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College Degree (college + degree)
Selected AbstractsComplementary and alternative medicine use in families of children with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2003Edward A Hurvitz MD In order to assess patterns of usage of complementary and alternative medicine (CAM) in families of children with cerebral palsy (CP), 213 families with a child (0 to 18 years) with CP were recruited at the university medical center in Ann Arbor, MI, USA as part of a descriptive survey. Two hundred and thirty-five surveys were distributed. Mean age of the child was 8 years 6 months (SD 4y: 9mo) and 56% of the sample was male with 35% full-time independent ambulators, while the rest used an assistive device or a wheelchair. Fifty-four percent were in special education classrooms. Families were given a survey on functional status of the child with CP, CAM usage of the child and the parent, factors influencing the decision to use CAM, demographics, and clinical information. Of the families, 56%, used one or more CAM techniques. Massage therapy (25%) and aquatherapy (25%) were the most common. Children of families that used CAM were significantly younger (7y: 9mo, SD 4y: 7mo) than non-users (9y: 6mo, SD 4y: 6mo: t -test p < 0.01 two-tailed). Children with quadriplegic CP, with spasticity, and those who could not walk independently were more commonly exposed to CAM (Pearson's X2 [PX2] p=0.01 two-tailed; for mobility, odds ratio [OR] of 2.5 with regression). Mothers with a college degree had a greater tendency to use CAM for their child than those without (PX2p=0.01 two-tailed). Fathers of children who used CAM were older than fathers of those who did not (37y: 9mo versus 33y: 2mo, p=0.04 two-tailed). There was no significant difference between groups for mother's age, father's education, income, or for population of home town. Parents who used CAM for themselves were more likely to try CAM for their child (70% versus 47%, OR 2.1), and were much more likely to be pleased with the outcome (71% versus 42%, OR 3.5). Child's age (younger), lack of independent mobility, and parental use of CAM were the most significant predictive factors identified via logistic regression. [source] Increased health care utilization among long-term cancer survivors compared to the average Dutch population: A population-based studyINTERNATIONAL JOURNAL OF CANCER, Issue 4 2007Floortje Mols Abstract In the present study, self-reported health care utilization of cancer survivors is compared with those of an age- and gender-matched normative population and predictors of health care utilization are identified. A population-based, cross-sectional survey among 1893 long-term survivors of endometrial and prostate cancer and malignant lymphomas (Hodgkin's and non-Hodgkin's) diagnosed between 1989 and 1998 was conducted using the cancer registry of the Comprehensive Cancer Centre South. Cancer survivors visited their general practitioner somewhat more often compared to the age and gender-matched general Dutch population but this effect was not always statistically significant. In addition, they visited their medical specialist significantly more often. Survivors only sporadically (0,3%) visited or required a dietician, sexologist, oncology nurse, pastor, creative therapy or recovery program. Contact with a psychologist, physiotherapist and other cancer survivors took place somewhat more often. Patients visited a medical specialist less often if they were diagnosed with endometrial cancer (OR = 0.2; 95% CI = 0.1,0.5), if they were diagnosed between 10,15 years ago (OR = 0.6; 95% CI = 0.1,0.5) and if they were not married or divorced (OR = 0.5; 95% CI = 0.3,0.9). Contact with a psychologist was related to having a university or college degree (OR = 3.6; 95% CI = 1.3,9.4). Cancer survivors visited their specialist more often compared to the normative population. Changes in health care, such as less administrative work for the specialist and more efficiency, are probably necessary in order to cope adequately with the increasing demand on the system. © 2007 Wiley-Liss, Inc. [source] Evaluation of NOC Measures in Home Care Nursing PracticeINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Gail M. Keenan PURPOSE To evaluate the reliability, validity, usefulness, and sensitivity of 89 NOC outcomes in two Visiting Nurse Associations in Michigan. METHODS Of a total 190 NOC outcomes 89 were assigned for testing. Interrater reliability and criterion validity were assessed a total of 50 times per outcome (on 50 different patients) across the study units. The total number of times the reliability and validity were assessed for each of the 89 measures studied ranged from 5,45. Three RN research assistants (RNRAs) oversaw and participated in data collection with the help of 15 clinicians. Convenience sampling was used to identify subjects. A roster of outcomes to be studied was maintained and matched with patient conditions whenever possible until the quota of outcomes assigned had been evaluated. Clinicians and RNRAs independently rated the outcomes and indicators applicable to the patient. NANDA diagnoses, NIC interventions, and medical diagnoses were recorded. FINDINGS A total of 258 patients (mean age 62) enrolled; 60% were women, 23% were from minority groups, and 78% had no college degree. Thirty-six of the 89 NOC measures were designated "clinically useful." The 10 outcomes with the highest interrater reliability were Caregiver Home Care Readiness; Caregiver Stressors; Caregiving Endurance Potential; Infection Status; Mobility Level; Safety Status: Physical Injury; Self-Care: Activities of Daily Living; Self-Care: Bathing; Self-Care: Hygiene; and Wound Healing: Secondary Intention. Criterion measurement and repeated ratings provided evidence to support the validity and sensitivity of the NOC outcomes. Evidence also suggested that NOC label level ratings could be a feasible, reliable, and valid method of evaluating nursing outcomes under actual use. For some measures, adjustments in the scales and anchors are needed to enhance reliability. For others, it may be unrealistic to reliably score in one encounter, thus scoring should be deferred until the clinician has adequate knowledge of the patient. CONCLUSIONS Continued study and refinement that are coordinated and integrated systematically strongly recommended. Comprehensive study in an automated system with a controlled format will increase the efficiency of future studies. [source] Sensitivity and Specificity of the Mini-Mental State Examination for Identifying Dementia in the Oldest-Old: The 90+ StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2007Kristin Kahle-Wrobleski PhD OBJECTIVES: To evaluate the sensitivity and specificity of the Mini-Mental State Examination (MMSE) in identifying dementia in the oldest-old when stratified by age and education. DESIGN: Cross-sectional. SETTING: Research clinic and in-home visits. PARTICIPANTS: Population-based sample of adults aged 90 and older (n=435) who are enrolled in the 90+ Study, a longitudinal, population-based study. MEASUREMENTS: Neurological examination to determine dementia diagnosis, MMSE, and demographic data. RESULTS: Receiver operating characteristic (ROC) analyses indicated that the MMSE had high diagnostic accuracy for identifying dementia in subjects aged 90 and older across different age and education groups (area under the ROC curve values ranged from 0.82 to 0.98). A range of possible cutoff values and corresponding sensitivity and specificity are provided for the following age groups: 90,93, 94,96, and ,97. Age groups were subdivided by educational attainment (,high school, vocational school or some college, college degree or higher). In subjects aged 90 to 93 with a college degree or higher, the suggested MMSE cutoff score is ,25 (sensitivity=0.82, specificity=0.80). In those aged 94 to 96 with a college degree or higher, the suggested cutoff is ,24 (sensitivity=0.85, specificity=0.80). Those aged 97 and older with an education of high school or less had the lowest suggested cutoff ,22 (sensitivity=0.80, specificity=0.76). CONCLUSION: Overall, the MMSE had good sensitivity and specificity across all age and educational groups. Optimal cutoff points were lower in the older age groups and those with less education, primarily to preserve specificity. This screening instrument is appropriate for use with the oldest-old. [source] Alleviating linear ecological bias and optimal design with subsample dataJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 1 2008Adam N. Glynn Summary., We illustrate that combining ecological data with subsample data in situations in which a linear model is appropriate provides two main benefits. First, by including the individual level subsample data, the biases that are associated with linear ecological inference can be eliminated. Second, available ecological data can be used to design optimal subsampling schemes that maximize information about parameters. We present an application of this methodology to the classic problem of estimating the effect of a college degree on wages, showing that small, optimally chosen subsamples can be combined with ecological data to generate precise estimates relative to a simple random subsample. [source] Assessing competency in nursing: a comparison of nurses prepared through degree and diploma programmesJOURNAL OF CLINICAL NURSING, Issue 1 2005Michael Clinton MSc Aims and objectives., The present study aimed to investigate the competencies of qualifiers from three-year degree and three-year diploma courses in England at one, two and three years after qualification. Background., The provision of three-year preregistration nursing degrees in the UK has increased in recent years and in many colleges degrees are offered alongside the existing three-year diploma courses. Yet little is known about the relationship between these different education programmes and the competence of qualifiers. Methods., A cross-sectional survey design was employed to make comparisons of both self-reported and line-manager-rated competencies of graduate and diplomate nurses who had qualified up to three years previously. Instruments., A revised version of the Nursing Competencies Questionnaire was used to measure both overall competence and also eight specific nursing competencies. A shortened version of this scale was also used to assess internal consistency across measures. Two additional competencies, research awareness and policy awareness, were also measured. Results., Structural equation modelling found very little difference in the overall competence and specific competencies of graduates and diplomates. Where differences were found in the self-report data, diplomates scored more highly than graduates in the constructs of planning and social participation; however, these differences became non-significant when background variables were controlled for. Limitations., The findings are interpreted with caution due to the size of differences, the size of some of the samples of respondents and the developmental stage of the instrument used. Conclusions., It does not appear that graduates and diplomates in England differ in their level of competence to any great extent as measured by the Nursing Competencies Questionnaire. Areas of further work are discussed in the light of the findings. Relevance to clinical practice., While this may alleviate concerns about clinical disparities between the two groups, it raises questions about the proposed benefits to nursing of three-year preregistration degrees in terms of quality of care during the first three years of qualification. [source] | ||||||||||