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PubMed2006

Clinical supervision for nurses in administrative and leadership positions: a systematic literature review of the studies focusing on administrative clinical supervision.

AIM: The aim of this systematic literature review was to describe administrative clinical supervision from the nursing leaders', directors' and administrators' perspective. BACKGROUND: Administrative clinical supervision is a timely and important topic as organizational structures in health care and nursing leadership are changing in addition to the increasing number of complex challenges present in health care. METHODS: The material in this review was drawn from national and international databases including doctoral dissertations, distinguished thesis and peer-reviewed articles. The material was analysed by means of content analysis. The theoretical framework for the analysis was based on the three main functions of clinical supervision: administrative, educational and supportive. FINDINGS: The findings demonstrated that the experiences of the administrative clinical supervision and its supportiveness were varying. The intervention was seen to provide versatility of learning experiences and support in challenging work experiences. Administrative clinical supervision effects and assures the quality of care. The effects as a means of development were explained through its resemblance to a leading specialist community. CONCLUSIONS: The findings support earlier perceptions concerning the importance and significance of administrative clinical supervision for nursing managers and administrators. However, more research is needed to develop administrative clinical supervision and to increase understanding of theoretical assumptions and relationships of the concepts on the background.

Adaptation, Psychological↗
PubMed1986

Reacquisition of contrastive stress in an adventitiously deaf speaker using a single-channel cochlear implant.

Acoustic correlates of contrastive stress, i.e., fundamental frequency (F0), duration, and intensity, and listener perceptions of stress, were investigated in a profoundly deaf subject (RS) pre/post single-channel cochlear implant and longitudinally, and compared to the overall patterns of age-peer profoundly deaf (JM) and normally hearing subjects (DL). The stimuli were a group of general American English words in which a change of function from noun to verb is associated with a shift of stress from initial to final syllable, e.g., CON'trast versus conTRAST'. Precochlear implant, RS was unable to produce contrastive stress correctly. Hearing one day post-stimulation resulted in significantly higher F0 for initial and final stressed versus unstressed syllables. Four months post-stimulation, RS maintained significantly higher F0 on stressed syllables, as well as generalization of significantly increased intensity and longer syllable duration differences for all stressed versus unstressed syllables. Perceptually, listeners judged RS's contrastive stress placement as incorrect precochlear implant and as always correct post-cochlear implant. JM's contrastive stress was judged as 96% correct, and DL's contrastive stress placement was 100% correct. It was concluded that RS reacquired all acoustic correlates needed for appropriate differentiation of contrastive stress with longitudinal use of the cochlear implant.

Acoustic Stimulation↗
PubMed2000

Should local research ethics committees monitor research they have approved?

The function of local research ethics committees is to consider the ethics of research proposals using human participants. After approval has been given, there is no comprehensive system in place to monitor research and ensure that recommendations are carried out. Some suggest that research ethics committees are ideally placed to fulfil this function by carrying out random monitoring of research they have reviewed. The health service guideline creating local research ethics committees is under review. This paper suggests that increasing the monitoring role of ethics committees in the present climate would be inappropriate. This is due to the large workload of the committees, their voluntary nature and the change a monitoring role might cause to the relationship between researcher and ethics committee, which might herald an increasing recourse to judicial review. A radical overhaul of the system would be necessary in order for ethics committees adequately to fulfil a monitoring function.

Clinical Protocols↗
PubMed1980

Ego development and sociometrically evaluated maturity: an investigation of the validity of the Washington University Sentence Completion Test of Ego Development.

The reported study was an attempt to validate the Washington University Sentence Completion Test of Ego Development (WU-SCT), using a broad, sociometric index of maturity as the criterion variable. Sixty college women living in a sorority house completed the WU-SCT and evaluated one another's readiness for mature functioning in each of four adult social roles: career, marriage, parenthood, and community involvement. The reliabilities and the intercorrelations of the ratings suggested that peers distinguished two facets of maturity. While results support the hypothesized relationship between WU-SCT scores and a global sociometric index of maturity, the test's substantial correlations with indices relating to relatively impersonal roles (career and community) and apparent lack of correlation with indices relating to intimate interpersonal roles (marital and parental) suggests that the validity of the WU-SCT may be less broad than Loevinger's theory would imply. Several alternative interpretations of the data are suggested.

Journal Article↗
PubMed1999

Consistency of hand use, exercise, and sports-related injuries.

In this study, we examined the relationships between the consistency of hand use, exercise, and sports-related injuries as an indirect test of the hypothesis that the consistency of hand use is a reflection of general motor coordination. As we predicted, the consistent hand-use group (n = 23) exercised more, were more likely to follow a regular exercise schedule, and reported having experienced more sports-related accidents than their inconsistent hand-use peers (n = 23).

Athletic Injuries↗
PubMed1999

Initial impact of the Fast Track prevention trial for conduct problems: II. Classroom effects. Conduct Problems Prevention Research Group.

This study examined the effectiveness of the universal component of the Fast Track prevention model: the PATHS (Promoting Alternative THinking Strategies) curriculum and teacher consultation. This randomized clinical trial involved 198 intervention and 180 comparison classrooms from neighborhoods with greater than average crime in 4 U.S. locations. In the intervention schools, Grade 1 teachers delivered a 57-lesson social competence intervention focused on self-control, emotional awareness, peer relations, and problem solving. Findings indicated significant effects on peer ratings of aggression and hyperactive-disruptive behavior and observer ratings of classroom atmosphere. Quality of implementation predicted variation in assessments of classroom functioning. The results are discussed in terms of both the efficacy of universal, school-based prevention models and the need to examine comprehensive, multiyear programs.

Analysis of Variance↗
PubMed1991

Social deprivation of infant rhesus monkeys alters the chemoarchitecture of the brain: I. Subcortical regions.

Rhesus monkeys (Macaca mulatta) reared during the first year of life without social contact develop persistent stereotyped movements, self-directed behaviors, and psychosocial abnormalities, but neurobiological mechanisms underlying the behaviors of socially deprived (SD) monkeys are unknown. Monkeys were reared in total social deprivation for the first 9 months of life; control monkeys were reared socially (SR) with mothers and peers. Subjects were killed at 19-24 yr of age. Because the behaviors of SD monkeys are reminiscent of changes in striatal or amygdalar function, we used immunocytochemistry for substance P (SP), leucine-enkephalin (LENK), somatostatin, calbindin, and tyrosine hydroxylase (TH) to evaluate qualitatively and quantitatively patterns of neurotransmitter marker immunoreactivity within subcortical regions. In SD monkeys, the chemoarchitecture of the striatum was altered. Neuronal cell bodies and processes immunoreactive for SP and LENK were depleted markedly in patch (striosome) and matrix regions of the caudate nucleus and putamen; the average density of SP-immunoreactive neurons was reduced 58% relative to SR monkeys. Calbindin and TH immunoreactivities were diminished in the matrix of caudate and putamen of SD monkeys. TH-immunoreactive neurons, but not cresyl violet-stained neurons, in the substantia nigra pars compacta were decreased (43%) in SD monkeys. Peptide-immunoreactive terminals were reduced in the globus pallidus and substantia nigra in SD monkeys. The nucleus accumbens was the least affected of striatal regions. Striatal somatostatin immunoreactivity wa qualitatively and quantitatively similar in SD and SR monkeys. Several regions, for example, bed nucleus of the stria terminalis, amygdala, and basal forebrain magnocellular complex, that were in the same sections and are enriched in these markers did not appear altered in SD monkeys, suggesting a regional specificity for vulnerability. The altered chemoarchitecture of some basal ganglia regions in adult monkeys that experienced social deprivation as infants suggests that the postnatal maturation of neurotransmitter phenotypes in some structures is influenced by social environment. Abnormal motor and psychosocial behaviors resulting from this form of social/sensory deprivation may result from alterations in peptidergic and dopaminergic systems within the basal ganglia.

Amygdala↗
PubMed1997

Estimating lead time and sensitivity in a screening program without estimating the incidence in the screened group.

Early indicators of the effectiveness of a screening test for chronic diseases such as breast cancer are the length of time the diagnosis is advanced by screening, the lead time, and the sensitivity of the screening test. This paper describes a model for simultaneously estimating the mean lead time and the sensitivity when only the number of cancers detected at the successive screenings and the number of cancers occurring in the time interval between the screening examinations are known. This model is particularly useful in assessing the effect of screening when the underlying cancer incidence in the screened group is unknown. The model is fitted to the data of 235 screen-detected breast cancer cases and 146 interval cancers diagnosed across 6 screening rounds of the program in Nijmegen. The maximum likelihood estimate for the mean lead time ranges from 1.3 years in the under age 50 group to 2.2 years in the age 50-65 group, both estimates having large confidence intervals. The corresponding sensitivity estimates are 0.92 and 1.00.

Adult↗
PubMed2004

How I quit being a "mental patient" and became a whole person with a neurochemical imbalance: conceptual and functional recovery from a psychotic episode.

This article describes the descent into psychosis of the author and his recovery, both mental and cognitive. It discusses the problems of stigma that the author overcame as he searched for a new identity as a person given a label. In discussing recovery, the article contrasts traditional mental health services with the PACT model described by Allness and Knoedler (1998). Finally the article argues for the validity of the Peer Specialist as part of a professional mental health team.

Adaptation, Psychological↗
PubMedDate not supplied

Variable effects of children's aggression, social withdrawal, and prosocial leadership as functions of teacher beliefs and behaviors.

Teachers' beliefs about aggressive and withdrawn behaviors in the classrooms and teachers' overall caring and support of students were hypothesized to influence the relations between these classroom behaviors and peer acceptance and self-perceived social competence. These hypotheses were tested in a sample of 82 middle school classes consisting of 4,650 students ages 13 to 16. The results suggest that teachers' aversion to aggression and empathy toward withdrawal enhanced the self-perceptions of both aggressive and withdrawn children and enforced peer rejection of aggression but not of social withdrawal. Teacher warmth had similar effects. Prosocial leadership had a positive social impact among students independent of teacher beliefs. These findings are discussed in an attempt to reconceptualize children's social behaviors and peer status.

Aggression↗
PubMed1998

Respiratory health, lung function, and airway responsiveness in school-age survivors of very-low-birth-weight.

The purpose of this study was to determine the respiratory symptoms, pulmonary function, and airway reactivity in school-age survivors of very-low-birth-weight and to describe the influence of birth weight and perinatal illness on their pulmonary function. Thirty (of 39) 10- to 11-year-old survivors of very-low-birth-weight (VLBW) recruited at birth into a prospective longitudinal study of development; 30 (of 32) normal-birth-weight peers recruited from the same school or census tract as the VLBW group at age 5; and 15 normal-birth-weight siblings of the VLBW group participated in the study. Outcome measures were mother's reports of respiratory health; forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1); FEV1/FVC; forced expiratory flow, midexpiratory phase (FEF25-75); peak expiratory flow rate (PEFR); and tolerance to methacholine. There were no differences between groups in mothers' reports of current respiratory health. Pulmonary function values were lower for the VLBW survivors but significant only for FEF25-75 (F = 4.13; P = 0.02). Number of days in the intensive care nursery correlated significantly with decreased FEV1 (r = -.40, df = 28, P = 0.03), FEV1/FVC (r = -.37, df = 28, P = 0.04, and FEF25-75 (r = -.39, df = 28, P = 0.03). Only the relationship between length of nursery stay and FEV1/FVC was independent of birth weight. Number of days on mechanical ventilation was significantly correlated with decreased FEV1 (-.44, df = 28, P = 0.01), FEV1/FVC (r = -.38, df = 28, P = 0.04), FEF25-75 (r = -.44, df = 28, P = 0.01, and PEFR (r = -.40, df = 28, P = 0.03). All of these relationships were independent of birth weight. There were no significant associations between perinatal risk factors and methacholine responsiveness. Differences between VLBW children and normal-birth-weight children in pulmonary function are modest even when statistically significant. Severity of perinatal illness influences pulmonary function parameters into late childhood.

Child↗
PubMed2002

Child, parent, and peer predictors of early-onset substance use: a multisite longitudinal study.

The purpose of this study was to identify kindergarten-age predictors of early-onset substance use from demographic, environmental, parenting, child psychological, behavioral, and social functioning domains. Data from a longitudinal study of 295 children were gathered using multiple-assessment methods and multiple informants in kindergarten and 1st grade. Annual assessments at ages 10, 11, and 12 reflected that 21% of children reported having initiated substance use by age 12. Results from longitudinal logistic regression models indicated that risk factors at kindergarten include being male, having a parent who abused substances, lower levels of parental verbal reasoning, higher levels of overactivity, more thought problems, and more social problem solving skills deficits. Children with no risk factors had less than a 10% chance of initiating substance use by age 12, whereas children with 2 or more risk factors had greater than a 50% chance of initiating substance use. Implications for typology, etiology, and prevention are discussed.

Adolescent↗
PubMedDate not supplied

Thinking out loud: an exploration of problem-solving language in preschoolers with and without language impairment.

This study investigates the use of language while engaged in solving a complex spatial problem. Children with specific language impairment (SLI) have been reported to lag behind age peers in certain cognitive tasks, despite normal range non-verbal intelligence test scores. It was hypothesized that these delays could reflect some failure to employ language to direct and facilitate thought. Dyads of preschool children were taped during a three-dimensional construction task. Task-relevant utterances were then coded for function and addressee. The speech of six children with SLI, aged 4;10, was compared with that of two control groups, one matched by age, the other by language level. The SLI group used less problem-solving speech and fewer modal expressions than their age peers. Not all differences were statistically significant, but the pattern of findings indicated that what differences did occur were due to overall reductions in the amount of speech rather than any specific failure to use language as a tool of thought. Correlations between the use of problem-solving speech and a measure of cognitive style indicated clear group differences. For children in the control groups, greater use of private speech was associated with greater cognitive efficiency; for children in the SLI group the relationship was in the opposite direction, greater use of private speech being associated with less cognitive efficiency. In all three groups, problem-solving speech could be addressed either to partner or to self, although some individual preferences were observed. The findings, while preliminary, suggest new directions for studies of cognitive deficits in children with SLI. They also indicate the importance of including socially directed utterances, and controls for language proficiency, in future research on private speech.

Analysis of Variance↗
PubMed2002

[Influence of social support by parents and peers on physical complaints in students].

The mechanisms mediating the connection between school-specific stressors and physical complaints, indicating psychosocial strain, are still unclear. Assuming that social support is an important part of the coping process, it is hypothesized that different sources of social support may have varying effects on the degree of physical complaints. The sample consisted of 326 students--182 girls and 144 boys--in grades 6 and 8. On average, female adolescents reported physical symptoms to a greater extent than did male adolescents. Confronted with school-specific stressors, girls showed a higher willingness to make use of peer-support. For boys and girls a high degree of anticipated peer-support was linked to a higher extent of physical complaints. Parental support buffered the effect of bad grades regarding the extend of physical complaints only for girls. The assumption of a longitudinal link between social support, school achievement, and the degree of physical complaints one year later was not supported. Results emphasize the importance of further research regarding the functions of different sources of social support for boys and girls.

Adaptation, Psychological↗
PubMed1985

What children say when the teacher is not around: conflicting goals in social comparison and performance assessment in the classroom.

Naturalistic observations and interviews with children in kindergarten, first, second, and fourth grades were used to examine developmental shifts in the focus of social comparison and the expression of comparative and evaluative interests in relation to possibly conflicting goals. First, observers coded the content of peer exchanges and direction of visual gaze during class work times. Children were then interviewed about help seeking and reading performance in the classroom. Classroom observations revealed that comparisons related to personal aspects of peers declined with age, whereas evaluative comments and comparisons related to performance assessment increased sharply in first grade. In the higher grades, blatantly evaluative and comparative statements decreased, whereas more subtle and functional performance-related exchanges continued to increase. Interviews showed that differences in classroom behaviors were associated with knowledge of classroom performance hierarchies, the salience of general ability, and self-evaluation. The data patterns are interpreted in terms of two converging processes: self-socialization and goal conflict. Implications for social comparison theory are also discussed.

Achievement↗
PubMed2006

Are drug experimenters better adjusted than abstainers and users?: a longitudinal study of adolescent marijuana use.

PURPOSE: Experimentation with substance use is normative during adolescence and prior research suggests that adolescents who refrain from experimentation may be psychologically maladjusted. This longitudinal study compared lifetime marijuana abstainers (n = 1177), experimenters (n = 873), and frequent users (n = 205) at grade 12 on psychosocial functioning during late adolescence and young adulthood. METHODS: Participants were recruited from middle schools in 1985 (grade 7) and assessed repeatedly, including in 1990 (grade 12) and 1995 (age 23). Self-report surveys assessed lifetime substance use at grade 12, and psychosocial functioning at grade 12 and age 23. Group differences after controlling for key demographics were estimated using multivariate logistic regression and analysis of covariance. RESULTS: Adolescent abstainers from marijuana often fared better (and in no case worse) than experimenters and frequent users both concurrently and later in life on school engagement, family and peer relations, mental health, and deviant behavior. Similar results were found in ancillary analyses using a definition of adolescent "abstainer" that also accounted for cigarette and alcohol use. CONCLUSIONS: Results refute the idea that adolescents who abstain from substance use are maladjusted, and suggest instead that they function better than experimenters later in life, during the transition to young adulthood.

Adolescent↗
PubMed2004

Biomechanics of locked plates and screws.

OBJECTIVE: To review the biomechanical principles that guide fracture fixation with plates and screws; specifically to compare and contrast the function and roles of conventional unlocked plates to locked plates in fracture fixation. We review basic plate and screw function, discuss the design rationale for the new implants, and examine the biomechanical evidence that supports the use of such implants. DATA SOURCES: Systematic review of the per reviewed English language orthopaedic literature listed on PubMed (National Library of Medicine online service). STUDY SELECTION: Papers selected for this review were drawn from peer review orthopaedic journals. All selected papers specifically discussed plate and screw biomechanics with regard to fracture fixation. PubMed search terms were: plates and screws, biomechanics, locked plates, PC-Fix, LISS, LCP, MIPO, and fracture fixation. DATA SYNTHESIS: The following topics are discussed: plate and screw function-neutralization plates and buttress plates, bridge plates; fracture stability-specifically how this effects gap strain and fracture union, conventional plate biomechanics, and locking plate biomechanics. CONCLUSIONS: Locked plates and conventional plates rely on completely different mechanical principles to provide fracture fixation and in so doing they provide different biological environments for healing. Locked plates may increasingly be indicated for indirect fracture reduction, diaphyseal/metaphyseal fractures in osteoporotic bone, bridging severely comminuted fractures, and the plating of fractures where anatomical constraints prevent plating on the tension side of the bone. Conventional plates may continue to be the fixation method of choice for periarticular fractures which demand perfect anatomical reduction and to certain types of nonunions which require increased stability for union.

Biomechanical Phenomena↗
PubMed2002

Pattern of learning disabilities in children with extremely low birth weight and broadly average intelligence.

OBJECTIVES: To examine the prevalence and pattern of specific areas of learning disability (LD) in neurologically normal children with extremely low birth weight (ELBW) (< or = 800 g) who have broadly average intelligence compared with full-term children with normal birth weight of comparable sociodemographic background, and to explore concurrent cognitive correlates of the specific LDs. DESIGN: Longitudinal follow-up; geographically defined region. SETTING: Regional follow-up program. MAIN OUTCOME MEASURES: Wechsler Intelligence Scale for Children-Revised, Gray Oral Reading Test-Revised, Test of Written Language-Revised, Wide Range Achievement Test-Revised, Developmental Test of Visual-Motor Integration. PARTICIPANTS: One hundred fourteen (87%) of 131 children with ELBW born between 1982 and 1987 were seen at ages 8 to 9 years. Of the 114 children, 74, who were neurologically normal, with a Verbal or Performance IQ greater than or equal to 85, formed the study group. A group of 30 full-term children with normal birth weight and similar sociodemographic status comprised a comparison group. The children were predominantly white and middle class. RESULTS: Significantly more children with ELBW (65%) met criteria for LD in 1 or more areas compared with 13% of the comparison children. In the ELBW group, the most frequently affected area was written output, then arithmetic, then reading. Visuospatial and visual-motor abilities in combination with verbal functioning primarily explained performance in arithmetic and reading among children with ELBW, unlike the control children, whose scores were associated only with verbal functioning. CONCLUSIONS: Complex LDs in multiple academic domains are common sequelae among broadly middle class, predominantly white, neurologically normal children with ELBW compared with control peers. The developmental etiology of LDs in children with ELBW and control peers differs.

Birth Weight↗