Key Words (key + word)

Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

Scoping mental health nursing education

Michael Clinton
ABSTRACT: In late 1999 the National Mental Health Working Group of the Australian Health Ministers Advisory Council commissioned the Australian and New Zealand College of Mental Health Nurses to undertake a scoping study of mental health nursing. A final report will be submitted to the National Mental Health Working Group in February 2000. The purpose of this article is to draw attention to some of the systemic problems that confront the education of mental health nurses in Australia. Shortcomings in the preparation of undergraduate students of nursing for commencing practice in mental health nursing are described and comments are given on issues affecting the quality of postgraduate mental health nursing education. KEY WORDS: mental health, nursing education. [source]

Key Words in Religious Studies , By Ron Geaves

Fred W. Burnett
No abstract is available for this article. [source]

A Bridge Too Far?

Floppy Fail the Apprentice Reader, How Biff, Kipper
Abstract This article is the result of a re-examination of reading scheme books. Taking a literary perspective, the implied reader was investigated in the most popular scheme, The Oxford Reading nee, in order to ascertain how the reader is constructed by the text. It is argued that such texts covertly construct a passive, struggling reader. As such, this has important implications for the National Literacy Strategy, particularly in the selection of texts for Guided Reading. Summary Reading scheme books are designed to bridge the gap between the oral language of the child and the literary language of the book. What is considered important is a recognisable primary world. There is little dialogue yet the language is supposed to reflect that of the child. Short simple sentences devoid of cohesive devices are considered easier to read because the apprentice reader is deemed not to have stamina. Key words such as nouns and verbs are emphasised and little attention is paid to rhythm, hence few elisions and much repetition. As such the reading scheme does not reflect the language of the child for there is little colloquial expression and the lack of literary features actually makes the text very difficult to read. Implied is a reader who is going to find the whole process difficult and has little to bring to the text. On the other hand the children's literature analysed enjoys a variety of narratives and subject matter yet all support the apprentice reader. Such literary texts employ cohesive devices, the third person has a sense of telling with echoes of the oral tradition while those in first person offer a sense of a teller close to the reader. Direct speech is used, which acts as a bridge from the oral to the literary world. The reader is being guided and helped and not left to struggle. Ironically, it is the literary text that offers more support than the supposedly carefully constructed reading scheme. Furthermore, it can be seen that the reading scheme examined constructs a passive reader to whom things happen. The construction of childhood itself is without joy, excitement and wonder. There is a dullness in the text and a dullness in the characters and the plot that constructs a negative view of reading and a negative construction of the child. The model in Figure 1 summarises the difference between the two types of text: Clearly this has implications for texts selected for pupils to read in the National Literacy Strategy, particularly for Guided Reading. There is no shortage in the UK of appropriate, well-written and superbly illustrated children's books that challenge, support and create an interest in literature. It remains a mystery why the dull reading scheme still has such a strong place in the primary classroom. [source]

Incidence of Deep Venous Thrombosis Associated with Femoral Venous Catheterization

Nabeela Z. Mian MD
ABSTRACT Objective: To determine in adult medical patients the incidence of deep venous thrombosis (DVT) resulting from femora] venous catheterization (FVC). Methods: A prospective, observational study was performed at a 420-bed community teaching hospital. Hep-arin-coated 7-Fr 20-cm femoral venous catheters were inserted unilaterally into a femoral vein. Each contra-lateral leg served as a control site. Age, gender, number of FVC days. DVT risk factors, administration of DVT prophylaxis, and DVT formation and site were tabulated for each patient. Venous duplex sonography was performed bilaterally on each patient within 7 days of femoral venous catheter removal. Results: Catheters were placed in 29 men and 13 women. Femoral DVT was identified by venous duplex sonography in 11 (26.2%) of the FVC legs and none (0%) in the control legs. Posterior tibial and popliteal DVT was identified in both the FVC and control legs of 1 patient. DVT formation at the site of FVC insertion was highly significant (p = 0.005). There were no statistically significant associations with age (p = 0.42), gender (p = 0.73), number of DVT risk factors (p = 0.17), number of FVC days (p = 0.89), or DVT prophylaxis (p , 099). Conclusion: Placement of femoral catheters for central venous access is associated with a significant incidence of femoral DVT as detected by venous duplex sonography criteria at the site of femoral venous catheter placement. Physicians must be aware of this risk when choosing this vascular access route for adult medical patients. Further studies to assess the relative risk for DVT and its clinical sequelae when using the femoral vs other central venous catheter routes are indicated. Key words: deep venous thrombosis; femoral vein; catheterization; pulmonary embolism. [source]

Key words and their role in information retrieval

Maria J. Grant
As any good library or information worker knows the accurate and consistent application of keywords can serve to enhance the content representation and retrieval of literature. Research has demonstrated that this aspect of the library and information science evidence base is particularly well represented. Drawing on the thesauri of the Library & Science Abstracts, Library, Information Science & Technology Abstracts and medline databases, the Health Information and Libraries Journal (HILJ) has recently updated and expanded the HILJ keyword list. Based on the content of reviews and original articles published in HILJ over the past 4 years, the keyword list will be used by submitting authors to represent the content of the manuscripts and enable more accurate matching of manuscript to HILJ referees. [source]

Priorities for Nursing Research in Korea

Mi Ja Kim
Purpose: To identify priorities for nursing research in Korea. Methods: A national sample of nurses in academic and clinical settings, representing varied clinical specialties, participated in two rounds of a Delphi survey. Participants listed five most important nursing research problems rated on three dimensions: the degree of nurses' lead role, contribution to nursing profession, and nurses' contribution to health and welfare of patients and clients. A total of 29 research areas were derived from 1,013 research problems identified from the Delphi surveys, and 26 expert panel members who participated in a 1-day workshop to determine the priority of these areas. Key words of 706 research articles published in the major nursing research journals in Korea were analyzed to identify priorities. Results: In the two rounds of Delphi surveys 347 of 1,047 nurses participated (31%,33% response rates respectively). Top three research areas common to both Delphi survey and literature analysis were: clinical nursing practice, nursing education, and nursing research. Cultural nursing was rated the lowest in the Delphi survey but was rated third by the expert panel members. Conclusions: In the clinical practice area, research on the advanced practice nursing system was the first priority research problem followed by development of nursing interventions, clinical competency, quality and effectiveness of nursing care, and standardized nursing tasks. Research on home health care, nursing education, utilization of nursing research, and geriatric nursing were other areas of priority. Nurses around the world are encouraged to develop collaborative research projects based on common priority areas. [source]

Cardiac Troponin I in Pastured and Race-Training Thoroughbred Horses

Wade Phillips
Cardiac troponin I (cTnI), a myocardial polypeptide, is a highly sensitive and specific biomarker of myocardial injury in people and dogs. The structure of cTnI is highly conserved across species, and equine myocardium has high reactivity with human immunoassays. The purpose of this study was to describe cTnI concentrations in normal pastured and race-training Thoroughbred horses. Ten horses on pasture and 10 horses in race training were studied. Horses were considered normal on the basis of physical examination, training performance, electrocardiography (ECG), and echocardiography. Serum cTnI concentrations were determined with a colorimetric immunoassay. The assay has an analytical sensitivity of 0.04 ng/mL. Serum cTnI concentrations in race-training horses were not significantly different from those of pastured horses. When groups were combined, mean cTnI concentration (±SD) was 0.047 ± 0.085 ng/mL, and the median was 0 (range, 0-0.35 ng/mL). The 90th percentile for both groups combined was 0.11 ng/mL. This study establishes a preliminary reference range for serum cTnI in normal Thoroughbred horses. Key words: Cardiac disease; Cardiac markers; Creatine kinase; Myocarditis. [source]

An Assessment of the Terminology Used by Diplomates and Students to Describe the Character of Equine Mitral and Aortic Valve Regurgitant Murmurs: Correlations with the Physical Properties of the Sounds

Jonathan M. Naylor
Twenty students and 16 diplomates listened to 7 recordings made from 7 horses with either aortic (n = 3) or mitral valve (n = 4) regurgitant murmurs. A total of 30 different terms were used to describe the character of these murmurs. However, only 4 terms were used in a repeatable and consistent manner. Most people described the character of a given mitral or aortic valve murmur with 1 or 2 terms. Diplomates drew from a pool of terms that was about half the size of that used by students,.1 ±2.0 terms for diplomats (mean ±1 SD) versus 13.1 ±1.8 terms for students (P < .001). Only blowing, honking, buzzing, and musical were markedly associated with the recording played. Frequency analysis of the murmurs allowed them to be classified as containing harmonics (n = 4) or not containing harmonics (n = 3). Blowing was used to describe murmurs without harmonics on 39 of 48 occasions and corresponds to the term noisy used in some older descriptions of equine murmurs. Honking, musical, and buzzing were markedly associated with murmurs that contained harmonics; these terms were used 23, 13, and 12 of a possible 64 times, respectively. The frequency of buzzing and honking murmurs (72.7 ±9.3 and 88.4 ±46.3 Hz, respectively) was markedly lower than that of musical murmurs (156.8 ±81.1 Hz) (all P values <.01). Honking murmurs (0.392 ±0.092 seconds) were shorter than those described as buzzing or musical (0.496 ±0.205 and 0.504 ±0.116 seconds, respectively). The data suggest that the terminology for the character of aortic and mitral regurgitant murmurs should be restricted to 4 terms: blowing, honking, buzzing, and musical. Honking, buzzing, and musical describe murmurs with a peak dominant frequency and harmonics; blowing describes murmurs without a peak frequency. Effective communication could be enhanced by playing examples of reference sounds when these terms are taught so that nomenclature is used more uniformly. Key words: Cardiac; Heart; Learning; Meaning. [source]

Exercise-induced hypersensitivity syndromes in recreational and competitive athletes: a PRACTALL consensus report (what the general practitioner should know about sports and allergy)

ALLERGY, Issue 8 2008
L. B. Schwartz
Exercise-induced (EI) hypersensitivity disorders are significant problems for both recreational and competitive athletes. These include EI-asthma, EI-bronchoconstriction, EI-rhinitis, EI-anaphylaxis and EI,urticaria. A group of experts from the European Academy of Allergology and Clinical Immunology and the American Academy of Allergy Asthma and Immunology met to discuss the pathogenesis of these disorders and how to diagnose and treat them, and then to develop a consensus report. Key words (exercise with asthma, bronchoconstriction, rhinitis, urticaria or anaphylaxis) were used to search Medline, the Cochrane database and related websites through February 2008 to obtain pertinent information which, along with personal reference databases and institutional experience with these disorders, were used to develop this report. The goal is to provide physicians with guidance in the diagnosis, understanding and management of EI-hypersensitivity disorders to enable their patients to safely return to exercise-related activities. [source]

Spread of a Terrestrial Tradition in an Arboreal Primate

Fernanda P. Tabacow
ABSTRACT We present data on the spread of terrestrial activities in one group of wild northern muriqui monkeys (Brachyteles hypoxanthus). Both males and females consumed fruit, drank, rested, traveled, and socialized terrestrially, but proportionately more males spent significantly more of their time on the ground than females, and females were more likely to engage in terrestrial activities when accompanied by males than when by themselves. Terrestrial activities occurred in both open and closed habitats where arboreal substrates were available and utilized by other individuals engaged in similar activities. Ecological and demographic factors may have stimulated the muriquis' vertical niche expansion, but increases in the frequency and diversity of terrestrial activities, the high proportion of group members that engage in terrestriality, and its diffusion along male-biased social bonds are consistent with the development of a local terrestrial tradition similar to other types of traditions described in other primates. [Key words: terrestriality, ecology, predation, tradition] [source]

Strategies for Managing Barriers to the Writing Process

NURSING FORUM, Issue 4 2000
Celia E. Wills RN
Publication is essential to advancing nursing knowledge for clinical practice, but relatively few nurses publish the results of their research or other writings about clinical practice issues. This article identifies some common barriers to writing for publication-personal factors, such as inadequate knowledge and writing skills, lack of confidence, and low motivation for writing for publication; and situational factors, such as limited time, energy, and other resources constraints-and discusses strategies for managing such barriers. Key words: [source]

Defining the Limits of Restoration: The Need for Realistic Goals

Joan G. Ehrenfeld
The search for a universal statement of goals for ecological restoration continues to generate discussion and controversy. I discuss the diverse roots of restoration ecology, and show how the complex lineages within the field have led to diverse, and divergent, sets of goals. I then review the three major themes that currently are used to develop statements of goals: restoration of species, restoration of whole ecosystems or landscapes, and the restoration of ecosystem services, and point out both the advantages and the limitations and problems associated with each category. Finally, I suggest that restoration ecology would be better served by recognizing that the diversity of conditions requiring restoration demands much flexibility in goal setting, and that restorationists should seek to develop guidelines for defining the sets of conditions under which different kinds of goals are appropriate. I further suggest that goals would be more easily and more appropriately set if restorationists would set forth at the outset the true scope and limitations of what is possible in a given project. Key words: goal-setting, wetlands, conservation biology, ecosystem management, ecosystem services, landscape management. [source]

Revegetation of Pb/Zn Mine Tailings, Guangdong Province, China

Z. H. Ye
The Lechang lead/zinc mine is located in the north part of Guangdong Province, southern China. The tailings residue from the extraction of lead/zinc ores was permanently stored in tailings ponds, which required revegetation to reduce the environmental impact. A field study was, therefore, conducted to evaluate the effects of different ameliorants, including: (1) pig manure (PM); (2) mushroom compost (MC); (3) burnt coal residue (BC); (4) fly ash (FA); and (5) surface soil on the growth of Agropyron elongatum (tall wheat grass), Cynodon dactylon (Bermuda grass), Lolium multiflorum (Italian ryegrass), and Trifolium repens (clover) in the tailings residue. The results from the core profiles indicated that adding FA (10 cm) or BC (15 cm) as a barrier layer between the cover soil and the tailings could increase pH, compared to the treatment with soil only. C. dactylon grew well and had a high cover (90,100%) in all the treatment plots except the control plots without any amendment. A. elongatum and L. multiflorum had a higher cover when grown in plots covered with a barrier layer using FA or BC (both with surface soil), than those grown in plots covered with surface soil only. Treatment plots receiving a thicker soil cover (30 cm) had a better dry weight yield than those with a thinner soil cover (15 cm), regardless of the barrier layer. The results from this study indicate that the use of either 15 cm BC or 10 cm FA as a barrier layer with surface soil, or the use of 38 tonnes PM/ha and 6 cm MC, were effective for the revegetation of Pb/Zn mine tailings. C. dactylon was the best species among the four species used for revegetation. Key words: reclamation, Pb/Zn mine tailings, burnt coal, mushroom compost, fly ash, Bermuda grass, Italian ryegrass, clover. [source]

Germination and Initial Root Growth of Four Legumes as Affected by Landfill Biogas Atmosphere

L. Marchiol
The most important problem in the restoration of closed landfills is the production of toxic gases by decomposition of refuse. Such gases affect the root system of plants growing on these sites. The aim of the present study was to assess the effects induced by landfill biogas contamination on germination and initial root growth of Vicia villosa (hairy vetch), Lotus corniculatus (birdsfoot trefoil), Trifolium pratense (red clover), and Trifolium repens (white clover). In laboratory conditions, simulated landfill and control gas were supplied to the seedlings. The composition of the simulated landfill gas used was: 16% O2, 8% CO2, 3% CH4, and 73% N2; a control gas was also tested (21% O2, 0. 035% CO2, and 78% N2). Percentage of germinated seeds was determined after 6 and 12 days from the starting date; at the same time qualitative assays of metabolic root functionality were also performed by using an agar technique in order to visualize changes in rhizosphere pH. At the end of the experiment, the length of the primary and secondary root was measured. Germination after 6 days was affected by the gas treatment; the landfill biogas caused a delay in germination with respect to the control in seeds of V. villosa and L. corniculatus. Root fresh weight and dry weight were significantly decreased by biogas treatment in V. villosa and T. repens. In contrast, root dry weight was higher in gas treated L. corniculatus and T. pratense compared to control seedlings. Total root system was significantly higher in treated T. pratense. The qualitative assay suggests, with the exception of T. pratense, a metabolic adjustment of the treated seedlings. Key words: restoration, landfill biogas, legumes. [source]

Pathologizing Possession: An Essay on Mind, Self, and Experience in Dissociation

Ashwin Budden
In this paper, critique the classic psychoanalytic anthropological construal of dissociative spirit possession as a pathological phenomenon. I review some of the relevant theoretical and ethnographic literature on this subject but focus on the work of two prominent psychoanalytic anthropologists to explore divergent views of the psychological nature of pathological and religious experience. Emphasis is placed on the necessity for taking into account the culture specific factors that shape dissociative possession, particularly with regard to spiritual experiences. I also move beyond this view to an embodiment approach that is useful for analyzing the experiential ground of spirit possession, and thus for providing insight into how particular individual and cultural realities are constructed through dissociation. Key words: dissociation, embodiment, possession, psychoanalytic anthropology, self "Perception is never an absolute revelation of 'what is' " -A.l. Hallovvell (1955: 84) [source]

Body and Mind in Mount Hagen, Highlands Papua New Guinea

Pamela J. Stewart
The concept of noman in Hagen encompasses a local theory of consciousness, agency, and morality. Interview materials are given to illustrate notions of how the noman works. The Hageners recognize a kind of duality between mind and body but no fundamental split between them. Their theory of consciousness is also a theory of morality and ethics, as well as a recognition of creative agency in life. Key words: Mount Hagen, person, gender, body/mind [source]

Neospora caninum infections in Australia and New Zealand

Objective To review the current state of knowledge of Neospora caninum infections with particular reference to Australia and New Zealand. Procedure Several databases were searched electronically including Medline, Current Contents, Vet CD using several Key words (Neospora caninum, neosporosis, abortion, cattle, dogs) and authors names. References in original articles were also traced and use made of the author's own original research in the field. ConclusionN caninum is recognised worldwide and is also widespread, in particular in dairy cattle, in Australia and New Zealand. It has been reported in both countries retrospectively (in dogs) from the early 1970s. Abortion storms in dairy herds appear to be the most common feature. Recent reports indicate that the dog is the definitive host, in which the sexual cyle is completed. Further studies are however required to establish important aspects of the epidemiology, such as mode of transmission. In the absence of an effective vaccine, the most effective control strategy is selective culling of infected animals and the prevention of access of dogs to expelled placentas and foetuses and, possibly, to raw beef. [source]

Individual versus social complexity, with particular reference to ant colonies

ABSTRACT Insect societies , colonies of ants, bees, wasps and termites , vary enormously in their social complexity. Social complexity is a broadly used term that encompasses many individual and colony-level traits and characteristics such as colony size, polymorphism and foraging strategy. A number of earlier studies have considered the relationships among various correlates of social complexity in insect societies; in this review, we build upon those studies by proposing additional correlates and show how all correlates can be integrated in a common explanatory framework. The various correlates are divided among four broad categories (sections). Under ,polyphenism' we consider the differences among individuals, in particular focusing upon ,caste' and specialization of individuals. This is followed by a section on ,totipotency' in which we consider the autonomy and subjugation of individuals. Under this heading we consider various aspects such as intracolony conflict, worker reproductive potential and physiological or morphological restrictions which limit individuals' capacities to perform a range of tasks or functions. A section entitled ,organization of work' considers a variety of aspects, e.g. the ability to tackle group, team or partitioned tasks, foraging strategies and colony reliability and efficiency. A final section,,communication and functional integration', considers how individual activity is coordinated to produce an integrated and adaptive colony. Within each section we use illustrative examples drawn from the social insect literature (mostly from ants, for which there is the best data) to illustrate concepts or trends and make a number of predictions concerning how a particular trait is expected to correlate with other aspects of social complexity. Within each section we also expand the scope of the arguments to consider these relationships in a much broader sense of'sociality' by drawing parallels with other ,social' entities such as multicellular individuals, which can be understood as ,societies' of cells. The aim is to draw out any parallels and common causal relationships among the correlates. Two themes run through the study. The first is the role of colony size as an important factor affecting social complexity. The second is the complexity of individual workers in relation to the complexity of the colony. Consequently, this is an ideal opportunity to test a previously proposed hypothesis that ,individuals of highly social ant species are less complex than individuals from simple ant species' in light of numerous social correlates. Our findings support this hypothesis. In summary, we conclude that, in general, complex societies are characterized by large colony size, worker polymorphism, strong behavioural specialization and loss of totipotency in its workers, low individual complexity, decentralized colony control and high system redundancy, low individual competence, a high degree of worker cooperation when tackling tasks, group foraging strategies, high tempo, multi-chambered tailor-made nests, high functional integration, relatively greater use of cues and modulatory signals to coordinate individuals and heterogeneous patterns of worker-worker interaction. Key words: Ants, insect societies, individual complexity, social complexity, polyphenism, totitpotency, work organization, functional integration, sociality. [source]

The Prevention of Extramarital Involvement: Steps Toward "Affair Proofing" Marriage

Howard J. Markman
In this paper I provide comments on the Allen et al. paper (this issue). I note that it provides the first critical, comprehensive, and integrative review of extramarital involvement (EMI) to appear in the literature, and I summarize some of its major contributions to the field. I then focus on how the review stimulated my thinking about current and future best practices in marriage education for the prevention of EMI. I conclude by suggesting several directions for future research and practice. Key words: affair prevention, infidelity, couples. [source]


ABSTRACT The sensory profiles of 72 beers commercially available in Italy were described and quantified using descriptive analysis procedures. Principal component analysis indicated that nearly 74% of the variance across samples can be described by the first six principal components. Raw materials and specifically grains impart flavors that are responsible for the main source of variations and discrimination among beers of the Italian market. Second direction of variation is summarized by the perceived overall structure of a given brand and its fruity ester flavors. Although sameness seems to be the key word for pale lagers of the market as emerges from the application of multivariate techniques, this study proved to be efficient in gaining an insight into the relationships between this class of beers and its flavor characteristics and revealed some subtle but clear differences among brands which took the lion's share of the market. PRACTICAL APPLICATIONS The results of this study have practical implications for brewers, importers and distributors. Brewers who wish to introduce or re-position a new or existing beer brand into the Italian market can benefit from these pieces of information to improve the knowledge of the sensory structure of the beer market to better plan their industrial strategies. Moskowitz stated that mapping technique can be used by researchers "to identify which products compete with each other, as well as to discover whether or not there exist in the category unfilled holes that have promise." As competition intensifies, companies need to orientate more precisely and enhance more efficiently towards consumers' satisfaction and sensory properties of food and beverages are universally reported as determinants of product quality and acceptance. [source]

Memory for Labor Pain: A Review of the Literature

BIRTH, Issue 4 2000
Catherine A Niven RGN
Background:Women's ability and accuracy in recalling labor pain are widely debated, even though clinicians commonly use such retrospective information in their practice. The objectives of this paper are to review the literature to establish if labor pain is forgotten, if recall is accurate, factors that affect the accuracy of recall, and consequences of recall.Methods:An electronic search of Medscape, Psychlit, Bath Information and Data Services, and CINAHL between 1990 and 1999 was undertaken using the key words "labor" and "labour,""pain," and "memory." Each key word produced thousands of hits, but the combination of all three was surprisingly unsuccessful. This review, therefore, used a manual and print search and a detailed knowledge of work in this and related fields.Results:The literature was relatively limited, and many studies demonstrated methodological problems. Inductive and deductive analysis suggested that women do not completely forget labor pain, and recall is often vivid but not always entirely accurate.Conclusions:Memories of labor pain can evoke intense negative reactions in a few women, but are more likely to give rise to positive consequences related to coping, self-efficacy, and self-esteem. [source]

Schizophrenia in homeless persons: a systematic review of the literature

D. Folsom
Objective:,This article systematically reviews studies of prevalence of schizophrenia in homeless persons. Method:,Medline and PsychInfo were searched using the key words: homeless person, mental illness, psychosis, and schizophrenia. The bibliographies of identified articles were also reviewed. Results:,Study designs varied considerably. The rate of schizophrenia in homeless persons reported in the 33 published reports, representing eight different countries, ranged from 2 to 45%. In the 10 methodologically superior studies, the prevalence range was 4,16% and the weighted average prevalence was 11%. In addition, rates were higher in younger persons, women and the chronically homeless. Slightly less than half of the homeless persons with schizophrenia were not currently receiving treatment. Conclusion:,Schizophrenia is much more prevalent among homeless persons than in the population at large. Future research should focus on better ways of meeting the mental health care needs of homeless people with schizophrenia. [source]

Emergency management of the morbidly obese

Peter Grant
Abstract Objectives: To identify the difficulties encountered with the emergency management of morbidly obese patients and formulate recommendations to streamline care. Methods: An English language literature search was undertaken using Medline (1966,2003) with key words ,morbid obesity',anaesthesia',imaging',obesity',emergency',transportation',retrieval',critical illness' and ,monitoring'. Potential articles were selected for content applicable to emergency medicine based on title and abstract and reviewed in detail. Reference lists were manually searched for further relevant articles. In view of the very limited systematic study in this area, all information deemed by the authors' to be of assistance to the emergency physician was included regardless of evidence level. Additional information was sought from standard critical care textbooks and their bibliographies and through personal communication with local ambulance and retrieval services. The authors' unpublished personal experience in providing emergency care to the morbidly obese was included for aspects of management not documented in medical literature. Results: Obesity levels and associated health problems are rapidly rising in Australia. Few studies were identified dealing with critical illness in the morbidly obese and none specifically addressing ED management. Problems identified included size related logistical issues, and limitations of physical assessment, monitoring and routine investigations. Invasive procedures, intubation and ventilation can be particularly problematic, and modified techniques may be required. Limited data indicates a poorer outcome from critical illness most marked in the case of blunt traumatic injury. Conclusion: Very obese patients present a variety of logistical and medical challenges for EDs. A series of recommendations are made based on available data. Further studies in this area would be desirable to more specifically address ED issues. [source]

Cognitive style: a psycholexically-derived personality-centred model

John RoodenburgArticle first published online: 20 FEB 200
Cognitive style suffers from a confusing multitude of conceptualizations, and dominance by information-processing type measures. This study sought to elucidate a comprehensive and universal set of personality-centred cognitive style constructs. A grounded approach based on the psycholexical hypothesis (effective in personality modelling) was adapted, explicating cognitive styles as evident in late adolescents. Approximately 700 Australian secondary teachers generated a lexicon of 1040 style adjectives, which were consolidated into 99 key words. 596 teachers rated 1192 senior secondary students against these. After removing acquiescence and a ubiquitous good,bad-ability factor, optimum structure appears to be a spherex abridgeable as three circumplexes, reported across six factor pure and 24 blended facets. Copyright © 2003 John Wiley & Sons, Ltd. [source]


EVOLUTION, Issue 11 2004
Nathan G. Swenson
Abstract Remington (1968) argued that 13 suture zones exist in North America. Remington defined a suture zone as, "a band of geographic overlap between major biotic assemblages, including some pairs of species or semispecies which hybridize in the zone" (p. 322). Although initially controversial, the idea that suture zones exist has picked up momentum over the past decade, due largely to the phylogeographic work of Hewitt, Avise, and their colleagues. Nevertheless, the reality of suture zones has not yet been subjected to rigorous analysis using statistical and geographic information system (GIS) approaches. To test for the existence of Remington's suture zones, we first identified 117 terrestrial hybrid zones in Canada and the United States through a literature search for the key words "cline,""contact zone,""hybrid zone," and "hybridization" in articles published between 1970 and 2002. The 117 hybrid zones were mapped using a GIS approach and compared with a digitized version of Remington's original suture zone map. Overall, there does appear to be an association between hybrid zones and suture zones, but this association is largely attributable to clustering of hybrid zones in only two of the 13 suture zones recognized by Remington. The results suggest that evolutionary biologists should retain some skepticism toward Remington's suture zones. [source]

The psychosocial spiritual experience of elderly individuals recovering from stroke: a systematic review

Marianne Lamb RN
Abstract Objectives, The objective of this review was to appraise and synthesise best available evidence on the psychosocial spiritual experience of elderly individuals recovering from stroke. Inclusion criteria, This review considered qualitative studies whose participants were adults, mean age of 65 years and older, and who had experienced a minimum of one stroke. Studies were included that described the participant's own experience of recovering from stroke. Search strategy, The search strategy sought to find both published and unpublished studies and papers, not limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of text words contained in the title and abstract, and of index terms used to describe the article. A second extensive search was then undertaken using all identified key words and index terms. Methodological quality, Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using the Qualitative Assessment and Review Instrument (QARI) developed by the Joanna Briggs Institute. Disagreements were resolved through consultation with a third reviewer. Data collection, Information was extracted from each paper independently by two reviewers using the data extraction tool from QARI developed by the Joanna Briggs Institute. Disagreements were resolved through consultation with a third reviewer. Data synthesis, Data synthesis aimed to portray an accurate interpretation and synthesis of concepts arising from the selected population's experience during their recovery from stroke. Results, A total of 35 studies were identified and of those 27 studies were included in the review. These qualitative studies examined the perceptions of elderly individuals who had experienced a stroke. Findings were analysed using JBI-QARI. The process of meta-synthesis using this program involved categorising findings and developing synthesised topics from the categories. Four syntheses were developed related to the perceptions and experiences of stroke survivors: sudden unexpected event, connectedness, reconstruction of life and life-altering event. Conclusion, The onset and early period following a stroke is a confusing and terrifying experience. The period of recovery involves considerable psychological and physical work for elderly individuals to reconstruct their lives. For those with a spiritual tradition, connectedness to others and spiritual connection is important during recovery. The experience of stroke is a life-altering one for most elderly individuals, involving profound changes in functioning and sense of self. [source]

Systematic review on embracing cultural diversity for developing and sustaining a healthy work environment in healthcare

Alan Pearson RN, FRCN, FRCNA
Abstract Objectives, The objective of this review was to evaluate evidence on the structures and processes that support development of effective culturally competent practices and a healthy work environment. Culturally competent practices are a congruent set of workforce behaviours, management practices and institutional policies within a practice setting resulting in an organisational environment that is inclusive of cultural and other forms of diversity. Inclusion criteria, This review included quantitative and qualitative evidence, with a particular emphasis on identifying systematic reviews and randomised controlled trials. For quantitative evidence, other controlled, and descriptive designs were also included. For qualitative evidence, all methodologies were considered. Participants were staff, patients, and systems or policies that were involved or affected by concepts of cultural competence in the nursing workforce in a healthcare environment. Types of interventions included any strategy that had a cultural competence component, which influenced the work environment, and/or patient and nursing staff in the environment. The types of outcomes of interest to this review included nursing staff outcomes, patient outcomes, organisational outcomes and systems level outcomes. Search strategy, The search sought both published and unpublished literature written in the English language. A comprehensive three-step search strategy was used, first to identify appropriate key words, second to combine all optimal key words into a comprehensive search strategy for each database and finally to review the reference lists of all included reviews and research reports. The databases searched were CINAHL, Medline, Current Contents, the Database of Abstracts of Reviews of Effectiveness, The Cochrane Library, PsycINFO, Embase, Sociological Abstracts, Econ lit, ABI/Inform, ERIC and PubMed. The search for unpublished literature used Dissertation Abstracts International. Methodological quality, Methodological quality was independently established by two reviewers, using standardised techniques from the Joanna Briggs Institute (JBI) System for the Unified Management, Assessment and Review of Information (SUMARI) package. Discussion with a third reviewer was initiated where a low level of agreement was identified for a particular paper. Following inclusion, data extraction was conducted using standardised data extraction tools from the JBI SUMARI suite for quantitative and qualitative research. Data synthesis was performed using the JBI Qualitative Assessment and Review Instrument and JBI Narrative, Opinion and Text Assessment and Review Instrument software to aggregate findings by identifying commonalities across texts. Quantitative data were presented in narrative summary, as statistical pooling was not appropriate with the included studies. Results, Of the 659 identified papers, 45 were selected for full paper retrieval, and 19 were considered to meet the inclusion criteria for this review. The results identified a number of processes that would contribute to the development of a culturally competent workforce. Appropriate and competent linguistic services, and intercultural staff training and education, were identified as key findings in this review. Conclusions, The review recommends that health provider agencies establish links with organisations that can address needs of culturally diverse groups of patients, include cultural competence in decision support systems and staff education as well as embed them in patient brochures and educational materials. The review also concluded that staff in-service programs consider the skills needed to foster a culturally competent workforce, and recruitment strategies that also explicitly address this need. [source]

Evidence-based clinical practice guidelines for renal cell carcinoma (Summary , JUA 2007 Edition)

Tomoaki Fujioka
Abstract: The text of these guidelines was published for general clinicians, general urologists, and patients, with the aim of providing a system of effective and efficient clinical practices for managing renal cell carcinoma based on evidence-based medicine,intended techniques. The guidelines contain the answers to a total of 21 clinical questions (CQ) that were formulated under the headings of ,risk factors and prophylaxis,',diagnosis,',surgical treatment and local treatment,' and ,systemic treatment,' along with the recommendation grades and systems/algorithms for clinical practice based on structured abstracts prepared through critical reviews of the relevant published reports; the literature search was conducted using the key words for each CQ. An abridged edition of these guidelines can be found on the web pages of the Japan Society of Clinical Oncology and the Medical Information Network Distribution Service. [source]

Evidence-based meta-analysis of pharmacotherapy for benign prostatic hypertrophy

Osamu Ishizuka
Abstract Evidence-based diagnosis and treatment have been proposed recently in various medical fields. Evidence-based diagnostic and therapeutic guidelines for benign prostatic hypertrophy (BPH), one of the most common urological diseases, have been proposed in foreign countries. This paper examines common therapeutic drugs for BPH in Japan from the viewpoint of evidence-based medicine (EBM). The term ,BPH' and drugs indicated for BPH were used as key words to search related articles in the PubMed website. A total of 813 articles extracted as of October 2001 were examined. The articles were ranked in levels ranging from I,V, where Level I indicated a large randomized controlled trial and Level V indicated a non-controlled case accumulation study. Among the 813 articles extracted, 132 clinical articles were suitable for evaluation. There were many reliable articles on the effectiveness of ,-blockers. However, it seemed necessary to examine further how to choose the optimum ,-blocker for each clinical case and the combination of antiandrogen drugs with ,-blockers. It was also considered necessary to evaluate the effectiveness of drugs, such as eviprostat and hachimi-jio-gan, that are available only in Japan. The present study evaluated the effectiveness of commonly available therapeutic drugs for BPH in Japan from a viewpoint of EBM. [source]

HIV disclosure among HIV positive individuals: a concept analysis

Rosemary W. Eustace
eustace r.w. & ilagan p.r. (2010) HIV disclosure among HIV positive individuals: a concept analysis. Journal of Advanced Nursing,66(9), 2094,2103. Abstract Aim., This paper is a report of an analysis of the concept of HIV disclosure. Background., There is a growing interest among healthcare providers and researchers in HIV disclosure as an effective HIV prevention and early disease management initiative. However, the concept still remains unclear. Conceptual clarity is important for providing an expanded theoretical definition and understanding of attributes of HIV disclosure. This information is useful in constructing better HIV disclosure measures in HIV/AIDS nursing practice and research. Data sources., A computer search of the following databases was conducted to capture the meaning and processes of HIV disclosure among HIV-positive individuals: PubMed, CINAHL and PSYCINFO. Only English language journals were used. Publication dates of the literature review ranged from 1999 to 2009. The following key words were used: HIV disclosure, self-disclosure, disclosure and serostatus disclosure. Methods., The Walker and Avant (2005) concept analysis model (Strategies for Theory Construction in Nursing, Pearson Prentice Hall, River, NJ, 2005) was used to guide the analysis process, which was completed in 2009. Results., The concept analysis revealed that HIV disclosure is a complex process characterized by the following attributes: experiencing an event, communicating something, timing, and contextual environment, protecting someone, relationship status and improving something or being therapeutic. In addition, the process of HIV disclosure varies across time. Conclusion., The proposed HIV disclosure attributes provide nursing scholars and researchers with new directions on how to reframe research questions, develop measurement tools to reflect better the diversity and fluidity of the process of HIV disclosure among HIV-positive individuals. Policy implications include the need to develop approaches that protect individual and public rights. [source]