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排序方式: 共有189条查询结果,搜索用时 15 毫秒
1.
TOBIAS HUND MD BENJAMIN ASCHER MD BERTHOLD RZANY MD SCM FOR THE SMILE STUDY GROUP 《Dermatologic surgery》2006,32(10):1256-1260
BACKGROUND: Several clinical scoring systems have been used to evaluate the efficacy of botulinum toxin A in the treatment of hyperkinetic wrinkles. So far very few have been investigated for their reproducibility. OBJECTIVE: The aim of this study was to investigate the reproducibility of two clinical four-point scales for lateral canthal lines (crow's feet), at rest and at maximum smile. MATERIAL AND METHODS: Based on standardized photographs, a consensus atlas depicting the different severity grades [from 0 (none) to 3 (severe)] was developed. After training based on the atlas, 49 photographs at rest and 48 at maximum smile were graded by the same group of investigators on 2 consecutive days (n=9 on Day 1; n=8 on Day 2). The scores were compared for reproducibility using kappa statistics. RESULTS: Overall, reproducibility was good for both scales. Interobserver reproducibility showed an agreement of 0.6 at rest and 0.58 at maximum smile (unweighted kappa). Intraobserver reproducibility showed an agreement between 0.47 and 0.86 at rest and between 0.62 and 0.81 at maximum smile (unweighted kappa). Using weighted kappa analysis, the agreement ranged between 0.63 and 0.91 at rest and between 0.71 and 0.85 at maximum smile. CONCLUSION: The clinical scales using scores of 0 to 3 for crow's feet, both at rest and at maximum smile, show a good inter- and intraobserver reproducibility. The use of these scores in clinical trials can be recommended. 相似文献
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Jennifer Greenwood SRN SCM DipN RNT DipEd MEd PhD 《Journal of advanced nursing》1993,18(8):1183-1187
The seminal work of Argyris and Schon on action theories, technical rationality and reflective practice is reviewed, it is argued that their work reflects important inconsistencies between their theorizing and the pedagogical interventions they implemented/recommended The implications of the results of these inconsistencies, which appear mirrored in nurse-education programmes in the United Kingdom and Australia, are discussed Tentative suggestions for the provision of a more adequate practical pedagogy are included 相似文献
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Julie Smith PhD BSc PGCE RGN RHV RNT Lynne Pearson BA PG Dip RGN SCM John Adams RGN PhD 《International journal of nursing practice》2014,20(6):623-628
Although service improvement projects have been incorporated into some postregistration nurse education modules in the UK, they have not been generally available to pre‐registration students. This paper reports on the implementation and evaluation of a pilot project in pre‐registration nurse education at one university in eastern England. It concludes that the nursing students found the project to be a useful addition to their course. Supportive reactions were obtained from nurse managers, mentors and academics. A need to improve communication with clinical areas through the use of web‐based materials was highlighted. 相似文献
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B. R. Lamberg SRN SCM ON MTD 《Journal of advanced nursing》1981,6(6):455-459
Early eye contact between mother and baby is considered important in the attachment process between mother and baby. How soon after birth is it possible for eye contact to occur? How soon after birth will a baby open his eyes spontaneously? Where is the baby physically at that time? Is hospital labour ward routine conducive to early eye-to-eye contact between mother and baby? Discussing these questions with midwifery colleagues, it became apparent that we were unable to answer with any degree of certainty, the question ‘How soon after birth will a baby open his eyes spontaneously?’ It was felt that ‘most babies open their eyes at or very soon after birth’. How soon was ‘very soon’? and did all babies open their eyes soon after birth? Were there any observable influencing factors? If so, what were they? In this study of 104 babies, 30 babies opened their eyes at birth, and the remainder, except three, opened their eyes ranging from within 1 minute of birth to within 20 minutes of birth (20 minutes being the time limit set for the study). Some babies were observed to open their eyes momentarily only the very first time, keeping their eyes open longer subsequently. 相似文献
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Lisa Dyson BA MSc Josephine M. Green BA CPsychol PhD Mary J. Renfrew BSc SCM PhD Brian McMillan BSSc PhD Mike Woolridge BSc DPhil 《分娩》2010,37(2):141-149
Abstract: Background: The importance of breastfeeding‐related health outcomes in reducing inequalities in health has been recognized as a National Health Service target to increase initiation rates especially among disadvantaged groups in England. This study examined the psychosocial factors influencing infant feeding intention among pregnant teenagers expecting their first baby and living in deprived urban areas in England. Methods: A mixed methods study, using a quantitative questionnaire based on the Theory of Planned Behaviour, was conducted in four English regions with predominantly white and Asian teenagers (n = 71). This method identified which of all known Theory of Planned Behaviour variables were the most important in influencing feeding intentions. Focus groups provided contextual insight into the meaning of these variables for white pregnant teenagers living in a northern English inner city (n = 17). Results: Moral norms were identified as the most predictive variable influencing teenage intention to formula feed or breastfeed. The likelihood that breastfeeding “will be embarrassing” was the only attitudinal belief rated as significantly important in influencing teenage intention to breastfeed. Three overarching themes emerged from the focus group data: “moral norms,”“sexuality of the breast,” and “self‐esteem,” with concerns relating to breastfeeding in public cutting across all themes. Conclusions: Breastfeeding was viewed as a morally inappropriate behavior by most of these teenagers, with formula feeding being perceived as the appropriate behavior. Existing breastfeeding promotion activities are likely to continue to fail to reach teenagers experiencing deprivation in England in the absence of effective strategies to change the underlying negative moral norms toward breastfeeding. (BIRTH 37:2 June 2010) 相似文献
9.
Rosemary Mander MSc PhD RGN SCM MTD Professor of Midwifery Graeme D. Smith BA PhD RGN Senior Lecturer 《Midwifery》2010,26(6):573-578
Objectiveto review all published papers examining medical diagnosis of Ogilvie's syndrome and pregnancy with a view to assessing the implications of the diagnosis and the condition itself for childbearing women, midwives and medical practitioners.Designsystematic review.Search strategyMEDLINE, CINAHL, EMBASE, Web of Science and Cochrane databases were searched from 1950 to 2006 inclusive. Papers were read by two independent researchers and selected if they informed the link between Ogilvie's syndrome and childbearing or were concerned with other aspects of maternal mortality.Findings23 papers fulfilled the selection criteria and were of a suitable standard. Inconsistencies in relation to the diagnosis of Ogilvie's syndrome were noted, and an increase in maternal deaths from this condition was reported up to 2002.Key conclusionsthis paper highlights the strengths and weaknesses of medical diagnosis, as exemplified by Ogilvie's syndrome. The scientific basis of diagnoses such as Ogilvie's syndrome may deserve attention. This diagnosis has been shown to be unstable, both in temporal and aetiological terms. The midwifery and nursing reaction to the abrupt appearance of this condition is, at best, unfortunate. The attribution of blame to midwifery practices is deserving of a more robust response.Implications for practicethere may be clinical implications of the diagnosis of Ogilvie's syndrome for other aspects of maternity (including any nursing) care. A particularly significant area is the widely recognised increase in the caesarean rate with which Ogilvie's syndrome has been closely linked. 相似文献
10.
Practices and Policies in the Initiation of Breastfeeding 总被引:1,自引:0,他引:1
MARY J. RENFREW HOUSTON RN SCM Ph D PEGGY ANNE FIELD RN SCM Ph D 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》1988,17(6):418-425
Despite increasing knowledge about factors affecting the initiation of breastfeeding, many mothers still encounter problems and discontinue breastfeeding earlier than desired. Many hospitals still have not implemented the practices that are known to be helpful in the establishment of breastfeeding. As a result, a study was conducted to examine the policies and practices affecting breastfeeding in hospitals in Alberta, Canada. A questionnaire-based survey of all Alberta hospitals (including directors of nursing and staff nurses) found that many practices were still relatively inflexible; did not always reflect accurate, research-based information; and were not geared to the needs of mothers and infants. The implications of these findings are discussed. 相似文献