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At least 1,099 records · Page 61Linked to original sources
PubMed2005

Primary care provider attitudes are associated with smoking cessation counseling and referral.

OBJECTIVE: Most primary care providers (PCPs) endorse the importance of smoking cessation, but counseling rates are low. We evaluated the consistency of PCP's attitudes toward smoking cessation counseling and corresponding smoking-cessation behaviors. DESIGN: This was a postintervention analysis of a population-based sample from a group randomized controlled trial to improve adherence to smoking cessation guidelines. SETTING: A total of 18 VA sites in Southwestern and Western United States participated. PARTICIPANTS: A total of 280 PCPs completed a survey at 12 months after the implementation of a smoking-cessation quality improvement (QI) program. Their patients also completed 12- (n = 1080) and 18-month (n = 924) follow-up surveys. INTERVENTION: The quality improvement intervention included local priority setting, quality improvement plan development, implementation, and monitoring. MEASUREMENTS AND MAIN RESULTS: PCPs at intervention sites were more likely to report counseling patients about smoking cessation (P = 0.04) but not referral. PCP attitude toward smoking-cessation counseling was strongly associated with reported counseling (P < 0.001) and with referral (P = 0.01). Other associations with counseling were the perceived barrier "patients are not interested in quitting" (P = 0.01) and fewer years in practice (P = 0.03); other associations with referral were specialty consultation (P < 0.0001) and the perceived barrier "referral not convenient" (P = 0.001) (negative association). PCP attitudes were associated with higher rates of counseling, referral, and program attendance. CONCLUSIONS: PCPs, regardless of intervention participation, had attitudes consistent with their reported smoking-cessation behaviors and more favorable attitudes were associated with higher rates of patient-reported smoking cessation behavior. Findings suggest that PCPs who endorse smoking-cessation counseling and referral may provide more treatment recommendations and have higher patient quit rates.

Attitude of Health Personnel↗
PubMedDate not supplied

ADCS Prevention Instrument Project: pilot testing of a book club as a psychosocial intervention and recruitment and retention strategy.

Both psychosocial and biologic interventions may delay or prevent Alzheimer disease. Staying mentally active may help older people maintain their cognitive abilities. In the Alzheimer Disease Cooperative Study Prevention Instrument Project a book club was introduced as a recruitment and retention device. A 3-arm study was designed and included: a nonrandomized, self-selected group (n=211) who chose not to participate in the book club, and 2 groups randomly assigned to receive 2 books per year in individual self-improvement (n=210) or community involvement (n=207) categories. Participants reported their reactions to the selections and other reading behaviors. Results from the first 2 years revealed that most book club participants agreed with Likert-type statements indicating the readings were enjoyable (P<0.001), had an impact on their thinking (P=0.01), and were shared by them with others (P=0.002). Respondents in the community involvement group agreed more strongly with these statements than those in the self-improvement category. Comments from participants in response to open-ended questions in the reader survey revealed such themes as developing plans for successful aging and reflecting on attitudes and behaviors in their own lives. Further longitudinal analyses are planned to determine whether the book club influenced retention and whether participation was associated with slowing cognitive decline.

Aged↗
PubMed1993

Revised epilepsy stressor inventory.

The relationship between high levels of stress and the occurrence of seizures has been postulated, and findings from studies are beginning to substantiate this hypothesis. Identifying stressors experienced by each person will help health care workers in developing plans of care. In the original epilepsy stressor inventory (ESI) persons selected stressors they had experienced that were associated with epilepsy. To facilitate congruency of the ESI with the Lazarus Transactional Stress Model, revisions were made that allow the person to rate the degree of stressfulness the stressor causes. An alpha of .93 was found indicating high internal consistency of the revised epilepsy stressor inventory (ESI-R). A test-retest reliability of .76 was found. Because the ESI-R is short (22 items) and easy to administer, it can be readily used in practice settings.

Adolescent↗
PubMed1999

Rethinking public health: new training for new times.

The new public health agenda will require major changes in the way health authorities, local authorities, Trusts and Primary Care Groups organise and manage their activities. The requirement is for inter-agency co-ordination and inter-professional and inter-sectoral working to a shared agenda, yet the human and resources development planning to achieve these goals has not been done. This paper summarises the key training issues and argues for a collaborative, decentralised and quality assured approach to multidisciplinary public health management education and training. Only with such a joined up human resources plan can Our Healthier Nation succeed where The Health of the Nation signally failed.

Health Planning↗
PubMed1988

A study of nurses' attitudes towards associate degree nursing students.

The purpose of this study was to examine the attitudes of staff nurses towards associate degree (AD) nursing students. The null hypothesis stated there will be no significant difference in the attitudes of staff nurses towards AD nursing students and associated concepts (nursing education, patient, physician, work, nurse.) The staff nurse's value as a role model is held in high regard yet little regard is given to her attitudes towards students. Through better understanding of staff nurses' attitudes, nurse educators can better plan, develop and coordinate clinical activities to provide an optimum learning environment. The findings showed the concept AD nursing student was significantly different from the rest, indicating a less positive attitude towards the AD nursing student than the related concepts. Implications for nursing practice are threefold. Nurse administrators must create an atmosphere and a philosophy which support the educational process within their institution, and recognize nurses' attitudes towards students. Practising nurses should examine their attitudes and willingness to work with students if their hospital offers their agency as a clinical facility. Educators must look closely at the units they assign students to, continually maintaining the lines of communication between staff nurses and clinical instructors. As service and education work together a quality environment can be provided in which there is optimum learning for the student. Both groups then contribute to the future of professional nursing.

Adolescent↗
PubMed2006

Closing the gap: collaborative learning as a strategy to embed evidence within occupational therapy practice.

RATIONALE: The principles of clinical governance apply as guidelines for good practice to all practitioners. However, evidence-based practice (EBP) is proving a challenge for practitioners who lack the confidence to consume published research. For therapists not wishing to undertake formal study there is a risk of becoming disempowered within a culture of EBP. Opportunities to develop skills in consuming research have focused on the information dissemination model that has limited effect. Mutual reflective learning processes are recommended to empower practitioners to bridge the theory-practice gap. AIM: An action research approach investigated practice based collaborative learning as a catalyst to increase therapist's competence and confidence in consuming research and to explore the transition toward EB practitioner. METHOD AND RESULTS: A diagnostic survey reaffirmed therapist's lack of confidence in EBP. Formative interviews (n = 5) found an over reliance on professional craft and personal knowledge. Research knowledge was not included in participants' construct of a good practitioner and engagement in higher order critical reflection was limited. Collaborative learning groups (n = 6) embedded in practice integrated research, theory, practice and critical reflection. Supported by the collegial learning environment, a learning package developed participants' confidence and competence in consuming published research. Summative interviews (n = 5) evaluated the group and found that therapists were empowered to incorporate propositional knowledge into their clinical reasoning, engage in critical reflection and challenge their practice. They felt confident to incorporate EBP into their continuing professional development plans. Sustainability of these changes requires commitment from the therapists and the workplace.

Cooperative Behavior↗
PubMed2005

Numeracy for adults with Down syndrome: it's a matter of quality of life.

BACKGROUND: Numeracy development is widely accepted as critical for adults in the general community which is equally the case for adults with Down syndrome. This paper reports some of the findings of a study including the research question: What is the justification for numeracy development for adults with Down syndrome? Investigating this question led to the search for a framework to support the ongoing development of numeracy. METHOD: The research used a case study methodology. Five adults were observed and interviewed in two contexts each. The data were analyzed to identify links to the quality of life model. RESULTS: The research illustrates how a quality of life approach can be used to justify and guide the lifelong development of numeracy. Data from the case studies linked numeracy to quality of life under the principles of personal contexts, variability, life-span perspective, values, choices and personal control, perceptions and self-image. CONCLUSIONS: The principles of quality of life can provide a framework for the development of numeracy in the context of adulthood and Down syndrome. Preparation for the numeracy needs of a long and satisfying adulthood should begin in early childhood, continue in schools with the teaching of underlying mathematics concepts and skills, and be modified and refined throughout adulthood by the use of a numeracy development plan. Carers and professionals interacting in the contexts need to adopt a teaching role for numeracy.

Adult↗
PubMed1994

Internal marketing within a health care organization: developing an implementation plan.

This paper discusses how the concept of internal marketing can be applied within a health care organization. In order to achieve a market orientation an organization must identify the needs and wants of its customers and how these may change in the future. In order to achieve this, internal marketing is a necessary step to the implementation of the organizations marketing strategy. An outline plan for the introduction of an internal marketing programme within an acute hospital trust is proposed. The plan identifies those individuals and departments who should be involved in the planning and implementation of the programme. The benefits of internal marketing to the Trust are also considered.

Hospital Administration↗
PubMed1994

Developing a promotion plan for health care marketing.

Promotion of a health care provider's services is essential for communication with its customers and consumers. It is relevant to an organization's marketing strategy and is an element of what is described as the marketing mix. This paper considers the relationship of promotion to the marketing of services and proposes a plan for the promotion of the organization as a whole which can also be applied to an individual service or specialty. Whilst specific reference is made to an National Health Service (NHS) Trust it is also relevant to a Directly Managed Unit.

Advertising↗
PubMed2004

Microsatellite variation reveals high levels of genetic variability and population structure in the gorgonian coral Pseudopterogorgia elisabethae across the Bahamas.

The primary mechanism of gene flow in marine sessile invertebrates is larval dispersal. In Pseudopterogorgia elisabethae, a commercially important Caribbean gorgonian coral, a proportion of the larvae drop to the substratum within close proximity to the maternal colony, and most matings occur between individuals in close proximity to each other. Such limited dispersal of reproductive propagules suggests that gene flow is limited in this gorgonian. In this study, we characterized the population genetic structure of P. elisabethae across the Bahamas using six microsatellite loci. P. elisabethae was collected from 18 sites across the Bahamas. Significant deviations from Hardy-Weinberg equilibrium due to deficits of heterozygotes within populations were detected for all 18 populations in at least one of the six screened loci. Levels of genetic structure among populations of P. elisabethae were high and significant. A distance analysis placed populations within three groups, one formed by populations located within Exuma Sound, a semi-isolated basin, another consisting of populations located outside the basin and a third group comprising two populations from San Salvador Island. The patterns of genetic variation found in this study are concordant with the life-history traits of the species and in part with the geography of the Bahamas. Conservation and management plans developed for P. elisabethae should considered the high degree of genetic structure observed among populations of the species, as well as the high genetic diversity found in the San Salvador and the Exuma Sound populations.

Animals↗
PubMedDate not supplied

Using participatory action research to provide health promotion for disadvantaged elders in Shaanxi province, China.

OBJECTIVES: The objectives of the study were to (a) determine health promotion issues concerning disadvantaged elders, (b) identify social, economic, environmental, and personal factors that adversely influence disadvantaged elders' health, and (c) enable various stakeholders working within a coordinated framework to promote health among elders. DESIGN: A participatory action research (PAR) model was used over a 2-year period in a remote disadvantaged rural village in Shaanxi province, China. SAMPLE: Participants were 20 elders and 5 local administrators including government officers and village leaders. RESULTS: Three themes were identified, including (a) health is the absence of illness and the ability to sustain self-sufficiency; (b) diseases are inevitable among elders; and (c) cost is the key barrier to accessing health services. Action plans were developed and plans were implemented by the participants and project team. CONCLUSIONS: The project demonstrated that PAR is an optimum research method, which allows researchers to facilitate collaboration with all participants through research and supports democratic dialogue and deliberation through the participation process. Interpersonal relationship skills of researchers are crucially important in building cooperation among all stakeholders. Local government mobilization is essential for successful implementation and sustainability of the project.

Aged↗
PubMed2004

Will insured citizens give up benefit coverage to include the uninsured?

OBJECTIVE: To describe the willingness of insured citizens to trade off their own health benefits to cover the uninsured. DESIGN: Descriptive study of individual and group decisions and decision making using quantitative and qualitative methods. SETTING AND PARTICIPANTS: Twenty-nine groups of citizens (N = 282) residing throughout Minnesota. INTERVENTIONS: Groups participated in Choosing Healthplans All Together (CHAT), a simulation exercise in which participants choose whether and how extensively to cover health services in a hypothetical health plan constrained by limited resources. We describe individual and group decisions, and group dialogue concerning whether to allocate 2% of their premium to cover uninsured children in Minnesota, or 4% of their premium to cover uninsured children and adults. MEASUREMENTS AND MAIN RESULTS: While discussing coverage for the uninsured, groups presented arguments about personal responsibility, community benefit, caring for the vulnerable, social impact, and perceptions of personal risk. All groups chose to insure children; 22 of 29 groups also insured adults. More individuals chose to cover the uninsured at the end of the exercise, after group deliberation, than before (66% vs 54%; P < .001). Individual selections differed from group selections more often for the uninsured category than any other. Nevertheless, 89% of participants were willing to abide by the health plan developed by their group. CONCLUSION: In the context of tradeoffs with their own health insurance benefits, groups of Minnesotans presented value-based arguments about covering the uninsured. All 29 groups and two thirds of individuals chose to contribute a portion of their premium to insure all children and most groups chose also to insure uninsured adults.

Adult↗
PubMed1995

The assessment of needs in psychiatric patients. Interrater reliability of the Swedish version of the Camberwell Assessment of Needs instrument and results from a cross-sectional study.

The assessment of needs has been put forth as an important dimension in both the planning, development and evaluation of psychiatric services. A needs assessment tool for routine use should ideally be brief, not require additional staff, be valid and reliable with respect to setting, gender and culture, and also be sensitive to changes in needs and differences in needs between subgroups of patients. In this study, the interrater reliability of the Swedish version of the Camberwell Assessment of Needs instruments (CAN), measuring needs in 22 areas, was investigated in a cross-sectional sample consisting of 119 psychiatric inpatients and outpatients. The prevalence and severity of needs, prevalence of unmet needs, as well as current help received was also investigated. The interrater reliability of the instrument was found to be good both measured as total percentages of agreement in ratings, where an agreement of 80% or above was found in 90% of the comparisons, and as measured by Cohen's kappa. Predominant needs in the sample were in addition to clinical needs concerning psychological distress and psychotic symptoms, social needs such as the need for company, daytime activities and information concerning condition and treatment. The CAN seems to be a instrument with a high interrater reliability also when used under routine conditions as in this study. It also seems to have a high degree of feasibility with regard to different types of patients and settings and a sensitivity concerning differences in needs in subgroups of patients.

Adolescent↗
PubMed1992

Effect of conventional dental restorative treatment on bacteria in saliva.

Dental caries results from the dissolution of mineralized dental tissues by the metabolic by-products of oral bacteria colonizing the surface of teeth. The principal modality for dealing with this infectious process is through restorative treatment which removes the pathologic tissue and replaces it with a variety of inert materials. The purpose of this study was to evaluate the effect of traditional restorative treatment on select oral bacterial populations. Fifty-two females demonstrating high levels of mutans streptococci (greater than or equal to 2.5 x 10(4) colony forming units (cfu) per ml saliva) with no more than four missing posterior teeth were recruited for this study. Salivary levels of mutans streptococci, lactobacilli, total streptococci, and total cultivable bacteria were evaluated before, during, and after restorative treatment. Initial DMFS scores were established by two standardized examiners using bitewing radiographs and clinical examination, which was conducted under optimal conditions. All restorative treatment was completed by faculty members of the University of Alabama School of Dentistry using treatment plans developed by the DMFS examiners. The participants received a mean of 16.4 restored surfaces, which resulted in significant reductions of all the bacterial populations tested. All microbial populations monitored were predicted to return to their baseline levels within 151 days after restorative treatment in 50% of the participants. This study shows that conventional restorative treatment results in a significant reduction of bacterial populations including those associated with the dental caries process, i.e., mutans streptococci and lactobacilli.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2005

Haemostatic management of intraoral bleeding in patients with von Willebrand disease.

OBJECTIVES: To develop plans for the haemostatic management of intraoral bleeding in patients with von Willebrand disease (VWD). SUBJECTS AND METHODS: Thirty-seven episodes of haemostatic management of intraoral bleeding in 19 VWD patients were analysed retrospectively based on the medical records. RESULTS AND CONCLUSIONS: When performing tooth extractions in patients with type 1 or 2A VWD [responsive to 1-deamino-8-D-arginine-vasopressin (DDAVP)], 0.35-0.4 microg kg(-1) of DDAVP should be administered intravenously at three times. In patients with type 2A VWD (unresponsive to DDAVP) or patients with type 2B or 2N VWD, 50-90 U [as ristocetin cofactor (VWF:RCof)] kg(-1) of a factor VIII concentrate containing von Willebrand factor (FVIII/VWF concentrate) should be administered twice in routine extractions, and four to six times in surgical extractions. Gingival bleeding related to primary teeth can be mostly managed by pressure haemostasis alone. However, when treating gingival bleeding caused by marginal periodontitis, it is often necessary to administer 0.4 microg kg(-1) of DDAVP or 40-70 U (as VWF:RCof) kg(-1) of a FVIII/VWF concentrate. As local haemostasis is difficult to achieve in bleeding from the tongue or labial or mandibular haematoma, it is necessary to administer 0.4 microg kg(-1) of DDAVP or 60-80 U (as VWF:RCof) kg(-1) of a FVIII/VWF concentrate. In addition, oral administration of 20 mg kg(-1) day(-1) of tranexamic acid should be combined with the regimens described above.

Adolescent↗
PubMed1986

School-based drug education in North America: what is wrong? What can be done?

This article reviews experimental literature concerning the impact of drug (including alcohol and tobacco) education. Major weaknesses are identified with respect to planning, development, implementation, and evaluation of programs. Of special significance are inadequate identification of program objectives and target groups, failure to appreciate the dynamics of effective influence, lack of attention to program dissemination and utilization, and lack of concern with establishing the impact of programs through careful evaluation.

Child↗
PubMed2002

Volume reconstruction for health care: a survey of computational methods.

In many scientific and technical applications, a three-dimensional (3D) object must be reconstructed, either to assist in understanding the object's structure or to ease its automatic handling and analysis. Volume reconstruction has been used in health care to diagnose, simulate, facilitate surgical planning, develop image-guided surgery, facilitate telemedicine, and to assist in many other applications. This paper presents a survey of computational methods used to achieve volume reconstruction. First, we review 3D imaging techniques. Second, since we consider image segmentation the most important and difficult phase of 3D reconstruction, we focus on this topic. Subsequently, we concentrate on some of the most successful techniques of segmentation used for 3D reconstruction, such as active contours. We also review computer graphics and visualization methods used with volume reconstruction. Finally, we indicate future lines for research in volume reconstruction and 3D imaging for health care.

Brain↗