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Dissemination
Kinds of Dissemination Terms modified by Dissemination Selected AbstractsPREMATURE ADOPTION AND DISSEMINATION OF PREVENTION PROGRAMMESADDICTION, Issue 4 2010SVEN ANDRÉASSON No abstract is available for this article. [source] Prognosis of dermal lymphatic invasion with or without clinical signs of inflammatory breast cancerINTERNATIONAL JOURNAL OF CANCER, Issue 1 2004Guenther Gruber Abstract It is still an open debate whether tumor emboli in dermal lymphatics without inflammatory signs represent a similar bad prognosis like inflammatory breast cancer. We evaluated the prognostic role of dermal lymphatic invasion (DLI) in breast cancer with (DLI + ID) or without (DLI w/o ID) inflammatory disease (ID). From August 1988 to January 2000, 42 patients with DLI were irradiated. Twenty-five were classified as pT4, 13 out of them as pT4d (inflammatory disease); the 17 remaining patients had 1 T1c, 12 T2 and 4 T3 cancers with DLI. Axillary dissection revealed node-positive disease in 39/41 patients (median, 9 positive nodes). Thirty-eight out of 42 patients received adjuvant systemic treatment(s). After a mean follow-up of 33 months, 22/42 patients (52%) are disease-free. The actuarial 3-year disease-free survival is 50% (DLI w/o ID, 61%; DLI + ID, 31%; p < 0.03); the corresponding overall survival was 69% (DLI w/o ID, 87%; DLI + ID, 37%; p = 0.005). The presence or absence of ID was the only significant parameter for all endpoints in multivariate analyses. Dissemination occurred in 19 (45%), local relapse in 7 (n = 17%) and regional failure in 4 (10%). Nine patients (21%) had contralateral breast cancer/relapse. Despite the same histopathologic presentation, DLI w/o ID offered a significantly better disease-free survival and overall survival than ID. The finding of dermal lymphatic tumor invasion predicts a high probability for node-positive disease. © 2003 Wiley-Liss, Inc. [source] Effectiveness of interventions that assist caregivers to support people with dementia living in the community: a systematic reviewINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 2 2008Deborah Parker BA, MSocSci Executive summary Objectives, The objective of this review was to assess the effectiveness of interventions that assist caregivers to provide support for people living with dementia in the community. Inclusion criteria, Types of participants, Adult caregivers who provide support for people with dementia living in the community (non-institutional care). Types of interventions, Interventions designed to support caregivers in their role such as skills training, education to assist in caring for a person living with dementia and support groups/programs. Interventions of formal approaches to care designed to support caregivers in their role, care planning, case management and specially designated members of the healthcare team , for example dementia nurse specialist or volunteers trained in caring for someone with dementia. Types of studies, This review considered any meta-analyses, systematic reviews, randomised control trials, quasi-experimental studies, cohort studies, case control studies and observational studies without control groups that addressed the effectiveness of interventions that assist caregivers to provide support for people living with dementia in the community. Search strategy, The search sought to identify published studies from 2000 to 2005 through the use of electronic databases. Only studies in English were considered for inclusion. The initial search was conducted of the databases, CINAHL, MEDLINE and PsychINFO using search strategies adapted from the Cochrane Dementia and Cognitive Improvement Group. A second more extensive search was then conducted using the appropriate Medical Subject Headings (MeSH) and keywords for other available databases. Finally, hand searching of reference lists of articles retrieved and of core dementia, geriatric and psycho geriatric journals was undertaken. Assessment of quality, Methodological quality of each of the articles was assessed by two independent reviewers using appraisal checklist developed by the Joanna Briggs Institute and based on the work of the Cochrane Collaboration and Centre for Reviews and Dissemination. Data collection and analysis, Standardised mean differences or weighted mean differences and their 95% confidence intervals were calculated for each included study reported in the meta-analysis. Results from comparable groups of studies were pooled in statistical meta-analysis using Review Manager Software from the Cochrane Collaboration. Heterogeneity between combined studies was tested using standard chi-square test. Where statistical pooling was not appropriate or possible, the findings are summarised in narrative form. Results, A comprehensive search of relevant databases, hand searching and cross referencing found 685 articles that were assessed for relevance to the review. Eighty-five papers appeared to meet the inclusion criteria based on title and abstract, and the full paper was retrieved. Of the 85 full papers reviewed, 40 were accepted for inclusion, three were systematic reviews, three were meta-analysis, and the remaining 34 were randomised controlled trials. For the randomised controlled trials that were able to be included in a meta-analysis, standardised mean differences or weighted mean differences and their 95% confidence intervals were calculated for each. Results from comparable groups of studies were pooled in statistical meta-analysis using Review Manager Software and heterogeneity between combined studies was assessed by using the chi-square test. Where statistical pooling was not appropriate or possible, the findings are summarised in narrative form. The results are discussed in two main sections. Firstly it was possible to assess the effectiveness of different types of caregiver interventions on the outcome categories of depression, health, subjective well-being, self-efficacy and burden. Secondly, results are reported by main outcome category. For each of these sections, meta-analysis was conducted where it was possible; otherwise, a narrative summary describes the findings. Effectiveness of intervention type, Four categories of intervention were included in the review , psycho-educational, support, multi-component and other. Psycho-educational Thirteen studies used psycho-educational interventions, and all but one showed positive results across a range of outcomes. Eight studies were entered in a meta-analysis. No significant impact of psycho-educational interventions was found for the outcome categories of subjective well-being, self-efficacy or health. However, small but significant results were found for the categories of depression and burden. Support Seven studies discussed support only interventions and two of these showed significant results. These two studies were suitable for meta-analysis and demonstrated a small but significant improvement on caregiver burden. Multi-component Twelve of the studies report multi-component interventions and 10 of these report significant outcomes across a broad range of outcome measures including self-efficacy, depression, subjective well-being and burden. Unfortunately because of the heterogeneity of study designs and outcome measures, no meta-analysis was possible. Other interventions Other interventions included the use of exercise or nutrition which resulted in improvements in psychological distress and health benefits. Case management and a computer aided support intervention provided mixed results. One cognitive behavioural therapy study reported a reduction in anxiety and positive impacts on patient behaviour. Effectiveness of interventions using specific outcome categories, In addition to analysis by type of intervention it was possible to analyse results based on some outcome categories that were used across the studies. In particular the impact of interventions on caregiver depression was available for meta-analysis from eight studies. This indicated that multi-component and psycho-educational interventions showed a small but significant positive effect on caregiver depression. Five studies using the outcome category of caregiver burden were entered into a meta-analysis and findings indicated that there were no significant effects of any of interventions. No meta-analysis was possible for the outcome categories of health, self-efficacy or subjective well-being. Implications for practice, From this review there is evidence to support the use of well-designed psycho-educational or multi-component interventions for caregivers of people with dementia who live in the community. Factors that appear to positively contribute to effective interventions are those which: ,,Provide opportunities within the intervention for the person with dementia as well as the caregiver to be involved ,,Encourage active participation in educational interventions for caregivers ,,Offer individualised programs rather than group sessions ,,Provide information on an ongoing basis, with specific information about services and coaching regarding their new role ,,Target the care recipient particularly by reduction in behaviours Factors which do not appear to have benefit in interventions are those which: ,,Simply refer caregivers to support groups ,,Only provide self help materials ,,Only offer peer support [source] The current state of the center for the creation and dissemination of new Japanese nursing science: The 21st century Center of Excellence at Chiba University School of NursingJAPAN JOURNAL OF NURSING SCIENCE, Issue 1 2006Kazuko ISHIGAKI Abstract Aim:, The Center of Excellence for the Creation and Dissemination of a New Japanese Nursing Science at Chiba University School of Nursing is now in its third year of operation. This center aims to develop nursing science that is appropriate for Japanese culture and to internationally disseminate the importance of culturally based care. Our project seeks to systematically transform the art of nursing practise into a nursing science. Method:, To date, multiple frameworks have been created through the qualitative meta-synthesis of research on effective nursing care. To create a nursing science, these frameworks derived from meta-synthesis must be verified and internalized in nursing practise. Results:, After three years of research, the following findings are emerging: professional care relationships in nursing practise in Japan are characterized by the bidirectional process between the nurse and the client, in which both gradually undergo a transformation in order to establish a collaborative, therapeutic relationship; Japanese nurses emphasize the importance of understanding adolescent clients' subjective understanding of their own life with self-care, as well as social support; and the priority for community health nurses in Japan is to create support systems in the community, regardless of whether the intended client is an individual, a family, a specific group, or the community as a whole. Conclusions:, Our future efforts will focus on verifying our findings through interdisciplinary and international comparative research and by integrating various frameworks in order to create a new Japanese nursing science. [source] Dissemination of research in clinical nursing journalsJOURNAL OF CLINICAL NURSING, Issue 2 2008Marilyn H Oermann Aim., The purposes of the study were to describe the extent of research, clinical and evidence-based practice articles published in clinical nursing journals and to explore the communication of research and practice knowledge in the clinical nursing literature using citation analysis. Background., For nursing research to have an impact on clinical practice and build evidence for practice, findings from research must transfer into the clinical practice literature. By analysing the extent of research published in clinical nursing journals, the citations in those articles, and other characteristics of the nursing literature, we can learn more about the linkages between research and practice in nursing. Design., This was a descriptive study of 768 articles and 18901 citations in those articles. Methods., Feature articles were classified into four groups , (i) original research reports; (ii) clinical practice articles (non-data based papers on a clinical topic); (iii) systematic reviews, integrative literature reviews, guidelines and papers describing evidence-based practice; and (iv) others. Each citation was then examined to determine if it was a reference to a research study or to a document on clinical practice. Results., Nearly a third of the articles in clinical nursing journals were reports on research studies; another third addressed clinical practice. Of the 14232 citations analysed in clinical nursing journals, 6142 were to research reports (43·2%) and about the same number of citations were to clinical documents (n = 5844, 41·1%). Medical research articles were cited most frequently , 27·1% of the citations in clinical journal articles. Nursing research articles were only 7·6% of the cited documents in clinical publications. Conclusions., Dissemination of research findings in the clinical nursing literature occurred at two levels: through articles that reported studies of potential value to the nurse's practice and citations to research publications within articles. Relevance to clinical practice., Disseminating research in journals that are geared to clinicians is essential to increase nurses' awareness of research findings that might be relevant to their practice. This study documented that articles in clinical nursing journals disseminated not only information about clinical practice, but also informed readers about research of potential value to the nurse's practice. [source] A multidisciplinary guideline for the acute phase of stroke: barriers perceived by Dutch neurologistsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2004Trudy Van Der Weijden PhD MD Abstract Rationale, aims and objectives, Guidelines for stroke management should improve quality of care. Dissemination of guidelines, however, does not guarantee guideline adherence. The aim of this paper is to investigate barriers for guideline adherence to bring about suggestions for possible implementation strategies. Method, Questionnaire survey among all Dutch neurologists working on neurology wards in general hospitals during the year 2000 in The Netherlands. Results, The neurologists expressed a high degree of agreement with the diagnostic and preventive recommendations, but expressed doubts with regard to the therapeutic recommendations, especially for the recombinant tissue plasminogen activator therapy. In general, barriers at the organizational and the multidisciplinary team level were most prominent. Conclusions, Active implementation of the guidelines seems necessary. Implementation strategies should be focused on the different sources of barriers: the caregiver, the patient and the organization of care. [source] Research Dissemination, Open Access, and the Cost of Doing BusinessJOURNAL OF FORENSIC NURSING, Issue 2 2006Louanne Lawson [source] Food consumption impacts of adherence to dietary norms in the United States: a quantitative assessmentAGRICULTURAL ECONOMICS, Issue 2-3 2007C. S. Srinivasan Dietary norms; Dietary adjustment; Food consumption impacts; Quadratic programming Abstract Promotion of adherence to healthy-eating norms has become an important element of nutrition policy in the United States and other developed countries. We assess the potential consumption impacts of adherence to a set of recommended dietary norms in the United States using a mathematical programming approach. We find that adherence to recommended dietary norms would involve significant changes in diets, with large reductions in the consumption of fats and oils along with large increases in the consumption of fruits, vegetables, and cereals. Compliance with norms recommended by the World Health Organization for energy derived from sugar would involve sharp reductions in sugar intakes. We also analyze how dietary adjustments required vary across demographic groups. Most socio-demographic characteristics appear to have relatively little influence on the pattern of adjustment required to comply with norms. Income levels have little effect on required dietary adjustments. Education is the only characteristic to have a significant influence on the magnitude of adjustments required. The least educated rather than the poorest have to bear the highest burden of adjustment. Our analysis suggests that fiscal measures like nutrient-based taxes may not be as regressive as commonly believed. Dissemination of healthy-eating norms to the less educated will be a key challenge for nutrition policy. [source] Toward A Common Language: Proposed Index Categories to Enhance Dissemination and Retrieval of Interior Design ScholarshipJOURNAL OF INTERIOR DESIGN, Issue 2 2004Stephanie A. Clemons Ph.D. ABSTRACT Dissemination and retrieval of scholarship within any given discipline and profession are necessary when defining the body of knowledge. Effective dissemination and retrieval of scholarly work is dependent upon selecting appropriate index categories to describe a publication. Therefore, an accurate categorization system is critical in guiding that dissemination/retrieval process necessary when building a comprehensive body of knowledge for a discipline and profession. The goal of this research was to develop a proposed categorization for systematizing dissemination and retrieval of scholarly work for the discipline and profession of interior design. As a first step in achieving this goal, this study intended to develop a revised categorization for systematizing the dissemination and retrieval of scholarship for the Journal of lnterior Design. The proposed categories would contribute to the interior design discipline and profession by providing: 1) consistency in subject matter categorization for interior design scholarship; 2) a common language within the shared body of knowledge of interior design that includes such disciplines as art, architecture, and social sciences; and 3) clearer identification of topics for future scholarship within the knowledge base for interior design and related areas. For this study, a framework developed by Marshall-Baker (2000) was used in the development of criteria and analysis. Her framework depicted overlapping and unique knowledge within and among fields related to interior design: art, architecture, and social science. Findings supported Marshall-Baker's research and further identified a common language among elated disciplines. This common language enhances communication among publishers, educators, researchers, practitioners, students, and employers. The body of knowledge in interior design will continue to require definition as new knowledge emerges and refinement takes place. Consistent index categorization of scholarship will enable scholars and reviewers of scholarly work to trace the evolution of research on particular topics, thereby assessing the contribution of scholarly work to the expansion and application of the body of knowledge in interior design. The findings offer a proposal for key words and categories identiking interior design scholarship for the purpose of dissemination and retrieval, as well as, providing a platform for common language across related disciplines. [source] Dissemination of Accruals Information, Role of Semi-Annual Reporting, and Analysts' Earnings Forecasts: Evidence from JapanJOURNAL OF INTERNATIONAL FINANCIAL MANAGEMENT & ACCOUNTING, Issue 2 2010Keiichi Kubota Our study investigates the effects of dissemination of accounting accruals information on stock prices using Japanese annual reports as our sample. We conduct month-by-month detailed analyses of price adjustment behavior with a particular focus on revisions of analysts' earnings forecasts and changes in trading volume around the period of upcoming semi-annual reports. We find that analysts' forecasts are often revised around this time, and analysts use this as auxiliary information. In addition, an accompanying re-adjustment of abnormal returns and an increase in trading volume are observed. Our findings demonstrate that informational uncertainty initially triggered by the announcement of annual reports decreases as semi-annual reports are disclosed and analysts change their earnings forecasts, and confirms the importance of semi-annual reporting. [source] Detection of disseminated tumour cells in bone marrow of patients with isolated liver metastases from colorectal cancerJOURNAL OF SURGICAL ONCOLOGY, Issue 4 2003Kristin Bjørnland MD Abstract Background and Objectives In colorectal cancer (CRC) patients, tumour recurrence is common following potentially curative surgery for liver metastases. This may be caused by occult tumour cells present at the time of surgery. Dissemination of micrometastatic cells may occur early in patients with solid cancer, and micrometastases may signify a poor prognosis. The aim of the present study was to evaluate the frequency of micrometastatic cells in the bone marrow of patients with potentially resectable liver metastases. Methods Twenty millilitres of bone marrow was aspirated from both anterior iliac crests from 48 patients. Mononuclear cells were isolated and incubated with superparamagnetic Dynabeads® coated with an anti-epithelial monoclonal antibody (MOC31). Magnetically selected cells were identified by light microscopy as cells with bead rosettes (>5 beads/cell). Results Micrometastatic tumour cells were identified in four of 48 (8%) patients who all had their liver metastases surgically removed. Two of the four died after 17 and 18 months, respectively, whereas two are alive after 10 and 12 months. None of the 19 inoperable patients had micrometastases. Conclusions The frequency of bone marrow micrometastases in patients with clinically isolated liver metastases from CRC was low. This is biologically interesting, but bone marrow status should not affect current treatment protocols. J. Surg. Oncol. 2003;82:224,227. © 2003 Wiley-Liss, Inc. [source] Disseminating early interventions following traumaJOURNAL OF TRAUMATIC STRESS, Issue 5 2006Jonathan I. Bisson Dissemination of effective early interventions following trauma is necessary to ensure the provision of the best possible care in a timely manner. To achieve this, agreement from all key stakeholders is required regarding the messages to be disseminated and the means of dissemination. This article is based on a National Institute of Mental Health sponsored symposium on the dissemination of early interventions at the 21st annual meeting of the International Society for Traumatic Stress Studies in Toronto in 2005. The current knowledge base regarding the effectiveness and dissemination of early interventions (defined here as those that are begun within the first 3 months after exposure) following trauma for children, adolescents, and adults is considered. [source] Dissemination of exposure therapy in the treatment of posttraumatic stress disorder,JOURNAL OF TRAUMATIC STRESS, Issue 5 2006Shawn P. Cahill Since the introduction of posttraumatic stress disorder (PTSD) into the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III; American Psychiatric Association, 1980), considerable research has demonstrated the efficacy of several cognitive,behavioral therapy (CBT) programs in the treatment of chronic PTSD. Among these efficacious treatments is exposure therapy. Despite all the evidence for the efficacy of exposure therapy and other CBT programs, few therapists are trained in these treatments and few patients receive them. In this article, the authors review extant evidence on the reasons that therapists do not use these treatments and recent research on the dissemination of efficacious treatments of PTSD. [source] Population morphometric analysis of the tropicopolitan bug Triatoma rubrofasciata and relationships with Old World species of Triatoma: evidence of New World ancestryMEDICAL AND VETERINARY ENTOMOLOGY, Issue 4 2001J. S. Patterson Abstract. Quantitative analysis of morphological characters of the head was used to reconstruct the evolutionary history of the tropicopolitan bug Triatoma rubrofasciata (De Geer) (Hemiptera: Reduviidae) and seven species of Old World Triatoma. Multivariate analysis demonstrates that T. rubrofasciata and the Old World species have a high degree of similarity with Nearctic Triatoma species, particularly T. rubida (Uhler). We interpret this to imply a common ancestry for these groups. Dissemination of T. rubrofasciata and subsequent derivation of the Old World species of Triatoma is deduced to have occurred over a period of not more than 350 years. [source] Borrelia burgdorferi adhesins identified using in vivo phage displayMOLECULAR MICROBIOLOGY, Issue 1 2007Styliani Antonara Summary Borrelia burgdorferi, the agent of Lyme disease, disseminates from the site of deposition by Ixodes ticks to cause systemic infection. Dissemination occurs through the circulation and through tissue matrices, but the B. burgdorferi molecules that mediate interactions with the endothelium in vivo have not yet been identified. In vivo selection of filamentous phage expressing B. burgdorferi protein fragments on the phage surface identified several new candidate adhesins, and verified the activity of one adhesin that had been previously characterized in vitro. P66, a B. burgdorferi ligand for ,3 -chain integrins, OspC, a protein that is essential for the establishment of infection in mammals, and Vls, a protein that undergoes antigenic variation in the mammal, were all selected for binding to the murine endothelium in vivo. Additional B. burgdorferi proteins for which no functions have been identified, including all four members of the OspF family and BmpD, were identified as candidate adhesins. The use of in vivo phage display is one approach to the identification of adhesins in pathogenic bacteria that are not easily grown in the laboratory, or for which genetic manipulations are not straightforward. [source] Making Things Happen in Higher Education: Dissemination of Student Affairs Research ResultsNEW DIRECTIONS FOR INSTITUTIONAL RESEARCH, Issue 108 2000S. Leellen Brigman Much good research is being done in student affairs, but few people know about it and the potential contribution it can make to institutional decision making. This chapter explores how to get the word out and market the results of student affairs research. [source] Spinal Epidural Abscess as a Result of Dissemination from Gluteal Abscess Secondary to Intramuscular Analgesic InjectionPAIN PRACTICE, Issue 5 2009Mehdi Sasani MD Abstract Spinal epidural abscess is a collection of suppurative material that forms between the dura mater and the ligamentum flavum. If not recognized early and treated correctly, it can lead to life-threatening sepsis. Here we report the case of a female patient, 51 years of age, with difficulty walking and bilateral leg pain after having had degenerative discogenic pain for many years. The patient had occasionally received intramuscular non-steroidal anti-inflammatory drug injections. The current report is that of an unusual case of epidural abscess that formed following multiple dose of intramuscular non-steroidal anti-inflammatory drug over a 1-year period. Hematogenous or direct dissemination is the suspected cause. To prevent serious morbidity and mortality, early diagnosis is essential. Patients with localized back pain who are at risk for developing such epidural spinal abscesses should receive a magnetic resonance imaging scan with contrast enhancement without delay. The existence of predisposing factors such as intramuscular injections should be considered in the assessment of suspected spinal epidural abscess. [source] Bullying in School: Evaluation and Dissemination of the Olweus Bullying Prevention ProgramAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2010Dan Olweus The nature and extent of bullying among school children is discussed, and recent attention to the phenomenon by researchers, the media, and policy makers is noted. The Olweus Bullying Prevention Program (OBPP) is a comprehensive, school-wide program that was designed to reduce bullying and achieve better peer relations among students in elementary, middle, and junior high school grades. Several large-scale studies from Norway are reviewed, which provide compelling evidence of the program's effectiveness in Norwegian schools. Studies that have evaluated the OBPP in diverse settings in the United States have not been uniformly consistent, but they have shown that the OBPP has had a positive impact on students' self-reported involvement in bullying and antisocial behavior. Efforts to disseminate the OBPP in Norway and the United States are discussed. [source] Comparison of the Dissemination and Implementation of Standardized Public Health Nursing Competencies in Academic and Practice SettingsPUBLIC HEALTH NURSING, Issue 2 2006B.S.N, M.S.N., Sonda Oppewal Ph.D. ABSTRACT Objectives: To assess the use of the "Core Competencies for Public Health Professionals" standards in practice and academic work settings by public health nurses (PHNs), and to determine differences between practitioners and faculty. Design: Nonexperimental, descriptive study using a cross-sectional survey. Sample: Three public health nursing (PHN) organizations sent invitations to all members. A total of 334 (18.7%) from an estimated 1,786 members completed the survey. Measurements: The investigators developed a 17-item web-based survey with open- and closed-ended responses, using Rogers' diffusion of innovations as a theoretical framework. Results: Respondents are equally familiar with the competencies for public health professionals disseminated by the Council on Linkages and for PHNs by the Quad Council of Public Health Nursing Organizations (Quad Council). Two thirds of PHNs are aware of the competencies after only 2 years, primarily from professional PHN organizations. Faculty are adopting and using the competencies at a significantly faster rate than practitioners. Conclusions: Faculty and practitioners who use the competencies value them, and rarely discontinued their use after adoption. Efforts to promote diffusion among faculty and especially practitioners need to continue. Professional organizations can actively provide and share examples of useable formats and best practices associated with the competencies. [source] Key Elements for Church-Based Health Promotion Programs: Outcome-Based Literature ReviewPUBLIC HEALTH NURSING, Issue 6 2002Jane Peterson Abstract Although not a new concept, church-based health promotion programs have yet to be widely researched. Few of the initial studies used randomized and controlled designs. Dissemination of study results has been sporadic, with findings often reported in church periodicals. A renewed interest in church-based health promotion programs (CBHPP) is emerging. The purpose of this article is to propose seven key elements found in a literature review to be beneficial in establishing church-based community health promotion programs that demonstrated desired health promotion outcomes. Based on the outcomes of successful CBHPP, the following key elements have been identified: partnerships, positive health values, availability of services, access to church facilities, community-focused interventions, health behavior change, and supportive social relationships. An example of one program that embodies these elements is presented. The Heart and Soul Program, designed to increase physical activity in midlife women to reduce their risk of cardiovascular disease with advancing age, is discussed within the context of the elements for successful church-based programs. CBHPP have effectively promoted health behaviors within certain communities. To promote health and wellness in light of our diverse society and health needs, health promotion professionals and churches can be dynamic partners. [source] Public Health in the Emergency Department: Overcoming Barriers to Implementation and DisseminationACADEMIC EMERGENCY MEDICINE, Issue 11 2009Mary Pat McKay MD Abstract This article is the outcome of a consensus building workshop entitled, "Overcoming Barriers to Implementation and Dissemination" convened at the 2009 Academic Emergency Medicine Consensus Conference, ,,Public Health in the ED: Surveillance, Screening, and Intervention." The participants were asked to address potential methods for overcoming barriers to the dissemination and implementation in the emergency department (ED) of evidenced-based practices to improve public health. The panel discussed three broad areas of interest including methods for disseminating evidence-based practices, barriers encountered during the process of implementation, and the importance of involvement in activities outside the ED including engagement in policy development and improvement. Four recommendations were discussed in detail and consensus was reached. The recommendations included 1) researchers and advocates should disseminate findings through multiple forums beyond peer-reviewed publications when an ED-based public health intervention has enough evidence to support integration into the routine practice of emergency care; 2) local barriers to implementation of public health interventions should be recognized and well understood from multiple perspectives prior to implementation; 3) innovation must be put into place and adapted based on local institutional context and culture as barriers and the best methods for overcoming them will vary across institutions; and 4) use of legislation, regulation, and incentives outside of the ED should support and strengthen ED-based interventions. For each area of interest, research dimensions to extend the current understanding of methods for effectively and efficiently implementing evidence-based public health interventions in the ED were discussed and consensus was achieved. [source] Management measures to control a feline leukemia virus outbreak in the endangered Iberian lynxANIMAL CONSERVATION, Issue 3 2009G. López Abstract The feline leukemia virus (FeLV) is a retrovirus that affects domestic cats all over the world. Its pathogenic effects generally include anemia, immunosuppression or tumors. Dissemination over populations is linked to cat sociality, because the virus is transmitted by direct contact. Although the domestic cat is its common host, FeLV infection has also been described in some wild felids. In the Iberian lynx Lynx pardinus, some sporadic FeLV infection cases have been reported since 1994, but an outbreak with the involvement of several animals has never been described until now. During spring 2007, an FeLV outbreak hit the Doñana (SW Spain) population. The infection rapidly spread throughout the densest subpopulation throughout Doñana. Infected animals showed very acute anemic disease, most of them dying in <6 months. To avoid FeLV dissemination, a control program was carried out that included removal of viremic lynxes, vaccination of negative individuals and reduction of the feral cat population. The program was implemented both in Doñana and in Sierra Morena populations. In Doñana, around 80% of the total lynx population and 90% of the outbreak focus subpopulation were evaluated. Seven out of the 12 infected individuals found died and two reverted to latency; the remaining viremic animals have been kept in captivity. The outbreak appears to have been successfully confined to the subpopulation where the virus appeared and no more cases have been found since August 2007. In the larger Sierra Morena population, 8% of the lynx population was surveyed. Thirty-four uninfected Iberian lynxes were vaccinated at least once. The FeLV prevalence was found to be 27% in the Doñana population and 0% in the Sierra Morena population. [source] Distinguishing the effects of light and temperature variations on the growth, development, multiplication potential and ex vitro survival rates of in vitro cassavaANNALS OF APPLIED BIOLOGY, Issue 3 2001M A B JORGE Summary Dissemination of cassava tissue culture plantlets is difficult in the arid tropics due to low eux vitro survival rates. Increased in vitro light intensity has been reported to induce high ex vitro survival rates. The results from earlier experiments suggested that it would be worthwhile to analyse the separate effects of in vitro light and of temperature on the in vitro growth pattern as well as differentiate its relation to ex vitro survival. Accordingly, analysis of a range of in vitro light intensities from 0 to 369 ,mol,1 m,2 photosynthetic photon flux density (PPFD) was conducted both with and without fans to control the heat. Temperature proved stable at low PPFD levels but increased above 204 ,mol s,1 m,2 when no fans were used. Increased PPFD levels induced larger fresh and dry masses as well as stem thickness. PPFD levels affected the developmental index (senescent leaf numbers) in vitro when it rose above 204 ,mol s,1 m,2 PPFD. Raised temperature ranges increased the multiplication index (node numbers) in vitro and ex vitro. It increased root number and leaf development (lobe anatomy). As in vitro temperatures of up to 40°C improve multiplication rates and PPFD levels above 101 ,mol s,1 m,2 were detrimental for ex vitro survival (as low as 60%), it is suggested that simpler and less costly laboratories with low light levels and a wide range of temperature tolerance could be successfully established in the tropics for in vitro cleaning and rapidly multiplying crops like cassava. [source] Early dissemination of Borrelia burgdorferi without generalized symptoms in patients with erythema migrans,APMIS, Issue 9 2001JARMO OKSI The diagnosis of erythema migrans (EM) is not always easy, and reports of culture- or PCR-confirmed diagnosis as well as reports of EM with simultaneous disseminated disease are few. Characteristics and incidence of EM in addition to frequency of early dissemination of B. burgdorferi were studied in the archipelago of South-Western Finland prospectively using questionnaires, skin biopsies and blood samples. Clinical EM was recognized in 82 patients (incidence 148/100000 inhabitants/year). Of skin biopsy samples, 35.5% were positive by PCR (the majority B. garinii), and 21.5% by cultivation (all B. garinii). Of blood samples, 3.8% were positive by PCR, and 7.7% by cultivation. Of the patients, 30.9% were seropositive at the first visit, and 52.9% 3 weeks later. Of the patients with laboratory confirmed diagnosis, the EM lesion was ring-like in 31.8% and homogenous in 65.9%. Dissemination of B. burgdorferi, based on culture or PCR positivity of blood samples, was detected in 11.0% of the patients. The frequency of generalized symptoms was nearly the same in patients with as in those without dissemination (22.2% vs 27.4%). Only 21.4% of the patients with culture-positive EM recalled a previous tick bite at the site of the EM lesion. We conclude that EM lesions are more often homogenous than ring-like. B. burgdorferi may disseminate early without generalized symptoms. [source] Dissemination of a Sjögren's syndrome,associated extranodal marginal-zone B cell lymphoma: Circulating lymphoma cells and invariant mutation pattern of nodal Ig heavy- and light-chain variable-region gene rearrangementsARTHRITIS & RHEUMATISM, Issue 1 2006A. Hansen Objective Both the genesis and outgrowth of extranodal marginal-zone B cell lymphomas (MZLs) of the mucosa-associated lymphoid tissue (MALT) type are generally thought to represent antigen-driven processes. We undertook this study to analyze lymphoma progression and dissemination outside of the MALT-type lesions. Methods Histopathologic and Ig heavy- and light-chain variable-region gene (VH/L) analyses were performed in sequential tissue samples from a patient with primary Sjögren's syndrome (SS) with glandular (parotid) manifestations and subsequent nodal dissemination of a low-grade MZL. Results This MZL expressed a CD20+,CD27+,sIgM/,+,IgD,,CD5,,CD10,,Bcl-6,,CD23,,p53,,p21,,MDM2, phenotype and mutated VH1,69/D2,21/JH4,,V,A27/J,2 Ig rearrangements. Notably, circulating lymphoma cells from the parotid glands occurred transiently in the patient's blood, as detected by single-cell polymerase chain reaction. In addition, 2 minor B cell clones (clones 2 and 3, with VH3,07/D3,22/JH3b,V,3L/J,2/3 and VH3,64/D3,03/JH2,V,A19/J,2 rearrangements, respectively) were also detected in the parotid glands and blood, and 1 of these (clone 2) was also detected in the lymph nodes. Ig VH/L analyses revealed ongoing (antigen-driven) mutations of the glandular lymphoma rearrangements, but an invariant mutation pattern of their nodal counterparts. Conclusion These data indicate coexpansion and transient (re)circulation of the lymphoma clone and 2 additional glandular B cell clones in a primary SS,associated extranodal MZL. Combined histologic and molecular features of the nodal lymphoma subclone reflect a process of "follicular colonization" that eventually froze the mutation machinery after accumulation of additional (antigen-driven) Ig VH/L mutations. [source] The impact of psoriasis guidelines on appropriateness of referral from primary to secondary care: a randomized controlled trialBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2006C.E.M. Griffiths Summary Background, Most patients with psoriasis have limited disease which can be managed effectively in primary care. There is a marked variation in the frequency of referrals between practices reflecting, in part, inadequate training of general practitioners (GPs) in the management of psoriasis. Objectives, To assess the effectiveness of guidelines and training sessions on the management of psoriasis in reducing inappropriate referrals from primary care. Methods, Patients aged 18 years or over with psoriasis were eligible for the cluster-randomized, randomized controlled trial if they were referred by their GP between 9 September 2002 and 31 December 2003 to one of four hospital dermatology departments in Greater Manchester, North-West England. All GPs from 165 health centres were invited to a lecture by a local dermatologist on the diagnosis and management of psoriasis. Health centres in the intervention arm received guidelines on the management of psoriasis in primary care, developed by local dermatologists, supplemented by the offer of a practice-based nurse-led training session; those in the control arm received neither guidelines nor training sessions. Results, Eighty-two health centres were randomized to the intervention arm and 83 to the control arm. Outcome data were available for 188 of the 196 eligible patients referred during the study period. Patients in the intervention arm were significantly more likely to be appropriately referred in comparison with patients in the control arm [difference = 19·1%; odds ratio (OR) 2·47; 95% confidence interval (CI) 1·31,4·68; intracluster correlation coefficient (ICC) = 0]. Only 25 (30%) health centres in the intervention arm took up the offer of training sessions. There was no significant difference in outcome between health centres in the intervention arm that received a training session and those that did not (OR 1·28, 95% CI 0·50,3·29, ICC = 0). Conclusions, Dissemination of guidelines on the management of psoriasis in primary care can significantly enhance the appropriateness of referral of patients to secondary care. [source] Track 4: Knowledge DisseminationBULLETIN OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE & TECHNOLOGY (ELECTRONIC), Issue 2 2000Donald W. King No abstract is available for this article. [source] Reflections on the Challenges of Effective Dissemination of Behavioural Family Intervention: Our Experience with the Triple P , Positive Parenting ProgramCHILD AND ADOLESCENT MENTAL HEALTH, Issue 4 2005Matthew R. Sanders This paper draws on learnings from dissemination and diffusion research to discuss predictors of dissemination outcomes, obstacles to effective dissemination, and phases of dissemination failure. A model is presented of effective dissemination of a multilevel system of intervention known as the Triple P-Positive Parenting Program (Triple P). This model takes a systems-contextual approach, addressing program design, skills training, practitioner confidence and self-regulation, and workplace support. Recommendations are made for agencies adopting evidence-based programs, particularly in relation to the selection, establishment and maintenance of new programs as well as guiding ongoing program development. Future directions for research into the dissemination of evidence-based practice are also discussed. [source] Persistent effects of a pedagogical device targeted at prevention of severe hypoglycaemia: A randomized, controlled studyACTA PAEDIATRICA, Issue 10 2005Sam Nordfeldt Abstract Aim: To study the long-term use of self-study material in type 1 diabetes patient education targeted at the prevention of severe hypoglycaemia. Methods: Randomized 1,1,1 control study in three local hospitals. We studied 332 type 1 diabetes patients from the geographic population, aged 2.6,18.9 y at entry. The intervention group received a videotape and brochure in which interviewed patients, parents and medical experts reviewed in detail practical skills for self-control and treatment, with the aim of preventing severe hypoglycaemia. There were two control groups: one received a videotape and brochure with general diabetes information and the other only traditional treatment. Primary endpoints were severe hypoglycaemia needing assistance by another person and HbA1c. Dissemination, reading/viewing level, patients' attitudes and extra contact with caregivers were also investigated. At 24 mo, 249 subjects provided data. Results: The yearly incidence of severe hypoglycaemia decreased at 24 mo from 42% to 25% (difference 17%, 95% CI 3,31, p=0.0241) in the intervention group, but not in controls. HbA1c remained unchanged. Video use during months 13,24 was higher in the intervention group than in controls (p=0.0477), ranging from 1,15 (median 2) times, among 37% of patients (months 1,12, 100%). Higher future use was anticipated for intervention material (p=0.0003). Extra caregiver contact was related to severe hypoglycaemia (p=0.0009). The cost of the material was Can pharmacokinetic,pharmacodynamic parameters provide dosing regimens that are less vulnerable to resistance?CLINICAL MICROBIOLOGY AND INFECTION, Issue 11 2008P. Courvalin Abstract Dissemination of antibiotic resistance in bacteria is associated with prescription of the corresponding drugs. Various pharmacokinetic,pharmacodynamic parameters have been developed with the intention of reducing the spread of resistance. In this review, it is considered whether dosing regimens based on these parameters can delay this spread. The evolution of bacterial resistance to antibiotics involves two successive but distinct and independent mechanisms. The first occurs by mutation in the genome, including the host chromosome and mobile accessory genetic elements such as plasmids or transposons, or, following acquisition of a resistance determinant from another bacterium, by horizontal gene transfer. These two genetic events happen by chance, which means that they do not rely on the presence of an antibiotic in the environment; that is, they are not induced, but simply revealed and propagated by the drugs. The second step is dissemination of resistance which can be due to the spread of bacteria (clonal epidemics), of replicons (plasmid epidemics) or of resistance determinants (gene epidemics). Resistance dissemination by each one of these three levels which superimpose in nature, is not only infectious but also exponential, since all three are associated with DNA replication (duplication) of the host chromosome, of a plasmid, or of a transposon. As opposed to emergence, dissemination is clearly associated with the selective pressure exerted by antibiotic prescription [1,2]. The consequence of this dual evolutionary pathway is that proper use of antibiotics will, at best, delay the spread of resistance. In this review, the pharmacokinetic,pharmacodynamic (PK,PD) parameters that are intended to lower resistance dissemination are considered exclusively. [source]
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