Contesting lifestyle risk and gendering coronary candidacy: lay epidemiology of heart disease in Finland in the 1970s

This study addresses two issues currently under critical discussion in the epidemiology of cardiovascular diseases (CVD), the relative neglect of women and the individualised nature of key risk factors. It focuses on the North Karelia project (NKP), a community programme aimed at coronary heart disease (CHD) prevention in a predominantly rural Finnish region in the early 1970s, that is, during a period when the epidemiological understanding of CVD still was relatively new and actively promoted. Adopting the notions of lay epidemiology and coronary candidacy, culturally mediated explanatory models lay people use to assess who is likely to develop heart disease and why, the study shows that locals targeted by the project critically engaged with both of these bias. Based on the rich materials resulting from project activities the study shows, first, how many locals subsumed the individualised and lifestyle‐based approach to CHD prevention promoted by NKP under a more general framework emphasising the health effects of ongoing structural changes in the area, and second, how women constructed themselves as viable coronary candidates. The case supports the position in the current discussions on lay expertise that wants to integrate lay experiences more firmly into epidemiological studies and public health.     

Undergraduate nursing students' attitudes and preparedness toward caring for dying persons – A longitudinal study

Nursing education needs to prepare students for care of dying patients. The aim of this study was to describe the development of nursing students' attitudes toward caring for dying patients and their perceived preparedness to perform end-of-life care. A longitudinal study was performed with 117 nursing students at six universities in Sweden. The students completed the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) questionnaire at the beginning of first and second year, and at the end of third year of education. After education, the students completed questions about how prepared they felt by to perform end-of-life care. The total FATCOD increased from 126 to 132 during education. Five weeks' theoretical palliative care education significantly predicted positive changes in attitudes toward caring for dying patients. Students with five weeks' theoretical palliative care training felt more prepared and supported by the education to care for a dying patient than students with shorter education. A minority felt prepared to take care of a dead body or meet relatives.     

Economical Sponge Phantom for Teaching,Understanding, and Researching A‐ and B‐Line Reverberation Artifacts in Lung Ultrasound

This project evaluated a low‐cost sponge phantom setup for its capability to teach and study A‐ and B‐line reverberation artifacts known from lung ultrasound and to numerically simulate sound wave interaction with the phantom using a finite‐difference time‐domain (FDTD) model. Both A‐ and B‐line artifacts were reproducible on B‐mode ultrasound imaging as well as in the FDTD‐based simulation. The phantom was found to be an easy‐to‐set up and economical tool for understanding, teaching, and researching A‐ and B‐line artifacts occurring in lung ultrasound. The FDTD method–based simulation was able to reproduce the artifacts and provides intuitive insight into the underlying physics.     

Contributing to an integrated profession: a model-based examination of the A-ONE

Yerxa’s [1] model of an integrated profession depicts a circular scholarly process whereby ideas formed in practice are subjected to research and then returned to practice through education. This knowledge-generating cycle supports occupational science and the development of our professional identity. The aim of this article is to demonstrate how Yerxa’s model was used to evaluate if three developmental cycles of the ADL-Focused Occupation-Based Neurobehavioral Evaluation (A-ONE) sufficiently represented all necessary model components required for implementation into practice. The three cycles were historical, educational and measurement. The necessary components included: (a) dilemmas in practice, (b) new ideas that emerged from those practice issues, (c) research to test those ideas and (d) education designed to integrate new knowledge into practice. The results of this analysis of the A-ONE supported adequate research related to ideas from practice being implemented back into practice. Through using the model of an integrated profession to reflect on ideas ignited within practice, and then implementing research to explore the potential contribution of those ideas to knowledge generation, we gain the power to influence the future development of occupational science and the profession.     

Organizational Structure,Team Process,and Future Directions of Interprofessional Health Care Teams

ABSTRACT

For a nationwide Geriatric Interdisciplinary Team Training (GITT) program evaluation of 8 sites and 26 teams, team evaluators developed a quantitative and qualitative team observation scale (TOS), examining structure, process, and outcome, with specific focus on the training function. Qualitative data provided an important expansion of quantitative data, highlighting positive effects that were not statistically significant, such as role modeling and training occurring within the clinical team. Qualitative data could also identify “too much” of a coded variable, such as time spent in individual team members' assessments and treatment plans. As healthcare organizations have increasing demands for productivity and changing reimbursement, traditional models of teamwork, with large teams and structured meetings, may no longer be as functional as they once were. To meet these constraints and to train students in teamwork, teams of the future will have to make choices, from developing and setting specific models to increasing the use of information technology to create virtual teams. Both quantitative and qualitative data will be needed to evaluate these new types of teams and the important outcomes they produce.     

Perceptions of Home Dialysis Training and Experience Among US Nephrology Fellows

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Low perceived service quality in community pharmacy is associated with poor medication adherence

ObjectiveCommunity pharmacists are highly accessible healthcare professionals, whose regular contact with patients provides ongoing opportunities to improve medication safety and promote medication adherence. This study investigates whether patients who experience low service quality in community pharmacies are less adherent to their regular medications.MethodsEight Australian pharmacies were recruited, 5 self-identified as having a price promotion business strategy and 3 with a service-focused business strategy. Patients taking regular prescribed medicines who had previously attended the pharmacy completed e-surveys in-store with measures of perceived service quality (pSQ) and self-reported adherence. Multivariate regression using multilevel modelling with bootstrapping was used to explore the relationships between variables.ResultsSurveys were completed by 319 respondents. Attending pharmacies with a price promotion business strategy was predictive of lower pSQ and poor medication adherence. The between-pharmacy slope of the relationship between pSQ and adherence was 2.25 (with 95 % confidence intervals = 1.50, 2.86) and was highest in pharmacies with lowest pSQ.ConclusionThis study highlights that when patients experience low service quality, in community pharmacies they are more likely to report poor adherence to their regular prescribed medicines.Practice implicationsCommunity pharmacies need to be designed and managed to allow pharmacists to provide high levels of patient-centred care.     

Training interventions for healthcare providers offering group-based patient education. A scoping review

ObjectivesTo provide overview of research on training interventions for healthcare providers aimed at promoting competencies in delivering group-based patient education.MethodsA systematic literature search identified relevant studies. Data was extracted on training details, study design, outcomes and experiences. Results were summarized and qualitative data analyzed using content analysis.ResultsTwenty-seven studies exploring various training interventions were included. Ten studies used qualitative methods, eight quantitative and nine mixed methods. Use of a comparison group, validated instruments and follow-up measures was rare. Healthcare providers’ reactions to training were mostly positive. Several studies indicated positive short-term effects on self-efficacy and knowledge. Results on observed skills and patient outcomes were inconclusive. Results on healthcare providers’ experience of delivery of group-based patient education following training were categorized into 1) Benefits of training interventions, 2) Barriers to implementation and 3) Delivery support.ConclusionsFurther evaluation of training for healthcare providers delivering group-based patient education is needed before conclusions on training efficacy can be drawn. The results indicate an expanding research field still in maturation.Practice implicationsEfficacy studies evaluating theoretically grounded training with clear attention on group facilitation and follow-up support are needed. Inclusion of validated instruments and long-term outcomes is encouraged.