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Various Settings (various + setting)
Selected AbstractsBrief alcohol intervention,where to from here?ADDICTION, Issue 6 2010Challenges remain for research, practice ABSTRACT Brief intervention (BI) is intended as an early intervention for non-treatment-seeking, non-alcohol-dependent, hazardous and harmful drinkers. This text provides a brief summary of key BI research findings from the last three decades and discusses a number of knowledge gaps that need to be addressed. Five areas are described: patient intervention efficacy and effectiveness; barriers to BI implementation by health professionals; individual-level factors that impact on BI implementation; organization-level factors that impact on BI implementation; and society-level factors that impact on BI implementation. BI research has focused largely upon the individual patient and health professional levels, with the main focus upon primary health care research, and studies are lacking in other settings. However, research must, to a larger degree, take into account the organizational and wider context in which BI occurs, as well as interaction between factors at different levels, in order to advance the understanding of how wider implementation of BI can be achieved in various settings and how different population groups can be reached. It is also important to expand BI research beyond its current parameters to investigate more ambitious long-term educational programmes and new organizational models. More widespread implementation of BI will require many different interventions (efforts, actions, initiatives, etc.) at different interlinked levels, from implementation interventions targeting individual health professionals' knowledge, skills, attitudes and behaviours concerning alcohol issues, BI and behaviour change counselling to efforts at the organizational and societal levels that influence the conditions for delivering BI as part of routine health care. [source] Electrical Stimulation of Sphenopalatine Ganglion for Acute Treatment of Cluster HeadachesHEADACHE, Issue 7 2010Mehdi Ansarinia MD (Headache 2010;50:1164-1174) Introduction., Cluster headaches (CH) are primary headaches marked by repeated short-lasting attacks of severe, unilateral head pain and associated autonomic symptoms. Despite aggressive management with medications, oxygen therapy, nerve blocks, as well as various lesioning and neurostimulation therapies, a number of patients are incapacitated and suffering. The sphenopalatine ganglion (SPG) has been implicated in the pathophysiology of CH and has been a target for blocks, lesioning, and other surgical approaches. For this reason, it was selected as a target for an acute neurostimulation study. Methods., Six patients with refractory chronic CH were treated with short-term (up to 1 hour) electrical stimulation of the SPG during an acute CH. Headaches were spontaneously present at the time of stimulation or were triggered with agents known to trigger clusters headache in each patient. A standard percutaneous infrazygomatic approach was used to place a needle at the ipsilateral SPG in the pterygopalatine fossa under fluoroscopic guidance. Electrical stimulation was performed using a temporary stimulating electrode. Stimulation was performed at various settings during maximal headache intensity. Results., Five patients had CH during the initial evaluation. Three returned 3 months later for a second evaluation. There were 18 acute and distinct CH attacks with clinically maximal visual analog scale (VAS) intensity of 8 (out of 10) and above. SPG stimulation resulted in complete resolution of the headache in 11 attacks, partial resolution (>50% VAS reduction) in 3, and minimal to no relief in 4 attacks. Associated autonomic features of CH were resolved in each responder. Pain relief was noted within several minutes of stimulation. Conclusion., Sphenopalatine ganglion stimulation can be effective in relieving acute severe CH pain and associated autonomic features. Chronic long-term outcome studies are needed to determine the utility of SPG stimulation for management and prevention of CH. [source] Application of the X-FEM to the fracture of piezoelectric materialsINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, Issue 11 2009E. Béchet Abstract This paper presents an application of the extended finite element method (X-FEM) to the analysis of fracture in piezoelectric materials. These materials are increasingly used in actuators and sensors. New applications can be found as constituents of smart composites for adaptive electromechanical structures. Under in service loading, phenomena of crack initiation and propagation may occur due to high electromechanical field concentrations. In the past few years, the X-FEM has been applied mostly to model cracks in structural materials. The present paper focuses at first on the definition of new enrichment functions suitable for cracks in piezoelectric structures. At second, generalized domain integrals are used for the determination of crack tip parameters. The approach is based on specific asymptotic crack tip solutions, derived for piezoelectric materials. We present convergence results in the energy norm and for the stress intensity factors, in various settings. Copyright © 2008 John Wiley & Sons, Ltd. [source] Drought Preparedness and Response in the Context of Sub-Saharan AfricaJOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 2 2000Donald A. Wilhite Although drought is a normal, recurring feature of climate, little progress has been made in drought management in most parts of the world. A United Nations study of selected Sub-Saharan African countries revealed that most states have little experience in proactive planning for drought. Only Botswana and South Africa have made serious efforts to develop drought preparedness and response. The lack of contingency planning for drought events in the region results from limited financial resources, inadequate understanding of drought impacts, and poor co-ordination among government agencies. A ten-step planning process, originally developed in 1991 for U.S. states, is suggested as an organizational tool for Sub-Saharan countries to use in the development of drought plans. The process, which emphasizes risk management rather than crisis management, is based on three primary components: (1) monitoring and early warning, (2) vulnerability and impact assessment, (3) mitigation and response. The steps in the process are generic; they can be adapted and applied to the various settings of Sub-Saharan Africa. [source] An exploration of mental health nursing students' experiences and attitudes towards using cigarettes to change client's behaviourJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 8 2010M. J. NASH msc pclt bsc (hons) rnt rmn fhea Accessible summary ,,This study explores the experiences of mental health nursing students in using cigarettes as a means of token economy. ,,The majority of the sample experienced the use of this particular intervention in various settings but also reported that other items apart from cigarettes were also used as part of a reward system. ,,Respondents generally did not like this practice, feeling that it did not work well, led to client staff conflict, was implemented in an ad hoc way and rarely recorded in a care plan. ,,An open debate on tobacco control and the use of cigarettes in behavioural change programmes is urgently required. Abstract Using cigarettes to change client behaviour is a common, yet little studied, practice in mental health care. A questionnaire survey was used to explore mental health nursing student's experiences and attitudes to this practice. The sample was four cohorts of mental health nursing students (n= 151). Of them, 84% had experienced the practice of using cigarettes to change client behaviour in acute wards (73%), rehabilitation wards (28%) and elderly care (14%). Cigarettes were used to change client behaviour in areas such as attending to personal hygiene (57%) or engaging in the ward routine (39%). However, items such as leave (60%) or drinks (tea and coffee) (38%) were also reportedly used. Of the respondents, 54% inferred that the practice did not work well with 46% stating it was not written up in care plans; 52% felt it was an ad hoc practice, 60% inferred that at times it was used as a punishment while 55% intimated that they felt bad withholding cigarettes. There are ethical and moral dilemmas around using lifestyle risk factors as rewards or using client's nicotine addiction as a means of controlling behaviour. The question of whether this intervention should ever be used, given its associated health risk, requires more critical debate in clinical practice. [source] The Alcohol Use Disorders Identification Test: An Update of Research FindingsALCOHOLISM, Issue 2 2007Duane F. Reinert Background: The Alcohol Use Disorders Identification Test (AUDIT) has been extensively researched to determine its capability to accurately and practically screen for alcohol problems. Methods: During the 5 years since our previous review of the literature, a large number of additional studies have been published on the AUDIT, abbreviated versions of it, its psychometric properties, and the applicability of the AUDIT for a diverse array of populations. The current article summarizes new findings and integrates them with results of previous research. It also suggests some issues that we believe are particularly in need of further study. Results: A growing body of research evidence supports the criterion validity of English version of the AUDIT as a screen for alcohol dependence as well as for less severe alcohol problems. Nevertheless, the cut-points for effective detection of hazardous drinking as well as identification of alcohol dependence or harmful use in women need to be lowered from the originally recommended value of 8 points. The AUDIT-C, the most popular short version of the AUDIT consisting solely of its 3 consumption items, is approximately equal in accuracy to the full AUDIT. Psychometric properties of the AUDIT, such as test,retest reliability and internal consistency, are quite favorable. Continued research is urged to establish the psychometric properties of non-English versions of the AUDIT, use of the AUDIT with adolescents and with older adults, and selective inclusion of alcohol biomarkers with the AUDIT in some instances. Conclusions: Research continues to support use of the AUDIT as a means of screening for the spectrum of alcohol use disorders in various settings and with diverse populations. [source] Personality constructs and measuresPSYCHOLOGY IN THE SCHOOLS, Issue 3 2007Hedwig Teglasi A psychological construct, such as personality, is an abstraction that is not directly seen but inferred through observed regularities in cognitive, affective, and behavioral responses in various settings. Two assumptions give meaning to the idea of construct validity. First, constructs represent real phenomena that exist apart from the potential ways in which they are measured. Second, constructs have a causal relation to their measures (see D. Boorsboom, G.J. Mellenbergh, & J. van Heerden, 2004). According to these twin assumptions, variation in a construct such as personality or intelligence causes individual differences in responses to items on measures; it also accounts for performance in real life settings. An alternative perspective equates a construct with the operation used for its measurement (M. Friedman, 1991) without a presumption of causality. This article elaborates on the implications of different assumptions about measurement, operation-referenced and construct-referenced, for advancing the science and practice of psychology. © 2007 Wiley Periodicals, Inc. Psychol Schs 44: 215,228, 2007. [source] | ||||||||||