Barriers and facilitators to nurses' acceptance of and implications for injury rates of an IV catheter safety device

This study has the purpose of determining the barriers and facilitators to nurses' acceptance of the Johnson and Johnson Protectiv®* Plus IV catheter safety needle device and implications for needlestick injuries at St. Luke's Episcopal Hospital, Houston, Texas. A one-time cross-sectional survey of 620 responding nurses was conducted by this researcher during December, 2000. The study objectives were to: (1) describe the perceived (a) organizational and individual barriers and facilitators and (b) acceptance of implementation of the IV catheter device; (2) examine the relative importance of these predictors; (3) describe (a) perceived changes in needlestick injuries after implementation of the device; (b) the reported incidence of injuries; and (c) the extent of underreporting by nurses; and (4) examine the relative importance of (a) the preceding predictors and (b) acceptance of the device in predicting perceived changes in needlestick injuries. Safety climate and training were evaluated as organizational factors. Individual factors evaluated were experience with the device, including time using it and frequency of use, and background information, including nursing unit, and length of time as a nurse in this hospital and in total nursing career. The conceptual framework was based upon the safety climate model. Descriptive statistics and multiple and logistic regression were utilized to address the study objectives. ^ The findings showed widespread acceptance of the device and a strong perception that it reduced the number of needlesticks. Acceptance was notably predicted by adequate training, appropriate time between training and device use, solid safety climate, and short length of service, in that order. A barrier to acceptance was nurses' longtime of use of previous needle technologies. Over four-fifths of nurses were compliant in always using the device. Compliance had two facilitators: length of time using device and, to a lesser extent, safety climate. Rates of compliance tended to be lower among nurses in units in which the device was frequently used. ^ High quality training and an atmosphere of caring about nurse safety stand out as primary facilitators that other institutions would need to adopt in order to achieve maximum success in implementing safety programs involving utilization of new safety devices. ^

RELATIONS AMONG REMEMBERED PARENTAL ACCEPTANCE AND BEHAVIORAL CONTROL IN CHILDHOOD, ADULTS' CURRENT PSYCHOLOGICAL ADJUSTMENT, AND CAREER INDECISIVENESS

This study tested the hypothesis that career indecisiveness among men tends to be associated with different levels of self-reported psychological adjustment and with different remembrances of parental (maternal and paternal) acceptance and behavioral control in childhood from those of women. One hundred twenty-six respondents ages 17 through 54 (M = 23.7 years, SD = 8.21 years) participated in this study. Thirty-seven where males; 90 were females. Measures used in this study included the Career Decision Scale, the Adult version of the Parental Acceptance-Rejection/Control Questionnaire for mothers and for fathers, and the Adult version of the Personality Assessment Questionnaire. Both men and women remembered their mothers as well as their fathers as being loving in childhood. Additionally, men and women remembered both parents as being moderately behaviorally controlling in childhood. Finally, both men and women reported a fair level of psychological maladjustment. And on average, both men and women were fairly indecisive about their careers. Results of analyses supported the hypothesis in that career indecisiveness among women but not men was significantly correlated with remembered maternal and paternal acceptance in childhood, as well as with self-reported psychological adjustment and age. However, only women’s self-reported psychological adjustment made a significant and unique contribution to variations in their reports of career indecisiveness. None of the predictor variables were significantly associated with career indecisiveness among men.

Behavioral cognitions and factors related to hepatitis B vaccine acceptance and compliance in a cohort of drug users in Houston, Texas

Purpose. Drug users are a large group of those at highest risk for contracting Hepatitis B (HBV). This study sought to identify predictors of HBV vaccine acceptance and compliance in a cohort of current drug users in Houston, Texas. Perceived severity of HBV, perceived risk of HBV, perceived peer support of HBV vaccine, and perceived benefits of HBV vaccine were also examined assess their relationship to HBV compliance. ^ Methods. A randomized intervention study was conducted in a cohort of current drug users in Houston, Texas. Participants were recruited by community outreach workers from two urban neighborhoods in Houston known for high drug use. Participants were randomized to a standard vaccine schedule group or an accelerated vaccine schedule group. Participants were also randomized to either a standard behavioral intervention group or an enhanced behavioral intervention group designed to increase HBV vaccine acceptance and compliance. Baseline visits included an interview for demographic factors, drug and sexual behaviors, and HBV beliefs; and participants received the first dose of the HBV vaccine and one of the behavioral interventions. ^ Results. Of 1,643 screening participants, 77% accepted the HBV vaccine. Participants ages ≥50 were twice as likely to accept the vaccine. African Americans and less frequent drug users were also significantly more likely to accept the vaccine. Of the 1,259 participants who enrolled in the study, 75% were compliant to the HBV vaccine. Predictors of compliance were found to be race, housing status, and alcohol use. Speedball users were found to be 74% less likely to be compliant the HBV vaccine. None of the behavioral constructs assessed were found to significantly predict HBV compliance. However, additional analyses found that there were significant changes in mean scores of the behavioral concepts when measured at six month follow-up. ^ Conclusion. Results from this study indicate that when offered a free vaccine in the drug user community, a large percentage will be compliant to the vaccine series. The behavioral cognitions commonly used in HBV compliance research need to be extended to accurately fit this cohort. Also, vaccine intervention focus needs to be on reaching the homeless segment of the drug users and the speedball users. ^

Systematic review of acceptance of the influenza vaccine among pregnant women

Exposure to influenza places pregnant women at risk for pneumonia and their fetus at risk for premature delivery or fatal stillbirth secondary to maternal hypoxia. Immunization rates are low among pregnant women. Influenza vaccine specific-health belief model constructs, such as cue to action messages from the health care professionals, may increase acceptance of the vaccine and improve immunization rates. A systematic review was conducted to evaluate the impact of physician recommendation upon acceptance of the influenza vaccine by pregnant women. Pregnant women were more likely to accept the influenza vaccine if they received a recommendation from their physician. These women were also more likely to accept the vaccine if they thought the vaccine protected mother and fetus against adverse effects of influenza and were less likely to accept the vaccine if they were concerned about side effects or risk to the fetus from the vaccine.^

Evaluating the Utility of Clinical Criteria for the Identification of Lynch Syndrome among Endometrial Cancer Patients

Background: Lynch Syndrome (LS) is a familial cancer syndrome with a high prevalence of colorectal and endometrial carcinomas among affected family members. Clinical criteria, developed from information obtained from familial colorectal cancer registries, have been generated to identify individuals at elevated risk for having LS. In 2007, the Society of Gynecologic Oncology (SGO) codified criteria to assist in identifying women presenting with gynecologic cancers at elevated risk for having LS. These criteria have not been validated in a population-based setting. Materials and Methods: We retrospectively identified 412, unselected endometrial cancer cases. Clinical and pathologic information were obtained from the electronic medical record, and all tumors were tested for expression of the DNA mismatch repair proteins through immunohistochemistry. Tumors exhibiting loss of MSH2, MSH6 and PMS2 were designated as probable Lynch Syndrome (PLS). For tumors exhibiting immunohistochemical loss of MLH1, we used the PCR-based MLH1 methylation assay to delineate PLS tumors from sporadic tumors. Samples lacking methylation of the MLH1 promoter were also designated as PLS. The sensitivity and specificity for SGO criteria for detecting PLS tumors was calculated. We compared clinical and pathologic features of sporadic tumors and PLS tumors. A simplified cost-effectiveness analysis was also performed comparing the direct costs of utilizing SGO criteria vs. universal tumor testing. Results: In our cohort, 43/408 (10.5%) of endometrial carcinomas were designated as PLS. The sensitivity and specificity of SGO criteria to identify PLS cases were 32.7 and 77%, respectively. Multivariate analysis of clinical and pathologic parameters failed to identify statistically significant differences between sporadic and PLS tumors with the exception of tumors arising from the lower uterine segment. These tumors were more likely to occur in PLS tumors. Cost-effectiveness analysis showed clinical criteria and universal testing strategies cost $6,235.27/PLS case identified and $5,970.38/PLS case identified, respectively. Conclusions: SGO 5-10% criteria successfully identify PLS cases among women who are young or have significant family history of LS related tumors. However, a larger proportion of PLS cases occurring at older ages with less significant family history are not detected by this screening strategy. Compared to SGO clinical criteria, universal tumor testing is a cost effective strategy to identify women presenting with endometrial cancer who are at elevated risk for having LS.

Classification criteria and commercial profile re-definition of the Family Farm Agriculture in Chile, Maule region

In Chile, small-scale farmers are classified according to old approaches from 1993 that do not include changes occurred in the last two decades. Maule is the region with most rural population in Chile which represents a significant stratum for development, innovation and competitiveness. This study explores a new approach of small-scale farmers -associated with Family Farm Agriculture (AFC) - classification in Chile and it describes a commercial profile or AFC-1 for famers of the Maule Region. A Cluster analysis to determine AFC-1 farmers is used. The analysis includes four association variables: Total Assets, Farm Income, Production Costs and Management Indicators. The results suggest that 16.4% of the farmers have a commercial profile and they could stay out support provided by the National Institute for Agricultural Development (INDAP). This group of farmers would not belong to AFC in short terms. This fact could bring restriction to AFC-1 farmers such as lack of credit access, less investment incentives and technical assistance. Thus, it would expect low process of technology adoption and welfare improvement. New agrarian policies must be warranted to support this important group of famers with a commercial profile.

La cooperación entre editores y bibliotecarios como estrategia institucional para la gestión de revistas científicas

El desarrollo sostenido de edición de revistas científicas ha abierto un campo de análisis y aplicación de conocimientos específicos para los bibliotecarios. El trabajo en cooperación con los editores enriquece a ambos actores pues, mientras los bibliotecarios conocen los estándares de normalización de la información y difusión del conocimiento científico, los editores se centran en las tareas académicas -pertinencia temática, relación con autores y evaluadores, revisión por pares. Los indicadores de evaluación de revistas científicas, tanto regionales como internacionales, se han afianzado en las últimas décadas a partir de acuerdos interinstitucionales y de la aceptación de los propios editores, aplicándose criterios de gestión y criterios formales de edición y evaluación. En este contexto, los editores necesitan un apoyo especializado que los acompañe en el proceso de desarrollo científico y técnico para conseguir que sus revistas se inserten en los principales núcleos de publicaciones científicas de cada disciplina. En este trabajo se presenta la experiencia de la Coordinación del Área de Publicaciones, en la Biblioteca de la Facultad de Humanidades y Ciencias de la Educación de la Universidad Nacional de La Plata, que edita actualmente más de 20 revistas

La orientación en América Latina : Consideraciones generales acerca de los criterios de coherencia, cooperación y calidad

La Orientación en América Latina, como campo de formación profesional y en comparación con Europa y Estados Unidos, es una actividad de reciente aceptación en los medios académicos. La misma se ha caracterizado por una constante evolución en su afán de adaptarse a los nuevos cambios y transformaciones sociales, políticas y económicas que se suceden en el continente latinoamericano. En esta ponencia se presenta un panorama general acerca de la Orientación en América Latina. Las principales consideraciones formuladas se relacionan con cuatro dimensiones: a) la dimensión política pública, donde se presentan la situación actual y las propuestas al respecto; b) la dimensión contextual que hace referencia a la formación del orientador y los diferentes escenarios de acción; c) la dimensión organizacional que se relaciona con la provisión de este servicio, y d) la dimensión metodológica donde se desarrollan los principales aspectos relacionados con la práctica de la Orientación.

Criteria of election of postgraduate courses in graduated students of technological/ humanistic/ artistic professions : Subjective and contextual involvements to arrive at the conclusion of them

El aumento en la cantidad de estudios de posgrado y de sus cursantes derivados de la demanda por mayores credenciales académicas en lo laboral y por la búsqueda personal para especializarse profesionalmente, es un fenómeno observado en Argentina desde mediados de los años 90. Obtener el título final de estos estudios resulta un porcentaje muy inferior en relación al número de sus inscriptos. Tales motivos focalizaron nuestra atención para analizar tanto los criterios de elección del posgrado como las condiciones contextuales y subjetivas para alcanzar la titulación. Este estudio, de tipo cualitativo, investiga en tres carreras de Especialización que se cursan en diferentes Universidades nacionales , los aspectos de su organización y estilo propuesto para cursar y lograr la finalización de los estudios, así como las motivaciones de la elección de cursantes y egresados en tres ramas diferentes: artística, humanística y tecnológica. El conocimiento sobre la lógica de la organización y la particularidad del objeto de estudio de cada carrera permite analizar diferencias y semejanzas entre ellas aportando algunas propuestas para considerar en programas de formación; mientras que los trayectos de cursantes y egresados explican aspectos subjetivos que intervienen en la finalización o no del posgrado.

La cooperación entre editores y bibliotecarios como estrategia institucional para la gestión de revistas científicas

El desarrollo sostenido de edición de revistas científicas ha abierto un campo de análisis y aplicación de conocimientos específicos para los bibliotecarios. El trabajo en cooperación con los editores enriquece a ambos actores pues, mientras los bibliotecarios conocen los estándares de normalización de la información y difusión del conocimiento científico, los editores se centran en las tareas académicas -pertinencia temática, relación con autores y evaluadores, revisión por pares. Los indicadores de evaluación de revistas científicas, tanto regionales como internacionales, se han afianzado en las últimas décadas a partir de acuerdos interinstitucionales y de la aceptación de los propios editores, aplicándose criterios de gestión y criterios formales de edición y evaluación. En este contexto, los editores necesitan un apoyo especializado que los acompañe en el proceso de desarrollo científico y técnico para conseguir que sus revistas se inserten en los principales núcleos de publicaciones científicas de cada disciplina. En este trabajo se presenta la experiencia de la Coordinación del Área de Publicaciones, en la Biblioteca de la Facultad de Humanidades y Ciencias de la Educación de la Universidad Nacional de La Plata, que edita actualmente más de 20 revistas

La orientación en América Latina : Consideraciones generales acerca de los criterios de coherencia, cooperación y calidad

La Orientación en América Latina, como campo de formación profesional y en comparación con Europa y Estados Unidos, es una actividad de reciente aceptación en los medios académicos. La misma se ha caracterizado por una constante evolución en su afán de adaptarse a los nuevos cambios y transformaciones sociales, políticas y económicas que se suceden en el continente latinoamericano. En esta ponencia se presenta un panorama general acerca de la Orientación en América Latina. Las principales consideraciones formuladas se relacionan con cuatro dimensiones: a) la dimensión política pública, donde se presentan la situación actual y las propuestas al respecto; b) la dimensión contextual que hace referencia a la formación del orientador y los diferentes escenarios de acción; c) la dimensión organizacional que se relaciona con la provisión de este servicio, y d) la dimensión metodológica donde se desarrollan los principales aspectos relacionados con la práctica de la Orientación.

Criteria of election of postgraduate courses in graduated students of technological/ humanistic/ artistic professions : Subjective and contextual involvements to arrive at the conclusion of them

El aumento en la cantidad de estudios de posgrado y de sus cursantes derivados de la demanda por mayores credenciales académicas en lo laboral y por la búsqueda personal para especializarse profesionalmente, es un fenómeno observado en Argentina desde mediados de los años 90. Obtener el título final de estos estudios resulta un porcentaje muy inferior en relación al número de sus inscriptos. Tales motivos focalizaron nuestra atención para analizar tanto los criterios de elección del posgrado como las condiciones contextuales y subjetivas para alcanzar la titulación. Este estudio, de tipo cualitativo, investiga en tres carreras de Especialización que se cursan en diferentes Universidades nacionales , los aspectos de su organización y estilo propuesto para cursar y lograr la finalización de los estudios, así como las motivaciones de la elección de cursantes y egresados en tres ramas diferentes: artística, humanística y tecnológica. El conocimiento sobre la lógica de la organización y la particularidad del objeto de estudio de cada carrera permite analizar diferencias y semejanzas entre ellas aportando algunas propuestas para considerar en programas de formación; mientras que los trayectos de cursantes y egresados explican aspectos subjetivos que intervienen en la finalización o no del posgrado.

SADA and DESYRE DSSs descriptive classification criteria (main issues related to DSS's)

Brownfield rehabilitation is an essential step for sustainable land-use planning and management in the European Union. In brownfield regeneration processes, the legacy contamination plays a significant role, firstly because of the persistent contaminants in soil or groundwater which extends the existing hazards and risks well into the future; and secondly, problems from historical contamination are often more difficult to manage than contamination caused by new activities. Due to the complexity associated with the management of brownfield site rehabilitation, Decision Support Systems (DSSs) have been developed to support problem holders and stakeholders in the decision-making process encompassing all phases of the rehabilitation. This paper presents a comparative study between two DSSs, namely SADA (Spatial Analysis and Decision Assistance) and DESYRE (Decision Support System for the Requalification of Contaminated Sites), with the main objective of showing the benefits of using DSSs to introduce and process data and then to disseminate results to different stakeholders involved in the decision-making process. For this purpose, a former car manufacturing plant located in the Brasov area, Central Romania, contaminated chiefly by heavy metals and total petroleum hydrocarbons, has been selected as a case study to apply the two examined DSSs. Major results presented here concern the analysis of the functionalities of the two DSSs in order to identify similarities, differences and complementarities and, thus, to provide an indication of the most suitable integration options.

La orientación en América Latina : Consideraciones generales acerca de los criterios de coherencia, cooperación y calidad

La Orientación en América Latina, como campo de formación profesional y en comparación con Europa y Estados Unidos, es una actividad de reciente aceptación en los medios académicos. La misma se ha caracterizado por una constante evolución en su afán de adaptarse a los nuevos cambios y transformaciones sociales, políticas y económicas que se suceden en el continente latinoamericano. En esta ponencia se presenta un panorama general acerca de la Orientación en América Latina. Las principales consideraciones formuladas se relacionan con cuatro dimensiones: a) la dimensión política pública, donde se presentan la situación actual y las propuestas al respecto; b) la dimensión contextual que hace referencia a la formación del orientador y los diferentes escenarios de acción; c) la dimensión organizacional que se relaciona con la provisión de este servicio, y d) la dimensión metodológica donde se desarrollan los principales aspectos relacionados con la práctica de la Orientación.