Supportive Environment (supportive + environment)

Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

Providing support for problem-based learning in dentistry: the Manchester experience

Gillian Hoad-Reddick
The introduction of problem-based learning (PBL) into any programme demands a period of adjustment on the part of faculty. Similarly, students new to PBL take time to adapt to what is, for the majority of them, an unfamiliar mode of learning. At Manchester, closed loop PBL is used throughout the first and second years of the dental programme; the method is interdisciplinary; there are no subject boundaries. Dental students work in groups of between 10 and 15, facilitated by a tutor from the Department of Biological Sciences, to research topics and share information in a mutually supportive environment. Each week a different problem forms the focus for learning. In this paper, we seek to describe the measures introduced in response to student feedback collected via routine meetings with the senior tutor, after meetings with their academic or personal tutors and through discussion at the staff students' committee, which we at Manchester have taken to facilitate the process of adaptation to PBL. Changes have been made in the areas of recruitment, pre-admission interviewing, induction (development of an induction booklet and communication skills module) and tutorial support (overhaul of personal tutor system and introduction of peer-assisted study (PAS) and personal and academic development programmes (PADPs)). Feedback on these changes, gathered via the routes described above, has been positive and continues to be central to our processes of development in these areas. Although the various ways in which PBL has been implemented worldwide may place limits on the transferability of our methods, this paper serves to illustrate some of the means available to support students in the transition to self-directed learning. The latter is not only an essential component of PBL but also something we should be seeking to foster in all students, no matter what philosophy and method of course delivery are utilized. [source]

Patient-friendly hospital environments: exploring the patients' perspective

Calbert H. Douglas BSc MSc PhD
Abstract Objective, To investigate the perceptions and attitudes of patients to the built environments of NHS Trust hospitals, in order to inform design excellence so as to make future hospitals places and spaces responsive to patient needs. Design, An exploratory study of patients perceptions based on qualitative semi-structured personal interviews. Setting and participants, Fifty one-to-one interviews held with hospital in-patients across the four directorates of surgery, medicine, care of the elderly and maternity at Salford Royal Hospitals NHS Trust, Salford, UK. Results, The research found that there was much similarity in the priorities, issues and concerns raised by patients in each of the four directorates. Patients perceived the built environment of the hospital as a supportive environment. Their accounts in each area pointed to the significance of the factors that immediately impacted on them and their families. Patients identified having a need for personal space, a homely welcoming atmosphere, a supportive environment, good physical design, access to external areas and provision of facilities for recreation and leisure. Responses suggest that patient attitudes and perceptions to the built environment of hospital facilities relates to whether the hospital provides a welcoming homely space for themselves and their visitors that promotes health and wellbeing. Conclusions, The findings have important implications for capital development teams, clinical staff, managers and NHS Estates personnel. Although the study has immediate relevance for Salford Royal Hospitals Trust, findings and recommendations reported provide NHS Estates and other relevant stakeholders with evidence-based knowledge and understanding of patients' perceptions and expectations of and preferences for particular facilities and estates provision in NHS hospitals. [source]

Innovations in United States genetics nursing: Practice and research

Dale H. LEA
Abstract Aim:, Clinical and research applications from human genome discoveries are growing and creating both opportunities and challenges to the integration of genetic concepts into practice and research. Nurses have a long history of caring for individuals, families, and groups with genetic conditions. In the past two decades, a small group of nurses in the USA have used a variety of strategies to further develop the field of genetics nursing. In this paper we identify innovative approaches to identifying genetics-related nursing roles and opportunities, as well as successful collaborative efforts beyond nursing to address the emerging health and societal challenges related to human genetics discoveries. Methods:, The information presented here comes from a variety of sources where the authors or genetics nurses directly participated, including: (i) a systematic literature review of genetics nursing; (ii) a comprehensive research study of models of delivering clinical genetics services and the roles of health professionals; and (iii) participation in numerous national research, planning, programmatic, and advisory groups involved with clinical genetics-related health services, research, education, and public policy. Results:, Genetics nurses in the US have developed innovative responses to genetics-related challenges within and beyond the profession of nursing. These include: (i) establishing an organization for nurses in genetics and gaining formal recognition of genetics as a specialty of nursing; (ii) defining the scope of genetics nursing practice and developing a new genetics nursing credential; (iii) establishing a multiprofessional genetics education coalition and defining genetic competency for health-care practice; (iv) creating new clinical practice roles for nurses that integrate emerging genetics concepts and skills into diverse clinical practice areas; (v) expanding nursing involvement in genetics-related research; and (vi) participation in high-level genetics advisory groups. Conclusions:, The US experience shows that nurses have made substantial progress in expanding their involvement in genetic services through visionary leadership, innovative approaches to challenges, establishing support with nurse colleagues, and engaging in multiprofessional efforts. The most important first step is developing a supportive environment for nurse advancement. In the US, the genetics nurses' organization known as the International Society of Nurses in Genetics (ISONG) has provided this base. [source]

Development of an educational/support group for pregnant women in prison

Ginette G. Ferszt Ph.D.
Abstract It is estimated that 6,10% of women are pregnant when they enter the prison system. The majority have had little, if any, prenatal care and/or childbirth education. Given economic constraints, the educational and support needs of this population are often not met. In response to these needs, an educational/support group was developed and led by a social worker, a mental health clinical nurse specialist, and a nurse midwife in a women's correctional facility in the Northeast. Women in various stages of pregnancy and early postpartum voluntarily attended. The need for education and psychosocial support was overwhelming. This group fostered a safe space for women to discuss real-life issues in a supportive environment. Meeting the educational and support needs of incarcerated women is paramount. [source]

Activation of epidermal growth factor receptors in astrocytes: From development to neural injury

Bin Liu
Abstract The epidermal growth factor receptor (EGFR) pathway controls the phenotypic characteristics of astrocytes. In the developing central nervous system (CNS), activation of the EGFR pathway induces astrocyte differentiation, forming the cribriform structure that surrounds axons and providing a supportive environment for neurons. In the adult CNS, the EGFR pathway is absent from astrocytes but is highly up-regulated and activated following neuronal injury. Activation of the EGFR pathway triggers quiescent astrocytes to become reactive astrocytes. Although astrocytes regulated by the EGFR pathway play constructive roles in the developing CNS, astrocytes that become reactive in response to activation of the EGFR pathway appear to be destructive to neurons in the adult CNS. The reappearance and activation of EGFRs in astrocytes under pathological conditions may activate a developmental process in an adult tissue. Regulation of EGFR function in astrocytes may be a new therapeutic strategy for the treatment of neural disorders. 2007 Wiley-Liss, Inc. [source]

Native American Graduate Nursing Students' Learning Experiences

Suzanne Steffan Dickerson
Purpose: To identify learning experiences of Native American graduate nursing students in a university-based nurse practitioner program. Design: The phenomenological approach of Heideggerian hermeneutics. Method: A purposive sample of 11 Native American graduate students in a nurse practitioner program were given the choice of participating in a focus group or completing an individual interview to elicit common meanings and shared experiences. Findings: Four themes and two constitutive patterns: (a) Native American students' worldviews reflected unwritten knowledge that served as a background of common understanding, (b) academic environment as a rigid environment with only one way to learn and constant evaluation, (c) faculty-student relationship barriers to establishing a supportive learning environment, and (d) strategies to survive, including a commitment to succeed, conforming to unwritten rules, helping each other, and ultimately changing themselves. Constitutive patterns were: (a) value conflicts when students' values conflicted with academic behavioral values, and (b) on the fringe, when students felt isolation from the main student body, and open to attack (evaluation). Students struggled to be successful in their commitment to complete the degree, but often questioned the applicability of the program in their cultural setting. Conclusions: A more flexible supportive environment is needed to support students' goals to attain degrees, as well as to encourage dialogue on differing cultural values. Faculty who teach culturally diverse students may need to examine rigid behavioral standards that mandate an assertive practitioner persona and may be a barrier to attainment of goals. [source]

Body Mass Index Measurement in Schools,

Allison J. Nihiser MPH
ABSTRACT Background:, School-based body mass index (BMI) measurement has attracted much attention across the nation from researchers, school officials, legislators, and the media as a potential approach to address obesity among youth. Methods:, An expert panel, convened by the Centers for Disease Control and Prevention (CDC) in 2005, reviewed and provided expertise on an earlier version of this article. The panel comprised experts in public health, education, school counseling, school medical care, and a parent organization. This article describes the purposes of BMI measurement programs, examines current practices, reviews existing research, summarizes the recommendations of experts, identifies concerns, and provides guidance including a list of safeguards and ideas for future research. Results:, The implementation of school-based BMI measurement for surveillance purposes, that is, to identify the percentage of students in a population who are at risk for weight-related problems, is widely accepted; however, considerable controversy exists over BMI measurement for screening purposes, that is, to assess the weight status of individual students and provide this information to parents with guidance for action. Although some promising results have been reported, more evaluation is needed to determine whether BMI screening programs are a promising practice for addressing obesity. Conclusions:, Based on the available information, BMI screening meets some but not all of the criteria established by the American Academy of Pediatrics for determining whether screening for specific health conditions should be implemented in schools. Schools that initiate BMI measurement programs should evaluate the effects of the program on BMI results and on weight-related knowledge, attitudes, and behaviors of youth and their families; they also should adhere to safeguards to reduce the risk of harming students, have in place a safe and supportive environment for students of all body sizes, and implement science-based strategies to promote physical activity and healthy eating. [source]

Interpersonal Issues Between Pain Physician and Patient: Strategies to Reduce Conflict

PAIN MEDICINE, Issue 8 2008
Kate Diesfeld BS
ABSTRACT Objective., This article analyzes scholarship on the interpersonal challenges that pain physicians face, with an emphasis on strategies to reduce conflicts within therapeutic relationships. Results., Scholarship on the dilemmas pain physicians face suggests that 1) there are unique and perhaps unrecognized features of pain medicine that generate stress; 2) interpersonal conflict may contribute to stress; and 3) clinicians' biases may interfere with the doctor,patient relationship and with the best practice of pain medicine. Application of a framework based on clinicians' beliefs and Papadimos' reflections on justice and temperance may reduce such conflicts. Conclusion., The challenges of pain medicine may be complicated by the clinician's undisclosed attitudes regarding their roles and their perceptions of pain sufferers. A strategy for physicians to examine their beliefs within a supportive environment may aid physicians caring for people with chronic pain. Papadimos' reflections upon the virtues of justice and tolerance guide this analysis. [source]

Japanese cancer patients' communication style preferences when receiving bad news

Maiko Fujimori
Abstract This study describes the communication style preferences of Japanese patients when receiving bad news, examines the factor structure of the measure for patients' preferences (MPP) in a Japanese population, and explores variables that may be associated with patients' communication style preferences. Five hundred twenty-nine cancer outpatients completed several psychosocial measures including the Japanese version of the MPP (MPP-J), the Mental Adjustment to Cancer Scale (MAC), and the Hospital Anxiety and Depression Scale (HADS). The patients desired detailed information and a supportive environment when receiving bad news. The MPP-J demonstrated a 5-factor structure: support, facilitation, medical information, clear explanation, and encouraging question-asking. Regression analyses indicated that a female gender, the fighting spirit and anxious preoccupation dimensions of the MAC were positively associated with all 5 MPP-J factors. In conclusion, Japanese cancer patients' preferences for communication when receiving bad news differ somewhat from those of American patients. Japanese physicians should encourage patients to ask questions and should consider the demographic (e.g. gender), medical (disease status) and psychosocial characteristics (fighting spirit and anxious preoccupation) of patients when delivering bad news. Copyright 2006 John Wiley & Sons, Ltd. [source]

Designing a Three-dimensional Expanded Polytetrafluoroethylene,Poly(lactic-co-glycolic acid) Scaffold for Tissue Engineering

Hung-Jen Shao
Abstract:, The purpose of this study was to design a three-dimensional expanded polytetrafluoroethylene (ePTFE),poly(lactic-co-glycolic acid) (PLGA) scaffold for tissue engineering. To test the feasibility of this composite scaffold, a series of two-dimensional culture experiments were performed to investigate the behavior of anterior cruciate ligament (ACL) cells on the ePTFE and PLGA membranes. It was found PLGA provided a cell-favorable substrate for cell adhesion, migration, and growth, indicating PLGA is an ACL cell-conductive material. Conversely, poor adhesion and proliferation of ACL cells were observed on the ePTFE, even on the collagen-coated ePTFE. Therefore, the scaffold was not fabricated by coating PLGA on the ePTFE surface because it is difficult to coat anything on the extremely hydrophobic ePTFE surface. Instead, the ePTFE embedded in the PLGA matrix was prepared by immersing ePTFE scrim yarns into the PLGA solution, and then precipitating PLGA to form a three-dimensional construction with porous morphology. The role of ePTFE is regarded as a reinforcing constituent to improve the mechanical strength of porous PLGA matrix to provide early repair strength for tissue healing. However, porous PLGA matrix acts as a supportive environment for allowing cell adhesion, migration, and growth to guide the repair and regeneration of ligament tissue. To test this assumption, a preliminary animal experiment of rabbit ACL wound healing with this three-dimensional ePTFE,PLGA scaffold was performed. These results are very encouraging because such a new scaffold made of ePTFE scrim yarns embedded in PLGA may serve as ACL prostheses in the ligament tissue engineering. [source]

Nurses with mental illness: Their workplace experiences

Terry Joyce
ABSTRACT:, This qualitative study explored the workplace experiences of nurses who have a mental illness. The ultimate goal of the study was to gain insights that would lead to the development of more supportive environments for these nurses. Interviews were conducted with 29 nurses in New South Wales, Australia. The interview transcripts were subjected to discourse analysis. One significant finding was the theme ,Crossing the boundary , from nurse to patient'. This encompassed three sub-themes: ,Developing a mental illness', ,Hospital admission', and ,Being managed'. For most of the participants, being a nurse with a mental illness was largely a negative experience. Often, nurses without a mental illness actively sought to reform the participants' behaviour to enforce what was seen as appropriate conduct for a professional nurse. This paper shows how nurses in this study dealt with the early concerns associated with mental illness. [source]

Development of a community health promotion center based on the World Health Organization's Ottawa Charter health promotion strategies

Chung Yul LEE
Abstract Aim:, To describe the development process of nursing school-led community health promotion centers (CHPC) to improve the health of the surrounding communities. Methods:, This study design was a research and development study. (i) Assessment of health needs by interviewing 359 people in the community to select health programs for the community health promotion center. (ii) Five health promotion strategies from the Ottawa Charter were applied to develop the community health promotion center for a city community. Results:, (i) The people in the community had higher socioeconomic status levels and better health behaviors compared to the general Korean population, and they also listed chronic health problem management as their first priority health service. (ii) Development of the community health promotion center was done based on the five World Health Organization's Ottawa Charter Health Promotion Strategies: build healthy public policy, create supportive environments, strengthen community actions, develop personal skills, and reorient health services. Conclusions:, The present study showed that the WHO's five Ottawa Charter Health Promotion Strategies were useful for developing health promotion centers in the community. [source]

The prediction of disruptive behaviour disorders in an urban community sample: the contribution of person-centred analyses

Keith B. Burt
Background:, Variable- and person-centred analyses were used to examine prediction of middle childhood behaviour problems from earlier child and family measures. Method:, A community sample of 164 families, initially recruited at antenatal clinics at two South London practices, was assessed for children's behaviour problems and cognitive ability, maternal mental health, and the family environment when the children were 4 years old. At age 11, children, mothers, and teachers reported the child's disruptive behaviour, and mothers and children were interviewed to identify cases of disruptive behaviour disorders (DBD). Results:, Neither social class nor ethnicity predicted the child's disruptive behaviour at age 11. Rather, path analyses and logistic regression analyses drew attention to early behavioural problems, maternal mental health and the child's cognitive ability at 4 as predictors of disruptive behaviour at age 11. Cluster analysis extended these findings by identifying two distinct pathways to disruptive symptoms and disorder. In one subgroup children who showed intellectual difficulties at 4 had become disruptive by 11. In a second subgroup mothers and children both showed psychological problems when the child was 4, and the children were disruptive at age 11. The person-centred approach also revealed a high-functioning group of cognitively able 4-year-olds in supportive environments, at especially low risk for DBD. Conclusions:, Combining variable- and person-centred analytic approaches can aid prediction of children's problems, draw attention to pertinent developmental pathways, and help integrate data from multiple informants. [source]

The Role of Champions in the External Commercialization of Knowledge,

Ulrich Lichtenthaler
Besides applying knowledge in their own products or services, firms may externally commercialize their knowledge assets (e.g., by means of outlicensing). The literature on champions, however, has focused on internal innovation. This gap in prior research is particularly remarkable as the potential for promoting external knowledge exploitation is high. Some pioneering firms realize great benefits, whereas most others experience major managerial difficulties. This paper tests five hypotheses regarding the emergence and impact of champions of external knowledge exploitation with data from 152 firms across industries. The results of the questionnaire-based study demonstrate the relevance of champions of external knowledge exploitation. Championing constitutes an essential success factor and has strongly contributed to the recent increase in external knowledge commercialization. These findings help to explain the discrepancies between the few successful and the majority of unsuccessful firms. Beyond existing insights, the emergence of champions is affected by external determinants in addition to internal determinants. There is an inverted U-shaped relationship between championing and the internal determinants, that is, organizational climate and active strategy. Moreover, there is a negative relationship between championing and market imperfection and an inverted U-shaped relationship between championing and competitive intensity, which both constitute external determinants of championing. In contrast to the traditional understanding, champions tend to emerge in supportive environments, in which internal and external barriers are relatively low. This surprising finding calls for rethinking the role and motivation of champions. [source]