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At least 199 records · Page 11Linked to original sources
PubMed2005

Impact evaluation of a five-day Short Course in Health Promotion: workforce development in action.

ISSUE ADDRESSED: This paper reports on impact evaluation of a series of five-day Short Courses in Health Promotion that have been delivered to more than 2,000 people since 2002 as part of a state-wide workforce development strategy. METHODS: A triangulated mixed methods research design was selected for the evaluation. Data were collected through a mail survey, key informant interviews, focus groups and organisational case studies. Stakeholder and participant involvement were central to the evaluation. RESULTS: Organisational change emerged as a key theme. Impacts of the short course were felt in relation to health promotion practice and on organisational capacity to conduct health promotion, while the development of confidence and skills of participants to engage in collaborative opportunities was a not-unexpected, but important, benefit of the course. CONCLUSIONS: A short course is effective if attention is given to quality delivery, adult learning methods, participant involvement, appropriate targeting, good planning, and adequate funding. However, respondents commonly report the need for organisational change in order for health promotion practice to be embedded into organisations and for practitioners to be supported in their efforts to re-orient services towards health promotion.

Attitude of Health Personnel↗
PubMedDate not supplied

Determining severe respiratory distress in older out-of-hospital patients.

OBJECTIVES: This preliminary investigation represents the first step in developing a clinical decision rule (CDR) to assist out-of-hospital providers in caring for older patients in respiratory distress. The specific aims of the study were: 1) to identify up to ten candidate clinical indicators of severe respiratory distress in older out-of-hospital patients and 2) to determine the feasibility of obtaining data on these indicators from out-of-hospital treatment records, and of obtaining a measure of severe respiratory distress from the emergency department (ED) medical record. METHODS: This mixed-methods study included a qualitative component to list possible clinical indicators of severe respiratory distress, and a Delphi survey N = six experts) to reduce the comprehensive list that resulted (aim 1). The feasibility of gathering clinical indicators and a measure of severe distress was evaluated using a retrospective chart review (N = 640) of out-of-hospital and ED medical records (aim 2). RESULTS: Nine clinical indicators were identified: level of consciousness/mentation, inability to speak in full sentences, position of the patient on arrival, decreased oxygen saturation, accessory muscle use, dyspnea, increased respiratory effort, altered respiratory rate, and retractions. There were sufficient data available on all indicators except dyspnea and retractions; a measure of severe distress was readily obtained from the ED medical record. CONCLUSION: Medical record data were available on seven out-of-hospital clinical indicators and an ED measure of severe distress. Further work needs to be done to refine the operational definitions of the indicators and to standardize the way they are documented in the out-of-hospital medical record.

Consensus↗
PubMed1996

Comparative shear bond strength of some orthodontic bonding resins to enamel.

The aim of this study was to compare the in vitro bond strength, to bovine enamel measured in shear, of the orthodontic adhesives Lee Insta-bond (LiB), Rely-a-Bond (RaB), Right-on (Ro), Concise precoating method (Cc), Concise mixed method (CaB), Super-C (Sc), and Orthon (Or), and of the glass ionomer cement Ketac-Cem (KC). The fracture surfaces after debonding were also examined in order to determine the sites of failure. The results indicate that there is a significant difference between the shear bond strength obtained with the different adhesives so that the mean shear bond strength decreases in the order [Ro approximately Cab approximately Sc] > [LiB approximately RaB approximately Cc] > Or > KC. Moreover, for Cab and Sc it was found that the shear bond strength varies depending on the location on the bovine tooth. The failure site was essentially at the resin-bracket interface, except for Concise, where only 50 per cent of the cases failed at the resin-bracket interface.

Adhesives↗
PubMedDate not supplied

Moving from a culture of blame to a culture of safety in the nursing home setting.

TOPIC: A culture of safety. PURPOSE: To explore the current culture of blame and what organizational elements must be impacted to move toward a culture of safety in the nursing home setting. METHODS: A mixed-method approach incorporating a case study and staff member survey results were used to explicate the organizational elements impacting the current nursing home culture. CONCLUSION: Nurse leaders can create an environment in which every member of the team feels a responsibility and an ability to insure that residents are safe by improving communication and participation in decision making.

Attitude of Health Personnel↗
PubMed2004

The promise of occupational science: a developmental assessment of an emerging academic discipline.

BACKGROUND: In the late 1980's, occupational science was introduced as a basic discipline that would provide a foundation for occupational therapy. As occupational science grows and develops, some question its relationship to occupational therapy and criticize the direction and extent of its growth and development. PURPOSE: This study was designed to describe and critically analyze the growth and development of occupational science and characterize how this has shaped its current status and relationship to occupational therapy. METHOD: Using a mixed methods design, 54 occupational science documents published in the years 1990 and 2000 were critically analyzed to describe changes in the discipline between two points in time. Data describing a range of variables related to authorship, publication source, stated goals for occupational science and type of research were collected. RESULTS: Descriptive statistics, themes and future directions are presented and discussed. PRACTICE IMPLICATIONS: Through the support of a discipline that is dedicated to the pursuit of a full understanding of occupation, occupational therapy will help to create a new and complex body of knowledge concerning occupation. However, occupational therapy must continue to make decisions about how knowledge produced within occupational science and other disciplines can be best used in practice.

Authorship↗
PubMedDate not supplied

Helping other mothers effectively work at raising young children with type 1 diabetes.

PURPOSE: This study examined the feasibility of a postdiagnosis parent mentoring intervention for mothers of young children (1-10 years old) newly diagnosed with type 1 diabetes. METHODS: A mixed-method, prospective, randomized, controlled clinical trial design was used. Parent mentors (experienced mothers who have successfully raised young children with type 1 diabetes) and mother participants with young children newly diagnosed with type 1 diabetes were recruited from 2 regional pediatric diabetes centers. The mentors were trained to provide informational, affirmational, and emotional support using Ireys' modified parent mentor curriculum. During a 6-month trial, mentors provided home visits and phone call support to the mothers who were randomized to the experimental group. The control group had the option of receiving the intervention after the 6-month trial. RESULTS: Mothers in the experimental group had fewer concerns, more confidence, identified more resources, and perceived diabetes having less of a negative impact on their family compared with mothers in the control group. Parent mentors provided important, practical day-to-day management information, reassurance, and emotional support during times of crises. CONCLUSIONS: A postdiagnosis parent mentoring intervention for mothers of children with diabetes appears to be feasible and potentially effective.

Child↗
PubMedDate not supplied

The art and complexity of primary care clinicians' preventive counseling decisions: obesity as a case study.

PURPOSE: Studies have often shown low rates of preventive counseling in primary care, and interventions aimed at improving counseling rates have had disappointing results. Using obesity as a case study, we looked for factors that influence clinicians' decisions to include preventive counseling in the brief primary care encounter. METHODS: A sequential, mixed methods study was conducted among clinicians in RIOS (Research Involving Outpatient Settings) Net, a Southwestern US practice-based research network. Thirty primary care clinicians participated in in-depth interviews or analytic focus groups, and 75% of 195 network members responded to a survey used to estimate the frequency of factors influencing decisions to undertake preventive counseling. RESULTS: Clinicians described a complex set of factors that influence decisions to provide preventive counseling for obesity. These can be grouped into 2 sets of factors: (1) relatively stable factors that "set the stage" for the encounter, such as the clinician's life values, definitions of success, and the availability of community resources; and (2) factors that are more dynamic, exerting their influence "as the door opens" into the examination room. These factors include the patient's agenda and receptivity to the proposed counseling, as well as the presence of teachable moments. Clinician, patient, and external factors are found in both groups. CONCLUSIONS: Clinician decisions to include obesity and other types of preventive counseling in the brief encounter reflect the art and complexity of management of the encounter. Future efforts to enhance the delivery of preventive counseling will need to move beyond linear models of behavior change to recognize this complex environment.

Adult↗
PubMed2004

An evaluation of a multidisciplinary team for intermediate care at home.

BACKGROUND: The implementation of the National Health Service Plan for the UK will see an expansion of services for intermediate care. Such services are usually targeted at older people and aim to: prevent 'avoidable' admissions to acute inpatient care; facilitate the timely discharge of patients from acute inpatient care; promote patient rehabilitation. A range of services might fall under the banner of intermediate care. They are usually delivered in patients' homes or in non-acute institutions. This paper describes an evaluation of a multidisciplinary Rapid Response Team (RRT). This service aimed to provide a home based alternative to care previously provided in an acute hospital bed which was acceptable to patients and carers and which maintained clinical care standards. The service was provided for the population of Hereford, a rural town in the middle of England. METHODS: A mixed-method descriptive design using quantitative and qualitative techniques was used to monitor: the characteristics of service users, the types and amounts of care received, any 'adverse' events arising from that care, and the acceptability of the service to patients and carers. A collaborative approach involving key stakeholders allowed appropriate data to be gathered from patient case notes, RRT staff, local health and social care providers, and patients and their carers. A suite of self-completed questionnaires was, therefore, designed to capture study data on patients and activities of care, and workshops and semi-structured interview schedules used to obtain feedback from users and stakeholders. RESULTS: Service users (231) were elderly (mean age 75.9), from three main diagnostic categories (respiratory conditions 19.0%, heart/stroke 16.2%, falls 13.4%), with the majority (57.0%) having both medical and social care needs. All patients received care at home (mean duration 5.6 days) with only 5.7% of patients having to be re-admitted to acute care. Overall, patients and carers had positive attitudes to the new service but some expressed concerns about their ability to influence the choice of care option (24.1% and 25.0% of patients and carers, respectively), whilst 22.7% of carers were concerned about the quality of information about care. CONCLUSIONS: Both the nature of schemes for intermediate care, and the policy context in which they are introduced, mean that pragmatic methodologies are often required to evaluate their impacts. Unfortunately, this need for pragmatism can then mean that it is difficult to reach definitive conclusions about the merits of schemes. However, the findings of this evaluation suggest that the Rapid Response Team provided an 'acceptable' alternative to an extended period of care in an acute setting. Such schemes may have relevance beyond the NHS of the UK as a means of providing a more appropriate and cost efficient match between patients' needs for care, the types of care provided, and the place in which care is provided.

Journal Article↗
PubMedDate not supplied

Comparison of three nonradiographic methods of mixed dentition analysis in cleft lip and palate patients.

PURPOSE: The purpose of this study was to investigate whether the application of mixed dentition analyses in cleft lip and palate patients differed from noncleft patients and to investigate which method provided the most accurate prediction in cleft lip and palate patients. METHODS: Study casts of 30 cleft lip and palate patients and 30 noncleft patients were used in this study. Each patient had dental casts at two stages of dental development. The methods compared included the Moyers, the Tanaka & Johnston (T/J) and the Boston University (BU) prediction methods. RESULTS: Analyses for both groups indicated that the predicted values yielded by each method were significantly different from one another but were all significantly correlated with actual tooth size. Moyers 50% and BU had the smallest mean difference values and no significant difference between the predicted and actual values for both cleft and noncleft control groups. CONCLUSIONS: Types of cleft had no effect on the size of the mandibular permanent canines and premolars. The application of mixed dentition analyses in cleft lip and palate patients does not differ from noncleft patients. Both Moyers 50% and the BU method have high accuracy and correlation in prediction of unerupted teeth in both groups.

Age Factors↗
PubMed1982

[Quantitative morphologic examination of the vesicle population of mixed synapses--method and significance].

Quantitative electron microscopic investigations have been performed regarding the population of clear round vesicles within the axosomatic mixed contacts between secondary vestibular and oculomotor neurons of the trout. The measurements are based on a subdivision of the axon terminal area into single fields which topographically belong to different synaptic types (active zone, gap junction) of this mixed contact. Furthermore, areas between active zones and gap junctions ("intermediate zones") and areas along the lateral membranes of the axon terminal ("border zones") have been analyzed. The following vesicle parameters have been estimated stereologically: volume density (Vvv), surface density (Svv), numerical vesicle density (Nvv) mean vesicle volume (Vv) and mean vesicle surface (Sv). In this connection, aspects of the homogeneous distribution, of number and size of the organelles hae been investigated. The results obtained show a characteristic distribution in number and size of vesicles inthe presynaptic areas of the different membrane specializations of this mixed synapses. The results further indicate that two different pools of clear round vesicles exist in this mixed synapse, clear synaptic vesicles for chemical transmission and gap junction vesicles. In relation to the synaptic vesicles, a recycling mechanism is suggested. Gap-junction vesicles may function as Ca++ transport organelles to regulate gap junction permeability. A possible role in trophic tasks of the gap junction is also discussed.

Animals↗
PubMed2005

Combining sources in stable isotope mixing models: alternative methods.

Stable isotope mixing models are often used to quantify source contributions to a mixture. Examples include pollution source identification; trophic web studies; analysis of water sources for soils, plants; or water bodies, and many others. A common problem is having too many sources to allow a unique solution. We discuss two alternative procedures for addressing this problem. One option is a priori to combine sources with similar signatures so the number of sources is small enough to provide a unique solution. Aggregation should be considered only when isotopic signatures of clustered sources are not significantly different, and sources are related so the combined source group has some functional significance. For example, in a food web analysis, lumping several species within a trophic guild allows more interpretable results than lumping disparate food sources, even if they have similar isotopic signatures. One result of combining mixing model sources is increased uncertainty of the combined end-member isotopic signatures and consequently the source contribution estimates; this effect can be quantified using the IsoError model (http://www.epa.gov/wed/pages/models/isotopes/isoerror1_04.htm). As an alternative to lumping sources before a mixing analysis, the IsoSource mixing model (http://www.epa.gov/wed/pages/models/isosource/isosource.htm) can be used to find all feasible solutions of source contributions consistent with isotopic mass balance. While ranges of feasible contributions for each individual source can often be quite broad, contributions from functionally related groups of sources can be summed a posteriori, producing a range of solutions for the aggregate source that may be considerably narrower. A paleo-human dietary analysis example illustrates this method, which involves a terrestrial meat food source, a combination of three terrestrial plant foods, and a combination of three marine foods. In this case, a posteriori aggregation of sources allowed strong conclusions about temporal shifts in marine versus terrestrial diets that would not have otherwise been discerned.

Algorithms↗
PubMedDate not supplied

Natural family planning with and without barrier method use in the fertile phase: efficacy in relation to sexual behavior: a German prospective long-term study.

A large prospective long-term study with users of natural family planning (NFP) methods has been conducted to analyze the relation between unintended pregnancy rates and sexual behavior with special reference to barrier method use in the fertile phase. Seven hundred and fifty eight NFP beginners, 19-45 years of age, 14870 cycles, 28 unintended pregnancies were studied. Of the couples, 54.2% use NFP only or predominantly and 45.9% use mixed methods (additional barrier method use in the fertile phase in 55.7% of the cycles). The overall pregnancy rate after 12 cycles of exposure is 2.2% according to the actuarial method. There is no significant difference between NFP users and mixed methods users and also no significant effect of duration of use in the first 5 years of exposure. During "perfect use" the pregnancy rate at 12 months is 0.63%. When only protected intercourse takes place in the fertile phase the pregnancy rate is 0.45%. The symptothermal method of NFP is most unforgiving for imperfect use (unprotected intercourse in the fertile phase). However, it is extremely effective when either abstinence or protected intercourse is used in the fertile phase.

Adult↗
PubMedDate not supplied

Studies on the applicability of tamarind kernel powder as a carrier in the dissolution enhancement of poorly water soluble drug, celecoxib.

In the present investigation, tamarind kernel powder (TP) was evaluated for its suitability as a carrier to improve the dissolution rate of poorly water-soluble drug, celecoxib (CC). The influence of polysaccharide concentration and method of preparation of solid mixtures on dissolution rate was investigated. Solid mixtures of CC and TP were prepared in different ratios (1:1, 1:4 & 1:9 w/w, CC:TP) using co-grinding technique to test the effect of polysac-charide concentration. Four different methods namely (i) physical mixing method (ii) co-grinding method (iii) kneading method and (iv) solvent deposition method were used to assess the effect of method of preparation. Solid mixtures were characterized by Differential Scanning Calorimetry (DSC), X-ray Diffraction (XRD) studies and solubility studies. Dissolution rate of CC was increased as the TP concentration increased and optimum weight ratio was found to be 1:4 (CC:TP). It was found that method of preparation of solid mixtures significantly effected the dissolution rate of CC from solid mixtures. The order of products basing on dissolution efficency is solvent deposition > co-grinding > kneading > physical mixing > pure CC. Among all the methods, though the solvent deposition technique improved the dissolution rate to maximum, co-grinding technique was found to be suitable from practical point of view and commercialization.

Calorimetry, Differential Scanning↗
PubMed1989

Contraceptive method choice in the Philippines, 1973-83.

Contraceptive use and method mix were analysed using Philippines national survey data of 1973, 1978, and 1983. The analyses suggest that the reported decline in contraceptive prevalence between 1978 and 1983 was due to under-reporting of use in 1973 and 1983. The shifts in contraceptive method mix were also partly from under-reporting of rhythm and other methods in 1973 and 1983. Nevertheless, the determinants of method choice were similar in all three sets of data. Filipino couples were making rational choices in terms of their contraceptive goals, access, evaluation, and competence. Modifications in the directions and magnitude of the relationships in determining method choice also occurred, partly reflecting the increased use of sterilization by older, higher parity women.

Adult↗
PubMedDate not supplied

A comparison of the performance of male and female CBD distributors in Peru.

This report presents the results of an operations research project to increase male involvement in family planning in Peru. Two community-based distribution (CBD) programs, PROFAMILIA of Lima and CENPROF of Trujillo, Peru, recruited male contraceptive distributors and compared their performance to that of female distributors recruited at the same time. Both programs found it harder to recruit men than women as distributors. Program supervisors, who were women, were less comfortable with men than with other women, even though there were no differences in distributor compliance with program norms. Male distributors were more likely to serve male clients and sell male methods (condoms), while female distributors were more likely to serve female clients and sell female methods (pills). Men sold as much or more total couple-years of protection than did women, and they recruited as many or more new acceptors. Gender was found to exert an impact on method mix independent of other distributor characteristics, such as age, education, marital status, and number of living children. The study suggests that family planning programs can influence method mix and client characteristics by recruiting men as CBD distributors.

Contraceptive Devices, Male↗
PubMedDate not supplied

A suggested method for mixing direct filling restorative gallium alloy.

Good wettability is one of the desirable physical properties of mercury-free gallium-based alloys (Gallium Alloy GF). However, wettability, while providing good adhesion to the cavity wall, has the adverse effect of causing stickiness to the inside of the capsule during mixing, and also to the metal hand instruments used for packing. To control this stickiness the alloy mixture was treated with a small amount of alcohol using two different methods. In both groups (alcohol-added and alcohol-treated groups), 5, 10, or 15 microliters of alcohol was added. However, for the alcohol-treated group, the alcohol was shaken from the mixture. In both groups, remarkable improvement was seen in their handling properties, for the alloy mixture did not adhere to the inside of the capsule and was easily taken out as one mass. Compressive strength, tensile strength, and creep were tested in the alcohol-added/-treated groups, and compared with those of a control (conventionally mixed gallium alloy) and a high-copper amalgam (Spherical-D). All tests were done according to ISO 1559 (International Organization for Standardization, 1986), and the results were analyzed using one-way ANOVA (Duncan, P < 0.05). Surface microhardness (KHN) and dimensional change during hardening were evaluated according to ISO 1559 and compared to the control results. In mixing Gallium Alloy GF, an addition of less than 5 microliters of alcohol had the effect of preventing the alloy mixture from sticking to the inside of the capsule and remarkably enhanced the handling properties. This suggested mixing technique did not alter either the mechanical properties tested for this material or the desirable dimensional expansion that occurs during hardening.

Alloys↗
PubMed2026

Advancing nursing education through social and emotional learning: A systematic review guided by the Collaborative for Academic, Social, and Emotional Learning framework.

BACKGROUND: With Generation Z entering the nursing workforce in growing numbers, strengthening social and emotional learning is critical for academic success, professional adaptation, and safe practice. However, the existing evidence remains fragmented because of varied interventions and inconsistent approaches. OBJECTIVES: This systematic review examined (1) the social and emotional learning essential for nursing students and nurses within the Collaborative for Academic, Social, and Emotional Learning framework, (2) their impact on educational and clinical outcomes, and (3) implications for advancing nursing education and practice. METHODS: Following Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, five international (PubMed, EMBASE, CINAHL, PsycINFO, Cochrane) and three Korean (RISS, KoreaMed, KMBASE) databases were searched up to June 2025. Eighteen studies involving 2,952 participants met the inclusion criteria, including quasi-experimental quantitative studies, descriptive quantitative studies, qualitative studies, and mixed-methods studies. The methodological quality of the included studies was appraised using the Mixed Methods Appraisal Tool. RESULTS: Within the Collaborative for Academic, Social, and Emotional Learning framework, relationship skills and self-management were the most frequently studied competencies, emphasizing teamwork, communication, and stress regulation. Self-awareness and social awareness were underexplored, despite their importance in empathy, resilience, and reflective practice. Responsible decision-making was the least studied competency, despite its importance in ethical reasoning. Social and emotional learning was consistently associated with enhanced adaptation, communication, leadership, relationships, and clinical performance. Effective strategies included blended learning, simulation, reflective activities, and mentorship, which are aligned with Generation Z's learning preferences. CONCLUSION: Although social and emotional learning integration is associated with improvements in educational and clinical outcomes in nursing, current research has largely centered on relational and stress-related competencies while underrepresenting responsible decision-making. To cultivate reflective, empathetic, and ethically grounded nurses, curricula should integrate social and emotional learning through a balanced and structured approach. REGISTRATION: This study was registered on PROSPERO (ID: CRD420251005683).

Humans↗