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Peer Support (peer + support)
Selected AbstractsRehabilitation and guidance as reported by women and men who had undergone coronary bypass surgeryJOURNAL OF CLINICAL NURSING, Issue 4 2007Kirsi Koivunen RN Aims and objectives., The purpose of this study was to describe the experience of rehabilitation reported by coronary artery disease patients who had undergone coronary artery bypass surgery. A further purpose was to describe the kind of guidance on rehabilitation that they were given during this period. Methods., The data consisted of thematic questionnaires completed by six women and eight men who had undergone coronary artery bypass surgery. They had recorded their experiences on these questionnaires at one-month intervals for a year after the surgery. The data were analysed using the method of content analysis. Results., On the basis of the results, women had experienced the most balanced period of physical, mental and social rehabilitation during the six months following surgery. Their recovery, however, suffered a setback after the first six months. On the basis of the results, men attained a better balance of physical, mental and social rehabilitation only after the six-month period following surgery. Even men had various problems in their rehabilitation, but their recovery proceeded more smoothly than that of women. Women hoped for more guidance throughout the process of rehabilitation. The support and help from wives had a positive impact on the process of men's recovery. Peer support was another significant source support. Conclusions., A person undergoing rehabilitation needs special guidance from health care professionals, especially when his/her rehabilitation does not proceed optimally. The findings suggest that, especially, the guidance of women should be improved because women seemed to suffer from many problems during their process of rehabilitation, including loneliness, insecurity, uncertainty, fears, depression and anxiety. Relevance to clinical practice., Expanding the role of practical nurses to provide both preventive and rehabilitation guidance should be seen as an important strategy in health care. Individual needs, gender differences and support from families and peers should be taken into consideration when planning and implementing guidance. [source] The Benefits of Peer Support With DiabetesNURSING FORUM, Issue 4 2004Sandra L. MacPherson MSN TOPIC. Peer coaching for diabetes support. purpose. To see if peer coaching assists a person with diabetes make the correct diet and activity choices. SOURCES OF INFORMATION. Journal articles, Internet. CONCLUSIONS. Peer support is helpful for people who are struggling to cope with diabetes. If peer support is offered, a structured follow-up program needs to be in place. [source] "I Am Not Alone": The Feasibility and Acceptability of Interactive Voice Response-Facilitated Telephone Peer Support Among Older Adults With Heart FailureCONGESTIVE HEART FAILURE, Issue 3 2007Michele Heisler MD Patient self-management is a critical determinant of heart failure (HF) outcomes, yet patients with HF are often frail and socially isolated, factors that may limit their ability to manage self-care and access clinic-based services. Mobilizing peer support among HF patients is a promising strategy to improve self-management support. In this pilot, the authors evaluated the feasibility and acceptability of an interactive voice response (IVR)-based platform to facilitate telephone peer support among older adults with HF. Participants completed a baseline survey, were offered a 3-hour training session in peer communication skills, and were paired with another patient who had HF. Participants were asked to contact their partner weekly using a toll-free IVR phone system that protected their anonymity and provided automated reminders if contacts were not made. Times and duration of participants' telephone contacts were monitored and recorded. After the 7-week intervention, participants completed surveys and brief face-to-face interviews. The authors found high levels of use and satisfaction and improvements in depressive symptoms among the 20 pilot study participants. An IVR peer-support intervention is feasible, is acceptable to patients, and may have positive effects on patients' HF social support and health outcomes, in conjunction with structured health system support, that warrant more rigorous evaluation in a randomized trial. [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] Barriers to, and facilitators of, research utilisation: a survey of Hong Kong registered nursesINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 2 2006David R Thompson RN BSc MA PhD MBA FRCN FESC Abstract Aim, Despite increasing efforts to promote the utilisation of research in daily nursing practice it is apparent that there are a number of obstacles to address. This paper reports a study to examine the barriers to, and facilitators of, research utilisation among registered nurses in Hong Kong. Methods, A survey design and a random sampling method was used. The final sample consisted of 1487 registered nurses working in private and public health-care sectors in Hong Kong. A bilingual version of the Research Utilisation Questionnaire, comprising a 31-item barriers scale, and an 8-item facilitators scale was used. The instrument was mailed to participants who were asked to return the completed questionnaire by mail. Results, The highest ranking barriers to research utilisation reported by respondents were related mainly to organisational factors with regards to inadequate facilities, no authority to change procedures, and time constraints. Hong Kong nurses, however, did not appear to see any problem with regards to items related to characteristics of research, such as conclusions drawn from research being justified, research articles not being published fast enough, and literature reporting conflicting results. This indicates that nurses are aware of research developments in nursing and can critically analyse research reports. With regards to facilitators of research utilisation, respondents agreed that managerial and peer support are the greatest facilitators. Conclusions, The results indicate that factors influencing research utilisation are multidimensional and should be taken into account by all involved in the research enterprise: researchers, practitioners, educators, managers and policy-makers. The results of this study provide directions on how to assist nurses in Hong Kong in their efforts to utilise research. [source] A systematic review of professional support interventions for breastfeedingJOURNAL OF CLINICAL NURSING, Issue 9 2008Leena Hannula PhD Objectives., The objectives of this systematic review were first, to describe how breastfeeding is professionally supported during pregnancy, at maternity hospitals and during the postnatal period. Secondly, to find out how effective interventions are in supporting breastfeeding. Background., Breastfeeding is an effective way to promote the health of infants. In many countries, the rates for breastfeeding remain lower than recommended. Many studies have examined breastfeeding promotion interventions; some of them are successful and some fail. It is important to find effective combinations of support. Design. Systematic review. Methods., Search of CINAHL, Medline and Cochrane Central Register databases were conducted for data collection. The search was limited to articles published in Finnish, Swedish and English between the year 2000 and March 2006, focusing on breastfeeding and breastfeeding support interventions. Two reviewers independently analysed 36 articles in the final analysis. Results., Interventions expanding from pregnancy to the intrapartum period and throughout the postnatal period were more effective than interventions concentrating on a shorter period. In addition, intervention packages using various methods of education and support from well-trained professionals are more effective than interventions concentrating on a single method. Conclusions., During pregnancy, the effective interventions were interactive, involving mothers in conversation. The Baby Friendly Hospital Initiative (BFHI) as well as practical hands off -teaching, when combined with support and encouragement, were effective approaches. Postnatally effective were home visits, telephone support and breastfeeding centres combined with peer support. Relevance to clinical practice., Professionals need breastfeeding education and support of their organisations to act as breastfeeding supporters. The BFHI -programme is effective and it would be wise to include the core components of the programme in breastfeeding promotion interventions. Mothers benefit from breastfeeding encouragement and guidance that supports their self-efficacy and feelings of being capable and empowered, and is tailored to their individual needs. [source] Peer evaluation in nurses' professional development: a pilot study to investigate the issuesJOURNAL OF CLINICAL NURSING, Issue 2 2000Riitta Vuorinen MNSc ,,Peer evaluation in nursing is a method by which the nurse evaluates the work of a peer, according to set evaluation criteria. ,,The aim of the study was to clarify the potential significance of peer evaluation with regard to nurses' career development and relates to the introduction of a career development programme for nurses in a Finnish University Hospital. ,,The research concepts were created on the basis of literature analysis. The concepts served as a basis for data collection, and five open-ended questions were devised from them. Informants (n = 24) gave free-form essay-type answers to these questions. The material was analysed using qualitative content analysis. ,,The results indicate that self-evaluation constitutes the basis for peer evaluation. Peer evaluation allows nurses to give and receive professional and personal support promoting professional development. Professional support offers possibilities for change and alternative action. Personal support requires respect for the peer's equality and individuality. Personal peer support can decrease feelings of uncertainty and insecurity caused by work. ,,The conclusion is drawn that peer evaluation is a means of promoting nurses' professional development to further on-the-job learning in collaboration with peers. [source] Implementing peer support in schools: using a theoretical framework in action researchJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 6 2004Maretha J. Visser Abstract The implementation of a peer support project in 13 schools from a disadvantaged background is discussed using the social ecological, systems and social construction theory as a theoretical guide in action research. The goal was to establish an alternative helping system in schools that was sustainable within the school system. In the implementation of peer support attention was given to the integration of the project into the existing context; encouraging participation on all levels, facilitating change and creating shared meanings, supporting the process of reorganizing and restructuring and providing feedback to facilitate further change. From a process evaluation of the programme implementation challenges in the implementation process were identified and recommendations made that could contribute to the optimal functioning and sustainability of the project to address the needs of learners and enhance well being in the school community. Copyright © 2004 John Wiley & Sons, Ltd. [source] Empowerment and peer support: structure and process of self-help in a consumer-run center for individuals with mental illness,JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 6 2009Russell K. Schutt Personal empowerment is a guiding philosophy of many mental health service programs, but there has been little empirical research on the empowerment process in these programs. The authors examine social processes and consumer orientations within a self-help drop-in center for individuals with psychiatric disabilities, using intensive interviews and focus groups. They investigate motives for consumer involvement, bases for program retention, and processes of participant change. Motives for involvement in the center were primarily instrumental, whereas the bases of retention were more often maintaining social support and developing self-esteem. Participants valued the center's nonstigmatizing environment and its supportive consumer staff. Some used the opportunity to become a staff member to move into a more normalized social role; all seemed to derive benefits from helping peers. There were indications of some staff members adopting a more authoritarian posture, but participants repeatedly lauded most staff for their supportive orientation. The authors conclude that the "helper/therapy" process was a key to successful empowerment. © 2009 Wiley Periodicals, Inc. [source] Community violence exposure and delinquent behaviors among youth: The moderating role of copingJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 5 2003Margaret Rosario This study examines the moderating roles of guardian and peer support and behavioral coping strategies on the relations between youths' community violence exposure and their delinquent behavior. A sample of 667 public school sixth-graders in a large inner-city school district, and their parents or guardians, were interviewed to assess youths' recent exposure to community violence, their delinquent behavior, and proposed moderating variables. Support from guardians buffered the relation between girls' victimization by community violence and delinquency. Support from peers buffered the effects of witnessing community violence on delinquent behavior of boys, but it amplified the effects of victimization for both girls and boys. Avoidant coping behavior buffered the effect of victimization on delinquency for boys but unexpectedly amplified the effect of witnessing violence on delinquency for girls. For both genders, confrontational coping strategies amplified the impact of victimization on delinquency and, for boys only, amplified the impact of witnessing violence as well. Controls were imposed for variables expected to influence the relation between exposure and delinquency, such as ethnicity, family violence, delinquent behavior of friends, and recruitment cohort. Suggestions for future research and implications for intervention are discussed. © 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 489,512, 2003. [source] The effects of a transitional discharge model for psychiatric patientsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2004W. REYNOLDS phd mphil rn This pilot randomized control trial was motivated by the discovery that many individuals with mental health problems are re-hospitalized within a year, with many being unable to fully adjust to community living. A solution was proposed in the form of an intervention called transitional discharge. The transitional discharge model included: (1) peer support, which is assistance from former patients who provide friendship, understanding and encouragement; and (2) overlap of inpatient and community staff in which the inpatient staff continue to work with the discharged patient until a working relationship is established with a community care provider. The overall aim of this study was to test the discharge model designed to assist patients discharged from acute admission wards to adjust to community living. This aim was tested through a number of related hypotheses, which suggest that, 5 months following discharge from an acute admission ward of a psychiatric hospital, individuals participating in a transitional discharge model: (1) report fewer symptoms; (2) report better levels of functioning; (3) have better quality of life; (4) are less likely to have been re-admitted to hospital. The study used a randomized experimental design with two conditions: experimental and usual treatment. In general, both the control and the experimental group demonstrated significant improvements in symptom severity and functional ability after 5 months. Usual treatment subjects in the control group were more than twice as likely to be re-admitted to hospital. This study needs to be replicated in Scotland with a larger sample and with a modified variation of the intervention called the Transitional Care Intervention. [source] Design, validation, and use of an evaluation instrument for monitoring systemic reformJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 6 2001Kathryn Scantlebury Over the past decade, state and national policymakers have promoted systemic reform as a way to achieve high-quality science education for all students. However, few instruments are available to measure changes in key dimensions relevant to systemic reform such as teaching practices, student attitudes, or home and peer support. Furthermore, Rasch methods of analysis are needed to permit valid comparison of different cohorts of students during different years of a reform effort. This article describes the design, development, validation, and use of an instrument that measures student attitudes and several environment dimensions (standards-based teaching, home support, and peer support) using a three-step process that incorporated expert opinion, factor analysis, and item response theory. The instrument was validated with over 8,000 science and mathematics students, taught by more than 1,000 teachers in over 200 schools as part of a comprehensive assessment of the effectiveness of Ohio's systemic reform initiative. When the new four-factor, 20-item questionnaire was used to explore the relative influence of the class, home, and peer environment on student achievement and attitudes, findings were remarkably consistent across 3 years and different units and methods of analysis. All three environments accounted for unique variance in student attitudes, but only the environment of the class accounted for unique variance in student achievement. However, the class environment (standards-based teaching practices) was the strongest independent predictor of both achievement and attitude, and appreciable amounts of the total variance in attitudes were common to the three environments. © 2001 John Wiley & Sons, Inc. J Res Sci Teach 38: 646,662, 2001 [source] Key Factors of Joint-Liability Loan Contracts: An Empirical AnalysisKYKLOS INTERNATIONAL REVIEW OF SOCIAL SCIENCES, Issue 2 2005Alexander S. Kritikos Summary This paper provides an empirical analysis of joint-liability micro-lending contracts. Using our data set, we examine the efficacy of various incentives set by this contract such as joint-liability between groups of borrowers or group access to future and to larger loans. As proposed by theory, we find that joint liability induces a group formation of low risk borrowers. After the loan disbursement, the incentive system leads to peer monitoring, peer support and peer pressure between the borrowers, thus helping the lending institution to address the moral hazard and enforcement problem. This paper also demonstrates that the mechanism realizes repayment rates of nearly 100% if the loan officers fulfill their complementary duties in the screening and enforcement process. Finally, we make clear that dynamic incentives, in contrast to theory, have to be restricted if the two long-term problems of the joint-liability approach, i.e. its mismatching problem and the domino effect, are to be tackled notably. [source] Exploring the barriers to exclusive breastfeeding in black and minority ethnic groups and young mothers in the UKMATERNAL & CHILD NUTRITION, Issue 3 2008Jenny Ingram Abstract UK health policy for many years has been to increase rates of breastfeeding because of the health benefits conferred on mothers and babies. World Health Organization recommends that babies should be breastfed exclusively for 6 months (without water or other fluids) and the National Institute for Health and Clinical Excellence promotes the provision of peer supporters or breastfeeding support groups to increase breastfeeding rates. This study aimed to explore the barriers to exclusive breastfeeding to 6 months with black and minority ethnic groups and with young mothers, and the strategies for overcoming these barriers, including peer support. Twenty-two mothers from Somali, Afro-Caribbean and South Asian communities or young mothers groups attended five focus groups. Transcripts were analysed using thematic and framework methods. There was enthusiasm for breastfeeding support groups, but with a wider remit to discuss other baby-related issues and provide general social support as well as support for breastfeeding. The Somali and South Asian women preferred the groups to be for their ethnic group, Afro-Caribbean women were keen that they should be open to all cultures and young mothers would like groups for their peers only. Encouraging mothers to breastfeed exclusively to 6 months should be promoted more and emphasized by health professionals when supporting women post-natally, and good support with breastfeeding management should be given to enable mothers to achieve this goal. Breastfeeding support groups may play a part in increasing breastfeeding continuation of breastfeeding, but for the groups studied this was not the greatest influence, with families and older women in the community having more influence in changing practice. [source] Leg clubs: A new approach to patient-centred leg ulcer managementNURSING & HEALTH SCIENCES, Issue 3 2000DNCERT, DipHE, Ellie Lindsay BSC(HONS) Abstract Loneliness is a significant health-care issue for many elderly patients in the community. The correlation between social isolation, poor compliance to treatment, and low healing rates for patients suffering from leg ulcers is well documented. Pain, odour, bandages etc. contribute to low self-esteem, depression and social stigma. Home visits by community nurses cannot provide the social and psychological support required by these patients. Responding to the holistic needs of this client group, the author set up Debenham Leg Club in 1995 to provide leg ulcer management in an informal, non-medical setting, where the emphasis is on social interaction, participation, empathy and peer support. This social model was conceived as a unique partnership between the district nurses and the local community, in which patients are empowered, through a sense of ownership, to become stakeholders in their own treatment. The value of the ,club' concept is evident in the happy, welcoming, uninhibited atmosphere that characterizes the clinic. Non-compliance to treatment has been virtually eliminated and evidence of greater healing rates has been illustrated through many patients whose long-standing ulcers have healed or greatly improved as a direct result of this change in approach. Patients' willingness to attend for systematic ,well leg' checks and ongoing health education has dramatically reduced the incidence of recurrence. [source] The Benefits of Peer Support With DiabetesNURSING FORUM, Issue 4 2004Sandra L. MacPherson MSN TOPIC. Peer coaching for diabetes support. purpose. To see if peer coaching assists a person with diabetes make the correct diet and activity choices. SOURCES OF INFORMATION. Journal articles, Internet. CONCLUSIONS. Peer support is helpful for people who are struggling to cope with diabetes. If peer support is offered, a structured follow-up program needs to be in place. [source] Perspectives on research evidence and clinical practice: a survey of Australian physiotherapistsPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2007Karen Grimmer-Somers Abstract Background and Purpose.,Physiotherapists' use of research evidence with clinical decision-making has interested researchers world-wide since 1980; however, little is known about such practices in Australia. The present survey sought information on Australian physiotherapists' perceptions of the importance of research, and barriers to uptake of evidence in clinical practice, when compared with an international cohort from 2001.,Method.,An Australian-relevant version of an English (UK) National Health Service (NHS) survey instrument was used to canvass 453 physiotherapists, randomly selected from the South Australian Physiotherapy Registration Board 2004,2005 records. The first survey was mailed in August 2005, a reminder was sent two weeks later to non-responders and a follow-up survey was sent in April 2006 to non-responders whose addresses had changed since 2005.,Results.,There was a 51% response rate. Of the non-responders, 12% were not contactable at their listed address, highlighting the mobility of Australian physiotherapists. Most respondents had undertaken research as students (59.5%) or as students and clinicians (11.5%). Of these, 37.1% were encouraged to embark on more research, and 20.5% were discouraged. The significant predictors of positive perceived importance of research were: previous research experience; being positive about undertaking further research; working in hospitals and holding a postgraduate degree. Clinicians working privately were significantly less likely than managers to be positive about research importance. The only significant predictor for not perceiving barriers to uptake of evidence was being positive about undertaking future research.,Conclusions.,The study identified constraints on uptake of evidence into practice that were related to accessing, reading and interpreting published research, and implementing findings. Found consistently across employment categories were barriers relating to lack of time, uncertainty about what the research reported, scepticism about the value of research and being isolated from peer support and literature sources. The responses indicated a positive shift towards evidence uptake since the 2001 NHS survey, suggesting an influence of increased exposure to information on evidence-based practice. A greater focus on research whilst training, the application of educational strategies for empowerment, better knowledge transfer and upskilling within the workplace, and ensuring dedicated time and organizational support for research activities are indicated. Copyright © 2007 John Wiley & Sons, Ltd. [source] Decisional needs assessment regarding Down syndrome prenatal testing: a systematic review of the perceptions of women, their partners and health professionalsPRENATAL DIAGNOSIS, Issue 13 2008Sylvie St-Jacques Abstract Objective To identify decisional needs of women, their partners and health professionals regarding prenatal testing for Down syndrome through a systematic review. Methods Articles reporting original data from real clinical situations on sources of difficulty and/or ease in making decisions regarding prenatal testing for Down syndrome were selected. Data were extracted using a taxonomy adapted from the Ottawa Decision-Support Framework and the quality of the studies was assessed using Qualsyst validated tools. Results In all 40 publications covering 32 unique studies were included. The majority concerned women. The most often reported sources of difficulty for decision-making in women were pressure from others, emotions and lack of information; in partners, emotion; in health professionals, lack of information, length of consultation, and personal values. The most important sources of ease were, in women, personal values, understanding and confidence in the medical system; in partners, personal values, information from external sources, and income; in health professionals, peer support and scientific meetings. Conclusion Interventions regarding a decision about prenatal testing for Down syndrome should address many decisional needs, which may indeed vary among the parties involved, whether women, their partners or health professionals. Very little is known about the decisional needs of partners and health professionals. Copyright © 2008 John Wiley & Sons, Ltd. [source] Recovery From Depression Among Clients Transitioning Out of PovertyAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2010Alisha Ali The objective of this study was to investigate whether a program designed to change the economic conditions of clients' lives could also have an impact on reducing their level of depression. The study focused on a sample of men and women attending a program designed to transition clients out of poverty through microlending and peer support. Results revealed that 40.5% of participants who met diagnostic criteria for major depression before beginning the program were no longer clinically depressed after participating in the program for 6 months. The results also revealed that the clients who reported that they felt a strong sense of interpersonal connection within the program were the most likely to recover from depression. [source] Incorporating a collaborative web-based virtual laboratory in an undergraduate bioinformatics courseBIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION, Issue 1 2010David Weisman Abstract Face-to-face bioinformatics courses commonly include a weekly, in-person computer lab to facilitate active learning, reinforce conceptual material, and teach practical skills. Similarly, fully-online bioinformatics courses employ hands-on exercises to achieve these outcomes, although students typically perform this work offsite. Combining a face-to-face lecture course with a web-based virtual laboratory presents new opportunities for collaborative learning of the conceptual material, and for fostering peer support of technical bioinformatics questions. To explore this combination, an in-person lecture-only undergraduate bioinformatics course was augmented with a remote web-based laboratory, and tested with a large class. This study hypothesized that the collaborative virtual lab would foster active learning and peer support, and tested this hypothesis by conducting a student survey near the end of the semester. Respondents broadly reported strong benefits from the online laboratory, and strong benefits from peer-provided technical support. In comparison with traditional in-person teaching labs, students preferred the virtual lab by a factor of two. Key aspects of the course architecture and design are described to encourage further experimentation in teaching collaborative online bioinformatics laboratories. [source] Breastfeeding promotion for infants in neonatal units: a systematic reviewCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2010M. J. Renfrew Abstract Background Breastfeeding/breastmilk feeding of infants in neonatal units is vital to the preservation of short- and long-term health, but rates are very low in many neonatal units internationally. The aim of this review was to evaluate the effectiveness of clinical, public health and health promotion interventions that may promote or inhibit breastfeeding/breastmilk feeding for infants admitted to neonatal units. Methods Systematic review with narrative synthesis. Studies were identified from structured searches of 19 electronic databases from inception to February 2008; hand searching of bibliographies; Advisory Group members helped identify additional sources. Inclusion criteria: controlled studies of interventions intended to increase breastfeeding/feeding with breastmilk that reported breastmilk feeding outcomes and included infants admitted to neonatal units, their mothers, families and caregivers. Data were extracted and appraised for quality using standard processes. Study selection, data extraction and quality assessment were independently checked. Study heterogeneity prevented meta-analysis. Results Forty-eight studies were identified, mainly measuring short-term outcomes of single interventions in stable infants. We report here a sub-set of 21 studies addressing interventions tested in at least one good-quality or more than one moderate-quality study. Effective interventions identified included kangaroo skin-to-skin contact, simultaneous milk expression, peer support in hospital and community, multidisciplinary staff training, and Unicef Baby Friendly accreditation of the associated maternity hospital. Conclusions Breastfeeding/breastmilk feeding is promoted by close, continuing skin-to-skin contact between mother and infant, effective breastmilk expression, peer support in hospital and community, and staff training. Evidence gaps include health outcomes and costs of intervening with less clinically stable infants, and maternal health and well-being. Effects of public health and policy interventions and the organization of neonatal services remain unclear. Infant feeding in neonatal units should be included in public health surveillance and policy development; relevant definitions are proposed. [source] Key worker services for disabled children: what characteristics of services lead to better outcomes for children and families?CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2006P. Sloper Abstract Background, Research has shown that families of disabled children who have a key worker benefit from this service and recent policy initiatives emphasize the importance of such services. However, research is lacking on which characteristics of key worker schemes for disabled children are related to better outcomes for families. Methods, A postal questionnaire was completed by 189 parents with disabled children who were receiving a service in seven key worker schemes in England and Wales. Path analysis was used to investigate associations between characteristics of the services and outcomes for families (satisfaction with the service, impact of key worker on quality of life, parent unmet need, child unmet need). Results, The four path models showed that key workers carrying out more aspects of the key worker role, appropriate amounts of contact with key workers, regular training, supervision and peer support for key workers, and having a dedicated service manager and a clear job description for key workers were associated with better outcomes for families. Characteristics of services had only a small impact on child unmet need, suggesting that other aspects of services were affecting child unmet need. Conclusions, Implications for policy and practice are discussed, including the need for regular training, supervision and peer support for key workers and negotiated time and resources for them to carry out the role. These influence the extent to which key workers carry out all aspects of the key worker's role and their amount of contact with families, which in turn impact on outcomes. [source] Pluralistic Ignorance and Political Correctness: The Case of Affirmative ActionPOLITICAL PSYCHOLOGY, Issue 2 2000Leaf Van Boven The pressure to appear politically correct can have important consequences for social life. In particular, the desire to appear politically correct, and to avoid being seen as racist, sexist, or culturally insensitive, can lead people to espouse publicly support for politically correct issues, such as support for affirmative action, despite privately held doubts. Such discrepancies between public behavior and private attitudes, when accompanied by divergent attributions for one's own behavior and the identical behavior of others, can lead to pluralistic ignorance. Two studies investigated pluralistic ignorance with respect to affirmative action among undergraduates. Their survey responses indicate that people overestimate their peers' support for affirmative action and underestimate their peers' opposition to affirmative action, that people's ratings of the political correctness of supporting affirmative action are correlated with their overestimation of support for affirmative action, and that people view their own attitudes toward affirmative action as unique. [source] |