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At least 1,801 records · Page 100Linked to original sources

Using communicative action in the primary prevention of cancer.

The primary prevention of disease, including cancer, has been a major part of health promotion and health education for decades. However, the long-term results of these strategies have been mixed, and primary prevention as an instrument of cancer control continues to fail to live up to either public or professional expectations. The authors identify and critique two possible factors contributing to this failure and then offer a model for the development and implementation of primary prevention strategies that addresses these factors. The model used is based on Habermas's theory of communicative action and recognizes the importance of a critical dialogue in health education and health promotion. The primary prevention programs currently being conducted by the Cancer Centre for the Southern Interior are presented as an example of the model in action.

British Columbia↗

Principles for pressure ulcer prevention in the community.

This article aims to examine the prevention of pressure ulcers in the community. Pressure ulcers continue to cause needless distress and anxiety for patients, carers and their families. Health professionals in the community often face extreme challenges when caring for patients who are at risk of developing pressure ulcers. This could be due to lack of appropriate assessment skills and having insufficient time to conduct an appropriate assessment. Having an understanding and awareness of the function of the skin and the aetiology of pressure ulcer development can assist the health professional in attempting to take a proactive approach to prevent pressure ulcer formation in the community setting.

Community Health Nursing↗

Determining preferred educational methods for neurological surgery residents regarding organ donation.

Design and implementation of professional education, especially physician education, continues to challenge procurement professionals. At the request of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons, the United Network for Organ Sharing undertook a project to develop educational materials for neurological surgery residents. A survey tool was developed and administered on site at 11 neurological surgery residency programs in the United States. The survey explored the types of learning environments, teaching methods, educational resources, and audiovisual aids that neurological surgery residents typically experience during their residency programs. In addition, the survey sought to uncover the residents' informational needs regarding organ and tissue donation presentations as well as their educational program preferences. Based on our findings, neurological surgery residents prefer presentations that are brief and to the point, that are easily understood, that require no reading, that contain limited important information, and that always include food.

Attitude of Health Personnel↗

A whole new outlook.

Explore the source record for details and available documents.

Attitude of Health Personnel↗

The total testing process and its implications for laboratory administration and education.

The Total Testing Process is a multistep process that begins and ends with the needs of the patient. Identifying the many steps in the Total Testing Process and planning and using an interdisciplinary team to begin a coordinated effort will improve the process and offer optimal patient care. Communication among departments and developing interdepartmental guidelines will improve the use, sampling, performance, and interpretation of health assessment procedures. A commitment to the continuous improvement of patient assessment will require the participation of numerous health professionals. It is time for every institution to bring individuals together, collectively identify solutions, implement an improvement plan, and evaluate the effectiveness of their efforts using outcome measures that both directly and indirectly relate to improved patient care. Doing it right the first time will benefit the patient and conserve our limited health-care dollars.

Accreditation↗

[Clinical experience with the treatment of gingival hyperplasia induced by calcium channel blocking agents].

The prevalence of the nifedipine-induced gingival hyperplasia is ranging from 0.5-83% in the dental literature. The pathomechanism of the nifedipine-induced gingival hyperplasia is not clearly understood. Evaluating the dental history and the course of disease of 34 patients treated and followed up at the Department of Periodontology the following answers were raised: What sort of local and systemic factors are enhancing the recurrence of the gingival overgrowth and how this can be anticipated in patients on continuous Ca channel blocking medication. Eight out of the 34 patients participating in the clinical trial did not remember the onset of their gingival overgrowth. 10 cases developed three years and three cases after less then one year of the onset of the drug administrations. 27 out of the 34 cases required gingival surgery and seven showed good clinical improvement after the hygienic phase of the comprehensive periodontal treatment. 70% of the gingival hyperplasia cases presented no clinical sign of recurrence one year after the completion of the active phase of the treatment. A positive correlation was found between the oral hygiene and the recurrence rate of gingival overgrowth. Oral hygiene seems to play a decisive role in the development of gingival enlargement. The present findings and substantial evidences from the dental literature indicate that the gingival enlargement can be successfully controlled even under the continuous nifedipine administration by meticulous professional and individual oral hygiene.

Calcium Channel Blockers↗

Philadelphia Panel evidence-based clinical practice guidelines on selected rehabilitation interventions for low back pain.

INTRODUCTION: A structured and rigorous methodology was developed for the formulation of evidence-based clinical practice guidelines (EBCPGs), then was used to develop EBCPGs for selected rehabilitation interventions for the management of low back pain. METHODS: Evidence from randomized controlled trials (RCTs) and observational studies was identified and synthesized using methods defined by the Cochrane Collaboration that minimize bias by using a systematic approach to literature search, study selection, data extraction, and data synthesis. Meta-analysis was conducted where possible. The strength of evidence was graded as level I for RCTs or level II for nonrandomized studies. DEVELOPING RECOMMENDATIONS: An expert panel was formed by inviting stakeholder professional organizations to nominate a representative. This panel developed a set of criteria for grading the strength of both the evidence and the recommendation. The panel decided that evidence of clinically important benefit (defined as 15% greater relative to a control based on panel expertise and empiric results) in patient-important outcomes was required for a recommendation. Statistical significance was also required, but was insufficient alone. Patient-important outcomes were decided by consensus as being pain, function, patient global assessment, quality of life, and return to work, providing that these outcomes were assessed with a scale for which measurement reliability and validity have been established. VALIDATING THE RECOMMENDATIONS: A feedback survey questionnaire was sent to 324 practitioners from 6 professional organizations. The response rate was 51%. RESULTS: Four positive recommendations of clinical benefit were developed. Therapeutic exercises were found to be beneficial for chronic, subacute, and postsurgery low back pain. Continuation of normal activities was the only intervention with beneficial effects for acute low back pain. These recommendations were mainly in agreement with previous EBCPGs, although some were not covered by other EBCPGs. There was wide agreement with these recommendations from practitioners (greater than 85%). For several interventions and indications (eg, thermotherapy, therapeutic ultrasound, massage, electrical stimulation), there was a lack of evidence regarding efficacy. CONCLUSIONS: This methodology of developing EBCPGs provides a structured approach to assessing the literature and developing guidelines that incorporates clinicians' feedback and is widely acceptable to practicing clinicians. Further well-designed RCTs are warranted regarding the use of several interventions for patients with low back pain where evidence was insufficient to make recommendations.

Acute Disease↗

[Quality assurance in dentistry].

An important subject regarding the quality of dental care is the development of a system of quality assurance. This system should be focused on preservation and improvement of the quality of dentistry. Activities like peer review, continuing dental education, (re-)registration and professional specialization could make a major contribution to the establishment of such a system.

Dentistry↗

Stuck in a rut?

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Burnout, Professional↗

Let's hear it for B players.

In the much-heralded war for talent, it's hardly surprising that companies have invested a lot of time, money, and energy in hiring and retaining star performers. For most CEOs, recruiting stars is simply more fun; for one thing, the young A players they interview often remind them of themselves at the same age. For another, A players' brilliance and drive is infectious; you simply want to be in their company. Besides, in these troubled times, when businesses are so vulnerable, people who seem to have what it takes to turn around a company's performance are almost irresistible. But our understandable fascination with star performers can lure us into the dangerous trap of underestimating the vital importance of the supporting actors. It's true that A players can make enormous contributions to performance. Yet, as the authors have found, companies' long-term performance--even survival--depends far more on the unsung commitment and contributions of their B players. These capable, steady performers are the best supporting actors of the corporate world. Companies are routinely blinded to the important role B players serve in saving organizations from themselves. They counter-balance the ambitions of the company's high-performing visionaries, whose much-esteemed strengths, when carried to an extreme, can lead to reckless or volatile behavior. In this sense, B players act as a stabilizing force for charismatic A players who might otherwise destabilize the organization. Unfortunately, organizations rarely learn to value their B players in ways that are gratifying for either the company or these employees. As a result, they see their profits sinking without understanding why. This article will help you to rethink the role of your organization's B players. The authors show how you can mentor and nurture B players to ensure their continued participation in the company.

Aptitude↗

What role will residency education take in the profession by the year 2000?

There is a need to expand the number of optometric residencies to meet the current increased demand from graduates seeking to fill the expanding number of residency positions, as well as the projected needs of the profession for the 21st century. Supportive rationales and recommendations for potential development of residencies are discussed.

Curriculum↗

Private practice: the time is now.

Nurses are creative professionals who have their own expertise in delivering personalized health care. Until we establish our own autonomy within the health care system, we will continue to be misjudged and undervalued. The development of an independent nursing practice is one method of demonstrating autonomy. What is needed is proper information, positive thinking and the courage to move forward. We need to support nurses in the pursuit of autonomy for the sake of ourselves, our clients, and the health care system.

Consultants↗

Does choice make a difference to contraceptive use? Evidence from east Java.

This study investigates sustained use of contraceptives among women in East Java, Indonesia. Interest is focused on the effect of whether the client's choice of contraceptive method was granted or denied, and the interaction between whether choice was granted or denied and husband-wife concurrence concerning method choice. Data were collected twice in a panel survey. The first round was conducted in family planning clinics among women initiating contraceptive use; the second was a follow-up household survey carried out 12 months later. Whether the user was granted her choice of method was found to be a very important determinant of sustained use of contraceptives. The interaction between whether choice was granted and whether there was husband-wife concurrence on method choice was also important. The highest rate of discontinuation occurred when method choice was denied in the presence of husband-wife agreement on method choice, and the lowest rate occurred when method choice was granted in the presence of such concurrence. The results imply that contraceptive continuation can be enhanced either when family planning workers pay more attention to the stated desires of their clients, or when policy is instituted allowing clients to use their method of choice.

Choice Behavior↗

Informatics programs in the United States and abroad.

Health informatics continues to gain recognition as a discipline in the United States and abroad, and professional societies are encouraging medical educators to include informatics in their curricula. Other health professions are also developing courses and requirements in informatics. The University of Maryland is establishing a database of informatics programs in the United States and abroad, and readers are invited to contribute information to this database.

Curriculum↗

Developing ambulatory and in-patient services for adolescents.

Adolescents require specialized health care because of their unique developmental needs. The medical or surgical treatment of a disorder may be straightforward and little different from that of a child or adult; but, because of cognitive, physical, and psychosocial stages of development, consideration of these attributes assumes great importance if optimal results are to be achieved. Establishing outpatient and inpatient facilities for adolescents requires meticulous planning and continuing commitment, careful selection of professional staff, elimination of barriers to health care, respect for privacy and confidentiality, and knowledge of laws affecting consent for care. Teenagers are often unsure of themselves, have difficulty relating to adults, and their actions often belie their true feelings. It is necessary to establish rapport and trust with patients and other professionals.

Adolescent↗

Custody and visitation. Problems and perspectives.

Child custody and visitation remain vexing problems requiring input from mental health professionals as public policy decisions are formulated. Difficult problems do not have easy solutions, but through continued exploration of the issues using clinical and research methods, perhaps innovative programs will be developed and evaluated. Ultimately, this may lead to better ways of helping families cope with the trauma and the consequences of the family break-up and the resulting attempt to establish custody and visitation.

Adaptation, Psychological↗

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