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Study Reviews (study + review)
Selected AbstractsAgreement Between Nosologist and Cardiovascular Health Study Review of Deaths: Implications of Coding DifferencesJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2009Diane G. Ives MPH OBJECTIVES: To compare nosologist coding of underlying cause of death according to the death certificate with adjudicated cause of death for subjects aged 65 and older in the Cardiovascular Health Study (CHS). DESIGN: Observational. SETTING: Four communities: Forsyth County, North Carolina (Wake Forest University); Sacramento County, California (University of California at Davis); Washington County, Maryland (Johns Hopkins University); and Pittsburgh, Pennsylvania (University of Pittsburgh). PARTICIPANTS: Men and women aged 65 and older participating in CHS, a longitudinal study of coronary heart disease and stroke, who died through June 2004. MEASUREMENTS: The CHS centrally adjudicated underlying cause of death for 3,194 fatal events from June 1989 to June 2004 using medical records, death certificates, proxy interviews, and autopsies, and results were compared with underlying cause of death assigned by a trained nosologist based on death certificate only. RESULTS: Comparison of 3,194 CHS versus nosologist underlying cause of death revealed moderate agreement except for cancer (kappa=0.91, 95% confidence interval (CI)=0.89,0.93). kappas varied according to category (coronary heart disease, kappa=0.61, 95% CI=0.58,0.64; stroke, kappa=0.59, 95% CI=0.54,0.64; chronic obstructive pulmonary disease, kappa=0.58, 95% CI=0.51,0.65; dementia, kappa=0.40, 95% CI=0.34,0.45; and pneumonia, kappa=0.35, 95% CI=0.29,0.42). Differences between CHS and nosologist coding of dementia were found especially in older ages in the sex and race categories. CHS attributed 340 (10.6%) deaths due to dementia, whereas nosologist coding attributed only 113 (3.5%) to dementia as the underlying cause. CONCLUSION: Studies that use only death certificates to determine cause of death may result in misclassification and potential bias. Changing trends in cause-specific mortality in older individuals may be a function of classification process rather than incidence and case fatality. [source] An Approach to Postmenopausal Osteoporosis Treatment: A Case Study ReviewJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 12 2003Cathy Kessenich DSN Purpose To review and discuss the clinical evaluation and therapeutic options for a postmenopausal woman with osteoporosis. Data Sources Review of scientific literature, practice guidelines, and a case study. Conclusions To prevent and treat postmenopausal osteoporosis, women should be encouraged to per-form weight-bearing exercise, to not smoke, and to optimize calcium and vitamin D intake through diet and supplements. Drug regimens are effective and well tolerated in post-menopausal women with osteoporosis. Implications for Practice Drugs currently approved by the U.S. Food and Drug Administration for the treatment of postmenopausal osteoporosis include the bisphosphonates risedronate and alendronate; the selective estrogen receptor modulator, raloxifene; and intranasal calcitonin-salmon spray. Bisphosphonates have demonstrated the most impressive fracture risk reduction in prospective clinical trials of women with post-menopausal osteoporosis. Risedronate has consistently demonstrated significant reductions in vertebral fracture risk at 1 year and in vertebral and nonvertebral fracture risk at 3 years. Alendronate has demonstrated significant reductions in vertebral and nonvertebral fracture risk after 3 years. [source] A Qualitative Case Study Review of Role Transition in Community NursingNURSING FORUM, Issue 4 2007Joyce Zurmehly PhD PURPOSE.,This paper aims to describe existing community nursing practices and to explore factors that are associated with the transition of clinical practice from acute care settings to community care settings. METHOD.,This qualitative case study assessment described existing community nurse practices and explored factors that were associated with the transition to community practice from acute care settings. The 48 participants in this case study were registered nurses who were working in community care nursing during the interview process. CONCLUSIONS.,The results of this investigation revealed themes derived from data collection, including autonomy, client and family, education, and community as nursing work. This study indicated that making the transition to community-based nursing includes conceptual as well as emotional adjustments. Community nursing practice was seen by the participants as nursing that captures a holistic approach incorporating multiple dimensions from psychological, sociological, economic, and physical to spiritual aspects that provides services in interaction between the community nurse, the client, and the family. The findings indicate a need for additional supportive preparation strategies incorporated into nursing orientation and continuing education programs. Future research investigating agency culture and socialization would provide a more definitive survey of perceptions and competencies needed for role. [source] Review and comparison between the Wells,Riley and dose-response approaches to risk assessment of infectious respiratory diseasesINDOOR AIR, Issue 1 2010G. N. Sze To Abstract, Infection risk assessment is very useful in understanding the transmission dynamics of infectious diseases and in predicting the risk of these diseases to the public. Quantitative infection risk assessment can provide quantitative analysis of disease transmission and the effectiveness of infection control measures. The Wells,Riley model has been extensively used for quantitative infection risk assessment of respiratory infectious diseases in indoor premises. Some newer studies have also proposed the use of dose-response models for such purpose. This study reviews and compares these two approaches to infection risk assessment of respiratory infectious diseases. The Wells,Riley model allows quick assessment and does not require interspecies extrapolation of infectivity. Dose-response models can consider other disease transmission routes in addition to airborne route and can calculate the infectious source strength of an outbreak in terms of the quantity of the pathogen rather than a hypothetical unit. Spatial distribution of airborne pathogens is one of the most important factors in infection risk assessment of respiratory disease. Respiratory deposition of aerosol induces heterogeneous infectivity of intake pathogens and randomness on the intake dose, which are not being well accounted for in current risk models. Some suggestions for further development of the risk assessment models are proposed. Practical Implications This review article summarizes the strengths and limitations of the Wells,Riley and the dose-response models for risk assessment of respiratory diseases. Even with many efforts by various investigators to develop and modify the risk assessment models, some limitations still persist. This review serves as a reference for further development of infection risk assessment models of respiratory diseases. The Wells,Riley model and dose-response model offer specific advantages. Risk assessors can select the approach that is suitable to their particular conditions to perform risk assessment. [source] The determinants of export performance: A review of the research in the literature between 1998 and 2005INTERNATIONAL JOURNAL OF MANAGEMENT REVIEWS, Issue 4 2008Carlos M.P. Sousa Considerable attention has been paid to the determinants of export performance. However, despite this research effort in identifying and examining the influence of such determinants, the literature is characterized by fragmentation and diversity, hindering theory development and practical advancement in the field. This paper attempts to review and synthesize the knowledge on the subject. As a result, this study reviews and evaluates 52 articles published between 1998 and 2005 to assess the determinants of export performance. The assessment reveals that: (a) more studies have been conducted outside the USA; (b) the majority of the studies focus on manufacturing firms, with relatively few studies examining the service sector; (c) the majority of the export studies continue to focus on small to medium-sized firms; (d) there is a continuous increase in the sample size; (e) despite the problems that may arise from the use of single informants, it seems that none of the studies reviewed here collected data from more than one informant in the firm; (f) an increasing number of studies have been using the export venture as the unit of analysis; (g) the level of statistical sophistication has improved; (h) the use of control and moderating variables in export performance studies has increased; (i) more studies have started to include the external environment in their models, including domestic market characteristics; and (j) market orientation as a key determinant of export performance emerges in this review. Finally, conclusions are drawn, along with some suggestions for further research. [source] Art psychotherapy in a consumer diagnosed with borderline personality disorder: A case studyINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2009Scott Lamont ABSTRACT This case study reviews 11 sessions of art psychotherapy with a consumer diagnosed with having borderline personality disorder. A consumer who reported difficulty in communicating her lived trauma verbally and engaged in self-harming behaviour was offered individual art therapy sessions following a consultation between an art therapy student and clinical nurse consultant in an attempt to understand her experiences and to collaboratively engage her. Notes were taken after each session by the art therapy student, reflecting conversations with this consumer while they were engaged in art making, which were subsequently explored within formal clinical supervision sessions with a mental health nurse consultant. An art portfolio is reproduced. It illustrates the expressive power of image creation. The key features of the images were that of lived trauma, the externalization of thoughts and feelings, and intense emotional expression. The results of this chronological art portfolio case study indicated therapeutic benefits from the intervention for this consumer. Further investigations of this type of intervention are warranted within the mental health setting. [source] Value of leisure time based on individuals' mode choice behaviorJOURNAL OF ADVANCED TRANSPORTATION, Issue 2 2004Ming-Shong Shiaw Abstract Values of time have been defined in various forms such as value of leisure time (shadow price of time), value of travel time, and value of saving time, and are mostly measured based on individuals' travel choice behavior. The main purpose of this study is to estimate the value of leisure time by general mode choice models. The estimated level can be used to evaluate the benefits from the increasing leisure time gained by people in Taiwan after the government has practiced a series of policies to shorten employee's working hours in the last few years. To justify the application, this study reviews and reinterprets the theoretical results of some major works on value of time derivations. Then to practically estimate the value of leisure time, it suggests a method of combining revealed preference and stated preference data for application. Finally, it conducts an empirical study on travelers' mode choices behavior in Taiwan to carry out the method suggested. The value of leisure time is estimated at 56NT$ per hour (around 1.65US$/hr), which is even lower than the minimum wage rate regulated by Taiwan government. [source] Urinary catheter care in the intensive care unitNURSING IN CRITICAL CARE, Issue 1 2004Anna Marklew Summary ,,Urinary catheters are associated with a number of complications, and nurses are ideally suited to minimize the associated risks by utilizing the available research in their practice ,,Urine tract infections caused by urine catheters are associated with increased mortality; however, urine catheter care is a nursing procedure, the importance of which is sometimes overlooked ,,This study reviews recommended guidelines on urine catheter care and current published literature on the subject ,,The aim of the study was to identify recommended practice and compare it with the current research and literature to conclude best practice ,,Conclusions made from this study are that existing guidelines correspond to the recommendations and findings in recent research and literature. However, more detailed guidelines and further research on how to prevent catheter-associated urine tract infections and other complications may be of benefit [source] | |||||||||||||