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At least 829 records · Page 46Linked to original sources
PubMed2000

[Does geriatric rehabilitation need a psychosocial foundation?].

In view of the differentiality and multidimensionality of ageing, especially with regard to geriatric rehabilitation, a look at psycho-social and also the environmental context is indispensable. Above all there are mental and social components that hide the physical consequences of acute incidents and that lead to a reduction in the quality of life. Yet it is a widespread opinion that expansion and the level of health care, in geriatry and in rehabilitation, are nowadays oriented toward what is seen to be medically necessary and economically feasible. Increasing mechanization, rationalization, standardization, and economizing are unambiguous indicators. All the other mental and social needs are problems ranking much lower in the health provision policy as well as in geriatric rehabilitation, and are still far behind the medical and economic requirements set by professional therapists, the health provision policy and the question of who pays for the benefits. However, in consideration of the available knowledge of gerontology, rehabilitation as well as health and nursing sciences and--above all--for humanitarian reasons a psycho-social foundation for geriatric rehabilitation seems to be indispensable.

Activities of Daily Living↗
PubMed2000

Osteoporosis. An overview of the National Osteoporosis Foundation clinical practice guide.

During the past decade, numerous organizations and associations have published recommendations for the prevention and treatment of osteoporosis. For the primary care physician, the most applicable of these--due to its reliance on clinical trial data and its scope--is the clinical guide published by the National Osteoporosis Foundation. The guide addresses risk assessment, bone mineral density testing, diagnosis, nutritional supplementation, and pharmacologic therapy, including consideration of the newer agents used to slow or manage osteoporosis progression. Reflecting one of the key deficiencies in the clinical trial data, the guide applies predominantly to a patient population of postmenopausal white females. The refined design of new osteoporosis studies will in time allow for recommendations that apply to a more diverse patient population.

Accidental Falls↗
PubMed2000

[The foundation for psychiatric treatment--from belief to science].

Like other clinical disciplines, psychiatry has been met with increasing demands to document the scientific foundations for its treatments. The introduction of evidence-based medicine has contributed to this. Psychiatry holds a unique position compared to other medical specialties because it deals not only with physical or biological matters, but also with questions of meaning and mental phenomena. The scientific and clinical approach to psychiatry must incorporate both these aspects. This cannot be accomplished through a purely hermeneutic or a purely relativistic position. In isolation, these approaches cannot contribute to bridging the gap between research and clinical practice. Evidence-based medicine, on the other hand, through a stronger emphasis on empirical scientific evidence as the basis of treatment methods, enables us to secure better and safer therapies for our patients and augment the professional status of psychiatry. A critical attitude towards established "truths" will prevent stagnation in static or dogmatic positions, and thereby promote continuous development. Quality assurance and scientific validation is basically a question of ethics, hence we cannot avoid attending to these issues.

Controlled Clinical Trials as Topic↗
PubMed2000

The Kaiser Family Foundation Community Health Promotion Grants Program: findings from an outcome evaluation.

OBJECTIVES: To present results from an outcome evaluation of the Henry J. Kaiser Family Foundation's Community Health Promotion Grants Program (CHPGP) in the West, which represented a major community-based initiative designed to promote improved health by changing community norms, environmental conditions, and individual behavior in 11 western communities. METHODS: The evaluation design: 14 randomly assigned intervention and control communities, 4 intervention communities selected on special merit, and 4 matched controls. Data for the outcome evaluation were obtained from surveys, administered every two years at three points in time, of community leaders and representative adults and adolescents, and from specially designed surveys of grocery stores. Outcomes for each of the 11 intervention communities were compared with outcomes in control communities. RESULTS: With the exception of two intervention communities-a largely Hispanic community and a Native American reservation-we found little evidence of positive changes in the outcomes targeted by the 11 intervention communities. The programs that demonstrated positive outcomes targeted dietary behavior and adolescent substance abuse. CONCLUSIONS: Improvement of health through community-based interventions remains a critical public health challenge. The CHPGP, like other prominent community-based initiatives, generally failed to produce measurable changes in the targeted health outcomes. Efforts should focus on developing theories and methods that can improve the design and evaluation of community-based interventions.

Adolescent↗
PubMed2000

[Optimizing antibiotics policy in the Netherlands. V. SWAB guidelines for perioperative antibiotic prophylaxis. Foundation Antibiotics Policy Team].

The Stichting Werkgroep Antibioticabeleid (SWAB, Foundation Antibiotics Policy Team) has issued guidelines for perioperative antibiotic prophylaxis in Dutch hospitals. Antibiotic prophylaxis is generally recommended for surgical procedures with relatively high postoperative infection rates and those in which consequences of infection are really serious. Studies have revealed that prophylaxis given within two hours before incision is most effective. Short-term, preferably single-dose prophylaxis, is as effective as multiple-dose prophylaxis in most procedures. For reasons of cost effectiveness and prevention of induction of resistance, single-dose prophylaxis is recommended. The antimicrobial agent of choice for perioperative prophylaxis should not be widely used as a therapeutic agent, should be selectively active against micro-organisms most frequently isolated from surgical site infections, and should have a plasma-half-life that makes single-dosing possible for most operations. Therefore cefazoline is an agent that is widely used for perioperative prophylaxis.

Antibiotic Prophylaxis↗
PubMedDate not supplied

Collaborating with the consortium: the development of a foundation in critical care skills programme.

This paper outlines the role and function of NHS education and training consortia and how one consortium is addressing the issues of supporting practitioner-led, practice-based training initiatives in critical care. In late 1997 the consortium sought to identify current problems with recruitment and retention of competent critical care nurses, access to training and development and to examine the quality and appropriateness of current pre- and postregistration training related to the critical care areas. A number of issues were identified, with the need for a Foundation in Critical Care Skills Programme' for junior nurses as the principle short term priority. A programme supported by the local consortium, in collaboration with seven NHS trusts' critical care areas (totalling 27 different departments/units), has been developed, incorporating skills workshops, completion of open learning materials, assessments of core competencies and the submission of a portfolio of evidence in support of a professional award (ENB Certificate). The importance and value of collaboration in the development of this practitioner-led consortium-supported venture is highlighted.

Cooperative Behavior↗
PubMed2001

The impact of psoriasis on quality of life: results of a 1998 National Psoriasis Foundation patient-membership survey.

BACKGROUND: Psoriasis can have a profound impact on a patient's quality of life. OBJECTIVES: To assess patients' perspectives on the impact of psoriasis on their lifestyle and emotional well-being and the social ramifications of living with the disease; to determine the range of therapies available; and to ascertain patients' satisfaction with the management of their disease. DESIGN: A 4-page, self-administered questionnaire was mailed on July 13 and 14, 1998, to the entire membership of the National Psoriasis Foundation (N = 40 350), and followed by a telephone survey of responders with severe psoriasis. MAIN OUTCOME MEASURES: Patients' perspectives on the psychosocial impact of psoriasis and the effectiveness of the management of their disease. RESULTS: Of the 40 350 questionnaires mailed out, a response rate of 43% was realized. The most frequent symptoms experienced by the mail-survey respondents were scaling (94%), itching (79%), and skin redness (71%); 39% reported that psoriasis covered 10% or more of their bodies. A total of 6194 patients with severe psoriasis were entered into the database for the telephone survey. Of these, 79% reported that psoriasis had a negative impact on their lives, 40% felt frustrated with the ineffectiveness of their current therapies, and 32% reported that treatment was not aggressive enough. CONCLUSIONS: The unprecedented response to the survey provides compelling evidence that individuals with psoriasis believe that the disease has a profound emotional and social as well as physical impact on their quality of life. Many patients with psoriasis, particularly those with severe disease, are frustrated with the management of their disease and by the perceived ineffectiveness of their therapies. Physicians may need to improve communication with their patients and should reevaluate their management of psoriasis.

Activities of Daily Living↗
PubMed2000

Money and microbes: Robert Koch, tuberculin and the Foundation of the Institute for Infectious Diseases in Berlin in 1891.

Starting from an assessment of how far Robert Koch's bacteriology had developed in the late 1880s this paper attempts to analyse different aspects of the process that led to the foundation of the Berlin Institute for Infectious Diseases in 1891. With the development of his supposed cure against tuberculosis, tuberculin, Koch attempted to give his research a new direction, earn a fortune with the profits and become more independent of Prussian government officials who, up to that point, had had a major influence on his career. In the period following the presentation of the cure in autumn 1890, however, it became clear that tuberculin's value in treatment was at most dubious. Thus, the failure of tuberculin meant that Koch had to drop his own plans and accommodate those of the Prussian Ministry of Culture. As a result he assumed directorship of the newly founded Institute for Infectious Diseases in Berlin. Even though this was definitely a prestigious position it reaffirmed Koch's dependency on Prussian government officials and was by no means the kind of institution he had aimed for at the outset.

Academies and Institutes↗
PubMed2001

The Stanley Foundation Bipolar Network. 2. Preliminary summary of demographics, course of illness and response to novel treatments.

BACKGROUND: The Stanley Foundation Bipolar Network (SFBN) evaluates treatments, course and clinical and neurobiological markers of response in bipolar illness. AIMS: To give a preliminary summary of emerging findings in these areas. METHOD: Studies with established and potentially antimanic, antidepressant and mood-stabilising agents range from open case series to double-blind randomised clinical trials, and use the same core assessment methodology, thereby optimising the comparability of the outcomes. The National Institute of Mental Health Life Chart Method is the core instrument for retrospective and prospective longitudinal illness description. RESULTS: The first groups of patients enrolled show a considerable degree of past and present symptomatology, psychiatric comorbidity and functional impairment. There are associations of both genetic and early environmental factors with more severe courses of illness. Open case series with add-on olanzapine, lamotrigine, gabapentin or topiramate show a differential spectrum of effectiveness in refractory patients. CONCLUSIONS: The SFBN provides important new data for the understanding and treatment of bipolar disorder.

Adult↗
PubMed1975

Computer generated track and field scoring tables: II. Theoretical foundation and development of a model.

An investigation is made into the subject of scoring tables for track and field with emphasis on the application of computers to calculate and output the tables. The resulting scoring tables represent an attempt to describe the effective quality of performance for track and field events. This paper is published in three parts. The first portion reviewed the historical development of scoring tables. This part concerns the theoretical foundation and development of a mathematical model. A set of underlying principles and construction guidelines are established as a basis for all scoring tables. In order to satisfy the goals, a model which includes an exponential term is developed. The concept of a zero offset is introduced as a boundary value for the low-level performances. The final part concerns an evaluation of the model and an analysis of the point scores for different events.

Computers↗
PubMed1994

Theoretical foundation, goals, and methodology of a new science--biospherics

Scientific endeavor is motivated by mankind's needs, desires, and inherent nature to explore. The history of scientific revolutions involves paradigmatic breakthroughs that uncover previously unknown perspectives by which a phenomenon can be viewed. In this issue a noted scientist, Nickolai Pechurkin, gives a seminal brief on the theoretical foundation, goals, and methodology leading to a new science--biospherics. While biospherics has so far eluded a simple definition, it is not something taken from "whole cloth." Biospherics has many antecedents, but most noticeably arises from the global scale research and theory associated with the technological advances of the Space-Age. The Space-Age also created the need for totally closed life-support systems which involve experimentation with artificial biospheres.

Biological Evolution↗
PubMed1995

[Discord between the Department of Defense and Toko on the foundation of the Bureau of the Army Doctors].

The relation between the Department of Defense and Toko was not intimate before the Bureau of Army Doctors, his relation to Toko was also not smooth. and then he had to employ the army doctors from the organization other than Toko. I pointed out that the transfer of the higher army doctors to the Bureau of the Army Doctors was done not just after its foundation, as it was said before, but in 1874, after the normalization of the relationship of the two.

Employee Grievances↗
PubMed2001

Data-driven practice improvement: the AANA Foundation closed malpractice claims study.

Research in anesthesia risk management has focused primarily on adverse patient outcomes. Most risk management studies have evaluated the practices of the physician anesthesiologist, while minimal research has been conducted to examine anesthesia care provided by Certified Registered Nurse Anesthetists (CRNAs). For this reason, the American Association of Nurse Anesthetists Foundation supported an examination of closed malpractice claim files from St Paul Fire and Marine Insurance Company that involved insured CRNAs. A team of 8 CRNA researchers investigated 223 closed claim files that involved incidents from 1989 to 1997. The results indicated that preoperative physical status, patient age, surgical procedure, type of anesthetic, age of anesthesia provider, and the type of anesthesia providers, (e.g., CRNA alone vs CRNA and anesthesiologist working together) did not have a statistically significant relationship with adverse anesthetic outcomes. However, providing appropriate care, being vigilant, encountering a less severe adverse outcome, and not being able to prevent the outcome were associated with smaller monetary awards. The findings of this study support those of similar studies.

Adolescent↗
PubMed2001

Office design and technology placement: fundamental foundations.

Build technology infrastructure on a solid foundation. Outline the technology vision, determine the budget, research products and vendors, plan a practical installation and support your investment with training. Reap the rewards of today's dental technologies by establishing your practice as high technology yet soft touch.

Capital Financing↗
PubMed2000

The Brain Tumor Foundation of Canada: the role of facilitators for its support groups.

The mission of the Brain Tumor Foundation of Canada is to fund brain tumor research, to provide patient and family support services, and to educate the public. The focus of this paper is on the role of support groups. Support groups are an important resource to support individuals with brain tumors and their families. There is an ongoing need for qualified professionals to act as facilitators for these groups. Neuroscience nurses are uniquely qualified for this role.

Academies and Institutes↗
PubMed2001

Critical theory: critical methodology to disciplinary foundations in nursing.

Increasingly in the nursing literature, theorists have examined the use of critical theory in nursing (especially as understood by Habermas) and many have advocated it as a research approach to guide knowledge development in nursing. There has been limited analysis, however, of critical theory's broader foundational implications for the discipline of nursing. Part of the difficulty stems from a failure to differentiate between the implications of Habermas's earlier work on knowledge interests and his later theory of communicative action. In this paper, Habermas's critical theory is explored along two dimensions: as a metatheoretical account of a methodology of critical theory as a research tradition; and as a theory of communicative action whose dialogical and normative assumptions have profound implications for a postfoundationalist grounding of nursing as a discipline and professional practice. The authors argue that critical theory is necessary for nursing and may be sufficient as a paradigmatic philosophical base for the discipline.

Communication↗
PubMed2002

The AANA Foundation closed malpractice claims study: obstetric anesthesia.

The purpose of this study was to evaluate the anesthesia care provided during obstetric adverse events. Malpractice claims filed against nurse anesthetists for care involving obstetric anesthesia (n = 41) were extracted from the American Association of Nurse Anesthetists Foundation Closed Claim database. The events represented in the claims occurred from 1990 to 1996 and represented anesthetics provided by both anesthetists and anesthesiologists. Risk factors for adverse outcomes identified in this study included advanced maternal age, ethnicity, and obesity. Patients requiring emergency cesarean sections under general anesthesia were found to be at considerable risk for sentinel events. The most common adverse outcome in the obstetric closed claim database was neonatal death (n = 11 [27%]), followed by maternal death (n = 9 [22%]) and complications resulting from regional anesthesia (n = 8 [20%]). The leading cause of maternal death and brain damage was a failure to secure a patient airway. The mode of delivery in 95% (n = 19) of the 20 claims in which death was the outcome was surgical. In the claims representing maternal death, 89% (8) of the 9 claims represented surgical deliveries under general anesthesia. These maternal death cases were designated emergent in 56% (5) of the claims. The anesthetic care was deemed appropriate in 56% (23) of the claims. The median payment for appropriate care ($2,866.00) was less than for care determined to be inappropriate ($45,000.00).

Anesthesia, Obstetrical↗
PubMedDate not supplied

The concept of species and the foundations of biology, a case study: the Callithrix jacchus group (Primates-Platyrrhini).

The axiomatic theory presented in Galleni and Forti [1999], being part of the foundational programme of Ennio De Giorgi, is based on the fundamental notions of quality, relation, operation and collection, and provides a very general axiomatization of the biological notions of living object, generation, species and speciation. Within this theoretical framework we consider here a difficult case of classification of species: the Callithrix jacchus group of the New World monkeys. Although the morphological analysis strongly suggests the individuation of six different species, nevertheless several experiments of crossing give evidence to fertility of hybrids. Since both the morphological and the hybridological criteria have shown to be of enormous importance in actual classification of species, this apparent contradiction seems very disappointing. Our axiomatization of speciation processes as operations acting in special time intervals permits to avoid the contradiction by allowing for individuals which, during such special periods, may belong to more than one species. Therefore we assume that one or more speciation processes are developing, starting from a unique protospecies and differentiating in six new ones. In order to obtain more evidence of these processes, new observations and suitable experiments are needed.

Animals↗