THE JAPANESE ECONOMIC REVIEW, Issue 4 2009
ATSUSHI YOSHIDA
We examine whether the school choice programme of public junior high schools in Adachi ward has caused student sorting and has thus increased the differences in scores between the schools. We find that students are sorted in the sense that the students living in the school attendance areas where there is a higher proportion of high-status occupations are more likely to select private schools even after the introduction of the school choice programme, or they select public schools with higher scores. Adachi's average scores relative to the Tokyo average have improved, while the between school differences in scores have not expanded. [source]

Relapse prevention with sex offenders: practice, theory and research

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2001
Gilles Launay Head of Psychology
Introduction Relapse prevention (RP) is now applied to sex offending. It has been questioned as to whether RP is worthwhile. This paper aims to evaluate this technique. The Rochester RP programme The purpose of the Rochester RP programme is to refine and strengthen skills gained in the prison department's sex offender treatment programme. The objective of the programme is to teach prisoners to recognize the chain of events leading up to their current offences and to practise strategies to interrupt this chain. Theoretical basis for RP Stopping an undesired behaviour and maintaining abstinence are two different problems. RP aims to address the maintenance problems. At the centre of RP theory is a study of the conditions that can turn lapse into relapse. Yet RP has been criticized as a lot of jargon saying very little. Ward and Hudson criticize RP constructs and their interaction. Such debates have few implications for clinical work and most of the criticism flies in the face of clinical experience. Research basis for RP Risk factors for sex offenders are being identified. Local evaluation of the Rochester programme suggests that prisoners do learn to identify risk factors and to develop coping strategies. As yet, however, there is no evidence as to whether RP works or not. Discussion A way to improve the efficacy of an RP programme may be to augment it with additional modules, e.g. behaviour therapy, drug treatment, continued work with the same prison staff and relaxation training. Conclusion RP theory is sound in essence but suffers from an overlay of cumbersome vocabulary. Reliable research is emerging. Copyright © 2001 Whurr Publishers Ltd. [source]

Beyond resilients, undercontrollers, and overcontrollers? an extension of personality prototype research

EUROPEAN JOURNAL OF PERSONALITY, Issue 1 2006
Philipp Yorck Herzberg
Prototypes of personality were investigated in two studies. In study I, clusters of Big-Five-based prototypes were examined using a general population sample of 1908 German adults. Convergent evidence suggested the appropriateness of a five-cluster solution, which corresponds to previously identified temperament based prototypes. In study II, the five-cluster solution was cross-validated in a sample of 256 prisoners. Moreover, it was shown that a population-based approach (using discriminant functions derived from study I) was superior over the traditional sample-based cluster approach (using Ward followed by k -means). The authors argue that future typological research can be sufficiently grounded on a five-prototype conception rather than on a three-prototype conception, and suggest a new and flexible assignment procedure. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Quantitative evaluation of automated skull-stripping methods applied to contemporary and legacy images: Effects of diagnosis, bias correction, and slice location

HUMAN BRAIN MAPPING, Issue 2 2006
Christine Fennema-Notestine
Abstract Performance of automated methods to isolate brain from nonbrain tissues in magnetic resonance (MR) structural images may be influenced by MR signal inhomogeneities, type of MR image set, regional anatomy, and age and diagnosis of subjects studied. The present study compared the performance of four methods: Brain Extraction Tool (BET; Smith [2002]: Hum Brain Mapp 17:143,155); 3dIntracranial (Ward [1999] Milwaukee: Biophysics Research Institute, Medical College of Wisconsin; in AFNI); a Hybrid Watershed algorithm (HWA, Segonne et al. [2004] Neuroimage 22:1060,1075; in FreeSurfer); and Brain Surface Extractor (BSE, Sandor and Leahy [1997] IEEE Trans Med Imag 16:41,54; Shattuck et al. [2001] Neuroimage 13:856,876) to manually stripped images. The methods were applied to uncorrected and bias-corrected datasets; Legacy and Contemporary T1 -weighted image sets; and four diagnostic groups (depressed, Alzheimer's, young and elderly control). To provide a criterion for outcome assessment, two experts manually stripped six sagittal sections for each dataset in locations where brain and nonbrain tissue are difficult to distinguish. Methods were compared on Jaccard similarity coefficients, Hausdorff distances, and an Expectation-Maximization algorithm. Methods tended to perform better on contemporary datasets; bias correction did not significantly improve method performance. Mesial sections were most difficult for all methods. Although AD image sets were most difficult to strip, HWA and BSE were more robust across diagnostic groups compared with 3dIntracranial and BET. With respect to specificity, BSE tended to perform best across all groups, whereas HWA was more sensitive than other methods. The results of this study may direct users towards a method appropriate to their T1 -weighted datasets and improve the efficiency of processing for large, multisite neuroimaging studies. Hum. Brain Mapping, 2005. © 2005 Wiley-Liss, Inc. [source]

The Philosophy of Halfness and the Philosophy of Duality: Julia Ward Howe and Ednah Dow Cheney

HYPATIA, Issue 2 2004
THERESE B. DYKEMANArticle first published online: 9 JAN 200
Julia Ward (1819,1910) and Ednah Dow littlehale (1824,1904), lifelong friends, wrote and lectured on many of the same issues, traveled across the country to lend support to causes, and taught together at the Concord School of Philosophy. Despite their close association and mutual efforts on similar issues, I argue that their philosophical principles were essentially different, in particular their approaches to an understanding of God, society, the sexes, art, and science. [source]

Improved aetiological diagnosis of ischaemic stroke in a Vascular Medicine Unit , the significance of transesophageal echocardiogram

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 3 2008
A. Martignoni
Summary Background:, The TOAST study estimates that 34% of ischaemic strokes are of undetermined aetiology. Improvements in the diagnosis of the pathogenetic mechanism of ischaemic stroke would translate into a better care, in analogy to other fields of vascular and internal medicine. Objective:, To measure the reduction of undetermined aetiology strokes performing a set of additional diagnostic tests. Design:, Consecutive case series with historical controls. Setting:, Internal Medicine Ward with a stroke area (SA) admitting most stroke patients of a large hospital in Italy. Subjects:, A total of 179 ischaemic stroke patients admitted to SA in 2004,2005 compared with 105 ischaemic stroke patients admitted to the whole department in 2001. Intervention:, To perform more diagnostic tests, including transesophageal echocardiography (TEE), in the greatest possible number of ischaemic stroke inpatients admitted in SA of the Internal Medicine Department, in the years 2004,2005. Results:, More diagnostic tests were performed during the study period than in 2001, especially TEE (56% of patients in 2004,2005 vs. 3% of patients in 2001). We observed a significant reduction of undetermined aetiology from 38% in 2001 to 16% in 2004,2005 (p < 0.0001), largely for an increased identification of cases of cardio-embolic mechanism (from 18% to 40%, p = 0.0002). In the years 2004,2005 the fraction of patients on anticoagulant treatment at discharge was 21% vs. 12% in 2001 (p = 0.041). Conclusion:, Performing more tests, particularly TEE, brought improvements in the aetiological diagnosis of stroke, increasing cardio-embolism diagnosis and anticoagulant treatment. [source]

Prescribing errors on medical wards and the impact of clinical pharmacists

INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 1 2003
Ms Alison Dale clinical services pharmacist
Objectives To assess the incidence of prescribing errors, predict patient outcome from clinical pharmacists' recommendations made in response to identified prescribing errors, and evaluate the influence of clinical pharmacists on recommendation implementation. Method Clinical pharmacy activities were conducted on two wards, one of which had an existing clinical pharmacy service (intervention ward) while the other did not (control ward). For the control ward, prescribing errors were documented but not followed up unless a potentially life-threatening problem was identified. Prescribing errors were identified and recommendations made by pharmacists. A consultant physician and pharmacist conducted an independent, blinded assessment of these recommendations to predict the impact on patient outcome if implemented. Recommendations were communicated to medical staff or implemented by the pharmacist on the intervention ward only. The proportion of recommendations implemented for intervention and control group patients were recorded. Setting Two medical wards in a UK district general hospital. The study was carried out over 12 weeks. Key findings There were 740 errors recorded for 235 patients. Fourteen recommendations could not be assessed. For all recommendations, the consultant and pharmacist predicted patient outcomes with life-saving (one consultant vs three pharmacist), major (186 vs 318), minor (328 vs 324), neutral (211 vs 85) or harmful (five vs five) impact respectively. For the intervention group, 79% of recommendations were implemented, including 81 of 92 (88%) predicted by the consultant to have major impact on patient outcomes. In the control group, only 18% of recommendations were spontaneously implemented, including only 10 of 94 (11%) recommendations predicted by the consultant to have major impact. Conclusion Ward-based clinical pharmacists identified large numbers of prescribing errors and made clinically significant recommendations. Implementation of recommendations was predicted to improve the outcome of patient care. Further research, specifically assessing the outcome of pharmacists' recommendations on patient care, is warranted. [source]

Christ and Culture , By Graham Ward

INTERNATIONAL JOURNAL OF SYSTEMATIC THEOLOGY, Issue 2 2007
Ralph Norman
First page of article [source]

Between the Rock and a Hard Place: In Support of (something like) a Reformed View of the Eucharist

INTERNATIONAL JOURNAL OF SYSTEMATIC THEOLOGY, Issue 2 2001
Douglas Farrow
In this article, Calvin's eucharistic theology is re-read in the light of Aquinas, Augustine, Irenaeus, Luther, Jean-Luc Marion, Graham Ward and Catherine Pickstock. It is found to have great strengths, sucessfully avoiding both static ideas of Christ's presence and individual nominalism, while allowing a prominent place for the Holy Spirit and room for the believer's faith. Calvin took account of the doctrine of the Ascension quite differently from Luther by stressing Christ's bodily absence from this world. The article argues that this dialectic of presence and absence would gain from giving it a temporal dimension, giving more weight to eschatology. [source]

Spaces of Work: Global Capitalism and Geographies of Labour , By Noel Castree, Neil Coe, Kevin Ward and Michael Samer

INTERNATIONAL JOURNAL OF URBAN AND REGIONAL RESEARCH, Issue 3 2009
Tod D. RutherfordArticle first published online: 6 OCT 200
No abstract is available for this article. [source]

Researchers' experience of co-operative inquiry in acute mental health care

JOURNAL OF ADVANCED NURSING, Issue 2 2005
Jan Kåre Hummelvoll BA DrPH RPN RNT
Aim., The aim of this article is to reflect upon our experiences of using co-operative inquiry in an acute mental health care setting, with a focus on the methodology used in a 4-year intervention programme developed in Norway between 1999 and 2003. Background., Action research plays a crucial role in assisting nurses to integrate theory and research with nursing practice. The central characteristic of this approach is the grounding of research in practice in collaboration with clinical practitioners. Methods., The research was a co-operative inquiry based on a hermeneutic-phenomenological approach. The research methods used were ethnographic, including participant observation and face-to-face interviews, questionnaires, focus group interviews, and our process notes. Findings., The different methods used in the co-operative inquiry design of the Project Teaching Ward (PTW) had both benefits and drawbacks. In particular, the focus group method proved useful due to its ability to stimulate participants' research interest, and thus motivating them to be actively involved in the development of knowledge. The particular knowledge development process used has been described as a local knowledge dialogue. This dialogue must incorporate critical subjectivity on the part of participants in order to ensure that the research has a reflective resistance, which is decisive for its validity and quality. The findings also highlight the importance of the different roles of project leader in lengthy action research collaboration. Conclusions., The PTW has illustrated that co-operative inquiry was well suited for developing knowledge relevant to practice, thus contributing to bridging the gap between practice and theory. In order for this to happen, the research collaboration should be characterized by patience, realism and engagement. [source]

Seafood Ecolabelling: Principles and Practice , Edited by Trevor Ward and Bruce Phillips

JOURNAL OF AGRARIAN CHANGE, Issue 4 2010
ELIZABETH HAVICE
No abstract is available for this article. [source]

Stepping up the pressure: arousal can be associated with a reduction in male aggression

AGGRESSIVE BEHAVIOR, Issue 6 2008
Andrew Ward
Abstract The attentional myopia model of behavioral control [Mann and Ward, 2007] was tested in an experiment investigating the relationship between physiological arousal and aggression. Drawing on previous work linking arousal and narrowed attentional focus, the model predicts that arousal will lead to behavior that is relatively disinhibited in situations in which promoting pressures to aggress are highly salient. In situations in which inhibitory pressures are more salient, the model predicts behavior that is relatively restrained. In the experiment, 81 male undergraduates delivered noise-blasts against a provoking confederate while experiencing either high or low levels of physiological arousal and, at the same time, being exposed to cues that served either to promote or inhibit aggression. In addition to supporting the predictions of the model, this experiment provided some of the first evidence for enhanced control of aggression under conditions of heightened physiological arousal. Implications for interventions designed to reduce aggression are discussed. Aggr. Behav. 34:584,592, 2008. © 2008 Wiley-Liss, Inc. [source]

Homocysteine, the MTHFR 677 C,T polymorphism and family history of premature cardiovascular disease

JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 3 2009
A. Carey
Background:, Cardiovascular disease (CVD) is the main cause of premature death in the UK and accounts for 36% of all premature male deaths and 27% of female deaths every year (British Heart Foundation, 2006). Although many risk factors for CVD are known, family history has been identified as being of particular importance in premature CVD (Lloyd-Jones et al., 2004). Recently, it was suggested that an elevated homocysteine (tHcy) may be associated with premature CVD (Homocystiene Studies Collaboration, 2002). The main genetic determinant of tHcy is the common 677 C,T polymorphism, in the enzyme methylenetetrahydrofolate reductase (MTHFR), which is prevalent in approximately 10% of the UK population. Relatively few studies have examined the association between tHcy and premature CVD and hardly any have considered the role of this polymorphism. The aim of this study therefore was to examine the relationships between the MTHFR 677 C,T polymorphism, tHcy and a family history of CVD in patients with established premature CVD. Methods:, An analysis was conducted on medical, lifestyle and family history data collected from patients and age-sex matched controls, recruited through the GENOVIT study in 2003. This case,control study involved n = 404 premature CVD patients and a similar number of age-sex matched controls, all of whom were screened for the TT genotype. A subset of patients (n = 196) and controls (n = 167) provided a blood sample, from which the tHcy concentration was established. Independent sample t -tests were used to determine differences between patients and controls and differences among genotype groups were examined using a one-way analysis of variance, followed by a Tukey's post hoc test. Results:, Plasma tHcy was significantly elevated in patients with a family history of CVD (compared to those without) (P = 0.013). A nonsignificant trend towards higher tHcy (compared to those without) was observed in patients with the TT genotype (P = 0.419). Furthermore, specifically in those with the TT genotype, those with a family history of CVD (compared to those without) showed significantly higher tHcy concentrations (P < 0.005). Those with the TT genotype who smoked had significantly higher tHcy (P < 0.05) than the CC and CT genotypes. Discussion:, The findings presented provide evidence to support an association between the MTHFR 677C,T polymorphism, elevated homocysteine and family history of premature CVD. Given that dietary levels of riboflavin have been shown to lower homocysteine specifically in individuals with the TT genotype (McNulty et al., 2006), these results have implications for the dietary management of premature CVD in those individuals with a genetic predisposition for elevated tHcy. In conclusion, further research in larger cohort numbers, regarding the correlation between family history, tHcy and the MTHFR polymorphism, would be beneficial for establishing their cause and effect relationship. References British Heart Foundation (2006) All Deaths and Deaths Under 75 by Cause and Sex, 2005, England, Wales, Scotland, N Ireland and United Kingdom. Available at http://www.bhf.org.uk/research_health_professionals/resources/heart_statistics.aspx. Homocystine Studies Collaboration (2002) Homocysteine and the risk of ishaemic heart disease and stroke. JAMA288, 2015,2022. Llyod-Jones, D.M., Nam, B.H., D'Agostino, R.B., Levy, D., Murabito, J.M., Wang, T.J., Wilson, P.W. & O'Donnell, C.J. (2004) Parental cardiovascular disease as a risk factor for cardiovascular disease in middle-aged adults, a prospective study of parents and offspring. JAMA291, 2204,2211. McNulty, H., Dowey le, R.C., Strain, J.J., Dunne, A., Ward, M., Molloy, A.M., McAnena. L.B., Hughes, J.P., Hannon-Fletcher, M. & Scott, J.M. Riboflavin lowers homocysteine in individuals homozygous for the MTHFR 677C->T polymorphism. Circulation113, 74,80. [source]

Making Sense of Inquiry Sensemaking

JOURNAL OF MANAGEMENT STUDIES, Issue 1 2000
Andrew D. Brown
This paper presents a discourse analysis of a report of a tribunal of inquiry in order to further our understanding of inquiry team sensemaking. The subject of the paper is the report of the Allitt Inquiry into attacks on children on Ward 4 at Grantham and Kesteven Hospital in the UK. Premised on an understanding of the report as an exercise in sensemaking, and sensemaking as a narrative process, the paper illustrates how authorial strategies centred on issues of normalization, observation and absolution are employed to create a rhetorical and verisimilitudinous artefact. This, it is argued, is accomplished as part of a more general strategy of depoliticizing the disaster event, legitimating social institutions (especially those connected with the medical profession), ameliorating anxieties by elaborating fantasies of omnipotence and control, and thenceforth acting as a sensitizing narrative archetype. [source]

Politics and Theological Liberalism: William Gladstone and Mrs Humphry Ward

JOURNAL OF RELIGIOUS HISTORY, Issue 2 2001
P. C. Erb
First page of article [source]

Apostle of human progress: Lester Frank Ward and american political thought, 1841,1913

JOURNAL OF THE HISTORY OF THE BEHAVIORAL SCIENCES, Issue 1 2005
John C. Burnham
No abstract is available for this article. [source]

Building landscapes: village development in Zimbabwe

LAND DEGRADATION AND DEVELOPMENT, Issue 3 2001
S. Moyo
Abstract This paper argues that there is a need to fill a specific empirical and conceptual gap in land policy analysis in Zimbabwe. This ,gap' has arisen from the predominantly macro level economic theoretical perspectives on the land question, and from an inadequate conceptualization of the local level character of the land debate in Zimbabwe. The purpose of this paper is to stress the importance of focusing on the land question from the standpoint of the peasant householders in the Communal Areas (CAs). These issues are raised through the examination of land use and land-use history in Mhezi Ward in Makoni District, Zimbabwe. This paper does not comment on the recent political moves to redistribute 1471 Large Scale Commercial Farms (LSCF) as this process must be discussed in another debate. Copyright © 2001 John Wiley & Sons, Ltd. [source]

Books and Multimedia Reviews

METEORITICS & PLANETARY SCIENCE, Issue 3 2001
Article first published online: 4 FEB 2010
Book reviewed in this article: Catalogue of Meteorites, Fifth Edition (Revised and Enlarged) by Monica M. Grady Extrasolar Planets: The Search for New Worlds by Stuart Clark The Moon: Resources, Future Development and Colonization by David Schrunk, Burton Sharpe, Bonnie Cooper and Madhu Thangavelu Rare Earth: Why Complex Life is Uncommon in the Universe by Peter D. Ward and Donald E. Brownlee [source]

Cultural Transformation and Religious Practice , By Graham Ward

MODERN THEOLOGY, Issue 3 2007
Randi Rashkover
First page of article [source]

Lumbar vertebral morphology and isthmic spondylolysis in a British medieval population

AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 2 2010
Carol V. Ward
Abstract The British medieval population from Wharram Percy, England, has a greater prevalence of isthmic spondylolysis (11.9% of skeletons, 8.5% at the L5 level) than in modern populations (3%,6%). This may in part be due to differences in activity patterns between groups. However, Ward and Latimer (Spine 30 [2005] 1808,1814) proposed that the likelihood of developing and maintaining spondylolytic defects is also influenced by a lack of sufficient increase in mediolateral separation between articular processes in the lowest lumbar segments, given the human lumbar lordosis. Here, we demonstrate that spondylolytic individuals from Wharram Percy tend to have a less pronounced difference between mediolateral facet joint spacing of adjacent segments in the lowest lumbar region than do unaffected individuals, as seen in modern clinical and skeletal populations. These comparisons suggest that regardless of lifestyle, insufficient mediolateral increase in facet spacing predisposes people to spondylolytic defects, and so interfacet spacing patterns may have predictive utility in a clinical context. We also compare the Wharram Percy sample to a modern sample from the Hamann Todd collection with a typically modern prevalence rate. Data do not support the hypothesis that the Wharram Percy individuals had a less pronounced interfacet increase than the Hamann Todd, although they do have narrower lumbar facet spacing at the lowest three levels. Further investigation of anatomical variation underlying population-specific prevalence rates needs to be conducted. Am J Phys Anthropol 2010. © 2009 Wiley-Liss, Inc. [source]

Theological Reflection: Sources , By Elaine Graham, Heather Walton, and Frances Ward

RELIGIOUS STUDIES REVIEW, Issue 2 2008
David H. Jensen
No abstract is available for this article. [source]

George Washington's Enforcers: Policing the Continental Army , By Harry M. Ward

THE HISTORIAN, Issue 4 2007
Nancy L. Rhoden
No abstract is available for this article. [source]

Erratum: JP Raynauld, C Buckland-Wright, R Ward, D Choquette, B Haraoui, J Martel-Pelletier, I Uthman, V Khy, J-L Tremblay, C Bertrand, J-P Pelletier.

ARTHRITIS & RHEUMATISM, Issue 11 2003
Efficacy of Long-Term Intraarticular Steroid Injections in Osteoarthritis of the Knee., Safety
The original article to which this Erratum refers was published in Arthritis & Rheumatism(2003) 48(2) 370,377 [source]

Oliver Russell and Linda Ward

BRITISH JOURNAL OF LEARNING DISABILITIES, Issue 2 2001
Andrew Holman
No abstract is available for this article. [source]

Disabled Children and Residential Schools: The Implications for Local Education Professionals

BRITISH JOURNAL OF SPECIAL EDUCATION, Issue 2 2003
Jenny Morris
Jenny Morris, freelance researcher, David Abbott, research associate at the Norah Fry Research Centre at the University of Bristol, and Linda Ward, Director of the Norah Fry Research Centre at the University of Bristol, carried out research to look at whether the current system of legislation and regulation is adequately protecting and promoting the interests of disabled children placed at residential schools. This article summarises some findings from the research which investigated the decision-making processes leading to residential special school placements and explored the involvement of education and social services authorities after placements have been made. The research found that the needs of individual children are not central to these decision-making processes; and that the local authorities who make such placements do not pay sufficient attention to protecting and promoting children's educational or care needs once they have gone away to school. Jenny Morris, David Abbott and Linda Ward indicate some of the ways in which current practice could be improved; make recommendations for future developments; and call for further research into the role of special residential schools in the context of policy on educational and social inclusion. [source]

Dynamic Surface Tensions of Fluorous Surfactant Solutions

CHINESE JOURNAL OF CHEMISTRY, Issue 4 2005
Gao Yan-An
Abstract Dynamic surface properties of aqueous solutions of cationic fluorous surfactant CF3CF2CF2O(CF(CF3)CF2O)2CF(CF3)CONH(CH2)3N+(C2H5)2CH3I - (abbrev. FC-4 ) were reported. The critical micelle concentration (cmc) (3.6×10 -5 mol/L) and equilibrium surface tensions ,eq were measured by Krüss K12 tension apparatus. Dynamic surface tension ,(t) was measured in the range of 15 ms to 200 s using the MBP tensiometer. The surface excess ,, as a function of concentration, was obtained from equilibrium tensiometry using the Gibbs equation. Data from these experiments were combined to analyze the ,(t) decays according to the asymptotic Ward and Tordai equation. The results show that at the initial adsorption stage, the dynamic surface tension data were all consistent with this diffusion-controlled mechanism, and at the end of the adsorption process, there were some evidences for an adsorption barrier, suggesting a mixed diffusion-controlled adsorption mechanism. Using measured quantities, the barrier strength was estimated as between 25 and 35 kJ/mol at 25 °C. The surface pressure plays an important role in contributing to the barrier. [source]

Impact of regular attendance by infectious disease specialists on the management of hospitalised adults with community-acquired febrile syndromes

CLINICAL MICROBIOLOGY AND INFECTION, Issue 10 2004
A. Borer
Abstract The impact of attendance by infectious disease specialists (IDS) on hospitalised adults with community-acquired infection was assessed by studying 402 consecutive febrile adults who were admitted randomly to either of two internal medicine wards over a 4-month period and given intravenous antibiotics. In ward 1, patients were attended by IDS, whereas those in ward 2 were attended by physicians from other specialties. In total, 160 patients were treated in ward 1 and 242 in ward 2 (median age 66 years; 49% male). The case-mix was comparable. Only 39% of ward 2 patients underwent minimal fever diagnostic tests compared to 82% in ward 1 (p < 0.001). Ward 1 and 2 patients received 188 and 315 antibiotic courses, respectively, of which 32% and 20% required approval from IDS (p 0.003). Patients in ward 1 were more likely to receive ceftriaxone (7.5% vs. 2%; p 0.002), erythromycin (7% vs. 1.5%; p 0.002) and cefuroxime (48% vs. 26%; p < 0.0001), but were less likely to receive amoxycillin,clavulanate (8% vs. 28%; p < 0.0001). The mean durations of therapy were 3.6 and 3.2 days (not significant), and therapy was deemed to be completely appropriate in 55.5% and 43% of cases, respectively (p 0.012). The crude mortality rates were 6.3% and 7.9%, respectively (not significant), while the medication costs were US$ 27.4 and US$ 26.4/patient/antibiotic day, respectively. Regular attendance by IDS resulted in significantly higher rates of accurate diagnosis and appropriate therapy. IDS prescribed more restricted (and expensive) agents, but preferred less expensive agents among unrestricted drugs, thereby offsetting the overall medication costs. [source]

Culture: A Possible Predictor of Morality for African American Adolescents

JOURNAL OF RESEARCH ON ADOLESCENCE, Issue 2 2009
Marisha L. Humphries
This study examined the ways in which cultural orientation (communalism and material well-being) and empathy influence the moral reasoning of African American middle to late adolescents. Specifically, this study utilized path analysis to investigate Ward's (1995) hypothesis that a communal orientation would promote morality among African American adolescents, while a material well-being orientation would mitigate against it. In addition, it was hypothesized that empathy would mediate the relationship between cultural orientation and moral reasoning. Thirty-seven high school students and 35 college students participated in the study. Results revealed that communalism was a significant predictor of empathy. Despite prediction, communalism and material well-being were not predictors of moral reasoning. The findings did not yield support for empathy functioning as a mediator between communalism and moral reasoning. These findings are discussed in terms of previous findings, methodological limitations, and implications for future research. [source]

Nursing Diagnoses in Psychiatric Acute Wards in Switzerland and Austria

INTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003
Harald Stefan
PURPOSE To examine the frequency and quality of documented nursing diagnoses and to compare the diagnoses regarding ward and patient characteristics. METHODS The following data were collected from 11 acute care wards in five psychiatric hospitals in Switzerland and Austria: documented nursing diagnoses, demographic characteristics of an unselected sample of 30 consecutively discharged patients in each ward, ward data, and data from three randomly selected complete charts from each ward. Free-text diagnoses were recoded into NANDA terminology. Frequencies were calculated and compared across settings and regarding patient and ward characteristics. Diagnoses were examined for quality and structure of the diagnostic statements. FINDINGS Mean age of patients was 40 ± 13 years, and the main psychiatric diagnoses were schizophrenia, mood disorders, substance abuse, and neurotic and personality disorders. Of the 664 nursing diagnoses located in 330 nursing records, 635 were proper nursing diagnoses; 83% of patients had at least 1 nursing diagnosis (X,= 2). The number of diagnoses correlated weakly with patient length of stay. Of the nursing diagnoses, 20% were made on admission day, and the majority of nursing diagnoses was active at discharge. Ninety percent of the diagnoses were formulated using NANDA terminology. The most frequently used categories were coping-related diagnoses,disturbed thought processes and self-care deficits. Numerous problem,etiology,symptom (PES)formatted diagnoses had diagnostic labels nested within the etiology. Countryand setting-specific similarities and differences were found with a significantly higher number of nursing diagnoses in Austria where use is mandated. In Austria, more somatic nursing diagnoses were found. The most frequent nursing diagnoses were similar in both countries. DISCUSSION The number of diagnoses corresponds to results reported in the international literature suggesting the justification for international comparison. Ten categories represent 60% of nursing diagnoses. Approximately 50% of nursing diagnoses were made in the first days after hospitalization, rendering their use practicable. A minority of nursing diagnoses were discontinued, possibly suggesting that some problems are difficult to solve or evaluate. The PES format and the NANDA terminology are used quite extensively even when not mandatory. NANDA terminology is deemed useful and practical, but problems occur when nursing diagnoses CONCLUSIONS Nursing diagnoses represent the main areas of nursing, but cultural differences exist regarding the diagnostic process. Thus, research is needed to test the appropriateness of nursing diagnoses to characterize nursing populations. [source]