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Six-week Period (six-week + period)
Selected AbstractsCoping as a mediator between personality and stress outcomes: a longitudinal study with cataract surgery patientsEUROPEAN JOURNAL OF PERSONALITY, Issue 3 2005Nina Knoll Personality and coping were specified as predictors of emotional outcomes of a mildly stressful medical procedure. Situation-specific coping was examined in contrast to dispositional coping, and it was tested whether one or the other would mediate the relationship between higher-order personality factors and stress outcomes. Cataract patients (N=110) participated at four measurement points in time during a six-week period surrounding their scheduled surgery. Dispositional coping did not mediate the personality,outcome relationship. In contrast, situation-specific coping acquired a mediator status between personality and adaptational criteria and accounted for independent outcome variance once personality traits were included as predictors in the models. Thus, the data suggest that whether or not coping mediates between personality factors and affective outcomes may be related to the methodological approaches of its operationalization. Copyright © 2005 John Wiley & Sons, Ltd. [source] Hospital Economics of the HospitalistHEALTH SERVICES RESEARCH, Issue 3 2003Douglas Gregory Objective To determine the economic impact on the hospital of a hospitalist program and to develop insights into the relative economic importance of variables such as reductions in mean length of stay and cost, improvements in throughput (patients discharged per unit time), payer methods of reimbursement, and the cost of the hospitalist program. Data Sources The primary data source was Tufts-New England Medical Center in Boston. Patient demographics, utilization, cost, and revenue data were obtained from the hospital's cost accounting system and medical records. Study Design The hospitalist admitted and managed all patients during a six-week period on the general medical unit of Tufts-New England Medical Center. Reimbursement, cost, length of stay, and throughput outcomes during this period were contrasted with patients admitted to the unit in the same period in the prior year, in the preceding period, and in the following period. Principal Findings The hospitalist group compared with the control group demonstrated: length of stay reduced to 2.19 days from 3.45 days (p<.001); total hospital costs per admission reduced to $1,775 from $2,332 (p<.001); costs per day increased to $811 from $679 (p<.001); no differences for readmission within 30 days of discharge to extended care facilities. The hospital's expected incremental profitability with the hospitalist was,$1.44 per admission excluding incremental throughput effects, and it was most sensitive to changes in the ratio of per diem to case rate reimbursement. Incremental throughput with the hospitalist was estimated at 266 patients annually with an associated incremental profitability of $1.3 million. Conclusion Hospital interventions designed to reduce length of stay, such as the hospitalist, should be evaluated in terms of cost, throughput, and reimbursement effects. Excluding throughput effects, the hospitalist program was not economically viable due to the influence of per diem reimbursement. Throughput improvements occasioned by the hospitalist program with high baseline occupancy levels are substantial and tend to favor a hospitalist program. [source] Creating supportive clinical learning environments: an intervention studyJOURNAL OF CLINICAL NURSING, Issue 1-2 2010Amanda Henderson Aim., To assess the impact of an intervention aimed to build capacity of registered nurses to enhance the clinical learning environment for undergraduate nursing students. Workplace learning is vital for the development of skills, attributes and knowledge of student nurses. Registered nurses need to be appropriately prepared to maximise student learning during clinical placement. Background., The quality of student learning during clinical practicum is largely dependent on interactions with ward staff. Design., A quasi-experimental design. Method., Measurement of students' perceptions of the psycho social learning environment during and outside of the intervention period was used to evaluate the capacity building intervention. The capacity building intervention consisted of interactive education in clinical areas over a six-week period for registered nurses in two acute surgical wards. Results., First, second and third year students (n = 62) who undertook their clinical practicum in the two surgical wards, before, during and six months after the capacity building intervention assessed the psycho-social learning environment at the time of their clinical practicum. Findings showed that students who undertook their clinical practicum during the intervention period rated the psycho-social clinical learning environment significantly higher than students who undertook their practicum at times outside of the intervention period. Conclusions., An experienced researcher/educator conducting capacity building sessions can effectively assist and support registered nurses to engage with students. Relevance to clinical practice., Capacity building sessions can improve practice, however, structures and processes that ensure continuation of practice change need to be embedded for improvements to be sustained. [source] Structured reminiscence: an intervention to decrease depression and increase self-transcendence in older womenJOURNAL OF CLINICAL NURSING, Issue 2 2006Cynthia Kellam Stinson MSN Aims/objectives., The purpose of this study was to assess the effect of group reminiscing on depression and self-transcendence of older women residing in an assisted living facility in southeast Texas. There were two major objectives for this study. One objective was to determine if depression decreased in older women after structured reminiscence group sessions held twice weekly for a six-week period. A second objective was to determine if self-transcendence increased after structured reminiscence group sessions held twice weekly for a six-week period. Background., Reminiscence has been studied to determine its impact on a variety of conditions including but not limited to depression, self-esteem, fatigue, isolation, socialization, well-being, language acquisition and cognitive functioning. This review of research specifically focused on reminiscence, depression, self-transcendence and older people. Design/methods., Two groups were assessed at baseline, three and six weeks to answer the research questions. A sample of 24 women between the ages of 72 and 96 years were randomly assigned to either a reminiscence (experimental) group or the activity (control) group of the facility. Pearson's r was used to determine the magnitude of the relationship between subjects' responses on the Geriatric Depression Scale and the Self-Transcendence Scale. A mixed design analysis of variance (anova) was used to determine if there was a difference between the experimental and control groups on scores of the Geriatric Depression Scale and the Self-Transcendence Scale at baseline, three and six weeks. Conclusions., Data revealed a non-significant decrease in depression and increase in self-transcendence in the reminiscence group at the completion of six weeks, indicating a trend toward a positive result with reminiscence group sessions. The study also revealed an inverse relationship between depression and self-transcendence. These findings underscore the importance of screening older people for depression. Relevance to clinical practice., One of the primary modalities used for the treatment of depression in elderly women is medication. Antidepressant medications lead to harmful side effects without alleviating the underlying depression. For these reasons, there is a need to research alternative therapies for treatment of depression in the older female. Reminiscence offers a possible intervention for treatment of depression in older women. [source] Consumption of raw brown onions variably modulate plasma lipid profile and lipoprotein oxidation in pigs fed a high-fat dietJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 1 2005Nicholas K Gabler Abstract This study was undertaken to determine the effects of two commercially available brown onion varieties, ,Cavalier' and ,Destiny', supplemented at two different levels, on blood lipid and oxidative status using the pig as a model. Twenty-five female cross-bred pigs were allocated to one of five dietary treatments that consisted of a high-fat control diet with no onion added, a low onion dose of 10 g onion MJ,1 DE and a high dose of 25 g onion MJ,1 DE for each variety of onion. Supplementation with ,Destiny' onion resulted in a 21% (p < 0.05) reduction in the averaged fasted and postprandial plasma triacylglyceride (TG) measurements taken over the six-week period in comparison with the control pigs. The average fasting and postprandial plasma cholesterol concentrations were significantly reduced by 5.5 and 12.4% in pigs that consumed the low and high dose of ,Destiny' onion, respectively (p < 0.010), while ,Cavalier' was only effective at lowering cholesterol levels by 10% at the lower dose of supplementation. Inhibition in the rate of serum lipoprotein oxidation, measured as lag time, was increased by 23% (p < 0.05) in plasma obtained from pigs that consumed ,Cavalier' compared with the control and ,Destiny' onion diets. These data indicate that onion consumption level may provide a dietary means of manipulating some of the risk indices associated with coronary heart disease, but the responses varied with type and dose of onion. Copyright © 2004 Society of Chemical Industry [source] Interpretation of two nutrition content claims: a New Zealand surveyAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2010Delvina Gorton Abstract Objective: To determine how various population groups in New Zealand interpret the nutrition content claims ,97% fat free' and ,no added sugar' on food labels. Methods: A survey of adult supermarket shoppers was conducted at 25 Auckland supermarkets over a six-week period in 2007. Supermarkets were located in areas where greater than 10% of the resident population were known to be M,ori, Pacific or Asian, based on 2001 Census meshblock data. Four questions in the survey assessed understanding and interpretation of the nutrition content claims ,97% fat free' and ,no added sugar'. Results: There were 1,525 people who completed the survey, with approximately equal representation from M,ori, Pacific, Asian and New Zealand European and Other ethnicities. Nearly three-quarters (72%) of participants correctly estimated the fat content of a 100 g product that was ,97% fat free', and understood that a product with ,no added sugars' could contain natural sugar. However, up to three-quarters of M,ori, Pacific, and Asian shoppers assumed that if a food carried a ,97% fat free' or ,no added sugar' claim it was therefore a healthy food. Similarly, low-income shoppers were significantly more likely than medium- or high-income shoppers to assume that the presence of a claim meant a food was definitely healthy. Conclusion: Percentage fat free and no added sugar nutrition content claims on food are frequently misinterpreted by shoppers as meaning the food is healthy overall and appear to be particularly misleading for M,ori, Pacific, Asian and low-income groups. Implications: Nutrition content claims have potential for harm if the food they are placed on is not healthy overall. Such claims should therefore only be permitted to be placed on healthy foods. [source] Double-blind randomized trial of risperidone versus divalproex in pediatric bipolar disorderBIPOLAR DISORDERS, Issue 6 2010Mani N Pavuluri Pavuluri MN, Henry DB, Findling RL, Parnes S, Carbray JA, Mohammed T, Janicak PG, Sweeney JA. Double-blind randomized trial of risperidone versus divalproex in pediatric bipolar disorder. Bipolar Disord 2010: 12: 593,605. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S. Objective:, To determine the relative effects of risperidone and divalproex in pediatric mania. Methods:, This is a double-blind, randomized, outpatient clinical trial with 66 children and adolescents (mean age = 10.9 ± 3.3 years; age range = 8,18 years) with mania who were randomly assigned to either risperidone (0.5,2 mg/day, n = 33) or divalproex (60,120 ,g/mL, n = 33) for a six-week period. Measures included the Young Mania Rating Scale (YMRS) and Child Depression Rating Scale-Revised (CDRS-R). Results:, Mixed-effects regression models, with interaction between time and the active drug as predictors, found that the risperidone group had more rapid improvement than the divalproex group (p < 0.05), although final scores did not differ significantly between groups. Mixed models using only those subjects who completed the six-week study found similar results. The response rate on YMRS was 78.1% for risperidone and 45.5% for divalproex (p < 0.01). The remission rate for risperidone was 62.5%, compared with 33.3% for divalproex (p < 0.05). Improvement on the CDRS-R was significantly higher for the risperidone group relative to the divalproex group (p < 0.05). There were no significant differences between groups in safety, but subject retention was significantly higher at study endpoint in the risperidone group (p < 0.01). Dropout rate was 24% in the risperidone group and 48% in the divalproex group, with increased irritability being the most common reason for dropout in the latter. There was no significant weight gain in either group. Conclusion:, Results suggest that risperidone was associated with more rapid improvement and greater reduction in manic symptoms compared to divalproex. Although the results suggest that both drugs are safe, risperidone's lower attrition rate and lower rate of adverse events may suggest better toleration. Clinical trials with larger samples are required to confirm these preliminary findings. [source] | ||||||||||