bluuebunny/crossref_metadata_2025 huggingface dataset:
Preventing Postpartum Depression Part II: A Critical Review of Nonbiological Interventions
Authors: Dennis Cindy-Lee E
Published: January 2017

Objective:

To critically review the literature to determine the current state of scientific knowledge concerning the prevention of postpartum depression (PPD) from a nonbiological perspective.

Methods:

Databases searched for this review include Medline, PubMed, Cinahl, PsycINFO, Embase, ProQuest, the Cochrane Library, and the World Health Organization Reproductive Health Library. Studies selected were peer-reviewed English-language articles published between January 1, 1966, and December 31, 2003. Criteria used to evaluate the interventions were derived from the standardized methodology developed by the Canadian Task Force on Preventive Health Care.

Results:

Twenty-nine studies that met criteria were examined. These included studies evaluating interpersonal psychotherapy, cognitive-behavioural therapy, psychological debriefing, antenatal classes, intrapartum support, supportive interactions, continuity of care, antenatal identification and notification, early postpartum follow-up, flexible postpartum care, educational strategies, and relaxation with guided imagery.

Conclusions:

While this review demonstrates that no specific approach can be strongly recommended for clinical practice, many explicit research implications have been highlighted. To further address PPD as a public health problem, it is critical to include ethnically and socioeconomically diverse women in research efforts examining the differences among depression symptoms, intervention response rates, and health service use.
Elements of Affective Instability Associated with Suicidal Behaviour in Patients with Borderline Personality Disorder
Authors: Links Paul S , Eynan Rahel , Heisel Marnin J , Nisenbaum Rosane
Published: January 2017

Objective:

To identify elements of affective instability associated with an increased likelihood of impulsivity and then to determine whether these elements characterize patients with borderline personality disorder (BPD) and suicidal behaviour.

Method:

We prospectively followed 82 individuals with BPD and a history of recurrent suicidal behaviour who recorded their current mood states, impulsivity, suicide ideation, and environmental stressors (triggers) 6 times daily over 3 weeks.

Results:

Our results suggested that mood amplitude was correlated with impulsivity and that 4 subgroups defined by mean scores on mood amplitude and negative mood intensity significantly differed in the number of suicidal behaviours reported in the last year.

Conclusions:

A subgroup of BPD patients appears to be at elevated risk for suicidal behaviour based on high mood amplitude and mean negative mood intensity. Clinicians might target this group for monitoring and interventions to reduce the likelihood of suicidal behaviour.
Postpartum Depression Symptoms in Newcomers
Authors: Stewart Donna E , Gagnon Anita , Saucier Jean-Francois , Wahoush Olive , Dougherty Geoffrey
Published: January 2017

Objectives:

To determine if postpartum depression (PPD) symptoms are more common in newcomer women than in Canadian-born women.

Methods:

Refugee, nonrefugee immigrant, asylum-seeking, and Canadian-born new mothers were administered questionnaires for depression, social support, interpersonal violence, and demographic information. We created a PPD variable based on a score of ⩾10 on the Edinburgh Postnatal Depression Scale (EPDS) and performed a logistic regression analysis for PPD.

Results:

Immigrants (35.1%), asylum seekers (31.1%), and refugees (25.7%) were significantly more likely than Canadian-born (8.1%) women to score ⩾10 ( P = 0.008) on the EPDS, with the regression model showing an increased risk (odds ratio) for refugee (4.80), immigrant (4.58), and asylum-seeking (3.06) women. Women with less prenatal care were also more likely to have an EPDS of ⩾10 ( P = 0.03). Newcomer women with EPDS scores of ⩾10 had lower social support scores than Canadian-born women ( P < 0.0001).

Conclusions:

Newcomer mothers have an increased risk for PPD symptoms. Social support interventions should be tested for their ability to prevent or alleviate this risk.
A Measure of Daily Distress in Practising Medicine
Authors: Lepnurm Rein , Lockhart Wallace S , Keegan David
Published: January 2017

Objective:

Existing measures of stress either focus on burnout or frustration and fatigue factors, often referred to as job strain. The objectives of this study were to: establish a reliable measure of distress that is sensitive enough to identify job strain at lower levels of distress and risk of burnout at higher levels of distress; and document levels of distress among the major medical specialties and across varying patterns of clinical practice.

Methods:

A stratified cross-sectional survey of physicians in Canada was conducted in 2004. Among the eligible population, 2810 physicians (56.7%) responded. Response bias was negligible. Responding physicians completed a 13-item measure of distress. Confirmatory factor analysis was used to establish the measure. Scheffe tests were used to document differences in the levels of distress among specializations and by clinical practice profile.

Results:

Factor analysis revealed reliable dimensions of: fatigue (α = 0.75) and reaction (α = 0.73). The distress measure was reliable (α = 0.82). Emergency physicians ( n = 4.51), surgeons ( n = 4.35), and general practitioners ( n = 4.33) reported the highest levels of distress, while administrative physicians ( n = 3.30), community health ( n = 3.35), and clinical specialists ( n = 3.46) reported the lowest levels of distress. Physicians with clinical and administrative responsibilities reported the highest levels of distress ( n = 4.40), compared with purely clinical physicians ( n = 3.94) and clinician-academics ( n = 3.98).

Conclusions:

Some specializations are associated with more distress than others. Administrative duties appear to add to distress for all physicians. Counterintuitively, adding academic as well as administrative responsibilities appears to add less distress than adding administrative duties alone. Academic duties are viewed as advancing medicine.
What We Have Learned about Electroconvulsive Therapy and its Relevance for the Practising Psychiatrist
Authors: Sienaert Pascal
Published: January 2017

In this narrative review, the current knowledge base on the efficacy and the practice of electroconvulsive therapy (ECT) is reviewed, and its relevance for the practising psychiatrist is appreciated. In the past decade, several large-scale studies have confirmed the significant superiority of ECT in the treatment of severe and refractory psychiatric conditions, such as major depressive disorder and bipolar disorder. However, the efficacy of ECT is not reflected in current treatment algorithms, where ECT is often reserved as a last resort. However, clinical characteristics, such as the presence of psychotic symptoms, suicidality, or catatonic signs, should prompt the clinician to consider ECT earlier in the treatment course. ECT is a safe procedure, without absolute contraindications for its use. Nevertheless, patients' fears and complaints should be acknowledged, and patients should be adequately informed about expected benefits and possible risks, such as memory problems, that are generally transient. Research focusing on further minimizing memory problems, while maintaining a superior efficacy, is ongoing. Adequate continuation treatment, either pharmacotherapy or continuation ECT, after a successful ECT course is of vital importance to maintain the benefits achieved and should be the focus of future research.
Initiation de la consommation d'ecstasy chez les adolescents québécois à la fin du secondaire: Prédicteurs distaux et proximaux
Authors: Gagnon Valérie , Fallu Jean-Sébastien , Brière Frédéric N , Janosz Michel
Published: January 2017

Objectif:

Identifier des prédicteurs distaux et proximaux de l'initiation de la consommation d'ecstasy à l'adolescence.

Méthode:

L'échantillon comprenait 2162 adolescents issus d'écoles secondaires de milieux défavorisés du Québec, suivis annuellement pendant 5 ans. L'analyse causale a été utilisée pour prédire l'initiation de la consommation d'ecstasy en secondaire 5 (16–17 ans) à partir de prédicteurs en secondaire 1 et 2 (12–14 ans) et en secondaire 4 (15–16 ans).

Résultats:

Les adolescents qui initiaient la consommation d'ecstasy en secondaire 5 présentaient un risque accru sur de multiples facteurs, comparativement aux non-consommateurs. L'initiation était principalement prédite par des facteurs de risque proximaux liés à la consommation individuelle ainsi qu'à la consommation et à la déviance des pairs. Néanmoins, plusieurs facteurs proximaux se développaient en continuité avec leur facteur distal correspondant (lien indirect). La consommation de marijuana était le prédicteur le plus puissant de l'initiation de la consommation d'ecstasy, le risque relatif étant, toutes choses égales par ailleurs, 2,04 fois plus élevé chez les adolescents ayant consommé de la marijuana l'année précédente (secondaire 4).

Conclusions:

L'initiation de la consommation d'ecstasy en secondaire 5 semble globalement liée à un profl extériorisé plutôt qu'intériorisé. Cette consommation était fortement associée à la consommation d'autres substances et partage probablement plusieurs facteurs de risque avec la consommation de ces autres substances, en particulier la consommation de marijuana.
Schizophrenia, An Illness with Bad Outcome: Myth or Reality?
Authors: Abdel-Baki Amal , Lesage Alain , Nicole Luc , Cossette Mariève , Salvat Emilie , Lalonde Pierre
Published: January 2017

Objective:

Different myths about schizophrenia endorsed by clinicians maintain the pessimism about outcome thus reducing chances of improvement. There are no recent North American studies on the long-term outcome of first-episode schizophrenia to clarify if these beliefs are myths or reality. Our study describes the long-term outcome (10 to 16 years) of a first-episode schizophrenia incidence cohort ( n = 142) in a Canadian urban centre between 1983 and 1999.

Method:

Clinical and social functioning at different time points were assessed retrospectively from medical files of a catchment area hospital in Montreal. Service use and deaths were noted from provincial databases of physician billings, hospitalization, and vital statistics.

Results:

Hospitalization days decreased considerably after the first year, with a small minority still needing it episodically after 4 years. Marital and occupational status were generally stable over time, but autonomy in living arrangements worsened. Thirty-three percent of subjects quit the Catchment Area Specialized Psychiatric Services. This group showed better social functioning while they were followed, were hospitalized less afterwards, and had fewer suicides, therefore indicating a better outcome for them. At the end of our study, 15% of the patients still alive were well enough to function without seeking medical help and 25% were not taking antipsychotic medication. Better outcome was predicted by older age at admission, being married, higher premorbid autonomy in living arrangements, and female sex.

Conclusion:

A significant proportion of first-episode schizophrenia patients achieve moderate long-term outcome, and the stability of global functioning is more frequent than deterioration, as shown in most industrialized countries.
Psychiatric Conditions and Behavioural Problems in Adolescents with Intellectual Disabilities: Correlates with Autism
Authors: Bradley Elspeth A , Ames Catherine S , Bolton Patrick F
Published: January 2017

Objective:

To determine whether psychiatric and behavioural disorders occur more frequently in adolescents with autism and intellectual disabilities, compared with those without autism.

Method:

A population-based case–control study was undertaken and 36 adolescents with autism were pairwise matched for age and IQ to 36 adolescents without autism. Caregivers were interviewed with structured psychiatric interview and questionnaire measures of psychiatric and behavioural problems.

Results:

Compulsive behaviours and stereotypies were significantly more common in adolescents with autism.

Conclusions:

Adolescents with autism are prone to compulsive behaviours and stereotypies as well as specific manifestations of anxiety, fears, and phobias.
An Overview of Treatments for Obesity in a Population with Mental Illness
Authors: Taylor Valerie H , Stonehocker Brian , Steele Margot , Sharma Arya M
Published: January 2017

Obesity is associated with early mortality and has overtaken smoking as the health problem with the greatest impact on quality of life, mortality, and morbidity. Despite public health initiatives and numerous commercial enterprises focusing on weight loss, obesity rates continue to rise. In part, this is because obesity is a multifaceted, complex illness, impacted by numerous social, psychological, and behavioural factors that are unrecognized in most current initiatives. One significant factor associated with obesity is mental illness. While having a psychiatric illness does not make weight gain inevitable, it does often require that additional tools be added to lifestyle recommendations around diet and exercise. The following article reviews the common approaches to obesity management and addresses how these strategies can be implemented in psychiatric care. It is important that health professionals involved in the care of people with a mental illness become familiar with the interventions available to control and treat the obesity epidemic, as this will improve treatment compliance and ultimately lead to improved physical and psychological outcomes.
Depression in Primary Care: Current and Future Challenges
Authors: Craven Marilyn A , Bland Roger
Published: January 2017

Objectives:

To describe the current state of knowledge about detection and treatment of major depressive disorder (MDD) by family physicians (FPs), and to identify gaps in practice and current and future challenges.

Methods:

We reviewed the recent literature on MDD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, or International Classification of Diseases, Revision 10) in primary care, with an emphasis on systematic reviews and meta-analyses addressing prevalence, the impact of an aging population and of chronic disease on MDD rates in primary care, detection and treatment rates by FPs, adequacy of treatment, and interventions that could improve recognition and treatment.

Results:

About 10% of primary care patients are likely to meet criteria for MDD. The number of cases will increase as the baby boomer cohort ages and as the prevalence of chronic disease increases. The bidirectional relation between MDD and chronic disease is now firmly established. Detection and treatment rates in primary care remain low. Treatment quality is frequently inadequate in terms of follow-up and monitoring. Formal case management and collaborative care interventions are likely to provide some benefits.

Conclusions:

Low detection rates and low treatment rates need to be addressed. Planned reassessment may improve detection rates when the FP is uncertain whether MDD is present, but further research is needed to determine why FPs frequently do not initiate treatment, even when MDD is detected. A caring, attentive FP who monitors depressed patients is likely to have considerable placebo effect. Greater focus on integrated, concurrent treatment for MDD and chronic physical diseases in the middle-aged and elderly is also required.
Reliability, Validity, and Clinical Use of the Dominic Interactive: A DSM-Based, Self-Report Screen for School-Aged Children
Authors: Bergeron Lise , Berthiaume Claude , St-Georges Marie , Piché Geneviève , Smolla Nicole
Published: January 2017

Objectives:

As no single informant can be considered the gold standard of child psychopathology, interviewing of children regarding their own symptoms is necessary. Our study focused on the reliability, validity, and clinical use of the Dominic Interactive (DI), a multimedia self-report screen to assess symptoms for the most frequent Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, mental disorders in school-aged children.

Methods:

A sample of 585 children aged 6 to 11 years from the community and psychiatric clinics was used to analyze the internal consistency, the test-retest estimate of reliability, and the criterion-related validity of the DI against the referral status. In addition, cross-informant correlation coefficients between this instrument (child report) and the Child Symptom Inventory (parent report) were explored in a subsample of 292 participants.

Results:

For the total sample, Cronbach alpha coefficients ranged from 0.63 to 0.91. Test–retest kappas varied from 0.42 to 0.62 for categories based on cut-off points, except for specific phobias. Intraclass correlation coefficients ranged from 0.70 to 0.81 for symptom scales. The DI discriminated between referred and nonreferred children in psychiatric clinics for all symptom scales. Significant cross-informant correlation coefficients were higher for the externalizing symptoms (0.35 to 0.48) than the internalizing symptoms (0.14 to 0.27).

Conclusions:

Findings of our study reasonably support adequate psychometric properties of the DI. This instrument offers a developmentally sensitive screening method to obtain unique information from young children about their mental health problems in front-line services, psychiatric clinics, and research settings.
Posttraumatic Stress Disorder in Adults: Impact, Comorbidity, Risk Factors, and Treatment
Authors: Sareen Jitender
Published: January 2017

During the last 30 years, there has been a substantial increase in the study of posttraumatic stress disorder (PTSD). Several high-profile traumatic events, such as the wars in Afghanistan and Iraq, and the terrorist attacks of September 11 on the World Trade Center, have led to a greater public interest in the risk and protective factors for PTSD. In this In Review paper, I discuss some of the important advances in PTSD. The paper provides a concise review of the evolution of PTSD diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, impact of PTSD in the community, an overview of the established risk factors for developing PTSD, and assessment and treatment. Throughout the paper, controversies and clinical implications are discussed.
Attention Deficits and Divorce
Authors: Bouchard Geneviève , Saint-Aubin Jean
Published: January 2017

Objective:

Building on previous work on the role of attention deficits associated with the regulation of executive control in psychiatric disorders, we examine whether these attention deficits are related to an interpersonal disturbance, the experience of divorce.

Method:

Attentional capacities of 95 randomly selected couples from the general population were measured with a well-established task, the Attentional Network Task, which assesses the efficiency of 3 attention networks (that is, alerting, orienting, and executive control). Among the 190 participants, 32 had experienced a divorce in the past. ANCOVAs were used to compare divorced people in marital or cohabiting unions with people in first unions in their performance on this purely cognitive task.

Results:

Our findings indicate that divorced people who are currently living in a cohabiting relationship show significantly lower executive control than other adults living as couples, after controlling for sex, age, income, and education. This subgroup of divorced people not only exhibit greater difficulty in responding to some stimuli while ignoring irrelevant ones but also manifest cognitive deficits in conflict resolution.

Conclusions:

This study highlights the links between attention and the long-term maintenance of intimate relationships. Our results may have important implications for the identification of people at risk for divorce.
Depression and Employment Status in Primary and Tertiary Care Settings
Authors: Rizvi Sakina J , Cyriac Anna , Grima Etienne , Tan Mary , Lin Peter , Gallaugher Laura Ashley , McIntyre Roger S , Kennedy Sidney H
Published: January 2017

Objective:

Major depressive disorder (MDD) is a leading cause of disability. Impairment in work function considerably adds to symptom burden and increases the economic impact of this disorder. Our study aimed to investigate the factors associated with work status in MDD within primary and tertiary care.

Method:

We used data from 2 large databases for our analysis—Study 1: the InSight database, a chart review of MDD patients treated by primary care physicians across Canada ( n = 986); and Study 2: the International Mood Disorders Collaborative Project, a cross-sectional study of mood disorder patients (Canadian data only: n = 274).

Results:

Both studies demonstrated high rates of unemployment and disability (30.3% to 42.1%). Quebec showed the highest rate of unemployment (21%) and British Columbia had the greatest percentage of patients on disability (15%). Employed and unemployed groups were similar based on clinical characteristics; however, unemployed people may have higher age, prevalence of medical comorbidity, and greater likelihood of receiving a benzodiazepine. Increased disability rates were associated with history of childhood abuse, duration of current major depressive episode, comorbidity, benzodiazepine use, as well as greater depression and anxiety severity. The unemployed–disability groups had greater somatic symptoms and anhedonia. In keeping with this, anhedonia was the strongest predictor of disability. Absenteeism was also high across both studies.

Conclusions:

Unemployment and disability rates in MDD are high. The presence of anhedonia and medical comorbidity significantly influenced work status, emphasizing the need for treatment strategies to alleviate the additional symptom burden in this subpopulation.
Is Cognitive Psychopathology Plausible? Illustrations from Memory Research
Authors: Danion Jean-Marie , Weingartner Herbert , Singer Leonard
Published: January 2017

Objective:

To examine the strengths and weaknesses of cognitive psychopathology through the specific examples of the memory impairments associated with the administration of benzodiazepines, with schizophrenia, and with depression.

Method:

These examples are analyzed with reference to a model of memory based on the principle of division between specialized and central processing structures. A basic contention is that it is useful to consider 2 broad classes of processes—automatic, associative, or sensory/perceptual processes on the one hand and intentional, strategic, or reflective processes on the other hand—as being separate.

Results:

The functional mechanisms of the memory impairments associated with these conditions are beginning to be identified, and there is preliminary evidence that a deficit in an elementary computation may have dramatic consequences on highest cognitive functions. There is also evidence that certain memory impairments are linked to specific dysfunctional outcomes in everyday life. By showing that specific rate-limiting factors of cognitive performance can be identified and are amenable to cognitive interventions, existing data open the door for theoretically and empirically based cognitive remediation of mental disorders.

Conclusion:

The bulk of available evidence (albeit limited) makes the enterprise of cognitive psychopathology quite plausible and convincing.
Case—Control Studies of Cardiovascular Medications as Risk Factors for Clinically Diagnosed Depressive Disorders in a Hospitalized Population
Authors: Patten Scott B , Williams Jeanne VA , Love Edgar J
Published: January 2017

Objective:

Certain medications used in cardiovascular therapeutics may contribute to the etiology of substance-induced mood disorders. These medications include digoxin, angiotensin converting enzyme (ACE) inhibitors, β- blockers, and calcium channel blockers. The objective of this study was to evaluate associations between these drugs and clinical diagnoses of depressive disorders in a population of hospitalized patients.

Method:

Two case–control studies were conducted. For each study, subjects were selected from a health records data base maintained at the Calgary General Hospital. Selection of subjects in the first study was restricted to those receiving a discharge diagnosis of congestive heart failure and in the second study to subjects receiving a discharge diagnosis of hypertension. In each of these 2 studies, a single case group was selected along with 2 control groups: a psychiatric control group consisting of subjects receiving a psychiatric diagnosis other than a depressive disorder and a nonpsychiatric control group receiving no psychiatric diagnoses. Drug exposures and other variables were recorded from a chart review.

Results:

Exposures to digoxin, β- blockers, and calcium channel blockers were not associated with depressive diagnoses. An association was observed, however, for ACE inhibitors. An elevated odds ratio (OR) was observed in each case-control study and was stronger infernale subjects and subjects over the age of 65.

Conclusions:

This is the first reported epidemiological evidence of an association between ACE inhibitors and depressive disorders. The design of this study does not permit a determination of whether the observed association was causal. Additional studies are needed.
Examining the ethos of conflict by exploring lay people’s representations of the Kurdish conflict in Turkey
Authors: Uluğ Özden Melis , Cohrs J Christopher
Published: January 2017

Societies in conflicts develop an ‘ethos of conflict’, a set of socially shared beliefs about the conflict. We argue that the ethos of conflict can be based on different representations of the conflict, and exploring such representations helps to analyze similarities and differences between and within conflict parties. We explored representations of the Kurdish conflict among 45 laypeople in a multi-ethnic city in Turkey based on comprehensive models of conflict analysis using an approach based on Q-methodology, which is suitable for uncovering socially shared viewpoints. Representations of conflict were conceptualized along three domains: causes and issues; relationships between the groups, processes and dynamics; and possible solutions. An integrated analysis across these domains revealed five qualitatively distinct viewpoints toward the conflict. The meaning of these viewpoints, their possible links to the ethos of conflict, differences and commonalities within and between conflict parties, the usefulness of our methodological approach to explore conflict viewpoints, and implications for conflict resolution are discussed.
High efficient anti-cancer drug delivery systems using tea polyphenols reduced and functionalized graphene oxide
Authors: Wang Xiaoqian , Hao Liying , Zhang Chaoliang , Chen Jiao , Zhang Ping
Published: January 2017

Targeted drug delivery is urgently needed for cancer therapy, and green synthesis is important for the biomedical use of drug delivery systems in the human body. In this work, we report two targeted delivery systems for anticancer drugs based on tea polyphenol functionalized and reduced graphene oxide (TPGs). The obtained TPGs demonstrated an efficient doxorubicin loading capacity as high as 3.430 × 106 mg g−1 and 3.932 × 104 mg g−1, and exhibited pH-triggered release. Furthermore, the kinetic models, adsorption isotherms, and possible loading mechanisms were investigated in details. Compared to TPG1 and free doxorubicin, TPG2 is biocompatible to normal cells even at high concentrations and promotes tumor cells death by delivering the doxorubicin mainly to the nuclei. These results were confirmed using cell viability tests and confocal laser microscopy. Moreover, apoptosis tests showed that the mechanism of cancer cell death induced by TPG1 and TPG2 might follow the similar mechanisms. Taken together, these results demonstrate that TPGs provide a multifunctional drug delivery system with a greater loading capacity and pH-sensitive drug release for enhanced cancer therapy. The high drug payload capability and enhanced antitumor efficacy demonstrate that we developed systems are promising for various biomedical applications and cancer therapy.
Tailored Educational Approaches for Consumer Health: A Model to Address Health Promotion in an Era of Personalized Medicine
Authors: Cohn Wendy F. , Lyman Jason , Broshek Donna K. , Guterbock Thomas M. , Hartman David , Kinzie Mable , Mick David , Pannone Aaron , Sturz Vanessa , Schubart Jane , Garson Arthur T.
Published: January 2017

Purpose:

To develop a model, based on market segmentation, to improve the quality and efficiency of health promotion materials and programs.

Design:

Market segmentation to create segments (groups) based on a cross-sectional questionnaire measuring individual characteristics and preferences for health information. Educational and delivery recommendations developed for each group.

Setting:

General population of adults in Virginia.

Participants:

Random sample of 1201 Virginia residents. Respondents are representative of the general population with the exception of older age.

Measures:

Multiple factors known to impact health promotion including health status, health system utilization, health literacy, Internet use, learning styles, and preferences.

Analysis:

Cluster analysis and discriminate analysis to create and validate segments. Common sized means to compare factors across segments.

Results:

Developed educational and delivery recommendations matched to the 8 distinct segments. For example, the “health challenged and hard to reach” are older, lower literacy, and not likely to seek out health information. Their educational and delivery recommendations include a sixth-grade reading level, delivery through a provider, and using a “push” strategy.

Conclusion:

This model addresses a need to improve the efficiency and quality of health promotion efforts in an era of personalized medicine. It demonstrates that there are distinct groups with clearly defined educational and delivery recommendations. Health promotion professionals can consider Tailored Educational Approaches for Consumer Health to develop and deliver tailored materials to encourage behavior change.
Physical Activity Interventions in Faith-Based Organizations: A Systematic Review
Authors: Tristão Parra Maíra , Porfírio Gustavo J. M. , Arredondo Elva M. , Atallah Álvaro N.
Published: January 2017

Objective:

To review and assess the effectiveness of physical activity interventions delivered in faith-based organizations.

Data Source:

We searched the Cochrane Library, DoPHER, EMBASE, LILACS, MEDLINE, PsycINFO, WHO ICTRP, and Clinicaltrials.gov databases until January 2016, without restriction of language or publication date.

Study Inclusion and Exclusion Criteria:

Randomized and nonrandomized controlled trials investigating physical activity interventions for adults delivered in faith-based organizations.

Data Extraction:

Two independent reviewers extracted data and assessed study methodological quality.

Data Synthesis:

We used relative risk and mean difference with 95% confidence interval to estimate the effect of the interventions on measures of physical activity, physical fitness, and health.

Results:

The review included 18 studies. Study participants were predominantly female, and the majority of trials were conducted in the United States. Study heterogeneity did not allow us to conduct meta-analyses. Although interventions delivered in faith-based organizations increased physical activity and positively influenced measures of health and fitness in participants, the quality of the evidence was very low.

Conclusion:

Faith-based organizations are promising settings to promote physical activity, consequently addressing health disparities. However, high-quality randomized clinical trials are needed to adequately assess the effectiveness of interventions delivered in faith-based organizations.
Breastfeeding in Women Having Experienced Childhood Sexual Abuse
Authors: Elfgen Constanze , Hagenbuch Niels , Görres Gisela , Block Emina , Leeners Brigitte
Published: January 2017

Background:

Childhood sexual abuse (CSA) can have a serious effect on general and obstetric health. Breastfeeding includes several triggers for memories of abuse experiences, which will likely influence decisions about breastfeeding and its implementation in daily life. This is important since breastfeeding improves maternal well-being and bonding with the child.

Research aim:

As breastfeeding strongly influences the long-term health of children, we investigated experiences with breastfeeding in women with a history of CSA.

Methods:

Data on breastfeeding were collected within a research project designed to compare labor and delivery experiences in women with a history of CSA to women without such antecedents. Data from 85 women having experienced CSA and 170 controls pair-matched for maternal age, children’s age, and nationality were evaluated. The clinical record of pregnancy and a self-administered questionnaire were used to collect data.

Results:

Although the prevalence of breastfeeding was similar in women with and without CSA experiences (96.5% vs. 90.6%), women exposed to CSA more often described complications associated with breastfeeding (77.7% vs. 67.1%, p = .08). Mastitis (49.4% vs. 27.6%, p < .01) and pain (29.4% vs. 18.8%, p = .15) were reported significantly more often by women after CSA. For 20% of women after CSA, breastfeeding was a trigger for memories of CSA. Furthermore, 58% of women with CSA reported dissociation when breastfeeding.

Conclusion:

In addition to the growing list of potential health consequences of CSA experience, this experience seems to be associated with an increased number of problems when breastfeeding. However, most women with a history of CSA intend to breastfeed despite particular challenges related to CSA. A support protocol tailored to the specific needs of these women during pregnancy and the lactation period may help to improve breastfeeding and the early mother–child relationship.
All the world’s a school
Authors: Young Jonathan
Published: January 2017

This article reports on a research project which focused on the aspirations and identities of students in an international school. Ten boys and ten girls were interviewed using semi-structured and photo-elicitation interviews. This research indicates convincingly that socio-economic background and international capital are crucial factors framing and influencing young people’s aspirations. This study shows that in the worlds of these ‘third’ and ‘fourth’ culture young people, identities are not at all ‘fragmented’, as has been previously claimed. Additionally, the participants are very similar owing to their privilege, and are not naïve about their own advantage. This study might help schools maximize on the international experiences of students to reflect on their global citizenship and altruism. This project has the possibility to help international school educators and leaders, who are active players in this culturally complex field, better support young people in their process of identity formation in a global society.
Understanding Corporate Culture
Authors: Kienle Patricia C.
Published: January 2017

Positions within health care organizations require clinical and organizational skills. Understanding the organization's political climate is key to the clinical coordinator's success. Approaching the corporate culture is similar to managing patient care: it requires diagnosis, treatment, and evaluation of the situation. Diagnostic issues include the status of the pharmacy services and analyses of the organization's performance in external and internal assessments. Treatment issues include management style, communication skills, and interaction with key players in the organization. Evaluation issues include the ability to objectively assess the worth of clinical programs.
Interpersonal Skills and the Clinical Coordinator
Authors: Petretich Deborah A.
Published: January 2017

A clinical coordinator deals with a wide variety of people on a daily basis. Whenever two or more people are involved in a process, a relationship is formed. In order to be effective at his or her job, a clinical coordinator must be skilled at building these interpersonal relationships. Although it is easy to identify failed interactions due to lack of these skills, it is often hard to pinpoint exactly what is necessary to develop and strengthen the areas important to building effective relationships. Communication skills become an integral part of the process of interacting with others. These skills may involve actions which are very visible to those around us. They may also involve strengthening an “inner” level that drives our motivation and attitude. The key to developing these skills is practice. It involves the willingness to effect change within ourselves in an attempt to better understand others. The qualities of honesty, sincerity, and consistency are also very important in mastering the art of effective communication. These skills come not so much from having great intellect, as they do from the ability to build trust.
Strategies for Effective Hospital Pharmacy Staff Development
Authors: Miller Sarah J. , Docktor William J. , North Ginnie Lee T.
Published: January 2017

An active staff development program (SDP) for pharmacists has been associated with provision of higher levels of pharmaceutical care within health-care institutions. Adequate support from pharmacy management, institutional administration, the medical staff, and the pharmacy staff itself is necessary for a successful, ongoing SDP. A SDP run concurrently with implementation of clinical pharmacy services allows pharmacists to immediately apply new skills and knowledge. Such a SDP should emphasize not only information necessary for performance of the clinical service, but also should develop drug information retrieval, problem solving, and organizational skills. A SDP should use a variety of media and methods, with an emphasis on interactive and active learning formats. The staff pharmacists should occasionally make some of the presentations themselves. Continuing education credit should be provided through the SDP. Feedback regarding the success of the newly implemented clinical services should be supplied to the pharmacists as a motivator for continued learning; feedback to administration is necessary for continued justification of both the SDP and clinical services. The hospital pharmacy literature is replete with accounts of successful staff development programs. At Saint Patrick Hospital, a SDP initiated concomitantly with implementation of new clinical services has enjoyed both success and longevity.
Transformational Leadership: A Model for Advanced Practice Holistic Nurses
Authors: McCaffrey Ruth , Reinoso Humberto
Published: January 2017

Advanced Practice Holistic Nurse (APHN) leaders could provide a model of leadership to advance value based health care systems in the United States. The American Nurses Association has recognized Holistic Nursing as a specialty because of the emphasis placed on patient-centered care, the development of therapeutic relationships, interconnection, and holism. Transformational leadership is a framework that uses vision, inspiration and intellectual stimulation to motivate people toward needed change. The APHN is well positioned to use transformational leadership methods to lead teams placing the patient at the center of health care decision making and bring the essence of holism to the forefront of health care. Highlighted are methods for positive communication, inspiration, negotiation, and conflict resolution as tools the APHN could use to become a transformational leader. The purpose of this article is to discuss a framework for transformational leadership development and implementation to establish the holistic ideals of APHNs in the health care system.
Managing the Fife ENT Waiting List: The 1989 Review of Problems
Authors: Coid Donald R.
Published: January 2017

In-patient activity of Fife Ear, Nose and Throat (ENT) wards and of Fife ENT consultants are higher than the Scottish averages. Out-patient activity appears to operate at a lower level and hundreds of patients remain on the Fife waiting list for operations. An analysis of 731 patients on the ENT waiting list in 1989 showed that 15% had been waiting for over three years. Over 350 hours of theatre time and over 3,200 in-patient bed days would be required to clear this waiting list. Adopting a guillotine tonsillectomy operative procedure without anaesthesia would make a major contribution to a rapid reduction of the waiting list. Although this is reported to be quick, relatively painless and remarkably free from haemorrhagic complications, it appears not to be acceptable in our medical culture at the moment. A life table analysis suggests that Fife is failing to operate on patients at a rate compatible with the needs of the community: current trends of operating suggest that over one half of patients will be on the waiting list for operations three years after being placed on it. The Secretary of State's 1989–90 waiting list initiative, the appointment of an extra ENT consultant and the allocation of additional operating theatre time may help to resolve these difficulties.
The Relationship between Technology and Task Design in Hospital Nursing Units
Authors: Hernandez S. Robert , Carter Haddock Cynthia , Quintana Jose B.
Published: January 2017

An empirical assessment of the use of the Hackman, Oldham, Janson, and Purdy (1975) implementing principles as a theoretical link between hospital nursing unit technology and job design is presented in this paper. While support for the implementing principles as an integrating mechanism was found to be weak, some insights into organization theory are noted and suggestions for future research resulting from this study are outlined.
Editorial
Authors: Peck Edward
Published: January 2017

By April 1994 only 4% of NHS units remained under the direct management of district health authorities. All the remaining 419 are NHS trusts. It is therefore timely to reflect on the experience of NHS trusts and the papers in this collection are intended to stimulate that reflection. This short introduction to those papers will serve two purposes: Firstly to refresh memories about the government aspirations for NHS trusts at the outset; and secondly to provide a guide to the content of the seven papers.

In January 1989 the government issued the White Paper Working for Patients (DoH, 1989a) which stated its intention to create self-governing hospitals within the NHS. A subsequent working paper gave further details on this proposal which the Department of Health presented as the ‘next logical step in the process of extending local responsibility’ (DoH, 1989b). ‘The working paper indicated that self-governing hospitals would be established under statute as ‘separate legal entities’ with specified ‘extensive powers and freedoms’. The initiation of a trust application was ‘open to a variety of interest – including the health authority, the hospital management team, a group of staff or people from the local community’.
A Provider Perspective
Authors: Fry Mike
Published: January 2017

In my two-year experience as a chief executive I have found a widespread tendency to greatly over-simplify trust status. This has led to casual observers adopting a stance regarding NHS trust, often based on the most flimsy acquaintance with any facts concerning them. For me, the reality of ‘self-government’ has been a complex blend of liberation, frustration, enervation and a heightened sense of both organisational potential and personal achievement.

I have no doubts that trust status has very positively aided the development of Christie Hospital; however I can be equally confident that few first wave chief executives could be as unequivocally positive as myself. Much of this relates to our former position as one of four units within a very large, financially challenged teaching authority. The Christie is a specialist cancer centre with substantial research and specialist facilities which are almost entirely non-exchequer funded. As such it was always a cuckoo in the health authority nest. Attempts at becoming the first non-London special health authority had failed and consequently the prospect of self-governing status was immediately attractive to a number of key opinion formers on the site. This is not to down play both the internal and external opposition to the Christie Trust Application, but rather to indicate at the outset that the organisation had an instinctively more positive reaction to the allure of trust status than was the case in many other places.
Effect of two-body and three-body microcontacts under dry friction on contact characteristics
Authors: Wu Horng-Wen , Chen Yang-Yuan
Published: January 2017

The wear debris generation is unavoidable between the contact interfaces of moving components. In three-body contact instances, friction and wear occur at these separate contact points. This paper discusses the characteristics of the three-body contact comprising the abrasive particle in the interface compared to the two-body contact. The results show that for the wear debris or foreign particles present in the interface of the three-body contact, as external load initially increases, the external load is fully borne by the contact characteristics of particle-to-surface. Until the external load rises to a particular critical external load, it enters the real three-body situation, and the critical external load thus increases with an increase in the ratio of particle diameter to surface roughness. For two contact surfaces, the summit deformation is the elastoplastic deformation in a wide range of external loads. As the external load is lower than the critical external load value of the three-body contact, the contact surface is under the particle-to-surface two-body contact, and the elastic deformation of surface peak has the largest proportion of contact area. When the external load is higher than the critical external load value, the elastoplastic deformation contact area quickly dominates, and the total contact area ratio approximates to the surface-to-surface two-body contact situation. In the range of engineering surface roughness (σ = 50–400 nm), at each external load and surface roughness, the total friction coefficient decreases with the increase in the ratio of particle diameter to surface roughness under the three-body contact, and this shows that the friction coefficient of surface-to-surface contact is larger than that of the sphere wear debris between the contact interface. At the same surface roughness, the friction coefficient may increase or decrease with an increase in the external load because it is determined by particle diameter. At the same ratio of particle diameter to surface roughness and external load, the friction coefficient increases with the decreasing surface roughness.
An improved whole-machine balancing method based on double auto-correlation measurement
Authors: Zhang Zhixin , Zhang Chuanyi , Wan Keda , Fu Yulong , Zhong Yuebo
Published: January 2017

The key phase signal is an important factor in the traditional whole-machine balancing method, but, sometimes, it is very hard to get that signal in the rotor system on the scene. A new method to get the unbalance component by only measuring the unbalance vibration amplitude is proposed in this paper. We discuss how to extract the rotor speed based on double auto-correlation; how to identify the unbalance vibration amplitude based on cross-correlation and the design of the special dynamic balancing instrument based on amplitude measurement. This method is also integrated in our newly developed instrument and the experiments prove it works well.