthermore, for high levels of family-oriented objectives, where steward-oriented behaviours prevail, the sub-group of family board members on the board will be mainly composed of family board members working in the firm.

Who should sit there? Effects of family-oriented objectives on board composition

The aim of this article is to shed new light on the antecedent of board composition in family firms. By integrating socioemotional wealth and stewardship theory, we hypothesise that family-oriented objectives not only affect the traditional dichotomous classification (family vs. non-family board members) but also the inner composition among family board members (e.g., family board members working in the firm vs. family board members not working in the firm). Our main findings suggest that the stronger the importance of family-oriented objectives, the greater the presence of family members on boards of directors. Furthermore, for high levels of family-oriented objectives, where steward-oriented behaviours prevail, the sub-group of family board members on the board will be mainly composed of family board members working in the firm.

PSYCHOLOGICAL AND ETHICAL ASPECTS OF THE PRESENCE OF FAMILY MEMBERS DURING CARDIAC RESUSCITATION IN CHILDREN

The presence of family members during medical investigations has given rise to intense debates. These disputes had at their center ethical, psychological and political issues. The authors approach, from a theoretical perspective, aspects related to the presence of family during medical interventions in children with cardiac problems, especially during cardiac resuscitation procedures. This field has accumulated the pros and cons generated by health policies in various countries, the level of collaboration of the family, the special training of doctors and of the whole cardiac resuscitation team, the participation of the family in work protocols and the creation of conditions for conducting cardiac resuscitation in this manner.

Never Events - the ongoing problem of the retained vaginal sponge/swab.

NHS England recently published their annual Never Events data summary (a Never Event is defined as ‘a serious incident that is wholly preventable as guidance or safety recommendations that provide strong systemic protective barriers are available at a national level and should have been implemented by all healthcare providers’). Between April and March 2014/15 there were 306 Never Events. One-third of these were ‘retention of a foreign object in a patient after a surgical/invasive procedure’, a definition that includes interventions related to vaginal birth. Closer analysis of the data reveals that there were 36 cases of retained vaginal sponges/swabs. This amounts to over one-third of all retained foreign objects, and accounts for nearly 12% of all Never Events. The retained vaginal sponge/swab after vaginal birth is a universal problem. A study carried out in the USA found that vaginal sponges/swabs accounted for 22% of retained foreign bodies, and that sponge/swab counts had been omitted after all 11 vaginal births (Gawande et al. N Engl J Med 2003;348:229–35). In 2010, the UK National Patient Safety Agency published a Rapid Response Report mandating NHS organisations to implement a seven-point action plan requiring formalised swab counting procedures after all vaginal births to minimise the risk of retained vaginal sponges/swabs (Table 1). The introduction of such counts has been shown to be acceptable to healthcare professionals in the USA (Lutgendorf et al. Mil Med 2011;176:702–4; Chagolla et al. MCN Am J Matern Child Nurs 2011;36:312–17). Repair of perineal trauma after vaginal birth presents unique challenges. Repairs are often carried out in the delivery room by a single professional with limited maternal analgesia and poor lighting. Once soaked in blood, vaginal sponges/swabs are often difficult to identify. Repairs are commonly carried out by trainees who may not grasp the importance of fastidious sponge/swab counts. The presence of family members and a new baby are further distractions. A retained vaginal sponge/swab can harm the patient, healthcare professionals and the organisation. The woman may experience discharge, infection, secondary haemorrhage and/or psychological harm. The repercussions can harm the professionals as a ‘second victim’. Organisational consequences can be financial and reputational, as Never Events are considered to reflect quality and safety processes within an organisation. Although the introduction of swab counts has been shown to reduce the incidence of retained surgical sponges/swabs, the system is not infallible. Sponges/swabs can be retained even when a documented count has been performed (Gawande et al. N Engl J Med 2003;348:229–35) so total reliance on swab counts is insufficient. Technology may provide an answer. A large study from the Mayo Clinic reported that the introduction of a data-matrix bar-coded counting system totally eliminated retained surgical sponges/swabs, providing an acceptable, reliable and cost-effective solution (Cima et al. Jt Comm J Qual Patient Saf 2011;37:51–8). Addressing the challenge of the retained vaginal sponge/swab would help to achieve the NHS's aspiration of zero Never Events. Until perineal suturing is afforded the same status as other surgical procedures, the problem is likely to remain. None declared. Completed disclosure of interests form available to view online as supporting information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Socio-emotional wealth and family: revisiting the connection

PurposeIn this commentary, the author aims to question whether the socio-emotional wealth (SEW) construct should be limited to family firms by noting that non-family owners and founders, i.e. those who yet have to involve family in their enterprise‘s operations, management or ownership, are also motivated to maximize their socioemotional wealth.Design/methodology/approachThe concept of SEW has generated significant traction in the family business literature and motivated an important body of work about how SEW alters decision-making in family firms. Professors Martin and Gomez–Mejia (this issue) extend past contributions by teasing apart complex relationships among the underlying dimensions of the construct. However, the domain of that paper, as well as the SEW construct, has heretofore been limited to family firms. The author builds his commentary on the work of Martin and Gomez–Mejia (this issue) to argue that the notion that SEW shapes decision-making in the owner controlled and owner-managed non-family firms, as well as family firms.FindingsThe author’s overarching conclusion is that there are several dimensions in which family interests materially alter decision-making but others in which family likely plays a moderating and possibly even a suppressor role. The surprising implication is that it may not be SEWper sethat distinguishes family firms from non-family firms but rather how the family dynamic alters the influence of SEW on outcomes of interest.Originality/valueAcknowledging that personal and familial SEW have a common foundation allows one to sharpen the research focus and shift it from questions about how SEW might alter decision-making in family firms to questions about how the presence of family members alters the influence of SEW on decision-making in owner-controlled and owner-managed firms. This commentary explicates the argument and offers some suggestions about how this re-framing might allow for the extension of the SEW concept from the family firm to its influence on founder-managed and non-family firms.

Supporting the neonatal nurse in the role of final comforter

The death of an infant in the neonatal intensive care unit (NICU) without the presence of family members can be a stressful event for the care nurse, who may feel obligated to provide love and comfort to the infant, in addition to medical care. The nurse may experience role conflict while attempting to meet all of the infant's perceived needs. This article explores the unique needs and circumstances of the NICU nurse in the role of final comforter for a dying infant when a family member is not present. The provision of such emotionally demanding work requires the nurse to receive education, mentoring, and support from colleagues and administration. NICU nurses who receive education on grief management and palliative care, mentorship from experienced nurses, and post-mortem grief support are better able to manage their own experiences with grief after the death of an infant in their care.

Iranian nurse attitudes towards the presence of family members during CPR

Aim: The presence of family members at the time of cardiopulmonary resuscitation (CPR) is essential in family-centered care. Since nurses have an important role in facilitating the attendance of patients' family members in this regard, the present study was conducted to examine nurse attitudes towards the family's presence during CPR. Methods: This study was conducted across three teaching hospitals in Kerman province located in South East of Iran. Using convenience sampling, all registered nurses were invited to participate in the study. Data were collected between January and March 2014 using the attitude questionnaire on family presence during resuscitation. Results: Of 303 nurses, 92.5% were women. The mean attitude score of nurses was 50.99 ±7.12. The main perceived barriers to family presence during resuscitation by Iranian nurses were increased stress and anxiety among CPR team members, traumatic experience for the family members, difficulty around stopping CPR in futile situations owing to family requests, and family impressions about the fear of litigation related to resuscitation. Conclusion: This study revealed that nurses may have not positive attitudes towards family presence during CPR. It is necessary to improve these attitudes via educational programmes.

Society Launches Quality Prescribing Campaign

Society Launches Quality Prescribing Campaign

Implications of Changes in Family Structure and Composition for the Psychological Well-Being of Filipino Women in Middle and Later Years.

The health implications of multigenerational coresidence for older adults is a well-researched topic in the aging literature. Much less is known of its impact for women in midlife. We used data from the Cebu Longitudinal Health and Nutrition Study (2002, 2005, 2007, and 2012) to study the influence of transitions in multigenerational household composition on depressive symptoms for women in midlife transitioning into old age. Our initial analysis showed little effect when we use the conventional classification of nuclear versus extended family and transition in and out of extended family. When we described shifts in the family environment by compositional changes, that is, change in the presence and absence of particular family members, we found significant association between depressive symptoms and two types of role transitions: the loss of a spouse in the household and the entry and exit of grandchildren in the household.

Food Security in Households of People Living With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: A Cross-sectional Study in a Subdivision of Darjeeling District, West Bengal.

Objectives:Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) adversely impacts food security in households of people living with HIV/AIDS (PLWHA). Little research has focused on food insecurity among PLWHA in India. The purpose of this study was to identify the prevalence of and factors relating to food security in households of PLWHA in the Siliguri subdivision of Darjeeling, West Bengal, India.Methods:A cross-sectional community-based study was carried out among 173 PLWHA residing in Siliguri and registered at the Anti-retroviral Therapy Centre of North Bengal Medical College & Hospital. Data was collected at the household level with interviews of PLWHA using a food security survey instrument. We analyzed the associations using logistic regression.Results:The prevalence of household food security among the participants was 50.9% (88/173). Five years or more of schooling, higher socioeconomic class and males were found to be significantly associated with a higher likelihood of food security. A later stage of the disease and the presence of other family members with HIV/AIDS were significantly associated with a lower likelihood of food security. The major coping strategies to deal with food insecurity in the acute phase HIV infection included borrowing money (56.1%), followed by spousal support, loans from microfinance institutions, banks, or money lenders, borrowing food, or selling agricultural products.Conclusions:The present study revealed that only about half of households with PLWHA were food secure. Prior interventions relating to periods of food and economic crisis as well as strategies for sustaining food security and economic status are needed in this area.

Attitudes of Health Care Providers Toward the Presence of Family Members During Invasive Procedures in Children

ABSTRACTThe purpose of this study is to explore the attitudes of health care providers in Jordan toward family members’ presence during invasive procedures for their children. A cross sectional descriptive design, using a non-experimental, explorative method was used in this study. A purposive sample of 75 health care providers (physicians, registered nurses) was recruited from 4 departments of the Queen Rania Military Hospital in Jordan. Results indicated that health care providers in this study have reported that they do not usually approve family presence during the performance of an invasive procedure to the child. Results also suggest that the benefits achieved from family presence during different invasive procedures are limited for the child, the family, and the overall process. The study concluded that family presence while performing an invasive procedure can be helpful once both family members and health care staff were aware of their roles and how to increase comfort and minimize pain experienced by the child. Future research is recommended to establish evidence on staff attitudes, educational and training requirements of staff and family, and the need for policies to help families promote better child health.

Are they trained? Prevalence, motivations and barriers to CPR training among cohabitants of patients with a coronary disease

Out-of-hospital cardiac arrest occurs most often at home and often in the presence of family members of the patient who witness the event. Cardiopulmonary resuscitation (CPR) training of the next of kin of at-risk patients is thus potentially beneficial. The aim of our study was to document the prevalence of appropriate training among cardiac patients' cohabitants, as well as the motivations or obstacles to seeking training. 153 cohabitants of 127 patients who were hospitalized 1year prior for confirmed coronary disease in a cardiology department (Paris, France) were interviewed using a structured questionnaire between October 2013 and March 2014. 38% of interrogated cohabitants had received CPR training, and in two-thirds of the cases, their training was undertaken prior to the onset of the patient's heart disease. The training received was often a single instruction session. Half took place more than 5years prior to the interview. For two-thirds of interrogated families, the reasons they sought training were related to professional or military duties. Training undertaken solely due to cohabitation with a patient affected by coronary disease represented only 3.5% of the trained respondents. A lack of information regarding existing training programs and a lack of concrete propositions were given as the main barriers to seeking training. The families of patients who are at-risk for cardiac arrests that were interrogated in our study are inadequately trained in CPR. The creation of dedicated training programs at cardiac rehabilitation services for patients' next of kin or the use of alternative methods such as self-instruction kits could potentially remedy this situation.

Board Diversity in Family Firms

In order to capture and lead the market, a board should be able to understand and quickly react to the changing global market. The market is very complex and highly segmented according to factors such as gender, age and ethnicity. Therefore, having a diverse board is advantageous because the board members have different backgrounds, ethnicities, genders, levels of education and ages, all of which may easily reflect the changing market. However, the presence of family members on the board may influence its performance in that they are appointed with less formality. This could impact the diversity of the board. The board of directors in a family firm may include people of the same ethnicity, gender or level of education, which could affect the firm’s performance.