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Subsequent Outcome (subsequent + outcome)
Selected AbstractsChange processes in residential cognitive therapy for bulimia nervosaEUROPEAN EATING DISORDERS REVIEW, Issue 5 2010Asle Hoffart Abstract The purpose of the study was to examine the relationships of process variables derived from the cognitive model of bulimia nervosa (BN) and weekly outcome. The participants were 39 patients with BN or subthreshold bulimia consecutively admitted to an inpatient treatment program for bulimia. Theory-derived process and outcome variables were measured repeatedly during the course of therapy with a gap of a week between each measurement. The data were analysed with time series methods (ARIMA). Weekly variations in the process variables: self-efficacy about resisting binge eating, dysfunctional beliefs, negative affect and positive affect influenced variations in subsequent outcome, whereas weekly outcome did not influence subsequent process. These results are consistent with the cognitive model of BN and suggest that self-efficacy, dysfunctional beliefs, negative affect and positive affect are potential targets for treatment that need further investigation. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Involving users in low back pain researchHEALTH EXPECTATIONS, Issue 4 2003Bie Nio Ong BA BEd MA PhD Abstract Objective, To involve users in the design of a research project that aims at describing a 12-month course of low back pain in an adult population sample (epidemiological strand), and to determine how patient and professional perceptions of low back pain and its treatment relate to the use of health-care and to subsequent outcome (qualitative strand). Design, Three focus groups were organized in the preparatory phase of the project with general practitioners, other health professionals and low back pain sufferers. Issues pertaining to the experience of living with, or treating low back pain were explored and users were asked to identify relevant research questions for consideration within the study. Findings, The focus groups revealed tensions between involving users as co-researchers for design issues and their role as sufferers and health professionals who want to share their narrative accounts of low back pain. The group discussions produced a wealth of material for analysis, but no explicitly stated research topics. Three key themes and the process of user involvement in the focus groups are discussed. Conclusions, The focus group format could be restrictive in that it allows for detailed exchange between participants, but is insufficiently geared towards the production of a research agenda. We draw conclusions as to possible approaches for user involvement in health services research design. [source] 2202 Kidney Transplant Recipients with 10 Years of Graft Function: What Happens Next?AMERICAN JOURNAL OF TRANSPLANTATION, Issue 11 2008A. J. Matas The ultimate goal of clinical transplantation is for the recipients to achieve long-term survival, with continuing graft function, that is equivalent to that of the age-matched general population. We studied subsequent outcome in kidney transplant recipients with 10 years of graft function. In all, 2202 kidney transplant recipients survived with graft function >10 years. For 10-year survivors, the actuarial 25-year patient survival rate for primary transplant living donor (LD) recipients was 57%; graft survival, 43%. For primary transplant deceased donor (DD) recipients, the actuarial 25-year patient survival rate was 39%; graft survival, 27%. The two major causes of late graft loss were death (with graft function) and chronic allograft nephropathy (tubular atrophy and interstitial fibrosis). The two major causes of death with function were cardiovascular disease (CVD) and malignancy. For nondiabetic recipients, the mean age at death with function from CVD was 54 ± 13 years; for diabetic recipients, 53 ± 7 years. By 20 years posttransplant, morbidity was common: >40% recipients had skin cancer (mean age for nondiabetic recipients, 53 ± 13 years; for diabetics, 49 ± 8 years), >10% had non-skin cancer (mean age for nondiabetic recipients, 53 ± 16 years; for diabetics, 46 ± 9 years), and >30% had CVD (mean age for nondiabetic recipients, 53 ± 15 years; for diabetics, 47 ± 9 years). We conclude that long-term transplant recipients have a high rate of morbidity and early mortality. As short-term results have improved, more focus is needed on long-term outcome. [source] Restructurer peu, restructurer mieux : leçons d'expériences ministérielles récentes au CanadaCANADIAN PUBLIC ADMINISTRATION/ADMINISTRATION PUBLIQUE DU CANADA, Issue 1 2010Luc Bernier Sommaire: Dans cet article, nous nous intéressons aux restructurations de ministères fonctionnels. Nous revoyons d'abord les raisons recensées pour restructurer. Puis, nous comparons ce qui s'est passé récemment dans trois provinces du Canada ainsi qu'au gouvernement fédéral dans ce domaine. Les exemples utilisés nous informent sur les raisons de restructurer et sur les conséquences des restructurations. Les cas relatés, tous territoires confondus, nous amènent à constater que certains domaines semblent plus problématiques que d'autres (par ex. : développement économique, environnement), c'est-à-dire qu'ils font plus souvent l'objet de restructurations sans que la solution choisie ne soit satisfaisante par la suite. Les raisons évoquées pour expliquer les restructurations ont trait à la complexité du dossier et aux priorités gouvernementales. Par ailleurs, pour ce qui est des conséquences, elles sont de trois ordres : à savoir les conséquences administratives et budgétaires (coûts liés aux déménagements, à l'imprimerie, etc.), les conséquences relatives à l'orientation du ministère (sa mission et sa vision), et les incidences sur le personnel (pertes d'emploi, impact sur le moral des employés, etc.). Sur le plan pratique, les premiers ministres doivent particulièrement éviter de restructurer lors de remaniements ministériels. Abstract: In this article, we take a look at restructuring initiatives involving functional departments. First, we review the documented reasons leading to the decision to restructure. Next, we compare recent restructuring activities in three Canadian provinces and at the federal government level. The examples used provide us with information on the reasons for engaging in the restructuring process, and its implications. The cases reported (all territories combined) reveal that some areas seem more problematic than others (for example, economic development, environment) , that is, they are the focus of more frequent restructuring, and the subsequent outcome is not always satisfactory. The reasons for explaining the restructurings point to the complexity of the file and government priorities. Furthermore, the consequences of the restructuring process fall into three main areas: implications at the administrative and budgetary levels (costs related to moving, printing, etc.), implications revolving around the department's direction (mission and vision), and implications on personnel (loss of employment, impact on employees' morale, etc.). On a practical level, the premiers must particularly avoid the restructuring of departments during Cabinet shuffles. [source] The affective costs of overconfidenceJOURNAL OF BEHAVIORAL DECISION MAKING, Issue 4 2004A. Peter McGraw Abstract Positive illusions, though often beneficial (Taylor & Brown, 1988), can diminish the pleasure of outcomes. This prediction follows from decision affect theory. We investigated this prediction by measuring the confidence that recreational basketball players felt while making shots and the pleasure they felt with subsequent outcomes. Results showed that most players were overconfident. Those who were more overconfident tended to experience less enjoyment with their outcomes. Using individual parameter estimates from decision affect theory, we estimated how each player would have felt if their self assessments had been accurate. For the vast majority, better calibration would have led to greater pleasure. In a second study, we randomly assigned players to a debiasing treatment condition or a control condition. Relative to the control players, debiased players were better calibrated and derived greater average pleasure from the task. Copyright © 2004 John Wiley & Sons, Ltd. [source] Leading change through an international faculty development programmeJOURNAL OF NURSING MANAGEMENT, Issue 8 2009LORA C. LACEY-HAUN PhD Aims, The purpose of the study was to evaluate the modification of an American model of academic leadership training for utilization in an African university and to pilot test the efficacy of the resulting model. Background, Traditionally many educators have moved into administrative positions without adequate training. Current world standards require leadership preparation for a wide array of persons. However, this opportunity did not yet exist in the study setting. Method, University leaders from the University of the Western Cape and the University of Missouri collaborated on revising and pilot testing a successful American academic leadership programme for use among African faculty. Cross-cultural adaptations, participant satisfaction and subsequent outcomes were assessed during the 2-year ,train-the-trainer' leadership development programme. Results, African faculty successfully modified the American training model, participated in training activities, and after 2 years, began to offer the service to other institutions in the region, which has increased the number of nurses in Africa who have had, and who will continue to have, the opportunity to move up the career ladder. Conclusion, The impact of the project extended further than originally expected, as the original plan to utilize the training materials at the University of the Western Cape (UWC) for the in-house faculty was expanded to allow UWC to utilize the modified materials to serve leadership development needs of faculty in other African universities. Implications for nursing management, Study findings will inform those interested in university policy and procedure on leadership training issues. The successful development of a self-sustaining leadership programme in which values of multiple cultures must be appropriately addressed has a significant impact for nursing administration. With the severe nursing shortage, health care institutions must develop cost effective yet quality development programmes to assure the succession of current staff into leadership positions. We no longer have the luxury of recruiting broadly and we must identify those talented nurses within our own institutions and prepare them for advanced leadership roles. This succession plan is especially important for the next generation of nurse leaders representing minority populations. In particular, nurse managers will find the overview of the literature for middle managers enlightening, and may find links to key resources that could be revised to be more culturally relevant for use in a wide array of settings. [source] Skin grafts: a rural general surgical perspective,ANZ JOURNAL OF SURGERY, Issue 5 2009Nigel J. Henderson Abstract Background:, Skin grafts are a common method of closing skin defects. The literature comparing methods of graft application and subsequent outcomes is poor, but reports indicate a graft failure rate between 2 and 30%. The aim of this study was to audit our current skin graft practice. Methods:, Data were collected prospectively on all skin grafts performed by the general surgical department between 1st December 2005 and 1st December 2006. A standardized proforma on each patient included data on age, gender, graft indication, application method, comorbidities, length of stay, and graft outcomes including graft take at 1, 2 and 6 weeks post-operatively. Results:, There were 85 grafts performed on 74 patients, median age 72 years (9,102 years), with 10 (12%) acute admissions. Prophylactic antibiotics were given to 50% (38 of 74) of patients. Successful grafts (>80% take) were performed in 68 (80%) patients. The overall graft complication rate was 24.7% (22 of 85 grafts). Infection occurred in 13 of 17 graft failures. No patients underwent re-operation for graft failure. Patients who received prophylactic antibiotics had a reduced risk of graft failure (Fisher's exact test, P = 0.016). Conclusion:, Skin grafts were performed successfully in the majority of patients. Graft complication and failure rates compare well with the world literature. The use of prophylactic antibiotics was the only predictor of successful graft take. [source] The impact of exposure to domestic violence on children and young people: a review of the literatureCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2008Richard Reading The impact of exposure to domestic violence on children and young people: a review of the literature HoltS., BuckleyH. & WhelanS. ( 2008 ) Child Abuse & Neglect , 32 , 797 , 810 . Objective This article reviews the literature concerning the impact of exposure to domestic violence on the health and developmental well-being of children and young people. Impact is explored across four separate yet interrelated domains (domestic violence exposure and child abuse, impact on parental capacity, impact on child and adolescent development and exposure to additional adversities), with potential outcomes and key messages concerning best practice responses to children's needs highlighted. Method A comprehensive search of identified databases was conducted within an 11-year framework (1995,2006). This yielded a vast literature that was selectively organized and analysed according to the four domains identified above. Results This review finds that children and adolescents living with domestic violence are at increased risk of experiencing emotional, physical and sexual abuse, of developing emotional and behavioural problems and of increased exposure to the presence of other adversities in their lives. It also highlights a range of protective factors that can mitigate against this impact, in particular a strong relationship with and attachment to a caring adult, usually the mother. Conclusion Children and young people may be significantly affected by living with domestic violence, and impact can endure even after measures have been taken to secure their safety. It also concludes that there is rarely a direct causal pathway leading to a particular outcome and that children are active in constructing their own social world. Implications for interventions suggest that timely, appropriate and individually tailored responses need to build on the resilient blocks in the child's life. Practice implications This study illustrate the links between exposure to domestic violence, various forms of child abuse and other related adversities, concluding that such exposure may have a differential yet potentially deleterious impact for children and young people. From a resilient perspective this review also highlights range of protective factors that influence the extent of the impact of exposure and the subsequent outcomes for the child. This review advocates for a holistic and child-centred approach to service delivery, derived from an informed assessment, designed to capture a picture of the individual child's experience and responsive to their individual needs. [source] | |||||||||||||