Knowledge of Food and Drug Interactions among Nurses: Assessment Strategy for Continuing Education

ERIC Educational Resources Information Center

Enwerem, Nkechi M.; Okunji, Priscilla O.

2017-01-01

The effect of medication errors on patient quality care and safety is a critical ongoing concern requiring solutions. Although medication safety has been a concern of all healthcare professions, registered nurses play an important role in medication safety as patients' advocates. A cross sectional study with structured questionnaire on common FDI…

Mentoring as It Relates to Persistence in Associate Degree Nursing Students

ERIC Educational Resources Information Center

Peltz, Caroline M.

2013-01-01

Students who are preparing to become registered nurses are more likely to attend community colleges due to the unequal distribution of financial resources to educational systems that have evolved from the impact of globalization. The purpose of this descriptive cross-sectional study was to increase the understanding of mentoring as it relates to…

Impact of nurses' cross-cultural competence on nursing intellectual capital from a social cognitive theory perspective.

PubMed

Lin, Hsien-Cheng

2016-05-01

To understand the relationships among certain key factors such as organizational climate, self-efficacy and outcome expectation on registered nurses, with regard to the development of registered nurses' cross-cultural competence. The focus is specifically on the use of a social cognitive framework for nurses for providing intercultural nursing care to international patients. This study also aims to examine the relationship between nurses' cross-cultural competence and nursing intellectual capital. Given the influence of globalization on healthcare services, healthcare providers need to have enough cross-cultural competence to effectively care for patients from different cultures. Thus, the development of cross-cultural competence in nursing care has become an important issue. A quantitative method and a cross-sectional design were employed in this study. Data were collected from 309 RN working in 16 healthcare institutions in Taiwan from May to August 2013. Structural equation modelling, in combination with the smart partial least squares method, was used to measure the relationships in the research model. The results show that outcome expectation has a stronger impact on nurses' cross-cultural competence than self-efficacy. In addition, it was found that the cross-cultural competence of nurses has a positive impact on nursing intellectual capital. Nursing supervisors should promote a higher level of outcome expectation on nurses to enhance the improvement of their cross-cultural competence. Raising the cross-cultural competence of nurses will aid in the accumulation of nursing intellectual capital. © 2016 John Wiley & Sons Ltd.

The association between patient safety culture and burnout and sense of coherence: A cross-sectional study in restructured and not restructured intensive care units.

PubMed

Vifladt, Anne; Simonsen, Bjoerg O; Lydersen, Stian; Farup, Per G

2016-10-01

To study the associations between registered nurses' (RNs) perception of the patient safety culture (safety culture) and burnout and sense of coherence, and to compare the burnout and sense of coherence in restructured and not restructured intensive care units (ICUs). Cross-sectional study. RNs employed at seven ICUs in six hospitals at a Norwegian Hospital Trust. One to four years before the study, three hospitals merged their general and medical ICUs into one general mixed ICU. The safety culture, burnout and sense of coherence were measured with the questionnaires Hospital Survey on Patient Safety Culture, Bergen Burnout Indicator and Sense of Coherence. Participant characteristics and working in restructured and not restructured ICUs were registered. In total, 143/289(49.5%) RNs participated. A positive safety culture was statistically significantly associated with a low score for burnout and a strong sense of coherence. No statistically significant differences were found in burnout and sense of coherence between RNs in the restructured and not restructured ICUs. In this study, a positive safety culture was associated with absence of burnout and high ability to cope with stressful situations. Burnout and sense of coherence were independent of the restructuring process. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

17 CFR 275.206(3)-2 - Agency cross transactions for advisory clients.

Code of Federal Regulations, 2010 CFR

2010-04-01

... advisory clients. 275.206(3)-2 Section 275.206(3)-2 Commodity and Securities Exchanges SECURITIES AND... Agency cross transactions for advisory clients. (a) An investment adviser, or a person registered as a... advisory client, if: (1) The advisory client has executed a written consent prospectively authorizing the...

Medical students' knowledge and attitudes toward organ donation: results of a Dutch survey.

PubMed

Figueroa, C A; Mesfum, E T; Acton, N T; Kunst, A E

2013-01-01

In the Netherlands, as in many other countries, a paucity of research exists on the attitudes and intentions of medical students toward organ donation. These students are of interest for the effect that increasing medical knowledge might have on the willingness to register as a donor. To examine which factors determine medical students' willingness to register as donors. We conducted a cross-sectional survey among medical students at the University of Amsterdam. Our questionnaire included questions on actual donor registration, motives, knowledge, and attitudes toward donation. To assess which factors were related to self-reported donor registration status, we conducted multivariate logistic regression analyses. We received 506 questionnaires (response rate at least 84%). The majority of respondents (80%) intended to donate organs, while 59% were registered. Self-reported medical knowledge and positive attitudes on donation were independently associated with registering as a donor. A rising study year was associated with registering as a donor; this could be explained by increasing medical knowledge and changing attitudes. The results of our study suggest that willingness to register as a donor increases with a rising level of knowledge on organ donation up to some minimal level. Copyright © 2013. Published by Elsevier Inc.

Prevalence of obesity and overweight and its associated factors among registered pensioners in Ghana; a cross sectional studies.

PubMed

Nuertey, Benjamin D; Alhassan, Alabira Iddrisu; Nuertey, Augustine D; Mensah, Isaac Asimadu; Adongo, Victor; Kabutey, Clement; Addai, Joyce; Biritwum, Richard Bekoe

2017-01-01

The elderly are faced with health problems such as cardiovascular diseases, type II diabetes mellitus, kidney disease, arthritis and other musculoskeletal problems, which can be linked to obesity and overweight. The aim of this study was to determine the prevalence of obesity and overweight and its associated factors amongst registered pensioners in Ghana. A cross-sectional study was conducted among members of the national pensioners association of Ghana. 4813 pensioners took part in the study. Thirteen study centers were used in the study with at least one center per regional capital. Questionnaires, physical examinations, blood and urine sample examinations were carried out. Overall, 16.3% of the pensioners were obese while 30.0% were overweight. Prevalence of obesity among males and females were 8.0% and 34.5% respectively. Pensioners who were hypertensive had 1.8 times the odds (95% CI = 1.5-2.0) of being obese/overweight. Serum triglycerides levels of 2.26 mmol/L (200 mg/dL) or more, were associated with 80% chance of obesity and overweight (OR = 1.8, 95% CI = 1.3 - 2.5). There was 30% increase in arthritis among obese/overweight pensioners compared to normal/underweight pensioners. Obesity and overweight pensioners were more likely to be using eyeglass (OR = 1.7, 95% CI = 1.3-2.2) and less likely to report hearing loss (OR = 0.7, 95% CI =0.5-1.0). The prevalence of obesity among the elderly in Ghana is high. Age had an inverse linear relationship with BMI among pensioners. Hypertension, arthritis and dyslipidemia were associated with obesity among registered pensioners.

Features of two-phase flow in a microchannel of 0.05×20 mm

NASA Astrophysics Data System (ADS)

Ronshin, Fedor

2017-10-01

We have studied the two-phase flow in a microchannel with cross-section of 0.05×20 mm2. The following two-phase flow regimes have been registered: jet, bubble, stratified, annular, and churn ones. The main features of flow regimes in this channel such as formation of liquid droplets in all two-phase flows have been distinguished.

Cricothyroid muscle and thyroarytenoid muscle dominance in vocal register control: preliminary results.

PubMed

Kochis-Jennings, Karen Ann; Finnegan, Eileen M; Hoffman, Henry T; Jaiswal, Sanyukta; Hull, Darcey

2014-09-01

Headmix and head registers use cricothyroid (CT) muscle dominant voicing, whereas chest and chestmix registers use thyroarytenoid (TA) muscle dominant voicing. Cross-sectional study. CT and TA electromyographic data obtained from five untrained singers and two trained singers were analyzed to determine CT and TA muscle dominance as a function of register. Simultaneous recordings of TA and CT muscle activity and audio were obtained during production of pitch glides and a variety of midrange and upper pitches in chest, chestmix, headmix, and head registers. TA dominant phonation was only observed for chest productions and headmix/head register productions below 300 Hz. All phonation above 300 Hz, regardless of register, showed CT:TA muscle activity ratios that were CT dominant or close to 1, indicating nearly equal CT and TA muscle activity. This was true for all subjects on all vocal tasks. For the subjects sampled in this study, pitch level appeared to have a greater effect on TA and CT muscle dominance than vocal register. Preliminary findings regarding CT and TA dominance and register control do not support the assumption that all chest and chestmix production has greater TA muscle activity than CT muscle activity or that all headmix and head production require greater CT muscle activity than TA muscle activity. The data indicate that pitch level may play a greater role in determining TA and CT dominance than register. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Blindness and partial sight in an elderly population.

PubMed Central

Gibson, J M; Lavery, J R; Rosenthal, A R

1986-01-01

A cross sectional, prevalence survey of eye disease in the population over 75 years old of Melton Mowbray has been used to examine the accuracy and completeness of the Blind and Partially Sighted Registers. The Blind Register had high sensitivity and specificity but was found to underestimate the prevalence of blindness by a factor of 1.1. The Partially Sighted Register had high specificity, but the sensitivity was only 50% and it underestimated the prevalence of partial sight by a factor of 1.5. Seven persons eligible for registration, but previously not registered, were found, two as blind and five as partially sighted. This represented 21% of the registrable visually impaired population. PMID:3756128

Registered nurses' perceptions of rewarding and its significance.

PubMed

Seitovirta, Jaana; Lehtimäki, Aku-Ville; Vehviläinen-Julkunen, Katri; Mitronen, Lasse; Kvist, Tarja

2017-11-07

To examine reward type preferences and their relationships with the significance of rewarding perceived by registered nurses in Finland. Previous studies have found relationships between nurses' rewarding and their motivation at work, job satisfaction and organisational commitment. Data were collected in a cross-sectional, descriptive, questionnaire survey from 402 registered nurses using the Registered Nurses' Perceptions of Rewarding Scale in 2015, and analysed with descriptive and multivariate statistical methods. Registered nurses assigned slightly higher values to several non-financial than to financial rewards. The non-financial reward types appreciation and feedback from work community, worktime arrangements, work content, and opportunity to develop, influence and participate were highly related to the significance of rewarding. We identified various rewards that registered nurses value, and indications that providing an appropriate array of rewards, particularly non-financial rewards, is a highly beneficial element of nursing management. It is important to understand the value of rewards for nursing management. Nurse managers should offer diverse rewards to their registered nurses to promote excellent performance and to help efforts to secure and maintain high-quality, safe patient care. The use of appropriate rewards is especially crucial to improving registered nurses' reward satisfaction and job satisfaction globally in the nursing profession. © 2017 John Wiley & Sons Ltd.

Cross-section analysis of the Magnum-PSI plasma beam using a 2D multi-probe system

NASA Astrophysics Data System (ADS)

Costin, C.; Anita, V.; Ghiorghiu, F.; Popa, G.; De Temmerman, G.; van den Berg, M. A.; Scholten, J.; Brons, S.

2015-02-01

The linear plasma generator Magnum-PSI was designed for the study of plasma-surface interactions under relevant conditions of fusion devices. A key factor for such studies is the knowledge of a set of parameters that characterize the plasma interacting with the solid surface. This paper reports on the electrical diagnosis of the plasma beam in Magnum-PSI using a multi-probe system consisting of 64 probes arranged in a 2D square matrix. Cross-section distributions of floating potential and ion current intensity were registered for a hydrogen plasma beam under various discharge currents (80-175 A) and magnetic field strengths (0.47-1.41 T in the middle of the coils). Probe measurements revealed a high level of flexibility of plasma beam parameters with respect to the operating conditions.

Changes in patient safety culture after restructuring of intensive care units: Two cross-sectional studies.

PubMed

Vifladt, Anne; Simonsen, Bjoerg O; Lydersen, Stian; Farup, Per G

2016-02-01

Compare changes in registered nurses' perception of the patient safety culture in restructured and not restructured intensive care units during a four-year period. Two cross-sectional surveys were performed, in 2008/2009 (time 1) and 2012/2013 (time 2). During a period of 0-3 years after time 1, three of six hospitals merged their general and medical intensive care units (restructured). The other hospitals maintained their structure of the intensive care units (not restructured). Intensive care units in hospitals at one Norwegian hospital trust. The safety culture was measured with Hospital Survey on Patient Safety Culture. At times 1 and 2, 217/302 (72%) and 145/289 (50%) registered nurses participated. Restructuring was negatively associated with change in the safety culture, in particular, the dimensions of the safety culture within the unit level. The dimensions most vulnerable for restructuring were manager expectations and actions promoting safety, teamwork within hospital units and staffing. In this study, the restructuring of intensive care units was associated with a negative impact on the safety culture. When restructuring, the management should be particularly aware of changes in the safety culture dimensions manager expectations and actions promoting safety, teamwork within hospital units and staffing. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Health of health care workers in Canadian nursing homes and pediatric hospitals: a cross-sectional study

PubMed Central

Hoben, Matthias; Knopp-Sihota, Jennifer A.; Nesari, Maryam; Chamberlain, Stephanie A.; Squires, Janet E.; Norton, Peter G.; Cummings, Greta G.; Stevens, Bonnie J.; Estabrooks, Carole A.

2017-01-01

Background: Poor health of health care workers affects quality of care, but research and health data for health care workers are scarce. Our aim was to compare physical/mental health among health care worker groups 1) within nursing homes and pediatric hospitals, 2) between the 2 settings and 3) with the physical/mental health of the Canadian population. Methods: Using cross-sectional data collected as part of the Translating Research in Elder Care program and the Translating Research on Pain in Children program, we examined the health of health care workers. In nursing homes, 169 registered nurses, 139 licensed practical nurses, 1506 care aides, 145 allied health care providers and 69 managers were surveyed. In pediatric hospitals, 63 physicians, 747 registered nurses, 155 allied health care providers, 49 nurse educators and 22 managers were surveyed. After standardization of the data for age and sex, we applied analyses of variance and general linear models, adjusted for multiple testing. Results: Nursing home workers and registered nurses in pediatric hospitals had poorer mental health than the Canadian population. Scores were lowest for registered nurses in nursing homes (mean difference -4.4 [95% confidence interval -6.6 to -2.6]). Physicians in pediatric hospitals and allied health care providers in nursing homes had better physical health than the general population. We also found important differences in physical/mental health for care provider groups within and between care settings. Interpretation: Mental health is especially poor among nursing home workers, who care for a highly vulnerable and medically complex population of older adults. Strategies including optimized work environments are needed to improve the physical and mental health of health care workers to ameliorate quality of patient care. PMID:29162609

Efficacy of hormonal and mental treatments with MMPI in FtM individuals: cross-sectional and longitudinal studies.

PubMed

Oda, Hiroyuki; Kinoshita, Toshihiko

2017-07-17

Cross-sex hormone treatment (CSHT) is an important option for gender dysphoria (GD) individuals to improve the quality of life. However, in Japan, sex reassignment surgery (SRS) and CSHT for GD had been discontinued until 1998 (over 30 years). After resumption, the number of GD individuals wishing treatment rapidly increased. On the other hand, the number of medical institutions available for evaluation was limited. For this reason, hormonal treatment has been administered to GD individuals requiring the prompt start of CSHT in the absence of mental health assessment by specialists. In this study, we examined the efficacy of CSHT and psychotherapy. The participants were 155 female-to-male (FtM) individuals who consulted our gender identity clinic, and were definitively diagnosed. A cross-sectional study was conducted by dividing them into two groups: groups with and without CSHT on the initial consultation (Group CSHT: n = 53, Group no-CSHT: n = 102). In all participants, Minnesota Multiphasic Personality Inventory (MMPI) and blood hormone tests were performed on the initial consultation. In addition, CSHT was combined with psychotherapy for a specific period in Group no-CSHT, and FtM individuals in whom an additional MMPI test could be conducted (Group combined treatment (CT), n = 14) were enrolled in a longitudinal study. In the cross-sectional study, there was no significant difference on the MMPI test. In the longitudinal study, there were improvements in the clinical scales other than the Mf scale on the MMPI test. In Group CT, the D, Sc, and Si scale scores on the initial consultation were significantly higher than in Group CSHT. However, there was no clinical scale with a significantly higher value after the start of treatment. The Pd scale score was significantly lower. CSHT improved mental health. Psychotherapy-combined CSHT may further improve it. The study was reviewed and approved by the Ethics Committee of Kansai Medical University (A comprehensive treatment for gender dysphoria: No. 0314 registered date 10th December 2003), and was approved at UMIN000028102 on 6th July 2017 as retrospectively registered.

Feasibility of in Vivo SAXS Imaging for Detection of Alzheiemer's Disease

NASA Astrophysics Data System (ADS)

Choi, Mina

Small-angle x-ray scattering (SAXS) imaging has been proposed as a technique to characterize and selectively image structures based on electron density structure which allows for discriminating materials based on their scatter cross sections. This dissertation explores the feasibility of SAXS imaging for the detection of Alzheimer's disease (AD) amyloid plaques. The inherent scatter cross sections of amyloid plaque serve as biomarkers in vivo without the need of injected molecular tags. SAXS imaging can also assist in a better understanding of how these biomarkers play a role in Alzheimer's disease which in turn can lead to the development of more effective disease-modifying therapies. I implement simulations of x-ray transport using Monte Carlo methods for SAXS imaging enabling accurate calculation of radiation dose and image quality in SAXS-computed tomography (CT). I describe SAXS imaging phantoms with tissue-mimicking material and embedded scatter targets as a way of demonstrating the characteristics of SAXS imaging. I also performed a comprehensive study of scattering cross sections of brain tissue from measurements of ex-vivo sections of a wild-type mouse brain and reported generalized cross sections of gray matter, white matter, and corpus callosum obtained and registered by planar SAXS imaging. Finally, I demonstrate the ability of SAXS imaging to locate an amyloid fibril pellet within a brain section. This work contributes to novel application of SAXS imaging for Alzheimer's disease detection and studies its feasibility as an imaging tool for AD biomarkers.

The effect of preceptor role effectiveness on newly licensed registered nurses' perceived psychological empowerment and professional autonomy.

PubMed

Watkins, Chanell; Hart, Patricia L; Mareno, Nicole

2016-03-01

The first year turnover rate for newly licensed registered nurses is roughly 30% and increases to about 57% in the second year (Twibell et al., 2012). An effective preceptorship has been shown to better facilitate the first year transition (Hodges et al., 2008) and increase retention rates (Pine and Tart, 2007). The purpose of this study was to examine the relationships between newly licensed registered nurses' perceived preceptor role effectiveness, psychological empowerment and professional autonomy. A prospective, cross-sectional, descriptive research design was used. Sixty-nine newly licensed registered nurses were recruited and surveyed. Newly licensed registered nurses were found to have moderately high levels of perceived preceptor role effectiveness, psychological empowerment, and professional autonomy. Preceptor role effectiveness had significant, moderately, positive relationships with professional autonomy and psychological empowerment. There was also a significant relationship found between professional autonomy and psychological empowerment. Results show that preceptor role effectiveness is linked to increased professional autonomy and psychological empowerment. Therefore, effective preceptorships are necessary in easing the newly licensed registered nurse's transition to practice. Strategies to ensure effective preceptorships and enhance the NRLN's transition to practice are proposed. Copyright © 2016 Elsevier Ltd. All rights reserved.

An analysis of characteristics of post-authorisation studies registered on the ENCePP EU PAS Register

PubMed Central

Carroll, Robert; Ramagopalan, Sreeram V.; Cid-Ruzafa, Javier; Lambrelli, Dimitra; McDonald, Laura

2017-01-01

Background: The objective of this study was to investigate the study design characteristics of Post-Authorisation Studies (PAS) requested by the European Medicines Agency which were recorded on the European Union (EU) PAS Register held by the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP). Methods: We undertook a cross-sectional descriptive analysis of all studies registered on the EU PAS Register as of 18 th October 2016. Results: We identified a total of 314 studies on the EU PAS Register, including 81 (26%) finalised, 160 (51%) ongoing and 73 (23%) planned. Of those studies identified, 205 (65%) included risk assessment in their scope, 133 (42%) included drug utilisation and 94 (30%) included effectiveness evaluation. Just over half of the studies (175; 56%) used primary data capture, 135 (43%) used secondary data and 4 (1%) used a hybrid design combining both approaches. Risk assessment and effectiveness studies were more likely to use primary data capture (60% and 85% respectively as compared to 39% and 14% respectively for secondary). The converse was true for drug utilisation studies where 59% were secondary vs. 39% for primary. For type 2 diabetes mellitus, database studies were more commonly used (80% vs 3% chart review, 3% hybrid and 13% primary data capture study designs) whereas for studies in oncology, primary data capture were more likely to be used (85% vs 4% chart review, and 11% database study designs). Conclusions: Results of this analysis show that PAS design varies according to study objectives and therapeutic area. PMID:29188016

Prevalence of clinical trial status discrepancies: A cross-sectional study of 10,492 trials registered on both ClinicalTrials.gov and the European Union Clinical Trials Register.

PubMed

Fleminger, Jessica; Goldacre, Ben

2018-01-01

Trial registries are a key source of information for clinicians and researchers. While building OpenTrials, an open database of public trial information, we identified errors and omissions in registries, including discrepancies between descriptions of the same trial in different registries. We set out to ascertain the prevalence of discrepancies in trial completion status using a cohort of trials registered on both the European Union Clinical Trials Register (EUCTR) and ClinicalTrials.gov. We used matching titles and registry IDs provided by both registries to build a cohort of dual-registered trials. Completion statuses were compared; we calculated descriptive statistics on the prevalence of discrepancies. 11,988 dual-registered trials were identified. 1,496 did not provide a comparable completion status, leaving 10,492 trials. 16.2% were discrepant on completion status. The majority of discrepancies (90.5%) were a 'completed' trial on ClinicalTrials.gov inaccurately marked as 'ongoing' on EUCTR. Overall, 33.9% of dual-registered trials described as 'ongoing' on EUCTR were listed as 'completed' on ClinicalTrials.gov. Completion status on registries is commonly inaccurate. Previous work on publication bias may underestimate non-reporting. We describe simple steps registry owners and trialists could take to improve accuracy.

Current and maintained health-enhancing physical activity in rheumatoid arthritis: a cross-sectional study.

PubMed

Demmelmaier, Ingrid; Bergman, Patrick; Nordgren, Birgitta; Jensen, Irene; Opava, Christina H

2013-07-01

To describe and identify the explanatory factors of variation in current and maintained health-enhancing physical activity (HEPA) in persons with rheumatoid arthritis (RA). In this cross-sectional study, current HEPA was assessed with the International Physical Activity Questionnaire and maintained HEPA with the Exercise Stage Assessment Instrument, the latter explicitly focusing on both aerobic physical activity and muscle strength training. Sociodemographic, disease-related, and psychosocial data were retrieved from the Swedish Rheumatology Quality (SRQ) registers and a postal questionnaire. The explained variations in the respective HEPA behaviors were analyzed with logistic regression. In all, 3,152 (58.5%) of 5,391 persons identified as eligible from the SRQ registers responded to the questionnaire. Current HEPA was reported by 69%, and maintained HEPA by 11% of the respondents. The most salient and consistent factors explaining variation in both current and maintained HEPA were self-efficacy, social support, and outcome expectations related to physical activity. To our knowledge, this is the first study exploring maintained physical activity in a large well-defined sample of persons with RA. Our results indicate that a minority perform maintained HEPA, including both aerobic physical activity and muscle strength training, and that psychosocial factors are the most salient and consistent in the explanation of HEPA variation. Copyright © 2013 by the American College of Rheumatology.

Fulfilment of administrative and professional organisational obligations and nurses' customer-oriented behaviours.

PubMed

Trybou, Jeroen; Gemmel, Paul

2016-07-01

The aim of the study was to examine the relationship between the perceived quality of organisational exchange and nurses' customer-oriented behaviours. Hospitals face increasing competitive market conditions. Registered nurses interact closely with patients and therefore play an important front-office role towards patients. A cross-sectional study was conducted. Registered nurses (n = 151) of a Belgian hospital received a questionnaire to assess the fulfilment of administrative and professional organisational obligations and their customer-oriented behaviours. We found a positive relationship between psychological contract fulfilment and nurses' customer-oriented behaviours. More precisely administrative and professional psychological contract fulfilment relates significantly to nurses' service delivery and external representation. In case of internal influence only administrative psychological contract fulfilment was significantly related. Nurses' perceptions of the fulfilment of administrative and professional obligations are important to their customer-oriented behaviours. Nurse managers must be aware of the impact of fulfilling both administrative and professional obligations of registered nurses in order to optimise their customer-oriented behaviours. © 2016 John Wiley & Sons Ltd.

Identifying ethical issues of the Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists.

PubMed

Jenkins, Constance L; Elliott, Aaron R; Harris, Janet R

2006-08-01

The purposes of this study were to identify the ethical issues Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists (CRNAs) encountered in their anesthesia practice and how disturbed they were by these issues. This descriptive study used a secondary data analysis of a cross-sectional survey of Army Nurse Corps officers and Department of the Army civilian registered nurses (N = 5,293). The CRNA subset (n = 97) was obtained from questionnaires that indicated a primary practice setting as anesthesia. The most frequently occurring ethical issue identified was conflict in the nurse-physician relationship, whereas the most disturbing issue was working with incompetent/impaired colleagues. Unresolved ethical conflicts can negatively influence the nurses' morale, leading to avoidance of the issue and contributing to burnout. Identifying the ethical issues and disturbance level experienced by CRNAs should contribute to the development of an ethics education program that addresses issues encountered in CRNA practice.

Complications in multiple gestation pregnancy: A cross-sectional study of ten maternal-fetal medicine centers in China

PubMed Central

Wei, Jun; Wu, Qi-Jun; Zhang, Tie-Ning; Shen, Zi-Qi; Liu, Hao; Zheng, Dong-Ming; Cui, Hong; Liu, Cai-Xia

2016-01-01

Complications in women with multiple gestation pregnancy have not been studied in China. We aimed to establish a database of women with multiple gestation pregnancy and investigate the complications related to multiple pregnancy. We conducted a cross-sectional study that included 3246 women with multiple gestation pregnancy and who had multiple live-birth deliveries; the women were registered at ten maternal-fetal medicine centers in China in 2013. All participants completed a detailed questionnaire that included basic demographic information, history of gestation and abnormal fetal development, risk factors during pregnancy, and pregnancy outcomes. Overall, 1553 (47.8%) women experienced pregnancy complications; these women were more likely to have lower height and less education than women who did not experience complications. However, women who experienced complications had a higher twin birth rate and were more likely to have received regular antenatal care and assisted reproductive technology than women without complications (P < 0.05). Notably, preterm birth was a primary complication in multiple pregnancy (n = 960). In conclusion, pregnancy complications, especially preterm birth, were relatively common in women with multiple gestation pregnancy. The findings from this cross-sectional study in China may be used as a foundation for investigating risk factors for complications in women with multiple gestation pregnancy in the future. PMID:27127170

Complications in multiple gestation pregnancy: A cross-sectional study of ten maternal-fetal medicine centers in China.

PubMed

Wei, Jun; Wu, Qi-Jun; Zhang, Tie-Ning; Shen, Zi-Qi; Liu, Hao; Zheng, Dong-Ming; Cui, Hong; Liu, Cai-Xia

2016-05-24

Complications in women with multiple gestation pregnancy have not been studied in China. We aimed to establish a database of women with multiple gestation pregnancy and investigate the complications related to multiple pregnancy. We conducted a cross-sectional study that included 3246 women with multiple gestation pregnancy and who had multiple live-birth deliveries; the women were registered at ten maternal-fetal medicine centers in China in 2013. All participants completed a detailed questionnaire that included basic demographic information, history of gestation and abnormal fetal development, risk factors during pregnancy, and pregnancy outcomes. Overall, 1553 (47.8%) women experienced pregnancy complications; these women were more likely to have lower height and less education than women who did not experience complications. However, women who experienced complications had a higher twin birth rate and were more likely to have received regular antenatal care and assisted reproductive technology than women without complications (P < 0.05). Notably, preterm birth was a primary complication in multiple pregnancy (n = 960). In conclusion, pregnancy complications, especially preterm birth, were relatively common in women with multiple gestation pregnancy. The findings from this cross-sectional study in China may be used as a foundation for investigating risk factors for complications in women with multiple gestation pregnancy in the future.

Intimate partner violence and HIV infection among women: a systematic review and meta-analysis

PubMed Central

Li, Ying; Marshall, Caitlin M; Rees, Hilary C; Nunez, Annabelle; Ezeanolue, Echezona E; Ehiri, John E

2014-01-01

Introduction To assess evidence of an association between intimate partner violence (IPV) and HIV infection among women. Methods Medline/PubMed, Embase, Web of Science, EBSCO, Ovid, Cochrane HIV/AIDS Group's Specialized Register and Cochrane Central Register of Controlled Trials were searched up to 20 May 2013 to identify studies that examined the association between IPV and HIV infection in women. We included studies on women aged ≥15 years, in any form of sexually intimate relationship with a male partner. Results Twenty-eight studies [(19 cross-sectional, 5 cohorts and 4 case-control studies) involving 331,468 individuals in 16 countries – the US (eight studies), South Africa (four studies), East Africa (10 studies), India (three studies), Brazil (one study) and multiple low-income countries (two studies)] were included. Results were pooled using RevMan 5.0. To moderate effect estimates, we analyzed all data using the random effects model, irrespective of heterogeneity level. Pooled results of cohort studies indicated that physical IPV [pooled RR (95% CI): 1.22 (1.01, 1.46)] and any type of IPV [pooled RR (95% CI): 1.28 (1.00, 1.64)] were significantly associated with HIV infection among women. Results of cross-sectional studies demonstrated significant associations of physical IPV with HIV infection among women [pooled OR (95% CI): 1.44 (1.10, 1.87)]. Similarly, results of cross-sectional studies indicated that combination of physical and sexual IPV [pooled OR (95% CI): 2.00 (1.24, 3.22) and any type of IPV [pooled OR (95% CI): 1.41 (1.16, 1.73)] were significantly associated with HIV infection among women. Conclusions Available evidence suggests a moderate statistically significant association between IPV and HIV infection among women. To further elucidate the strength of the association between IPV and HIV infection among women, there is a need for high-quality follow-up studies conducted in different geographical regions of the world, and among individuals of diverse racial/cultural backgrounds and varying levels of HIV risks. PMID:24560342

Validation of heart failure diagnosis registered in primary care records in two primary care centres in Barcelona (Spain) and factors related. A cross-sectional study

PubMed Central

Verdú-Rotellar, Jose María; Frigola-Capell, Eva; Alvarez-Pérez, Rosa; da Silva, Daniela; Enjuanes, Cristina; Domingo, Mar; Mena, Amparo; Muñoz, Miguel-Angel

2017-01-01

Abstract Background: Heart failure (HF) diagnosis as reported in primary care medical records is not always properly confirmed and could result in over-registration. Objectives: To determine the proportion of registered HF that can be confirmed with information from primary care medical records and to analyse related factors. Methods: A cross-sectional study. The medical records of 595 HF patients attended in two primary healthcare centres in Barcelona (Spain) were revised and validated by a team of experts who classified diagnosis into confirmed, unconfirmed, and misdiagnosis. Variables potentially related to the confirmation of the diagnosis were analysed. The revision of medical records and data collection took place from 15 January to 31 March 2014. Results: Mean (standard deviation) age was 78 (10) years and 58% were women. The diagnosis could be confirmed in 53.6% of patients. Factors associated with a greater probability of having a confirmed diagnosis were age (yearly OR: 0.97, 95%CI: 0.95–0.99), cardiologist follow-up (OR: 3.66, 95%CI: 2.46–5.48), history of ischaemic heart disease (OR: 2.18, 95%CI: 1.36–2.48), atrial fibrillation (OR: 2.01, 95%CI: 1.34–3.03), and prescription of loop diuretics (OR: 3.24, 95%CI: 2.14–4.89). Conclusion: Only in half of the patients labelled as HF in primary care medical records could this diagnosis be further confirmed. Variables regularly registered in clinical practice could help general practitioners identify those patients requiring a revision of their HF diagnosis. PMID:28376668

Work related stress and its anticipated solutions among post-graduate medical resident doctors: a cross-sectional survey conducted at a tertiary municipal hospital in Mumbai, India.

PubMed

Rajan, Pavithra; Bellare, Bharati

2011-03-01

It is now known that resident doctors registered for postgraduate studies are prone to work related stress and eventual burnout. Though stress can happen in any profession, reduced performance of resident doctors due to vocational stress could cause an increase in medical errors and thus affect the quality of life of the patients. Resident doctors at a Municipal hospital in India form a unique population as number of stresses they undergo are many and varied. To study the prevalence of work-related stress and its anticipated solutions among the resident doctors registered for postgraduate studies in clinical subjects at a tertiary Municipal hospital. A stratified sampling cross-sectional survey was conducted at the Inpatient, Outpatient, and Intensive Care Units at a tertiary Municipal hospital in Mumbai, India. Data collection was done using a validated 20-point questionnaire to assess the factors causing stress and their anticipated solutions. Simple percentage analysis of stress questionnaire. 71 resident doctors completed the survey. The major stressors in this cohort were inadequate hostel/quarter facilities (92.1%), and the need to perform extra duties (80.0%). Also, non-conducive environment for clinical training and studies (81.7%), inadequate study (78.9%) and break (81.2%), threat from deadly infections (74.6%), and overburdening with work (69.0%) were the other major stress causing factors. The perceived stress busters were good music (40.8%) and family and friends (40.8%). Eighty-seven percent of the respondents perceived regular physical exercise to be an effective mode of stress management and 83.8% expressed their need to have a simple therapeutic gymnasium established within the campus with a qualified trainer. There is a high level of work related stress among the resident doctors registered for postgraduate clinical studies at a tertiary Municipal hospital in Mumbai. One of the perceived stress busters is regular physical exercise that is structured and under supervision.

Registered nurses' use of research findings in the care of older people.

PubMed

Boström, Anne-Marie; Kajermo, Kerstin Nilsson; Nordström, Gun; Wallin, Lars

2009-05-01

To describe registered nurses' reported use of research in the care of older people and to examine associations between research use and factors related to the elements: the communication channels, the adopter and the social system. Research use among registered nurses working in hospital settings has been reported in many studies. Few studies, however, have explored the use of research among registered nurses working in the care of older people. A cross-sectional survey. In eight municipalities, all registered nurses (n = 210) working in older people care were invited to participate (response rate 67%). The Research Utilisation Questionnaire was adopted. Questions concerning the work organisation and research-related resources were sent to the Community Chief Nurse at each municipality. Descriptive statistics and logistic regression were applied. The registered nurses reported a relatively low use of research findings in daily practice, despite reporting a positive attitude to research. The registered nurses reported lack of access to research reports at the work place and that they had little support from unit managers and colleagues. Registered nurses working in municipalities with access to research-related resources reported more use of research than registered nurses without resources. The factors 'Access to research findings at work place', 'Positive attitudes to research' and 'Nursing programme at university level' were significantly associated with research use. There is a great potential to increase registered nurses' use of research findings in the care of older people. Factors which were linked to the communication channels and the adopter were associated with research use. Strategies to enhance research use should focus on access to and adequate training in using information sources, increased knowledge on research methodology and nursing science and a supportive organisation.

Virtual plate pre-bending for the long bone fracture based on axis pre-alignment.

PubMed

Liu, Bin; Luo, Xinjian; Huang, Rui; Wan, Chao; Zhang, Bingbing; Hu, Weihua; Yue, Zongge

2014-06-01

In this paper, a modeling and visualizing system for assisting surgeons in correctly registering for the closed fracture reduction surgery is presented. By using this system, the geometric parameters of the target fixation plate before the long bone fracture operation can be obtained. The main processing scheme consists of following steps: firstly (image data process), utilize the Curvelet transform to denoise the CT images of fracture part and then reconstruct the 3D models of the broken bones. Secondly (pre-alignment), extract the axial lines of the broken bones and spatially align them. Then drive the broken bone models to be pre-aligned. Thirdly (mesh segmentation), a method based on vertex normal feature is utilized to obtain the broken bone cross-sections mesh models. Fourthly (fine registration), the ICP (Iterative Closest Point) algorithm is used to register the cross-sections and the broken bone models are driven to achieve the fine registration posture. Lastly (plate fitting), an accurate NURBS surface fitting method is used to construct the virtual plate. The experiment proved that the obtained models of the pre-bended plates were closely bonded to the surface of the registered long bone models. Finally, the lengths, angles and other interested geometric parameters can be measured on the plate models. Copyright © 2014 Elsevier Ltd. All rights reserved.

Attention to nurses' rewarding - an interview study of registered nurses working in primary and private healthcare in Finland.

PubMed

Seitovirta, Jaana; Vehviläinen-Julkunen, Katri; Mitronen, Lasse; De Gieter, Sara; Kvist, Tarja

2017-04-01

To identify meaningful types of rewards and the consequences of rewards as expressed by Finnish registered nurses working in primary and private healthcare. Previous studies have found significant associations between nurses' rewards and both their commitment and job satisfaction. Furthermore, appropriate rewards can have beneficial effects on factors including workforce stability and occupational satisfaction that are highly important in times of nurse shortages. A cross-sectional, qualitative interview study. Data were collected via individual semi-structured interviews (n = 20) with registered nurses working in Finland's primary and private healthcare, and subjected to qualitative content analysis. Six meaningful types of rewards were identified by the registered nurses: Financial compensation and benefits, Work-Life balance, Work content, Professional development, Recognition, and Supportive leadership. Rewards encouraged respondents to perform their work correctly and reinforced occupational satisfaction, but also caused feelings of envy and stress. It is essential to pay attention to nurses' preferences for particular rewards and to reward management. When designing effective reward systems for registered nurses, it is not sufficient to provide financial rewards alone, as various kinds of non-financial rewards are both meaningful and necessary. When trying to improve registered nurses' commitment and job satisfaction through reward management, it is important to listen to nurses' opinions to create a reward system that integrates financial and non-financial rewards and is fair from their perspective. Healthcare organisations that offer registered nurses a holistic reward system are more likely to retain satisfied and committed nurses at a time of increasing nursing shortages. © 2016 John Wiley & Sons Ltd.

Sputum smear examination and time to diagnosis in patients with smear-negative pulmonary tuberculosis in the Pacific.

PubMed

Viney, K; Bissell, K; Tabutoa, K; Kienene, T; Linh, N N; Briand, K; Harries, A D

2012-12-21

National tuberculosis programmes (NTPs) in Kiribati and the Marshall Islands, 2006-2010. To determine the proportion of all tuberculosis (TB) cases that were pulmonary smear-negative, and for these patients to determine how many sputum smears were examined and the time from sputum smear examination to registration. A retrospective cross-sectional study involving a record review of national TB and laboratory registers. Of 2420 TB cases identified, 709 (29%) were registered as smear-negative pulmonary TB. Of the 695 (98%) with information on smear examination, 222 (32%) had no smear recorded, 61 (9%) had one smear, 86 (12%) two smears and 326 (47%) three smears. Among the 473 patients who had at least one smear, 238 (50%) were registered before sputum examination, 131 (28%) within 1 week, 72 (15%) between 1 and 4 weeks, and 34 (7%) >4 weeks after sputum examination. NTPs in Kiribati and the Marshall Islands are diagnosing 29% of all TB patients as smear-negative pulmonary TB. Many patients do not have smears done or are registered before undergoing smear examination. Corrective measures are needed.

Generational differences in work ethic among 3 generations of registered nurses.

PubMed

Jobe, Laura L

2014-05-01

The purpose of this study was to understand if differences in dimensions of work ethic exist among 3 generations of nurses working in an inpatient setting at an acute care facility. Generational differences are linked with increased turnover, with work ethic frequently cited as an important difference. The quantitative, quasi-experimental cross-sectional study recruited inpatient registered nurses from 2 teaching hospitals in a southern US metropolitan area to complete the Multidimensional Work Ethic Profile online. The 285 completed surveys indicated that similarities exist among the 3 generations, with statistically significant differences only in leisure, hard work, and delay of gratification dimensions. Understanding differences in work ethic dimensions could lead to strategies for improving the generational conflict. These results also lead to the conclusion that work ethic differences may not be the cause of the generational conflict among nurses.

Publication and reporting of clinical trial results: cross sectional analysis across academic medical centers.

PubMed

Chen, Ruijun; Desai, Nihar R; Ross, Joseph S; Zhang, Weiwei; Chau, Katherine H; Wayda, Brian; Murugiah, Karthik; Lu, Daniel Y; Mittal, Amit; Krumholz, Harlan M

2016-02-17

To determine rates of publication and reporting of results within two years for all completed clinical trials registered in ClinicalTrials.gov across leading academic medical centers in the United States. Cross sectional analysis. Academic medical centers in the United States. Academic medical centers with 40 or more completed interventional trials registered on ClinicalTrials.gov. Using the Aggregate Analysis of ClinicalTrials.gov database and manual review, we identified all interventional clinical trials registered on ClinicalTrials.gov with a primary completion date between October 2007 and September 2010 and with a lead investigator affiliated with an academic medical center. The proportion of trials that disseminated results, defined as publication or reporting of results on ClinicalTrials.gov, overall and within 24 months of study completion. We identified 4347 interventional clinical trials across 51 academic medical centers. Among the trials, 1005 (23%) enrolled more than 100 patients, 1216 (28%) were double blind, and 2169 (50%) were phase II through IV. Overall, academic medical centers disseminated results for 2892 (66%) trials, with 1560 (35.9%) achieving this within 24 months of study completion. The proportion of clinical trials with results disseminated within 24 months of study completion ranged from 16.2% (6/37) to 55.3% (57/103) across academic medical centers. The proportion of clinical trials published within 24 months of study completion ranged from 10.8% (4/37) to 40.3% (31/77) across academic medical centers, whereas results reporting on ClinicalTrials.gov ranged from 1.6% (2/122) to 40.7% (72/177). Despite the ethical mandate and expressed values and mission of academic institutions, there is poor performance and noticeable variation in the dissemination of clinical trial results across leading academic medical centers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Influence of work-family-school role conflicts and social support on psychological wellbeing among registered nurses pursuing advanced degree.

PubMed

Xu, Lijuan; Song, Rhayun

2016-08-01

The purpose of the study was to determine how work-family-school role conflict and social support influence psychological well-being among registered nurses pursuing an advanced degree. A cross-sectional, correlational study design was used. Convenience sampling was used to recruit 320 registered nurses pursuing an advanced nursing degree at 13 hospitals in Korea, from June to October 2011. Data were analyzed using structural equation modeling with the AMOS program. Confirmatory factor analyses were conducted to evaluate the measurement model prior to the testing of study hypotheses before and after controlling for extraneous variables. The fit parameters of the modified model (χ(2)/df=2.01, GFI=0.91, AGFI=0.89, CFI=0.92, SRMR=0.068, and RMSEA=0.065) indicated its suitability as the research model. This model explained 45% of the variance in work-related psychological well-being and 52% of the variance in general psychological well-being. Both social support and work-family-school role conflict exerted significant effects on work-related psychological well-being and general psychological well-being. The findings of the present study imply that work-family-school role conflict influences the psychological well-being of registered nurses pursuing an advanced degree. It is necessary for nursing administrators to develop strategies to help registered nurses to manage their multiple roles and improve both their work-related psychological well-being and their general psychological well-being. Copyright © 2015 Elsevier Inc. All rights reserved.

Hip fracture prevalence in grandfathers is associated with reduced cortical cross-sectional bone area in their young adult grandsons.

PubMed

Rudäng, Robert; Ohlsson, Claes; Odén, Anders; Johansson, Helena; Mellström, Dan; Lorentzon, Mattias

2010-03-01

Parent hip fracture prevalence is a known risk factor for osteoporosis. The role of hip fracture prevalence in grandparents on areal bone mineral density (aBMD) and bone size in their grandsons remains unknown. The objective of the study was to examine whether hip fracture prevalence in grandparents was associated with lower aBMD and reduced cortical bone size in their grandsons. This was a population-based cohort study in Sweden. Subjects included 1015 grandsons (18.9 +/- 0.6) (mean +/- sd) and 3688 grandparents. aBMD, cortical bone size, volumetric bone mineral density and polar strength strain index of the cortex in the grandsons in relation to hip fracture prevalence in their grandparents were measured. Grandsons of grandparents with hip fracture (n = 269) had lower aBMD at the total body, radius, and lumbar spine, but not at the hip, as well as reduced cortical cross-sectional area at the radius (P < 0.05) than grandsons of grandparents without hip fracture. Subgroup analysis demonstrated that grandsons of grandfathers with hip fracture (n = 99) had substantially lower aBMD at the lumbar spine (4.9%, P < 0.001) and total femur (4.1%, P = 0.003) and lower cortical cross-sectional area of the radius (4.1%, P < 0.001) and tibia (3.3%, P < 0.011). Adjusting bone variables for grandson age, weight, height, smoking, calcium intake, and physical activity and taking grandparent age at register entry, years in register, and grandparent sex into account strengthened or did not affect these associations. Family history of a grandfather with hip fracture was associated with reduced aBMD and cortical bone size in 19-yr-old men, indicating that patient history of hip fracture in a grandfather could be of value when evaluating the risk of low bone mass in men.

Patient safety: numerical skills and drug calculation abilities of nursing students and registered nurses.

PubMed

McMullan, Miriam; Jones, Ray; Lea, Susan

2010-04-01

This paper is a report of a correlational study of the relations of age, status, experience and drug calculation ability to numerical ability of nursing students and Registered Nurses. Competent numerical and drug calculation skills are essential for nurses as mistakes can put patients' lives at risk. A cross-sectional study was carried out in 2006 in one United Kingdom university. Validated numerical and drug calculation tests were given to 229 second year nursing students and 44 Registered Nurses attending a non-medical prescribing programme. The numeracy test was failed by 55% of students and 45% of Registered Nurses, while 92% of students and 89% of nurses failed the drug calculation test. Independent of status or experience, older participants (> or = 35 years) were statistically significantly more able to perform numerical calculations. There was no statistically significant difference between nursing students and Registered Nurses in their overall drug calculation ability, but nurses were statistically significantly more able than students to perform basic numerical calculations and calculations for solids, oral liquids and injections. Both nursing students and Registered Nurses were statistically significantly more able to perform calculations for solids, liquid oral and injections than calculations for drug percentages, drip and infusion rates. To prevent deskilling, Registered Nurses should continue to practise and refresh all the different types of drug calculations as often as possible with regular (self)-testing of their ability. Time should be set aside in curricula for nursing students to learn how to perform basic numerical and drug calculations. This learning should be reinforced through regular practice and assessment.

Profile of advanced nursing practice in Spain: A cross-sectional study.

PubMed

Sevilla Guerra, Sonia; Miranda Salmerón, Josep; Zabalegui, Adelaida

2018-03-01

In this study, we described the profile of advanced nursing practice in Spain. A cross-sectional study design was used to explore the extent and patterns of advanced nursing practice activity within the domains of expert care planning, integrated care, interprofessional collaboration, education, research, evidence-based practice, and professional leadership. Data were collected in 2015/2016. Purposive sampling yielded a sample of 165 specialist and expert nurses employed by a dual tertiary and community hospital in an urban setting. The study included specialist and expert nurses who had a higher practice profile than registered general nurses. The performance of activities according to age, current position, years of experience, nursing grade, and education was compared. Practice domains were more strongly influenced by the predictors of nursing position and professional career ladder. Age and experience predictors were found to be weak predictors of advanced practice domains. This study offers essential information of the nursing workforce, and clarifies both the advanced nursing practice profile and nomenclature in the context of study. © 2017 John Wiley & Sons Australia, Ltd.

Characteristics of Innovators Adopting a National Personal Health Record in Portugal: Cross-Sectional Study

PubMed Central

Rodolfo, Inês; Pereira, Ana Marta; de Sá, Armando Brito

2017-01-01

Background Personal health records (PHRs) are increasingly being deployed worldwide, but their rates of adoption by patients vary widely across countries and health systems. Five main categories of adopters are usually considered when evaluating the diffusion of innovations: innovators, early adopters, early majority, late majority, and laggards. Objective We aimed to evaluate adoption of the Portuguese PHR 3 months after its release, as well as characterize the individuals who registered and used the system during that period (the innovators). Methods We conducted a cross-sectional study. Users and nonusers were defined based on their input, or not, of health-related information into the PHR. Users of the PHR were compared with nonusers regarding demographic and clinical variables. Users were further characterized according to their intensity of information input: single input (one single piece of health-related information recorded) and multiple inputs. Multivariate logistic regression was used to model the probability of being in the multiple inputs group. ArcGis (ESRI, Redlands, CA, USA) was used to create maps of the proportion of PHR registrations by region and district. Results The number of registered individuals was 109,619 (66,408/109,619, 60.58% women; mean age: 44.7 years, standard deviation [SD] 18.1 years). The highest proportion of registrations was observed for those aged between 30 and 39 years (25,810/109,619, 23.55%). Furthermore, 16.88% (18,504/109,619) of registered individuals were considered users and 83.12% (91,115/109,619) nonusers. Among PHR users, 32.18% (5955/18,504) engaged in single input and 67.82% (12,549/18,504) in multiple inputs. Younger individuals and male users had higher odds of engaging in multiple inputs (odds ratio for male individuals 1.32, CI 1.19-1.48). Geographic analysis revealed higher proportions of PHR adoption in urban centers when compared with rural noncoastal districts. Conclusions Approximately 1% of the country’s population registered during the first 3 months of the Portuguese PHR. Registered individuals were more frequently female aged between 30 and 39 years. There is evidence of a geographic gap in the adoption of the Portuguese PHR, with higher proportions of adopters in urban centers than in rural noncoastal districts. PMID:29021125

Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies

PubMed Central

Katagiri, Ryoko; Yuan, Xiaoyi; Kobayashi, Satomi; Sasaki, Satoshi

2017-01-01

Background Although several reports concerning the association of iodine excess and thyroid disease have appeared, no systematic review of the association between iodine excess intake and thyroid diseases, especially hyperthyroidism and hypothyroidism, has yet been reported. Method We conducted a systematic search of Ovid MEDLINE, PubMed, Cochrane Central Register of Controlled Trials databases, Ichushi-Web and CiNii database for intervention trials and observational studies. Search terms were constructed from related words for excess AND iodine intake or excretion AND thyroid hormones or diseases AND study designs. After considering the qualitative heterogeneity among studies, a meta-analysis was conducted and odds ratios and 95% confidence intervals (CI) were estimated in random-effects models. A protocol was registered with PROSPERO (No. CRD42015028081). Results 50 articles were included, including three intervention trials, six case-control studies, six follow-up studies and 35 cross-sectional studies. Three cross-sectional studies in adults included in meta-analysis. Odds ratio of overt and subclinical hypothyroidism between excess and adequate populations were 2.78 (CI:1.47 to 5.27) and 2.03 (CI:1.58 to 2.62) in adults, respectively. Source of excess iodine status was mainly iodized salt or water in included studies. Conclusion Although universal salt iodization has improved goiter rates, chronic exposure to excess iodine from water or poorly monitored salt are risk factors for hypothyroidism in free-living populations. Monitoring of both iodine concentration in salt as well as the iodine concentration in local drinking water are essential to preventing thyroid diseases. Hypothyroidism should be also carefully monitored in areas with excess iodine. Because of the low quality and limited number of included studies, further evidence and review are required. PMID:28282437

A cross-sectional study examining factors related to critical thinking in nursing.

PubMed

Lang, Gary Morris; Beach, Nick Lee; Patrician, Patricia A; Martin, Cheryl

2013-01-01

The purpose of this study was to examine critical thinking skills among registered nurses who work in a military hospital. Sixty-five nurses were administered the Health Sciences Reasoning Test to obtain scores in inductive reasoning, deductive reasoning, interpretation, analysis, and evaluation skills. Results showed no significant association between critical thinking skills and years of experience; however, differences were identified among racial/ethnic groups. It is hoped that findings from this study create a platform for dialogue among staff development nurses who are best situated to develop strategies that address these issues.

Public Opinion on School-Based Sex Education in South Carolina

ERIC Educational Resources Information Center

Alton, Forrest L.; Valois, Robert F.; Oldendick, Robert; Drane, J. Wanzer

2009-01-01

The purpose of this article was to determine opinions on the use of abstinence only versus comprehensive sex education by registered voters in South Carolina. A cross-sectional, random-digit dial sample was utilized. Approximately 81% of respondents indicated support for sex education that emphasizes abstinence but also teaches about the benefits…

Physical activity behaviour in men with inflammatory joint disease: a cross-sectional register-based study.

PubMed

Hammer, Nanna Maria; Midtgaard, Julie; Hetland, Merete Lund; Krogh, Niels Steen; Esbensen, Bente Appel

2018-05-01

Physical activity is recommended as an essential part of the non-pharmacological management of inflammatory joint disease, but previous research in this area has predominantly included women. The aim of this study was to examine physical activity behaviour in men with inflammatory joint disease. The study was conducted as a cross-sectional register-based study. Data on physical activity behaviour in men with RA, PsA and AS were matched with sociodemographic and clinical variables extracted from the DANBIO registry. Logistic regression analyses using multiple imputations were performed to investigate demographic and clinical variables associated with regular engagement in physical activity (moderate-vigorous ⩾2 h/week). Descriptive statistics were applied to explore motivation, barriers and preferences for physical activity. A total of 325 men were included of whom 129 (40%) engaged in regular physical activity. In univariate analyses, higher age, visual analogue scale (VAS) for pain, VAS fatigue, VAS patient's global, CRP level, disease activity, functional disability and current smoking were negatively associated with regular engagement in physical activity. In the final multivariable regression model only a high VAS fatigue score (⩾61 mm) (OR = 0.228; CI: 0.119, 0.436) remained significantly independently associated with regular physical activity. A majority of men with inflammatory joint disease do not meet the recommendations of regular physical activity. Both sociodemographic and clinical parameters were associated with engagement in physical activity, and fatigue especially seems to play a pivotal role in explaining suboptimal physical activity behaviour in this patient group.

Contribution of the Activities Diary to the pediatric teaching

PubMed Central

Fernandes, Vitor de Almeida; Scucuglia, Ana Cláudia B.; T.Gonsaga, Ricardo Alessandro; Biscegli, Terezinha Soares

2013-01-01

OBJECTIVE To describe the fifth-year medical students' self-evaluation based on the reflexive discourse of the Activities Diaries (portfolio) from the Pediatric Internship I and Child Care Rotations. METHODS Cross sectional, qualitative and descriptive study using the collective subject discourse of the diaries used during the internship of the Medical School, in Catanduva, São Paulo, from January to November, 2011. The registered students' testimonials in the portfolio sections called self-assessment and students' impression were assessed according to their central ideas (discipline organization, breastfeeding outpatient clinic, number of admissions in the pediatric hospital ward and satisfaction with the Child Health training ), related to the teaching of Pediatrics and Child Care. The portfolios with incomplete registers were excluded. RESULTS The testimonials of 47 interns (75% of the students) were analyzed, and 21.3% of them expressed satisfaction with the discipline organization and 27.7% praised the inclusion of the breastfeeding outpatient clinics in the course. For 25.5% of the academics, the number of admissions in the pediatric wards was insufficient for an ideal learning; however, 70.2% were satisfied with the Child Health training. CONCLUSIONS This critical analysis allowed a summary of the reflections, suggestions and critics registered by the interns and can be used as a tool for improvement of the professional cycle. PMID:24142320

The perceived impact of the European registration system for genetic counsellors and nurses.

PubMed

Paneque, Milena; Moldovan, Ramona; Cordier, Christophe; Serra-Juhé, Clara; Feroce, Irene; Pasalodos, Sara; Haquet, Emmanuelle; Lambert, Debby; Bjørnevoll, Inga; Skirton, Heather

2017-09-01

The aim of the European Board of Medical Genetics has been to develop and promote academic and professional standards necessary in order to provide competent genetic counselling services. The aim of this study was to explore the impact of the European registration system for genetic nurses and counsellors from the perspectives of those professionals who have registered. Registration system was launched in 2013. A cross-sectional, online survey was used to explore the motivations and experiences of those applying for, and the effect of registration on their career. Fifty-five Genetic Nurses and Counsellors are registered till now, from them, thirty-three agreed to participate on this study. The main motivations for registering were for recognition of their work value and competence (30.3%); due to the absence of a registration system in their own country (15.2%) and the possibility of obtaining a European/international certification (27.3%), while 27.3% of respondents registered to support recognition of the genetic counselling profession. Some participants valued the registration process as an educational activity in its own right, while the majority indicated the greatest impact of the registration process was on their clinical practice. The results confirm that registrants value the opportunity to both confirm their own competence and advance the genetic counselling profession in Europe.

Support from a prenatal instructor during childbirth is associated with reduced rates of caesarean section in a Mexican study.

PubMed

Campero, Lourdes; Hernández, Bernardo; Osborne, Jomo; Morales, Sara; Ludlow, Teresa; Muñoz, Christian

2004-12-01

to assess the association between non-clinical factors and the incidence of caesarean section (CS); to estimate the effect of a prenatal instructor's presence during childbirth on birth outcome (vaginal or CS). cross-sectional study from a register of women who attended prenatal classes. Multivariate logistic regression was used to measure the effects of each variable on whether the birth was vaginal or CS. Mexico City, Mexico. 992 births to 847 women from the register of the Birth Education Centre (CEPAPAR) between 1987 and 2000. the incidence of CS was 33%. The most commonly reported (by the women) reason for performing a CS was dystocia (53%). Most women were middle or upper-middle class professionals, and 85% of the women gave birth in private institutions. Odds of having a CS were higher among women who gave birth in a large hospital, women who were over 25 years of age, primigravidae, and women who were not supported by a prenatal instructor during childbirth. non-clinical factors considerably affect the type of birth outcome (vaginal vs. CS). A system in which a prenatal instructor provided support to the woman during childbirth could contribute significantly to reducing initial and repeat CS.

Sputum smear examination and time to diagnosis in patients with smear-negative pulmonary tuberculosis in the Pacific

PubMed Central

Bissell, K.; Tabutoa, K.; Kienene, T.; Linh, N. N.; Briand, K.; Harries, A. D.

2012-01-01

Setting: National tuberculosis programmes (NTPs) in Kiribati and the Marshall Islands, 2006–2010. Objective: To determine the proportion of all tuberculosis (TB) cases that were pulmonary smear-negative, and for these patients to determine how many sputum smears were examined and the time from sputum smear examination to registration. Design: A retrospective cross-sectional study involving a record review of national TB and laboratory registers. Results: Of 2420 TB cases identified, 709 (29%) were registered as smear-negative pulmonary TB. Of the 695 (98%) with information on smear examination, 222 (32%) had no smear recorded, 61 (9%) had one smear, 86 (12%) two smears and 326 (47%) three smears. Among the 473 patients who had at least one smear, 238 (50%) were registered before sputum examination, 131 (28%) within 1 week, 72 (15%) between 1 and 4 weeks, and 34 (7%) >4 weeks after sputum examination. Conclusion: NTPs in Kiribati and the Marshall Islands are diagnosing 29% of all TB patients as smear-negative pulmonary TB. Many patients do not have smears done or are registered before undergoing smear examination. Corrective measures are needed. PMID:26392971

Work values and intention to become a registered nurse among healthcare assistants.

PubMed

Trede, Ines; Schweri, Juerg

2014-06-01

To examine the work values of Swiss healthcare assistant students, who, at the end of their vocational education in hospitals and nursing homes, choose to pursue a registered nurse degree. A prospective, cross-sectional survey was administered to a full cohort of healthcare assistant students in their last year of study in the canton of Bern (n=272). Multivariate methods (logistic regression) were applied to estimate the joint effect of work experience and work values in choosing to pursue a registered nurse education. Among work values, extrinsic values (regarding wage, career und educational perspectives) had a strong effect on the decisions of healthcare assistant students to pursue further education as registered nurses. Grades, socio-economic background and satisfaction during education also had an effect. Higher valuation of income, career and further education affect the career intentions of nursing assistants who have already obtained a recognized healthcare education and nursing experience. Teachers and trainers should actively identify the work values and expectations of these students. Provision of adequate advice and suggestions for the career development of these students may be an important route by which to address the nursing shortage and recruitment problems. © 2013.

Opinion of Pakistani physiotherapists/students about anatomy as a subject and method of teaching anatomy: a cross sectional survey.

PubMed

Khan, Muhammad Sikander Ghayas; ul Ain, Qurrat; Hussan, Syed Imtiaz; Basher, Salman; Iram, Humaira; Umar, Bilal

2015-02-01

To recognise and identify the importance of Anatomy as a subject for physiotherapists/students. The cross-sectional descriptive study was conducted from January to October 2011 at Riphah International University, Lahore, and comprised physiotherapists registered with Pakistan Physical Therapy Association and students pursuing undergraduate physiotherapy studies at the University. A survey proforma consisting of six questions was used for data collection which was analysed using SPSS 17. Of the 500 questionnaires distributed among physiotherapists and students, 286(57.2%) were collected back duly filled. Overall, 280(97.9%) respondents said Anatomy was important in physical therapy, 179(62.58%) said Anatomy was a difficult subject to retain knowledge of, 155 (54.38%) were of the view that only Clinical Anatomy should be studied, 204 (71.32%) were in favour of performing dissection, 259 (90.55%) found that teaching videos were essential for the study of Anatomy, and 89 (31.11%) believed Anatomy could be memorised by multiple readings. Despite being a difficult subject, Anatomy is an essential subject for medical professionals.

Are smooth pursuit eye movements altered in chronic whiplash-associated disorders? A cross-sectional study.

PubMed

Kongsted, A; Jørgensen, L V; Bendix, T; Korsholm, L; Leboeuf-Yde, C

2007-11-01

To evaluate whether smooth pursuit eye movements differed between patients with long-lasting whiplash-associated disorders and controls when using a purely computerized method for the eye movement analysis. Cross-sectional study comparing patients with whiplash-associated disorders and controls who had not been exposed to head or neck trauma and had no notable neck complaints. Smooth pursuit eye movements were registered while the subjects were seated with and without rotated cervical spine. Thirty-four patients with whiplash-associated disorders with symptoms more than six months after a car collision and 60 controls. Smooth pursuit eye movements were almost identical in patients with chronic whiplash-associated disorders and controls, both when the neck was rotated and in the neutral position. Disturbed smooth pursuit eye movements do not appear to be a distinct feature in patients with chronic whiplash-associated disorders. This is in contrast to results of previous studies and may be due to the fact that analyses were performed in a computerized and objective manner. Other possible reasons for the discrepancy to previous studies are discussed.

Nurses' knowledge and educational needs regarding genetics.

PubMed

Seven, Memnun; Akyüz, Aygül; Elbüken, Burcu; Skirton, Heather; Öztürk, Hatice

2015-03-01

Nurses now require a basic knowledge of genetics to provide patient care in a range of settings. To determine Turkish registered nurses' current knowledge and educational needs in relation to genetics. A descriptive, cross-sectional study. Turkish registered nurses working in a university hospital in Turkey were recruited. All registered nurses were invited to participate and 175 completed the study. The survey instrument, basic knowledge of health genetics, confidence in knowledge and the nurses' need for genetics education were used to collect data. The majority (81.1%, n=142) of participants indicated that genetics was not taught during their degree program, although 53.1% to 96% of respondents felt confident in defining different genetic concepts. The average genetics knowledge score was 6.89±1.99 of a possible 11 (range 0-11). The majority (70.3%) expressed a strong wish to attend a continuing nursing education program in genetics. The study shows that although Turkish nurses are not sufficiently knowledgeable to apply genetics in practice, they are willing to have more education to support their care of patients. Nurses need to have more education related to genetics in accordance with advances in human genetics to optimize health care. Copyright © 2014 Elsevier Ltd. All rights reserved.

The primacy of vital signs--acute care nurses' and midwives' use of physical assessment skills: a cross sectional study.

PubMed

Osborne, Sonya; Douglas, Clint; Reid, Carol; Jones, Lee; Gardner, Glenn

2015-05-01

Registered nurses and midwives play an essential role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Yet, evidence suggests that clinical deterioration frequently goes unnoticed in hospitalised patients. While much attention has been paid to early warning and rapid response systems, little research has examined factors related to physical assessment skills. To determine a minimum data set of core skills used during nursing assessment of hospitalised patients and identify nurse and workplace predictors of the use of physical assessment to detect patient deterioration. The study used a single-centre, cross-sectional survey design. The study included 434 registered nurses and midwives (Grades 5-7) involved in clinical care of patients on acute care wards, including medicine, surgery, oncology, mental health and maternity service areas, at a 929-bed tertiary referral teaching hospital in Southeast Queensland, Australia. We conducted a hospital-wide survey of registered nurses and midwives using the 133-item Physical Assessment Skills Inventory and the 58-item Barriers to Registered Nurses' Use of Physical Assessment Scale. Median frequency for each physical assessment skill was calculated to determine core skills. To explore predictors of core skill utilisation, backward stepwise general linear modelling was conducted. Means and regression coefficients are reported with 95% confidence intervals. A p value <.05 was considered significant for all analyses. Core skills used by most nurses every time they worked included assessment of temperature, oxygen saturation, blood pressure, breathing effort, skin, wound and mental status. Reliance on others and technology (F=35.77, p<.001), lack of confidence (F=5.52, p=.02), work area (F=3.79, p=.002), and clinical role (F=44.24, p<.001) were significant predictors of the extent of physical assessment skill use. The increasing acuity of the acute care patient plausibly warrants more than vital signs assessment; however, our study confirms nurses' physical assessment core skill set is mainly comprised of vital signs. The focus on these endpoints of deterioration as dictated by early warning and rapid response systems may divert attention from and devalue comprehensive nursing assessment that could detect subtle changes in health status earlier in the patient's hospitalisation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Trends in nursing research in France: a cross-sectional analysis.

PubMed

Dupin, C M; Chami, K; Petit dit Dariel, O; Debout, C; Rothan-Tondeur, M

2013-06-01

To examine the engagement of French registered nurses with the Ministry of Health's initiative to spur scientific inquiry in the community. French nursing research has suffered from a lack of dedicated funding. Positive signs of change have recently appeared, with the launch of the first national public funding programme dedicated to nursing research. This initiative, begun in 2010, was launched by the French Ministry of Health. Through this initiative, 149 registered nurses, serving as principal investigators, and their teams submitted research proposals between 2010 and 2011. The administrative guidelines of the funding programme are clearly oriented towards producing quantitative and exogenous nursing research. A cross-sectional analysis of 149 nursing research projects submitted during the first and second years of a French national funding programme for hospital-based nursing research was conducted. Research proposals were included in the analysis whether they received funding or not. Data collection took place in 2011. The categories used in the analysis were the following: (1) the socio-demographic data on the registered nurse principal investigators, (2) the research teams and (3) the research proposals (methodologies, bibliography, focus of the research, output, the status of the research proposals). This study highlights the presence of methodological homogeneity among the research proposals submitted for funding. Clear tendencies were towards interventional and quantitative studies and those with an exogenous factor research objective. Between 2010 and 2011, 25 projects were funded out of 149 submitted. They were mostly quantitative and/or focused on the exogenous factors in patient care. The socio-political context of a funding programme designed to encourage nursing research has had an implicit influence on the type of research to which French nurses have committed themselves to and the scientific positions with which these nurse researchers align themselves. © 2013 The Authors. International Nursing Review © 2013 International Council of Nurses.

Nurses' practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country, multilevel study.

PubMed

Leineweber, Constanze; Chungkham, Holendro Singh; Lindqvist, Rikard; Westerlund, Hugo; Runesdotter, Sara; Smeds Alenius, Lisa; Tishelman, Carol

2016-06-01

Nursing turnover is a major issue for health care managers, notably during the global nursing workforce shortage. Despite the often hierarchical structure of the data used in nursing studies, few studies have investigated the impact of the work environment on intention to leave using multilevel techniques. Also, differences between intentions to leave the current workplace or to leave the profession entirely have rarely been studied. The aim of the current study was to investigate how aspects of the nurse practice environment and satisfaction with work schedule flexibility measured at different organisational levels influenced the intention to leave the profession or the workplace due to dissatisfaction. Multilevel models were fitted using survey data from the RN4CAST project, which has a multi-country, multilevel, cross-sectional design. The data analysed here are based on a sample of 23,076 registered nurses from 2020 units in 384 hospitals in 10 European countries (overall response rate: 59.4%). Four levels were available for analyses: country, hospital, unit, and individual registered nurse. Practice environment and satisfaction with schedule flexibility were aggregated and studied at the unit level. Gender, experience as registered nurse, full vs. part-time work, as well as individual deviance from unit mean in practice environment and satisfaction with work schedule flexibility, were included at the individual level. Both intention to leave the profession and the hospital due to dissatisfaction were studied. Regarding intention to leave current workplace, there is variability at both country (6.9%) and unit (6.9%) level. However, for intention to leave the profession we found less variability at the country (4.6%) and unit level (3.9%). Intention to leave the workplace was strongly related to unit level variables. Additionally, individual characteristics and deviance from unit mean regarding practice environment and satisfaction with schedule flexibility were related to both outcomes. Major limitations of the study are its cross-sectional design and the fact that only turnover intention due to dissatisfaction was studied. We conclude that measures aiming to improve the practice environment and schedule flexibility would be a promising approach towards increased retention of registered nurses in both their current workplaces and the nursing profession as a whole and thus a way to counteract the nursing shortage across European countries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

District nurses' and registered nurses' training in and use of motivational interviewing in primary care settings.

PubMed

Östlund, Ann-Sofi; Wadensten, Barbro; Häggström, Elisabeth; Kristofferzon, Marja-Leena

2014-08-01

To examine to what extent district nurses and registered nurses have training in motivational interviewing, to what extent they use it and what prerequisites they have for using it; to compare district nurses and registered nurses, as well as to compare users and nonusers of motivational interviewing; and to examine possible relationships between use of motivational interviewing and the variables training, supervision and feedback in motivational interviewing and prerequisites for use. Motivational interviewing is an effective method for motivating patients to change their lifestyle, used increasingly in primary care. A cross-sectional survey study. A study-specific questionnaire was sent to all district nurses and registered nurses (n = 980) in primary care in three counties in Sweden, from September 2011-January 2012; 673 (69%) responded. Differences between groups as well as relationships between study variables were tested. According to self-reports, 59% of the respondents had training in motivational interviewing and 57% used it. Approximately 15% of those who reported using it had no specific training in the method. More district nurses than registered nurses had training in motivational interviewing and used it. The following factors were independently associated with the use of motivational interviewing: training in and knowledge of motivational interviewing, conditions for using it, time and absence of 'other' obstacles. Having knowledge in motivational interviewing and personal as well as workplace prerequisites for using it may promote increased use of motivational interviewing. Having the prerequisites for using motivational interviewing at the workplace is of significance to the use of motivational interviewing. In the context of primary care, district nurses seem to have better prerequisites than registered nurses for using motivational interviewing. © 2013 John Wiley & Sons Ltd.

Patient engagement with research: European population register study.

PubMed

McKevitt, Christopher; Fudge, Nina; Crichton, Siobhan; Bejot, Yannick; Daubail, Benoît; Di Carlo, Antonio; Fearon, Patricia; Kolominsky-Rabas, Peter; Sheldenkar, Anita; Newbound, Sophie; Wolfe, Charles D A

2015-12-01

Lay involvement in implementation of research evidence into practice may include using research findings to guide individual care, as well as involvement in research processes and policy development. Little is known about the conditions required for such involvement. To assess stroke survivors' research awareness, use of research evidence in their own care and readiness to be involved in research processes. Cross sectional survey of stroke survivors participating in population-based stroke registers in six European centres. The response rate was 74% (481/647). Reasons for participation in register research included responding to clinician request (56%) and to 'give something back' (19%); however, 20% were unaware that they were participating in a stroke register. Research awareness was generally low: 57% did not know the purpose of the register they had been recruited to; 73% reported not having received results from the register they took part in; 60% did not know about any research on stroke care. Few participants (7.6%) used research evidence during their consultations with a doctor. The 34% of participants who were interested in being involved in research were younger, more highly educated and already research aware. Across Europe, stroke survivors already participating in research appear ill informed about stroke research. Researchers, healthcare professionals and patient associations need to improve how research results are communicated to patient populations and research participants, and to raise awareness of the relationship between research evidence and increased quality of care. © 2014 John Wiley & Sons Ltd.

Nurse staffing and patient outcomes in Belgian acute hospitals: cross-sectional analysis of administrative data.

PubMed

Van den Heede, Koen; Sermeus, Walter; Diya, Luwis; Clarke, Sean P; Lesaffre, Emmanuel; Vleugels, Arthur; Aiken, Linda H

2009-07-01

Studies have linked nurse staffing levels (number and skill mix) to several nurse-sensitive patient outcomes. However, evidence from European countries has been limited. This study examines the association between nurse staffing levels (i.e. acuity-adjusted Nursing Hours per Patient Day, the proportion of registered nurses with a Bachelor's degree) and 10 different patient outcomes potentially sensitive to nursing care. DESIGN-SETTING-PARTICIPANTS: Cross-sectional analyses of linked data from the Belgian Nursing Minimum Dataset (general acute care and intensive care nursing units: n=1403) and Belgian Hospital Discharge Dataset (general, orthopedic and vascular surgery patients: n=260,923) of the year 2003 from all acute hospitals (n=115). Logistic regression analyses, estimated by using a Generalized Estimation Equation Model, were used to study the association between nurse staffing and patient outcomes. The mean acuity-adjusted Nursing Hours per Patient Day in Belgian hospitals was 2.62 (S.D.=0.29). The variability in patient outcome rates between hospitals is considerable. The inter-quartile ranges for the 10 patient outcomes go from 0.35 for Deep Venous Thrombosis to 3.77 for failure-to-rescue. No significant association was found between the acuity-adjusted Nursing Hours per Patient Day, proportion of registered nurses with a Bachelor's degree and the selected patient outcomes. The absence of associations between hospital-level nurse staffing measures and patient outcomes should not be inferred as implying that nurse staffing does not have an impact on patient outcomes in Belgian hospitals. To better understand the dynamics of the nurse staffing and patient outcomes relationship in acute hospitals, further analyses (i.e. nursing unit level analyses) of these and other outcomes are recommended, in addition to inclusion of other study variables, including data about nursing practice environments in hospitals.

Nurses' attitudes toward family importance in heart failure care.

PubMed

Gusdal, Annelie K; Josefsson, Karin; Thors Adolfsson, Eva; Martin, Lene

2017-03-01

Support from the family positively affects self-management, patient outcomes and the incidence of hospitalizations among patients with heart failure. To involve family members in heart failure care is thus valuable for the patients. Registered nurses frequently meet family members of patients with heart failure and the quality of these encounters is likely to be influenced by the attitudes registered nurses hold toward families. To explore registered nurses' attitudes toward the importance of families' involvement in heart failure nursing care and to identify factors that predict the most supportive attitudes. Cross-sectional, multicentre web-survey study. A sample of 303 registered nurses from 47 hospitals and 30 primary health care centres completed the instrument Families' Importance in Nursing Care - Nurses' Attitudes. Overall, registered nurses were supportive of families' involvement. Nonetheless, attitudes toward inviting families to actively take part in heart failure nursing care and involve families in planning of care were less supportive. Factors predicting the most supportive attitudes were to work in a primary health care centre, a heart failure clinic, a workplace with a general approach toward families, to have a postgraduate specialization, education in cardiac and/or heart failure nursing care, and a competence to work with families. Experienced registered nurses in heart failure nursing care can be encouraged to mentor their younger and less experienced colleagues to strengthen their supportive attitudes toward families. Registered nurses who have designated consultation time with patients and families, as in a nurse-led heart failure clinic, may have the most favourable condition for implementing a more supportive approach to families.

Dentists' Preferences for Diagnosis, Management and Referral of Chronic Oro-Facial Pain: Results from a National Survey

ERIC Educational Resources Information Center

Aggarwal, Vishal R.; Joughin, Amy; Zakrzewska, Joanna; Appelbe, Priscilla; Tickle, Martin

2012-01-01

Aim: To explore the diagnosis, treatment and referral patterns of chronic oro-facial pain patients by generalist primary care dentists (GDPs) in the UK. Methods: A cross-sectional survey was conducted using a non-stratified random sample of 500 GDPs who were selected from the General Dental Council register. A self-complete postal questionnaire…

The Learning Process and Technological Change in Wind Power: Evidence from China's CDM Wind Projects

ERIC Educational Resources Information Center

Tang, Tian; Popp, David

2016-01-01

The Clean Development Mechanism (CDM) is a project-based carbon trade mechanism that subsidizes the users of climate-friendly technologies and encourages technology transfer. The CDM has provided financial support for a large share of Chinese wind projects since 2002. Using pooled cross-sectional data of 486 registered CDM wind projects in China…

Importance and Satisfaction of Preventive Health Strategies in Institutions for People with Intellectual Disabilities: A Perspective of Institutional Directors

ERIC Educational Resources Information Center

Lin, J. D.; Yen, C. F.; Wu, J. L.

2005-01-01

Aim: To explore the perceptions of institutional directors on the preventive health strategies for people with intellectual disabilities in institutions. Methods: A structured questionnaire was conducted by a cross-sectional postal survey in all registered institutions in Taiwan in 2002. A total of 157 questionnaires were mailed, of which 121…

Navigation-supported diagnosis of the substantia nigra by matching midbrain sonography and MRI

NASA Astrophysics Data System (ADS)

Salah, Zein; Weise, David; Preim, Bernhard; Classen, Joseph; Rose, Georg

2012-03-01

Transcranial sonography (TCS) is a well-established neuroimaging technique that allows for visualizing several brainstem structures, including the substantia nigra, and helps for the diagnosis and differential diagnosis of various movement disorders, especially in Parkinsonian syndromes. However, proximate brainstem anatomy can hardly be recognized due to the limited image quality of B-scans. In this paper, a visualization system for the diagnosis of the substantia nigra is presented, which utilizes neuronavigated TCS to reconstruct tomographical slices from registered MRI datasets and visualizes them simultaneously with corresponding TCS planes in realtime. To generate MRI tomographical slices, the tracking data of the calibrated ultrasound probe are passed to an optimized slicing algorithm, which computes cross sections at arbitrary positions and orientations from the registered MRI dataset. The extracted MRI cross sections are finally fused with the region of interest from the ultrasound image. The system allows for the computation and visualization of slices at a near real-time rate. Primary tests of the system show an added value to the pure sonographic imaging. The system also allows for reconstructing volumetric (3D) ultrasonic data of the region of interest, and thus contributes to enhancing the diagnostic yield of midbrain sonography.

Remote network control plasma diagnostic system for Tokamak T-10

NASA Astrophysics Data System (ADS)

Troynov, V. I.; Zimin, A. M.; Krupin, V. A.; Notkin, G. E.; Nurgaliev, M. R.

2016-09-01

The parameters of molecular plasma in closed magnetic trap is studied in this paper. Using the system of molecular diagnostics, which was designed by the authors on the «Tokamak T-10» facility, the radiation of hydrogen isotopes at the plasma edge is investigated. The scheme of optical radiation registration within visible spectrum is described. For visualization, identification and processing of registered molecular spectra a new software is developed using MatLab environment. The software also includes electronic atlas of electronic-vibrational-rotational transitions for molecules of protium and deuterium. To register radiation from limiter cross-section a network control system is designed using the means of the Internet/Intranet. Remote control system diagram and methods are given. The examples of web-interfaces for working out equipment control scenarios and viewing of results are provided. After test run in Intranet, the remote diagnostic system will be accessible through Internet.

A survey of work engagement and psychological capital levels.

PubMed

Bonner, Lynda

2016-08-11

To evaluate the relationship between work engagement and psychological capital (PsyCap) levels reported by registered nurses. PsyCap is a developable human resource. Research on PsyCap as an antecedent to work engagement in nurses is needed. A convenience sample of 137 registered nurses participated in this quantitative cross-sectional survey. Questionnaires measured self-reported levels of work engagement and psychological capital. Descriptive and inferential statistics were used for data analysis. There was a statistically significant correlation between work engagement and PsyCap scores (r=0.633, p<0.01). Nurses working at band 5 level reported statistically significantly lower PsyCap scores compared with nurses working at band 6 and 7 levels. Nurses reporting high levels of work engagement also reported high levels of PsyCap. Band 5 nurses might benefit most from interventions to increase their PsyCap. This study supports PsyCap as an antecedent to work engagement.

Nurses' Perspectives on the Geriatric Nursing Practice Environment and the Quality of Older People's Care in Ontario Acute Care Hospitals.

PubMed

Fox, Mary T; Sidani, Souraya; Butler, Jeffrey I; Tregunno, Deborah

2017-06-01

Background Cultivating hospital environments that support older people's care is a national priority. Evidence on geriatric nursing practice environments, obtained from studies of registered nurses (RNs) in American teaching hospitals, may have limited applicability to Canada, where RNs and registered practical nurses (RPNs) care for older people in predominantly nonteaching hospitals. Purpose This study describes nurses' perceptions of the overall quality of care for older people and the geriatric nursing practice environment (geriatric resources, interprofessional collaboration, and organizational value of older people's care) and examines if these perceptions differ by professional designation and hospital teaching status. Methods A cross-sectional survey, using Dillman's tailored design, that included Geriatric Institutional Assessment Profile subscales, was completed by 2005 Ontario RNs and registered practical nurses to assess their perceptions of the quality of care and geriatric nursing practice environment. Results Scores on the Geriatric Institutional Assessment Profile subscales averaged slightly above the midpoint except for geriatric resources which was slightly below. Registered practical nurses rated the quality of care and geriatric nursing practice environment higher than RNs; no significant differences were found by hospital teaching status. Conclusions Nurses' perceptions of older people's care and the geriatric nursing practice environment differ by professional designation but not hospital teaching status. Teaching and nonteaching hospitals should both be targeted for geriatric nursing practice environment improvement initiatives.

Quantifying behavioural determinants relating to health professional reporting of medication errors: a cross-sectional survey using the Theoretical Domains Framework.

PubMed

Alqubaisi, Mai; Tonna, Antonella; Strath, Alison; Stewart, Derek

2016-11-01

The aims of this study were to quantify the behavioural determinants of health professional reporting of medication errors in the United Arab Emirates (UAE) and to explore any differences between respondents. A cross-sectional survey of patient-facing doctors, nurses and pharmacists within three major hospitals of Abu Dhabi, the UAE. An online questionnaire was developed based on the Theoretical Domains Framework (TDF, a framework of behaviour change theories). Principal component analysis (PCA) was used to identify components and internal reliability determined. Ethical approval was obtained from a UK university and all hospital ethics committees. Two hundred and ninety-four responses were received. Questionnaire items clustered into six components of knowledge and skills, feedback and support, action and impact, motivation, effort and emotions. Respondents generally gave positive responses for knowledge and skills, feedback and support and action and impact components. Responses were more neutral for the motivation and effort components. In terms of emotions, the component with the most negative scores, there were significant differences in terms of years registered as health professional (those registered longest most positive, p = 0.002) and age (older most positive, p < 0.001) with no differences for gender and health profession. Emotional-related issues are the dominant barrier to reporting and are common to all professions. There is a need to develop, test and implement an intervention to impact health professionals' emotions. Such an intervention should focus on evidence-based behaviour change techniques of reducing negative emotions, focusing on emotional consequences and providing social support. • This research used the Theoretical Domains Framework to quantify the behavioural determinants of health professional reporting of medication errors. • Questionnaire items relating to emotions surrounding reporting generated the most negative responses with significant differences in terms of years registered as health professional (those registered longest most positive) and age (older most positive) with no differences for gender and health profession. • Interventions based on behaviour change techniques mapped to emotions should be prioritised for development.

Association between registered nurse staffing and management outcomes of patients with type 2 diabetes within primary care: a cross-sectional linkage study

PubMed Central

Lukewich, Julia; Edge, Dana S.; VanDenKerkhof, Elizabeth; Williamson, Tyler; Tranmer, Joan

2016-01-01

Background: As the organization of primary care continues to evolve toward more interdisciplinary team structures, demonstrating effectiveness of care delivery is becoming important, particularly for nonphysician providers. Nurses are the most common nonphysician provider within primary care. The purpose of this study was to examine the relation between primary care delivery models that incorporate registered nurses and clinical outcomes of patients with type 2 diabetes. Methods: Patient data from the Canadian Primary Care Sentinel Surveillance Network were matched with survey data from 15 Family Health Team practices in southeastern Ontario. Included patients were adults with type 2 diabetes mellitus who had at least 1 primary care encounter at a Family Health Team practice that completed the organizational survey between Apr. 1, 2013, and Mar. 31, 2014. The clinical outcomes explored included hemoglobin A1c, fasting plasma glucose, blood pressure, low-density lipoprotein cholesterol and urine albumin:creatinine ratio. Results: Of the 15 practices, 13 (86.7%) had at least 1 registered nurse. The presence of 1 or more registered nurses in the practice was associated with increased odds of patients' having their hemoglobin A1c, fasting plasma glucose, blood pressure and low-density lipoprotein cholesterol values meet recommended targets. Practices with the lowest ratios of patients with diabetes to registered nurse had a significantly greater proportion of patients with hemoglobin A1c and fasting plasma glucose values on target than did practices with the highest ratios of patients to registered nurse (p < 0.01 and p = 0.03, respectively). Interpretation: The findings suggest that registered nurse staffing within primary care practice teams contributes to better diabetic care, as measured by diabetes management indicators. This study sets the groundwork for further exploration of nursing and organizational contributions to patient care in the primary care setting. PMID:27398372

Psychiatric Comorbidity at the Time of Diagnosis in Adults With ADHD: The CAT Study.

PubMed

Piñeiro-Dieguez, Benjamín; Balanzá-Martínez, Vicent; García-García, Pilar; Soler-López, Begoña

2016-12-01

The CAT (Comorbilidad en Adultos con TDAH) study aimed to quantify and characterize the psychiatric comorbidity at the time of diagnosis of ADHD in adult outpatients. Cross-sectional, multicenter, observational register of adults with ADHD diagnosed for the first time. In this large sample of adult ADHD (n = 367), psychiatric comorbidities were present in 66.2% of the sample, and were more prevalent in males and in the hyperactive-impulsive and combined subtypes. The most common comorbidities were substance use disorders (39.2%), anxiety disorders (23%), and mood disorders (18.1%). In all, 88.8% patients were prescribed pharmacological treatment for ADHD (in 93.4% of cases, modified release methylphenidate capsules 50:50). A high proportion of psychiatric comorbidity was observed when adult outpatients received a first-time diagnosis of ADHD. The systematic registering of patients and comorbidities in clinical practice may help to better understand and manage the prognostic determinants in adult ADHD. © The Author(s) 2014.

Using advanced mobile devices in nursing practice--the views of nurses and nursing students.

PubMed

Johansson, Pauline; Petersson, Göran; Saveman, Britt-Inger; Nilsson, Gunilla

2014-09-01

Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses' and nursing students' views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research. © The Author(s) 2013.

High caseload of childhood tuberculosis in hospitals on Java Island, Indonesia: a cross sectional study.

PubMed

Lestari, Trisasi; Probandari, Ari; Hurtig, Anna-Karin; Utarini, Adi

2011-10-11

Childhood tuberculosis (TB) has been neglected in the fight against TB. Despite implementation of Directly Observed Treatment Shortcourse (DOTS) program in public and private hospitals in Indonesia since 2000, the burden of childhood TB in hospitals was largely unknown. The goals of this study were to document the caseload and types of childhood TB in the 0-4 and 5-14 year age groups diagnosed in DOTS hospitals on Java Island, Indonesia. Cross-sectional study of TB cases recorded in inpatient and outpatient registers of 32 hospitals. Cases were analyzed by hospital characteristics, age groups, and types of TB. The number of cases reported in the outpatient unit was compared with that recorded in the TB register. Of 5,877 TB cases in the inpatient unit and 15,694 in the outpatient unit, 11% (648) and 27% (4,173) respectively were children. Most of the childhood TB cases were under five years old (56% and 53% in the inpatient and outpatient clinics respectively). The proportion of smear positive TB was twice as high in the inpatient compared to the outpatient units (15.6% vs 8.1%). Extra-pulmonary TB accounted for 15% and 6% of TB cases in inpatient and outpatient clinics respectively. Among children recorded in hospitals only 1.6% were reported to the National TB Program. In response to the high caseload and gross under-reporting of childhood TB cases, the National TB Program should give higher priority for childhood TB case management in designated DOTS hospitals. In addition, an international guidance on childhood TB recording and reporting and improved diagnostics and standardized classification is required.

GP utilisation by education level among adults with COPD or asthma: a cross-sectional register-based study.

PubMed

Hetlevik, Øystein; Melbye, Hasse; Gjesdal, Sturla

2016-06-09

There is a marked socioeconomic gradient in the prevalence of chronic obstructive pulmonary disease (COPD) and asthma, but a large proportion of patients remain undiagnosed. It is a challenge for general practitioners (GPs) to both identify patients and contribute to equity and high quality in services delivered. The aim of this study was to identify patients with COPD and asthma diagnoses recorded by GPs and explore their utilisation of GP services by education level. This was a cross-sectional, national, register-based study from Norwegian general practice in the period 2009-2011. Based on claims from GPs, the number of patients aged ⩾40 years with a diagnosis of COPD or asthma and their GP services utilisation were estimated and linked to the national education database. Multivariate Poisson and logistic regression models were used to explore the variations in GP utilisation. In the population aged ⩾40 years, 2.8% had COPD and 3.8% had asthma according to GPs' diagnoses. COPD was four times more prevalent in patients with basic education than higher education; this increase was ⩽80% for asthma. Consultation rates were 12% higher (P<0.001) for COPD and 25% higher (P<0.001) for asthma in patients with low versus high education in the age group of 40-59 years after adjusting for comorbidity, and patient and GP characteristics. Approximately 25% of COPD patients and 20% of asthma patients had ⩾1 spirometry test in general practice in 2011, with no significant education differences in adjusted models. The higher consultation rate in lower-education groups indicates that GPs contribute to fair distribution of healthcare.

Effect of Staff Turnover on Staffing: A Closer Look at Registered Nurses, Licensed Vocational Nurses, and Certified Nursing Assistants

ERIC Educational Resources Information Center

Kash, Bita A.; Castle, Nicholas G.; Naufal, George S.; Hawes, Catherine

2006-01-01

Purpose: We examined the effects of facility and market-level characteristics on staffing levels and turnover rates for direct care staff, and we examined the effect of staff turnover on staffing levels. Design and Methods: We analyzed cross-sectional data from 1,014 Texas nursing homes. Data were from the 2002 Texas Nursing Facility Medicaid Cost…

29 CFR 504.1 - Cross-reference.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FACILITIES USING NONIMMIGRANT ALIENS AS REGISTERED NURSES § 504.1 Cross-reference. Regulations governing labor condition attestations by facilities using nonimmigrant aliens as registered nurses are found at...

29 CFR 504.1 - Cross-reference.

Code of Federal Regulations, 2011 CFR

2011-07-01

... FACILITIES USING NONIMMIGRANT ALIENS AS REGISTERED NURSES § 504.1 Cross-reference. Regulations governing labor condition attestations by facilities using nonimmigrant aliens as registered nurses are found at...

Effect of Thyrotropin Suppression Therapy on Bone in Thyroid Cancer Patients

PubMed Central

Hawley, Sarah T.; Haymart, Megan R.

2016-01-01

Background. The thyroid cancer incidence is rising. Despite current guidelines, controversy exists regarding the degree and duration of thyrotropin suppression therapy. Also, its potential skeletal effects remain a concern to physicians caring for thyroid cancer patients. We conducted a review of published data to evaluate existing studies focusing on the skeletal effects of thyrotropin suppression therapy in thyroid cancer patients. Materials and Methods. A systematic search of the PubMed, Ovid/Medline, and Cochrane Central Register of Controlled Trials databases was conducted. The retained studies were evaluated for methodological quality, and the study populations were categorized into premenopausal women, postmenopausal women, and men. Results. Twenty-five pertinent studies were included. Seven studies were longitudinal and 18 were cross-sectional. Of the 25 included studies, 13 were assigned an excellent methodological quality score. Three of 5 longitudinal studies and 3 of 13 cross-sectional studies reported decreased bone mineral density (BMD) in premenopausal women; 2 of 4 longitudinal studies and 5 of 13 cross-sectional studies reported decreased BMD in postmenopausal women. The remaining studies showed no effect on BMD. The only longitudinal study of men showed bone mass loss; however, cross-sectional studies of men did not demonstrate a similar effect. Conclusion. Studies to date have yielded conflicting results on the skeletal effects of thyrotropin suppression therapy and a knowledge gap remains, especially for older adults and men. Existing data should be cautiously interpreted because of the variable quality and heterogeneity. Identifying groups at risk of adverse effects from thyrotropin suppression therapy will be instrumental to providing focused and tailored thyroid cancer treatment. Implications for Practice: The standard treatment for thyroid cancer includes total thyroidectomy with or without radioactive iodine ablation, often followed by thyrotropin suppression therapy. Despite current guidelines, controversy exists regarding the degree and duration of thyrotropin suppression therapy, and discordant results have been reported on its adverse effects on bone. The present review provides physicians with existing data on the skeletal effects of thyrotropin suppression therapy, highlighting the need for further research to identify the groups at risk of adverse skeletal effects. This knowledge will aid in developing tailored thyroid cancer treatment. PMID:26659220

Effect of Thyrotropin Suppression Therapy on Bone in Thyroid Cancer Patients.

PubMed

Papaleontiou, Maria; Hawley, Sarah T; Haymart, Megan R

2016-02-01

The thyroid cancer incidence is rising. Despite current guidelines, controversy exists regarding the degree and duration of thyrotropin suppression therapy. Also, its potential skeletal effects remain a concern to physicians caring for thyroid cancer patients. We conducted a review of published data to evaluate existing studies focusing on the skeletal effects of thyrotropin suppression therapy in thyroid cancer patients. A systematic search of the PubMed, Ovid/Medline, and Cochrane Central Register of Controlled Trials databases was conducted. The retained studies were evaluated for methodological quality, and the study populations were categorized into premenopausal women, postmenopausal women, and men. Twenty-five pertinent studies were included. Seven studies were longitudinal and 18 were cross-sectional. Of the 25 included studies, 13 were assigned an excellent methodological quality score. Three of 5 longitudinal studies and 3 of 13 cross-sectional studies reported decreased bone mineral density (BMD) in premenopausal women; 2 of 4 longitudinal studies and 5 of 13 cross-sectional studies reported decreased BMD in postmenopausal women. The remaining studies showed no effect on BMD. The only longitudinal study of men showed bone mass loss; however, cross-sectional studies of men did not demonstrate a similar effect. Studies to date have yielded conflicting results on the skeletal effects of thyrotropin suppression therapy and a knowledge gap remains, especially for older adults and men. Existing data should be cautiously interpreted because of the variable quality and heterogeneity. Identifying groups at risk of adverse effects from thyrotropin suppression therapy will be instrumental to providing focused and tailored thyroid cancer treatment. The standard treatment for thyroid cancer includes total thyroidectomy with or without radioactive iodine ablation, often followed by thyrotropin suppression therapy. Despite current guidelines, controversy exists regarding the degree and duration of thyrotropin suppression therapy, and discordant results have been reported on its adverse effects on bone. The present review provides physicians with existing data on the skeletal effects of thyrotropin suppression therapy, highlighting the need for further research to identify the groups at risk of adverse skeletal effects. This knowledge will aid in developing tailored thyroid cancer treatment. ©AlphaMed Press.

Assessing the impact of workplace bullying on nursing competences among registered nurses in Jordanian public hospitals.

PubMed

Al-Sagarat, Ahmad; Qan'ir, Yousef; Al-Azzam, Manar; Obeidat, Hala; Khalifeh, Anas

2018-04-23

To assess the impact of nursing competences on workplace bullying among registered nurses in Jordanian public hospitals. Workplace bullying has serious organizational and health effects on nursing staff. Little is known about the relationship between bullying and nursing competence worldwide. A cross-sectional descriptive study using a quantitative method was adopted for this study. The Negative Act Questionnaire-Revised (NAQ-R) and Nurse Professional Competence (NPC) questionnaire were used. A convenience sample of 272 nurses completed the study questionnaires. The results revealed that there were negative correlations between all NAQ scales and all NPC scales. The higher scores indicated better degrees of perceived competency, while the lower scores indicated the frequency of bullying reported by nurses. These results suggest that nurses who have more clinical competencies are less likely to experience work-related bullying. The study found that workplace bullying against nursing staff is still a considerable problem in participating Jordanian hospitals. To prohibit bullying behavior, nurse administrators have to construct a work environment that demonstrates respect and fairness and which is transmitted through nurses' communication pathways. © 2018 Wiley Periodicals, Inc.

Patient safety in practical nurses' education: A cross-sectional survey of newly registered practical nurses in Canada.

PubMed

VanDenKerkhof, Elizabeth; Sears, Nancy; Edge, Dana S; Tregunno, Deborah; Ginsburg, Liane

2017-04-01

Practical nurses have experienced an increasing scope of practice, including an expectation to care for complex patients and function on interdisciplinary teams. Little is known about the degree to which patient safety principles are addressed in practical nursing education. To examine self-reported patient safety competencies of practical nurses. A cross-sectional online survey (July 2014) and face-to-face interviews (June 2015). Ontario, Canada. Survey participants were practical nurses newly registered with the College of Nurses of Ontario between January 2012 and December 2013. Interview participants were faculty and students in a practical nursing program in Ontario. Survey respondents completed the Health Professional Education in Patient Safety Survey online. Self-reported competencies in various patient safety domains were compared between classroom and clinical settings. Faculty members were interviewed about educational preparation of practical nurses and students were interviewed to provide insight into interpretation of survey questions. The survey response rate was 28.4% (n=1104/3883). Mean domain scores indicated a high level of confidence in patient safety competence (<4.0/5.0). Confidence was highest in respondents registered with the College of Nurses of Ontario >2years and in those who obtained their education outside of Canada. Faculty believed their approach to teaching and learning instilled a deep understanding of the limits to practical nurse autonomous practice. Practical nurses were confident in what they learned about patient safety in their educational programs. The high degree of patient safety competence may be a true reflection of practical nurses understanding of, and comfort with, the limits of their knowledge and, ultimately, the limits of their individual autonomous practice. Further exploration as to whether the questionnaire requires additional modification for use with practical nurse populations is warranted. However, this study provides the first examination of practical nurses' perspectives and perceptions about patient safety education. Copyright © 2017 Elsevier Ltd. All rights reserved.

Staffing and job satisfaction: nurses and nursing assistants.

PubMed

Kalisch, Beatrice; Lee, Kyung Hee

2014-05-01

The aim of this study was to examine the relationship between staffing and job satisfaction of registered nurses (RNs) and nursing assistants (NAs). Although a number of previous studies have demonstrated the link between the numbers of patients cared for on the last shift and/or perceptions of staffing adequacy, we could find only one study that utilized a measure of actual staffing (opposed to perceptions of staffing adequacy) and correlated it with job satisfaction of registered nurses. This cross-sectional study included 3523 RNs and 1012 NAs in 131 patient care units. Staff were surveyed to determine job satisfaction and demographic variables. In addition, actual staffing data were collected from each of the study units. Hours per patient day was a significant positive predictor for registered nurse job satisfaction after controlling for covariates. For NAs, a lower skill mix was marginally significant with higher job satisfaction. In addition, the more work experience the NAs reported, the lower their job satisfaction. Adequate staffing levels are essential for RN job satisfaction whereas NA job satisfaction depends on the number of assistive personnel in the mix of nursing staff. Two implications are (1) providing adequate staffing is critical to maintain RN job satisfaction and (2) the NA job needs to be re-engineered to make it a more attractive and satisfying career. © 2012 John Wiley & Sons Ltd.

Effect of Prior Health-Related Employment on the Registered Nurse Workforce Supply.

PubMed

Yoo, Byung-kwan; Lin, Tzu-chun; Kim, Minchul; Sasaki, Tomoko; Spetz, Joanne

2016-01-01

Registered nurses (RN) who held prior health-related employment in occupations other than licensed practical or vocational nursing (LPN/LVN) are reported to have increased rapidly in the past decades. Researchers examined whether prior health-related employment affects RN workforce supply. A cross-sectional bivariate probit model using the 2008 National Sample Survey of Registered Nurses was esti- mated. Prior health-related employment in relatively lower-wage occupations, such as allied health, clerk, or nursing aide, was positively associated with working s an RN. ~>Prior health-related employ- ment in relatively higher-wage categories, such as a health care manager or LPN/LVN, was positively associated with working full-time as an RN. Policy implications are to promote an expanded career ladder program and a nursing school admission policy that targets non-RN health care workers with an interest in becoming RNs.

Multi-volumetric registration and mosaicking using swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography

NASA Astrophysics Data System (ADS)

Bozic, Ivan; El-Haddad, Mohamed T.; Malone, Joseph D.; Joos, Karen M.; Patel, Shriji N.; Tao, Yuankai K.

2017-02-01

Ophthalmic diagnostic imaging using optical coherence tomography (OCT) is limited by bulk eye motions and a fundamental trade-off between field-of-view (FOV) and sampling density. Here, we introduced a novel multi-volumetric registration and mosaicking method using our previously described multimodal swept-source spectrally encoded scanning laser ophthalmoscopy and OCT (SS-SESLO-OCT) system. Our SS-SESLO-OCT acquires an entire en face fundus SESLO image simultaneously with every OCT cross-section at 200 frames-per-second. In vivo human retinal imaging was performed in a healthy volunteer, and three volumetric datasets were acquired with the volunteer moving freely and refixating between each acquisition. In post-processing, SESLO frames were used to estimate en face rotational and translational motions by registering every frame in all three volumetric datasets to the first frame in the first volume. OCT cross-sections were contrast-normalized and registered axially and rotationally across all volumes. Rotational and translational motions calculated from SESLO frames were applied to corresponding OCT B-scans to compensate for interand intra-B-scan bulk motions, and the three registered volumes were combined into a single interpolated multi-volumetric mosaic. Using complementary information from SESLO and OCT over serially acquired volumes, we demonstrated multivolumetric registration and mosaicking to recover regions of missing data resulting from blinks, saccades, and ocular drifts. We believe our registration method can be directly applied for multi-volumetric motion compensation, averaging, widefield mosaicking, and vascular mapping with potential applications in ophthalmic clinical diagnostics, handheld imaging, and intraoperative guidance.

High agreement between the new Mongolian electronic immunization register and written immunization records: a health centre based audit

PubMed Central

Mungun, Tuya; Dorj, Narangerel; Volody, Baigal; Chuluundorj, Uranjargal; Munkhbat, Enkhtuya; Danzan, Gerelmaa; Nguyen, Cattram D; La Vincente, Sophie; Russell, Fiona

2017-01-01

Introduction Monitoring of vaccination coverage is vital for the prevention and control of vaccine-preventable diseases. Electronic immunization registers have been increasingly adopted to assist with the monitoring of vaccine coverage; however, there is limited literature about the use of electronic registers in low- and middle-income countries such as Mongolia. We aimed to determine the accuracy and completeness of the newly introduced electronic immunization register for calculating vaccination coverage and determining vaccine effectiveness within two districts in Mongolia in comparison to written health provider records. Methods We conducted a cross-sectional record review among children 2–23 months of age vaccinated at immunization clinics within the two districts. We linked data from written records with the electronic immunization register using the national identification number to determine the completeness and accuracy of the electronic register. Results Both completeness (90.9%; 95% CI: 88.4–93.4) and accuracy (93.3%; 95% CI: 84.1–97.4) of the electronic immunization register were high when compared to written records. The increase in completeness over time indicated a delay in data entry. Conclusion Through this audit, we have demonstrated concordance between a newly introduced electronic register and health provider records in a middle-income country setting. Based on this experience, we recommend that electronic registers be accompanied by routine quality assurance procedures for the monitoring of vaccination programmes in such settings. PMID:29051836

Acculturation, quality of life and work environment of international nurses in a multi-cultural society: A cross-sectional, correlational study.

PubMed

Goh, Yong-Shian; Lopez, Violeta

2016-05-01

The aim is to examine the acculturation level of international nurses working in a multi-cultural society. The relationship between acculturation, working environment and quality of life of international nurses was also explored. A cross-sectional, correlational study using self-report questionnaire was conducted on 814 international nurses using stratified random sampling based on the nationality distribution of international nurses registered with the Singapore Nursing Board. Outcome measures included World Health Organisation Quality of Life-BREF (WHOQOL_BREF) and Practice Environment Scale of the Nursing Work Index-Revised (PES-NWI-R). Data were collected from June to December 2012. There were variations in the acculturation level among different nationality groups of international nurses. Acculturation levels were the lowest among Mainland Chinese international nurses (M=27.47, SD 5.23). A positive correlation was found between acculturation and quality of life whereas a lower perception of work environment was associated with lower acculturation level. Data obtained from this study can be utilized to develop interventions targeted at the unique needs of the international nurses as they migrate. Copyright © 2015 Elsevier Inc. All rights reserved.

A Survey of Registered Dietitians’ Concern and Actions Regarding Climate Change in the United States

PubMed Central

Hawkins, Irana W.; Balsam, Alan L.; Goldman, Robert

2015-01-01

Dietary choices are a tool to reduce greenhouse gas emissions. While registered dietitians are on the front lines of food and nutrition recommendations, it is unclear how many are concerned with climate change and take action in practice in the United States. We explored concern about climate change among registered dietitians, and identified factors that may influence practice-related behaviors. Our study population included a random sample of all registered dietitians credentialed in the United States. Primary data were gathered using a cross-sectional survey. Of the 570 survey responses, 75% strongly agreed or agreed that climate change is an important issue while 34% strongly agreed or agreed that dietitians should play a major role in climate change mitigation strategies. Thirty-eight percent engaged in activities that promoted diet as a climate change mitigation strategy. Vegetarian (p = 0.002) and vegan dietitians (p = 0.007) were significantly more likely than non-vegetarian and non-vegan dietitians to engage in activities that promoted diet as a climate change mitigation strategy. Overall, concern for climate change among dietitians varied significantly by the region of the country in which the dietitian resided, and awareness that animal products are implicated in climate change. Registered dietitians in the United States are concerned with climate change. However, there is a discrepancy between concern and practice-based actions. These results suggest the need for educational and experiential opportunities connecting climate change mitigation to dietetics practice. PMID:26217666

Excited-state absorption and fluorescence dynamics of Er3+:KY3F10

NASA Astrophysics Data System (ADS)

Labbé, C.; Doualan, J. L.; Moncorgé, R.; Braud, A.; Camy, P.

2018-05-01

We report here on a complete investigation of the excited-state absorption and fluorescence dynamics of Er3+ doped KY3F10 single crystals versus dopant concentrations and optical excitation conditions. Radiative and effective (including non-radiative relaxations) emission lifetimes and branching ratios are determined from a Judd-Ofelt analysis of the absorption spectra and via specific fluorescence experiments using wavelength selective laser excitations. Excited-state absorption and emission spectra are registered within seven spectral domains, i.e. 560 nm, 650 nm, 710 nm, 810 nm, 970 nm, 1550 nm and 2750 nm. A maximum gain cross-section of 0.93 × 10-21 cm2 is determined at the potential laser wavelength of 2.801 μm for a population ratio of 0.48. Saturation of fluorescence intensities and variations of population ratios versus pumping rates are registered and confronted with a rate equation model to derive the rates of the most important up-conversion and cross-relaxation energy transfers occurring at high dopant concentrations.

Combating Unmeasured Confounding in Cross-Sectional Studies: Evaluating Instrumental-Variable and Heckman Selection Models

PubMed Central

DeMaris, Alfred

2014-01-01

Unmeasured confounding is the principal threat to unbiased estimation of treatment “effects” (i.e., regression parameters for binary regressors) in nonexperimental research. It refers to unmeasured characteristics of individuals that lead them both to be in a particular “treatment” category and to register higher or lower values than others on a response variable. In this article, I introduce readers to 2 econometric techniques designed to control the problem, with a particular emphasis on the Heckman selection model (HSM). Both techniques can be used with only cross-sectional data. Using a Monte Carlo experiment, I compare the performance of instrumental-variable regression (IVR) and HSM to that of ordinary least squares (OLS) under conditions with treatment and unmeasured confounding both present and absent. I find HSM generally to outperform IVR with respect to mean-square-error of treatment estimates, as well as power for detecting either a treatment effect or unobserved confounding. However, both HSM and IVR require a large sample to be fully effective. The use of HSM and IVR in tandem with OLS to untangle unobserved confounding bias in cross-sectional data is further demonstrated with an empirical application. Using data from the 2006–2010 General Social Survey (National Opinion Research Center, 2014), I examine the association between being married and subjective well-being. PMID:25110904

Estimating mortality using data from civil registration: a cross-sectional study in India

PubMed Central

Rao, Chalapati; Lakshmi, PVM; Prinja, Shankar; Kumar, Rajesh

2016-01-01

Abstract Objective To analyse the design and operational status of India’s civil registration and vital statistics system and facilitate the system’s development into an accurate and reliable source of mortality data. Methods We assessed the national civil registration and vital statistics system’s legal framework, administrative structure and design through document review. We did a cross-sectional study for the year 2013 at national level and in Punjab state to assess the quality of the system’s mortality data through analyses of life tables and investigation of the completeness of death registration and the proportion of deaths assigned ill-defined causes. We interviewed registrars, medical officers and coders in Punjab state to assess their knowledge and practice. Findings Although we found the legal framework and system design to be appropriate, data collection was based on complex intersectoral collaborations at state and local level and the collected data were found to be of poor quality. The registration data were inadequate for a robust estimate of mortality at national level. A medically certified cause of death was only recorded for 965 992 (16.8%) of the 5 735 082 deaths registered. Conclusion The data recorded by India’s civil registration and vital statistics system in 2011 were incomplete. If improved, the system could be used to reliably estimate mortality. We recommend improving political support and intersectoral coordination, capacity building, computerization and state-level initiatives to ensure that every death is registered and that reliable causes of death are recorded – at least within an adequate sample of registration units within each state. PMID:26769992

Non-disclosure of violence among female sex workers: evidence from a large scale cross-sectional survey in India.

PubMed

Mahapatra, Bidhubhusan; Battala, Madhusudana; Porwal, Akash; Saggurti, Niranjan

2014-01-01

One of the indicators critical to the success of violence reduction programmes among female sex workers (FSWs) is the pattern of disclosure of violence. This study examines the rate of non-disclosure of violence among FSWs in India by perpetrators of violence and programme exposure. Data were drawn from a cross-sectional study conducted among FSWs in 2009 across four states of India: Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu. The analytical sample included 1341 FSWs who experienced physical violence in past six months. Multilevel logistic regression stratified by state was conducted to examine predictors of non-disclosure. About 54% of FSWs did not disclose their experience of violence to anyone with considerable variations in the pattern of disclosure across states. Another 36% of FSWs shared the experience with NGO worker/peer. Compared to violence perpetrated by paying partners/stranger, that by non-paying partner were twice more likely to report non-disclosure (53% vs. 68%, Adjusted Odds Ratio [AOR]: 1.8, 95% Confidence Interval [CI]: 1.3-2.4). Similarly, FSWs who were not registered with an NGO/sex worker collective were 40% more likely to report non-disclosure of violence against those registered (58% vs. 53%, AOR: 1.4, 95% CI: 1.1-1.9). Non-disclosure of physical violence is quite high among FSWs which can be a barrier to the success of violence reduction efforts. Immediate efforts are required to understand the reasons behind non-disclosure based on which interventions can be developed. Community collectivisation and designing gender-based interventions with the involvement of non-paying partners should be the way forward.

Non-Disclosure of Violence among Female Sex Workers: Evidence from a Large Scale Cross-Sectional Survey in India

PubMed Central

Mahapatra, Bidhubhusan; Battala, Madhusudana; Porwal, Akash; Saggurti, Niranjan

2014-01-01

Objective One of the indicators critical to the success of violence reduction programmes among female sex workers (FSWs) is the pattern of disclosure of violence. This study examines the rate of non-disclosure of violence among FSWs in India by perpetrators of violence and programme exposure. Methods Data were drawn from a cross-sectional study conducted among FSWs in 2009 across four states of India: Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu. The analytical sample included 1341 FSWs who experienced physical violence in past six months. Multilevel logistic regression stratified by state was conducted to examine predictors of non-disclosure. Results About 54% of FSWs did not disclose their experience of violence to anyone with considerable variations in the pattern of disclosure across states. Another 36% of FSWs shared the experience with NGO worker/peer. Compared to violence perpetrated by paying partners/stranger, that by non-paying partner were twice more likely to report non-disclosure (53% vs. 68%, Adjusted Odds Ratio [AOR]: 1.8, 95% Confidence Interval [CI]: 1.3–2.4). Similarly, FSWs who were not registered with an NGO/sex worker collective were 40% more likely to report non-disclosure of violence against those registered (58% vs. 53%, AOR: 1.4, 95% CI: 1.1–1.9). Conclusions Non-disclosure of physical violence is quite high among FSWs which can be a barrier to the success of violence reduction efforts. Immediate efforts are required to understand the reasons behind non-disclosure based on which interventions can be developed. Community collectivisation and designing gender-based interventions with the involvement of non-paying partners should be the way forward. PMID:24846145

Hospital organizational factors influence work-family conflict in registered nurses: Multilevel modeling of a nation-wide cross-sectional survey in Sweden.

PubMed

Leineweber, C; Chungkham, H S; Westerlund, H; Tishelman, C; Lindqvist, R

2014-05-01

The present shortage of registered nurses (RNs) in many European countries is expected to continue and worsen, which poses a substantial threat to the maintenance of healthcare in this region. Work-family conflict is a known risk factor for turnover and sickness absence. This paper empirically examines whether the nurse practice environment is associated with experienced work-family conflict. A multilevel model was fit with the individual RN at the 1st, and the hospital department at the 2nd level using cross-sectional RN survey data from the Swedish part of RN4CAST, an EU 7th framework project. The data analyzed here is based on a national sample of 8356 female and 592 male RNs from 369 hospital departments. We found that 6% of the variability in work-family conflict experienced by RNs was at the department level. Organizational level factors significantly accounted for most of the variability at this level with two of the work practice environment factors examined, staffing adequacy and nurse involvement in hospital affairs, significantly related to work-family conflict. Due to the design of the study, factors on ward and work group levels could not be analyzed, but are likely to account for additional variance which in the present analysis appears to be on the individual level, with private life factors likely explaining another major part. These results suggest that higher level organizational factors in health care have a significant impact on the risk of work-family conflict among RNs through their impact on the nurse practice environment. Lower level organizational factors should be investigated in future studies using hierarchical multilevel sampling. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Factors associated with recent intimate partner violence experience amongst currently married women in Afghanistan and health impacts of IPV: a cross sectional study.

PubMed

Gibbs, Andrew; Corboz, Julienne; Jewkes, Rachel

2018-05-03

Intimate partner violence (IPV) is exceedingly common in conflict and post-conflict settings. We first seek to describe factors associated with past 12 month IPV amongst currently married women in Afghanistan, focused on the factors typically assumed to drive IPV. Second, to describe whether IPV is independently associated with a range of health outcomes. Cross-sectional analysis of currently married Afghan women, comprising the baseline study of a trial to prevent IPV. We use multinomial regression, reporting adjusted relative-risk ratios to model factors associated with the different forms of IPV, comparing no IPV, emotional IPV only, and physical IPV and emotional IPV. Second we assessed whether experience of emotional IPV, and physical IPV, were independently associated with health outcomes, reporting adjusted ß coefficients and adjusted odds ratios as appropriate. Nine hundred thirty five currently married women were recruited, 11.8% experienced only emotional IPV and 23.1% experienced physical and emotional IPV. Emotional IPV only was associated with attending a women's group, greater food insecurity, her husband having more than one wife, experiencing other forms of family violence, and more inequitable community gender norms. Experiencing both physical IPV and emotional IPV was associated with attending a women's group, more childhood trauma, husband cruelty, her husband having more than one wife, experiencing other forms of family violence, more inequitable community gender norms, and greater reported disability. Emotional IPV and physical IPV were independently associated with worse health outcomes. IPV remains common in Afghanistan. Economic interventions for women alone are unlikely to prevent IPV and potentially may increase IPV. Economic interventions need to also work with husbands and families, and work to transform community level gender norms. NCT03236948 . Registered 28 July 2017, retrospectively registered.

Spirit at work and hope among the ruins: registered nurses' covenant of care.

PubMed

Wagner, Joan I J; Gregory, David M

2015-09-01

To explore registered nurses' (RNs) perspectives about the health care system, management/leadership, patients and spirit at work (SAW). Researchers investigating RNs experiences of reduced job satisfaction and diminishing organisational commitment are looking carefully at spirit at work as a means to foster healthier workplaces. A descriptive, cross-sectional mixed methods design was used to measure and explore the relationships between spirit at work, job satisfaction and organisational commitment. A 2012 postal survey sent by the provincial licensing body to a random sample of 217 surgical and 158 home care registered nurses' in western Canada returned 179 surveys. Seventy-five respondents answered the open-ended survey question. Their responses warrant further content analysis and serve as the foundation of this article. Participants noted that organisational structures and policies, combined with unsupportive leadership, were associated with a reduced sense of community, lack of trust and diminished accountability. Spirit at work was described as sustaining registered nurses' and providing them with hope as they fulfilled their covenant of care with patients. Leadership attention to the advancement of SAW may support the covenant of care between the registered nurses and patient while fostering healthier workplaces. © 2014 John Wiley & Sons Ltd.

How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study.

PubMed

McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia

2015-09-01

Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

Variations in Care Quality Outcomes of Dying People: Latent Class Analysis of an Adult National Register Population.

PubMed

Öhlén, Joakim; Russell, Lara; Håkanson, Cecilia; Alvariza, Anette; Fürst, Carl Johan; Årestedt, Kristofer; Sawatzky, Richard

2017-01-01

Symptom relief is a key goal of palliative care. There is a need to consider complexities in symptom relief patterns for groups of people to understand and evaluate symptom relief as an indicator of quality of care at end of life. The aims of this study were to distinguish classes of patients who have different symptom relief patterns during the last week of life and to identify predictors of these classes in an adult register population. In a cross-sectional retrospective design, data were used from 87,026 decedents with expected deaths registered in the Swedish Register of Palliative Care in 2011 and 2012. Study variables were structured into patient characteristics, and processes and outcomes of quality of care. A latent class analysis was used to identify symptom relief patterns. Multivariate multinomial regression analyses were used to identify predictors of class membership. Five latent classes were generated: "relieved pain," "relieved pain and rattles," "relieved pain and anxiety," "partly relieved shortness of breath, rattles and anxiety," and "partly relieved pain, anxiety and confusion." Important predictors of class membership were age, sex, cause of death, and having someone present at death, individual prescriptions as needed (PRN) and expert consultations. Interindividual variability and complexity in symptom relief patterns may inform quality of care and its evaluation for dying people across care settings. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

The Profile of Saudi Nursing Workforce: A Cross-Sectional Study

PubMed Central

Magarey, Judy; Wiechula, Richard

2017-01-01

Introduction The Royal Monarchy in Saudi Arabia decreed that all sectors of the workforce would be subject to a policy of “Saudisation” to reduce the reliance on the expatriate workforce and to reduce the unemployment rate of Saudi nationals (Al-Mahmoud et al., 2012). Methodology A cross-sectional design was chosen to investigate the research questions. The population of this study comprised Saudi Registered Nurses working in MOH hospitals in Riyadh which is the main health care provider in Saudi Arabia (Aboul-Enein, 2002; MOH, 2009). Results and Findings A total number of 1,198 questionnaires were distributed and 61.2% (n = 741) were returned. The findings of the study showed that the questionnaires were collected from an equal portion of the study locale and that a sample of 741 is enough to create a strong conclusion and answer the problem set in this study and all the questions in the study have been provided with answers with enough data and literatures to supports its findings. Conclusion and Recommendations The results indicate that an increase in the recruitment of Saudi males may simply reflect cultural issues such as gender specific facilities and the Saudisation program's nondiscriminatory approach to employment of both genders into nursing. PMID:29214078

[Work-related Stress and the Allostatic Load Index - A Systematic Review].

PubMed

Mauss, D; Li, J; Schmidt, B; Angerer, P; Jarczok, M N

2017-12-01

Work-related stress is a growing social challenge and has been associated with reduced employee health, well-being, and productivity. One tool to measure the stress-related wear and tear of the body is the Allostatic Load Index (ALI). This review summarizes recent evidence on the association between work-related stress and ALI in working adults. A systematic literature search following the PRISMA-Statement was conducted in 21 databases including Medline, PubPsych, MedPilot, and Cochrane Register. Publications addressing work related-stress and medical parameters using ALI were considered. Data on study population, analytic techniques, and results were tabulated. Methodological quality was evaluated using a standardized checklist. 9 articles were identified with a total of 3 532 employees from 5 countries reporting cross-sectional data from the years 2003-2013. Overall, 7 studies reported a positive and significant association between work-related stress and ALI, while 2 studies showed no or an insignificant association. Substantial heterogeneity was observed in methods applied and study quality. This systematic review provides evidence that work-related stress is associated with ALI in cross-sectional studies. This association needs to be demonstrated by future studies using longitudinal data on working populations. © Georg Thieme Verlag KG Stuttgart · New York.

Obesity: attitudes of undergraduate student nurses and registered nurses.

PubMed

Poon, Man-Yuk; Tarrant, Marie

2009-08-01

To investigate undergraduate student nurses' and registered nurses' attitudes towards obese persons and towards the management of obese patients. Obesity is a global public health problem. Escalating rates of overweight and obesity are also taking a toll in Asian countries that have historically had much lower rates. Despite the growing prevalence of obesity worldwide, studies show that nurses and other health professionals hold negative attitudes towards obese people, which may affect the care of obese patients. Cross-sectional study. A self-administered questionnaire was completed by 352 undergraduate student nurses and 198 registered nurses. The questionnaire consisted of the Fat Phobia Scale, the Attitudes Toward Obese Adult Patients Scale and a demographic profile. Data were analysed using descriptive statistics and student's t-tests. Overall mean scores on the Fat Phobia Scale (3.53 SD 0.47) indicated average levels of fat phobia and mean scores on the Attitudes Toward Obese Adult Patients scale (2.64 SD 0.51) indicated neutral attitudes towards obese patients. Registered nurses had significantly higher levels of fat phobia and more negative attitudes than did student nurses. The majority of participants perceived that obese people liked food, overate, and were shapeless, slow and unattractive. Additionally, over one-half of participants believed that obese adults should be put on a diet while in hospital. Results of this study show that both registered nurses and student nurses have negative perceptions of obesity and are unlikely to attribute positive characteristics to obese individuals. That registered nurses hold more negative attitudes towards obese person is cause for concern. Given the increasing prevalence of obesity and the disproportionate number of obese persons affected by many health conditions, current and future nurses should have positive professional attitudes towards obese individuals. Obesity needs to be more adequately addressed, both in basic nursing education programs and in continuing professional education for practising nurses.

Multi-contrast MRI registration of carotid arteries based on cross-sectional images and lumen boundaries

NASA Astrophysics Data System (ADS)

Wu, Yu-Xia; Zhang, Xi; Xu, Xiao-Pan; Liu, Yang; Zhang, Guo-Peng; Li, Bao-Juan; Chen, Hui-Jun; Lu, Hong-Bing

2017-02-01

Ischemic stroke has great correlation with carotid atherosclerosis and is mostly caused by vulnerable plaques. It's particularly important to analysis the components of plaques for the detection of vulnerable plaques. Recently plaque analysis based on multi-contrast magnetic resonance imaging has attracted great attention. Though multi-contrast MR imaging has potentials in enhanced demonstration of carotid wall, its performance is hampered by the misalignment of different imaging sequences. In this study, a coarse-to-fine registration strategy based on cross-sectional images and wall boundaries is proposed to solve the problem. It includes two steps: a rigid step using the iterative closest points to register the centerlines of carotid artery extracted from multi-contrast MR images, and a non-rigid step using the thin plate spline to register the lumen boundaries of carotid artery. In the rigid step, the centerline was extracted by tracking the crosssectional images along the vessel direction calculated by Hessian matrix. In the non-rigid step, a shape context descriptor is introduced to find corresponding points of two similar boundaries. In addition, the deterministic annealing technique is used to find a globally optimized solution. The proposed strategy was evaluated by newly developed three-dimensional, fast and high resolution multi-contrast black blood MR imaging. Quantitative validation indicated that after registration, the overlap of two boundaries from different sequences is 95%, and their mean surface distance is 0.12 mm. In conclusion, the proposed algorithm has improved the accuracy of registration effectively for further component analysis of carotid plaques.

Embolism Formation during Freezing in the Wood of Picea abies1

PubMed Central

Mayr, Stefan; Cochard, Hervé; Améglio, Thierry; Kikuta, Silvia B.

2007-01-01

Freeze-thaw events can cause embolism in plant xylem. According to classical theory, gas bubbles are formed during freezing and expand during thawing. Conifers have proved to be very resistant to freeze-thaw induced embolism, because bubbles in tracheids are small and redissolve during thawing. In contrast, increasing embolism rates upon consecutive freeze-thaw events were observed that cannot be explained by the classical mechanism. In this study, embolism formation during freeze-thaw events was analyzed via ultrasonic and Cryo-scanning electron microscope techniques. Twigs of Picea abies L. Karst. were subjected to up to 120 freeze-thaw cycles during which ultrasonic acoustic emissions, xylem temperature, and diameter variations were registered. In addition, the extent and cross-sectional pattern of embolism were analyzed with staining experiments and Cryo-scanning electron microscope observations. Embolism increased with the number of freeze-thaw events in twigs previously dehydrated to a water potential of −2.8 MPa. In these twigs, acoustic emissions were registered, while saturated twigs showed low, and totally dehydrated twigs showed no, acoustic activity. Acoustic emissions were detected only during the freezing process. This means that embolism was formed during freezing, which is in contradiction to the classical theory of freeze-thaw induced embolism. The clustered pattern of embolized tracheids in cross sections indicates that air spread from a dysfunctional tracheid to adjacent functional ones. We hypothesize that the low water potential of the growing ice front led to a decrease of the potential in nearby tracheids. This may result in freezing-induced air seeding. PMID:17041033

Immunisation registers in Italy: a patchwork of computerisation.

PubMed

Alfonsi, V; D'Ancona, F; Rota, M C; Giambi, C; Ranghiasci, A; Iannazzo, S

2012-04-26

In Italy, the 21 regional health authorities are in charge of organising and implementing their own vaccination strategy, based on the national vaccine plan. Immunisation coverage varies greatly among the regions for certain vaccines. Efforts to increase childhood immunisation coverage have included initiatives to develop and implement computerised immunisation registers in as many regions as possible. We undertook a cross-sectional online survey in July 2011 to provide an updated picture of the use, heterogeneity and main functions of different computerised immunisation registers used in the Italian regions and to understand the flow of information from local health units to the regional authorities and to the Ministry of Health. Comparing current data with those obtained in 2007, a substantial improvement is evident. A total of 15 regions are fully computerised (previously nine), with 83% of local health units equipped with a computerised register (previously 70%). Eight of the 15 fully computerised regions use the same software, simplifying data sharing. Only four regions are able to obtain data in real time from local health units. Despite the progress made, the capacity to monitor vaccination coverage and to exchange data appears still limited.

Nurses' attitudes towards euthanasia: a cross-sectional study in Iran.

PubMed

Naseh, Ladan; Rafiei, Hossein; Heidari, Mohammad

2015-01-01

Nurses have an important role in caring for terminally ill patients. They are often confronted with euthanasia but little is known about their attitudes towards it. The present study aimed to examine Iranian Muslim nurses' attitudes towards euthanasia. In this exploratory cross-sectional study, all qualified registered nurses working in two teaching hospitals (Kashani and Hajar hospitals) in Iran were invited to participate. The Euthanasia Attitude Scale (EAS) was used to assess the nurses' attitude towards euthanasia. Of 266 nurses who fit the criteria, 190 participated in the study (response rate 72.9%); 91.1% (n=173) were female and 8.9% (n=17) were male. In total, 57.4%, 3.2% and 39.5% of nurses reported a negative, neutral and positive attitude to euthanasia respectively. Nurses reported their most negative attitude to the domain 'practical consideration' with mean of 2.36±0.9 and most positive attitude to the domain 'treasuring life' with a mean EAS score of 2.85±0.4. The majority of Muslim nurses were found to have negative attitudes to euthanasia. We recommend that future studies should be conducted to examine Muslim nurses' attitudes to euthanasia in different cultures to determine the role of culture and religious beliefs in attitude to euthanasia.

Tomography using monochromatic thermal neutrons with attenuation and phase contrast

NASA Astrophysics Data System (ADS)

Dubus, Francois; Bonse, Ulrich; Biermann, Theodor; Baron, Matthias; Beckmann, Felix; Zawisky, Michael

2002-01-01

Attenuation-contrast tomography with monochromatic thermal neutrons was developed and operated at guide station S18 of the institute Laue-Langevin in Grenoble. From the S18 spectrum the neutron wavelength (lambda) equals 0.18 nm was selected by employing a fore crystal with the silicon 220 reflection at a Bragg angle (Theta) equals 30 degrees. Projections were registered by a position sensitive detector (PSD) consisting of a neutron-to-visible-light converter coupled to a CCD detector. Neutron tomography and its comparison with X-ray tomography is studied. This is of special interest since the cross section for neutron attenuation ((sigma) atom) and the cross section for neutron phase shift (bc) are isotope specific and, in addition, by no means mostly monotonous functions of atomic number Z as are attenuation coefficient ((mu) x) and atomic scattering amplitude (f) in the case of X-rays. Results obtained with n-attenuation tomography will be presented. Possibilities and the setup of an instrument for neutron phase-contrast tomography based on single-crystal neutron interferometry will be described.

Examining the Promotion of Healthy Eating among Exercise Specialists: A Cross-sectional Study.

PubMed

Johnson, Steven T; Cornish, Stephen M; Lytvyak, Ellina; Taylor, Lorian M; Bell, Gordon; Vallance, Jeff; Fraser, Shawn; Murray, Terra

2015-06-01

The aim of this cross-sectional study was to survey exercise specialists about nutrition counselling practices, their own dietary practices, and to identify potential relationships. An electronic survey was used to examine characteristics and strategies used for assessing and promoting healthy eating to clients. Exercise specialists (n = 94) were recruited through a public registry and through targeted advertising on 2 professional websites in Alberta, Canada. Eighty-five percent of respondents promoted healthy eating to clients. Confidence in assessing and promoting healthy eating was moderate to low. Those with more than 6 years of professional experience reported higher confidence compared with those with less than 1 year of experience in assessing healthy eating (P < 0.05) and promoting healthy eating (P < 0.01). Confidence was higher among those with more professional experience but who did not meet Canada's Food Guide recommendations (P < 0.05). Professional experience, personal dietary practices, and confidence are important characteristics when considering the assessment and promotion of healthy eating by exercise specialists. Promoting collaborative relationships between registered dietitians and exercise specialists would likely benefit exercise specialists when they are assessing and promoting healthy eating among their clients.

An Epidemiological Profile of CrossFit Athletes in Brazil

PubMed Central

Sprey, Jan W.C.; Ferreira, Thiago; de Lima, Marcos V.; Duarte, Aires; Jorge, Pedro B.; Santili, Claudio

2016-01-01

Background: CrossFit is a conditioning and training program that has been gaining recognition and interest among the physically active population. Approximately 440 certified and registered CrossFit fitness centers and gyms exist in Brazil, with approximately 40,000 athletes. To date, there have been no epidemiological studies about the CrossFit athlete in Brazil. Purpose: To evaluate the profile, sports history, training routine, and presence of injuries among athletes of CrossFit. Study Design: Descriptive epidemiological study. Methods: This cross-sectional study was based on a questionnaire administered to CrossFit athletes from various specialized fitness centers in Brazil. Data were collected from May 2015 to July 2015 through an electronic questionnaire that included demographic data, level of sedentary lifestyle at work, sports training history prior to starting CrossFit, current sports activities, professional monitoring, and whether the participants experienced any injuries while practicing CrossFit. Results: A total of 622 questionnaires were received, including 566 (243 women [42.9%] and 323 men [57.1%]) that were completely filled out and met the inclusion criteria and 9% that were incompletely filled out. Overall, 176 individuals (31.0%) mentioned having experienced some type of injury while practicing CrossFit. We found no significant difference in injury incidence rates regarding demographic data. There was no significant difference regarding previous sports activities because individuals who did not practice prior physical activity showed very similar injury rates to those who practiced at any level. Conclusion: CrossFit injury rates are comparable to those of other recreational or competitive sports, and the injuries show a profile similar to weight lifting, power lifting, weight training, Olympic gymnastics, and running, which have an injury incidence rate nearly half that of soccer. PMID:27631016

Population study of disease burden, management, and treatment of bipolar disorder in Sweden: a retrospective observational registry study.

PubMed

Carlborg, Andreas; Ferntoft, Lena; Thuresson, Marcus; Bodegard, Johan

2015-02-01

The aim of the study was to describe temporal changes in bipolar disorder during 20 years within the Swedish population and to investigate clinical and socioeconomic characteristics, drug treatment, and mortality among patients with bipolar disorder. We conducted a retrospective, nationwide registry study (the Swedish Population Register) that included all patients diagnosed with bipolar disorder (1991-2010) and linked individual data from the Swedish National Patient Register, the National Prescribed Drug Register, and the Population Register (NCT01455961). A cross-sectional cohort analysis was performed for years 2006 versus 2009. Data were analyzed using descriptive statistics. During the study period, the annual incidence of diagnosed bipolar disorder increased 3.5-fold, and patients were diagnosed at a younger age. Mortality among patients with bipolar disorder was twice that of the general population. Compared to an age-standardized population, 30% fewer patients with bipolar disorder were available for work. Among the 40% employed, 64% reported sick leave (46% >100 days/year). Despite similar education levels, disposable income was lower compared to the general population. The most commonly preceding psychiatric diagnoses were depressive or anxiety disorders. Comparing the data for 2006 and 2009 demonstrated similar somatic comorbidity burdens and socioeconomic levels. There was also a decrease in dispensed antipsychotic medications and lithium, while antiepileptic prescriptions increased slightly. Antidepressant dispenses remained virtually unchanged. In Sweden, the incidence and prevalence of diagnosed bipolar disorder have increased during the last 20 years. Compared to the general population, these patients had similar education levels, lower employment levels, less disposable income, more sick leave, and twice the mortality. A trend towards earlier diagnosis, more use of antidepressants, and less use of lithium was seen. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Introduction of the second-generation direct-acting antivirals (DAAs) in chronic hepatitis C: a register-based study in Sweden.

PubMed

Frisk, P; Aggefors, K; Cars, T; Feltelius, N; Loov, S A; Wettermark, B; Weiland, O

2018-07-01

Introduction of the direct-acting antivirals (DAAs) for treatment of chronic hepatitis C (CHC) infection has been challenging in all health systems. In Sweden, a national protocol for managed introduction was developed. It was optional, but all county councils agreed to implement and follow it. The purpose of this study was to study (a) cure rates among all patients initiated on treatment in 2014-2015, (b) prescribers' adherence to the drug recommendations and treatment eligibility criteria in the protocol, and (c) introduction rate in the six Swedish healthcare regions. A cross-sectional study where national data from the Prescribed Drug Register and the quality register InfCare Hepatitis defined the study population, and clinical data from the Patient Register and InfCare Hepatitis were used to monitor outcomes. Descriptive statistics were used. A total of 3447 patients were initiated on treatment during 2014-2015. The overall cure rate, based on data from 85% of the cohort, was 96%, with variation between genotypes. Adherence to drug recommendations increased over time and varied between 43.2 and 94.2%. Adherence to the treatment eligibility criteria was initially 80% and increased to 87% when treatment restrictions were widened. The introduction rate differed initially between the regions and reached stable levels 15-18 months after the launch of the first DAA. The estimated overall cure rate was 96%, with some variations between genotypes. A high level of adherence to the introduction protocol as well as similar introduction rates in the health care regions indicate that the introduction protocol, alongside with other measures taken, contributed considerably to a rapid uptake and equal distribution of DAAs in Sweden.

Work ability and work-related stress: A cross-sectional study of obstetrical nurses in urban northeastern Ontario.

PubMed

Nowrouzi, Behdin; Lightfoot, Nancy; Carter, Lorraine; Larivière, Michel; Rukholm, Ellen; Schinke, Robert; Belanger-Gardner, Diane

2015-01-01

The aim of this study was to determine: 1) if quality of work life (QWL), location of cross-training, stress variables, and various demographic factors in nurses are associated with work ability, and 2) nursing occupational stress, QWL, and various associated factors are related with nurses' work ability. There is limited research examining the obstetrical nursing environment. Given the amount of time and energy people expend at the workplace, it is crucial for employees to be satisfied with their lives at work. This cross sectional study was conducted in 2012 in four hospitals in northeastern Ontario, Canada. A stratified random sample of registered nurses (n= 111) were selected. The majority of participants were female (94.6%) ranging in age from 24 to 64 years (M = 41.9, s.d. = 10.2). For the stress and QWL model, one variable: QWL (home-work support - see Methods for definition) (p= 0.015), cross-trained (see Methods for definition) nurses (p= 0.048), and having more than 4 patients per shift (p= 0.024) significantly contributed to the variance in work ability scores. In the logistic regression model, the odds of a higher work ability for nurses who received home-work support were estimated to be 1.32 (95% CI, 1.06 to 1.66) times the odds of a higher work ability for nurses who did not receive home-work support. Work ability in the work environment of obstetrical nursing is important. To be high functioning, workplaces should maximize the use of their employees' actual and potential skills.

Pediatric skin care: what do nurses really know?

PubMed

Drake, Jennifer; Redfern, Wendi S; Sherburne, Eileen; Nugent, Melodee L; Simpson, Pippa

2012-10-01

The purpose of this study was to explore pediatric nurses' knowledge of pressure ulcer prevention, investigate their beliefs and practices, and identify the barriers and facilitators to providing evidence-based pressure ulcer preventive practices. An exploratory, descriptive, and cross-sectional survey was taken of registered nurses in a freestanding children's hospital. Nurses have adequate knowledge of general pressure ulcer prevention; however, they struggle with individualization. Further, analysis revealed that nursing knowledge did not always correlate with nursing practice. Nurses require education on individualized interventions and access to user-friendly, interactive, and comprehensive resources, including unit-based champions and order sets. © 2012, Wiley Periodicals, Inc.

Helium-induced one-neutron transfer to levels in 162Dy

NASA Astrophysics Data System (ADS)

Andersen, E.; Helstrup, H.; Løvhøiden, G.; Thorsteinsen, T. F.; Guttormsen, M.; Messelt, S.; Tveter, T. S.; Hofstee, M. A.; Schippers, J. M.; van der Werf, S. Y.

1992-12-01

Levels in 162Dy have been studied in the 161Dy(α, 3He) and 163Dy( 3He, α) reactions with 50 MeV α- and 3He-beams from the KVI cyclotron in Groningen. The reaction products were analyzed in the QMG/2 magnetic spectrograph and registered in a two-dimensional detector system. The observed levels and cross sections are well described by the Nilsson model with the exception of the three levels at 1578, 1759 and 1990 keV. The present data combined with previous results strongly indicate that these levels are the spin-4, -6, and -8 members of the S-band.

Mode of delivery is not associated with celiac disease.

PubMed

Dydensborg Sander, Stine; Hansen, Anne Vinkel; Størdal, Ketil; Andersen, Anne-Marie Nybo; Murray, Joseph A; Husby, Steffen

2018-01-01

The purpose of this study was to investigate the association between mode of delivery and the risk of celiac disease in two large population-based birth cohorts with different prevalence of diagnosed celiac disease. This is an observational register-based cohort study using two independent population cohorts. We used data from administrative registers and health administrative registers from Denmark and Norway and linked the data at the individual level. We included all children who were born in Denmark from January 1, 1995 to December 31, 2010 and all children who were born in Norway from January 1, 2004 to December 31, 2012. We included 1,051,028 children from Denmark. Cesarean sections were registered for 196,512 children (18.9%). Diagnosed celiac disease was registered for 1,395 children (0.13%). We included 537,457 children from Norway. Cesarean sections were registered for 90,128 children (16.8%). Diagnosed celiac disease was registered for 1,919 children (0.35%). We found no association between the mode of delivery and the risk of diagnosed celiac disease. The adjusted odds ratio for celiac disease for children delivered by any type of cesarean section compared to vaginal delivery was 1.11 (95% CI: 0.96-1.29) in the Danish cohort and 0.96 (95% CI: 0.84-1.09) in the Norwegian cohort. The adjusted odds ratio for celiac disease for children delivered by elective cesarean section compared to vaginal delivery was 1.20 (95% CI: 1.00-1.43) in the Danish cohort and 0.96 (95% CI: 0.79-1.17) in the Norwegian cohort. In this large registry-based study, mode of delivery was not associated with an increased risk of diagnosed celiac disease.

Burns due to acid assaults in Bogotá, Colombia.

PubMed

Guerrero, Linda

2013-08-01

Acid burns are not very frequent, occupying between 3% and maximum 14% of all etiologies. They mostly occur at home or at work, however there has been an increase in publications outlining chemical burns where aggression is the cause of this burn. There is a different epidemiological profile between developed countries and developing ones. It seems an ongoing upsurge is occurring in the number of registered attacks within developing countries in recent years. A cross sectional retrospective review of attacks by acid was done in Bogota, Colombia from 1995 to the first trimester 2012. A cumulative number of 35 burn patients were registered during the study period. It is found that the main target, almost the unique target, of this attack are young women belonging to low socioeconomic status with low education degree and high dependence on her partner. The patient's age mean was 22.7 years, ranging from 13 to 41 years. The physical and psychological scars were very severe. Copyright © 2012. Published by Elsevier Ltd.

Job satisfaction of Slovenian hospital nursing workforce.

PubMed

Prosen, Mirko; Piskar, Franka

2015-03-01

To test the psychometric properties of the McCloskey-Mueller Satisfaction Scale and to assess which of the McCloskey-Mueller Satisfaction Scale dimensionalities have a considerable impact on job satisfaction of nursing employees in three public Slovenian hospitals. Job satisfaction of nurses is linked to productivity, turnover, absenteeism and patient outcomes. Little is known about the factors contributing to job satisfaction among Slovenian hospital nurses. Understanding the contributing factors could help nurse managers to take appropriate measures. A cross-sectional survey study was used to obtain a sample of 169 registered nursing assistants and 74 registered nurses working in three public hospitals in Slovenia, from which data was obtained using the McCloskey-Mueller Satisfaction Scale. Dimensionality was tested using exploratory factor analysis. A seven-factor structure of 29 items was obtained, which accounted for 54.3% of the total variance in job satisfaction, and was internally consistent (Cronbach's alpha coefficient of the instrument was 0.78). The first factor 'Satisfaction with Interaction Opportunities', which is a component of the social rewards dimension in the McCloskey-Mueller Satisfaction Scale, explained 30.6% of the variation. The registered nursing assistants' job dissatisfaction was higher than that of the registered nurses. Both were mostly dissatisfied with professional opportunities. Using the factor analysis, a seven-factor structure was found instead of the originally introduced eight-factor model, which suggests a need for further redevelopment of the McCloskey-Mueller Satisfaction Scale. The results suggest that operational management needs to revitalize the work environment by ensuring proactive leadership and allowing participation in the decision-making process, while health-care organisations need to support the professional development of registered nursing assistants and registered nurses in order to achieve sustainable effects in job satisfaction. © 2013 John Wiley & Sons Ltd.

Utilization of Antenatal HealthCare Services among Fishermen Population in Kanchipuram District, Tamil Nadu: A Cross-sectional Study.

PubMed

Danasekaran, Raja; Raja, Pavithra; Ranganathan, Karnaboopathy

2017-01-01

Considering the global and national level commitments in improving the maternal health as well as reducing the maternal mortality, assessment of factors influencing the delivery of antenatal healthcare services becomes essential. The aim is to assess the utilization of antenatal health services and to identify the factors influencing their utilization among women of fishermen population in Kanchipuram district, Tamil Nadu. The cross-sectional study was carried out among the mothers in Kovalam area of Kanchipuram district. Details were collected using a pretested questionnaire and analyzed using statistical software. The study included 284 mothers, of which 35% were illiterates. Nearly 60.21% have got registered with the Government sector, 59.51% of the mothers had three or more antenatal visits, 64.08% have received two doses of tetanus toxoid, and 73.24% have taken iron and folic acid tablets. Factors which were identified to have statistically significant association with better utilization of antenatal health services were age >30 years, higher educational status, skilled workers, those having their first child, and higher socioeconomic class. This study has reported the fact that antenatal healthcare services were not utilized fully by the community and the fishermen population being a special group has to be given the needed attention from the healthcare delivery system.

Vitamin D levels and risk for periodontal disease: A systematic review.

PubMed

Pinto, J P N S; Goergen, J; Muniz, F W M G; Haas, A N

2018-06-01

To evaluate the existing evidence supporting or refuting the following questions: (i) Do patients with lower vitamin D levels have higher risk for periodontal disease? (ii) Are periodontal treatment outcomes improved by the adjuvant supplementation of vitamin D or by elevated serum vitamin D levels? MEDLINE, SCOPUS, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched up to September 2017. Studies were included if they had measured serum vitamin D levels or vitamin D intake and any periodontal parameter. Overall, 27 studies were included (13 cross-sectional studies, 6 case-control studies, 5 cohort studies, 2 randomized clinical trials and 1 case series study). Sixty-five percent of the cross-sectional studies reported significant associations between low vitamin D levels and poor periodontal parameters. None of the observational longitudinal studies found that periodontal disease progression could be attributed to lower vitamin D levels. No interventional studies that evaluated the use of vitamin D supplementation as a solely adjuvant to periodontal treatment was found. No meta-analysis was performed due to high variability across studies. The data to support or refute the association between vitamin D levels and periodontal disease are inconclusive at the moment. More rigorously designed longitudinal studies with standardized definitions of periodontal disease and vitamin D are necessary. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Protective Nursing Advocacy: Translation and Psychometric Evaluation of an Instrument and a Descriptive Study of Swedish Registered Nurse Anesthetists' Beliefs and Actions.

PubMed

Sundqvist, Ann-Sofie; Anderzén-Carlsson, Agneta; Nilsson, Ulrica; Holmefur, Marie

2018-02-01

To translate and adapt the Protective Nursing Advocacy Scale (PNAS) into a Swedish version (PNAS-Swe), evaluate its psychometric properties, and describe registered nurse anesthetists' (RNAs) advocacy beliefs and actions from a protective perspective. A cross-sectional design was used. First, the PNAS was translated into Swedish. Next, the content and construct validity of the PNAS four subscales was evaluated. Finally, the PNAS-Swe was used to describe Swedish RNA beliefs and actions regarding protective nursing advocacy. The final PNAS-Swe has 29 items in four subscales. The RNAs reported that they feel that they should provide protective nursing advocacy for their patients. There were no differences in gender, or associations with age, or work experience regarding their advocacy beliefs or actions. The PNAS-Swe is valid for use in a Swedish context. Protective nursing advocacy is important to the RNAs, which is in congruence with earlier qualitative studies. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

[Behavioral risk factors and readiness in amateur marathon runners 18-64 years of age in Bogotá, Colombia, 2014].

PubMed

Ramírez-Góngora, María Del Pilar; Prieto-Alvarado, Franklyn Edwin

2016-01-01

Participation in amateur street marathons has become increasingly popular and requires prior individual health risk assessment. The objective was to identify risk factors and readiness in registered runners. This was a cross-sectional study in a random sample (n = 510) of registered amateur runners 18-64 years of age, using a digital survey with IPAQ, Par-Q+, and STEPwise, with an expected physical inactivity rate of 35% (±5%). The study explored physical activity, (binge) alcohol consumption, fruit, vegetable, and salt intake, smoking, and readiness. Self-reported rates were: 97.4% recommended level of physical activity, 2.4% optimal fruit and vegetable intake, 3.7% smoking, and 44.1% binge drinking. 19.8% were Par-Q+ positive and 5.7% practiced supervised exercise. The analysis showed differences by age, sex, and socioeconomic status. Recreational runners followed the recommended levels of physical activity but did not score well on other risk factors. Prior evaluation of lifestyle-related risk factors and readiness provides a safer athletic strategy.

Exploring leadership roles, goals, and barriers among Kansas registered nurses: a descriptive cross-sectional study.

PubMed

Peltzer, Jill N; Ford, Debra J; Shen, Qiuhua; Fischgrund, Avery; Teel, Cynthia S; Pierce, Janet; Jamison, Marian; Waldon, Trynn

2015-01-01

The Institute of Medicine's Future of Nursing report advocates for full nurse leader representation across multiple settings to address current challenges in our health care system. The purpose of this study was to examine nursing leadership development needs among Kansas registered nurses (RNs). Data were collected through an online survey and analyzed using quantitative and qualitative methods. Nearly 1,000 Kansas RNs participated. Most reported holding one or more leadership positions. Prevalent leadership goals were health care organization volunteer administrative roles. The most frequently identified barrier to developing leadership roles was time constraints. Many wanted to develop skills to serve on a board, 20% were interested in personal leadership development, and 19% in policy development. Based on the findings, the Kansas Action Coalition leadership team is developing programs to address the leadership needs of Kansas RNs. By building capacity in advanced leadership roles, RNs will be better prepared serve as full partners and lead efforts to promote the health of Kansans. Copyright © 2015 Elsevier Inc. All rights reserved.

Registered nurses' reflections on bioscience courses during the undergraduate nursing programme: an exploratory study.

PubMed

Craft, Judy A; Hudson, Peter B; Plenderleith, Mark B; Gordon, Christopher J

2017-06-01

To explore new graduate registered nurses' reflections of bioscience courses during their nursing programme and the relationship between bioscience content and their clinical practice. Undergraduate nursing students internationally find bioscience courses challenging, which may be due to the volume of content and level of difficulty of these courses. Such challenges may be exacerbated by insufficient integration between bioscience theory and nursing clinical practice. A descriptive, cross-sectional mixed methods study was conducted. A 30-item questionnaire with five written response questions which explored recently registered nurses' reflections on bioscience courses during their nursing degree was employed. Descriptive analyses were reported for individual items. Thematic analysis of qualitative responses was grouped to reveal emerging themes. Registered nurses' (n = 22) reflections revealed that bioscience courses were a significant challenge during their undergraduate programme, and they lacked confidence explaining the biological basis of nursing. Participants would like improved knowledge of the relevant bioscience for nursing and agreed that bioscience courses should be extended into the undergraduate final year. The importance of relating bioscience content to nursing practice was elaborated extensively throughout written responses. Although registered nurses reflected that bioscience courses were difficult with large volumes of content, having more bioscience with greater relevance to nursing applications was considered important in their current clinical practice. It is suggested that bioscience academics develop greater contextual links between bioscience content and clinical practice relevant to nursing. After working as a registered nurse, there was appreciation of bioscience relevance for clinical practice, and the nurses believed they would have benefitted from more nursing-related bioscience during their undergraduate programme. Focussed integration of bioscience with clinical nursing courses should be driven by academics, nurse educators and clinical nurses to provide a biological basis for patient care to nursing students. © 2016 John Wiley & Sons Ltd.

Career satisfaction among dental practitioners in Srikakulam, India.

PubMed

Kaipa, Sudhakar; Pydi, Siva Kumar; Krishna Kumar, Rathikota Veeravenkata Sathyasai; Srinivasulu, Gomasani; Darsi, Venkata Rajesh Kumar; Sode, Munikumar

2015-01-01

This cross-sectional study was designed to measure the level and distribution of job satisfaction of registered dental practitioners and to explore the factors associated with it. The study was conducted among 66 registered dentists in Srikakulam, India. Job satisfaction was measured by using a modified version of the Dentists Satisfaction Survey questionnaire. The statistical tests employed were "t" test and analysis of variance (ANOVA). Post hoc test (Scheffe test) was employed for multiple comparisons. The response rate was 82.5%. The mean score of overall job satisfaction among dentists was 3.08 out of 5. The most satisfying aspect was income (3.7) and the least satisfying aspect was staff (2.5). Overall satisfaction increased with age. Male practitioners showed less satisfaction with staff, income, and overall satisfaction and more satisfaction in professional relations and time, when compared to females. Job satisfaction was found to be more in practitioners with postgraduate qualification. This study suggests that patient relations, perception of income, personal time, and staff are the important factors for job satisfaction among dentists. The findings of this study will be helpful to policymakers to design plans in order to increase the level of job satisfaction.

Career satisfaction among dental practitioners in Srikakulam, India

PubMed Central

Kaipa, Sudhakar; Pydi, Siva Kumar; Krishna Kumar, Rathikota Veeravenkata Sathyasai; Srinivasulu, Gomasani; Darsi, Venkata Rajesh Kumar; Sode, Munikumar

2015-01-01

Background: This cross-sectional study was designed to measure the level and distribution of job satisfaction of registered dental practitioners and to explore the factors associated with it. Materials and Methods: The study was conducted among 66 registered dentists in Srikakulam, India. Job satisfaction was measured by using a modified version of the Dentists Satisfaction Survey questionnaire. The statistical tests employed were “t” test and analysis of variance (ANOVA). Post hoc test (Scheffe test) was employed for multiple comparisons. Results: The response rate was 82.5%. The mean score of overall job satisfaction among dentists was 3.08 out of 5. The most satisfying aspect was income (3.7) and the least satisfying aspect was staff (2.5). Overall satisfaction increased with age. Male practitioners showed less satisfaction with staff, income, and overall satisfaction and more satisfaction in professional relations and time, when compared to females. Job satisfaction was found to be more in practitioners with postgraduate qualification. Conclusion: This study suggests that patient relations, perception of income, personal time, and staff are the important factors for job satisfaction among dentists. The findings of this study will be helpful to policymakers to design plans in order to increase the level of job satisfaction. PMID:25767766

An Epidemiological Profile of CrossFit Athletes in Brazil.

PubMed

Sprey, Jan W C; Ferreira, Thiago; de Lima, Marcos V; Duarte, Aires; Jorge, Pedro B; Santili, Claudio

2016-08-01

CrossFit is a conditioning and training program that has been gaining recognition and interest among the physically active population. Approximately 440 certified and registered CrossFit fitness centers and gyms exist in Brazil, with approximately 40,000 athletes. To date, there have been no epidemiological studies about the CrossFit athlete in Brazil. To evaluate the profile, sports history, training routine, and presence of injuries among athletes of CrossFit. Descriptive epidemiological study. This cross-sectional study was based on a questionnaire administered to CrossFit athletes from various specialized fitness centers in Brazil. Data were collected from May 2015 to July 2015 through an electronic questionnaire that included demographic data, level of sedentary lifestyle at work, sports training history prior to starting CrossFit, current sports activities, professional monitoring, and whether the participants experienced any injuries while practicing CrossFit. A total of 622 questionnaires were received, including 566 (243 women [42.9%] and 323 men [57.1%]) that were completely filled out and met the inclusion criteria and 9% that were incompletely filled out. Overall, 176 individuals (31.0%) mentioned having experienced some type of injury while practicing CrossFit. We found no significant difference in injury incidence rates regarding demographic data. There was no significant difference regarding previous sports activities because individuals who did not practice prior physical activity showed very similar injury rates to those who practiced at any level. CrossFit injury rates are comparable to those of other recreational or competitive sports, and the injuries show a profile similar to weight lifting, power lifting, weight training, Olympic gymnastics, and running, which have an injury incidence rate nearly half that of soccer.

Pre-stroke seizures: A nationwide register-based investigation.

PubMed

Zelano, Johan; Larsson, David; Kumlien, Eva; Åsberg, Signild

2017-07-01

The relationship between cerebrovascular disease and seizures is clearly illustrated by poststroke epilepsy. Seizures can also be the first manifestation of cerebrovascular disease and case-control studies have demonstrated that seizures carry an increased risk of subsequent stroke. Thus, seizures could serve as a marker for vascular risk that merits intervention, but more data is needed before proper trials can be conducted. The occurrence of pre-stroke seizures has not been assessed on a national scale. We asked what proportion of strokes in middle-aged and elderly patients was preceded by seizures. All patients over 60 years of age with first-ever stroke in 2005-2010 (n=92,596) were identified in the Swedish stroke register (Riksstroke) and cross-sectional data on a history of a first seizure or epilepsy diagnosis in the ten years preceding stroke were collected from national patient registers with mandatory reporting. 1372 patients (1.48%) had a first seizure or epilepsy diagnosis registered less than ten years prior to the index stroke. The mean latency between seizure and stroke was 1474days (SD 1029 days). Seizures or epilepsy preceded 1.48% of strokes in patients >60years of age. Based on recent national incidence figures, 5-20% of incident cases of seizures or epilepsy after 60 years of age could herald stroke, depending on age group. These proportions are of a magnitude that merit further study on how to reduce the risk of stroke in patients with late-onset seizures or epilepsy. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Trends in the psychopharmacological treatment of bipolar disorder: a nationwide register-based study.

PubMed

Bjørklund, Louise; Horsdal, Henriette Thisted; Mors, Ole; Østergaard, Søren Dinesen; Gasse, Christiane

2016-04-01

In bipolar disorder, treatment with antidepressants without concomitant use of mood stabilisers (antidepressant monotherapy) is associated with development of mania and rapid cycling and is therefore not recommended. The present study aimed to investigate the psychopharmacological treatment patterns in bipolar disorder over time, with a focus on antidepressant monotherapy. Cohort study with annual cross-sectional assessment of the use of psychotropic medications between 1995 and 2012 for all Danish residents aged 10 years or older with a diagnosis of bipolar disorder registered in the Danish Psychiatric Central Research Register. Users of a given psychotropic medication were defined as individuals having filled at least one prescription for that particular medication in the year of interest. We identified 20 618 individuals with bipolar disorder. The proportion of patients with bipolar disorder using antidepressants, atypical antipsychotics and anticonvulsants increased over the study period, while the proportion of patients using lithium, typical antipsychotics and benzodiazepines/sedatives decreased. The proportion of patients treated with antidepressant monotherapy decreased from 20.5% in 1997 to 12.1% in 2012, and among antidepressant users, the proportion in monotherapy decreased from 47.7% to 23.9%, primarily driven by a decrease in the use of tricyclic antidepressants. The results show an increase in the proportion of patients with bipolar disorder being treated with antidepressants in the period from 1997 to 2012. However, in accordance with international treatment guidelines, the extent of antidepressant monotherapy decreased during the same period.

Mapping health outcome measures from a stroke registry to EQ-5D weights.

PubMed

Ghatnekar, Ola; Eriksson, Marie; Glader, Eva-Lotta

2013-03-07

To map health outcome related variables from a national register, not part of any validated instrument, with EQ-5D weights among stroke patients. We used two cross-sectional data sets including patient characteristics, outcome variables and EQ-5D weights from the national Swedish stroke register. Three regression techniques were used on the estimation set (n=272): ordinary least squares (OLS), Tobit, and censored least absolute deviation (CLAD). The regression coefficients for "dressing", "toileting", "mobility", "mood", "general health" and "proxy-responders" were applied to the validation set (n=272), and the performance was analysed with mean absolute error (MAE) and mean square error (MSE). The number of statistically significant coefficients varied by model, but all models generated consistent coefficients in terms of sign. Mean utility was underestimated in all models (least in OLS) and with lower variation (least in OLS) compared to the observed. The maximum attainable EQ-5D weight ranged from 0.90 (OLS) to 1.00 (Tobit and CLAD). Health states with utility weights <0.5 had greater errors than those with weights ≥ 0.5 (P<0.01). This study indicates that it is possible to map non-validated health outcome measures from a stroke register into preference-based utilities to study the development of stroke care over time, and to compare with other conditions in terms of utility.

Norms and nurse management of conflicts: keys to understanding nurse-physician collaboration.

PubMed

Keenan, G M; Cooke, R; Hillis, S L

1998-02-01

In this cross-sectional study, registered nurses from 36 emergency rooms completed an abridged version of the Organizational Culture Inventory (Cooke & Lafferty, 1989) and responded to nine hypothetical conflict vignettes. Stepwise regressions were performed with nurse conflict style intentions as dependent variables and 10 independent variable (three sets of norms, five measures of conflict styles expected to be used by the physician, gender, and education). Nurses' expectations for physicians to collaborate and strong constructive and aggressive norms were found to explain a moderate amount of variance (32%) in nurses' intentions to collaborate in conflicts conducive to nurse-physician collaboration. The findings of this study provide support for the proposed theoretical framework and can be used to design interventions that promote nurse-physician collaboration.

Choosing Public Health Dentistry as a Career: A Cross-Sectional Study

PubMed Central

Naidu, Guntipalli M.; Prasad, Ghanasyam M.; Kandregula, Chaitanya Ram; Babburi, Suresh; KVNR, Pratap

2014-01-01

Objectives: The purpose of this study was to assess the attitude of dental students towards considering Public Health Dentistry as their future career. Materials and Methods: A questionnaire based, cross-sectional survey was conducted, which included dental students from different years of study. It consisted of 27 questions that were graded on five point Likert scale. Results: A total of 293 of the 320 registered undergraduate students participated in the study, with an overall response rate of 91.5%. Among the sample, 80 (27%) were males and 213 (73%) were females. Among the total sample which was studied, it was observed that only one third (35.4%) of them had high attitude towards selecting Public Health Dentistry as a future career, and nearly two thirds of them (58.02%) had an average attitude, with very few students having low attitude (6.48%). Conclusion: The present study concluded that there was an average attitude of 58% among dental students, which showed that they had a considerable amount of interest in pursuing post graduation in this speciality. Efforts should be intensified, both by dental council and by the dental colleges, to develop this speciality, keeping in mind the increasing attitude of dental undergraduates towards it. This also helps in increasing the number of dental personnel who are specialized in implementation of oral health policy, which does not exist in India. PMID:24701534

A Comparison of Medical Birth Register Outcomes between Maternity Health Clinics and Integrated Maternity and Child Health Clinics in Southwest Finland

PubMed Central

Kaljonen, Anne; Ahonen, Pia; Mäkinen, Juha; Rautava, Päivi

2016-01-01

Introduction: Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. Methods: A comparative, register-based cross-sectional design was used. The data of women (N = 2741) who had given birth in the Turku University Hospital area between 1 January 2009 and 31 December 2009 were collected from the Finnish Medical Birth Register. Comparisons were made between the women who were clients of the maternity health clinics and integrated maternity and child health clinics. Results: There were no clinically significant differences between the clients of maternity health clinics and integrated maternity and child health clinics regarding the utilisation of maternity care services or the explored health outcomes. Conclusions: The organisational model of the maternity health clinic does not impact the utilisation of maternity care services or maternal and perinatal health outcomes. Primary maternity care could be provided effectively when integrated with child health services. PMID:27761106

A Comparison of Medical Birth Register Outcomes between Maternity Health Clinics and Integrated Maternity and Child Health Clinics in Southwest Finland.

PubMed

Tuominen, Miia; Kaljonen, Anne; Ahonen, Pia; Mäkinen, Juha; Rautava, Päivi

2016-07-08

Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. A comparative, register-based cross-sectional design was used. The data of women (N = 2741) who had given birth in the Turku University Hospital area between 1 January 2009 and 31 December 2009 were collected from the Finnish Medical Birth Register. Comparisons were made between the women who were clients of the maternity health clinics and integrated maternity and child health clinics. There were no clinically significant differences between the clients of maternity health clinics and integrated maternity and child health clinics regarding the utilisation of maternity care services or the explored health outcomes. The organisational model of the maternity health clinic does not impact the utilisation of maternity care services or maternal and perinatal health outcomes. Primary maternity care could be provided effectively when integrated with child health services.

[Prevalence of non-alcoholic fatty liver disease in a population with elevated transaminases and level of accuracy of the diagnosis in Primary Care].

PubMed

Samperio-González, María Amelia; Selvi-Blasco, Marta; Manzano-Montero, Mónica; Méndez-Gómez, Judit; Gil-Prades, Montserrat; Azagra, Rafael

2016-05-01

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of elevated transaminases in adults. Determine the prevalence of NASH in patients with sustained hypertransaminasemia, and Know the adequacy of the registered in Primary Care (AP) diagnosis. 1) Cross-sectional study with a random sample of patients with elevated alanine aminotransferase (ALT) held (ALT> 32 for ≥6 months), ruling out other causes of liver disease, according to clinical, laboratory and ultrasound scan criteria in AP and 2) cross-sectional description of all cases diagnosed with NASH recorded (K76 - ICD10) with diagnostic adequacy analysis according to standard criteria. 290 patients were analyzed: 76 were diagnosed as NASH (26.1%), 44 women (57.9%). Multivariate analysis adjusted for age and sex showed no association between NASH and male gender (OR: 0.5; CI95%: 0.3-0.9), diabetes mellitus (DM) (OR: 2.42; CI95%: 1.2-4.9) and hypertension blood pressure (HBP) (OR: 3.07; CI 95% 1.6-5.6). Of the 209 diagnosed with NASH record: 51 (24.4%) met the criteria for NASH. The rest had insufficient records. 53.1% lacked sustained hypertransaminasemia; 48% of viral serology; 11% supported and 53.1% abdominal ultrasound registration of alcohol. Severe NASH is frequent among patients with sustained hypertransaminasemia. The DM and hypertension significantly increase the risk of NASH. The diagnosis of NASH is recorded without considering all criteria and mainly NASH made by ultrasonography. They should unify diagnostic criteria in the register of NASH. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Factors associated with final year nursing students' desire to work in the primary health care setting: Findings from a national cross-sectional survey.

PubMed

Bloomfield, Jacqueline G; Aggar, Christina; Thomas, Tamsin H T; Gordon, Christopher J

2018-02-01

Registered nurses are under-represented in the primary health care setting both internationally and in Australia, and this shortage is predicted to worsen. To address the increasingly complex healthcare needs of an ageing population, it is vital to develop and sustain a primary health care nursing workforce, yet attracting nurses is challenging. In Australia, registered nurses graduating from university typically commence their careers in hospital-based transition to professional practice programs. Similar programs in primary health care settings may be a valuable strategy for developing the primary health care nursing workforce, yet little is known about nursing students desire to work in this setting, factors that influence this, or their expectations of primary health care-focused transition to professional practice programs. This study sought to identify factors associated with final year nursing students' desire to work in primary health care setting including demographic factors, expectations of future employment conditions, and job content. It also explored expectations of graduate transition programs based in primary health care. A cross-sectional survey design comprising a quantitative online survey. 14 Australian universities from all states/territories, both rural and urban. 530 final-year nursing students. Binary logistic regression identifying factors contributing to desire to work in primary health care. The desire of nursing students to work in primary health care is associated with older age, greater perceived value of employment conditions including flexibility, and less perceived importance of workplace support. Collaborative efforts from primary health care nurses, health professionals, academics and policy makers are needed to attract new graduate nurses to primary health care. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Effort-Reward Imbalance and Burnout Among ICU Nursing Staff: A Cross-Sectional Study.

PubMed

Padilla Fortunatti, Cristobal; Palmeiro-Silva, Yasna K

Occupational stress is commonly observed among staff in intensive care units (ICUs). Sociodemographic, organizational, and job-related factors may lead to burnout among ICU health workers. In addition, these factors could modify the balance between efforts done and rewards perceived by workers; consequently, this imbalance could increase levels of emotional exhaustion and depersonalization and decrease a sense of personal accomplishment. The purpose of this study was to analyze the relationship between effort-reward imbalance and burnout dimensions (emotional exhaustion, depersonalization, and personal accomplishment) among ICU nursing staff in a university hospital in Santiago, Chile. A convenience sample of 36 registered nurses and 46 nurse aides answered the Maslach Burnout Inventory and Effort-Reward Imbalance Questionnaire and provided sociodemographic and work-related data. Age and effort-reward imbalance were significantly associated with emotional exhaustion in both registered nurses and nurse aides; age was negatively correlated with emotional exhaustion, whereas effort-reward imbalance was positively correlated. Age was negatively associated with depersonalization. None of the predictors were associated with personal accomplishment. This study adds valuable information about relationships of sociodemographic factors and effort-reward imbalance and their impact on dimensions of burnout, particularly on emotional exhaustion.

Pre-surgical register of tobacco consumption.

PubMed

Gavilán, Eva; Moreno, Montse; Pérez, Àngels; Castellano, Yolanda; Fernández, Esteve; Martínez, Cristina

2018-03-24

Smoking cessation before surgery decreases the risk of complications. The aim of this study was to analyse the smoking register, associated variables and a short talk given to smokers in pre-surgical visits. Cross-sectional study. The pre-surgical records of 680 patients were assessed. We selected patient sociodemographic variables, surgical intervention characteristics, smoking status and consumption pattern. Logistic regression was used to study the variables association with smoking. A percentage of 97.2 of the pre-surgical records include information on tobacco consumption. Overall 20% of surgical patients are smokers. The probability of smoking is higher among men (adjusted odds ratio [aOR] 2.6, 95% confidence interval [CI] 1.7-4.0) and≤60 years (aOR 5.4, 95% CI 3.2-9.1). None of the records had information regarding a short talk given to patients to give up smoking. Smoking consumption was prevalent, but the characterisation of a smoker's profile and short talk given to patient before surgery was practically nonexistent. Ensuring that patients who smokes receives a short talk to give up smoking before surgery is necessary. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

High Prevalence of Mycoplasma pneumoniae and Chlamydia pneumoniae in Children with Acute Respiratory Infections from Lima, Peru

PubMed Central

del Valle-Mendoza, Juana; Orellana-Peralta, Fiorella; Marcelo-Rodríguez, Alvaro; Verne, Eduardo; Esquivel-Vizcarra, Mónica; Silva-Caso, Wilmer; Aguilar-Luis, Miguel Angel; Weilg, Pablo; Casabona-Oré, Verónica; Ugarte, Claudia; del Valle, Luis J.

2017-01-01

Background Mycoplasma pneumoniae and Chlamydia pneumoniae are atypical pathogens responsible for pneumonia and a leading cause of morbidity and mortality in low income countries. The study objective is to determine the prevalence of this pathogens in Peruvian children with acute respiratory infections. Methods A consecutive cross-sectional study was conducted in Lima, Peru from May 2009 to September 2010. A total of 675 children admitted with clinical diagnoses of acute respiratory infections were tested for Mycoplasma pneumoniae and Chlamydia pneumoniae detection by polymerase chain reaction (PCR), and clinical symptoms were registered by the attending physician. Results Mycoplasma pneumonia was detected in 25.19% (170/675) of nasopharyngeal samples and Chlamydia pneumonia in 10.52% (71/675). The most common symptoms in patients with these atypical pathogens were rhinorrhea, cough and fever. A higher prevalence of Mycoplasma pneumoniae cases were registered in summer, between December 2009 and March 2010. Conclusions Mycoplasma pneumoniae and Chlamydia pneumonia are a significant cause of morbidity in Peruvian children with acute respiratory infections (ARI). Further studies should evaluate the use of reliable techniques such as PCR in Peru in order to avoid underdiagnoses of these atypical pathogens. PMID:28129377

Occupational accidents among mototaxi drivers.

PubMed

Amorim, Camila Rego; de Araújo, Edna Maria; de Araújo, Tânia Maria; de Oliveira, Nelson Fernandes

2012-03-01

The use of motorcycles as a means of work has contributed to the increase in traffic accidents, in particular, mototaxi accidents. The aim of this study was to estimate and characterize the incidence of occupational accidents among the mototaxis registered in Feira de Santana, BA. This is a cross-sectional study with descriptive and census data. Of the 300 professionals registered at the Municipal Transportation Service, 267 professionals were interviewed through a structured questionnaire. Then, a descriptive analysis was conducted and the incidence of accidents was estimated based on the variables studied. Relative risks were calculated and statistical significance was determined using the chi-square test and Fisher's exact test, considering p < 0.05. Logistic regression was used in order to perform simultaneous adjustment of variables. Occupational accidents were observed in 10.5% of mototaxis. There were mainly minor injuries (48.7%), 27% of them requiring leaves of absence from work. There was an association between the days of work per week, fatigue in lower limbs and musculoskeletal complaints, and accidents. Knowledge of the working conditions and accidents involved in this activity can be of great importance for the adoption of traffic education policies, and to help prevent accidents by improving the working conditions and lives of these professionals.

Health insurance and healthcare utilisation for Shenzhen residents: a tale of registrants and migrants?

PubMed Central

2012-01-01

Background Shenzhen’s rapid growth and urbanisation has attracted a large, mobile, migrant working population. This article explores health protection through the means of social health insurance between migrants and registrants and their point of access to healthcare. Methods A cross-sectional questionnaire survey was conducted in Shenzhen, with a random sample of 793 registered and 750 non-registered residents. Chi-square test and multivariate logistic regression were applied to analyse the association between health insurance coverage with Hukou registration status and healthcare utilisation. Results Amongst 1543 respondents, 43.1% of non-registered residents were uninsured. Being non-registered strongly predicted for no insurance (OR = 5.00; CI 3.53,7.07) and have purchased additional/ private insurance (OR = 2.99; CI 1.66,5.37). Migrants who self-reported chronic health conditions were also more likely to utilise health services in general (OR = 2.77; CI 1.18,6.52). Conclusions Inadequate health insurance coverage for migrants as observed in Shenzhen remains a challenge for the Chinese health reform. Our results suggest that the current insurance system must seek to include migrants in order to achieve universal coverage and improved health protection for its population. PMID:23061720

The Relationship of Workplace Culture With Nursing-Sensitive Organizational Factors.

PubMed

Hahtela, Nina; McCormack, Brendan; Paavilainen, Eija; Slater, Paul; Helminen, Mika; Suominen, Tarja

2015-01-01

The aim of this study is to explore the relations of workplace culture on nursing-sensitive organizational factors. The need for standardized and valid measures for nursing-sensitive organizational outcomes has already been recognized in the literature. A cross-sectional questionnaire survey of 21 inpatient acute care units in 9 organizations at the municipal primary healthcare level was conducted. Participants included licensed practical nurses, registered nurses, and nurse managers. Workplace culture, especially the overarching factor of stress, correlated with the use of supplemental nursing staff and patients' length of stay. It is essential to find and test workplace-sensitive indicators so that managers will have a wider range of methods to plan and evaluate nursing outcomes.

Job-related stress in psychiatric assistant nurses.

PubMed

Yada, Hironori; Abe, Hiroshi; Omori, Hisamitsu; Ishida, Yasushi; Katoh, Takahiko

2018-01-01

We aimed to clarify how stress among psychiatric assistant nurses (PANs) differed from Registered Nurses (PRNs). Cross-sectional survey study was conducted with PRNs and PANs working in six psychiatric hospitals in Japan. The Psychiatric Nurse Job Stressor Scale (PNJSS) and the job stressor and stress reaction subscales of the Brief Job Stress Questionnaire measured stress in 68 PANs and 140 PRNs. The results were statistically analysed. Psychiatric assistant nurses had significantly higher scores than PRNs on the job stressor subscales in psychiatric nursing ability, interpersonal relations and in the stress reaction subscales of irritability and somatic symptoms. "Psychiatric nursing ability," "Communication" and "Use of techniques" were associated with almost all stress reactions in PANs than in PRNs.

Predicting nurses' turnover intentions by demographic characteristics, perception of health, quality of work attitudes.

PubMed

Al-Hussami, Mahmoud; Darawad, Muhammad; Saleh, Ali; Hayajneh, Ferial Ahmed

2014-02-01

The purpose of this paper is to examine the impact of demographic variables, organizational commitment levels, perception of health and quality of work on turnover intentions. A self-reported cross-sectional survey design was used to collect data from Jordanian registered nurses who were working between June 2011 and November 2011. The findings showed strong effects of the quality of work, perception of health and normative organizational commitments on turnover intentions. This study sheds the light on the important work outcomes in health-care organizations. Increasing nursing quality of work and normative organizational commitment are good strategies for reducing turnover intentions. © 2013 Wiley Publishing Asia Pty Ltd.

Nurse Bullying: Impact on Nurses' Health.

PubMed

Sauer, Penny A; McCoy, Thomas P

2017-12-01

Workplace bullying has been experienced by 27% to 80% of nurses who have participated in studies. Bullying behaviors negatively impact the health of nurses. This study examined whether nurses' resilience had an impact on the effects of bullying on the nurse's health. This cross-sectional descriptive study surveyed licensed registered nurses in one state. The sample ( N = 345) was predominately female (89%) and Caucasian (84%), with an average age of 46.6 years. In this sample, 40% of nurses were bullied. Higher incidence of bullying was associated with lower physical health scores ( p = .002) and lower mental health scores ( p = .036). Nurses who are bullied at work experience lower physical and mental health, which can decrease the nurses' quality of life and impede their ability to deliver safe, effective patient care.

Cross-sectional study of Pfizer-sponsored clinical trials: assessment of time to publication and publication history.

PubMed

Mooney, LaVerne A; Fay, Lorna

2016-07-18

To estimate the proportion of Pfizer-sponsored clinical trials that completed in 2010 and are published as manuscripts in the peer-reviewed literature, and to assess the manuscript development history. Retrospective, cross-sectional analysis. Clinical trials registered in ClinicalTrials.gov that completed in 2010 for approved, Pfizer prescription products in patients or vaccines in healthy participants. The proportion of studies for which the primary outcome(s) was published and the median time from study completion to publication. The manuscript development history included the number of times a manuscript was submitted before it was accepted for publication. Among registered clinical trials for which Pfizer was the sponsor that completed in 2010, 76 met all inclusion criteria. The primary outcome(s) for 65 (85%) studies was published in 71 manuscripts; the median time to publication was 31 months (range 3-63 months). Of the remaining 11 studies, 2 had been submitted to at least one journal, 2 had not yet been submitted and 7 had no plans to publish because the study had terminated early due to recruitment challenges. Manuscripts accepted at the first choice journal were published at median time of 28 months (range 8-63, n=31), those accepted at second choice journal were published at 32 months (3-45, n=19), and for those accepted at third choice journal, it was 40 months (range 24-53, n=13). The publication rate and median time to publication from study completion for Pfizer-sponsored studies were comparable to those previously reported for combined analyses of industry and non-industry sectors. Opportunities exist for sponsors, authors and journals to explore ideas that would facilitate more timely publication for clinical trial results. However, to be effective, such changes may need to revisit the entire publication process. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The Most Frequently Used English Phrasal Verbs in American and British English: A Multicorpus Examination

ERIC Educational Resources Information Center

Liu, Dilin

2011-01-01

This study uses the Corpus of Contemporary American English and the British National Corpus as data and Biber, Johansson, Leech, Conrad, and Finegan's (1999) and Gardner and Davies' (2007) informative studies as a starting point and reference. The study offers a cross-English variety and cross-register examination of the use of English phrasal…

Postmarket studies required by the US Food and Drug Administration for new drugs and biologics approved between 2009 and 2012: cross sectional analysis.

PubMed

Wallach, Joshua D; Egilman, Alexander C; Dhruva, Sanket S; McCarthy, Margaret E; Miller, Jennifer E; Woloshin, Steven; Schwartz, Lisa M; Ross, Joseph S

2018-05-24

To characterize postmarketing requirements for new drugs and biologics approved by the US Food and Drug Administration (FDA), and to examine rates and timeliness of registration, results reporting, and publication of required prospective cohort studies, registries, and clinical trials. Cross sectional analysis. Postmarketing requirements for all new drugs and biologics approved by the FDA between 1 January 2009 and 31 December 2012, with follow-up up to 15 November 2017. Postmarketing requirements and their characteristics known at the time of FDA approval, including FDA authority, study design, and study characteristics. Rates and timeliness of registration and results reporting on ClinicalTrials.gov and publication in peer reviewed journals of required prospective cohort studies, registries, and clinical trials. Between 2009 and 12, the FDA approved 97 new drugs and biologics for 106 indications with at least one postmarketing requirement at the time of first approval, for a total of 437 postmarketing requirements. Postmarket study descriptions were short (median word count 44 (interquartile range 29-71)) and often lacked information to determine an up to date progress (131 (30%)). 220 (50.3%) postmarketing requirements were for new animal or other studies (including pharmacokinetic studies); 134 (30.7%) were for prospective cohort studies, registries, and clinical trials; and 83 (19.0%) were for secondary analyses or follow-up studies. Of 110 clinical trials, 38 (34.5%), 44 (40.0%), 62 (56.4%), 66 (60.0%), and 98 (89.1%) did not report enough information to establish use of randomization, comparator type, allocation, outcome, and number of patients to be enrolled, respectively. Of 134 required prospective cohort studies, registries, and clinical trials, 102 (76.1%) were registered on ClinicalTrials.gov; of 50 registered and completed studies, 36 (72.0%) had reported results on ClinicalTrials.gov. Among 65 completed studies, 47 (72.3%) had either reported results or were published a median of 47 months (interquartile range 32-67) after FDA approval. 32 (68.1%) of these 47 studies did not report results publicly by the time of their original FDA report submission deadline. Postmarketing requirements for new drugs and biologics were often briefly described and did not contain enough information to characterize study designs. Approximately three quarters of postmarketing requirements for prospective cohort studies, registries, and clinical trials were registered on ClinicalTrials.gov, and nearly three quarters of completed studies reported results or were published, suggesting that at least a quarter of these required studies are not being publicly disseminated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Validation and cross-cultural pilot testing of compliance with standard precautions scale: self-administered instrument for clinical nurses.

PubMed

Lam, Simon C

2014-05-01

To perform detailed psychometric testing of the compliance with standard precautions scale (CSPS) in measuring compliance with standard precautions of clinical nurses and to conduct cross-cultural pilot testing and assess the relevance of the CSPS on an international platform. A cross-sectional and correlational design with repeated measures. Nursing students from a local registered nurse training university, nurses from different hospitals in Hong Kong, and experts in an international conference. The psychometric properties of the CSPS were evaluated via internal consistency, 2-week and 3-month test-retest reliability, concurrent validation, and construct validation. The cross-cultural pilot testing and relevance check was examined by experts on infection control from various developed and developing regions. Among 453 participants, 193 were nursing students, 165 were enrolled nurses, and 95 were registered nurses. The results showed that the CSPS had satisfactory reliability (Cronbach α = 0.73; intraclass correlation coefficient, 0.79 for 2-week test-retest and 0.74 for 3-month test-retest) and validity (optimum correlation with criterion measure; r = 0.76, P < .001; satisfactory results on known-group method and hypothesis testing). A total of 19 experts from 16 countries assured that most of the CSPS findings were relevant and globally applicable. The CSPS demonstrated satisfactory results on the basis of the standard international criteria on psychometric testing, which ascertained the reliability and validity of this instrument in measuring the compliance of clinical nurses with standard precautions. The cross-cultural pilot testing further reinforced the instrument's relevance and applicability in most developed and developing regions.

Job satisfaction and horizontal violence in hospital staff registered nurses: the mediating role of peer relationships.

PubMed

Purpora, Christina; Blegen, Mary A

2015-08-01

To describe the association between horizontal violence and job satisfaction in hospital staff registered nurses and the degree to which peer relationships mediates the relationship. Additionally, the association between nurse and work characteristics and job satisfaction were determined. Horizontal violence is a major predictor of nurses' job satisfaction. Yet, not enough is known about the relationship between these variables. Job satisfaction is an important variable to study because it is a predictor of patient care quality and safety internationally. Peer relationships, a job satisfier for nurses, was identified as a potential mediator in the association between horizontal violence and job satisfaction. Cross-sectional mediational model testing. An anonymous four-part survey of a random sample of 175 hospital staff registered nurses working in California provided the data. Data about horizontal violence, peer relationships, job satisfaction, and nurse and work characteristics were collected between March-August 2010. A statistically significant negative relationship was found between horizontal violence and peer relationships, job satisfaction and a statistically significant positive relationship was found between peer relationships and job satisfaction. Peer relationships mediated the association between horizontal violence and job satisfaction. Job satisfaction was reported as higher by nurses who worked in teaching hospitals. There were no statistically significant differences in job satisfaction based on gender, ethnicity, basic registered nurse education, highest degree held, size of hospital or clinical area. The results suggest that peer relationships can attenuate the negative relationship between horizontal violence and job satisfaction. This adds to the extant literature on the relationship between horizontal violence and job satisfaction. The findings highlight peer relationships as an important factor when considering effective interventions that foster hospital staff registered nurses' job satisfaction in the presence of horizontal violence. © 2015 John Wiley & Sons Ltd.

Cigarettes and waterpipe smoking among medical students in Syria: a cross-sectional study.

PubMed

Almerie, M Q; Matar, H E; Salam, M; Morad, A; Abdulaal, M; Koudsi, A; Maziak, W

2008-09-01

To investigate tobacco use, beliefs and attitudes among medical students in Syria. A cross-sectional study of a random sample of 570 medical students (first and fifth year) registered at the Damascus University Faculty of Medicine in 2006-2007. We used a self-administered questionnaire for demo-graphic information, smoking behaviour (cigarette, waterpipe), family and peer smoking, attitudes and beliefs about smoking and future role in advising patients to quit smoking. The overall prevalence of tobacco use was 10.9% for cigarettes (15.8% men, 3.3% women), 23.5% for waterpipe (30.3% men, 13.4% women) and 7.3% for both (10.1% men, 3.1% women). Both smoking methods were more popular among the fifth year students (15.4% and 27%) compared to their younger counterparts (6.6% and 19.7%). Regular smoking patterns predominated for cigarettes (62%), while occasional use patterns predominated for waterpipes (83%). More than two thirds of students (69%) thought they might not address or would have difficulty addressing smoking in their future patients. The level of tobacco use among Syrian medical students is alarming and highlights the rapidly changing patterns of waterpipe use, especially among female students. Medical schools should work harder to tackle this phenomenon and address it more efficiently in their curricula.

Tobacco use among designated air pollution victims and its association with lung function and respiratory symptoms: a retrospective cross-sectional study

PubMed Central

Kotaki, Kenji; Senjyu, Hideaki; Tanaka, Takako; Yano, Yudai; Miyamoto, Naomi; Nishinakagawa, Tsuyoshi; Yanagita, Yorihide; Asai, Masaharu; Kozu, Ryo; Tabusadani, Mitsuru; Sawai, Terumitsu; Honda, Sumihisa

2014-01-01

Objectives We sought to elucidate the long-term association of tobacco use and respiratory health in designated pollution victims with and without obstructive pulmonary defects. Design A retrospective cross-sectional study. Setting The register of pollution victims in Kurashiki, Japan. Participants 730 individuals over 65 years of age previously diagnosed with pollution-related respiratory disease. Patients were classified into four groups according to their smoking status and whether they had obstructive pulmonary disease. We then compared the prevalence of respiratory symptoms and lung function over time between groups. Primary outcome measures Spirometry was performed and a respiratory health questionnaire completed in the same season each year for up to 30 years. Results Rates of smoking and respiratory disease were high in our sample. Although respiratory function in non-smoking patients did not completely recover, the annual rate of change in lung function was within the normal range (p<0.01). However, smokers had worse lung function and were more likely to report more severe pulmonary symptoms (p<0.01). Conclusions Patients’ respiratory function did not fully recover despite improved air quality. Our results suggest that, in the context of exposure to air pollution, tobacco use causes additional loss of lung function and exacerbates respiratory symptoms. PMID:25082419

[Factors associated with road accidents in the city of Lubumbashi].

PubMed

Kandolo, Simon Ilunga; Matungulu, Charles Matungulu; Mukanya, Pascal Kimba; Umba, Irène Kabange; Kabamba, Julie Ndayi; Numbi, Oscar Luboya; Ilunga, Benjamin Kabyla; Kaj, Françoise Malonga; Lubaba, Célestin Banza; Ngongo, Ghislain Mashini

2014-01-01

We conducted a retrospective non-comparative cross-sectional study in Lubumbashi on factors associated with road accidents. To contribute to the reduction of morbidity and mortality related to road accidents based on a better understanding of this phenomenon in the city of Lubumbashi, to assess the frequency and the growth of road accidents in the city of Lubumbashi and to determine the factors predisposing to these accidents. This non-controlled retrospective cross-sectional descriptive study covered the period from 1st January to 31st December 2008, and included all cases of vehicles registered by the police department after an accident. A total of 1,915 road traffic were reported, mostly caused by public transport vehicles (59%) driven by young adult males (89% of cases) with a mean age of 28 years. The main cause was speeding combined with other factors (34% of cases). The majority of these accidents occurred in the city of Lubumbashi (52.9% of cases) between 6:00 a.m. and 6:00 p.m. (74% of cases). Transit vehicles were exposed to a greater risk of road accidents (59%). There is an urgent need for accurate information on the rules of the road for drivers and road users to reduce the mortality and morbidity due to road accidents.

When does hardship matter for health? Neighborhood and individual disadvantages and functional somatic symptoms from adolescence to mid-life in The Northern Swedish Cohort.

PubMed

Gustafsson, Per E; San Sebastian, Miguel

2014-01-01

A large body of research has shown that health is influenced by disadvantaged living conditions, including both personal and neighborhood conditions. Little is however known to what degree the health impact of different forms of disadvantage differ along the life course. The present study aims to examine when, during the life course, neighborhood and individual disadvantages relate to functional somatic symptoms. Participants (n = 992) came from The Northern Swedish Cohort and followed from age 16, 21, 30 until 42 years. Functional somatic symptoms, socioeconomic disadvantage, and social and material adversity were measured through questionnaires and linked to register data on neighborhood disadvantage. Data was analyzed with longitudinal and cross-sectional multilevel models. Results showed that neighborhood disadvantage, social and material adversity and gender all contributed independently to overall levels of symptoms across the life course. Cross-sectional analyses also suggested that the impact of disadvantage differed between life course periods; neighborhood disadvantage was most important in young adulthood, and the relative importance of material versus social adversity increased as participants grew older. In summary, the study suggests that disadvantages from different contextual sources may affect functional somatic health across the life course, but also through life course specific patterns.

Scope of practice and supervision of orthodontic therapists in the United Kingdom: Part 1: a national cross-sectional survey of orthodontists.

PubMed

Dugdale, Charlotte A; Ahmed, Farooq; Waring, David; Malik, Ovais H

2018-03-01

Since the introduction of orthodontic therapists (OTs), there has been little research on the scope of practice and the level of supervision they receive. This study investigates how OTs are being utilised and supervised, and how this compares with current recommendations. A postal cross-sectional survey was mailed to all UK General Dental Council (GDC) registered specialist orthodontists. A 59.7% response rate (747) was achieved. 52% of the respondents reported they worked with/employed an OT. The majority of orthodontists worked with an OT in primary care (67%) seeing predominantly NHS (56%) patients and performed a wide range of duties. Orthodontists reported a perceived increase in clinical output (74%) and time available for treatment planning (61%). The majority (85%) of orthodontists indicated they provide a written prescription for the OT. Forty-two per cent reported the prescription did not contain the required information as stipulated by the GDC. OTs are valued members of the orthodontic team, improving productivity and allowing orthodontists more time for treatment planning. The majority of orthodontists appeared to be working to the BOS and GDC recommendations, with greater awareness needed regarding the provision of a written treatment prescription.

Access to and utilisation of GP services among Burmese migrants in London: a cross-sectional descriptive study.

PubMed

Aung, Nyein Chan; Rechel, Bernd; Odermatt, Peter

2010-10-12

An estimated 10,000 Burmese migrants are currently living in London. No studies have been conducted on their access to health services. Furthermore, most studies on migrants in the United Kingdom (UK) have been conducted at the point of service provision, carrying the risk of selection bias. Our cross-sectional study explored access to and utilisation of General Practice (GP) services by Burmese migrants residing in London. We used a mixed-method approach: a quantitative survey using self-administered questionnaires was complemented by qualitative in-depth interviews for developing the questionnaire and triangulating the findings of the survey. Overall, 137 questionnaires were received (a response rate of 57%) and 11 in-depth interviews conducted. The main outcome variables of the study included GP registration, barriers towards registration, GP consultations, barriers towards consultations, and knowledge on entitlements to health care. Quantitative data were analysed using descriptive statistics, association tests, and a multivariate analysis using logistic regression. The qualitative information was analysed using content analysis. The respondents were young, of roughly equal gender (51.5% female), well educated, and had a fair level of knowledge on health services in the UK. Although the GP registration rate was relatively high (80%, 109 out of 136), GP service utilisation during the last episode of illness, at 56.8% (54 out of 95), was low. The statistical analysis showed that age being younger than 35 years, lacking prior overseas experience, having an unstable immigration status, having a shorter duration of stay, and resorting to self-medication were the main barriers hindering Burmese migrants from accessing primary health care services. These findings were corroborated by the in-depth interviews. Our study found that having formal access to primary health care was not sufficient to ensure GP registration and health care utilisation. Some respondents faced difficulties in registering with GP practices. Many of those who have registered prefer to forego GP services in favour of self-medication, partly due to long waiting times and language barriers. To ensure that migrants enjoy the health services they need and to which they are entitled, more proactive steps are required, including those that make health services culturally responsive.

Preventive health care and owner-reported disease prevalence of horses and ponies in Great Britain.

PubMed

Ireland, J L; Wylie, C E; Collins, S N; Verheyen, K L P; Newton, J R

2013-10-01

This study aimed to describe the provision of preventive health care and owner-reported disease prevalence in horses and ponies within Great Britain (GB), and to assess geographical variations in health care provision. A cross-sectional survey was conducted, using a postal questionnaire administered to a random sample of veterinary-registered owners of horses and ponies in GB (n=797). The majority of animals received regular preventive health care: 95.6% had regular hoof care; 71.3% were vaccinated for both influenza and tetanus and median time since last anthelmintic administration was 8.7 weeks. Thirty-one percent of owners indicated their animal was overweight/obese. A new health problem within the previous 7 days was reported for 7.4% of animals, 59.3% of which were veterinary-diagnosed. Thirty-two percent of animals were reported to have a long-term/recurrent condition, of which osteoarthritis (13.9%) was the most prevalent. Obesity, musculoskeletal disorders, and dermatological conditions were the most prevalent conditions affecting veterinary-registered horses/ponies. Copyright © 2013 Elsevier Ltd. All rights reserved.

A study on ground truth data for impact damaged polymer matrix composites

NASA Astrophysics Data System (ADS)

Wallentine, Sarah M.; Uchic, Michael D.

2018-04-01

This study presents initial results toward correlative characterization of barely-visible impact damage (BVID) in unidirectional carbon fiber reinforced polymer matrix composite laminate plates using nondestructive ultrasonic testing (UT) and destructive serial sectioning microscopy. To produce damage consistent with BVID, plates were impacted using an instrumented drop-weight tower with pneumatic anti-rebound brake. High-resolution, normal-incidence, single-sided, pulse-echo, immersion UT scans were performed to verify and map internal damage after impact testing. UT C-scans were registered to optical images of the specimen via landmark registration and the use of an affine transformation, allowing location of internal damage in reference to the overall plate and enabling specimen preparation for subsequent serial sectioning. The impact-damaged region was extracted from each plate, prepared and mounted for materialographic sectioning. A modified RoboMet.3D version 2 was employed for serial sectioning and optical microscopy characterization of the impact damaged regions. Automated montage capture of sub-micron resolution, bright-field reflection, 12-bit monochrome optical images was performed over the entire specimen cross-section. These optical images were post- processed to produce 3D data sets, including segmentation to improve visualization of damage features. Impact-induced delaminations were analyzed and characterized using both serial sectioning and ultrasonic methods. Those results and conclusions are presented, as well as future direction of the current study.

Noise sensitivity: Symptoms, health status, illness behavior and co-occurring environmental sensitivities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baliatsas, Christos, E-mail: c.baliatsas@nivel.nl

Epidemiological evidence on the symptomatic profile, health status and illness behavior of people with subjective sensitivity to noise is still scarce. Also, it is unknown to what extent noise sensitivity co-occurs with other environmental sensitivities such as multi-chemical sensitivity and sensitivity to electromagnetic fields (EMF). A cross-sectional study performed in the Netherlands, combining self-administered questionnaires and electronic medical records of non-specific symptoms (NSS) registered by general practitioners (GP) allowed us to explore this further. The study sample consisted of 5806 participants, drawn from 21 general practices. Among participants, 722 (12.5%) responded “absolutely agree” to the statement “I am sensitive tomore » noise”, comprising the high noise-sensitive (HNS) group. Compared to the rest of the sample, people in the HNS group reported significantly higher scores on number and duration of self-reported NSS, increased psychological distress, decreased sleep quality and general health, more negative symptom perceptions and higher prevalence of healthcare contacts, GP-registered NSS and prescriptions for antidepressants and benzodiazepines. These results remained robust after adjustment for demographic, residential and lifestyle characteristics, objectively measured nocturnal noise exposure from road-traffic and GP-registered morbidity. Co-occurrence rates with other environmental sensitivities varied between 9% and 50%. Individuals with self-declared sensitivity to noise are characterized by high prevalence of multiple NSS, poorer health status and increased illness behavior independently of noise exposure levels. Findings support the notion that different types of environmental sensitivities partly overlap. - Highlights: • People with self-reported noise sensitivity experience multiple non-specific symptoms. • They also report comparatively poorer health and increased illness behavior. • Co-occurrence with other environmental sensitivities is moderate to high. • Road-traffic noise and GP-registered morbidity did not account for these results.« less

Registration for deceased organ and tissue donation among Ontario immigrants: a population-based cross-sectional study

PubMed Central

Li, Alvin Ho-ting; Lam, Ngan N.; Dhanani, Sonny; Weir, Matthew; Prakash, Versha; Kim, Joseph; Knoll, Greg; Garg, Amit X.

2016-01-01

Background: Canada has low rates of deceased organ and tissue donation. Immigrants to Canada may differ in their registered support for deceased organ donation based on their country of origin. Methods: We used linked administrative databases in Ontario (about 11 million residents aged ≥ 16 yr) to study the proportion of immigrants and long-term residents registered for deceased organ and tissue donation as of October 2013. We used modified Poisson regression to identify and quantify predictors of donor registration. Results: Compared with long-term residents (n = 9 244 570), immigrants (n = 1 947 646) were much less likely to register for deceased organ and tissue donation (11.9% v. 26.5%). Immigrants from the United States, Australia and New Zealand had the highest registration rate (40.0%), whereas immigrants with the lowest registration rates were from Eastern Europe and Central Asia (9.4%), East Asia and Pacific (8.4%) and sub-Saharan Africa (7.9%). The largest numbers of unregistered immigrants were from India (n = 202 548), China (n = 186 678) and the Philippines (n = 125 686). Characteristics among the immigrant population associated with a higher likelihood of registration included economic immigrant status, living in a rural area (population < 10 000), living in an area with a lower ethnic concentration, less material deprivation, a higher education, ability to speak English and French, and more years residing in Canada. Interpretation: Immigrants in Ontario were less likely to register for deceased organ and tissue donation than long-term residents. There is a need to better understand reasons for lower registration rates among Canadian immigrants and to create culture-sensitive materials to build support for deceased organ and tissue donation. PMID:28443265

Leadership styles of nurse managers and registered sickness absence among their nursing staff.

PubMed

Schreuder, Jolanda A H; Roelen, Corné A M; van Zweeden, Nely F; Jongsma, Dianne; van der Klink, Jac J L; Groothoff, Johan W

2011-01-01

Sickness absence leads to understaffing and interferes with nursing efficiency and quality. It has been reported in literature that managerial leadership is associated with self-reported sickness absence in the working population. This study investigated the relationship between managerial leadership and sickness absence in health care by associating nurse managers' leadership styles with registered sickness absence among their nursing staff. The cross-sectional study included 699 nurses working in six wards (staff range = 91-140 employees) of a Dutch somatic hospital employing a total of 1,153 persons. The nurse managers heading the wards were asked to complete the Leadership Effectiveness and Adaptability Description questionnaire for situational leadership. The Leadership Effectiveness and Adaptability Description scores were linked to employer-registered nursing staff sickness absence. High relationship-high task behavior (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.65-0.85) and high relationship-low task behavior (OR = 0.37, 95% CI = 0.14 -0.98) were inversely related to the number of short (one to seven consecutive days) episodes of sickness absence among the staff. Low relationship-high task styles (OR = 2.44, 95% CI = 1.14-5.22) as well as low relationship-low task styles (OR = 2.44, 95% CI = 1.26-4.71) were positively associated with the number of short episodes of sickness absence. However, the leadership styles only explained 10% of the variance in short episodes of sickness absence. Leadership styles are associated with registered sickness absence. The nursing staff of relationship-oriented nurse managers has fewer short episodes of sickness absence than the staff of task-oriented managers. Training nurse managers in relational leadership styles may reduce understaffing and improve nursing efficiency and quality.

Cross-Cultural Register Differences in Infant-Directed Speech: An Initial Study.

PubMed

Farran, Lama K; Lee, Chia-Cheng; Yoo, Hyunjoo; Oller, D Kimbrough

2016-01-01

Infant-directed speech (IDS) provides an environment that appears to play a significant role in the origins of language in the human infant. Differences have been reported in the use of IDS across cultures, suggesting different styles of infant language-learning. Importantly, both cross-cultural and intra-cultural research suggest there may be a positive relationship between the use of IDS and rates of language development, underscoring the need to investigate cultural differences more deeply. The majority of studies, however, have conceptualized IDS monolithically, granting little attention to a potentially key distinction in how IDS manifests across cultures during the first two years. This study examines and quantifies for the first time differences within IDS in the use of baby register (IDS/BR), an acoustically identifiable type of IDS that includes features such as high pitch, long duration, and smooth intonation (the register that is usually assumed to occur in IDS), and adult register (IDS/AR), the type of IDS that does not include such features and thus sounds as if it could have been addressed to an adult. We studied IDS across 19 American and 19 Lebanese mother-infant dyads, with particular focus on the differential use of registers within IDS as mothers interacted with their infants ages 0-24 months. Our results showed considerable usage of IDS/AR (>30% of utterances) and a tendency for Lebanese mothers to use more IDS than American mothers. Implications for future research on IDS and its role in elucidating how language evolves across cultures are explored.

Cross-Cultural Register Differences in Infant-Directed Speech: An Initial Study

PubMed Central

Farran, Lama K.; Lee, Chia-Cheng; Yoo, Hyunjoo; Oller, D. Kimbrough

2016-01-01

Infant-directed speech (IDS) provides an environment that appears to play a significant role in the origins of language in the human infant. Differences have been reported in the use of IDS across cultures, suggesting different styles of infant language-learning. Importantly, both cross-cultural and intra-cultural research suggest there may be a positive relationship between the use of IDS and rates of language development, underscoring the need to investigate cultural differences more deeply. The majority of studies, however, have conceptualized IDS monolithically, granting little attention to a potentially key distinction in how IDS manifests across cultures during the first two years. This study examines and quantifies for the first time differences within IDS in the use of baby register (IDS/BR), an acoustically identifiable type of IDS that includes features such as high pitch, long duration, and smooth intonation (the register that is usually assumed to occur in IDS), and adult register (IDS/AR), the type of IDS that does not include such features and thus sounds as if it could have been addressed to an adult. We studied IDS across 19 American and 19 Lebanese mother-infant dyads, with particular focus on the differential use of registers within IDS as mothers interacted with their infants ages 0–24 months. Our results showed considerable usage of IDS/AR (>30% of utterances) and a tendency for Lebanese mothers to use more IDS than American mothers. Implications for future research on IDS and its role in elucidating how language evolves across cultures are explored. PMID:26981626

[Health Care Situation and Barriers for Working with Children of Mentally Ill Parents from the Perspective of Adult Psychiatry in Germany - A Nationwide Survey].

PubMed

Wlodarczyk, Olga; Metzner, Franka; Pawils, Silke

2017-10-01

Objective The aim of the present study was to assess the health care situation and barriers to support minor children of mentally ill parents from the perspective of adult psychiatry in Germany. Methods Based on the German Hospital Register mental health practitioners of all psychiatric clinics in Germany were asked to answer a 37-item questionnaire. Overall, 441 practitioners of 239 psychiatric clinics participated in the cross sectional study. Results Most important barriers were high workload, scarce resources, patient-focused treatment, missing expertise as well as insufficient awareness. Conclusions More resources, training, clear declaration of competence and coordination of services are necessary to implement family sensitive services in psychiatric clinics. © Georg Thieme Verlag KG Stuttgart · New York.

Geoneutrinos

DOE Office of Scientific and Technical Information (OSTI.GOV)

Machulin, I. N., E-mail: machulin@lngs.infn.it; Collaboration: Borexino Collaboration

2015-12-15

Academician M.A. Markov in the 1960s first proposed detecting the electron antineutrino in the reaction of inverse beta decay on a proton to study the processes inside the Earth. The radioactive isotopes {sup 238}U, {sup 232}Th, and {sup 40}K present in our planet decay with radiation of neutrinos (antineutrinos). Neutrinos that are produced reach the Earth’s surface practically without absorption and carry information about the internal structure of the planet. However, because of the smallness of the antineutrino fluxes and interaction cross sections with matter, antineutrinos of geological origin were first registered in only two experiments (Borexino and Kamland) inmore » recent years. The experimental observation of antineutrinos from the isotope decays in the depths of the Earth is the only way to study the radiation in our planetary interior.« less

Does contextual unemployment matter for health status across the life course? A longitudinal multilevel study exploring the link between neighbourhood unemployment and functional somatic symptoms.

PubMed

Brydsten, Anna; Gustafsson, Per E; Hammarström, Anne; San Sebastian, Miguel

2017-01-01

This study examines whether neighbourhood unemployment is related to functional somatic symptoms, independently of the individual employment, across the life course and at four specific life course periods (age 16, 21, 30 and 42). Self-reported questioner data was used from a 26-year prospective Swedish cohort (n=1010) with complementary neighbourhood register data. A longitudinal and a set of age-specific cross-sectional hierarchal linear regressions was carried out. The results suggest that living in a neighbourhood with high unemployment has implications for residents' level of functional somatic symptoms, regardless of their own unemployment across time, particularly at age 30. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Clinical Trials in Dentistry: A Cross-sectional Analysis of World Health Organization-International Clinical Trial Registry Platform.

PubMed

Sivaramakrishnan, Gowri; Sridharan, Kannan

2016-06-01

Clinical trials are the back bone for evidence-based practice (EBP) and recently EBP has been considered the best source of treatment strategies available. Clinical trial registries serve as databases of clinical trials. As regards to dentistry in specific data on the number of clinical trials and their quality is lacking. Hence, the present study was envisaged. Clinical trials registered in WHO-ICTRP (http://apps.who.int/trialsearch/AdvSearch.aspx) in dental specialties were considered. The details assessed from the collected trials include: Type of sponsors; Health condition; Recruitment status; Study design; randomization, method of randomization and allocation concealment; Single or multi-centric; Retrospective or prospective registration; and Publication status in case of completed studies. A total of 197 trials were identified. Maximum trials were from United States (n = 30) and United Kingdom (n = 38). Seventy six trials were registered in Clinical Trials.gov, 54 from International Standards of Reporting Clinical Trials, 13 each from Australia and New Zealand Trial Register and Iranian Registry of Clinical Trials, 10 from German Clinical Trial Registry, eight each from Brazilian Clinical Trial Registry and Nederland's Trial Register, seven from Japan Clinical Trial Registry, six from Clinical Trial Registry of India and two from Hong Kong Clinical Trial Registry. A total of 78.7% studies were investigator-initiated and 64% were completed while 3% were terminated. Nearly four-fifths of the registered trials (81.7%) were interventional studies of which randomized were the large majority (94.4%) with 63.2% being open label, 20.4% using single blinding technique and 16.4% were doubled blinded. The number, methodology and the characteristics of clinical trials in dentistry have been noted to be poor especially in terms of being conducted multi-centrically, employing blinding and the method for randomization and allocation concealment. More emphasis has to be laid down on the quality of trials being conducted in order to provide justice in the name of EBP. Copyright © 2016 Elsevier Inc. All rights reserved.

Demographic and occupational predictors of stress and fatigue in French intensive-care registered nurses and nurses' aides: a cross-sectional study.

PubMed

Jones, Gabrielle; Hocine, Mounia; Salomon, Jérôme; Dab, William; Temime, Laura

2015-01-01

Healthcare workers (HCWs) working in intensive-care units (ICUs) are exposed to high physical and mental demands potentially affecting their health or having repercussions on patient care. Although several studies have explored the links between some aspects of working conditions in hospitals and HCW health, the complex dynamics at play are not fully understood. This study aimed to explore the impact of a wide array of demographic, employment and organizational factors related to fatigue and stress of French ICU HCWs. A cross-sectional study was conducted in ICUs of Paris-area hospitals between January 18, 2013 and April 2, 2013. All types of adult ICUs were included (medical, surgical and polyvalent). Included in the study were HCWs with patient contact (doctors, residents, registered nurses, nurse's aides and physical therapists). Participation was proposed to all eligible HCWs present during on-site visits. Temporary staff not typically assigned to the given ICU was excluded. Data were collected using an individual questionnaire administered in interviews during day and night shifts (N=682). Stress and fatigue outcomes included the 10-item Perceived Stress Scale (PSS10), the Nottingham Health Profile sleep and energy level rubrics and the current fatigue state at the interview. Multivariate analysis was restricted to nurse and nurse's aide data (n=536). Doctors and residents reported fewer sleep difficulties but were more likely to report a tired current state. Female gender was associated with higher stress levels and greater fatigue for all outcomes, while greater social support of supervisor or colleagues decreased stress and fatigue. At the organizational level, longer shifts (12 h vs. 8 h) were associated with tired current state and greater sleep difficulties. Personnel on rotating shifts had lower stress and a better current state, while those on night shifts had greater sleep and energy level difficulties. Even when controlling for demographic factors, employment and organizational elements remained significantly associated with stress and fatigue outcomes. To improve HCW health it is important to consider simultaneously factors at the individual and organizational level. Copyright © 2014 Elsevier Ltd. All rights reserved.

Early Life Cognitive Abilities and Body Weight: Cross-Sectional Study of the Association of Inhibitory Control, Cognitive Flexibility, and Sustained Attention with BMI Percentiles in Primary School Children

PubMed Central

Wirt, Tamara; Schreiber, Anja; Kesztyüs, Dorothea; Steinacker, Jürgen M.

2015-01-01

The objective of this study was to investigate the association of different cognitive abilities with children's body weight adjusted for further weight influencing sociodemographic, family, and lifestyle factors. Cross-sectional data of 498 primary school children (7.0 ± 0.6 years; 49.8% boys) participating in a health promotion programme in southwest Germany were used. Children performed a computer-based test battery (KiTAP) including an inhibitory control task (Go-Nogo paradigm), a cognitive flexibility task, and a sustained attention task. Height and weight were measured in a standardized manner and converted to BMI percentiles based on national standards. Sociodemographic features (migration background and parental education), family characteristics (parental body weight), and children's lifestyle (TV consumption, physical activity, consumption of sugar-sweetened beverages and breakfast habits) were assessed via parental questionnaire. A hierarchical regression analysis revealed inhibitory control and cognitive flexibility to be significant cognitive predictors for children's body weight. There was no association concerning sustained attention. The findings suggest that especially cognitive abilities known as executive functions (inhibitory control and cognitive flexibility) are associated with children's body weight. Future longitudinal and intervention studies are necessary to investigate the directionality of the association and the potential of integrating cognitive training in obesity prevention strategies. This trial is registered with ClinicalTrials.gov DRKS00000494. PMID:25874122

Reporting of embryo transfer methods in IVF research: a cross-sectional study.

PubMed

Gambadauro, Pietro; Navaratnarajah, Ramesan

2015-02-01

The reporting of embryo transfer methods in IVF research was assessed through a cross-sectional analysis of randomized controlled trials (RCTs) published between 2010 and 2011. A systematic search identified 325 abstracts; 122 RCTs were included in the study. Embryo transfer methods were described in 42 out of 122 articles (34%). Catheters (32/42 [76%]) or ultrasound guidance (31/42 [74%]) were most frequently mentioned. Performer 'blinding' (12%) or technique standardization (7%) were seldom reported. The description of embryo transfer methods was significantly more common in trials published by journals with lower impact factor (less than 3, 39.6%; 3 or greater, 21.5%; P = 0.037). Embryo transfer methods were reported more often in trials with pregnancy as the main end-point (33% versus 16%) or with positive outcomes (37.8% versus 25.0%), albeit not significantly. Multivariate logistic regression confirmed that RCTs published in higher impact factor journals are less likely to describe embryo transfer methods (OR 0.371; 95% CI 0.143 to 0.964). Registered trials, trials conducted in an academic setting, multi-centric studies or full-length articles were not positively associated with embryo transfer methods reporting rate. Recent reports of randomized IVF trials rarely describe embryo transfer methods. The under-reporting of research methods might compromise reproducibility and suitability for meta-analysis. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Early life cognitive abilities and body weight: cross-sectional study of the association of inhibitory control, cognitive flexibility, and sustained attention with BMI percentiles in primary school children.

PubMed

Wirt, Tamara; Schreiber, Anja; Kesztyüs, Dorothea; Steinacker, Jürgen M

2015-01-01

The objective of this study was to investigate the association of different cognitive abilities with children's body weight adjusted for further weight influencing sociodemographic, family, and lifestyle factors. Cross-sectional data of 498 primary school children (7.0 ± 0.6 years; 49.8% boys) participating in a health promotion programme in southwest Germany were used. Children performed a computer-based test battery (KiTAP) including an inhibitory control task (Go-Nogo paradigm), a cognitive flexibility task, and a sustained attention task. Height and weight were measured in a standardized manner and converted to BMI percentiles based on national standards. Sociodemographic features (migration background and parental education), family characteristics (parental body weight), and children's lifestyle (TV consumption, physical activity, consumption of sugar-sweetened beverages and breakfast habits) were assessed via parental questionnaire. A hierarchical regression analysis revealed inhibitory control and cognitive flexibility to be significant cognitive predictors for children's body weight. There was no association concerning sustained attention. The findings suggest that especially cognitive abilities known as executive functions (inhibitory control and cognitive flexibility) are associated with children's body weight. Future longitudinal and intervention studies are necessary to investigate the directionality of the association and the potential of integrating cognitive training in obesity prevention strategies. This trial is registered with ClinicalTrials.gov DRKS00000494.

Effects of learning climate and registered nurse staffing on medication errors.

PubMed

Chang, Yunkyung; Mark, Barbara

2011-01-01

Despite increasing recognition of the significance of learning from errors, little is known about how learning climate contributes to error reduction. The purpose of this study was to investigate whether learning climate moderates the relationship between error-producing conditions and medication errors. A cross-sectional descriptive study was done using data from 279 nursing units in 146 randomly selected hospitals in the United States. Error-producing conditions included work environment factors (work dynamics and nurse mix), team factors (communication with physicians and nurses' expertise), personal factors (nurses' education and experience), patient factors (age, health status, and previous hospitalization), and medication-related support services. Poisson models with random effects were used with the nursing unit as the unit of analysis. A significant negative relationship was found between learning climate and medication errors. It also moderated the relationship between nurse mix and medication errors: When learning climate was negative, having more registered nurses was associated with fewer medication errors. However, no relationship was found between nurse mix and medication errors at either positive or average levels of learning climate. Learning climate did not moderate the relationship between work dynamics and medication errors. The way nurse mix affects medication errors depends on the level of learning climate. Nursing units with fewer registered nurses and frequent medication errors should examine their learning climate. Future research should be focused on the role of learning climate as related to the relationships between nurse mix and medication errors.

Mapping health outcome measures from a stroke registry to EQ-5D weights

PubMed Central

2013-01-01

Purpose To map health outcome related variables from a national register, not part of any validated instrument, with EQ-5D weights among stroke patients. Methods We used two cross-sectional data sets including patient characteristics, outcome variables and EQ-5D weights from the national Swedish stroke register. Three regression techniques were used on the estimation set (n = 272): ordinary least squares (OLS), Tobit, and censored least absolute deviation (CLAD). The regression coefficients for “dressing“, “toileting“, “mobility”, “mood”, “general health” and “proxy-responders” were applied to the validation set (n = 272), and the performance was analysed with mean absolute error (MAE) and mean square error (MSE). Results The number of statistically significant coefficients varied by model, but all models generated consistent coefficients in terms of sign. Mean utility was underestimated in all models (least in OLS) and with lower variation (least in OLS) compared to the observed. The maximum attainable EQ-5D weight ranged from 0.90 (OLS) to 1.00 (Tobit and CLAD). Health states with utility weights <0.5 had greater errors than those with weights ≥0.5 (P < 0.01). Conclusion This study indicates that it is possible to map non-validated health outcome measures from a stroke register into preference-based utilities to study the development of stroke care over time, and to compare with other conditions in terms of utility. PMID:23496957

Longitudinal data for interdisciplinary ageing research. Design of the Linnaeus Database.

PubMed

Malmberg, Gunnar; Nilsson, Lars-Göran; Weinehall, Lars

2010-11-01

To allow for interdisciplinary research on the relations between socioeconomic conditions and health in the ageing population, a new anonymized longitudinal database - the Linnaeus Database - has been developed at the Centre for Population Studies at Umeå University. This paper presents the database and its research potential. Using the Swedish personal numbers the researchers have, in collaboration with Statistics Sweden and the National Board for Health and Welfare, linked individual records from Swedish register data on death causes, hospitalization and various socioeconomic conditions with two databases - Betula and VIP (Västerbottens Intervention Programme) - previously developed by the researchers at Umeå University. Whereas Betula includes rich information about e.g. cognitive functions, VIP contains information about e.g. lifestyle and health indicators. The Linnaeus Database includes annually updated socioeconomic information from Statistics Sweden registers for all registered residents of Sweden for the period 1990 to 2006, in total 12,066,478. The information from the Betula includes 4,500 participants from the city of Umeå and VIP includes data for almost 90,000 participants. Both datasets include cross-sectional as well as longitudinal information. Due to the coverage and rich information, the Linnaeus Database allows for a variety of longitudinal studies on the relations between, for instance, socioeconomic conditions, health, lifestyle, cognition, family networks, migration and working conditions in ageing cohorts. By joining various datasets developed in different disciplinary traditions new possibilities for interdisciplinary research on ageing emerge.

Attitudes of Dental Hygienists towards Independent Practice and Professional Autonomy.

PubMed

Catlett, April

2016-08-01

The purpose of this cross-sectional, quantitative research was to examine if registered dental hygienists feel competent to work independently based on regulations of dental supervision. A stratified sample of 360 dental hygienists from 8 states completed the Dempster Practice Behaviors Scale survey. ANOVA and MANOVA analyses revealed how state dentist supervision level, age, degree of education, employment status, gender and years of clinical experience affect the perceived autonomy of professional dental hygienists. The response rate included 360 dental hygienists from 8 states. According to the findings age, education level and gender affected the hygienist's level of autonomy. In all 8 states, the registered dental hygienists have a high level of autonomy and feel competent to work independently. The DPBS scores of the sample registered dental hygienists suggest that they feel prepared and competent to perform preventive dental hygiene services without dentist supervision. The attitudes of the dental hygienist sample from each of the 4 state dentist supervision levels supports a move toward achieving professional jurisdiction of preventive dental care within the U.S. Copyright © 2016 The American Dental Hygienists’ Association.

Chinese nurses' perceived barriers and facilitators of ethical sensitivity.

PubMed

Huang, Fei Fei; Yang, Qing; Zhang, Jie; Khoshnood, Kaveh; Zhang, Jing Ping

2016-08-01

An overview of ethical sensitivity among Chinese registered nurses is needed to develop and optimize the education programs and interventions to cultivate and improve ethical sensitivity. The study was conducted to explore the barriers to and facilitators of ethical sensitivity among Chinese registered nurses working in hospital settings. A convergent parallel mixed-methods research design was adopted. In the cross-sectional quantitative study, the Chinese Moral Sensitivity Questionnaire-revised version was used to assess the levels of ethical sensitivity among registered nurses, and the scores were correlated with key demographics, training experiences in ethics, and workplace cultural environments (n = 306). In the qualitative study, semi-structured interviews were used to elicit the nurses' perceptions of the barriers and facilitators in nurturing ethical sensitivity (n = 15). The data were collected from February to June 2014. This study was approved by the Institutional Review Boards of Yale University and Central South University. Despite moderately high overall Chinese Moral Sensitivity Questionnaire-revised version scores, the ethical sensitivity among Chinese nurses lags in practice. Barriers to ethical sensitivity include the lack of knowledge related to ethics, lack of working experience as a nurse, the hierarchical organizational climate, and the conformist working attitude. The positive workplace cultural environments and application of ethical knowledge in practice were considered potential facilitators of ethical sensitivity. The findings of this study were compared with studies from other countries to examine the barriers and facilitators of ethical sensitivity in Chinese nurses. This mixed-methods study showed that even though the Chinese nurses have moderately high sensitivity to the ethical issues encountered in hospitals, there is still room for improvement. The barriers to and facilitators of ethical sensitivity identified here offer new and important strategies to support and enhance the nurses' sensitivity to ethical issues. © The Author(s) 2015.

Nurse-physician teamwork in the emergency department: impact on perceptions of job environment, autonomy, and control over practice.

PubMed

Ajeigbe, David O; McNeese-Smith, Donna; Leach, Linda Searle; Phillips, Linda R

2013-03-01

Teamwork is essential to safety. Few studies focus on teamwork between nurses and physicians in emergency departments (EDs). The aim of this study was to examine differences between staff in the interventional group EDs (IGEDs) and control group EDs (CGEDs) on perception of job environment, autonomy, and control over practice. This was a comparative cross-sectional study of the impact of teamwork on perceptions of job environment, autonomy, and control over practice by registered nurses and physicians (MDs) in EDs. Staff in the IGEDs showed significant differences compared with staff who worked in the CGEDs on staff perception of job environment, autonomy, and control over practice. Active teamwork practice was associated with increased perceptions of a positive job environment, autonomy, and control over practice of both nurses and physicians.

Examining the antecedents of engaged nurses in Italy: perceived organisational support (POS); satisfaction with training and development; discretionary power.

PubMed

Trinchero, Elisabetta; Brunetto, Yvonne; Borgonovi, Elio

2013-09-01

This paper used Social Exchange Theory to empirically examine whether perceived organisational support, satisfaction with training and development and perception of discretionary power are antecedents of engagement for registered nurses working in Italian public and private hospitals (n = 827). According to Social Exchange Theory, effective workplace relationships support employees and encourage nurses to use training to enhance their workplace outcomes. This research used a cross-sectional design. Data were collected from registered nurses working in six Italian hospitals using a survey-based, self-report strategy. Regression analysis found that the variance of process-oriented supervision accounted for 6.9% of Italian registered nurse's perception of engagement, training and development accounted for 26.8% and discretionary power accounted for 2.1%. Workplace relationships enhance autonomy and engagement. Effective workplace relationship impacts positively on nurses' outcome. This paper confirms the relevance of training to enhance engagement of nurses. It also confirms the importance of workplace relationships in enhancing autonomy and engagement. Previous research has identified the importance of nurses' autonomy in an environment where there are shortages of nurses. This study confirms a similar situation for Italian nurses. The findings underline the relevance of investments in continuous professional development to enhance nurses' engagement in private and public health-care settings. © 2013 John Wiley & Sons Ltd.

The influence of fetal head circumference on labor outcome: a population-based register study.

PubMed

Elvander, Charlotte; Högberg, Ulf; Ekéus, Cecilia

2012-04-01

To investigate the association between postnatal head circumference and the occurrence of the three main indications for instrumental delivery, namely prolonged labor, signs of fetal distress and maternal distress. We also studied the association between postnatal fetal head circumference and the use of vacuum extraction and emergency cesarean section. Population-based register study. Nationwide study in Sweden. A total of 265 456 singleton neonates born to nulliparous women at term between 1999 and 2008 in Sweden. Register study with data from the Swedish Medical Birth Register. Prolonged labor, signs of fetal distress, maternal distress, use of vacuum extraction and emergency cesarean section. The prevalence of each outcome increased gradually as the head circumference increased. Compared with women giving birth to a neonate with average size head circumference (35 cm), women giving birth to an infant with a very large head circumference (39-41 cm) had significantly higher odds of being diagnosed with prolonged labor [odds ratio (OR) 1.49, 95% confidence interval (CI) 1.33-1.67], signs of fetal distress (OR 1.73, 95% CI 1.49-2.03) and maternal distress (OR 2.40, 95% CI 1.96-2.95). The odds ratios for vacuum extraction and cesarean section were thereby elevated to 3.47 (95% CI 3.10-3.88) and 1.22 (95% CI 1.04-1.42), respectively. The attributable risk proportion percentages associated with vacuum extraction and cesarean section were 46 and 39%, respectively among the cases exposed to a head circumference of 37-41 cm. Large fetal head circumference is associated with complicated labor and is etiological to a considerable proportion of assisted vaginal births and emergency cesarean sections. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Job satisfaction, work environment and successful ageing: Determinants of delaying retirement among acute care nurses.

PubMed

Wargo-Sugleris, Michele; Robbins, Wendie; Lane, Christianne Joy; Phillips, Linda R

2018-04-01

To determine the relationships between job satisfaction, work environment and successful ageing and how these factors relate to Registered Nurses' intent to retire. Although little studied, retention of older nurses by delaying early retirement, before age 65, is an important topic for research. Qualitative and quantitative studies have indicated that job satisfaction work environment and successful ageing are key motivators in acute care Registered Nurses retention and/or delaying retirement. This study was designed to provide information to administrators and policy makers about retaining older, experienced RNs longer and more productively. This was a correlational, descriptive, cross-sectional study. An online survey of acute care Registered Nurses (N = 2,789) aged 40 years or older working in Florida was conducted from September - October 2013. Participants completed items related to job satisfaction, work environment, successful ageing and individual characteristics. Hypotheses derived from the modified Ellenbecker's Job Retention Model were tested using regression analysis. Job satisfaction scores were high. Highest satisfaction was with scheduling issues and co-workers; lowest with advancement opportunities. Successful ageing scores were also high with 81% reporting excellent or good health. Work environment explained 55% of the variance in job satisfaction. Years to retirement were significantly associated with successful ageing (p < .001), age (p < .001) and income (p < .010). This study provides quantitative evidence that environment and successful ageing are important areas that have an impact on job satisfaction and delay of retirement in older nurses and further studies in these areas are warranted to expand on this knowledge. © 2017 John Wiley & Sons Ltd.

The characteristics and distribution of dentist workforce in Saudi Arabia: A descriptive cross-sectional study.

PubMed

AlBaker, Abdulaziz A; Al-Ruthia, Yazed Sulaiman H; AlShehri, Mohammed; Alshuwairikh, Samar

2017-12-01

The Kingdom of Saudi Arabia has shown steady growth in the dental workforce over the last 20 years. Although the number of dental colleges has significantly increased in the last decade, there is not any study so far that described the status of the licensed dentist workforce in the kingdom. The present study aimed to explore the demographic distribution and professional characteristics of licensed dentist workforce in Saudi Arabia. This was a descriptive cross-sectional study using the Saudi Commission for Health Specialties (SCFHS) database to identify the number of licensed dentists in Saudi Arabia as well as their professional and demographic characteristics as of December 2016. The data was categorized based on gender, nationality, dental specialty, health sector, geographic location, and professional rank. The number of licensed dentists working in the kingdom as of December 2016 was 16887 dentists, and the vast majority of them are professionally registered as general dentists (70.27%). The percentage of general dentists among the professionally registered female dentists is significantly higher than their male counterparts (79.71% vs. 64.80%; P  < 0.001). Only 22.08% of the dentists working in the kingdom are Saudi. Most of the dentist workforce in the kingdom are male (61.06%). The mean age of the Saudi dentists is slightly but significantly younger than non-Saudi dentists (37.7 vs. 40.7 years; P  < 0.001). Over 80% of the Saudi dentists are working in the regions of Riyadh, Makkah, and Eastern province. About 66% of the Saudi dentists are working in the public health sector in comparison to only 20.46% of the non-Saudi dentists ( P  < 0.001). Most of the dental care in Saudi Arabia is provided by non-Saudi dentists in both private and public health sectors. With the rising unemployment rate among Saudi dentists, the governmental bodies that are responsible of dental labor market regulations such as the ministries of health, economy and planning, and labor should come up with a policy to gradually but carefully replace the non-Saudi dentists in both public and private sectors with Saudi dentists.

Deceased Organ Donation Registration and Familial Consent among Chinese and South Asians in Ontario, Canada

PubMed Central

Li, Alvin Ho-ting; McArthur, Eric; Maclean, Janet; Isenor, Cynthia; Prakash, Versha; Kim, S. Joseph; Knoll, Greg; Shah, Baiju; Garg, Amit X.

2015-01-01

Objective For various reasons, people of Chinese (China, Hong Kong or Taiwan) and South Asian (Indian subcontinent) ancestry (the two largest ethnic minority groups in Ontario, Canada) may be less likely to register for deceased organ donation than the general public, and their families may be less likely to consent for deceased organ donation at the time of death. Methods We conducted two population-based studies: (1) a cross-sectional study of deceased organ donor registration as of May 2013, and (2) a cohort study of the steps in proceeding with deceased organ donation for patients who died in hospital from October 2008 to December 2012. Results A total of 49 938 of 559 714 Chinese individuals (8.9%) and 47 774 of 374 291 South Asians (12.8%) were registered for deceased organ donation, proportions lower than the general public (2 676 260 of 10 548 249 (25.4%). Among the 168 703 Ontarians who died in a hospital, the families of 33 of 81 Chinese (40.1%; 95% CI: 30.7%-51.6%) and 39 of 72 South Asian individuals (54.2%; 95% CI: 42.7-65.2%) consented for deceased organ donation, proportions lower than the general public (68.3%; 95% CI: 66.4%-70.0%). Conclusions In Ontario, Canada Chinese and South Asian individuals are less likely to register and their families are less likely to consent to deceased organ donation compared to the remaining general public. There is an opportunity to build support for organ and tissue donation in these two large ethnic communities in Canada. PMID:26230320

A Study in Difference: Structures and Cultures in Registered Training Organisations. Support Document 3

ERIC Educational Resources Information Center

Clayton, Berwyn; Fisher, Thea; Harris, Roger; Bateman, Andrea; Brown, Mike

2008-01-01

This document supports the report "A Study in Difference: Structures and Cultures in Registered Training Organisations." The first section outlines the methodology used to undertake the research and covers the design of the research, sample details, the data collection process and the strategy for data analysis and reporting. The…

Three-dimensional Fourier-domain optical coherence tomography of alveolar mechanics in stepwise inflated and deflated isolated and perfused rabbit lungs

NASA Astrophysics Data System (ADS)

Krueger, Alexander; Knels, Lilla; Meissner, Sven; Wendel, Martina; Heller, Axel R.; Lambeck, Thomas; Koch, Thea; Koch, Edmund

2007-07-01

Fourier domain optical coherence tomography (FD-OCT) was used to acquire three-dimensional image stacks of isolated and perfused rabbit lungs (n = 4) at different constant pulmonary airway pressures (CPAP) and during vascular fixation. After despeckling and applying a threshold, the images were segmented into air and tissue, and registered to each other to compensate for movement between CPAP steps. The air-filled cross-sectional areas were quantified using a semi-automatic algorithm. The cross-sectional area of alveolar structures taken at all three perpendicular planes increased with increasing CPAP. Between the minimal CPAP of 3 mbar and the maximum of 25 mbar the areas increased to about 140% of their initial value. There was no systematic dependency of inflation rate on initial size of the alveolar structure. During the perfusion fixation of the lungs with glutaraldehyde morphometric changes of the alveolar geometry measured with FD-OCT were negligible.

Health and re-employment in a two year follow up of long term unemployed.

PubMed Central

Claussen, B; Bjørndal, A; Hjort, P F

1993-01-01

STUDY OBJECTIVE--The aim was to examine re-employment and changes in health during a two year follow up of a representative sample of long term unemployed. DESIGN--This was a cross sectional study and a two year follow up. Health was measured by psychometric testing, Hopkins symptom checklist, General health questionnaire, and medical examination. Health related selection to continuous unemployment and recovery by re-employment was estimated by logistic regression with covariances deduced from the labour market theories of human capital and segmented labour market. SETTING--Four municipalities in Greenland, southern Norway. SUBJECTS--Participants were a random sample of 17 to 63 year old people registered as unemployed for more than 12 weeks. MAIN RESULTS--In the cross sectional study, the prevalence of depression, anxiety, and somatic illness was from four to 10 times higher than in a control group of employed people. In the follow up study, there was considerable health related selection to re-employment. A psychiatric diagnosis was associated with a 70% reduction in chances of obtaining a job. Normal performance on psychometric testing showed a two to three times increased chance of re-employment. Recovery of health following re-employment was less than expected from previous studies. CONCLUSIONS--Health related selection to long term unemployment seems to explain a substantial part of the excess mental morbidity among unemployed people. An increased proportion of the long term unemployed will be vocationally handicapped as years pass, putting a heavy burden on social services. Images PMID:8436885

Educational Intervention for Nutrition Education in Patients Attending an Outpatient Wound Care Clinic: A Feasibility Study.

PubMed

Green, Lisa M; Ratcliffe, Desi; Masters, Kathleen; Story, Lachel

2016-01-01

The purpose of this study was to determine whether nurses could use a structured intervention to educate patients with wounds about foods that promote healing and whether this educational intervention could be provided in a cost-effective manner. Cross-sectional survey. The study was conducted at an outpatient wound care center located on a hospital campus in the Southern United States; 3 full-time nurses and 2 nurses employed on part-time status delivered the intervention. A nutrition education intervention was developed through collaborative efforts of a registered dietitian and a nurse. A cross-sectional survey design was used to (1) evaluate nurses' perceptions of the intervention and (2) identify barriers to implementation of the intervention. Direct costs related to materials and nursing time required to deliver the intervention were calculated. Participants indicated they were competent to deliver the structured intervention, and all were willing to continue its use. Survey results indicated that nurses believed the intervention was beneficial to their patients and they indicated that patients were responsive to the intervention. The intervention was found to be low cost ($8.00 per teaching session); no barriers to implementation of the intervention were identified. The results of this exploratory study suggest that a structured nutrition education intervention can be provided by nurses in outpatient wound clinics at low cost. Further study is needed to determine the impact of this intervention on nutritional intake and wound healing.

A cross-sectional study to identify organisational processes associated with nurse-reported quality and patient safety

PubMed Central

Tvedt, Christine; Sjetne, Ingeborg Strømseng; Helgeland, Jon; Bukholm, Geir

2012-01-01

Objectives The purpose of this study was to identify organisational processes and structures that are associated with nurse-reported patient safety and quality of nursing. Design This is an observational cross-sectional study using survey methods. Setting Respondents from 31 Norwegian hospitals with more than 85 beds were included in the survey. Participants All registered nurses working in direct patient care in a position of 20% or more were invited to answer the survey. In this study, 3618 nurses from surgical and medical wards responded (response rate 58.9). Nurses' practice environment was defined as organisational processes and measured by the Nursing Work Index Revised and items from Hospital Survey on Patient Safety Culture. Outcome measures Nurses' assessments of patient safety, quality of nursing, confidence in how their patients manage after discharge and frequency of adverse events were used as outcome measures. Results Quality system, nurse–physician relation, patient safety management and staff adequacy were process measures associated with nurse-reported work-related and patient-related outcomes, but we found no associations with nurse participation, education and career and ward leadership. Most organisational structures were non-significant in the multilevel model except for nurses’ affiliations to medical department and hospital type. Conclusions Organisational structures may have minor impact on how nurses perceive work-related and patient-related outcomes, but the findings in this study indicate that there is a considerable potential to address organisational design in improvement of patient safety and quality of care. PMID:23263021

A pilot study of the relationship between diet and mental health in female university students enrolled in a training course for registered dietitians.

PubMed

Mochimasu, Kazumi Dokai; Miyatake, Nobuyuki; Hase, Ayako

2016-09-01

The purpose of the present pilot study was to investigate the link between diet and mental health in female university students enrolled in a training course for registered dietitians. A total of 62 female university students, with a mean age of 18.79 ± 0.45 years, participated in this cross-sectional study. Diet surveys were performed using the brief-type self-administered diet history questionnaire (BDHQ). Mental health was also evaluated using the general health questionnaire-12 (GHQ-12), which was the shortest form and clinically available. Lifestyles such as physical activity levels were also evaluated. The mean energy intake was 1379 ± 575 kcal and the mean GHQ score was 3.11 ± 2.41. Among nutrients, vegetable fat and sucrose showed a weak positive correlation with the GHQ scores. Among food groups, potatoes, fats and oils, and confectioneries also showed a weak positive correlation with the GHQ scores. A multiple regression analysis showed that the confectioneries were the determining factor for the GHQ scores. Proper education concerning their diets and reducing confectioneries in their daily lives might be beneficial for the mental health of female university students.

17 CFR 270.18f-1 - Exemption from certain requirements of section 18(f)(1) (of the Act) for registered open-end...

Code of Federal Regulations, 2010 CFR

2010-04-01

... requirements of section 18(f)(1) (of the Act) for registered open-end investment companies which have the right... EXCHANGE COMMISSION (CONTINUED) RULES AND REGULATIONS, INVESTMENT COMPANY ACT OF 1940 § 270.18f-1 Exemption from certain requirements of section 18(f)(1) (of the Act) for registered open-end investment companies...

Nursing contributions to chronic disease management in primary care.

PubMed

Lukewich, Julia; Edge, Dana S; VanDenKerkhof, Elizabeth; Tranmer, Joan

2014-02-01

As the prevalence of chronic diseases continues to increase, emphasis is being placed on the development of primary care strategies that enhance healthcare delivery. Innovations include interprofessional healthcare teams and chronic disease management strategies. To determine the roles of nurses working in primary care settings in Ontario and the extent to which chronic disease management strategies have been implemented. We conducted a cross-sectional survey of a random sample of primary care nurses, including registered practical nurses, registered nurses, and nurse practitioners, in Ontario between May and July 2011. Nurses in primary care reported engaging in chronic disease management activities but to different extents depending on their regulatory designation (licensure category). Chronic disease management strategy implementation was not uniform across primary care practices where the nurses worked. There is the potential to optimize and standardize the nursing role within primary care and improve the implementation of chronic disease management strategies.

The Single Event Upset (SEU) response to 590 MeV protons

NASA Technical Reports Server (NTRS)

Nichols, D. K.; Price, W. E.; Smith, L. S.; Soli, G. A.

1984-01-01

The presence of high-energy protons in cosmic rays, solar flares, and trapped radiation belts around Jupiter poses a threat to the Galileo project. Results of a test of 10 device types (including 1K RAM, 4-bit microP sequencer, 4-bit slice, 9-bit data register, 4-bit shift register, octal flip-flop, and 4-bit counter) exposed to 590 MeV protons at the Swiss Institute of Nuclear Research are presented to clarify the picture of SEU response to the high-energy proton environment of Jupiter. It is concluded that the data obtained should remove the concern that nuclear reaction products generated by protons external to the device can cause significant alteration in the device SEU response. The data also show only modest increases in SEU cross section as proton energies are increased up to the upper limits of energy for both the terrestrial and Jovian trapped proton belts.

Morphological features of the macerated cranial bones registered by the 3D vision system for potential use in forensic anthropology.

PubMed

Skrzat, Janusz; Sioma, Andrzej; Kozerska, Magdalena

2013-01-01

In this paper we present potential usage of the 3D vision system for registering features of the macerated cranial bones. Applied 3D vision system collects height profiles of the object surface and from that data builds a three-dimensional image of the surface. This method appeared to be accurate enough to capture anatomical details of the macerated bones. With the aid of the 3D vision system we generated images of the surface of the human calvaria which was used for testing the system. Performed reconstruction visualized the imprints of the dural vascular system, cranial sutures, and the three-layer structure of the cranial bones observed in the cross-section. We figure out that the 3D vision system may deliver data which can enhance estimation of sex from the osteological material.

Study of BenW (n = 1-12) clusters: An electron collision perspective

NASA Astrophysics Data System (ADS)

Modak, Paresh; Kaur, Jaspreet; Antony, Bobby

2017-08-01

This article explores electron scattering cross sections by Beryllium-Tungsten clusters (BenW). Beryllium and tungsten are important elements for plasma facing wall components, especially for the deuterium/tritium phase of ITER and in the recently installed JET. The present study focuses on different electron impact interactions in terms of elastic cross section (Qel), inelastic cross section (Qinel), ionization cross section (Qion), and momentum transfer cross section (Qmtcs) for the first twelve clusters belonging to the BenW family. It also predicts the evolution of the cross section with the size of the cluster. These cross sections are used as an input to model processes in plasma. The ionization cross section presented here is compared with the available reported data. This is the first comprehensive report on cross section data for all the above-mentioned scattering channels, to the best of our knowledge. Such broad analysis of cross section data gives vital insight into the study of local chemistry of electron interactions with BenW (n = 1-12) clusters in plasma.

Factors influencing turnover intention among registered nurses in Samar Philippines.

PubMed

Labrague, Leodoro J; Gloe, Donna; McEnroe, Denise M; Konstantinos, Kostas; Colet, Paolo

2018-02-01

Despite the massive nurse migration and turnover of nurses in the Philippines, there remains a lack of studies describing factors influencing the migration of Filipino nurses. This study explored the effects of nurses' characteristics, work satisfaction, and work stress with the intent to leave an organization among registered nurses in the Philippines. This study utilized a descriptive, cross-sectional approach. One hundred sixty six (166) nurses participated in the study during the months of September 2015 to December 2015. Three standardized instruments were used in the study: Job Satisfaction Index (JSI), Job Stress Scale (JSS), and Turnover Intention Inventory Scale (TIIS). Data were analyzed using descriptive and inferential statistical tools. Nurses' ages were found to significantly influence their turnover intentions. Job satisfaction (β=-0.47, p=0.001) and job stress (β=0.23, p=0.001) strongly predicted turnover intentions in the nurses. The mean values for the job satisfaction scale, job stress scale, and turnover intention inventory scale were 3.13 (SD=0.60), 2.74 (SD=0.71), and 2.43 (SD=0.67) respectively. Several predictors of turnover intentions were determined in this study through nurses' age, job satisfaction, and job stress as being the most influential factors. Efforts to increase nurses' job satisfaction and reduce job stress should be implemented to halt further loss of these skilled groups of healthcare professionals. Copyright © 2017 Elsevier Inc. All rights reserved.

"The way we do things around here": an international comparison of treatment culture in nursing homes.

PubMed

Hughes, Carmel M; Donnelly, Ailis; Moyes, Simon A; Peri, Kathy; Scahill, Shane; Chen, Charlotte; McCormack, Brendan; Kerse, Ngaire

2012-05-01

In this study, we sought to measure treatment culture (beliefs, values, and normative practices associated with medication prescribing and administration) in two samples of nursing homes (in Northern Ireland and New Zealand) and to document the range of scoring achieved by staff in both countries. Responses between nurse managers and registered nurses were also compared. A cross-sectional study using an adapted treatment culture questionnaire was distributed by mail (in June and September 2008) to 159 nursing homes in Northern Ireland and completed by the nurse manager and registered nurses. In New Zealand, staff in 14 facilities participated and questionnaires were distributed by a research assistant who visited the homes (March to November 2008). Completed questionnaires were scored using a prespecified scoring system, with a higher score indicating a more resident-centered treatment culture and a lower score indicating a more traditional approach to care. The maximum score possible was 75. Scores were compared between countries and between different categories of staff. Views were also sought and knowledge tested (from structured questions) on the use of psychotropic prescribing in the nursing home environment. The response rates for nurse managers and nurses in Northern Ireland were 35.5% and 10.1%, respectively; in New Zealand, the response rate was 90.9% for managers and 71% for nurses. The mean score for the Northern Ireland and New Zealand homes was 39.5 and 39.1, respectively (P > .05). There were also no differences between scores achieved by nurse managers and registered nurses between and across both countries. There were some cross-country differences on the approach to challenging behavior in residents and nurses (in both countries) were more likely than nurse managers to report (incorrectly) that haloperidol is indicated for short-term insomnia. This quantitative assessment has raised interesting issues in relation to the measurement of treatment culture in the nursing home setting in two countries. Further insights into the importance of treatment culture will be pursued in qualitative studies. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Cross-sectional and longitudinal study of the impact of posterior meniscus horn lesions on adjacent cartilage composition, patient-reported outcomes and gait biomechanics in subjects without radiographic osteoarthritis.

PubMed

Russell, C; Pedoia, V; Souza, R B; Majumdar, S

2017-05-01

The aim of this study was to assess cross-sectional and longitudinal effects of meniscal lesions on adjacent cartilage T 1ρ and T 2 relaxation times, patient-reported outcomes and gait biomechanics. Thirty patients with no cartilage morphological defects reported by Whole Organ MRI Score (WORMS) magnetic resonance imaging (MRI) grading and no radiographic osteoarthritis (OA) (Kellgren--Lawrence (KL) ≤ 1) were selected, 15 with posterior meniscus horn lesions and 15 matched controls without meniscal lesions. All were imaged on a 3T MR scanner for three consecutive years, except those who dropped from the study. Sagittal and frontal plane kinematic gait data were acquired at baseline. The Knee Injury and Osteoarthritis Outcome Score (KOOS) survey was taken each time. All images were automatically segmented and registered to an atlas for voxel-by-voxel cross-sectional and longitudinal analyses. Relaxation time comparisons between groups showed elevated T 1ρ of the lateral tibia (LP) and elevated T 2 of the medial tibia (MT) and LT at 1 and 2 years in the lesion group. Longitudinal comparisons within each group revealed greater relaxation time elevations over one and 2 years in the group with lesions. KOOS Quality of Life (QOL) was significantly different between the groups at all time points (P < 0.05), as were other KOOS subcategories. No significant differences in the frontal or sagittal biomechanics were observed between the groups at baseline. Individuals with healthy cartilage and posterior meniscal horn lesions have increased relaxation times when compared to matched controls, increased relaxation time changes over 2 years, and consistently report a lower KOOS QOL, yet show no difference in gait biomechanics. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Health and re-employment in a two year follow up of long term unemployed.

PubMed

Claussen, B; Bjørndal, A; Hjort, P F

1993-02-01

The aim was to examine re-employment and changes in health during a two year follow up of a representative sample of long term unemployed. This was a cross sectional study and a two year follow up. Health was measured by psychometric testing, Hopkins symptom checklist, General health questionnaire, and medical examination. Health related selection to continuous unemployment and recovery by re-employment was estimated by logistic regression with covariances deduced from the labour market theories of human capital and segmented labour market. Four municipalities in Greenland, southern Norway. Participants were a random sample of 17 to 63 year old people registered as unemployed for more than 12 weeks. In the cross sectional study, the prevalence of depression, anxiety, and somatic illness was from four to 10 times higher than in a control group of employed people. In the follow up study, there was considerable health related selection to re-employment. A psychiatric diagnosis was associated with a 70% reduction in chances of obtaining a job. Normal performance on psychometric testing showed a two to three times increased chance of re-employment. Recovery of health following re-employment was less than expected from previous studies. Health related selection to long term unemployment seems to explain a substantial part of the excess mental morbidity among unemployed people. An increased proportion of the long term unemployed will be vocationally handicapped as years pass, putting a heavy burden on social services.

The association of suicide-related Twitter use with suicidal behaviour: a cross-sectional study of young internet users in Japan.

PubMed

Sueki, Hajime

2015-01-01

Infodemiology studies for suicide prevention have become increasingly common in recent years. However, the association between Twitter use and suicide has only been partially clarified. This study examined the association between suicide-related tweets and suicidal behaviour to identify suicidal young people on the Internet. A cross-sectional survey was conducted using Internet survey panels (n=220,848) comprising users in their 20s, through a major Japanese Internet survey company. Final analyses included the data of 1000 participants. Of the participants (n=1000) used in the final analysis, 61.3% were women and the mean age was 24.9 years (SD=2.9, range=20-29). Logistic regression analyses showed that tweeting "want to die" and "want to commit suicide" was significantly related to suicidal ideation and behaviour. Lifetime suicide attempts, the most powerful predictor of future suicide out of all suicidal behaviours, were more strongly associated with tweeting "want to commit suicide" than tweeting "want to die". Having a Twitter account and tweeting daily were not associated with suicidal behaviour. An online panel survey has some inherent biases, such as coverage bias. Respondents were already registered as members of a particular Internet survey company in Japan, which limits the possibility of generalization. Twitter logs may be used to identify suicidal young Internet users. This study provides a basis for the early identification of individuals at high risk for suicide. Copyright © 2014 Elsevier B.V. All rights reserved.

Compliance with prospective trial registration guidance remained low in high-impact journals and has implications for primary end point reporting.

PubMed

Dal-Ré, Rafael; Ross, Joseph S; Marušić, Ana

2016-07-01

To examine compliance with International Committee of Medical Journal Editors' (ICMJE) policy on prospective trial registration along with predictors of compliance. Cross-sectional analysis of all articles reporting trial results published in the six highest-impact general medicine journals in January-June 2014 that were registered in a public trial registry. The main outcome measure was compliance with ICMJE policy. The time frame for trial primary end point ascertainment was used to assess whether retrospective registration could have allowed changing of primary end points following an interim analysis. Forty of 144 (28%) articles did not comply with the ICMJE policy. Trials of non-FDA-regulated interventions were less compliant than trials of FDA-regulated interventions (i.e., medicines, medical devices) (42% vs. 21%; P = 0.016). Twenty-nine of these 40 (72%; 20% overall) were registered before any interim analysis of primary end points could have been conducted; 11 (28%; 8% overall) were registered after primary end point ascertainment, such that investigators could have had the opportunity to conduct an interim analysis before trial registration. Twenty-eight percent of trials published in high-impact journals were retrospectively registered including nearly 10% that were registered after primary end point ascertainment could have had taken place. Prospective registration should be prompted and enforced to ensure transparency and accountability in clinical research. Copyright © 2016 Elsevier Inc. All rights reserved.

Uptake of the NHS Health Checks programme in a deprived, culturally diverse setting: cross-sectional study.

PubMed

Dalton, Andrew R H; Bottle, Alex; Okoro, Cyprian; Majeed, Azeem; Millett, Christopher

2011-09-01

The UK is embarking on a national cardiovascular risk assessment programme called NHS Health Checks; in order to be effective, high and equitable uptake is paramount. A cross-sectional study, using data extracted from electronic medical records of persons aged 35-74 years estimated to be at a high risk of developing cardiovascular disease, to examine the uptake of the Health Checks using logistic regression and statin prescribing. A total of 44.8% of high risk patients invited for a Health Check attended. Uptake was lower among younger men but higher among patients from south Asian (AOR = 1.71 [1.29-2.27] compared with white) or mixed ethnic backgrounds (AOR = 2.42 [1.50-3.89]), and patients registered with smaller practices (AOR = 2.53 [1.09-5.84] <3000 patients compared with 3000-5999). The percentage of patients confirmed to be at high risk of CVD prescribed a statin increased from 24.7 to 44.8%. Uptake of cardiovascular risk assessment and prescribing of statins in high risk patients was considerably lower than projected in the first year of NHS Health Checks programme. Targeting efforts to increase uptake and adherence to interventions in high risk populations and reinvesting resources into population wide strategies to reduce obesity, smoking and salt intake may prove more cost-effective in reducing the burden of cardiovascular disease in the UK.

Prevalence and clinical characteristics of CMV coinfection among HIV infected individuals in Guinea-Bissau: A cross-sectional study.

PubMed

Grønborg, Helene L; Jespersen, Sanne; Egedal, Johanne H; Correia, Faustino G; Medina, Candida; Krarup, Henrik; Hønge, Bo L; Wejse, Christian

2018-05-31

To describe the prevalence of CMV in a cohort of HIV infected individuals in Guinea-Bissau, West Africa and to evaluate differences in patients' clinical characteristics associated with their CMV status. Newly diagnosed HIV infected adults were invited to participate in this cross-sectional study, from May until December 2015. Enrolled patients were interviewed and underwent a full physical examination focusing on CMV disease manifestations. Blood samples were analyzed for CMV serology, QuantiFERON-CMV response and CMV DNA. Mortality follow-up were registered for one year after inclusion. In total, 180 patients were enrolled. Anti-CMV IgG positivity was found in 138/138 (100%) and 4/138 (2.8%) were anti-CMV IgM positive. A positive QuantiFERON-CMV response was found in 60/70 (85.7%) of the patients and 83/137 (60.6%) had CMV viremia. QuantiFERON-CMV response and detectable CMV DNA were associated with lower CD4 cell count, older age, and upper gastrointestinal complaints. During one year of follow-up, the IRR for death among CMV DNA positive patients was 1.5 (p=0.5). CMV coinfection was detected among all enrolled patients and CMV viremia was highly prevalent. Only age and upper gastrointestinal complaints were associated with the patients' CMV status. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Cigarettes & waterpipe smoking among medical students in Syria: a cross-sectional study

PubMed Central

Matar, HE; Salam, M; Morad, A; Abdulaal, M; Koudsi, A; Maziak, W

2008-01-01

Summary Objectives To investigate tobacco use practices, beliefs and attitude among medical students in Syria. Methods This is a cross-sectional study among a random sample of 570 medical students (1st and 5th year) registered at Damascus Faculty of Medicine, 2006–07. We used a self-administered questionnaire inquiring about demographic information, smoking behaviour (cigarette, waterpipe), family and peer smoking, attitudes and beliefs about smoking and future role in advising patients to quit smoking. Results The overall prevalence of tobacco use was 10.9% for cigarette (15.8% men, 3.3% women), 23.5% for waterpipe (30.3% men, 13.4% women), and 7.3% for both (10.1% men, 3.1% women). Both smoking methods were more popular among 5th year students (15.4% and 27%) compared to their younger counterparts (6.6% and 19.7%). Regular smoking patterns predominated for cigarettes (62%), while occasional use patterns predominated for waterpipe (83%). More than two thirds of students (69%) think they may not or have difficulty addressing smoking in their future patients. Conclusion The level of tobacco use among Syrian medical students is alarming and point at the rapidly changing patterns towards waterpipe use, especially among female students. Medical schools should work harder to tackle this phenomenon and address it more efficiently in their curricula. PMID:18713509

40 CFR 432.5 - Incorporation by reference.

Code of Federal Regulations, 2012 CFR

2012-07-01

... sections in this part, as noted. The Director of the Federal Register approves the incorporation by... published in the Federal Register. The material is available for purchase at the address in paragraph (b) of this section and is available for inspection at the Office of the Federal Register, 800 North Capitol...

40 CFR 432.5 - Incorporation by reference.

Code of Federal Regulations, 2014 CFR

2014-07-01

... sections in this part, as noted. The Director of the Federal Register approves the incorporation by... published in the Federal Register. The material is available for purchase at the address in paragraph (b) of this section and is available for inspection at the Office of the Federal Register, 800 North Capitol...

Exploring the Relationship Between Professional Commitment and Job Satisfaction Among Nurses.

PubMed

Hsu, Hsiu-Chin; Wang, Pao-Yu; Lin, Li-Hui; Shih, Whei-Mei; Lin, Mei-Hsiang

2015-09-01

This cross-sectional study explored the relationship between professional commitment and job satisfaction among nurses. A total of 132 registered nurses were recruited from a hospital in northern Taiwan. A self-reported structured questionnaire was used to collect data. Findings revealed significant differences among nurses in willingness to make an effort and their marital status, appraisal in continuing their careers, job level, and goals and values related to working shifts. Significant differences were found between inner satisfaction and work sector and marital status. Nurses' professional commitment was strongly related to job satisfaction; aspects of professional commitment explained 32% of the variance in job satisfaction. Study results may inform health care institutions about the importance of nurses' job satisfaction and professional commitment so hospital administration can improve these aspects of organizational environment. © 2015 The Author(s).

Cross sectional analysis of the association between mode of school transportation and physical fitness in children and adolescents.

PubMed

Ostergaard, Lars; Kolle, Elin; Steene-Johannessen, Jostein; Anderssen, Sigmund A; Andersen, Lars Bo

2013-07-17

To investigate the associations between body composition, cardiorespiratory and muscular fitness in relation to travel mode to school in children and adolescents. Children and adolescents from 40 elementary schools and 23 high schools representing all regions in Norway were invited to participate in the study. Anthropometry, cardiorespiratory and muscular fitness were tested at the school location. Questionnaires were used in order to register mode of transport to school, age, gender and levels of leisure time physical activity. A total of 1694 (i.e. 60% of all invited participants) children and adolescents at a mean age of 9.6 and 15.6 respectively (SD = 0.4 for both groups) were analyzed for associations with physical fitness variables. Males cycling to school had lower sum of skin folds than adolescents walking to school. Higher cardiorespiratory fitness in adolescents and male cyclists compared to walkers and passive commuters were observed. Among children, cycling and walking to school, higher isometric muscle endurance in the back extensors compared to passive commuters was observed. Based on this national representative cross-sectional examination of randomly selected children and adolescents there is evidence that active commuting, especially cycling, is associated with a favourable body composition and better cardiorespiratory and muscular fitness as compared to passive commuting.

Antibiotic prescriptions for inpatients having non-bacterial diagnosis at medicine departments of two private sector hospitals in Madhya Pradesh, India: a cross-sectional study

PubMed Central

Landstedt, Kristoffer; Sharma, Ashish; Johansson, Fredrik; Stålsby Lundborg, Cecilia; Sharma, Megha

2017-01-01

Objectives To present and compare antibiotic prescribing for inpatients among the most common non-bacterial diagnoses groups at medicine departments of a teaching (TH) and a non-teaching hospital (NTH) in central India. Setting An observational cross-sectional study was conducted at two tertiary care settings in Ujjain district, Madhya Pradesh, India. Data and participants The data were collected manually, using a customised form. Complete records of all inpatients, who were >15 years of age and had stayed for at least one night in either of the hospitals during 2008–2011, were analysed. Outcome measures Inpatients were grouped according to the presence or absence of a bacterial infectious diagnosis, viral/malaria fever or cardiovascular disease. Classes of antibiotics prescribed to these groups and adherence to the available prescribing guidelines were compared between the hospitals using the notes from the patient files and the diagnoses. Results Of 20 303 inpatients included in the study, 66% were prescribed antibiotics. Trade name prescribing and use of broad-spectrum antibiotics were more frequent at the NTH than at the TH (p<0.001). At the TH a significantly higher proportion of patients having fever without registered bacterial infection were prescribed antibiotics (82%) compared with the NTH (71%, p<0.001). Patients admitted for cardiovascular diagnosis without registered bacterial infections received antibiotic prescriptions at both hospitals (NTH 47% and TH 37%) but this was significantly higher at the NTH (p<0.001). None of the diagnoses were confirmed by microbiology reports. Conclusions Prescribing antibiotics, including broad-spectrum antibiotics, to inpatients without bacterial infections—that is, viral fever, malaria and cardiovascular disease, was common at both hospitals, which increases the risk for development of bacterial resistance, a global public health threat. In view of the overprescribing of antibiotics, the main recommendations are development and implementation of local prescription guidelines, encouragement to use laboratory facilities and prescription analysis, with antibiotic stewardship programmes. PMID:28391232

Antibiotic prescriptions for inpatients having non-bacterial diagnosis at medicine departments of two private sector hospitals in Madhya Pradesh, India: a cross-sectional study.

PubMed

Landstedt, Kristoffer; Sharma, Ashish; Johansson, Fredrik; Stålsby Lundborg, Cecilia; Sharma, Megha

2017-04-08

To present and compare antibiotic prescribing for inpatients among the most common non-bacterial diagnoses groups at medicine departments of a teaching (TH) and a non-teaching hospital (NTH) in central India. An observational cross-sectional study was conducted at two tertiary care settings in Ujjain district, Madhya Pradesh, India. The data were collected manually, using a customised form. Complete records of all inpatients, who were >15 years of age and had stayed for at least one night in either of the hospitals during 2008-2011, were analysed. Inpatients were grouped according to the presence or absence of a bacterial infectious diagnosis, viral/malaria fever or cardiovascular disease. Classes of antibiotics prescribed to these groups and adherence to the available prescribing guidelines were compared between the hospitals using the notes from the patient files and the diagnoses. Of 20 303 inpatients included in the study, 66% were prescribed antibiotics. Trade name prescribing and use of broad-spectrum antibiotics were more frequent at the NTH than at the TH (p<0.001). At the TH a significantly higher proportion of patients having fever without registered bacterial infection were prescribed antibiotics (82%) compared with the NTH (71%, p<0.001). Patients admitted for cardiovascular diagnosis without registered bacterial infections received antibiotic prescriptions at both hospitals (NTH 47% and TH 37%) but this was significantly higher at the NTH (p<0.001). None of the diagnoses were confirmed by microbiology reports. Prescribing antibiotics, including broad-spectrum antibiotics, to inpatients without bacterial infections-that is, viral fever, malaria and cardiovascular disease, was common at both hospitals, which increases the risk for development of bacterial resistance, a global public health threat. In view of the overprescribing of antibiotics, the main recommendations are development and implementation of local prescription guidelines, encouragement to use laboratory facilities and prescription analysis, with antibiotic stewardship programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

1 CFR 6.4 - Monthly list of sections affected.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Monthly list of sections affected. 6.4 Section 6.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.4 Monthly list of sections affected. A monthly list of sections of the Code of...

1 CFR 6.4 - Monthly list of sections affected.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1 General Provisions 1 2011-01-01 2011-01-01 false Monthly list of sections affected. 6.4 Section 6.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.4 Monthly list of sections affected. A monthly list of sections of the Code of...

1 CFR 6.4 - Monthly list of sections affected.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1 General Provisions 1 2012-01-01 2012-01-01 false Monthly list of sections affected. 6.4 Section 6.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.4 Monthly list of sections affected. A monthly list of sections of the Code of...

1 CFR 6.4 - Monthly list of sections affected.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1 General Provisions 1 2014-01-01 2012-01-01 true Monthly list of sections affected. 6.4 Section 6.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.4 Monthly list of sections affected. A monthly list of sections of the Code of...

1 CFR 6.4 - Monthly list of sections affected.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1 General Provisions 1 2013-01-01 2012-01-01 true Monthly list of sections affected. 6.4 Section 6.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.4 Monthly list of sections affected. A monthly list of sections of the Code of...

Validation of Long Bone Mechanical Properties from Densitometry

NASA Technical Reports Server (NTRS)

Whalen, R.; Katz, B.; Cleek, T.; Hargens, Alan R. (Technical Monitor)

1995-01-01

The objective of this study was to assess whether cross-sectional areal properties, calculated from densitometry, correlate to the true flexural properties. Right and left male embalmed tibiae were used in the study. Prior to scanning, the proximal end of each tibia was potted in a fixture with registration pins, flushed thoroughly with water under pressure to remove trapped air, and then placed in a constant thickness water bath attached to a precision indexer. Two sets of three scans of the entire tibia were taken with an Hologic QDR 1000/W densitometer at rotations of 0, 45, and 90 degrees about the tibia long axis. An aluminum step phantom and a bone step phantom, machined from bovine cortical bone, were also in the bath and scanned separately. Pixel attenuation data from the two sets of scans were averaged to reduce noise. Pixel data from the high energy beam were then converted to equivalent thicknesses using calibration equations. Cross-sectional areal properties (centroid, principal area moments and principal angle) along the length were computed from the three registered scans using methods developed in our laboratory. Flexural rigidities. Four strain gages were bonded around the circumference of each of 5 cross-sections encompassing the entire diaphysis. A known transverse load was then applied to the distal end and the bone was rotated 360 degrees in eight increments of 45 degrees each. Strains from the eight orientations were analyzed along with the known applied bending moments at each section to compute section centroids, curvatures, principal flexural rigidities and principal angle. Reference axes between the two methods were maintained within +/- 0.5 degrees using an electronic inclinometer. Principal angles (flexural - areal) differed by -2.0 +/- 4.0 degrees, and 1.0 +/- 2.5 degrees for the right and left tibia, respectively. Section principal flexural rigidities were highly correlated to principal areal moments (right: r(sup 2)= 0.997; left: r(sup 2)= 0.978) indicating a nearly constant effective flexural modulus. Right and left tibia exhibited a very high degree of symmetry when comparing either flexural or areal properties. To our knowledge this is the first study to validate the use of densitometry (DXA) to predict three dimensional structural properties of long bones. Our initial results support the conclusion that bone mineral and its distribution are the primary determinants of flexural modulus and rigidity.

Home-care nursing staff in self-directed teams are more satisfied with their job and feel they have more autonomy over patient care: a nationwide survey.

PubMed

Maurits, Erica E M; de Veer, Anke J E; Groenewegen, Peter P; Francke, Anneke L

2017-10-01

The aims of this study were: (1) To examine whether working in a self-directed team is related to home-care nursing staff's job satisfaction; (2) To assess the mediating effect of self-perceived autonomy over patient care; (3) To investigate the moderating effect of educational level on the association between autonomy over patient care and job satisfaction. Self-directed teams are being introduced in home care in several countries. It is unknown whether working in a self-directed team is related to nursing staff's job satisfaction. It is important to gain insight into this association since self-directed teams may help in retaining nursing staff. A cross-sectional study based on two questionnaire surveys in 2014 and 2015. The study involved 191 certified nursing assistants and registered nurses employed in Dutch home-care organizations (mean age of 50). These were members of the Dutch Nursing Staff Panel, a nationwide panel of nursing staff working in various healthcare settings. Self-direction is positively related to nursing staff's job satisfaction. This relationship is partly mediated by autonomy over patient care. For certified nursing assistants and registered nurses with a bachelor's degree, a greater sense of autonomy over patient care in self-directed teams is positively related to job satisfaction. No significant association was found between autonomy over patient care and job satisfaction for registered nurses with an associate degree. This study suggests that home-care organizations should consider the use of self-directed teams as this increases nursing staff's job satisfaction and may therefore help to retain nursing staff in home care. © 2017 John Wiley & Sons Ltd.

Cross Correlation versus Normalized Mutual Information on Image Registration

NASA Technical Reports Server (NTRS)

Tan, Bin; Tilton, James C.; Lin, Guoqing

2016-01-01

This is the first study to quantitatively assess and compare cross correlation and normalized mutual information methods used to register images in subpixel scale. The study shows that the normalized mutual information method is less sensitive to unaligned edges due to the spectral response differences than is cross correlation. This characteristic makes the normalized image resolution a better candidate for band to band registration. Improved band-to-band registration in the data from satellite-borne instruments will result in improved retrievals of key science measurements such as cloud properties, vegetation, snow and fire.

Hypertension in Pregnancy: A Community-Based Study

PubMed Central

Mehta, Bharti; Kumar, Vijay; Chawla, Sumit; Sachdeva, Sandeep; Mahopatra, Debjyoti

2015-01-01

Background: Hypertensive disorders during pregnancy occur in women with preexisting primary or secondary chronic hypertension, and in women who develop new-onset hypertension in the second half of pregnancy. The present study was undertaken to study the prevalence and correlates of hypertension in pregnancy in a rural block of Haryana. Materials and Methods: This cross-sectional study was carried out in the all 20 subcenters under Community Health Center (CHC) Chiri, Block Lakhanmajra. All the pregnant women registered at the particular subcenter at a point of time of visit were included in the study. Appropriate statistical tests were used for analysis. Results: A total of 931 pregnant women were included in the present study. Prevalence of hypertension in pregnancy was found to be 6.9%. Maternal age ≥25 years, gestational period ≤20 weeks, history of cesarean section, history of preterm delivery, and history of hypertension in previous pregnancy were found to be significantly associated with prevalence of hypertension in pregnancy. Conclusion: Nearly one in 14 pregnant women in rural areas of Haryana suffers from a hypertensive disorder of pregnancy. Early diagnosis and treatment through regular antenatal checkup is a key factor to prevent hypertensive disorders of pregnancy and its complications. PMID:26435602

RN Job Satisfaction and Retention After an Interprofessional Team Intervention.

PubMed

Baik, Dawon; Zierler, Brenda

2018-04-01

Despite continuing interest in interprofessional teamwork to improve nurse outcomes and quality of care, there is little research that focuses on nurse job satisfaction and retention after an interprofessional team intervention. This study explored registered nurse (RN) job satisfaction and retention after a purposeful interprofessional team training and structured interprofessional bedside rounds were implemented. As part of a larger study, in this comparative cross-sectional study, pre- and post-intervention data on RN job satisfaction and turnover rate were collected and analyzed. It was found that RNs had significantly higher job satisfaction after the interprofessional team intervention. The 6-month period turnover rate in the post-intervention period was slightly lower than the 6-month period turnover rate in pre-intervention period; however, the rate was too low to provide statistical evidence. Ongoing coaching and supportive work environments to improve RN outcomes should be considered to enhance quality of care and patient safety in healthcare.

Leadership, Knowledge Sharing, and Creativity: The Key Factors in Nurses' Innovative Behaviors.

PubMed

Kim, Sung-Jin; Park, Myonghwa

2015-12-01

This study identified the factors that affect the innovative behaviors of nurses at general hospitals based on their individual and organizational characteristics. The predictors of innovative nursing behaviors, such as self-leadership, individual knowledge sharing, creative self-efficacy, organizational knowledge sharing, and innovative organizational cultures, should be explored at individual and organizational level. This study administered a cross-sectional survey to 347 registered nurses working at 6 general hospitals (with >300 beds) in central South Korea. Data were collected using a self-report questionnaire and analyzed using structural equation modeling. Self-leadership, creative self-efficacy, and individual knowledge sharing directly affected individual innovative behaviors. Organizational knowledge sharing indirectly affected individual innovative behaviors, and this effect was mediated by an innovative organizational culture. This study contributes to the knowledge base regarding the effective management of individuals and organizations through innovative behavior; furthermore, it provides future directions for nursing interventions.

Family correlates of childhood binge eating: A systematic review.

PubMed

Saltzman, Jaclyn A; Liechty, Janet M

2016-08-01

Binge Eating Disorder is the most prevalent eating disorder in the US, and binge eating has been identified in children as young as five. As part of a larger registered systematic review, we identified family correlates of binge eating in children (C-BE) aged 12 and under. Using established guidelines, we searched PubMed and PsycInfo for peer-reviewed studies published in English between 1980 and April 2015 that examined family correlates and predictors of C-BE. This yielded 736 records for review; after exclusions fifteen studies were reviewed. Risk of bias was assessed. A risk factor typology was used to classify correlates. Nine of the included studies were cross-sectional and six longitudinal. Family weight teasing and parent emotional unresponsiveness were correlates of C-BE. Parent weight, education/socio-economic situation, and parent race/ethnicity were not associated with C-BE in any study reviewed. There was insufficient or unclear evidence regarding associations between C-BE and parent disordered eating, weight or thinness concern, harsh discipline, maternal dieting, attachment security, and mealtimes and feeding practices. Limitations included too few studies on many of the correlates to summarize, inconsistency of findings, homogenous samples, and predominately cross-sectional designs. Weight-related teasing in families and parental emotional unresponsiveness are correlates of C-BE and important areas to address in parent education and eating disorder prevention programs with families. Further longitudinal studies on putative risk factors for binge eating in childhood are needed to address current limitations, enable synthesis across studies, and inform public health efforts to prevent binge eating problems in children. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cross-sectional study on the obstetric performance of primigravidae in a teaching hospital in Lagos, Nigeria.

PubMed

Okunade, Kehinde Sharafadeen; Okunola, Halimat; Oyeneyin, Lawal; Habeeb-Adeyemi, Fatimah N

2016-01-01

A woman carrying her first pregnancy is starting a new life, and this is a crucial time in her obstetric career. This study was aimed to compare the obstetric performance of primigravidae to that of the multigravidae with a view to suggesting ways of preventing the associated complications. The study was a cross-sectional case-control study carried out among women who delivered in the study center over a year period. Relevant data of primigravid parturients who delivered in the hospital were retrieved from the labor ward register, and an equal number of multigravidae who delivered during the same study were selected by simple random sampling as the control group. Primigravidae constituted 15.3% of the total number of parturients seen during the study period. The age range of the primigravidae was 20-48 years and with a mean age of 28.24 ± 4.28 years. The obstetric complications seen in statistically significant proportion among the primigravidae case group include hypertensive disorder ( P = 0.048), prolonged pregnancy ( P = 0.039), prolonged labor ( P = 0.006), oxytocin augmentation ( P = 0.022), cephalopelvic disproportion ( P = 0.001), obstructed labor ( P = 0.008), instrumental delivery ( P = 0.035), cesarean delivery rates ( P = 0.011), and increased neonatal unit admission rate ( P = 0.002). Primigravidity is a high-risk pregnancy with several associated obstetric complications. Primigravidae should, therefore, be managed by specialists in well-equipped hospitals that will provide comprehensive antenatal and intrapartum care which will eventually result in a satisfactory obstetric outcome.

78 FR 14539 - Notice of Receipt of Pesticide Products; Registration Applications To Register New Uses

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... products containing currently registered active ingredients pursuant to the provisions of section 3(c) of... registered active ingredients. Pursuant to the provisions of FIFRA section 3(c)(4), EPA is hereby providing..., crop subgroup 3-07B including Chinese chive (fresh leaves), chive (fresh leaves), elegans hosta...

17 CFR 140.72 - Delegation of authority to disclose confidential information to a registered entity, swap...

Code of Federal Regulations, 2014 CFR

2014-04-01

..., registered futures association or self-regulatory organization. 140.72 Section 140.72 Commodity and... or self-regulatory organization. (a) Pursuant to the authority granted under sections 2(a)(11), 8a(5... execution facility, swap data repository, registered futures association, or self-regulatory organization as...

Sediment Mobilization and Storage Dynamics of a Debris Flow Impacted Stream Channel using Multi-Temporal Structure from Motion Photogrammetry

NASA Astrophysics Data System (ADS)

Bailey, T. L.; Sutherland-Montoya, D.

2015-12-01

High resolution topographic analysis methods have become important tools in geomorphology. Structure from Motion photogrammetry offers a compelling vehicle for geomorphic change detection in fluvial environments. This process can produce arbitrarily high resolution, geographically registered spectral and topographic coverages from a collection of overlapping digital imagery from consumer cameras. Cuneo Creek has had three historically observed episodes of rapid aggradation (1955, 1964, and 1997). The debris flow deposits continue to be major sources of sediment sixty years after the initial slope failure. Previous studies have monitored the sediment storage volume and particle size since 1976 (in 1976, 1982, 1983, 1985, 1986, 1987, 1998, 2003). We reoccupied 3 previously surveyed stream cross sections on Sept 30, 2014 and March 30, 2015, and produced photogrammetric point clouds using a pole mounted camera with a remote view finder to take nadir view images from 4.3 meters above the channel bed. Ground control points were registered using survey grade GPS and typical cross sections used over 100 images to build the structure model. This process simultaneously collects channel geometry and we used it to also generate surface texture metrics, and produced DEMs with point cloud densities above 5000 points / m2. In the period between the surveys, a five year recurrence interval discharge of 20 m3/s scoured the channel. Surface particle size distribution has been determined for each observation period using image segmentation algorithms based on spectral distance and compactness. Topographic differencing between the point clouds shows substantial channel bed mobilization and reorganization. The net decline in sediment storage is in excess of 4 x 10^5 cubic meters since the 1964 aggradation peak, with associated coarsening of surface particle sizes. These new methods provide a promising rapid assessment tool for measurement of channel responses to sediment inputs.

Predicting nurse burnout from demands and resources in three acute care hospitals under different forms of ownership: a cross-sectional questionnaire survey.

PubMed

Hansen, Niklas; Sverke, Magnus; Näswall, Katharina

2009-01-01

Health care organizations have changed dramatically over the last decades, with hospitals undergoing restructurings and privatizations. The aim of this study is to enhance the understanding of the origin and prevalence of burnout in health care by investigating factors in the psychosocial work environment and comparing three Swedish emergency hospitals with different types of ownership. A cross-sectional design was used. We selected a total sample of 1800 registered nurses from three acute care hospitals, one private for-profit, one private non-profit and one publicly administered. A total of 1102 questionnaires were included in the analyses. The examined ownership types were a private for-profit, a private non-profit and a traditional publicly administered hospital. All were situated in the Stockholm region, Sweden. Data were collected by questionnaires using validated instruments, in accordance with the Job Demands-Resources Model and Maslach's Burnout Inventory. Descriptive statistics, correlation analyses, multivariate covariance analyses and multiple regression analyses were conducted. The results showed that the burnout levels were the highest at the private for-profit hospital and lowest at the publicly administered hospital. However, in contrast to expectations the demands were not higher overall at the for-profit organization or lowest at the public administration unit, and overall, resources were not better in the private for-profit or worse at the publicly administered hospital. Multiple regression analyses showed that several of the demands included were related to higher burnout levels. Job resources were linked to lower burnout levels, but not for all variables. Profit orientation in health care seems to result in higher burnout levels for registered nurses compared to a publicly administered hospital. In general, demands were more predictive of burnout than resources, and there were only marginal differences in the pattern of predictors across hospitals.

Can the impact of gender equality on health be measured? A cross-sectional study comparing measures based on register data with individual survey-based data.

PubMed

Sörlin, Ann; Öhman, Ann; Ng, Nawi; Lindholm, Lars

2012-09-17

The aim of this study was to investigate potential associations between gender equality at work and self-rated health. 2861 employees in 21 companies were invited to participate in a survey. The mean response rate was 49.2%. The questionnaire contained 65 questions, mainly on gender equality and health. Two logistic regression analyses were conducted to assess associations between (i) self-rated health and a register-based company gender equality index (OGGI), and (ii) self-rated health and self-rated gender equality at work. Even though no association was found between the OGGI and health, women who rated their company as "completely equal" or "quite equal" had higher odds of reporting "good health" compared to women who perceived their company as "not equal" (OR = 2.8, 95% confidence interval = 1.4 - 5.5 and OR = 2.73, 95% CI = 1.6-4.6). Although not statistically significant, we observed the same trends in men. The results were adjusted for age, highest education level, income, full or part-time employment, and type of company based on the OGGI. No association was found between gender equality in companies, measured by register-based index (OGGI), and health. However, perceived gender equality at work positively affected women's self-rated health but not men's. Further investigations are necessary to determine whether the results are fully credible given the contemporary health patterns and positions in the labour market of women and men or whether the results are driven by selection patterns.

An examination of retention factors among registered nurses in Northeastern Ontario, Canada: Nurses intent to stay in their current position.

PubMed

Nowrouzi, Behdin; Rukholm, Ellen; Lariviere, Michel; Carter, Lorraine; Koren, Irene; Mian, Oxana; Giddens, Emilia

2016-03-10

The purpose of the study was to examine factors related to the retention of registered nurses in northeastern Ontario, Canada. A cross-sectional survey of registered nurses working in northeastern Ontario, Canada was conducted. Logistic regression analyses were used to consider intent to stay in current employment in relation to the following: 1) demographic factors, and 2) occupation and career satisfaction factors. A total of 459 (29.8% response rate) questionnaires were completed. The adjusted odds logistic regression analysis of RNs who intended to remain in their current position for the next five years, demonstrated that respondents in the 46 to 56 age group (OR: 2.65; 95% CI: 1.50 to 4.69), the importance of staff development in the organization (OR: 3.04; 95% CI: 1.13 to 8.13) northeastern Ontario lifestyle (OR: 2.61; 95% CI: 1.55 to 4.40), working in nursing for 14 to 22.5 years (OR: 2.55; 95% CI: 1.10 to 5.93), and working between 0 to 1 hour of overtime per week (OR: 1.20; 95% CI: 1.20 to 4.64) were significant factors in staying in their current position for the next five years. This study shows that a further understanding of the work environment could assist with developing retention for rural nurses. Furthermore, employers may use such information to ameliorate the working conditions of nurses, while researchers may use such evidence to develop interventions that are applicable to improving the working conditions of nurses.

Medical engagement and organizational characteristics in general practice.

PubMed

Ahnfeldt-Mollerup, Peder; dePont Christensen, René; Halling, Anders; Kristensen, Troels; Lykkegaard, Jesper; Nexøe, Jørgen; Barwell, Fred; Spurgeon, Peter; Søndergaard, Jens

2016-02-01

Medical engagement is a mutual concept of the active and positive contribution of doctors to maintaining and enhancing the performance of their health care organization, which itself recognizes this commitment in supporting and encouraging high quality care. A Medical Engagement Scale (MES) was developed by Applied Research Ltd (2008) on the basis of emerging evidence that medical engagement is critical for implementing radical improvements. To study the importance of medical engagement in general practice and to analyse patterns of association with individual and organizational characteristics. A cross-sectional study using a sampled survey questionnaire and the official register from the Danish General Practitioners' Organization comprising all registered Danish GPs. The Danish version of the MES Questionnaire was distributed and the survey results were analysed in conjunction with the GP register data. Statistically adjusted analyses revealed that the GPs' medical engagement varied substantially. GPs working in collaboration with colleagues were more engaged than GPs from single-handed practices, older GPs were less engaged than younger GPs and female GPs had higher medical engagement than their male colleagues. Furthermore, GPs participating in vocational training of junior doctors were more engaged than GPs not participating in vocational training. Medical engagement in general practice varies a great deal and this is determined by a complex interaction between both individual and organizational characteristics. Working in collaboration, having staff and being engaged in vocational training of junior doctors are all associated with enhanced levels of medical engagement among GPs. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Socioeconomic impact of TB on patients registered within RNTCP and their families in the year 2007 in Chennai, India.

PubMed

Ananthakrishnan, Ramya; Jeyaraj, Anita; Palani, Gopal; Sathiyasekaran, B W C

2012-07-01

Tuberculosis patients are registered in government clinics under Directly Observed Treatment Short-course (DOTS) program in Chennai city catering to 4.34 million population. With the entire country geographically covered under the DOTS program, research into socioeconomic impact of TB on patients and their households is crucial for providing comprehensive patient-friendly TB services and to document the benefits of DOTS. To assess the social and economic impact of TB on patients registered under DOTS program and their families. A cross-sectional study of 300 TB patients was done using a pre-coded semi-quantitative questionnaire between March and June 2007 in all the Tuberculosis Units (TUs) of Chennai city. Social and economic impact was perceived by 69.0% and 30.3% patients, respectively. About 24.3% suffered from both social and economic impact, while 75% patients suffered from any one form of impact. Social impact was perceived by more female patients as compared to males (80.7% vs. 62%; P < 0.001). More patients with extra-pulmonary disease (44.4%) and patients belonging to joint families (40.7%) perceived economic impact (P < 0.05). After 8 years of DOTS implementation, the present study has shown that with the availability of DOTS, percentage of patients who mortgaged assets or took loans has reduced. Social impact of TB is still perceived by two-thirds of the patients (69%). Elimination or reduction of social stressors with specific, focused, and intense social support services, awareness generation, and counseling to patients and families need to be built into the program.

The impact of organizational support and leader-member exchange on the work-related behaviour of nursing professionals: the moderating effect of professional and organizational identification.

PubMed

Trybou, Jeroen; Gemmel, Paul; Pauwels, Yarrid; Henninck, Charlene; Clays, Els

2014-02-01

The aim of this study was to examine the relations between perceived organizational support, the quality of leader-member exchange, in-role and extra-role behaviour, professional identification and organizational identification among registered nurses and nurse assistants. Theoretically, employees will reciprocate received beneficial treatment with positive attitudes and behaviour. Recently, it has been shown that this principle may be more complex than originally anticipated. A quantitative, cross-sectional survey design was used. The quality of social exchange and identification was scored by the involved registered nurses and nurse assistants; in-role and extra-role behaviour was rated by the head nurse. The survey was administered to nurses and nurse assistants (n = 196) working in five Belgian nursing homes. Data were collected from February-March 2012. Pearson correlation analyses, t-test analyses and hierarchical regression were used to analyse the data. Our results showed no relationship between perceived organizational support and leader-member exchange and in-role behaviour. A positive relationship was found between perceived organizational support and extra-role behaviour and a trend towards significance between leader-member exchange and extra-role behaviour. Organizational and professional identification moderated the relationship between perceived organizational support and extra-role behaviour. Our study demonstrates the importance of social exchange to nurses and nurse assistants and therefore nursing administrators and leaders. When registered nurses and nurse assistants perceive high-quality social exchange, they are more likely to go the extra mile on behalf of the organization. Fostering social identification could enhance this. © 2013 John Wiley & Sons Ltd.

A consumer register: an acceptable and cost-effective alternative for accessing patient populations.

PubMed

Bryant, Jamie; Sanson-Fisher, Rob; Fradgley, Elizabeth; Hobden, Breanne; Zucca, Alison; Henskens, Frans; Searles, Andrew; Webb, Brad; Oldmeadow, Christopher

2016-10-10

Population-based registries are increasingly used to recruit patient samples for research, however, they have several limitations including low consent and participation rates, and potential selection bias. To improve access to samples for research, the utility of a new model of recruitment termed the 'Consumer Register', that allows for direct patient recruitment from hospitals, was examined. This paper reports: (i) consent rates onto the register; (ii) preferred methods and frequency of contact; and (iii) the feasibility of establishing the register, including: (a) cost per person recruited to the register; (b) the differential cost and consent rates of volunteer versus paid data collectors; and (c) participant completion rates. A cross-sectional survey was conducted in five outpatient clinics in Australia. Patients were approached by volunteers or paid data collectors and asked to complete a touch-screen electronic survey. Consenting individuals were asked to indicate their willingness and preferences for enrolment onto a research register. Descriptive statistics were used to examine patient preferences and linear regression used to model the success of volunteer versus paid data collectors. The opportunity and financial costs of establishing the register were calculated. A total of 1947 patients (80.6 %) consented to complete the survey, of which, 1486 (76.3 %) completed the questionnaire. Of the completers, the majority (69.4 %, or 1032 participants) were willing to be listed on the register and preferred to be contacted by email (50.3 %). Almost 39 % of completers were willing to be contacted three or more times in a 12 month period. The annual opportunity cost of resources consumed by the register was valued at $37,187, giving an opportunity cost per person recruited to the register of $36. After amortising fixed costs, the annual financial outlay was $23,004 or $22 per person recruited to the register. Use of volunteer data collectors contributed to an annual saving of $14,183, however paid data collectors achieved significantly higher consent rates. Successful enrolment onto the register was completed for 42 % of the sample. A Consumer Register is a promising and feasible alternative to population-based registries, with the majority of participants willing to be contacted multiple times via low-resource methods such as email. There is an effectiveness/cost trade off in the use of paid versus volunteer data collectors.

Physical restraint: perceptions of nurse managers, registered nurses and healthcare assistants.

PubMed

Leahy-Warren, P; Varghese, V; Day, M R; Curtin, M

2018-02-09

To examine the perceptions of nurse managers, registered nurses and healthcare assistants of physical restraint use on older people in a long-term care setting in the Republic of Ireland. The use of physical restraint, although controversial, persists in long-term care settings, despite recommendations for restraint-free environments. Perception and attitude of staff can influence use of physical restraint. A descriptive cross-sectional design was used. A total of 250 nursing and healthcare assistant staff were recruited. A questionnaire incorporating demographics and the Perceptions of Restraint Use Questionnaire was used. Descriptive and inferential statistical analyses were conducted. Mean age of respondents (n = 156) was 41 years, and the majority were female. Overall, a low level of importance was attached to the use of restraint. Nurse managers and registered nurses compared favourably with healthcare assistants who attached a higher importance to use of restraint. Across all three staff groups, greatest importance was attached to the use of physical restraint for reducing falls, followed by prevention of treatment interference. Restraint was least favoured as a means of impairment management. Education was not an explanatory factor in perceived importance of physical restraint use. Nurse managers and registered nurses are unlikely to use physical restraint. However, there is concern regarding perception of healthcare assistants on use of restraint. Results from this study compare favourably with those in countries that have no policy on physical restraint use. Educational programmes alone are insufficient to address use of physical restraint. Attention to skill mix with adequate support for healthcare assistants in long-term care settings is recommended. © 2018 International Council of Nurses.

The association between health utility and joint status among people with severe haemophilia A: findings from the KAPPA register.

PubMed

Osooli, M; Steen Carlsson, K; Baghaei, F; Holmström, M; Rauchensteiner, S; Holme, P A; Hvitfeldt, L; Astermark, J; Berntorp, E

2017-05-01

People with severe haemophilia A have reportedly impaired health related quality of life (utility) mainly due to recurrent bleeding, arthropathy and treatment burden. To estimate utilities and evaluate their potential correlates - most importantly the joint status - among people with severe haemophilia A. In this cross-sectional study, eligible participants had severe haemophilia A, were aged ≥15, negative for factor VIII inhibitor and included in the KAPPA register of Denmark, Norway and Sweden. Data on demographics, treatment history, haemophilia joint health score, and EQ-5D utility were obtained from the register. We used box plots to present utilities and joint status and ordinary least squares regression to evaluate correlates of utilities. Participants were consecutively enrolled in the KAPPA register between April 2013 and June 2016. Overall, 173 participants with median age of 34 (interquartile range: 25-45) were included. Twelve (6.9%) participants were on episodic treatment while 161 (93.1%) were treated using prophylaxis. Concomitant diseases and positive inhibitor history were reported for 73 (43.2%) and 21 (12.1%) participants, respectively. The highest median utility (1.0) was observed among those aged <29 on prophylaxis and those aged 30-44 who had started prophylaxis by age 3. In the multi-variable regression, joint scores of 16-25 (Coef. -0.18, 95% CI: -0.30, -0.06), 26-35 (Coef. -0.21, 95% CI: -0.36, -0.06) and >35 (Coef. -0.37, 95% CI: -0.52, -0.23) were associated with lower utilities. Moderate to severe joint manifestations are associated with reduced utilities among persons with severe haemophilia A. © 2017 John Wiley & Sons Ltd.

Exploring factors associated with the incidence of sexual harassment of hospital nurses by patients.

PubMed

Hibino, Yuri; Hitomi, Yoshiaki; Kambayashi, Yasuhiro; Nakamura, Hiroyuki

2009-01-01

To identify factors affecting nurse-perceived sexual harassment and specific types of patient sexual behavior experienced by Japanese nurses. Cross-sectional questionnaire study of Japanese hospital nurses. Self-administered questionnaires (N=600) were distributed to Japanese hospital nurses, and 464 were returned (response rate of 77.3%). Two instruments were used: one was for determining sexual harassment by patients, and the other was for determining specific types of patient behavior that had sexual connotations. Registered nurses were at a much higher risk of sexual harassment than were nurse assistants. In addition, registered nurses had a much more positive attitude toward gender equality compared with assistant nurses. A positive attitude toward gender equality mediated by a relatively high education level might be associated with increasing reports of sexual harassment. An increasing incidence of sexual harassment claims among nurses should prompt hospital organizations to take proper action against it. Education on gender equality was thus considered a long-term solution for reducing the sexual harassment of Japanese hospital nurses. Establishing a safer working environment could enable nurses to provide better care for patients and thereby promote the development of good relationships between nurses and patients.

Current Continuing Professional Education Practice among Malaysian Nurses

PubMed Central

Chong, Mei Chan; Francis, Karen; Cooper, Simon; Abdullah, Khatijah Lim

2014-01-01

Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562) of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6%) and tertiary education was the most unpopular activity (10, 1.3%). The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE) is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses' (RNs) needs and not simply organizational requirements. PMID:24523961

[Hip fracture in older adults: prevalence and costs in two hospitals. Tabasco, Mexico, 2009].

PubMed

Quevedo-Tejero, Elsy del Carmen; Zavala-González, Marco Antonio; Hernández-Gamas, Arianna del Carmen; Hernández-Ortega, Hilda María

2011-01-01

To determine hip fracture prevalence and direct healthcare costs in elderly users of the reference hospitals of the Mexican Institute of Social Insurance (IMSS by spanish initials) and Mexican Oils (PEMEX by spanish initials), from Villahermosa, Tabasco, Mexico, during 2009. This is a cross-sectional study. The information was based on the registers of surgical interventions and institutional reports of the elderly inpatients who had a registered attention in their institution. Descriptive statistical analysis was performed considering the following variables: age, gender, hip fracture type, occurrence month, direct healthcare cost. Out of 10,765 records of hospitalized elderly, 57 hip fracture cases were found (33 in the IMSS and 24 in PEMEX). Hip fracture prevalence was 0.5%, (IMSS 1.1% and PEMEX 0.3%), being more frequent in women and older than 69. The most frequent fracture type was the femur neck one (78.9%). The estimated cost of healthcare in the hospital per patient was USD 5,803 in the IMSS and USD 11,800 in PEMEX. The hip fracture prevalence was higher in the IMSS users. Estimated healthcare costs per patient were higher than the reported in other institutions of the of the mexican health national system.

Social capital and knowledge sharing: effects on patient safety.

PubMed

Chang, Chia-Wen; Huang, Heng-Chiang; Chiang, Chi-Yun; Hsu, Chiu-Ping; Chang, Chia-Chen

2012-08-01

This article is a report on a study that empirically examines the influence of social capital on knowledge sharing and the impact of knowledge sharing on patient safety. Knowledge sharing is linked to many desirable managerial outcomes, including learning and problem-solving, which are essential for patient safety. Rather than studying the tangible effects of rewards, this study examines whether social capital (including social interaction, trust and shared vision) directly supports individual knowledge sharing in an organization. This cross-sectional study analysed data collected through a questionnaire survey of nurses from a major medical centre in northern Taiwan. The data were collected over a 9-month period from 2008 to 2009. The data analysis was conducted using the Partial Least Squares Graph v3.0 program to evaluate the measurement properties and the structural relationships specified in the research model. Based on a large-scale survey, empirical results indicate that Registered Nurses' perceptions of trust and shared vision have statistically significant and direct effects on knowledge sharing. In addition, knowledge sharing is significantly and positively associated with patient safety. The findings suggest that hospital administrators should foster group trust and initiate a common vision among Registered Nurses. In addition, administrators and chief knowledge officers of hospitals should encourage positive intentions towards knowledge sharing. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Knowledge, attitudes and barriers towards prevention of pressure ulcers in intensive care units: a descriptive cross-sectional study.

PubMed

Strand, Tillan; Lindgren, Margareta

2010-12-01

Pressure ulcer incidence varies between 1 and 56% in intensive care and prevention is an important quest for nursing staff. Critically ill patients that develop pressure ulcers suffer from increased morbidity and mortality and also requires prolonged intensive care. The aim of this study was to investigate registered nurses' and enrolled nurses' (1) attitudes, (2) knowledge and (3) perceived barriers and opportunities towards pressure ulcer prevention, in an ICU setting. These are important aspects in the Theory of Planned Behaviour, a conceptual framework when trying to predict, understand and change specific behaviours. The study is descriptive. Questionnaires were distributed to registered nurses and enrolled nurses in four ICUs in a Swedish hospital. The mean score regarding attitude was 34 ± 4. Correct categorisation of pressure ulcers was made by 46.8% of nursing staff with enrolled nurses having significantly less correct categorisation (p=0.019). Pressure relief (97.3%) and nutritional support (36.1%) were the most frequently reported preventive measures. Reported barriers were lack of time (57.8%) and severely ill patients (28.9%); opportunities were knowledge (38%) and access to pressure relieving equipment (35.5%). This study highlights areas where measures can be made to facilitate pressure ulcer prevention in intensive care units, such as raising knowledge and making pressure ulcer prevention a part of daily care. Copyright © 2010 Elsevier Ltd. All rights reserved.

Does a Caesarean section increase the time to a second live birth? A register-based cohort study.

PubMed

O'Neill, Sinéad M; Khashan, Ali S; Henriksen, Tine B; Kenny, Louise C; Kearney, Patricia M; Mortensen, Preben B; Greene, Richard A; Agerbo, Esben

2014-11-01

Does a primary Caesarean section influence the rate of, and time to, subsequent live birth compared with vaginal delivery? Caesarean section was associated with a reduction in the rate of subsequent live birth, particularly among elective and maternal-requested Caesareans indicating maternal choice plays a role. Several studies have examined the relationship between Caesarean section and subsequent birth rate with conflicting results primarily due to poor epidemiological methods. This Danish population register-based cohort study covered the period from 1982 to 2010 (N = 832 996). All women with index live births were followed until their subsequent live birth or censored (maternal death, emigration or study end) using Cox regression models. In all 577 830 (69%) women had a subsequent live birth. Women with any type of Caesarean had a reduced rate of subsequent live birth (hazard ratio [HR] 0.86, 95% confidence intervals [CI] 0.85, 0.87) compared with spontaneous vaginal delivery. This effect was consistent when analyses were stratified by type of Caesarean: emergency (HR 0.87, 95% CI 0.86, 0.88), elective (HR 0.83, 95% CI 0.82, 0.84) and maternal-requested (HR 0.61, 95% CI 0.57, 0.66) and in the extensive sub-analyses performed. Lack of biological data to measure a woman's fertility is a major limitation of the current study. Unmeasured confounding and limited availability of data (maternal BMI, smoking, access to fertility services and maternal-requested Caesarean section) as well as changes in maternity care over time may also influence the findings. This is the largest study to date and shows that Caesarean section is most likely not causally related to a reduction in fertility. Maternal choice to delay or avoid childbirth is the most plausible explanation. Our findings are generalizable to other middle- to high-income countries; however, cross country variations in Caesarean section rates and social or cultural differences are acknowledged. Funding was provided by the National Perinatal Epidemiology Centre, Cork, Ireland and conducted as part of the Health Research Board PhD Scholars programme in Health Services Research (Grant No. PHD/2007/16). L.C.K. is a Science Foundation Ireland Principal Investigator (08/IN.1/B2083) and the Director of the SFI funded Centre, INFANT (12/RC/2272). The authors have no competing interests to declare. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Diagnostic values of glycated haemoglobin and diagnosis of diabetes: Results of a cross-sectional survey among general practitioners in the province of Reggio Emilia, Italy.

PubMed

Ballotari, Paola; Roncaglia, Francesca; Chiatamone Ranieri, Sofia; Greci, Marina; Manicardi, Valeria; Giorgi Rossi, Paolo

2016-03-01

The aim of this study was to investigate whether subjects included in the diabetes register solely because their HbA1c was over the diagnostic threshold received a diagnosis of diabetes from their general practitioner (GP). The study included all registered cases in 2009-2010 aged 18 or over that were identified only by the laboratory database because they had one or more HbA1c over the 6.5% threshold and for whom we did not find any information in the search of full electronic clinical records. Multilevel logistic regression was used to examine the influence of GP and patient characteristics. There were 228 participating GPs (76.3% of those invited) and 832 assessed subjects (68.8% of study population). There was a strong clustering among the GPs (residual intraclass correlation = 0.52, 95% CI 0.40-0.64). About one in two (55.5%) subjects with two or more HbA1c > =6.5% has been diagnosed as diabetic and the percentage declined - unless zeroing - in case the abnormal value was only one (28.3%). The likelihood of being labelled 'no diabetes' was greater in subjects aged less than 65 or over 74 with respect to the reference age group (OR 1.89, 95% CI 1.13-3.15; OR 1.55 95% CI 0.94-2.53). The same likelihood consistently decreased when HbA1c test was accompanied by abnormal fasting plasma glucose (FPG) assay (OR 0.20, 95% CI 0.12-0.32). A permanent exchange of information between the diabetes register and GPs should be maintained to improve the care of patients and the awareness of criteria for diabetes diagnosis among GPs.

Perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a RN-to-BSN program.

PubMed

Hsiao, Chiu-Yueh; Lee, Shu-Hsin; Chen, Suh-Jen; Lin, Shu-Chin

2013-08-01

Advances in genetics have had a profound impact on health care. Yet, many nurses, as well as other health care providers, have limited genetic knowledge and feel uncomfortable integrating genetics into their practice. Very little is known about perceived genetic knowledge and clinical comfort among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program. To examine perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program and to assess how genetics has been integrated into their past and current nursing programs. The study also sought to examine correlations among perceived knowledge, integration of genetics into the nursing curriculum, and clinical comfort with genetics. A descriptive, cross-sectional study. Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program were recruited. A total of 190 of 220 nurses returned the completed survey (86.36% response rate). Descriptive statistics and the Pearson product-moment correlation were used for data analysis. Most nurses indicated limited perceived knowledge and clinical comfort with genetics. Curricular hours focused on genetics in a current nursing program were greater than those in past nursing programs. The use of genetic materials, attendance at genetic workshops and conferences, and clinically relevant genetics in nursing practice significantly related with perceived knowledge and clinical comfort with genetics. However, there were no correlations between prior genetic-based health care, perceived knowledge, and clinical comfort with genetics. This study demonstrated the need for emphasizing genetic education and practice to ensure health-related professionals become knowledgeable about genetic information. Given the rapidly developing genetic revolution, nurses and other health care providers need to utilize genetic discoveries to optimize health outcomes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Factors Influencing Female Registered Nurses' Work Behavior

PubMed Central

Brewer, Carol S; Kovner, Christine T; Wu, Yow-Wu; Greene, William; Liu, Yu; Reimers, Cordelia W

2006-01-01

Objective To analyze factors that are related to whether registered nurses (RNs) work (WK) or do not work (NW) in nursing; and if the RN works, whether she works full- (FT) or part-time (PT). Data Sources Secondary data from National Sample Survey of Registered Nurses 2000 (NSSRN), the InterStudy Competitive Edge Part III Regional Market Analysis (2001), and the Area Resource File (2002). Study Design Using a cross-sectional design we tested the relationship between WK or NW and FT or PT; and demographic, job-related, and metropolitan statistical area (MSA)-level variables. Data Collection/Extraction Methods We combined the data sources noted above to produce the analytic sample of 25,471 female RNs. Principal Findings Working in nursing is not independent of working FT or PT. Age (55 and older), other family income, and prior other work experience in health care are negatively related to working as an RN. The wage is not related to working as an RN, but negatively influences FT work. Age, children, minority status, student status, employment status, other income, and some job settings have a negative impact on working FT. Previous health care work has a positive effect on whether married RNs worked. Married RNs who are more dissatisfied are less likely to work FT. A greater number of market-level factors influence FT/PT than WK/NW behavior. Conclusions An important contribution of this study is demonstrating that MSA-level variables influence RN work behavior. The market environment seems to have little effect on whether a nurse works, but is influential on how much the nurse works, and has differential effects on married versus single nurses. PMID:16704517

Global Health Education: a cross-sectional study among German medical students to identify needs, deficits and potential benefits (Part 1 of 2: Mobility patterns & educational needs and demands).

PubMed

Bozorgmehr, Kayvan; Schubert, Kirsten; Menzel-Severing, Johannes; Tinnemann, Peter

2010-10-08

In recent years, education and training in global health has been the subject of recurring debate in many countries. However, in Germany, there has been no analysis of the educational needs or demands of medical students, or the educational deficits or potential benefits involved in global health education. Our purpose is to analyse international health elective patterns of medical students enrolled at German universities and assess whether or how they prepare for their electives abroad. We examine the exposure of medical students enrolled at German universities to training courses in tropical medicine or global health and assess students' perceived needs and demands for education in global health. Cross-sectional study among medical students in Germany including all 36 medical schools during the second half of the year 2007. All registered medical students were eligible to participate in the study. Recruitment occurred via electronic mailing-lists of students' unions. We developed a web-based, semi-structured questionnaire to capture students' international mobility patterns, preparation before electives, destination countries, exposure to and demand for global health learning opportunities. 1126 online-replies were received and analysed from all registered medical students in Germany (N = 78.067). 33.0% of all respondents (370/1126) declared at least one international health elective and of these, 36.0% (133/370) completed their electives in developing countries. 36.0% (131/363) did not prepare specifically at all, 59.0% (214/363) prepared either by self-study or declared a participation in specific preparation programmes. 87.8% of 5th and 6th year students had never participated in a global health course and 72.6% (209/288) had not completed a course in tropical medicine. 94.0% (861/916) endorsed the idea of introducing global health into medical education. Students in our sample are highly mobile during their studies. International health electives are common, also in developing countries. Formal preparation beyond self-study is virtually non-existent amongst our sample and the participation rate in courses of tropical medicine or global health is appallingly low. We have identified unmet perceived needs and the demand for more learning opportunities in global health in our sample, urging for reforms to adjust curricula to a globalising world.

Global Health Education: a cross-sectional study among German medical students to identify needs, deficits and potential benefits (Part 1 of 2: Mobility patterns & educational needs and demands)

PubMed Central

2010-01-01

Background In recent years, education and training in global health has been the subject of recurring debate in many countries. However, in Germany, there has been no analysis of the educational needs or demands of medical students, or the educational deficits or potential benefits involved in global health education. Our purpose is to analyse international health elective patterns of medical students enrolled at German universities and assess whether or how they prepare for their electives abroad. We examine the exposure of medical students enrolled at German universities to training courses in tropical medicine or global health and assess students' perceived needs and demands for education in global health. Methods Cross-sectional study among medical students in Germany including all 36 medical schools during the second half of the year 2007. All registered medical students were eligible to participate in the study. Recruitment occurred via electronic mailing-lists of students' unions. We developed a web-based, semi-structured questionnaire to capture students' international mobility patterns, preparation before electives, destination countries, exposure to and demand for global health learning opportunities. Results 1126 online-replies were received and analysed from all registered medical students in Germany (N = 78.067). 33.0% of all respondents (370/1126) declared at least one international health elective and of these, 36.0% (133/370) completed their electives in developing countries. 36.0% (131/363) did not prepare specifically at all, 59.0% (214/363) prepared either by self-study or declared a participation in specific preparation programmes. 87.8% of 5th and 6th year students had never participated in a global health course and 72.6% (209/288) had not completed a course in tropical medicine. 94.0% (861/916) endorsed the idea of introducing global health into medical education. Conclusion Students in our sample are highly mobile during their studies. International health electives are common, also in developing countries. Formal preparation beyond self-study is virtually non-existent amongst our sample and the participation rate in courses of tropical medicine or global health is appallingly low. We have identified unmet perceived needs and the demand for more learning opportunities in global health in our sample, urging for reforms to adjust curricula to a globalising world. PMID:20932277

Usage of purchased self-tests for HIV and sexually transmitted infections in Amsterdam, the Netherlands: results of population-based and serial cross-sectional studies among the general population and sexual risk groups

PubMed Central

Bil, Janneke P; Prins, Maria; Stolte, Ineke G; Dijkshoorn, Henriëtte; Heijman, Titia; Snijder, Marieke B; Davidovich, Udi; Zuure, Freke R

2017-01-01

Objectives There are limited data on the usage of commercially bought self-tests for HIV and other sexually transmitted infections (STIs). Therefore, we studied HIV/STI self-test usage and its determinants among the general population and sexual risk groups between 2007 and 2015 in Amsterdam, the Netherlands. Setting Data were collected in four different studies among the general population (S1–2) and sexual risk groups (S3–4). Participants S1–Amsterdam residents participating in representative population-based surveys (2008 and 2012; n=6044) drawn from the municipality register; S2–Participants of a population-based study stratified by ethnicity drawn from the municipality register of Amsterdam (2011–2015; n=17 603); S3–Men having sex with men (MSM) participating in an HIV observational cohort study (2008 and 2013; n=597) and S4–STI clinic clients participating in a cross-sectional survey (2007–2012; n=5655). Primary and secondary outcome measures Prevalence of HIV/STI self-test usage and its determinants. Results The prevalence of HIV/STI self-test usage in the preceding 6–12 months varied between 1% and 2% across studies. Chlamydia self-tests were most commonly used, except among MSM in S3. Chlamydia and syphilis self-test usage increased over time among the representative sample of Amsterdam residents (S1) and chlamydia self-test usage increased over time among STI clinic clients (S4). Self-test usage was associated with African Surinamese or Ghanaian ethnic origin (S2), being woman or MSM (S1 and 4) and having had a higher number of sexual partners (S1–2). Among those in the general population who tested for HIV/STI in the preceding 12 months, 5–9% used a self-test. Conclusions Despite low HIV/STI self-test usage, we observed increases over time in chlamydia and syphilis self-test usage. Furthermore, self-test usage was higher among high-risk individuals in the general population. It is important to continue monitoring self-test usage and informing the public about the unknown quality of available self-tests in the Netherlands and about the pros and cons of self-testing. PMID:28939577

Intention to leave profession, psychosocial environment and self-rated health among registered nurses from large hospitals in Brazil: a cross-sectional study.

PubMed

de Oliveira, Daiana Rangel; Griep, Rosane Härter; Portela, Luciana Fernandes; Rotenberg, Lucia

2017-01-10

Nurses' intention to leave their profession is a worldwide concern. Studies have shown that it can take the form of a chain reaction: many nurses first leave the unit, then the hospital, and finally the profession. Organisation and other labour factors, personal and conjunctural, have been associated with the intention to quit nursing. This study aimed to examine the factors associated with the intention to leave the profession among registered nurses (RNs) at large public hospitals in Brazil. This was a cross-sectional study, conducted from 2010 to 2011: all RNs at Rio de Janeiro's 18 largest public hospitals (>150 beds) were invited to participate. The study sample comprised 3,229 RNs (82.7% of those eligible), who answered a self-completed, multidimensional paper questionnaire. The outcome was defined as thoughts of leaving the profession sometimes a month or more. We based the analyses on hierarchical logistic regression models, considering three blocks of determinants: socio-demographic data (block I), occupational factors (block II), and health conditions (block III). Of the study population, 22.1% indicated the intention to leave the profession. In the final model after adjustment, the variables associated with the intention to leave were as follows: male sex (odds ratio [OR] = 1.65), not holding a leadership position (OR = 1.28), highly demanding work (OR = 2.49), passive work (OR = 2.10), effort-reward imbalance (OR = 2.00), poor self-rated health (OR = 1.92), over-commitment to the job (OR = 1.87), and poor supervisor support (OR = 1.33). The likelihood of expressing the intention to leave increased with age (OR = 0.98 for the oldest). Self-rated health and factors connected with the work environment, particularly those that generate psychosocial strain, were most strongly associated with the intention to leave the profession. From the profiles of nurses who wished to leave the profession, we found that for many people who go into nursing-especially men and younger entrants-their prospects of remaining in the profession are poor. The potential role of psychosocial job characteristics and self-rated health indicates the need for long-term action involving all stakeholders, i.e. managers, employers, and workers.

Compiling a register of patients with moderate or severe learning disabilities: experience at one United Kingdom general practice.

PubMed

Lodge, Keri-Michèle; Milnes, David; Gilbody, Simon M

2011-03-01

Background Identifying patients with learning disabilities within primary care is central to initiatives for improving the health of this population. UK general practitioners (GPs) receive additional income for maintaining registers of patients with learning disabilities as part of the Quality and Outcomes Framework (QOF), and may opt to provide Directed Enhanced Services (DES), which requires practices to maintain registers of patients with moderate or severe learning disabilities and offer them annual health checks.Objectives This paper describes the development of a register of patients with moderate or severe learning disabilities at one UK general practice.Methods A Read code search of one UK general practice's electronic medical records was conducted in order to identify patients with learning disabilities. Confirmation of diagnoses was sought by scrutinising records and GP verification. Cross-referencing with the practice QOF register of patients with learning disabilities of any severity, and the local authority's list of clients with learning disabilities, was performed.Results Of 15 001 patients, 229 (1.5%) were identified by the Read code search as possibly having learning disabilities. Scrutiny of records and GP verification confirmed 64 had learning disabilities and 24 did not, but the presence or absence of learning disability remained unclear in 141 cases. Cross-referencing with the QOF register (n=81) and local authority list (n=49) revealed little overlap.Conclusion Identifying learning disability and assessing its severity are tasks GPs may be unfamiliar with, and relying on Read code searches may result in under-detection. Further research is needed to define optimum strategies for identifying, cross-referencing and validating practice-based registers of patients with learning disabilities.

Compiling a register of patients with moderate or severe learning disabilities: experience at one United Kingdom general practice

PubMed Central

2011-01-01

Background Identifying patients with learning disabilities within primary care is central to initiatives for improving the health of this population. UK general practitioners (GPs) receive additional income for maintaining registers of patients with learning disabilities as part of the Quality and Outcomes Framework (QOF), and may opt to provide Directed Enhanced Services (DES), which requires practices to maintain registers of patients with moderate or severe learning disabilities and offer them annual health checks. Objectives This paper describes the development of a register of patients with moderate or severe learning disabilities at one UK general practice. Methods A Read code search of one UK general practice's electronic medical records was conducted in order to identify patients with learning disabilities. Confirmation of diagnoses was sought by scrutinising records and GP verification. Cross-referencing with the practice QOF register of patients with learning disabilities of any severity, and the local authority's list of clients with learning disabilities, was performed. Results Of 15 001 patients, 229 (1.5%) were identified by the Read code search as possibly having learning disabilities. Scrutiny of records and GP verification confirmed 64 had learning disabilities and 24 did not, but the presence or absence of learning disability remained unclear in 141 cases. Cross-referencing with the QOF register (n=81) and local authority list (n=49) revealed little overlap. Conclusion Identifying learning disability and assessing its severity are tasks GPs may be unfamiliar with, and relying on Read code searches may result in under-detection. Further research is needed to define optimum strategies for identifying, cross-referencing and validating practice-based registers of patients with learning disabilities. PMID:22479290

Relationship of moderate and low isometric lumbar extension through architectural and muscular activity variables: a cross sectional study

PubMed Central

2013-01-01

Background No study relating the changes obtained in the architecture of erector spinae (ES) muscle were registered with ultrasound and different intensities of muscle contraction recorded by surface EMG (electromyography) on the ES muscle was found. The aim of this study was analyse the relationship in the response of the ES muscle during isometric moderate and light lumbar isometric extension considering architecture and functional muscle variables. Methods Cross-sectional study. 46 subjects (52% men) with a group mean age of 30.4 (±7.78). The participants developed isometric lumbar extension while performing moderate and low isometric trunk and hip extension in a sitting position with hips flexed 90 degrees and the lumbar spine in neutral position. During these measurements, electromyography recordings and ultrasound images were taken bilaterally. Bilaterally pennation angle, muscle thickness, torque and muscle activation were measured. This study was developed at the human movement analysis laboratory of the Health Science Faculty of the University of Malaga (Spain). Results Strong and moderate correlations were found at moderate and low intensities contraction between the variable of the same intensity, with correlation values ranging from 0.726 (Torque Moderate – EMG Left Moderate) to 0.923 (Angle Left Light – Angle Right Light) (p < 0.001). This correlation is observed between the variables that describe the same intensity of contraction, showing a poor correlation between variables of different intensities. Conclusion There is a strong relationship between architecture and function variables of ES muscle when describe an isometric lumbar extension at light or moderate intensity. PMID:24252273

What is the degree of innovation routinely implemented in Dutch radiotherapy centres? A multicentre cross-sectional study.

PubMed

Jacobs, Maria; Boersma, Liesbeth; Dekker, Andre; Bosmans, Geert; van Merode, Frits; Verhaegen, Frank; de Ruysscher, Dirk; Swart, Rachelle; Kengen, Cindy; Lambin, Philippe

2016-11-01

To study the implementation of innovation activities in Dutch radiotherapy (RT) centres in a broad sense (product, technological, market and organizational innovations). A descriptive cross-sectional study was conducted in 15 Dutch RT centres. A list of innovations implemented from 2011 to 2013 was drawn up for each centre using semi-structured interviews. These innovations were classified into innovation categories according to previously defined innovation indicators. Where applicable, each innovation was rated by each centre on the effort required to implement it and on its expected effects, to get an impression of how far reaching and radical the innovations were and to be able to compare the number of innovations between centres. The participating RT centres in the Netherlands implemented 12 innovations per year on average (range 5-25); this number was not significantly different for academic (n = 13) or non-academic centres (n = 10). Several centres were dealing with the same innovations at the same time. The average required effort and expected output did not differ significantly between product, technological and organizational innovation or between academic and non-academic centres. The number of innovations observed per centre varied across a large range, with a large overlap in terms of the type of innovations that were implemented. Registering innovations using the innovation indicators applied in our study would make it possible to improve collaboration between centres, e.g. with common training modules, to avoid duplication of work. Advances in knowledge: This study is the first of its kind investigating innovation implementation in RT in a broad sense.

Interest in nursing among academic degree holders in Israel: A cross-sectional quantitative study.

PubMed

Ben Natan, Merav

2016-03-01

The shortage of nurses is a global problem. One strategy for producing more registered nurses worldwide and in Israel in particular is to offer graduate entry nursing programs for individuals with non-nursing academic degrees. In order to recruit academic degree holders into the nursing profession, it is important to identify factors that might attract them. The purpose of this study was to explore whether the perception of nurse characteristics by academic degree holders is associated with their interest in enrolling in a graduate entry nursing program or in recommending this program to a family member, and whether ethnic background, gender and interaction with a nurse have an effect on this interest. A cross-sectional quantitative study. The setting of the study was on the campus of Tel Aviv University. A convenience sample of 522 individuals with an academic education, men and women, aged 18-60 and equally distributed between Jewish and Arab Israelis, took part in the study. Participants completed a questionnaire based on the Porter Nursing Image Scale. A moderate positive correlation was found between perception of nurses and interest in nursing (r=0.32, p<0.01). Arab Israelis, women, and individuals who have or have had interactions with nurses, viewed nurses in a more positive light and had a higher interest in nursing than their counterparts. Efforts should be made to foster a positive public image of nursing among the population of people with an academic education. Recruitment strategies should be tailored to each of this population's subgroups. Copyright © 2015 Elsevier Ltd. All rights reserved.

Nurses who work in rural and remote communities in Canada: a national survey.

PubMed

MacLeod, Martha L P; Stewart, Norma J; Kulig, Judith C; Anguish, Penny; Andrews, Mary Ellen; Banner, Davina; Garraway, Leana; Hanlon, Neil; Karunanayake, Chandima; Kilpatrick, Kelley; Koren, Irene; Kosteniuk, Julie; Martin-Misener, Ruth; Mix, Nadine; Moffitt, Pertice; Olynick, Janna; Penz, Kelly; Sluggett, Larine; Van Pelt, Linda; Wilson, Erin; Zimmer, Lela

2017-05-23

In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions. A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territories, living outside of the commuting zones of large urban centers and in the north of Canada. Rural workforce characteristics reported here suggest the persistence of key characteristics noted in a previous Canada-wide survey of rural registered nurses (2001-2002), namely the aging of the rural nursing workforce, the growth in baccalaureate education for registered nurses, and increasing casualization. Two thirds of the nurses grew up in a community of under 10 000 people. While nurses' levels of satisfaction with their nursing practice and community are generally high, significant variations were noted by nurse type. Nurses reported coming to rural communities to work for reasons of location, interest in the practice setting, and income, and staying for similar reasons. Important variations were noted by nurse type and region. The proportion of the rural nursing workforce in Canada is continuing to decline in relation to the proportion of the Canadian population in rural and remote settings. Survey results about the characteristics and practice of the various types of nurses can support workforce planning to improve nursing services and access to care.

1 CFR 11.2 - Federal Register.

Code of Federal Regulations, 2010 CFR

2010-01-01

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Leadership, staffing and quality of care in nursing homes

PubMed Central

2011-01-01

Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78). Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses and quality of care is complex. Increasing staffing levels or the ratio of registered nurses alone is not likely sufficient for increasing quality of care. PMID:22123029

Publication proportions for registered breast cancer trials: before and following the introduction of the ClinicalTrials.gov results database.

PubMed

Asiimwe, Innocent Gerald; Rumona, Dickson

2016-01-01

To limit selective and incomplete publication of the results of clinical trials, registries including ClinicalTrials.gov were introduced. The ClinicalTrials.gov registry added a results database in 2008 to enable researchers to post the results of their trials as stipulated by the Food and Drug Administration Amendment Act of 2007. This study aimed to determine the direction and magnitude of any change in publication proportions of registered breast cancer trials that occurred since the inception of the ClinicalTrials.gov results database. A cross-sectional study design was employed using ClinicalTrials.gov, a publicly available registry/results database as the primary data source. Registry contents under the subcategories 'Breast Neoplasms' and 'Breast Neoplasms, Male' were downloaded on 1 August 2015. A literature search for included trials was afterwards conducted using MEDLINE and DISCOVER databases to determine publication status of the registered breast cancer trials. Nearly half (168/340) of the listed trials had been published, with a median time to publication of 24 months (Q1 = 14 months, Q3 = 42 months). Only 86 trials were published within 24 months of completion. There was no significant increase in publication proportions of trials that were completed before the introduction of the results database compared to those completed after (OR = 1.00, 95 % CI = .61 to 1.63; adjusted OR = 0.84, 95 % CI = .51 to 1.39). Characteristics associated with publication included trial type (observational versus interventional adjusted OR = .28, 95 % CI = .10 to .74) and completion/termination status (terminated versus completed adjusted OR = .22, 95 % CI = .09 to .51). Less than a half of breast cancer trials registered in ClinicalTrials.gov are published in peer-reviewed journals.

Social acceptance among tuberculosis patients at Puskesmas Amplas Medan, Indonesia

NASA Astrophysics Data System (ADS)

Eyanoer, P. C.

2018-03-01

Social acceptance is a confession, compilation, and appreciation for an individual which come from other individual or social groups in their entirety which makes individual feels safe, comfortable, and their existence is appreciated. A cross-sectional study consisted of 42 pulmonary TB patients registered at Puskesmas Amplas was done to analyze their social acceptance in the society. Data was collected by direct interview using structured questionnaire. The result showed that majority had either high and very high social acceptance with 45.20% and 31.0% respectively with high family support and high self-confidence (73.8%). Bivariate analysis showed a significant association between family support and self confidence with social acceptance (p value<0.05). The correlation coefficient (r) of self confidenceis 0.629 while family support were is 0.455 (p-value<0.05). This study concludes that both family support and self-confidence have a significant correlation with social acceptance.

Centralized vs. Decentralized Nursing Stations: An Evaluation of the Implications of Communication Technologies in Healthcare.

PubMed

Bayramzadeh, Sara; Alkazemi, Mariam F

2014-01-01

This study aims to explore the relationship between the nursing station design and use of communication technologies by comparing centralized and decentralized nursing stations. The rapid changes in communication technologies in healthcare are inevitable. Communication methods can change the way occupants use a space. In the meantime, decentralized nursing stations are emerging as a replacement for the traditional centralized nursing stations; however, not much research has been done on how the design of nursing stations can impact the use of communication technologies. A cross sectional study was conducted using an Internet-based survey among registered nurses in a Southeastern hospital in the United States. Two units with centralized nursing stations and two units with decentralized nursing stations were compared in terms of the application of communication technologies. A total of 70 registered nurses completed the survey in a 2-week period. The results revealed no significant differences between centralized and decentralized nursing stations in terms of frequency of communication technologies used. However, a difference was found between perception of nurses toward communication technologies and perceptions of the use of communication technologies in decentralized nursing stations. Although the study was limited to one hospital, the results indicate that nurses hold positive attitudes toward communication technologies. The results also reveal the strengths and weaknesses of each nursing station design with regard to communication technologies. Hospital, interdisciplinary, nursing, technology, work environment.

Relationship between the presence of baccalaureate-educated RNs and quality of care: a cross-sectional study in Dutch long-term care facilities.

PubMed

Backhaus, Ramona; van Rossum, Erik; Verbeek, Hilde; Halfens, Ruud J G; Tan, Frans E S; Capezuti, Elizabeth; Hamers, Jan P H

2017-01-19

Recent evidence suggests that an increase in baccalaureate-educated registered nurses (BRNs) leads to better quality of care in hospitals. For geriatric long-term care facilities such as nursing homes, this relationship is less clear. Most studies assessing the relationship between nurse staffing and quality of care in long-term care facilities are US-based, and only a few have focused on the unique contribution of registered nurses. In this study, we focus on BRNs, as they are expected to serve as role models and change agents, while little is known about their unique contribution to quality of care in long-term care facilities. We conducted a cross-sectional study among 282 wards and 6,145 residents from 95 Dutch long-term care facilities. The relationship between the presence of BRNs in wards and quality of care was assessed, controlling for background characteristics, i.e. ward size, and residents' age, gender, length of stay, comorbidities, and care dependency status. Multilevel logistic regression analyses, using a generalized estimating equation approach, were performed. 57% of the wards employed BRNs. In these wards, the BRNs delivered on average 4.8 min of care per resident per day. Among residents living in somatic wards that employed BRNs, the probability of experiencing a fall (odds ratio 1.44; 95% CI 1.06-1.96) and receiving antipsychotic drugs (odds ratio 2.15; 95% CI 1.66-2.78) was higher, whereas the probability of having an indwelling urinary catheter was lower (odds ratio 0.70; 95% CI 0.53-0.91). Among residents living in psychogeriatric wards that employed BRNs, the probability of experiencing a medication incident was lower (odds ratio 0.68; 95% CI 0.49-0.95). For residents from both ward types, the probability of suffering from nosocomial pressure ulcers did not significantly differ for residents in wards employing BRNs. In wards that employed BRNs, their mean amount of time spent per resident was low, while quality of care on most wards was acceptable. No consistent evidence was found for a relationship between the presence of BRNs in wards and quality of care outcomes, controlling for background characteristics. Future studies should consider the mediating and moderating role of staffing-related work processes and ward environment characteristics on quality of care.

Hep-CORE: a cross-sectional study of the viral hepatitis policy environment reported by patient groups in 25 European countries in 2016 and 2017.

PubMed

Lazarus, Jeffrey V; Stumo, Samya R; Harris, Magdalena; Hendrickx, Greet; Hetherington, Kristina L; Maticic, Mojca; Jauffret-Roustide, Marie; Tallada, Joan; Simojoki, Kaarlo; Reic, Tatjana; Safreed-Harmon, Kelly

2018-04-01

The first World Health Organization (WHO) global health sector strategy on hepatitis B and C viruses (HBV and HCV) has called for the elimination of viral hepatitis as a major public health threat by 2030. This study assesses policies and programmes in support of elimination efforts as reported by patient groups in Europe. In 2016 and 2017, hepatitis patient groups in 25 European countries participated in a cross-sectional survey about their countries' policy responses to HBV and HCV. The English-language survey addressed overall national response; public awareness/engagement; disease monitoring; prevention; testing/diagnosis; clinical assessment; and treatment. We performed a descriptive analysis of data and compared 2016 and 2017 findings. In 2017, 72% and 52% of the 25 European study countries were reported to not have national HBV and HCV strategies respectively. The number of respondents indicating that their governments collaborated with civil society on viral hepatitis control increased from 13 in 2016 to 18 in 2017. In both 2016 and 2017, patient groups reported that 9 countries (36%) have disease registers for HBV and 11 (44%) have disease registers for HCV. The number of countries reported to have needle and syringe exchange programmes available in all parts of the country dropped from 10 (40%) in 2016 to 8 in 2017 (32%). In both 2016 and 2017, patient groups in 5 countries (20%) reported that HCV treatment is available in non-hospital settings. From 2016 to 2017, the reported number of countries with no restrictions on access to direct-acting antivirals for HCV increased from 3 (12%) to 7 (28%), and 5 fewer countries were reported to refuse treatment to people who are currently injecting drugs. The patient-led Hep-CORE study offers a unique perspective on the readiness of study countries to undertake comprehensive viral hepatitis elimination efforts. Viral hepatitis monitoring should be expanded to address policy issues more comprehensively and to incorporate civil society perspectives, as is the case with global HIV monitoring. Policy components should also be explicitly added to the WHO framework for monitoring country-level progress against viral hepatitis. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Dead time corrections for inbeam γ-spectroscopy measurements

NASA Astrophysics Data System (ADS)

Boromiza, M.; Borcea, C.; Negret, A.; Olacel, A.; Suliman, G.

2017-08-01

Relatively high counting rates were registered in a proton inelastic scattering experiment on 16O and 28Si using HPGe detectors which was performed at the Tandem facility of IFIN-HH, Bucharest. In consequence, dead time corrections were needed in order to determine the absolute γ-production cross sections. Considering that the real counting rate follows a Poisson distribution, the dead time correction procedure is reformulated in statistical terms. The arriving time interval between the incoming events (Δt) obeys an exponential distribution with a single parameter - the average of the associated Poisson distribution. We use this mathematical connection to calculate and implement the dead time corrections for the counting rates of the mentioned experiment. Also, exploiting an idea introduced by Pommé et al., we describe a consistent method for calculating the dead time correction which completely eludes the complicated problem of measuring the dead time of a given detection system. Several comparisons are made between the corrections implemented through this method and by using standard (phenomenological) dead time models and we show how these results were used for correcting our experimental cross sections.

Profiling of the injected charge drift current transients by cross-sectional scanning technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gaubas, E., E-mail: eugenijus.gaubas@ff.vu.lt; Ceponis, T.; Pavlov, J.

2014-02-07

The electric field distribution and charge drift currents in Si particle detectors are analyzed. Profiling of the injected charge drift current transients has been implemented by varying charge injection position within a cross-sectional boundary of the particle detector. The obtained profiles of the induction current density and duration of the injected charge drift pulses fit well the simulated current variations. Induction current transients have been interpreted by different stages of the bipolar and monopolar drift of the injected carriers. Profiles of the injected charge current transients registered in the non-irradiated and neutron irradiated Si diodes are compared. It has beenmore » shown that the mixed regime of the competing processes of drift, recombination, and diffusion appears in the measured current profiles on the irradiated samples. The impact of the avalanche effects can be ignored based on the investigations presented. It has been shown that even a simplified dynamic model enabled us to reproduce the main features of the profiled transients of induced charge drift current.« less

Embodying pervasive discrimination: a decomposition of sexual orientation inequalities in health in a population-based cross-sectional study in Northern Sweden.

PubMed

Gustafsson, Per E; Linander, Ida; Mosquera, Paola A

2017-01-21

Studies from Sweden and abroad have established health inequalities between heterosexual and non-heterosexual people. Few studies have examined the underpinnings of such sexual orientation inequalities in health. To expand this literature, the present study aimed to employ decomposition analysis to explain health inequalities between people with heterosexual and non-heterosexual orientation in Sweden, a country with an international reputation for heeding the human rights of non-heterosexual people. Participants (N = 23,446) came from a population-based cross-sectional survey in the four northernmost counties in Sweden in 2014. Participants completed self-administered questionnaires, covering sexual orientation, mental and general physical health, social conditions and unmet health care needs, and sociodemographic data was retrieved from total population registers. Sexual orientation inequalities in health were decomposed by Blinder-Oaxaca decomposition analysis. Results showed noticeable mental and general health inequalities between heterosexual and non-heterosexual orientation groups. Health inequalities were partly explained (total explained fraction 64-74%) by inequalities in degrading treatment (24-26% of the explained fraction), but to a considerable degree also by material conditions (38-45%) and unmet care needs (25-43%). Psychosocial experiences may be insufficient to explain and understand health inequalities by sexual orientation in a reputedly 'gay-friendly' setting. Less overt forms of structural discrimination may need to be considered to capture the pervasive material discrimination that seems to underpin the embodiment of sexual minority inequalities. This ought to be taken into consideration in research, policy-making and monitoring aiming to work towards equity in health across sexual orientations.

Health and quality of life outcomes impairment of quality of life in type 2 diabetes mellitus: a cross-sectional study.

PubMed

Zurita-Cruz, Jessie N; Manuel-Apolinar, Leticia; Arellano-Flores, María Luisa; Gutierrez-Gonzalez, Alejandro; Najera-Ahumada, Alma Gloria; Cisneros-González, Nelly

2018-05-15

Type 2 diabetes mellitus (DM2) is a chronic disease, and for treatment to succeed, it is necessary to harmonize the mental health of the patient with the environment, which impacts quality of life and adherence to medical regimens. The objetive of this study is describe the quality of life of patients with DM2 and the factors relates to its modification. This investigation was a cross-sectional study. Patients over 18 years of age with DM2 were selected. The following variables related to quality of life were studied: age, sex, occupation, marital status, years of DM2 evolution, comorbidities and presence of depression (Beck Depression Inventory). Perceived quality of life was measured with a health-related quality of life (HRQoL) scale, the 36-Item Short-Form Survey (SF-36). Patients were classified according to SF-36 HRQoL score (< 50, 51-75 and > 76 points). Among the 1394 patients included, the median age was 62 years. Global HRQoL had a median of 50.1 points. Bivariate analysis showed that age, marital status, sex, occupation, comorbidities, duration of DM2 and comorbidities had impacts on HRQoL. The logistic regression model identified age (odds ratio [OR] 1.04) and depression (OR 4.4) as independent factors that influenced overall quality of life. Patients with DM2 have poor HRQoL, which is associated with a high frequency of depression. Older age and the presence of depression impair patient HRQoL. R-2013-781-052. Registered 20 December 2014.

Pain rather than self-reported sedentary time explains variation in perceived health and activity limitation in persons with rheumatoid arthritis: a cross sectional study in Sweden.

PubMed

Demmelmaier, Ingrid; Åsenlöf, Pernilla; Bergman, Patrick; Nordgren, Birgitta; Opava, Christina H

2017-06-01

To investigate (1) the amount of self-reported time spent sedentary among a large cohort of persons with rheumatoid arthritis (RA), and (2) the contribution of sedentary time to explain perceived health and activity limitation in RA beyond that of previously known correlates. This cross-sectional study used data from a postal questionnaire and the Swedish Rheumatology Quality registers (SRQ). The International Physical Activity Questionnaire was used to assess sedentary time (sitting) and moderate, vigorous and walking activity (MVPA). Sociodemographics, pain, fatigue, fear-avoidance beliefs, anxiety/depression, disease duration, MVPA and sedentary time were included in multiple regression models with perceived health (Visual Analogue Scale 0-100) and activity limitation (Stanford Health Assessment Questionnaire) as dependent variables. In all 3152 (59%) of 5391 persons identified as eligible from the SRQ, responded to the questionnaire. 2819 individuals with complete data on all study variables were analysed. Mean time (SD) spent sedentary was 257 (213) minutes per day. Sedentary time did not contribute significantly to explain perceived health and only minimally to explain activity limitation. Instead, variation was mainly explained by pain; for perceived health (Beta = 0.780, p < 0.001) and for activity limitation (Beta = 0.445, p < 0.001).The results indicate a non-significant role of sedentary time and a need for increased focus on pain in the management of RA. Future studies should use prospective designs and objective assessment methods to further investigate the associations between sedentary time and health outcomes in persons with RA.

Comparison of Cognitive Performance Tests for Promethazine Pharmacodynamics in Human Subjects

NASA Technical Reports Server (NTRS)

Vaksman, Z.; Boyd, J. L.; Wang, Z.; Putcha, L.

2005-01-01

The objective of this study is to compare cognitive function tests, Automated Neurological Assessment Metrics (ANAM) based Readiness Evaluation System (ARES(Registered TradeMark)) on a Palm Pilot and Windows based Spaceflight Cognitive Assessment Tool (WinSCAT(Registered TradeMark)) on a personal computer (PC) to assess performance effects of promethazine (PMZ) after administration to human subjects. In a randomized placebo-controlled cross-over design, subjects received 12.5, 25, and 50 mg intramuscular (IM) PMZ or a placebo and completed 14 sessions with WinSCAT(Registered TradeMark) (v. 1.26) and ARES(Registered TradeMark) (v. 1.27) consecutively for 72 h post dose. Maximum plasma concentrations (4.25, 6.25 and 13.33 ng/ml) were linear with dose and were achieved by 0.75, 8, and 24 h after dosing for the three doses, respectively. No significant differences in cognitive function after PMZ dosing were detected using WinSCAT(Registered TradeMark), however, tests from ARES(Registered TradeMark) demonstrated concentration dependent decrements in reaction time associated with PMZ dose.

17 CFR 270.30b1-1 - Semi-annual report for registered management investment companies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... registered management investment companies. 270.30b1-1 Section 270.30b1-1 Commodity and Securities Exchanges....30b1-1 Semi-annual report for registered management investment companies. Every registered management... management investment company that has filed a registration statement with the Commission registering its...

46 CFR 401.510 - Operation without Registered Pilots.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Operation without Registered Pilots. 401.510 Section 401... REGULATIONS Penalties; Operations Without Registered Pilots § 401.510 Operation without Registered Pilots. (a... Registered Pilot when the vessel or its cargo is in distress or jeopardy. (b) A vessel may be navigated in...

17 CFR 270.26a-2 - Exemptions from certain provisions of sections 26 and 27 for registered separate accounts and...

Code of Federal Regulations, 2010 CFR

2010-04-01

... deduction of certain fees and charges from the assets of such accounts. 270.26a-2 Section 270.26a-2... registered separate accounts and others regarding custodianship of and deduction of certain fees and charges... by any State or other governmental entity and, if the separate account is registered under the Act as...

SPECIES - EVALUATING THERMODYNAMIC PROPERTIES, TRANSPORT PROPERTIES & EQUILIBRIUM CONSTANTS OF AN 11-SPECIES AIR MODEL

NASA Technical Reports Server (NTRS)

Thompson, R. A.

1994-01-01

Accurate numerical prediction of high-temperature, chemically reacting flowfields requires a knowledge of the physical properties and reaction kinetics for the species involved in the reacting gas mixture. Assuming an 11-species air model at temperatures below 30,000 degrees Kelvin, SPECIES (Computer Codes for the Evaluation of Thermodynamic Properties, Transport Properties, and Equilibrium Constants of an 11-Species Air Model) computes values for the species thermodynamic and transport properties, diffusion coefficients and collision cross sections for any combination of the eleven species, and reaction rates for the twenty reactions normally occurring. The species represented in the model are diatomic nitrogen, diatomic oxygen, atomic nitrogen, atomic oxygen, nitric oxide, ionized nitric oxide, the free electron, ionized atomic nitrogen, ionized atomic oxygen, ionized diatomic nitrogen, and ionized diatomic oxygen. Sixteen subroutines compute the following properties for both a single species, interaction pair, or reaction, and an array of all species, pairs, or reactions: species specific heat and static enthalpy, species viscosity, species frozen thermal conductivity, diffusion coefficient, collision cross section (OMEGA 1,1), collision cross section (OMEGA 2,2), collision cross section ratio, and equilibrium constant. The program uses least squares polynomial curve-fits of the most accurate data believed available to provide the requested values more quickly than is possible with table look-up methods. The subroutines for computing transport coefficients and collision cross sections use additional code to correct for any electron pressure when working with ionic species. SPECIES was developed on a SUN 3/280 computer running the SunOS 3.5 operating system. It is written in standard FORTRAN 77 for use on any machine, and requires roughly 92K memory. The standard distribution medium for SPECIES is a 5.25 inch 360K MS-DOS format diskette. The contents of the diskettes are compressed using the PKWARE archiving tools. The utility to unarchive the files, PKUNZIP.EXE, is included. This program was last updated in 1991. SUN and SunOS are registered trademarks of Sun Microsystems, Inc.

Views and experiences of the NHS Health Check provided by general medical practices: cross-sectional survey in high-risk patients.

PubMed

Krska, Janet; du Plessis, Ruth; Chellaswamy, Hannah

2015-06-01

Since the NHS Health Check programme was initiated in 2009, no survey has sought patients' views of Checks provided by GP practices and few studies have reported views of the wider public. This study sought the views and experiences of patients with potentially high-cardiovascular disease (CVD) risk. Cross-sectional postal survey of all the patients with an actual or estimated CVD risk score of at least 20% over 10 years, registered with 16 general practices in Sefton, North West England, with no follow-up. The response rate was 23.4% (644/2958), 67.4% had attended and 73.8% of those not yet invited indicated willingness to attend. Both groups had positive views towards Health Checks, but more non-attenders agreed these should only be performed by doctors. Attenders had better self-reported health and healthy lifestyle than non-attenders. Overall 86.6% of attenders recalled receiving one or more pieces of lifestyle advice and 71.0% claimed to have made at least one lifestyle change; however, perception and understanding of CVD risk appeared limited. Both attenders and non-attenders had positive views towards NHS Health Checks in general practice and resultant self-reported lifestyle change in attenders was high. Clearer written information and explanation of personal CVD risk are required. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Work-family conflict as a risk factor for sickness absence.

PubMed

Jansen, N W H; Kant, I J; van Amelsvoort, L G P M; Kristensen, T S; Swaen, G M H; Nijhuis, F J N

2006-07-01

(1) To study both cross-sectional and prospective relationships between work-family conflict and sickness absence from work; (2) to explore the direction of the relationships between the different types of conflict (work-home interference and home-work interference) and sickness absence; and (3) to explore gender differences in the above relationships. Data from the Maastricht Cohort Study were used with six months of follow up (5072 men and 1015 women at T6). Work-family conflict was measured with the Survey Work-Home Interference Nijmegen (SWING). Sickness absence was assessed objectively through individual record linkage with the company registers on sickness absence. In the cross-sectional analyses, high levels of work-family conflict, work-home interference, and home-work interference were all associated with a higher odds of being absent at the time of completing the questionnaire, after controlling for age and long term disease. Differences in average number of absent days between cases and non-cases of work-home interference were significant for men and most pronounced in women, where the average number of absent days over six months follow up was almost four days higher in women with high versus low-medium work-home interference. A clear relation between work-family conflict and sickness absence was shown. Additionally, the direction of work-family conflict was associated with a different sickness absence pattern. Sickness absence should be added to the list of adverse outcomes for employees struggling to combine their work and family life.

Central and peripheral fat body mass have a protective effect on osteopenia or osteoporosis in adults and elderly?

PubMed

Freitas, P M S S; Garcia Rosa, M L; Gomes, A M; Wahrlich, V; Di Luca, D G; da Cruz Filho, R A; da Silva Correia, D M; Faria, C A; Yokoo, E M

2016-04-01

This cross-sectional study involves randomly selected men aged 50 to 99 years and postmenopausal women. Either central fat mass or peripheral fat mass were associated to osteoporosis or osteopenia independently from fat-free body mass and other confounding factors. Obesity and osteoporosis are public health problems that probably share common pathophysiological mechanisms. The question if body fat mass, central or peripheral, is protective or harmful for osteoporosis or osteopenia is not completely resolved. This study aims to investigate the association between osteoporosis or osteopenia, and fat body mass (central and peripheral) independently from fat-free body mass, in men aged 50 to 99 years old and postmenopausal women randomly selected in the community. This is a cross-sectional investigation with a random sample of registered population in Niterói Family Doctor Program (FDP), State of Rio de Janeiro, Brazil. Bone mineral density (BMD) and fat-free mass were assessed by dual X-ray absorptiometry (DXA). There was statistically significant bivariate association between bone loss with gender, age, skin color, alcohol consumption at risk dose, use of thiazide, fat-free body mass, and fat body mass (central and peripheral). In the multiple analysis of fat-free body mass, central and peripheral fat body mass showed an independent and protective effect on the presence of osteoporosis or osteopenia (p value <0.001). Since both obesity and osteoporosis are public health problems worldwide, strategies aimed at preventing both conditions should be encouraged during aging.

Tobacco use among designated air pollution victims and its association with lung function and respiratory symptoms: a retrospective cross-sectional study.

PubMed

Kotaki, Kenji; Senjyu, Hideaki; Tanaka, Takako; Yano, Yudai; Miyamoto, Naomi; Nishinakagawa, Tsuyoshi; Yanagita, Yorihide; Asai, Masaharu; Kozu, Ryo; Tabusadani, Mitsuru; Sawai, Terumitsu; Honda, Sumihisa

2014-07-31

We sought to elucidate the long-term association of tobacco use and respiratory health in designated pollution victims with and without obstructive pulmonary defects. A retrospective cross-sectional study. The register of pollution victims in Kurashiki, Japan. 730 individuals over 65 years of age previously diagnosed with pollution-related respiratory disease. Patients were classified into four groups according to their smoking status and whether they had obstructive pulmonary disease. We then compared the prevalence of respiratory symptoms and lung function over time between groups. Spirometry was performed and a respiratory health questionnaire completed in the same season each year for up to 30 years. Rates of smoking and respiratory disease were high in our sample. Although respiratory function in non-smoking patients did not completely recover, the annual rate of change in lung function was within the normal range (p<0.01). However, smokers had worse lung function and were more likely to report more severe pulmonary symptoms (p<0.01). Patients' respiratory function did not fully recover despite improved air quality. Our results suggest that, in the context of exposure to air pollution, tobacco use causes additional loss of lung function and exacerbates respiratory symptoms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A comparative study of biological and metabolic biomarkers between healthy individuals and patients with acne vulgaris: A cross-sectional study protocol.

PubMed

Kim, Kyuseok; Ha, Injin; Kim, Eunok; Kim, Kyunglee

2017-11-01

Acne is a multifactorial dermatosis, which is influenced not only by hormones but also by the biochemical relationship between them and the pilosebaceous unit. Inflammatory cytokines, chemokines, active oxygen, and zinc are known to be associated with the development of acne. Further, steroid metabolism is known as one of the important factors related to sebum secretion and comedone formation in acne. However, there is a lack of studies comparing these human biomarkers between healthy individuals and patients with acne. In particular, no study has investigated the relationship between human biomarkers and patterns of acne yet.The purpose of this study is to investigate diagnostic human biomarkers in acne by comparing the biological and metabolic biomarkers between healthy individuals and patients with acne and identify the relationship between human biomarkers and patterns of acne.This study is a protocol for a cross-sectional study. Forty healthy participants and 60 patients with acne will be recruited at 1 center. We will collect their blood samples and analyze the molecular biological and metabolic biomarkers (cytokines, chemokines, reactive oxygen species, corticotropin-releasing hormone, zinc, amino acid, 1-carbon metabolite, lipid metabolite, etc.). Further, we will administer questionnaires regarding their diet, sleep, stress, and other factors relating to acne and measure their skin elasticity.The study protocol was approved by the Institutional Review Board of Oriental Medical Hospital at Kyung Hee Medical Center (KOMCIRB-161118-HR-062). Written informed consent will be obtained from all the participants. The trial was registered in the Clinical Research Information Service, Republic of Korea: KCT0002212.This trial will provide evidence regarding diagnostic human biomarkers in acne and the relationship between the human biomarkers and patterns of acne.

The Role of Preceptorship and Group Cohesion on Newly Licensed Registered Nurses' Satisfaction and Intent to Stay.

PubMed

Bontrager, Sarah; Hart, Patricia L; Mareno, Nicole

2016-03-01

Thirteen percent of newly licensed registered nurses (NLRNs) vacate their first job after 1 year, and 37% report that they feel ready to change jobs. Turnover can lead to consistent and detrimental nursing shortages in nursing units, as well as increased costs for health care systems. A descriptive, prospective, cross-sectional design was used to understand how preceptor role effectiveness and group cohesion affect NLRNs' satisfaction and intent to stay. NLRNs reported high levels of perceived preceptor role effectiveness, group cohesion, and job satisfaction, with only moderate levels of intent to stay. Statistically significant relationships were found among preceptor role effectiveness, job satisfaction, and intent to stay, as well as among group cohesion, job satisfaction, and intent to stay. Preceptor role effectiveness and group cohesion are predictors of NLRNs' level of job satisfaction. Job satisfaction is a predictor of NLRNs' intent to stay. Effective preceptors and positive group cohesion are factors that are important to NLRNs' job satisfaction and intent to stay. Copyright 2016, SLACK Incorporated.

Factors associated with work satisfaction of registered nurses.

PubMed

Kovner, Christine; Brewer, Carol; Wu, Yow-Wu; Cheng, Ying; Suzuki, Miho

2006-01-01

To examine the factors that influence the work satisfaction of a national sample of registered nurses in metropolitan statistical areas (MSAs). A cross-sectional mailed survey design was used. The sample consisted of RNs randomly selected from 40 MSAs in 29 states; 1,907 RNs responded (48%). The sample of 1,538 RNs working in nursing was used for analysis. The questionnaire included measures of work attitudes and demographic characteristics. The data were analyzed using ordinary least-squares regression. More than 40% of the variance in satisfaction was explained by the various work attitudes: supervisor support, work-group cohesion, variety of work, autonomy, organizational constraint, promotional opportunities, work and family conflict, and distributive justice. RNs who were White, self-perceived as healthy, and working in nursing education were more satisfied. RNs that were more career oriented were more satisfied. Of the benefits options, only paid time off was related to satisfaction. Work-related factors were significantly related to RNs' work satisfaction.

Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey

PubMed Central

Laverty, Anthony A; Harris, Matthew J; Watt, Hilary C; Greaves, Felix; Majeed, Azeem

2017-01-01

Objective To examine associations between the contract and ownership type of general practices and patient experience in England. Design Multilevel linear regression analysis of a national cross-sectional patient survey (General Practice Patient Survey). Setting All general practices in England in 2013–2014 (n = 8017). Participants 903,357 survey respondents aged 18 years or over and registered with a general practice for six months or more (34.3% of 2,631,209 questionnaires sent). Main outcome measures Patient reports of experience across five measures: frequency of consulting a preferred doctor; ability to get a convenient appointment; rating of doctor communication skills; ease of contacting the practice by telephone; and overall experience (measured on four- or five-level interval scales from 0 to 100). Models adjusted for demographic and socioeconomic characteristics of respondents and general practice populations and a random intercept for each general practice. Results Most practices had a centrally negotiated contract with the UK government (‘General Medical Services’ 54.6%; 4337/7949). Few practices were limited companies with locally negotiated ‘Alternative Provider Medical Services’ contracts (1.2%; 98/7949); these practices provided worse overall experiences than General Medical Services practices (adjusted mean difference −3.04, 95% CI −4.15 to −1.94). Associations were consistent in direction across outcomes and largest in magnitude for frequency of consulting a preferred doctor (−12.78, 95% CI −15.17 to −10.39). Results were similar for practices owned by large organisations (defined as having ≥20 practices) which were uncommon (2.2%; 176/7949). Conclusions Patients registered to general practices owned by limited companies, including large organisations, reported worse experiences of their care than other patients in 2013–2014. PMID:29096580

A Canadian Cross-Sectional Survey on Psychosocial Supports for People Living Type 1 or 2 Diabetes: Health-Care Providers' Awareness, Capacity, and Motivation.

PubMed

Nichols, Jennica; Vallis, Michael; Boutette, Stephanie; Gall Casey, Carolyn; Yu, Catherine H

2017-11-09

Addressing psychosocial issues is critical for diabetes self-management. This work explores health-care professionals' (HCPs') 1) perceived relevance of various psychosocial issues in diabetes management and 2) confidence in working on these issues within their services. An online cross-sectional survey was developed based on the Capacity-Opportunity-Motivation Behaviour Model. It assessed self-rated confidence in supporting patients with psychosocial issues (capability), perceived relevance of these issues (motivation) and facilitators of skill development (opportunity). An e-mail invitation was sent to all Diabetes Canada's professional members, conference delegates and committee members. Qualitative responses were analyzed using thematic analysis. Of the 260 responses received (25% response rate), many were Diabetes Canada professional members (83%) and/or certified diabetes educators (66%). The largest professional groups in the sample were registered nurses (44%) and registered dietitians (33%). All psychosocial issues were perceived as somewhat or extremely important by at least 80% of respondents (range, 80% to 97%). However, HCPs were less confident in supporting their patients with these psychosocial issues; significantly fewer respondents reported that they felt somewhat or extremely confident (range, 26% to 62%). Depression (80%) and anxiety (80%) were the issues in which guidance was most desired. Most respondents wanted some form of formal self-management support training (83%). Preferred training methods included in-person workshops (56%), webinars (56%) and conference sessions (51%). Motivation to address psychosocial issues in diabetes was high, but capacity to do so and opportunity to learn how were both low. These findings can be used to develop a targeted strategy to help address this gap. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey.

PubMed

Cowling, Thomas E; Laverty, Anthony A; Harris, Matthew J; Watt, Hilary C; Greaves, Felix; Majeed, Azeem

2017-11-01

Objective To examine associations between the contract and ownership type of general practices and patient experience in England. Design Multilevel linear regression analysis of a national cross-sectional patient survey (General Practice Patient Survey). Setting All general practices in England in 2013-2014 ( n = 8017). Participants 903,357 survey respondents aged 18 years or over and registered with a general practice for six months or more (34.3% of 2,631,209 questionnaires sent). Main outcome measures Patient reports of experience across five measures: frequency of consulting a preferred doctor; ability to get a convenient appointment; rating of doctor communication skills; ease of contacting the practice by telephone; and overall experience (measured on four- or five-level interval scales from 0 to 100). Models adjusted for demographic and socioeconomic characteristics of respondents and general practice populations and a random intercept for each general practice. Results Most practices had a centrally negotiated contract with the UK government ('General Medical Services' 54.6%; 4337/7949). Few practices were limited companies with locally negotiated 'Alternative Provider Medical Services' contracts (1.2%; 98/7949); these practices provided worse overall experiences than General Medical Services practices (adjusted mean difference -3.04, 95% CI -4.15 to -1.94). Associations were consistent in direction across outcomes and largest in magnitude for frequency of consulting a preferred doctor (-12.78, 95% CI -15.17 to -10.39). Results were similar for practices owned by large organisations (defined as having ≥20 practices) which were uncommon (2.2%; 176/7949). Conclusions Patients registered to general practices owned by limited companies, including large organisations, reported worse experiences of their care than other patients in 2013-2014.

[An epidemic outbreak of mumps. A study of vaccinal efficacy].

PubMed

López Hernández, B; Martín Vélez, R M; Román García, C; Peñalver Sánchez, I; López Rosique, J A

2000-02-28

Description of an outbreak of mumps in an urban area. Study of the effectiveness of the mumps component of the triple virus (TV) vaccination. Cross sectional descriptive study of the outbreak. The cases were obtained from the Andalusian Register of Infectious Diseases (SVEA in Spanish). The effectiveness of the vaccine was studied through a retrospective cohort design, with the cohorts defined according to their vaccination history. Urban area of low social class and income and young population pyramid. The outbreak occurred between March and November 1997. The effectiveness of vaccination at one school was studied. PATIENTS AND OTHER PARTICIPANTS, RESIDENTS IN THE AREA: The source of the population was the 1996 municipal census. The declared cases of mumps were taken from the SVEA. The state of vaccination was documented through a review of the school registration records, vaccination cards and the health centre register of names. A total of 283 cases of mumps were declared. There were more cases in the 0-10 age group than at older ages. 79% of cases were vaccinated (95% CI, 74.3-73.7). Effectiveness of a dose of the mumps component of the vaccine was low (46%; CI, 0-84), though the effectiveness of a second dose was higher (87%; CI, 27-99). The low effectiveness of the mumps component of the TV vaccination was confirmed. It is proposed that the age for the second dose should be brought forward to school-starting age (primary, first year). Ensuring school vaccination is recommended.

Leprosy among schoolchildren in the Amazon region: A cross-sectional study of active search and possible source of infection by contact tracing

PubMed Central

Dias, Luiz Claudio; Galban, Enrique; Leturiondo, André; Palheta, Jamile; Santos, Monica; Moraes, Milton Ozório; Talhari, Carolina

2018-01-01

Background The high rate of leprosy cases among children under 15 years of age in Brazil indicates ongoing transmission within the community. The identification of the new leprosy cases among contacts can help identify the source of infection and interrupt the transmission chain. This study aims to determine the detection rate of previously undiagnosed cases of leprosy among schoolchildren who are under 15 years of age living in Manaus, Amazonas, Brazil, and their possible source of infection by contact tracing. Methodology/Principal findings This was a school-based, cross-sectional study in which the identification of active leprosy cases was conducted in 277 out of 622 randomly selected public schools in Manaus, Amazonas, Brazil. Suspected cases of leprosy were referred to the Alfredo da Matta Foundation, a reference center for leprosy in Manaus. A total of 34,547 schoolchildren were examined, and 40 new leprosy cases were diagnosed. Among new cases, 57.5% were males, and 80.0% demonstrated paucibacillary leprosy. A total of 196 of 206 registered contacts were screened, and 52.5% of the newly diagnosed children’s cases had at least one positive household contact. In these contacts, grandparents (52.4%) were the most common co-prevalent cases, while 14.3% were uncles, 9.5% were parents and 9.5% were granduncles. Seven contacts (5.0%), including four siblings of child patients were newly diagnosed. Our data indicate that the prevalence is 11.58 per 10,000, which is 17 times higher than the registered rate. Conclusions/Significance This study suggests that the detection rate of leprosy among schoolchildren may have remained unchanged over the past thirty years. It also indicates that that active case finding is necessary for reaching the World Health Organization’s goals of zero detection among children, especially in endemic areas where the prevalence of leprosy is obscure. Moreover, we assert that all children must have their household contacts examined in order to identify the possible source of infection and interrupt the disease’s transmission. Novel strategies to reinforce contact tracing associated with large-scale strategies of chemo- and immune-prophylaxis should be expanded to prevent the perpetuation of the disease cycle. PMID:29481570

Anxiety symptoms among Chinese nurses and the associated factors: a cross sectional study.

PubMed

Gao, Yu-Qin; Pan, Bo-Chen; Sun, Wei; Wu, Hui; Wang, Jia-Na; Wang, Lie

2012-09-14

Nurses are an indispensable component of the work force in the health care system. However, many of them are known to work in a stressful environment which may affect their mental well-being; the situation could be worse in rapidly transforming societies such as China. The purpose of this study was to investigate anxiety symptoms and the associated factors in Chinese nurses working in public city hospitals. A cross-sectional survey was performed for Chinese nurses in public city hospitals of Liaoning Province, northeast China. Seven hospitals in different areas of the province were randomly selected for the study. The Zung Self-Rating Anxiety Scale was used to measure anxiety symptoms. Effort-reward imbalance questionnaire and Job Content Questionnaire were used to assess the work stressors. Univariate analysis and stepwise multivariate logistic regression analysis were used to identify the factors associated with anxiety symptoms. All registered nurses in the seven city hospitals, totaling 1807 registered nurses were surveyed. Of the returned questionnaires, 1437 were valid (79.5%) for analysis. Utilizing the total raw score ≥ 40 as the cut-off point, the prevalence of anxiety symptoms in these nurses was 43.4%. Demographic factors (education, chronic disease and life event), lifestyle factors (regular meals and physical exercise), work conditions (hospital grade, job rank, monthly salary, nurse-patient relationships, job satisfaction and intention of leaving), job content (social support and decision latitude), effort-reward imbalance and overcommitment were all significantly related to the anxiety symptoms. Multivariate logistic regression analysis showed main factors associated with anxiety symptoms were lower job rank (OR 2.501), overcommitment (OR 2.018), chronic diseases (OR 1.541), worse nurse-patient relationship (OR 1.434), higher social support (OR 0.573), lower hospital grade (OR 0.629), taking regular meals (OR 0.719) and higher level of job satisfaction (OR 0.722). A large proportion of Chinese nurses working in public city hospitals had anxiety symptoms, which warrants immediate investigation and intervention from the hospital administrators. Meanwhile, results of the study suggest that proper counseling, promotion of healthy lifestyle behavior and improvements to the social environment in the work place may be helpful toward reducing or preventing the anxiety symptoms.

Anxiety symptoms among Chinese nurses and the associated factors: a cross sectional study

PubMed Central

2012-01-01

Background Nurses are an indispensable component of the work force in the health care system. However, many of them are known to work in a stressful environment which may affect their mental well-being; the situation could be worse in rapidly transforming societies such as China. The purpose of this study was to investigate anxiety symptoms and the associated factors in Chinese nurses working in public city hospitals. Methods A cross-sectional survey was performed for Chinese nurses in public city hospitals of Liaoning Province, northeast China. Seven hospitals in different areas of the province were randomly selected for the study. The Zung Self-Rating Anxiety Scale was used to measure anxiety symptoms. Effort-reward imbalance questionnaire and Job Content Questionnaire were used to assess the work stressors. Univariate analysis and stepwise multivariate logistic regression analysis were used to identify the factors associated with anxiety symptoms. Results All registered nurses in the seven city hospitals, totaling 1807 registered nurses were surveyed. Of the returned questionnaires, 1437 were valid (79.5%) for analysis. Utilizing the total raw score ≥ 40 as the cut-off point, the prevalence of anxiety symptoms in these nurses was 43.4%. Demographic factors (education, chronic disease and life event), lifestyle factors (regular meals and physical exercise), work conditions (hospital grade, job rank, monthly salary, nurse-patient relationships, job satisfaction and intention of leaving), job content (social support and decision latitude), effort-reward imbalance and overcommitment were all significantly related to the anxiety symptoms. Multivariate logistic regression analysis showed main factors associated with anxiety symptoms were lower job rank (OR 2.501), overcommitment (OR 2.018), chronic diseases (OR 1.541), worse nurse-patient relationship (OR 1.434), higher social support (OR 0.573), lower hospital grade (OR 0.629), taking regular meals (OR 0.719) and higher level of job satisfaction (OR 0.722). Conclusions A large proportion of Chinese nurses working in public city hospitals had anxiety symptoms, which warrants immediate investigation and intervention from the hospital administrators. Meanwhile, results of the study suggest that proper counseling, promotion of healthy lifestyle behavior and improvements to the social environment in the work place may be helpful toward reducing or preventing the anxiety symptoms. PMID:22978466

Assessment of pediatric residents burnout in a tertiary academic centre

PubMed Central

Jamjoom, Roaa S.; Park, Yoon S.

2018-01-01

Objectives: To study burnout among pediatric residents at King Abdulazaiz University Hospital in Jeddah, Saudi Arabia. Methods: This is a cross-sectional survey that was administered to all pediatric residents enrolled in the Saudi Paediatric Board program (PGY1-PGY4) in a large tertiary academic hospital in the Western region of Saudi Arabia (King Abdulaziz University Hospital). The survey were sent via E-mail to 50 registered general pediatric residents. Results: Seventy percent of the pediatric residents completed the survey. More than 70% of residents experiencing severe burnout. Forty-three percent suffering emotional exhaustion, 71.8% experiencing depersonalization and 40.6% suffering from low accomplishment. Conclusion: Burnout syndrome appear to be a serious threat to resident well-being in our program. Moreover, pediatric residents in our institute experienced higher levels of depersonalization than their peers nationally and internationally. PMID:29543309

Validity and reliability of the "German Utilization Questionnaire-Dissemination and Use of Research" to measure attitude, availability, and support toward implementation of research in nursing practice.

PubMed

Haslinger-Baumann, Elisabeth; Lang, Gert; Müller, Gerhard

2014-01-01

In nursing practice, research results have to undergo a systematic process of transformation. Currently in Austria, there is no empirical data available concerning the actual implementation of research results. An English validated questionnaire was translated into German and tested for validity and reliability. A survey of 178 registered nurses (n = 178) was conducted in a multicenter, quantitative, cross-sectional study in Austria in 2011. Cronbach's alpha values (.82-.92) were calculated for 4 variables ("use," "attitude," "availability," "support") after the reduction of 7 irrelevant items. Exploratory factor analysis was calculated with Kaiser-Meyer-Olkin (KMO) ranging from .78 to .92; the total variance ranged from 46% to 56%. A validated German questionnaire concerning the implementation of research results is now available for the nursing practice.

Estimating the prevalence of borderline personality disorder in psychiatric outpatients using a two-phase procedure.

PubMed

Korzekwa, Marilyn I; Dell, Paul F; Links, Paul S; Thabane, Lehana; Webb, Steven P

2008-01-01

The prevalence of borderline personality disorder (BPD) in outpatient clinics varies greatly (7%-27%) depending on the setting and methodology. We examined the cross-sectional rate of BPD in a general adult outpatient university clinic using a 2-phase procedure: (1) we screened all registered patients with the self-report SCID-II-PQ and (2) we administered the Revised Diagnostic Interview for Borderlines (DIB-R). Sixty-six percent (239/360) of the clinic patients completed the screening: About 72.4% (173/239) (95% confidence interval [CI] = 66.7%, 78.1%) were positive for BPD on the Structured Clinical Interview for DSM-IV Personality Disorders-Patient Questionnaire (SCID-II-PQ), and 22.6% (54/239) (95% CI = 17.3%, 27.9%) were positive for BPD on the DIB-R. Our BPD rate was somewhat higher than recent semistructured interview studies (9%-18%). We believe this is due, in part, to our cross-sectional design and our decision not to exclude acute Axis I disorders. Mostly, however, we believe that our 22.6% incidence of BPD arises from the high morbidity of our sample. Demographic data from 130 of 131 DIB-R completers reveal the following: mean age was 40.2 years, 75.4% were female, most patients were unable to work, and they averaged 3.8 lifetime hospitalizations.

Can the impact of gender equality on health be measured? a cross-sectional study comparing measures based on register data with individual survey-based data

PubMed Central

2012-01-01

Background The aim of this study was to investigate potential associations between gender equality at work and self-rated health. Methods 2861 employees in 21 companies were invited to participate in a survey. The mean response rate was 49.2%. The questionnaire contained 65 questions, mainly on gender equality and health. Two logistic regression analyses were conducted to assess associations between (i) self-rated health and a register-based company gender equality index (OGGI), and (ii) self-rated health and self-rated gender equality at work. Results Even though no association was found between the OGGI and health, women who rated their company as “completely equal” or “quite equal” had higher odds of reporting “good health” compared to women who perceived their company as “not equal” (OR = 2.8, 95% confidence interval = 1.4 – 5.5 and OR = 2.73, 95% CI = 1.6-4.6). Although not statistically significant, we observed the same trends in men. The results were adjusted for age, highest education level, income, full or part-time employment, and type of company based on the OGGI. Conclusions No association was found between gender equality in companies, measured by register-based index (OGGI), and health. However, perceived gender equality at work positively affected women’s self-rated health but not men’s. Further investigations are necessary to determine whether the results are fully credible given the contemporary health patterns and positions in the labour market of women and men or whether the results are driven by selection patterns. PMID:22985388

Are the children of the clients' visible or invisible for nurses in adult psychiatry?--a questionnaire survey.

PubMed

Korhonen, Teija; Pietilä, Anna-Maija; Vehviläinen-Julkunen, Katri

2010-03-01

Children in families affected by mental illness are at an increased risk for developing psychopathology, emotional and behavioural problems. Nurses have direct and frequent contact with patients and their families, and are in a unique position to evaluate the situation of these children before problems arise. The aim of this study is to describe the interaction that practical mental health nurses (MHNs) and registered mental health currently have with children of their clients and predictors of this interaction when a parent is receiving psychiatric care. This is a cross-sectional study. In 2005, questionnaires were sent to all registered (n = 373) and practical MHNs (n = 235) working in 45 adult psychiatric inpatient and outpatient units in five Finnish university hospitals. The total response rate was 51%, while 60% (n = 222) of registered MHNs and 36% (n = 88) of practical MHNs responded. Most of the nurses did not meet children of their clients regularly, although they reported that information about children of the clients were gathered regularly at the units, and discussed clients' children with them. The personal characteristics of nurses, such as gender, age, marital status and being a parent, were significantly related to the nurse's propensity to pay attention to the children of their clients in adult psychiatry. Nurses' professional experience, further family education and use of family-centred care at the unit increased their interaction with the children of their patients. These results indicate that clients' children are not entirely invisible for most of the nurses in adult psychiatry. Knowledge of the risks faced by these children and implementation of the preventive approach should be included in the basic education of nurses.

Nursing home spending, staffing, and turnover.

PubMed

Kash, Bita A; Castle, Nicholas G; Phillips, Charles D

2007-01-01

Recent work on nursing home staffing and turnover has stressed the importance of ownership and resources. However, few studies have examined spending behaviors, which might also influence staffing levels and staff turnover rates. This study investigates whether spending behaviors measured by financial ratios are associated with staffing levels and staff turnover in nursing homes. We analyzed cross-sectional data from 1,014 Texas homes. Data were from the 2002 Texas Nursing Facility Medicaid Cost Report and the 2003 Area Resource File. First, we examined differences in financial ratios by ownership type. Next, the effect of 10 financial ratios on staffing levels and turnover rates for registered nurses, licensed vocational nurses, and certified nursing assistants was examined using robust regression models. Descriptive data indicated that expense ratios related to resident care activities and staff development were significantly higher among not-for-profit than for-profit homes. Higher profits were associated with lower staffing levels, but not higher turnover rates. Administrative expenses (a measure of management capacity) had a negative impact both on staffing levels and staff turnover for licensed vocational nurses and certified nursing assistants, but they did not affect registered nurse staffing. Employee benefit expenses exhibited a positive impact on registered nurse and licensed vocational nurse staffing levels. The addition of information on financial ratios to models predicting staffing indicators reduced the effect of ownership on these indicators. Solutions to the staffing and turnover problem should focus on more effective management practices. Certain levels of administrative and staff benefit expenses may be necessary to improve professional staff recruitment and reduce both staffing and turnover costs. Differences in these financial ratios may partially explain the role played by ownership in determining staffing levels and turnover.

A cross-sectional analysis of HIV and hepatitis C clinical trials 2007 to 2010: the relationship between industry sponsorship and randomized study design.

PubMed

Goswami, Neela D; Tsalik, Ephraim L; Naggie, Susanna; Miller, William C; Horton, John R; Pfeiffer, Christopher D; Hicks, Charles B

2014-01-22

The proportion of clinical research sponsored by industry will likely continue to expand as federal funds for academic research decreases, particularly in the fields of HIV/AIDS and hepatitis C (HCV). While HIV and HCV continue to burden the US population, insufficient data exists as to how industry sponsorship affects clinical trials involving these infectious diseases. Debate exists about whether pharmaceutical companies undertake more market-driven research practices to promote therapeutics, or instead conduct more rigorous trials than their non-industry counterparts because of increased resources and scrutiny. The ClinicalTrials.gov registry, which allows investigators to fulfill a federal mandate for public trial registration, provides an opportunity for critical evaluation of study designs for industry-sponsored trials, independent of publication status. As part of a large public policy effort, the Clinical Trials Transformation Initiative (CTTI) recently transformed the ClinicalTrials.gov registry into a searchable dataset to facilitate research on clinical trials themselves. We conducted a cross-sectional analysis of 477 HIV and HCV drug treatment trials, registered with ClinicalTrials.gov from 1 October 2007 to 27 September 2010, to study the relationship of study sponsorship with randomized study design. The likelihood of using randomization given industry (versus non-industry) sponsorship was reported with prevalence ratios (PR). PRs were estimated using crude and stratified tabular analysis and Poisson regression adjusting for presence of a data monitoring committee, enrollment size, study phase, number of study sites, inclusion of foreign study sites, exclusion of persons older than age 65, and disease condition. The crude PR was 1.17 (95% CI 0.94, 1.45). Adjusted Poisson models produced a PR of 1.13 (95% CI 0.82, 1.56). There was a trend toward mild effect measure modification by study phase, but this was not statistically significant. In stratified tabular analysis the adjusted PR was 1.14 (95% CI 0.78, 1.68) among phase 2/3 trials and 1.06 (95% CI 0.50, 2.22) among phase 4 trials. No significant relationship was found between industry sponsorship and use of randomization in trial design in this cross-sectional study. Prospective studies evaluating other aspects of trial design may shed further light on the relationship between industry sponsorship and appropriate trial methodology.

A cross-sectional analysis of HIV and hepatitis C clinical trials 2007 to 2010: the relationship between industry sponsorship and randomized study design

PubMed Central

2014-01-01

Background The proportion of clinical research sponsored by industry will likely continue to expand as federal funds for academic research decreases, particularly in the fields of HIV/AIDS and hepatitis C (HCV). While HIV and HCV continue to burden the US population, insufficient data exists as to how industry sponsorship affects clinical trials involving these infectious diseases. Debate exists about whether pharmaceutical companies undertake more market-driven research practices to promote therapeutics, or instead conduct more rigorous trials than their non-industry counterparts because of increased resources and scrutiny. The ClinicalTrials.gov registry, which allows investigators to fulfill a federal mandate for public trial registration, provides an opportunity for critical evaluation of study designs for industry-sponsored trials, independent of publication status. As part of a large public policy effort, the Clinical Trials Transformation Initiative (CTTI) recently transformed the ClinicalTrials.gov registry into a searchable dataset to facilitate research on clinical trials themselves. Methods We conducted a cross-sectional analysis of 477 HIV and HCV drug treatment trials, registered with ClinicalTrials.gov from 1 October 2007 to 27 September 2010, to study the relationship of study sponsorship with randomized study design. The likelihood of using randomization given industry (versus non-industry) sponsorship was reported with prevalence ratios (PR). PRs were estimated using crude and stratified tabular analysis and Poisson regression adjusting for presence of a data monitoring committee, enrollment size, study phase, number of study sites, inclusion of foreign study sites, exclusion of persons older than age 65, and disease condition. Results The crude PR was 1.17 (95% CI 0.94, 1.45). Adjusted Poisson models produced a PR of 1.13 (95% CI 0.82, 1.56). There was a trend toward mild effect measure modification by study phase, but this was not statistically significant. In stratified tabular analysis the adjusted PR was 1.14 (95% CI 0.78, 1.68) among phase 2/3 trials and 1.06 (95% CI 0.50, 2.22) among phase 4 trials. Conclusions No significant relationship was found between industry sponsorship and use of randomization in trial design in this cross-sectional study. Prospective studies evaluating other aspects of trial design may shed further light on the relationship between industry sponsorship and appropriate trial methodology. PMID:24450313

77 FR 8817 - Agency Information Collection Activities; Proposed Collection, Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-15

... final rulemaking on ``Provisions Common to Registered Entities'' under which the Commission would... Commission's final rulemaking on provisions common to registered entities,\\3\\ the Commission seeks to...\\ to enhance compliance by registered entities. This section permits a registered entity to elect to...

20 CFR 346.1 - Central register.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Central register. 346.1 Section 346.1 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT RAILROAD HIRING § 346.1 Central register. (a) The Board shall maintain a central register of railroad...

20 CFR 346.1 - Central register.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Central register. 346.1 Section 346.1 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT RAILROAD HIRING § 346.1 Central register. (a) The Board shall maintain a central register of railroad...

20 CFR 346.1 - Central register.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Central register. 346.1 Section 346.1 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT RAILROAD HIRING § 346.1 Central register. (a) The Board shall maintain a central register of railroad...

20 CFR 346.1 - Central register.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Central register. 346.1 Section 346.1 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT RAILROAD HIRING § 346.1 Central register. (a) The Board shall maintain a central register of railroad...

78 FR 57685 - Guidance Regarding Deduction and Capitalization of Expenditures Related to Tangible Property

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-19

...This document contains final regulations that provide guidance on the application of sections 162(a) and 263(a) of the Internal Revenue Code (Code) to amounts paid to acquire, produce, or improve tangible property. The final regulations clarify and expand the standards in the current regulations under sections 162(a) and 263(a). These final regulations replace and remove temporary regulations under sections 162(a) and 263(a) and withdraw proposed regulations that cross referenced the text of those temporary regulations. This document also contains final regulations under section 167 regarding accounting for and retirement of depreciable property and final regulations under section 168 regarding accounting for property under the Modified Accelerated Cost Recovery System (MACRS) other than general asset accounts. The final regulations will affect all taxpayers that acquire, produce, or improve tangible property. These final regulations do not finalize or remove the 2011 temporary regulations under section 168 regarding general asset accounts and disposition of property subject to section 168, which are addressed in the notice of proposed rulemaking on this subject in the Proposed Rules section in this issue of the Federal Register.

Changing presentation of cutaneous malignant melanoma.

PubMed

Klit, Anders; Lassen, Cecilie Brandt; Olsen, Caroline Holkmann; Lock-Andersen, Jørgen

2015-10-01

The incidence of cutaneous malignant melanoma is rapidly increasing in Denmark like in other Northern and Western European countries. Our objective was to investigate the characteristics of current patients suffering from cutaneous malignant melanoma. We evaluated patient and tumour characteristics in a cross-sectional study based on data from the Danish Melanoma Register. We included all patients diagnosed with cutaneous malignant melanoma in Healthcare Region Zealand in 2012 and 2013. We identified 520 patients with invasive cutaneous malignant melanoma. More females than males suffered from cutaneous malignant melanoma. Furthermore, females were younger than males, and the anatomical distribution of malignant melanoma varied between the genders. Outcome of sentinel lymph node biopsy was associated with tumour thickness. When comparing findings in our study with earlier Danish studies, we see a trend towards an increase in age at diagnosis. Furthermore, tumour thickness is decreasing and the topical distribution of cutaneous malignant melanoma in females changes towards a male pattern. none. The study has been approved by the Danish National Data Protection Agency.

Relying on Visiting Foreign Doctors for Fistula Repair: The Profile of Women Attending Fistula Repair Surgery in Somalia.

PubMed

Gele, Abdi A; Salad, Abdulwahab M; Jimale, Liban H; Kour, Prabhjot; Austveg, Berit; Kumar, Bernadette

2017-01-01

Obstetric fistula is treatable by surgery, although access is usually limited, particularly in the context of conflict. This study examines the profile of women attending fistula repair surgery in three hospitals in Somalia. A cross-sectional study was conducted in Somalia from August to September 2016. Structured questionnaires were administered to 81 women who registered for fistula repair surgery in the Garowe, Daynile, and Kismayo General Hospitals in Somalia. Findings revealed that 70.4% of the study participants reported obstetric labor as the cause of their fistula, and 29.6% reported iatrogenic causes. Regarding the waiting time for the repair surgery, 45% waited for the surgery for over one year, while the rest received the surgery within a year. The study suggests that training for fistula surgery has to be provided for healthcare professionals in Somalia, fistula centers should be established, and access to these facilities has to be guaranteed for all patients who need these services.

Evaluation of dermal symptoms in hypothyroidism and hyperthyroidism.

PubMed

Razi, Ahad; Golforoushan, Farideh; Nejad, Amir Bahrami Shahla Babaee; Goldust, Mohamad

2013-06-01

Many symptoms arise in thyroid diseases. The aim of this study was to evaluate the dermal symptoms in hypothyroidism and hyperthyroidism. In this cross sectional study, 120 patients with hyperthyroidism and 50 patients suffering from hypothyroidism were studied. Cutaneous, hair and nail clinical symptoms were studied and registered in a special questionnaire. Mean age of patients suffering from hypothyroidism and hyperthyroidism were 38.24 +/- 14.45 and 25.86 +/- 14.69 years old. Dry and Coarse/rough skin were the most prevalent manifestations in the skin involvement in hypothyroidism since softness was the most prevalent ones in hyperthyroidism. Fragileness was the most prevalent symptom in patients with nail involvement in hypothyroidism since soft skin was the most prevalent ones in hyperthyroidism. Coarse/rough skin was observed more in patients with hair involvement in hypothyroidism since the most prevalent ones was separation of nail from its bed in hyperthyroidism. High prevalence of skin, hair and nail symptoms in thyroid patients, early diagnosis of the signs may be helpful in premature diagnosis and treatment of thyroid diseases.

Relying on Visiting Foreign Doctors for Fistula Repair: The Profile of Women Attending Fistula Repair Surgery in Somalia

PubMed Central

Salad, Abdulwahab M.; Jimale, Liban H.; Kour, Prabhjot; Austveg, Berit; Kumar, Bernadette

2017-01-01

Obstetric fistula is treatable by surgery, although access is usually limited, particularly in the context of conflict. This study examines the profile of women attending fistula repair surgery in three hospitals in Somalia. A cross-sectional study was conducted in Somalia from August to September 2016. Structured questionnaires were administered to 81 women who registered for fistula repair surgery in the Garowe, Daynile, and Kismayo General Hospitals in Somalia. Findings revealed that 70.4% of the study participants reported obstetric labor as the cause of their fistula, and 29.6% reported iatrogenic causes. Regarding the waiting time for the repair surgery, 45% waited for the surgery for over one year, while the rest received the surgery within a year. The study suggests that training for fistula surgery has to be provided for healthcare professionals in Somalia, fistula centers should be established, and access to these facilities has to be guaranteed for all patients who need these services. PMID:28761443

Electron impact scattering study of hypohalous acids HOX (X = F, Cl, Br, I)

NASA Astrophysics Data System (ADS)

Yadav, Hitesh; Bhutadia, Harshad; Prajapati, Dinesh; Desai, Hardik; Vinodkumar, Minaxi; Vinodkumar, P. C.

2018-05-01

In this article we aim to report total cross sections (TCS) QT, total elastic cross sections (Qel), total inelastic cross sections (Qinel) i.e. (total ionizations cross sections (Qion)+total electronic excitation cross sections (Qexc)) from threshold of the target to 5000 eV energy range. We have used a well-defined theoretical methodology Spherical Complex Optical Potential (SCOP) to compute QT, Qel and Qinel and Complex Scattering Potential - ionization contribution (CSP - ic) method to report the (Qion). The cross-sectional data reported here for the Hypohalous Acids is for the first time and the present data can become a guideline for the experimentalist to study these targets.

Prevalence of Sexual Harassment and its Associated Factors among Registered Nurses Working in Government Hospitals in Melaka State, Malaysia.

PubMed

Suhaila, O; Rampal, K G

2012-10-01

This study focuses on sexual harassment, a form of psycological hazard that female registered nurses face throughout their day to day routine. The objective of this study is to find the prevalence of sexual harassment among female registered nurses working in government hospitals in Melaka, Malaysia and factors affecting them. This is a cross sectional study conducted on 455 female registered nurses who have worked more than one year in the present 3 government hospitals in Melaka, Malaysia. A validated and pre tested questionnaires were given for the respondents to answer. Before respondents answer the questionaires, they are required to read the definition and the forms of sexual harassment provided. This is to help them to understand the correct definition and forms of sexual harassment that they could have experienced. The researcher is available during the distribution of the questionnaires and the respondents are free to ask the researcher anything that they do not understand about it. The results of this study show that the prevalence of sexual harassment among these nurses was 51.2% with the past one year incidence recorded at 22.8%. The most common forms of sexual harassment were verbal (46.6% ), visual (24.8% ), psycological (20.9%), physical (20.7%) and non -verbal (16.7% ). The study showed that 74.7% of the victims suffered from psychological effects brought upon by their encounter with various types of sexual harrasement at work. The study also found that the victims' self-perception of their physicality was a contributing factor to the prevalance of this situation. Those who were pretty, with attractive body figure, a friendly character and easy going had a higher prevalence of sexual harassment in the workplace. Meanwhile, those who were strict, and those who had a fierce character were not prone to sexual harassment. The prevalence of sexual harassment among registered nurses in the workplace found in this study was high and self-perception profile of the victims of sexual harassment was the main contributing factor to the problem. Sexual harassment in the workplace should not be taken lightly because the resulting effects was not only felt by the victims, but also by their family members, colleagues and patients under their care. Hence, steps should be taken by the hospital managements to manage and prevent this problem from occuring again in the future.

Palliative Care Research--A Systematic Review of foci, designs and methods of research conducted in Sweden between 2007 and 2012.

PubMed

Henoch, Ingela; Carlander, Ida; Holm, Maja; James, Inger; Sarenmalm, Elisabeth Kenne; Hagelin, Carina Lundh; Lind, Susanne; Sandgren, Anna; Öhlén, Joakim

2016-03-01

In 2007, a literature review was undertaken of palliative care research from Sweden during the 1970s-2006, paving the way for a follow-up study to explore the recent developments. The aim was to systematically examine palliative care research from Sweden between 2007 and 2012, with special attention to methods, designs and research foci. A literature review was undertaken. The databases Academic search elite, Age line, Ahmed, Cinahl, PsychInfo, PubMed, Scopus, Soc abstracts, Web of science and Libris were reviewed for Swedish palliative care research studies published from 2007 to 2012, applying the search criteria 'palliative care OR palliative medicine OR end-of-life care OR terminal care OR hospice care OR dying OR death'. A total of 263 papers met the inclusion criteria, indicating an increased volume of research compared to the 133 articles identified in the previous review. Common study foci were symptom assessment and management, experiences of illness and care planning. Targeting non-cancer-specific populations and utilisation of population-based register studies were identified as new features. There was continued domination of cross-sectional, qualitative and mono-disciplinary studies, not including ethnic minority groups, nonverbally communicable people or children <18 years of age. The trend is that Swedish palliative care research has expanded in volume from 2007 to 2012 compared to during the 1970s to 2006, with increasing participation of non-cancer-specific populations. A domination of qualitative approaches and small, cross-sectional studies with few interventions is still characteristic. Still more strategies are needed to expand the knowledge development of palliative care to respond to demographical, epidemiological, therapeutic and healthcare structure changes. © 2015 Nordic College of Caring Science.

17 CFR 49.19 - Core principles applicable to registered swap data repositories.

Code of Federal Regulations, 2014 CFR

2014-04-01

... registered swap data repositories. 49.19 Section 49.19 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION (CONTINUED) SWAP DATA REPOSITORIES § 49.19 Core principles applicable to registered swap data repositories. (a) Compliance with core principles. To be registered, and maintain...

46 CFR 401.510 - Operation without Registered Pilots.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 8 2011-10-01 2011-10-01 false Operation without Registered Pilots. 401.510 Section 401.510 Shipping COAST GUARD (GREAT LAKES PILOTAGE), DEPARTMENT OF HOMELAND SECURITY GREAT LAKES PILOTAGE REGULATIONS Penalties; Operations Without Registered Pilots § 401.510 Operation without Registered Pilots. (a...

1 CFR 5.1 - Publication policy.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1 General Provisions 1 2014-01-01 2012-01-01 true Publication policy. 5.1 Section 5.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.1 Publication... Federal Register shall publish a serial publication called the Federal Register to contain the following...

1 CFR 5.1 - Publication policy.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1 General Provisions 1 2012-01-01 2012-01-01 false Publication policy. 5.1 Section 5.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.1 Publication... Federal Register shall publish a serial publication called the Federal Register to contain the following...

1 CFR 5.1 - Publication policy.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1 General Provisions 1 2013-01-01 2012-01-01 true Publication policy. 5.1 Section 5.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.1 Publication... Federal Register shall publish a serial publication called the Federal Register to contain the following...

Influence of community pharmacists׳ attitudes on antibiotic dispensing behavior: a cross-sectional study in Portugal.

PubMed

Roque, Fátima; Soares, Sara; Breitenfeld, Luiza; Figueiras, Adolfo; Herdeiro, Maria Teresa

2015-01-01

The emergence of microbial resistance is widely associated with inappropriate antibiotic use. Self-medication with antibiotics acquired directly from pharmacies without a medical prescription has been reported by several European countries as being an important cause of such inappropriate use. The goal of this study was to identify and evaluate community pharmacists׳ attitudes toward and knowledge of antibiotics and microbial resistance and to assess what influence, if any, these attitudes might have on their propensity to dispense unprescribed antibiotics. We conducted a cross-sectional study covering all community pharmacists registered with the Official College of Pharmacists in Portugal׳s Central Region. A self-administered questionnaire on attitudes toward microbial resistance and antibiotic use was mailed to 1197 pharmacists. Responses ranged from 0 (total disagreement) to 10 (total agreement). Logistic regression was used to model the association between respondents׳ attitudes and their propensity to dispense antibiotics without an earlier medical prescription. The overall response rate was 64.8%. Agreement with the dispensing of unprescribed antibiotics was highest in the case of dental diseases and ailments, followed by urinary tract infections. Although none of the sociodemographic data were associated with a propensity to dispense antibiotics without a medical prescription, the attitudes shown to be significantly associated with this propensity were complacency about patients, responsibility of others, and precaution or fear. Because the attitudes of community pharmacists can influence their readiness to dispense unprescribed antibiotics, educational interventions addressing such attitudes should be implemented to improve antibiotic use. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

Factors deterring dentistry, medical, pharmacy, and social science undergraduates from pursuing nursing as a healthcare career: a cross-sectional study in an Asian university.

PubMed

Wu, Ling Ting; Wang, Wenru; Holroyd, Eleanor; Lopez, Violeta; Liaw, Sok Ying

2018-01-26

Globally more registered nurses need to be recruited to meet the needs of aging populations and increased co-morbidity. Nursing recruitment remains challenging when compared to other healthcare programs. Despite healthcare students having similar motivation in joining the healthcare industry, many did not consider nursing as a career choice. This study aims to identify the deterrents to choosing nursing among healthcare undergraduates by examining the differences in the factors influencing healthcare career choices and nursing as a career choice. A cross sectional study was conducted using a 35-parallel items instrument known as Healthcare Career Choice and Nursing Career Choice scale. Six hundred and four (n = 604) first year medical, pharmacy, dentistry and social science students from a university in Singapore completed the survey. Nursing as a career was perceived by healthcare students to be more likely influenced by prior healthcare exposure, the nature of the work, job prospects, and social influences. Lack of autonomous decision making, perceived lower ability to make diagnosis, having to attend to patients' hygiene needs, engendered stigma, and lack of parental support were identified as deterring factors to choosing nursing as a career. An understanding of the deterrents to choosing nursing as career allows policy makers and educational leaders to focus on recruitment strategies. These include providing more exposure to nurses' roles in early school years, helping young people to overcome the fear of providing personal hygiene care, promoting nurses' autonomous nursing practice, addressing gender stigma, and overcoming parental objection.

Methodology Series Module 3: Cross-sectional Studies.

PubMed

Setia, Maninder Singh

2016-01-01

Cross-sectional study design is a type of observational study design. In a cross-sectional study, the investigator measures the outcome and the exposures in the study participants at the same time. Unlike in case-control studies (participants selected based on the outcome status) or cohort studies (participants selected based on the exposure status), the participants in a cross-sectional study are just selected based on the inclusion and exclusion criteria set for the study. Once the participants have been selected for the study, the investigator follows the study to assess the exposure and the outcomes. Cross-sectional designs are used for population-based surveys and to assess the prevalence of diseases in clinic-based samples. These studies can usually be conducted relatively faster and are inexpensive. They may be conducted either before planning a cohort study or a baseline in a cohort study. These types of designs will give us information about the prevalence of outcomes or exposures; this information will be useful for designing the cohort study. However, since this is a 1-time measurement of exposure and outcome, it is difficult to derive causal relationships from cross-sectional analysis. We can estimate the prevalence of disease in cross-sectional studies. Furthermore, we will also be able to estimate the odds ratios to study the association between exposure and the outcomes in this design.

Methodology Series Module 3: Cross-sectional Studies

PubMed Central

Setia, Maninder Singh

2016-01-01

Cross-sectional study design is a type of observational study design. In a cross-sectional study, the investigator measures the outcome and the exposures in the study participants at the same time. Unlike in case–control studies (participants selected based on the outcome status) or cohort studies (participants selected based on the exposure status), the participants in a cross-sectional study are just selected based on the inclusion and exclusion criteria set for the study. Once the participants have been selected for the study, the investigator follows the study to assess the exposure and the outcomes. Cross-sectional designs are used for population-based surveys and to assess the prevalence of diseases in clinic-based samples. These studies can usually be conducted relatively faster and are inexpensive. They may be conducted either before planning a cohort study or a baseline in a cohort study. These types of designs will give us information about the prevalence of outcomes or exposures; this information will be useful for designing the cohort study. However, since this is a 1-time measurement of exposure and outcome, it is difficult to derive causal relationships from cross-sectional analysis. We can estimate the prevalence of disease in cross-sectional studies. Furthermore, we will also be able to estimate the odds ratios to study the association between exposure and the outcomes in this design. PMID:27293245

Contribution of jaw muscle size and craniofacial morphology to human bite force magnitude.

PubMed

Raadsheer, M C; van Eijden, T M; van Ginkel, F C; Prahl-Andersen, B

1999-01-01

The existence of an interaction among bite force magnitude, jaw muscle size (e.g., cross-sectional area, thickness), and craniofacial morphology is widely accepted. Bite force magnitude depends on the size of the jaw muscles and the lever arm lengths of bite force and muscle forces, which in turn are dictated by craniofacial morphology. In this study, the relative contributions of craniofacial morphology and jaw muscle thickness to the bite force magnitude were studied. In 121 adult individuals, both magnitude and direction of the maximal voluntary bite force were registered. Craniofacial dimensions were measured by anthropometrics and from lateral radiographs. The thicknesses of the masseter, temporal, and digastric muscles were registered by ultrasonography. After a factor analysis was applied to the anthropometric and cephalometric dimensions, the correlation between bite force magnitude, on the one hand, and the "craniofacial factors" and jaw muscle thicknesses, on the other, was assessed by stepwise multiple regression. Fifty-eight percent of the bite force variance could be explained. From the jaw muscles, only the thickness of the masseter muscle correlated significantly with bite force magnitude. Bite force magnitude also correlated significantly positively with vertical and transverse facial dimensions and the inclination of the midface, and significantly negatively with mandibular inclination and occlusal plane inclination. The contribution of the masseter muscle to the variation in bite force magnitude was higher than that of the craniofacial factors.

Hepatitis A Is a Health Hazard for Iranian Pilgrims Who Go to Holly Karbala: A Preliminary Report

PubMed Central

Ghasemian, Roya; Babamahmoodi, Farhang; Ahangarkani, Fatemeh

2016-01-01

Background Iraq is a highly endemic area for the prevalence of hepatitis A and annually hosts a large number of Iranian pilgrims, most of whom are susceptible to infection with the hepatitis A virus (HAV). Objectives This study reports the health hazard of hepatitis A for Iranian pilgrims who go to holly Karbala from the Mazandaran province. Patients and Methods In this cross-sectional study, the data of all patients with acute hepatitis A admitted in the Razi teaching hospital from November 23, 2014 to January 24, 2015, with a history of recently returning from holly Karbala or being exposed to Karbala pilgrims, were registered. Results A total number of nine patients were registered. Seven patients were male and two were female. The mean age was 30.11 ± 10.09.Two patients were from the same family. All patients had typical symptoms of acute hepatitis A. None of the patients died nor did fulminant occur in any patients. In addition, all patients were treated with supportive treatment and subsequently recovered. Conclusions This number of pilgrim patients with acute hepatitis A from a single province compels us to conduct more evaluations and follow up monitoring on all persons travelling to Karbala and be sensitive to early diagnoses of the pilgrims. In the future, it is important to be mindful of administering the HAV vaccine and Ig. PMID:27630729

Judicial demand of medications through the Federal Justice of the State of Paraná

PubMed Central

Nisihara, Renato Mitsunori; Possebom, Ana Carolina; Borges, Luiza de Martino Cruvinel; Shwetz, Ana Claudia Athanasio; Bettes, Fernanda Francis Benevides

2017-01-01

ABSTRACT Objective To describe the profile of lawsuits related to drug requests filled at the Federal Justice of the State of Paraná. Methods A cross-sectional study, and the data were obtained through consulting the lawsuits at the online system of the Federal Justice of Paraná. Results Out of 347 lawsuits included in the study, 55% of plaintiffs were women, with a median age of 56 years. Oncology was the field with more requests (23.6%), and the highest mean costs. A wide variety of diseases and broad variety of requested drugs were found in the lawsuits. Approximately two-thirds of them were requested by the brand name, and the most often requested drugs were palivizumab and tiotropium bromide. Only 14.5% of the requested medicines were registered in the National Medication Register. The Public Defender’s Office filled actions in 89.6% of cases and all lawsuits had an interim relief. The mean time for approval was 35 days and 70% of requests were granted. Conclusion Oncology was the field with the highest demand for medicines at the Federal Justice of Paraná in 2014. A great variety of medications was requested. The Public Defender´s Office represented most lawsuits. All demands had an interim relief, and the majority of requests were granted, within an average of 35 days. PMID:28444095

76 FR 69732 - Pesticide Products; Receipt of Applications To Register New Uses

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-09

... registered active ingredients, pursuant to the provisions of section 3(c) of the Federal Insecticide..., pursuant to section 3(c)(4) of FIFRA. DATES: Comments must be received on or before December 9, 2011... 3(c) of FIFRA, and is publishing this Notice of such applications pursuant to section 3(c)(4) of...

Attributes of nursing work environment as predictors of registered nurses' job satisfaction and intention to leave.

PubMed

Choi, Sandy Pin-Pin; Cheung, Kin; Pang, Samantha Mei-Che

2013-04-01

To examine how front-line registered nurses' perception of their work environment associates with and predicts nurse outcomes in terms of job satisfaction and turnover intention. Mounting evidence has pointed to an inseparable link between attributes of the nursing work environment and nurse outcomes. However, there is a paucity of research examining nurses' perception of their work environment beyond the Western context. This cross-sectional survey involved 1271 registered nurses working in 135 inpatient units in 10 public hospitals in Hong Kong. The instrument comprised items developed from in-depth interviews with front-line nurses that explored nurses' perception of their work environment. Factor analysis identified five dimensions (professionalism, co-worker relationship, management, staffing and resources, and ward practice) of the nursing work environment. Logistic regression analysis further identified professionalism, management and ward practice as significant factors in predicting nurses' turnover intention, and staffing and resources as an additional factor in predicting their job satisfaction. Attributes of the nursing work environment have a significant bearing on nurses' job satisfaction and intention to leave. Managerial effort should focus on improving nurses' work conditions through detailed resource planning, effective management and removal of work constraints that affect nursing practice. © 2012 Blackwell Publishing Ltd.

Changing prevalence of severe congenital heart disease: Results from the National Register for Congenital Heart Defects in Germany.

PubMed

Pfitzer, Constanze; Helm, Paul C; Ferentzi, Hannah; Rosenthal, Lisa-Maria; Bauer, Ulrike M M; Berger, Felix; Schmitt, Katharina R L

2017-12-01

To assess the prevalence of congenital heart disease (CHD) in Germany in relation to phenotypes, severity and gender. Cross-sectional registry study. We analyzed data from patients with CHD born between 1996 and 2015. A total of 26 630 patients, registered with the NRCHD, were born between 1996 and 2015. 10 927 patients were excluded from the current analysis due to prior registration with the NRCHD under the German PAN Prevalence Study, which showed a potential bias in the inclusion of this patient population (proportion of mild cardiac lesions was comparatively high due to improved diagnostic capability for earlier identifying minor lesions). At least 15 703 patients with demographic data and detailed medical information were included in the current study. None. Prevalence of CHD in Germany differentiated into gender, severity, and phenotype. In total, 15 703 patients with CHD (47.1% female) were included in this study. The five most common phenotypes were found to be ventricular septal defect (19.2%), atrial septal defect (13.0%), Tetralogy of Fallot (9.3%), univentricular heart (9.4%), and coractation of the aortae (7.0%). The prevalence of CHD in regard to severity changed over the duration of the observation period. From 1996 to 2007, the number of simple CHD rose steadily (P < .001), whereas the number of severe CHD has grown significantly since 2008/2009 (P < .001). In regard to gender, the prevalence of simple CHD was higher in females, whereas complex lesions were more common in males (P < .001). Our study shows a growing number of registered severe CHD in the recent decade in Germany. This development is noteworthy as it implicates a growing demand for first intensive hospital care, expert pediatric cardiologic aftercare, and consequently higher economic impact for this patient population. © 2017 Wiley Periodicals, Inc.

1 CFR 12.1 - Federal Register.

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17 CFR 49.19 - Core principles applicable to registered swap data repositories.

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2010-07-01

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10 CFR 76.37 - Federal Register notice.

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2014-01-01

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Ethical issues in palliative care for nursing homes: Development and testing of a survey instrument.

PubMed

Preshaw, Deborah Hl; McLaughlin, Dorry; Brazil, Kevin

2018-02-01

To develop and psychometrically assess a survey instrument identifying ethical issues during palliative care provision in nursing homes. Registered nurses and healthcare assistants have reported ethical issues in everyday palliative care provision. Identifying these issues provides evidence to inform practice development to support healthcare workers. Cross-sectional survey of Registered nurses and healthcare assistants in nursing homes in one region of the UK. A survey instrument, "Ethical issues in Palliative Care for Nursing homes", was developed through the findings of qualitative interviews with Registered nurses and healthcare assistants in nursing homes and a literature review. It was reviewed by an expert panel and piloted prior to implementation in a survey in 2015 with a convenience sample of 596 Registered nurses and healthcare assistants. Descriptive and exploratory factor analyses were used to assess the underlying structure of the Frequency and Distress Scales within the instrument. Analysis of 201 responses (response rate = 33.7%) revealed four factors for the Frequency Scale and five factors for the Distress Scale that comprise the Ethical issues in Palliative Care for Nursing homes. Factors common to both scales included "Processes of care," "Resident autonomy" and "Burdensome treatment." Additionally, the Frequency Scale included "Competency," and the Distress Scale included "Quality of care" and "Communication." The Ethical issues in Palliative Care for Nursing homes instrument has added to the palliative care knowledge base by considering the ethical issues experienced specifically by Registered nurses and healthcare assistants within the nursing home. This research offers preliminary evidence of the psychometric properties of the Ethical issues in Palliative Care for Nursing homes survey instrument. The two largest factors highlight the need to address the organisational aspects of caring and provide training in negotiating conflicting ethical principles. © 2017 John Wiley & Sons Ltd.

Learning styles of registered nurses enrolled in an online nursing program.

PubMed

Smith, Anita

2010-01-01

Technological advances assist in the proliferation of online nursing programs which meet the needs of the working nurse. Understanding online learning styles permits universities to adequately address the educational needs of the professional nurse returning for an advanced degree. The purpose of this study was to describe the learning styles of registered nurses (RNs) enrolled in an online master's nursing program or RN-bachelor of science in nursing (BSN) program. A descriptive, cross-sectional design was used. Kolb's learning style inventory (Version 3.1) was completed by 217 RNs enrolled in online courses at a Southeastern university. Descriptive statistical procedures were used for analysis. Thirty-one percent of the nurses were accommodators, 20% were assimilators, 19% were convergers, and 20% were divergers. Accommodators desire hand-on experiences, carrying out plans and tasks and using an intuitive trial-and-error approach to problem solving. The learning styles of the RNs were similar to the BSN students in traditional classroom settings. Despite their learning style, nurses felt that the online program met their needs. Implementing the technological innovations in nursing education requires the understanding of the hands-on learning of the RN so that the development of the online courses will satisfactorily meet the needs of the nurses who have chosen an online program. Copyright 2010 Elsevier Inc. All rights reserved.

The Nursing Performance Instrument: Exploratory and Confirmatory Factor Analyses in Registered Nurses.

PubMed

Sagherian, Knar; Steege, Linsey M; Geiger-Brown, Jeanne; Harrington, Donna

2018-04-01

The optimal performance of nurses in healthcare settings plays a critical role in care quality and patient safety. Despite this importance, few measures are provided in the literature that evaluate nursing performance as an independent construct from competencies. The nine-item Nursing Performance Instrument (NPI) was developed to fill this gap. The aim of this study was to examine and confirm the underlying factor structure of the NPI in registered nurses. The design was cross-sectional, using secondary data collected between February 2008 and April 2009 for the "Fatigue in Nursing Survey" (N = 797). The sample was predominantly dayshift female nurses working in acute care settings. Using Mplus software, exploratory and confirmatory factor analyses were applied to the NPI data, which were divided into two equal subsamples. Multiple fit indices were used to evaluate the fit of the alternative models. The three-factor model was determined to fit the data adequately. The factors that were labeled as "physical/mental decrements," "consistent practice," and "behavioral change" were moderately to strongly intercorrelated, indicating good convergent validity. The reliability coefficients for the subscales were acceptable. The NPI consists of three latent constructs. This instrument has the potentialto be used as a self-monitoring instrument that addressesnurses' perceptions of performance while providing patient care.

Health facility-based data on women receiving sulphadoxine-pyrimethamine during pregnancy in Tanzania: lessons to learn from a cross-sectional survey in Mkuranga and Mufindi districts and other national survey reports

PubMed Central

2014-01-01

Background A study of health facility (HF) data on women receiving sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria during pregnancy (IPTp) was carried out at antenatal care clinics in Mkuranga and Mufindi districts. Methods A review of health management information system (HMIS) registers, interviews with health-care workers (HWs) and district and national level malaria control program managers corroborated by inter-temporal assessment through observations at HF levels. Statistical data were analyzed in Excel and interpreted in triangulation with qualitative data from interviews and observations. Results Data indicated that IPTp doses administered to women were inadequate and partly inconsistent. HMIS registers lacked space for IPT records, forcing HWs to manipulate their record-keeping. The proportion/number of IPTp recipients in related to the supply of SP for free delivery, to women’s attendance behaviours, showed variation by quarter and year of reporting. Conclusion It is impossible to achieve rational health service planning when the HMIS is weak. Whilst it is acknowledged that the HMIS is already overloaded, concerted measures are urgently needed to accommodate data on new interventions and other vertical programs if malaria programs are to achieve their goals. PMID:24433529

Pain treatment and its cost in old people with dementia: a descriptive analysis from the Registry of Dementias of Girona (ReDeGi).

PubMed

Calvó-Perxas, Laia; López-Pousa, Secundino; Turró-Garriga, Oriol; de Eugenio, Rosa; Linares, Marta; Fernández, Maria Del Mar; Castellanos, Mar; Casas, Isabel; Turón-Estrada, Antoni; Casadevall, Teresa; Coromina, Joan; Vilalta-Franch, Joan; Garre-Olmo, Josep

2013-05-01

Pain prevalence is high among elderly people, and equally prevalent in those with dementia. The aim of this study was to describe the use analgesics, as well as the cost of these treatments in old people with dementia. We used a cross-sectional design using 1186 cases registered by the Registry of Dementias of Girona from 2007 to 2008. All drugs were categorized following the Anatomic Therapeutic Chemical classification and grouped according to the World Health Organization (WHO) analgesic ladder steps. Descriptive statistical methods were used. Analgesics were prescribed to 78.6% (95% CI, 76.2-81.0) of the registered cases. Of them, 80.6% (95% CI, 78.0-83.2) were treated following step 1 of the WHO analgesic ladder, 16.8% (95% CI, 14.4-19.3) following step 2 and 2.6% (95% CI, 1.5-3.6) following step 3. Pain treatment in old people with dementia had a cost of 42.1 € per patient and year, with no significant differences depending on the subtype of dementia. The use of analgesics in our sample was not associated to age or to dementia severity, which are themselves risk factors for increased pain. Moreover, no differences were detected depending on the subtype of dementia.

Prevalence and treatment of atherogenic dyslipidemia in the primary prevention of cardiovascular disease in Europe: EURIKA, a cross-sectional observational study.

PubMed

Halcox, Julian P; Banegas, José R; Roy, Carine; Dallongeville, Jean; De Backer, Guy; Guallar, Eliseo; Perk, Joep; Hajage, David; Henriksson, Karin M; Borghi, Claudio

2017-06-17

Atherogenic dyslipidemia is associated with poor cardiovascular outcomes, yet markers of this condition are often ignored in clinical practice. Here, we address a clear evidence gap by assessing the prevalence and treatment of two markers of atherogenic dyslipidemia: elevated triglyceride levels and low levels of high-density lipoprotein cholesterol. This cross-sectional observational study assessed the prevalence of two atherogenic dyslipidemia markers, high triglyceride levels and low high-density lipoprotein cholesterol levels, in the study population from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; N = 7641; of whom 51.6% were female and 95.6% were White/Caucasian). The EURIKA population included European patients, aged at least 50 years with at least one cardiovascular risk factor but no history of cardiovascular disease. Over 20% of patients from the EURIKA population have either triglyceride or high-density lipoprotein cholesterol levels characteristic of atherogenic dyslipidemia. Furthermore, the proportions of patients with one of these markers were higher in subpopulations with type 2 diabetes mellitus or those already calculated to be at high risk of cardiovascular disease. Approximately 55% of the EURIKA population who have markers of atherogenic dyslipidemia are not receiving lipid-lowering therapy. A considerable proportion of patients with at least one major cardiovascular risk factor in the primary cardiovascular disease prevention setting have markers of atherogenic dyslipidemia. The majority of these patients are not receiving optimal treatment, as specified in international guidelines, and thus their risk of developing cardiovascular disease is possibly underestimated. The present study is registered with ClinicalTrials.gov (ID: NCT00882336).

Osteoporosis knowledge and attitudes: a cross-sectional study among female nursing school students in Damascus.

PubMed

Sayed-Hassan, Rima; Bashour, Hyam; Koudsi, Abir

2013-01-01

This study was conducted to determine the level of osteoporosis knowledge and beliefs among nursing college students in Damascus. A worrying deficit of knowledge was found. They believed osteoporosis to be a serious disease but did not feel susceptible to or concerned about it. Innovative educational interventions should be considered. Increasing awareness, knowledge, and promoting healthy behaviors about osteoporosis and related risk factors are effective prevention measures for building and maintaining strong bone throughout the life-span. We hypothesized a lack of knowledge and unhealthy beliefs about osteoporosis among young women in our setting. The level of osteoporosis knowledge, beliefs, and behavior among nursing college students in Damascus was evaluated in this study. A cross-sectional study was conducted on a convenience sample of female young students seen at the nursing school. All students registered for the year 2011-2012 were included in the study. A self-administered questionnaire was implemented. The questionnaire included background information and both osteoporosis-related tools (Arabic version), namely the Osteoporosis Knowledge Assessment Tool (OKAT) and the Osteoporosis Health Belief Scale. A total of 353 female students answered the questionnaire with a response rate of 98.3%. A worrying deficit of knowledge was found among surveyed Syrian young adult females with a total mean score of 7.9 (2.7) out of possible 20 points, being 39.6% of possible maximum score on the OKAT. Those young women believed osteoporosis to be a serious disease but did not feel susceptible to or concerned about the illness. Perceived moderate to high barriers to exercises and calcium intake indicated negative health beliefs. The findings generally reveal poor knowledge about osteoporosis among nursing school female students at Damascus. Integration of osteoporosis in school curricula and public education efforts is urgently needed.

Nurses' knowledge of foot care in the context of home care: a cross-sectional correlational survey study.

PubMed

Stolt, Minna; Suhonen, Riitta; Puukka, Pauli; Viitanen, Matti; Voutilainen, Päivi; Leino-Kilpi, Helena

2015-10-01

This study aimed to explore nurses' knowledge of foot care and related factors in home care nursing. Nurses caring for older people are increasingly confronted with clients who have multiple foot problems and need support with their foot health. The role of nurses in promoting foot health, caring for existing foot problems and supporting older people in foot self-care is especially important in the home care context. However, this entails up-to-date foot care knowledge and practices. A cross-sectional correlational survey study design. Nurses' knowledge of foot care was evaluated using the Nurses' Foot Care Knowledge Test developed for this study. The data were analysed with descriptive and inferential statistics. Nurses (registered nurses, public health nurses and licensed practical nurses) from public home care (n = 322, response rate 50%) participated the study. Nurses' knowledge in foot care varied. The knowledge scores were highest for skin and nail care and lowest for the identification and care of foot structural deformities. Longer working experience in the current work place and participation in continuing education explained higher Nurses' Foot Care Knowledge Test scores. Nurses need more knowledge, and hence continuing education, in the foot care of older people to effectively prevent, recognise and care for foot problems and promote independent living in the community. Nurses' have clinically relevant knowledge gaps. Therefore, foot care knowledge of nurses needs to be improved by continuing education in clinical settings. Adequate foot care knowledge among nurses is important to identify, prevent and care foot problems especially in older people. © 2015 John Wiley & Sons Ltd.

Heart failure in nursing home residents; a cross-sectional study to determine the prevalence and clinical characteristics.

PubMed

Daamen, Mariëlle A M J; Hamers, Jan P H; Gorgels, Anton P M; Brunner-La Rocca, Hans-Peter; Tan, Frans E S; van Dieijen-Visser, Marja P; Schols, Jos M G A

2015-12-16

Heart failure (HF) is expected to be highly prevalent in nursing home residents, but precise figures are scarce. The aim of this study was to determine the prevalence of HF in nursing home residents and to get insight in the clinical characteristics of residents with HF. The study followed a multi-centre cross-sectional design. Nursing home residents (n = 501) in the southern part of the Netherlands aged over 65 years and receiving long-term somatic or psychogeriatric care were included in the study. The diagnosis of HF and related characteristics were based on data collected from actual clinical examinations (including history, physical examination, ECG, cardiac markers and echocardiography), patient records and questionnaires. A panel of two cardiologists and a geriatrician ultimately judged the data to diagnose HF. The overall prevalence of HF in nursing home residents was 33 %, of which 52 % had HF with preserved ejection fraction. The symptoms dyspnoea and oedema and a cardiac history were more common in residents with HF. Diabetes mellitus, chronic obstructive pulmonary disease (COPD) were also more prevalent in those with HF. Residents with HF had a higher score on the Mini Mental State Examination. 54 % of those with HF where not known before, and in 31 % with a history of HF, this diagnosis was not confirmed by the expert panel. This study shows that HF is highly prevalent in nursing home residents with many unknown or falsely diagnosed with HF. Equal number of HF patients had reduced and preserved left-ventricular ejection fraction. The Netherlands National Trial Register NTR2663 (27-12-2010).

Work-related psychosocial risk factors and mental health problems amongst nurses at a university hospital in Estonia: a cross-sectional study.

PubMed

Freimann, Tiina; Merisalu, Eda

2015-07-01

Rapid changes in the Estonian health care system have placed extra pressure on the nursing profession, but the potential impacts of psychosocial changes have not been investigated. We aimed to explore the work-related psychosocial risk factors and their relationships with mental health problems (MHPs) amongst nurses at the university hospital in Estonia. A cross-sectional survey was undertaken amongst registered nurses at Tartu University Hospital (TUH). Psychosocial work factors and MHPs (stress, somatic symptoms, depressive symptoms and burnout) were measured using version two of the Copenhagen Psychosocial Questionnaire (COPSOQ II). Descriptive statistics and Pearson's r correlation with sequential Bonferroni correction were used to analyse the data. The analysis was based on 404 nurses (45% of the full-time working population of nurses). The highest mean scores recorded for the positive work-related psychosocial factors studied were meaning of work, role clarity, social relationships and mutual trust between employees. The highest scores for the negative factors studied were the demands for hiding emotions, work pace, cognitive and emotional demands. Stress and burnout showed the highest mean scores amongst the MHPs. Quantitative and emotional demands were positively related to all of the studied MHPs, while work pace and role conflicts had a positive correlation with stress and burnout. All of the studied negative psychosocial factors were significantly correlated with burnout. work-related psychosocial risk factors such as quantitative demands work load, emotional demands, work pace and role conflicts, had significant positive relationships with MHPS in nurses in Estonia, and may contribute to high levels of stress as well as burnout amongst nurses: . © 2015 the Nordic Societies of Public Health.

What is the degree of innovation routinely implemented in Dutch radiotherapy centres? A multicentre cross-sectional study

PubMed Central

Boersma, Liesbeth; Dekker, Andre; Bosmans, Geert; van Merode, Frits; Verhaegen, Frank; de Ruysscher, Dirk; Swart, Rachelle; Kengen, Cindy; Lambin, Philippe

2016-01-01

Objective: To study the implementation of innovation activities in Dutch radiotherapy (RT) centres in a broad sense (product, technological, market and organizational innovations). Methods: A descriptive cross-sectional study was conducted in 15 Dutch RT centres. A list of innovations implemented from 2011 to 2013 was drawn up for each centre using semi-structured interviews. These innovations were classified into innovation categories according to previously defined innovation indicators. Where applicable, each innovation was rated by each centre on the effort required to implement it and on its expected effects, to get an impression of how far reaching and radical the innovations were and to be able to compare the number of innovations between centres. Results: The participating RT centres in the Netherlands implemented 12 innovations per year on average (range 5–25); this number was not significantly different for academic (n = 13) or non-academic centres (n = 10). Several centres were dealing with the same innovations at the same time. The average required effort and expected output did not differ significantly between product, technological and organizational innovation or between academic and non-academic centres. Conclusion: The number of innovations observed per centre varied across a large range, with a large overlap in terms of the type of innovations that were implemented. Registering innovations using the innovation indicators applied in our study would make it possible to improve collaboration between centres, e.g. with common training modules, to avoid duplication of work. Advances in knowledge: This study is the first of its kind investigating innovation implementation in RT in a broad sense. PMID:27660890

Discrepancies between ClinicalTrials.gov recruitment status and actual trial status: a cross-sectional analysis.

PubMed

Jones, Christopher W; Safferman, Michelle R; Adams, Amanda C; Platts-Mills, Timothy F

2017-10-11

To determine the accuracy of the recruitment status listed on ClinicalTrials.gov as compared with the actual trial status. Cross-sectional analysis. Random sample of interventional phase 2-4 clinical trials registered between 2010 and 2012 on ClinicalTrials.gov. For each trial which was listed within ClinicalTrials.gov as ongoing, two investigators performed a comprehensive literature search for evidence that the trial had actually been completed. For each trial listed as completed or terminated early by ClinicalTrials.gov, we compared the date that the trial was actually concluded with the date the registry was updated to reflect the study's conclusion status. Among the 405 included trials, 92 had a registry status indicating that study activity was either ongoing or the recruitment status was unknown. Of these, published results were available for 34 (37%). Among the 313 concluded trials, the median delay between study completion and a registry update reflecting that the study had ended was 141 days (IQR 48-419), with delays of over 1 year present for 29%. In total, 125 trials (31%) either had a listed recruitment status which was incorrect or had a delay of more than 1 year between the time the study was concluded and the time the registry recruitment status was updated. At present, registry recruitment status information in ClinicalTrials.gov is often outdated or wrong. This inaccuracy has implications for the ability of researchers to identify completed trials and accurately characterise all available medical knowledge on a given subject. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Health-related quality of life in Asian patients with breast cancer: a systematic review

PubMed Central

Gernaat, Sofie A M; Hartman, Mikael

2018-01-01

Objective To summarise the evidence on determinants of health-related quality of life (HRQL) in Asian patients with breast cancer. Design Systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and registered with PROSPERO (CRD42015032468). Methods According to the PRISMA guidelines, databases of MEDLINE (PubMed), Embase and PsycINFO were systematically searched using the following terms and synonyms: breast cancer, quality of life and Asia. Articles reporting on HRQL using EORTC-QLQ-C30, EORTC-QLQ-BR23, FACT-G and FACT-B questionnaires in Asian patients with breast cancer were eligible for inclusion. The methodological quality of each article was assessed using the quality assessment scale for cross-sectional studies or the Newcastle-Ottawa Quality Assessment Scale for cohort studies. Results Fifty-seven articles were selected for this qualitative synthesis, of which 43 (75%) were cross-sectional and 14 (25%) were longitudinal studies. Over 75 different determinants of HRQL were studied with either the EORTC or FACT questionnaires. Patients with comorbidities, treated with chemotherapy, with less social support and with more unmet needs have poorer HRQL. HRQL improves over time. Discordant results in studies were found in the association of age, marital status, household income, type of surgery, radiotherapy and hormone therapy and unmet sexuality needs with poor global health status or overall well-being. Conclusions In Asia, patients with breast cancer, in particular those with other comorbidities and those treated with chemotherapy, with less social support and with more unmet needs, have poorer HRQL. Appropriate social support and meeting the needs of patients may improve patients’ HRQL. PMID:29678980

Which anthropometric measures best indicate type 2 diabetes among Russian, Somali and Kurdish origin migrants in Finland? A cross-sectional study.

PubMed

Skogberg, Natalia; Laatikainen, Tiina; Lundqvist, Annamari; Lilja, Eero; Härkänen, Tommi; Koponen, Päivikki

2018-05-17

To compare the performance of body mass index (BMI), waist-to-height ratio (WHtR), waist circumference (WC) and waist-to-hip ratio (WHR) in detecting type 2 diabetes among Russian, Somali and Kurdish (born in Iraq/Iran) origin migrants and Finns. Cross-sectional study comparing health examination survey data of Russian, Somali and Kurdish origin migrants (n=917) aged 30-64 years who took part in the Migrant Health and Wellbeing Survey with the general Finnish population in the Health 2011 Survey (n=887). Participants were randomly selected from the National Population Register. Six cities in Finland, where a substantial majority of migrants live. Anthropometric measures included objectively measured BMI, WHtR, WC and WHR. Type 2 diabetes was defined based on self-report, laboratory measures of glycated haemoglobin and register data. Test performance was assessed using receiver operating characteristics curves, using area under the curve (AUC) as a measure of accuracy. Among Finns, test performance was highest for WC (AUC=0.81, 95% CI 0.74 to 0.87) and WHtR (AUC=0.81, 95% CI 0.75 to 0.87). Test performance was similar for BMI (AUC=0.80, 95% CI 0.67 to 0.92), WC (AUC=0.79, 95% CI 0.67 to 0.91) and WHtR (AUC=0.70, 95% CI 0.66 to 0.93) among Russians. WC and WHtR had highest test performance also among Somali (AUC=0.74, 95% CI 0.64 to 0.84 for WC and AUC=0.75, 95% CI 0.65 to 0.85 for WHtR) and Kurds (AUC=0.71, 95% CI 0.61 to 0.81 for WC and AUC=0.70, 95% CI 0.59 to 0.80 for WHtR).Among migrants, WHR had the poorest test performance. WC and WHtR performed overall the best across all study groups, however, accuracy of detection was lower particularly among Somali and Kurds. Currently used diabetes risk assessment tools assume a strong association between anthropometrics and diabetes. These tools need to be validated among non-Western populations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Which anthropometric measures best indicate type 2 diabetes among Russian, Somali and Kurdish origin migrants in Finland? A cross-sectional study

PubMed Central

Laatikainen, Tiina; Lundqvist, Annamari; Lilja, Eero; Härkänen, Tommi; Koponen, Päivikki

2018-01-01

Objectives To compare the performance of body mass index (BMI), waist-to-height ratio (WHtR), waist circumference (WC) and waist-to-hip ratio (WHR) in detecting type 2 diabetes among Russian, Somali and Kurdish (born in Iraq/Iran) origin migrants and Finns. Design and participants Cross-sectional study comparing health examination survey data of Russian, Somali and Kurdish origin migrants (n=917) aged 30–64 years who took part in the Migrant Health and Wellbeing Survey with the general Finnish population in the Health 2011 Survey (n=887). Participants were randomly selected from the National Population Register. Setting Six cities in Finland, where a substantial majority of migrants live. Outcome measures Anthropometric measures included objectively measured BMI, WHtR, WC and WHR. Type 2 diabetes was defined based on self-report, laboratory measures of glycated haemoglobin and register data. Test performance was assessed using receiver operating characteristics curves, using area under the curve (AUC) as a measure of accuracy. Results Among Finns, test performance was highest for WC (AUC=0.81, 95% CI 0.74 to 0.87) and WHtR (AUC=0.81, 95% CI 0.75 to 0.87). Test performance was similar for BMI (AUC=0.80, 95% CI 0.67 to 0.92), WC (AUC=0.79, 95% CI 0.67 to 0.91) and WHtR (AUC=0.70, 95% CI 0.66 to 0.93) among Russians. WC and WHtR had highest test performance also among Somali (AUC=0.74, 95% CI 0.64 to 0.84 for WC and AUC=0.75, 95% CI 0.65 to 0.85 for WHtR) and Kurds (AUC=0.71, 95% CI 0.61 to 0.81 for WC and AUC=0.70, 95% CI 0.59 to 0.80 for WHtR). Among migrants, WHR had the poorest test performance. Conclusion WC and WHtR performed overall the best across all study groups, however, accuracy of detection was lower particularly among Somali and Kurds. Currently used diabetes risk assessment tools assume a strong association between anthropometrics and diabetes. These tools need to be validated among non-Western populations. PMID:29773697

75 FR 75207 - Regulation SBSR-Reporting and Dissemination of Security-Based Swap Information

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-02

...In accordance with Section 763 (``Section 763'') and Section 766 (``Section 766'') of Title VII (``Title VII'') of the Dodd-Frank Wall Street Reform and Consumer Protection Act (the ``Dodd-Frank Act''), the Securities and Exchange Commission (``SEC'' or ``Commission'') is proposing Regulation SBSR--Reporting and Dissemination of Security-Based Swap Information (``Regulation SBSR'') under the Securities Exchange Act of 1934 (``Exchange Act'').\\1\\ Proposed Regulation SBSR would provide for the reporting of security- based swap information to registered security-based swap data repositories or the Commission and the public dissemination of security-based swap transaction, volume, and pricing information. Registered security-based swap data repositories would be required to establish and maintain certain policies and procedures regarding how transaction data are reported and disseminated, and participants of registered security-based swap data repositories that are security- based swap dealers or major security-based swap participants would be required to establish and maintain policies and procedures that are reasonably designed to ensure that they comply with applicable reporting obligations. Finally, proposed Regulation SBSR also would require a registered SDR to register with the Commission as a securities information processor on existing Form SIP. ---------------------------------------------------------------------------

75 FR 51328 - Agency Information Collection Activities: Request for Comments for a New Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

... National Transportation Systems Center (Volpe Center) have designed the survey and will submit the survey... Phase 2 Implementation Study Survey. The Federal Register notice with a 60-day public comment period...-LU Section 6009 Phase 2 Implementation Study Survey. Background: Section 6009 of the Safe...

Perceived Sexual Difficulties and Sexual Counseling in Men and Women Across Heart Diagnoses: A Nationwide Cross-Sectional Study.

PubMed

Rundblad, Lucas; Zwisler, Ann Dorthe; Johansen, Pernille Palm; Holmberg, Teresa; Schneekloth, Nanna; Giraldi, Annamaria

2017-06-01

Ischemic heart disease and heart failure often lead to sexual difficulties in men, but little is known about the sexual difficulties in women and patients with other heart diagnoses or the level of information patients receive about the risk of sexual difficulties. To investigate perceived sexual difficulties and associated factors in a mixed population of men and women newly diagnosed with heart disease and provide insight into sexual counseling and information given by health care professionals. This article reports on a cross-sectional, questionnaire study sent to a randomly selected sample of men and women newly diagnosed with heart failure, ischemic heart disease, atrial fibrillation, or heart valve surgery. Eligible patients were identified by diagnosis using the Danish National Patient Register, which contains all diagnoses. Sexual difficulties were self-reported using single-item questions, and factors associated with sexual difficulties were collected from the survey and national registers. The study population consisted of 1,549 men and 807 women (35-98 years old) with heart failure (n = 243), ischemic heart disease (n = 1,036), heart valve surgery (n = 375), and atrial fibrillation (n = 702). Sexual difficulties were reported by 55% of men and 29% of women. In a multiple regression analysis, difficulties in men were associated with being older (≥75 years old; odds ratio [OR] = 1.97, 95% CI = 1.13-3.43), having heart failure (OR = 2.07, 95% CI = 1.16-3.71), diabetes (OR = 1.80, 95% CI = 1.15-2.82), hypertension (OR = 1.43, 95% CI = 1.06-1.93), receiving β-blockers (OR = 1.37, 95% CI = 1.02-1.86), or having anxiety (OR = 2.25, 95% CI = 1.34-3.80) or depression (OR = 2.74, 95% CI = 1.38-5.43). In women, difficulties were significantly associated with anxiety (OR = 3.00, 95% CI = 1.51-5.95). A total of 48.6% of men and 58.8% of women did not feel informed about sexuality, and 18.1% of men and 10.3% of women were offered sexual counseling. Heart disease increases the risk of sexual difficulties and there is a need for improved information and counseling about sex and relationships for patients. This large nationwide survey of men and women combined a survey with administrative data from national registries. However, this study used non-validated single-item questions to assess sexual difficulties without addressing sexual distress. More than half the men and one fourth the women across common heart diagnoses had sexual difficulties. No difference was found among diagnoses, except heart failure in men. Despite guidelines recommending sexual counseling, sexual difficulties were not met by sufficient information and counseling. Rundblad L, Zwisler AD, Johansen PP, et al. Perceived Sexual Difficulties and Sexual Counseling in Men and Women Across Heart Diagnoses: A Nationwide Cross-Sectional Study. J Sex Med 2017;14:785-796. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

20 CFR 655.1116 - Element VI-What notification must facilities provide to registered nurses?

Code of Federal Regulations, 2010 CFR

2010-04-01

... provide to registered nurses? 655.1116 Section 655.1116 Employees' Benefits EMPLOYMENT AND TRAINING... Requirements Must a Facility Meet to Employ H-1C Nonimmigrant Workers as Registered Nurses? § 655.1116 Element VI—What notification must facilities provide to registered nurses? (a) The sixth attestation element...

20 CFR 655.1116 - Element VI-What notification must facilities provide to registered nurses?

Code of Federal Regulations, 2011 CFR

2011-04-01

... provide to registered nurses? 655.1116 Section 655.1116 Employees' Benefits EMPLOYMENT AND TRAINING... Requirements Must a Facility Meet to Employ H-1C Nonimmigrant Workers as Registered Nurses? § 655.1116 Element VI—What notification must facilities provide to registered nurses? (a) The sixth attestation element...

17 CFR 270.17f-2 - Custody of investments by registered management investment company.

Code of Federal Regulations, 2010 CFR

2010-04-01

... registered management investment company. 270.17f-2 Section 270.17f-2 Commodity and Securities Exchanges....17f-2 Custody of investments by registered management investment company. (a) The securities and similar investments of a registered management investment company may be maintained in the custody of such...

17 CFR 274.130 - Form N-Q, quarterly schedule of portfolio holdings of registered management investment company.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of portfolio holdings of registered management investment company. 274.130 Section 274.130 Commodity... INVESTMENT COMPANY ACT OF 1940 Forms for Reports § 274.130 Form N-Q, quarterly schedule of portfolio holdings of registered management investment company. This form shall be used by registered management...

1 CFR 5.2 - Documents required to be filed for public inspection and published.

Code of Federal Regulations, 2010 CFR

2010-01-01

... inspection and published. 5.2 Section 5.2 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.2 Documents required to be filed for public inspection and published... Register and published in the Federal Register: (a) Presidential proclamations and Executive orders in the...

31 CFR 538.319 - U.S. registered money transmitter.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false U.S. registered money transmitter. 538.319 Section 538.319 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... Definitions § 538.319 U.S. registered money transmitter. The term U.S. registered money transmitter means any...

31 CFR 538.319 - U.S. registered money transmitter.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false U.S. registered money transmitter. 538.319 Section 538.319 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... Definitions § 538.319 U.S. registered money transmitter. The term U.S. registered money transmitter means any...

31 CFR 538.319 - U.S. registered money transmitter.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false U.S. registered money transmitter. 538.319 Section 538.319 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... Definitions § 538.319 U.S. registered money transmitter. The term U.S. registered money transmitter means any...

31 CFR 538.319 - U.S. registered money transmitter.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false U.S. registered money transmitter. 538.319 Section 538.319 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... Definitions § 538.319 U.S. registered money transmitter. The term U.S. registered money transmitter means any...

31 CFR 542.323 - U.S. registered money transmitter.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false U.S. registered money transmitter. 542.323 Section 542.323 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... Definitions § 542.323 U.S. registered money transmitter. The term U.S. registered money transmitter means any...

31 CFR 537.323 - U.S. registered money transmitter.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false U.S. registered money transmitter. 537.323 Section 537.323 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... Definitions § 537.323 U.S. registered money transmitter. The term U.S. registered money transmitter means any...

31 CFR 537.323 - U.S. registered money transmitter.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false U.S. registered money transmitter. 537.323 Section 537.323 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... Definitions § 537.323 U.S. registered money transmitter. The term U.S. registered money transmitter means any...

31 CFR 537.323 - U.S. registered money transmitter.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false U.S. registered money transmitter. 537.323 Section 537.323 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... Definitions § 537.323 U.S. registered money transmitter. The term U.S. registered money transmitter means any...

31 CFR 537.323 - U.S. registered money transmitter.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false U.S. registered money transmitter. 537.323 Section 537.323 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... Definitions § 537.323 U.S. registered money transmitter. The term U.S. registered money transmitter means any...

28 CFR 3.3 - Registration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Registration. 3.3 Section 3.3 Judicial Administration DEPARTMENT OF JUSTICE GAMBLING DEVICES § 3.3 Registration. Persons required to register pursuant to section 3 of the Act shall register with the Assistant Attorney General, Criminal Division...

28 CFR 3.3 - Registration.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Registration. 3.3 Section 3.3 Judicial Administration DEPARTMENT OF JUSTICE GAMBLING DEVICES § 3.3 Registration. Persons required to register pursuant to section 3 of the Act shall register with the Assistant Attorney General, Criminal Division...

28 CFR 3.3 - Registration.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Registration. 3.3 Section 3.3 Judicial Administration DEPARTMENT OF JUSTICE GAMBLING DEVICES § 3.3 Registration. Persons required to register pursuant to section 3 of the Act shall register with the Assistant Attorney General, Criminal Division...

28 CFR 3.3 - Registration.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Registration. 3.3 Section 3.3 Judicial Administration DEPARTMENT OF JUSTICE GAMBLING DEVICES § 3.3 Registration. Persons required to register pursuant to section 3 of the Act shall register with the Assistant Attorney General, Criminal Division...

28 CFR 3.3 - Registration.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Registration. 3.3 Section 3.3 Judicial Administration DEPARTMENT OF JUSTICE GAMBLING DEVICES § 3.3 Registration. Persons required to register pursuant to section 3 of the Act shall register with the Assistant Attorney General, Criminal Division...

Strong correlations between empathy, emotional intelligence, and personality traits among podiatric medical students: A cross-sectional study.

PubMed

Bertram, Kurtis; Randazzo, John; Alabi, Nathaniel; Levenson, Jack; Doucette, John T; Barbosa, Peter

2016-01-01

The ability of health-care providers to demonstrate empathy toward their patients results in a number of positive outcomes improving the quality of care. In addition, a provider's level of emotional intelligence (EI) can further the doctor-patient relationship, stimulating a more personalized and comprehensive manner of treating patients. Furthermore, personality traits of a clinician may positively or negatively influence that relationship, as well as clinical outcomes. This study was designed to evaluate empathy levels in podiatric medical students in a 4-year doctoral program. Moreover, this study aimed to determine whether EI, personality traits, and demographic variables exhibit correlations with the observed empathy patterns. This cross-sectional study collected data using an anonymous web-based survey completed by 150 students registered at the New York College of Podiatric Medicine. There were four survey sections: (1) demographics, (2) empathy (measured by the Jefferson Scale of Physicians' Empathy), (3) EI (measured by the Assessing Emotions Scale), and (4) personality traits (measured by the NEO-Five-Factor Inventory-3). Empathy levels were significantly correlated with EI scores (r = 0.62, n = 150, P< 0.0001). All the five domains of personality were also shown to correlate with empathy scores, as well as with EI scores. With respect to demographics, Asian-American students had lower mean empathy scores than students of other races (P = 0.0018), females had higher mean empathy scores compared to men (P = 0.001), and undergraduate grade point average correlated with empathy scores in a nonmonotonic fashion (P = 0.0269). When measuring the variables, it was evident that there was a strong correlation between empathy, EI, and personality in podiatric medical students. Given the suggested importance and effect of such qualities on patient care, these findings may serve as guidance for possible amendments and warranted curriculum initiatives in medical education.

Augmented Cross-Sectional Studies with Abbreviated Follow-up for Estimating HIV Incidence

PubMed Central

Claggett, B.; Lagakos, S.W.; Wang, R.

2011-01-01

Summary Cross-sectional HIV incidence estimation based on a sensitive and less-sensitive test offers great advantages over the traditional cohort study. However, its use has been limited due to concerns about the false negative rate of the less-sensitive test, reflecting the phenomenon that some subjects may remain negative permanently on the less-sensitive test. Wang and Lagakos (2010) propose an augmented cross-sectional design which provides one way to estimate the size of the infected population who remain negative permanently and subsequently incorporate this information in the cross-sectional incidence estimator. In an augmented cross-sectional study, subjects who test negative on the less-sensitive test in the cross-sectional survey are followed forward for transition into the nonrecent state, at which time they would test positive on the less-sensitive test. However, considerable uncertainty exists regarding the appropriate length of follow-up and the size of the infected population who remain nonreactive permanently to the less-sensitive test. In this paper, we assess the impact of varying follow-up time on the resulting incidence estimators from an augmented cross-sectional study, evaluate the robustness of cross-sectional estimators to assumptions about the existence and the size of the subpopulation who will remain negative permanently, and propose a new estimator based on abbreviated follow-up time (AF). Compared to the original estimator from an augmented cross-sectional study, the AF Estimator allows shorter follow-up time and does not require estimation of the mean window period, defined as the average time between detectability of HIV infection with the sensitive and less-sensitive tests. It is shown to perform well in a wide range of settings. We discuss when the AF Estimator would be expected to perform well and offer design considerations for an augmented cross-sectional study with abbreviated follow-up. PMID:21668904

Augmented cross-sectional studies with abbreviated follow-up for estimating HIV incidence.

PubMed

Claggett, B; Lagakos, S W; Wang, R

2012-03-01

Cross-sectional HIV incidence estimation based on a sensitive and less-sensitive test offers great advantages over the traditional cohort study. However, its use has been limited due to concerns about the false negative rate of the less-sensitive test, reflecting the phenomenon that some subjects may remain negative permanently on the less-sensitive test. Wang and Lagakos (2010, Biometrics 66, 864-874) propose an augmented cross-sectional design that provides one way to estimate the size of the infected population who remain negative permanently and subsequently incorporate this information in the cross-sectional incidence estimator. In an augmented cross-sectional study, subjects who test negative on the less-sensitive test in the cross-sectional survey are followed forward for transition into the nonrecent state, at which time they would test positive on the less-sensitive test. However, considerable uncertainty exists regarding the appropriate length of follow-up and the size of the infected population who remain nonreactive permanently to the less-sensitive test. In this article, we assess the impact of varying follow-up time on the resulting incidence estimators from an augmented cross-sectional study, evaluate the robustness of cross-sectional estimators to assumptions about the existence and the size of the subpopulation who will remain negative permanently, and propose a new estimator based on abbreviated follow-up time (AF). Compared to the original estimator from an augmented cross-sectional study, the AF estimator allows shorter follow-up time and does not require estimation of the mean window period, defined as the average time between detectability of HIV infection with the sensitive and less-sensitive tests. It is shown to perform well in a wide range of settings. We discuss when the AF estimator would be expected to perform well and offer design considerations for an augmented cross-sectional study with abbreviated follow-up. © 2011, The International Biometric Society.

76 FR 24020 - Cross-Media Electronic Reporting: Authorized Program Revision Approval, State of Illinois

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9293-7] Cross-Media Electronic Reporting: Authorized Program Revision Approval, State of Illinois AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY... final Cross-Media Electronic Reporting Rule (CROMERR) was published in the Federal Register (70 FR 59848...

Positron induced scattering cross sections for hydrocarbons relevant to plasma

NASA Astrophysics Data System (ADS)

Singh, Suvam; Antony, Bobby

2018-05-01

This article explores positron scattering cross sections by simple hydrocarbons such as ethane, ethene, ethyne, propane, and propyne. Chemical erosion processes occurring on the surface due to plasma-wall interactions are an abundant source of hydrocarbon molecules which contaminate the hydrogenic plasma. These hydrocarbons play an important role in the edge plasma region of Tokamak and ITER. In addition to this, they are also one of the major components in the planetary atmospheres and astrophysical mediums. The present work focuses on calculation of different positron impact interactions with simple hydrocarbons in terms of the total cross section (Qtot), elastic cross section (Qel), direct ionization cross section (Qion), positronium formation cross section (Qps), and total ionization cross section (Qtion). Knowing that the positron-plasma study is one of the trending fields, the calculated data have diverse plasma and astrophysical modeling applications. A comprehensive study of Qtot has been provided where the inelastic cross sections have been reported for the first time. Comparisons are made with those available from the literature, and a good agreement is obtained with the measurements.

A Cross-sectional population-based investigation into behavioral change in amyotrophic lateral sclerosis: subphenotypes, staging, cognitive predictors, and survival.

PubMed

Burke, Tom; Pinto-Grau, Marta; Lonergan, Katie; Bede, Peter; O'Sullivan, Meabhdh; Heverin, Mark; Vajda, Alice; McLaughlin, Russell L; Pender, Niall; Hardiman, Orla

2017-05-01

Amyotrophic Lateral Sclerosis (ALS) is a clinically heterogeneous neurodegenerative disorder associated with cognitive and behavioral impairment. The primary aim of this study was to identify behavioral subphenotypes in ALS using a custom designed behavioral assessment tool (Beaumont Behavioural Inventory, BBI). Secondary aims were to (1) investigate the predictive nature of cognitive assessment on behavioral change, (2) report the behavioral profile associated with the C9 orf 72 expansion, (3) categorize behavioral change through disease staging, and (4) to investigate the relationship between cross-sectional behavioral classification and survival. A cross-sectional population-based research design was applied to examine behavioral data from ALS patients ( n  = 317) and healthy controls ( n  = 66). Patients were screened for the C9orf72 repeat expansion. A subcohort of ALS patients completed an extensive cognitive assessment battery ( n  = 65), to investigate predictors of behavior change. Principal component analysis (PCA) determined factors associated with altered behavior. Survival data were extracted from the Irish ALS register. No behavioral changes were reported in 180 patients (57%); 95 patients had mild-moderate behavioral change (30%); 42 patients met the cut-off for Clinically Severe Behavioral Change (13%), suggestive of a bvFTD diagnosis. The most frequently endorsed behaviors in ALS were reduced concern for hygiene (36.8%), irritability (36.2%), new unusual habits (33.4%), and increased apathy (31.1%). Five independent factors were identified through factor analysis. Social cognitive performance was predictive of behavior change ( P  = 0.031), yielding an R 2  = 0.188. Behavioral categorization (mild/moderate/severe) at the time of assessment was not associated with survival ( P  = 0.198). These data imply the presence of distinct subphenotypes of behavioral change in ALS, which most likely reflect subcategories of extramotor network disruption.

How to Use Benchmark and Cross-section Studies to Improve Data Libraries and Models

NASA Astrophysics Data System (ADS)

Wagner, V.; Suchopár, M.; Vrzalová, J.; Chudoba, P.; Svoboda, O.; Tichý, P.; Krása, A.; Majerle, M.; Kugler, A.; Adam, J.; Baldin, A.; Furman, W.; Kadykov, M.; Solnyshkin, A.; Tsoupko-Sitnikov, S.; Tyutyunikov, S.; Vladimirovna, N.; Závorka, L.

2016-06-01

Improvements of the Monte Carlo transport codes and cross-section libraries are very important steps towards usage of the accelerator-driven transmutation systems. We have conducted a lot of benchmark experiments with different set-ups consisting of lead, natural uranium and moderator irradiated by relativistic protons and deuterons within framework of the collaboration “Energy and Transmutation of Radioactive Waste”. Unfortunately, the knowledge of the total or partial cross-sections of important reactions is insufficient. Due to this reason we have started extensive studies of different reaction cross-sections. We measure cross-sections of important neutron reactions by means of the quasi-monoenergetic neutron sources based on the cyclotrons at Nuclear Physics Institute in Řež and at The Svedberg Laboratory in Uppsala. Measurements of partial cross-sections of relativistic deuteron reactions were the second direction of our studies. The new results obtained during last years will be shown. Possible use of these data for improvement of libraries, models and benchmark studies will be discussed.

Competency measurements: testing convergent validity for two measures.

PubMed

Cowin, Leanne S; Hengstberger-Sims, Cecily; Eagar, Sandy C; Gregory, Linda; Andrew, Sharon; Rolley, John

2008-11-01

This paper is a report of a study to investigate whether the Australian National Competency Standards for Registered Nurses demonstrate correlations with the Finnish Nurse Competency Scale. Competency assessment has become popular as a key regulatory requirement and performance indicator. The term competency, however, does not have a globally accepted definition and this has the potential to create controversy, ambiguity and confusion. Variations in meaning and definitions adopted in workplaces and educational settings will affect the interpretation of research findings and have implications for the nursing profession. A non-experimental cross-sectional survey design was used with a convenience sample of 116 new graduate nurses in 2005. The second version of the Australian National Competency Standards and the Nurse Competency Scale was used to elicit responses to self-assessed competency in the transitional year (first year as a Registered Nurse). Correlational analysis of self-assessed levels of competence revealed a relationship between the Australian National Competency Standards (ANCI) and the Nurse Competency Scale (NCS). The correlational relation between ANCI domains and NCS factors suggests that these scales are indeed used to measure related dimensions. A statistically significant relationship (r = 0.75) was found between the two competency measures. Although the finding of convergent validity is insufficient to establish construct validity for competency as used in both measures in this study, it is an important step towards this goal. Future studies on relationships between competencies must take into account the validity and reliability of the tools.

Prevalence of malaria parasitaemia and malaria related anaemia among pregnant women in Abakaliki, South East Nigeria.

PubMed

Nwonwu, E U; Ibekwe, P C; Ugwu, J I; Obarezi, H C; Nwagbara, O C

2009-06-01

Malaria currently is regarded as the most common and potentially the most serious infection occurring in pregnancy in many sub Saharan African countries. This study was undertaken to evaluate the prevalence of malaria parasitaemia and malaria related anaemia among pregnant women in Abakaliki, South East, Nigeria. This is a cross sectional, descriptive study conducted in two tertiary health institutions in Abakaliki, South East, Nigeria (Ebonyi State University Teaching Hospital And Federal Medical Centre). Using systematic sampling method, 193 pregnant women were selected from the health institutions for the study. Their blood were analysed for haemoglobin status and malaria parasite. Data were also collected using an interviewer administered questionnaire. All the data were analysed using Epi info version 6 statistical software. Response rate was 100%. Twenty nine percent prevalence of malaria parasitaemia was detected, more common among primigravidae. Women with higher parity had higher frequency of anaemia in pregnancy. More than half of the pregnant women (51%) were in their second trimester at the time of booking. There was no case of severe anaemia requiring blood transfusion. Our pregnant women register late for antenatal care. Prevalence of malaria parasitaemia is high in our environment as well as anaemia in pregnancy, using the standard WHO definition. It is suggested that effort should be intensified to make our women register early for antenatal care in order to identify complications early. Intermittent preventive treatment for malaria should be incorporated into routine drugs for antenatal women.

The registered distance of the celestial sphere: some historical cross-cultural data.

PubMed

Plug, C

1989-02-01

Estimates of the diameters of the sun and moon expressed in centimetres have been reported by several authors in the past. These estimates imply that the sizes of the sun and moon are perceived as if these bodies are only some tens of metres distant. In this study five units of length that were used by ancient astronomers to estimate arcs on the celestial sphere were investigated. The purpose was to determine whether the lengths and angles represented by these units imply a specific registered distance of the star sphere. The sizes of the Babylonian cubit, Arab fitr and shibr, Greek eclipse digit, and Chinese chang support the conclusion that the registered distance of the stars was about 10 to 40 metres in these four cultures over the last two millennia.

Reply to:"Early food allergy and respiratory allergy symptoms, and attention-deficit/hyperactivity disorder in Chinese children: a cross-sectional study: methodological issues".

PubMed

Shen, Chun; Hu, Yan; Li, Fei

2018-04-16

We have read Shadmani et al.'s comments with appreciation for their interest in our study[1]. They pointed out three methodological issues. The first one is the inherent limitation of cross-sectional studies. We absolutely agree with them that it is not possible to establish a true cause and effect relationship in cross-sectional studies. That's why we stated "a cross-sectional study" in the title, never used confusing terms such as "predictor", "risk factor" in the paper and have discussed this limitation in the Discussion. However, cross-sectional studies with large sample size are helpful to identify risk factors of health-related status, and are widely used in epidemiological studies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Influence of strut cross-section of stents on local hemodynamics in stented arteries

NASA Astrophysics Data System (ADS)

Jiang, Yongfei; Zhang, Jun; Zhao, Wanhua

2016-05-01

Stenting is a very effective treatment for stenotic vascular diseases, but vascular geometries altered by stent implantation may lead to flow disturbances which play an important role in the initiation and progression of restenosis, especially in the near wall in stented arterial regions. So stent designs have become one of the indispensable factors needed to be considered for reducing the flow disturbances. In this paper, the structural designs of strut cross-section are considered as an aspect of stent designs to be studied in details. Six virtual stents with different strut cross-section are designed for deployments in the same ideal arterial model. Computational fluid dynamics (CFD) methods are performed to study how the shape and the aspect ratio (AR) of strut cross-section modified the local hemodynamics in the stented segments. The results indicate that stents with different strut cross-sections have different influence on the hemodynamics. Stents with streamlined cross-sectional struts for circular arc or elliptical arc can significantly enhance wall shear stress (WSS) in the stented segments, and reduce the flow disturbances around stent struts. The performances of stents with streamlined cross-sectional struts are better than that of stents with non-streamlined cross-sectional struts for rectangle. The results also show that stents with a larger AR cross-section are more conductive to improve the blood flow. The present study provides an understanding of the flow physics in the vicinity of stent struts and indicates that the shape and AR of strut cross-section ought to be considered as important factors to minimize flow disturbance in stent designs.

IBD-related work disability in the community: Prevalence, severity and predictive factors. A cross-sectional study

PubMed Central

Ramos, Alexis; Sicilia, Beatriz; Vergara, Mercedes; Figuerola, Ariadna; Motos, Jaume; Sastre, Adoración; Villoria, Albert; Gomollón, Fernando

2015-01-01

Background and aims Data on the prevalence of work disability in patients with inflammatory bowel disease (IBD) are heterogeneous. As most studies have been performed in selected, often severe, IBD patients, the true prevalence of disability in the community remains controversial. The aim of this cross-sectional study was to evaluate the prevalence and severity of disability and its predictive factors in a community-based IBD population. Patients and methods Patients recorded in the community-based IBD register at the Hospital Universitario de Burgos were contacted. After informed consent they completed a set of questionnaires including demographic, clinical, disability and quality of life data. The statistical study was performed using SPSS 21. Results A total of 293 patients were included – 151 Crohn's disease (CD), 142 ulcerative colitis (UC), 137 female, mean age: 45 ± 11 years, mean time since diagnosis: 10.6 ± 11 years. Twelve patients (4.1%) had a work-disability pension. In addition, 93 (32%) of all patients had an officially recognized disability degree, which was generally moderate (n = 73, 25%) or severe (N = 16, 5%). Age, time since IBD diagnosis, CD, perianal disease, incontinence, active disease, the need for anti-TNF or psychological treatment, previous surgeries and the number of diagnostic tests and medical visits in the previous year were predictors of disability. Major predictors of qualifying for a disability pension were age, IBD activity, incontinence, need for biological drugs and ostomy. Conclusion Mild to moderate work disability is frequent in IBD. However, only a minority of patients develop severe disability qualifying them for a pension. PMID:26279841

Nursing and midwifery use, perceptions and barriers to evidence-based practice: a cross-sectional survey.

PubMed

Fry, Margaret; Attawet, Jutharat

2018-03-01

The study aimed to explore how nurses and midwives obtain, use and embed evidence in everyday practice. The study design was cross-sectional survey method. The setting was one local health district in metropolitan Sydney, Australia. All nurses and midwives working within the local health district, with access to an email account, were invited to participate in the study. An online survey questionnaire was distributed to explore how evidence is obtained, used and embedded within the clinical setting. The data were analysed using descriptive statistics (frequency and percentages). Pearson's Chi-square tests were used for comparison between groups. There were 204 survey respondents. The findings identified that the majority (n = 157; 76.96%) of respondents obtained evidence primarily from clinical practice guidelines. The majority (n = 149; 73.04%) of respondents reportedly searched databases and used evidence related to general clinical practice. There was a statistical difference (χ = 17.069; df = 8; P = 0.029) when comparing leadership positions and other registered practitioner groups in the frequency of searching for evidence. Most respondents (n = 138; 67.65%) were confident in their ability to change practice on the basis of available evidence. Thematic analysis identified four barriers to sustaining evidence-based practice, which included: the need for time; the need for organizational and management support; the need for educational opportunities and challenges to accessing evidence. The study provided an understanding of how nurses and midwives obtain, use and embed evidence into everyday practice. More importantly, the role of leadership is significant to support a process of knowledge generation, research translation and the implementation of evidence into clinical settings.

Characteristics and outcome of unplanned out-of-institution births in Norway from 1999 to 2013: a cross-sectional study.

PubMed

Gunnarsson, Björn; Smárason, Alexander K; Skogvoll, Eirik; Fasting, Sigurd

2014-10-01

To study the incidence, maternal characteristics and outcome of unplanned out-of-institution births (= unplanned births) in Norway. Register-based cross-sectional study. All births in Norway (n = 892 137) from 1999 to 2013 with gestational age ≥22 weeks. Analysis of data from the Medical Birth Registry of Norway from 1999 to 2013. Unplanned births (n = 6062) were compared with all other births (reference group). The annual incidence rate of unplanned births was 6.8/1000 births and remained stable during the period of study. Young multiparous women residing in remote municipalities were at the highest risk of experiencing unplanned births. The unplanned birth group had higher perinatal mortality rate for the period, 11.4/1000 compared with 4.9/1000 for the reference group (incidence rate ratio 2.31, 95% confidence interval 1.82-2.93, p < 0.001). Annual perinatal mortality rate for unplanned births did not change significantly (p = 0.80) but declined on average by 3% per year in the reference group (p < 0.001). The unplanned birth group had a lower proportion of live births in all birthweight categories. Live born neonates with a birthweight of 750-999 g in the unplanned birth group had a more than five times higher mortality rate during the first week of life, compared with reference births in the same birthweight category. Unplanned births are associated with adverse outcome. Excessive mortality is possibly caused by reduced availability of necessary medical interventions for vulnerable newborns out-of-hospital. © 2014 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

Effects of Stress on Critical Care Nurses: A National Cross-Sectional Study.

PubMed

Vahedian-Azimi, Amir; Hajiesmaeili, Mohammadreza; Kangasniemi, Mari; Fornés-Vives, Joana; Hunsucker, Rita L; Rahimibashar, Farshid; Pourhoseingholi, Mohammad A; Farrokhvar, Leily; Miller, Andrew C

2017-01-01

Health care is a demanding field, with a high level of responsibility and exposure to emotional and physical danger. High levels of stress may result in depression, anxiety, burnout syndrome, and in extreme cases, post-traumatic stress disorder. The aim of this study was to determine which personal, professional, and organizational variables are associated with greater perceived stress among critical care nurses for purposes of developing integrative solutions to decrease stress in the future. We conducted a correlation research survey using a cross-sectional design and an in-person survey method. The questionnaire consisted of 2 parts: (1) socioeconomic, professional, and institutional variables and (2) work stressors. Surveys were conducted between January 1, 2011, and December 1, 2015. Multistage cluster random sampling was utilized for data collection. Inclusion criteria were (1) age ≥18 years, (2) registered nurse, (3) works in the intensive care unit (ICU), and (4) willing and able to complete the survey. We surveyed 21 767 ICU nurses in Iran and found that male sex, lower levels of peer collaboration, working with a supervisor in the unit, nurse-patient ratios, and working in a surgical ICU were positively associated with greater stress levels. Increasing age and married status were negatively associated with stress. Intensive care unit type (semi-closed vs open), ICU bed number, shift time, working on holidays, education level, and demographic factors including body mass index, and number of children were not significantly associated with stress levels. As the largest study of its kind, these findings support those found in various European, North, and South American studies. Efforts to decrease workplace stress of ICU nurses by focusing on facilitating peer collaboration, improving resource availability, and staffing ratios are likely to show the greatest impact on stress levels.

Motivational and contextual determinants of HPV-vaccination uptake: A longitudinal study among mothers of girls invited for the HPV-vaccination.

PubMed

Pot, Mirjam; van Keulen, Hilde M; Ruiter, Robert A C; Eekhout, Iris; Mollema, Liesbeth; Paulussen, Theo W G M

2017-07-01

In the Netherlands, HPV-vaccination uptake among 12-year-old girls remains to be lower (61% in 2016) than expected. The present study is about 1) replicating the extent to which social-psychological determinants found in earlier cross-sectional studies explain HPV-vaccination intention, and 2) testing whether HPV-vaccination intention, as well as other social-psychological determinants, are good predictors of future HPV-vaccination uptake in a longitudinal design. A random sample of mothers of girls invited for the vaccination in 2015 was drawn from the Dutch vaccination register (Praeventis) (N=36,000) and from three online panels (N=2483). Two months prior to the vaccination of girls, their mothers were requested to complete a web-based questionnaire by letter (Praeventis sample) or by e-mail (panel samples). HPV-vaccination uptake was derived from Praeventis. Backward linear and logistic regression analyses were conducted to examine most dominant predictors of HPV-vaccination intention and uptake, respectively. The total sample used for data analyses consisted of 8062 mothers. Response rates were 18% for the Praeventis sample and 47% for the panel samples. HPV-vaccination intention was best explained by attitude, beliefs, subjective norms, habit, and perceived relative effectiveness of the vaccination; they explained 83% of the variance in HPV-vaccination intention. Intention appeared to be the only stable predictor of HPV-vaccination uptake and explained 43% of the variance in HPV-vaccination uptake. These results confirm what was found by earlier cross-sectional studies, and provide strong leads for selecting relevant targets in the planning of future communication strategies aiming to improve HPV-vaccination uptake. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Knowledge gap regarding dementia care among nurses in Taiwanese acute care hospitals: A cross-sectional study.

PubMed

Lin, Pei-Chao; Hsieh, Mei-Hui; Chen, Meng-Chin; Yang, Yung-Mei; Lin, Li-Chan

2018-02-01

The quality of dementia care in hospitals is typically substandard. Staff members are underprepared for providing care to older people with dementia. The objective of the present study was to examine dementia care knowledge, attitude and behavior regarding self-education about dementia care among nurses working in different wards. This was a descriptive cross-sectional study. The present study was carried out from July 2013 to December 2013. In total, 387 nurses working in different wards were recruited from two hospitals in Taiwan by using convenience sampling. The nurses completed a self-report questionnaire on demographic data, experience and learning behavior, and attitude towards dementia care, and a 16-item questionnaire on dementia care knowledge. Descriptive and inferential statistics were used to analyze the status and differences in dementia care knowledge among nurse in different wards. The average dementia care knowledge score was 10.46 (SD 2.13), with a 66.5% mean accuracy among all nurses. Dementia care knowledge was significantly associated with age, nursing experience, possession of a registered nurse license, holding a bachelor's degree, work unit, training courses and learning behavior towards dementia care. The dementia care knowledge of the emergency room nurses was significantly lower than that of the psychiatric and neurology ward nurses. A significantly lower percentage of emergency room nurses underwent dementia care training and actively searched for information on dementia care, compared with the psychiatric and neurology ward nurses. Hospital nurses show a knowledge gap regarding dementia care, especially emergency room nurses. Providing dementia care training to hospital nurses, particularly emergency room nurses, is crucial for improving the quality of care for patients with dementia. Geriatr Gerontol Int 2018; 18: 276-285. © 2017 Japan Geriatrics Society.

Food Security in Households of People Living With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: A Cross-sectional Study in a Subdivision of Darjeeling District, West Bengal

PubMed Central

2016-01-01

Objectives: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) adversely impacts food security in households of people living with HIV/AIDS (PLWHA). Little research has focused on food insecurity among PLWHA in India. The purpose of this study was to identify the prevalence of and factors relating to food security in households of PLWHA in the Siliguri subdivision of Darjeeling, West Bengal, India. Methods: A cross-sectional community-based study was carried out among 173 PLWHA residing in Siliguri and registered at the Anti-retroviral Therapy Centre of North Bengal Medical College & Hospital. Data was collected at the household level with interviews of PLWHA using a food security survey instrument. We analyzed the associations using logistic regression. Results: The prevalence of household food security among the participants was 50.9% (88/173). Five years or more of schooling, higher socioeconomic class and males were found to be significantly associated with a higher likelihood of food security. A later stage of the disease and the presence of other family members with HIV/AIDS were significantly associated with a lower likelihood of food security. The major coping strategies to deal with food insecurity in the acute phase HIV infection included borrowing money (56.1%), followed by spousal support, loans from microfinance institutions, banks, or money lenders, borrowing food, or selling agricultural products. Conclusions: The present study revealed that only about half of households with PLWHA were food secure. Prior interventions relating to periods of food and economic crisis as well as strategies for sustaining food security and economic status are needed in this area. PMID:27499166

Incidence and risk factors of workplace violence against nurses in a Chinese top-level teaching hospital: A cross-sectional study.

PubMed

Chen, Xiaoming; Lv, Ming; Wang, Min; Wang, Xiufeng; Liu, Junyan; Zheng, Nan; Liu, Chunlan

2018-04-01

To investigate the incidence of workplace violence involving nurses and to identify related risk factors in a high-quality Chinese teaching hospital. A cross-sectional study design was used. The final sample comprised responses from 1831 registered nurses collected with a whole-hospital survey from June 1 to June 15, 2016. The demographic characteristics of the nurses who had experienced any form of violence were collected, and logistic regression analysis was applied to evaluate the risk factors for nurses related to workplace violence. Out of the total number of nurses surveyed, 904 (49.4%) nurses reported having experienced any type of violence in the past year. The frequencies of exposure to physical and non-physical violence were 6.3% (116) and 49.0% (897), respectively. All the incidence rates of violence were lower than those of other studies based on regional hospitals in China and were at the same level found in developed countries and districts. Binary logistic regression analysis revealed that nurses at levels 2 to 4 and female nurses in clinical departments were the most vulnerable to non-physical violence. For physical violence, the two independent risk factors were working in an emergency department and having 6-10 years of work experience. Workplace violence directly threatens nurses from high-quality Chinese teaching hospitals. However, the incidence of WPV against nurses in this teaching hospital was better than that in regional hospitals. This study also provides reference material to identify areas where nurses encounter relatively high levels of workplace violence in high-quality Chinese teaching hospitals. Copyright © 2018 Elsevier Inc. All rights reserved.

Patient-reported safety incidents in older patients with long-term conditions: a large cross-sectional study

PubMed Central

Panagioti, Maria; Blakeman, Thomas; Hann, Mark; Bower, Peter

2017-01-01

Background Increasing evidence suggests that patient safety is a serious concern for older patients with long-term conditions. Despite this, there is a lack of research on safety incidents encountered by this patient group. In this study, we sought to examine patient reports of safety incidents and factors associated with reports of safety incidents in older patients with long-term conditions. Methods The baseline cross-sectional data from a longitudinal cohort study were analysed. Older patients (n=3378 aged 65 years and over) with a long-term condition registered in general practices were included in the study. The main outcome was patient-reported safety incidents including availability and appropriateness of medical tests and prescription of wrong types or doses of medication. Binary univariate and multivariate logistic regression analyses were undertaken to examine factors associated with patient-reported safety incidents. Results Safety incidents were reported by 11% of the patients. Four factors were significantly associated with patient-reported safety incidents in multivariate analyses. The experience of multiple long-term conditions (OR=1.09, 95% CI 1.05 to 1.13), a probable diagnosis of depression (OR=1.36, 95% CI 1.06 to 1.74) and greater relational continuity of care (OR=1.28, 95% CI 1.08 to 1.52) were associated with increased odds for patient-reported safety incidents. Perceived greater support and involvement in self-management was associated with lower odds for patient-reported safety incidents (OR=0.95, 95% CI 0.93 to 0.97). Conclusions We found that older patients with multimorbidity and depression are more likely to report experiences of patient safety incidents. Improving perceived support and involvement of patients in their care may help prevent patient-reported safety incidents. PMID:28559454

Spiritual intelligence of nurses in two Chinese social systems: a cross-sectional comparison study.

PubMed

Yang, Ke-Ping; Wu, Xin-Juan

2009-09-01

The spirituality of healthcare providers and their clients is becoming a crucial issue in a world increasingly preoccupied with material issues. In light of such, how do nurses enhance their spiritual intelligence against such materialist pressures? After a 60-year separation of Chinese on both sides of the Taiwan Strait and the rancor between their two governments, what are the similarities and the differences in nurse spirituality profiles between these two different societies? With increasing contact between the two, this issue should be examined and explored, as it has the potential to become an essential unspoken element underpinning holistic care quality. The purpose of this study was to compare spiritual intelligence between nurses in two different Chinese societies. A cross-sectional descriptive and inferential study was conducted at five medical centers in China and Taiwan. A total of 524 registered hospital nurses were recruited as participants. We used R. N. Wolman's (2001) self-reported PsychoMatrix Spirituality Inventory to measure participant levels of spiritual intelligence. The PsychoMatrix Spirituality Inventory incorporated seven factors, including divinity, mindfulness, extrasensory perception, community, intellectuality, trauma, and childhood spirituality. Results showed that social systems did have an impact on nurses' spiritual intelligence. Childhood spirituality and religious beliefs and activities greatly affected and effectively predicted nurses' spiritual intelligence. Nurses on either side of the Taiwan Strait all reported a need to deal with their daily lives pragmatically, objectively, and rationally and relied on empirical evidence in work settings. As social and economic contacts increase across the Taiwan Strait, it is imperative that nurses adopt cultural awareness and sensitivity as they provide holistic care to clients. This study opens doors to dialogue about and a better understanding of nurses' spiritual intelligence in Taiwan and China.

Food Security in Households of People Living With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: A Cross-sectional Study in a Subdivision of Darjeeling District, West Bengal.

PubMed

Dasgupta, Pallabi; Bhattacherjee, Sharmistha; Das, Dilip Kumar

2016-07-01

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) adversely impacts food security in households of people living with HIV/AIDS (PLWHA). Little research has focused on food insecurity among PLWHA in India. The purpose of this study was to identify the prevalence of and factors relating to food security in households of PLWHA in the Siliguri subdivision of Darjeeling, West Bengal, India. A cross-sectional community-based study was carried out among 173 PLWHA residing in Siliguri and registered at the Anti-retroviral Therapy Centre of North Bengal Medical College & Hospital. Data was collected at the household level with interviews of PLWHA using a food security survey instrument. We analyzed the associations using logistic regression. The prevalence of household food security among the participants was 50.9% (88/173). Five years or more of schooling, higher socioeconomic class and males were found to be significantly associated with a higher likelihood of food security. A later stage of the disease and the presence of other family members with HIV/AIDS were significantly associated with a lower likelihood of food security. The major coping strategies to deal with food insecurity in the acute phase HIV infection included borrowing money (56.1%), followed by spousal support, loans from microfinance institutions, banks, or money lenders, borrowing food, or selling agricultural products. The present study revealed that only about half of households with PLWHA were food secure. Prior interventions relating to periods of food and economic crisis as well as strategies for sustaining food security and economic status are needed in this area.

Explaining socio-economic differences in intention to smoke among primary school children

PubMed Central

2014-01-01

Background Smoking prevalence is higher among low socio-economic status (LSES) groups, and this difference may originate from a higher intention to smoke in childhood. This study aims to identify factors that explain differences in intention to smoke between children living in high socio-economic status (HSES) and LSES neighbourhoods. Methods Cross-sectional data were derived from the baseline assessment of a smoking prevention intervention study. Dutch primary school children, aged 10 – 11 years (N = 2,612), completed a web-based questionnaire about their attitude, subjective norm, self-efficacy expectations, modelling and intention to smoke. Linear and logistic regression analyses were performed to assess potential individual cognitive (attitude, subjective norm and self-efficacy) and social environmental (modelling) mediators between SES and intention to smoke. Results Multiple mediation models indicated that modelling mediated the association between SES (B = -0.09 (p < 0.01)) and intention to smoke (B = 1.06 (p < 0.01)). Mainly the father, mother and other family members mediated this association. Gender did not moderate the association between SES and intention to smoke and the potential mediators indicating that there are no differences in mediating factors between boys and girls. Conclusions This study indicates that future smoking prevention studies may focus on the social environment to prevent smoking onset. However, replication of this study is warranted. Trial registration This study was approved by the Medical Ethics Committee of the Atrium-Orbis-Zuyd Hospital (NL32093.096.11 / MEC 11-T-25) and registered in the Dutch Trial Register (NTR3116). PMID:24555819

Patent Medicine Sellers: How Can They Help Control Childhood Malaria?

PubMed Central

Akuse, Rosamund M.; Eseigbe, Edwin E.; Ahmed, Abubakar; Brieger, William R.

2010-01-01

Roll Back Malaria Initiative encourages participation of private health providers in malaria control because mothers seek care for sick children from them. This study investigated Patent Medicine Sellers (PMS) management of presumptive malaria in children in order to identify how they can assist malaria control. A cross-sectional survey of 491 PMS in Kaduna, Nigeria, was done using interviews and observation of shop activities. Most (80%) customers bought drugs without prescriptions. Only 29.5% were given instructions about doses. Between 40–100% doses of recommended antimalarials were incorrect. Some (22%) PMS did not ask questions about illness for which they were consulted. Most children treated in shops received injections. PMS facilitate homecare but have deficiencies in knowledge and practice. Interventions must focus on training them to accurately determine doses, give advice about drug administration, use oral medication, and ask about illness. Training should be made a prerequisite for registering and reregistering shops. PMID:22332020

Theoretical study of EAS hadronic structure

NASA Technical Reports Server (NTRS)

Popova, L.

1985-01-01

The structure of extensive air showers (EAS) is determined mainly by the energetic hadrons. They are strongly collimated in the core of the shower and essential difficulties are encountered for resolution of individual hadrons. The properties for resolution are different from the variety of hadron detectors used in EAS experiments. This is the main difficulty in obtaining a general agreement between actually registered data with different detectors. The most plausible source for disagreement is the uncertainty in determination of the energy of individual hadrons. This research demonstrates that a better agreement can be obtained with the average tendency of hadronic measurements if one assumes a larger coefficient of inelasticity and stronger energy increase of the total inelastic cross section in high energy pion interactions. EAS data above 10 to the 5th power GeV are revealing a faster development of hadronic cascades in the air then can be expected by extrapolating the parameters of hadron interactions obtained in accelerator measurements.

Abortion, an increasing public health concern in Ecuador, a 10-year population-based analysis.

PubMed

Ortiz-Prado, Esteban; Simbaña, Katherine; Gómez, Lenin; Stewart-Ibarra, Anna M; Scott, Lisa; Cevallos-Sierra, Gabriel

2017-01-01

To describe the epidemiology of abortion in Ecuador from 2004 to 2014 and compare the prevalence between the public and the private health care systems. This is a cross-sectional analysis of the overall mortality and morbidity rate due to abortion in Ecuador, based on public health records and other government databases. From 2004 to 2014, a total of 431,614 spontaneous abortions, miscarriage and other types of abortions were registered in Ecuador. The average annual rate of abortion was 115 per 1,000 live births. The maternal mortality rate was found to be 43 per 100,000 live births. Abortion is a significant and wide-ranging problem in Ecuador. The study supports the perception that in spite of legal restrictions to abortion in Ecuador, women are still terminating pregnancies when they feel they need to do so. The public health system reported >84% of the national overall prevalence.

Predictors of nurses' experience of verbal abuse by nurse colleagues.

PubMed

Keller, Ronald; Krainovich-Miller, Barbara; Budin, Wendy; Djukic, Maja

Between 45% and 94% of registered nurses (RNs) experience verbal abuse, which is associated with physical and psychological harm. Although several studies examined predictors of RNs' verbal abuse, none examined predictors of RNs' experiences of verbal abuse by RN colleagues. To examine individual, workplace, dispositional, contextual, and interpersonal predictors of RNs' reported experiences of verbal abuse from RN colleagues. In this secondary analysis, a cross-sectional design with multiple linear regression analysis was used to examine the effect of 23 predictors on verbal abuse by RN colleagues in a sample of 1,208 early career RNs. Selected variables in the empirical intragroup conflict model explained 23.8% of variance in RNs' experiences of verbal abuse by RN colleagues. A number of previously unstudied factors were identified that organizational leaders can monitor and develop or modify policies to prevent early career RNs' experiences of verbal abuse by RN colleagues. Copyright © 2017 Elsevier Inc. All rights reserved.

Use of antidementia drugs in frontotemporal lobar degeneration.

PubMed

López-Pousa, Secundino; Calvó-Perxas, Laia; Lejarreta, Saioa; Cullell, Marta; Meléndez, Rosa; Hernández, Erélido; Bisbe, Josep; Perkal, Héctor; Manzano, Anna; Roig, Anna Maria; Turró-Garriga, Oriol; Vilalta-Franch, Joan; Garre-Olmo, Josep

2012-06-01

Clinical evidence indicates that acetylcholinesterase inhibitors (AChEIs) are not efficacious to treat frontotemporal lobar degeneration (FTLD). The British Association for Psychopharmacology recommends avoiding the use of AChEI and memantine in patients with FTLD. Cross-sectional design using 1092 cases with Alzheimer's disease (AD) and 64 cases with FTLD registered by the Registry of Dementias of Girona. Bivariate analyses were performed, and binary logistic regressions were used to detect variables associated with antidementia drugs consumption. The AChEIs were consumed by 57.6% and 42.2% of the patients with AD and FTLD, respectively. Memantine was used by 17.2% and 10.9% of patients with AD and FTLD, respectively. Binary logistic regressions yielded no associations with antidementia drugs consumption. There is a discrepancy regarding clinical practice and the recommendations based upon clinical evidence. The increased central nervous system drug use detected in FTLD requires multicentric studies aiming at finding the best means to treat these patients.

Physical Restraint Use With Elderly Patients: Perceptions of Nurses and Nursing Assistants in Spanish Acute Care Hospitals.

PubMed

Fariña-López, Emilio; Estévez-Guerra, Gabriel J; Polo-Luque, M Luz; Hanzeliková Pogrányivá, Alica; Penelo, Eva

Physical restraint is often used during the hospitalization of elderly people. However, this procedure is associated with adverse outcomes; therefore, it is necessary to be aware of the circumstances that promote restraint use, such as the perceptions of professionals who use it. The purpose of the research was to determine the situations in which nursing staff considered the use of physical restraint as most important and to evaluate the possible associations with the sociodemographic and professional variables. A descriptive cross-sectional multicenter study was carried out in 52 units of eight Spanish acute hospitals. A survey of registered nurses and nursing assistants was used to collect data related to sociodemographic characteristics, experience, training in restraint use, and the Perception of Restraint Use Questionnaire (PRUQ)-which assesses the perceived importance of reasons frequently given for the use of physical restraint. The sample comprised 508 registered nurses and 347 nursing assistants. Almost all (98%) had used physical restraint, and 82% thought their training in the use of physical restraint was insufficient. Nursing assistants scored higher than registered nurses (p < .005, d = .68) on PRUQ total score and individual item scores, suggesting they thought the factors were more important in restraint use. Both registered nurses and nursing assistants considered restraint as most important in the prevention of falls and in the removal of medical devices such as intravenous lines and urinary catheters. Associations between PRUQ total score and other variables (unit type, sociodemographic factors, hospital) were nonsignificant. The professionals considered restraint as very important in preventing safety problems. In order to improve the quality of care, it is essential to identify the factors that can have an effect on the application of physical restraint. Educational programs are of fundamental importance, but to be more effective in reducing the use of physical restraint, they should address commonly held views on rationale for restraint use and be accompanied by institutional policies promoting a restraint-free environment.

Usage of purchased self-tests for HIV and sexually transmitted infections in Amsterdam, the Netherlands: results of population-based and serial cross-sectional studies among the general population and sexual risk groups.

PubMed

Bil, Janneke P; Prins, Maria; Stolte, Ineke G; Dijkshoorn, Henriëtte; Heijman, Titia; Snijder, Marieke B; Davidovich, Udi; Zuure, Freke R

2017-09-21

There are limited data on the usage of commercially bought self-tests for HIV and other sexually transmitted infections (STIs). Therefore, we studied HIV/STI self-test usage and its determinants among the general population and sexual risk groups between 2007 and 2015 in Amsterdam, the Netherlands. Data were collected in four different studies among the general population (S1 - 2) and sexual risk groups (S3 - 4). S1 - Amsterdam residents participating in representative population-based surveys (2008 and 2012; n=6044) drawn from the municipality register; S2 - Participants of a population-based study stratified by ethnicity drawn from the municipality register of Amsterdam (2011-2015; n=17 603); S3 - Men having sex with men (MSM) participating in an HIV observational cohort study (2008 and 2013; n=597) and S4 - STI clinic clients participating in a cross-sectional survey (2007-2012; n=5655). Prevalence of HIV/STI self-test usage and its determinants. The prevalence of HIV/STI self-test usage in the preceding 6-12 months varied between 1% and 2% across studies. Chlamydia self-tests were most commonly used, except among MSM in S3. Chlamydia and syphilis self-test usage increased over time among the representative sample of Amsterdam residents (S1) and chlamydia self-test usage increased over time among STI clinic clients (S4). Self-test usage was associated with African Surinamese or Ghanaian ethnic origin (S2), being woman or MSM (S1 and 4) and having had a higher number of sexual partners (S1-2). Among those in the general population who tested for HIV/STI in the preceding 12 months, 5-9% used a self-test. Despite low HIV/STI self-test usage, we observed increases over time in chlamydia and syphilis self-test usage. Furthermore, self-test usage was higher among high-risk individuals in the general population. It is important to continue monitoring self-test usage and informing the public about the unknown quality of available self-tests in the Netherlands and about the pros and cons of self-testing. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

17 CFR 249.332 - Form N-Q, quarterly schedule of portfolio holdings of registered management investment company.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of portfolio holdings of registered management investment company. 249.332 Section 249.332 Commodity... management investment company. This form shall be used by registered management investment companies, other than small business investment companies registered on Form N-5 (§§ 239.24 and 274.5 of this chapter...

17 CFR 270.17g-1 - Bonding of officers and employees of registered management investment companies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... employees of registered management investment companies. 270.17g-1 Section 270.17g-1 Commodity and... ACT OF 1940 § 270.17g-1 Bonding of officers and employees of registered management investment companies. (a) Each registered management investment company shall provide and maintain a bond which shall...

26 CFR 46.4701-1 - Tax on issuer of registration-required obligation not in registered form.

Code of Federal Regulations, 2010 CFR

2010-04-01

... obligation not in registered form. 46.4701-1 Section 46.4701-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) MISCELLANEOUS EXCISE TAXES EXCISE TAX ON POLICIES ISSUED BY FOREIGN INSURERS AND OBLIGATIONS NOT IN REGISTERED FORM Excise Tax on Obligations Not in Registered Form § 46.4701...

Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries

PubMed Central

Dall'Ora, Chiara; Griffiths, Peter; Ball, Jane; Simon, Michael; Aiken, Linda H

2015-01-01

Objectives 12 h shifts are becoming increasingly common for hospital nurses but there is concern that long shifts adversely affect nurses’ well-being, job satisfaction and intention to leave their job. The aim of this study is to examine the association between working long shifts and burnout, job dissatisfaction, dissatisfaction with work schedule flexibility and intention to leave current job among hospital nurses. Methods Cross-sectional survey of 31 627 registered nurses in 2170 general medical/surgical units within 488 hospitals across 12 European countries. Results Nurses working shifts of ≥12 h were more likely than nurses working shorter hours (≤8) to experience burnout, in terms of emotional exhaustion (adjusted OR (aOR)=1.26; 95% CI 1.09 to 1.46), depersonalisation (aOR=1.21; 95% CI 1.01 to 1.47) and low personal accomplishment (aOR=1.39; 95% CI 1.20 to 1.62). Nurses working shifts of ≥12 h were more likely to experience job dissatisfaction (aOR=1.40; 95% CI 1.20 to 1.62), dissatisfaction with work schedule flexibility (aOR=1.15; 95% CI 1.00 to 1.35) and report intention to leave their job due to dissatisfaction (aOR=1.29; 95% CI 1.12 to 1.48). Conclusions Longer working hours for hospital nurses are associated with adverse outcomes for nurses. Some of these adverse outcomes, such as high burnout, may pose safety risks for patients as well as nurses. PMID:26359284

Cross-sectional analysis of patient phone calls to an inflammatory bowel disease clinic.

PubMed

Corral, Juan E; Yarur, Andres J; Diaz, Liege; Simmons, Okeefe L; Sussman, Daniel A

2015-01-01

Patients with inflammatory bowel disease (IBD) require close follow up and frequently utilize healthcare services. We aimed to identify the main reasons that prompted patient calls to gastroenterology providers and further characterize the "frequent callers". This retrospective cross-sectional study included all phone calls registered in medical records of IBD patients during 2012. Predictive variables included demographics, psychiatric history, IBD phenotype, disease complications and medical therapies. Primary outcome was the reason for call (symptoms, medication refill, procedures and appointment issues). Secondary outcome was the frequency of changes in management prompted by the call. 209 patients participated in 526 calls. The mean number of calls per patient was 2.5 (range 0-27); 49 (23.4%) patients met the criterion of "frequent caller". Frequent callers made or received 75.9% of all calls. Crohn's disease, anxiety, extra-intestinal manifestations and high sedimentation rate were significantly associated with higher call volume. 85.7% of frequent callers had at least one call that prompted a therapeutic intervention, compared to 18.9% of non-frequent callers (P<0.001). The most common interventions were ordering laboratory or imaging studies (15.4%), dose adjustments (12.1%), changes in medication class (8.4%), and expediting clinic visits (8.4%). Most phone calls originated from a minority of patients. Repeated calling by the same patient and new onset of gastrointestinal (GI) and non-GI symptoms were important factors predicting the order of diagnostic modalities or therapeutic changes in care. Triaging calls to IBD healthcare providers for patients more likely to require a change in management may improve healthcare delivery.

Under-reporting of conflicts of interest among trialists: a cross-sectional study

PubMed Central

Schroll, Jeppe; Gøtzsche, Peter C; Lundh, Andreas

2015-01-01

Objectives To determine the prevalence of conflicts of interest (COIs) among Danish physicians who are authors of clinical drug trial reports and determine the extent of undisclosed COIs in trial publications. Design Cross-sectional study. Setting The 100 most recent drug trial reports with at least one Danish non-industry employed physician author published in a journal adhering to the International Committee of Medical Journal Editors' (ICMJE) manuscript guidelines. For each article, two observers independently extracted trial characteristics and the authors' COIs. Disclosed COIs were compared to what was registered on the Danish Health and Medicines Authority's public disclosure list. Participants Trial authors who are Danish physicians. Main outcome measures Number of disclosed and undisclosed COIs. Results One observer screened 928 articles and two observers assessed 120 articles for eligibility. The 100 included trials were published from February 2011 to May 2013 and included 318 Danish non-industry employed authors. Eighty-six of the 318 authors (27%) reported one or more COIs in the journal article. We found undisclosed COIs for 40 of 318 authors (13%) related to the trial sponsor or manufacturer of trial drugs. Seventy-nine of 318 authors (25%) had undisclosed COIs related to competing companies manufacturing drugs for the same indication and 136 (43%) had undisclosed COIs with any drug manufacturer. Conclusions Almost half of all authors had undisclosed COIs in clinical trials reported in journals adhering to the International Committee of Medical Journal Editors’ manuscript guidelines. Self-declared COIs cannot be trusted, but public registries may assist editors in ensuring that more COIs are being reported. PMID:25389230

Incidence of pulmonary and venous thromboembolism in pregnancies after in vitro fertilisation: cross sectional study.

PubMed

Henriksson, Peter; Westerlund, Eli; Wallén, Håkan; Brandt, Lena; Hovatta, Outi; Ekbom, Anders

2013-01-15

To estimate the risk of pulmonary embolism and venous thromboembolism in pregnant women after in vitro fertilisation. Cross sectional study. Sweden. 23,498 women who had given birth after in vitro fertilisation between 1990 and 2008 and 116,960 individually matched women with natural pregnancies. Risk of pulmonary embolism and venous thromboembolism (identified by linkage to the Swedish national patient register) during the whole pregnancy and by trimester. Venous thromboembolism occurred in 4.2/1000 women (n=99) after in vitro fertilisation compared with 2.5/1000 (n=291) in women with natural pregnancies (hazard ratio 1.77, 95% confidence interval 1.41 to 2.23). The risk of venous thromboembolism was increased during the whole pregnancy (P<0.001) and differed between the trimesters (P=0.002). The risk was particularly increased during the first trimester, at 1.5/1000 after in vitro fertilisation versus 0.3/1000 (hazard ratio 4.22, 2.46 to 7.26). The proportion of women experiencing pulmonary embolism during the first trimester was 3.0/10,000 after in vitro fertilisation versus 0.4/10,000 (hazard ratio 6.97, 2.21 to 21.96). In vitro fertilisation is associated with an increased risk of pulmonary embolism and venous thromboembolism during the first trimester. The risk of pulmonary embolism is low in absolute terms but because the condition is a leading cause of maternal mortality and clinical suspicion is critical for diagnosis, an awareness of this risk is important. ClinicalTrials.gov NCT01524393.

Low hepatitis B testing among migrants: a cross-sectional study in a UK city.

PubMed

Evlampidou, Iro; Hickman, Matthew; Irish, Charles; Young, Nick; Oliver, Isabel; Gillett, Sophie; Cochrane, Alexandra

2016-06-01

In 2012, hepatitis B virus (HBV) testing of people born in a country with a prevalence of ≥2% was recommended in the UK. Implementation of this recommendation requires an understanding of prior HBV testing practice and coverage, for which there are limited data. To estimate the proportion of migrants tested for HBV and explore GP testing practices and barriers to testing. A cross-sectional study of (a) migrants for whom testing was recommended under English national guidance, living in Bristol, and registered with a GP in 2006-2013, and (b) GPs practising in Bristol. NHS patient demographic data and HBV laboratory surveillance data were linked. A person was defined as 'HBV-tested' if a laboratory result was available. An online GP survey was undertaken, using a structured questionnaire. Among 82 561 migrants for whom HBV testing was recommended, 9627 (12%) were 'HBV-tested'. The HBV testing coverage was: Eastern Africa 20%; Western Africa 15%; South Eastern Asia 9%; Eastern Asia 5%. Of 19 GPs, the majority did not use guidelines to inform HBV testing in migrants and did not believe routine testing of migrants was indicated; 12/17 GPs stated that workload and lack of human, and financial resources were the most significant barriers to increased testing. The majority of migrants to a multicultural UK city from medium-/high-prevalence regions have no evidence of HBV testing. Much greater support for primary care in the UK and increased GP awareness of national guidance are required to achieve adherence to current testing guidance. © British Journal of General Practice 2016.

Screening diabetes in tuberculosis patients in eastern rural China: a community-based cross-sectional study.

PubMed

Zhao, Q; Xiao, X; Lu, W; Qiu, L-X; Zhou, C-M; Jiang, W-L; Xu, B; Diwan, V

2016-10-01

To understand the prevalence of diabetes mellitus (DM) and tuberculosis (TB) comorbidity in rural China and to identify factors associated with TB-DM comorbidity and screening efficacy. A community-based cross-sectional study was carried out in four counties in eastern rural China. All TB patients newly registered from April 2013 to March 2014 were screened for DM using fasting blood glucose (FBG). Screening-positive patients were further examined using glycosylated haemoglobin A1C (HbA1c). Ninety-seven (7.7%) of the 1252 recruited TB patients had DM, 44 (45.4%) of whom were newly diagnosed. The DM-TB patients were significantly older than non-diabetics (mean age 57 ± 13 years vs. 49 ± 19 years, P < 0.001). The risk of DM-TB was higher in patients aged >40 years (OR 3.039) and in overweight patients (OR 2.595). The number needed to screen (NNS) among TB patients to identify one case of DM was 12.97. The NNS to identify one new DM patient (27.4) was lower in participants aged >40 years (20.5), those who were illiterate (19.9), those with a family history of DM (9.3), those with missing bacille Calmette-Guérin vaccination (11.3), current smokers (14.2) and those with body mass index >24 (11.4). Regular DM screening in TB patients is practical in rural China. Better efficacy of DM-TB detection could be obtained by screening high-risk populations, such as overweight TB patients or those with a family history of DM.

Structural empowerment and anticipated turnover among behavioural health nurses.

PubMed

Smith, Thomas; Capitulo, Kathleen Leask; Quinn Griffin, Mary T; Fitzpatrick, Joyce J

2012-07-01

The aim of this pilot study was to examine the relationship between structural empowerment and anticipated turnover among behavioural health nurses. There have been several studies relating structural empowerment to a range of organizational characteristics and personal attributes of nurses themselves. There are also previous studies linking the key variables in the present study, but no previous research of behavioural health nurses was available. A quantitative design was used for this cross-sectional pilot study. All registered nurses (RN) working on inpatient units in the study facility were invited to participate (n = 97). An anonymous survey was sent to all potential participants. The response rate was 53% (n = 50). The majority of participants perceived themselves as moderately empowered. There was a significant negative correlation between empowerment and anticipated turnover. The results of this pilot study among behavioural health nurses are similar to the results among nurses working in other clinical areas. Nurse managers should be cognizant of the factors that enhance nurses' perceptions of empowerment, particularly related to issues of retention and anticipated turnover among behavioural health nurses. © 2012 Blackwell Publishing Ltd.

49 CFR 1103.1 - Register of practitioners.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false Register of practitioners. 1103.1 Section 1103.1 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE PRACTITIONERS General Information § 1103.1 Register of...

Trunk Muscle Size and Composition Assessment in Older Adults with Chronic Low Back Pain: An Intra-Examiner and Inter-Examiner Reliability Study.

PubMed

Sions, Jaclyn Megan; Smith, Andrew Craig; Hicks, Gregory Evan; Elliott, James Matthew

2016-08-01

To evaluate intra- and inter-examiner reliability for the assessment of relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area, i.e., total cross-sectional area minus intramuscular fat, from T1-weighted magnetic resonance images obtained in older adults with chronic low back pain. Reliability study. n = 13 (69.3 ± 8.2 years old) After lumbar magnetic resonance imaging, two examiners produced relative cross-sectional area measurements of multifidi, erector spinae, psoas, and quadratus lumborum by tracing regions of interest just inside fascial borders. Pixel-intensity summaries were used to determine muscle-to-fat infiltration indices; relative muscle cross-sectional area was calculated. Intraclass correlation coefficients were used to estimate intra- and inter-examiner reliability; standard error of measurement was calculated. Intra-examiner intraclass correlation coefficient point estimates for relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area were excellent for multifidi and erector spinae across levels L2-L5 (ICC = 0.77-0.99). At L3, intra-examiner reliability was excellent for relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area for both psoas and quadratus lumborum (ICC = 0.81-0.99). Inter-examiner intraclass correlation coefficients ranged from poor to excellent for relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area. Assessment of relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area in older adults with chronic low back pain can be reliably determined by one examiner from T1-weighted images. Such assessments provide valuable information, as muscle-to-fat infiltration indices and relative muscle cross-sectional area indicate that a substantial amount of relative cross-sectional area may be magnetic resonance-visible intramuscular fat in older adults with chronic low back pain. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

1 CFR 5.10 - Forms of publication.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1 General Provisions 1 2011-01-01 2011-01-01 false Forms of publication. 5.10 Section 5.10 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.10 Forms of publication. Pursuant to section 1506 of title 44, United States Code, the Administrative Committee publishes...

1 CFR 5.10 - Forms of publication.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Forms of publication. 5.10 Section 5.10 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.10 Forms of publication. Pursuant to section 1506 of title 44, United States Code, the Administrative Committee publishes...

40 CFR 168.22 - Advertising of unregistered pesticides, unregistered uses of registered pesticides and FIFRA...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Advertising of unregistered pesticides, unregistered uses of registered pesticides and FIFRA section 24(c) registrations. 168.22 Section 168.22 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS STATEMENTS OF...

40 CFR 168.22 - Advertising of unregistered pesticides, unregistered uses of registered pesticides and FIFRA...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Advertising of unregistered pesticides, unregistered uses of registered pesticides and FIFRA section 24(c) registrations. 168.22 Section 168.22 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS STATEMENTS OF...

40 CFR 168.22 - Advertising of unregistered pesticides, unregistered uses of registered pesticides and FIFRA...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Advertising of unregistered pesticides, unregistered uses of registered pesticides and FIFRA section 24(c) registrations. 168.22 Section 168.22 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS STATEMENTS OF...

40 CFR 168.22 - Advertising of unregistered pesticides, unregistered uses of registered pesticides and FIFRA...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Advertising of unregistered pesticides, unregistered uses of registered pesticides and FIFRA section 24(c) registrations. 168.22 Section 168.22 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS STATEMENTS OF...

50 CFR 216.23 - Native exceptions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... section for the purpose of processing, and will be returned directly or through a registered agent to the... registered under paragraph (c) of this section for the purpose of processing, and will be returned directly..., processing, and shipping materials; (iii) A proposal for a system of bookkeeping and/or inventory segregation...

50 CFR 216.23 - Native exceptions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... section for the purpose of processing, and will be returned directly or through a registered agent to the... registered under paragraph (c) of this section for the purpose of processing, and will be returned directly..., processing, and shipping materials; (iii) A proposal for a system of bookkeeping and/or inventory segregation...

50 CFR 216.23 - Native exceptions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... section for the purpose of processing, and will be returned directly or through a registered agent to the... registered under paragraph (c) of this section for the purpose of processing, and will be returned directly..., processing, and shipping materials; (iii) A proposal for a system of bookkeeping and/or inventory segregation...

50 CFR 216.23 - Native exceptions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... section for the purpose of processing, and will be returned directly or through a registered agent to the... registered under paragraph (c) of this section for the purpose of processing, and will be returned directly..., processing, and shipping materials; (iii) A proposal for a system of bookkeeping and/or inventory segregation...

50 CFR 216.23 - Native exceptions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... section for the purpose of processing, and will be returned directly or through a registered agent to the... registered under paragraph (c) of this section for the purpose of processing, and will be returned directly..., processing, and shipping materials; (iii) A proposal for a system of bookkeeping and/or inventory segregation...

26 CFR 48.4101-1 - Taxable fuel; registration.

Code of Federal Regulations, 2012 CFR

2012-04-01

... vendors of diesel fuel and kerosene under section 6427. (2) A person is registered under section 4101 only... an enterer, refiner, terminal operator, or throughputter with respect to kerosene and is registered... store kerosene (and no other type of taxable fuel); or (C) Is a commercial airline, an operator of...

26 CFR 48.4101-1 - Taxable fuel; registration.

Code of Federal Regulations, 2013 CFR

2013-04-01

... vendors of diesel fuel and kerosene under section 6427. (2) A person is registered under section 4101 only... an enterer, refiner, terminal operator, or throughputter with respect to kerosene and is registered... store kerosene (and no other type of taxable fuel); or (C) Is a commercial airline, an operator of...

1 CFR 5.10 - Forms of publication.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1 General Provisions 1 2014-01-01 2012-01-01 true Forms of publication. 5.10 Section 5.10 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.10 Forms of publication. Pursuant to section 1506 of title 44, United States Code, the Administrative Committee publishes...

1 CFR 5.10 - Forms of publication.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1 General Provisions 1 2013-01-01 2012-01-01 true Forms of publication. 5.10 Section 5.10 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.10 Forms of publication. Pursuant to section 1506 of title 44, United States Code, the Administrative Committee publishes...

1 CFR 5.10 - Forms of publication.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1 General Provisions 1 2012-01-01 2012-01-01 false Forms of publication. 5.10 Section 5.10 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.10 Forms of publication. Pursuant to section 1506 of title 44, United States Code, the Administrative Committee publishes...

Postmarketing studies for novel drugs approved by both the FDA and EMA between 2005 and 2010: a cross-sectional study

PubMed Central

Zeitoun, Jean-David; Ross, Joseph S; Atal, Ignacio; Vivot, Alexandre; Downing, Nicholas S; Baron, Gabriel; Ravaud, Philippe

2017-01-01

Objectives To characterise postmarketing studies for drugs that were newly approved by the US Food and Drug Administration and the European Medicines Agency. Design and setting Cross-sectional analysis of postmarketing studies registered in ClinicalTrials.gov until September 2014 for all novel drugs approved by both regulators between 2005 and 2010. Regulatory documents from both agencies were used. Primary and secondary outcome measures All identified postmarketing studies were classified according to planned enrolment, funding, status and geographical location, and we determined whether studies studied the originally approved indication. Results Overall, 69 novel drugs approved between 2005 and 2010 were eligible for inclusion. A total of 6679 relevant postmarketing studies were identified; 5972 were interventional (89.4%). The median number of studies per drug was 55 (IQR 33–119) and median number of patients to be enrolled per study was 60 (IQR 28–183). Industry was the primary sponsor of 2713 studies (40.6%) and was a primary or secondary sponsor in 4176 studies (62.5%). In all, 2901 studies (43.4%) were completed, 487 (7.3%) terminated, 1013 (15.2%) active yet not recruiting, 1895 (28.4%) recruiting and 319 (4.8%) not yet recruiting. A total of 80% of studies were conducted in only one country and 84.4% took place in Europe and/or North America; 2441 (36.5%) studied another indication than the originally approved indication. Studies designed in the originally approved indication were found to be more industry-sponsored than others 68.7%vs53.7%; P<0.0001. Conclusions Postmarketing pharmaceutical research was highly variable and predominantly located in North America and Europe. Postmarketing studies were frequently designed to study indications other than the originally approved one. Although some findings were reassuring, others question the lack of coordination of postmarketing research. PMID:29273664

Consistency between cross-sectional and longitudinal SNP: blood lipid associations.

PubMed

Costanza, Michael C; Beer-Borst, Sigrid; James, Richard W; Gaspoz, Jean-Michel; Morabia, Alfredo

2012-02-01

Various studies have linked different genetic single nucleotide polymorphisms (SNPs) to different blood lipids (BL), but whether these "connections" were identified using cross-sectional or longitudinal (i.e., changes over time) designs has received little attention. Cross-sectional and longitudinal assessments of BL [total, high-, low-density lipoprotein cholesterol (TC, HDL, LDL), triglycerides (TG)] and non-genetic factors (body mass index, smoking, alcohol intake) were measured for 2,002 Geneva, Switzerland, adults during 1999-2008 (two measurements, median 6 years apart), and 20 SNPs in 13 BL metabolism-related genes. Fixed and mixed effects repeated measures linear regression models, respectively, were employed to identify cross-sectional and longitudinal SNP:BL associations among the 1,516 (76%) study participants who reported not being treated for hypercholesterolemia at either measurement time. One-third more (12 vs. 9) longitudinal than cross-sectional associations were found [Bonferroni-adjusted two-tailed p < 0.00125 (=0.05/2)/20) for each of the four ensembles of 20 SNP:individual BL associations tested under the two study designs]. There was moderate consistency between the cross-sectional and longitudinal findings, with eight SNP:BL associations consistently identified across both study designs: [APOE.2 and APOE.4 (rs7412 and rs429358)]:TC; HL/LIPC (rs2070895):HDL; [APOB (rs1367117), APOE.2 and APOE.4 (rs7412 and rs429358)]:LDL; [APOA5 (rs2072560) and APOC III (rs5128)]:TG. The results suggest that cross-sectional studies, which include most genome-wide association studies (GWAS), can assess the large majority of SNP:BL associations. In the present analysis, which was much less powered than a GWAS, the cross-sectional study was around 2/3 (67%) as efficient as the longitudinal study.

Impact of asthma medication and familial factors on the association between childhood asthma and attention-deficit/hyperactivity disorder: a combined twin- and register-based study: Epidemiology of Allergic Disease.

PubMed

Holmberg, K; Lundholm, C; Anckarsäter, H; Larsson, H; Almqvist, C

2015-05-01

Asthma and attention-deficit/hyperactivity disorder (ADHD) are prevalent in childhood and may cause functional impairment and stress in families. Previous research supports an association between asthma and ADHD in children, but several aspects of this relationship are unclear. Our aim was to study whether the association between asthma and ADHD is restricted to either the inattentive or the hyperactive/impulsive symptoms of ADHD, to explore the impact of asthma severity and asthma medication and the contribution of shared genetic and environmental risk factors on the asthma-ADHD relationship. Data on asthma, ADHD, zygosity and possible confounders were collected from parental questionnaires at 9 or 12 years on 20 072 twins through the Swedish Twin Register, linked to the Swedish Medical Birth Register, the National Patient Register and the Prescribed Drug Register. The association between asthma and ADHD, the impact of asthma severity and medication, was assessed by generalized estimating equations. Cross-twin-cross-trait correlations (CTCT) were estimated to explore the relative importance of genes and environment for the association. Asthmatic children had a higher risk of also having ADHD [odds ratio (OR) 1.53, 95% confidence interval (CI): 1.16-2.02]. The association was not restricted to either of the two dimensions of ADHD. The magnitude of the association increased with asthma severity (OR 2.84, 95% CI: 1.86-4.35) for ≥ 4 asthma attacks in the last 12 months and was not affected by asthma treatment. The CTCTs possibly indicate that the genetic component in overlap of the disorders is weak. Childhood asthma, especially severe asthma, is associated with ADHD. Asthma medication seems not to increase the risk of ADHD. Clinicians should be aware of the potential of ADHD in asthma. Optimal asthma care needs to be integrated with effective evaluation and treatment of ADHD in children with co-existing disorders. © 2015 John Wiley & Sons Ltd.

The effect of vegetarian diets on iron status in adults: A systematic review and meta-analysis.

PubMed

Haider, Lisa M; Schwingshackl, Lukas; Hoffmann, Georg; Ekmekcioglu, Cem

2018-05-24

Vegetarian diets exclude meat, seafood, and products containing these foods. Although the vegetarian lifestyle could lead to a better health status in adults, it may also bear risks for certain nutritional deficiencies. Cross-sectional studies and narrative reviews have shown that the iron status of vegetarians is compromised by the absence of highly bioavailable haem-iron in meatless diets and the inhibiting effect of certain components present in plant foods on non-haem iron bioavailability. The databases Pubmed, Scopus, Embase, and Cochrane CentralRegister of Controlled Trials were searched for studies comparing serum ferritin, as the major laboratory parameter for iron status of adult vegetarians with non-vegetarian control groups. A qualitative review was conducted as well as an inverse-variance random-effects meta-analysis to pool available data. In addition the effect of vegetarian diets according to gender was investigated with a subgroup analysis. The results were validated using a sensitivity analysis. A total of 27 cross-sectional studies and three interventional studies were selected for the systematic review. The meta-analysis which combined data of 24 cross-sectional studies showed that adult vegetarians have significantly lower serum ferritin levels than their non-vegetarian controls (-29.71 µg/L, 95% CI [-39.69, -19.73], p < 0.01). Inclusion of semi-vegetarian diets did not change the results considerably (-23.27 µg/L, 95% CI [-29.77, -16.76], p < 0.01). The effects were more pronounced in men (-61.88 µg/L, 95% CI [-85.59, -38.17], p < 0.01) than in both premenopausal women (-17.70 μg/L, 95% CI [-29.80, -5.60], p < 0.01) and all women (-13.50 μg/L, 95% CI [-22.96, -4.04], p < 0.01), respectively. In conclusion our results showed that vegetarians are more likely to have lower iron stores compared with non-vegetarians. However, since high iron stores are also a risk factor for certain non-communicable diseases, such as type 2 diabetes, it is recommended that not only vegetarians but also non-vegetarians should regularly control their iron status and improve their diet regarding the content and bioavailability of iron by consuming more plants and less meat.

75 FR 29891 - Special Local Regulation; Maggie Fischer Memorial Great South Bay Cross Bay Swim, Great South Bay...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-28

...-AA08 Special Local Regulation; Maggie Fischer Memorial Great South Bay Cross Bay Swim, Great South Bay... Lighthouse Dock, Fire Island, NY due to the annual Maggie Fischer Memorial Great South Bay Cross Bay Swim..., Maggie Fischer Memorial Great South Bay Cross Bay Swim, Great South Bay, NY, in the Federal Register (74...

Systematics of isotopic production cross sections from interactions of relativistic 40Ca in hydrogen

NASA Astrophysics Data System (ADS)

Chen, C.-X.; Albergo, S.; Caccia, Z.; Costa, S.; Crawford, H. J.; Cronqvist, M.; Engelage, J.; Greiner, L.; Guzik, T. G.; Insolia, A.; Knott, C. N.; Lindstrom, P. J.; McMahon, M.; Mitchell, J. W.; Potenza, R.; Russo, G. V.; Soutoul, A.; Testard, O.; Tull, C. E.; Tuvé, C.; Waddington, C. J.; Webber, W. R.; Wefel, J. P.

1997-09-01

The isotopic production cross sections for 40Ca projectiles at 357, 565, and 763 MeV/nucleon interacting in a liquid hydrogen target have been measured by the Transport Collaboration at the LBL HISS facility. The systematics of these cross sections are studied, and the results indicate that nuclear structure effects are present in the isotope production process during the relativistic collisions. The newly measured cross sections are also compared with those predicted by semiempirical and parametric formulas, but the predictions do not fully describe the systematics such as the energy dependence. The consequences of the cross section systematics in galactic cosmic ray studies are also discussed.

Experimental study of low-energy charge transfer in nitrogen

NASA Technical Reports Server (NTRS)

Smith, A.

1979-01-01

Total charge transfer cross sections were obtained for the N2(+)-N2 system with relative translational ion energies between 9 and 441 eV. Data were obtained to examine the dependence of total cross section on ion energy. The effect of ion excitation on the cross sections was studied by varying the electron ionization energy in the mass spectrometer ion source over an electron energy range between 14.5 and 32.1 eV. The dependence of total cross section on the neutralization chamber gas pressure was examined by obtaining data at pressure values from 9.9 to 0.000199 torr. Cross section values obtained were compared with experimental and theoretical results of other investigations.

12 CFR 1102.304 - Federal Register publication.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Federal Register publication. 1102.304 Section 1102.304 Banks and Banking FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL APPRAISER REGULATION Description of Office, Procedures, Public Information § 1102.304 Federal Register publication. The ASC...

7 CFR 3015.204 - Federal Register publications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Federal Register publications. 3015.204 Section 3015.204 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL... Register publications. (a) Program regulations. Most grant programs have program-specific regulations...

12 CFR 1102.304 - Federal Register publication.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Federal Register publication. 1102.304 Section 1102.304 Banks and Banking FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL APPRAISER REGULATION Description of Office, Procedures, Public Information § 1102.304 Federal Register publication. The ASC...

7 CFR 3015.204 - Federal Register publications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Federal Register publications. 3015.204 Section 3015.204 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL... Register publications. (a) Program regulations. Most grant programs have program-specific regulations...

30 CFR 45.4 - Independent contractor register.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Independent contractor register. 45.4 Section... ADMINISTRATIVE REQUIREMENTS INDEPENDENT CONTRACTORS § 45.4 Independent contractor register. (a) Each independent contractor shall provide the production-operator in writing the following information: (1) The independent...

Nurses’ Perceived Barriers to and Facilitators of Research Utilization in Mainland China: A Cross-Sectional Survey

PubMed Central

Chien, Wai-Tong; Bai, Qin; Wong, Wai-Kit; Wang, Huizhen; Lu, Xueqin

2013-01-01

Despite the drive towards evidence-based practice, the extent to which research evidence is being implemented in nursing practice is unclear, particularly in developing countries. This study was to assess the levels of perceived barriers to and facilitators of research utilization in practice among Chinese nurses and inter-relationships between these barriers and facilitators and their socio-demographic characteristics. A cross-sectional, descriptive survey was conducted in 2011 with 743 registered nurses randomly selected from four general hospitals in China. They completed the Barriers to Research Utilization and Facilitators of Research Utilization scales. Correlation tests were used to test the relationships between the nurses’ perceived barriers and facilitators, their demographic characteristics and research training and involvement. The Chinese nurses’ level of perceived barriers was moderate on average and lower than that in previous research. Among the 10 top-ranked items, six were from the subscale ‘Organizational Characteristics’. Their perceived barriers were correlated positively with age and post-registration experience and negatively with research training undertaken. Junior diplomatic nurses reported a significantly higher degree of barriers than those senior ones with postgraduate education. Higher and more diverse barriers to research utilization in practice are perceived by Chinese nurses than those in Western countries and they are associated with a few socio-demographic factors. Future research on these barriers/facilitators and their relationships with occupational and socio-cultural factors in Chinese and other Asian nurses is recommended. PMID:23919099

Parental perception of built environment characteristics and built environment use among Latino families: a cross-sectional study.

PubMed

Heerman, William J; Mitchell, Stephanie J; Thompson, Jessica; Martin, Nina C; Sommer, Evan C; van Bakergem, Margaret; Taylor, Julie Lounds; Buchowski, Maciej S; Barkin, Shari L

2016-11-22

Perception of undesirable features may inhibit built environment use for physical activity among underserved families with children at risk for obesity. To examine the association of perceived availability, condition, and safety of the built environment with its self-reported use for physical activity, we conducted a cross-sectional analysis on baseline data from a randomized controlled trial. Adjusted Poisson regression was used to test the association between the primary independent variables (perceived availability, physical condition, and safety) with the primary outcome of self-reported use of built environment structures. Among 610 parents (90% Latino) of preschool-age children, 158 (26%) reported that there were no available built environment structures for physical activity in the neighborhood. The use of built environment structures was associated with the perceived number of available structures (B = 0.34, 95% CI 0.31, 0.37, p < 0.001) and their perceived condition (B = 0.19, 95% CI 0.12, 0.27, p = 0.001), but not with perceived safety (B = 0.00, 95% CI -0.01, 0.01, p = 0.7). In this sample of underserved families, perceived availability and condition of built environment structures were associated with use rather than perceived safety. To encourage physical activity among underserved families, communities need to invest in the condition and availability of built environment structures. Registered at ClinicalTrials.gov ( NCT01316653 ) on March 11, 2011.

A comparison of total reaction cross section models used in particle and heavy ion transport codes

NASA Astrophysics Data System (ADS)

Sihver, Lembit; Lantz, M.; Takechi, M.; Kohama, A.; Ferrari, A.; Cerutti, F.; Sato, T.

To be able to calculate the nucleon-nucleus and nucleus-nucleus total reaction cross sections with precision is very important for studies of basic nuclear properties, e.g. nuclear structure. This is also of importance for particle and heavy ion transport calculations because, in all particle and heavy ion transport codes, the probability function that a projectile particle will collide within a certain distance x in the matter depends on the total reaction cross sections. Furthermore, the total reaction cross sections will also scale the calculated partial fragmentation cross sections. It is therefore crucial that accurate total reaction cross section models are used in the transport calculations. In this paper, different models for calculating nucleon-nucleus and nucleus-nucleus total reaction cross sections are compared and discussed.

Medical students' research productivity and career preferences; a 2-year prospective follow-up study.

PubMed

Möller, Riitta; Shoshan, Maria

2017-03-03

Linking undergraduate medical education to scientific research is necessary for the quality of future health care, and students´ individual research projects are one way to do so. Assessment of the impact of such projects is of interest for both educational and research-oriented segments of medical schools. Here, we examined the scholarly products and medical students' career preferences 2 years after a mandatory research project course. A prospective cross-sectional questionnaire study. All 581 students registered on a 20-week research project course between September 2010 through September 2012 were e-mailed a questionnaire 2 years after completing the course. In total, 392 students (mean age 27 years; 60% females) responded (67% response rate). 59 students (15%) were co-authors on a scientific paper published in an international journal, 6 students had published in a national journal, and 57 students had co-authored a paper submitted for publication. Totally, 122 scientific papers had been submitted. Moreover, 67 (17%) students had given 107 oral or poster presentations nationally or internationally during the follow-up. Career-wise, 36 students (9%) had been registered as PhD students and an additional 127 students (34%) were planning to register. Those who did not plan doctoral studies were significantly older (p = 0.013) than those who did. However, 35% reported that they would in the coming 5 years prefer to work as clinicians only, and this group was significantly younger than those who envisaged participation in research. There were no significant gender differences. Approximately a third of the students had authored papers and/or public presentations, and a similar fraction had career plans involving a PhD degree. The results indicate that the project course had a positive impact on continued supervisor-student collaboration on a professional level, but also that strategies to encourage young doctors to perform clinical research may be needed.

Male RNs: Work Factors Influencing Job Satisfaction and Intention to Stay in the Profession.

PubMed

Rajacich, Dale; Kane, Debbie; Lafreniere, Kathryn; Freeman, Michelle; Cameron, Sheila; Daabous, James

2014-09-01

Males represent approximately 6.8% of registered nurses in Canada and consequently constitute an untapped health workforce resource. The authors investigated environmental work factors in the acute-care setting and their influence on male RNs' job satisfaction and intention to stay in the profession. They conducted a cross-sectional study of male RNs employed in acute-care settings in the province of Ontario. Correlations and multiple regression analyses were used to examine career satisfaction and intentions. Nurses who were most satisfied with their career valued extrinsic rewards (pay, vacation, and benefits), control and responsibility, and opportunities for professional development; those who were least satisfied and voiced their intention to leave the profession tended to work part time, experience gender mistreatment, and be dissatisfied with extrinsic awards, scheduling, and organizational support. A unique finding of this study relates to the significant predictive relationship between gender mistreatment and males' intention to leave. Copyright© by Ingram School of Nursing, McGill University.

Are pricing and reimbursement decision-making criteria aligned with public preferences regarding allocation principles in the Polish healthcare sector?

PubMed

Kolasa, Katarzyna

2014-10-01

Given growing interest in multicriteria decision making and multiple cost-effectiveness thresholds' approach, it was decided to investigate its usefulness in Poland. The pricing and reimbursement (P&R) regulations were reviewed and a cross-sectional survey was conducted amongst nurses. The study investigated whether P&R rules are aligned with the preferences of healthcare professional towards the concept of equity. The references to aversion to inequalities in health and capacity to benefit were recognized as the most and least important principle respectively by the group of nurses. Different weightings of health gain dependent on disease severity were accepted by half of the study's population. In the review of legal acts, references to capacity to benefit were frequently found. The opposite was registered for other concepts of equity. There is room for further improvement with respect to the alignment between the Polish P&R decision making criteria and public preferences regarding allocation principles.

Lifestyle and Depression among Hong Kong Nurses.

PubMed

Cheung, Teris; Yip, Paul S F

2016-01-16

Recent longitudinal data suggest a close association between depression and lifestyle. Little work to date has estimated the prevalence of depression in the nursing workforce in China, nor considered what lifestyle factors might be correlated with it-a gap filled by the present study. The study's web-based cross-sectional survey solicited data from qualified nurses aged between 21 and 65 registered with the Hong Kong Nursing Council. The Depression, Anxiety and Stress Scale 21 was used to measure 850 nurses for depression, anxiety and symptoms of stress; a generalized linear regression model examined associations between lifestyle factors and depression. Mean depression symptom scores show a downward linear trend for male and female participants. Gender and age, however, did not emerge as significant predictors of depression. Three lifestyles factors (sleep, entertainment and hobbies) showed a significant association with depression. Nurses should make therapeutic lifestyle changes to improve their work-life balance and safeguard their functioning at work and personal well-being.

Baccalaureate education in nursing and patient outcomes.

PubMed

Blegen, Mary A; Goode, Colleen J; Park, Shin Hye; Vaughn, Thomas; Spetz, Joanne

2013-02-01

The aim of this study was to examine the effects of registered nurse (RN) education by determining whether nurse-sensitive patient outcomes were better in hospitals with a higher proportion of RNs with baccalaureate degrees. The Future of Nursing report recommends increasing the percentage of RNs with baccalaureate degrees from 50% to 80% by 2020. Research has linked RN education levels to hospital mortality rates but not with other nurse-sensitive outcomes. This was a cross-sectional study that, with the use of data from 21 University HealthSystem Consortium hospitals, analyzed the association between RN education and patient outcomes (risk-adjusted patient safety and quality of care indicators), controlling for nurse staffing and hospital characteristics. Hospitals with a higher percentage of RNs with baccalaureate or higher degrees had lower congestive heart failure mortality, decubitus ulcers, failure to rescue, and postoperative deep vein thrombosis or pulmonary embolism and shorter length of stay. The recommendation of the Future of Nursing report to increase RN education levels is supported by these findings.

Cultural Awareness Among Nursing Staff at an Academic Medical Center.

PubMed

McElroy, Jennifer; Smith-Miller, Cheryl A; Madigan, Catherine K; Li, Yin

2016-03-01

The goal is to identify areas for targeted improvement in regard to cultural awareness and competence among nursing staff and in the work environment. Many facilities have initiated programs to facilitate cultural competence development among nursing staff; however, there has been little examination of the effect of these initiatives, assessment of experienced nurses' cultural awareness, or investigation of nurse leader's role in promoting cultural competence in the literature. In this cross-sectional descriptive study, a cultural awareness survey was modified and electronically distributed to all registered nurses and assistive personnel at an academic medical center. The modified survey instrument showed good reliability and validity among the study population. Most nursing staff exhibited a moderate to high level of cultural awareness and held positive opinions about nursing leadership and the work environment with regard to cultural issues. In increasingly diverse work environments, assessing the cultural awareness of nursing staff enables nurse leaders to evaluate efforts in promoting cultural competence and to identify specific areas in which to target staff development efforts and leadership training.

[Temporo-mandibular disorders and family functioning].

PubMed

Quinteromarmol-Juárez, Myriam; Espinosa-de Santillana, Irene Aurora; Martínez-Torres, Jorge; Vargas-García, Hugo Alberto

2008-01-01

To compare family functionality of patients with and without temporomandibular disorders (TMD). A comparative cross-sectional study was conducted with 130 patients attending to a maxillofacial surgery service. patient with or without TMD, age between 18 and 60 years, able to read and write and accepted to participate in the study. We registered sociodemographic variables, and we applied a questionnaire to identify risk factors for TMD, and finally intensity of pain was measure by a visual analogous scale. All patients were clinically evaluated to ascertain TMD according to the research diagnostic criteria for TMD proposed by Dworkin in 1992. The Family Adaptability and Cohesion Scale III (FACES-III) was used to evaluate family functionality. The mean of age was 34 +/- 10 years, ratio women : men, was 2 : 1; 67.7% were married or had a partner; the mean of education was 14 +/- 3.5 years; 56 % of women had TMD; 67.6 % had familiar dysfunction. Families of patients with TMD were dysfunctional more frequently and this suggests a relation.

Obstetric and perinatal health outcomes related to schizophrenia: A national register-based follow-up study among Finnish women born between 1965 and 1980 and their offspring.

PubMed

Simoila, Laura; Isometsä, Erkki; Gissler, Mika; Suvisaari, Jaana; Halmesmäki, Erja; Lindberg, Nina

2018-05-04

This national register-based study assesses obstetric and perinatal health outcomes in women with schizophrenia and their offspring. Using the Care Register for Health Care, we identified Finnish women who were born in 1965- 1980 and diagnosed with schizophrenia. For each case, five age- and place-of-birth- matched controls were obtained from the Central Population Register of Finland. They were followed from the day when the disorder was diagnosed in specialized health-care (the index day) until 31.12.2013. Information related to births was obtained from the Medical Birth Register and the Register of Congenital Malformations. We focused on singleton pregnancies that led to a delivery after the index day. We restricted the analysis of deliveries in controls to those that occurred after the index day of the case. Maternal age, marital status, smoking status, sex of the newborn, and parity were used as covariates in adjusted models. We identified 1162 singleton births among women with schizophrenia and 4683 among controls. Schizophrenic women had a 1.4-fold increased risk of induction of labor, delivery by cesarean section, and delivery by elective cesarean section. Regarding offspring, the risk of premature birth and the risk of low Apgar score at 1 min (<7) were 1.6-fold, of resuscitation 2.5-fold, and of neonatal monitoring 2.1-fold higher. Schizophrenia associates with some specific delivery methods, but delivery complications are rare and their prevalence does not differ from that observed among community women. Maternal schizophrenia associates with some negative perinatal health outcomes of the offspring. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

17 CFR 239.14 - Form N-2 for closed end management investment companies registered on Form N-8A.

Code of Federal Regulations, 2010 CFR

2010-04-01

... management investment companies registered on Form N-8A. 239.14 Section 239.14 Commodity and Securities... Registration Statements § 239.14 Form N-2 for closed end management investment companies registered on Form N... closed end management investment companies registered under the Investment Company Act of 1940 on form N...

Biomechanical Factors Associated With Jump Height: A Comparison of Cross-Sectional and Pre-to-Posttraining Change Findings.

PubMed

Marshall, Brendan M; Moran, Kieran A

2015-12-01

Previous studies investigating the biomechanical factors associated with maximal countermovement jump height have typically used cross-sectional data. An alternative but less common approach is to use pre-to-posttraining change data, where the relationship between an improvement in jump height and a change in a factor is examined more directly. Our study compared the findings of these approaches. Such an evaluation is necessary because cross-sectional studies are currently a primary source of information for coaches when examining what factors to train to enhance performance. The countermovement jump of 44 males was analyzed before and after an 8-week training intervention. Correlations with jump height were calculated using both cross-sectional (pretraining data only) and pre-to-posttraining change data. Eight factors identified in the cross-sectional analysis were not significantly correlated with a change in jump height in the pre-to-post analysis. Additionally, only 6 of 11 factors identified in the pre-to-post analysis were identified in the cross-sectional analysis. These findings imply that (a) not all factors identified in a cross-sectional analysis may be critical to jump height improvement and (b) cross-sectional analyses alone may not provide an insight into all of the potential factors to train to enhance jump height. Coaches must be aware of these limitations when examining cross-sectional studies to identify factors to train to enhance jump ability. Additional findings highlight that although exercises prescribed to improve jump height should aim to enhance concentric power production at all joints, a particular emphasis on enhancing hip joint peak power may be warranted.

The European Initiative ProYouth for the promotion of mental health and the prevention of eating disorders screening results in Hungary.

PubMed

Szabó, Kornélia; Czeglédi, Edit; Babusa, Bernadett; Szumska, Irena; Túry, Ferenc; Sándor, Imola; Bauer, Stephanie

2015-03-01

The ProYouth programme focuses on the promotion of mental health and the prevention of eating disorders (EDs) among young people. The aim of our study was to explore whether the programme can address individuals who are at risk for developing 2EDs. This study is designed as an online cross-sectional survey (n = 664, 12.2% men, 87.8% women, mean age: 24.9 years, SD = 5.4 years, range: 18-40 years). Measures included demographic data, self-reported weight and height, the Patient Health Questionnaire for Depression and Anxiety, Short Evaluation of Eating Disorders, Weight Concerns Scale and previous/current treatment for EDs. In terms of severity of EDs, 22.9% (n = 152) of the screened participants were symptom free, 48.8% (n = 324) had considerable concerns about their weight, 11.1% (n = 74) were slightly impaired, 15.1% (n = 100) had severe impairment and 2.1% (n = 14) of participants are currently under treatment for EDs. In total, 56.3% of users (n = 374) registered in the programme. According to our results, those who had considerable concerns about their weight and individuals who were severely impaired registered with a greater odds to the programme than those who were symptom free [odds ratio (OR) = 1.64, p = .021 and OR = 1.90, p = .023, respectively]. Furthermore, those who previously received treatment for their ED registered to the programme with greater odds than those who did not (OR = 2.40, p = .017). ProYouth successfully addressed those who have elevated concerns about their weight and who also registered with greater odds to the programme than those who were symptom free regarding EDs. The screening results show that there is a greater need for specialized care targeting EDs in Hungary than what is currently available. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Studies of electron-molecule collisions - Applications to e-H2O

NASA Technical Reports Server (NTRS)

Brescansin, L. M.; Lima, M. A. P.; Gibson, T. L.; Mckoy, V.; Huo, W. M.

1986-01-01

Elastic differential and momentum transfer cross sections for the elastic scattering of electrons by H2O are reported for collision energies from 2 to 20 eV. These fixed-nuclei static-exchange cross sections were obtained using the Schwinger variational approach. In these studies the exchange potential is directly evaluated and not approximated by local models. The calculated differential cross sections, obtained with a basis set expansion of the scattering wave function, agree well with available experimental data at intermediate and larger angles. As used here, the results cannot adequately describe the divergent cross sections at small angles. An interesting feature of the calculated cross sections, particularly at 15 and 20 eV, is their significant backward peaking. This peaking occurs in the experimentally inaccessible region beyond a scattering angle of 120 deg. The implication of this feature for the determination of momentum transfer cross sections is described.

Electron-induced scattering dynamics of Boron, Aluminium and Gallium trihalides in the intermediate energy domain

NASA Astrophysics Data System (ADS)

Verma, Pankaj; Alam, Mohammad Jane; Ahmad, Shabbir; Antony, Bobby

2018-05-01

This article is focused on the calculation of electron-induced ionisation and total scattering cross sections by Boron, Aluminium and Gallium trihalide molecules in the intermediate energy domain. The computational formalism, spherical complex optical potential has been employed for the study of these two scattering cross sections. The ionisation cross section has been derived from the inelastic cross section using a semi-empirical method called complex scattering potential-ionisation contribution (CSP-ic) method. We have also calculated the ionisation cross section using the BEB theory with Hartree-Fock and density functional theory (DFT- ωB97XD) orbitals so that a comparison can be made with the cross sections predicted by CSP-ic method. For this theoretical study, we have also calculated polarisability and bond length of some targets which were not found in literature using DFT/B3LYP in Gaussian 09 software.

Knowledge and Attitudes of Nurses Toward Pressure Injury Prevention: A Cross-Sectional Multisite Study.

PubMed

Barakat-Johnson, Michelle; Barnett, Catherine; Wand, Timothy; White, Kathryn

The purpose of the study was to examine the knowledge and attitudes of nurses on pressure injury prevention and determine if there was a relationship between knowledge, attitude, and years of experience following an unexplained increase in reported hospital-acquired pressure injuries across 1 health district in Sydney, Australia. Multisite cross-sectional study. Registered and enrolled nurses working in acute, medical, and rehabilitation units in 4 hospitals and 5 community health centers across a local health district. Using a modified version of the Pressure Ulcer Knowledge Test and the Staff Attitude Scale, nurses were invited to complete the survey online or on paper. A total of 3123 surveys were distributed and 998 were returned yielding a response rate of 32%. Approximately one-third of nurse respondents who participated in the survey had been practicing for 5 to 10 years. Almost 80% of participants scored 33/47 or more (70% or more correct) on the knowledge survey; the mean score was 35.21. The mean score for the attitudes test was 44.43 ± 4.77, out of 55 (80.7%), indicating a positive attitude toward pressure injury prevention. There was a significant positive correlation between nurses' years of experience and attitudes, but there was no correlation between years of experience and knowledge. Knowledge and attitudes were also significantly positively correlated. Nurses had sound knowledge and held positive attitudes toward pressure injury prevention. Positive attitudes were associated with greater time spent in the workforce. Additional research is required to examine relationships between knowledge of and attitude toward pressure injury prevention and clinical practice. Further research is also needed to determine if improving knowledge and attitudes results in a sustained reduction of hospital-acquired pressure injuries.

Low back pain among nurses in Slovenian hospitals: cross-sectional study.

PubMed

Skela-Savič, B; Pesjak, K; Hvalič-Touzery, S

2017-12-01

The study investigated the prevalence and factors predicting low back pain among nurses in Slovenian hospitals. The risk factors for low back pain are physical and psychosocial. Implementation of interventions for reducing low back pain calls for management support, accessible equipment, education, knowledge and risk assessment. Low back pain prevalence and incidence among healthcare workers is very high compared to the general population and is a strong risk factor for long-term sickness absence. A cross-sectional study design was utilized. We used validated instruments: Nordic Musculoskeletal Disorder Questionnaire, Stanford Presenteeism Scale and Perceived Stress Scale. The sample included 1744 nursing employees from 16 Slovenian hospitals, ranging from practical nurses, registered nurses, nurses with a bachelor's degree and those with a master's degree. Results revealed a prevalence of low back pain among 85.9% of respondents. Relevant risk factors included female gender, age, length of employment, years in current position, shift work and the number of nurses per shift. In the regression model, factors predicting low back pain included presenteeism with a negative effect on work, presenteeism and maintaining work productivity, inability to control daily life, number of nurses per shift and respondents' age. Future activities should be oriented towards eliminating or reducing risks for low back pain incidents and towards different strategies, guidelines and actions which empower individuals and provide knowledge to manage and prevent low back pain. Slovenian healthcare system planning needs a national strategy to successfully promote LBP preventive and controlling strategies. Management can plan preventive and curative measures to reduce low back pain prevalence among nursing personnel. Management should also implement policies reflecting research findings. © 2017 International Council of Nurses.

Prevalence of factors related to active reproductive health behavior: a cross-sectional study Indonesian adolescent.

PubMed

Susanto, Tantut; Rahmawati, Iis; Wuryaningsih, Emi Wuri; Saito, Ruka; Syahrul; Kimura, Rumiko; Tsuda, Akiko; Tabuchi, Noriko; Sugama, Junko

2016-01-01

Complex and diverse factors are related to reproductive health (RH) behavior among adolescents according to the social and cultural context of each countries. This study examined the prevalence of active RH and factors related to active RH behavior among Indonesian adolescents. A cross-sectional study was conducted among 1,040 of students who were selected through a multi-stage random sampling technique. A self-administered questionnaire was developed, including the World Health Organization Illustrative Questionnaire for Interview-Surveys with Young People, pubertal development scale, and sexual activity scale, modified in accordance to the Indonesian context. The data were analyzed using descriptive and comparative statistics, as well as logistic regression analyses. The prevalence of active RH behavior were more higher in boys (56.6%; 95% confidence interval [CI], 50.6% to 62.6%) than in girls (43.7%; 95% CI, 37.6% to 49.8%). Negative attitudes towards RH were a factor related to active RH behavior in both boys and girls. Smoking and kind relationship envisioned before marriage ( pacaran [courtship] and nikah siri [non-registered marriage]) were factors related to active RH behavior in boys; whereas the absence of access to information on substance abuse was an additional factor in girls. Moreover, an interaction was found between access to information on development and smoking (boys) and attitudes on RH (girls) as independent variables associated with active RH behavior. Sex education for adolescents in Indonesia, particularly in the context of a health promotion program, should be developed based on prevalent social, cultural, and religious values to prevent active RH behavior. Such programs should focus on the kind of relationship envisioned before marriage and smoking for boys and access to information on subtance abuse for girls.

Ethnic differences and parental beliefs are important for overweight prevention and management in children: a cross-sectional study in the Netherlands

PubMed Central

2012-01-01

Background The prevalence of obesity and overweight is highest among ethnic minority groups in Western countries. The objective of this study is to examine the contribution of ethnicity and beliefs of parents about overweight preventive behaviours to their child’s outdoor play and snack intake, and to the parents’ intention to monitor these behaviours. Methods A cross-sectional survey was conducted among parents of native Dutch children and children from a large minority population (Turks) at primary schools, sampled from Youth Health Care registers. Results Native Dutch parents observed more outdoor play and lower snack intake in their child and had stronger intentions to monitor these behaviours than parents of Turkish descent. In the multivariate analyses, the parents’ attitude and social norm were the main contributing factors to the parental intention to monitor the child’s outdoor play and snack intake. Parental perceived behavioural control contributed to the child’s outdoor play and, in parents who perceived their child to be overweight, to snacking behaviour. The associations between parents’ behavioural cognitions and overweight related preventive behaviours were not modified by ethnicity, except for perceived social norm. The relationship between social norm and intention to monitor outdoor play was stronger in Dutch parents than in Turkish parents. Conclusions As the overweight related preventive behaviours of both children and parents did differ between the native and ethnic minority populations of this study, it is advised that interventions pay attention to cultural aspects of the targeted population. Further research is recommended into parental behavioural cognitions regarding overweight prevention and management for different ethnicities. PMID:23057582

Prevalence of factors related to active reproductive health behavior: a cross-sectional study Indonesian adolescent

PubMed Central

Kimura, Rumiko; Tsuda, Akiko; Tabuchi, Noriko

2016-01-01

OBJECTIVES Complex and diverse factors are related to reproductive health (RH) behavior among adolescents according to the social and cultural context of each countries. This study examined the prevalence of active RH and factors related to active RH behavior among Indonesian adolescents. METHODS A cross-sectional study was conducted among 1,040 of students who were selected through a multi-stage random sampling technique. A self-administered questionnaire was developed, including the World Health Organization Illustrative Questionnaire for Interview-Surveys with Young People, pubertal development scale, and sexual activity scale, modified in accordance to the Indonesian context. The data were analyzed using descriptive and comparative statistics, as well as logistic regression analyses. RESULTS The prevalence of active RH behavior were more higher in boys (56.6%; 95% confidence interval [CI], 50.6% to 62.6%) than in girls (43.7%; 95% CI, 37.6% to 49.8%). Negative attitudes towards RH were a factor related to active RH behavior in both boys and girls. Smoking and kind relationship envisioned before marriage (pacaran [courtship] and nikah siri [non-registered marriage]) were factors related to active RH behavior in boys; whereas the absence of access to information on substance abuse was an additional factor in girls. Moreover, an interaction was found between access to information on development and smoking (boys) and attitudes on RH (girls) as independent variables associated with active RH behavior. CONCLUSIONS Sex education for adolescents in Indonesia, particularly in the context of a health promotion program, should be developed based on prevalent social, cultural, and religious values to prevent active RH behavior. Such programs should focus on the kind of relationship envisioned before marriage and smoking for boys and access to information on subtance abuse for girls. PMID:27866406

Improving job satisfaction of Chinese doctors: the positive effects of perceived organizational support and psychological capital.

PubMed

Fu, J; Sun, W; Wang, Y; Yang, X; Wang, L

2013-10-01

The huge population basic and the transformational changes to healthcare system in China have gained wide public attention in recent years. Along with these issues is a growing literature about doctor's job satisfaction; however, more is known about its negative related factors. Thus, this study was an attempt to assess the level of job satisfaction among Chinese doctors and to explore factors that enhance their job satisfaction. Cross-sectional questionnaire-based survey. A cross-sectional study was conducted during the period of September/October 2010. A questionnaire containing job satisfaction assessed by Minnesota Satisfaction Questionnaire (MSQ), demographic characteristics, work conditions, psychological capital (PsyCap) and perceived organizational support (POS) was distributed to 1300 registered doctors in Liaoning province. A total of 984 respondents became our subjects (effective response rate 75.7%). Hierarchical regression was performed to explore the factors associated with satisfaction. The average MSQ score was 65.86 (level ranking for MSQ, 20-100) in our study population. Hierarchical regression analysis showed that POS (β = 0.412, P < 0.001), PsyCap (β = 0.255, P < 0.001), incentive system (β = 0.119, P < 0.001) and educational background (β = 0.056, P = 0.042) were positively associated with job satisfaction. The job satisfaction of Chinese doctors was at a moderate level. POS and PsyCap seemed to be the most crucial factors in relation to job satisfaction. Therefore, efficient measures such as building a supportive work environment and developing doctors' PsyCap should be considered by health administrators in order to promote job satisfaction among Chinese doctors. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Health care utilisation under the 30-Baht Scheme among the urban poor in Mitrapap slum, Khon Kaen, Thailand: a cross-sectional study

PubMed Central

Coronini-Cronberg, Sophie; Laohasiriwong, Wongsa; Gericke, Christian A

2007-01-01

Background In 2001, the Government of Thailand introduced a universal coverage scheme with the aim of ensuring equitable health care access for even the poorest citizens. For a flat user fee of 30 Baht per consultation, or for free for those falling into exemption categories, every scheme participant may access registered health services. The exemption categories include children under 12 years of age, senior citizens aged 60 years and over, the very poor, and volunteer health workers. The functioning of these exemption mechanisms and the effect of the scheme on health service utilisation among the poor is controversial. Methods This cross-sectional study investigated the prevalence of 30-Baht Scheme registration and subsequent self-reported health service utilisation among an urban poor population in the Teparuk community within the Mitrapap slum in Khon Kaen city, northeastern Thailand. Furthermore, the effectiveness of the exemption mechanisms in reaching the very poor and the elderly was examined. Factors for users' choice of health facilities were identified. Results Overall, the proportion of the Teparuk community enrolled with the 30-Baht Scheme was high at 86%, with over one quarter of these exempted from paying the consultation fee. User fee exemption was significantly more frequent among households with an above-poverty-line income (64.7%) compared to those below the poverty line (35.3%), χ2 (df) = 5.251 (1); p-value = 0.018. In addition, one third of respondents over 60 years of age were found to be still paying user fees. Self-reported use of registered medical facilities in case of illness was stated to be predominantly due to the service being available through the scheme, with service quality not a chief consideration. Overall consumer satisfaction was high, especially among those not required to pay the 30 Baht user fee. Conclusion Whilst the 30-Baht Scheme seems to cover most of the poor population of Mitrapap slum in Khon Kaen, the user fee exemption mechanism only works partially with regard to reaching the poorest and exempting senior citizens. Service utilisation and satisfaction are highest amongst those who are fee-exempt. Service quality was not an important factor influencing choice of health facility. Ways should be sought to improve the effectiveness of the current exemption mechanisms. PMID:17883874

40 CFR 168.69 - Registered export pesticide products.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Registered export pesticide products. 168.69 Section 168.69 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE... Pesticides § 168.69 Registered export pesticide products. (a) Each export pesticide product that is...

40 CFR 168.69 - Registered export pesticide products.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Registered export pesticide products. 168.69 Section 168.69 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE... Pesticides § 168.69 Registered export pesticide products. (a) Each export pesticide product that is...

16 CFR 300.4 - Registered identification numbers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Registered identification numbers. 300.4 Section 300.4 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS RULES AND REGULATIONS UNDER THE WOOL PRODUCTS LABELING ACT OF 1939 Labeling § 300.4 Registered...

17 CFR 5.22 - Registered futures association membership.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Registered futures association membership. 5.22 Section 5.22 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION OFF-EXCHANGE FOREIGN CURRENCY TRANSACTIONS § 5.22 Registered futures association membership. (a) Each person...

5 CFR 351.404 - Retention register.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Retention register. 351.404 Section 351.404 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS REDUCTION IN FORCE Scope of Competition § 351.404 Retention register. (a) When a competing employee is to be released...

5 CFR 351.404 - Retention register.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Retention register. 351.404 Section 351.404 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS REDUCTION IN FORCE Scope of Competition § 351.404 Retention register. (a) When a competing employee is to be released...

5 CFR 351.404 - Retention register.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Retention register. 351.404 Section 351.404 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS REDUCTION IN FORCE Scope of Competition § 351.404 Retention register. (a) When a competing employee is to be released...

5 CFR 351.404 - Retention register.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Retention register. 351.404 Section 351.404 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS REDUCTION IN FORCE Scope of Competition § 351.404 Retention register. (a) When a competing employee is to be released...

5 CFR 351.404 - Retention register.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Retention register. 351.404 Section 351.404 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS REDUCTION IN FORCE Scope of Competition § 351.404 Retention register. (a) When a competing employee is to be released...

17 CFR 403.1 - Application of part to registered brokers and dealers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Application of part to registered brokers and dealers. 403.1 Section 403.1 Commodity and Securities Exchanges DEPARTMENT OF THE TREASURY REGULATIONS UNDER SECTION 15C OF THE SECURITIES EXCHANGE ACT OF 1934 PROTECTION OF CUSTOMER...

17 CFR 404.1 - Application of part to registered brokers and dealers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Application of part to registered brokers and dealers. 404.1 Section 404.1 Commodity and Securities Exchanges DEPARTMENT OF THE TREASURY REGULATIONS UNDER SECTION 15C OF THE SECURITIES EXCHANGE ACT OF 1934 RECORDKEEPING AND...