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Selected AbstractsRegion of birth, income and breastfeeding in a Swedish countyACTA PAEDIATRICA, Issue 11 2009T Wallby Abstract Aim:, To study the relationship between maternal region of birth, disposable income and breastfeeding initiation and duration. Methods:, The study population consisted of 12 197 term born, singleton infants, born 1997,2001 in the county of Uppsala. Data on breastfeeding at 1 week, 6 months and 12 months were collected from the register of statistics of the Child Health Care Unit in Uppsala and socioeconomic indicators from Swedish national registers. Multivariate analysis was conducted using Cox regression. Results:, No influence of disposable income or region of birth on breastfeeding initiation was observed. Breastfeeding rates at 6 months were lower for mothers with disposable incomes in quartile 1,3 compared with mothers with the highest incomes in quartile 4 (hazard ratios (HRs) 0.88,0.90, adjusted HRs 0.92). The breastfeeding rates at 12 months were higher for mothers born in all regions compared with mothers born in Sweden (HRs 1.25,2.45, adjusted HRs 1.20,2.14). Conclusions:, The findings in the present study show that disposable income is a strong predictor for breastfeeding at 6 months in the Swedish context. Region of birth of the mother predicted long term breastfeeding, ,12 months. This calls for professionals in the maternity and child health care to pay extra attention to breastfeeding in low-income mothers in all ethnic groups. [source] Problem-solving competency of nursing graduatesJOURNAL OF ADVANCED NURSING, Issue 5 2004Leana R. Uys DSocSc Aim., This paper reports a study describing and evaluating the outcomes of problem-based learning (PBL) programmes in nursing schools in South Africa in terms of the competence of graduates to solve problem in actual clinical settings, and comparing this competence with that of graduates from non-PBL programmes. Background., The nursing literature tends to equate problem-solving with patient-centred problems or the nursing process. However, it is also a skill used in managing the work role, working in a team and managing a health care unit. Problem-solving refers to the process of selectively attending to information in a patient care setting. The investigation of problem-solving in nursing is complicated by the complex relationships between different cognitive processes. Methods., A qualitative evaluation study, descriptive and comparative in nature, was carried out. In-depth interviews were held with graduates and their supervisors, asking them to identify problem-solving incidents in which they had been involved. Template analysis style and Benner's interpretive approach were used to analyse the data. Findings., The majority of the incidents described by the graduates (84%) were graded at the advanced beginner level or above. The majority of incidents at the novice level came from the non-PBL group. ,Using people skills' and ,being assertive' were the two problem-solving strategies most often used. The PBL group fared better than the non-problem-based group in the level of their problem-solving ability. Conclusion., The findings of this study suggest that further research is warranted into the problem-solving abilities of PBL graduates, their personal development over time and at different stages of practice. In addition, it would be interesting to follow the development of their problem-solving abilities over time. [source] Etiology and Distribution of Headaches in Two Brazilian Primary Care UnitsHEADACHE, Issue 3 2000Marcelo E. Bigal MD Objectives.,To determine (a) which patients seek primary care services with a complaint of headache, (b) the percentages of the various types of headache in this population, and (c) the impact of the care provided to these patients on the basic health care network. Background.,Headache is one of the most frequent symptoms reported in medical practice, resulting in significant medical services costs and loss of patient productivity, as well as reduced quality of life. Methods.,A prospective study was conducted in two towns (Ribeirão Preto and São Carlos) in the State of São Paulo, Brazil. The participants in the study consisted of 6006 patients (52.4% women) with highly varied acute symptoms. The patients ranged in age from 14 to 98 years. Results.,Headache as the main complaint was reported by 561 (9.3%) of the patients considered, with 312 (55.6%) of those patients presenting with primary headache, 221 (39.4%) with headaches secondary to systemic disorders, and 28 (5.0%) with headaches secondary to neurological disorders. Migraine, the most prevalent primary headache, accounted for 45.1% of patients reporting headache as the single symptom. The most frequent etiologies of headaches secondary to systemic disorders were fever, acute hypertension, and sinusitis. The most frequent headaches secondary to neurological disorders were posttraumatic headaches, headaches secondary to cervical disease, and expansive intracranial processes. Of the 26 cases of drug abuse, 20 were secondary to alcohol (hangover). Headaches secondary to systemic disorders were more frequent in the extreme age ranges. Conclusions.,Headache is a very frequent symptom among patients seen at primary health care units and should be considered a public health problem. The dissemination of the diagnostic criteria of the International Headache Society among primary health care physicians is urgently needed in order to avoid the repeated return of patients or their referral to more differentiated emergency units, which overburden an already insufficient health care network. [source] Nursing attitudes towards acute mental health care: development of a measurement toolJOURNAL OF ADVANCED NURSING, Issue 5 2005John A. Baker BNurs MSc MPhil RN Aim., This paper reports the development, piloting and validation of a tool to measure attitudes for use with nursing staff working in acute mental health care units. Background., The quality of care provided for service users in acute mental health care has come under both scrutiny and severe criticism. The attitudes of staff working in these environments have been cited as a contributory factor in poor care. No measure of attitudes specific to acute mental health has been reported. Methods., A 64-question measure was constructed and distributed to a sample of qualified and unqualified nurses drawn from seven mental health care units in the North of England. Exploratory factor analysis and a number of other statistical tests were performed to validate the questionnaire. Results., Preliminary analysis reduced the original 64 questions to 37. Five components were retained, accounting for 42% of the variance, and the five rotated factors were identified. The resultant ,Attitudes Towards Acute Mental Health Scale' (ATAMHS) achieved good internal reliability, with a Cronbach's alpha of 0·72. Conclusion., The construction and validation of the ATAMHS measure will enable improved understanding of the attitudes of nursing staff working in acute mental health care settings to occur. This measure is available for use in a clinical area of nursing in which attitude change is of fundamental importance for future development of care. [source] Equitable access to dental care for an at-risk group: a review of services for Australian refugeesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2007Natasha Davidson Objective: Despite the poor dental health of refugees, few specific services are available. This review maps public dental services for refugees across Australian jurisdictions, identifies gaps in provision, identifies barriers to accessing dental care, and provides recommendations for improving access and oral health promotion for this group. Methods: Data were sought from the State and Territory services for: a) the survivors of torture; b) oral health care units; and c) auditors-general reports of dental services. Eligibility criteria and estimated waiting times for general dental services, criteria for access to emergency care and availability of interpreter services were reviewed. Results: Marked variation exists across Australian jurisdictions in available dental services and criteria for access to public dental care for refugees. There is limited priority access to general dental services for refugees. Waiting times for public dental treatment in most, if not all, jurisdictions are unacceptably long (range 13,58 months). Few interpreter services exist for refugees seeking to access dental services. Conclusions: Access to dental services for refugees across Australia remains fragmented and limited, particularly in rural and regional areas. Refugees are not using services because of several barriers, including long waiting times, variation in assessment criteria, different eligibility criteria and limited interpreter services. Consequently, their pattern of service use does not accurately reflect their needs. Implications: Australia needs better co-ordinated, more extensive dental services that are easily accessible for this very high risk group. Identification of refugees as a special needs group and provision of targeted interventions addressing barriers to care are needed to establish adequate dental care. [source] The Tree Theme Method as an intervention in psychosocial occupational therapy: Client acceptability and outcomesAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 3 2009A. Birgitta Gunnarsson Background/aim:,The Tree Theme Method (TTM) is an intervention in which the client paints trees representing certain periods in his/her life. The intervention comprises five sessions, using trees as a starting point to tell one's life story. This study, which is part of an implementation project, aimed to examine the therapeutic alliance and client satisfaction, in relation to perceptions of everyday occupations and health-related factors, with clients going through a TTM intervention. Methods:,Nine occupational therapists recruited 35 clients, at general outpatient mental health care units, for the TTM intervention. Self-rating instruments, targeting therapeutic alliance (HAq-II), different aspects of daily occupations (Canadian Occupational Performance Measure, Satisfaction with Daily Occupations), health-related factors (Sense of Coherence measure, Mastery Scale, Symptom Checklist-90-R) and client satisfaction (Client Satisfaction Questionnaire), were administrated before and after the intervention. Results:,A good initial therapeutic alliance, experienced by both therapists and clients, was correlated to increased changes regarding occupational performance and self-mastery. According to the therapists' ratings, a good initial therapeutic alliance was correlated to increased sense of coherence and a decreased level of psychiatric symptoms. The results showed positive significant changes in occupational performance and health-related factors. High ratings of the therapeutic alliance by the therapists were also related to high client satisfaction. Conclusions:,The TTM seemed to function well in psychosocial occupational therapy, but there is a need for further implementation studies to deepen our understanding of the treatment process, comprising both technique and formation of the therapeutic alliance. [source] | ||||||||||