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Discontinuation, leaving reasons and course evaluation comments of students on the common foundation programme.

There is considerable financial incentive, at all levels, to reduce student nurse wastage and maintain recruitment to a workforce of professional nurses. This strategy is being pursued in a period following major educational change, when the attrition levels and leaving reasons of students need to be reassessed. Previous reports have identified a high voluntary loss of students on the common foundation programme (CFP) of the pre-registration nursing course. In order to achieve a better understanding of the basic problems faced by student nurses who consider leaving the CFP, questionnaires were distributed to three groups of students: current CFP students; students who had completed the CFP; and students who had discontinued training. The questionnaire responses show that course-based problems, identified as prime leaving reasons by the current and completed student groups, differ from the actual leaving reasons of discontinued students obtained by exit questionnaire. The attitudes of participating and discontinued students to theory, clinical and pastoral components of the CFP are not dissimilar. Some trends in attrition rate relate significantly to student category. Our results have implications for the management of student nurse attrition.

Adult↗

Student nurse satisfaction: implications for the common foundation programme.

This decade has seen a major restructuring of pre-registration nurse education within the higher education system that was costly and initially largely unpopular with qualified nurses and students. Major flaws have been identified in the common foundation programme (CFP) and student attrition rates remain too high. Our detailed survey of student satisfaction within the CFP shows that clinical placement is the most popular course component and that poor organization remains the worst aspect of the course. Teaching was more highly regarded than the organizational component of the course, although students found room for improvement. Core teaching modules such as bioscience and nursing interventions achieved better ratings than supporting modules, for example social policy or research and reflection on practice. The establishment of contact between personal tutors and students appeared to be slow. The described deficiencies have since been addressed in curriculum planning and the development of new course structure.

Adult↗

Meeting report: pharmacology in pediatric oncology. Summary of the 10th international expert meeting of the Kind Philipp Foundation for leukemia research, June 10 - 13, 2001 at the Schloss Reisensburg, Günzburg an der donau.

The Kind-Philipp foundation invited a group of international experts from academia, industry, and regulatory institutions to discuss aspects of new drug development in pediatric oncology. The current design, conduct and infrastructure of clinical trials in Europe and the United States, recent regulatory changes of drug development, and the impact of the likely availability of more targeted anti-cancer agents on drug development for pediatric cancers were discussed. This included a review of risk factors, surrogate markers, novel targets, and new anti-cancer agents for pediatric cancers. A special effort was made to define the requirements of well performed clinical trials, including target evaluation, trial design, use of pharmacokinetic (PK) studies, surrogate markers, ethical, and statistical aspects. The greater need for collaboration beyond the National level was recognized.

Child↗

An external quality assessment program for von Willebrand factor laboratory analysis: an overview from the European concerted action on thrombosis and disabilities foundation.

The laboratory diagnosis of von Willebrand disease (vWD) is complex and requires a panel of different laboratory tests. Because of this complexity, a proper quality control process is necessary. Since 2003, the European Concerted Action on Thrombosis and Disabilities Foundation has provided an external quality control program for several laboratory tests included in the diagnosis of vWD. Currently, ~180 different laboratories participate in this program, of which the vast majority perform both von Willebrand factor (vWF):antigen (Ag) and activity tests. The lowest between-laboratory variation was observed for the vWF antigen assay (10 to 24%), with a better performance for the latex immunoassay (8 to 24%) than the enzyme immunoassay (13 to 25%). Both the ristocetin cofactor activity assay (RCo) and the collagen-binding assay showed a higher between-laboratory variation (20 to 40% and 17 to 29%, respectively). We have observed that the within-laboratory repeatability for normal samples ranged from 0 to 40% for the antigen assay and from 0 to 86% for the ristocetin cofactor activity assay. Normal samples were interpreted correctly by the majority of the participants. However, type 1 vWD samples were wrongly interpreted by 20 to 40% of the participants, which was mainly caused by a discordance in the vWF:RCo/vWF:Ag ratio. It can be concluded that further improvement in the laboratory diagnosis of vWD is necessary.

Clinical Laboratory Techniques↗

[The psychosomatic foundations for the development of ambulatory deliveries (author's transl)].

The psychosomatic aspects of obstetrics received a scientific foundation by new investigations. This had a positive effect in obstetric departments by the establishment of family centered rooming-in services and the early post-partum contact between mother and infant. The psychology demand for a return to domiciliary deliveries appears to be exaggerated. The realistic evaluation of home deliveries shows that the physical risks of home deliveries are to high. A practical intermediary method of delivery is the ambulatory delivery with delivery in the hospital under an emotional home type environment in a birthing room.

Ambulatory Care↗

[Cataract Eye Camp in India, Xerophthalmia Project. Experiences last January within the scope of the Combat Blindness Foundation at the Sitapur Ophthalmology Hospital in India].

In India are approximately 4 million blind people by advanced or mature cataract. For only 10 US$ one patient can be operated in eye camps in the villages by an intracapsular cataract cryoextraction an + 12.00 dptr. aphakia glasses. Also estimated four million people are blind by xerophthalmia. The project is to examine all the babies and little children in the villages and to give them for 2 years each month vitamin-A-medication. On the other side the parents of children suffering from xerophthalmia are instructed to plant vegetables rich in vitamin A. The goal of both projects is to make a cataract and xerophthalmia free zone in Uttar Pradesh, which should spread over the entire country. Both projects are sponsored by Combat Blindness Foundation, P.O. Box 5, 332 Madison Wisconsin 53705 USA, Professor Suresh Chandra, chairman.

Adult↗

Tracking controlled chaos: Theoretical foundations and applications.

Tracking controlled states over a large range of accessible parameters is a process which allows for the experimental continuation of unstable states in both chaotic and non-chaotic parameter regions of interest. In algorithmic form, tracking allows experimentalists to examine many of the unstable states responsible for much of the observed nonlinear dynamic phenomena. Here we present a theoretical foundation for tracking controlled states from both dynamical systems as well as control theoretic viewpoints. The theory is constructive and shows explicitly how to track a curve of unstable states as a parameter is changed. Applications of the theory to various forms of control currently used in dynamical system experiments are discussed. Examples from both numerical and physical experiments are given to illustrate the wide range of tracking applications. (c) 1997 American Institute of Physics.

Journal Article↗

The Fermi-Pasta-Ulam problem as a challenge for the foundations of physics.

The Fermi-Pasta-Ulam (FPU) problem is discussed in connection with its physical relevance, and it is shown how apparently there exist only two possibilities: either the FPU problem is just a curiosity, or it has a fundamental role for the foundations of physics, casting a new light on the relations between classical and quantum mechanics. To this end, a short review is given of the main conceptual proposals that have been advanced. Particular emphasis is given to the perspective of a metaequilibrium scenario, which appears to be the only possible one for the FPU paradox to survive in the physically relevant case of infinitely many particles.

Journal Article↗

Understanding people who smoke and how they change: a foundation for smoking cessation in primary care, part 1.

The purpose of this article is to develop an understanding of people who smoke and how they change as a foundation for the delivery of smoking cessation interventions in primary care. Central to our approach is the transtheoretical model of change (TMC). The TMC is an evidence-based model of behavior change that has been developed and tested during the past 2 decades by Prochaska and his colleagues in the context of smoking cessation. We use a review of the literature, in-depth interviews of people who successfully quit smoking, and our experience applying the TMC in the context of primary care and a smoking cessation clinic to explore the clinical work of smoking cessation. This article on smoking cessation will be presented in 2 issues. Part 1 describes the theoretical information known about smoking cessation: why smoking is a powerful behavior, the scientific background of the TMC, and the building-block constructs of the TMC. The first section of part 2 is a review of the Public Health Service clinical practice guideline, Treating Tobacco Use and Dependence, published in 2000. The second section of part 2 is a discussion of clinical assessments and strategies for working with smokers, which is grounded in the Public Health Service practice guideline, our understanding of people who smoke, and the TMC. Woven throughout are transcripts of interviews with 4 people in which they describe their smoking experiences and their pathways to cessation.

Adaptation, Psychological↗

Emergency Medical Services Outcomes Project (EMSOP) II: developing the foundation and conceptual models for out-of-hospital outcomes research.

Development of methodologically acceptable outcomes models for emergency medical services (EMS) is long overdue. In this article, the Emergency Medical Services Outcomes Project proposes a conceptual framework that will provide a foundation for future EMS outcomes research. The "Episode of Care Model" and the "Out-of-Hospital Unit of Service Model" are presented. The Episode of Care Model is useful in conditions in which interventions and outcomes, especially survival and major physiologic dysfunction, are linked in a time-dependent manner. Conditions such as severe trauma, anaphylaxis, airway obstruction, respiratory arrest, and nontraumatic cardiac arrest are amenable to this methodology. The Out-of-Hospital Unit of Service Model is essentially a subunit of the Episode of Care Model. It is valuable for evaluating conditions that have minimal-to-moderate therapeutic time dependency. This model should be used when studying outcomes limited to the out-of-hospital interval. An example of this is pain management for injuries sustained in motor vehicle crashes. These models can be applied to a wide spectrum of conditions and interventions. With the scrutiny of health care expenditures ever increasing, the identification of clinical interventions that objectively improve patient outcome takes on growing importance. Therefore, the development, dissemination, and use of meaningful methodologies for EMS outcomes research is key to the future of EMS system development and maintenance.

Aftercare↗

Longitudinal relationship among growth, nutritional status, and pulmonary function in children with cystic fibrosis: analysis of the Cystic Fibrosis Foundation National CF Patient Registry.

OBJECTIVE: To determine prospectively the relationship among growth, nutritional status, and pulmonary function over a 4-year period in a large cohort of children with cystic fibrosis (CF). STUDY DESIGN: CF Foundation National CF Patient Registry data collected from 1991 to 1995 for 968 children (507 male) aged 5 to 8 years with pancreatic insufficiency and forced expiratory volume in 1 second within 60% to 140% of predicted values (FEV(1)%) were analyzed longitudinally. Variables hypothesized to affect FEV(1)% included age, sex, z scores for height, weight, percent of height-appropriate body weight, and annual number of days hospitalized. RESULTS: The significant decline in FEV(1)% was curvilinear and dependent on baseline FEV(1)%; children with initial FEV(1)% > or = 90 declined 2.6 U/y more than those with initial FEV(1)% <90. Boys gained but girls declined in z scores for height. Girls decreased in z scores for weight at a greater rate than boys. The z scores for weight and percent of height-appropriate body weight were significantly associated with longitudinal changes in FEV(1)%, after adjustment was done for hospitalizations. CONCLUSIONS: Growth, nutritional status, and pulmonary function are not stable in prepubertal children with CF and pancreatic insufficiency. Important sex-related differences in growth occur before puberty. Growth and nutritional status are associated with changes in FEV(1)%, suggesting that nutritional intervention may slow the decline in pulmonary function in children with CF.

Body Height↗

First, build the foundations: practical considerations in general practitioner-mental health service liaison.

The co-working relationship between general practitioners and local mental health services lies at the heart of the success of recent changes in mental health care. These changes have seen large-scale deinstitutionalisation, a shift to primary and community care, and a government policy of prevention and partnerships. This article outlines a liaison project developed jointly by the South-East New South Wales Division of General Practice and the Southern Area Mental Health Service to address these issues. We describe the development of a protocol of basic standards which were practical, pragmatic and possible and, when fully established, would be the foundation of effective, efficient and efficacious shared care in mental health.

Australia↗

Foundations of "new" social science: institutional legitimacy from philosophy, complexity science, postmodernism, and agent-based modeling.

Since the death of positivism in the 1970s, philosophers have turned their attention to scientific realism, evolutionary epistemology, and the Semantic Conception of Theories. Building on these trends, Campbellian Realism allows social scientists to accept real-world phenomena as criterion variables against which theories may be tested without denying the reality of individual interpretation and social construction. The Semantic Conception reduces the importance of axioms, but reaffirms the role of models and experiments. Philosophers now see models as "autonomous agents" that exert independent influence on the development of a science, in addition to theory and data. The inappropriate molding effects of math models on social behavior modeling are noted. Complexity science offers a "new" normal science epistemology focusing on order creation by self-organizing heterogeneous agents and agent-based models. The more responsible core of postmodernism builds on the idea that agents operate in a constantly changing web of interconnections among other agents. The connectionist agent-based models of complexity science draw on the same conception of social ontology as do postmodernists. These recent developments combine to provide foundations for a "new" social science centered on formal modeling not requiring the mathematical assumptions of agent homogeneity and equilibrium conditions. They give this "new" social science legitimacy in scientific circles that current social science approaches lack.

Journal Article↗

Prospects for exploring the molecular-genomic foundations of therapeutic hypnosis with DNA microarrays.

A new perspective on how therapeutic hypnosis and neuroscience may be integrated on the molecular-genomic level is offered as a guide for basic research and clinical applications. An update of Watson and Crick's original formulation of molecular biology is proposed to illustrate how psychosocial experiences modulate gene expression, protein synthesis, and brain plasticity during memory trace reactivation for the reorganization of neural networks that encode fear, stress, and traumatic symptoms. Examples of the scientific literature on DNA microarrays are used to explore how this new technology could integrate therapeutic hypnosis, neuroscience, and psychosocial genomics as a new foundation for mind-body medicine. Researchers and clinicians in therapeutic hypnosis need to partner with colleagues in neuroscience and molecular biology that utilize DNA microarray technology. It is recommended that hypnotic susceptibility scales of the future incorporate gene expression data to include the concept of "embodied imagination" and the "ideo-plastic faculty" on a molecular-genomic level as well as the psychological and behavioral level of ideomotor and ideosensory responses that are currently assessed.

Brain↗

Engineering aesthetics and aesthetic ergonomics: theoretical foundations and a dual-process research methodology.

Although industrial and product designers are keenly aware of the importance of design aesthetics, they make aesthetic design decisions largely on the basis of their intuitive judgments and "educated guesses". Whilst ergonomics and human factors researchers have made great contributions to the safety, productivity, ease-of-use, and comfort of human-machine-environment systems, aesthetics is largely ignored as a topic of systematic scientific research in human factors and ergonomics. This article discusses the need for incorporating the aesthetics dimension in ergonomics and proposes the establishment of a new scientific and engineering discipline that we can call "engineering aesthetics". This discipline addresses two major questions: How do we use engineering and scientific methods to study aesthetics concepts in general and design aesthetics in particular? How do we incorporate engineering and scientific methods in the aesthetic design and evaluation process? This article identifies two special features that distinguish aesthetic appraisal of products and system designs from aesthetic appreciation of art, and lays out a theoretical foundation as well as a dual-process research methodology for "engineering aesthetics". Sample applications of this methodology are also described.

Equipment Design↗

The rationale and foundations of group psychotherapy for women with metastatic breast cancer.

Group psychotherapy has become an important modality of intervention in contemporary psychooncology. This article reviews and describes the rationale and foundations for group psychotherapy for women with metastatic breast cancer. It emerges from a replication study of an earlier study performed by Spiegel (Spiegel, Bloom, Kraemer & Gottheil, 1989), which demonstrated that participation in structured group psychotherapy resulted in improved psychosocial adjustment and a significant survival effect on women with metastatic breast cancer. Other intervention studies, psychosocial effects of psychosocial interventions, as well as psychosocial variables associated with the course of illness, are described. The contribution of existential considerations in psychotherapy is also articulated as a component of the group-supportive expressive intervention. Clinical illustrations, emerging from ongoing treatment groups, are used to demonstrate theoretical concepts.

Adaptation, Psychological↗

The empirical foundations of psychoanalytic approaches to psychological testing.

The view that psychoanalytic approaches to psychological testing lack empirical foundations is disputed by systematically examining the ways in which psychoanalytic theory expands the sources of data available to the psychological tester at each step in the assessment process. The contention is made that it is unscientific to restrict the concept of what constitutes scientific rigor to formal experimentation with statistical analysis.

Humans↗