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Selected AbstractsDental therapists' experience in the immediate management of traumatized teethDENTAL TRAUMATOLOGY, Issue 2 2006Teresa Loh Abstract,,, The optimal immediate management of traumatized teeth is known to be important for long-term success. One hundred and sixty-seven school dental therapists with General Certificate of Education ,Ordinary' (GCE ,O') level qualification were surveyed on their knowledge and experience on immediate management of dental trauma. The results showed only 41.2% felt comfortable with their present knowledge on the subject. A high proportion of the respondents (94.6%) indicated a need for more knowledge. All therapists concurred on the need to replant a permanent tooth and most (85.1%) agreed that this should be done within 30 min. More than half (54.8%) were not sure of the optimal storage medium for avulsed teeth. Their attitude towards acquiring knowledge in this aspect was good (80.5%) and all would take immediate action to settle appointments for trauma cases. [source] Students' evaluation of online course materials in Fixed Prosthodontics: a case studyEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2001Elizabeth S. Pilcher Purpose: The purpose of this study was to assess a new online course format for dental students. Preclinical Fixed Prosthodontics I is a didactic and laboratory course given in the first year of the dental school curriculum. In the spring semester of 1999, the didactic portion of the course was offered in a web-based format as a supplement to the traditional lecture format. Methods: The study population was 53 first year dental students at one school. The study design was a one group post test without a control group. The online questionnaire consisted of multiple choice questions, Leikert scale questions and open-ended questions. Data were collected using Filemaker Pro and analyzed using EpiInfo. Results: Student response rate was 96% (52/53). All of the students responded that they felt comfortable with their computer skills in utilizing this course format. Most (96%) responded that the online materials were either very helpful or helpful to them. About half, (54%) recommended that the online format be continued as a supplement to traditional lectures, while 28% recommended replacing traditional lectures with the new format in order to provide more laboratory time in the course. The syllabus, lecture materials, bulletin board and handouts were found to be the most helpful online features. The least helpful features were the listserve, decision tree, and e-mail options. Most frequently mentioned strengths of the online material were listed as 1) the ability to view material at their own pace and at a time convenient to them, 2) quality photographs in lecture materials and 3) online quizzes. Weaknesses of the course were ranked by students as 1) problems with access to the materials and the intranet system, 2) taking quizzes online and 3) difficulty in printing the web-based lecture materials. Conclusions: The delivery of web-based material as a course supplement in Fixed Prosthodontics I was determined to be an overall success. Fine tuning of problems with access to the materials took place throughout the course. The student feedback will help direct future development of web-based course materials in the dental school curriculum. [source] Upper limb movement interruptions are correlated to freezing of gait in Parkinson's diseaseEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 7 2009Alice Nieuwboer Abstract Freezing of gait (FOG) in patients with Parkinson's disease (PD) is a common problem of unknown origin, which possibly reflects a general motor control deficit. We investigated the relationship between the frequency of freezing episodes during gait and during a bimanual task in control and subjects with PD with and without FOG. Group differences in spatiotemporal characteristics were also examined as well as the effects of visual cueing. Twenty patients with PD in the off-phase of the medication cycle and five age-matched controls performed a repetitive drawing task in an anti-phase pattern on a digitizer tablet. The task was offered at two different speeds (comfortable and maximal) and two different amplitudes (small and large) with and without visual cueing. The results showed that freezing episodes in the upper limbs occurred in only 10.4% of patient trials and that their occurrence was correlated with FOG scores (Spearman's rho = 0.64). Overall, few spatiotemporal differences were found between freezers, non-freezers and controls, except for an overshooting of the target amplitude in controls. Effects of visual cueing were largely similar in all groups, except for the variability of relative phase, which decreased in non-freezers and controls, and was unaffected in freezers. Despite the fact that general motor differences between subgroups were small, freezing episodes were manifest during a bimanual repetitive upper limb task and were correlated to FOG. Further study into upper limb movement breakdown is warranted to understand the parallel deficits that lead up to FOG. [source] Does History End with Postmodernism?FAMILY PROCESS, Issue 4 2001Toward an Ultramodern Family Therapy Although the end of history has often been announced, human thought continues to renew itself, always incorporating, in each of its stages, important aspects of what has come before. In this sense, neither family therapy in general, nor its more particular postmodern orientations, have led to a radical break with the past. Neither can they claim to have reached a comfortable, definitive position. The subjectivist turn that introduced postmodernism into the systemic model has enriched it with important theoretical and practical elements, such as the critique of a therapist's supposed objectivity, circular and reflexive questioning, or the technique of externalization. This article proposes to take the renewal of systemic family therapy farther by addressing still unresolved issues, such as the role of the individual in relational systems, the place of emotions, or the construction of a relational psychopathology. The term "ultramodern family therapy" is proposed until such time as there is agreement upon a better one. [source] A Descriptive Comparison of Ultrasound-guided Central Venous Cannulation of the Internal Jugular Vein to Landmark-based Subclavian Vein CannulationACADEMIC EMERGENCY MEDICINE, Issue 4 2010Daniel Theodoro MD Abstract Objectives:, The safest site for central venous cannulation (CVC) remains debated. Many emergency physicians (EPs) advocate the ultrasound-guided internal jugular (USIJ) approach because of data supporting its efficiency. However, a number of physicians prefer, and are most comfortable with, the subclavian (SC) vein approach. The purpose of this study was to describe adverse event rates among operators using the USIJ approach, and the landmark SC vein approach without US. Methods:, This was a prospective observational trial of patients undergoing CVC of the SC or internal jugular veins in the emergency department (ED). Physicians performing the procedures did not undergo standardized training in either technique. The primary outcome was a composite of adverse events defined as hematoma, arterial cannulation, pneumothorax, and failure to cannulate. Physicians recorded the anatomical site of cannulation, US assistance, indications, and acute complications. Variables of interest were collected from the pharmacy and ED record. Physician experience was based on a self-reported survey. The authors followed outcomes of central line insertion until device removal or patient discharge. Results:, Physicians attempted 236 USIJ and 132 SC cannulations on 333 patients. The overall adverse event rate was 22% with failure to cannulate being the most common. Adverse events occurred in 19% of USIJ attempts, compared to 29% of non,US-guided SC attempts. Among highly experienced operators, CVCs placed at the SC site resulted in more adverse events than those performed using USIJ (relative risk [RR] = 1.89, 95% confidence interval [CI] = 1.05 to 3.39). Conclusions:, While limited by observational design, our results suggest that the USIJ technique may result in fewer adverse events compared to the landmark SC approach. ACADEMIC EMERGENCY MEDICINE 2010; 17:416,422 © 2010 by the Society for Academic Emergency Medicine [source] Navigating a Way through Plurality and Social ResponsibilityINTERNATIONAL JOURNAL OF ART & DESIGN EDUCATION, Issue 1 2008David A. GallArticle first published online: 21 JAN 200 Teachers need to have a clearer understanding of the dynamic process effecting change in culture and identity if they are to overcome fears about teaching diversity. This article draws on Eastern and Western insights on culture to clarify its dynamic process. In particular, teachers need to be aware of the two phases of culture: in one it appears as an organic integrity that suffers violence when any aspect of it is changed, removed or replaced; in the other it appears as a mechanical assemblage of parts momentarily caught in a particular relationship, comfortable with change. Each moment requires appropriate curriculum planning and pedagogical practice. Crucial to achieving that end is keeping the two phases distinct while exploring and exposing their relationship in culture and identity transformation. This will help a great deal to alleviate teachers'fears about teaching diversity or multiculturalism. [source] Risk of perineal damage is not a reason to discourage a sitting birthing position: a secondary analysisINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2010A. De Jonge Summary Aim:, To examine the association between semi-sitting and sitting position at the time of birth and perineal damage amongst low-risk women in primary care. Background:, Evidence on the association between birthing positions and perineal trauma is not conclusive. Most studies did not distinguish between positions during the second stage of labour and position at the time of birth. Therefore, although birthing positions do not seem to affect the overall perineal trauma rate, an increase in trauma with upright position for birthing cannot be ruled out. Methods:, Secondary analysis was performed on data from a large trial. This trial was conducted amongst primary care midwifery practices in the Netherlands. A total of 1646 women were included who had a spontaneous, vaginal delivery. Perineal outcomes were compared between women in recumbent, semi-sitting and sitting position. Logistic regression analysis was used to examine the effects of these positions after controlling for other factors. Findings:, No significant differences were found in intact perineum rates between the position groups. Women in sitting position were less likely to have an episiotomy and more likely to have a perineal tear than women in recumbent position. After controlling for other factors, the odds ratios (OR) were 0.29 [95% confidence interval (CI): 0.16,0.54] and 1.83 (95% CI: 1.22,2.73) respectively. Women in semi-sitting position were more likely to have a labial tear than women in recumbent position (OR: 1.43, 95% CI: 1.00,2.04). Conclusion:, A semi-sitting or sitting birthing position does not need to be discouraged to prevent perineal damage. Women should be encouraged to use positions that are most comfortable to them. [source] Use of dry powder inhalers in COPDINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 12 2007D. S. Wilson Summary Introduction:, This was a study of 30 chronic obstructive pulmonary disease (COPD) patients to assess the ease of use and preference of four dry powder inhalers , accuhaler, aerolizer, handihaler, turbohaler , the accuhaler and turbohaler are multidose devices, whereas the aerolizer and handihaler are single dose devices. Method:, None of the subjects had previous experience of dry powder inhalers. The correct technique for each inhaler was divided into 12 steps including one critical step that if not performed would result in no drug delivery. Subjects were shown the correct technique for each inhaler in a random order and were assessed immediately and 1 h later. Each subject was asked to rank the four devices for preference and ease of use, as well as to assess how comfortable it felt to inhale through the device using a visual analogue scale. Results:, The numbers of perfect scores were not significantly different between devices, but the number of fatal errors that would result in no drug delivery was significantly more common in single dose devices (p < 0.01). There were significant differences in the rankings of each device (Friedman test, p < 0.005) with the turbohaler being ranked first most often and the handihaler last. The turbohaler scored highest for comfort of inhalation and the accuhaler lowest, but differences were small. Conclusions:, In COPD patients starting on dry powder inhalers, multidose devices appear to be preferred, have fewer problems and are easier to use effectively. [source] A preliminary comparative analysis of 3D body scanner, manually taken girth body measurements and size chart measurementsINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 3 2010Pinkie E. Zwane Abstract In an attempt to provide a technological solution to the influx of cheap imports in South Africa and bridging the technology divide between Africa and the rest of the world, the Council for Scientific and Industrial Research procured a three-dimensional body scanner from the Textile and Clothing Technology Corporation, in the US. The pilot study was aimed at introducing the technology to the South African consumers, and to compare the scanned data with the manually taken measurements. A convenience sample of 56 females in South Africa was interviewed using a structured questionnaire. Interviews were used to capture views on acceptance of the technology, prior to being scanned. Scanning garments made from a stretchy fabric were designed and sewn in four sizes of small, medium, large and extra large. A covariance, one sample t -test and paired t - tests were used for data analyses. Almost all respondents felt comfortable with the designed scanning garments and the scanning process. The scanner measurements were generally more numerical in value than the manual measurements for a body part as expected, although the disparity was on the higher side than expected. The discernible difference between means of scanned data and standard values in the currently used sizing charts highlighted the long overdue need to update the sizing charts using a national anthropometric database generated locally. [source] Construction and validation of a patient- and user-friendly nursing home version of the Geriatric Depression Scale,INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 9 2007K. Jongenelis Abstract Objective To construct a patient- and user-friendly shortened version of the Geriatric Depression Scale (GDS) that is especially suitable for nursing home patients. Methods The study was carried out on two different data bases including 23 Dutch nursing homes. Data on the GDS (n,=,410), the Mini Mental State Examination (n,=,410) and a diagnostic interview (SCAN; n,=,333), were collected by trained clinicians. Firstly, the items of the GDS-15 were judged on their clinical applicability by three clinical experts. Subsequently, items that were identified as unsuitable were removed using the data of the Assess project (n,=,77), and internal consistency was calculated. Secondly, with respect to criterion validity (sensitivity, specitivity, area under ROC and positive and negative predictive values), the newly constructed shortened GDS was validated in the AGED data set (n,=,333), using DSM-IV diagnosis for depression as measured by the SCAN as ,gold standard'. Results The eight-item GDS that resulted from stage 1 showed good internal consistency in both the Assess data set (,,=,0.86) and the AGED dataset (,,=,0.80). In the AGED dataset, high sensitivity rates of 96.3% for major depression and 83.0% for minor depression were found, with a specificity rate of 71.7% at a cut-off point of 2/3. Conclusion The GDS-8 has good psychometric properties. Given that the GDS-8 is less burdening for the patient, more comfortable to use and less time consuming, it may be a more feasible screening test for the frail nursing home population. Copyright © 2007 John Wiley & Sons, Ltd. [source] Clinical randomized controlled trial of chemomechanical caries removal (CarisolvÔ)INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2006M. A. LOZANO-CHOURIO Summary., Objectives., The purpose of this study was to compare the chemomechanical caries-removal system (CarisolvÔ) with high-speed excavation in cavitated occlusal caries of primary molars. Design and setting., The study was a randomized controlled, clinical trial in which the two techniques were compared in each subject. Participants were chosen from public schools, in Maracaibo County, Zulia State, Venezuela. Sample and methods. The sample consisted of 80 primary molars selected from 40 children (mean age 7·7 ± 0·7 years). Each patient had at least two contralateral primary molars with cavitated occlusal caries and approximately equal-size access to lesions. The outcome variables were: clinically complete caries removal, size of the opening of the cavity, volume of carious tissue removed, pain during caries removal, anaesthesia requested by the patient, caries-removal time, and behaviour and preference of patients. Results., All treated molars were clinically caries free whichever caries-removal procedure was used. When Carisolv, was used the final cavity entrance sizes were smaller (P < 0·001) and the estimated volume of tissue removed was less (P < 0·001). The time taken for caries removal was three times longer (7·51 ± 1·83 min, P < 0·001). Some pain was reported by seven (17·5%) participants when Carisolv was used, compared with 16 (40%) when high-speed excavation was used (P < 0·05). Using the Carisolv method there was a higher proportion of patients with positive behaviour (P < 0·01), and 71·0% (P < 0·05) preferred this treatment. Conclusion., Carisolv is an effective clinical alternative treatment for the removal of occlusal dentinal caries in cavitated primary molars; it is more conservative of dental tissue and appeared to be more comfortable for most patients, although the clinical time spent is longer than when using high-speed excavation. [source] Administering local anaesthesia to paediatric dental patients , current status and prospects for the futureINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2002D. Ram Summary .,Fear-related behaviours have long been recognized as the most difficult aspect of patient management and can be a barrier to good care. Anxiety is one of the major issues in the dental treatment of children, and the injection is the most anxiety-provoking procedure for both children and adults. There is a constant search for ways to avoid the invasive, and often painful, nature of the injection, and to find more comfortable and pleasant means for anaesthesia before dental procedures. Objective. The purpose of the present review is to summarize relevant data on topics connected with the administration of local anaesthesia. Methods. The review will survey the current available methods, viz. electronic anaesthesia, lidocaine patch, computerized anaesthesia (the Wand), and the syrijet as well as the conventional injection, used for paediatric patients. Conclusions. Usually new techniques for locally anaesthetizing dental patients are tested on adults. However, despite recent research in the field, the injection remains the method of choice. It is necessary to continue to conduct studies using new techniques on adults and children, so that a more acceptable technique can be found. [source] Using cost-analysis techniques to measure the value of nurse practitioner careINTERNATIONAL NURSING REVIEW, Issue 4 2002D. Vincent PhD Abstract Nurse practitioners are in a unique position to deliver high-quality care to a variety of populations and are being utilized in many countries worldwide. Although certain aspects of the nurse practitioner role may differ from country to country, limited financial support and competition for access to patients make it incumbent on nurse practitioners to document the cost-effectiveness of their care. Cost analysis, a business tool that can be used by any practitioner in any health care system, was used to examine business practices of an academic-based nurse-managed centre. In order for this tool to be effective, nurse practitioners must become comfortable with using cost-analysis techniques in their practices. Linking outcome data with cost data was found to be one method for explicating the value of nurse practitioner practice. Nurse practitioners must also recognize that they are competing with primary-care physician practices and other primary health-care practices. It is vital for nurse practitioners to document both the quality and the costs of their care in order to compete with physicians and other health care providers, in order to influence policy and other health-care decision makers. [source] Ginger compress therapy for adults with osteoarthritisJOURNAL OF ADVANCED NURSING, Issue 10 2010Tessa Therkleson therkleson t. (2010) Ginger compress therapy for adults with osteoarthritis. Journal of Advanced Nursing,66(10), 2225,2233. Abstract Aim., This paper is a report of a study to explicate the phenomenon of ginger compresses for people with osteoarthritis. Background., Osteoarthritis is claimed to be the leading cause of musculoskeletal pain and disability in Western society. Management ideally combines non-pharmacological strategies, including complementary therapies and pain-relieving medication. Ginger has been applied externally for over a thousand years in China to manage arthritis symptoms. Method., Husserlian phenomenological methodology was used and the data were collected in 2007. Ten purposively selected adults who had suffered osteoarthritis for at least a year kept daily diaries and made drawings, and follow-up interviews and telephone conversations were conducted. Findings., Seven themes were identified in the data: (1) Meditative-like stillness and relaxation of thoughts; (2) Constant penetrating warmth throughout the body; (3) Positive change in outlook; (4) Increased energy and interest in the world; (5) Deeply relaxed state that progressed to a gradual shift in pain and increased interest in others; (6) Increased suppleness within the body and (7) More comfortable, flexible joint mobility. The essential experience of ginger compresses exposed the unique qualities of heat, stimulation, anti-inflammation and analgesia. Conclusion., Nurses could consider this therapy as part of a holistic treatment for people with osteoarthritis symptoms. Controlled research is needed with larger numbers of older people to explore further the effects of the ginger compress therapy. [source] Decision-making for acutely ill nursing home residents: nurses in the middleJOURNAL OF ADVANCED NURSING, Issue 5 2009Ruth Palan Lopez Abstract Title.,Decision-making for acutely ill nursing home residents: nurses in the middle. Aim., This paper is a report of a study to generate a model of nursing behaviours and social processes inherent in decision-making for acutely ill nursing home residents. Background., Most research concerning clinical decision-making in nursing homes focuses on the perspectives of doctors. Much less is known about the perspectives and actions of nurses with regard to decision-making, despite the centrality of their roles in nursing homes. Method., Grounded theory was used. Data were collected in 2004 in four nursing homes in the United States of America using in-depth, semi-structured interviews, 74 hours of non-participant observation and informal conversational interviews with key nursing staff involved in decision-making. Findings., Nurses strive to create a plan of care acceptable to family members and doctors, consistent with wishes of residents and most comfortable for residents. A unifying theme of satisfying all sides emerged as representative of the negotiation strategies used by nurses to address these competing points of view. Four phases in this negotiation occurred: weighing the significance; notifying the family; feeling it out; and playing the middleman. The outcome was either a decision for life-prolongation or for palliative care. Conclusion., Decisions for nursing home residents are complex and involve weighing and balancing the interests and preferences of many concerned participants, including residents, families and doctors. This process requires skill in clinical judgment, communication and collaboration. [source] Review of upper airway resistance syndrome: nursing and clinical managementJOURNAL OF CLINICAL NURSING, Issue 17 2009Tara B Giblin Aims., This study aims to help nurses and nurse practitioners identify and manage paediatric patients with upper airway resistance syndrome. A review of upper airway resistance syndrome is provided, including the signs and symptoms of upper airway resistance syndrome, criteria for diagnosis, recommendations for treatment and implications for nursing in paediatric primary care. Background., Nurses often encounter sleep-related problems in the paediatric primary care setting. Commonly, these problems are well known and include snoring and obstructive sleep apnoea. Upper airway resistance syndrome is a relatively new diagnosis among sleep-related breathing disorders with which nurses and nurse practitioners should be familiar. Upper airway resistance syndrome is characterised by incomplete obstruction of the airway during sleep, leading to increased respiratory efforts and frequent arousals despite normal oxygen saturations. Design., Systematic review. Method. A review of the sleep literature identified articles regarding sleep and/or sleep-related breathing disorders and paediatrics, and upper airway resistance syndrome. Articles published since 2002 were prioritised; however, all articles describing upper airway resistance syndrome since 1993 were considered. Conclusion., Timely recognition of sleep-disordered breathing is crucial to ensuring that patients receive effective and appropriate treatment. Upper airway resistance syndrome should be a part of the differential diagnosis when assessing a child with a sleep-related breathing disorder. Relevance to clinician practice., Nurses and nurse practitioners should become comfortable and skilled in performing a thorough sleep history and physical examination to help identify when a child should receive a sleep study or referral to a specialist. [source] The Acute Care Nurse Practitioner: challenging existing boundaries of emergency nurses in the United KingdomJOURNAL OF CLINICAL NURSING, Issue 3 2006Tracey Norris BSc Hons Aim., This study explored the opinions of nurses and doctors working in emergency departments towards the development of the Acute Care Nurse Practitioner service in the United Kingdom. Background., Studies carried out in the United States and Canada suggest that the Acute Care Nurse Practitioner can have a positive impact on the critically ill or injured patients' experiences in the emergency department. This role is well developed in the United States and Canada, but is still in its infancy in the United Kingdom. Design and methods., A descriptive, exploratory design incorporating questionnaires (n = 98) and semi-structured interviews (n = 6) was employed. The sample included nurses and doctors from seven emergency departments and minor injury units. Results., Respondents felt it was important for the Acute Care Nurse Practitioner to have obtained a specialist nurse practitioner qualification and that the Acute Care Nurse Practitioner should retain a clinical remit. While participants seemed comfortable with nurses undertaking traditional advanced skills such as suturing, reluctance was displayed with other advanced skills such as needle thoracocentesis. Three main themes were identified from the interviews: inter-professional conflict, autonomy and the need for the Acute Care Nurse Practitioner. Discussions., Doctors were reluctant to allow nurses to practise certain additional advanced skills and difficulties appear to be centred on the autonomy and other associated inter-professional conflicts with the role of the Acute Care Nurse Practitioner. Conclusion., Nurses and doctors identified a need for the Acute Care Nurse Practitioner, but the blurring of boundaries between doctors and nurses can result in inter-professional conflict unless this is addressed prior to the introduction of such advanced practitioners. Relevance to clinical practice., As the role of the emergency nurse diversifies and expands, this study re-affirms the importance of inter-professional collaboration when seeking approval for role expansions in nursing. [source] Being there, experiencing and creating space for dialogue: about working with children in family therapyJOURNAL OF FAMILY THERAPY, Issue 4 2008Peter Rober While most authors agree that it is important to mobilize the active participation of children in the family therapy session, a lot of family therapists exclude children from participating because they do not feel comfortable with children. Teaching family therapists to feel more comfortable around children is a good idea, but perhaps it is not enough. In this article, the author reflects on the complexity of the issue of the comfort of the therapist in a session with children and families. In the discussion of the case story of Elly and her mother, practitioners are reminded that the therapist's experiencing in the session can help her to understand something of what goes on in the families she is working with. [source] Magistrates' Everyday Work and Emotional LabourJOURNAL OF LAW AND SOCIETY, Issue 4 2005Sharyn Roach Anleu The concept of emotional labour describes the management of emotions as part of everyday work performance. Much of the research in this field has been in relation to jobs in the service sector where (mostly female) employees are required to shape their own feelings in order to make customers or clients feel at ease, comfortable or happy. There has been relatively little attention paid to the importance of emotional labour in professional occupations. This paper examines the emotional labour of magistrates in court. Magistrates must often regulate their own emotions and those of some court users, many of whom are not legally represented and who express a variety of emotions, including anger and distress, and experience social problems that may elicit emotions or emotional responses from the magistrate. The paper reports findings from interviews with over 40 magistrates throughout Australia and begins to address the significance of emotional labour for this branch of the judiciary. [source] Are nurses prepared for retirement?JOURNAL OF NURSING MANAGEMENT, Issue 6 2008JUDITH BLAKELEY BScN Aim, This study explored various factors and income sources that registered nurses believe are important in retirement planning. Background, In many countries worldwide, many registered nurses are approaching retirement age. This raises concerns related to the level of preparedness of retiring nurses. Methods, A mail-out questionnaire was sent to 200 randomly selected nurses aged 45 and older. SPSS descriptors were used to outline the data. Multiple t -tests were conducted to test for significant differences between selected responses by staff nurses and a group of nurse managers, educators and researchers. Results, Of 124 respondents, 71% planned to retire by age 60. Only 24% had done a large amount of planning. The top four planning strategies identified were related to keeping healthy and active, both physically and mentally; a major financial planning strategy ranked fifth. Work pensions, a government pension and a personal savings plan were ranked as the top three retirement income sources. No significant differences were found between the staff nurse and manager groups on any of the items. Implications for nursing managers/conclusions, The results of this study suggest that managers' preparation for retirement is no different from that of staff nurses. All nurses may need to focus more on financial preparation, and begin the process early in their careers if they are to have a comfortable and healthy retirement. Nurse managers are in a position to advocate with senior management for early and comprehensive pre-retirement education for all nurses and to promote educational sessions among their staff. Managers may find the content of this paper helpful as they work with nurses to help them better prepare for retirement. This exploratory study adds to the limited amount of research available on the topic. [source] Discussing withdrawing and withholding of life-sustaining medical treatment in a tertiary paediatric hospital: A survey of clinician attitudes and practicesJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 7-8 2008Tom Forbes Aim: To better understand current attitudes and practices relating to discussions concerning the withholding and withdrawing of life-sustaining medical treatment (WWLSMT) among medical staff in the paediatric setting. Methods: An anonymous online survey of paediatricians (senior medical staff , SMS) and paediatric trainees (junior medical staff , JMS) likely to be involved in the care of children with life limiting illness. Results: A total of 162 responses were obtained (response rate 42%). SMS indicated feeling more comfortable with their abilities to discuss WWLSMT than JMS. Barriers to discussing WWLSMT were numerous and included clinician concerns about family readiness for the discussion, prognostic uncertainty, family disagreement with the treating team regarding the child's prognosis/diagnosis and concerns about how to manage family requests for treatments that are not perceived to be in the child's best interests. Fifty-eight per cent of JMS and 35.8% of SMS reported receiving no specific communication training regarding WWLSMT. Most learned through experience and by observing more senior colleagues. There was a high level of support for additional training in this area and for the provision of resources such as discussion guidelines and a structured form for documenting the outcomes WWLSMT discussions. Conclusion: The majority of JMS feel less comfortable with their abilities to facilitate these discussions than their senior colleagues. The results of this study suggest that although confidence correlates with experience, junior and senior clinicians are eager to improve their skills through ongoing professional development and the provision of resources. The education needs of JMS and SMS appear to be different. [source] The Role of Academic Discipline and Gender in High School Teachers' AIDS-Related Knowledge and AttitudesJOURNAL OF SCHOOL HEALTH, Issue 1 2001Lori J. Dawson ABSTRACT Adolescents represent the fastest growing segment of HIV+ individuals in the United States. Therefore, high school teachers should be both knowledgeable of and comfortable with issues related to HIV/AIDS. This study examined high school teachers' AIDS-related knowledge and attitudes. One hundred forty-one high school teachers from nine central Massachusetts high schools participated. Participants completed the "HIV/AIDS Knowledge and Attitudes Scales for Teachers," as well as questions regarding their teaching experience and academic disciplines. Results indicated a direct relationship between teachers' knowledge of HIV/AIDS and positive or supportive attitudes toward HIV/AIDS. Significant differences were found based on academic discipline, with allied health teachers scoring significantly higher on the knowledge scale than teachers in any other discipline. Specific examples are discussed, as is the need for increased teacher training and comprehensive AIDS education. [source] Cognitive dysfunction and the neurobiology of ageing in catsJOURNAL OF SMALL ANIMAL PRACTICE, Issue 10 2007D. Gunn-Moore With improvements in nutrition and veterinary medicine the life expectancy of pet cats is increasing. Accompanying this growing geriatric population there are increasing numbers of cats with signs of apparent senility. A recent study suggests that 28 per cent of pet cats aged 11 to 14 years develop at least one geriatric onset behavioural problem, and this increases to over 50 per cent for cats of 15 years of age or older. While behavioural changes may result from systemic illness, organic brain disease or true behavioural problems, the possibility of age-related cognitive dysfunction is often overlooked. Studies have revealed a number of changes in the brains of geriatric cats that showed signs of cognitive dysfunction, and potential causes include vascular insufficiency leading to hypoxia, increased free radical damage and the deposition of ,-amyloid plaques and/or the modification of other proteins. By recognising the importance of behavioural changes in old cats, investigating them fully for potentially treatable medical conditions, and instigating dietary and environmental modifications to meet their changing needs, we can make the lives of our geriatric cats much more comfortable and rewarding. [source] Drinking to Cope in Socially Anxious Individuals: A Controlled StudyALCOHOLISM, Issue 12 2003Suzanne E. Thomas Background: Several hypotheses exist to account for the higher than normal rate of alcoholism in individuals with high trait anxiety (or anxiety disorders). Most of these suggest that the practice of drinking alcohol to reduce anxiety leads to an increased risk of alcoholism in vulnerable individuals. The first assumption of the hypothesis is that anxious individuals use alcohol to cope with their anxiety. Few studies have examined this issue systematically, and none have used a nonanxious matched control group. Methods: Twenty-three individuals with high social anxiety and 23 nonsocially anxious matched controls were included in the study. Groups were similar on demographic variables and alcohol use. All participants were queried regarding the use of alcohol to cope, the practice of avoiding social situations if alcohol was not available, and the degree of relief attained by alcohol. Participants also were asked about using alcohol in 11 specific situations. Results: The socially anxious group was significantly more likely than controls to report using alcohol to feel more comfortable in social situations and to avoid social situations if alcohol was unavailable. They also reported a greater degree of relief of anxiety from alcohol. Exploratory analyses revealed that socially anxious individuals reported using alcohol more to cope with social interactions than with social performance situations. Conclusions: Individuals high in social anxiety deliberately drink alcohol to cope with their social fears. They report that alcohol is moderately effective at reducing their anxiety, which is seemingly sufficient to allow them to endure social situations. The data support the first assumption of the self-medication hypothesis,that alcohol is used to reduce social discomfort in socially anxious individuals; however, the study was not designed to address the veracity of the self-medication hypothesis as a whole. Results can help guide future studies that examine the relationship between social anxiety and alcohol. [source] Teaching Spirituality to Nurse Practitioner Students: The Importance of the Interconnection of Mind, Body, and SpiritJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 3 2001Margie Maddox EdD SpirituaLism is dormant, not dead, Let us hope. How to revive it, to rekindle it into life, is the great question , Florence Nightingale PURPOSE To describe the author's experience in locating and implementing a spiritual assessment tool in teaching a first semester clinical nurse prac-titioner (NP) course. DATA SOURCES Selected articles and responses of NP students to the use of the tool. CONCLUSIONS A spiritual assessment is an important component of a comprehensive health assessment. The use of a formal structured protocol provides a framework for beginning students to become comfortable with sprirituality and spiritual assessments and to begin to recognize spiritual distress in clients. IMPLICATIONS FOR PRACTICE The protocol used in the course is very extensive and might not be practical in a busy practice setting. An alternative, 4-point assessment is provided. [source] The view of gastroenterologists on non-cardiac chest pain in AsiaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2007T. K. CHEUNG Summary Background, Non-cardiac chest pain is an important disorder in Asia. The practice and views of gastroenterologists on non-cardiac chest pain in this region are not known. Aims, To determine the current understanding, diagnostic practice and treatment strategies among gastroenterologists on the management of non-cardiac chest pain in Asia. Methods, A 24-item questionnaire was sent to gastroenterologists in Mainland China, Hong Kong, Malaysia, Indonesia, Philippines, Singapore, Taiwan and Thailand. Results, 186 gastroenterologists participated with a response rate of 74%. 98% of gastroenterologists managed patients with non-cardiac chest pain over the last 6 months. 64% felt that the number of non-cardiac chest pain patients was increasing and 85% believed that the most common cause of non-cardiac chest pain was GERD. 94% of the gastroenterologists believed that they should manage non-cardiac chest pain patients, but only 41% were comfortable in diagnosing non-cardiac chest pain. The average number of investigations performed was four in non-cardiac chest pain patients, and oesophago-gastro-duodenoscopy was the most commonly used initial test. A proton pump inhibitor was considered the first-line treatment in non-cardiac chest pain and was reported as the most effective treatment by the gastroenterologists. Conclusion, Most gastroenterologists were practicing evidence-based medicine, but frequent use of investigations and a lack of awareness of the role of visceral hypersensitivity in non-cardiac chest pain patients were noted. [source] The leadership-teamship-followership continuumLEADER TO LEADER, Issue 29 2003Patrick L. Townsend Everyone needs to be comfortable in and effective at three key roles. [source] Polyolefin: changing supply-demand framework and new technologyMACROMOLECULAR SYMPOSIA, Issue 1 2003Kissho Kitano Abstract Polyolefin industry is now under a remarkable change of international supply-demand framework and its market is splitting into commodity and high performance products. It is getting more important for a material being harmless and comfortable, while the "life cycle cost", which includes the cost during use and the recycle cost after use, is regarded as more important to evaluate a material. Those changes are accelerating the inter-material penetration. Several examples of the material design and production technologies, which responded to the changing market needs and developed new applications of polyolefin, are discussed. [source] Safe medication practice: attitudes of medical students about to begin their intern yearMEDICAL EDUCATION, Issue 4 2008Ian D Coombes Objectives, Interns are expected to prescribe effectively and safely. This study aimed to assess medical students' perceptions of their readiness to prescribe, associated risks and outcome if involved in an error, as well as their perceptions of available support. Methods, We carried out a survey of 101 students prior to their intern year using a structured questionnaire. An indication of agreement with 21 closed statements was sought. Thematic clusters were identified by factor analysis. Results, Most students (84) felt they would be able to prescribe for most simple complaints and complete discharge prescriptions (81). In high-risk situations, fewer students felt comfortable with prescribing: only 54 felt sufficiently confident to prescribe warfarin and 66 felt confident enough to order i.v. fluids. Many felt support such as guidelines was available (87) and that, if in doubt, they could clarify instructions and seek advice. Students were aware of errors occurring within the medication system; however, most (99) believed that the medicines they prescribed would be safely administered. There was a mixed perception of medication errors: 40 felt that their prescribing errors would not be dealt with constructively and 79 indicated that a culture existed at their hospitals where clinicians would be blamed if they made a prescribing error. Conclusions, At the end of medical school education and prior to assuming responsibility for prescribing, students felt unprepared and perceived that negative outcomes would result if they were involved in errors. These findings indicate that much more work is needed to prepare doctors to prescribe safely, improve the safety of prescribing systems and address the issue of blame. [source] Codeswitching in English Courses in Chinese UniversitiesMODERN LANGUAGE JOURNAL, Issue 3 2010HANS VAN DER MEIJ This study examines the views of teachers and students on the frequency of teacher codeswitching in English major courses in Chinese universities. An important distinction made in the inquiry is the difference between,believed,and,desired,presence in short or long moments of codeswitching. Lessons were recorded to assess the accuracy of teachers' beliefs on codeswitching frequency. The data indicate that teachers felt comfortable with their current practices. They were unaware, however, that their actual codeswitching practice was 7 times more frequent and took 10 times longer than believed. Students wanted (even) more and longer switches. Both teachers and students perceive the classroom as a compound bilingual space in which teacher codeswitching is desirable and functional. The conclusion further discusses the factors that presumably affect the diverse outcomes that many studies, including this one, report for codeswitching frequency. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||