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PubMedDate not supplied

Addressing spiritual concerns in family medicine: a team approach.

Spiritual conflicts and concerns often accompany serious illness, but many family physicians are slow to recognize these concerns or unsure how to address them. The case of a patient with spinal cord injury and who later developed an astrocytoma is used to illustrate a team approach that involved a family physician, a spiritual counselor, and a psychologist. Narrative writing exercises in which the patient was encouraged to tell his own story also played a role in treatment. The case report includes the patient's own description of his experience with spirituality and spiritual counseling, as well as the perspectives of the spiritual counselor.

Adult↗
PubMed2004

Professional and veterinary competencies: addressing human relations and the human-animal bond in veterinary medicine.

PURPOSE: The purpose of this study was to determine the nature and degree of coverage of human relations and the human-animal bond in veterinary curricula across North America. The attitudes and opinions of a cohort of veterinary students and alumni about human relations skills and human-animal bond training in the veterinary program was also investigated. METHOD: Twenty veterinary schools across North America were contacted and data were collected regarding their coverage of human relations and the human-animal bond in the curriculum. A survey was developed to measure attitudes and opinions about this type of training. The survey was disseminated to students in years 1 to 4 and alumni from the Ontario Veterinary College (OVC). Data were analyzed descriptively. RESULTS: Based on availability of contact people, 20 schools in North America were contacted, and all participated in the study. Each of the veterinary schools surveyed has incorporated strategies for teaching human relations skills through required courses, electives, guest speakers, and/or community service programs. The overall participation rate for OVC students was 53%. Ninety-nine percent of all students surveyed agreed that their ability to deal with people using effective human relations skills was a concern, and all students said they would like to receive more training in this area. There was a 41% participation rate for OVC alumni. Fifty-five percent of alumni said they had learned enough in the veterinary program to employ effective human relations skills in practice, yet 65% felt they had not received enough instruction in addressing the human-animal bond specifically. CONCLUSIONS: It is apparent that veterinary schools recognize the need to prepare entry-level practitioners to deal with the human-animal bond and with human relations. It is also evident that students and practitioners value receiving information of this nature in the curriculum and desire further training. Specific learning objectives for veterinary curricula have been outlined based on findings from this study.

Adult↗
PubMed2005

ATLes: the strategic application of Web-based technology to address learning objectives and enhance classroom discussion in a veterinary pathology course.

A case-based program called ATLes (Adaptive Teaching and Learning Environments) was designed for use in a systemic pathology course and implemented over a four-year period. Second-year veterinary students working in small collaborative learning groups used the program prior to their weekly pathology laboratory. The goals of ATLes were to better address specific learning objectives in the course (notably the appreciation of pathophysiology), to solve previously identified problems associated with information overload and information sorting that commonly occur as part of discovery-based processes, and to enhance classroom discussion. The program was also designed to model and allow students to practice the problem-oriented approach to clinical cases, thereby enabling them to study pathology in a relevant clinical context. Features included opportunities for students to obtain additional information on the case by requesting specific laboratory tests and/or diagnostic procedures. However, students were also required to justify their diagnostic plans and to provide mechanistic analyses. The use of ATLes met most of these objectives. Student acceptance was high, and students favorably reviewed the online ''Content Links'' that made useful information more readily accessible and level appropriate. Students came to the lab better prepared to engage in an in-depth and high-quality discussion and were better able to connect clinical problems to underlying changes in tissue (lesions). However, many students indicated that the required time on task prior to lab might have been excessive relative to what they thought they learned. The classroom discussion, although improved, was not elevated to the expected level-most likely reflecting other missing elements of the learning environment, including the existing student culture and the students' current discussion skills. This article briefly discusses the lessons learned from ATLes and how similar case-based exercises might be combined with other approaches to enhance and enliven classroom discussions in the veterinary curriculum.

Computer-Assisted Instruction↗
PubMed1980

A nobleness of purpose. The 1980 AANS presidential address.

In the annual address, the President of the American Association of Neurological Surgeons reviews the responsibilities and the continued dedication of the members of the Society to the goals of excellence in patient care, education, and investigation. Insistence upon first-class standards of training has not waivered despite cynical impugnment of our motivation. Dividends of advantage to the general welfare can come from assistance in the design of enlightened legislation, in the assessment of the scientific basis and therapeutic value of various procedures, and in the support of rigorous training for neurosurgeons, fostering the development of excellent clinicians as well as investigators.

Attitude to Health↗
PubMed1991

Now is our time. The 1991 AANS presidential address.

The President of the American Association of Neurological Surgeons (AANS) in his presidential address discussed the challenges faced by neurosurgery today. He stressed three essentials to meeting the future: an effective and introspective organization; ample participation by the membership of the specialty; and a plan. He defined some of the problems before neurosurgery and the strategic planning process that has been undertaken during his presidency.

Forecasting↗
PubMedDate not supplied

Student assistance program: a new approach for student success in addressing behavioral health and life events.

College health centers, whether large or small, often find it challenging to provide counseling and supportive services for all students (including remotely located students) 24 hours a day, 7 days a week. Student assistance programs (SAPs) are services provided to students through a contractual arrangement to the university or college as a part of student services. The goal is to address psychosocial concerns that may interfere with academic performance within the realm of short-term counseling. These services range from traditional behavioral health concerns about stress and depressive reactions to how to find child care with foreign-speaking services. In this article, the authors describe a method to provide such short-term counseling to a 2,200-student health-science campus. They present data from 1 year of service as well as the benefits and limitations.

Counseling↗
PubMedDate not supplied

Addressing sexuality-related needs in practice: perspectives of maternal/child and women's health nurses.

A quantitative, descriptive survey was conducted using Waterhouse's instrument, Survey of Sexuality-Related Nursing Practice. The purpose of this study was to examine the extent to which maternal/child and women's health nurses address sexuality in their practice and to assess the influence of select variables on that practice. A sample of maternal/child and women's health registered nurses (n = 130) was systematically selected from the 1995 Association of Women's Health, Obstetric and Neonatal Nurses' (AWHONN) District VII mailing list. Findings reveal incongruities in maternal/child and women's health nurses' perspectives and the incorporation of sexuality-related nursing interventions into practice.

Adult↗
PubMed2006

Addressing the challenges of cardiorenal syndrome.

In heart failure, as the heart gets worse, often so do the kidneys, complicating the treatment of heart failure and worsening the prognosis. This article addresses challenges in the use of diuretics, angiotensin-converting enzyme (ACE) inhibitors, and other therapies in the cardiorenal syndrome, as well as novel therapies that hold promise, such as arginine vasopressin antagonists, adenosine A1 receptor antagonists, and ultrafiltration.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2005

A parent-driven, computer-based vaccine information system: addressing variability in information needs for the varicella vaccine.

OBJECTIVE: To determine the variability of parental interest in the depth of detail provided regarding vaccine information. PARTICIPANTS AND METHODS: We performed a cross-sectional, observational study in a primary care pediatric practice from September 1 to September 30, 1995. We provided each participant an opportunity to use a self-directed, computer-based information system using the varicella vaccine as a prototype. The system covered 7 topics regarding the vaccine and offered 5 stages of information, ranging from general, indisputable information at stage 1 to less common, potentially unresolved details at stage 5. Parents viewed stage 1 information for each topic. Parents would then choose to either view more stages or view the next topic. RESULTS: Of 130 parents visiting the pediatric practice, 112 (86%) agreed to participate. We found substantial variability in the amount of information sought. Some parents stopped with stage 1 information (15%-45%, depending on the topic), whereas others indicated they would seek more information beyond the fifth stage (2%-14%). Overall, parents reported high satisfaction with the system. CONCLUSION: Quantifiable variability exists in parents' requirements for vaccine information, and our information system addresses this issue.

Adult↗
PubMed2006

Improving the implementation of an early literacy program by child health nurses through addressing local training and cultural needs.

This study evaluates the implementation of an early literacy program by child health nurses (CHNs) in Geraldton and the Midwest regions of Western Australia. Children's early preschool exposure to reading is an important step in developing literacy skills in later schooling. The program aims to improve early literacy development by supplying parents with an appropriate book and information on reading to children at the child's seven-to-nine months of age health check. This study highlights the potential role of CHNs in encouraging early literacy in regional communities. However, a barrier to the successful implementation of the program was found to be its dependence on attendance at a predetermined health check. This was especially so for the Aboriginal population, which had a significantly lower attendance rate. Dependence on personal and professional experience amongst CHNs also resulted in sub-optimal implementation of the program. Recommendations to broaden the scope of the intervention, in timing and location, and to develop appropriate training for CHNs are discussed. It is shown that the implementation of such evidence-based programs must address local community and service provider issues to reach their full potential.

Attitude of Health Personnel↗
PubMed1999

Childhood obesity: addressing the issue.

Childhood obesity is a major health issue in pediatric practice. The old idea that "a chubby baby is a healthy baby" is not necessarily the case. Social stigmas and recidivism surrounding obesity make addressing families and their children difficult; however, with early intervention, treatment can be successful. Prevention of obesity with health maintenance surveillance and family-focused behavior modification is the foundation for a healthy lifestyle and may prove the most effective way of avoiding long-term obesity-related morbidity.

Adolescent↗
PubMed2002

A post-colonial analysis of healthcare discourses addressing aboriginal women.

Annette Browne and Vicki Smye use post-colonial theoretical perspectives to inform a critical analysis of healthcare discourses related to cervical cancer among Canadian aboriginal women. They also examine how decontextualised discourses addressing aboriginal women's risks for cervical cancer can perpetuate negative stereotypical images of aboriginal women while downplaying or ignoring the historical, social and economic context of women's health risks.

American Indian or Alaska Native↗
PubMedDate not supplied

Addressing nursing shortages in sub-Saharan Africa.

The desperate situation of the health workforce in sub-Saharan Africa (SSA) cannot be overstated. This has been a significant and confounding factor in the decline in life expectancy in a number of SSA countries. This article identifies the reasons for the global shortage of nurses and recommends actions to address the crisis in Africa.

Africa South of the Sahara↗
PubMedDate not supplied

Using the extended PLISSIT model to address sexual healthcare needs.

Sexual health is a holistic concept which encompasses much more than the prevention of infections and unwanted pregnancy. This article defines sexuality and sexual health before discussing the nurse's role in identifying and meeting patients' sexuality and sexual health needs. The Ex-PLISSIT model is proposed as a useful tool for nurses working in primary care to address sexuality and sexual health.

Communication↗
PubMed2003

Addressing the needs of lesbian, gay, bisexual, transgendered, queer, and questioning clients within university psychiatric services: reflections and recommendations.

Concerns still exist among lesbian-, gay-, bisexual-, transgendered-, and queer-identified individuals (LGBTQ individuals) about their reception and treatment by psychiatric service providers. The Psychiatric Service at the University of Toronto and the Office of LGBTQ Resources and Programs convened a committee to address expanding the capacities of the Service related to the needs of LGBTQ and questioning students. In this paper, we describe the committee's role, initiatives, and successes and discuss challenges encountered in the process. The model of community development drawn from in this work can be adapted for use in other community health settings.

Bisexuality↗
PubMed1998

Addressing Medicare coverage for biofeedback in the treatment of urinary incontinence.

Clinicians use biofeedback as a tool to assist in muscle re-education when treating patients with urinary incontinence. Although the literature on biofeedback suggests its effectiveness, it lacks consensus and data on the frequency and number of biofeedback sessions necessary. Patient selection for pelvic floor muscle exercise with and without biofeedback is also not clearly identified. Medicare carriers in 21 states have written policies that specifically recognize biofeedback in the treatment of urinary incontinence. In states with these policies, problematic issues include failure to recognize the appropriate biofeedback code, number of services recognized, and bundling other services with biofeedback. In states without a written policy, attention needs to focus on developing a local medical review policy. Clinicians can make a difference by understanding the factors hindering the process, including the inadequacy of the literature and confusion over muscle re-education and the role of biofeedback. There is a need to identify a standard that addresses the diversity of clinicians and their opinions. This article reviews urinary incontinence and the role of biofeedback, focusing on Medicare coverage and how clinicians can help develop local carrier policies to supplement the national policy.

Biofeedback, Psychology↗
PubMed1991

The human resource role in addressing the nursing shortage.

A new initiative on the part of hospital management is needed to involve itself and the HRD more actively in addressing the nursing shortage. Hospital management can provide organizational support, the HRD the needed leadership, and financial managers the measuring tools to adopt a retention posture or balanced solution approach. Ultimately, hospital management wants to know how increased expenditures on human resources, and specifically nurses, affect the bottom line. However, two points need to be mentioned. First, not all steps taken by the HRD will require a dollar investment (for example, improved communication), but they will need the attention and support of hospital management. Secondly, if hospital management is waiting for an exact, accounting-supported cost-benefit analysis that justifies additional expenditures on nurses, then the effort will probably never be made. It is difficult to show a cause-and-effect relationship between discretionary expenditures (such as research and development, advertising, employee training programs) and the bottom line.

Efficiency↗
PubMedDate not supplied

Planning for community benefit. A seven-step process helps providers define and address important needs.

The Catholic Health Association's (CHA's) Standards for Community Benefit ask Catholic healthcare organizations to show their commitment to addressing community needs. The standards call on providers to stress the importance of community service in a variety of contexts--from their statements of philosophy and values to the decisions made in their board and executive staff meetings. At the heart of the Standards for Community Benefit is the requirement that an organization's governing body adopt a community benefit plan. The community benefit plan can help orient staff, physicians, and volunteers to the facility's charitable role. A provider can also use a completed plan to elicit community members' views on the organization's interpretation of community needs, its priorities, and performance. Not-for-profit healthcare organizations can prepare a community benefit plan by completing the following steps: Restate the organization's mission and commitment Define the community being served Identify unmet community needs Determine and describe the organization's leadership role Determine and describe the organization's community service role Seek public comment on the plan Prepare a formal, written community benefit plan.

Catchment Area, Health↗