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Abstract
To design a brief cognitive screener with acceptable sensitivity and specificity for identifying subjects with cognitive impairment. Cohort one is assembled from a community-based survey coupled with a second-stage diagnostic evaluation using formal diagnostic criteria for dementia. Cohort two is assembled from referrals to a specialty clinic for dementing disorders ...
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Nursing Economic$ (September 2011)
by Robin P. Newhouse, Julie Stanik-Hutt, Kathleen M. White, et al.Meg Johantgen, Eric B. Bass, George Zangaro, Renee F. Wilson, Lily Fountain, Donald M. Steinwachs, Lou Heindel, Jonathan P. Weiner
Abstract
In this systematic review, Robin P. Newhouse, PhD, RN, NEA-BC, and co-authors compare APRN processes and outcomes to those of physician providers. Sixty-nine studies published between 1990 and 2008 were analyzed and 28 outcomes were summarized for nurses practicing in APRN roles. Newhouse and her co-authors describe patient outcomes for each of three groups: nurse practitioners, certified nurse-midwives and clinical nurse specialists. Outcomes with similar or better grades than those of physician comparison groups include: Nurse practitioners: Glucose control, lipid control, patient satisfaction, ...
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Abstract
Given the rapid changes in the communication landscape brought about by participative Internet use and social media, it is important to develop a better understanding of these technologies and their impact on health communication. The first step in this effort is to identify the characteristics of current social media users. Up-to-date reporting of current social media use will help monitor the growth of social media ...
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Abstract
The great majority of medical diagnoses are made using automatic, efficient cognitive processes, and these diagnoses are correct most of the time. This analytic review concerns the exceptions: the times when these cognitive processes fail and the final diagnosis is missed or wrong. We argue that physicians in general underappreciate the likelihood that their diagnoses are wrong and that this tendency to overconfidence is related to both intrinsic and systemically reinforced factors. We present a comprehensive review of the available literature ...
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Epidemiologic reviews, Vol. 20, No. 1. (1998), pp. 81-90
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(2011)
posted to boek
by bhengeveld
to the group Nursing Essentials
on 2011-10-29 16:04:19
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BMJ, Vol. 315, No. 7108. (6 September 1997), pp. 576-580
Abstract
Objective: To estimate the clinical and cost effectiveness of compression systems for treating venous leg ulcers.Methods: Systematic review of research. Search of 19 electronic databases including Medline, CINAHL, and Embase. Relevant journals and conference proceedings were hand searched and experts were consulted.Main outcome measures: Rate of healing and proportion of ulcers healed within a time period.Study selection: Randomised controlled trials, published or unpublished, with no restriction on date or language, that evaluated compression as a treatment for venous leg ulcers.Results: 24 ...
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Abstract
Knowledge among Dutch hospital nurses about the usefulness of measures to prevent pressure ulcers seems to be moderate. Being employed in an institution that monitors pressure ulcer care hardly affects the knowledge level. Knowledge about prevention has improved little since 1991. ...
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The New England journal of medicine In New England Journal of Medicine, Vol. 363, No. 22. (25 November 2010), pp. 2124-2134, doi:10.1056/nejmsa1004404
Abstract
In the 10 years since publication of the Institute of Medicine's report To Err Is Human, extensive efforts have been undertaken to improve patient safety. The success of these efforts remains unclear. We conducted a retrospective study of a stratified random sample of 10 hospitals in North Carolina. A total ...
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Abstract
the current study reveals a relatively high NPV and low PPV and TPA for the STRATIFY instrument, suggesting that it may not be optimal for identifying high-risk individuals for fall prevention. Further, the study demonstrates that population and setting affect STRATIFY performance. ...
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Abstract
Background: Despite limited evidence, it is often asserted that natural frequencies (for example, 2 in 1000) are the best way to communicate absolute risks.Objective: To compare comprehension of treatment benefit and harm when absolute risks are presented as natural frequencies, percents, or both.Design: Parallel-group randomized trial with central allocation and masking of investigators to group assignment, conducted through an Internet survey in September 2009. (ClinicalTrials.gov registration number: NCT00950014)Setting: National sample of U.S. adults randomly selected from a professional survey firm's research ...
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Abstract
Only behavior management therapies, specific types of caregiver and residential care staff education, and possibly cognitive stimulation appear to have lasting effectiveness for the management of dementia-associated neuropsychiatric symptoms. Lack of evidence regarding other therapies is not evidence of lack of efficacy. Conclusions are limited because of the paucity of high-quality research (only nine level-1 studies were identified). More high-quality investigation is needed. ...
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Abstract
Objective To determine whether a systematic approach to the treatment of pain can reduce agitation in people with moderate to severe dementia living in nursing homes.Design Cluster randomised controlled trial.Setting 60 clusters (single independent nursing home units) in 18 nursing homes within five municipalities of western Norway.Participants 352 residents with moderate to severe dementia and clinically significant behavioural disturbances randomised to a stepwise protocol for the treatment of pain for eight weeks with additional follow-up four weeks after the end of ...
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Abstract
BACKGROUND:Falls are common among older people and persons with dementia constitute an additional risk group. The aim of this study was to describe the nursing staff's opinion of caring for older persons with dementia with the focus on causes of falls, fall-preventing interventions, routines of documentation and report and the nursing staff's experiences and reactions when fall incidents occur. A further aim was to compare these areas between registered nurses (RNs) and enrolled nurses (ENs) and staff with [less than or ...
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Abstract
To improve the quality of end-of-life care, general practitioner (GP) awareness of where their patients prefer to die is important. To examine GP awareness of patients' preferred place of death (POD), associated patient- and care-related characteristics, and the congruence between preferred and actual POD in The Netherlands, a mortality follow-back study was conducted between January 2005 and December 2006. Standardized registration forms were used to collect data on all nonsudden deaths (n=637) by means of the Dutch Sentinel Network, a nationally ...
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Abstract
Although stroke is acknowledged as a long-term condition, population estimates of outcomes longer term are lacking. Such estimates would be useful for planning health services and developing research that might ultimately improve outcomes. This burden of disease study provides population-based estimates of outcomes with a focus on disability, cognition, and psychological outcomes up to 10 y after initial stroke event in a multi-ethnic European population. Data were collected from the population-based South London Stroke Register, a prospective population-based register documenting all ...
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Abstract
The success of evidence-based practice depends on the clear and effective communication of statistical information. To evaluate the effects of using alternative statistical presentations of the same risks and risk reductions on understanding, perception, persuasiveness and behaviour of health professionals, policy makers, and consumers. ...
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Abstract
Accessible patient-friendly materials are a useful and cost-effective way of increasing patients' knowledge and allaying their fears. This article describes how nursing leadership at a hospital in Connecticut created a patient education committee to review and help draft materials and developed a Web site to centralize these materials for staff and patients. A patient panel was implemented to test materials; results highlighted the need for planning and testing of materials on target audiences. ...
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Abstract
Pseudoscience, superstitions, and quackery are serious problems that threaten public health and in which many variables are involved. Psychology, however, has much to say about them, as it is the illusory perceptions of causality of so many people that needs to be understood. The proposal we put forward is that these illusions arise from the normal functioning of the cognitive system when trying to associate causes and effects. Thus, we propose to apply basic research and theories on causal learning to ...
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by Kerry Dwan, Douglas G. Altman, Juan A. Arnaiz, et al.Jill Bloom, An-Wen W. Chan, Eugenia Cronin, Evelyne Decullier, Philippa J. Easterbrook, Erik Von Elm, Carrol Gamble, Davina Ghersi, John P. Ioannidis, John Simes, Paula R. Williamson
Abstract
The increased use of meta-analysis in systematic reviews of healthcare interventions has highlighted several types of bias that can arise during the completion of a randomised controlled trial. Study publication bias has been recognised as a potential threat to the validity of meta-analysis and can make the readily available evidence unreliable for decision making. Until recently, outcome reporting bias has received less attention. ...
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Holland/Belgium Management Review, No. 130. (2010), pp. 2-7
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by Karen L. Gamble, Alison A. Motsinger-Reif, Akiko Hida, et al.Hugo M. Borsetti, Stein V. Servick, Christopher M. Ciarleglio, Sam Robbins, Jennifer Hicks, Krista Carver, Nalo Hamilton, Nancy Wells, Marshall L. Summar, Douglas G. McMahon, Carl Hirschie H. Johnson
Abstract
Daily cycles of sleep/wake, hormones, and physiological processes are often misaligned with behavioral patterns during shift work, leading to an increased risk of developing cardiovascular/metabolic/gastrointestinal disorders, some types of cancer, and mental disorders including depression and anxiety. It is unclear how sleep timing, chronotype, and circadian clock gene variation contribute to adaptation to shift work. ...
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Abstract
Background:
The Vivian Bullwinkel Oration honours the life and work of an extraordinary nurse. Given her story and that of her World War II colleagues, the topic of nursing heroism in the 21st century could not be more germane.DiscussionIs heroism a legitimate part of nursing, or are nurses simply 'just doing their job' even when facing extreme personal danger? In this paper I explore the place and relevance of heroism in contemporary nursing. I propose that nursing heroism deserves ...
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The Western journal of medicine, Vol. 176, No. 2. (March 2002), pp. 98-103
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Nursing Philosophy, No. 10. (2009), pp. 124-136
Abstract
Compassion unites people during times of suffering and distress. Unfortunately, compassion cannot take away suffering.Why then, is compassion important for people who suffer? Nurses work in a domain where human suffering is evidently present. In order to give meaning to compassion in the domain of professional care, it is necessary to describe what compassion is. The purpose of this paper is to explore questions and contradictions in the debate on compassion related to nursing care. The paper reviews classical philosophers as ...
Note (first note only)
Voor een Nederlandse versie, zie: Compassie als antwoord op leed. Een verkenning naar compassie in het domein zorg.
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Algemeen Nederlands Tijdschrift voor Wijsbegeerte, Vol. 100, No. 2. (2008), pp. 103-120
Abstract
Dit artikel geeft een overzicht van de vragen en tegenstellingen over com- passie in de filosofie en wil het belang van compassie voor het domein zorg beargumenteren. ...
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TvZ Tijdschrift voor Verpleegkundigen (March 2010), pp. 44-46
Abstract
In een deelonderzoek van een kwalitatieve studie naar de betekenis van compassie in de verpleegkundige praktijk zijn 12 verpleegkundigen en 11 zorgvragers in diepteinterviews ondervraagd over drie aspecten van compassie. Uit de antwoorden blijkt dat compassie voor de meeste zorgvragers en verpleegkundigen een onlosmakelijk onderdeel van de zorg is. ...
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Verpleegkunde, No. 4. (December 2010), pp. 18-25
Abstract
DOEL. Dit artikel beschrijft wat chronisch zieke ouderen en verpleegkundigen onder compassie verstaan en welke betekenis zij toekennen aan compassie in het domein zorg. METHODE. Om inzicht te krijgen in de betekenis van compassie in de context van langdurige verpleegkundige zorg, is kwalitatief onderzoek verricht in drie zorgsettings. De onderzoeksmethode betreft een kwalitatieve analyse van 61 interviews met patiënten en hun verpleegkundigen. RESULTAAT. Het blijkt dat compassie, zoals verwoord door de geïnterviewden, een gelaagd concept is dat is samengesteld uit de ...
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CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Vol. 164, No. 9. (1 May 2001), pp. 1291-1296
Abstract
This study suggests that the intervention program had no effect on the prescribing of PIPs. ...
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posted to flatus
by bhengeveld
to the group Nursing Essentials
on 2011-01-28 11:43:16
Abstract
Flatulence can cause discomfort and distress but there are few published data of normal patterns and volumes. Twenty four hour collections were made using a rectal catheter in 10 normal volunteers taking their normal diet plus 200 g baked beans. Total daily volume ranged from 476 to 1491 ml (median 705 ml). Women and men (both n = 5) expelled equivalent amounts. The median daily flatus hydrogen volume was 361 ml/24 h (range 42-1060) and the carbon dioxide volume 68 ml/24 ...
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Abstract
Purpose To analyze the need for palliative care in hospital patients who have cancer. Palliative care is an essential component of comprehensive cancer care and identification of palliative care needs (PCNs) of patients with cancer is a topic that has not been thoroughly studied.Patients and Methods Data were collected prospectively from inpatients of University Medical Center Freiburg in Freiburg, Germany, with 982 hospital beds included in the study. During the observation period of 17 months, each patient discharged from a hospital ...
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posted to delirium geriatrie seh
by bhengeveld
to the group Nursing Essentials
on 2011-01-27 11:05:37
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Annals of internal medicine, Vol. 130, No. 12. (15 June 1999), pp. 995-1004
Abstract
An important problem exists in the interpretation of modern medical research data: Biological understanding and previous research play little formal role in the interpretation of quantitative results. This phenomenon is manifest in the discussion sections of research articles and ultimately can affect the reliability of conclusions. The standard statistical approach has created this situation by promoting the illusion that conclusions can be produced with certain ...
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Abstract
Intravenous doses of medications require formulations that permit accurate preparation and administration. Current equipment does not permit accurate measurement of volumes less than 0.1 mL. In a study of four hypothetical standard pediatric patients, we found that 28 common medications required less than 0.1 mL of available formulation to prepare the dose. In a clinical study of actual use in a pediatric intensive care unit (ICU), 5245 (7.4%) of 71 218 intravenous doses required preparation from less than 0.1 mL of ...
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CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Vol. 178, No. 1. (1 January 2008), pp. 42-48, doi:10.1503/cmaj.061743
Abstract
Our data suggest that the reduction of provider fatigue and production of pediatric-strength solutions or industry-prepared infusions may reduce medication errors. ...
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posted to dood sterven transplantatie
by bhengeveld
to the group Nursing Essentials
on 2011-01-21 23:07:34
Abstract
A series of papers in Philosophy, Ethics and Humanities in Medicine (PEHM) have recently disputed whether non-heart beating organ donors are alive and whether non-heart beating organ donation (NHBD) contravenes the dead donor rule. Several authors who argue that NHBD involves harvesting organs from live patients appeal to "strong irreversibility" (death beyond the reach of resuscitative efforts to restore life) as a necessary criterion that patients must meet before physicians can declare them to be dead. Sam Shemie, who defends our ...
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Abstract
Urinary and fecal incontinence are comorbid conditions affecting over 50% of nursing home residents. Management should focus on identifying and treating underlying causes. Despite appropriate management, residents may remain incontinent because of dementia and health- or restraint-related immobility. This article reviews the results of studies that have documented how prompted voiding programs can significantly reduce urinary and fecal incontinence, particularly if the intervention includes dietary and exercise components. Documentation of noninvasive and efficacious interventions by randomized, controlled trials and the labor ...
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The Journal of neuropsychiatry and clinical neurosciences, Vol. 10, No. 2. (1998), pp. 199-204
Abstract
The authors studied 61 geropsychiatric patients with delirium from a cohort of 843 consecutive admissions to a geriatric clinical research unit. A central study goal was to assess how the presence of dementia affected the presentation of delirium. Eighteen delirious (D) and 43 delirious-demented (D-D) patients were compared on the Delirium Rating Scale (DRS), Mini-Mental State Examination (MMSE), Brief Psychiatric Rating Scale (BPRS), and EEG. D-D patients had lower MMSE scores, but no differences were found in total DRS or BPRS ...
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Australian family physician, Vol. 35, No. 4. (April 2006), pp. 237-241
posted to dementie incontinentie
by bhengeveld
to the group Nursing Essentials
on 2011-01-21 12:56:15
Abstract
Management is directed at turning around reversible factors, preserving independence and dignity of the patient, and providing sensitive and empathetic care even if the problem is not completely remediable. In those with more advanced dementia, timed and prompted voiding have shown the most promise. ...
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by Paula Rochon, Melanie Sekeres, John Hoey, et al.Joel Lexchin, Lorraine Ferris, David Moher, Wei Wu, Sunila Kalkar, Marleen Van Laethem, Andrea Gruneir, Jennifer Gold, James Maskalyk, David Streiner, Nathan Taback, An W. Chan
Abstract
BACKGROUND:Financial conflicts of interest (fCOI) can introduce actions that bias clinical trial results and reduce their objectivity. We obtained information from investigators about adherence to practices that minimize the introduction of such bias in their clinical trials experience.METHODS:Email survey of clinical trial investigators from Canadian sites to learn about adherence to practices that help maintain research independence across all stages of trial preparation, conduct, and dissemination. The main outcome was the proportion of investigators that reported full adherence to preferred trial ...
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Abstract
10.1136/bmj.39535.491238.94 ...
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Abstract
Background: most people in contemporary western society die of the chronic diseases of old age. Whilst palliative care is appropriate for elderly patients with chronic, non-malignant disease, few of these patients access such care compared with cancer patients. Objective referral criteria based on accurate estimation of survival may facilitate more timely referral of non-cancer patients most appropriate for specialist palliative care.Objective: to identify tools and predictor variables that might aid clinicians estimate survival and assess palliative status in non-cancer patients aged ...
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Abstract
BACKGROUND:Dietary restraint is largely unsuccessful for controlling obesity. As an alternative, subjects can easily be trained to reliably recognize sensations of initial hunger (IH) a set of physiological sensations which emerge spontaneously, not necessarily at planned mealtimes, and may be the afferent arm of a homeostatic system of food intake regulation. Previously we have reported that IH is associated with blood glucose concentration (BG) below 81.8 mg/dL (4.55 mmol/l), (low blood glucose, LBG), and that a pattern of meals in which ...
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by Chad Kerksick, Jennifer W. Bunn, Donovan Fogt, et al.Ashli Thomas, Lem Taylor, Bill Campbell, Colin Wilborn, Travis Harvey, Mike Roberts, Paul La Bounty, Melyn Galbreath, Brandon Marcello, Christopher Rasmussen, Richard Kreider
Abstract
BACKGROUND:This study's purpose investigated the impact of different macronutrient distributions and varying caloric intakes along with regular exercise for metabolic and physiological changes related to weight loss.METHODS:One hundred forty-one sedentary, obese women (38.7 +/- 8.0 yrs, 163.3 +/- 6.9 cm, 93.2 +/- 16.5 kg, 35.0 +/- 6.2 kg * m-2, 44.8 +/- 4.2% fat) were randomized to either no diet + no exercise control group (CON) a no diet + exercise control (ND), or one of four diet + exercise groups ...
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Abstract
This study begins to identify specific interventions for future research and applies the Dignity-Conserving Care Model to further understand dignified dying from an international nursing perspective. ...
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