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At least 1,297 records · Page 72Linked to original sources
PubMed1996

Improving the treatment of nocturnal asthma: use of an office questionnaire to identify nocturnal asthma symptoms.

Nocturnal asthma is a major problem in many asthma patients and it is important to recognize and treat it. We previously reported the incidence of nocturnal asthma in our practice (1); the current study was done to try to improve upon the incidence of nocturnal asthma in our patients. After our previous survey, which indicated a 67% incidence of nocturnal asthma in our practice, we instituted a previsit questionnaire regarding nocturnal asthma to be filled out by all follow-up asthma patients in our office. After a period of time, we mailed a nocturnal asthma questionnaire to all asthma patients to see if the intervention had improved our incidence of nocturnal asthma. This questionnaire was identical to the one used in our prior study and was mailed to 2019 patients. We had 602 responders, 560 of whom had asthma. A total of 328 of these patients (59%) had nocturnal asthma. This was similar to the results of our previous survey, and our initial conclusion was that the new in-office questionnaire that we instituted had not improved the situation. Then we discovered that the in-office questionnaire had inadvertently been distributed only to the patients of one or our physicians (Dr. A). His patients were then compared with those of the other two doctors (Drs. B and C), and it was found that Dr. A's patients had fewer nocturnal symptoms than did the patients of the other doctors. The percent of asthmatics with nocturnal asthma 4-7 nights per week (more than half the nights in a week) for Dr. A was 16%, for Dr. B 47%, and for Dr. C 39%. The use of a short office questinnaire for asthma patients before they see the doctor for follow-up visits leads to greater recognition and better treatment of nocturnal asthma.

Asthma↗
PubMed1985

Research and treatment: the need for a combined effort.

Institutional, ideological, practical, and logistical constraints have impeded treatment research efforts in the substance abuse fields. There is a need for innovation in the design and conduct of treatment research studies, including studies that are less restrictive of therapists' judgments and more sensitive to individual client differences. Among the advantages of a greater collaboration between clinicians and researchers are the facilitation of research on the matching of clients to treatments and the enhanced impact of research findings on clinical practice.

Humans↗
PubMed2006

Assessment of female participation in an employee 20-week walking incentive program at Marshfield Clinic: a large multispecialty group practice.

OBJECTIVE: We evaluated the short-term effect of a worksite-based walking incentive program to promote physical activity and well-being in employees of a private healthcare clinic. DESIGN: A prospective, observational follow-up study. SETTING: The study was conducted at Marshfield Clinic, a large private multispecialty group practice healthcare institution in Marshfield,Wisconsin, USA. PATIENTS: Subjects for this study were Marshfield Clinic physicians and staff. METHODS: From March 31, 2005 to August 20, 2005, physical activity level, body mass index (BMI) and other well-being characteristics were observed pre- and post-program among 191 female participants from the Marshfield Clinic. A brief Web site-accessible, self-reported survey assessed the effectiveness of the exercise program. RESULTS: Our data show a statistically significant (p <0.0001) increase in participants' physical activity level, while a significant (p = 0.021) decrease in mean BMI was observed. However, there was no evidence of our incentive program reducing participants' blood pressure. CONCLUSION: Preliminary findings of our study suggest that the goal of worksite programs designed to support employees in their efforts to improve or maintain their level of wellness is potentially achievable. Continuing research is needed to further assess whether persistent health benefits can be induced by worksite wellness programs.

Exercise↗
PubMed1997

The York Factory medical journals, 1846-52.

The York Factory medical journals are the only surviving medical ledgers in the 200-year history of the Hudson's Bay Company, written by two physicians posted at one of the Company's largest and pre-eminent posts, York Factory. The daily journals offer us a unique glimpse, albeit for a seven-year span from 1846 to 1852, into the incidence and prevalence, duration, severity, treatment, outcomes, and seasonality of illness and disease. Occupations are noted, as are age and gender, in many of the entries. There are a total of 1,653 cases seen by the two physicians over the time period, 5 percent of which are Native. Several women were seen by the physicians, primarily for gynecological disorders. Gastro-intestinal disorders were a major source of morbidity at this time and place.

Canada↗
PubMed2005

[National survey on the current status of programs to teach end-of-life care to undergraduates of medical and nursing schools in Japan].

AIM: We conducted a national survey to examine the current status of programs to teach end-of-life care to undergraduates of Japanese medical and nursing schools in 2004. METHODS: Our survey focused on the following areas: (1) the present status of curricula to teach end-of-life care, (2) topics covered in the curricula, (3) details of the timing of existing end-of-life care teaching programs and of departments responsible for it, (4) teaching methods, (5) education assessment tool, (6) reading list of textbooks. RESULTS: 50.6% of the medical schools and 40.9% of the nursing schools participated. Most of the schools offered end-of-life care education programs, and 45% of the medical schools and 68.9% of the nursing schools offered education concerning end-of-life care for elderly. The most frequent teaching timing was the fourth year of medical school and the third year of nursing school. Broader end-of-life topics were covered in the curriculum in the nursing schools than the medical schools. One fourth of the nursing schools offered a separate course in end-of-life care. The mean number of teaching hours was 7.6 in the medical schools and 35.5 in the nursing schools. More nursing schools offered educational programs in which students can gain experience with end-of-life care than medical schools. A few institutions used practiced examinations to evaluate students' learning. A reading list of end-of-life care textbooks was provided in 10% of the medical schools and 35.6% of the nursing schools. CONCLUSION: Our survey suggested that systematizing end-of-life care education and improvement in text content are on the way.

Adult↗
PubMed2004

CEO's perceptions of hospitalists: diffusion of the strategy.

Many hospitals have initiated a strategy to reduce costs and improve quality of care by using physicians as "hospitalists." A hospitalist specializes in inpatient care. This article reports the findings of survey research examining CEO perceptions of the hospitalist model, with particular interest in diffusion of the strategy in rural and low managed care hospital markets. Findings indicate there is less diffusion of the hospitalist model to rural areas because of lack of information about the cost effectiveness of the program and medical staff resistance. Recommendations to increase adoption of the hospitalist strategy include educating about the benefits of the strategy and paying attention to areas of concern by the medical staff.

Attitude of Health Personnel↗
PubMedDate not supplied

Thinking about tomorrow for nursing: changes and challenges.

Many changes will be forthcoming in planning and implementing nursing practice in community-based settings in the future. Nursing education will experience major challenges in planning and developing curricula as a response to more mature people becoming nurses for the first time. Clinical practice "without walls," a change from what we have traditionally known, will require creative approaches toward bringing nurse colleagues along who have only practiced in institutions. This article is intended to stimulate new ideas and solutions for nursing to meet new challenges brought on by health care reform.

Community Health Nursing↗
PubMedDate not supplied

Nurse manager orientation: guidelines to meet the challenge of a rapidly changing role.

A management development program at The Johns Hopkins Hospital in Baltimore addresses the competency needs of 68 nurse managers. Orientation of new nurse managers is a significant component of the program. The orientation is based on performance standards and identification of organizational resources and opportunities to assist the managers to meet the standards. A convenience sample of 10 nurse managers, assistant directors, and directors of nursing reviewed the program 1 year after implementation and found it had improved the quality of orientation by providing structure and organization. The model can be applied to other institutions and practice roles.

Education, Nursing, Continuing↗
PubMed2003

Integrating hospitalists into the pediatric intensive care unit.

The role of the pediatric hospitalist has an extremely bright future in many facets of the pediatric healthcare spectrum. The role of the hospitalist in the PICU is only one of many that shows great promise and will likely change our current models of care for children. The greatest challenge will be the education of healthcare providers who may see these changes as erosion in care, rather than as an important asset in providing quality care for children.

Child↗
PubMed2006

Intracranial hemangioblastomas: an institutional experience.

BACKGROUND AND AIMS: We present our Institutional experience with intracranial hemangioblastomas. SETTINGS AND DESIGN: A retrospective study. MATERIALS AND METHODS: This study included all patients of intracranial hemangioblastomas admitted in our institution over a period of 11 years from January 1992 through June 2003. RESULTS: There were a total of 69 patients (45 males and 24 females). The average age at presentation was 34.5 years. The tumor was located in the cerebellar hemispheres, vermian and brainstem regions in 42 (60%) patients, 19 (28%) patients and 8 (12%) patients, respectively. Hydrocephalus was seen in 48 (69%) patients. Thirty-three patients underwent CSF diversion procedures prior to surgery on the tumor. All except one underwent definitive surgery. The mortality was 8 (11%). Sixty eight patients underwent surgery on the tumor. The follow-up ranged from 1 month to 11 years. Fifteen patients developed recurrent lesions. CONCLUSION: Lifelong surveillance is necessary in cases with hemangioblastomas to identify recurrences especially in those patients having VHL syndrome.

Adult↗
PubMed1998

Massage as a nursing intervention: using reflection to achieve change in practice.

The process of reflection can be used by nurse educators to more fully understand the nature of nursing practice and to actively use that understanding to bring about change through education. This paper documents a process of reflection carried out by a nurse educator within an action research project. The project was intended to assist palliative care nurses to learn the skill of massage and successfully integrate this therapy into their practice. Reflection takes place before the action to achieve change is implemented, in order to identify factors which will affect the development and implementation of the project. The reflection includes discussion of methodological issues, consideration of the influence of massage and holism in nursing practice and the influence of practice and institutional factors on palliative care nursing.

Health Services Research↗