Aim: This paper is a description of a study protocol designed to evaluate the factors that enable or constrain the delivery and sustainability of Early Warning Systems and the Acute Life-threatening Events--Recognition and Treatment training course in practice.
Background: Rapid response system initiatives have been introduced to try to improve early detection and treatment of patients who deteriorate on general hospital wards. However, recent systematic reviews of the effectiveness of these initiatives show no effect on patient outcomes.
Background: Self-expandable metal stents (SEMS) are an accepted palliation for malignant colorectal obstruction. Outcomes of stent insertion solely in older patients are unknown.
Objective: To compare outcomes of SEMS insertion for malignant colorectal disease, in older versus younger patients.
Objectives: To investigate the opinions of general practitioners, orthopaedic surgeons, rheumatologists, sport and exercise medicine (SEM) registrars and public health consultants on training, caseload, the most appropriate setting and the position of SEM within the National Health Service (NHS) in the UK.
Method: A cross-sectional questionnaire-based survey investigated the opinions of the above professionals from three primary care trusts and associated hospitals in London and Birmingham.
Results: With a 50% response rate (n = 226), 93% (208/224) of participants felt that there was a role for SEM in the NHS.
As part of a larger mixed-methods study, data from 20 personal journals were analyzed to examine the experience of a 12-week yoga treatment program for binge eating among a sample of 25 women who were obese. Qualitative analysis revealed a positive shift experienced by the women during the program, summarized by a general structural description: disconnection versus connection. Women's comments suggested that the program appeared to encourage a healthy reconnection to food, as well as the development of physical self-empowerment, through cultivating present-moment awareness.
View Article and Find Full Text PDFWorldviews Evid Based Nurs
September 2010
Background: Recent research has questioned the reliability and validity of the Nursing Work Index-Revised (NWI-R) instrument, raising the possibility that managers reconfiguring hospitals in line with the factors derived from the NWI-R may be misdirecting resources.
Aim: To test the factor structure of the NWI-R.
Approach: A population of 864 acute hospital nurses was surveyed using the NWI-R, and a response rate of 449 (52%) was achieved.
Objective: To examine the efficacy of a 12-week yoga program aimed at reducing binge eating severity.
Design: A randomised trial was undertaken assigning participants to yoga (n=45) or wait-list control (n=45) groups. Of these, 25 in each group were analysed.
Aim: This paper is a report of the protocol for a review to identify, critically appraise and synthesize the best current evidence supporting the use of weaning protocols compared to non-protocolized practice in liberating patients from mechanical ventilation.
Background: Patients experiencing difficulty in weaning require a longer hospital stay and have higher morbidity and mortality. Consequently, efforts to reduce weaning time are desirable to reduce the duration of ventilation and related complications.
Background: The standard approach in a randomized controlled trial (RCT) is to randomize individuals to intervention and control groups. Yet, nursing and other health interventions are often implemented at the levels of health service organizational unit or geographical area. It may be more appropriate to conduct a cluster RCT.
View Article and Find Full Text PDFObjective: The aim of the current review was to determine the predictive strength of low recovery expectations for activity limitation outcomes in people with non-chronic NSLBP.
Methods: A systematic review of prognostic studies was performed. Included studies took baseline measures in the non-chronic phase of NSLBP, included at least one baseline measure of recovery expectation, defined as a prediction or judgement made by the person with NSLBP regarding any aspect of prognosis, and studied a sample with at least 75% of participants with NSLBP.
In this paper, we examine the war of words between those who contend that health care practice, including nursing, should primarily be informed by research (the evidence-based practice movement), and those who argue that there should be no restrictions on the sources of knowledge used by practitioners (the postmodernists). We review the postmodernist interventions of Dave Holmes and his colleagues, observing that the postmodernist style to which they adhere, which includes the use of continental philosophy, metaphors, and acerbic delivery, tends to obscure their substantive arguments. The heated nature of some responses to them has tended to have the same effect.
View Article and Find Full Text PDFObjective: To estimate the incidence, cause, and complications of pancreatitis in pregnancy and to identify factors associated with adverse outcomes.
Methods: This study was a chart review of all pregnant patients diagnosed with pancreatitis from 1992-2001 at 15 participating hospitals. Information was collected on presentation, management, and outcome, along with the number of deliveries at each hospital.
Background: Hip protectors are protective pads designed to cover the greater trochanter and attenuate or disperse the force of a fall sufficiently to prevent a hip fracture. Promising results from randomised controlled trials in nursing homes have resulted in hip protectors being widely recommended in the health care literature and in national guidelines.
Objectives: The objectives of the study were to identify characteristics of individual residents, and the organisational features of the homes in which they live, which may affect adherence to wearing hip protectors.
Objectives: To investigate the factors influencing the acceptability of hip protectors to residents of nursing and residential homes, especially the effect of hip protector type, and resident characteristics.
Design: A randomised controlled trial with 12 weeks follow-up. Participants were randomised to receive either Safehip or HipSaver hip protectors.
The bipolar version of Profile of Mood States was completed by 124 participants (58 women and 66 men, M age 26.5, SD=3.9 yr.
View Article and Find Full Text PDFObjectives: to evaluate the effectiveness of a policy of making hip protectors available to residents of nursing homes.
Design: a cluster randomised controlled trial of the policy in nursing and residential homes, with the home as the unit of randomisation.
Setting: 127 nursing and residential homes in the greater Belfast area of Northern Ireland.
Propofol whole blood and plasma concentrations at offset of hypnosis in eighteen patients were inversely related to patient age and body fat. The relationship between propofol concentrations and body fat is derived from the relationship between age and body fat and age was the single independent predictor of concentrations at offset of propofol hypnosis.
View Article and Find Full Text PDFChanges in mood following exercise are well documented; however, one particular limitation of research examining mood changes associated with exercise is that studies have not controlled for a possible expectancy effect. Given the difficulty associated with utilising a placebo control group in exercise settings and that no current questionnaires are available to measure beliefs concerning mood improvements during and after exercise, the present studies aimed to develop a suitable instrument for assessing these beliefs. In the first of these studies, 220 regular runners were respondents in developing the new scale.
View Article and Find Full Text PDFPurpose: To examine the effect of lifestyle on the effectiveness of a low-intensity dietary intervention.
Design: A secondary data analysis was performed using data from the Eating Patterns Study, a randomized controlled trial that found that self-help materials with physician advice was effective in changing dietary intake and behavior.
Setting: Primary care clinics in a large health maintenance organization.
Background: Ambulance services produce a large quantity of data, which can yield valuable summary statistics. For strategic planning purposes, an economic framework is proposed, and the following four resource allocation questions are answered, using data from the Surrey Ambulance Service: (1) To satisfy government response time targets, how many additional ambulances will be required, ceteris paribus? (2) To minimize average response time (r*) with given resources, how should ambulances be rostered temporally? (3) Which innovations are worth undertaking? (4) How would an increase in demand affect r*?
Methods: The 'Ambulance Response Curve' --the relation between response time and the number of available but not-in-use ambulances--is used to estimate how much r* will be reduced by deploying an additional ambulance. Estimating the marginal cost of an ambulance allows us to estimate the opportunity cost of each second of response time, and to compare the cost of three 'innovations' with that of increasing resources.
Aust N Z J Ment Health Nurs
June 1999
Psychosocial rehabilitation, for those with a serious mental illness, is of significant importance due to both its frequency and cost to government. This paper describes the implementation and preliminary assessments of a new psychosocial rehabilitation program in New South Wales. Of particular urgency was the requirement to establish baseline measures for ongoing service evaluation at the unit.
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