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PubMed2006

Parenting interventions for children with autism spectrum and disruptive behavior disorders: opportunities for cross-fertilization.

Empirical support exists for parent training/education (PT/PE) interventions for children with disruptive behavior disorders (DBD) and autism spectrum disorders (ASD). While the models share common roots, current approaches have largely developed independently and the research findings have been disseminated in two different literature traditions: mental health and developmental disabilities. Given that these populations often have overlapping clinical needs and are likely to receive services in similar settings, efforts to integrate the knowledge gained in the disparate literature may be beneficial. This article provides a systematic overview of the current (1995-2005) empirical research on PT/PE for children with DBD and ASD; attending to factors for cross-fertilization. Twenty-two ASD and 38 DBD studies were coded for review. Literature was compared in three main areas: (1) research methodology, (2) focus of PT/PE intervention, and (3) PT/PE procedures. There was no overlap in publication outlets between the studies for the two populations. Results indicate that there are opportunities for cross-fertilization in the areas of (1) research methodology, (2) intervention targets, and (3) format of parenting interventions. The practical implications of integrating these two highly related areas of research are identified and discussed.

Autistic Disorder↗
PubMed1980

Psychosocial aspects of neoplastic disease. III. Group support for the oncology nurse.

The attitudes of oncology nurses to job-related concepts were assessed by the Semantic Differential List prior to beginning and following six months of weekly 1.5 hour psychodynamically oriented support group sessions. These attitudes were compared to oncology nurses not in the group experience during the same time span. The oncology nurses who had completed the group experience had more negative attitude shifts to the job-pertinent concepts and also showed a greater amount of attitude change in the negative direction than those oncology nurses not in the group. These findings point to the importance of denial in cancer center personnel and indicate that an educational model of group therapy may be more appropriate for this group of health professionals.

Adult↗
PubMed1994

Designing an integrated curriculum with a common core for an inter-disciplinary course in community nursing.

This paper presents a curriculum model for inter-disciplinary courses in community nursing. The concern that the development of these courses could produce a generic nurse, resulting in the loss of specialist skills and knowledge from nurse practice is addressed. The argument is made, that by examining the field of practice and the field of study of the various nurse groups, it is possible to design a curriculum which will ensure that what is distinct and special for each nurse group can be maintained, developed and extended, within an inter-disciplinary course. The field of practice examined here is community nursing, but the principles of curriculum design should be equally relevant to all the nursing profession.

Community Health Nursing↗
PubMed1994

The use of a curriculum model in an Accident and Emergency Department.

This paper describes the adaptation and use of Beattie's curriculum model in an Accident and Emergency (A/E) Department. The rationale behind the undertaking was to reduce the incongruity between the triangle of the college, A/E and the student that creates the theory-practice gap in the context of A/E nursing. The article discusses firstly the decision to use a curriculum model. Secondly the reasons for the choice of model and the factors influencing that choice are discussed. The difficulties in applying the model and teaching methods that may be employed are examined. Student evaluation and the difficulties encountered in implementing the model is the final avenue explored. The article concludes that the strength of Beattie's model in A/E lie in its eclecticism. By combining all four approaches, the practical and theoretical contexts become integrated and in doing so reduce the theory/practice gap between A/E, the college and the student. It also provides a sense of balance for both student and teacher alike, amalgamating the four design briefs with the differing teaching methods thus catering for both group and individual student's differing learning styles.

Clinical Competence↗
PubMed2004

Towards a learning networked organisation: human capital, compatibility and usability in e-learning systems.

In all parts of organisations there flourish developments of different new subsystems in areas of knowledge and learning. Over recent decades, new systems for classification of jobs have emerged both at the level of organisations and at a macro-labour market level. Recent developments in job evaluation systems make it possible to cope with the new demands for equity at work (between, for example, genders, races, physical abilities). Other systems have emerged to describe job requirements in terms of skills, knowledge and competence. Systems for learning at work and web-based learning have created a demand for new ways to classify and to understand the process of learning. Often these new systems have been taken from other areas of the organisation not directly concerned with facilitating workplace learning. All these new systems are of course closely interrelated but, in most organisations, a major problem is the severe lack of cohesion and compatibility between the different subsystems. The aim of this paper is to propose a basis for how different human resource systems can be integrated into the business development of an organisation. We discuss this problem and develop proposals alternative to integrated macro-systems. A key element in our proposition is a structure for classification of knowledge and skill to be used in all parts of the process. This structure should be used as an added dimension or an overlay on all other subsystems of the total process. This will facilitate a continued use of all existing systems within different organisations. We develop Burge's (personal communication) model for learning to show that learning is not a successive linear process, but rather an iterative process. In this way we emphasise the need for greater involvement of learners in the development of learning systems towards increased usability in a networked system. This paper is divided into two parts which are closely related. The first part gives an overview of the lack of compatibility between the different subsystems. In this first part we note two paradoxes which impact learning and for which we propose solutions. The second part deals with 'usability' aspects of these competency-related systems; in particular, usability in e-learning systems. In this second part we describe an example of a new organisational structure. We conclude by discussing four key concepts that are necessary conditions for organisations to address when developing their human capital. Establishing these conditions helps ensure compatibility and usability in e-learning systems.

Computer-Assisted Instruction↗
PubMed2006

Is the grass greener? A survey of female pediatric surgeons in the United Kingdom.

BACKGROUND/PURPOSE: Since 1990, at least 50% of UK medical school entrants have been females, although women comprise only 2% of surgical consultants. If women continue to reject surgical careers, recruitment will be limited to a decreasing pool of male applicants. A recent North American study suggested lack of mentorship and role models may be contributory factors. We undertook a survey of UK female pediatric surgeons to ascertain career satisfaction and professional development. METHODS: UK female pediatric surgeons were identified from the British Association of Pediatric Surgeons members' handbook 2004 and via personal communication. Postal or e-mail questionnaires were sent and anonymized responses were analyzed. RESULTS: Thirty-three questionnaires were distributed to all 16 female consultants (13% of BAPS consultant workforce) and 17 trainees (SpRs [specialist registrars/higher surgical trainees]). Twenty-seven (82%) replies were received. Of 27 (85%) respondents, 23 worked full time; "on-call" commitments range from 1 in 2 (2 consultants) to 1 in 8, with several trainees working shifts. Eighteen (67%) respondents had taken a career break-11 for maternity leave. Twelve (44%) are planning further "time-out," of whom 10 are SpRs. Ninety-three percent are contented with their career and would choose pediatric surgery again. However, 19 (70%) reported factors that had hindered their development, 13 (68%) included insufficient research time, whereas only 3 cited a lack of mentorship. CONCLUSIONS: Female representation in medicine is increasing. In contrast to North American experience, very few UK female pediatric surgeons felt hampered by lack of mentorship or role models. Education and training committees need to work proactively to ensure training programs achieve clinical excellence to continue to attract women into pediatric surgery. For women in the United Kingdom, pediatric surgery challenges will also be met by ensuring healthy "work-life balance," along with flexibility in training and established consultant practice.

Career Choice↗
PubMedDate not supplied

The Scholarship of Engagement in nursing.

We propose the time is right for the Scholarship of Engagement to serve as a model of scholarship in schools of nursing given the shift towards community-based research and the emphasis of community-based research in the recently published National Institutes of Health (NIH) roadmap initiative. Thus, this article addresses the need of nursing academe to embrace a broader paradigm of scholarship, the Scholarship of Engagement, in order to expand knowledge development via implementation of the NIH roadmap. The need for implementation of a broader paradigm of nursing science within the context of nursing academics' roles is discussed.

Benchmarking↗
PubMedDate not supplied

The Carolina nursing experience: a service perspective on an academic-service partnership.

There is a renewed interest in and commitment to the strengthening of academic-service partnerships. This article will explore the developing relationship between the University of North Carolina at Chapel Hill School of Nursing and the University of North Carolina Hospitals--an example of a research university/academic medical center arrangement. The roles of academic and service leaders will be presented in terms of both the formation and maintenance of the partnership. The benefits for the various stakeholders will be presented.

Academic Medical Centers↗
PubMed2004

Life-course experiences and mortality by adult social class among young men.

Circumstances over the life-course may contribute to adult social class differences in mortality. However, it is only rarely that the life-course approach has been applied to mortality studies among young adults. The aim of this study is to determine to what extent social class differences in mortality among young Finnish men are explained by living conditions in the parental home and life paths related to transitions in youth. The data for males born in 1956-60 based on the 1990 census records are linked with death records (3184 deaths) by cause of death for 1991-98, and with information on life-course circumstances from the 1970, 1975, 1980, and 1985 censuses. Controlling for living conditions in the parental home-social class, family type, number of siblings, language and region of residence-reduced the high excess mortality of the lower non-manual (RR 1.51, 95% CI: 1.28-1.79), skilled manual (RR 2.94, 2.54-3.40), and unskilled manual class (RR 4.08, 3.51-4.73) by 10% in all-cause mortality. The equivalent reduction for cardiovascular disease was 28% and for alcohol-related causes 16%. The effect of parental home on mortality differences was mainly mediated through its effect on youth paths (pathway model). Educational, marital, and employment paths had a substantial effect-independent of parental home-on social class differences from various causes of death. When all these variables were controlled for adult social class differences in cause specific mortality were reduced by 75-86%. Most of this reduction in mortality differences can be attributed to educational path. However, marital and employment paths had their independent effects, particularly on the excess mortality of unskilled manual workers with disproportionately common exposure to long-term unemployment and living without a partner. In summary, social class differences in total mortality among men in their middle adulthood were only partly determined by parental home but they were mainly attributable to educational, marital, and employment paths in youth.

Adult↗
PubMed1996

Reported pressure ulcer prevention and management techniques by persons with spinal cord injury.

OBJECTIVE: The purpose of this study was to identify factors that resulted in severe pressure ulcers in a community-based sample of 23 persons with spinal cord injury (SCI). DESIGN: A correlational design was used. SUBJECTS: Twenty men and three women, 57% with tetraplegia and 43% with paraplegia, participated. Adult participants with an ulcer of 12 weeks' duration or less were recruited from the plastic surgery clinic of a regional SCI center. MEASURES: A structured survey assessed demographic, SCI and ulcer characteristics; detection method; immediacy and appropriateness of action; time from detection to clinic visit; number of prior ulcers; and knowledge and practice of ulcer prevention techniques. Ulcer characteristics (ie, location, size, and stage) were assessed by examination and compared with participants' descriptions of their ulcers. RESULTS: Severe ulcers and ulcers that progressed in severity after initial detection were less accurately described by participants. Individuals who waited longer to come to the clinic presented with more severe ulcers. Taking immediate or appropriate action when an ulcer was detected was related to reported performance of more preventive behaviors. Contrary to expectation, immediacy and appropriateness of action, and knowledge and practice of preventive behaviors were unrelated to severity, progression of severity, and time from detection to the clinic visit. The findings suggest that educational programs should emphasize more strongly immediate visits to a physician upon detection of an ulcer. Furthermore, such educational models should be assessed for their effectiveness in reducing ulcers and preventing progression in severity once persons with SCI return to the community.

Adult↗
PubMed1997

The development of a training model to improve health professionals' skills, self-efficacy and outcome expectancies when communicating with cancer patients.

Health professionals such as doctors and nurses are in a key position to help reduce the high prevalence of affective disorders and psychological problems experienced by cancer patients. This role, however, is inhibited by ineffective communication practices which include the use of distancing strategies and avoidance by the health professional. A number of contributory factors such as skill deficits and anxiety about negative consequences for the patient and the health professional have been identified in previous research and brief problem-focused training workshops developed to address these factors with only limited success. Researchers in applied psychology have recommended that the development of training programmes and their evaluation are based upon approaches which take into account cognitive and affective factors as well as change in skills. The aim of this paper is to develop a conceptual model of communication behaviour in the cancer setting. The model aims to take account of the role that knowledge and skill deficits, self-efficacy and outcome expectancy beliefs and perceived support plays in the ability and willingness of health professionals to assess their patients' concerns. It has been applied to guide the development of a revised approach to brief, problem-focused workshops for health professionals. It also allows a systematic and multi-dimensional evaluation of training outcomes. Preliminary results indicate this is a promising area of communications research.

Clinical Competence↗
PubMed1982

Sources of support perceived by parents of children with cancer: implications for counselling.

Providing social support for families of pediatric cancer patients remains a challenge. The perceived helpfulness of 11 potential support sources was assessed by 107 parents of children with cancer. They rated the spouse, the medical community, and parents from a mutual help group as the most helpful. Mental health professionals and the church were seen less frequently and perceived as less helpful. No significant differences were found in the patterns of social support among parents with children in different stages of treatment. More than half the parents responding to a question on what they needed most during their children's illness mentioned emotional support and counselling. Mental health professionals may find that crisis/supportive and educative models and frequent contact are useful counselling approaches in dealing with families of cancer patients. A team approach to pediatric oncological treatment, consisting of a primary physician, nurse, and psychological consultant, may be a way to optimize the early and flexible involvement of psychosocial staff in total care.

Child↗
PubMed1999

Counseling model: creating a healing environment in hospitals.

There are ways in which more holistic approaches to medicine can be achieved through the establishment of alternative hospitals and health-care centers, as has happened in the United States, and changes in midwifery and care for the dying through a more compassionate approach and the use of prescriptive music. Transformations of medical care in The Netherlands are also taking place, with existing hospitals gradually developing more patient-centered approaches and organizations like the Helen Dowling Institute providing tailor-made forms of psycho-social counseling for those with cancer and life-threatening illness.

Counseling↗
PubMed2000

Substance misuse in Russia: a partnership for policy change and service development.

The paper provides an account of a joint project of education and training of doctors and nurses in St. Petersburg, funded by the Know How Fund Health Sector Small Partnership Scheme (Russia). Contextual material on substance misuse in Russia is introduced prior to focussing on the situation in St. Petersburg. Reference is made to historical and contemporary material and attention is drawn to the reliability of statistical data on alcohol and drug misuse. The aims of the project and the work carried out are outlined. The response of politicians, policy makers and health care workers to the changes in policy, provision and practice in St. Petersburg are discussed. Evidence from two evaluations is considered - an external evaluation for the project sponsors and an 'insider' evaluation. The latter utilised a framework developed by Cranfield and Stoneman. The paper concludes with a discussion of the tentative nature of education and training programmes, which involve issues regarding the suitability and transferability of educational models and therapeutic skills to a different culture.

Journal Article↗
PubMedDate not supplied

Transforming academic nursing: from balance through integration to coherence.

Academic institutions continue to be challenged to enhance their productivity in the face of diminishing resources. Escalating demands on full-time faculty must come from a fundamental transformation in the focus and, hence, design of that work. This article presents a model of a mission transformed from the current representation of the tripartite activities involved with teaching, research, and service to a new representation of the inherent holism of that work. This transformation moves the academy's mission to a single, integrative focus on knowledge work. When the essence of the academy's unique mission is expressed as knowledge work, the unity of knowledge development, dissemination, and application can be actualized in the work lives of a community of scholars. A fuller realization of the inherently holistic nature of this knowledge work is seen as a transformation to coherence at the levels of university, unit, and scholar. Coherence within the academic lives of individuals, the collective community of scholars, and the broader organization is the essential feature for the long-term success of the institution and the career of a scholar.

Efficiency, Organizational↗
PubMed1991

Psychosocial family intervention in schizophrenia: a review of empirical studies.

This paper reviews the recent empirical studies on psychosocial family intervention in schizophrenia. Six family educational intervention studies and five more intensive family work studies with 2-year follow-up have been included. A series of questions is asked relating to the effects of such interventions, the efficacy of the different educational models, the active ingredients of these multi-component treatment packages, and the contribution of this new generation of studies to our understanding of the mechanisms through which these interventions work. Suggestions for further research are made. Finally, from the published manuals, the common components of these diverse, multi-component treatment packages of different family-intervention studies are identified.

Combined Modality Therapy↗
PubMed2002

Measuring acculturation among Central American women with the use of a brief language scale.

The purpose of this study was to test the reliability and validity of a brief language usage scale as a measure of acculturation in 197 Central American immigrant women. This study presents an analysis of cross-sectional survey data collected during face-to-face interviews conducted in Spanish as part of the program evaluation of the Infant Feeding for Hispanic Supplemental Nutrition Program for Women, Infants, and Children (WIC) Populations a Peer Education Model. The Short Acculturation Scale, a four-item language usage scale exploring the participants' language preferences, was used as a measure of acculturation. The participant's age, length of time in the United States, and perceived social support for breastfeeding were used as validation measures. Results demonstrated good internal reliability for the acculturation summary scale. Consistent with previous studies, significant correlations (p < 0.01) were found between acculturation and mother's age, perceived social support for breastfeeding, and mother's length of time in the United States. The reliability and validity data from this group of Central American immigrants support the continued use of this brief measure of acculturation in diverse Latino subpopulations when multidimensional measures are neither practical nor feasible.

Journal Article↗