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PubMed1988

Decree No. 013/PRG concerning creation of a National Guinean Commission of Literacy and Adult Education, 21 January 1987.

This Decree creates a National Guinean Commission of Literacy and Adult Education under the Minister of National Education. The following are among the goals of the Commission: 1) to regroup the organizations, both public and private, that are engaged in adult education and literacy, with the goal of making their activities more useful; 2) to formulate adult education programs and strategies to combat illiteracy, keeping in mind the policy of human advancement; 3) to harmonize and coordinate all literacy programs and adult education activities; 4) to further the development and implementation of programs relating to literacy, adult education, and continuing and professional education; 5) to undertake studies and research relating to literacy, national languages, and adult education; and 6) to collect and disseminate information, documents, and studies in the area of literacy and adult education in Guinea and elsewhere. Further provisions of the Decree deal with the composition, organization, and resources of the Commission, among other things.

Adult↗
PubMed1995

Information-seeking practices of dental hygienists.

This paper reports on a survey of the information-seeking, critical-analysis, and computer-application practices of dental hygienists. Questionnaires were mailed to a convenience sample of seventy-one dental hygiene practitioners. A 62% response rate was achieved. Results indicated that discussions with colleagues, continuing education courses, journals, and newsletters were the sources used most frequently for professional development and information retrieval. To evaluate professional information, these hygienists tended to rely on personal experience, credibility of the journal, and discussions with colleagues. Word processing was the most frequently used computer application; online database searching was rare in this group. Computer used within the employment setting was primarily for business rather than clinical applications. Many hygienists were interested in attending continuing education courses on use of computers to acquire professional information.

Adult↗
PubMed2001

Learning in clinical nursing practice.

In this study, a qualitative interpretivist perspective was used to analyze the following research question: How does clinical nursing practice facilitate learning? Forty nurses working in acute care, long-term care, and home care were interviewed about their clinical practice experiences and the learning that resulted. Data were analyzed using a constant comparative method. Study results indicate that clinical nursing practice facilitates both personal and professional development of nurses by fostering an examination of the concepts of self-respect, hope, control, vulnerability, acceptance, loss, and persistence. Implications for continuing educators and staff development instructors are drawn.

Adult↗
PubMed1998

[Maternal brain death during pregnancy].

The case of a pregnant patient who had a massive intracraneal haemorrhage at 18 weeks of gestation is presented. Patient's neurological damage evolved to brain death, but the fetus continued in good condition. The decision of withdrawing life support or to continue supporting the mother's life to allow fetal development aroused difficult ethical questions, both to relatives and professionals. This is an exceptional situation of a heart beating cadaver and a non viable fetus whose life depends on the continuation of treatments that are considered as experimental. A good decision should be based on the respect to a body in brain death, the fetal right to life, family's wishes and values, the use of experimental treatments, and the rational use of a public hospital's resources. The conclusion was that the continuation of life support treatments was not an ethical obligation. Withdrawing life support to allow fetal death in this case means foregoing an experimental treatment and to respect family's autonomy and the right of the patient's death with dignity. Similar cases need to be discussed with a multidisciplinary analysis in their own particularity.

Adult↗
PubMedDate not supplied

Competency-based learning for the surgical assistant.

In the first of two articles about the benefits and drawbacks of occupational standards, the authors describe a competency-based programme of continuing education for surgical assistants. The structure and content of the modules offered are discussed and the authors emphasise the validation of the courses by institutions of higher education. Next week's article will examine occupational standards in relation to professional development.

Competency-Based Education↗
PubMedDate not supplied

A behavioral inventory for professionalism in nursing.

The purpose of this article is to describe the development of an evaluative behavioral inventory based on Miller's Model for Professionalism in Nursing and to report results of an investigation of registered nurses (RNs) in eight western states. The Professionalism in Nursing Inventory was mailed to 1,600 computer-generated randomly selected names of RNs, resulting in 515 complete and usable inventories. Results indicated that the majority of respondents demonstrated professional behaviors in continuing education activities, autonomous quality assurance participation, community service, and a theory-based nursing practice. Behaviors not considered a priority with a majority of the respondents were publication, research activities, and participation in the constituent state organizations of the American Nurses Association. Approximately 4 per cent of the respondents commented that employing agencies and administrative (nursing) personnel were concerned with output, not professional behaviors. More than 91 per cent of these respondents believed that a self-evaluative instrument for professional behaviors was necessary and that the tool should be developed by nurses.

Adult↗
PubMed1988

Public Law 100-202, Joint Resolution making further continuing appropriations for the fiscal year 1988, and for other purposes, 22 December 1987.

This US Act provides the following with respect to universal access to child immunization: "The Congress calls upon the President to direct the Agency for International Development, working through the Centers for Disease Control and other appropriate Federal agencies, to work in a global effort to provide enhanced support towards achieving the goal of universal access to childhood immunization by 1990 by 1) assisting in the delivery, distribution, and use of vaccines, including a) the building of locally sustainable systems and technical capacities in developing countries to reach, by the appropriate age, not less than 80% of their annually projected target population with the full schedule of required immunizations and b) the development of a sufficient network of indigenous professionals and institutions with responsibility for developing, monitoring, and assessing immunization program and continually adapting strategies to reach the goal of preventing immunizable diseases and 2) performing, supporting, and encouraging research and development activities, in both the public and the private sector, that will be targeted at developing new vaccines and at modifying and improving existing vaccines to make them more appropriate for use in developing countries. In support of this global effort, the President should appeal to the people of the US and the US private sector to support public and private efforts to provide the resources necessary to achieve universal access to childhood immunization by 1990." The Act also does the following with respect to various forms of bilateral assistance: 1) prohibits the use of funds for an organization or program that supports coercive abortion or involuntary sterilization; 2) prohibits the use of funds for the performance of abortion as a method of family planning (FP); 3) provides that in awarding grants for natural FP under section 104 of the Foreign Assistance Act no applicant shall be discriminated against because of such applicant's religious or conscientious commitment to offer only natural FP. In addition, the Act stipulates that with respect to appropriations for the Department of Health and Human Services no funds will be used to perform abortions except where the life of the mother would be endangered if the fetus were carried to term.

Abortion, Induced↗
PubMed1995

Quality development based on informatics in health care: steps in the Danish national strategy illustrated by four cases.

The first step for quality development is identification of the quality problem. This should be followed by a set up of criteria and standards and relevant data should be collected to perform quality assessment. The quality-level is evaluated and in cases with non-satisfying results, the problem(s) should be identified and the process repeated [1]. Identification of the best results for continuous quality improvement and professional self-assessment is part of the process [1]. Decentralization of the whole quality development process is an aim. The Ministry of Health is politically responsible for the process and the National Board of Health is responsible for the implementation of the process at the national level. To support continuous quality development, three bills were passed in the government in 1992: 1) Free choice of hospital for the patients; 2) Appropriate local and regional distribution of specialized functions, to ensure optimal treatment of rare and complicated diseases; 3) Coordinated planning and organization of the health services. The strategy for quality development illustrated by four cases. Four projects were identified to illustrate steps in the national strategy for quality development. PROBLEM IDENTIFICATION. ESTEEM [2,3]: Using knowledge-based systems for interpretation of EMG (electromyography) in different laboratories disclosed great variations in clinical usability. The variations could be explained by different examination techniques, test planning protocols, and diagnostic criteria. It was concluded that the use of a EMG-knowledge based system disclosed great problems for standardization of procedures dependent on EMG measurements. QUALITY ASSESSMENT. Hip fracture quality project [unpublished data]: The assumption for the study was that early and active rehabilitation after hip fracture would promote the ability of the patients to cope with activities of daily living (ADL) and prevent development of complications. About 85% of the patients were expected to be able to go home on the 12th day, but this was the case for only 56% of the patients. It was concluded that the pre-set standard was not achieved and that the post-operative care was carried out in an ineffective way. QUALITY IMPROVEMENT. Laboratory quality project [4]: Quality control assessment procedures have been implemented for years in hospital laboratories. The aim of the study was to evaluate the size of analytical bias between two local hospital laboratories using the same reference intervals. The results showed that only a few of the routine analyses meet the goals for acceptance of general reference intervals in a geographical area. The problems were reflected in the quality assessment results but, nevertheless, no action seems to have been taken to minimize the bias. It is concluded that interpretation of quality control data is a great problem. QUALITY MONITORING AND EVALUATION. National databases for health care quality [5]: Principles for development, implementation, and use of national databases has been worked out by The National Board of Health. Clinical departments will get a tool to monitor and improve the daily working routines. National databases for clinical monitoring exist for vascular surgery, laparoscopic surgery, treatment of breast cancer, and surgery for hip fractures.

Denmark↗
PubMed1993

Drug-induced gingival overgrowth.

Certain anticonvulsants, cyclosporine, and a variety of calcium channel blockers have been shown to produce clinically and histologically similar gingival enlargements in certain susceptible patients. These drugs appear to be similar with respect to their pharmacologic mechanism of action at the cellular level. The primary target tissue is the most essential difference among them. Therefore it is tempting to speculate that these agents may act similarly on a common secondary target tissue, such as gingival connective tissue, and cause a hyperplastic response. This tissue reaction may involve a disturbance of calcium ion influx into specific cell populations with a resulting alteration in collagen metabolism and other host cell response mechanisms. A connection between ion exchange, folate uptake, collagenase activation, and bacterial inflammation may exist. Until a more effective approach can be developed from future research results, treatment should continue to emphasize plaque control, professional debridement, and resective gingival procedures to improve function, esthetics, and access for home care.

Anticonvulsants↗
PubMed2005

The Perruche case and the issue of compensation for the consequences of medical error.

The case of Nicolas Perruche gave rise to a national debate in France over compensation for serious consequences of medical error. Ultimately, legislation was enacted banning the cause of action known in Anglo-American law as wrongful life, and an agency was established to adjudicate subsequent claims. As other developed nations continue to wrestle with rapid increases in the cost of professional liability coverage and health care in general, a review of the Perruche case and its influence on French health policy may advance the discussion beyond the current stalemate of hardened advocacy positions.

Compensation and Redress↗
PubMed1998

Standards of training in clinical hypnosis: preparing professionals for the 21st century.

During the past 40 years, there has been increased interest in clinical hypnosis among qualified health care professionals. However, training programs in the past have been quite variable. This has led to the identification of a need for an accepted standard curriculum in clinical hypnosis. The present research surveyed professionals regarding qualifications and training in clinical hypnosis. The continued growth of clinical hypnosis among professionals may ultimately rest upon the development of an educational standard that integrates clinical skills and knowledge from research.

Education↗
PubMed2000

Pain management: clinician survey and institutional needs assessment.

In 1996, 738 BUMC clinicians, representing 8 disciplines and >24 specialties, were surveyed using the Clinician Survey and Institutional Needs Assessment. This survey was developed by the Education Development Center, Inc., and distributed to 50 participating health care institutions in 21 states as part of the Mayday Pain Management Project. The BUMC findings revealed a gap between clinician knowledge and application of that knowledge to patient case scenarios. Clinician knowledge deficits included equianalgesic dosing, analgesic administration and dosing principles, nonpharmacological treatments, and assessment and management of pain in special populations. Fears and misconceptions about oversedation and drug abuse persist. Participants identified several legal and regulatory issues related to pain management, as well as improved collaboration among health care team members, as opportunities for professional growth. Based on these findings, BUMC has developed a pain management continuous quality improvement program.

Journal Article↗
PubMed1995

The case for a code of ethics in an ambulatory care setting.

The health care industry leads others in the development and use of professional codes of ethics. However, ambulatory care facilities continue to operate without coherent ethical guidelines addressing the workplace itself. New diagnostic and treatment capabilities, coupled with economic pressures, have intensified the ethical dilemmas facing the ambulatory care practice. This article argues that office codes of ethics decrease the risk of liability exposure, clarify the expectations of patients and staff, and foster responsible ethical reflection in the workplace. Material for this article was gathered from relevant literature in the areas of business ethics, bioethics, and health care management.

Ambulatory Care↗
PubMed2001

Developing a shared leadership model at the unit level.

As the nursing profession again faces a serious shortage, many are seeking ways to attract and retain talented people in the nursing profession. Creating both empowering and healthy work environments is a way to achieve this goal. Shared leadership is a nursing management model that supports staff nurses in extending their influence about decisions that affect their practice, work environment, professional development, and self-fulfillment. It is a way to strengthen continuous learning and enhance relationships, which are the foundation upon which nurses can develop a new type of relationship with management and with each other.

Communication↗
PubMed2002

ONS 2002 environmental scan: a basis for strategic planning.

PURPOSE/OBJECTIVES: To analyze information about the environments in which the Oncology Nursing Society (ONS) operates as a basis for strategic planning. DATA SOURCES: Published reports and ONS internal surveys. DATA SYNTHESIS: Analysis of internal and external trends resulted in a list of implications with regard to managing change, avoiding mistakes, and identifying critical issues for ONS leadership. The team presented ONS leaders with a tool that helped to guide the development of the 2003-2006 Strategic Plan. CONCLUSIONS: The continuing vitality of professional nursing societies such as ONS is critical to the vitality of the profession of nursing itself. Monitoring the environment in which these organizations operate--and effectively using the knowledge that is gained--contributes to their long-term viability and growth. A stronger ONS is in a position to better serve its members, who ensure high-quality care to people with cancer.

Bioterrorism↗
PubMed1996

The fishing news.

The delivery of healthcare throughout the world is rapidly changing due to economic and other factors, both national and international. Psychiatry, a marginal and poorly understood profession in the community, is particularly vulnerable to these changes. Psychiatrists and their representing organisations, such as the Royal Australian and New Zealand College of Psychiatrists, have a key role in advocating for equitable, high standard care for their patients. They need to engage with other professionals involved in psychiatric care, patients and the community to ensure continuing development of services. By recognising the factors influencing psychiatric services, strategies to address them can be developed. Actions taken by the Royal Australian and New Zealand College are described.

Australia↗
PubMed1989

[The role of the life and works of Adolf Zsigmondy and Ottó Zsigmondy in the history of dentistry].

Adolf Zsigmondy and his son Ottó Zsigmondy were dentists of Hungarian origin who lived in Vienna. It was A. Zsigmondy's idea the method of teeth marking on the Zsigmondy-cross called later after him. This is the basis of the presently used marking method recommended by the FDI. He was the first to describe the contact and wear of the approximal side of the teeth. He continued to develop the cohesive gold fillings. O. Zsigmondy's more limited professional field of research was the preserving dentistry, he used sodium-superoxide for widening the rootcanal and he made permanent fillings of black hard guttapercha. On basis of observations carried out on himself he described the two-phase or temporal mastication called after him. He was also much engaged with professional politics, in his publications he strove for recognition of dentistry as an organic part of medical science.

Austria↗