Research utilization and clinical nurse educators: A systematic review

Background Clinical nurse educators and other linking agents such as clinical nurse specialists, advanced nurse practitioners, and nurses working in research leadership positions are an important link in the facilitation of evidence‐based practice in health care organizations. Aim The purpose of this paper is to report the findings of a systematic review of the literature regarding clinical nurse educators and research utilization, using the Promoting Action on Research Implementation in Health Services framework as a backdrop for the analysis. Findings There is a positive relationship between research utilization and attitude toward research, higher levels of education, and reading professional nursing journals among clinical nurse educators. The authors suggest that not all clinical nurse educators have the necessary critical appraisal skills and research knowledge to use research effectively in practice. Conclusions Few studies have examined clinical nurse educators and the determinants of their research utilization behaviour in clinical practice. Future research on clinical nurse educators needs to focus on the outcomes of research utilization, including the effectiveness of their role as facilitators and the contexts in which they practice.     

A new framework for research leading to sports injury prevention

This paper proposes a new sports injury research framework, the Translating Research into Injury Prevention Practice framework, or TRIPP. This model builds on the fact that only research that can, and will, be adopted by sports participants, their coaches and sporting bodies will prevent injuries. Future advances in sports injury prevention will only be achieved if research efforts are directed towards understanding the implementation context for injury prevention, as well as continuing to build the evidence base for their efficacy and effectiveness of interventions. There is no doubt that intervention research in the sporting field can be difficult and many challenges need to be overcome; however, that should not be put up as a barrier towards undertaking it. Over the next few years, sports injury researchers will need to think carefully about the "best" study designs and analysis tools to achieve this. All reported sports injury studies, of whatever design, should include information on key implementation factors such as player/club recruitment rates and other biases as well as the rate of uptake of the interventions being tested, including reasons for use/non-use. However, it will only be broad research endeavours that adopt the TRIPP six-staged approach that will lead to real-world injury prevention gains.     

Impaired functional connectivity at EEG alpha and theta frequency bands in major depression

Recent reports on functional brain imaging in major depression have lead to an assumption that observed psychopathology might be related to an altered brain functional connectivity. Our hypothesis was that an increase in brain functional connectivity occurs in major depression. As a measure of functional connectivity, the electroencephalogram (EEG) structural synchrony approach was used in 12 medication-free depressive outpatients and 10 control subjects. Differences in the number and strength of structurally synchronized EEG patterns were compared between groups. In depressive patients the number and strength of short cortex functional connections were significantly larger for the left than for the right hemisphere, while the number and strength of long functional connections were significantly larger for the right than for the left hemisphere. Some of the functional connections were positively correlated with the severity of depression, thus being predictive. These were short-range anterior, posterior, and left hemisphere functional connections for the alpha frequency band and short-range anterior functional connections for the theta frequency band. The topology of the most representative functional connections among all patients with major depression indicated that the right anterior and left posterior brain parts may discriminate depressive patients from healthy controls. The obtained data support our hypothesis that there is an increase in brain functional connectivity in major depression. This finding was interpreted within the semantic framework, where different specialization of left (monosemantic context) and right (polysemantic context) hemispheres is functionally insufficient in patients with depression.     

“四步框架”法改变病案统计工作模式探讨

随着医院信息化建设的加速。电子病历、医生工作站、病案统计软件的应用,让我们思考沿用多年的病案统计工作模式是否需要改进？如何改进？本文利用“四步框架”法对病案统计工作模式的改变进行了探讨,为创造病案统计工作的全新价值,实现信息共享、自动化管理提供了一条新思路。     

Assessing program needs and planning change

Assessments of treatment staff training needs, preferences, and barriers can help guide and improve training activities and transfer evidence-based technologies into clinical practice. The Texas Christian University (TCU) Program Training Needs (PTN) assessment consists of 54 items organized into seven domains: Program Facilities and Climate, Program Computer Resources, Staff Training Needs, Preferences for Training Content, Preferences for Training Strategy, Training Barriers, and Satisfaction With Training. Data collected from 589 counselors representing 194 treatment programs showed that the PTN was psychometrically sound and predictably associated with results from a more comprehensive assessment of organizational functioning. Importantly, fewer barriers to training and greater staff satisfaction with training were reported for programs with higher levels of organizational functioning. In addition to representing an efficient source of staff's perceptions about organizational operations and needs, the PTN empowers staff with a "voice" through which they can contribute to strategic planning and priority setting for organizational actions.     

Population pharmacokinetic/pharmacodynamic (PK/PD) modelling of the hypothalamic-pituitary-gonadal axis following treatment with GnRH analogues

AIMS: To develop a population pharmacokinetic/pharmacodynamic (PK/PD) model of the hypothalamic-pituitary-gonadal (HPG) axis describing the changes in luteinizing hormone (LH) and testosterone concentrations following treatment with the gonadotropin-releasing hormone (GnRH) agonist triptorelin and the GnRH receptor blocker degarelix. METHODS: Fifty-eight healthy subjects received single subcutaneous or intramuscular injections of 3.75 mg of triptorelin and 170 prostate cancer patients received multiple subcutaneous doses of degarelix of between 120 and 320 mg. All subjects were pooled for the population PK/PD data analysis. A systematic population PK/PD model-building framework using stochastic differential equations was applied to the data to identify nonlinear dynamic dependencies and to deconvolve the functional feedback interactions of the HPG axis. RESULTS: In our final PK/PD model of the HPG axis, the half-life of LH was estimated to be 1.3 h and that of testosterone 7.69 h, which corresponds well with literature values. The estimated potency of LH with respect to testosterone secretion was 5.18 IU l(-1), with a maximal stimulation of 77.5 times basal testosterone production. The estimated maximal triptorelin stimulation of the basal LH pool release was 1330 times above basal concentrations, with a potency of 0.047 ng ml(-1). The LH pool release was decreased by a maximum of 94.2% by degarelix with an estimated potency of 1.49 ng ml(-1). CONCLUSIONS: Our model of the HPG axis was able to account for the different dynamic responses observed after administration of both GnRH agonists and GnRH receptor blockers, suggesting that the model adequately characterizes the underlying physiology of the endocrine system.     

Read All About It: Media Construction of a Heroin Epidemic

As part of a larger study on heroin trends in the city of Baltimore, the authors examined articles in the general circulation newspaper that serves the city and surrounding suburbs. Using computer archives, articles from 1992 to 1998 were searched for mentions of heroin. A method of analysis was developed that focused on the flow of articles through time with an emphasis on headlines and content summaries, with the goal of tracking the development of a new “topic framework” heroin use in the suburbs. The analysis shows how it is that certain stories work while others do not, and how eventually the topic framework is established so that the new trend is constituted as a community communicative resource. In the conclusion the model is generalized and four principles are hypothesized that account for why the topic framework finally took off.     

H. G. Dickson's problems with the ICIDH definition of impairment

The paper discusses H. G. Dickson's clinical commentary entitled ‘Problems with the ICIDH definition of impairment’. It is argued that Dickson's problems are brought about by an incorrect interpretation of the ICIDH concepts impairment and disability, and of the nature of their interrelationship.