The caregiver narratives suggested a need for more education in practical caregiving; access to patient care equipment and supplies; and a need for ongoing support and guidance by knowledgeable medical personnel during caregiving.
In view of current concern about a possible pandemic of virulent avian influenza, it is timely to revisit the public health response to the "Spanish" influenza of 1918. St. Louis, Missouri, was the most successful of nine largest cities in limiting the death toll from influenza and pneumonia through the use of public health measures during the first 8 weeks of the epidemic. A second wave of cases increased the final death rate, but it remained below that of other major cities. Public health officials attributed the lower death rate to the early and rigorous ban on public gatherings.
The purpose of this study was to describe home health agency preferences with respect to staff nurse qualifications, and practices in hiring and orienting new staff. An 85-item home health staff nurse selection and orientation questionnaire was used to collect data from a random sample of 287 midwestern home health agencies in 12 states. Qualifications rated most highly were medical-surgical experience, venipuncture skills, completion of a physical assessment course, intravenous therapy skills, and patient-teaching skills. With agency sponsorship (traditional, proprietary, and hospital-based) as the independent variable, the three types of agencies were significantly different on ratings of six qualifications and six orientation topics. None of the agencies rated a BSN degree as very important or required, and the same was true for completion of a student experience in community health nursing. Preference for qualifications in this study is consistent with increasing acuteness of patients' illness and technologic complexity of home care.
T his interprofessional group of authors brings a novel linkage between nursing and the application of environmental science to agriculture, and previous publications report various aspects of nursing practice, occupational health, and agricultural development in The Gambia. For example, an earlier article with a more specifically agricultural focus (Kuye et al., 2006) traced the development of agriculture in The Gambia in detail and briefly addressed health implications for agricultural workers. The authors discussed the impact on health in terms of musculoskeletal injury from lifting and carrying heavy loads; exposure to dust, smoke inhalation, and agrichemicals without personal protective equipment (acute and chronic intoxications, skin reactions); and potential injury in work with large draught animals. In the current article, the authors aim to describe agriculture-related illness and injury in Gambian farm workers and have a particular interest in health problems associated with the use of agrichemicals. The World Health Organization Health and Environmental Linkages Initiative (WHO HELI, 2007) estimates that unintentional poisonings kill 355,000 people globally each year, two thirds of them in developing countries, and that such poisonings are strongly associated with occupational use of toxic chemicals at dangerous levels, including unsustainable forms of agriculture. Poor rural populations, including women and children who not only work but also live close to fields and orchards, are especially at risk of a range of developmental, reproductive, immune system, endocrine, nervous system problems, and certain cancers (WHO HELI, 2007). In this descriptive study, the authors do not report incidence statistics for farm worker occupational illness or injury in The Gambia but do indicate that the extensive and often incorrect use of agrichemicals is a problem in this region of Africa. The relevance of the issue beyond The Gambia is supported by the WHO HELI (2007) prediction of increasing production and use of chemicals in developing countries, leading to environmental degradation and increased health risks to workers. This study triangulates data from face-to-face interviews with 20 Gambian farmers in their native language and written questionnaires in English with 21 government nursing personnel who practiced in the area.
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