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At least 613 records · Page 34Linked to original sources
PubMed1994

Pediatric clerkship performance in diverse community clinical settings.

OBJECTIVE: To determine whether multiple and diverse clinical settings and resources in a pediatric clerkship result in satisfactory performance by medical students and affect their choice of a pediatric residency after graduation. DESIGN: Retrospective study 1985 through 1990. SETTING: Medical students in a pediatric clerkship in a medical school that is part of a land grant university where the clinical curriculum is conducted in six geographically distinct communities. MAIN OUTCOME MEASURE: (1) Three performance criteria including: multiple choice final examination score, clinical performance evaluations by preceptors, and formal evaluation of patient written records. (2) Students matching with a pediatric or combined internal medicine/pediatric residency. RESULTS: Of 499 students 92.8% successfully passed all three criteria with no statistically significant differences between communities. A smaller percentage of students (15.2%) (community range, 6 to 18.5%) entered straight or combined pediatric residencies, whether or not a pediatric residency was present in the community. CONCLUSIONS: Medical students can achieve satisfactory competency in pediatric clerkships offered in diverse clinical settings, and choose pediatric residency training whether or not they are exposed to a pediatric residency during their clerkship. A problem-based learning curriculum does not hinder selecting pediatrics as a career choice.

Career Choice↗
PubMed2002

The influence of social support on breast cancer screening in a multicultural community sample.

PURPOSE/OBJECTIVES: To examine the relationship between women's reported social support and their adherence to recommended breast cancer screening guidelines. DESIGN: Descriptive, cross-sectional survey. SETTING: Community women's organizations throughout the San Francisco Bay Area. SAMPLE: 833 mostly low-income women with a mean age of 46.2 years from three racial or ethnic groups (i.e., Latina, Caucasian, and African American) who were not breast cancer survivors. METHODS: Social support was measured with a five-item, four-point, Likert scale developed for the study (Cronbach's alpha = 0.7248). Adherence to screening guidelines was measured by asking frequency of performing breast self-examination (BSE) and frequency of obtaining a clinical breast examination (CBE) and a mammogram. Research assistants and leaders of women's organizations conducted the survey in work and community settings. MAIN RESEARCH VARIABLES: Social support, performance of BSE, obtaining a CBE and a mammogram, income, education, spoken language, and level of acculturation. FINDINGS: Higher levels of social support were related to higher income and higher education. Lower levels of social support were associated with being Latina, completing the survey in Spanish, and being born abroad. Women who did not adhere to screening guidelines (for BSE or CBE) reported less social support. CONCLUSIONS: Social support is associated with adherence to breast cancer screening guidelines. IMPLICATIONS FOR NURSING: Nurses should assess women's levels of social support as a factor when evaluating adherence to breast cancer screening guidelines.

Adult↗
PubMed2001

Inter-rater reliability of stroke sub-type classification by neurologists and nurses within a community-based stroke incidence study.

The stroke classification developed for use in the Oxfordshire Community Stroke Project (OCSP) is simple, clinically meaningful and requires no investigations. However, its inter-rater reliability in a community setting is unknown. We aimed to assess the inter-rater reliability of this classification among neurologists and nurses within a community-based stroke incidence study. Fifty-four stroke patients with cerebral infarction who were registered in the North East Melbourne Stroke Incidence Study (NEMESIS) were assigned OCSP classifications by two neurologists and one of seven research nurses. There was moderate agreement between neurologists (kappa = 0.53), fair agreement between neurologist 1 and nurse (kappa = 0.31) and moderate agreement between neurologist 2 and nurse (kappa = 0.45). Disagreement about the neurological signs was an important reason for classification differences. The OCSP classification can be easily applied in a community setting with moderate inter-rater reliability and is thus a useful instrument for commun ity-based epidemiological studies.

Australia↗
PubMed1997

Perceptions of school violence as a problem and reports of violent events: a national survey of school social workers.

Awareness of violence as a problem is important in developing school-based interventions to reduce violence. How would social workers who reported a potentially lethal event in their schools within the past year rate the seriousness of the problem in their schools? What variables would be associated with the perception of a serious violence problem in a school? These questions were explored in a national survey of school social workers. The results suggest that school social workers did not perceive violence as a serious problem on the basis of a single event even when the event was life threatening. From a zero-tolerance perspective, school violence as a problem was underestimated in all community settings but more often in suburban and rural settings than in inner-city or urban settings. The social workers' perception of a serious problem was contingent on the presence of multiple types of violence and the community setting of the school.

Adult↗
PubMed2004

Course and short-term outcomes of separation anxiety disorder in a community sample of twins.

OBJECTIVE: To assess the course and short-term outcomes associated with separation anxiety disorder (SAD) in a community setting. METHOD: The subjects were 161 of 2,061 8- to 17-year-old twins with SAD from a community-based twin study. Subjects were born between 1974 and 1983. Subjects and parents were personally interviewed about the subject's current psychiatric history between 1990 and 1993. A follow-up interview was conducted, on average, 18 months later. Logistic regression was used to identify predictors and outcomes of persistent SAD. RESULTS: Of the 161 subjects with SAD at time 1, 80% had remitted and 59% were free of any disorder at follow-up. Children with persistent SAD had a significantly higher prevalence of oppositional defiant disorder, significantly more impairment associated with symptoms of attention-deficit/hyperactivity disorder, and mothers who were less satisfied with their marriage at time 1 than children with transient episodes. Children with persistent SAD had a significantly higher prevalence of overanxious disorder or a new minor or major depressive disorder at time 2 than children with transient SAD. After controlling for comorbidity, only an elevated risk of new depressive disorders at time 2 distinguished children with persistent SAD. CONCLUSIONS: Many children with SAD in a community setting are well at follow-up, on average, 18 months later. A minority of children with persistent SAD are at significantly increased risk of a new depressive disorder, especially those with a history of oppositional defiant disorder, impairment associated with symptoms of attention deficit hyperactivity disorder, or parental marital difficulties.

Adolescent↗
PubMed2003

Blood-borne viruses and their survival in the environment: is public concern about community needlestick exposures justified?

BACKGROUND: More than 30 million needle syringes are distributed per year in Australia as a component of harm-reduction strategies for injecting drug users (IDU). Discarded needle syringes create considerable anxiety within the community, but the extent of needlestick injuries and level of blood-borne virus transmission risk is unclear. We have undertaken a review of studies of blood-borne virus survival as the basis for advice and management of community needlestick injuries. METHODS: A Medline review of published articles on blood-borne virus survival and outcome from community injuries. RESULTS: Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) can all survive outside the human body for several weeks, with virus survival influenced by virus titer, volume of blood, ambient temperature, exposure to sunlight and humidity. HBV has the highest virus titers in untreated individuals and is viable for the most prolonged periods in needle syringes stored at room temperature. However, prevalence of HBV and HIV are only 1-2% within the Australian IDU population. In contrast, prevalence of HCV is 50-60% among Australian IDUs and virus survival in needle syringes has been documented for prolonged periods. There have been no published cases of blood-borne virus transmission following community needlestick injury in Australia. CONCLUSION: The risk of blood-borne virus transmission from syringes discarded in community settings appears to be very low. Despite this, procedures to systematically follow up individuals following significant needlestick exposures sustained in the community setting should be developed.

Attitude to Health↗
PubMed1989

Faculty mentorship: support for nurse practitioner students and staff within the rural community health setting.

As pointed out in the introduction, there are certain practical concepts within our base of nursing knowledge that can only be taught through experience. Many things are easier to teach by example. As we turn back the clock in nursing, we can see how Florence Nightingale, Clara Barton, and Lillian Wald were role models to their nursing peers in their era. They taught nursing by example, by role modeling their clinical expertise. Today, this model is still effective and faculty mentoring of nurse practitioner students and CHNs in a compassionate and collegial leadership results in higher quality of health care for our nation's needy clients and their families. But greater yet are the opportunities for flexible nurse practitioner faculty practice and personal interactions on many levels for nursing faculty who wish to share their expertise. Mentorship by nurse practitioner faculty for nurse practitioner students and CHNs in a rural clinical setting has revealed many positive aspects in providing quality care for rural clients and growth for nurses. Exposure to the rural community health system helps us, as nurses, to identify the many strengths it possesses for innovative rural nursing practice.

Community Health Nursing↗
PubMed2006

Methicillin-resistant Staphylococcus aureus: a new community-acquired pathogen?

PURPOSE OF REVIEW: The main goal of this review is to describe the emergence of methicillin-resistant Staphylococcus aureus (MRSA) as a community pathogen. RECENT FINDINGS: Community-acquired MRSA has emerged as an important infection in the community setting. It has primarily been associated with skin and soft-tissue infections, but can also cause severe pulmonary infections, including pneumonia and empyema. Community-acquired MRSA is typically more susceptible to a wider class of antibiotics than healthcare-associated MRSA. Community-acquired MRSA is also more virulent compared with healthcare-associated MRSA isolates. Community-acquired MRSA usually contains the gene encoding Panton-Valentive leukocidin, which is a toxin that creates lytic pores in the cell membranes of neutrophils and induces the release of neutrophil chemotactic factors that promote inflammation and tissue destruction. The optimal antibiotic treatment for Panton-Valentive leukocidin-positive community-acquired MRSA is unknown; however, antibiotics with activity against MRSA and the ability to inhibit toxin production may be optimal (linezolid or clindamycin for susceptible isolates). SUMMARY: Clinicians should be aware of the emergence of community-acquired MRSA as an important cause of serious infections arising in the community setting. Appropriate antibiotic therapy should be initiated as soon as infection with this pathogen is suspected.

Community-Acquired Infections↗
PubMed2006

The development of an instrument for assessing Community-Based Education of undergraduate students of Community and Health Sciences at the University of the Western Cape.

CONTEXT: In Community-Based Education (CBE) students are expected to develop problem solving, communication and critical thinking capabilities. Assessment provides an opportunity for students to improve these skills, it helps them to gain increased motivation, high achievement, it reduces anxiety over grading, and it improves communication between learners and teachers. The aim of this study was to develop a common instrument for assessing undergraduate students of Health Sciences in their placements for CBE. OBJECTIVES: (1) Identify the skill requirements of students in CBE; (2) Develop a common instrument for assessing undergraduate students in Health Sciences. METHODS: The study was based in the Faculty of Community and Health Sciences at the University of the Western Cape. Existing documents relevant to the assessment of CBE were collected and analyzed to provide background information. Focus group discussions were held with lecturers from various departments, key persons from the departments and students were audiotaped and later the data analyzed into emerging themes. This was followed with a workshop by relevant experts in CBE, to identify the essential items to be included in the proposed assessment tool. The instrument was piloted with two departments in various community settings. RESULTS: The participants identified knowledge, transferable skills, professionalism and attitudes as important elements for assessment. The instrument piloted was very comprehensive and suitable for use by students of any profession in a range of communities. CONCLUSION: It is recommended that the instrument can be used to assess students in any learning experience based in a community setting.

Adult↗
PubMed2000

Developing a community-based reminiscence group for the elderly.

Advanced practice nurses expect to care for many older adults in a variety of community settings. Through the process of reminiscence, older adults can actively evaluate their life experiences and explore the meaning of memorable events. This paper discusses the experiences of two advanced practice nurses who collaborated to conduct a reminiscence therapy group with community-based senior citizens. The process of reminiscence and group theory will be examined as applied to the well elderly in a community setting.

Aged↗