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Results for “provisioning behaviour”

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At least 235 records · Page 13Linked to original sources

PubMed1996

Patterns of help-seeking behaviour for toddlers from two contrasting socio-economic groups: new evidence on a neglected topic.

OBJECTIVE: This descriptive study aimed to assess patterns in help-seeking behaviour for common childhood symptoms. METHOD: Clinic attenders aged 9-18 months of two child health clinics on Tyneside, UK, one with substantial economic deprivation, were studied. Outcome measures were parental reporting of common symptoms, utilization of professional advice and general practitioner records of consultations. RESULTS: Children in the affluent area had had fewer general practitioner consultations (mean 7.3) than those in the poorer area (mean 15.1; 95% CI for difference 4.3-11.4). They were less likely to present with an episode of diarrhoea or cold but were as likely as the poorer group to present with fever. Behaviour problems were reported less frequently (23% versus 47%), but if present, this was far more likely to result in help seeking than in the poorer group (86% versus 33%; P < 0.05). CONCLUSIONS: Variations in help-seeking behaviour between two economically contrasting groups were identified; this has implications for clinical understanding and service provision in primary care.

Chi-Square Distribution↗

PubMed2006

Spectators & spectacles: nurses, midwives and visuality.

AIM: In this paper we reflect on how linear perspective vision influences the practice of nurses and midwives and to advance understanding of clinical practice in technologically intensive environments through examination of drawings by nurses and midwives and through critical analysis. BACKGROUND: There is increasing emphasis on vision in Western culture, and both nurses and midwives spend a great deal of time observing their clinical environment(s). Healthcare practitioners work increasingly in image-based realities and nurses rely on visual skills. Vision and visual representation are central to our practice and are important to examine because we look often at technology to assess people and care. DISCUSSION: The world in which we practise is one of meaning(s). Technological development is transformative in nature and produces changes that alter the way(s) we give care. Amongst all this change, it is unclear how we practise in environments characterized by increasing technology and it is unknown how nursing and midwifery practice alter as a result. CONCLUSION: Simple drawings included in this paper highlight an important and shared experience of clinical practice(s). They emphasize the importance and scope of the visual sense and expose practitioner behaviour that has enormous implications for current and future professional development and person-focussed care provision. Experiences described in this paper require further examination and highlight substantial changes to nurse-patient relationships, health care and the way we practise.

Attitude of Health Personnel↗

PubMed1994

Food-purchasing behaviour in an Aboriginal community. 2. Evaluation of an intervention aimed at children.

The previously described survey of food-purchasing behaviour in a central-Australian Aboriginal community demonstrated that children have sufficient disposable income to provision themselves directly from food outlets. Subsequently, a community-based intervention project developed strategies to provide healthier choices for these children. Two years after the initial survey, a follow-up survey was conducted in which all food purchases by children under the age of 15 in the community were recorded over a two-week period. The results demonstrate an improvement in the quality of foods and beverages purchased by children at the time of the second survey.

Adolescent↗

PubMed2004

Almost the real thing.

Simulation training offers tuition that is constructive, realistic and highly participatory, and by representing believable working environments, simulators are ideal for undertaking technical and behavioural training, for individuals, small groups or entire teams. With current government led changes in healthcare provision such as implementing the European working time directive (DoH 2003), healthcare training opportunities with real patients are likely to become scarcer. The challenge will then be to train skilled, knowledgeable and proficient individuals in other ways. Simulation centres should offer part of the solution.

Education, Nursing↗

PubMed2000

The sexual activity of 654 fourth form Hawkes Bay students.

AIMS: To describe the self reported patterns of sexual behaviour of 4th form High School Students from the Hawkes Bay region of New Zealand, in 1998. METHODS: Subjects completed a self administered written anonymous questionnaire in a supervised classroom situation. RESULTS: 654 4th form students, median age fourteen years, completed the questionnaire--45% male, 54% female. 39.4% of the sample reported having had sex/intercourse. Maori students were nearly three times (74.9%) as likely as European students (26.7%) to be sexually active (p < 0.0001). 20.1% of these sexually active 4th formers report more than five partners. 11.9% of the total group and 30.2% of those who are sexually active, reported having first sex at age 12 or younger. CONCLUSIONS: The sexual activity of this sample of 4th form students is higher than reported previously in New Zealand, particularly so for Maori. Further research is needed to examine sexual behaviours and attitudes of young New Zealanders in the different communities to enhance the development and provision of geographically and culturally appropriate early sexuality education programmes and services. These should be designed to have particular relevance to the needs of young Maori.

Adolescent↗

PubMed1998

Accreditation manual for nephrology.

The IRS did not develop a new theory of accreditation but drew up a methodology for assessing public policies, which internalised accreditation philosophy and was based on a theory of the decision-making process. Two questions underlie this theory: 1) whether health is a professional organisation, a company or a public policy, 2) whether accreditation in the internationally accepted meaning of the term is the most effective system of continuous improvement for this sector as it is organised in Italy. According to the IRS, health is all three of these things and accreditation responds adequately to the complexity of the sector. In fact: a) internalises professional knowledge (and is therefore ideal for a professional organisation); b) it triggers a process of continuous improvement of the product/service supplied (and that is ideal for a company that must maintain the competitiveness of its product/service as high as possible); c) it uses a methodology which highlights the mechanisms of interaction between the actors (a methodology underlying decision making theory where there are actors who decide, knowing that they have to find a consensus and who exchange resources in a virtuous circle. The principal qualitative element identified by the IRS methodology was the internalisation by the health system of patients' expectations and patients' satisfaction in the welfare process. The main feature of the accreditation methodology designed by the IRS is that the assessment focuses neither on structures (which would have been useful to measure the degree of reliability) nor on the compilation of behaviour guidelines, but is centred on the assessment of a function, on the quality of the provision of a specialist health service. The decision to assess a specialist function (e.g. nephrology) and not a structure (e.g. a nephrology department or a hospital) gives maximum importance to the figure of the professional.

Accreditation↗

PubMed2006

[Provision of smoking cessation therapy].

INTRODUCTION: Smoking cessation therapies help well motivated smokers give up and increase the chance of success. BACKGROUND: Medical, behavioural and cognitive cessation therapies are aimed at relieving the secondary effects of stopping smoking: withdrawal symptoms and the urgent need to smoke. A prolonged follow up helps to prevent relapse. VIEWPOINT: The education of doctors and the development of new drugs should increase the rate of successful withdrawal. CONCLUSION: All doctors, particularly respiratory physicians, should be involved in smoking cessation. The aim of this practical guide is to help them in everyday practice.

Humans↗

PubMed2000

Interventions for encouraging sexual lifestyles and behaviours intended to prevent cervical cancer.

BACKGROUND: Cervical cancer is one of the most common cancers affecting women world-wide. Prevention falls into two main categories - primary and secondary. Primary prevention is characterised by health promotion to promote lifestyles and behaviours minimising risk of cervical cancer. Interventions to promote the use of condoms for sexual intercourse (especially early intercourse amongst young women), sexual partner reduction, and negotiated safer sex strategies has been recommended as one approach to limit the spread of Human Papilloma Virus (HPV), one of the major risk factors for cervical cancer. OBJECTIVES: To determine the effectiveness of health education interventions to promote sexual risk reduction behaviours amongst women in order to reduce transmission of HPV. SEARCH STRATEGY: Electronic searching of EMBASE, ERIC, MEDLINE, PsycLIT, Social Science Citation Index and the CCTR were undertaken using a highly sensitive search strategy. Hand-searching took place of selected journals and reference lists. SELECTION CRITERIA: Studies were included if they evaluated educational interventions targeting women only, and measured the impact on : either a behavioural outcome such as condom use for sexual intercourse, partner reduction, or abstinence; or a clinical outcome such as incidence of a sexually transmitted disease (STD). DATA COLLECTION AND ANALYSIS: Data were extracted and methodological quality was assessed independently by two reviewers and any discrepancies were resolved between them. Ten per cent of the total number of studies were reviewed additionally by a third reviewer as a quality check and differences in judgement were resolved accordingly. MAIN RESULTS: Thirty trials met the inclusion criteria for the review. All of them had the primary aim of preventing HIV and other STDs rather than cervical cancer. Four core methodological qualities were present in 10 of the 30 studies and constitute the subset from which potentially reliable conclusions may be drawn. Each of the 10 studies showed a statistically significant positive effect on sexual risk reduction, typically with increased use of condoms for vaginal intercourse. This positive effect was generally sustained up to three months after intervention. REVIEWER'S CONCLUSIONS: Educational interventions targeting socially and economically disadvantaged women in which information provision is complemented by sexual negotiation skill development can encourage at least short-term sexual risk reduction behaviour. This has the potential to reduce the transmission of HPV, thus possibly reduce the incidence of cervical carcinoma.

Female↗

PubMed2001

Neurodevelopmental status at 1 year predicts neuropsychiatric outcome at 14-15 years of age in very preterm infants.

BACKGROUND: Neurodevelopmental and behavioural problems have been repeatedly reported in very preterm survivors, often showing themselves later in childhood as poor school performance. Early identification of problems would mean that appropriate remedial therapy can be implemented. We have previously shown that neurodevelopmental status at 1 year was predictive of outcome at 8 years in a cohort of preterm infants. The aim of this paper was to see if neurodevelopmental outcome in adolescence could be predicted by assessment by 1 year in the same cohort of preterm infants. STUDY DESIGN: Prospective cohort study. SUBJECTS: 150 adolescents, born before 33 weeks gestation. OUTCOME MEASURES: Neurological examination, developmental quotient, vision and hearing by 1 year. At 14-15 years, neurological examination, school performance questionnaire, Schonnell test of reading age, a premorbid adjustment score, Rutter behavioural score and for those born from 1981, cognitive tests (WISC-R). RESULTS: A highly significant relationship existed between neurological status by 1 year and the need for extra educational provision, overall neurodevelopmental status, cognitive function in those that had their IQs measured and premorbid adjustment score of prepsychotic symptoms in adolescence. However, status at 1 year was not predictive of adolescent reading age or behavioural score. CONCLUSIONS: Neurodevelopmental assessment at 1 year is predictive of school performance and outcome in the adolescent period.

Adolescent↗

PubMed2001

Financial cost of social exclusion: follow up study of antisocial children into adulthood.

OBJECTIVES: To compare the cumulative costs of public services used through to adulthood by individuals with three levels of antisocial behaviour in childhood. DESIGN: Costs applied to data of 10 year old children from the inner London longitudinal study selectively followed up to adulthood. SETTING: Inner London borough. PARTICIPANTS: 142 individuals divided into three groups in childhood: no problems, conduct problems, and conduct disorder. MAIN OUTCOME MEASURES: Costs in 1998 prices for public services (excluding private, voluntary agency, indirect, and personal costs) used over and above basic universal provision. RESULTS: By age 28, costs for individuals with conduct disorder were 10.0 times higher than for those with no problems (95% confidence interval of bootstrap ratio 3.6 to 20.9) and 3.5 times higher than for those with conduct problems (1.7 to 6.2). Mean individual total costs were 70 019 pounds sterling for the conduct disorder group (bootstrap mean difference from no problem group 62 pound sterling; 898 pound sterling 22 692 pound sterling to 117 pound sterling) and 24 324 pound sterling (16 707 pound sterling; 6594 pound sterling to 28 149 pound sterling) for the conduct problem group, compared with 7423 pound sterling for the no problem group. In all groups crime incurred the greatest cost, followed by extra educational provision, foster and residential care, and state benefits; health costs were smaller. Parental social class had a relatively small effect on antisocial behaviour, and although substantial independent contributions came from being male, having a low reading age, and attending more than two primary schools, conduct disorder still predicted the greatest cost. CONCLUSIONS: Antisocial behaviour in childhood is a major predictor of how much an individual will cost society. The cost is large and falls on many agencies, yet few agencies contribute to prevention, which could be cost effective.

Child↗

PubMed2003

Methods for studying private sector supply of public health products in developing countries: a conceptual framework and review.

The private sector is an important supplier of public health products (PHPs) in developing countries. Although there are concerns about the quality and affordability of these products, private providers also offer possibilities for expanding access to key commodities. This paper proposes a conceptual framework for understanding the public health implications of private sales of PHPs. It reviews methods for studying these sales, together with their advantages and shortcomings. Ten methods are identified which can be used for studying the behaviour of providers and consumers. The effects of seasonal variation are discussed, together with the challenges of creating a sampling frame and studying illicit behaviour. We conclude that relatively little is known about the sales of PHPs, that more is known about contraceptives and drugs than about the newer products, and that the demand side of the market has been studied in greater depth than the behaviour of suppliers. The existing toolbox is biased towards formal providers, and thus, probably towards understanding the provision of PHPs to those who are better off. Methods for studying the supply of PHPs in outlets used by poor people is a priority area for further methodological development.

Commerce↗

PubMed2006

Regional differences in injecting practices and other substance use-related behaviour among entrants into opioid maintenance pharmacotherapy treatment in New South Wales, Australia.

BACKGROUND: Investigations of injecting drug users (IDUs) have been conducted largely in urban areas. Those studies that compare rural and urban IDUs often utilise small and possibly unrepresentative samples. AIM: To investigate regional differences in the characteristics of IDUs. METHODS: The study compared the demographic, drug use-related, and treatment characteristics of 1045 urban, 213 regional, and 254 rural opioid maintenance pharmacotherapy (OMP) treatment entrants recruited as part of a feasibility study into the implementation of a state-based treatment outcome monitoring system. RESULTS: Participants from regional and rural New South Wales (NSW) were significantly more likely to report sharing of needles and other injection equipment and higher non-opioid drug use and polydrug use than their urban counterparts. In addition, they were more likely to be living with dependent children, to be unemployed, and to be experiencing greater psychological problems than their urban counterparts. Needle sharing also was independently associated with being younger, female, having been arrested, or having non-opioid drugs of concern. CONCLUSIONS: Reasons for the higher rates of blood-borne virus (BBV) transmission risk-related behaviour among rural and regional IDUs should be investigated further and considered when planning for the targeted provision of harm reduction activities.

Adolescent↗

PubMed2002

Dementia: an update to refresh your memory.

The number of people with dementia and cognitive impairment is predicted to rise exponentially in the future. The increasing awareness of dementia in the community has led to a better understanding of the impact of this condition on individuals, their families and their carers. There is burgeoning research in the pathogenesis of dementia, and advances have been made in pharmacological treatments for the management of symptoms, including behavioural and psychological disturbances. However, the mainstay of management rests in comprehensive clinical assessment, education, counselling and provision of support for those affected and their families. The present paper provides a clinical update on recent advances in diagnosis and management of the most common forms of dementia.

Alzheimer Disease↗

PubMed2005

Age related trends in the incidence of endometrial cancer in South East England 1962-1997.

Important population demographic changes have occurred over the last 50 years in the UK. Birth rates have fallen, obesity rates have increased and there has been an increase in the use of reproductive hormones, factors which may influence the epidemiology of endometrial cancer. We analysed the age-related trends in the incidence of endometrial cancer in South East England between 1962 and 1997 to determine if there was a correlation with the population demographic changes over this time period. We undertook a retrospective review of systematically collected data, looking specifically at the change in overall incidence of endometrial cancer and the age-related incidence for each five year group from 25 to 85 + years. The overall incidence of endometrial cancer remained unchanged over the 35-year study period. In women aged 35-54 years there was a decrease in incidence of endometrial cancer and this was significant in the 40-45 year age group. The study also revealed a statistically significant increase in incidence of endometrial cancer in women aged over 65 years with a greater rate of increase in older women, particularly those aged over 85. Thus, there is evidence from this study of significant changes in the age-related incidence of endometrial cancer in the 35-year study period that may be explained by alterations in life style and behaviour. The increased incidence in women aged 85 and over have potential implications for the planning and provision of cancer services in the future.

Adult↗

PubMed2006

Sexual health education for people with mental health problems: what can we learn from the literature?

Research into sexual risk behaviour among people with 'severe' mental health problems suggested that they are likely to engage in high-risk sexual behaviour, for a number of reasons, putting them at risk of sexually transmitted diseases. The aim of this review is to describe approaches, content and outcomes of sexual health education programmes, developed and implemented for people with mental health problems. A literature review from 1980 to 2005 was carried out using the electronic databases CINAHL, PsycINFO, British Nursing Index, Pubmed and Medline, and the Cochrane library was also searched. The literature search was confined to papers written in English. The keywords 'sexuality', 'sexual health education', 'sexual health promotion', 'HIV', 'sexually transmitted disease' were combined with 'mental illness', 'chronic mental illness''severe mental illness''persistent mental illness''psychiatry', 'mental disorder', 'education interventions' and 'evaluation'. A vast amount of literature was recovered on sexual risk behaviour in people with severe mental health problems, and sexual dysfunction as a result of prescribed medication. As the focus of the review was on sexual health education, this literature was omitted. Although the literature on sexual health education for people experiencing mental health problems was sparse, 14 studies were located that either described or evaluated sexual health education programmes. Most sex education programmes focused on topics such as HIV and other sexually transmitted diseases, negotiating safe sex and skill development in condom use. Findings suggested that the people who attended benefited from sexual health education programmes, facilitated in a sensitive and supportive manner. Education tended to produce a reduction in sexual risk behaviour as opposed to complete cessation. Nevertheless, it is appropriate to consider integrating such education with service provision. The results of the review provide guidance to service providers and mental health nurses wishing to develop and evaluate sexual health education programmes for service users. Areas for future research are also identified.

Attitude to Health↗

PubMed1996

Can child fatalities in house fires be prevented?

OBJECTIVES: To analyse all child deaths in house fires in Scotland between 1980 and 1990. METHODS: Retrospective study of all child house fire fatalities based on the 'sudden death' investigation instigated by the procurator fiscal in whose jurisdiction the death occurred. The necropsy, toxicology, police, and fire brigade reports were examined in each case. RESULTS: There were 168 child deaths occurring in 118 house fires. In the 0-5 years age group 40% of deaths occurred in fires started as a direct result of the actions of children. The careless disposal of smoking materials was the most frequent cause of fatal fires killing older children. Upholstery and bedding were common materials of first ignition, accounting for over half the incidents. The majority of children were dead before the arrival of the emergency services and most died as a result of the inhalation of smoke. CONCLUSIONS: This survey emphasises the importance of 'self escape' which, particularly in the case of young children, requires the assistance of adult carers. The number of fires started as a result of children playing with sources of ignition raises important questions of supervision and the provision of a safe environment. There is, we contend, a need to highlight the importance of individual behaviour and responsibility while recognising the need to develop measures that are relevant to, and effective in, a particular socioeconomic context.

Adult↗

PubMed2004

[The role of the Order of Veterinarians in the quality control of private veterinarians in France].

Instituted by the law of 23 August 1947, the missions of the Order of Veterinarians include monitoring compliance by all of its members (private veterinarians) with their professional obligations and with the rules laid down bythe Code of Practice of the profession. This code provides a national guide to good practice with which private veterinarians must comply, both in their personal behaviour and in their relations with their colleagues, the administration and their partners. Any violation of the provisions of the Code may result in disciplinary procedures being invoked by the administrative and judiciary authorities, or by any other interested person. This procedure leads to sanctions ranging from a warning to ten years suspension. In order to carry out its monitoring task, the Order needs to know the precise number and quality of its members and must then assess the quality of the service provided by these professionals in terms of respect for the Code of Practice. The Order must audit the competence of veterinarians, throughout their lives, by means of a continuing quality assurance mechanism for ongoing assessment of their knowledge; this mechanism has yet to be created. Finally, the Order must constantly listen to users of the profession, who must be provided with the best service at the lowest cost.

Animals↗

PubMed2005

Injections--how safe.

Injection, is a skin-piercing event performed by a syringe and needle with the purpose of introducing a curative substance or vaccine in a patient. According to WHO, safe injection is one which does not harm to the recepient, does not expose the health worker to any risk and does not result in waste that is dangerous for the community. To achieve this injection should be prepared on a clean workspace, provider should clean his hands appropriately, sterility of the syringe and needle to be maintained, skin of the recipient should be cleaned and above all sharps waste should be managed appropriately. Common danger of unsafe injection is infection. Most medication used in primary care can be administered orally. So firstly the behaviour of healthcare providers and patients must be changed so as to decrease overuse of injections, secondly provision of sufficient quantities of appropriate injection equipment and infection control supplies should be made available and thirdly a sharp waste management system should be set up.

Blood-Borne Pathogens↗