oalib

OALib Journal期刊

ISSN: 2333-9721

费用：99美元

投稿

时间不限

( 2673 )

( 2672 )

( 2454 )

( 2208 )

自定义范围…

匹配条件： “Donna L. Agan” ，找到相关结果约252956条。
列表显示的所有文章，均可免费获取
第1页/共252956条
每页显示 条
Compassionate Care: Can it be Defined and Measured? The Development of the Compassionate Care Assessment Tool
Lori Burnell,Donna L. Agan
International Journal of Caring Sciences , 2013,
Abstract: Background: Compassion has not been universally defined or understood, nonetheless is recognized as a component of nursing excellence. If compassionate care is routine in health care delivery models, nursing behaviors and actions that exemplify compassion ought to be easily identifiable to patients. However, a standardized scale measuring compassionate care attributes has been notably absent.Objective: To address this gap and ascertain the importance of compassionate care to patients, a Compassionate Care Assessment Tool (CCAT) was formulated. This new tool, derived from a pilot study of two published surveys, combined the constructs of compassion and caring to generate 28 elements of compassionate care.Methodology: The CCAT was administered to 250 hospitalized patients. Patients were asked to rate (a) the importance of these items to compassionate care and (b) the extent to which nurses made this type of care apparent to them.Results: Four categorical segments illustrated compassion from the patients’ perspective: the ability to establish meaningful connections, meet expectations, exhibit caring attributes, and function as a capable practitioner.Conclusions: The provision of compassionate care requires a holistic approach. Patients value nurses forming personal connections, serving as their advocates, and responding to their individual needs.
Feasibility of Remote Real-Time Guidance of a Cardiac Examination Performed by Novices Using a Pocket-Sized Ultrasound Device
Tuan V. Mai,David T. Ahn,Colin T. Phillips,Donna L. Agan,Bruce J. Kimura
Emergency Medicine International , 2013, DOI: 10.1155/2013/627230
Abstract: Background. The potential of pocket-sized ultrasound devices (PUDs) to improve global healthcare delivery is limited by the lack of a suitable imaging protocol and trained users. Therefore, we investigated the feasibility of performing a brief, evidence-based cardiac limited ultrasound exam (CLUE) through wireless guidance of novice users. Methods. Three trainees applied PUDs on 27 subjects while directed by an off-site cardiologist to obtain a CLUE to screen for LV systolic dysfunction (LVSD), LA enlargement (LAE), ultrasound lung comets (ULC+), and elevated CVP (eCVP). Real-time remote audiovisual guidance and interpretation by the cardiologist were performed using the iPhone 4/iPod (FaceTime, Apple, Inc.) attached to the PUD and transmitted data wirelessly. Accuracy and technical quality of transmitted images were compared to on-site, gold-standard echo thresholds. Results. Novice versus sonographer imaging yielded technically adequate views in 122/135 (90%) versus 130/135 (96%) ( ). CLUE’s combined SN, SP, and ACC were 0.67, 0.96, and 0.90. Technical adequacy (%) and accuracy for each abnormality ( ) were LVSD (85%, 0.93, ), LAE (89%, 0.74, ), ULC+ (100%, 0.94, ), and eCVP (78%, 0.91, ). Conclusion. A novice can perform the CLUE using PUD when wirelessly guided by an expert. This method could facilitate PUD use for off-site bedside medical decision making and triaging of patients. 1. Background Although pocket-sized ultrasound devices (PUDs) can augment the physical exam, their potential to improve global healthcare delivery in the emergent setting or in areas of limited resources has been limited by the lack of a suitable imaging protocol and trained users [1]. We have previously shown that an evidence-based, 5-minute “quick-look” cardiac limited ultrasound exam (CLUE) has diagnostic and prognostic value [2], affects medical decision making [3], and can be taught to internal medicine residents [4]. Unlike the traditional bedside cardiac examination, CLUE has the potential for wireless transmission. Recent reports have shown the feasibility of remotely mentored ultrasound examination to evaluate apnea and pneumothorax in trauma [5] and in off-line remote expert echo interpretation using a smartphone-based application [6]. We investigated the feasibility of utilizing low-cost, readily available wireless video conferencing software to guide novice users in performing CLUE in real time. 2. Methods The CLUE examined 4 targets using 4 previously-validated, nonquantitative ultrasound “signs” [2]. In brief, the parasternal long axis view was assessed for
IM Residency Ultrasound
Bruce J. Kimura, MD, FACC,David J. Shaw, MD, FACC, FACP,Donna L. Agan, EdD,James N. Phan, RDCS, RVT,Stan A. Amundson, MD, FACP
- , 2012, DOI: 10.1002/jhm.1944
Abstract: AbstractBACKGROUND:Despite the future potential of using ultrasound stethoscopes to augment the bedside cardiac physical, few data exist on a general cardiovascular imaging protocol that can be taught to physicians on a perpetual basis as a curriculum in graduate medical education.METHODS:During the past decade, we developed and integrated a cardiovascular limited ultrasound training program within the confines of an internal medicine residency. The evidence‐based rationale for the exam, the teaching methods, and curriculum are delineated, and subsequent observations regarding program requirements, proficiency, and academic outcomes are explored. Analysis of variance and linear regression assessed for relationships between academic scores, chief resident selection, and gender to proficiency in ultrasound.RESULTS:A brief, 5‐minute cardiovascular limited ultrasound exam (CLUE) was taught using both didactic and bedside methods, and practiced primarily within the cardiology consult, outpatient clinic, and intensive care rotations. Program costs were minimized by employing readily available institutional resources. After a 2‐year lead‐in training phase, the subsequent 4 years of senior resident performance (n = 41 residents) showed an 81% pass rate in CLUE competency. Resident ultrasound performance did not relate to academic scores (r = 0.05, P = 0.75), chief resident selection, nor gender. Observations regarding resident pitfalls in CLUE practice and increased participation in extracurricular research are described.CONCLUSIONS:We report our initial experience in developing and implementing a training program for bedside cardiovascular ultrasound examination that employed evidence‐based techniques, set proficiency goals, and assessed resident performance. It may be feasible to teach future internist–hospitalists the technique of bedside ultrasound during residency. Journal of Hospital Medicine 2012;. ？ 2012 Society of Hospital Medicin
A review of central nervous system leukaemia in paediatric acute myeloid leukaemia
Donna L. Johnston
Journal of Hematological Malignancies , 2011, DOI: 10.5430/jhm.v1n1p1
Abstract: The treatment of pediatric acute myeloid leukemia (AML) is the subject of many studies by collaborative groups around the world. These studies have examined both variations in the timing of chemotherapy agents being given, as well as the addition or omission of specific chemotherapeutic agents. In cooperative group studies, the methods utilized for the treatment of central nervous system (CNS) leukemia have remained relatively stable over the years. However, there are significant differences among the different cooperative groups as to the therapy used to treat both overt CNS leukemia and the therapy used for the prevention of CNS leukemia. Similarly, the criterion used to define the presence of CNS leukemia differs among the groups. The majority of cooperative groups classify CNS findings in a similar manner, specifically CNS1 status is less than 5 white blood cells in the cerebrospinal fluid (CSF) with no blasts present, CNS2 status is less than 5 white blood cells in the CSF with the presence of blasts, and CNS3 status is 5 or more white blood cells in the CSF with the presence of blasts (all in an atraumatic tap). This manuscript will examine both the definition and therapy of CNS leukemia in pediatric AML cooperative group trials as well as the incidence of CNS relapse in these trials, with recommendations for therapy based on these studies.
The Teaching and Learning Cycle: Integrating Curriculum, Instruction, and Assessment
Donna L. Jones
Christian Perspectives in Education , 2008,
Abstract: The philosophies of educators and government entities guide the teaching and learning cycle of curriculum, instruction, and assessment. The educator’s worldview plays an important part in developing these concepts which is demonstrated throughout history. Studying the history of the educational philosophers reveals their beliefs about curriculum, instruction, and assessments and the effects on education today. It shows the importance of integrating all three concepts in the educational process creating the teaching and learning cycle.
Birdsong: Is It Music to Their Ears?
Donna L. Maney
Frontiers in Evolutionary Neuroscience , 2012, DOI: 10.3389/fnevo.2012.00014
Abstract: Since the time of Darwin, biologists have wondered whether birdsong and music may serve similar purposes or have the same evolutionary precursors. Most attempts to compare song with music have focused on the qualities of the sounds themselves, such as melody and rhythm. Song is a signal, however, and as such its meaning is tied inextricably to the response of the receiver. Imaging studies in humans have revealed that hearing music induces neural responses in the mesolimbic reward pathway. In this study, we tested whether the homologous pathway responds in songbirds exposed to conspecific song. We played male song to laboratory-housed white-throated sparrows, and immunolabeled the immediate early gene product Egr-1 in each region of the reward pathway that has a clear or putative homologue in humans. We found that the responses, and how well they mirrored those of humans listening to music, depended on sex and endocrine state. In females with breeding-typical plasma levels of estradiol, all of the regions of the mesolimbic reward pathway that respond to music in humans responded to song. In males, we saw responses in the amygdala but not the nucleus accumbens – similar to the pattern reported in humans listening to unpleasant music. The shared responses in the evolutionarily ancient mesolimbic reward system suggest that birdsong and music engage the same neuroaffective mechanisms in the intended listeners.
An ounce of prevention
Donna L. Williams
- , 2016, DOI: 10.21037/9267
Abstract: Life expectancy worldwide increased dramatically in the 20th century. While most babies born in 1900 lived 50 years or less, life expectancies now exceed 80 years in several countries, and there is no indication of a tapering off of this trend in the 21st century. With the exception of immunizations, these increases are not as much attributable to medical breakthroughs as they are to changes in lifestyle and better living conditions including clean water and better nutrition (1). Can the same be said for decreases in cancer mortality
The Promotional Priorities of the '92 Elections
Begi？, Agan
- , 1993,
Abstract: Sa？etak In studying the way in which parties presented their programs at the 1992 elections for the House of Representatives in the Croatian parliament one must start with a study of the parties' definitions of the social reality. The prominent political problems which were seen as priorities in the definition of the social reality can be divided into into four large groups of problems: economy, internal policy, foreign policy and war. An analysis of these will reveal the differences in the parties' priorities of interests. The parties' definition of the political reality make it possible to distinguish one party from the others and at the same time they indicate various types of cooperation between them and enabling them to establish some "thematic alliances", deceptive because determined by party interests, values and starting points
Promotivni prioriteti izbora 1992.
Begi？, Agan
- , 1993,
Abstract: Sa？etak U istra？ivanjima predstavljanja programa na izborima za Zastupni？ki dom Hrvatskog sabora u 1992. godini valja po？i od ispitivanja strana？ke definicije dru？tvene zbilje. Istaknuti politi？ki problemi koji su odre？eni kao prioriteti definicije dru？tvene stvarnosti, strukturirani su u ？etiri velike problemske skupine: gospodarstvo, unutarnja politika, vanjska politika i rat, ？ijim ra？？lanjivanjem se pokazuju razli？ite interesne pozicije. Strana？ke definicije politi？ke zbilje s jedne strane omogu？avaju ustanovljenje odre？enih "tematskih saveza" koji su samo prividnog karaktera jer su uvjetovani strana？kim interesima, vrijednostima i ishodi？tima
Combining Epidemiologic and Biostatistical Tools to Enhance Variable Selection in HIV Cohort Analyses
Christopher Rentsch, Ionut Bebu, Jodie L. Guest, David Rimland, Brian K. Agan, Vincent Marconi
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0087352
Abstract: Background Variable selection is an important step in building a multivariate regression model for which several methods and statistical packages are available. A comprehensive approach for variable selection in complex multivariate regression analyses within HIV cohorts is explored by utilizing both epidemiological and biostatistical procedures. Methods Three different methods for variable selection were illustrated in a study comparing survival time between subjects in the Department of Defense’s National History Study and the Atlanta Veterans Affairs Medical Center’s HIV Atlanta VA Cohort Study. The first two methods were stepwise selection procedures, based either on significance tests (Score test), or on information theory (Akaike Information Criterion), while the third method employed a Bayesian argument (Bayesian Model Averaging). Results All three methods resulted in a similar parsimonious survival model. Three of the covariates previously used in the multivariate model were not included in the final model suggested by the three approaches. When comparing the parsimonious model to the previously published model, there was evidence of less variance in the main survival estimates. Conclusions The variable selection approaches considered in this study allowed building a model based on significance tests, on an information criterion, and on averaging models using their posterior probabilities. A parsimonious model that balanced these three approaches was found to provide a better fit than the previously reported model.
第1页/共252956条
每页显示 条


Home
Copyright © 2008-2020 Open Access Library. All rights reserved.