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Increased Awareness (increased + awareness)
Selected AbstractsTaking an Undergraduate Nutrition Course Results in Favorable Attitudes Toward a Healthful Diet and Improved Intake of Several Key NutrientsFAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 1 2009Roman Pawlak The purpose of this research was to assess the impact of introductory undergraduate nutrition course on students' attitudes toward healthy diet and on students' intake of nutrients. A pre and post-test design was used to assess changes in self-reported nutrient intake. Open-ended questions were asked to elicit responses about how/whether the course had any impact on their attitudes toward foods and dietary behavior. A statistically significant increase in fiber, folate, potassium, and calcium intake were observed, comparing post to pre-test. A decrease in saturated fat intake in terms of energy percentage was observed. Increased awareness of the impact of diet on health was reported by students. A desire to increase intake of fruits, vegetables, and whole grains, and to decrease intake of fat and sugar was also reported. Students reported a willingness to eat less fast food and candies as well as drink fewer sodas. Thus, in this study a college nutrition course did effectively increase awareness of a healthy diet as well as change in attitude and modify dietary behavior. [source] Identification and management of women with inherited bleeding disorders: a survey of obstetricians and gynaecologists in the United KingdomHAEMOPHILIA, Issue 4 2006C. CHI Summary., A mail survey of members and fellows of Royal College of Obstetricians and Gynaecologists was carried out to determine current practices of obstetricians and gynaecologists in the United Kingdom in the management of women with inherited bleeding disorders. In total, 3929 questionnaires were sent, 707 returned and analysis was limited to 545 valid questionnaires. In the past 5 years, 91% have managed women with inherited bleeding disorders. The majority (83%) considered inherited bleeding disorders to be under diagnosed in obstetrics and gynaecology. More than 80% considered the prevalence of von Willebrand's disease (VWD) to be <0.2% in the general population and <1% in women with menorrhagia and no gynaecological pathology, although the reported prevalence is 1% and 5,25% respectively. Twelve percent of the respondents would arrange testing for VWD when reviewing an 18-year-old with menorrhagia and no pelvic pathology, while only 2% would do the same for a 35-year-old with the same presentation. Twenty-one percent thought elective caesarean section is indicated in all fetuses known to be at risk of being affected by haemophilia. Eighty-four percent considered vacuum extraction unsafe in these cases, but 76% would consider the use of low forceps. In conclusion, obstetricians and gynaecologists underestimate inherited bleeding disorders as an underlying cause for menorrhagia. Increased awareness and management guidelines are essential in minimizing haemorrhagic complications and improving quality of care of these women. [source] Tracing Salmonella in Alheira processing plantsJOURNAL OF APPLIED MICROBIOLOGY, Issue 1 2007A. Esteves Abstract Aims:, To investigate the sources of Salmonella spp. in Alheira and how to trace it, by studying the way that Salmonella spp. is distributed across production lines, by applying multifactorial correspondence analysis to occurrence data, and through the use of polymerase chain reaction (PCR) molecular typing methods. Methods and Results:, Four production lines, four batches of Alheira and 14 sampling sites were analysed over four sampling periods. Eighty-five Salmonella spp. isolates were obtained from the 896 microbial analyses performed. The basic occurrence analysis values, multiple correspondence analysis and PCR molecular typing methods confirmed that the presence of Salmonella spp. in Alheira was directly related to it being present in casings. Results obtained from PCR molecular typing added a measure of detail, highlighting potential cross-path contamination caused by contaminated surfaces. Conclusions:, The presence of Salmonella spp. in Alheira was a result of the use of contaminated casings, as well as cross-path contamination caused by contaminated surfaces. An analysis of the occurrence data indicated that these casings were the source of Salmonella spp. contamination in Alheira. PCR molecular typing methodology, which is known to have a greater discriminatory power and tracing capacity, indicated the presence of cross-path contamination. Significance and Impact of this Study:, Increased awareness of Salmonella spp. contamination sources and their spread across the production line helps shape the development of new strategies for controlling this pathogen. [source] Ecotourism and biodiversity conservation in Jozani,Chwaka Bay National Park, ZanzibarAFRICAN JOURNAL OF ECOLOGY, Issue 2009Layla A. Salum Abstract This study is based on a study undertaken to assess how ecotourism has influenced biodiversity conservation in Jozani,Chwaka Bay National Park (JCBNP). It involved two communities surrounding the park, namely Pete and Kitogani. Field data were collected using structured questionnaires, key informant interviews and field observations. Questionnaires were administered to 76 households, whereas key informant interviews were conducted with foresters and JCBNP officials. Data analysis was undertaken using standard statistical methods. Findings from the study show that biodiversity management in the JCBNP has improved considerably after the introduction of ecotourism. The number of endemic colobus monkeys (Piliocolobus kirkii) and other rare species has increased. However, this achievement has been attained by restricting surrounding communities from using forest resources without providing alternative sources of livelihood. Findings also show that the benefits from ecotourism do not reach individual households, but the community as whole, in form of various social services. This has caused some resentment among the local people leading to their reluctance to reduce their direct use of ecosystem services available in the JCBNP, claiming that they cannot sustain their livelihood without such services. This has become a major source of conflict between the JCBNP and surrounding communities. Increased awareness and knowledge on biodiversity conservation would be needed for the communities surrounding the park to realize the potential and long-term benefits of ecotourism, and hence the need for their increased involvement in biodiversity management. [source] Reversible Cerebellar Lesions Induced by Metronidazole Therapy for Helicobacter PyloriJOURNAL OF NEUROIMAGING, Issue 4 2004Hirono Ito MD ABSTRACT Metronidazole is widely used for chronic or refractory infection and has recently also been used for the treatment of Helicobacter pylori. The authors report the case of a Japanese patient presenting with reversible cerebellar lesions induced by prolonged administration of metronidazole for treatment of H pylori with magnetic resonance imaging findings. Although rare, prolonged and high-dose administration of metronidazole may induce cerebellar lesions. Increased awareness of this phenomenon is important, as these lesions are reversible with discontinuation of this drug. [source] Novel alternatively spliced endoplasmic reticulum retention signal in the cytoplasmic loop of Proteolipid Protein-1JOURNAL OF NEUROSCIENCE RESEARCH, Issue 3 2007Cherie Southwood Abstract Increased awareness about the importance of protein folding and trafficking to the etiology of gain-of-function diseases has driven extensive efforts to understand the cell and molecular biology underlying the life cycle of normal secretory pathway proteins and the detrimental effects of abnormal proteins. In this regard, the quality-control machinery in the endoplasmic reticulum (ER) has emerged as a major mechanism by which cells ensure that secreted and transmembrane proteins either adopt stable secondary, tertiary, and quaternary structures or are retained in the ER and degraded. Here we examine cellular and molecular aspects of ER retention in transfected fibroblasts expressing missense mutations in the Proteolipid Protein-1 (PLP1) gene that cause mild or severe forms of neurodegenerative disease in humans. Mild mutations cause protein retention in the ER that is partially dependent on the presence of a cytoplasmically exposed heptapeptide, KGRGSRG. In contrast, retention associated with severe mutations occurs independently of this peptide. Accordingly, the function of this novel heptapeptide has a significant impact on pathogenesis and provides new insight into the functions of the two splice isoforms encoded by the PLP1 gene, PLP1 and DM-20. © 2006 Wiley-Liss, Inc. [source] Drug rash with eosinophilia and systemic symptoms secondary to sulfasalazineJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2010Jeremy Rosenbaum Abstract A severe cutaneous eruption in an unwell patient can be a major cause of physician anxiety. With numerous differential diagnoses, an early accurate diagnosis can be challenging. infectious causes are the most important to exclude in a timely manner and drug rash and eosinophilia with systemic symptoms (DRESS) is another differential diagnosis that should be considered in children. This hypersensitivity reaction is associated with multisystem involvement. Children with underlying chronic diseases may have impairment of normal metabolic pathways and are also often on multiple medications. Therefore, drugs should always be considered in the aetiopathology of any new symptoms and signs. This case report informs readers of the association of sulfasalazine and DRESS in an 11-year-old with inflammatory bowel disease and discusses its pathogenesis and treatment. Increased awareness of this disorder will hopefully lead to increased reporting and consequently illuminate the syndrome more clearly and help guide its prevention and treatment. [source] The diagnosis and management of Kawasaki diseaseJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2005J Royle Abstract:, Kawasaki disease (KD) is a systemic vasculitis of childhood with a predilection for the coronary arteries. It is the predominant cause of paediatric acquired heart disease in developed countries. The aetiology of KD remains unknown and consequently there is no diagnostic test. The diagnosis is made using a constellation of clinical criteria that in isolation have poor sensitivity and specificity. Early treatment prevents overt coronary artery damage in the majority of children. The long-term effects of childhood KD on later cardiovascular health remain unknown. A recent study showed that treatment of KD in Australia is suboptimal, with late diagnosis occurring in approximately half of the cases and an unacceptably high incidence of acute cardiac involvement. These guidelines highlight the difficulties in the diagnosis of KD and offer some clues that may assist early recognition of this important paediatric disease. They also detail current treatment recommendations and the evidence on which they are based. Increased awareness of the epidemiology and spectrum of the clinical presentation of KD is essential for early recognition and optimal management. [source] Diarrhea A to Z: America to ZimbabweJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 6 2009Lori A. Spies RN NP-C Abstract Purpose: To review international statistics on the morbidity and mortality of diarrhea, pathophysiology, global incidence, and implications for the clinical practice of nurse practitioners (NPs). Data sources: Selective review of literature. Conclusions: Because of ever-increasing international travel, immigration, and rising awareness of global health issues, NPs must be current on the prevention, diagnosis, and treatment of diarrhea. Implications for Practice: Increased awareness of diarrhea as a significant international health issue mandates that NPs counsel clients who travel to high-risk areas about preventive measures to avoid exposure or manage symptoms while traveling. Guidelines for evidence-based treatments of diarrheal illness are widely available and should be followed. [source] Initial Experience with an Active-Fixation Defibrillation Electrode and the Presence of Nonphysiological SensingPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 12 2001RAHUL N. DOSHI DOSHI, R.N., et al.: Initial Experience with an Active-Fixation Defibrillation Electrode and the Presence of Nonphysiological Sensing. Nonphysiological sensing by a pacing and defibrillation electrode may result in inappropriate defibrillator discharges and/or inhibition of pacing. Active-fixation electrodes may be more likely to sense diaphragmatic myopotentials because of the protrusion of the screw for fixation. In addition, the movement of the fixation screw in an integrated bipolar lead system could also result in inappropriate sensing. This may be increasingly important in patients who are pacemaker dependent because the dynamic range of the autogain feature of these devices is much more narrow. Five of 15 consecutive patients who received a CPI model 0154 or 0155 active-fixation defibrillation electrode with an ICD system (CPI Ventak AV3DR model 1831 or CPI Ventak VR model 1774 defibrillator) are described. In 2 of the 15 patients, nonphysiological sensing appearing to be diaphragmatic myopotentials resulted in inappropriate defibrillator discharges. Both patients were pacemaker dependent. Changes in the sensitivity from nominal to less sensitive prevented inappropriate discharges. In one patient, discreet nonphysiological sensed events with the electrogram suggestive of ventricular activation was noted at the time of implantation. This was completely eliminated by redeployment of the active-fixation lead in the interventricular septum. In two other patients, discreet nonphysiological sensed events resulted in intermittent inhibition of ventricular pacing after implantation. These were still seen in the least sensitive autogain mode for ventricular amplitude. These were not seen on subsequent interrogation 1 month after implantation. Increased awareness of nonphysiological sensing is recommended. The CPI 0154 and 0155 leads seem to be particularly prone to this abnormality. Particular attention should be made when deploying an active-fixation screw for an integrated bipolar lead. This increased awareness is more important when a given individual is pacemaker dependent, which may warrant DFT testing in a least or less sensitive mode in these patients. [source] Increased awareness of COPD in the Norwegian populationTHE CLINICAL RESPIRATORY JOURNAL, Issue 2 2007Amund Gulsvik No abstract is available for this article. [source] Traumatic spinal cord injury and concomitant brain injury: a cohort studyACTA NEUROLOGICA SCANDINAVICA, Issue 2010E. M. Hagen Hagen EM, Eide GE, Rekand T, Gilhus NE, Gronning M. Traumatic spinal cord injury and concomitant brain injury: a cohort study. Acta Neurol Scand: 2010: 122 (Suppl. 190): 51,57. © 2010 John Wiley & Sons A/S. Objective,,, To assess the temporal trends in the incidence and demographic characteristics of traumatic spinal cord injury (TSCI) with clinical concomitant traumatic brain injury (TBI), in an unselected, geographically defined cohort, 1952,2001. Material and methods,,, The patients were identified from hospital records. TBI was classified as none, mild, moderate, and severe. Results,,, Of 336 patients, 157 (46.7%) patients had a clinical concomitant TBI. Clinical TBI was classified as mild in 30.1%, moderate in 11.0% and severe in 5.7%. The average annual incidence increased from 3.3 per million in the first decade to 10.7 per million in the last. Alcohol was the strongest risk factor of clinical TBI (OR = 3.69) followed by completeness of TSCI (OR = 2.18). Conclusions,,, The incidence of TSCI with concomitant TBI has increased during the last 50 years. Alcohol and completeness of injury are strong risk factors. Increased awareness of dual diagnoses is necessary. [source] Physical and psychological long-term and late effects of cancer,CANCER, Issue S11 2008Kevin D. Stein PhD Abstract The number of long-term cancer survivors (,5 years after diagnosis) in the U.S. continues to rise, with more than 10 million Americans now living with a history of cancer. Along with such growth has come increasing attention to the continued health problems and needs of this population. Many cancer survivors return to normal functioning after the completion of treatment and are able to live relatively symptom-free lives. However, cancer and its treatment can also result in a wide range of physical and psychological problems that do not recede with time. Some of these problems emerge during or after cancer treatment and persist in a chronic, long-term manner. Other problems may not appear until months or even years later. Regardless of when they present, long-term and late effects of cancer can have a negative effect on cancer survivors' quality of life. This article describes the physical and psychological long-term and late effects among adult survivors of pediatric and adult cancers. The focus is on the prevalence and correlates of long-term and late effects as well as the associated deficits in physical and emotional functioning. In addition, the emergence of public health initiatives and large-scale research activities that address the issues of long-term cancer survivorship are discussed. Although additional research is needed to fully understand and document the long-term and late effects of cancer, important lessons can be learned from existing knowledge. Increased awareness of these issues is a key component in the development of follow-up care plans that may allow for adequate surveillance, prevention, and the management of long-term and late effects of cancer. Cancer 2008. © 2008 American Cancer Society. [source] 2431: The eyelid margin: an underestimated contributor to ocular surface health and diseaseACTA OPHTHALMOLOGICA, Issue 2010E KNOP Purpose The eyelid margin is frequently underestimated in the consideration of factors in ocular surface health and disease. Clinically the whole free end of the lid margin is often addressed simply as "margin" without further differentiation. It is attempted to review the structure, embryology and function of the lid margin as well as its involvement in ocular surface pathology. Methods A review based on the available literature on the lid margin is prepared together with own findings on the histology of normal and pathological tissues. Results The human lid margin is divided into distinct zones that consist, coming from the skin side, of a rounded outer lid border, a free lid margin (between the eye lashes and the opening of the meibomian glands), the muco-cutaneous junction and a sharp inner lid border. The embryological development of the eye lids and their tissue components (loose connective tissue, lid muscles, ciliary hairs, Meibomian glands and vascular and neural components) takes place during the period of sealed lids. During this time the development of the Meibomian glands shows considerable similarity to that of the ciliary hairs. The sealing of the mesodermal lid folds and their eventual separation is dependent on several factors that may be involved in pathology. Various disease states, as well as the aging process, can lead to destruction of the lid margin and, conversely, this can lead to deterioration of the cornea and conjunctiva. Conclusion The eyelid margin is an underestimated contributor to ocular surface health and disease. Increased awareness of the anatomy, embryology, physiology and pathophysiology of the lid margin and it tissue components appears important for the preservation of ocular surface integrity. Support DFG KN317/11 [source] Longitudinal Diminution of Tumor Size for Basal Cell Carcinoma Suggests Shifting Referral Patterns for Mohs SurgeryDERMATOLOGIC SURGERY, Issue 1 2008ANDREW L. KAPLAN MD BACKGROUND The Mohs technique for removal of cutaneous malignancies offers tissue-sparing benefits compared with other treatment methods. With wider acceptance and availability of Mohs surgery, referral patterns may be shifting toward the treatment of smaller, lower-risk tumors. OBJECTIVE The objective was to examine whether referral patterns for basal cell carcinoma (BCC) at an academic Mohs surgery practice have shifted over recent years toward referral for smaller, lower risk tumors. METHODS A retrospective longitudinal comparison of tumor characteristics was performed for BCCs treated at our institution from a recent year (2004) and a past year (1996). Statistical analyses were used to identify differences in tumor size, distribution by anatomic site, and primary versus recurrent status. RESULTS Complete data were available for 603 BCCs treated in 1996 and 1,514 BCCs treated in 2004. A 24% decrease in preoperative tumor surface area was observed from 1996 (1.25 cm2) to 2004 (0.95 cm2). Tumors were twice as likely to be recurrent in 1996 (15.1%) than in 2004 (7.4%). There were no significant differences in the anatomic distribution of lesions in the years compared. CONCLUSIONS Findings at our institution suggest that in recent years, referral patterns have shifted toward a preference for Mohs surgery for the treatment of smaller, primary BCCs. This may be a result of increased awareness by the dermatologic and medical community of the numerous advantages of Mohs surgery and a greater appreciation of its tissue-sparing properties, which may result in less complex and more successful aesthetic reconstructions. [source] Understanding and beliefs of diabetes in the UK Bangladeshi populationDIABETIC MEDICINE, Issue 6 2009S. M. Choudhury Abstract Aims, To examine the understanding and beliefs of people with diabetes from the Bangladeshi community living in the UK. Methods, Structured interviews were carried out with 14 people invited to a peer educational programme. All interviews were on a one-to-one basis and were in Sylheti or in English. Interviews were transcribed and analysed by two independent researchers. Results, The majority of participants did not know what caused diabetes. Knowledge of the management of diabetes was linked to controlling sugar intake and a number of participants reported eating bitter foods such as bitter gourd to control their diabetes. There was little access to information as many participants did not speak English and did not have a Bengali-speaking doctor. The majority of participants felt that education classes should teach them what the doctor thought was important and that these classes would best be advertised by word of mouth. Therefore, participants were quite passive about their own self management and relied very strongly on the doctor's views and recommendations. Conclusions, Findings from this study can be used to help health professionals working with Bangladeshi people. There is a need for improved information for Bangladeshi people and much of this information might need to come from health professionals. In addition, there is a need for increased awareness by health professionals of practices used by Bangladeshi people, such as eating bitter gourd (which may enhance the effects of rosiglitazone), and the influence these practices could have on the individual's diabetes management. [source] The myth of plant species saturationECOLOGY LETTERS, Issue 4 2008Thomas J. Stohlgren Abstract Plant species assemblages, communities or regional floras might be termed ,saturated' when additional immigrant species are unsuccessful at establishing due to competitive exclusion or other inter-specific interactions, or when the immigration of species is off-set by extirpation of species. This is clearly not the case for state, regional or national floras in the USA where colonization (i.e. invasion by exotic species) exceeds extirpation by roughly a 24 to 1 margin. We report an alarming temporal trend in plant invasions in the Pacific Northwest over the past 100 years whereby counties highest in native species richness appear increasingly invaded over time. Despite the possibility of some increased awareness and reporting of native and exotic plant species in recent decades, historical records show a significant, consistent long-term increase in exotic species (number and frequency) at county, state and regional scales in the Pacific Northwest. Here, as in other regions of the country, colonization rates by exotic species are high and extirpation rates are negligible. The rates of species accumulation in space in multi-scale vegetation plots may provide some clues to the mechanisms of the invasion process from local to national scales. [source] Mineral metabolism disturbances in patients with chronic kidney diseaseEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 8 2007B. Kestenbaum Abstract Background Kidney disease, especially chronic kidney disease (CKD), is a worldwide public health problem with serious adverse health consequences for affected individuals. Secondary hyperparathyroidism, a disorder characterized by elevated serum parathyroid hormone levels, and alteration of calcium and phosphorus homeostasis are common metabolic complications of CKD that may impact cardiovascular health. Materials and methods Here, we systematically review published reports from recent observational studies and clinical trials that examine markers of altered mineral metabolism and clinical outcomes in patients with CKD. Results Mineral metabolism disturbances begin early during the course of chronic kidney disease, and are associated with cardiovascular disease and mortality in observational studies. Vascular calcification is one plausible mechanism connecting renal-related mineral metabolism with cardiovascular risk. Individual therapies to correct mineral metabolism disturbances have been associated with clinical benefit in some observational studies; clinical trials directed at more comprehensive control of this problem are warranted. Conclusions There exists a potential to improve outcomes for patients with CKD through increased awareness of the Bone Metabolism and Disease guidelines set forth by the National Kidney Foundation,Kidney Disease Outcomes Quality Initiative. Future studies may include more aggressive therapy with a combination of agents that address vitamin D deficiency, parathyroid hormone and phosphorus excess, as well as novel agents that modulate circulating promoters and inhibitors of calcification. [source] Self-Assessment of Speaking Skills and Participation in a Foreign Language ClassFOREIGN LANGUAGE ANNALS, Issue 1 2009Diane De Saint Léger French; relevant to all languages Abstract: This article investigates the ways in which learners' perception of themselves as second language (L2) speakers evolved over a 12-week period. Thirty-two students of the advanced French stream in a tertiary institution participated in this semester-long study. Students self-assessed their speaking skills and their level of participation in French oral tasks in weeks 4, 6, and 12, and set learning goals accordingly. Self-perception evolved in a positive fashion over time, particularly in relation to fluency, vocabulary, and overall confidence in speaking in the L2. In addition, individual goal-setting encouraged learners to take increased responsibility toward their own learning, although increased awareness did not necessarily lead to concrete actions to modify learning behavior. To conclude, this study highlights the potential pedagogical benefits of self-assessment at both the cognitive and affective levels. [source] New insights into autoimmune liver diseasesHEPATOLOGY RESEARCH, Issue 8 2008Teru Kumagi Autoinflammatory liver disease represents an important aspect of global hepatological practice. The three principal disease divisions recognized are autoimmune hepatitis, primary sclerosing cholangitis and primary biliary cirrhosis. Largely, but not exclusively, these diseases are considered to be autoimmune in origin. Increased recognition of outlier and overlap syndromes, changes in presentation and natural history, as well as the increased awareness of IgG4-associated sclerosing cholangitis, all highlight the limitations of the classic terminology. New insights continue to improve the care given to patients, and have arisen from carefully conducted clinical studies, therapeutic trials, as well as genetic and laboratory investigations. The challenges remain to treat patients before liver injury becomes permanent and to prevent the development of organ failure. [source] Cardiotoxicity with 5-fluorouracil and capecitabine: more than just vasospastic anginaINTERNAL MEDICINE JOURNAL, Issue 4 2010T. Stewart Abstract In this case series we present a variety of different cardiac toxicities with 5-fluorouracil and its pro-drug capecitabine, including myocardial infarction, cardiomyopathy, sinoatrial and atrioventricular node dysfunction, tako-tsubo cardiomyopathy and QT prolongation with torsade-de pointes ventricular tachycardia. We stress the fact that while vasospasm is a well-recognized side-effect of this class of chemotherapeutic agent, broader cardiotoxicity is commonly seen and an increased awareness of the range of toxicity is necessary if repeat toxicity is to be avoided. [source] The evidence-based supply of non-prescription medicines: barriers and beliefsINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2004Margaret C. Watson MRC fellow ABSTRACT Context The reclassification of prescription only medicines (POMs) to pharmacy only (P) and general sale list (GSL) status is ongoing in the UK. Pharmacy staff need support to ensure the appropriate supply of these non-prescription medicines (NPMs). Objective To investigate the type of evidence used in the decision to supply NPMs and the barriers associated with their supply. Methods A participant observation study was conducted in nine pharmacies in one area of Scotland (Grampian). In-depth interviews were conducted with one pharmacist and one medicine counter assistant (MCA) from each pharmacy to explore and compare their attitudes and beliefs towards evidence-based practice (EBP) and the supply of NPMs. Key findings Most consultations were product requests. Pharmacy staff had little awareness or understanding of the term EBP and no specific evidence was used in the majority of consultations. Pharmacists' attitudes towards EBP varied. Personal experience or feedback from customers were cited as evidence upon which treatment recommendations were based. Many barriers and problems were associated with the supply of NPMs. These included: lack of evidence; MCAs' self-perception of their role; questioning and communication skills; safety; and training needs. There was a gap between pharmacists' and MCAs' perceptions of who should be referred to the pharmacist. Many staff used the WWHAM mnemonic for questioning customers, but this was often used as a matter of rote rather than as a framework to engage the customer in a relevant and constructive consultation. The development of adequate communication skills to allow core information to be obtained to support decision making needs to be addressed. Conclusion An increased awareness of EBP and its role in quality care needs to be promoted to community pharmacists and MCAs. There is currently no formal continuing education provision or requirement for MCAs in the UK. Pharmacy staff, particularly MCAs, require continuing education on the supply of NPMs. [source] Mechanical Circulatory Support for AMI and Cardiogenic ShockJOURNAL OF CARDIAC SURGERY, Issue 4 2010Yasir Abu-Omar D.Phil. The dismal prognosis associated with post-MI cardiogenic shock, allied with surgical and technological advancements, has shifted the treatment paradigm toward wider use of mechanical circulatory support devices (MCSD). Current experience demonstrates that better outcomes may be achieved with early MCSD deployment (prior to the onset of end-organ dysfunction). However, perceived limitations with existing devices mean that they remain infrequently applied. There is an urgent need for increased awareness of MCSD options among clinicians treating post-MI shock patients. (J Card Surg 2010;25:434-441) [source] Interprofessional education: the interface of nursing and social workJOURNAL OF CLINICAL NURSING, Issue 1-2 2010Engle Angela Chan Aims., To examine the influence of interdisciplinary seminars on undergraduate nursing and social work students' perceptions of their learning. Background., Collaboration is considered to be important for health professionals in working towards good patient care, and interdisciplinary education is seen as one way of addressing this need for greater collaboration and team work. Today's health professionals are dealing with an increasing number of older and chronically ill patients. The biopsychosocial dimensions inherent in such chronic illnesses bring about a closer working relationship between the nursing and social work professions to foster good patient care. No local research in Hong Kong, however, has looked specifically at how these two professions can develop their collaborative skills and qualities through interdisciplinary education. Design., Mixed methods design. Method., Data from questionnaires, videotape recordings of the sessions and follow-up phone interviews were used for quantitative and qualitative analyses. Results., The findings revealed three themes: an increased awareness of each other's professional values and personal judgement, a recognition of each other's disciplinary knowledge emphases and more, and an appreciation for, and learning about each other's roles for future collaboration. Conclusions., Whilst, it is usual to identify health professionals as non-judgemental, it is also important to recognise the existence of their personal and professional values and beliefs that shape their decision-making. Equally beneficial for students is their reported understanding of the other discipline's emphasis on the physical or social aspects of care, and the interrelationships and complementary values that lead to students' appreciation of each other's roles and the possibility for their future collaboration in the holistic care of patients. Relevance to clinical practice., The sharing of each other's knowledge and their appreciation of the corresponding roles enhanced students' decision-making capacity and the extension of the holistic approach beyond one profession, which is essential for good patient care. [source] Evidentiary Standards for Forensic Anthropology,JOURNAL OF FORENSIC SCIENCES, Issue 6 2009Angi M. Christensen Ph.D. Abstract:, As issues of professional standards and error rates continue to be addressed in the courts, forensic anthropologists should be proactive by developing and adhering to professional standards of best practice. There has been recent increased awareness and interest in critically assessing some of the techniques used by forensic anthropologists, but issues such as validation, error rates, and professional standards have seldom been addressed. Here we explore the legal impetus for this trend and identify areas where we can improve regarding these issues. We also discuss the recent formation of a Scientific Working Group for Forensic Anthropology (SWGANTH), which was created with the purposes of encouraging discourse among anthropologists and developing and disseminating consensus guidelines for the practice of forensic anthropology. We believe it is possible and advisable for anthropologists to seek and espouse research and methodological techniques that meet higher standards to ensure quality and consistency in our field. [source] Developing a sustainability ethic in leadersJOURNAL OF LEADERSHIP STUDIES, Issue 2 2009Anthony Middlebrooks The triple bottom line of fiscal, social, and environmental success considerably alters how organizations (and stakeholders) measure sustainable success. More important, however, is the conceptual shift required to understand and successfully lead organizations within this increasingly accepted paradigm. This article uses a mixed-methods approach to explore the conceptual development of a sustainability ethic in aspiring leaders. More specifically, the authors report research examining the curriculum and pedagogy of a leadership education effort, in this case a college-level course, aimed at effecting change in both individual aspiring leaders and their immediate community. The article describes the philosophical and research base for the curriculum and specific activities with their pedagogical approach. Results show evidence of increased awareness, importance, and commitment to sustainability as well as changes in how students conceptualize sustainability leadership. Findings offer insights for further developing leadership education for sustainability. [source] An outbreak of HBV and HCV infection in a paediatric oncology ward: Epidemiological investigations and prevention of further spreadJOURNAL OF MEDICAL VIROLOGY, Issue 3 2003Uga Dumpis Abstract Hospital-acquired hepatitis B (HBV) and C virus (HCV) infections continue to occur despite increased awareness of this problem among the medical community. One hundred six patients were infected in a haematology oncology ward for children, over the time period 1996 to 2000. Serum samples from 45 such patients and 3 from infected medical personnel were used for nucleic acid amplification. HBV core, as well as HCV core and hypervariable region 1 (HVR1) nucleotide sequences, were analysed by phylogenetic tree analysis, in order to characterise the epidemiological pattern of viral transmission on the ward. Samples from 32 patients were positive for HBV-DNA or HCV-RNA by PCR. Ten patients were positive for both markers. Seventeen out of twenty-three HCV core gene sequences were found to be evolutionarily related and clustered separately from other local sequences in the phylogenetic tree, indicating nosocomial transmission. This was confirmed by analysis of HVR1 gene sequences. One nurse and one physician from the ward were HCV RNA positive, but their HCV sequences were not related evolutionarily to those of the patient cluster. Fifteen out of nineteen HBV core gene sequences were also clustered together and were positioned separately in the relevant tree. Epidemiological investigation excluded a common source infection and indicated that spread of infection was most likely due to inappropriate infection control measures on the ward. No obvious risk factors for transmission were identified during the retrospective survey in patients with related sequences, except use of multidose vials for saline and poor staff compliance with routine hand hygiene procedures. The preventive measures that were introduced reduced the incidence of infection significantly. No new cases of HBV infection and only three anti-HCV seroconversions occurred over a period of 19 months. The introduction and maintenance of strict prevention measures over a 2 year period, combined with HBV vaccination, reduced significantly the incidence of new HCV and HBV infections. J. Med. Virol. 69:331,338, 2003. © 2003 Wiley-Liss, Inc. [source] Intra-oral Dirofilaria repens infection: report of seven casesJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 8 2003W. M. Tilakaratne Abstract Cutaneous dirofilariasis usually affects animals such as cats and dogs which are known to be the natural host of Dirofilaria. Dirofilariasis displays a worldwide distribution. Certain geographic regions account for the majority of reported cases. South-eastern United States, Australia and Europe have been identified as endemic regions (1, 2). However, new endemic areas are arising with increased awareness in African and Asian regions. Out of about 40 different species of Dirofilaria only a few species are commonly known to infect man, namely Dirofilaria immitus, D. tenices and D. repens. Human infection occurs when a human becomes a blood meal of an infected arthropod vector and on accidental entering of the worm. Rarely this zoonotic infection affects the oral mucosa (3). Man is the dead end of this parasite. Since the human body is an abnormal environment for the parasite, the development of the larvae is inhibited by means of retardation of sexual maturity. Lesions are presented as single non-tender subcutaneous nodules, and most patients are asymptomatic. Diagnosis is established by H&E sections prepared from excised nodules. In a majority of the cases, only a single worm either a male or a female could be identified. The worm is usually dead and degenerated with a massive inflammatory cell infiltration. Seven new cases presented as intra-oral nodules with their clinicopathological correlation are discussed. [source] Youth Voices as Change Agents: Moving Beyond the Medical Model in School-Based Health Center PracticeJOURNAL OF SCHOOL HEALTH, Issue 7 2005Leslie A. Mandel Freshmen were recruited to participate in a Youth Advisory Board Project that included weekly afterschool meetings. Adult supervision was provided by SBHC staff that included 2 clinical social workers and 1 youth empowerment specialist. Through this effort, students were (1) trained in nonprofit board development and governance structures; (2) urged to identify gaps in services; (3) taught to select, prioritize, and implement action projects; and (4) offered clinical support around personal issues. Students brought a wealth of life experiences, knowledge of teen attitudes, information regarding trends in risk-taking behaviors, and feedback about experiences in the SBHC. In addition, their increased awareness of the SBHC service elements led to identification of obstacles to youth participation in care, feedback regarding positive and negative health care experiences within the SBHC, as well as with external health care providers, and ideas about unrecognized needs leading to gaps in services. This experience demonstrated that young health care consumers, with support, can focus their attention and begin to utilize analytical thinking skills to shape health outcomes and inform service delivery. (J Sch Health. 2005;75(7):239,242) [source] Self-Image of People in Their FiftiesNURSING & HEALTH SCIENCES, Issue 3 2002Laiad Jamjan People in their fifties experience a transitional phase in aging. The impact of physical and emotional change is considerable due to deteriorated health and economic status. With the onset of aging, self-image of the pre-senescent provides an understanding of one's perceptions and thoughts on aging. Therefore, increased awareness of the pre-senescents' needs has resulted in further development of the nurse's role in health promotion. The main aim of this study was to gain a better understanding of self-image, a key factor of health promotion in the pre-senescent. The study participants consisted of 10 women in their fifties from the Aging Club at 43rd Health Center, Bangkok, Thailand. Focus group interview was used to explore self-image. The interview focused on the concept of health, aging, retirement, and the impact of change. Health results: The majority (80%) of the participants agreed that the definition of health was the equilibrium of basic needs. The definition of good health to them was a delightful mood. They described the concept of good health as either the balance of excretion, sleep and rest, or being free of disease and personal illness. Three participants complained of health problems because they had to take care of their husbands. Deteriorated health was found to be the stimulus to such aging states as blurred vision, hearing loss, menopause, and osteoporosis. Aging: The participants accepted that aging was a naturally occurring phenomenon. ,Age is only a number', ,If our minds are still young, our bodies will be youthful.' They did not want to be called ,old'. Retirement: Represents a time when they will be lonely and lack financial support. This also was described as the autumn of life. It was seen as the time to enjoy the golden years of life. The impact of changes: The participants experienced emotional changes such as increased sensitivity of feelings and needed family support. They also complained of physical changes (i.e. loss of appetite, teeth and agility). Only one participant, who had improved her emotional maturity, was proud of aging. Conclusion: For the pre-senescent, the aging transition begins with the changes in one's physical and mental condition. An optimistic attitude towards this process enables the pre-senescent to approach and better accept the process of aging. Nurses therefore need to continue to develop holistic approaches in caring for the aging. [source] | ||||||||||||||||||||||||||||||||||