Thesis (M.S.C.I.T.)--Regis University, Denver, Colo., 2008. / Title from PDF title page (viewed on Feb. 02, 2009). Includes bibliographical references.

Thesis (M.S.)--University of Wisconsin--Madison, 1963. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 7 uppsatser.

Much of the practice is clinical neuropsychology is performed in the role of consultant and although the neuropsychologist is dependent upon referrals made from outside sources, relatively little attention has been devoted to the investigation of the referral process. Surveys of clinicians and referral sources have reported breakdowns of referral sources by discipline and general topics of referral questions based on recollection, but direct analysis of referral patterns across the same period has not been undertaken. The purpose of the study is to document the advancement of neuropsychology from providing psychological testing to establishing itself as a multifaceted discipline with a significant diagnostic purview that is regularly relied upon to contribute to important decisions in the lives of patients. By examining the referral questions rather than neuropsychologists' or referral sources' recollection of referrals, this study expands what is known about referral content and patterns. In an effort to explain question content without relying upon recollection, a coding rubric was designed to capture the breadth of presenting problems and requests seen in the original referral questions. Two-thousand-six-hundred referral questions were selected from the odd year over the 25 year period from 1983 to 2007, yielding a total of 2600 referral questions. Cochran's Kappa was used to conduct interrater reliability analyses in three stages across the entire rating process. Content analysis showed that 79.1% of all questions had at more than minimal content. The most common request was for assistance with diagnostic considerations, which was present in 66.4% of all cases. Assistance with differential diagnoses was requested in 27.4% of all cases with the majority of these composed of requests for assistance in differentiating between psychiatric and neurological or other medical considerations. There was evidence for a trend over time in the gradual decline of requests for assistance with psychiatric differential diagnosis and requests for the MMPI from 1993 to the present. Memory problems and dementia are the most common presenting problems, although there is evidence of a slight decline in these evaluations beginning in 1997. Requests for specific recommendations, particularly those related to making recommendations regarding treatment planning were found to steadily increase across the sampling period. Limitations and implications for practice were discussed.

Thesis (M.S.)--University of Missouri-Columbia, 2007. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on March 28, 2008) Vita Includes bibliographical references.

Recent studies have suggested that the diagnostic reliability and accuracy of breast ultrasonography in place of mammography in women with dense breast tissue results in more accurate breast cancer screening in this population. Since breast cancer is the second leading cause of cancer deaths among United States women, a more accurate and reliable breast cancer screening tool is needed (American Cancer Society [ACS], 2014). This process starts with describing breast screening practice patterns of nurse practitioners and analyzing their attitudes and beliefs of alternative screening modalities gathered from the survey results obtained from this DNP project. The purpose of this study is to determine the attitudes and beliefs of if nurse practitioners towards the use of ultrasonography alone in lieu of mammography followed by sonography in women aged 40-74 with mammographically dense breast tissue. A survey consisting of 23 questions was sent to nurse practitioners in Arizona through the Coalition of Arizona Nurses in Advanced Practice listserv, and through an email list provided by the president of the Allied Health Providers of Yuma. Analysis of survey responses indicated that the majority of respondents believe that it is difficult to detect cancer using mammography in women with dense breast tissue, and more than half of respondents believe that ultrasounds are more accurate and reliable at detecting cancer in women with dense breast tissue. The results also demonstrate that the majority of nurse practitioners surveyed are not familiar with current literature regarding ultrasonography screening in women with dense breast tissue.

Implementation strategies for the use of clinical practice guidelines are an integral component in bridging the gap between the best research evidence and clinical practice. However, despite some remarkable investments in health research regarding clinical practice guidelines implementation strategies, it is not yet known which of these are the most effective for intensive care units. The purpose of this research study was to systematically identify and /or search, appraise, extract and synthesize the best available evidence for clinical practice guidelines implementation strategies in intensive care units, in order to develop a draft guideline for clinical practice guidelines implementation strategies in the intensive care units. A systematic review design was used to systematically identify and /or search, appraise, extract and synthesize the best available evidence from the eligible included Level 2 studies (randomized controlled trials and quasi-experimental studies). Level 2 studies were applicable because they present robust evidence in the research results regarding effectiveness of clinical practice guideline implementation strategies. Furthermore, although other systematic reviews conducted in this area before, they included studies of In addition, no systematic review was identified that reviewed Level 2 studies and developed a guideline for clinical practice guideline implementation strategies in the intensive care units. Hence, including only Level 2 studies was distinctive to this research study. Databases searched included: CINAHL with full text, Google Scholar, Academic search complete, Cochrane Register for Randomized Controlled Trials Issue 8 of 12, August 2013, and MEDLINE via PUBMED. Hand search in bound journals was also done. The search strategy identified 315 potentially relevant studies. After the process of critical appraisal, thirteen Level 2 studies were identified as relevant for the review. Of the 13 relevant studies, 10 were randomized controlled trials and three were quasi experimental studies. After the critical appraisal ten RCTs were included in the systematic review. Three studies (quasi-experimental) were excluded on the basis of methodological quality after the critical appraisal and agreement by the two independent reviewers. The Joanna Briggs Institute Critical Appraisal MASTARI Instrument for Randomized Controlled trials/ Experimental studies, and The Joanna Briggs Institute data extraction tools were used to critically appraise, and extract data from the ten included randomized controlled trials. The two reviewers who performed the critical appraisal were qualified critical care professional nurses and experts in research methodology. These reviewers conducted the critical appraisal independently to ensure the objectivity of the process. Appropriate ethical considerations were maintained throughout the process of the research study. The results indicated that 80 percent of the included studies were conducted in adult intensive care units while 20 percent were conducted in the neonatal intensive care units. Furthermore, 60 percent of the studies were conducted in the United States of America, 10 percent in France, a further 10 percent in Taiwan, another 10 percent in England and yet another 10 percfent was conducted in Australia and Newzealand. The included studies utilized more than one (multifaceted) implementation strategies to implement clinical practice guidelines in the intensive care units. The first most utilized were: printed educational materials; Information/ educational sessions/meetings; audit and feedback and champion/local opinion leaders; seconded by educational outreach visits; and computer or internet usage. Third most used were active/passive reminders; systems support; academic detailing/ one-on-one sessions teleconferences/videoconferences and workshops/in services. Fourth most used were ollaboration/interdisciplinary teams; slide shows, teleconferences/videoconferences and discussions. Fifth most used were practical training; monitoring visits and grand rounds. However all the strategies were of equal importance. Conclusively, the included studies utilized multifaceted implementation strategies. However, no study indicated the use of a guideline for the implementation strategies in the process of clinical practice guidelines implementation. The systematic review developed a draft guideline for clinical practice guideline implementation strategies in the intensive care units. The guideline will enhance effective implementation of clinical practice guidelines in such a complex environment.

BACKGROUND: Complementary and alternative medicine (CAM) use has steadily increased globally over the past two decades and is increasingly playing a role in the healthcare system in the United States. CAM practice-based effectiveness research requires an understanding of the settings in which CAM practitioners provide services. This paper describes and quantifies practice environment characteristics for a cross-sectional sample of doctors of chiropractic (DCs), licensed acupuncturists (LAcs), and licensed massage therapists (LMTs) in the United States. METHODS: Using a cross-sectional telephone survey of DCs (n = 32), LAcs (n = 70), and LMTs (n = 184) in the Tucson, AZ metropolitan area, we collected data about each location where practitioners work, as well as measures on practitioner and practice characteristics including: patient volume, number of locations where practitioners worked, CAM practitioner types working at each location, and business models of practice. RESULTS: The majority of practitioners reported having one practice location (93.8% of DCs, 80% of LAcs and 59.8% of LMTs) where they treat patients. Patient volume/week was related to practitioner type; DCs saw 83.13 (SD = 49.29) patients/week, LAcs saw 22.29 (SD = 16.88) patients/week, and LMTs saw 14.21 (SD =10.25) patients per week. Practitioners completed surveys for N = 388 practice locations. Many CAM practices were found to be multidisciplinary and/or have more than one practitioner: 9/35 (25.7%) chiropractic practices, 24/87 (27.6%) acupuncture practices, and 141/266 (53.0%) massage practices. Practice business models across CAM practitioner types were heterogeneous, e.g. sole proprietor, employee, partner, and independent contractor. CONCLUSIONS: CAM practices vary across and within disciplines in ways that can significantly impact design and implementation of practice-based research. CAM research and intervention programs need to be mindful of the heterogeneity of CAM practices in order to create appropriate interventions, study designs, and implementation plans.

<p>Tuberculosis (TB) is a major contributor to the disease burden in developing countries resulting in deaths of approximately 2 million people a year. South Africa (SA) has one of the highest annual&nbsp / TB incidences with an estimate of 558 per 100 000 population (2003) and the situation shows no sign of abating. TB remains the most common opportunistic infection and cause of death&nbsp / amongst HIV- infected patients. Both TB and HIV treatment depend exclusively on multi-drug regimens that require close monitoring among health care professionals. With increasing workload&nbsp / due to staff shortage and high patient load, the quality of care in nurse-led primary care clinics maybe compromised. Existing clinic staff may overlook drug-drug interactions, side effects and may&nbsp / not be aware of the consequences when a formulation is modified during multi-drug therapy administration. As the custodian of medicines, pharmacists are ideally placed to monitor therapy.&nbsp / Clinicbased training programmes which are offered to nurses provide an opportunity to work alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic outcome of TB and HIV drug regimens could be closely monitored. </p>

Incomplete understanding of attrition from the physician workforce has hampered policy-makers’ efforts to achieve optimal alignment of the supply of physicians with population demand for medical services. This longitudinal study of Ontario primary care physicians uses health administrative data to characterize changes in physicians’ practice patterns over time. We examined the workload and scopes of practice of 21,240 physicians between 1992 and 2013. We found that physicians reduce their workloads gradually as they age, retiring from clinical practice at an average age of 70.5. Furthermore, we found that 60% of family physicians who stop providing comprehensive primary care continue to provide clinical services for an average of three years, with reduced workloads, before retiring fully. Our findings clarify the process of physician attrition from the workforce and will help to improve estimates of attrition and make physician workforce planning more accurate and effective.