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Loss to Specialized Cardiology Follow-Up in Adults Living with Congenital Heart Disease

Congenital Heart Disease 2024年第1期19卷 49-63页

作者： Cheryl Dickson Danielle Osborn David Baker Judith Fethney David S.Celermajer Rachael Cordina Department of Cardiology Royal Prince Alfred HospitalSydneyAustralia Department of Cardiothoracic Surgery Westmead HospitalSydneyAustralia susan wakil school of nursing and Midwifery The University of SydneySydneyAustralia Sydney Medical school The University of SydneySydneyAustralia

Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care *** less is understood about the loss to follow-up(LTF)after a successful *** is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature ***:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)***:Patients with moderate or highly complex CHD and gaps in care of>3 years(deﬁned as LTF)were identiﬁed from a comprehensive ACHD *** telephone interviews examined current care and barriers to clinic ***:Overall,407(22%)of ACHD patients(n=1842)were *** mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were *** to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful *** Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to *** study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.

关键词： Loss to follow-up follow-up adult congenital heart disease lapse in care gaps in care care gaps care continuity ACHD predictors

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The association of diet quality and physical activity with cardiovascular disease and mortality in 85,545 older Australians:A longitudinal study

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Journal of Sport and Health Science 2024年第6期13卷 841-850页

作者： Ding Ding Joe Van Buskirk Stephanie Partridge Philip Clare Edward Giovannucci Adrian Bauman Nicole Freene Robyn Gallagher Binh Nguyen Sydney school of Public Health Faculty of Medicine and Healththe University of SydneyCamperdownNSW 2006Australia Charles Perkins Centre the University of SydneyCamperdownNSW 2006Australia Sydney Local Health District CamperdownNSW 2050Australia school of Health Sciences Faculty of Medicine and Healththe University of SydneyCamperdownNSW 2006Australia National Drug and Alcohol Research Centre UNSW SydneySydneyNSW 2052Australia Departments of Nutrition and Epidemiology Harvard T.H.Chan School of Public HealthBostonMA 02115USA Faculty of Health University of CanberraCanberraACT 2617Australia susan wakil school of nursing and Midwifery the University of SydneyCamperdownNSW 2050Australia

Background:A quality diet and an active lifestyle are both important cornerstones of cardiovascular disease(CVD)***,despite their interlinked effects on metabolic health,the 2 behaviors are rarely considered jointly,particularly within the context of CVD *** examined the independent,interactive,and joint associations of diet and physical activity with CVD hospitalization,CVD mortality,and all-cause ***:CVD-free Australian participants aged 4574 years(n=85,545)reported physical activity,diet,sociodemographic,and lifestyle characteristics at baseline(20062009)and follow-up(20122015),and data were linked to hospitalization and death registries(03/31/2019 for CVD hospitalization and all-cause mortality and 12/08/2017 for CVD mortality).Diet quality was categorized as low,medium,and high based on meeting dietary *** activity was operationalized as(a)total moderate-to-vigorous physical activity(MVPA)as per guidelines,and(b)the composition of MVPA as the ratio of vigorous-intensity physical activity(VPA)to total *** used a left-truncated cause-specific Cox proportional hazards model using time-varying ***:During a median of 10.7 years of follow-up,6576 participants were admitted to the hospital for CVD and 6581 died from all causes(876 from CVD during 9.3 years).A high-quality diet was associated with a 17%lower risk of all-cause mortality than a low-quality diet,and the highest MVPA category(compared with the lowest)was associated with a 44%and 48%lower risk of CVD and all-cause mortality,*** interactions between diet and physical activity were *** all outcomes,the lowest risk combinations involved a high-quality diet and the highest MVPA *** for total MVPA,some VPA was associated with further risk reduction of CVD hospitalization and all-cause ***:For CVD prevention and longevity,one should adhere to both a healthy d

关键词： Diet Physical activity Cardiovascular disease Mortality Cohort studies

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Potential risk factors for constipation in the community

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World Journal of Gastroenterology 2021年第21期27卷 2795-2817页

作者： Barry L Werth Sybele-Anne Christopher susan wakil school of nursing and Midwifery Faculty of Medicine and HealthUniversity of SydneySydney 2006New South WalesAustralia

Constipation is a common community health *** are many factors that are widely thought to be associated with constipation but real-world evidence of these associations is difficult to *** potential risk factors may be categorised as demographic,lifestyle and health-related *** review presents the available evidence for each factor by an assessment of quantitative data from cross-sectional studies of community-dwelling adults published over the last 30 *** appears that there is evidence of an association between constipation and female gender,residential location,physical activity and some health-related factors such as self-rated health,some surgery,certain medical conditions and certain *** available evidence for most other factors is either conflicting or ***,further research is necessary to determine if each factor is truly associated with constipation and whether it can be regarded as a potential risk *** is recommended that studies investigating a broad range of factors are conducted in populations in community *** analyses should be performed to account for all possible confounding *** this way,valuable evidence can be accumulated for a better understanding of potential risk factors for constipation in the community.

关键词： Adults Constipation Epidemiology Factors Community

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The experience of transition from nursing students to newly graduated registered nurses in Singapore

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International Journal of nursing Sciences 2020年第1期7卷 81-90页

作者： Ming Wei Jeffrey Woo Stuart Andrew Newman school of Health&Social Sciences Nanyang PolytechnicSingapore susan wakil school of nursing and Midwifery The University of SydneyNew South WalesAustralia

Objectives:To investigate the experience of newly graduated registered nurses(NGRNs)in Singapore following their initial 6-12 months of transition from nursing student to registered ***:This mixed-methods study consisted of two *** the first phase,data were collected via the administration of the online survey to 30 *** questionnaire contained 42 items of the fourpoint Likert scale *** the second phase,a focus group interview was conducted with 5 NGRNs to gather complementary information regarding the major findings from the first ***:The survey revealed despite most NGRNs(80%)in this study expressed overall satisfied with their transition,the item score was(2.97±0.61)out of 4,the majority(83.3%)also perceived their transition to professional practice being stressful,the item score was(3.07±0.74)out of *** themes emerged from the interview,'personal transition experience','professional transition experience',and'organizational transition experience',which are entwined to construct overall NGRNs'transition ***:This study reaffirms the theory-practice gap *** signifies the need for closer collaboration between educational,healthcare industry and regulatory stakeholders to examine and address factors that influence their transition experience to better support them for workforce readiness.

关键词： Hospital nursing staff nursing students Role Singapore

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Exploring social movement concepts and actions in a knowledge uptake and sustainability context: A concept analysis

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International Journal of nursing Sciences 2022年第4期9卷 411-421页

作者： Doris Grinspun Katherine Wallace Shelly-Anne Li susan McNeill Janet Elaine Squires Jesús Bujalance Maryanne D’Arpino Gina De Souza Nataly Farshait John Gabbay Ian D.Graham Alison Hutchinson Kim Kinder Celia Laur Tina Mah Julia E.Moore Jennifer Plant Jodi Ploquin P.Jim A.Ruiter Daphney St-Germain Margie Sills-Maerov May Tao Marita Titler Junqiang Zhao Registered Nurses’Association of Ontario TorontoCanada Lawrence S.Bloomberg Faculty of nursing University of TorontoTorontoCanada school of nursing University of OttawaOttawaCanada Ottawa Hospital Research Institute OttawaCanada Regional University Hospital of Malaga MalagaSpain Healthcare Excellence Canada OttawaCanada HIROC TorontoCanada University of Southampton SouthamptonEnglandUK Department of Epidemiology and Community Medicine University of OttawaOttawaCanada school of nursing and Midwifery Deakin University AustraliaVictoriaAustralia Women’s College Hospital Institute for Health System Solutions and Virtual Care(WIHV) TorontoCanada Institute for Health Policy Management and EvaluationUniversity of TorontoTorontoCanada Schlegel-UW Research Institute for Aging WaterlooCanada The Center for Implementation TorontoCanada Queensway Carleton Hospital OttawaCanada Alberta Health Services EdmontonCanada Salus Global(retired) LondonCanada Laval University Pavilion Ferdinand-Vandry Quebec CityCanada Thought Architects EdmontonCanada Toronto Public Health TorontoCanada school of nursing University of MichiganAnn ArborUnited States

Objectives:To share a concept analysis of social movement aimed at advancing its application to evidence uptake and sustainability in ***:We applied Walker and Avant method to clarify the concept of social movement in the context of knowledge uptake and ***-reviewed and grey literature databases were systematically searched for relevant reports that described how social movement action led to evidence-based practice changes in health and community ***,abstracts and full texts were reviewed independently and in duplicate,resulting in 38 included ***:Social movement action for knowledge uptake and sustainability can be defined as individuals,groups,or organizations that,as voluntary and intrinsically motivated change agents,mobilize around a common cause to improve outcomes through knowledge uptake and *** 10 defining attributes,three antecedents and three consequences that we identified are dynamic and interrelated,often mutually reinforcing each other to fortify various aspects of the social *** of defining attributes include an urgent need for action,collective action and collective *** concept analysis resulted in the development of the Social Movement Action ***:Social movement action can provide a lens through which we view implementation *** action and collective identity e concepts less frequently canvassed in implementation science literature e can lend insight into grassroots approaches to uptake and *** can also inform providers and change leaders on the practicalities of harnessing social movement action for realworld change *** mobilizing individuals,groups,or organizations through social movement approaches,they can engage as powered change agents and teams that impact the individual,organizational and health systems levels to facilitate knowledge uptake and sustainability.

关键词： Collective action Collective identity Grassroots Implementation science Knowledge-to-action Mobilization Social movement action

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BMC Family Practice论文摘要汇编——大城市和乡村地区基层医疗机构进行AF-SMART心房颤动筛查项目的实施效果评估

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中国全科医学 2020年第8期23卷 979-979页

作者： ORCHARD J LI J GALLAGHER R 本刊编辑部 Heart Research Institute/Charles Perkins Centre University of Sydney Sydney Australia susan wakil school of nursing Faculty of Medicine and Health/Charles Perkins Centre University of Sydney Sydney Australia Edinburgh Napier University Edinburgh UK

背景国际指南建议对65岁及以上人群进行心房颤动筛查。本研究组于2016年11月—2019年6月在16个大城市和农村地区进行了机会性心房颤动筛查以进行心房颤动筛查、管理和指南推荐治疗研究(AF-SMART)。在这些研究中试用了定制的电子健康工... 详细信息

背景国际指南建议对65岁及以上人群进行心房颤动筛查。本研究组于2016年11月—2019年6月在16个大城市和农村地区进行了机会性心房颤动筛查以进行心房颤动筛查、管理和指南推荐治疗研究(AF-SMART)。在这些研究中试用了定制的电子健康工具支持各个阶段的心房颤动筛查。方法对AF-SMART项目的实施效果进行评价,并以此为依据决定是否需要扩大筛查人口比例。项目实施的最初理论是基于本研究组以前的研究结果、政策文件和其他相关筛查研究。在本研究中,本研究组对所选诊所的全科医生、护士和管理者进行了45场半结构式访谈。通过访谈收集了观察数据和定量数据,并进行分析和阐释以完善AF-SMART项目理论。结果全科医生和护士均喜欢使用这些电子健康工具,尽管有时候出现了技术性问题会使筛查过程中断。但是筛查耗时较久,因此筛查系统需要改进变得更加有效。由资深全科医生尤其是来自护理团队的资深全科医生领导的筛查小组的筛查范围更大。定期反馈筛查数据有助于提高筛查质量和激励筛查的进行。在分级诊疗过程中,筛查效果较好的以护士为主导的小组需要对筛查结果异常的人群制定明确的随访方案。参与实施AF-SMART项目能获得更多益处,比如增加对心房颤动的了解、更多了解心血管疾病预防范畴等。在诊所能有效安排职员工作时间的情况下,对目标人群进行短期集中筛查(工作模式类似在短期内集中接种流感疫苗)能获得较好的效果。结论当筛查小组由资深全科医生领导,有为异常筛查结果人群制定的随访方案并且筛查人群可定期向医务人员反馈随访数据的情况下,心房颤动筛查能够比较成功的实施。而这些与筛查成功相关的因素和激励机制、领导权、护士授权和有效的筛查系统相关。这些因素和机制有助于长期提高心房颤动筛查和治疗比例,被指南推荐为预防心房颤动相关脑卒中的关键策略。

关键词：全科医生基层医疗机构电子健康国际指南分级诊疗筛查结果心房颤动定量数据

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Self-management of coronary heart disease in older patients after elective percutaneous transluminal coronary angioplasty

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Journal of Geriatric Cardiology 2016年第5期13卷 393-400页

作者： susan Dawkes Graeme D Smith Lawrie Elliott Robert Raeside Jayne H Donaldson school of nursing Midwifery and Social Care Edinburgh Napier University Scotland United Kingdom Department of nursing and Community Health Glasgow Caledonian University Scotland United Kingdom Employment Research Institute Edinburgh Napier University Scotland United Kingdom school of Health Sciences University of Stirling Scotland United Kingdom

Objective To explore how older patients self-manage their coronary heart disease （CHD） aider undergoing elective percutaneous transluminal coronary angioplasty （PTCA）. Methods This mixed methods study used a sequential, explanatory design and recruited a convenience sample of patients （n = 93） approximately three months after elective PTCA. The study was conducted in two phases. Quantitative data collected in Phase 1 by means of a self-administered survey were subject to univariate and bivariate analysis. Phase 1 findings in- formed the purposive samplhag for Phase 2 where ten participants were selected from the original sample for an in-depth interview. Qualita- tive data were analysed using thematic analysis. This paper will primarily report the findings from a sub-group of older participants （n = 47） classified as 65 years of age or older. Results 78.7% （n = 37） of participants indicated that they would manage recurring angina symptoms by taking glyceryl trinitrate and 34% （n = 16） thought that resting would help. Regardless of the duration or severity of the symptoms 40.5% （n = 19） would call their general practitioner or an emergency ambulance for assistance during any recurrence of angina symptoms. Older participants weighed less （P = 0.02） and smoked less （P = 0.01） than their younger counterparts in the study. Age did not seem to affect PTCA patients＇ likelihood of altering dietary factors such as fruit, vegetable and saturated fat consumption （P = 0.237）. Conclusions The findings suggest that older people in the study were less likely to know how to correctly manage any recurring angina symptoms than their younger counterparts but they had fewer risk factors for CHD. Age was not a factor that influenced participants＇ likelihood to alter lifestyle factors.

关键词： Angina pectoris Coronary disease Percutaneous transluminal coronary angioplasty Self-management

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nursing culture assessment tool (NCAT): Empirical validation for use in long-term care

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International Journal of nursing Sciences 2014年第3期1卷 241-249页

作者： Tracey L.Yap susan M.Kennerly Elizabeth P.Flint Duke University school of nursing 307 Trent Dr.DurhamNC 27710United States Duke University Center for the Study of Aging and Human Development Box 3003 DUMCDurhamNC 27710United States University of North Carolina at Charlotte school of nursing United States

Background:Capturing general aspects of the occupational subculture of nursing is needed in long-term care(LTC)given its latent influence on the quality of care that residents receive and on the ability of nursing staff(licensed nurses and certified nursing assistants)to implement evidence-based practice *** psychometrically validated nursing Culture Assessment Tool(NCAT)provides a comprehensive assessment using six dimensions(teamwork,communication,satisfaction,professional commitment,behaviors,and expectations),and evaluation of these dimensions could help positively reshape the culture before any change ***:Aims were to:(1)assess the validity and reliability of the NCAT across nursing staff in a single type of clinical setting e LTC facilities,and(2)present a refined theoretical model of the interaction of culture and practice ***:A cross-sectional,exploratory investigation of the NCAT in LTC settings was *** construct validity of the 19-item NCAT's six subscales was investigated by confirmatory factor analysis using a sample of licensed nurses and certified nursing assistants(n?318).Results:The model fit was judged using the comparative fit index(0.94)and standardized root mean-square residual(0.05).Cronbach's alpha correlation coefficients of items in each subscale and in the overall scale ranged from 0.76 to ***:A summary of the NCAT development and report on its psychometric properties when administered in LTC settings is provided,extending previous findings of the NCAT's enhanced stability when used in assessing nursing staff perceptions in LTC and by demonstrating that the NCAT is a reliable and valid psychometric screening tool for nursing culture.

关键词： nursing culture Staff assessment Long-term care Occupational subculture framework

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Kangaroo Care (Skin-to-Skin) for Clustered Pain Procedures: Case Study

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World Journal of Neuroscience 2016年第1期6卷 43-51页

作者： Raouth R. Kostandy susan M. Ludington-Hoe school of nursing Cleveland State University Cleveland USA Bolton school of nursing Case Western Reserve University Cleveland USA

Background: Pain management for term newborns undergoing clustered painful procedures has not been tested. Kangaroo Care (chest-to-chest, skin-to-skin position of infant on mother) effectively reduces pain of single procedures, but its effect on pain from clustered procedures is not known. Aim: The aim was to test Kangaroo Care’s effect on pain in one term infant who received clustered painful procedures while determining feasibility of the Kangaroo Care intervention. Design, Setting, and Participant: A case study design was used with one healthy term newborn who received two heel sticks and one injection in one session in the mother’s postpartum room. Method: Heart rate and oxygen saturation (recorded from Massimo Pulse Oximeter every 30 seconds), crying time (total seconds of crying on videotape) and behavioral state (using Anderson Behavioral State Scoring system every 30 seconds) were measured before (5 minutes), during (10.5 minutes) and after (30 minutes) the three clustered painful procedures in a newborn who was in Kangaroo Care during all observations. One staff nurse administered the clustered procedures. Results: Heart rate increased sequentially with each heelstick, oxygen saturation remained unchanged, sleep predominated, and crying was minimal throughout the procedures. Conclusion: Kangaroo Care appeared to reduce pain from clustered painful procedures and can be further tested.

关键词： Kangaroo Care Pain Clustered Procedures Healthy Term Infant

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Clinical nursing competency assessment:a scoping review

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Frontiers of nursing 2021年第4期8卷 341-356页

作者： Oboshie Anim-Boamah Christmal Dela Christmals susan Jennifer Armstrong Department of nursing Education School of Therapeutic SciencesFaculty of Health SciencesUniversity of WitwatersrandJohannesburg-BraamfonteinGauteng 2050South Africa

Objective:To ensure that only competent graduates are licensed to practice nursing,councils conduct licensing examinations,which may include among others clinical competency *** review explored current practices in clinical competency assessment of nursing students as part of a larger study aimed at developing an evidence-based,context-specific framework for clinical competency assessment in a sub-Saharan African(SSA)***:A scoping guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews(PRISMA-ScR)was ***:Findings from 28 out of 1151 studies identified from Scopus,PubMed,CINAHL,Wiley Online Library,and ProQuest were included and *** show that a good assessment system must be valid,reliable,transparent,feasible,fair,objective,and must provide feedback and continually improve to have an educational *** competency assessment systems must be developed on sound empirical evidence,pilot tested,and involve thorough training and evaluation of the *** evaluation of the assessment system is also essential to ensure the quality and relevance of the assessment *** one of the included studies was conducted in ***:The paucity of clinical competency assessment research in sub-Saharan Africa may lead to benchmarking assessment systems on research conducted outside the ***-Saharan Africa has a set of circumstances that demand a context-specific clinical competency assessment framework to guide clinical competency assessment.

关键词： clinical competency assessment licensing examination nursing scoping review sub-Saharan Africag

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