In a busy clinical environment, access to knowledge must be rapid and specific to the clinical query at hand. This requires indices which support easy navigation within a knowledge source. We have ...developed a computer-based tool for trouble-shooting pulmonary artery waveforms using a graphical index. Preliminary results of domain knowledge tests for a group of clinicians exposed to the system (N = 33) show a mean improvement on a 30-point test of 5.33 (p < 0.001) compared to a control group (N = 19) improvement of 0.47 (p = 0.61). Survey of the experimental group (N = 25) showed 84% (p = 0.001) found the system easy to use. We discuss lessons learned in indexing this domain area to computer-based indexing of guidelines for pressure ulcer prevention.
8 9 10 11 Exercise testing RECOMMENDATIONS Exercise testing is effective in prognostically grouping patients and can provide information in addition to that obtained from invasive testing; all ...patients with clinically certain angina should have an exercise test (B) Exercise testing will mean referral to an open access service when this is available and referral to a cardiologist when it is not (C) If a patient who requires an exercise test is physically incapable of performing the test he or she should be referred to a cardiologist for consideration of other forms of investigation (C) Patients having an exercise test for prognostic investigation and treatment should have the test performed while taking their normal medication (B) Whether or not a patient has diabetes and the oestrogen status of women should be recorded on a request form, as these influence the performance of the test and interpretation of the result (B). Clinical factors-pain on minimal exertion, nocturnal pain, rapidly progressive symptoms, possible aortic stenosis, failure to respond to medical treatment, previous myocardial infarction Age and duration of disease Comorbidity Risk factors Patient preference Clinician factors (such as uncertainty in the doctor) Threat to employment or unacceptable interference with lifestyle or recreation.
Adding the findings of the Swedish Angina Pectoris Aspirin Trial 5 (published after the analyses of the Antiplatelet Trialists' Collaboration) has offered a firmer basis from which to derive ...recommendations for practice and permitted clear recommendations on the dose of aspirin that is effective.
Following a high-profile publicity campaign across South Tyneside aimed at professionals and patients, 52.4 per cent of all patients admitted with suspected myocardial infarction during a six-month ...period received 300mg of aspirin. Twelve months later GPs' performance had improved from 25 per cent to 52.9 per cent of patients directly admitted by GPs being prescribed aspirin when first seen. Following a definite myocardial infarction 78.4 per cent of patients were discharged taking 75mg of aspirin, with no valid reason for omission in 6.6 per cent of patients. Six months after discharge 71.8 per cent of patients were still taking aspirin. Twelve months later 90 per cent of discharged patients were taking aspirin. GP PACT data showed a marked increase in prescribing 75mg aspirin during the period. The use of a publicity campaign to disseminate the message to both professionals and patients has resulted in a beneficial increase in aspirin prescribing for myocardial infarction across the district.
This paper describes a microcomputer system for providing computer-based access to expert knowledge in the area of troubleshooting pulmonary artery (PA) catheter waveforms. The system is used by both ...nurses and physicians in an 18-bed medical intensive care unit. Its dominant features are 1) problem-focused access to knowledge, and 2) heavy use of graphics and images to explicate knowledge. The system is used by both nurses and physicians in an 18-bed medical intensive care unit. An evaluation protocol is in place to examine the impact of the system on clinicians' knowledge, their decision-making skills, their satisfaction with the system, and costs of orientation related to PA waveform troubleshooting.
The Positive Perspective on Youth Development Seligman, Martin E.P.; Berkowitz, Marvin W.; Catalano, Richard F. ...
Treating and Preventing Adolescent Mental Health Disorders,
08/2005
Book Chapter
Odprti dostop
This contribution addresses positive youth development with respect to mental illness and mental health.We discuss positive characteristics of youth and their settings and how these are related to ...thriving.We summarize what is known about programs and institutions that promote positive development. In conclusion, we take stock of what we know and what we do not know.
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