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Increased Confidence (increased + confidence)
Selected AbstractsFrequency of Use of Suturing and Repair Techniques Preferred by Dermatologic SurgeonsDERMATOLOGIC SURGERY, Issue 5 2006BETH ADAMS MD BACKGROUND There are many closure techniques and suture types available to cutaneous surgeons. Evidence-based data are not available regarding the frequency of use of these techniques by experienced practitioners. OBJECTIVE To quantify, by anatomic site, the frequency of use of common closure techniques and suture types by cutaneous surgeons. METHOD A prospective survey of the members of the Association of Academic Dermatologic Surgeons that used length-calibrated visual-analog scales to elicit the frequency of use of specific suture techniques. RESULTS A response rate of 60% (61/101) indicated reliability of the received data. Epidermal layers were closed most often, in descending order, by simple interrupted sutures (38,50%), simple running sutures (37,42%), and vertical mattress sutures (3,8%), with subcuticular sutures used more often on the trunk and extremities (28%). The most commonly used superficial sutures were nylon (51%) and polypropylene (44%), and the most common absorbable suture was polyglactin 910 (73%). Bilayered closures, undermining, and electrocoagulation were used, on average, in 90% or more sutured repairs. The median diameters (defined as longest extent along any axis) of most final wound defects were 1.1 to 2.0 cm (56%) or 2.1 to 3.0 cm (37%). Fifty-four percent of wounds were repaired by primary closure, 20% with local flaps, and 10% with skin grafting, with the remaining 15% left to heal by second intent (10%) or referred for repair (5%). Experience-related differences were detected in defect size and closure technique: defects less than 2 cm in diameter were seen by less experienced surgeons, and defects greater than 2 cm by more experienced surgeons (Wilcoxon's rank-sum test: p=.02). But more experienced surgeons were less likely to use bilayered closures (r=,0.28, p=.036) and undermining (r=,0.28, p=.035). CONCLUSIONS There is widespread consensus among cutaneous surgeons regarding optimal suture selection and closure technique by anatomic location. More experienced surgeons tend to repair larger defects but, possibly because of their increased confidence and skill, rely on less complicated repairs. [source] Helping smokers to decide on the use of efficacious smoking cessation methods: a randomized controlled trial of a decision aidADDICTION, Issue 3 2006Marc C. Willemsen ABSTRACT Aims Most smokers attempt to stop smoking without using help. We evaluated the efficacy of a decision aid to motivate quitters to use efficacious treatment. Setting and participants A total of 1014 were recruited from a convenience sample of 3391 smokers who intended to quit smoking within 6 months. Design and intervention Smokers were assigned randomly to either receive the decision aid or no intervention. The decision aid was expected to motivate quitters to use efficacious cessation methods and contained neutral information on treatment methods, distinguishing between efficacious and non-efficacious treatments. Measurements Baseline questionnaire and follow-ups were used 2 weeks and 6 months after the start of the intervention., Findings The decision aid increased knowledge of cessation methods and induced a more positive attitude towards these methods. Furthermore, 45% reported increased confidence about being able to quit and 43% said it helped them to choose between treatments. However, no clear effect on usage of treatment aids was found, but the intervention group had more quit attempts (OR = 1.52, 95% CI 1.14,2.02) and higher point prevalence abstinence at 6-month follow-up (20.2% versus 13.6%; OR = 1.51, 95% CI = 1.07,2.11). Conclusions An aid to help smokers decide to use efficacious treatment when attempting to quit smoking had a positive effect on smoking cessation, while failing to increase the usage of efficacious treatment. This finding lends support to the notion that the mere promotion of efficacious treatments for tobacco addiction might increase the number of quit attempts, irrespective of the actual usage of treatment. [source] ,Taking off the suit': engaging the community in primary health care decision-makingHEALTH EXPECTATIONS, Issue 1 2006Elizabeth Anderson MSc RGN Abstract Objective, To explore the process of public involvement in planning primary health care. Background, Recent policy in the UK promotes public involvement in planning health but there have been difficulties in engaging communities in the process. Surveys of health service organizations have found that there has been a failure to adapt to new approaches. It has become important to understand why this has occurred if policy initiatives to encourage involvement are to succeed. Design, Qualitative study. Data collected through individual interviews and focus groups. Setting, Two new primary healthcare developments in deprived areas in Bristol and Weston-Super-Mare. Participants, Thirty-six professionals and 23 local residents in Bristol; six professionals and three local residents in Weston-Super-Mare. Results, Three themes were identified: process, partnership and power. The main findings were that exceptional people with a shared commitment to public involvement were necessary to motivate others and develop partnerships. Local people were drawn into the process and with increased confidence became powerful advocates for their community. Creative and varied methods to involve the public were important in achieving balance between professionals and lay people. However, conflicts over practical decisions arose from a lack of clarity over who had power to influence decisions. Conclusion, Most of the participants were enthusiastic about their experience of public involvement in planning primary health care. Features crucial to sustainable involvement included a commitment from leaders within statutory agencies, support over a long period to build the confidence of local people, willingness to use informal approaches that are in tune with local culture, and a recognition of the concerns of both service users and providers. [source] Financial Dollarization and European Union MembershipINTERNATIONAL FINANCE, Issue 2 2010Kyriakos C. Neanidis We analyse the effect of European Union (EU) membership on financial dollarization for the Central and Eastern European countries. Using a unique monthly data set that spans about two decades, we find that both the accession process towards EU membership and EU entry have a direct impact on deposit dollarization (DD) and loan dollarization (LD). EU membership reduces DD while it increases LD. The negative effect on DD captures the increased confidence of the private sector in the domestic currency, as they consider the EU admission process a reflection of their government's commitment to promoting policies of long-run currency stability. The positive impact on credit dollarization is the outcome of a greater convergence of exchange rates to the euro and the subsequent anticipation of lower currency risk, which diminishes the cost of foreign currency borrowing. [source] A preliminary analysis of narratives on the impact of training in solution-focused therapy expressed by students having completed a 6-month training courseJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2010S. SMITH ba (hons) ba pgctlt rmn rnt fhea Accessible summary ,,Students who participated in a six month training course in SFBT reported significant changes in their relationships with clients. ,,They reported increased trust in clients as people, increased confidence in their own professional role, and increased enthusiasm for working with clients. ,,Students demonstrated an in-depth knowledge and understanding of solution focused principles and practice, enabling them to own their practice and respond creatively to individual clients. ,,It is suggested that substantive training in solution focused brief therapy may help to enhance the professional role and cultural identity of participants, particularly those from a nursing background. Abstract Solution-focused brief therapy (SFBT) is a therapeutic approach utilized in a wide variety of settings. Its roots are in systemic and family therapy, and the emphasis in practice is on helping clients identify what their life will be like when they no longer have their problem, and how close they are to experiencing that situation now. The literature suggests that SFBT is at least as effective as other forms of psychotherapy. This pilot-study explored the impact of a training course in SFBT on the nurses who took part. Interviews were carried out with participants (n= 8) and narrative accounts were analysed and grouped according to emerging themes. Three major themes were perceived; Trust in clients, Positivity and Confidence, and these were supported by interconnected minor themes relating to the eclectic use of the approach, the use of language within the approach, and the application of SFBT in wider life. It is argued that training in SFBT may have a positive impact on the therapeutic and professional role of nurses, and that further studies are required to explore the impact of SFBT training on the professional and cultural identity of nurses. [source] Project SOAR: A Training Program to Increase School Counselors' Knowledge and Confidence Regarding Suicide Prevention and InterventionJOURNAL OF SCHOOL HEALTH, Issue 10 2000Keith A. King ABSTRACT: School counselors are often the lead individuals in school suicide prevention programs. All school counselors in Dallas, Texas, receive training through Project SOAR (Suicide, Options, Awareness, and Relief), a suicide prevention program. This study assessed Dallas school counselors' knowledge of suicidal risk factors and perceived ability to initiate appropriate steps when confronted with a suicidal student. A two-page, 44-item survey was distributed to all Dallas school counselors attending a mandatory meeting in spring 1999. A total of 186 school counselors (75%) responded. Most had been a school counselor for less than 10 years and one-half received initial SOAR training less than four years ago. The majority strongly agreed that they could recognize suicidal warning signs, assess a student's risk for suicide, and offer support to a suicidal student. In addition, most knew the intervention steps to take when a student assessed at high suicidal risk. When compared to school counselors nationwide, these counselors reported increased confidence in identifying students at suicidal risk. [source] Evaluation of saturation labelling two-dimensional difference gel electrophoresis fluorescent dyesPROTEINS: STRUCTURE, FUNCTION AND BIOINFORMATICS, Issue 7 2003Joanne Shaw Abstract Two-dimensional difference gel electrophoresis (2-D DIGE) enables an increased confidence in detection of protein differences. However, due to the nature of the minimal labelling where only approximately 5% of a given protein is labelled, spots cannot be directly excised for mass spectrometry (MS) analysis and detection sensitivity could be further enhanced. Amersham Biosciences have developed a second set of CyDyeÔ DIGE CyÔ3 and Cy5 dyes, which aim to overcome these limitations through saturation-labelling of cysteine residues. The dyes were evaluated in relation to their sensitivity and dynamic range, their useability as multiplexing reagents and the possibility of direct spot picking from saturation-labelled gels for MS analysis. The saturation-labelling dyes were superior in sensitivity to their minimal-labelling counterparts, silver stain and Sypro Ruby, however, the resulting 2-D spot pattern was significantly altered from that of unlabelled or minimal-labelled protein. The dyes were found to be useful as multiplexing reagents although preferential labelling of proteins with one dye over another was observed but was controlled for through experimental design. Protein identities were successfully obtained from material directly excised from saturation-labelled gels eliminating the need for post-stained preparative gels. [source] Simulation as a tool to improve the safety of pre-hospital anaesthesia , a pilot study,ANAESTHESIA, Issue 9 2009A. J. Batchelder Summary We conducted a pilot study of the effects of simulation as a tool for teaching doctor-paramedic teams to deliver pre-hospital anaesthesia safely. Participants undertook a course including 43 full immersion, high-fidelity simulations. Twenty videos taken from day 4 and days 9/10 of the course were reviewed by a panel of experienced pre-hospital practitioners. Participants' performance at the beginning and the end of the course was compared. The total time from arrival to inflation of the tracheal tube cuff was longer on days 9/10 than on day 4 (mean (SD) 14 min 52 s (2 min 6 s) vs 11 min 28 s (1 min 54 s), respectively; p = 0.005), while the number of safety critical events per simulation were fewer (median (IQR [range]) 1.0 (0,1.8 [0,2]) vs 3.5 (1.5,4.8 [0,8], respectively; p = 0.011). Crew resource management behaviours also improved in later simulations. On a personal training needs analysis, participants reported increased confidence after the course. [source] Evaluation of the rural South Australian Tri-division Adolescent Health ProjectAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2003Lucio Naccarella ABSTRACT:The Adolescent Health Project (AHP) was a rural pilot project aimed at strengthening the relationship between general practitioners (GPs) and adolescents within three Divisions of general practice. The evaluation assessed the implementation of the AHP model and strategies and their impact. The AHP used a centralised management/support and local delivery model. The AHP improved GP relationships and comfort with dealing with young people, and improved GP relationships with school counsellors. Divisional relationships with local schools improved. Students reported increased knowledge about GPs, increased confidence and comfort with accessing GPs. The AHP delivered a popular project to GPs, GP clinics, schools, school counsellors and students, which built the capacity of divisions, GPs, and schools to improve adolescent health care provision. Further research questions have emerged: What are the patterns of relationships between GPs and adolescents, and between GPs and school counsellors, and what strategies work best to sustain such relationships? [source] EVALUATION OF THE RURAL SOUTH AUSTRALIAN TRI-DIVISION ADOLESCENT HEALTH PROJECTAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2003Lucio Naccarella ABSTRACT: The Adolescent Health Project (AHP) was a rural pilot project aimed at strengthening the relationship between general practitioners (GPs) and adolescents within three Divisions of general practice. The evaluation assessed the implementation of the AHP model and strategies and their impact. The AHP used a centralised management/support and local delivery model. The AHP improved GP relationships and comfort with dealing with young people, and improved GP relationships with school counsellors. Divisional relationships with local schools improved. Students reported increased knowledge about GPs, increased confidence and comfort with accessing GPs. The AHP delivered a popular project to GPs, GP clinics, schools, school counsellors and students, which built the capacity of divisions, GPs, and schools to improve adolescent health care provision. Further research questions have emerged: What are the patterns of relationships between GPs and adolescents, and between GPs and school counsellors, and what strategies work best to sustain such relationships? [source] | ||||||||||