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At least 703 records · Page 39Linked to original sources
PubMed2002

Previous BFHI training and nurses' knowledge, attitudes and practices regarding exclusive breastfeeding.

The UNICEF/WHO Baby Friendly Hospital Initiative (BFHI) programme was developed to train health workers and equip them with the required knowledge and skills to protect, promote and support breastfeeding among mothers through the implementation of the "Ten Steps to Successful Breastfeeding". This study was conducted to assess the effect of BFHI training on knowledge, attitudes and support practices of nurses with regards to exclusive breastfeeding. A total of 298 nurses in maternal and child health care units were interviewed, of these 113 (37.1%) had participated in the BFHI training workshop. Significantly higher proportions of the BFHI trained nurses had the correct knowledge regarding the causes and management of common breastfeeding problems. The overall knowledge scores of the BFHI trained nurses was significantly higher than that of the untrained (11.9 +/- 1.8 versus 10.7 +/- 2.4 P < 0.01). Higher proportions of BFHI trained nurses reported correct support practices for the initiation and establishment of exclusive breastfeeding among mothers. The findings show that nurses who had participated in the BFHI training workshop were significantly more knowledgeable about some aspects of exclusive breastfeeding, they had more positive attitudes and were more likely to employ correct practices for the promotion of exclusive breastfeeding.

Attitude of Health Personnel↗
PubMed1978

The St John's randomized trial of the family practice nurse: health outcomes of patients.

From June 1975, to May 1976, in a large family practice in St. John's, Newfoundland, a randomized controlled trial was conducted to assess the effectiveness of a family practice nurse. Effectiveness was assessed using standardized health outcome measures of physical, emotional, and social function which could be applied easily and objectively by non-clinicians to the two groups of patients under study: patients receiving conventional care and patients receiving care from the family practice nurse. After establishing the comparability of these two groups of patients at the beginning of the study, these measurements showed similar levels of physical, emotional, and social function in the two groups after 1 year of receiving either family practice nurse or conventional care. These results agree with previous controlled trials of family practice nurses which have indicated that family practice nurses are effective and safe.

Adolescent↗
PubMed1999

GI endoscopic reprocessing practices in the United States.

BACKGROUND: Patient infection from contaminated gastrointestinal (GI) endoscopes can generally be attributed to failure to follow appropriate reprocessing guidelines. Recently, the Food and Drug Administration recommended a 45-minute exposure of GI endoscopes to 2.4% glutaraldehyde solutions heated to 25 degrees C. Simultaneously, the American Society for Gastrointestinal Endoscopy (ASGE), the American Gastroenterological Association, and the Society of Gastroenterology Nurses and Associates endorsed a reprocessing guideline that emphasized manual precleaning and recommended a 20-minute exposure to a 2.4% glutaraldehyde solution at room temperature. Since then, little information has become available regarding actual reprocessing practices in the United States. METHODS: A previously developed questionnaire regarding endoscopic disinfection practices was mailed to randomly selected members of the ASGE. RESULTS: The survey was sent to 730 members and 294 responded (40.3%). Appropriate manual cleaning (suctioning detergent through the accessory channel and brushing the channel and valves) is performed by 90.7% of respondents; 69.9% then use automated reprocessors for disinfection or sterilization. Glutaraldehyde is the most widely used chemical disinfectant; 85.3% use glutaraldehyde as one of their primary disinfectants. The most commonly used disinfection time with 2.4% glutaraldehyde is 20 minutes (83.9%) followed by 45 minutes (11.4%). Only 23.8% of users of 2.4% glutaraldehyde heat their solution; 59.6% of centers test disinfectant concentration daily or more frequently; 74.0% sterilize nondisposable forceps before use; 29.2% of centers re-use disposable endoscopic accessories (which are more frequently disinfected rather than sterilized). Twelve respondents reported cases of endoscopic cross infection. CONCLUSIONS: A significant minority of endoscopy centers still do not completely conform to recent ASGE, American Gastroenterological Association, and the Society of Gastroenterology Nurses and Associates guidelines on disinfection, and they may not be appropriately disinfecting GI endoscopes. Rigid adherence to recommended guidelines is strongly encouraged to ensure patient safety.

Data Collection↗
PubMed2000

Practice-related changes in lumbar loading during rapid voluntary pulls made while standing.

OBJECTIVE: To determine if five days of practice on a novel dynamic, multi-joint pulling task resulted in lower magnitudes of lumbar loading or a more consistent relationship between pulling force and lumbar loading. DESIGN: A repeated measures design compared how practice influenced the magnitude of lumbar torque and the correlations between lumbar torque and pulling force. BACKGROUND: Previous studies suggest that practice can decrease the magnitude of lumbar loading on simple manual material handling tasks, but it is unknown whether practice reduces lumbar loading for more complex tasks. Neither is it known whether the consistency of lumbar loading increases with practice. METHODS: Ten healthy adults practiced impulse-like horizontal pulls to targets equaling 20%, 40% and 80% of their estimated maximal dynamic pulling force over 5 days. Movements were unrestrained, other than keeping the feet flat on the ground. We used a four-segment, sagittal plane inverse dynamics model to compute lumbar, hip, knee, and ankle torques on days 1 and 5 from ground reaction forces and moments, pulling forces, and kinematics. RESULTS: An analysis of variance showed significant practice-related changes in lumbar torque at the time of peak pulling force (lumbar torque(peakPF)). The lumbar torque(peakPF) decreased for the 20% pulls, did not change for the 40% pulls, and increased for the 80% pulls. Two subjects showed a significant decrease in lumbar torque(peakPF) for all three force levels. Coefficients of determination between pulling force and lumbar torque (r(2)(PF,LT): a measure of the consistency of the relationship between these two variables) were significantly higher on day 5 than day 1. CONCLUSIONS: Practice on a novel pulling task changed the magnitude of lumbar torques and increased their correlation with pulling force, suggesting that subjects learned strategies that improve motor control of lumbar torques. Relevance The study showed that the magnitude and consistency of lumbar loading changed spontaneously as subjects practiced a novel multijoint pulling task. Such changes may decrease the risk of low-back injury.

Adult↗
PubMed1998

An experimental evaluation of recent electron dosimetry codes of practice.

As from the 1 January 1997, the recent IPEMB code of practice for electron dosimetry is the recommended protocol for electron beam dosimetry in the UK, replacing the previous HPA code of practice and its IPSM addendum. New recommendations for electron beam dosimetry have also been formulated recently by the AAPM and the IAEA on the use of parallel-plate ionization chambers in high-energy electron beams. Against this background, the procedures recommended in each of these codes of practice have been followed from intercomparison of the field instrument ionization chamber with a secondary standard through to the determination of absorbed dose at the reference position in the electron beam. Absorbed doses have been determined for a number of electron beam energies ranging from nominal 5 MeV through to 17 MeV, and for four different types of field instrument ionization chamber: an NE2571 graphite walled cylindrical chamber; an NACP parallel-plate chamber; a Markus parallel-plate chamber; and a Roos parallel-plate chamber. The differences in the determination of absorbed dose between the IPEMB protocol and the HPA/IPSM protocol vary from +0.5% to +1.6% at the depth of maximum dose. In addition the IPEMB measured doses are 0.2% larger than those measured following the IAEA code of practice. It may also be stated that the IPEMB measured doses at the depth of maximum dose are up to 1.5%, but generally less than 1.0%, lower than those measured by the AAPM protocol.

Calibration↗
PubMed2001

The readiness of New Zealand general dental practitioners for medical emergencies.

A risk of medical emergency accompanies every dental procedure, but little is known of general dental practitioners' readiness for such events. The few previous studies have shown that nearly all dentists have received training in medical emergencies at some time, most of this training being postgraduate. Up to 20 percent of dentists have reported feeling inadequately prepared for medical emergencies, and most are receptive to the idea of receiving further medical emergency-related training. We conducted a postal survey of 314 dentists concerning their readiness for, and experience of, medical emergencies within general dental practice; 199 dentists (63.4 percent) responded. Medical emergencies had occurred in 129 practices (65.2 percent) within the previous 10 years, at a mean rate of 2.0 events per 10,000 patients treated under local analgesia, other forms of pain control, or sedation. Vaso-vagal events had occurred in 121 (61.1 percent) practices within the previous year, the mean rate being 6.9 events per 10,000 patients treated using the same modes. More than half the respondents were dissatisfied with the training they had received for medical emergencies as undergraduate students, and 28 (14.1 percent) currently felt inadequately prepared for an emergency in practice. When asked how their preparedness could be improved, 165 (83.3 percent) opted for hands-on courses, 15 (7.5 percent) opted for lectures alone, and 5 (2.5 percent) opted for other courses alone. One in 20 felt no need for further training. Further training in the management of medical emergencies should be made available to New Zealand's dentists.

Cardiopulmonary Resuscitation↗
PubMed1996

Medical referrals for hypnotherapy: opinions of physicians, residents, family practice outpatients, and psychiatry outpatients.

Previous studies surveying attitudes and education regarding the clinical use of hypnosis have been conducted with patient populations only. The current study was undertaken to assess the attitudes, experiences, training levels, and interest in future education regarding the use of hypnosis by staff physicians, medical resident physicians, family practice outpatients, and psychiatry outpatients. All subjects were drawn from a 400-physician group practice in Central Texas affiliated with a large university health science center. Results indicate that the majority of physicians (79%) and residents (67%) had received no prior training and even fewer had experienced hypnosis. The percentages for personal experience with hypnosis were similar for psychiatric outpatients, physicians, and residents. The need for patient and practitioner education was elucidated by the high rate of endorsement of misconceptions regarding hypnosis by patients (over half) and by some medical practitioners as well. Limited awareness of the appropriate applications of hypnosis was reported. However, 85% of practitioners expressed an interest in hypnosis education. Further research in medical setting demographics is recommended to validate generalizability of results and facilitate construction of medical education programs in hypnosis.

Adolescent↗
PubMed2005

The Primary Care for the Underserved Conference as a building block to social capital: impact on practice, research, and education.

A previous article traced the evolution of the Primary Care for the Underserved Conference into a new professional culture (Beauchesne & Patsdaughter, 2005). This article focuses on the relevance of the conference series as a building block of social capital. The authors critically examine the impact of the conference on health care practice, research, and education. The authors analyze two sources of data (conference evaluation and email surveys) using a descriptive, qualitative approach. Findings support the conference as a significant source of social capital for health professionals. The article includes an exemplar describing the impact of this conference on individual practitioners.

Congresses as Topic↗
PubMed1990

Quantitation of the criticality of chiral centers toward stereoselective recognition: epimeric eudismic analysis of 1,3-oxathiolane muscarinic agonists and antagonists.

Recently published data on the affinities of 14 pairs of chiral ligands, (1,3-oxathiolanes) for muscarinic receptors in three different tissues were subjected to eudismic analyses. The enantiomeric eudismic-affinity correlations (EACs) found by Gualtieri et al. were confirmed and extended to the submolecular level: (1) regressions of the eudismic index (log affinity ratio; EI) against eutomer potency of the average affinities were highly significant, indicating that the binding sites in all three tissues are identical; (2) for the five agonists the EAC was shifted to lower affinities and had a small slope (EAQ), in agreement with previous observations in other systems; (3) of the nine antagonists, six gave an excellent regression with unit slope, practically superimposable on that previously obtained for 10 structurally different oxotremorine derivatives, while two others (1,3-oxathiolanes) could be plotted on a separate line with the same EAQ, but shifted to higher affinities; (4) the aberrant low EI of the last antagonist could be explained in terms of its structure. Furthermore, an epimeric EAC (EEAC) revealed additional important information for quantitative stereo-structure-activity relationships (QSSAR): the 25 possible epimeric comparisons were found to group into 6 different EACs in accord with differences in their structure: (1) the agonists fell on three separate lines of nearly identical (unitary) slope, which grouped cleanly in terms of the center of epimerization (positions 2, 3, and 5); (2) the antagonists of lower affinity fell on three lines with a common X-intercept but with different slopes corresponding to epimerization at the different centers of chirality, indicating that these display quantitative differences in their criticality toward stereoselective recognition; (3) the remaining two antagonists of higher affinity fell on a separate line, again of unit slope.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2002

Coordination deficits on the ipsilesional side after unilateral stroke: the effect of practice on nonisodirectional ipsilateral coordination.

Previous studies have identified motor deficits on the ipsilesional side of patients recovering from a cerebro-vascular accident (CVA), including deficits in interlimb coordination. In the present study, unilateral stroke patients and a control group of healthy age-matched controls performed nonisodirectional coordination of the ipsilateral limbs across two days of practice with feedback. Findings revealed that control subjects were already quite successful at initiation of practice but further improved the coordination pattern across both days. The group of CVA patients also showed some improvement but problems with coordination of the ipsilateral limb segments persisted across practice. Variability in both timing and amplitude of both limb segments did improve with practice in both groups but these measures remained significantly higher in the CVA patients. Even though isodirectional and nonisodirectional coordination of the ipsilateral limb segments are normally considered to be part of the intrinsic motor repertoire, the present study suggests that nonisodirectional ipsilesional limb coordination poses considerable difficulties for CVA patients that are not easily overcome with feedback-assisted practice.

Aged↗
PubMedDate not supplied

Persistence of personal health practices over a 1-year period.

A large amount of research has been devoted to identifying the psychosocial and demographic correlates of personal preventive health practices. An additional factor to consider, however, is the stability of personal health practices over time. At least over short periods, the prediction of current behavior may be substantially improved by having information about an individual's previous performance of the practice being studied. To address this question, data from Wave 1 (1979) and Wave 2 (1980) of the National Survey of Personal Health Practices were examined. Using nine health practices as indices, performance reported at Wave 1 was used to predict performance of that same practice as reported at Wave 2, 1 year later. A two-step analysis strategy was followed to estimate how much more variance could be explained when the behavioral reports were added to a list of psychosocial and demographic predictors. Results showed that over the 1-year interval, the Wave 1 behavioral reports were by far the strongest predictors of their corresponding measures obtained at Wave 2. The explained variance was increased substantially for most of the nine health practices, suggesting a strong tendency for persistence of the practices. Psychosocial and demographic variables tended to account for much smaller amounts of variance and often dropped out of the prediction equation when the Wave 1 behavior report was entered in the second step of analysis. Health practices other than the corresponding Wave 1 index did not improve prediction of the Wave 2 index greatly. The tendency for previous behavior to persist may overshadow the influence of other factors and account for the modest amounts of explained variance that are usually found for psychosocial and demographic indices in cross-sectional surveys. Although stability does not imply rigidity or impossibility of change, the strength of prediction found in these data attest to the "force of habit" that community interventions can encounter.

Adult↗
PubMed1997

Acting at a disaster site: experiences expressed by Swedish nurses.

In a previous study the knowledge and views of nursing students on how they thought nurses, both in their professional role and as private persons, should act at a disaster site were evaluated. In the present study the practical functional role and experiences of nurses (n = 16) in two major disaster situations (one 'load and go' and one 'stay and play' type of emergency situation) were assessed from personal interviews along a standardized questionnaire. Nurses more routinely involved in emergency care and nurses with no or limited previous practical experience of disaster nursing were included in the study. Leadership-type actions, i.e. a systematic way of attempting to survey and to comprehend the situation, what has happened, and how many injured there may be at the site of the accident, were reported by most of the experienced nurses, while inexperienced nurses were involved mainly in the immediate care of injured according to directions given by more experienced members of the emergency team. Readiness for action, reflected by having a feeling of being prepared for work at the disaster site, was experienced more often by nurses with considerable previous experience of disaster nursing than by nurses with limited experience. Negative experiences, such as feelings of being insufficient, of unreality, mental strain, and problems in understanding the organization, were commonly mentioned by the inexperienced nurses. The present study stresses the importance, for all types of nurses, of more systematic training in disaster nursing.

Adult↗
PubMed1995

Family practice bashing as perceived by students at a university medical center.

BACKGROUND AND OBJECTIVES: Medical schools are being asked to produce more family physicians, but it is not always clear how this can be accomplished. Previous research has focused on students' characteristics and attitudes that predict specialty choice but has paid less attention to feedback they receive in the academic medical center environment. METHODS: In early 1993, a self-administered questionnaire was mailed to 160 students from all classes of the University of California, San Francisco Medical School who had previously shown interest in family practice. Data are shown for the 138 respondents. RESULTS: Most students from all years had received positive feedback about their interest in family practice, usually from family physicians. By the fourth year, 95% of students had received negative feedback, usually from physicians in other specialties. Many students gave poignant examples of pejorative comments about family practice by faculty and house staff. Negative feedback seemed strongest at the time students were making decisions about residency. By the fourth year, only 39% of these previously interested students chose family practice. CONCLUSION: Serious efforts to encourage students to enter family practice must address the problem of negative feedback from other specialties. To promote positive feedback, contact with family physicians should be increased, especially in the third and fourth years.

Academic Medical Centers↗
PubMed1988

Increasing patient participation using an extended consultation: an inner city study.

An inner city practice in Birmingham has developed a new style of extended consultation to increase patient participation in primary care, based on previous initiatives in the practice, in particular allowing patients access to medical records, adopting an open reception style, and including consultations with a nurse practitioner. In a three stage consultation lasting approximately 30 minutes patients were offered a session with a receptionist for assisted access to medical records, a session of 15-20 minutes with a doctor or nurse and a self help session with a receptionist. This extended consultation was welcomed by patients, who showed a marked degree of participation, and it also increased the satisfaction and cooperation of project staff. This type of consultation provides a model for increasing patient participation in general practice.

Appointments and Schedules↗
PubMed2004

Practice of and attitudes toward breast self-examination (BSE): a cross-cultural comparison between younger women in Scotland and Greece.

Breast self-examination (BSE) is a method of early detection of breast cancer. Although BSE is recommended for all women, it is mostly suitable and readily available for younger women. BSE beliefs and practices of women in Scotland, a country with organised health campaigns about BSE, were compared with those of women in Greece, a country without such campaigns. Our sample consisted of 68 university students in Scotland and Greece, aged 18 to 26 years old. All participants completed a questionnaire assessing demographics, health history, knowledge, BSE practice, health beliefs, and health-related personality. BSE practice was found to be associated with different variables across the two cultural groups. Adherence rates were found particularly higher than previous reports and BSE practice did not differ significantly between women in Scotland and Greece. Nevertheless, the two groups differed significantly in their knowledge, attitudes toward BSE, and health-related personality. On the basis of these findings, cultural factors should be considered in organising BSE campaigns. Also the present findings identified BSE-related beliefs and practices specific to younger age groups. These could be considered and addressed in order to organise BSE campaigns in Greece and improve future UK programs especially tailored for this age group.

Adolescent↗
PubMed1993

Relation between night visit rates and deprivation measures in one general practice.

OBJECTIVE: To compare night visit rates in different electoral wards of one general practice with the Jarman and Townsend deprivation scores and unemployment rates. DESIGN: Analysis of computerised workload data. SETTING: General practice in centre of Mansfield, Nottinghamshire. OUTCOME MEASURE: Visits made in 588 nights to the 11,998 patients on the practice list. RESULTS: Night visit rates in 15 electoral wards varied from 19.6 to 55.3 visits per 1000 patients per year. The rates showed a significant association with the Townsend score (p = 0.004) and the unemployment rate (p = 0.03) but not with the Jarman score (p = 0.3). The Townsend score explained 49% of the variability; unemployment explained 31% and the Jarman score explained 9%. CONCLUSIONS: Even in a general practice not eligible for deprivation payments there was a 2.8-fold variation in night visit rates between wards. In this practice the Townsend score was significantly better at predicting night visit rates than the Jarman score. This method of looking at internal variation in workloads in computerised practices could give more direct data on the relation between deprivation and general practice workload than has previously been available.

England↗