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Results for “shared approaches”

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At least 163 records · Page 9Linked to original sources

PubMed2007

Severe asthma: lessons from the Severe Asthma Research Program.

Severe asthma affects only a small percentage of the asthma population. However, these patients remain poorly understood and difficult to treat. Because the numbers are relatively small (10% or less of the asthma population), a network approach with shared protocols, samples, and data provides a unique opportunity to recruit the numbers of subjects necessary to perform adequately powered studies. The Severe Asthma Network (Severe Asthma Research Program) was established by the National Heart, Lung, and Blood Institute in 2001 to advance collectively the study of severe asthma to determine factors that differentiated these patients or subjects from those with milder asthma. Nearly 800 subjects have been recruited in less than 4 years to begin to address these differences. Future studies will specifically evaluate the role of inflammatory/oxidative processes, infection, genetics, and the distal lung in the pathogenesis of severe asthma.

Asthma↗

PubMed1986

Promotion of oral health and prevention of common pediatric dental problems.

Many effective methods currently are available for preventing oral diseases and promoting oral health. The responsibility for ensuring the optimal use of these approaches is shared by members of the dental profession and other primary care providers in the present health care delivery system. Recognition of each provider's role and greater collaborative efforts could enhance the gains that already have been made with respect to improving the oral health status of children and adolescents.

Child↗

PubMed1992

Monitoring diabetes mellitus: the pharmacist's role.

The pharmacist is in a unique position to monitor and counsel the patient with diabetes mellitus. Providing these services requires familiarity with both the disease and its contemporary management. Pharmacists can provide the necessary counseling and guidance regarding the myriad products and devices available to the patient and can serve as a resource to the physician and other health care professionals. Pharmacists with a special interest in diabetes are encouraged to develop services that are compatible with their practice resources. This shared-care approach to treatment will help contribute to the goal of a normal lifestyle for the person with diabetes mellitus.

Blood Glucose Self-Monitoring↗

PubMed2004

Empowering communication: a community-based intervention for patients.

The "How to Talk to Your Doctor" community education forums operate under the assumption that information exchange and consumer involvement in healthcare can empower communities in need. We report on the development and preliminary evaluation of this community-based intervention designed to activate and enhance patients' communicative abilities in the medical encounter. We review evidence supporting the feasibility of and benefits that can be expected from improving patients' communication competency. Our intervention is simple and flexible so, therefore, can be portable to a large number of communities. Our preliminary evaluation suggests that the intervention is well-received and produces improved self-perceptions of communication competence across diverse settings and participants. We describe our intervention and its development and dissemination as a model for improving patients' communicative abilities through a community-based, active learner approach. By sharing our experiences, the barriers we encountered, and our ongoing efforts to improve patient communication in the medical encounter, we hope to empower patients to communicate better with their physicians.

Communication↗

PubMedDate not supplied

Evaluation of a shared-work program for reducing assistance provided to supported workers with severe multiple disabilities.

Concern has been expressed recently regarding the need to enhance the performance of individuals with highly significant disabilities in community-based, supported jobs. We evaluated a shared-work program for reducing job coach assistance provided to three workers with severe multiple disabilities in a publishing company. Following systematic observations of the assistance provided as each worker worked on entire job tasks, steps comprising the tasks were then re-assigned across workers. The re-assignment involved assigning each worker only those task steps for which the respective worker received the least amount of assistance (e.g., re-assigning steps that a worker could not complete due to physical disabilities), and ensuring the entire tasks were still completed by combining steps performed by all three workers. The shared-work program was accompanied by reductions in job coach assistance provided to each worker. Work productivity of the supported workers initially decreased but then increased to a level equivalent to the higher ranges of baseline productivity. These results suggested that the shared-work program appears to represent a viable means of enhancing supported work performance of people with severe multiple disabilities in some types of community jobs. Future research needs discussed focus on evaluating shared-work approaches with other jobs, and developing additional community work models specifically for people with highly significant disabilities.

Adult↗

PubMed1999

Postoperative management of the patient undergoing pulmonary thromboendarterectomy.

The postoperative course of the patient undergoing pulmonary thromboendarterectomy poses a unique series of challenges in terms of ventilatory care and hemodynamic management. Experience, cooperation, and interaction are necessary among the various disciplines providing care for these patients during the preoperative, operative, and postoperative phases of care. The purpose of this article is to share the approach necessary for the optimal postoperative care of the patient undergoing thromboendarterectomy, to present the theoretical justification for this care, and to delineate the areas of uncertainty that still exist.

Endarterectomy↗

PubMed1996

Panniculitis: recent developments and observations.

Dermatopathologists rarely greet a biopsy of panniculitis with total confidence that a specific, definitive diagnosis will be rendered. As with many other areas in dermatopathology, our understanding of the pathogenesis of many forms of panniculitis is incomplete. This article examines a subset of panniculitis primarily from a pathogenetic standpoint, with the intention of providing a differential diagnosis for those cases in which ischemic changes are seen in the subcutis. The diverse group of conditions evoked by this approach also shares the distinction of having been the focus of nosologic and causative controversy, both historically and currently. In particular, stasis-associated sclerosing panniculitis, vascular calcification-cutaneous necrosis syndrome (calciphylaxis), oxalosis, and nodular vasculitis-erythema induratum are examined in depth. Erythema nodosum and variants, other granulomatous panniculitides, and panniculitides showing cytophagocytosis are also discussed with current perspectives.

Diagnosis, Differential↗

PubMed2001

Stressors and coping methods among chronic haemodialysis patients in Hong Kong.

The purpose of the study was to determine the stressors and coping methods of chronic haemodialysis patients in Hong Kong. Relationships among treatment-related stressors, coping methods and length of time on haemodialysis were explored. Fifty subjects completed the Haemodialysis Stressor Scale (HSS) and Jalowiec Coping Scale (JCS). Results revealed that limitation of fluid was the most frequently identified stressor, followed by limitation of food, itching, fatigue and cost. The most common coping methods are 'accepted the situation because very little could be done', followed by 'told oneself not to worry because everything would work out fine' and 'told oneself that the problem was really not that important.' It was found that the traditional philosophies of the Chinese--Confucianism, Buddhism, and Taoism--share an approach to the understanding and management of life stressors as different from that adopted by Western philosophies. The findings of this study can further facilitate nurse practitioners in providing support, information, and alternative solutions when assisting patients in coping with long-term haemodialysis.

Activities of Daily Living↗

PubMed2002

Quality of life: an outcomes perspective.

This article compares a traditional biomedical model with an outcomes model for evaluating medical and rehabilitation care. The traditional model emphasizes diagnosis and disease-specific outcomes. In contrast, the outcomes model emphasizes life expectancy and health-related quality of life (QOL). Although the models are similar, they lead to different conclusions with regard to some interventions. For some conditions, diagnosis and treatment may reduce the impact of a particular disease without extending life expectancy or improving QOL. Older individuals with multiple comorbidities may not benefit from treatments for a particular disease if competing health problems threaten life or reduce QOL. Overall outcomes and benefits of treatment can be summarized by using measures of life expectancy that adjust for QOL. The quality-adjusted life year (QALY) has been proposed as a comprehensive summary index. QALYs have gained widespread usage in many areas of medicine. The outcomes model has been applied widely in rehabilitation research, but few studies estimate the benefits of treatments using QALYs. These methodologies can also serve as a basis for approaches to sharing medical decisions between patients and providers. Opportunities to apply these new methods are discussed.

Aged↗

PubMed2001

Therapeutic caring: a learning disability experience.

This paper is a reflective account of our experiences of giving Therapeutic Touch (TT), for the first time within a learning disability setting, to a client who has profound learning disabilities. Using a case study approach, we share our story of this pathfinder journey of discovery and show how the process of reflection was instrumental in enabling us to gain insight on the unfolding therapeutic and caring relationship which we developed with this client. Issues relating to informed consent were addressed, however these were complex and needed special consideration. As client consent could not be achieved through verbal means we needed to draw on our senses and use intuitive skills together with team involvement. IntroducingTT into a learning disability setting was breaking new ground, and as this case study has shown it does appear to have the potential to enhance therapeutic caring.

Adult↗

PubMed1992

Lead poisoning in children. The ramifications and the road to prevention.

Environmental lead poisoning is easier to prevent than to treat, and it can be destructive or deadly if ignored. Dr Schlenker, medical director of the Milwaukee Health Department, shares his approach to screening young children for potentially dangerous blood lead levels, educating the community about prevention of lead poisoning, and eradicating environmental sources of lead.

Child↗

PubMed1993

Becoming a part of the community: implementing a public health vision in student health services.

Principles from public health and community health nursing provide an approach to student health services that enhances interdisciplinary collaboration and advocacy for access to care. Staff participation in the campus community requires administrative support, both in philosophy and in making outreach activities accessible to staff. Student health services at University of Maine's Cutler Health Center in Orono is implementing outreach and community involvement as ongoing aspects of the college health nursing role. Increased collaboration, visibility of nurses on campus, and improved community assessment and intervention are among the outcomes observed during the past 2 years. This article describes the principles that guide this approach and shares some community involvement experiences, including the response to a student suicide attempt, social support for students after a residence hall fire, and case management/consultation services.

Community Health Services↗

PubMed2006

Novel genes identified in a high-density genome wide association study for nicotine dependence.

Tobacco use is a leading contributor to disability and death worldwide, and genetic factors contribute in part to the development of nicotine dependence. To identify novel genes for which natural variation contributes to the development of nicotine dependence, we performed a comprehensive genome wide association study using nicotine dependent smokers as cases and non-dependent smokers as controls. To allow the efficient, rapid, and cost effective screen of the genome, the study was carried out using a two-stage design. In the first stage, genotyping of over 2.4 million single nucleotide polymorphisms (SNPs) was completed in case and control pools. In the second stage, we selected SNPs for individual genotyping based on the most significant allele frequency differences between cases and controls from the pooled results. Individual genotyping was performed in 1050 cases and 879 controls using 31 960 selected SNPs. The primary analysis, a logistic regression model with covariates of age, gender, genotype and gender by genotype interaction, identified 35 SNPs with P-values less than 10(-4) (minimum P-value 1.53 x 10(-6)). Although none of the individual findings is statistically significant after correcting for multiple tests, additional statistical analyses support the existence of true findings in this group. Our study nominates several novel genes, such as Neurexin 1 (NRXN1), in the development of nicotine dependence while also identifying a known candidate gene, the beta3 nicotinic cholinergic receptor. This work anticipates the future directions of large-scale genome wide association studies with state-of-the-art methodological approaches and sharing of data with the scientific community.

Case-Control Studies↗

PubMedDate not supplied

The creation, implementation, and evaluation of a nurse residency program through a shared leadership model in the intensive care setting.

This education strategy was used at a 404-bed level-one trauma center where 60% of the beds are for critical care. In June 1999, 93 nurses underwent critical care orientation. By June 2000, only 8 of these nurses remained. Exit interviews revealed the primary reason for leaving was dissatisfaction with orientation. The Education Department undertook a shared leadership approach to identify strategies for resolution of the perceived orientation problem. The Preceptor Leadership Council was formed to create a Nurse Residency Program for new nurses. Membership consisted of staff nurse lead preceptors and clinical educators. Outcomes following the implementation of the program indicated an overall increase in satisfaction with nursing orientation in the intensive care unit as well as a significant reduction in turnover rates. Strategies used to create, implement, and evaluate the program are presented.

Humans↗

PubMedDate not supplied

Cross-cultural nursing. A report of faculty collaboration through regional networking.

Healthcare environments increasingly are becoming culturally diverse. A project to incorporate multicultural issues in curricula, identify cross-cultural student learning opportunities, and increase faculty skills in teaching transcultural concepts is described. Through regional networking, faculty members identified barriers to teaching cross-cultural concepts and strategies to address those barriers. Recommendations call for proactive approaches for sharing resources to strengthen cultural dimensions in schools of nursing, particularly in rural areas that lack cultural diversity.

Cooperative Behavior↗

PubMed2005

A modified vapor-diffusion crystallization protocol that uses a common dehydrating agent.

In the vapor-diffusion protein-crystallization method, a small drop containing protein sample mixed with a crystallization solution is equilibrated against a reservoir solution in a sealed chamber. Whereas the chemical composition of the crystallization solution is critical for success, the primary role of the reservoir solution is to slowly concentrate the crystallization drop in a controlled fashion. Accordingly, it might be possible to use any reservoir solution of appropriate dehydrating strength. The important practical consequence is that many different experiments can share the same reservoir solution. This approach, called the ;shared reservoir solution' method, significantly simplifies manual and robotic experiment setup, reduces cost and allows a completely new design of optically superior and higher density crystallization plates. Although this research was motivated by these practical advantages, recent reports and the authors' results indicate that this method may actually increase crystallization success. The authors suggest that this may indicate that a protein has a preferred water activity for crystallization. Here, present practical and theoretical considerations as well as experimental tests of the shared reservoir solution method are presented.

Aldose-Ketose Isomerases↗

PubMed1992

Persuading general practitioners to prescribe--good husbandry or a recipe for chaos?

Edinburgh's Community Drug Problem Service was set up three years ago in response to the high prevalence of HIV infection amongst local injecting drug users and the lack of existing statutory drug services in Lothian. From the outset, a policy of shared care and substitute prescribing by the druguser's general practitioner (GP) was adopted. Over 800 referrals later, this discussion paper looks at the methods used to persuade GPs to cooperate in longterm drug management, and examines the advantages, disadvantages and outcome of such a shared care approach.

Drug Prescriptions↗

PubMedDate not supplied

Sharing the caring: a Swedish approach to short-term care of mentally handicapped children.

The setting up of a short-stay home, which offers temporary care for mentally handicapped children living with their parents in the Swedish county of Ostergötland, is described. It illustrates an approach which parents, care staff and the supervising psychologist have all found satisfactory in contrast to the provision available in hospital units.

Child↗