Literature review on advance care planning of nursing home residents

Aim: Conduct a search and analytic review of literature regarding attributes of Advance Care Planning (ACP) and Advance Directive in order to identify the experiences and the best care strategies for older adults resident in nursing homes or long term institutions. Methodology: An extensive electronic search was undertaken in the following databases: Pubmed (via Ovid search), Cumulative Index of Nursing and Allied Health (CINAHL, via EBHOST), psychINFO and Cochrane. After analyzing and eliminating duplicates and professional's point of view (19), 144 titles were considered relevant: 28 opinion papers, 94 descriptive/qualitative studies or predictive studies, 17 experimental and five systematic reviews. Most of them were produced in North America and only 10 were in French. Results: With regard to European experiences, studies are scarce and further research could benefit from North American evidence. Contrary to Europe, nurses in North America play a major role in the process of care planning. The major findings were related to the poor efficacy of the completion of Advance Directives, even in presence of a substantial variety of implementation strategies. The evidence supports interventions that conceptualize ACP as a process, with an emphasis on the ascertainment of patients' values and beliefs and the necessity to include the family or loved ones from the beginning of the process in order to favor the expression and sharing of one's life perspectives and priorities in care. The most relevant findings were associated with the conceptualization of the ACP as a change in health behaviors which needs an involvement in different stages to overcome a variety of barriers. Conclusion: Rigorous research in ACP for the older adults in Swiss nursing homes that promote respect and dignity in this frail population is needed. How to best achieve patients and families goals should be the focus of nursing intervention and research in this domain.

Recursos governatius. Doctrina de la Direcció General de Dret i Entitats Jurídiques (maig-setembre 2008)

Comentaris a les Resolucions de la Direcció General de Dret i Entitats Jurídiques de 5 de maig 2008, 16 de juliol 2008 i 29 de setembre 2008.

Recursos governatius. Doctrina de la Direcció General de Dret i Entitats Jurídiques IV

Comentaris a les Resolucions de la Direcció General de Dret i Entitats Jurídiques 22 de gener 2007, de 24 de gener 2007, de 15 de febrer 2007, de 16 de febrer 200 i de 19 de febrer 2007.

Recursos governatius. Doctrina de la Direcció General de Dret i Entitats Jurídiques (maig 2007-febrer 2008)

Comentaris a les Resolucions de la Direcció General de Dret i Entitats Jurídiques de 2 de maig 2007, de 10 de juliol 2007, d'11 de juliol 2007, de 16 de juliol 2007, de 17 de juliol 2007, de 22 d'octubre 2007, de 21 de desembre 2007 i 4 de febrer 2008.

Recursos governatius. Doctrina de la Direcció General de Dret i Entitats Jurídiques (febrer-abril 2008).

Comentaris a les Resolucions de la Direcció General de Dret i Entitats Jurídiques de 6 de febrer 2008, 8 de febrer 2008, 20 de febrer 2008, 2 d'abril 2008 i 18 d¿abril 2008.

Recursos governatius. Doctrina de la Direcció General de Dret i Entitats Jurídiques V

Comentaris a les Resolucions de la Direcció General de Dret i Entitats Jurídiques de 20 de març 2007, de 26 d'abril 2007, de 27 d'abril 2007 i de 30 d'abril 2007

Iowa Agri-News, July 12, 2011, Vol. 11, no. 12

Crop and livestock summaries for the state of Iowa, produced by the Iowa Department of Agriculture. Preivous titles Agri-News.

A systematic review of longitudinal population-based studies on the predictors of smoking cessation in adolescent and young adult smokers.

OBJECTIVE: To describe the determinants of self-initiated smoking cessation of duration of at least 6 months as identified in longitudinal population-based studies of adolescent and young adult smokers. METHODS: A systematic search of the PubMed and EMBASE databases using smoking, tobacco, cessation, quit and stop as keywords was performed. Limits included articles related to humans, in English, published between January 1984 and August 2010, and study population aged 10-29 years. A total of 4502 titles and 871 abstracts were reviewed independently by 2 and 3 reviewers, respectively. Nine articles were retained for data abstraction. Data on study location, timeframe, duration of follow-up, number of data collection points, sample size, age/grade of participants, number of quitters, smoking status at baseline, definition of cessation, covariates and analytic method were abstracted from each article. The number of studies that reported a statistically significant association between each determinant investigated and cessation were tabulated, from among all studies that assessed the determinant. RESULTS: Despite heterogeneity in methods across studies, five factors robustly predicted quitting across studies in which the factor was investigated: not having friends who smoke, not having intentions to smoke in the future, resisting peer pressure to smoke, being older at first use of cigarette and having negative beliefs about smoking. CONCLUSIONS: The literature on longitudinal predictors of cessation in adolescent and young adult smokers is not well developed. Cessation interventions for this population will remain less than optimally effective until there is a solid evidence base on which to develop interventions.

Physical activity level and health-related quality of life in the general adult population: a systematic review.

OBJECTIVE: Little is known regarding health-related quality of life and its relation with physical activity level in the general population. Our primary objective was to systematically review data examining this relationship. METHODS: We systematically searched MEDLINE, EMBASE, CINAHL, and PsycINFO for health-related quality of life and physical activity related keywords in titles, abstracts, or indexing fields. RESULTS: From 1426 retrieved references, 55 citations were judged to require further evaluation. Fourteen studies were retained for data extraction and analysis; seven were cross-sectional studies, two were cohort studies, four were randomized controlled trials and one used a combined cross sectional and longitudinal design. Thirteen different methods of physical activity assessment were used. Most health-related quality of life instruments related to the Medical Outcome Study SF-36 questionnaire. Cross-sectional studies showed a consistently positive association between self-reported physical activity and health-related quality of life. The largest cross-sectional study reported an adjusted odds ratio of "having 14 or more unhealthy days" during the previous month to be 0.40 (95% Confidence Interval 0.36-0.45) for those meeting recommended levels of physical activity compared to inactive subjects. Cohort studies and randomized controlled trials tended to show a positive effect of physical activity on health-related quality of life, but similar to the cross-sectional studies, had methodological limitations. CONCLUSION: Cross-sectional data showed a consistently positive association between physical activity level and health-related quality of life. Limited evidence from randomized controlled trials and cohort studies precludes a definitive statement about the nature of this association.

Iowa and Some Iowans : a Bibliography for Schools and Librarians, 1996

Iowa and Some Iowans is a classed bibliography of materials by Iowans or about Iowa. It is in the same order in which the average school or public library or media center would shelve materials, that is, nonfiction in order using the Dewey Decimal System, and fiction in alphabetical order by author. Biographies and autobiographies are generally entered 920's. A few may be entered under the subject with which the biography is related. An attempt is made to provide most of the information needed to catalog each title including the Iowa-related subject headings, and the joint authors, artists and series titles pertinent to the bibliography. These items are included at the bottom of the entry as numbered “tracings” and are a record of the items included in the indexes. The author or creator of a work and the title of the work are indexed also. Fourth Edition 1996. NOTE: this digital version has some pagination discrepancies in the transition from chapter to chapter, but all content is included.

Publication bias in animal research: a systematic review protocol.

BACKGROUND: Systematic reviews and meta-analyses of pre-clinical studies, in vivo animal experiments in particular, can influence clinical care. Publication bias is one of the major threats of validity in systematic reviews and meta-analyses. Previous empirical studies suggested that systematic reviews and meta-analyses have become more prevalent until 2010 and found evidence for compromised methodological rigor with a trend towards improvement. We aim to comprehensively summarize and update the evidence base on systematic reviews and meta-analyses of animal studies, their methodological quality and assessment of publication bias in particular. METHODS/DESIGN: The objectives of this systematic review are as follows: âeuro¢To investigate the epidemiology of published systematic reviews of animal studies until present. âeuro¢To examine methodological features of systematic reviews and meta-analyses of animal studies with special attention to the assessment of publication bias. âeuro¢To investigate the influence of systematic reviews of animal studies on clinical research by examining citations of the systematic reviews by clinical studies. Eligible studies for this systematic review constitute systematic reviews and meta-analyses that summarize in vivo animal experiments with the purpose of reviewing animal evidence to inform human health. We will exclude genome-wide association studies and animal experiments with the main purpose to learn more about fundamental biology, physical functioning or behavior. In addition to the inclusion of systematic reviews and meta-analyses identified by other empirical studies, we will systematically search Ovid Medline, Embase, ToxNet, and ScienceDirect from 2009 to January 2013 for further eligible studies without language restrictions. Two reviewers working independently will assess titles, abstracts, and full texts for eligibility and extract relevant data from included studies. Data reporting will involve a descriptive summary of meta-analyses and systematic reviews. DISCUSSION: Results are expected to be publicly available later in 2013 and may form the basis for recommendations to improve the quality of systematic reviews and meta-analyses of animal studies and their use with respect to clinical care.

Pediatric advance care planning: a systematic review.

BACKGROUND AND OBJECTIVES: Advance care planning (ACP) is increasingly regarded as the gold standard in the care of patients with life-limiting illnesses. Research has focused on adults, but ACP is also being practiced in pediatrics. We conducted a systematic review on empirical literature on pediatric ACP (pACP) to assess current practices, effects, and perspectives of pACP. METHODS: We searched PubMed, BELIT, and PSYCinfo for empirical literature on pACP, published January 1991 through January 2012. Titles, abstracts, and full texts were screened by 3 independent reviewers for studies that met the predefined criteria. The evidence level of the studies was assessed. Relevant study outcomes were retrieved according to predefined questions. RESULTS: We included 5 qualitative and 8 quantitative studies. Only 3 pACP programs were identified, all from the United States. Two of them were informed by adult programs. Major pACP features are discussions between families and care providers, as well as advance directives. A chaplain and other providers may be involved if required. Programs vary in how well they are evaluated; only 1 was studied by using a randomized controlled trial. Preliminary data suggest that pACP can successfully be implemented and is perceived as helpful. It may be emotionally relieving and facilitate communication and decision-making. Major challenges are negative reactions from emergency services, schools, and the community. CONCLUSIONS: There are few systematic pACP programs worldwide and none in Europe. Future research should investigate the needs of all stakeholders. In particular, the perspective of professionals has so far been neglected.

Iowa Department of Public Health: SFY 2015 Annual County Service Contract Listing, 2016

Iowa Department of Public Health SFY 2015 Annual County Service Contract Listing. This publication strives to identify all service contracts administered by the Iowa Department of Public Health during the period of July 1, 2014 through June 30, 2015. Contracts may have been increased or decreased, and contract titles changed during the published period. Contracts listed in this summary are shown in alphabetical order by contractor within the county. Interdepartmental Agreements with state government agencies are at the back of the listing. Each page is divided into eight columns which identify the following: column 1: the county of the contractor; column 2: the contractor; column 3: the contract number; column 4: the contract title; column 5: the contract amount; column 6: the funding source; column 7: the start date of the contract and column 8: the end date of the contract.

Los referentes culturales y su tratamiento en la traducción del manga: los casos de La espada del inmortal, GALS!, Vidas etílicas y Ranma ½

L’objecte d’estudi d’aquesta investigació és l’observació i categorització dels referents culturals que apareixen en obres manga (còmic japonès) i la descripció del tractament que reben els elements esmentats en les versions traduïdes. Es tracta d’un estudi sincrònic de la traducció del primer volum de quatre obres publicades a España en castellà: La espada del inmortal, GALS!, Vidas etílicas i Ranma ½. Cadascun d’ells s’ha escollit per pertànyer a un gènere de manga dirigit a un segment de la població japonesa determinat: seinen (homes), shôjo (nenes-noies), jôsei (dones) y shônen (nens-nois)