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Little Evaluation (little + evaluation)
Selected AbstractsSurveying older people from minority ethnic groups: an evaluation of a primary care sampling method for UK African-Caribbean eldersINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2002Dr Robert Stewart Abstract There are substantial logistical difficulties in conducting community surveys of minority ethnic group populations. Primary care lists have been identified as an important potential resource but the representativeness of samples derived through this method has received little evaluation. In a community survey of psychiatric morbidity, African-Caribbean people aged 55,75 were identified by practice staff from registration lists for seven primary care teams in south London. The sensitivity of the process was evaluated by contacting a random sample of people whose ethnicity was not known. Participants aged 65,75 (n = 174) were also compared to a similarly aged group sampled through household enumeration (n = 34) with respect to demographic factors, risk factors for vascular disease, depression and cognitive function. For those with correct addresses, the identified group was estimated to include 72% of the potentially eligible population. Only 8% of contacted people were found not to be eligible in terms of ethnicity. Compared to the household enumeration sample, the primary care sample had marginally higher socio-economic status but was similar with respect to all other measured characteristics. Primary care list sampling with staff-assigned ethnicity therefore appeared highly specific, reasonably sensitive, and did not seem to introduce substantial bias for this population. Copyright © 2002 Whurr Publishers Ltd. [source] Retinol Intake and Bone Mineral Density in the Elderly: The Rancho Bernardo Study,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 8 2002Joanne H. E. Promislow Abstract Retinol is involved in bone remodeling, and excessive intake has been linked to bone demineralization, yet its role in osteoporosis has received little evaluation. We studied the associations of retinol intake with bone mineral density (BMD) and bone maintenance in an ambulatory community-dwelling cohort of 570 women and 388 men, aged 55,92 years at baseline. Regression analyses, adjusted for standard osteoporosis covariates, showed an inverse U-shaped association of retinol, assessed by food-frequency questionnaires in 1988,1992, with baseline BMD, BMD measured 4 years later, and BMD change. Supplemental retinol use, reported by 50% of women and 39% of men, was an effect modifier in women; the associations of log retinol with BMD and BMD change were negative for supplement users and positive for nonusers at the hip, femoral neck, and spine. At the femoral neck, for every unit increase in log retinol intake, supplement users had 0.02 g/cm2 (p = 0.02) lower BMD and 0.23% (p = 0.05) greater annual bone loss, and nonusers had 0.02 g/cm2 (p = 0.04) greater BMD and 0.22% (p = 0.19) greater bone retention. However, among supplement users, retinol from dietary and supplement sources had similar associations with BMD, suggesting total intake is more important than source. In both sexes, increasing retinol became negatively associated with skeletal health at intakes not far beyond the recommended daily allowance (RDA), intakes reached predominately by supplement users. This study suggests there is a delicate balance between ensuring that the elderly consume sufficient vitamin A and simultaneously cautioning against excessive retinol supplementation. [source] Review: evaluating information systems in nursingJOURNAL OF CLINICAL NURSING, Issue 5 2008Cristina Oroviogoicoechea MSc Aims., To review existing nursing research on inpatient hospitals' information technology (IT) systems in order to explore new approaches for evaluation research on nursing informatics to guide further design and implementation of effective IT systems. Background., There has been an increase in the use of IT and information systems in nursing in recent years. However, there has been little evaluation of these systems and little guidance on how they might be evaluated. Methods., A literature review was conducted between 1995 and 2005 inclusive using CINAHL and Medline and the search terms ,nursing information systems', ,clinical information systems', ,hospital information systems', ,documentation', ,nursing records', ,charting'. Results., Research in nursing information systems was analysed and some deficiencies and contradictory results were identified which impede a comprehensive understanding of effective implementation. There is a need for IT systems to be understood from a wider perspective that includes aspects related to the context where they are implemented. Conclusions., Social and organizational aspects need to be considered in evaluation studies and realistic evaluation can provide a framework for the evaluation of information systems in nursing. Relevance to clinical practice., The rapid introduction of IT systems for clinical practice urges evaluation of already implemented systems examining how and in what circumstances they work to guide effective further development and implementation of IT systems to enhance clinical practice. Evaluation involves more factors than just involving technologies such as changing attitudes, cultures and healthcare practices. Realistic evaluation could provide configurations of context-mechanism-outcomes that explain the underlying relationships to understand why and how a programme or intervention works. [source] A national survey of computerized decision support systems available to nurses in EnglandJOURNAL OF NURSING MANAGEMENT, Issue 7 2009NATASHA MITCHELL PhD Aim, To examine the characteristics of computerized decision support systems (CDSS) currently available to nurses working in the National Health Service (NHS) in England. Method, A questionnaire survey sent to a stratified random sample of 50% of all NHS care providers (Trusts) in England, asking respondents to provide information on CDSS currently used by nurses. Results, Responses were received from 108 of the 277 Trusts included in the sample. Electronic patient record systems were the most common type of CDSS reported by Trusts (n = 61) but they were least likely to have features that have been associated with improved clinical outcomes. Conclusions, The availability of CDSS with features that have been associated with improved patient outcomes for nurses in the NHS in England is limited. There is some evidence that the nature of the Trust affects whether or not nurses have access to CDSS to assist their decision making. Implications for nursing management, The implementation of CDSS is increasing throughout the NHS. Many CDSS are introduced without adequate evidence to support its introduction and there is little evaluation of the benefits once they are implemented. Policy makers and nursing management should consider whether the introduction of CDSS aids nurse decision making and benefits patient outcomes. [source] Clinical characteristics and patterns of referral to a primary mental health team: A retrospective studyASIA-PACIFIC PSYCHIATRY, Issue 2 2009Sean Jespersen MB CHB FC Psych SA MMed Psych FRANZCP Abstract Introduction: The Primary Mental Health Team (PMHT) initiative in Victoria began almost 10 years ago, but there has been little evaluation of this important strategy to improve integration between mental health services and primary care. The present study investigated the demographic and clinical characteristics of patients referred to a PMHT in order to guide development of the service and better meet the needs of primary care providers and their patients. Methods: The referral forms (n=153) and assessment records (n=89) of patients referred consecutively to a PMHT over a 12-month period were investigated in a retrospective file review. Results: Most referrals were from general practitioners requesting consultations. Sixty-five percent of patients were female, 41% were not in a relationship and 47% were unemployed. Fewer children and elderly people were referred. Illnesses tended to be chronic with multiple symptoms, and in half of those referred there had been a poor response to treatment in primary care. Many were victims of abuse and used substances. Medical illnesses were often present and levels of psychosocial stress and functional impairment were high. Referrers appeared to overestimate risk, over diagnose depression, and under diagnose personality disorders and mixed anxiety and depression. Psychotherapy was the most common recommendation made by the PMHT. Discussion: In spite of the limitations of this study the findings are a useful description of the PMHT experience. The review enabled the team to describe and better understand the needs of primary care providers and their patients, and had a significant impact on the subsequent development and expansion of the PMHT. [source] Promoting stability and continuity of care for looked after children: a survey and critical reviewCHILD & FAMILY SOCIAL WORK, Issue 1 2005S. Holland ABSTRACT This paper reports on a two-pronged research study: a critical review of reported research concerning continuity and stability for children looked after away from home, and a telephone survey of UK managers responsible for looked after children. The review found limited research in this specific field that met the criteria of the critical review, but reports some evidence in favour of sibling co-placement, kinship care, parental participation, professional foster care and individualized, multidimensional support. The survey revealed a culture of innovation in this field in the UK voluntary and statutory sectors, but with little evaluation of the independent effects of new interventions. The paper places the research in the context of current policy initiatives in the UK and discusses the implications of the findings for research and practice. [source] | |||||||||||||||||||