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Greater Effort (greater + effort)
Selected AbstractsRival research programmes and their influence on nursing practiceJOURNAL OF NURSING MANAGEMENT, Issue 2 2004David Newbold BSc In most forms of industry, there is an explicit link between research and development and subsequent technological processes. New discoveries can alter the direction or trajectory of technological progress. In this respect, health care is no different to any other form of industry. There are several theories of science which attempt to explain this link and predict its behaviour. According to Lakatos (1978), rival research programmes may co-exist, whilst Brouwer (1990) suggests they may vie with each other to alter the direction of technological progress. Presently, there are at least two research programmes which are competing to capture the activities of nurses. These are: the Health Care as Industrial Process programme, generating guideline driven nursing, and use of care pathways to maximize throughput plus labour substitution to minimize costs; and the Health Care as Therapeutic Interaction programme, focused on the management and delivery of the fundamental aspects of nursing care, and the use of emotional labour and psychological care to enable patients to cope and make sense of their situation. Ideally, the direction of practice should reflect both of these valid research programmes, with nurses as the staff best placed to integrate medical technology with humanity. Arguably, it is the Industrial Process programme which is currently dominant, at the price of decreased quality of care, and loss of the health benefits of therapeutic interaction. Greater effort is needed, in terms of research to reduce the apparent ,invisibility' of emotional labour, and education of nurses to boost therapeutic interaction skills. In order to re-direct the trajectory, managers should acknowledge and accommodate aspects of therapeutic interaction in service re-engineering, and use quality assurance tools which may accurately detect and monitor therapeutic interaction by nurses. [source] Oral Sex and Condom Use Among Young People In the United KingdomPERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 1 2006Nicole Stone CONTEXT:: The development of UK national targets to reduce the transmission of HIV and other STDs has focused health promotion efforts on advocating the use of condoms during penetrative vaginal and anal sex. However, other behaviors that can facilitate STD transmission,such as oral sex and, in particular, fellatio,have received limited attention. METHODS:: Between 2003 and 2005, a sample of 1,373 full- and part-time students, primarily aged 16,18, completed questionnaires about their knowledge, attitudes and experiences related to sexual behavior and health. Chi-square tests were used to assess differences by sexual experience and gender. Supplementary data were obtained from sexual event diaries completed by 108 young people. RESULTS:: Fifty-six percent of survey respondents had experienced fellatio or cunnilingus, including 22% of those who had not yet engaged in penetrative intercourse. Of young people who had had vaginal intercourse, 70% had previously had oral sex. Among those who had experienced fellatio once, 17% had used a condom, but only 2% of respondents who had engaged in fellatio more than once reported consistent use. Reduced pleasure and lack of motivation, desire and forethought were reasons given for not using condoms during fellatio; hygiene, avoidance of the dilemma of whether to spit or swallow ejaculate, and taste were commonly cited as triggers for use. CONCLUSION:: Greater efforts are needed to publicize the risk of exposure to STDs that many young people face because of unprotected noncoital sexual activities before, as well as after, they enter into relationships involving intercourse. [source] Markers of hepatitis B virus infection and immunity in Victoria, Australia, 1995 to 2005AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2010Benjamin Cowie Abstract Objective: Estimating the prevalence of chronic hepatitis B virus (HBV) infection in generally low-prevalence populations containing communities with a higher disease burden is difficult. This study was conducted to estimate the prevalence of serological markers of infection with, and immunity to, HBV in the Victorian population and to analyse trends in these estimates over time. Methods: A serological survey of 3,212 samples of convenience collected in the years 1995, 2000 and 2005 was conducted using a selection procedure designed to reduce selection bias. All samples were tested for hepatitis B surface and core antibodies; all core antibody positive samples (indicating previous infection) were then tested for the presence of hepatitis B surface antigen (HBsAg). Results: HBsAg prevalence was 1.1% (95%CI 0.8-1.6%) with significant differences observed by area of residence, age, gender and test year. Serological evidence of immunisation in infants and adolescents were lower than established estimates following the introduction of universal vaccination for these groups. Conclusions: This study emphasises the significant and growing problem of chronic HBV infection in Victoria and suggests lower than expected population immunity deriving from universal vaccination programs. Implications: Greater efforts are needed to formulate a comprehensive public health response to address this relatively neglected blood borne viral infection, the burden of which is very significant in some marginalised sections of our community. Increased attention to improving the universality of our immunisation programs is also needed. [source] Nutrition and exercise behavior among patients with bipolar disorder,BIPOLAR DISORDERS, Issue 5 2007Amy M Kilbourne Objectives:, There have been few comprehensive studies of nutrition and exercise behaviors among patients with bipolar disorder (BPD). Based on a national sample of patients receiving care in the Veterans Affairs (VA) health care system, we compared nutrition and exercise behaviors among individuals diagnosed with BPD, others diagnosed with schizophrenia, and others who did not receive diagnoses of serious mental illness (SMI). Methods:, We conducted a cross-sectional study of patients who completed the VA's Large Health Survey of Veteran Enrollees section on health and nutrition in fiscal year (FY) 1999 and who either received a diagnosis of BPD (n = 2,032) or schizophrenia (n = 1,895), or were included in a random sample of non-SMI VA patients (n = 3,065). We compared nutrition and exercise behaviors using multivariable logistic regression, controlling for patient socio-economic and clinical factors, and adjusting for patients clustered by site using generalized estimating equations. Results:, Patients with BPD were more likely to report poor exercise habits, including infrequent walking (odds ratio, OR = 1.33, p < 0.001) or strength exercises (OR = 1.28, p < 0.001) than those with no SMI. They were also more likely to self-report suboptimal eating behaviors, including having fewer than two daily meals (OR = 1.32, p < 0.001) and having difficulty obtaining or cooking food (OR = 1.48, p < 0.001). Patients with BPD were also more likely to report having gained ,10 pounds in the past 6 months (OR = 1.59, p < 0.001) and were the least likely to report that their health care provider discussed their eating habits (OR = 0.84, p < 0.05) or physical activity (OR = 0.81, p < 0.01). Conclusions:, Greater efforts are needed to reduce the risk of poor nutrition and exercise habits among patients diagnosed with BPD. [source] Studying Biodiversity on Private LandsCONSERVATION BIOLOGY, Issue 1 2003Jodi Hilty Private lands harbor a great amount of biodiversity, including at least some habitat for 95% of the federally listed species in the United States. It is important to conduct conservation biology research on private lands, but our review of the literature indicates that few conservation-oriented field studies are conducted on private property. Based on our success in obtaining permission to conduct research on 43 land parcels in Sonoma County, California, we developed methods to enhance a conservation biologist's chance of obtaining permission to work on private lands. We provide guidelines for researchers to conduct studies successfully on private land with the goal of improving access, data collection, and relationships with private landowners. We also discuss constraints researchers face, such as designing studies appropriate for working on privately owned parcels. In light of the importance of these lands to biodiversity conservation, greater effort should be made to conduct research on private lands. Resumen: Más de la mitad de la tierra en los Estados Unidos es propiedad privada. Las tierras de propiedad privada albergan una gran cantidad de biodiversidad, incluyendo al menos algunos hábitats para el 95% de las especies incluidas en la lista nacional de especies en peligro de extinción en los Estados Unidos. Es importante llevar a cabo investigación sobre biología de la conservación en tierras privadas, pero nuestra revisión de la literatura indica que existen pocos estudios a campo orientados hacia la conservación en propiedades privadas. En base a nuestro éxito en obtener permisos para llevar a cabo estudios de investigación en 43 parcelas de tierra en el condado de Sonoma, California, desarrollamos métodos para mejorar las posibilidades de los biólogos conservacionistas de obtener permisos para trabajar en tierras privadas. Hemos provisto lineamientos para que los investigadores lleven a cabo estudios exilosos en tierras privadas con el objeto de mejorar el acceso, la recolección de datos y las relaciones con los dueños de tierras privadas. También discutimos las limitantes que los investigadores enfrentan, tales como el diseño de estudios adecuados para trabajar en parcelas de propiedad privada. Dada la importancia de estas tierras para la conservación de la biodiversidad, se debería realizar un esfuerzo mayor para llevar a cabo investigaciones en tierras privadas. [source] New pharmacological strategies against metastatic spreadFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 5 2008G.Y. Perret Abstract Although metastatic spread is the most frequent cause of death in cancer patients, there are very few drugs specifically targeting this process. Bases for a new antimetastatic drug discovery strategy are weak because a great number of unknowns characterize the complete understanding of the metastatic cascade mechanisms. Moreover, the current experimental models are too simplistic and do not account for the complexity of the phenomenon. Some targets have been identified but too few are validated. Among them, the metastasis suppressor genes seem to be the most promising. In spite of this, during recent years, a dozen of molecules, which fulfil the definition of a specific metastatic drug that inhibits the metastases without altering the growth of the primary tumour (which can be eradicated by surgery), have been identified and assessed for the proof of the concept. The continuation of this effort would benefit in terms of efficiency, if the objectives were defined more precisely. It is particularly important to distinguish molecules that prevent spread of the metastatic cells of the early-stage primary tumour from the ones which induce a regression of the established metastases or to inhibit the transition from disseminated occult tumour cells to dormant micrometastasis. This second goal is a priori more relevant in the current clinical setting where the detection of early metastatic spread is very difficult, and therefore would call for greater effort on the part of the scientific community. [source] SPOTTED DOLPHIN EVASIVE RESPONSE IN RELATION TO FISHING EFFORTMARINE MAMMAL SCIENCE, Issue 1 2005Cleridy E. Lennert-Cody Abstract Spotted dolphins in the eastern Pacific Ocean associate with yellowfin tuna. During the chase and encirclement phases of purse-seining for tunas, dolphin attempt to evade encirclement with the purse-seine net. We used data on evasive behavior (1982,2001) and numbers of purse-seine sets (1959,2001) to study the relationship between evasion and fishing effort. Results show that in nearshore areas first exploited by the fishery in the early 1960s, dolphins exhibited high evasion, but with a limited correlation between evasion and cumulative effort. In areas farther offshore next exploited in the mid-to late-1960s, dolphins showed high evasion and a significant correlation between evasion and cumulative effort. Dolphins in far-western and southern areas, first exploited in the late 1960s to early 1970s, exhibited low evasion, with little relationship to cumulative effort. We hypothesize that this spatial pattern is the result of two types of pressure from fishing: early effort in nearshore areas with a high risk of mortality that generated a lasting evasive response, followed by a longer period of even greater effort but with lower risk of mortality that generated evasion by longer-term learning. [source] An appraisal of medical students' reflection-in-learningMEDICAL EDUCATION, Issue 3 2000Sobral Introduction How do students reflect as they strive for some control of learning early in their clinical activities? The purpose of this study was to examine the reflection-in-learning profile of medical students as they started their clinical apprenticeship. Methods A measure of reflection-in-learning was used to appraise the level and direction of change of reflection in relation to a course experience. The study involved 103 medical students of both sexes who were beginning clinical activities. Assessments of self-regulation of learning, of the meaningfulness of the learning experience, and of diagnostic thinking were also obtained. Results The results showed that 81% of the students had an increase in scores for reflection-in-learning between the beginning and the end of a course. At the end of the course, the level of reflection-in-learning was significantly associated with self-perceived competence for self-regulated learning and with the meaningfulness of the learning experience. In the following term, students who had high reflection-in-learning scores at the end of the course had higher grade-point averages and greater self-reported diagnostic ability in comparison with those with low scores. Conclusions There was some evidence of an improved quality of reflection as the students strive for some control of learning. Overall, the findings support the idea that a greater effort at reflection is associated with a more positive learning experience. They also suggest that reflection-in-learning is related to readiness for self-regulation of learning and may be conducive to enhanced diagnostic ability. In conclusion, measuring reflection-in-learning may be a useful tool in the appraisal of medical students' learning profiles. [source] Children who have complex health needs: parents' experiences of their child's educationCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2009J. Hewitt-Taylor Abstract Background An increasing number of children have complex and continuing health needs. These children have the same right to a full range of education opportunities as other children. Methods This paper reports on the findings from a small qualitative study of the experiences of parents whose children have complex heath needs, related to their experiences of their child's education. Interviews with parents were used to generate data. Findings Parents encounter a number of challenges to their children achieving equal opportunities in relation to education. The factors which influence their opportunities include: staffing issues, funding issues, the attitudes of individuals and organizations, staff confidence in meeting children's needs, clarity over responsibilities and funding. For parents, what seemed most important is not whether their child accesses mainstream education, but whether the school which they attend assists them to achieve their potential. Children who have complex health needs may have to make a greater effort than their peers to achieve educational goals, and may miss considerable school time. This can impact on their leisure time. Accessing pre-school education can be difficult for children who have complex health needs. Conclusions Inclusion in education should include pre-school provision, and more work in this area would be beneficial. Inclusion in mainstream education is only beneficial if it enables the child to participate fully with their peers. This requires practical and organizational issues to be addressed, services to be well co-ordinated, responsibilities and funding to be clear, and staff to be enabled to be confident in meeting the child's needs. However, it is also vital that individuals and organizations have a positive attitude to children and to inclusion. The additional effort and time which children may have to spend on their school work because of their health needs should also be recognized and supported appropriately. [source] Using surveillance data to promote occupational health and safety policies and practice at the state level: A case study,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2010Geoffrey M. Calvert MD Abstract Background Following the investigation of a birth defects cluster involving migrant farmworkers employed in North Carolina and Florida, it became clear that greater efforts were needed to protect agricultural workers from pesticide exposure. Methods Documentation is drawn from peer-reviewed published articles, government reports and news accounts. Results The birth defects cluster was identified and investigated by state and federal pesticide poisoning surveillance system staff. Following the investigation, efforts were initiated to highlight pesticides as an important public health issue needing more attention. A series of subsequent events led to the creation and passage of important legislation recently enacted in North Carolina. The legislation resulted in funding to promote various activities to prevent harm from pesticides including strengthening surveillance, improving the quality of pesticide compliance inspections, and increasing and improving pesticide safety training. The legislation also broadened the coverage of anti-retaliation rules to include agricultural workers, and increased recordkeeping requirements pertaining to pesticide applications. Conclusion The important and positive impacts that can occur through surveillance activities are highlighted. As such, it is important to continue to support and improve occupational illness and injury surveillance programs. Am. J. Ind. Med. 53:188,193 2010. Published 2009 Wiley-Liss, Inc. [source] A Stereotype, Wrapped in a Cliché, Inside a Caricature: Russian Foreign Policy and OrientalismPOLITICS, Issue 3 2010James D.J. Brown This article distils Edward Said's celebrated critique of Orientalism and applies it to the mainstream Western discourse on Russian foreign policy. It finds that the literature in this field, while not as afflicted as the material towards which Said's strident criticism was originally directed, displays a number of the characteristic symptoms of Orientalism , the exaggeration of difference, assumption of Western superiority and resort to clichéd analytical models. To overcome this malaise, it is proposed that scholars make greater efforts to break free of these ,mind-forg'd manacles' and reflect more deeply upon the assumptions underpinning their scholarship. [source] Acute occupational pesticide-related illness in the US, 1998,1999: Surveillance findings from the SENSOR-pesticides program,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2004Geoffrey M. Calvert MD Abstract Background Concern about the adverse public health and environmental effects of pesticide use is persistent. Recognizing the importance of surveillance for acute occupational pesticide-related illness, we report on surveillance for this condition across multiple states. Methods Survey data collected between 1998 and 1999 were obtained from the seven states that conduct acute occupational pesticide-related illness surveillance as part of the Sentinel Event Notification System for Occupational Risks (SENSOR) program. Data were collected by these state programs in a standardized manner and analyzed. Acute occupational pesticide-related illness incidence rates for those employed in agriculture and those employed in non-agricultural industries were also calculated. Results Between 1998 and 1999, a total of 1,009 individuals with acute occupational pesticide-related illness were identified by states participating in the SENSOR-pesticides program. The mean age was 36 years, and incidence rates peaked among 20,24 year-old workers. The overall incidence rate was 1.17 per 100,000 full time equivalents (FTEs). The incidence rate among those employed in agriculture was higher (18.2/100,000 FTEs) compared to those employed in non-agricultural industries (0.53/100,000 FTEs). Most of the illnesses were of low severity (69.7%). Severity was moderate in 29.6% of the cases, and high in four cases (0.4%). Three fatalities were identified. Insecticides were responsible for 49% of all illnesses. Conclusions Surveillance is an important tool to assess acute pesticide-related illness, and to identify associated risk factors. Our findings suggest that these illnesses continue to be an important occupational health problem, especially in agriculture. As such, greater efforts are needed to prevent acute occupational pesticide-related illness. Am. J. Ind. Med. 45:14,23, 2004. Published 2003 Wiley-Liss, Inc. [source] | ||||||||||||||||