Healthcare delivery is transforming from hospital-centric episodic care to a more patient-centric comprehensive and continuing care that caters to the changing needs of an ageing population and finite healthcare resources. The transition period during which patients move between healthcare settings is a period of vulnerability that requires well-executed care transitions. The relatively less-developed primary, intermediate and long-term care sector further underlines the importance of good transitional care. This article serves to introduce Family Physicians to the importance of transitional care, its broad concepts and a simple framework to help manage complex patients comprehensively in any Family Medicine practice setting.

Objective To investigate the effects of interleukin 10(IL 10) on the intercellular adhesion molecule 1(ICAM 1) expression of rat hepatic stellate cells. Method Hepatic stellate cells were isolated and purified from rat liver by collagenase Ⅳ perfusion and density gradient centrifugation with Nycodenz. Passaged hepatic stellate cells were divided randomly into four groups: control group (A group), TNF? 100 U/ml group (B group), TNF? 100 U/ml plus IL 10 2 ng/ml group (C group). TNF? 100 U/ml plus IL 10 20 ng/ml group (D group). 24 h after incubation expression of ICAM 1 protein and mRNA in hepatic stellate cells were detected by using cell ELISA and semi quantitative RT PCR method. Results The yield rate of hepatic stellate cells was 2.5?10 7 per rat. The cell viability was above 98%. The purity of hepatic stellate cells was more then 92%. Expression of ICAM 1 protein (1.400 ?0.077) and mRNA(1.301?0.095) in B group were significantly higher than that in A group [0.559?0.071 ( P

Objective To investigate the application value of Atlas titanium cable in the treatment of comminuted patellar fractures (CPF).Methods 80 patients with CPF in our hospital from January, 2010 to January, 2013 were randomly selected and divided into observation group (n=40) and control group (n=40) by digital random method.Observation group adopted Atlas tita-nium cable internal fixation treatment while control group adopted the improved tension band steel wire in the hollow compression screws fixation treatment.Preoperative (t0), postoperative 1 month (t1), 6 months (t2) and 1 year (t3) Bostman patellar injury curative effect score (BPICES), operation time, intraoperative blood loss, postoperative knee joint exercise time for the first time, length of hospital stay, treatment costs and complications of two groups were compared.Results Preoperative BPICES of two groups had no statistical significant difference (p>0.05).Compared with t0, t2 and t3 BPICES and the rate of optimal curative effects, two groups increased; Compared with the control group, t2 and t3 BPICES and the rate of optimal curative effects of observation group also increased, and the difference was statistically significant (p<0.05).Operation time, intraoperative blood loss, postoperative knee joint exercise time for the first time, length of hospital stay of observation group were (52.26 ±10.29) min, (70.48 ±10.49) ml, (4.78 ±1.48) d and (5.98 ±1.06) d respectively, which were lower than the (79.95 ±8.42) min, (123.36 ±21.18) ml, (9.14 ±4.48) d and (11.18 ±2.68) d of the control group;Therapy cost of observation group was (16 284.47 ±2 145.78) Yuan, which was higher than the (9 892.48 ±1 456.42) Yuan of the control group (p <0.05).Compared with control group, peptide wire/wire Piercing the skin, pain, infection, skin irritation, slippery bursa phlogistic, internal fixation of fracture parted, fracture end separation and other complications total incidence of observation group were lower (p<0.05).Conclusion Atlas titanium wire trea-ting of patients with CPF had shorter operation time and hospitalization time , less postoperative complications.It can promote the rapid recovery of knee joint function, but its cost is higher.Thus it is suitable for CPF patients with better economic conditions .

Adolescent ; Adult ; Aged ; Bronchoalveolar Lavage Fluid ; Feasibility Studies ; Female ; Hematologic Neoplasms ; microbiology ; Humans ; Lung Diseases, Fungal ; diagnosis ; etiology ; Male ; Mannans ; analysis ; Middle Aged ; Young Adult

OBJECTIVE To enhance the rational usage of antimicrobial agents in hospitalized patients by comprehensive interventional measures in clinics.METHODS The selected indictors recommended by WHO were applied to evaluate the use of antimicrobial agents in hospitalized patients.The hospital information was gained from hospital administration section.The prescription and treatment data were collected from the discharged patients′ medical history.Intervention was involved in managerial and educational strategies.RESULTS After intervention,the average number of antimicrobial agents prescribed per inpatient fell from 2.13 to 1.97.The average cost of antimicrobial agents prescribed per inpatient fell from 1765.23 yuan to 1136.18 yuan(P

OBJECTIVE To develop the nosocomial infection information management subsystem,as a subsystem of the hospital information system,and to enhance the monitoring methods of hospital infections. It can monitor and provide necessary infection information for all administers of the hospitals. METHODS After collecting the data of hospital infections and analyzing the datum structure of the hospital information system,we developed the software of nosocomial infection information management subsystem using PowerBuilder9.0 and Oracle Database. RESULTS The subsystem could monitor infection of all inpatients,collect and analyze the data of infection examination,patients infected,usage of antibiotics and intervening operations,therefore,relieve information administers from collection works and make them focus on analysis,guidance and problem solutions. CONCLUSIONS As a part of the hospital information system,nosocomial infection information management subsystem can improve the effectivity and efficiency of hospital infection administers due to its accuracy,timeliness and wide coverage.

Objective To explore the mechanism of Didang Qigui Recipe on preventing diabetes. Methods Ten female rats were set randomly as normal group, and others 70 were injected with STZ (60 mg/kg) to establish the diabetic model. After the model was established, 50 model rats were randomly divided into five groups:the model group, Didang Qigui Recipe group, the gliclazide group, Didang Qigui Recipe high-dose group, Didang Qigui Recipe and gliclazide group, with 10 rats in each group. All groups were given a gavage with related medicine. With treatment being given respectively, eight weeks later, contents of IL-1βand IL–2 in serum were detected by ELISA and structure of pancreatic β cells was observed by immunohistochemistry and microscope. Results Compared with the model group, the contents of IL-1βand IL-2 in serum of rats decreased in treatment groups, especially in Didang Qigui Recipe group and Didang Qigui and gliclazide group (P<0.05). The degree of apoptosis in pancreaticβcells, especially in the above two groups, has been less affected than other groups (P<0.05). Conclusion Didang Qigui Recipe has preventive and therapeutic effects on diabetes by inhibition of inflammatory response and protection structure of pancreaticβcells.

Discharge planning is an integral component of transitional care. Patients need to have their care needs assessed early in the admission to put in place a robust care plan that can meet the medical, functional, and social needs of the patient. The care plan must then be clearly communicated to the next care provider as well as the patient and his caregiver to avoid gaps during transition across different settings and providers. For patients with complex care needs in the community, an intensive form of primary care far beyond what is offered in traditional primary care is needed. This can be achieved by being connected to the health system and resources, additional efforts in providing the care coordination to navigate the health system, and optimising clinical and social care around the patient’s needs.

Family engagement should be part of a holistic management of any patient. This is especially so in patients who have an acute change in their health condition or function that stresses their social setup. Conducting a family conference is one of the many ways to engage patients and their caregivers and address their bio-psycho-social needs. It is a focused and purposeful approach that engages every member of the health care team and family members in facilitating a common understanding and decision-making with the aim of improving patient care and outcome. A family conference is resource intensive, and should be planned well to maximise the goals that it was set out to achieve. This article was written as a primer to help family physicians understand the indications, preparations needed, and steps to take in conducting a family conference. To facilitate a family conference confidently is a skill and an art that requires practice and constant refinement.

Nurses are the highest numbered healthcare professionals who work in a knowledgedriven environment, where accurate and updated information is needed when delivering care to clients. Information literacy has therefore become one of the criteria in determining nurses’ readiness for evidencebased practice in recent years. In the actual day-to-day care practice, are nurses ready for this? Objective: To determine the information literacy competency in readiness for evidence-based practice among clinical practicing registered nurses in a private hospital in Penang, Malaysia
Evidence-Based Practice ; Nurses ; Education, Nursing