Home About us Contact
|
Home About us Contact | ||
|
|
||
Greater Involvement (greater + involvement)
Selected AbstractsRACE, FRIENDSHIP NETWORKS, AND VIOLENT DELINQUENCYCRIMINOLOGY, Issue 4 2006DANA L. HAYNIE Although a growing body of literature emphasizes the role of friendship networks and peer relations for youth involvement in violence and delinquency, little research has examined the role of friendship networks in understanding the varying involvement of different racial-ethnic groups in violence. Using data from approximately 13,000 respondents to the first two waves of the National Longitudinal Study of Adolescent Health (Add Health), we explore the ability of friendship networks to account for the differential rates of violence among racial-ethnic groups. In addition, we evaluate whether race moderates the degree to which friendship characteristics predict adolescent violence. Findings indicate significant differences in the structure and behavioral orientation of friendship networks across racial-ethnic identities. Moreover, incorporating characteristics of friendship networks into multivariate analyses accounts for greater involvement in violence among black and Hispanic youths. Network racial heterogeneity and friends' popularity also emerge as particular network characteristics that operate differently for black and white youth. [source] Participation and enjoyment of leisure activities in school-aged children with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 10 2008Annette Majnemer PhD OT The objective of this study was to characterize participation in leisure activities in children with cerebral palsy (CP) and identify determinants of greater involvement. Ninety-five children of school age (9y 7mo [SD 2y 1mo]) with CP were recruited, and participation was evaluated with the Children's Assessment of Participation and Enjoyment in a subset (67/95; 42 males, 25 females) who could actively participate in completion of the assessment. Most had mild motor dysfunction (Gross Motor Function Classification System: 59% level I, 23% level II, 18% levels III,V) and had a spastic subtype of CP (23 hemiplegia, 17 diplegia, 16 quadriplegia, 11 other). Biomedical, child, family and environmental predictor variables were considered in the analysis. Results demonstrated that these children were actively involved in a wide range of leisure activities and experienced a high level of enjoyment. However, involvement was lower in skill-based and active physical activities as well as community-based activities. Mastery motivation and involvement in rehabilitation services enhanced involvement (intensity and diversity) in particular leisure activities, whereas cognitive and behavioral difficulties, activity limitations, and parental stress were obstacles to participation. [source] Role of the general practitioner in smoking cessationDRUG AND ALCOHOL REVIEW, Issue 1 2006NICHOLAS A. ZWAR Abstract This paper reflects on the role of general practitioners in smoking cessation and suggests initiatives to enhance general practice as a setting for effective smoking cessation services. This paper is one of a series of reflections on key issues in smoking cessation. In this article we highlight the extent that general practitioners (GPs) have contact with the population, evidence for effectiveness of GP advice, barriers to greater involvement and suggested future directions. General practice has an extensive population reach, with the majority of smokers seeing a GP at least once per year. Although there is level 1 evidence of the effectiveness of smoking cessation advice from general practitioners, there are substantial barriers to this advice being incorporated routinely into primary care consultations. Initiatives to overcome these barriers are education in smoking cessation for GPs and other key practice staff; teaching of medical students about tobacco and cessation techniques, clinical practice guidelines; support for guideline implementation; access to pharmacotherapies; and development of referral models. We believe the way forward for the role of the GPs is to develop the practice as a primary care service for providing smoking cessation advice. This will require education relevant to the needs of a range of health professionals, provision of and support for the implementation of clinical practice guidelines, access for patients to smoking cessation pharmacotherapies and integration with other cessation services such as quitlines [source] Fluvial Geomorphology and River ManagementGEOGRAPHICAL RESEARCH, Issue 3 2000I. Douglas Australian river landscapes offer many challenges for management. Much Australian river research is novel, but practical concerns have always had an influence on the research agenda. Australia's distinctive contributions to fluvial geomorphology include recognition of the great age of many fluvially eroded landscapes; understanding complex levee, terrace and valley fill sequences; analysing the impacts of rare major floods; interpreting the effects of impoundment, mining and urbanisation; and understanding the great anastomosing inland river systems. River restoration is now a major theme in the literature of river engineering, fluvial geomorphology and landscape design. Great achievements are occurring in geo-ecological river management and engineering. Changing people's thinking is becoming at least as important as gaining new scientific knowledge. The existing understanding needs to be more widely shared and enhanced by greater involvement with Asian countries where river management issues daily affect the lives of millions of people. [source] Psychosocial factors involved in delayed consultation by patients with head and neck cancerHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 4 2005Olivier Rozniatowski DESS Abstract Background. In the north of France, a delay in primary consultation has been noted among patients with head and neck cancer. This group is often correlated with lower socioeconomic status and a lack of medical information. Therefore, the choice to seek consultation is often influenced by symptoms such as pain and change in the size of tumors in the neck. We studied this delay in seeking consultation, focusing on psychosocial variables such as professional and social background, the involvement of a spouse/partner, and the presence of anxiety and depression. Methods. Two rating scales were administered to 50 patients with large tumors (T3/T4) and 50 patients with small tumors (T1/T2), and the results were compared. These rating scales were as follows: (1) a 17-item questionnaire assessing sociodemographic data, presenting symptoms, factors generating the consultation, and reasons for delay; and (2) the Hospital Anxiety and Depression Scale (HADS). Results. Both groups were predominantly male and working-class. Significant differences were observed in time since symptom onset and in conscious delay in seeking medical attention. The group with large tumors was characterized by lower involvement of a spouse/partner, conscious delay before first consultation, greater social isolation, fewer medical visits, and lower HADS anxiety scores. The group with small tumors sought consultation sooner and was characterized by greater involvement of a spouse/partner, correlated with significant anxiety. Depression was not a factor influencing delay within either group. Conclusions. The interpersonal relationship with a spouse/partner seemed to be essential in the dynamics surrounding consultation. Anxiety, rather than socioeconomics status, was a discriminating factor in the delay in seeking consultation. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source] Exploring the experiences of partners who live with a chronic low back pain suffererHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2004Julia Miller BSc MA Abstract Chronic low back pain (CLBP) is a condition that causes individuals considerable distress. It also presents a significant challenge to the health service and is often viewed by clinicians as frustrating to manage. The purpose of the present paper is to explore the experiences of individuals in the immediate social sphere of those suffering from CLBP and their role in care-giving for their partner. An approach was taken using two qualitative research methods to gather data: journals and focus groups. Findings from the journals and the focus groups revealed issues for partners of CLBP sufferers in relation to living with their partners' pain, perceptions of healthcare and the dominance of illness over social contacts. Key themes revealed the complex emotions experienced by respondents, and underlined the need for their role as care givers and partners to be acknowledged by healthcare professionals. The data also highlighted respondents' desire to have greater involvement in their partners' healthcare, which includes provision of relevant information and involvement with therapeutic interventions. The findings emphasise the need for healthcare professionals to include and acknowledge partners and others in the immediate social sphere of patients in the management of chronic conditions. [source] Informal care: the views of people receiving careHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2002S. McCann BA MPsychSc Abstract Informal care is perceived to be the best option for people who require assistance to look after themselves. National and international studies of informal care have focused on the carer, not on the care provided, or the needs and experiences of the care recipients. In the present study, 55 people receiving informal care (21 males and 24 females, mean age = 67.6) were surveyed to determine the type of assistance that they receive, perceptions of the quality of their care, feelings about being looked after by a carer and their perceptions of the services which would be useful. A random sample of 531 households were selected as part of a larger study into informal care in the west of Ireland. A total of 98 carers were identified and 55 of the people they looked after were well enough to participate in the study. Over two-thirds of carers assisted with household chores (e.g. cleaning, preparing meals and shopping). Other activities which carers assisted with included keeping the person safe from household accidents (62%), personal care (42%), and dressing and undressing (31%). Whilst most were very satisfied with the quality of care, a minority reported dissatisfaction, and stated that their carer showed signs of anger and frustration. Common concerns related to the health of the carer, their safety when the carer is not available and the cost of being cared for. Financial support for the person receiving care and the carer were the main priorities for these individuals. The present study points to a need for greater involvement of care recipients in planning services relating to informal care, and support and access to health professionals for people receiving care. People receiving care are also concerned about the level of financial support for themselves and their carers. [source] Affording Universal Higher EducationHIGHER EDUCATION QUARTERLY, Issue 2 2002Lauchlan Chipman Can we achieve universal or near,universal higher education within the next two decades, without a massive increase in government investment in higher education? It is argued that the answer is yes, with greater involvement of the private, for,profit sector, or by encouraging existing not,for,profit universities to open for,profit campuses, at which the emphasis is on high,quality and convenient undergraduate teaching, with little or no research, and a concentration on high,demand, low,cost disciplines. This position requires us to recognise that research engagement is not conceptually essential for an institution to count as a university, understood both historically and through international comparison. Rather, this assumption operates as a significant entry barrier to new, low,cost entrants. This paper provides a case study of the ways in which Central Queensland University has extended its operations by developing surplus,generating campuses through joint,venture operations with the private sector, and argues such an operation could just as easily be developed as a free,standing, for,profit mode of university degree delivery , provided that present, artificial, protectionist limitations on the use of the name ,university' are removed. Degree programmes of such institutions should, of course, be subject to the same quality assurance standards as apply to existing universities. [source] Discrete dynamic Bayesian network analysis of fMRI dataHUMAN BRAIN MAPPING, Issue 1 2009John Burge Abstract We examine the efficacy of using discrete Dynamic Bayesian Networks (dDBNs), a data-driven modeling technique employed in machine learning, to identify functional correlations among neuroanatomical regions of interest. Unlike many neuroimaging analysis techniques, this method is not limited by linear and/or Gaussian noise assumptions. It achieves this by modeling the time series of neuroanatomical regions as discrete, as opposed to continuous, random variables with multinomial distributions. We demonstrated this method using an fMRI dataset collected from healthy and demented elderly subjects (Buckner, et al., 2000: J Cogn Neurosci 12:24-34) and identify correlates based on a diagnosis of dementia. The results are validated in three ways. First, the elicited correlates are shown to be robust over leave-one-out cross-validation and, via a Fourier bootstrapping method, that they were not likely due to random chance. Second, the dDBNs identified correlates that would be expected given the experimental paradigm. Third, the dDBN's ability to predict dementia is competitive with two commonly employed machine-learning classifiers: the support vector machine and the Gaussian naïve Bayesian network. We also verify that the dDBN selects correlates based on non-linear criteria. Finally, we provide a brief analysis of the correlates elicited from Buckner et al.'s data that suggests that demented elderly subjects have reduced involvement of entorhinal and occipital cortex and greater involvement of the parietal lobe and amygdala in brain activity compared with healthy elderly (as measured via functional correlations among BOLD measurements). Limitations and extensions to the dDBN method are discussed. Hum Brain Mapp, 2009. © 2007 Wiley-Liss, Inc. [source] A comparison of label-based review and ALE meta-analysis in the Stroop taskHUMAN BRAIN MAPPING, Issue 1 2005Angela R. Laird Abstract Meta-analysis is an important tool for interpreting results of functional neuroimaging studies and is highly influential in predicting and testing new outcomes. Although traditional label-based review can be used to search for agreement across multiple studies, a new function-location meta-analysis technique called activation likelihood estimation (ALE) offers great improvements over conventional methods. In ALE, reported foci are modeled as Gaussian functions and pooled to create a statistical whole-brain image. ALE meta-analysis and the label-based review were used to investigate the Stroop task in normal subjects, a paradigm known for its effect of producing conflict and response inhibition due to subjects' tendency to perform word reading as opposed to color naming. Both methods yielded similar activation patterns that were dominated by response in the anterior cingulate and the inferior frontal gyrus. ALE showed greater involvement of the anterior cingulate as compared to that in the label-based technique; however, this was likely due to the increased spatial level of distinction allowed with the ALE method. With ALE, further analysis of the anterior cingulate revealed evidence for somatotopic mapping within the rostral and caudal cingulate zones, an issue that has been the source of some conflict in previous reviews of the anterior cingulate cortex. Hum Brain Mapp 25:6,21, 2005. © 2005 Wiley-Liss, Inc. [source] The relationship between healthcare professionals and the parents of chronically ill children: negotiating the boundaries between dependence and expertiseINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 1 2007Alda Hummelinck senior clinical pharmacist Objective Mutual respect and understanding between parents and healthcare professionals are fundamental to the realisation of a partnership in the provision of care to chronically ill children. The aim of this study was an exploration of parents' perspectives on their relationship with healthcare professionals and their involvement in decisions about their child's care. Setting The paediatric department of a district general hospital in the West Midlands, England. Method Qualitative methodology using semi-structured interviews with 27 parents from 20 families with a chronically ill child. Key findings In the time following the child's diagnosis, parents' attitudes towards healthcare professionals often moved from reliance and trust to scepticism and suspicion. This change in attitude derived from their experience of inadequate communication and perception of professionals' failure to understand the reality of the intense and relentless demands and challenges that confront families providing care for a chronically ill child. Parents tended to be initially accepting and deferential to professional expertise. Over time, however, as their experience and confidence increased, they often desired a greater involvement in decisions about treatment and care. This transition, between initial, or episodic, dependency and active partnership, was often not recognised or accommodated by professionals. It was difficult for both parties to negotiate the transition from parents' dependency on health professionals to becoming more independent managers of care. Conclusions Professionals should be aware of parents' preferred and changing level of involvement in care and decision making, and endeavour to accommodate these throughout the process of providing care for chronically ill children. [source] Poverty decline, agricultural wages, and nonfarm employment in rural India: 1983,2004AGRICULTURAL ECONOMICS, Issue 2 2009Peter Lanjouw Poverty; Agricultural labor; India; Nonfarm employment Abstract We analyze five rounds of National Sample Survey data covering 1983, 1987/1988, 1993/1994, 1999/2000, and 2004/2005 to explore the relationship between rural diversification and poverty. Poverty in rural India has declined at a modest rate during this time period. We provide region-level estimates that illustrate considerable geographic heterogeneity in this progress. Poverty estimates correlate well with region-level NSS data on changes in agricultural wage rates. Agricultural labor remains the preserve of the uneducated and also to a large extent of the scheduled castes and scheduled tribes. We show that while agricultural labor grew as a share of total economic activity over the first four rounds, it had fallen back to the levels observed at the beginning of our survey period by 2004. This all-India trajectory also masks widely varying trends across states. During this period, the rural nonfarm sector has grown modestly, mainly between the last two survey rounds. Regular nonfarm employment remains largely associated with education levels and social status that are rare among the poor. However, casual labor and self-employment in the nonfarm sector reveals greater involvement by disadvantaged groups in 2004 than in the preceding rounds. The implication of this for poverty is not immediately clear,the poor may be pushed into low-return casual nonfarm activities due to lack of opportunities in the agricultural sector rather than being pulled by high returns offered by the nonfarm sector. Econometric estimates reveal that expansion of the nonfarm sector is associated with falling poverty via two routes: a direct impact on poverty that is likely due to a pro-poor marginal incidence of nonfarm employment expansion; and an indirect impact attributable to the positive effect of nonfarm employment growth on agricultural wages. The analysis also confirms the important contribution to rural poverty reduction from agricultural productivity, availability of land, and consumption levels in proximate urban areas. [source] The adoption of intensive monocrop horticulture in southern CameroonAGRICULTURAL ECONOMICS, Issue 3 2004James Gockowski Logit; Monocrop; Agricultural intensification; Cash crop synergy Abstract Results from a 1997 survey of 208 households in the humid forest zone of southern Cameroon indicate that African policy makers seeking to intensify agricultural production should focus attention on the horticultural sub-sector. The survey, which gathered information on horticultural production practices, found that the average expenditure on agro-chemical inputs by horticultural producers using monocrop production systems was 190US$/ha, which greatly exceeds the FAO reported national average expenditure of 6.50 US$/ha. A logit model of monocrop adoption indicated that the size of land holding per household had a negative effect on adoption, congruent with population-driven technical change and that increases in unit transportation costs significantly decreased the probability of adoption. These findings suggest that policy makers should target horticultural intensification in areas of higher population density and promote investment in rural roads. The age of the household head had a significant negative and elastic effect on adoption, which in combination with an increase in the cohort of younger farmers in the rural population induced by macro-economic events contributed to the spread of intensified horticulture. In the study area, roughly two-thirds of rural households also produce cocoa and the quantity of cocoa produced was positively associated with adoption of intensive horticultural systems suggesting that export crop promotion indirectly facilitated diversification of agriculture. Women's participation in intensive monocrop production was limited and efforts to promote their greater involvement are recommended. [source] Paternal Involvement with Children: The Influence of Gender IdeologiesJOURNAL OF MARRIAGE AND FAMILY, Issue 1 2004Ronald E. Bulanda Although prior social science research has established the ability of gender ideologies to influence the domestic division of labor, it has neglected to disentangle their potentially unique influence on paternal involvement with children. Past research examining the influence of gender ideology on parenting behaviors does not acknowledge potential differences that may result from accounting for each parent's gender ideology. Using both waves of the National Survey of Families and Households (N = 1,088), I assess the effect of both mother's and father's gender ideology on two measures of paternal involvement. Whereas egalitarian fathers demonstrate greater involvement than traditional fathers, mother's gender ideology failed to predict paternal involvement. Egalitarian mothers do not appear to negotiate greater father involvement successfully. [source] Enabling student placement through strategic partnerships between a health-care organization and tertiary institutionsJOURNAL OF NURSING MANAGEMENT, Issue 1 2007AMANDA HENDERSON RN RM ICU (Cert) BSc GradDipNurs(Ed) MSc Soc PhD Nursing management needs to demonstrate its commitment to clinical education for undergraduate nursing students. The vision for the nursing leadership and management team at Princess Alexandra Hospital is to guide and support the development of hospital clinicians, at all levels in the organization, to effectively facilitate undergraduate students' learning during their clinical practical experiences. This paper examines the evolution of the meaning, commitment and practices that have been intrinsic to the development of strategic partnerships between the health-care organization and tertiary institutions to ensure that hospital staff who consistently facilitate student learning in the clinical context are well supported. The partnerships are based on open channels of communication between the health-care organization and the tertiary institutions whereby each party identifies its needs and priorities. This has resulted in increased hospital staff satisfaction through greater involvement by them in the placements of students, and enhanced understanding of clinicians of the student placement process that has contributed to improved satisfaction and outcomes for the students. [source] Should service user involvement be consigned to history?JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2006A critical realist perspective Service user involvement in the UK healthcare agenda is now widely expected. Historically, service user groups have been increasingly successful in their demands for greater involvement. Hierarchies of involvement exist that include consultation and partnership working. Psychiatry is an archetypal arena in terms of power and control. The traditional view of interpreting the place of service users within this arena is that the service user is at the bottom of this hierarchy; involvement allows transcendence of the power hierarchy. Critical realist theory is offered as an alternative approach to understanding these complex relationships. It is argued that contemporary models of involvement perpetuate and sustain the power positions of the dominant discourse within psychiatry. It is suggested that a critical realism perspective, offers a model that does not kowtow to the dominant discourse but rather recognizes that service users now possess power, especially in terms of being able to provide services that statutory services providers now require. Is it time for service users to call the tune, and, in doing so, establish a power position outside the traditional hierarchy of power? [source] Latest news and product developmentsPRESCRIBER, Issue 17 2007Article first published online: 6 NOV 200 Drug information stilllacking for mentally ill Half of people with mental illness still have no say in the medication they are prescribed and one-third are not informed about side-effects, according to the latest report by the Healthcare Commission and the Commission for Social Care Inspection (www.health-carecommission.org.uk). The annual national review of adult mental health services found overall improvement among local intervention teams in 2005/06 compared with the preceding year, though all could improve further and the performance of 46 per cent were rated as only fair or weak. A survey of 7446 people with schizophrenia also showed that only 46 per cent had access to psychological treatments. More incentives for shift of care in Scotland Scotland has made good progress on shifting NHS care into the community but joined-up thinking, better information and incentives are needed to overcome barriers to better management of long-term conditions in adults, says Audit Scotland (www.audit-scotland.gov.uk). Reviewing progress on the 2005 strategy document Delivering for Health, Audit Scotland found good progress on asthma and diabetes services , partly due to the effects of the GMS contract. Better information about clinical activity, costs and effectiveness is needed to help redesign services. Patients with more than one long-term condition do not receive co-ordinated care and many want greater involvement in their care, the report concluded. Acorn, QOF and Guy Rotherham awards Entries are invited for the 2007 annual Acorn, QOF and Guy Rotherham Awards. The awards are run in association with the NHS Alliance, Improvement Foundation, British Cardiac Society, British Cardiac Patients Society and Prescriber. The CHD QOF Award, sponsored by Schering-Plough, recognises the achievement of an individual practice that gains maximum points in the CHD and heart failure QOF domains, and a second award is given to the primary care organisation (PCO) that achieves the best average scores across its practices. The entry form can be found at www.escriber.com. The closing date is 12 October. Entries are also invited for the Guy Rotherham Award from PCOs that can demonstrate they have delivered a high-impact change resulting in better outcomes and services for patients. For online entry go to www.improvementfoundation.org/guy rotherhamaward. Closing date is 5 October. Award winners will receive free entry for three to the NHS Alliance conference and the conference dinner. The winner of the Guy Rotherham Award will also receive £3000. NICE scores five out of six NICE acted unreasonably in relying solely on the Mini-Mental State Examination (MMSE) to define severity of Alzheimer's disease in its updated technology appraisals, with the effect of discriminating against people with learning or language difficulties, the High Court has ruled. The five other claims by Eisai that NICE acted unreasonably and irrationally were not upheld. This was the first court action against NICE in its eight-year history. It has now promised to publish revised appraisals on its website on 7 September and is consulting with Eisai, Shire Pharmaceuticals and the Alzheimer's Society on the best approach. PPRS reform follows Office of Fair Trading report The Government is to renegotiate the Pharmaceutical Price Regulation Scheme (PPRS) following the critical report by the Office of Fair Trading (OFT). In February, the OFT recommended renegotiation of the PPRS to reward innovation and obtain better value for patients. In particular, it called for a pricing scheme based on value for patients, ie effectiveness, rather than profit controls. The DoH, acknowledging the report's complexity, says it will take four principles into account in its negotiations during the forthcoming months: value for money, promoting innovation, assisting the uptake of new cost-effective medicines and promoting market stability. MHRA launches e-bulletin The MHRA (www.mhra.gov.uk) has next issue can be downloaded. The launched an electronic bulletin to August bulletin includes items on provide health professionals with antidepressants and suicide, updates about the safe use of medi-adverse effects of dopamine ago-cines. Users need to sign up to nists and information about smokreceive an e-mail alert when the ing cessation and isotretinoin. DURG call for abstracts The Drug Utilisation Research Group is calling for abstracts for its 19th annual meeting ,Target-driven medicine , is this the end of prescribing freedom?' to be held on 7 February 2008 at the Royal Society of Medicine, London. Abstracts are requested on any aspects of drug utilisation research. A bursary of £500 will be awarded for the best abstract received. The closing date for receipt of abstracts is 26 November. Further information about abstract submission is available at www.durg.org.uk. GP prescribing up by half Prescription volume and costs in England increased by approximately half over the decade to 2006, according to data published by the Information Centre for Health and Social Care (www.ic.nhs.uk). The number of items dispensed per year increased by 55 per cent and the cost by 60 per cent in real terms. The average number of items per head of population was 10.0 in 1996 and 14.8 in 2006; older people received 21.2 items per head in 1996 but 40.8 in 2006. MR morphines similar Modified-release preparations of morphine are equivalent in the treatment of severe pain, according to a new review by Bandolier (www.jr2.ox.ac.uk). The analysis of 54 randomised trials, which reviewed the release mechanisms and clinical data for four brands, showed these preparations provide effective analgesia for malignant and nonmalignant pain; about 4 per cent of patients were unable to tolerate the adverse effects of morphine. NSAIDs compared in OA Etoricoxib (Arcoxia) and naproxen are equally effective in the long-term treatment of osteoarthritis (Ann Rheum Dis 2007;66:945,51). Extension studies for two one-year trials showed that, after a total of 138 weeks, the two drugs had almost identical effects on pain and function assessments. All treatments were generally well tolerated, but serious cardiovascular effects were more common with etoricoxib and serious GI effects more common with naproxen. CPN nystatin allowed Community practitioner nurses (CPNs) may now prescribe oral nystatin (Nystan) to treat oral thrush in neonates, following a special amendment to the regulations limiting their prescribing to licensed indications. CPNs may now prescribe oral nystatin at the dose recommended in the BNF for Children provided they are sure of the diagnosis. In doing so, they accept clinical and medicolegal responsibility for their actions. There are no other exceptions to the prohibition of off-label prescribing. Copyright © 2007 Wiley Interface Ltd [source] Natural disaster and mental health in AsiaPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2004MASAHIRO KOKAI md Abstract, The purpose of the present article was to review the literature on disaster mental health in relation to natural disasters such as earthquakes, volcanic eruptions, typhoons and cyclones throughout Asia. Articles reviewed show that disaster psychiatry in Asia is beginning to emerge from and leave behind the stigma attached to mental health. The emergence of the acceptance of disaster mental health throughout Asia can be attributed in part to the acceptance of the notion of post-traumatic stress disorder (PTSD). This has allowed greater involvement of mental health professionals in providing ongoing support to survivors of natural disasters as well as providing greater opportunities for further research. Also, articles reviewed in the present paper commonly suggested the need for using standardized diagnostic tools for PTSD to appropriately interpret the discrepancy of results among studies. The importance of post-disaster support services and cultural differences is highlighted. [source] Vocational assessment of secondary students with disabilities and the school psychologistPSYCHOLOGY IN THE SCHOOLS, Issue 6 2008Christopher J. Fives Although much progress has been made in the identification and remediation of academic learning difficulties, less attention has been given to the career development of students with disabilities. Through their psychoeducational evaluations school psychologists are in an excellent position to provide useful information about the vocational functioning of these students. Some school practitioners may be hesitant to contribute fully to the vocational assessment process because they are unfamiliar with vocational behavior literature. In an effort to encourage greater involvement, the school psychologist's role as member of a career assessment team is discussed, and vocational theory and research concerning interest, ability, and personality characteristics are reviewed. Assessment and data integration strategies are offered. © 2008 Wiley Periodicals, Inc. [source] Evaluation of the needs and concerns of partners of women at high risk of developing breast/ovarian cancerPSYCHO-ONCOLOGY, Issue 2 2006Shab Mireskandari Abstract This exploratory study investigates the experience of partners of women at high risk of developing breast/ovarian cancer and reports on the partners' views concerning their relationship, communication, future planning, children and childbearing, involvement in decision-making regarding screening and prophylactic measures, and information and support needs. In-depth interviews were conducted with 15 partners. Of these, seven were partners of women who were BRCA1/2 mutation carriers, five were partners of women with unknown mutation status, and three were partners of women who were non-carriers. None of the women had a previous diagnosis of breast or ovarian cancer. Partners of carriers and women with unknown mutation status were found to be more distressed than partners of non-carriers, with partners of mutation carriers reporting the most difficulties. Factors associated with better adjustment and coping for partners included dealing with this situation as a team with their wife, greater involvement in decision-making, satisfaction with their supportive roles and being optimistic. Decision-making difficulties in relation to prophylactic measures, concerns about their children possibly being at increased cancer risk, as well as the need to receive information directly from health professionals and the wish to meet other partners were also discussed. Copyright © 2005 John Wiley & Sons, Ltd. [source] Do patients benefit from participating in medical decision making?PSYCHO-ONCOLOGY, Issue 1 2006Longitudinal follow-up of women with breast cancer Abstract This study sought to examine the relationships between decisional role (preferred and assumed) at time of surgical treatment (baseline), congruence between assumed role at baseline and preferred role 3 years later (follow-up), and quality of life at follow-up. Two hundred and five women diagnosed with breast cancer completed the decisional role preference scale at baseline and follow-up, and the EORTC QLQ-C30 at follow-up. A statistically significant number of women had decisional role regret, with most of these women preferring greater involvement in treatment planning than was afforded them. Women who indicated at baseline that they were actively involved in choosing their surgical treatment had significantly higher overall quality of life at follow-up than women who indicated passive involvement. These actively involved women had significantly higher physical and social functioning and significantly less fatigue than women who assumed a passive role. Quality of life was significantly related to reports of experienced involvement in treatment decision making, but not to reports of preferred involvement, or congruence between preferred and experienced involvement. Copyright © 2005 John Wiley & Sons, Ltd. [source] The influence of maternal and child characteristics and paternal support on interactions of mothers and their medically fragile infants,RESEARCH IN NURSING & HEALTH, Issue 1 2007Tzu-Ying Lee Abstract The influences of maternal characteristics, infant characteristics, and paternal support on maternal positive involvement and developmental stimulation were examined over time in 59 mothers and their medically fragile infants using an ecological framework. Higher maternal education was associated with greater maternal positive involvement. More maternal depressive symptoms, more infant technological dependence, and lower birthweights were associated with less maternal positive involvement at 6 months but greater involvement at 12 months. Higher paternal helpfulness facilitated positive involvement in mothers with low depressive symptoms but not in those with elevated symptoms. Higher maternal education and more depressive symptoms were associated with more developmental stimulation. Thus, maternal interactive behaviors are affected by maternal, infant, and environment factors, and these effects change over time. © 2007 Wiley Periodicals, Inc. Res Nurs Health 30: 17,30, 2007 [source] Effect of perinatal asphyxia on thyroid-stimulating hormone and thyroid hormone levelsACTA PAEDIATRICA, Issue 3 2003DN Pereira Aim: To compare serum concentrations of thyroid hormones,T4, T3, free T4 (FT4) and reverse T3 (rT3),and thyroid-stimulating hormone (TSH) found in the umbilical cord blood of term newborns with and without asphyxia and those found in their arterial blood collected between 18 and 24 h after birth. A further aim of the study was to assess the association between severity of hypoxic-ischemic encephalopathy and altered thyroid hormone and TSH levels, and between mortality and FT4 levels in the arterial blood of newborns between 18 and 24 h of life. Methods: A case-control study was carried out. The case group comprised 17 term newborns (Apgar score ,3 and ,5 at the first and fifth minutes; umbilical cord blood pH ,7.15) who required bag and mask ventilation for at least one minute immediately after birth. The control group consisted of 17 normal, term newborns (Apgar score ,8 and ,9 at the first and fifth minutes; umbilical cord blood pH ,7.2). Cord blood and arterial blood samples were collected immediately after birth and 18 to 24 h after birth, respectively, and were used in the blood gas analysis and to determine serum concentrations of T4, T3, FT4, rT3 and TSH by radioimmunoassay. All newborns were followed-up until hospital discharge or death. Results: Gestational age, birthweight, sex, size for gestational age, mode of delivery and skin color (white and non-white) were similar for both groups. No differences were found in mean levels of cord blood TSH, T4, T3 and FT4 between the groups. In the samples collected 18 to 24 h after birth, mean levels of TSH, T4, T3 and FT4 were significantly lower in the asphyxiated group than in the control group. Mean concentrations of arterial TSH, T4 and T3 between 18 and 24 h of life were lower than concentrations found in the cord blood analysis in asphyxiated newborns, but not in controls. In addition, asphyxiated newborns with moderate/severe hypoxic-ischemic encephalopathy presented significantly lower mean levels of TSH, T4, T3 and FT4 than those of controls. None of the asphyxiated newborns with FT4 ,2.0 ng/dl died; 6 out of the 11 asphyxiated newborns with FT4 < 2.0 ng/dl died. Conclusions: Serum concentrations of TSH, T4, T3 and FT4 are lower in asphyxiated newborns than in normal newborns between 18 and 24 h of life; this suggests central hypothyroidism secondary to asphyxia. Asphyxiated newborns with moderate/severe hypoxic-ischemic encephalopathy present a greater involvement of the thyroid function and consequently a greater risk of death. [source] | |||||||||||||