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Terms modified by Search Terms Selected AbstractsRecognizing Opportunities for Spiritual Enhancement in Young AdultsINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2001Roberta Cavendish PhD Purpose. To describe opportunities in the lives of young adults that strengthen or enhance spirituality. Methods. Descriptive, qualitative. Tape-recorded, semi-structured interviews were conducted with 13 well adults the ages 18 to 24. Interview transcripts, field notes, vignettes, and research committee minutes were analyzed to reduce coded data into conceptual categories and themes. Findings. Seven themes emerged from the participant's responses to probes: Beliefs, Connectedness, Inner Motivating Factors, Life Events, Divine Providence, Understanding the Mystery, and Walking Through. Conclusions. The accurate assessment of spiritual needs of young adults may be contingent on the assessment of their developmental needs. Knowing the opportunities that present in the lives of young adults to foster spiritual growth is important for nurses, who often are present when these opportunities occur. Practice Implications. Standardized language is limited for accurate nursing diagnosis of human responses in the spiritual domain. The findings support a new wellness nursing diagnosis, "Readiness for Enhanced Spirituality," to conceptualize a spirituality continuum and support wellness diagnoses. Search Terms: Nursing diagnosis, psychosocial development, religiosity, spirituality, transitions stage [source] Sensitivity, Specificity, and Usefulness of the Dutch Fatigue ScaleINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2001Lucas J. Tiesinga PhD Purpose. To test the sensitivity, specificity, and usefulness of the Dutch Fatigue Scale (DUFS), which is based on NANDAs defining characteristics of fatigue. Methods. A cross-sectional design was used among domiciliary patients (N = 213) with chronic heart failure (n = 138) and with breastfeeding postpartum women (n = 75). Findings. Calculations of the sensitivity and specificity of the DUFS, comparisons of the average DUFS sumscores between both nonfatigued and fatigued subjects, as well as between patients with chronic heart failure and postpartum women, and correlation coefficients performed with sociodemographic factors (age, gender, education) demonstrate acceptable psychometric properties. Conclusions. The DUFS is a reliable and valid measurement tool for the assessment of fatigue. Practice Implications. Accurate recognition of the existence and extent of fatigue must precede interventions. Easy to use, reliable tools for the bedside nurse are invaluable assets to practice. Search Terms: Fatigue, measurement of fatigue, psychometric testing [source] A systematic review of work-place interventions for alcohol-related problemsADDICTION, Issue 3 2009Gloria Webb ABSTRACT Aims The aims of this study were to (1) gauge any improvement in methodological quality of work-place interventions addressing alcohol problems; and (2) to determine which interventions most effectively reduce work-place-related alcohol problems. Methods A literature search was undertaken of the data bases, Ovid Medline, PsychINFO, Web of Science, Scopus, HSELINE, OSHLINE and NIOSHTIC-2 for papers published between January 1995 and September 2007 (inclusive). Search terms varied, depending on the database. Papers were included for analysis if they reported on interventions conducted at work-places with the aim of reducing alcohol problems. Methodological adequacy of the studies was assessed using a method derived from the Cochrane Collaboration guidelines. Results Ten papers reporting on work-place alcohol interventions were located. Only four studies employed randomized controlled trials (RCT), but all these had methodological problems. Weaknesses in all studies related to representativeness of samples, consent and participation rates, blinding, post-test time-frames, contamination and reliability, and validity of measures used. All except one study reported statistically significant differences in measures such as reduced alcohol consumption, binge drinking and alcohol problems. Conclusions The literature review revealed few methodologically adequate studies of work-place alcohol interventions. Study designs, types of interventions, measures employed and types of work-places varied considerably, making comparison of results difficult. However, it appears from the evidence that brief interventions, interventions contained within health and life-style checks, psychosocial skills training and peer referral have potential to produce beneficial results. [source] Interventions to improve adherence to medication in people with type 2 diabetes mellitus: the role of nursesEUROPEAN DIABETES NURSING, Issue 2 2006Deputy Director, H Hearnshaw BSc, PhD Reader in Primary Care Abstract Summary Nurses now provide the majority of education and support for people with diabetes both in community and hospital settings. However, there are very few studies on nurse-led interventions to improve adherence to medication, a crucial element of the self-management of diabetes. The four studies reviewed formed a subgroup of a Cochrane review on interventions to improve adherence to medication in people with type 2 diabetes. Search terms were ,type 2 diabetes mellitus' and ,compliance' or ,adherence'. Studies were included if they assessed adherence to medical treatment specifically, rather than other aspects of self-management. Out of the 21 studies selected for review, four described an intervention delivered by a nurse. All four studies were from the USA and used an intervention delivered by telephone. Different interventions (two educational programmes, one automated telephone management system, one tracking system for health service and medication use) were backed up by a scripted nurse call. While patients in two studies reported improvements in self-care behaviour, only one measured a significant improvement in blood glucose control. Although some studies asked patients to report on their adherence to medication taking, responses from patients were not explicitly presented. The studies reviewed show the potential for generating evidence for the effectiveness of nurse-led diabetes management programmes. Further high-quality studies into this area are desperately needed, and they should consider new ways of evaluating complex interventions to generate more evidence. Copyright © 2006 FEND. [source] Relevance of Cues for Assessing Hallucinated Voice ExperiencesINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2003Margaret England PhD PURPOSE. To assess psychiatric nurses' views of the importance of itemized content represented on an Inventory of Voice Experiences (IVE) for ongoing assessment of atypical auditory sense perception in people who hear voices. METHODS. Over 6 months, 317 experienced psychiatric nurses rated 58 assessment cues for hallucinated voice experiences. Cronbach's alpha, Cohen's kappa, and Bartko's intraclass correlation coefficients were used to measure concordance of the nurses' judgments against two hypothetical standards derived for purposes of the study. FINDINGS. There was moderate support for both the internal consistency of the nurses' judgments concerning the importance of itemized content represented on the WE and overall equivalence of the content. There was modest-to-moderate concordance of the nurses' original and subsequent judgments but a lack of concordance of the nurses' judgments with equally weighted judgments of the principal investigator even though the judgments of the investigator were based on extant literature and published reports of voice hearers. CONCLUSIONS. Results may reflect the effects of repeated testing, but it also is possible that some nurses did not have enough knowledge or professional experience to quantify judgments about the importance of hallucinated voice descriptions tied to the items on the WE. The findings are being used to refine the IVE. PRACTICE IMPLICATIONS. Findings provide nurses with opportunities for discerning specific characteristics, antecedents, and consequences of voice hearing along with their implications for health and well-being. Discernment of this information will facilitate identification of more specific and meaningful options for helping voice hearers manage their voices. Search terms: Auditory hallucinations, schizophrenia [source] Experienced and Less-Experienced Nurses Diagnostic Reasoning: Implications for Fostering Students' Critical ThinkingINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2 2003Catherine G. Ferrario DNSc PURPOSE. To compare the use of mental representations (heuristics) in diagnostic reasoning of expert (,5 years' experience) and novice (<5 years' experience) emergency nurses. METHODS. Clinical simulations were completed by a nationwide randomly selected sample of 173 experienced and 46 less-experienced emergency nurses (N =229). FINDINGS. Experienced nurses used the heuristic, Judging by Causal Systems (diagnostic inferences deduced from systems of causal factors) significantly more did than less-experienced nurses. PRACTICE IMPLICATIONS. Standardized nursing diagnoses may cut short the time needed to develop representational thinking and spare cognitive reserves for reasoning needed for complex patients. Faculty need to promote students' cognitive development through strategies that promote active, reflective, and integrative learning. Search terms: Clinical experience, diagnostic reasoning [source] Applicability of the International Classification of Nursing Practice (ICNP®) in the Areas of Nutrition and Skin CareINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 1 2003Margareta Ehnfors PhD PURPOSE. To evaluate completeness, granularity, multiple axial content, and clinical utility of the beta version of the ICNP® in the context of standardized nursing care planning in a clinical setting. METHODS. An 35-bed acute care ward for infectious diseases at a Swedish university hospital was selected for clinical testing. A convenience sample of 56 patient records with data on nutrition and skin care was analyzed and mapped to the ICNP. FINDINGS. Using the ICNP terminology, 59%-62% of the record content describing nursing phenomena and 30%-44% of the nursing interventions in the areas of nutrition and skin care could be expressed satisfactorily. For about a quarter of the content describing nursing phenomena and interventions, no corresponding ICNP term was found. CONCLUSIONS. The ICNP needs to be further developed to allow representation of the entire range of nursing care. Terms need to be developed to express patient participation and preferences, normal conditions, qualitative dimensions and characteristics, nonhuman focus, and duration. PRACTICE IMPLICATIONS. The practical usefulness of the ICNP needs further testing before conclusions about its clinical benefits can be determined. Search terms: ICNP®, nursing classification, standardized terminology, VIPS [source] Environmental Nursing Diagnoses: A Proposal for Further Development of Taxonomy IIINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 1 2003Pauline M. Green PhD PURPOSE. To propose further development of environmental diagnoses and to offer recommendations for expanding Taxonomy II to include more diagnostic labels that encompass the environmental domain. SOURCES. Literature in the disciplines of nursing, biology, toxicology, public health, sociology, and anthropology. DATA SYNTHESIS. Nurses need language to describe the human responses of individuals, families, communities, and global society to environmental health threats. CONCLUSIONS. New environmental diagnoses will lead to refinement of language that describes the contribution of nursing to an emerging international and community health priority. PRACTICE IMPLICATIONS. Environmental diagnostic labels will allow nurses to name responses and plan interventions that respond to instances or risks of exposure to threats from the physical and sociocultural environment. Search terms: Environmental contamination, environmental health threats, exposure, nursing diagnoses [source] Initial Validation of the Perioperative Nursing Data Set in FinlandINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2 2002Kristiina Junttilla MNSc PURPOSE. To explore the relevance of the Perioperative Nursing Data Set (PNDS) in Finland. METHODS. A three-round Delphi technique (10 participants) and content analysis of 134 articles from the Journal of the Finnish Operating Room Nurses Association. FINDINCS. All the PNDS outcomes, 86% of the diagnoses, and 87% of the interventions were found to be relevant. The Delphi panel suggested, and content analysis revealed, 6 new outcomes, 43 new diagnoses, and 11 new interventions. Consensus was achieved on 77%. The phrases used in perioperative articles corresponded with those of PNDS 56%-78% of the time. CONCLUSIONS.PNDS can be used to describe perioperative nursing in Finland. Further conceptualization and validation are needed before using the data set in perioperative practice. IMPLICATIONS FOR PRACTICE. Although PNDS cannot be implemented in Finland as is, it is a valid structure for further development of the terminology, contents, methods, and practice of Finnish perioperative documentation. Première validation d'une base de données concernant les soins infirmiers périopératoires en Finlande BUT.Explorer la pertinence d'une base de données concernant les soins infirmiers périopératoires en Finlande. MÉTHODE.La méthode de Delphi à 3 tours (10 participants) et l'analyse de contenu de 134 articles publiés dans le Journal de l'Association Finlandaise des Infirmières de bloc opératoire. RÉSULTATS.Tous les résultats, 86% des diagnostics et 87% des interventions de la BDSIP se sont révélés pertinents. Le panel Delphi et l'analyse de contenu ont permis d'identifier 6 nouveaux résultats, 43 nouveaux diagnostics, et 11 nouvelles interventions. Le consensus a atteint 77%. Les phrases utilisées dans les articles sur les soins périopératoires correspondaient à l'ensemble de la BDSIP avec un écart de 56%-78%. CONCLUSIONS.La BDSIP peut être utilisée pour décrire les soins périopératoires en Finlande. II faut cependant poursuivre le processus de conceptualisation et de validation avant d'utiliser cette base de données dans le milieu clinique périopératoire. IMPLICATIONS POUR LA PRATIQUE. It Serait prématuré d'utiliser la BDSIP actuelle, en Finlande, mais elle constitue une structure valide pour développer la terminologie, les contenus, les méthodes et la pratique, tels qu'ils pourraient apparaître dans les dossiers des patients en périopératoire. Mots-clés:Base de données de soins infirmiers, dossiers, nomenclature, soins périopératoires ValidaçãTo Inicial do Conjunto de Dados de Enfermagem Perioperatória na Finlàndia OBJETIVO.Explorar a relevância do Conjunto de Dados de Enfermagem Perioperatória (PNDS) na Finlândia. MÉTODO.Técnica de Delphi em três rodadas (10 participantes) e análise de conteúdo de 134 artigos da Revista da AssociaçãTo Finlandesa de Enfermeiras de Centro Cirúrgico. ACHADOS.Todos os resultados esperados do PNDS, 86% dos diagnósticos e 87% das intervenções foram considerados relevantes. O painel Delphi sugeriu, e a análise de conteúdo revelou, 6 novos resultados esperados, 43 novos diagnósticos e 11 novas intervenções. Foi obtido consenso em 77%. As frases utilizadas em artigos perioperatórios corresponderam àquelas do PNDS de 56%-78% das vezes. CONCLUSÕTES.O PNDS pode ser utilizado para descrever a enfermagem perioperatória na Finlândia. É preciso ampliar a conceptualizaçãTo e validaçãTo antes de usar o conjunto de dados na prática perioperatória. IMPLICAÇÕTES PARA A PRÁTICA.Embora o PNDS não possa ser implementado na Finlândia como está, trata-se de uma estrutura válida para um maior desenvolvimento da terminologia, conteúdo, método e prática da documentaçõo perioperatória Finlandesa. Palavras para busca:Conjunto de dados de enfermagem, documentaçõo, enfermagem perioperatória, nomenclatura Validación Inicial del Conjunto Mínimo de Datos de la Enfermeria de Quirófano en Finlandia PROPÓSITO.Explorar la relevancia del Conjunto Mínimo de Datos de la Enfermería de Quirófano (PNDS) en Finlandia métodos. Una técnica Delphi a tres vueltas (10 participantes) y el análisis de contenido de 134 artículos de la Revista de la Asociación Finlandesa de Enfermeras de Quirófano. RESULTADOS.Todos los resultados del PNDS se encontraron relevantes el 86% de los diagnósticos y el 87% de las intervenciones. El panel Delphi sugirió, y el unúlisis de contenido reveló, seis nuevos resultados, 43 nuevos diagnósticos, y 11 nuevas intervenciones. El consenso general se logró en el 77%. Las frases utilizadas en los artículos, correspondieron con el PNDS en el 56%-78% de las ocasiones. CONCLUSIONES. El PNDS puede ser utilizado para describir la Enfermería de Quirófano en Finlandia. Conceptualización y validación posterior, son necesarias antes de usar el conjunto de datos en la práctica de quirófano. IMPLICACIONES PARA LA PRÁCTICA.Aunque el PNDS no puede llevarse a cabo en Finlandia tal como está, es una estructura válida para desarrollos posteriores de la terminología, contenidos, métodos y práctica de la documentación de quirófano finlandesa. Términos de búsqueda:Conjunto Mínimo de Datos de Enfermería, enfermería de quirófano, documentación, nomenclatura Search terms:Documentation, nomenclature, nursing data set, perioperative nursing [source] Nursing Diagnosis and Nursing Theory: Exploration of Factors Inhibiting and Supporting Simultaneous UseINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2 2002FAAN, Noreen C. Frisch PhD PURPOSE. To explore the values and philosophies of nursing theories that inhibit the simultaneous use of nursing diagnosis and nursing theory. SOURCES.Published articles, books, book chapters. DATA SYNTHESIS. Four factors in the literature and reflected in practice may have had a negative influence on the use of nursing diagnoses: (a) commitment to the uniqueness of each person, (b) an abandonment of the nursing process, (c) a perspective that nursing care is an evolving interaction, and (d) a belief that theory-derived language is more articulate and precise than standard classifications. PRACTICE IMPLICATIONS.Strategies for combining theory and diagnoses include emphasizing the diagnostic terms as professional shorthand and permitting flexibility in modifying diagnoses as needed; widely disseminating the concept that classification can be used effectively with newer iterations of the nursing process reflecting circular, simultaneous, and intuitive processes; developing classification language based on concepts of hypothesis and perception; and including diagnostic categories associated with theoretical perspectives. Search terms:Nursing classifications, nursing diagnoses, nursing theory Diagnostics infirmiers et théories de soins: Exploration des facteurs qui freinent et soutiennent leur utilisation simultanée BUT.Explorer les valeurs et les conceptions à la base des théories de soins qui inhibent I'utilisation des diagnostics infirmiers avec les théories de soin. SOURCES.Articles, manuels, chapitres d'ouvrages. SYNTHÈSE DES DONNÉES.Les données de la littérature professionnelle et l'examen de la pratique ont permis d'identifier quatre facteurs qui ont pu avoir une influence négative sur l'utilisation des diagnostics infirmiers: (a) l'importance donnée au caractère unique de chaque personne; (b) l'abandon de la démarche de soins; (c) l'idée que le soin est fait d'interactions en évolution constante; (d) la croyance que le langage découlant de la théorie est plus précis et articulé que les classifications normalisées. IMPLICATIONS POUR LA PRATIQUE.Quelques stratégies pourraient faciliter la combinaison de la théorie et des diagnostics, notamment: souligner le fait que les termes des diagnostics constituent une sorte de sténographie professionnelle et permettre la flexibilité pour les modifier; disséminer le fait que les classifications peuvent être utiles dans une démarche de soin rénovée, reflétant les aspects circulaires, simultanés et intuitifs du raisonnement; développer un langage basé sur les concepts d'hypothéses et de perceptions et inclure des catégories diagnostiques associées à des courants théoriques. Mots-clés:Classifications de soins, diagnostics infirmiers, théories de soins Diagnóstico de enfermagem e teoria de enfermagem: Exploração dos fatores inibidores e estimuladores do seu uso simultâneo OBJETIVO.Explorar os valores e filosofias das teorias de enfermagem que inibem o uso simultâneo dos diagnósticos de enfermagem e das teorias de enfermagem. FONTES.Artigos publicados, livros, capítulos de livros. SÍNTESE DOS DADOS.Quatro fatores citados na literatura e refletidos na prática podem ter tido uma influência negativa no uso dos diagnóstics de enfermagem: (a) compromisso com a singularidade de cada pessoa, (b) um abandono do processo de enfermagem, (c) uma perspectiva de que o cuidado de enfermagem é uma interação que evolui e (d) uma crença de que uma linguagem derivada da teoria é mais articulada e precisa do que classificações padronizadas. IMPLICAÇÕES PARA A PRÁTICA.Estratégias para combinar teoria e diagnósticos incluem enfatizar os termos diagnóstics como uma taquigrafia profissional e permitir flexibilidade para modificar diagnósticos sempre que necessário, disseminando amplamente o conceito de que a classificação pode ser usada efetivamente com novas repetições do processo de enfermagem, refletindo processos circulares, simultâneos e intuitivos; desenvolver uma linguagem de classificação baseada em conceitos de hipótese e percepção; e incluir categorias diagnósticas associadas com perspectivas teóricas. Palavras para busca:Classificações de enfermagem, diagnóstico de enfermagem, teoria de enfermagem Diagnóstico enfermero y teoría enfermera: Exploración de factores que inhiben y apoyan una utilización simultánea PROPÓSITO.Explorar los valores y filosofías de teorías enfermeras, que inhiben la utilización simultánea de diagnósticos y teorías enfermeras. FUENTES.Artículos publicados, libros, capítulos de libros. SÍNTESIS DE LOS DATOS.Cuatro factores reflejados en la práctica y en la bibliografía, pueden haber tenido una influencia negativa en la utilizatión de los diagnósticos de enfermería: (a) compromiso a la singularidad de cada persona, (b) abandono del proceso de enfermería, (c) una perspectiva de que los cuidados de enfermería son una interacción que evoluciona y (d) una creencia de que el lenguaje derivado de la teoría, es más preciso y expresa mejor que las clasificaciones estándar. IMPLICACIONES PARA LA PRÁCTICA.Las estrategias para combinar la teoría y los diagnósticos enfermeros, incluyen: Dar énfasis a los términos diagnósticos como una abreviatura profesional, permitir ser flexible al modificar diagnósticos si es necesario, diseminar ampliamente el concepto de que la clasificación puede usarse eficazmente con nuevas iteraciones del proceso enfermero que reflejen procesos circulares, simultáneos e intuitivos, desarrollar lenguajes de clasificación basados en los conceptos de hipótesis y percepción, Incluir categorías diagnósticas asociadas con perspectivas teóricas. Términos de búsqueda:Diagnósticos enfermeros, clasificaciones enfermeras y teoría enfermera [source] Use of Nursing Diagnoses and Interventions in Public Health Nursing PracticeINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 1 2002Jennifer C. Rivera MSN PURPOSE. To determine the frequency of use of NANDA diagnoses and the Nursing Interventions Classification in care plans written by public health nurses (PHNs) in Orange County, CA. METHODS.Retrospective chart review. FINDINGS. The frequency pattern of nursing diagnoses and nursing interventions used in care plans is consistent with the scope of practice of the PHN, whose emphasis is on health promotion and disease prevention. CONCLUSIONS. The most commonly used diagnoses and interventions provide evidence of a core set of interventions useful for PHN practice. IMPLICATIONS FOR PRACTICE.Linking diagnoses and interventions allow PHNs to build a body of knowledge based on patient care and improve clinical decision-making process. Search terms:Interventions, nursing diagnosis, public health nursing Utilisation des diagnostics infirmiers et interventions en santé publique BUT.Déterminer la fréquence des diagnostics infirmiers (ANADI) et des interventions (NIC) dans les plans de soins rédigés par les infirmières de santé publique dans le Comté d'Orange, CA. METHODE.Étude rétrospective des dossiers. RÉSULTATS.La répartition des diagnostics infirmiers et des interventions utilisés dans les plans de soin est cohérente avec la pratique des infirmières en santé publique, c'est-à-dire qu'elle souligne l'importance de la promotion de la santé et la prévention de la maladie. CONCLUSIONS.Les diagnostics et interventions les plus fréquemment utilisés permettent d'identifier le groupe d'interventions au centre de la pratique des soins en santé publique. IMPLICATIONS POUR LA PRATIQUE.L'articulation des diagnostics et interventions de soins permet de construire un corpus de connaissances en santé publique basée sur le soin des patients et d'améliorer le processus de décision clinique. Mots-clés:Diagnostics infirmiers, interventions, soins infirmiers en santé publique Utilización de los diagnósticos e intervenciones de enfermería en la práctica de enfermería de salud pública PROPÓSITO.Determinar la frecuencia del uso de los diagnósticos de la NANDA y de la clasificación de las intervenciones enfermeras (NIC), en planes del cuidados escritos por enfermeras de salud pública en el Condado de Orange, California. MÉTODOS.Revisión retrospectiva de gráficos. RESULTADOS. El patrón de frecuencia de diagnósticos de enfermería y de intervenciones enfermeras utilizados en los planes del cuidados, es consistente con el ámbito asistencial de las enfermeras de salud pública, cuyo énfasis está en la promoción de salud y la prevención de la enfermedad. CONCLUSIÓN.Los diagnósticos e intervenciones más comúnmente utilizados, proporcionan evidencia de un grupo nuclear de intervenciones útiles a la práctica de enfermería de salud pública. IMPLICACIONES PARA LA PRÁCTICA.Conectar los diagnósticos y las intervenciones permite a las Enfermeras de Salud Pública construir un cuerpo de conocimientos basado en el cuidado de los pacientes y mejorar el proceso de toma de decisiones en la práctica clínica. Términos de búsqueda:Diagnóstico enfermero, enfermería de salud pública, intervenciones Uso de diagnósticos e intervenções de enfermagem na prótica de enfermagem em Saúde Pública OBJETIVO.Determinar a freqüência de uso dos diagnósticos da NANDA e da Classificação de Intervenções de Enfermagem (NIC) em planos de cuidados escritos por enfermeiras da área de Saúde Pública no Condado de Orange, Califórnia. MÉTODO.Revisão retrospectiva de fichas. ACHADOS.O padrão de freqüência de diagnósticos de enfermagem e intervenções de enfermagem utilizados em planos de cuidados é compatível com o escopo da prática das enfermeiras da área de Saúde Pública, cuja ênfase está na promoção da saúde e prevenção de doenças. CONCLUSãO.Os diagnósticos e intervenções mais comumente utilizados evidenciam a existência de um conjunto de intervenções principais, que éútil para a prática destas enfermeiras. IMPLICAÇõES PARA A PRÁTICA. A ligação entre diagnósticos e intervenções permite às enfermeiras da área de saúde pública construírem um corpo de conhecimentos baseado no cuidado do paciente e melhora o processo de tomada de decisão. Palavras para busca:Diagnóstico de enfermagem, enfermagem em saúde publica, intervenções [source] Learning for holistic care: addressing practical wisdom (phronesis) and the spiritual sphereJOURNAL OF ADVANCED NURSING, Issue 6 2009Helen L. Leathard Abstract Title.,Learning for holistic care: addressing practical wisdom (phronesis) and the spiritual sphere. Aim., This paper is a discussion of practical wisdom (phronesis) and spirituality in holistic caring and strategies to facilitate their application in nurse education. Background.,Phronesis, with its inherent spiritual qualities, is an established aspect of the persona of excellent clinical leaders. There is a strong case for recognizing the value of this characteristic in all nurses, and a strategy is required for engendering the development of phronesis during nurse education. Data sources., Electronic searches of Google Scholar and CINAHL were conducted for English language publications in the period 1996,2008. Search terms included combinations of phronesis, spirituality, health, education, pharmacology, medicines and medication education, holistic care and spiritual care. Selection of items for inclusion was based on their pertinence to the arguments being developed and their value as leads to earlier material. Discussion., The links between the attributes of effective clinical leaders and those required for holistic caring are explicated and related to phronesis, the acquisition of which involves spiritual development. An explanatory account of phronesis and its applicability to nursing leads to an explanation of how its spiritual aspects in particular might be incorporated into learning for holistic care. Reference to research in medicines-related education illustrates how the principles can be applied in nurse education. Conclusion., Nursing quality could be enhanced if adequate opportunities for acquiring phronesis through experiential learning were provided in nursing curricula. Phronesis and spiritual care could be incorporated into existing models of nursing care or new models devised to use these critical concepts. [source] Review of non-invasive ventilation in the emergency department: clinical considerations and management prioritiesJOURNAL OF CLINICAL NURSING, Issue 23 2009Louise Rose Aims and objectives., We aimed to synthesise evidence from published literature on non-invasive ventilation to inform nurses involved in the clinical management of non-invasive ventilation in the emergency department. Background., Non-invasive ventilation is a form of ventilatory support that does not require endotracheal intubation and is used in the early management of acute respiratory failure in emergency departments. Safe delivery of this intervention requires a skilled team, educated and experienced in appropriate patient selection, available devices and monitoring priorities. Design., Systematic review. Method., A multi-database search was performed to identify works published in the English language between 1998,2008. Search terms included: non-invasive ventilation, continuous positive airway pressure and emergency department. Inclusion and exclusion criteria for the review were identified and systematically applied. Results., Terminology used to describe aspects of non-invasive ventilation is ambiguous. Two international guidelines inform the delivery of this intervention, however, much research has been undertaken since these publications. Strong evidence exists for non-invasive ventilation for patients with acute exacerbation of congestive heart failure and chronic obstructive pulmonary disease. Non-invasive ventilation may be delivered with various interfaces and modes; little evidence is available for the superiority of individual interfaces or modes. Conclusions., Early use of non-invasive ventilation for the management of acute respiratory failure may reduce mortality and morbidity. Though international guidelines exist, specific recommendations to guide the selection of modes, settings or interfaces for various aetiologies are lacking due to the absence of empirical evidence. Relevance to clinical practice., Monitoring of non-invasive ventilation should focus on assessment of response to treatment, respiratory and haemodynamic stability, patient comfort and presence of air leaks. Complications are related to mask-fit and high air flows; serious complications are few and occur infrequently. The use of non-invasive ventilation has resource implications that must be considered to provide effective and safe management in the emergency department. [source] Inappropriate prescribing in the elderlyJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2007P. Gallagher MB MRCPI Summary Background and objective:, Drug therapy is necessary to treat acute illness, maintain current health and prevent further decline. However, optimizing drug therapy for older patients is challenging and sometimes, drug therapy can do more harm than good. Drug utilization review tools can highlight instances of potentially inappropriate prescribing to those involved in elderly pharmacotherapy, i.e. doctors, nurses and pharmacists. We aim to provide a review of the literature on potentially inappropriate prescribing in the elderly and also to review the explicit criteria that have been designed to detect potentially inappropriate prescribing in the elderly. Methods:, We performed an electronic search of the PUBMED database for articles published between 1991 and 2006 and a manual search through major journals for articles referenced in those located through PUBMED. Search terms were elderly, inappropriate prescribing, prescriptions, prevalence, Beers criteria, health outcomes and Europe. Results and discussion:, Prescription of potentially inappropriate medications to older people is highly prevalent in the United States and Europe, ranging from 12% in community-dwelling elderly to 40% in nursing home residents. Inappropriate prescribing is associated with adverse drug events. Limited data exists on health outcomes from use of inappropriate medications. There are no prospective randomized controlled studies that test the tangible clinical benefit to patients of using drug utilization review tools. Existing drug utilization review tools have been designed on the basis of North American and Canadian drug formularies and may not be appropriate for use in European countries because of the differences in national drug formularies and prescribing attitudes. Conclusion:, Given the high prevalence of inappropriate prescribing despite the widespread use of drug-utilization review tools, prospective randomized controlled trials are necessary to identify useful interventions. Drug utilization review tools should be designed on the basis of a country's national drug formulary and should be evidence based. [source] A Selective Review of Maternal Sleep Characteristics in the Postpartum PeriodJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2009Lauren P. Hunter ABSTRACT Objective: To determine the current knowledge of postpartum womens' sleep patterns, sleep disturbances, consequences of sleep disturbances, and known strategies for prevention in order to provide best practice recommendations for health care providers. Data Sources: A literature search from 1969 through February 2008 was conducted using the CINHL, Index of Allied Health Literature, Ovid, PsycINFO, and PubMed electronic databases in addition to reference lists from selected articles and other key references. Search terms included sleep, postpartum, sleep deprivation, and sleep disturbance. Study Selection: A critical review of all relevant articles from the data sources was conducted with attention to the needs of postpartum womens' sleep and implications for health care providers. Data Extraction: Literature was reviewed and organized into groups with similar characteristics. Data Synthesis: An integrative review of the literature summarized the current state of research related to sleep alterations in postpartum women. Conclusions: Postpartum women experience altered sleep patterns that may lead to sleep disturbances. The most common reasons for sleep disturbances are related to newborn sleep and feeding patterns. Although present, the relationships among sleep disturbance, fatigue, and depression in postpartum women lack clarity due to their ambiguous definitions and the variety of the studies conducted. Providers should encourage prenatal education that assists the couple in developing strategies for decreasing postpartum sleep deprivation. Alterations of in-hospital care and home care should be incorporated to improve the new family's sleep patterns. [source] Should children be screened to undergo early treatment for otitis media with effusion?CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2003A systematic review of randomized trials Abstract Background Otitis media with effusion (OME) is the most common cause of acquired hearing loss in childhood and has been associated with delayed language development and behavioural problems. Some have argued that children should be screened and treated early if found to have clinically important OME. The aim of this review was to assess evidence from randomized controlled trials about the effectiveness of screening and treating children with clinically important OME in the first 4 years of their life. The primary outcome was language development. Methods We searched the Cochrane Controlled Trials Register, MEDLINE and EMBASE and reference lists of all included studies in February 2003. We also contacted the first authors of the studies included in this review. Search terms included otitis media; otitis media with effusion; glue ear; OME; screen; children; treatment; language; and behaviour. Data extraction and methodological quality assessment were performed by at least two of us for each study independently, using methods described in the Cochrane Collaboration Handbook. Results From the three included randomized controlled trials evaluating interventions among children with OME identified through screening, we found no evidence of clinically important benefit in language development. Conclusions The identified randomized trials do not show an important benefit on language development from screening the general population of asymptomatic children in the first 4 years of life to undergo early treatment for OME. Screening asymptomatic children in the first 4 years of life for OME is not recommended. [source] Inhibition of the histamine-induced weal and flare response: a valid surrogate measure for antihistamine clinical efficacy?CLINICAL & EXPERIMENTAL ALLERGY, Issue 3 2007P. Devillier Summary Histamine plays a central role in allergic responses. Inhibition of the weal and flare response to histamine is a traditional pharmacodynamic tool to measure the activity of H1 -receptor antagonists. The time course and duration of cutaneous weal and flare inhibition are often used as surrogate measures of clinical efficacy. Pharmacodynamic differences among antihistamines are often interpreted to indicate differences in clinical efficacy. A systematic review of literature from 1980 to 2006 regarding the histamine induced weal and flare was undertaken. Search terms included ,histamine', ,skin test', ,weal', ,flare', and ,antihistamine'; retrieved articles were searched for relevant studies not identified initially. Data from human studies on the inhibition of the weal and flare by second-generation antihistamines were extracted and assessed. A literature search from 1980 to 2006 was undertaken for comparative studies of second-generation antihistamines in the clinical settings of allergic rhinitis (AR) and chronic idiopathic urticaria; data extracted from these studies underwent systematic review. Differences were noted among second-generation antihistamines in terms of their ability to inhibit the histamine-induced weal and flare. Corresponding differences in terms of clinical efficacy in AR and chronic urticaria were not identified following a systematic review. The reasons for the disconnect between pharmacodynamic effects and clinical efficacy may include differences between the route and concentration of histamine, the involvement of mediators other than histamine in the allergic response, and the short time course of pharmacodynamic studies. The histamine-induced weal and flare response is a pharmacodynamic test that should not be used to compare the clinical efficacy of different antihistamines, and is not an adequate alternative to clinical end-point assessments in AR or chronic idiopathic urticaria. [source] Efficacy of enamel matrix derivatives (Emdogain®) in treatment of replanted teeth , a systematic review based on animal studiesDENTAL TRAUMATOLOGY, Issue 5 2008Annette Wiegand A review of the published literature [search term: (Emdogain OR enamel matrix derivative OR enamel matrix protein] AND [avulsion OR replantation OR autotransplantation)] was conducted by two independent investigators according to defined selection criteria. For data extraction of the identified animal studies, the following histomorphometric findings were considered: (i) healed PDL, (ii) surface resorption, (iii) inflammatory resorption and (iv) replacement resorption. The heterogenity of data collection and the small amount of identified publications did not allow for statistical analysis. Four controlled trials (CT) conducted in animals, but no randomized controlled trials (RCT) or clinical controlled trials (CCT) could be received from the systematic search. From the selected studies, two CT gave evidence of EMD treatment to be effective in inducing healing of replanted teeth, while one CT found no differences between EMD treated teeth and controls. Finally, one CT compared EMD and sodium fluoride application, but revealed no differences between the treatments. The data of controlled trials available are limited and conflicting. No firm conclusion regarding the efficacy of EMD application on healing of replanted or autotransplanted permanent teeth can be drawn because of lack of RCT and CCT. [source] Paliperidone palmitate , review of the efficacy, safety and cost of a new second-generation depot antipsychotic medicationINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2010L. Citrome Summary Objective:, To describe the efficacy, safety and cost of paliperidone palmitate, a depot antipsychotic medication recently approved for the treatment of schizophrenia. Data sources:, A literature search was conducted by querying the websites http://www.pubmed.gov, http://www.fda.gov, http://www.accessdata.fda.gov/scripts/cder/drugsatfda and http://www.clinicaltrials.gov for the search term ,paliperidone palmitate'. Cost information was obtained from the pharmaceutical vendor servicing a local state-operated psychiatric facility. Study selection:, All available reports of studies were identified. Product labelling provided additional information. Data extraction:, Descriptions of the principal results and calculation of the number needed to treat (NNT) and number needed to harm (NNH) for relevant dichotomous outcomes were extracted from the study reports and synopses. Additional safety outcomes subject to NNH analysis were obtained from product labelling. Data synthesis:, Paliperidone palmitate is a newly available depot formulation of paliperidone (the 9-OH metabolite of risperidone). Upon injection into the deltoid or gluteal muscle, the release of the drug starts as early as day 1, reaches maximum plasma concentrations at 13 days and lasts for as long as 126 days. Maximum concentration following deltoid injection is approximately 28% higher compared with injection into the gluteal muscle, and thus paliperidone palmitate requires initiation by two initial deltoid injections spread 1 week apart to achieve therapeutic concentrations rapidly. Subsequent injections are at 4-week intervals. Acute efficacy was evidenced by four short-term double-blind, randomised, placebo-controlled, fixed-dose studies of acutely relapsed adult inpatients who met DSM-IV criteria for schizophrenia. NNT for a 30% or greater decrease in the Positive and Negative Syndrome Scale total score compared with placebo was consistently lower for the higher dose strengths of 156 and 234 mg, suggesting a therapeutic dose,response. Treatment with paliperidone palmitate at doses between 39 and 156 mg significantly delayed the time to recurrence of symptoms of schizophrenia after 24 weeks of maintained symptom stability. The NNT vs. placebo to avoid a recurrence of symptoms was 5 (95% CI 4,7). Overall, paliperidone palmitate was reasonably well tolerated, with low rates of extrapyramidal symptoms or body weight gain; however, these may be more common at higher doses. Injection site reactions occurred at a rate ranging from 4% to 10%, depending on the dose regimen, compared with 2% for the pooled placebo arms. The acquisition cost of a maintenance dose of paliperidone palmitate calculated on a per day basis is similar to that for risperidone microspheres, but about double the cost for oral paliperidone and approximately 19 times the cost of oral generic risperidone. Conclusions:, Paliperidone palmitate is efficacious for the acute and maintenance treatment of schizophrenia and is reasonably well tolerated. It offers several advantages over other available second-generation depot antipsychotics: it comes in prefilled syringes in a number of different dosage strengths; it does not require refrigeration; it does not require supplementation with oral antipsychotics; it can be administered once monthly; it can be administered with a very small bore needle; the injection volume is small; the injection site can be either the deltoid or gluteal muscles; it does not require an additional precautionary observation period after the injection. For patients for whom oral risperidone or paliperidone is otherwise effective, paliperidone palmitate offers a guaranteed delivery system that enhances adherence. However, the high acquisition cost of paliperidone palmitate will likely be an important obstacle to its routine use. [source] Iloperidone for schizophrenia: a review of the efficacy and safety profile for this newly commercialised second-generation antipsychoticINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 8 2009L. Citrome Summary Objective:, The aim of the study was to describe the efficacy and safety of iloperidone for the treatment of schizophrenia. Data sources:, The pivotal registration trials were accessed by querying http://www.pubmed.gov, http://www.fda.gov and http://www.clinicaltrials.gov for the search term ,iloperidone'. Study selection:, Four published primary reports of phase III studies were identified as well as preclinical animal and receptor affinity studies that describe potential mechanisms of action and pharmacogenomic studies that identify potential genetic biomarkers for efficacy and tolerability. Product labelling provided additional data. Data extraction:, Descriptions of the principal results and calculation of number needed to treat (NNT) and number needed to harm (NNH) for relevant dichotomous outcomes were extracted from the study reports. Additional safety outcomes subject to NNH analysis were obtained from product labelling. Data synthesis:, Iloperidone is a second-generation antipsychotic agent indicated for the acute treatment of schizophrenia in adults. Iloperidone has been evaluated in several double-blind placebo-controlled clinical trials. The oral formulation has demonstrated efficacy in reducing the symptoms of acute schizophrenia at fixed daily doses ranging from 12 to 24 mg. Data reported for categorical definitions of response using the Positive and Negative Syndrome Scale were limited to one study and specifically to rates of achieving a , 20% decrease in the positive subscale from baseline; significantly more patients receiving iloperidone 24 mg/day (72%) than placebo (52%) met this criterion, yielding a NNT of five. Iloperidone should be titrated slowly to avoid orthostatic hypotension, potentially delaying the achievement of a therapeutic dose level. There appears to be a dose relationship for adverse events such as dizziness, somnolence and dry mouth; for example NNH vs. placebo for somnolence was 25 for iloperidone 10,16 mg/day and 10 for 20,24 mg/day. There is a possibility of a therapeutic dose response as well. Iloperidone is essentially free of extra-pyramidal side effects. Iloperidone is associated with weight gain comparable with risperidone. Long-term double-blind maintenance studies have demonstrated iloperidone's non-inferiority to haloperidol for relapse prevention. Product labelling includes a warning about the potential for QT interval prolongation. At present there are no efficacy studies available that are powered to directly compare iloperidone with other second-generation antipsychotics. The development of a depot formulation of iloperidone as well as efforts to identify genetic biomarkers for prediction of both efficacy and tolerability are in progress. Conclusions:, Aside from paliperidone, iloperidone is the first new second-generation antipsychotic to be commercialised in the USA since 2002. From the limited registration data, iloperidone appears to be relatively well tolerated once titrated to a therapeutic level and can be a useful option to consider. The development of a depot formulation and potential for genetic biomarkers may make this agent compelling. Further comparisons with other available agents among patients with schizophrenia in the ,real world' are needed. [source] Should night eating syndrome be included in the DSM?INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 7 2006Ruth H. Striegel-Moore PhD Abstract Objective: This article examines the status of the literature on night-eating syndrome (NES) according to five criteria that have been proposed by Blashfield, Sprock, and Fuller1 (Compr Psychiatry 1990;31:15,19) to determine whether NES warrants inclusion in the psychiatric nosology as a distinct eating disorder. Method: Relevant research papers were identified in Medline and PsychInfo using the search term "night-eating syndrome." Results: None of the five criteria was met. Specifically, at the time of review, there were not yet 25 empirical papers on NES; no commonly accepted definition of or assessment approach to NES has been adopted; the utility and validity of NES need to be established, and NES needs to be differentiated more clearly from other eating disorder syndromes. Conclusion: This review suggests that the most pressing step toward clarifying the status of NES is to develop a uniform definition of NES. Once accomplished, research can progress to accumulating the necessary evidence to determine whether NES should be included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006 [source] BENTHIC MARINE ALGAL HERBARIUM OF LONG ISLAND SOUND DIGITAL COLLECTIONJOURNAL OF PHYCOLOGY, Issue 2001Article first published online: 24 SEP 200 Cudiner, S.2, Gillies, N.2 & Yarish, C.1 1Department of Ecology and Evolutionary Biology, University of Connecticut, Stamford, CT 06901-23151; 2Jeremy Richard Library, University of Connecticut, Stamford, CT 06901-2315 University of Connecticut presents the "Benthic Marine Algal Herbarium of Long Island Sound Digital Collection." When Phase One of this project is completed, this collection will include an online herbarium of all Long Island Sound macroalgae species. The database will be on the web and open to the public. The taxonomy and descriptive text are part of a collaboration between the University of Connecticut and NEAS. Database features include the ability to create searches and generate sets based on subjects, division, class, order, family, genus, habitat, species, keyword, location, etc. Each record will be cataloged according to Dublin Core cataloging guidelines. All species have a thumbnail image and a larger image for full viewing. TIFF files will be archived and available in the future (10mg images). Certain species will be marked as a teaching collection and made available upon request on a CDrom for teaching purposes. Future plans include expanding the database geographically in the Northeast. The database is located and maintained on a server at the Homer Babbidge Library on the UConn Storrs campus. The information is in Microsoft Access, and is made available for viewing and searching on the web through ColdFusion. This online collection is in the process of being created, a test site is now available at: http://norman.lib.uconn.edu:6550/algae/algaesearch.cfm (hit enter for all records or use search term: lamin) [source] Clinical use of physical activity measuresJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 2 2009CRNP (Associate Professor), Lorraine M Reiser PhD Abstract Purpose:, To provide a review of physical activity measures and subjective and objective methods of its measurement. Considerations for the use of these measurements in research and practice will be discussed. Data sources:, The PubMed, CINAHL, and Health and Psychosocial Instruments databases, and the Centers for Disease Control Web site were searched using the search term "Physical Activity Measurement." Conclusions:, Physical activity is a lifestyle factor that is a key focus in chronic disease,related research, prevention, and interventions. Healthy People 2010 set goals of decreasing the prevalence of preventable diseases by encouraging healthier lifestyle patterns. Shifts toward more sedentary lifestyles have resulted in increases in life-limiting disease states, including obesity, diabetes, heart disease, cancer, and osteoporosis. Physical activity measurements have been used widely in research studies but are less commonly used in primary care. Measuring individuals' physical activity levels as part of the health assessment will enhance the provider's ability to engage in health promotion and suggest health protection interventions. The strengths, weaknesses, and potential applications to practice of physical activity measures are summarized in an effort to familiarize nurse practitioners (NPs) with commonly used tools and encourage integration of physical activity assessment into their current practice. Implications for practice:, NPs are in an ideal position to promote health by encouraging appropriate amounts of physical activity. Screening, health promotion, and disease prevention are part of the core competencies of NP practice established by the National Organization of Nurse Practitioner Faculties. Increased knowledge of physical activity measures will enhance the NP's ability to evaluate relevant physical activity research for use in evidence-based practice. Incorporation of simple yet appropriate physical activity measurements into practice will expand the NP's ability to identify and thus address sedentary lifestyles in their clientele. [source] Comparison of full-text searching to metadata searching for genes in two biomedical literature cohortsJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 14 2007Bradley M. Hemminger Researchers have traditionally used bibliographic databases to search out information. Today, the full-text of resources is increasingly available for searching, and more researchers are performing full-text searches. This study compares differences in the number of articles discovered between metadata and full-text searches of the same literature cohort when searching for gene names in two biomedical literature domains. Three reviewers additionally ranked 100 articles in each domain. Significantly more articles were discovered via full-text searching; however, the precision of full-text searching also is significantly lower than that of metadata searching. Certain features of articles correlated with higher relevance ratings. A significant feature measured was the number of matches of the search term in the full-text of the article, with a larger number of matches having a statistically significant higher usefulness (i.e., relevance) rating. By using the number of hits of the search term in the full-text to rank the importance of the article, performance of full-text searching was improved so that both recall and precision were as good as or better than that for metadata searching. This suggests that full-text searching alone may be sufficient, and that metadata searching as a surrogate is not necessary. [source] Opening up the Solution Space: The Role of Analogical Thinking for Breakthrough Product InnovationCREATIVITY AND INNOVATION MANAGEMENT, Issue 2 2008Oliver Gassmann The purpose of this paper is to investigate the approach of analogical thinking for product innovation. We collected data on projects from four engineering firms where analogical thinking was successfully applied for the development of breakthrough innovations. Results show that abstracting the problem by in-depth technical and contextual analysis is pivotal when searching for analogical solutions. Furthermore, the chances of identifying highly novel analogous solutions are increased if the problem is abstracted to the level of its structural similarities to other settings. We also found that the identification of structural similarities is supported when firms not only rely on the cognitive abilities of the individual but also employ an active search based on abstract search terms. Based on these insights, we propose a process model for the development of product innovations by means of analogical thinking. [source] Prevalence and predictors of recurrence of major depressive disorder in the adult populationACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2010F. Hardeveld Hardeveld F, Spijker J, De Graaf R, Nolen WA, Beekman ATF. Prevalence and predictors of recurrence of major depressive disorder in the adult population. Objective:, Knowledge of the risk of recurrence after recovery of a major depressive disorder (MDD) is of clinical and scientific importance. The purpose of this paper was to provide a systematic review of the prevalence and predictors of recurrence of MDD. Method:, Studies were searched in Medline en PsychINFO using the search terms ,recur*', ,relaps*', ,depress*', ,predict*' and course. Results:, Recurrence of MDD in specialised mental healthcare settings is high (60% after 5 years, 67% after 10 years and 85% after 15 years) and seems lower in the general population (35% after 15 years). Number of previous episodes and subclinical residual symptoms appear to be the most important predictors. Gender, civil status and socioeconomic status seem not related to the recurrence of MDD. Conclusion:, Clinical factors seem the most important predictors of recurrence. Data from studies performed in the general population and primary care on the recurrent course of MDD are scarce. [source] The association of physical activity and depression in Type 2 diabetesDIABETIC MEDICINE, Issue 10 2008Z. Lysy Abstract Aims Physical inactivity and depressed mood are both associated with a higher likelihood of diabetes-related complications; the association between physical activity and depressed mood in Type 2 diabetes has not been reviewed previously. We have reviewed (i) the strength of this association and (ii) the impact of depression-specific management and physical activity interventions on mood and activity levels in overweight adults with Type 2 diabetes. Methods Studies published between January 1996 and September 2007 were identified (Ovid - medline, Psych- Info and embase) using pertinent search terms (keyword/title). Results Of the 12 studies included (10 cross-sectional, two trials), most employed a standardized questionnaire for depressed mood but only one item for physical activity. In adults with Type 2 diabetes, the inactive are 1.72 to 1.75 times more likely to be depressed than the more active; the depressed are 1.22 to 1.9 times more likely to be physically inactive than the non-depressed. Two randomized trials demonstrated that a depression management programme improved mood, but only one demonstrated increased physical activity. Conclusions Studies to date suggest an association between depressed mood and physical inactivity in adults with Type 2 diabetes, although objective measures of physical activity have not been employed. Depression-specific management may improve mood and possibly activity. A trial comparing the impact of depression-specific management compared with exercise intervention on depressed mood and activity in Type 2 diabetes is justified. [source] Review article: Indications for thoracolumbar imaging in blunt trauma patients: A review of current literatureEMERGENCY MEDICINE AUSTRALASIA, Issue 2 2009Enda O'Connor Abstract Thoracolumbar spine injury is a common complication of blunt multitrauma and up to one third of fractures are associated with spinal cord dysfunction. Delayed fracture diagnosis increases the risk of neurological complications. While validated screening guidelines exist for traumatic c-spine injury equivalent guidelines for thoracolumbar screening are lacking. We conducted a literature review evaluating studies of thoracolumbar injury in trauma patients to generate indications for thoracolumbar imaging. We performed MEDLINE and Pubmed searches using MeSH terms "Wounds, Nonpenetrating", "Spinal Fractures", "Spinal Injuries" and "Diagnostic Errors", MeSH/subheading terms "Thoracic Vertebrae/injuries" and "Lumbar Vertebrae/injuries" and keyword search terms "thoracolumbar fractures", "thoracolumbar injuries", "thoracolumbar trauma", "missed diagnoses" and "delayed diagnoses". Limits and inclusion criteria were defined prior to searching. We evaluated 16 articles; 5 prospective observational studies (1 cohort study) and 11 retrospective observational studies. Predictors of TL injury in prospective studies , high-risk injury mechanism, distracting injury, impaired cognition, symptoms/signs of vertebral fracture and known cervical fracture , were defined and used to construct a decision algorithm, which in a total of 14189 trauma patients from all eligible studies recommended TL screening in 856(99.1%) of 864 patients with TL fractures and would probably have directed TL imaging in the remaining 8 patients. There is limited low level evidence guiding surveillance TL imaging in adult blunt trauma patients. Despite this, we propose and evaluate an algorithm with a high negative predictive value for TL fractures. This should be incorporated into spinal injury assessment protocols. [source] Pharmacogenetic of response efficacy to antipsychotics in schizophrenia: pharmacodynamic aspects.FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 2 2010Review, implications for clinical research Abstract Pharmacogenetics constitutes a new and growing therapeutic approach in the identification of the predictive factors of the response to antipsychotic treatment. This review aims to summarize recent finding into pharmacodynamic approach of pharmacogenetics of antipsychotics and particularly second generation. Studies were identified in the MEDLINE database from 1993 to July 2008 by combining the following Medical Subject Heading search terms: genetic, polymorphism, single nucleotide polymorphism, pharmacogenetics, antipsychotics, and response to treatment as well as individual antipsychotics names. Only pharmacodynamics studies were analyzed and we focused on efficacy studies. We also reviewed the references of ll identified articles. Most studies follow a polymorphism-by-polymorphism approach, and concern polymorphisms of genes coding for dopamine and serotonin receptors. Haplotypic approach has been considered in some studies. Few have studied the combinations of polymorphisms of several genes as a predictive factor of the response to antipsychotics. We present this gene-by-gene approach while detailing the features of the polymorphisms being studied (functionality, linkage disequilibrium) and the features of the studies (studied treatment(s), prospective/retrospective study, pharmacological dosage). We discuss the heterogeneity of the results and their potential clinical implications and extract methodological suggestions for the future concerning phenotype characterization, genotypes variants studied and methodological and statistical approach. [source] Definitions of hypotension after spinal anaesthesia for caesarean section: literature search and application to parturientsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2010S. KlÖHR Background: Spinal anaesthesia for caesarean section may cause hypotension, jeopardizing the foetus and its mother. We aimed to identify the spectrum of definitions of hypotension used in the scientific literature. In a second part, we applied these definitions to a prospective cohort in order to evaluate the effect of different definitions on the incidence of hypotension. Methods: A systematic literature search in PubMed was performed from 1999 to 2009 with the search terms ,hypotension' and ,caesarean section'. Consecutive parturients undergoing caesarean section under spinal anaesthesia were included in a prospective study. Results: Sixty-three eligible publications (7120 patients) were retrieved, revealing 15 different definitions of hypotension. A decrease below 80% baseline and the combined definition of a blood pressure below 100 mmHg or a decrease below 80% baseline were the two most frequent definitions, found in 25.4% and 20.6% of the papers, respectively. When applying the spectrum of definitions to a prospective cohort, the incidences of hypotension varied between 7.4% and 74.1%. The incidence increased from 26.7% to 38.5% when using a value below 75% of baseline instead of below 70% of baseline. Conclusion: There is not one accepted definition of hypotension in the scientific literature. The incidence of hypotension varies depending on the chosen definition. Even minor changes of the definition cause major differences in the frequency of hypotension. This makes it difficult to compare studies on interventions to treat/prevent hypotension and probably hampers progress in this area of research. [source] | ||||||||||||||||||||||||||||||||||