Prevalence of mental health problems among adolescents varies from 10 to 30%. Therefore, mental health promotion in school has risen as a very important developing area in public health services. The need is international. Despite the large number of projects and recommendations on the promotion of schoolchildren's mental health, the literature does not offer a comprehensive theoretical description of what mental health work with people of this particular age really is as a whole. The theory can be constructed by combining and comparing the viewpoints of the different parties--the employees, the schoolchildren and their families--as well as previous knowledge of the subject. The purpose of this research was to produce a description of the concepts used by employees when addressing the subject of promoting mental health in the upper level of comprehensive schools (grades 7-9). The description has been produced by analysing interviews with nine people who work with schoolchildren, as well as workgroup memos related to the development work. The respondents work in the fields of primary healthcare, specialised healthcare, the education authority and social services. The analysis was conducted by applying the grounded theory method. The research target was a Finnish upper-level comprehensive school with 446 pupils. Four key concepts were found: The concept of a school environment comprises the physical and social conditions in the school, the curricula and other instructions. Human resources comprise representatives of various organisations, their competencies and time-consumption opportunities. The schoolchildren and their families and also their friends are key operators and partners. The concept of work to promote mental health is related to enhancing the school's conditions, recognising problems and offering help, co-operation and joint agreement. The produced description clarifies the overall picture of mental health work in schools and facilitates the finding of key development areas.
The purpose of this study was to describe communicative patterns about change in demanding physiotherapy treatment situations.
A multiple case study of eleven treatment courses was carried out, based on in-depth individual interviews, focus group interview, personal notes and repeated video-recordings. To compare communication within and over sessions, a two-step procedure was applied: identification of communication patterns and detailed analysis of selected dialogues from video-recorded sequences.
One main communicative pattern was identified: Seeking for common ground--demanding negotiating process. This pattern was interrupted by short episodes of two types of challenges; the pattern of ambivalence and uncertainty, and the pattern of impatience and disagreement. Communication between the participants appeared as a demanding and complex process of negotiations during the treatment processes. The physiotherapists' sensitivity of and ability to negotiate the tasks, the emotions related to tasks and the nature of the relationships, seemed to facilitate change. The patients' and the physiotherapists' capacity to bear and come through demanding situations created new ways of interaction.
The demanding situations may generate a potential for the development and the improvement of treatment outcomes. Understanding such episodes as open and dynamic, in contrast to defining the patient as demanding, suggests a useful perspective for treatment.
The aim of the study was to describe the experiences of different types of domestic violence among adolescents and associations between the family background and different types of domestic violence.
The survey included 1393 ninth-graders from one Finnish municipality.
Domestic violence is fairly common in the lives of adolescents. Sixty-seven percent of respondents had experienced parental symbolic aggression, 55% mild violence and 9% severe violence during their childhood. Twelve percent of adolescents had witnessed parent-to-parent violence. Witnessing domestic violence and exposure to parental violence is associated with a number of adolescents' background factors such as self-perceived health, satisfaction with life, family relationships, parenting practice, school bullying and sexual activity.
The findings stress the relevance of corporal punishment and witnessing domestic violence as a risk factor for more severe domestic violence and sexual abuse. Different types of domestic violence have a major effect on adolescent well-being and risk behaviours. To break the negative cycle, nurses and other professionals working with adolescents in different settings should pay attention to all forms of violence, including the milder ones.
Adipocere is a postmortem decomposition product consisting of mostly a mixture of free fatty acids (FFAs) that are formed because of the hydrolysis of triglycerides in adipose tissues. This article describes a simple and robust method for the extraction, identification, and quantification of FFA commonly found in adipocere using gas chromatography-mass spectrometry (GC/MS). This method was applied to analyze tissues from Kwäday Dän Ts'ìnchí, ancient remains discovered in a retreating glacier in the Tatshenshini-Alsek Park, British Columbia, Canada in August 1999. The lyophilized tissues were grinded and extracted with hexane. The trimethylsilyl fatty acid derivatives were analyzed by GC/MS, and the relative abundances of myristic acid, palmitic acid, oleic acid, and stearic acid were determined. Milligram per gram levels of saturated fatty acids were found in the tissues of the ancient remains, while the levels of unsaturated fatty acids, such as palmitoleic acid, were found to be negligible. The results provided further evidence of the existence of adipocere found during forensic examination of the Kwäday Dän Ts'ìnchí ancient remains.
The early mutans streptococci (MS) bacteria colonization is connected to early childhood caries. The aim of this study is to examine associations between the MS-colonization and background factors in young children, in order to enhance the oral health program in a low caries prevalence community.
An age cohort of 512 children was screened for MS in the oral biofilm at the age of 18 months. The caretakers were, using a structured form, interviewed of demographical factors and habits connected to oral health: antibiotic treatments, child's appetite, frequency of night feeding, use of sugary products or drinks, and maternal xylitol use. The associations were evaluated with logistic regression analysis.
Mutans streptococci colonization was significantly associated with both the occupation of the caretaker and the non-Finnish background.
The early MS-colonization, in preschool children, strongly associates with the socioeconomic status of the family.
This paper is a report of a study of Registered Nurses' attitudes and beliefs towards discussing sexuality with patients.
The World Health Organization regards sexuality as an essential and integrated part of being human. Studies show that diseases and treatments can affect sexuality and that a positive and respectful attitude towards sexuality is important to achieving sexual health.
The study had a correlative and comparative design. The Sexual Attitudes and Beliefs Survey was distributed to a convenience sample of 100 Swedish nurses in 2006, with a response rate of 88%.
Over 90% of nurses understood how patients' diseases and treatment might affect their sexuality. About two-thirds felt comfortable talking about sexual issues and agreed that it was their responsibility to encourage talk about sexual concerns. However, 80% did not take time to discuss sexual concerns, and 60% did not feel confident in their ability to address patients' sexual concerns. Older nurses felt more confident in their ability to address patients' sexual concerns, and the older the nurses, the more positive were their attitudes towards discussing sexuality. Nurses with further education also had a more positive attitude towards discussing sexuality.
Education is essential to improve nurses' ability to give patients the holistic care they deserve. Studies are needed to understand fully what mechanisms underlie the barriers that clearly prevent nurses from addressing patients' sexuality.
This paper is a report of a study examining the effect of supportive counselling by public health nurses on postpartum depression.
Depression is a common condition following childbirth and may have negative consequences for the child's development, the woman's health and the relationship between the parents. Psychological intervention is a treatment alternative to biological treatment options and may prevent longer-term postpartum depression.
The study was designed as a pragmatic trial. The study population comprised postpartum women, residing in two Norwegian municipalities, who had delivered a live-born child between June 2005 and December 2006. A total of 228 women were included in the study: 64 in the comparison municipality and 164 in the experimental municipality. Public health nurses (26) in the experimental municipality were trained in identifying postpartum depression and in providing supportive counselling. Pre-tests were conducted using the Edinburgh Postnatal Depression Scale at 6 weeks postpartum. Post-tests using the same Scale were performed at 3 and 6 months postpartum.
The depression score decreased statistically significantly in the experimental group compared to the comparison group both at 3 and 6 months postpartum.
Supportive counselling based on a non-directive counselling method provided by public health nurses is an effective treatment method for postpartum depression. Further research is required to assess the mothers' evaluation of the treatment and appraise methods used for management of postpartum depression in primary health care.
The aim of the study was to describe critical thinking dispositions among newly graduated nurses in Norway, and to study whether background data had any impact on critical thinking dispositions.
Competence in critical thinking is one of the expectations of nursing education. Critical thinkers are described as well-informed, inquisitive, open-minded and orderly in complex matters. Critical thinking competence has thus been designated as an outcome for judging the quality of nursing education programmes and for the development of clinical judgement. The ability to think critically is also described as reducing the research-practice gap and fostering evidence-based nursing.
A cross-sectional descriptive study was performed. The data were collected between October 2006 and April 2007 using the California Critical Thinking Disposition Inventory. The response rate was 33% (n = 618). Pearson's chi-square tests were used to analyse the data.
Nearly 80% of the respondents reported a positive disposition towards critical thinking. The highest mean score was on the Inquisitiveness subscale and the lowest on the Truth-seeking subscale. A statistically significant higher proportion of nurses with high critical thinking scores were found among those older than 30 years, those with university education prior to nursing education, and those working in community health care.
Nurse leaders and nurse teachers should encourage and nurture critical thinking among newly graduated nurses and nursing students. The low Truth-seeking scores found may be a result of traditional teaching strategies in nursing education and might indicate a need for more student-active learning models.
To examine the prognosis and incidence of social fears and phobia in an elderly population sample followed for 5 years.
A general population sample (N = 612) of non-demented men (baseline age 70) and women (baseline age 70 and 78-86) was investigated in 2000-2001 and in 2005-2006 with semi-structured psychiatric examinations including the Comprehensive Psychopathological Rating Scale, and the Mini International Neuropsychiatric Interview. Social phobia was diagnosed according to the DSM-IV criteria.
Among nine individuals with DSM-IV social phobia in 2000, 5 (55.6%) had no social fears in 2005, and 1 (11.1%) still met the criteria for DSM-IV social phobia. Among individuals without DSM-IV social phobia in 2000 (N = 603), 12 (2.0%) had DSM-IV social phobia in 2005.
These findings challenge the notion that social phobia is a chronic disorder with rare occurrence in old age.
Health-related quality-of-life (HRQoL) data are often included in Phase III clinical trials. We evaluate and classify the value added to Phase III trials by HRQoL outcomes, through a review of the National Cancer Institute of Canada Clinical Trials Group clinical trials experience within various cancer patient populations. HRQoL may add value in a variety of ways, including the provision of data that may contrast with or may support the primary study outcome; or that assess a unique perspective or subgroup, not addressed by the primary outcome. Thus, HRQoL data may change the study's interpretation. Even in situations where HRQoL measurement does not alter the clinical interpretation of a trial, important methodologic advances can be made. A classification of the added value of HRQoL information is provided, which may assist in choosing trials for which measurement of HRQoL outcomes will be beneficial.