Clinically sound and person centred: streamlining clinical decision support guidance for multiple long-term condition care.

The care of people with multiple long-term conditions (MLTCs) is complex and time-consuming, often denying them the agency to self-manage their conditions-or for the clinician they visit to provide streamlined, person-centred care. We reconfigured The Practical Approach to Care Kit, our established, evidence-based, policy-aligned clinical decision support tool for low-resource primary care settings, to provide consolidated clinical guidance for a patient journey through a primary care facility. This places the patient at the centre of that journey and shifts the screening, monitoring and health education activities of multimorbidity care more equitably among the members of the primary care team.

Outcomes of patients enrolled in an antiretroviral adherence club with recent viral suppression after experiencing elevated viral loads.

Background: Eligibility for differentiated antiretroviral therapy (ART) delivery models has to date been limited to low-risk stable patients.

Objectives: We examined the outcomes of patients who accessed their care and treatment through an ART adherence club (AC), a differentiated ART delivery model, immediately following receiving support to achieve viral suppression after experiencing elevated viral loads (VLs) at a high-burden ART clinic in Khayelitsha, South Africa.

Methods: Beginning in February 2012, patients with VLs above 400 copies/mL either on first- or second-line regimens received a structured intervention developed for patients at risk of treatment failure.

Role of the ERp57 protein (1,25D3-MARRS receptor) in murine mammary gland growth and development.

The protein disulfide isomerase ERp57 (GRp58/PDIA3/1,25D3-MARRS) has been implicated in a multitude of signaling pathways throughout the entire body. Most thoroughly studied for its protein-folding role, ERp57 has also been found to have multiple binding partners, and have significant effects on cellular growth. ERp57 has been studied n the context of several neurodegenerative disorders, metabolic conditions, and can be used as a prognosis marker in certain cancers.

Expansion of the Adherence Club model for stable antiretroviral therapy patients in the Cape Metro, South Africa 2011-2015.

Objective: The ambitious '90-90-90' treatment targets require innovative models of care to support quality antiretroviral therapy (ART) delivery. While evidence for differentiated models of ART delivery is growing, there are few data on the feasibility of scale-up. We describe the implementation of the Adherence Club (AC) model across the Cape Metro health district in Cape Town, South Africa, between January 2011 and March 2015.

Male risk taking, female odors, and the role of estrogen receptors.

Male risk-taking and decision making are affected by sex-related cues, with men making riskier choices and decisions after exposure to either women or stimuli associated with women. In non-human species females and, or their cues can also increase male risk taking. Under the ecologically relevant condition of predation threat, brief exposure of male mice to the odors of a sexually receptive novel female reduces the avoidance of, and aversive responses to, a predator.

Agonistic behavior in males and females: effects of an estrogen receptor beta agonist in gonadectomized and gonadally intact mice.

Affiliative and agonistic social interactions are mediated by gonadal hormones. Research with estrogen receptor alpha (ERalpha) or beta (ERbeta) knockout (KO) mice show that long-term inactivation of ERalpha decreases, while inactivation of ERbeta increases, male aggression. Opposite effects were found in female alphaERKO and betaERKO mice.

Seven-year experience of a primary care antiretroviral treatment programme in Khayelitsha, South Africa.

Objectives: We report on outcomes after 7 years of a community-based antiretroviral therapy (ART) programme in Khayelitsha, South Africa, with death registry linkages to correct for mortality under-ascertainment.

Design: This is an observational cohort study.

Methods: Since inception, patient-level clinical data have been prospectively captured on-site into an electronic patient information system.

Integrating clinical guidelines into nursing education.

A project planning group consisting of college and university representatives from a collaborative undergraduate nursing program developed an inclusive, process-oriented faculty development initiative to enhance the integration of clinical guidelines in clinical courses. In the first phase, results of a needs assessment were used to inform the development of a six-hour workshop for the third year clinical faculty in acute care, mental health, and community health. Pre-post surveys were conducted with students and clinical faculty during the first phase.

The process of Master's education in nursing: evolution or revolution?

In this qualitative, descriptive study, the process of achieving change in knowledge and attitudes through Master's education in nursing is examined. Twenty-two recent graduates from three Ontario universities participated in semi-structured, taped interviews. Participants recounted personal and professional changes they attributed to completing a Master's program in Nursing and their experience of the process of change.

Outcomes of master's education in nursing.

This qualitative, descriptive study examined changes in perspective experienced by 22 recent graduates of Master's in Nursing programs from three Ontario universities. Participants responded to semi-structured, taped interviews and recounted personal, practice, and attitudinal changes they could attribute to completing a Master's program in Nursing. Among outcomes were personal ones including greater self-confidence, credibility, and acuity of critical thinking.

A toolbox of technical supports for nurses new to Web learning.

This article describes a number of strategies that have been used by an online Nurse Practitioner program to help learners and faculty become comfortable and proficient in the technical skills necessary for an Internet-based program. Various components of the "toolbox" of help strategies and how they have evolved over time are described. Results of a project to systematically develop and evaluate the toolbox are discussed.

Ten universities, one program: successful collaboration to educate nurse practitioners.

For more than 7 years, 10 schools of nursing in Ontario have collaborated to prepare primary healthcare nurse practitioners. The authors discuss the establishment of the consortium and its benefits and drawbacks.

Integrating Web-based technology into distance education for nurses in China: computer and Internet access and attitudes.

To increase continuing education accessibility, nurses around the world are turning to Web-based instruction. However, for Internet education to be successful, particularly in developing countries, nurses must have access to computers and the Internet as well as positive attitudes toward this form of learning. As part of a distance education project for nurses of the Tianjin Municipality in China, a survey of nurses was conducted to examine their sources of professional knowledge as well as their computer and Internet access and attitudes.

Perspective transformation in RN-to-BSN distance education.

This study examines perspective transformation (or professional resocialization) in RN-to-BSN students obtaining their degree by distance education. A socialization scale was used to compare newly admitted and graduating RN-to-BSN students who had taken their courses onsite, by distance education, or a mixture of the two methods. The scores of entering and graduating RN-to-BSN students also were compared to those of graduates from the generic program to identify if program and experience are factors in scores achieved.

Nurse practitioner preferences for distance education methods related to learning style, course content, and achievement.

The relationships among multiple distance delivery methods, preferred learning style, content, and achievement was sought for primary care nurse practitioner students. A researcher-designed questionnaire was completed by 86 (71%) participants, while 6 engaged in follow-up interviews. The results of the study included: participants preferred learning by "considering the big picture"; "setting own learning plans"; and "focusing on concrete examples.

Women's knowledge about the physical and emotional changes associated with menopause.

In 1992, a survey was undertaken to study women's knowledge of the physical and emotional changes associated with menopause. Two groups of midlife women: a random sample (n = 381) and a sample of women who attended menopause seminars (n = 95) were asked to select from a list of 39 changes those they thought were directly caused by menopause. Information from readily available books written for a general audience was used to construct the marking guide for a "commonly available knowledge" score.

Using concept maps and visual representations for collaborative curriculum development.

A picture is worth a thousand words, and in the development of collaborative curricula among colleges and universities, a concept map or visual representation may save thousands of hours of semantic wrangling. Using pictures in curriculum development allows participants with varying backgrounds to share their visions and values, and promotes work at the conceptual level before detailed planning proceeds. A curriculum development team found the use of concept mapping and visual representations to be one of their most valuable means of developing consensus among three faculty groups and practicing nurses.

Taxol on the surface of leaves and inside the needles of three species and two varieties of Taxus.

Leaves of three outside-growing Taxus species (Taxus baccata L.; T. baccava var.

The menopause and hormone replacement therapy: Australian general practitioners' self-reported opinions, attitudes and behaviour.

Objectives: We describe the attitude and views of general practitioners towards the menopause and hormone replacement therapy (HRT) in metropolitan Brisbane, Australia.

Methods: A total of 216 general practitioners were nominated by a random sample of urband-welling women aged 45-54 years who formed the Brisbane Women's health study. A 20-30 minute face-to-face questionnaire with the general practitioners was administered and analysed by demographic characteristics.

Women's perceptions and experience of menopause: a focus group study.

Focus groups were used to investigate women's perception and experience of menopause, hormone replacement therapy, osteoporosis and doctor-patient relationships. Forty women aged between 45 and 55 years participated in seven focus groups. Most women thought that these topics were not widely or freely discussed in the community.

Nurse managers: perceptions of their role.

A qualitative study on the role of the nurse manager was conducted based on interviews with nurse managers in an acute care teaching hospital. Role descriptions revealed many similarities to Mintzberg's (1973) model of management roles, but additional roles, related to the nurse manager's professional responsibilities were identified. Conflicts within and among roles and a strong need for support were themes that were identified throughout the interviews.

Do psycho-social factors contribute more to symptom reporting by middle-aged women than hormonal status?

Six hundred women aged between 45 and 54 were randomly selected from the electoral roll in Brisbane, Australia. A questionnaire addressing their symptoms, hormone status and psycho-social factors was successfully administered to 381 women (64% of the original sample; 83% of those contactable). Although cardiovascular symptoms were experienced by 25% of the sample, the most common (hot flushes) ranked only tenth on a list of recently experienced symptoms.

Nurses' experiences of a post-RN course by computer mediated conferencing: friendly users.

Students who had completed a post-RN university nursing course by computer mediated conferencing participated in a qualitative study examining their experience with this mode of delivery of distance education. All seven students reported that great difficulties with the technology at the beginning of the course caused them extreme frustration. However, despite the lack of user-friendliness of the technology, the students participated actively, functioned as a group, developed strong personal ties, and mastered the required content via the computer.