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31.
Monique Lhussier HND MSc PhD Simon Eaton BMedSci BMBS FRCP DM CertMEd Natalie Forster BA PGCert Mathew Thomas BA Sue Roberts MBBS MSc FRCP Susan M Carr BA MSc PhD 《Health expectations》2015,18(5):605-624
Objective
This article focuses on approaches within clinical practice that seek to actively involve patients with long‐term conditions (LTCs) and how professionals may understand and implement them. Personalized care planning is one such approach, but its current lack of conceptual clarity might have impeded its widespread implementation to date. A variety of overlapping concepts coexist in the literature, which have the potential to impair both clinical and research agendas. The aim of this article is therefore to explore the meaning of the concept of care planning in relation to other overlapping concepts and how this translates into clinical practice implementation.Methods
Searches were conducted in the Cochrane database for systematic reviews, CINHAL and MEDLINE. A staged approach to conducting the concept mapping was undertaken, by (i) an examination of the literature on care planning in LTCs; (ii) identification of related terms; (iii) locating reviews of those terms. Retrieved articles were subjected to a content analysis, which formed the basis of our concept maps. (iv) We then appraised these against knowledge and experience of the implementation of care planning in clinical practice.Results and Conclusions
Thirteen articles were retrieved, in which the core importance of patient‐centredness, shared decision making and self‐management was highlighted. Literature searches on these terms retrieved a further 24 articles. Our concept mapping exercise shows that whilst there are common themes across the concepts, the differences between them reflect the context and intended outcomes within clinical practice. We argue that this clarification exercise will allow for further development of both research and clinical implementation agendas. 相似文献32.
The 2004 Canadian recommendations for the management of hypertension: Part III--Lifestyle modifications to prevent and control hypertension 总被引:1,自引:0,他引:1
Touyz RM Campbell N Logan A Gledhill N Petrella R Padwal R;Canadian Hypertension Education Program 《The Canadian journal of cardiology》2004,20(1):55-59
OBJECTIVE: To provide updated, evidence-based recommendations regarding the role of lifestyle modification in the treatment and prevention of hypertension. OUTCOMES: Lifestyle modification interventions including exercise, weight reduction, alcohol consumption, dietary modification, intake of dietary cations and stress management are reviewed. Antioxidants and fish oil supplements are also reviewed, although specific recommendations cannot be made at present. EVIDENCE: MEDLINE searches were conducted from January 2002 to September 2003 to update the 2001 recommendations for the management of hypertension. Supplemental searches in the Cochrane Collaboration databases were also performed. Reference lists were scanned, experts were contacted, and the personal files of the subgroup members and authors were used to identify additional published studies. All relevant articles were reviewed and appraised independently using prespecified levels of evidence by content and methodology experts. RECOMMENDATIONS: Key recommendations include the following: lifestyle modification should be extended to nonhypertensive individuals who are at risk for developing high blood pressure; 30 min to 45 min of aerobic exercise should be performed on most days (four to five days) of the week; an ideal body weight (body mass index 18.5 kg/m2 to 24.9 kg/m2) should be maintained and weight loss strategies should use a multidisciplinary approach; alcohol consumption should be limited to two drinks or fewer per day, and weekly intake should not exceed 14 standard drinks for men and nine standard drinks for women; a reduced fat, low cholesterol diet that emphasizes fruits, vegetables and low fat dairy products, and maintains an adequate intake of potassium, magnesium and calcium, should be followed; salt intake should be restricted to 65 mmol/day to 100 mmol/day in hypertensive individuals and less than 100 mmol/day in normotensive individuals at high risk for developing hypertension; and stress management should be considered as an intervention in selected individuals. VALIDATION: All recommendations were graded according to the strength of the evidence and voted on by the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. Individuals with irreconcilable competing interests (declared by all members, compiled and circulated before the meeting) relative to any specific recommendation were excluded from voting on that recommendation. Only those recommendations achieving at least 70% consensus are reported here. These guidelines will continue to be updated annually. 相似文献
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34.
Charles Dzviga Catherine Matevi Philippe Bonniaud Fran?ois Lavaud Bruno Girodet Joelle Birnbaum Claude Lambert the Interest Group on Insect Venom Hypersensitivity Allergy from the French Society of Allergology French Federation of Continuous Medical Education in Allergology 《Archives of Medical Science》2016,12(1):150-155
Introduction
Venom immunotherapy (VIT) is the only efficient prevention for sting-induced anaphylaxis, but its application is not without risks and needs precautions and standardization. European guidelines were proposed in 2005, but recent practice surveys and more recent knowledge raise the need for an update. The aim of this study was to analyze VIT practices in France, based on previous surveys in Europe but also extended to outcome event management.Material and methods
A paper questionnaire was sent widely to persons involved in venom treatment.Results
Eighty-six responses could be included from physicians actively involved in VIT induction evenly distributed in France. The survey shows that VIT was engaged from grade III down to grade I reactions, starting preferentially with the ultra-rush protocol. Premedication was used by 42% only and risks induced by co-treatment with β-blockers were well known but not with angiotensin-converting enzyme inhibitors. However, side effects were very variably managed from arrest to enhancement in doses, time-delay or duration. Similarly, we observed a large discrepancy in treatment evaluation (skin tests, biology, timing and interpretation), decision making for treatment termination (when and how long to be prolonged) and post-treatment follow-up (adrenaline kit, event record) as well as procedures in case of late relapse (new induction, different doses).Conclusions
Our study shows that most recommendations were fully or partially followed and may need reminding, but many points need to be completed or updated with new tools and knowledge acquired during the last 10 years. 相似文献35.
Characteristics of ''best'' and ''worst'' clinical teachers as perceived by university nursing faculty and students 总被引:7,自引:0,他引:7
Judith Mogan RN MA Assistant Professor Janet E. Knox RN MN Nursing Consultant—Education 《Journal of advanced nursing》1987,12(3):331-337
This study identified and compared characteristics of 'best' and 'worst' clinical teachers as perceived by university nursing faculty and students. The Nursing Clinical Teacher Effectiveness Inventory (NCTEI) was distributed to 201 volunteer subjects. This survey instrument, developed by the authors, contains 48 clinical teacher characteristics grouped into five categories. Each participant was asked to rate, using the NCTEI, the 'best' and them the 'worst' clinical teacher from past observations. Results showed both groups perceived that being a good role model was the highest rated characteristic for 'best' teachers and the 'lowest' rated characteristic for 'worst' teachers. Faculty and students' perceptions were fairly similar as to highest rated characteristics of 'best' clinical teachers. Less agreement was noted about the characteristics of 'worst' clinical teachers. When categories of clinical teacher characteristics were compared, there were significant differences between the ratings of faculty and students for 'best' clinical teachers, but none for 'worst' clinical teachers. 相似文献
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38.
Longitudinal Association Between Physical Activity and Frailty Among Community-Dwelling Older Adults
Xuxi Zhang MPH Siok Swan Tan PhD Carmen Betsy Franse PhD Lovorka Bilajac PhD Tamara Alhambra-Borrás PhD Jorge Garcés-Ferrer PhD Arpana Verma MD PhD Greg Williams MSc Gary Clough PGCert Elin Koppelaar PhD Tasos Rentoumis MSc Rob van Staveren MSc Antonius J. J. Voorham PhD Francesco Mattace-Raso MD PhD Amy van Grieken PhD Hein Raat MD PhD 《Journal of the American Geriatrics Society》2020,68(7):1484-1493
39.
造血损伤救治是核辐射损伤救治中面临的主要挑战之一,面对大批量伤员,如何迅速准确地对造血损伤做出伤情评估与诊断,并进行快速造血重建对维护国家核安全,加强军事卫勤保障力量具有重大意义.我们通过文献检索和评价,经专家组讨论,征求全军辐射医学专业委员会及全军血液学专业委员会专家建议,制定了"核辐射损伤造血重建策略专家共识",该... 相似文献
40.
Henny M Olsson Director PhD BSc UC in Nursing BSc in Midwifery BSc in Public Health Nursing UD in Nursing Education ResearchSupervisor Mats T Gullberg BSc in Behavioural Sciences Personnel Management Research Assistant Faculty of Health Sciences 《Nurse education today》1987,7(6):270-277
This article deals with professional role acquisition in nurses and discusses results from three studies concerning expectations and attitudes towards this acquisition. The studies have been carried out in Sweden. The discussion comprises expressed expectations and attitudes of nurse students and registered nurses in relation to our theoretical perspectives presented in a former article. The theoretical perspectives concentrate on three aspects of social action: change-drama, interchange-ritual, and maintenance-routine. The results indicate that the professional nurse role is acquired according to a traditional pattern, in spite of changes in curriculum and goals of nursing education and health care. Changes made to develop and improve the conditions under which role acquisitions take place. 相似文献