RESUMEN

BACKGROUND: Improving transitions in care is a major focus of health care planning. In the research team's prior intervention study, the length of stay (LOS) was reduced when patients at high risk for readmission were identified early in their acute care stay and received complex management. OBJECTIVE: This study will describe the characteristics of patients receiving complex case management in an urban acute care hospital. PRIMARY PRACTICE SETTING: Acute care hospital. METHODOLOGY AND SAMPLE: This was a retrospective chart review of patients in a previous quality assurance study. A random selection of patients who previously underwent high-risk screening using the LACE (Length of stay; Acuity of the admission; Comorbidity of the patient; Emergency department use) index and received complex case management (the intervention group) were reviewed. The charts of a random selection of patients from the previous comparison group were also reviewed. Patient characteristics were collected and compared using descriptive statistics. RESULTS: In the intervention group, more patients had their family physicians (FPs) documented (93.1% [81/87] vs. 89.2% [66/74]). More patients in the intervention group (89.7% [77/87] vs. 85.1% [63/74]) lived at home prior to admission. More patients in the intervention group had a family caregiver involved (44.8% [39/87] vs. 41.9% [31/74]). At discharge, more patients in the intervention group (87.1% [74/85]) were discharged home compared with the comparison group (78.4% [58/74]). IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: (1) Having an identified FP, living at home, and having family caregiver(s) characterized those with lower LOS and discharged home. (2) Case management, risk screening, and discharge planning improve patient outcomes. (3) This study identified the importance of having a FP and engaged family caregivers in improving care outcomes.

Asunto(s)

Manejo de Caso , Humanos , Manejo de Caso/normas , Manejo de Caso/estadística & datos numéricos , Masculino , Estudios Retrospectivos , Femenino , Persona de Mediana Edad , Anciano , Tiempo de Internación/estadística & datos numéricos , Anciano de 80 o más Años , Adulto , Alta del Paciente/estadística & datos numéricos , Alta del Paciente/normas

RESUMEN

There is an increasing global concern about the availability of water for agricultural use. Drought stress negatively impacts plant physiology and crop productivity. Soybean (Glycine max) is one of the important oilseed crops, and its productivity is often reduced by drought. In this study, a commercial extract of Ascophyllum nodosum (ANE) was evaluated for its potential to alleviate drought stress in soybean. The aim of this study was to determine the effects of ANE on the response of soybean plants to drought stress by monitoring stomatal conductance, relative leaf water content, antioxidant activity and expression of stress-responsive genes. Plants treated with ANE had higher relative water content and higher stomatal conductance under drought stress. During early recovery in the post-drought phase, ANE treated plants had significantly higher stomatal conductance. The antioxidant activity was also found higher in the plants treated with ANE. In addition, ANE-treatment led to changes in the expression of stress-responsive genes: GmCYP707A1a, GmCYP707A3b, GmRD22, GmRD20, GmDREB1B, GmERD1, GmNFYA3, FIB1a, GmPIP1b, GmGST, GmBIP and GmTp55. Taken together, these results suggest that applications of ANE improve the drought tolerance of soybean by changing physiology and gene expression.