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The study that this article is based on was designed to portray and assess the appropriateness of the learning environment in hospital settings for Resident Medical Officers (RMOs) in New South Wales (NSW), Australia. It included visits to selected hospitals and a mailed statewide survey of RMOs. This article focuses on the latter component of the study, the survey of 209 RMOs practicing during the last quarter of 1992 in various clinical rotations in NSW hospitals. The study lends support to the perceived importance of organizational and sociopsychological variables as determinants of learning. These attributes include appropriate levels of autonomy, variety and workload, quality of supervision and social support, and, most important, the overall orientation toward teaching and learning, reflecting the culture prevailing in the clinical unit. The study provided an inventory of learning opportunities and their usefulness for the training of RMOs. It also explored the opportunity to practice particular procedures and skills in the respective clinical rotations. 相似文献
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Objectives
To assess the association between fatigue, cognition, domains of the EuroQol five-dimensional questionnaire (EQ-5D-3L), disability, and utilities estimated with several Western European value sets in patients with multiple sclerosis (MS).Methods
Data from a multinational, cross-sectional, observational study of patients with MS (N = 16,808) conducted in 16 European countries were used. Health-related quality of life data were collected through the EQ-5D-3L, and fatigue and cognitive difficulties were self-assessed on a 10-point visual analogue scale. Associations were assessed using Pearson correlation and multivariate regression model.Results
Symptoms of fatigue and cognitive difficulties were present in 90% and 70% of patients at all levels of disability, respectively, and thus only weakly correlated to disability. Problems in the EQ-5D-3L domains were common even at mild disability levels. Mobility, usual activities, and pain issues were experienced by 80% to 90% of patients with moderate and high levels of disability. Mobility, usual activities, and self-care were strongly correlated to disability. Disability, MS type, fatigue, and cognition were associated with utility in regression models, although the coefficients of fatigue and cognition were small.Conclusions
The strong relationship of disability with utility was confirmed. Despite this, fatigue and cognitive difficulties were associated with utility estimated with different European value sets. 相似文献76.
Kristine Lund Jenny Hultqvist Ulrika Bejerholm Elisabeth Argentzell Mona Eklund 《Scandinavian journal of occupational therapy》2020,27(6):462-473
AbstractBackground: There exist few recovery and occupation-based interventions for mental health service users. Balancing Everyday Life (BEL) is a new occupation-based lifestyle intervention that was created to fill this need.Aim: To gain group leaders’ and participants’ perspectives of the BEL intervention content and format, including factors that helped, hindered, and could be improved.Methods: A constructivist grounded theory method guided data collection and analysis. Interviews took place with 12 BEL group leaders and 19 BEL participants from out-patient psychiatry settings and community-based day centers in Sweden.Results: BEL’s structure and content were appreciated, yet flexibility was desired to adapt to participant needs. BEL could act as a bridge, helping participants connect with others, and to a more engaged and balanced everyday life. Facilitating factors included a person-focused (versus illness-focused) approach, physical and emotional environments, and connection. Barriers included room resources. More sessions were desired for the intervention.Conclusion: Group leaders and participants experienced BEL as a useful tool to instigate meaningful change and connection in the participants’ lives. The combination of a positive person-focused approach and group support was appreciated. These results could inform future research, evaluation, and development of occupation-focused lifestyle interventions for mental health service users. 相似文献
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Olson N O'Meara ES Jenny NS Folsom AR Bovill EG Furberg CD Heckbert SR Psaty BM Cushman M 《American journal of hematology》2008,83(7):524-527
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme involved in inflammation and platelet function. Inherited deficiency and elevated levels are associated with atherosclerosis. Given potential common etiologies of atherosclerosis and venous thrombosis (VT), we hypothesized that low and high Lp-PLA2 would be associated with VT risk. Lp-PLA(2) mass and activity were measured in baseline samples of Cardiovascular Health Study participants (5,888 men and women age > or =65), excluding 354 reporting pre-baseline VT. The study endpoint was VT unrelated to cancer after 11.6 years follow-up. Hazard ratios were estimated using Cox proportional hazard models, adjusting for age, race, sex, and body-mass index. With 129 cases of VT, there was no association of Lp-PLA2 activity with risk. Adjusted hazard ratios were 1.19 (CI 0.62, 2.29) and 0.87 (CI 0.43, 1.76) for the lowest and highest decile, respectively, compared to the 10-25th percentile. Corresponding hazard ratios for Lp-PLA2 mass were 1.63 (CI 0.79, 3.34) and 1.33 (CI 0.61, 2.87). Results were robust to several definitions of low or high Lp-PLA2. While the association of Lp-PLA(2) levels with arterial disease events implies a role for this enzyme in atherogenesis, our findings suggest that it is not prothrombotic. 相似文献
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Overcoming challenges to meaningful informed consent for whole genome sequencing in pediatric cancer research 下载免费PDF全文
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Martin Stroedicke Yacine Bounab Nadine Strempel Konrad Klockmeier Sargon Yigit Ralf P. Friedrich Gautam Chaurasia Shuang Li Franziska Hesse Sean-Patrick Riechers Jenny Russ Cecilia Nicoletti Annett Boeddrich Thomas Wiglenda Christian Haenig Sigrid Schnoegl David Fournier Rona K. Graham Michael R. Hayden Stephan Sigrist Gillian P. Bates Josef Priller Miguel A. Andrade-Navarro Matthias E. Futschik Erich E. Wanker 《Genome research》2015,25(5):701-713