669 results on '"Shields L"'
Search Results
302. Comprehensive Geriatric Assessment for Prevention of Delirium After Hip Fracture: A Systematic Review of Randomized Controlled Trials.
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Shields L, Henderson V, and Caslake R
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- Aged, Hip Fractures psychology, Humans, Institutionalization, Delirium prevention & control, Geriatric Assessment methods, Hip Fractures surgery, Randomized Controlled Trials as Topic
- Abstract
Objectives: To assess the efficacy of comprehensive geriatric assessment (CGA) in prevention of delirium after hip fracture., Design: Systematic review and metaanalysis., Setting: Ward based models on geriatrics wards and visiting team based models on orthopaedics wards were included., Participants: Four trials (three European, one U.S.; 973 participants) were identified. Two assessed ward-based, and two assessed team-based interventions., Measurements: MEDLINE, EMBASE, CINAHL and PsycINFO databases; Clinicaltrials.gov; and the Central Register of Controlled Trials were searched. Reference lists from full-text articles were reviewed. Incidence of delirium was the primary outcome. Length of stay, delirium severity, institutionalization, long-term cognition and mortality were predefined secondary outcomes. Duration of delirium was included as a post hoc outcome., Results: There was a significant reduction in delirium overall (relative risk (RR) = 0.81, 95% confidence interval (CI) = 0.69-0.94) in the intervention group. Post hoc subgroup analysis found this effect to be preserved in the team-based intervention group (RR = 0.77, 95% CI = 0.61-0.98) but not the ward-based group. No significant effect was observed on any secondary outcome., Conclusion: There was a reduction in the incidence of delirium after hip fracture with CGA. This is in keeping with results of non-randomized controlled trials and trials in other populations. Team-based interventions appeared superior in contrast to the Ellis CGA paper, but it is likely that heterogeneity in interventions and population studied affected this., (© 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.)
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- 2017
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303. Tools to assess risk of bias in systematic reviews of nursing intervention in China: Global implications of the findings.
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Zhang J, Wang J, Han L, Cao X, and Shields L
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- China, Humans, Risk Assessment, Bias, Data Accuracy, Nursing Research standards, Periodicals as Topic standards, Publishing standards, Review Literature as Topic
- Abstract
Background: The number of systematic reviews (SRs) of nursing interventions is increasing in China. Authors of such studies are encouraged to use a risk of bias tool for assessing individual studies. Therefore, it is important to know how these tools have been applied in SRs in Chinese nursing., Purpose: The purpose of the study is to examine risk of bias tools used by Chinese nursing researchers to assess the quality of individual studies included in SRs of nursing interventions., Methods: We searched the Chinese Biomedical Literature Database, Chinese Journal Full-Text Database, Chinese Academic Journal Full-Text Database, and Wanfang Database. Each relevant review found was subjected to quality assessment, data synthesis, and comprehensively described., Discussion: Two hundred eight SRs were identified, most (94.7%) of which used the words "systematic review" or "meta-analysis" in their titles. Most used quality assessment rather than risk of bias as their major method to gauge quality; 7.6% reported on six domains of the Cochrane risk of bias tool. Only four provided a risk of bias graph/summary figure., Conclusions: Many SRs of nursing interventions are published in Chinese journals, and their assessment of risk of bias is usually either lacking or incomplete, potentially producing misleading results. This may also be the case in other countries. Assessment of risk of bias in SRs is a requisite. Authors who systematically review nursing literature should follow the latest Cochrane Collaboration Handbook., (Copyright © 2016 Elsevier Inc. All rights reserved.)
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- 2017
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304. Family-centred care in cystic fibrosis: a pilot study in North Queensland, Australia.
- Author
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Smyth W, Abernethy G, Jessup M, Douglas T, and Shields L
- Abstract
Aims: The aims were to: (i) examine perceptions of family-centred care of parents of children with cystic fibrosis and healthcare professionals who care for them; (ii) test design and tools in a regional population., Design: Quantitative pilot study of existing questionnaire., Methods: The methods involved were comparative, cross-sectional survey of parents of children with cystic fibrosis and health staff in North Queensland, using "Perceptions of Family Centered Care - Parent" and "Perceptions of Family Centered Care - Staff" questionnaires; and descriptive study of tools., Results: Eighteen staff, 14 parents (78%, 61%); using Mann-Whitney U, showed no significant differences in scores in categories: 'support' 'respect', 'collaboration'. Comments about suitability of questionnaires varied, but were largely positive.
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- 2017
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305. All is not well with family-centred care.
- Author
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Shields L
- Subjects
- England, Family Health, Family Nursing, Family Practice
- Abstract
Family-centred care is in trouble. For 30 years, hospitals and health services around the world have been trying to implement it.
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- 2017
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306. Attitudes to lesbian, gay, bisexual and transgender parents seeking health care for their children in two early parenting services in Australia.
- Author
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Bennett E, Berry K, Emeto TI, Burmeister OK, Young J, and Shields L
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- Attitude of Health Personnel, Australia, Bisexuality statistics & numerical data, Child, Cross-Sectional Studies, Female, Homosexuality, Female statistics & numerical data, Homosexuality, Male statistics & numerical data, Humans, Male, Patient Acceptance of Health Care statistics & numerical data, Sexual and Gender Minorities psychology, Surveys and Questionnaires, Parenting psychology, Sexual and Gender Minorities statistics & numerical data, Transgender Persons statistics & numerical data
- Abstract
Aims and Objectives: To examine the attitudes to and knowledge and beliefs about homosexuality of nurses and allied professionals in two early parenting services in Australia., Background: Early parenting services employ nurses and allied professionals. Access and inclusion policies are important in community health and early childhood service settings. However, little is known about the perceptions of professionals who work within early parenting services in relation to lesbian, gay, bisexual and transgender families., Design: This is the final in a series of studies and was undertaken in two early parenting services in two states in Australia using a cross-sectional design with quantitative and qualitative approaches., Methods: Validated questionnaires were completed by 51 nurses and allied professionals and tested with chi-squared test of independence (or Fisher's exact test), Mann-Whitney U-test, Kruskal-Wallis one-way analysis of variance or Spearman's rank correlation. Thematic analysis examined qualitative data collected in a box for free comments., Results: Of the constructs measured by the questionnaires, no significant relationships were found in knowledge, attitude and gay affirmative practice scores by sociodemographic variables or professional group. However, attitude scores towards lesbians and gay men were significantly negatively affected by conservative political affiliation (p = 0·038), held religious beliefs (p = 0·011) and frequency of praying (p = 0·018). Six overall themes were found as follows: respect, parenting role, implications for the child, management, disclosure, resources and training., Conclusions: The study provided an in-depth analysis of the attitudes, knowledge and beliefs of professionals in two early parenting services, showing that work is needed to promote acceptance of diversity and the inclusion of lesbian, gay, bisexual and transgender families in planning, developing, evaluating and accessing early parenting services., Relevance to Clinical Practice: Access and inclusion plans for lesbian, gay, bisexual and transgender families are crucial in early parenting services in Australia and should be included in professional development programmes., (© 2016 John Wiley & Sons Ltd.)
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- 2017
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307. Interventions for promoting participation in shared decision-making for children with cancer.
- Author
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Coyne I, O'Mathúna DP, Gibson F, Shields L, Leclercq E, and Sheaf G
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- Adolescent, Child, Child, Preschool, Humans, Decision Making, Neoplasms, Patient Participation
- Abstract
Background: This is an update of the Cochrane systematic review of shared decision-making (SMD) making published in 2013. Children's rights to have their views heard in matters that affect their lives are now well established since the publication of the UN Convention treaty (1989). Children with cancer generally prefer to be involved in decision-making and consider it important that they have the opportunity to take part in decision-making concerning their health care, even in end-of-life decisions. There is considerable support for involving children in healthcare decision-making at a level commensurate with their experience, age and abilities. Thus, healthcare professionals and parents need to know how they should involve children in decision-making and what interventions are most effective in promoting SDM for children with cancer., Objectives: To examine the effects of SDM interventions on the process of SDM for children with cancer who are aged four to 18 years., Search Methods: We searched the following sources for the review: Cochrane Central Register of Controlled Studies (CENTRAL) (the Cochrane Library 2016, Issue 1); PubMed (NLM) (1946 to February 2016); Embase (Ovid) (1974 to February 2016); CINAHL (EBSCO) (1982 to February 2016); ERIC (ProQuest) (1966 to February 2016); PsycINFO (EBSCO) (1806 to February 2016); BIOSIS (Thomson Reuters) (1980 to December 2009 - subscription ceased at that date); ProQuest Dissertations and Theses (1637 to February 2016); and Sociological Abstracts (ProQuest) (1952 to February 2016). In addition we searched the reference lists of relevant articles and review articles and the following conference proceedings (2005 up to and including 2015): American Academy on Communication in Healthcare (AACH), European Society for Medical Oncology (ESMO), European CanCer Organisation (ECCO), European Association for Communication in Healthcare (EACH), International Conference on Communication in Healthcare (ICCH), International Shared Decision Making Conference (ISDM), Annual Conference of the International Society for Paediatric Oncology (SIOP) and Annual Scientific Meeting of the Society for Medical Decision Making (SMDM). We scanned the ISRCTN (International Standard Randomised Controlled Trial Number) register and the National Institutes of Health (NIH) Register for ongoing trials on 29 February 2016., Selection Criteria: For this update, we included randomised controlled trials (RCTs) and controlled clinical trials (CCTs) of SDM interventions for children with cancer aged four to 18 years. The types of decisions included were: treatment, health care and research participation decisions. The primary outcome was SDM as measured with any validated scale., Data Collection and Analysis: Two review authors undertook the searches, and three review authors independently assessed the studies obtained. We contacted study authors for additional information., Main Results: No studies met the inclusion criteria, and hence no analysis could be undertaken., Authors' Conclusions: No conclusions can be made on the effects of interventions to promote SDM for children with cancer aged four to 18 years. This review has highlighted the dearth of high-quality quantitative research on interventions to promote participation in SDM for children with cancer. There are many potential reasons for the lack of SDM intervention studies with children. Attitudes towards children's participation are slowly changing in society and such changes may take time to be translated or adopted in healthcare settings. The priority may be on developing interventions that promote children's participation in communication interactions since information-sharing is a prerequisite for SDM. Restricting this review to RCTs was a limitation and extending the review to non-randomised studies (NRS) may have produced more evidence. For this update, we included only RCTs and CCTs. Clearly more research is needed.
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- 2016
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308. Dame Maud McCarthy (1859-1949): Matron-in-Chief, British Expeditionary Forces France and Flanders, First World War.
- Author
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Shields R and Shields L
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- France, History, 19th Century, History, 20th Century, New South Wales, South Africa, United Kingdom, Military Nursing history, Military Personnel history
- Abstract
Emma Maud McCarthy was one of the most decorated nurses of the First World War. Born in Sydney in 1859, she trained as a nurse at The London Hospital in England. She was one of the first nurses to go to the South African War and in 1914 was one of the first members of Queen Alexandra's Imperial Nursing Service. Maud McCarthy went to France as Matron-in-Chief of British, Colonial and US nursing services until the end of hostilities in 1918. After the First World War she became Matron-in-Chief of the Territorial Army Nursing Service and retired five years later. She was appointed Dame Grand Cross in 1918 and earned awards from Britain, France, Belgium and America. Her influence on nursing was profound. One of the first senior nurses to recognise the impact of war on minds, she set up separate units for men who had self-harmed and she pioneered nurse anaesthetists in the British Armed Forces. Dame Maud McCarthy was an administrator par excellence whose determination to provide the best conditions possible for both her nurses and the men for whom they cared made possible the highest standards of nursing care in the First World War., (© The Author(s) 2015.)
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- 2016
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309. Determination of MLC model parameters for Monaco using commercial diode arrays.
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Kinsella P, Shields L, McCavana P, McClean B, and Langan B
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- Algorithms, Gamma Rays, Humans, Monte Carlo Method, Radiotherapy Dosage, Software, Quality Assurance, Health Care standards, Radiometry methods, Radiotherapy Planning, Computer-Assisted methods, Radiotherapy, Intensity-Modulated instrumentation, Radiotherapy, Intensity-Modulated methods, Semiconductors
- Abstract
Multileaf collimators (MLCs) need to be characterized accurately in treatment planning systems to facilitate accurate intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT). The aim of this study was to examine the use of MapCHECK 2 and ArcCHECK diode arrays for optimizing MLC parameters in Monaco X-ray voxel Monte Carlo (XVMC) dose calculation algorithm. A series of radiation test beams designed to evaluate MLC model parameters were delivered to MapCHECK 2, ArcCHECK, and EBT3 Gafchromic film for comparison. Initial comparison of the calculated and ArcCHECK-measured dose distributions revealed it was unclear how to change the MLC parameters to gain agreement. This ambiguity arose due to an insufficient sampling of the test field dose distributions and unexpected discrepancies in the open parts of some test fields. Consequently, the XVMC MLC parameters were optimized based on MapCHECK 2 measurements. Gafchromic EBT3 film was used to verify the accuracy of MapCHECK 2 measured dose distributions. It was found that adjustment of the MLC parameters from their default values resulted in improved global gamma analysis pass rates for MapCHECK 2 measurements versus calculated dose. The lowest pass rate of any MLC-modulated test beam improved from 68.5% to 93.5% with 3% and 2 mm gamma criteria. Given the close agreement of the optimized model to both MapCHECK 2 and film, the optimized model was used as a benchmark to highlight the relatively large discrepancies in some of the test field dose distributions found with ArcCHECK. Comparison between the optimized model-calculated dose and ArcCHECK-measured dose resulted in global gamma pass rates which ranged from 70.0%-97.9% for gamma criteria of 3% and 2 mm. The simple square fields yielded high pass rates. The lower gamma pass rates were attributed to the ArcCHECK overestimating the dose in-field for the rectangular test fields whose long axis was parallel to the long axis of the ArcCHECK. Considering ArcCHECK measurement issues and the lower gamma pass rates for the MLC-modulated test beams, it was concluded that MapCHECK 2 was a more suitable detector than ArcCHECK for the optimization process., (© 2016 The Authors)
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- 2016
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310. How can mental health and faith-based practitioners work together? A case study of collaborative mental health in Gujarat, India.
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Shields L, Chauhan A, Bakre R, Hamlai M, Lynch D, and Bunders J
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- Adult, Community Mental Health Services organization & administration, Female, Humans, India, Interviews as Topic, Male, Middle Aged, Qualitative Research, Young Adult, Cooperative Behavior, Faith Healing, Help-Seeking Behavior, Mental Disorders psychology, Mental Disorders therapy
- Abstract
Despite the knowledge that people with mental illness often seek care from multiple healing systems, there is limited collaboration between these systems. Greater collaboration with existing community resources could narrow the treatment gap and reduce fragmentation by encouraging more integrated care. This paper explores the origins, use, and outcomes of a collaborative programme between faith-based and allopathic mental health practitioners in India. We conducted 16 interviews with key stakeholders and examined demographic and clinical characteristics of the user population. Consistent with previous research, we found that collaboration is challenging and requires trust, rapport-building, and open dialogue. The collaboration reached a sizeable population, was reviewed favourably by key stakeholders-particularly on health improvement and livelihood restoration-and perhaps most importantly, views the client holistically, allowing for both belief systems to play a shared role in care and recovery. Results support the idea that, despite differing practices, collaboration between faith-based and allopathic mental health practitioners can be achieved and can benefit clients with otherwise limited access to mental health care., (© The Author(s) 2016.)
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- 2016
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311. How is Family Centered Care Perceived by Healthcare Providers from Different Countries? An International Comparison Study.
- Author
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Feeg VD, Paraszczuk AM, Çavuşoğlu H, Shields L, Pars H, and Al Mamun A
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- Adult, Australia, Child, Female, Humans, Internationality, Male, Outcome Assessment, Health Care, Perception, Personal Satisfaction, Psychometrics, Qualitative Research, Surveys and Questionnaires, Turkey, United States, Attitude of Health Personnel, Child Health Services organization & administration, Child, Hospitalized statistics & numerical data, Health Personnel organization & administration, Patient-Centered Care organization & administration
- Abstract
Unlabelled: Family-centered care (FCC) is a healthcare delivery model in which planning care for a child incorporates the entire family. The purpose of this study was to describe and compare how healthcare providers from three countries with varied cultural and healthcare systems perceive the concept FCC by measuring attitudes, and to psychometrically identify a measure that would reflect "family-centeredness.", Design and Methods: The Working with Families questionnaire, translated when appropriate, was used to capture participants' perceptions of caring for hospitalized children and their parents from pediatric healthcare providers in the United States, Australia and Turkey (n=476)., Results: The results indicated significantly more positive attitudes reported for working with children than parents for all countries and individual score differences across countries: the U.S. and Turkey child scores were significantly higher than Australia, whereas the U.S. and Australia parent scores were both significantly higher than Turkey., Conclusions: Perceptions of working with families were different for nurses from the three countries that call for a clearer understanding about perceptions in relation to delivery systems. Further analyses revealed FCS scores to be significantly different between nurses and physicians and significantly correlated with age, number of children and education., Practice Implications: The results of this study add to our understanding of influences on practice from different countries and healthcare systems. The FCS score may be useful to determine baseline beliefs and ascertain effectiveness of interventions designed to improve FCC implementation., (Copyright © 2016 Elsevier Inc. All rights reserved.)
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- 2016
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312. Parental Experience of Information and Education Processes Following Diagnosis of Their Infant With Cystic Fibrosis Via Newborn Screening.
- Author
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Jessup M, Douglas T, Priddis L, Branch-Smith C, and Shields L
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- Adaptation, Psychological, Adult, Attitude to Health, Caregivers psychology, Cystic Fibrosis nursing, Female, Humans, Infant, Newborn, Male, Medical Informatics, Needs Assessment, Neonatal Screening, Parenting psychology, Qualitative Research, Queensland, Sampling Studies, Caregivers education, Cystic Fibrosis diagnosis, Children with Disabilities, Parents education
- Abstract
Unlabelled: Following diagnosis with cystic fibrosis (CF), initial education powerfully influences parental adjustment and engagement with care teams. This study explored the education needs of ten parents following their infant's diagnosis with CF via newborn screening., Design and Methods: Phenomenological study using van Manen's approach, with ten participant parents of children 1-8 years with CF., Results: Parents recounted varying degrees of coping with information they acknowledged as overwhelming and difficult. For some it was too much too soon, while others sought such clarity to put CF into context., Conclusions: Participants delivered insight into their engagement with their education about CF. Their recommendations for appropriate context, content, format and timing of delivery enable development of education that is accurate and relevant., (Copyright © 2016 Elsevier Inc. All rights reserved.)
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- 2016
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313. Family-centred care: the 'captive mother' revisited.
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Shields L
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- Family, Female, Humans, Mothers, Patient Admission, Delivery of Health Care methods, Parent-Child Relations, Patient-Centered Care methods
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- 2016
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314. Family presence during resuscitation in a paediatric hospital: health professionals' confidence and perceptions.
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McLean J, Gill FJ, and Shields L
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- Adult, Child, Clinical Competence, Critical Care, Cross-Sectional Studies, Female, Humans, Male, Medical Staff, Hospital, Middle Aged, Nursing Staff, Hospital, Professional-Family Relations, Self Concept, Surveys and Questionnaires, Attitude of Health Personnel, Family, Hospitals, Pediatric, Resuscitation
- Abstract
Aims and Objectives: To investigate medical and nursing staff's perceptions of and self-confidence in facilitating family presence during resuscitation in a paediatric hospital setting., Background: Family presence during resuscitation is the attendance of family members in a location that affords visual or physical contact with the patient during resuscitation. Providing the opportunity for families to be present during resuscitation embraces the family-centred care philosophy which underpins paediatric care. Having families present continues to spark much debate amongst health care professionals., Design: A descriptive cross-sectional randomised survey using the 'Family Presence Risk/Benefit Scale' and the 'Family Presence Self-Confidence Scale 'to assess health care professionals' (doctors and nurses) perceptions and self-confidence in facilitating family presence during resuscitation of a child in a paediatric hospital., Methods: Surveys were distributed to 300 randomly selected medical and nursing staff. Descriptive and inferential statistics were used to compare medical and nursing, and critical and noncritical care perceptions and self-confidence., Results: Critical care staff had statistically significant higher risk/benefit scores and higher self-confidence scores than those working in noncritical care areas. Having experience in paediatric resuscitation, having invited families to be present previously and a greater number of years working in paediatrics significantly affected participants' perceptions and self-confidence. There was no difference between medical and nursing mean scores for either scale., Conclusion: Both medical and nursing staff working in the paediatric setting understood the needs of families and the philosophy of family-centred care is a model of care practised across disciplines., Relevance to Clinical Practice: This has implications both for implementing guidelines to support family presence during resuscitation and for education strategies to shift the attitudes of staff who have limited or no experience., (© 2016 John Wiley & Sons Ltd.)
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- 2016
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315. Optimal target for blood pressure control - how low should we go?
- Author
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Soiza RL and Shields L
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- Antihypertensive Agents, Humans, Hypertension, Blood Pressure drug effects, Blood Pressure Determination
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- 2016
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316. Posttraumatic Stress and Depression in the Nonoffending Caregivers of Sexually Abused Children: Associations With Parenting Practices.
- Author
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Jobe-Shields L, Swiecicki CC, Fritz DR, Stinnette JS, and Hanson RF
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- Adolescent, Child, Depression diagnosis, Depressive Disorder diagnosis, Female, Humans, Male, Mental Health, Stress Disorders, Post-Traumatic diagnosis, Stress, Psychological diagnosis, Stress, Psychological psychology, Caregivers psychology, Child Abuse, Sexual psychology, Depression psychology, Depressive Disorder psychology, Parenting psychology, Stress Disorders, Post-Traumatic psychology
- Abstract
Caregiver mental health is a known correlate of parenting practices, and recent research indicated that parental depression following childhood sexual abuse disclosure is associated with concurrent parenting difficulties. The present study extended this line of research by investigating posttraumatic stress symptoms and depression in a sample of caregivers (N = 96) of children who experienced sexual abuse recruited from a child advocacy center as well as parenting practices reported by both caregivers and their children (mean age = 10.79 years, SD = 3.29; 79% female). Twenty-four percent of caregivers met criteria for presumptive clinical depression, clinically significant posttraumatic stress, or both. Results indicated elevated caregiver-reported inconsistent parenting in the context of clinically significant distress across symptom groups; children reported particularly elevated inconsistent parenting for caregivers with posttraumatic stress only. Caregiver depression was associated with low self-reported positive parenting and caregiver involvement in addition to self-reported inconsistencies. Directions for future research are offered to further elucidate the relationships between caregiver mental health and parenting practices following childhood sexual abuse.
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- 2016
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317. Courage under Adversity: Luba Bielicka-Blum (1906-1973) and the Nursing School of the Warsaw Ghetto.
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Ben-Sefer E and Shields L
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- Courage, History, 20th Century, Holocaust history, Humans, Nurse Administrators history, Poland, Schools, Nursing organization & administration, World War II, Jews history, Schools, Nursing history
- Abstract
The Warsaw Ghetto was a place where Jews were kept until deportation to Nazi death camps. It contained a nursing school, run by Luba Bielicka-Blum. We explore the contribution of Luba Bielicka-Blum to nursing and specifically, the nursing school of the Warsaw Ghetto by using primary sources of Bielicka-Blum's daughter's archive held by Yad Veshem, supported by secondary sources. We conclude that, despite extreme hardship and abject horror, the nursing school in the Warsaw Ghetto continued to provide the highest level of nursing education possible. The relatively unknown story of Luba Bielicka-Blum and her determination to continue the education of nurses in the Warsaw Ghetto demonstrates the courage of a nursing leader during dreadful times.
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- 2016
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318. Introduction: Australian Perspectives: Genocide, the Health Professions, and an Inglorius Past.
- Author
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Robertson M, Shields K, and Shields L
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- Australia, Europe, Health Occupations history, Health Personnel ethics, History, 20th Century, Humans, Genocide history, Health Personnel history
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- 2016
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319. Psychosocial characteristics and predictors of health-care use in families of young children with cystic fibrosis in Western Australia.
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Douglas T, Green J, Park J, Turkovic L, Massie J, and Shields L
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- Child, Child, Preschool, Female, Forecasting, Humans, Male, Mental Health, Parents, Prospective Studies, Social Class, Western Australia, Cystic Fibrosis psychology, Health Services statistics & numerical data
- Abstract
Objective: Early childhood psychosocial experiences determine future health and health-care use. Identifying psychosocial predictors in cystic fibrosis may inform intervention strategies that can reduce health-care utilization., Design: The study was designed as a prospective cohort study., Setting: The study was set in the only cystic fibrosis clinic in Western Australia., Patients: The patients were children up to 6 years diagnosed with cystic fibrosis in Western Australia between 2005 and 2011., Main Outcome Measures: Psychosocial data collected for each year of life were compared with Australian population data and analysed as predictors of annual hospital, emergency and outpatient visits., Results: Compared with the Australian population, cystic fibrosis families demonstrated lower socio-economic status and labour supply (P < 0.001), increased residential mobility (P < 0.001) and trends towards increased rates of parental separation (P = 0.066). Marital discord and maternal and child psychological stress significantly predicted increased hospital admissions, emergency and outpatient visits., Conclusions: Social gradients may exist for families of young children with cystic fibrosis in Western Australia with potential implications for child health. Family psychological and relationship stress predicted increased child cystic fibrosis-related health-care use., (© 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).)
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- 2016
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320. Impact of Birth Preparedness and Complication Readiness Interventions on Birth with a Skilled Attendant: A Systematic Review.
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Solnes Miltenburg A, Roggeveen Y, Shields L, van Elteren M, van Roosmalen J, Stekelenburg J, and Portela A
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- Female, Humans, Pregnancy, Allied Health Personnel, Maternal Health Services, Parturition, Pregnancy Complications prevention & control
- Abstract
Background: Increased preparedness for birth and complications is an essential part of antenatal care and has the potential to increase birth with a skilled attendant. We conducted a systematic review of studies to assess the effect of birth preparedness and complication readiness interventions on increasing birth with a skilled attendant., Methods: PubMed, Embase, CINAHL and grey literature were searched for studies from 2000 to 2012 using a broad range of search terms. Studies were included with diverse designs and intervention strategies that contained an element of birth preparedness and complication readiness. Data extracted included population, setting, study design, outcomes, intervention description, type of intervention strategy and funding sources. Quality of the studies was assessed. The studies varied in BP/CR interventions, design, use of control groups, data collection methods, and outcome measures. We therefore deemed meta-analysis was not appropriate and conducted a narrative synthesis of the findings., Results: Thirty-three references encompassing 20 different intervention programmes were included, of which one programmatic element was birth preparedness and complication readiness. Implementation strategies were diverse and included facility-, community-, or home-based services. Thirteen studies resulted in an increase in birth with a skilled attendant or facility birth. The majority of authors reported an increase in knowledge on birth preparedness and complication readiness., Conclusions: Birth Preparedness and Complication Readiness interventions can increase knowledge of preparations for birth and complications; however this does not always correspond to an increase in the use of a skilled attendant at birth.
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- 2015
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321. The emergence of precision therapeutics: New challenges and opportunities for Canada's health leaders.
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Slater J, Shields L, Racette RJ, Juzwishin D, and Coppes M
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In the era of personalized and precision medicine, the approach to healthcare is quickly changing. Genetic and other molecular information are being increasingly demanded by clinicians and expected by patients for prevention, screening, diagnosis, prognosis, health promotion, and treatment of an increasing number of conditions. As a result of these developments, Canadian health leaders must understand and be prepared to lead the necessary changes associated with these disruptive technologies. This article focuses on precision therapeutics but also provides background on the concepts and terminology related to personalized and precision medicine and explores Canadian health leadership and system issues that may pose barriers to their implementation. The article is intended to inspire, educate, and mobilize Canadian health leaders to initiate dialogue around the transformative changes necessary to ready the healthcare system to realize the benefits of precision therapeutics., (© 2015 Collège canadien des leaders en santé)
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- 2015
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322. L'émergence de la thérapeutique de précision: de nouveaux défis et de nouvelles possibilités pour les leaders en santé du Canada.
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Slater J, Shields L, Racette RJ, Juzwishin D, and Coppes M
- Abstract
À l'ère de la médecine personnalisée et de la médecine de précision, l'approche envers les soins est en rapide mutation. Les cliniciens exigent de plus en plus d'information génétique et moléculaire et les patients s'attendent à la fournir pour la prévention, le dépistage, le diagnostic, le pronostic, la promotion de la santé et le traitement d'un nombre croissant de maladies. Les leaders en santé canadiens doivent comprendre les changements nécessaires liés à ces technologies perturbantes et ouvrir la voie. Le présent article s'attarde sur la thérapeutique de précision, mais contient également de l'information générale sur les concepts et la terminologie liés à la médecine personnalisée et à la médecine de précision. Il explore également le leadership en santé canadien et les problèmes liés au système qui peuvent nuire à leur mise en œuvre. L'article vise à inspirer, informer et mobiliser les leaders en santé canadiens à amorcer un dialogue sur les transformations nécessaires pour préparer le système de santé à profiter des bienfaits de la thérapeutique de précision., (© 2015 Collège canadien des leaders en santé)
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- 2015
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323. Family composition and symptom severity among Veterans with comorbid PTSD and substance use disorders.
- Author
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Jobe-Shields L, Flanagan JC, Killeen T, and Back SE
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- Adolescent, Adult, Aged, Child, Child, Preschool, Comorbidity, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Severity of Illness Index, United States epidemiology, Young Adult, Family Characteristics, Stress Disorders, Post-Traumatic epidemiology, Substance-Related Disorders epidemiology, Veterans statistics & numerical data
- Abstract
Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) frequently co-occur and affect a substantial proportion of military Veterans. Although the impact of parental PTSD and SUD on child development is well-documented, little is known about the influence of family composition on PTSD/SUD symptom severity. The present study investigated children in the home as an independent risk factor for symptom severity in a sample of treatment-seeking Veterans (N = 94; 92% male) with comorbid PTSD/SUD. Twenty-seven percent of the sample had minor children (age 18 or younger) living in the home. Veterans with children in the home evidenced significantly higher PTSD symptomatology as measured by the Clinical Administered PTSD Scale (CAPS; M = 82.65 vs. M = 72.17; t = -2.18; p < .05), and reported using marijuana more frequently than Veterans without children in the home (34% vs. 13% of past 60 days; t = -2.35, p < .05). In a multivariate model, having children in the home accounted for unique variance (ΔR(2) = .07) in PTSD severity after accounting for a range of covariates; however, having children in the home did not account for unique variance in substance use. Directions for future research as well as potential clinical implications for parents seeking treatment for PTSD/SUD are discussed., (Copyright © 2015. Published by Elsevier Ltd.)
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- 2015
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324. Polyvictimization, income, and ethnic differences in trauma-related mental health during adolescence.
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Andrews AR 3rd, Jobe-Shields L, López CM, Metzger IW, de Arellano MA, Saunders B, and Kilpatrick DG
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- Adolescent, Black or African American statistics & numerical data, Black People statistics & numerical data, Child, Depression ethnology, Ethnicity, Female, Hispanic or Latino statistics & numerical data, Humans, Income, Male, Population Surveillance, Poverty, Socioeconomic Factors, Stress Disorders, Post-Traumatic ethnology, Violence ethnology, Violence psychology, White People statistics & numerical data, Adolescent Behavior ethnology, Crime Victims psychology, Healthcare Disparities ethnology, Life Change Events, Mental Health ethnology
- Abstract
Purpose: The purpose of the present study was to investigate ethnic differences in trauma-related mental health symptoms among adolescents, and test the mediating and moderating effects of polyvictimization (i.e., number of types of traumas/victimizations experienced by an individual) and household income, respectively., Methods: Data were drawn from the first wave of the National Survey of Adolescents-replication study (NSA-R), which took place in the US in 2005 and utilized random digit dialing to administer a telephone survey to adolescents ages 12-17. Participants included in the current analyses were 3312 adolescents (50.2 % female; mean age 14.67 years) from the original sample of 3614 who identified as non-Hispanic White (n = 2346, 70.8 %), non-Hispanic Black (n = 557, 16.8 %), or Hispanic (n = 409, 12.3 %). Structural equation modeling was utilized to test hypothesized models., Results: Non-Hispanic Black and Hispanic participants reported higher levels of polyvictimization and trauma-related mental health symptoms (symptoms of posttraumatic stress and depression) compared to non-Hispanic Whites, though the effect sizes were small (γ ≤ 0.07). Polyvictimization fully accounted for the differences in mental health symptoms between non-Hispanic Blacks and non-Hispanic Whites, and partially accounted for the differences between Hispanics and non-Hispanic Whites. The relation between polyvictimization and trauma-related mental health symptoms was higher for low-income youth than for high-income youth., Conclusions: Disparities in trauma exposure largely accounted for racial/ethnic disparities in trauma-related mental health. Children from low-income family environments appear to be at greater risk of negative mental health outcomes following trauma exposure compared to adolescents from high-income families.
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- 2015
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325. Protocol for a study of the psychosocial determinants of health in early childhood among children with cystic fibrosis.
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Douglas T, Jordan B, Priddis L, Anderson V, Sheehan J, Kane RT, Massie J, Branch-Smith C, and Shields L
- Subjects
- Child, Child, Preschool, Humans, Infant, Cystic Fibrosis physiopathology, Health Status
- Abstract
Aims: To investigate the causal associations between family relationships, family functioning, social circumstances and health outcomes in young children with cystic fibrosis., Background: The anticipated health gains for patients with cystic fibrosis, promised by early diagnosis through newborn screening, have yet to be fully realized, despite advances in cystic fibrosis health care with aggressive management in multidisciplinary clinics and the development of specific medications. Adverse psychosocial functioning may underpin the current lack of progress as it is well recognized that compromised early parent-child attachment relationship experiences and adverse social circumstances have negative impacts on lifelong health status and health resource use, even in healthy children., Design: A cross-sectional (initial) and longitudinal (progressive), multicentre study of children aged 3 months-6 years with cystic fibrosis, who have been diagnosed by newborn screening., Methods: Questionnaire and observational measures of parent psychosocial functioning, parenting and parent-child attachment and social markers; and including clinical outcomes of regular health surveillance with clinical, lung imaging (computerized tomography) and bronchoalveolar lavage for airway microbiology and inflammation., Conclusion: This will be the first study to investigate the causal effect of psychosocial functioning, parenting and attachment on physical health outcome measures in children with cystic fibrosis., (© 2015 John Wiley & Sons Ltd.)
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- 2015
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326. Parent-Child Automaticity: Links to Child Coping and Behavior and Engagement in Parent Training.
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Jobe-Shields L, Moreland AD, Hanson RF, and Dumas J
- Abstract
This research investigated parent-child automaticity (i.e., automatic ways of thinking, feeling, and interacting) as it relates to child coping and behavior and caregiver engagement in a preventive parenting program, as well as program-related changes in automaticity. 610 caregivers (93% mothers) of children ages 3-6 years (52% boys; 49% African American) enrolled in the Parenting our Children to Excellence (PACE) program, and completed pre- and post- intervention assessments ( N = 544 at post-intervention). Daycare providers also provided reports of school coping and behavior. Parent-child automaticity predicted parent and teacher- reported child social coping and aggressive behavior. Contrary to hypotheses, parents reporting elevated parent-child automaticity attended significantly more PACE sessions. A significant time x attendance interaction indicated decreased automaticity following the PACE program. Parent-child automaticity during the preschool years is an important correlate of child behavior and coping, and may be a motivating factor for parents to attend parent training programs.
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- 2015
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327. Dynamin-related protein 1 is required for normal mitochondrial bioenergetic and synaptic function in CA1 hippocampal neurons.
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Shields LY, Kim H, Zhu L, Haddad D, Berthet A, Pathak D, Lam M, Ponnusamy R, Diaz-Ramirez LG, Gill TM, Sesaki H, Mucke L, and Nakamura K
- Subjects
- Animals, Axons physiology, CA1 Region, Hippocampal metabolism, Dynamins deficiency, Dynamins genetics, Dynamins metabolism, Energy Metabolism, Female, Male, Mice, Mice, Knockout, Neurons metabolism, Synapses physiology, CA1 Region, Hippocampal physiology, Dynamins physiology, Mitochondria metabolism, Neurons physiology
- Abstract
Disrupting particular mitochondrial fission and fusion proteins leads to the death of specific neuronal populations; however, the normal functions of mitochondrial fission in neurons are poorly understood, especially in vivo, which limits the understanding of mitochondrial changes in disease. Altered activity of the central mitochondrial fission protein dynamin-related protein 1 (Drp1) may contribute to the pathophysiology of several neurologic diseases. To study Drp1 in a neuronal population affected by Alzheimer's disease (AD), stroke, and seizure disorders, we postnatally deleted Drp1 from CA1 and other forebrain neurons in mice (CamKII-Cre, Drp1lox/lox (Drp1cKO)). Although most CA1 neurons survived for more than 1 year, their synaptic transmission was impaired, and Drp1cKO mice had impaired memory. In Drp1cKO cell bodies, we observed marked mitochondrial swelling but no change in the number of mitochondria in individual synaptic terminals. Using ATP FRET sensors, we found that cultured neurons lacking Drp1 (Drp1KO) could not maintain normal levels of mitochondrial-derived ATP when energy consumption was increased by neural activity. These deficits occurred specifically at the nerve terminal, but not the cell body, and were sufficient to impair synaptic vesicle cycling. Although Drp1KO increased the distance between axonal mitochondria, mitochondrial-derived ATP still decreased similarly in Drp1KO boutons with and without mitochondria. This indicates that mitochondrial-derived ATP is rapidly dispersed in Drp1KO axons, and that the deficits in axonal bioenergetics and function are not caused by regional energy gradients. Instead, loss of Drp1 compromises the intrinsic bioenergetic function of axonal mitochondria, thus revealing a mechanism by which disrupting mitochondrial dynamics can cause dysfunction of axons.
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- 2015
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328. Patients' perceptions of hospital-acquired infections in northern Queensland, Australia: a pilot study.
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Smyth W, Abernethy G, Mason M, Carrucan J, Hayes M, and Shields L
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- Adult, Aged, Aged, 80 and over, Female, Hospitals, Humans, Male, Middle Aged, Pilot Projects, Queensland, Surveys and Questionnaires, Young Adult, Cross Infection diagnosis, Health Knowledge, Attitudes, Practice, Patients psychology
- Published
- 2015
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329. What do service users want? A content analysis of what users may write in psychiatric advance directives in India.
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Pathare S, Shields L, Nardodkar R, Narasimhan L, and Bunders J
- Subjects
- Adult, Ambulatory Care, Decision Making, Educational Status, Female, Humans, India, Male, Patient Advocacy, Proxy, Social Support, Advance Directives, Mental Disorders therapy, Patient Preference
- Abstract
Although psychiatric advance directives give service users control over their care, very few studies exist on the content of PADs. This paper aims to contribute to this evidence base by presenting the content of psychiatric advance directives in India. Participants were 75 clients seeking outpatient care at a mental health services organisation in Tamil Nadu, India, who agreed to draft a PAD. Most clients were comfortable with appointing a representative (usually a family member) to make decisions on their behalf during a period of decisional incapacity or relapse, were willing to accept admission to the hospital/clinic and take medication if required, wanted to have a trusted person to discuss their mental health problems. No client used the opportunity to outright refuse treatment. This study highlights an important first step in improving the quality of mental health care by documenting user preferences for care in India. More in-depth research is needed to elicit rich descriptions of experiences of care and user-centred understanding of rights., (Copyright © 2014 Elsevier B.V. All rights reserved.)
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- 2015
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330. Rainbows: a primary health care initiative for primary schools.
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Munns A, Forde KA, Krouzecky M, and Shields L
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- Adult, Child, Child, Preschool, Cohort Studies, Female, Humans, Male, Middle Aged, Schools, Western Australia, Community Health Nursing organization & administration, Grief, Nursing Staff education, Parents psychology, Primary Health Care organization & administration, Stress, Psychological nursing, Students psychology
- Abstract
Within the current Australian health system is the understanding of a need to change from the predominate biomedical model to incorporate a comprehensive primary health care centred approach, embracing the social contexts of health and wellbeing. Recent research investigated the benefits of the primary health care philosophy and strategies in relation to the Rainbows programme which addresses grief and loss in primary school aged students in Western Australia. A multidisciplinary collaboration between the Western Australian Departments of Health and Education enabled community school health nurse coordinators to train teacher facilitators in the implementation of Rainbows, enabling support for students and their parents. The results of this qualitative study indicate that all participants regard Rainbows as effective, with many perceived benefits to students and their families.
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- 2015
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331. Gender, mental illness and the Hindu Marriage Act, 1955.
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Pathare S, Nardodkar R, Shields L, Bunders JF, and Sagade J
- Subjects
- Developing Countries, Female, Humans, India, Judgment, Male, Divorce legislation & jurisprudence, Hinduism, Marriage legislation & jurisprudence, Mental Disorders, Spouses
- Abstract
Introduction: Section 5(ii) of The Hindu Marriage Act, 1955 (HMA) states that under certain circumstances, mental illness is accepted as a ground for the annulment of marriage, while Section 13(1) (iii) states that mental illness is a ground for divorce. There is little data on how this provision is used and applied in matrimonial petitions. This paper assesses judicial practices in divorce cases, exploring the extent to which gender and the diagnosis of mental illness affect the decision to grant annulment or divorce., Methods: The paper analyses judgments related to annulment and divorce at the Family Court in Pune and at the High Courts in India., Results: In the Family Court at Pune, 85% of the cases were filed by husbands, who alleged that their spouse was mentally ill. Medical evidence of mental illness was presented in only 36% of the cases and in many cases, divorce/nullity was granted even in the absence of medical evidence. In 14% of the cases, nullity/divorce was granted even when both spouses were not present. Of the Family Court cases reaching the High Court, 95% were filed by male petitioners. The High Courts reversed the lower courts' judgments in 50% of the cases., Discussion: Our analysis highlights the need for standardised guidelines for lower courts on what constitutes adequate medical proof of mental illness when hearing a petition related to nullity or divorce under HMA. It also provides a critical review of Section 5(ii) of HMA.
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- 2015
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332. Cell survival and DNA damage in normal prostate cells irradiated out-of-field.
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Shields L, Vega-Carrascal I, Singleton S, Lyng FM, and McClean B
- Subjects
- Bystander Effect radiation effects, Cell Communication radiation effects, Cell Line, Tumor, Cell Survival radiation effects, DNA Breaks, Double-Stranded, Histones analysis, Humans, Male, Radiation Dosage, DNA Damage, Prostate radiation effects, Radiotherapy, Intensity-Modulated
- Abstract
Interest in out-of-field radiation dose has been increasing with the introduction of new techniques, such as volumetric modulated arc therapy (VMAT). These new techniques offer superior conformity of high-dose regions to the target compared to conventional techniques, however more normal tissue is exposed to low-dose radiation with VMAT. There is a potential increase in radiobiological effectiveness associated with lower energy photons delivered during VMAT as normal cells are exposed to a temporal change in incident photon energy spectrum. During VMAT deliveries, normal cells can be exposed to the primary radiation beam, as well as to transmission and scatter radiation. The impact of low-dose radiation, radiation-induced bystander effect and change in energy spectrum on normal cells is not well understood. The current study examined cell survival and DNA damage in normal prostate cells after exposure to out-of-field radiation both with and without the transfer of bystander factors. The effect of a change in energy spectrum out-of-field compared to in-field was also investigated. Prostate cancer (LNCaP) and normal prostate (PNT1A) cells were placed in-field and out-of-field, respectively, with the PNT1A cells being located 1 cm from the field edge when in-field cells were being irradiated with 2 Gy. Clonogenic and γ-H2AX assays were performed postirradiation to examine cell survival and DNA damage. The assays were repeated when bystander factors from the LNCaP cells were transferred to the PNT1A cells and also when the PNT1A cells were irradiated in-field to a different energy spectrum. An average out-of-field dose of 10.8 ± 4.2 cGy produced a significant reduction in colony volume and increase in the number of γ-H2AX foci/cell in the PNT1A cells compared to the sham-irradiated control cells. An adaptive response was observed in the PNT1A cells having first received a low out-of-field dose and then the bystander factors. The PNT1A cells showed a significant increase in γ-H2AX foci formation when irradiated to 20 cGy in-field in comparison to out-of-field. However, no significant difference in cell survival or colony volume was observed whether the PNT1A cells were irradiated in-field or out-of-field. Out-of-field radiation dose alone can have a damaging effect on the proliferation of PNT1A cells when a clinically relevant dose of 2 Gy is delivered in in-field. Out-of-field radiation with the transfer of bystander factors induces an adaptive response in the PNT1A cells.
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- 2014
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333. Neurological and biological foundations of children's social and emotional development: an integrated literature review.
- Author
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Nelson HJ, Kendall GE, and Shields L
- Subjects
- Animals, Child, Child, Preschool, Humans, Infant, Brain physiology, Child Development physiology, Emotions physiology, Social Behavior, Social Environment
- Abstract
This article provides an integrated review of the expert literature on developmental processes that combine social, biological, and neurological pathways, and the mechanisms through which these pathways may influence school success and health. It begins with a historical overview of the current understanding of how attachment relationships and social environments influence brain development and plasticity and are, therefore, central to the physical and mental health of individuals and populations. It then expands on the effect of plasticity in relation to behavior and learning at school. This article concludes with a discussion of the role the school nurse may play in supporting health and learning by recognizing signs of relational stress and by advocating for prevention strategies., (© The Author(s) 2013.)
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- 2014
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334. Adolescent Reactions to Maternal Responsiveness and Internalizing Symptomatology: A Daily Diary Investigation.
- Author
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Jobe-Shields L, Parra GR, Buckholdt KE, and Tillery RN
- Abstract
A daily diary methodology was employed to gather teens' perceptions of maternal responsiveness to daily stressful events and teens' reactions to maternal responsiveness in a diverse sample (792 entries from 104 teens; 81% African American, mean age 13.7 years). Additionally, parents and teens completed baseline reports of internalizing symptoms. Diary findings were congruent with prior studies employing self-report measures of global maternal responses to emotion (e.g., higher probability of Accepting reactions to supportive responses, higher probabilities of Attack, Avoid-Withdraw reactions to non-supportive responses). Elevated baseline internalizing symptoms were related to perception of elevated Punish and Magnify responses during the week, and more Avoidant (Avoid-Withdraw and Avoid-Protect) reactions to responsiveness. Results are discussed in the context of reciprocal emotion socialization processes.
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- 2014
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335. The responsibility of care. A conversation about the registered nurse's role.
- Author
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Shields L
- Subjects
- Australia, Humans, Job Description, Clinical Competence, Nurse Practitioners organization & administration, Nurse's Role, Nurse-Patient Relations, Nursing Staff, Hospital organization & administration
- Published
- 2014
336. Trauma-focused cognitive-behavioral therapy for children and adolescents: assessing the evidence.
- Author
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de Arellano MA, Lyman DR, Jobe-Shields L, George P, Dougherty RH, Daniels AS, Ghose SS, Huang L, and Delphin-Rittmon ME
- Subjects
- Adolescent, Child, Child, Preschool, Evidence-Based Medicine, Female, Humans, Infant, Male, Meta-Analysis as Topic, Review Literature as Topic, Cognitive Behavioral Therapy methods, Stress Disorders, Post-Traumatic therapy
- Abstract
Objective: Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a conjoint parent-child treatment developed by Cohen, Mannarino, and Deblinger that uses cognitive-behavioral principles and exposure techniques to prevent and treat posttraumatic stress, depression, and behavioral problems. This review defined TF-CBT, differentiated it from other models, and assessed the evidence base., Methods: Authors reviewed meta-analyses, reviews, and individual studies (1995 to 2013). Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, PILOTS, the ERIC, and the CINAHL. They chose from three levels of research evidence (high, moderate, and low) on the basis of benchmarks for number of studies and quality of their methodology. They also described the evidence of effectiveness., Results: The level of evidence for TF-CBT was rated as high on the basis of ten RCTs, three of which were conducted independently (not by TF-CBT developers). TF-CBT has demonstrated positive outcomes in reducing symptoms of posttraumatic stress disorder, although it is less clear whether TF-CBT is effective in reducing behavior problems or symptoms of depression. Limitations of the studies include concerns about investigator bias and exclusion of vulnerable populations., Conclusions: TF-CBT is a viable treatment for reducing trauma-related symptoms among some children who have experienced trauma and their nonoffending caregivers. Based on this evidence, TF-CBT should be available as a covered service in health plans. Ongoing research is needed to further identify best practices for TF-CBT in various settings and with individuals from various racial and ethnic backgrounds and with varied trauma histories, symptoms, and stages of intellectual, social, and emotional development.
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- 2014
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337. Systematic literature review of incidence rates of low-speed vehicle run-over incidents in children.
- Author
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Griffin B, Watt K, Kimble R, Wallis B, and Shields L
- Subjects
- Adolescent, Child, Child, Preschool, Female, Humans, Incidence, Infant, Infant, Newborn, Male, New Zealand epidemiology, United States epidemiology, Accidents, Traffic mortality, Child Mortality
- Abstract
Aim: To systematically review the literature investigating the incidence of fatal and or nonfatal low-speed vehicle run-over (LSVRO) incidents in children aged 0-15 years., Methods: The following databases were searched using specific search terms, from their date of conception up to June 2011: Cochrane Library, Medline, CINAHL, Embase, AMI, Sociological Abstracts, ERIC, PsycArticles, PsycInfo, Urban Studies and Planning; Australian Criminology Database; Dissertations and Thesis; Academic Research Library; Social Services Abstracts; Family and Society; Scopus; and Web of Science. A total of 128 articles were identified in the databases (33 found by hand searching). The title and abstract of these were read, and 102 were removed because they were not primary research articles relating to LSVRO-type injuries. Twenty-six articles were assessed against the inclusion (reporting population level incidence rates) and exclusion criteria, 19 of which were excluded, leaving a total of five articles for inclusion in the review., Findings: Five studies were identified that met the inclusion criteria. The incidence rate in nonfatal LSVRO events varied in the range of 7.09 to 14.79 per 100,000 and from 0.63 to 3.2 per 100,000 in fatal events., Discussion: Using International Classification of Diseases codes for classifying fatal or nonfatal LSVRO incidents is problematic as there is no specific code for LSVRO. The current body of research is void of a comprehensive secular population data analysis. Only with an improved spectrum of incidence rates will appropriate evaluation of this problem be possible, and this will inform nursing prevention interventions. The effect of LSVRO incidents is clearly understudied. More research is required to address incidence rates in relation to culture, environment, risk factors, car design, and injury characteristics., Conclusions: The lack of nursing research or policy around this area of injury, most often to children, indicates a field of inquiry and policy development that needs attention., (© 2013 Sigma Theta Tau International.)
- Published
- 2014
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338. Intergenerational Transmission of Emotion Dysregulation Through Parental Invalidation of Emotions: Implications for Adolescent Internalizing and Externalizing Behaviors.
- Author
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Buckholdt KE, Parra GR, and Jobe-Shields L
- Abstract
We examined parent emotion dysregulation as part of a model of family emotion-related processes and adolescent psychopathology. Participants were 80 parent-adolescent dyads (mean age = 13.6; 79 % African-American and 17 % Caucasian) with diverse family composition and socioeconomic status. Parent and adolescent dyads self-reported on their emotion regulation difficulties and adolescents reported on their perceptions of parent invalidation (i.e., punishment and neglect) of emotions and their own internalizing and externalizing behaviors. Results showed that parents who reported higher levels of emotion dysregulation tended to invalidate their adolescent's emotional expressions more often, which in turn related to higher levels of adolescent emotion dysregulation. Additionally, adolescent-reported emotion dysregulation mediated the relation between parent invalidation of emotions and adolescent internalizing and externalizing behaviors. Potential applied implications are discussed.
- Published
- 2014
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339. The need to reform mental health legislation in Commonwealth countries.
- Author
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Pathare S, Shields L, Sagade J, and Nardodkar R
- Abstract
The United Nations Convention on the Rights of Persons with Disabilities (CRPD) serves as a comprehensive and legally binding framework for the rights of persons with mental illness. The extent to which countries have adapted their mental health legislation to reflect the binding provisions outlined in the CRPD is unclear. This paper reviews the situation across the Commonwealth.
- Published
- 2014
340. The core business of caring: a nursing oxymoron?
- Author
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Shields L
- Subjects
- Australia, Nurse-Patient Relations, Delivery of Health Care organization & administration, Nursing Process
- Abstract
Nursing has always regarded caring as its core business. The historical record about caring in nursing is non-specific, and little direct evidence exists about caring as part of nursing. Caring is not restricted to nursing, is possibly influenced by public perceptions of nursing, and can be subverted for maleficent ends. This paper discusses these points, and then moves to explain how caring fares in the Australian health care system. Australia has been blighted by a "cultural cringe" which sees anything from overseas as more valuable than anything Australian. This is as true for nursing, and caring within that, as for any other aspect of Australian life. However, Australia has one of the best health care systems in the world, and nursing as a profession is a world leader. The argument of this paper is that the core business of caring could be under threat in Australia unless nurses recognize their particularly good contribution to the profession and subsequent patient/client care, and celebrate that. Examples are taken from the United Kingdom where there is a crisis of caring within nursing and health. These are used to explain how Australian nursing can avoid the pitfalls and retain caring as its core business.
- Published
- 2014
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341. Home oxygen therapy for infants and young children with acute bronchiolitis and other lower respiratory tract infections: the HiTHOx program.
- Author
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Zappia T, Peter S, Hall G, Vine J, Martin A, Munns A, Shields L, and Verheggenn M
- Subjects
- Acute Disease, Child, Preschool, Female, Humans, Infant, Male, Program Evaluation, Bronchiolitis therapy, Home Care Services, Oxygen Inhalation Therapy, Respiratory Tract Infections therapy
- Abstract
Background: Acute lower respiratory tract infection (LRTI) including bronchiolitis, is one of the leading causes of pediatric hospital admissions worldwide. Recent studies have demonstrated that some children with acute bronchiolitis can be successfully managed using home oxygen therapy., Aim: To report the impact of a Hospital in The Home Oxygen therapy program (HiTHOx) for selected infants and young children with acute bronchiolitis and other LRTI., Findings: The HiTHOx program appears to be a safe model of care for carefully selected infants and young children with acute bronchiolitis and LRTI that reduces the hospital length of stay., Conclusions: The HiTHOx program provides an alternative model of care for infants and young children with acute LRTI. Implementation of models of care similar to that of the HiTHOx program in other pediatric health services may have the potential to create additional bed capacity, at the time of year when it is most needed.
- Published
- 2013
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342. Tertiary paediatric hospital health professionals' attitudes to lesbian, gay, bisexual and transgender parents seeking health care for their children.
- Author
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Nicol P, Chapman R, Watkins R, Young J, and Shields L
- Subjects
- Child, Cross-Sectional Studies, Female, Humans, Male, Surveys and Questionnaires, Attitude of Health Personnel, Health Services Accessibility, Hospitals, Pediatric organization & administration, Parents, Sexual Behavior
- Abstract
Aims and Objectives: To ascertain health professionals' knowledge, attitudes and beliefs towards lesbian, gay, bisexual and transgender parents seeking health care for their children in a paediatric tertiary hospital setting which practises family-centred care., Background: Lesbian, gay, bisexual and transgender parents are often reluctant to disclose their sexual orientation to health professionals for fear of discrimination and compromised quality of care. Staff knowledge, attitudes and beliefs can influence disclosure by parents, but little is known about knowledge, attitudes and beliefs in paediatric tertiary hospital staff towards lesbian, gay, bisexual and transgender parents accessing care for their children., Design: Descriptive comparative study of health staff using a cross-sectional survey., Methods: A set of validated anonymous questionnaires was used to assess knowledge about homosexuality, attitudes towards lesbians and gay men, and gay affirmative practice. Three open-ended questions were also used to assess beliefs about encouraging disclosure of lesbian, gay, bisexual and transgender parenting roles and how this may impact on care., Results: Of the 646 staff surveyed, 212 (32.8%) responded. Knowledge and attitudes were significantly associated with professional group, gender, Caucasian race, political voting behaviour, presence of religious beliefs, the frequency of attendance at religious services, the frequency of praying, and having a friend who was openly lesbian, gay, bisexual and transgender., Conclusion: This study highlighted that staff working in a tertiary paediatric hospital setting, with family-centred care models in place, held attitudes and beliefs that may impact on the experience of hospitalisation for lesbian, gay, bisexual and transgender parents, and the quality of care received by their children., Relevance to Clinical Practice: To promote equitable care to all families, organisations should ensure that family-centred care policies and guidelines are adopted and appropriately implemented. In addition to formal education, affirmative health service action and innovative methods may be required., (© 2013 John Wiley & Sons Ltd.)
- Published
- 2013
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343. Perceptions of Parental Awareness of Emotional Responses to Stressful Life Events.
- Author
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Jobe-Shields L, Parra GR, and Buckholdt KE
- Abstract
There is a need to better understand family processes related to recovery from past stressful life events. The present study aimed to investigate links between perceptions of parental awareness regarding stressful life events, continued event-related rumination, and current symptoms of depression. Students at a diverse, urban university completed a life events checklist and a semi-structured interview regarding family processing of stressful life events, as well as self-report measures of event-related rumination and depression. Results indicated that perceptions of mothers' and fathers' awareness of sadness regarding stressful life events as well as mothers' and fathers' verbal event processing predicted symptoms of event-related rumination and depression. Results support the inclusion of perceptions of parental awareness in the understanding of how emerging adults continue to cope with past stressful life events.
- Published
- 2013
- Full Text
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344. Children's social/emotional characteristics at entry to school: implications for school nurses.
- Author
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Nelson H, Kendall G, and Shields L
- Subjects
- Child, Female, Humans, Interpersonal Relations, Linear Models, Male, Surveys and Questionnaires, Western Australia, Child Behavior, Emotions, School Nursing, Social Behavior
- Abstract
Children entering school need to build healthy peer relationships; school, however, is the central place for bullying. School nurses have a growing focus on providing care for students with social, emotional and behavioural problems. We examined the relational development of children at school entry in regard to aggression and empathy, showing that teacher-reported aggression decreased between Pre-primary and Year One, while empathy increased between Year One and Year Two classes. No gender difference was found in teacher-reported total, or covert aggression. Understanding how development of empathy can be supported in children at school entry is important, thereby supporting development of pro-social behaviour and decreasing bullying. School nurses must understand the importance of surrounding children with safety in relationships as they begin school.
- Published
- 2013
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345. Indigenous families' use of a tertiary children's hospital in Australia.
- Author
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Munns A and Shields L
- Subjects
- Awareness, Health Status Indicators, Humans, Western Australia, Australian Aboriginal and Torres Strait Islander Peoples, Cultural Competency, Hospitals, Pediatric statistics & numerical data
- Abstract
There has been little research into Australian Indigenous families' use of a tertiary paediatric hospital in Western Australia. Scrutiny of existing scientific literature and the reports of government and non-governmental organisations from 1995 onwards did not identify clear referral pathways, health-seeking behaviours or preferences of Indigenous families for a culturally safe hospital model. Family-centred care requires an understanding of how Indigenous children and families arrive at a health service, and the cultural and practical implications of large distances and of leaving other family members behind.
- Published
- 2013
- Full Text
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346. Interventions for promoting participation in shared decision-making for children with cancer.
- Author
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Coyne I, O'Mathúna DP, Gibson F, Shields L, and Sheaf G
- Subjects
- Adolescent, Child, Child, Preschool, Humans, Decision Making, Neoplasms, Patient Participation
- Abstract
Background: Children's rights to have their views heard in matters that affect their lives are now well established since the publication of the UN Convention treaty (1989). Children with cancer generally prefer to be involved in decision-making and consider it important that they have the opportunity to take part in decision-making concerning their health care, even in end-of-life decisions. There is considerable support for involving children in healthcare decision-making at a level commensurate with their experience, age and abilities. Thus healthcare professionals and parents need to know how they should involve children in decision-making and what interventions are most effective in promoting shared decision-making (SDM) for children with cancer., Objectives: To examine the effects of SDM interventions on the process of SDM for children with cancer who are aged four to 18 years., Search Methods: We searched the following sources: Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library, Issue 9, 2012); PubMed (1946 to September 2012); EMBASE (1974 to September 2012); CINAHL (1982 to September 2012); PsycINFO (1806 to September 2012); BIOSIS (1980 to December 2009 - subscription ceased at that date); ERIC (1966 to September 2012); ProQuest Dissertations and Theses (1637 to September 2012); and Sociological Abstracts (1952 to September 2012). We searched for information about trials not registered in these resources, either published or unpublished, by searching the reference lists of relevant articles and review articles and the following conference proceedings (2005-2012):American Academy on Communication in Healthcare (AACH), European Society for Medical Oncology (ESMO), European Cancer Conference (ECCO), European Association for Communication in Healthcare (EACH), International Conference on Communication in Healthcare (ICCH), International Shared Decision Making Conference (ISDM 2005-2011 as held every two years), Annual Conference of the International Society for Paediatric Oncology (SIOP) and Annual Scientific Meeting of the Society for Medical Decision Making (SMDM).We searched the International Scientific and Technical Proceedings database (2005 to September 2012). We also searched Dissertation Abstracts (from 1980 to September 2012).We scanned the ISRCTN (International Standard Randomized Controlled Trial Number) register and the National Institute of Health (NIH) Register for ongoing trials at: www.controlled-trials.com and clinicaltrials.gov on the 1 October 2012. We contacted authors for further details. We also contacted experts in this field.We did not impose language restrictions., Selection Criteria: Randomised controlled trials (RCTs) of SDM interventions for children with cancer aged four to 18 years. The types of decisions included were: treatment, health care, and research participation decisions. The primary outcome was SDM as measured with any validated scale., Data Collection and Analysis: Two review authors undertook the searches, and three review authors independently assessed the studies obtained. We contacted study authors for additional information., Main Results: No studies met the inclusion criteria, and hence no analysis could be undertaken., Authors' Conclusions: No conclusions can be made on the effects of interventions to promote SDM for children with cancer aged four to 18 years. This review has highlighted the dearth of high-quality quantitative research on interventions to promote participation in SDM for children with cancer. There are many potential reasons for the lack of SDM intervention studies with children. Attitudes towards children's participation are slowly changing in society and such changes may take time to be translated or adopted in healthcare settings. The priority may be on developing interventions that promote children's participation in communication interactions since information-sharing is a prerequisite for SDM. Restricting this review to RCTs was a limitation and extending the review to non-randomised studies (NRS) may have produced more evidence. We plan to expand the types of studies in future updates. Clearly more research is needed.
- Published
- 2013
- Full Text
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347. A protocol for a systematic review of birth preparedness and complication readiness programs.
- Author
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Solnes Miltenburg A, Roggeveen Y, van Elteren M, Shields L, Bunders J, van Roosmalen J, and Stekelenburg J
- Subjects
- Female, Health Resources, Health Services Needs and Demand, Humans, Pregnancy, Research Design, Systematic Reviews as Topic, Allied Health Personnel, Delivery, Obstetric, Maternal Death prevention & control, Maternal Health Services, Pregnancy Complications mortality, Prenatal Care methods, Program Evaluation
- Abstract
Background: One of the effective strategies for reducing the number of maternal deaths is delivery by a skilled birth attendant. Low utilization of skilled birth attendants has been attributed to delay in seeking care, delay in reaching a health facility and delay in receiving adequate care. Health workers could play a role in helping women prepare for birth and anticipate complications, in order to reduce delays. There is little evidence to support these birth preparedness and complication readiness (BP/CR) programs; however, BP/CR programs are frequently implemented. The objective of this review is to assess the effect of BP/CR programs on increasing skilled birth attendance in low-resource settings., Methods: Due to the complexity of BP/CR programs and the need to understand why certain programs are more effective than others, we will combine both quantitative and qualitative studies in this systematic review. Search terms were selected with the assistance of a health information specialist. Three reviewers will independently select and assess studies for quality. Data will be extracted by one reviewer and checked for accuracy and completeness by a second reviewer. Discussion between the reviewers will resolve disagreements. If disagreements remain, a third party will be consulted. Data analysis will be carried out in accordance with the BP/CR matrix, developed by the Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO). Study data will be grouped and analyzed by quality and study design and regrouped according to type of intervention strategy., Discussion: This review will provide: 1) an insight into existing BP/CR programs, 2) recommendations on effective elements of the different approaches, 3) proposals for concrete action plans for health professionals in the field of reproductive health in resource-poor settings and 4) an overview of existing knowledge gaps requiring further research., Trial Registration: PROSPERO registration no.: CRD42012003124.
- Published
- 2013
- Full Text
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348. A personal essay on the role of the nurse.
- Author
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Shields L
- Subjects
- Queensland, Nurse's Role
- Abstract
Nursing has suffered a lack of understanding by the general public, who often can see no further than stereotypes of heroine, harlot, harridan or handmaiden. These have colored nursing's development as a profession, in Australia as in the rest of the world. Australia, as the 'lucky country' has one of the best health systems in the world, and Australian nurses are amongst those at the forefront of the profession. However, it appears that Australian nurses, as with many sections of Australian society, do not recognize that they hold high professional standards. With the influence of the international nursing shortage and the ever-growing technological advances within health care, alternatives to nurses, and to the registered nurse, are emerging. It is vitally important that nursing controls and regulates these developments. Only by protecting the legitimate role of the nurse, ensuring that education standards are maintained at the highest appropriate level, and generating and using new nursing knowledge will outcomes for all those who come to us for care be of the highest order. This essay proposes that Australian nurses need to overcome the 'cultural cringe' and recognize that they are in charge of a profession which meets the highest international standards.
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- 2013
- Full Text
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349. Lesbian, gay, bisexual, and transgender parents seeking health care for their children: a systematic review of the literature.
- Author
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Shields L, Zappia T, Blackwood D, Watkins R, Wardrop J, and Chapman R
- Subjects
- Child, Female, Humans, Male, Patient Acceptance of Health Care psychology, Pediatrics standards, Bisexuality psychology, Delivery of Health Care standards, Homosexuality, Female psychology, Homosexuality, Male psychology, Transgender Persons psychology
- Abstract
Background: Few studies have examined the issues faced by lesbian, gay, bisexual, and transgender (LGBT)-parented families in relation to their access to and satisfaction with healthcare services for their children. It is thought that LGBT individuals have experienced negative interactions with the healthcare environment., Aims: To systematically review the literature investigating the experience of LGBT parents seeking health care for their children., Methods: A search of the following databases: Cochrane Library, CINAHL, Embase, Google Scholar, Medline, PsychInfo, Science Direct, Sociological Abstracts, Proquest, Scopus, and Web of Science was conducted. Using the PRISMA flow chart and processes of the United Kingdom Centre for Reviews and Dissemination, we selected and analysed relevant studies., Findings: Four studies that met the inclusion criteria were identified. Studies showed that while the experience of LGBT parents seeking health care was largely positive, strategies need to be implemented to improve the quality of healthcare services for LGBT families and ensure that their needs are met., Discussion: Although many LGBT parents have positive experiences of health care, some still experience discrimination and prejudice., Implications for Practice: Specific educational interventions are needed to support LGBT parents seeking health care for their children., Conclusions: Further research is required to explore LGBT-parented families' experiences of healthcare services, and this should include children's experiences., (© 2012 Sigma Theta Tau International.)
- Published
- 2012
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350. MicroRNA-125b transforms myeloid cell lines by repressing multiple mRNA.
- Author
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Bousquet M, Nguyen D, Chen C, Shields L, and Lodish HF
- Subjects
- Animals, Apoptosis genetics, Cell Differentiation genetics, Cell Transformation, Neoplastic genetics, Cell Transformation, Neoplastic pathology, HL-60 Cells, Humans, Leukemia, Promyelocytic, Acute genetics, Leukemia, Promyelocytic, Acute pathology, Mice, Mice, Nude, MicroRNAs genetics, Myelodysplastic Syndromes genetics, Myelodysplastic Syndromes metabolism, Myelodysplastic Syndromes pathology, Myeloid Cells pathology, Neoplasm Proteins genetics, Neoplasm Proteins metabolism, Neoplastic Stem Cells pathology, RNA, Neoplasm genetics, Stem Cell Transplantation, Transplantation, Heterologous, Cell Transformation, Neoplastic metabolism, Leukemia, Promyelocytic, Acute metabolism, MicroRNAs metabolism, Myeloid Cells metabolism, Neoplastic Stem Cells metabolism, RNA, Neoplasm metabolism
- Abstract
Background: We previously described a t(2;11)(p21;q23) chromosomal translocation found in patients with myelodysplasia or acute myeloid leukemia that leads to over-expression of the microRNA miR-125b, and we showed that transplantation of mice with murine stem/progenitor cells overexpressing miR-125b is able to induce leukemia. In this study, we investigated the mechanism of myeloid transformation by miR-125b., Design and Methods: To investigate the consequences of miR-125b over-expression on myeloid differentiation, apoptosis and proliferation, we used the NB4 and HL60 human promyelocytic cell lines and the 32Dclone3 murine promyelocytic cell line. To test whether miR-125b is able to transform myeloid cells, we used the non-tumorigenic and interleukin-3-dependent 32Dclone3 cell line over-expressing miR-125b, in xenograft experiments in nude mice and in conditions of interleukin-3 deprivation. To identify new miR-125b targets, we compared, by RNA-sequencing, the transcriptome of cell lines that do or do not over-express miR-125b., Results: We showed that miR-125b over-expression blocks apoptosis and myeloid differentiation and enhances proliferation in both species. More importantly, we demonstrated that miR-125b is able to transform the 32Dclone3 cell line by conferring growth independence from interleukin-3; xenograft experiments showed that these cells form tumors in nude mice. Using RNA-sequencing and quantitative real-time polymerase chain reaction experiments, we identified multiple miR-125b targets. We demonstrated that ABTB1, an anti-proliferative factor, is a new direct target of miR-125b and we confirmed that CBFB, a transcription factor involved in hematopoiesis, is also targeted by miR-125b. MiR-125b controls apoptosis by down-regulating genes involved in the p53 pathway including BAK1 and TP53INP1., Conclusions: This study demonstrates that in a myeloid context, miR-125b is an oncomiR able to transform cell lines. miR-125b blocks myeloid differentiation in part by targeting CBFB, blocks apoptosis through down-regulation of multiple genes involved in the p53 pathway, and confers a proliferative advantage to human and mouse myeloid cell lines in part by targeting ABTB1.
- Published
- 2012
- Full Text
- View/download PDF
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