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Issue 198 - 27 Sept 2011

Articles on Measles

1. Monitoring progress towards measles elimination
Weekly Epidemiological Record, 12/3/2010, Vol. 85 Issue 49: p490-495
The article focuses on monitoring the progress in the global measles elimination program of the World Health Organization (WHO) as of 2010. It stresses that the success of measles elimination can only be accomplished in the presence of a surveillance system which are the integrated epidemiological and laboratory-based surveillance. It also presents the descriptions of the recommended core indicators and targets of the WHO for the worldwide measles elimination.

2. Global reductions in measles mortality 2000--2008 and the risk of measles resurgence
Weekly Epidemiological Record, 12/4/2009, Vol. 84 Issue 49: p509-516
The article reports on the reductions in measles mortality from 2000-2008 as well as the risk of measles resurgence based on the World Health Organization (WHO)-UNICEF accelerated strategy. It notes that there was a second opportunity for measles immunization offered in 46/47 priority countries. It points out that effective measles surveillance entails the establishment of case-based surveillance.

3. Measles vaccines: WHO position paper
Weekly Epidemiological Record, 8/28/2009, Vol. 84 Issue 35: p349-360
The article presents the position paper of the World Health Organization (WHO) on measles vaccines. It cites that the measles is a highly infectious virus and is transmitted by direct contact with aerosolized respiratory droplets. It presents the strains and characteristics of the measles vaccines and says that these are safe, effective and may be interchangeably used within immunization programmes. Information on the duration of the vaccine's protection, adverse reactions and cost-effectiveness are also given.

4. Measles in Europe: an epidemiological assessment
Child: Care, Health & Development, May 2009, Vol. 35 Issue 3: p435-436
Measles persists in Europe despite the incorporation of the measles vaccine into routine childhood vaccination programmes more than 20 years ago. Our aim was therefore to review the epidemiology of measles in relation to the goal of elimination by 2010.
Methods: National surveillance institutions from 32 European countries submitted data for 2006–2007. Data for age-group, diagnosis confirmation, vaccination, hospital treatment, the presence of acute encephalitis as a complication of disease and death were obtained. A total of 30 countries also supplied data about importation of disease. Clinical, laboratory-confirmed, and epidemiologically linked cases that met the requirements for national surveillance were analysed. Cases were separated by age: younger than 1 year, 1–4 years, 5–9 years, 10–14 years, 15–19 years, and older than 20 years. Countries with indigenous measles incidence per 100 000 inhabitants per year of 0, less than 0.1, 0.1–1, and more than 1 were grouped into categories of zero, low, moderate, and high incidence, respectively.
Findings: For the 2 years of the study, 12 132 cases of measles were recorded with most cases ( n = 10 329; 85%) from five countries: Romania, Germany, UK, Switzerland and Italy. Most cases were unvaccinated or incompletely vaccinated children; however, almost a fifth were aged 20 years or older. For the same 2 years, seven measles-related deaths were recorded. High measles incidence in some European countries revealed suboptimum vaccination coverage. Of the 210 cases that were reported as being imported, 117 (56%) came from another country within Europe and 43 (20%) from Asia.
Interpretation: The suboptimum vaccination coverage raises serious doubts that the goal of elimination by 2010 can be attained. Achievement and maintenance of optimum vaccination coverage and improved surveillance are the cornerstones of the measles elimination plan for Europe. [ABSTRACT FROM AUTHOR]

Articles from Health Expectations Journal

5. Involving service users in qualitative analysis: approaches and assessment
By Entwistle, Vikki A. Health Expectations, Jun 2010,
Vol. 13 Issue 2: p111-112
The editor discusses articles within the issue including one by Irene Tuffrey-Wijne and Gary Butler on co-researching with people with learning disabilities and one by Steven Gillard and colleagues on a comparison between data collected by university researchers and service user researchers.

6. Beliefs and beyond: what can we learn from qualitative studies of lay people’s understandings of cancer risk?
By Lipworth, Wendy al. Health Expectations, Jun 2010,
Vol. 13 Issue 2: p113-124
Clinicians and public health professionals are centrally concerned with mediating risk. However, people often resist the risk-related information that is communicated to them by experts, or have their own models of risk that conflict with expert views. Quantitative studies have clearly demonstrated the importance of health beliefs and various cognitive and emotional processes in shaping risk perception. More recently, a growing body of qualitative research has emerged, exploring lay conceptualizations, experiences and constructions of cancer risk. To date, this literature has not been synthesized.
Objective: We report the findings of a synthesis of qualitative literature regarding the ways in which lay people construct and experience cancer risk.
Design: We identified 87 articles and used the method of ‘thematic synthesis’ to identify and interpret key concepts from existing studies.
Results: Eight analytic categories were developed: (i) perceptions of risk factors; (ii) process of risk perception; (iii) seeking control and taking responsibility (motivational factors); (iv) experiencing cancer directly; (v) constructing risk temporally; (vi) embodying risk; (vii) identifying with risk; and (viii) constructing risk in a social context.
Conclusions: Qualitative enquiry can provide us with a rich and nuanced picture of the ways in which people understand, experience and construct risk and how being ‘at risk’ is managed, and can assist us in our communication with both individual patients and populations. [ABSTRACT FROM AUTHOR]

7. Information and decision support needs of parents considering amniocentesis: interviews with pregnant women and health professionals
By Durand, Marie-Anne et al. Health Expectations, Jun 2010,
Vol. 13 Issue 2: p125-138
Our aim was to clarify and categorize information and decision support needs of pregnant women deciding about amniocentesis.
Background: Prenatal screening for Down’s syndrome (implemented in routine practice) generates a quantifiable risk of chromosome abnormality. To increase certainty, chromosomal material needs to be obtained through amniocentesis or other diagnostic test. Amniocentesis carries risks of pregnancy loss. Methods: Semi-structured interviews were conducted with health professionals and pregnant women who had considered amniocentesis. The data were qualitatively analysed using a two-step thematic content analysis.
Results: A sample of 17 health professionals and 17 pregnant women were interviewed. Professionals demonstrated little consensus regarding the miscarriage rate, the potential consequences of amniocentesis testing and the uncertainty associated with the tests. Furthermore, methods employed to communicate risks varied between professionals. Pregnant women reported heightened stress and anxiety. Twelve out of 17 women described the decision as complex and difficult to make while five participants were satisfied with the information and support provided. Women would have liked more information about the risks involved, the results, the consequences of an amniocentesis and associated emotional difficulties. Women highlighted the need for personalized information, presented in multiple ways, while remaining simple and unbiased.
Conclusions: There is variation in the provision of information related to amniocentesis testing. The majority of pregnant women reported difficulties making a decision and identified dimensions of information and decision support where improvements were needed. [ABSTRACT FROM AUTHOR]

8. Deliberation before determination: the definition and evaluation of good decision making
By: Elwyn, Glyn & Miron-Shatz, Talya. Health Expectations, Jun 2010, Vol. 13 Issue 2: p139-147
In this article, we examine definitions of suggested approaches to measure the concept of good decisions, highlight the ways in which they converge, and explain why we have concerns about their emphasis on post-hoc estimations and post-decisional outcomes, their prescriptive concept of knowledge, and their lack of distinction between the process of deliberation, and the act of decision determination.
Background: There has been a steady trend to involve patients in decision making tasks in clinical practice, part of a shift away from paternalism towards the concept of informed choice. An increased understanding of the uncertainties that exist in medicine, arising from a weak evidence base and, in addition, the stochastic nature of outcomes at the individual level, have contributed to shifting the responsibility for decision making from physicians to patients. This led to increasing use of decision support and communication methods, with the ultimate aim of improving decision making by patients. Interest has therefore developed in attempting to define good decision making and in the development of measurement approaches.
Method: We pose and reflect whether decisions can be judged good or not, and, if so, how this goodness might be evaluated.
Results: We hypothesize that decisions cannot be measured by reference to their outcomes and offer an alternative means of assessment, which emphasizes the deliberation process rather than the decision’s end results. We propose decision making comprises a pre-decisional process and an act of decision determination and consider how this model of decision making serves to develop a new approach to evaluating what constitutes a good decision making process. We proceed to offer an alternative, which parses decisions into the pre-decisional deliberation process, the act of determination and post-decisional outcomes.
Discussion: Evaluating the deliberation process, we propose, should comprise of a subjective sufficiency of knowledge, as well as emotional processing and affective forecasting of the alternatives. This should form the basis for a good act of determination. [ABSTRACT FROM AUTHOR]

9. Disclosing clinical adverse events to patients: can practice inform policy?
By Sorensen, Ros et al. Health Expectations, Jun 2010, Vol. 13 Issue 2: p148-159
To understand patients’ and health professionals’ experience of Open Disclosure and how practice can inform policy. Background: Open Disclosure procedures are being implemented in health services worldwide yet empirical evidence on which to base models of patient–clinician communication and policy development is scant.
Design, setting and participants: A qualitative method was employed using semi-structured open-ended interviews with 154 respondents (20 nursing, 49 medical, 59 clinical/administrative managerial, 3 policy coordinators, 15 patients and 8 family members) in 21 hospitals and health services in four Australian states.
Results: Both patients and health professionals were positive about Open Disclosure, although each differed in their assessments of practice effectiveness. We found that five major elements influenced patients’ and professionals’ experience of openly disclosing adverse events namely: initiating the disclosure, apologizing for the adverse event, taking the patient’s perspective, communicating the adverse event and being culturally aware.
Conclusions: Evaluating the impact of Open Disclosure refines policy implementation because it provides an evidence base to inform policy. Health services can use specific properties relating to each of the five Open Disclosure elements identified in this study as training standards and to assess the progress of policy implementation. However, health services must surmount their sensitivity to revealing the extent of error so that research into patient experiences can inform practice and policy development. [ABSTRACT FROM AUTHOR]

10. Patient participation as dialogue: setting research agendas
By Abma, Tineke A.& Broerse, Jacqueline E. W. Health Expectations, Jun 2010, Vol. 13 Issue 2: p160-173
Collaboration with patients in healthcare and medical research is an emerging development. We aimed to develop a methodology for health research agenda setting processes grounded in the notion of participation as dialogue.
Methods: We conducted seven case studies between 2003 and 2007 to develop and validate a Dialogue Model for patient participation in health research agenda setting. The case studies related to spinal cord injury, neuromuscular diseases, renal failure, asthma/chronic obstructive pulmonary disease, burns, diabetes and intellectual disabilities.
Results: The Dialogue Model is grounded in participatory and interactive approaches and has been adjusted on the basis of pilot work. It has six phases: exploration; consultation; prioritization; integration; programming; and implementation. These phases are discussed and illustrated with a case description of research agenda setting relating to burns.
Conclusions: The dialogue model appeared relevant and feasible to structure the process of collaboration between stakeholders in several research agenda setting processes. The phase of consultation enables patients to develop their own voice and agenda, and prepares them for the broader collaboration with other stakeholder groups. Challenges include the stimulation of more permanent changes in research, and institutional transitions. [ABSTRACT FROM AUTHOR]

11. Co-researching with people with learning disabilities: an experience of involvement in qualitative data analysis
By Tuffrey-Wijne, Irene & Butler, Gary. Health Expectations, Jun 2010, Vol. 13 Issue 2: p174-184
People with learning disabilities have been included in research as co-researchers since the 1990s. However, there is limited literature about the processes of involving people with learning disabilities in the more intellectual and analytical stages of the research process.
Aims: To examine the potential contribution of people with learning disabilities to data analysis in qualitative research.
Methods: This article is a reflection on one research experience. The two authors include one researcher with and one without learning disabilities. They each describe their experience and understanding of user involvement in analysing the data of an ethnographic study of people with learning disabilities who had cancer. The researcher with learning disabilities was given extensive vignettes and extracts from the research field notes, and was supported to extract themes, which were cross-compared with the analysis of other members of the research team.
Results: The researcher with learning disabilities coped well with the emotive content of the data and with the additional support provided, he was able to extract themes that added validity to the overall analysis. His contribution complemented those of the other members of the research team. There were unexpected benefits, in particular, in terms of a more reciprocal and supportive relationship between the two researchers.
Conclusion: It is possible and valuable to extend involvement to data analysis, but to avoid tokenism and maintain academic rigour, there must be a clear rationale for such involvement. Extra support, time and costs must be planned for. [ABSTRACT FROM AUTHOR]

12. What difference does it make?’ Finding evidence of the impact of mental health service user researchers on research into the experiences of detained psychiatric patients
By Gillard, Steven et al. Health Expectations, Jun 2010, Vol. 13 Issue 2: p185-194
Interest in the involvement of members of the public in health services research is increasingly focussed on evaluation of the impact of involvement on the research process and the production of knowledge about health. Service user involvement in mental health research is well-established, yet empirical studies into the impact of involvement are lacking.
Objective: To investigate the potential to provide empirical evidence of the impact of service user researchers (SURs) on the research process.
Design: The study uses a range of secondary analyses of interview transcripts from a qualitative study of the experiences of psychiatric patients detained under the Mental Health Act (1983) to compare the way in which SURs and conventional university researchers (URs) conduct and analyse qualitative interviews.
Results: Analyses indicated some differences in the ways in which service user- and conventional URs conducted qualitative interviews. SURs were much more likely to code (analyse) interview transcripts in terms of interviewees’ experiences and feelings, while conventional URs coded the same transcripts largely in terms of processes and procedures related to detention. The limitations of a secondary analysis based on small numbers of researchers are identified and discussed.
Conclusions: The study demonstrates the potential to develop a methodologically robust approach to evaluate empirically the impact of SURs on research process and findings, and is indicative of the potential benefits of collaborative research for informing evidence-based practice in mental health services. [ABSTRACT FROM AUTHOR]

Journals - Table of Contents

13. From The Journal of Nursing Administration, September 2011, Volume 41, Number 9
Selecting the Best Design Team Partners [This article focuses on the nurse leaders' role in selecting the best possible design partner to ensure a collaborative working relationship throughout the project]
13B. Improving Processes Through Evolutionary Optimization [This is the 18th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, I discuss methods to optimize complex healthcare processes through learning, adaptation, and evolutionary planning]
13C. County and State Quality Data to Inform Expanded Roles for Nursing's Future [In this article, the author describes sources to identify major issues in healthcare quality, nursing's role in addressing quality issues, and Web-based resources for county and state quality data to guide nurses' future engagement]
13D. Perspectives on Executive Relationships: Influence [In this article, the author presents the views of 6 Magnet® hospital chief nursing executives regarding their relationships with executive-level colleagues]
13E. Adoption of National Quality Forum Safe Practices by Magnet® Hospitals [Our results also indicated that smaller hospitals (in bed size), hospitals with larger share of Medicare patients, higher nurse intensity levels (mean hours of nursing care per day), and higher levels of competition among hospitals in Leapfrog rollout regions were associated with higher CSPS]
13F. Health Information Technology in the Workplace: Findings From a 2010 National Survey of Registered Nurses [The objective of this study was to examine RNs' experiences with health information technology (HIT) and their perceptions of the effect of this technology on quality of care and daily work]
13G. Hands-Free Communication Technology: A Benefit for Nursing? [The introduction of mobile communication devices (MCDs) has dramatically altered how nurses communicate]
13H. Visioning as a Hiring Strategy for Quality Outcomes
13I. Translating Caring Theory Into Practice: The Carolina Care Model
13J. A Nurse Practitioner Residency Pilot Program: A Journey of Learning

14. From Primary Health Care, September 2011, Volume 21, Number 7
The RCN Community Health Nursing Journal

14A. RCN calls for local experiences
News and analysis
14B. RCN calls for funds to secure the future of health visiting; Simple interventions reduce numbers of 'did not attends'
14C. Boost to quality of respiratory diseases care; New standards aim to improve provision of dermatology services; reduction in mental health funding is at odds with strategy
14D. Cold homes cause ill-health; An uncertain future for school nursing
Measuring up waiting times [ Roy Lilley struggles to understand the rhetoric surrounding NHS performance statistics]
The role of practice nurses in educating patients to self-care
14G. Giving patients information online [A tool to help patients make treatment choices is described by Alan Nye]
14H. A guide to the recognition and treatment of plantar fasciitis
14I. Experiences of researchers in understanding domestic violence
Continuing professional development
14J. Ovarian cancer: symptoms, treatment and long-term patient management


15. Safeguard LegalSAFE 2011
One day conference covering topical issues relating to health and safety and employment law.

Auckland: 8 November 2011
Heritage Hotel, 35 Hobson Street, Auckland
Wellington: 9 November 2011
Copthorne Hotel, Oriental Parade, Wellington
Christchurch: 10 November 2011
The Chateau on the Park, 189 Deans Avenue, Riccarton
More details or to register call Annette Vao on 09 360 3712 or

16. Stress and Wellness in the Workplace
Date: 1 December, 2011
Venue: Wellington Town Hall, Wellington

News - National

17. Fears of surge in Dementia
Stuff - 21 Sept 2011

More than 26,000 New Zealanders may be unaware they are in the grip of dementia. Alzheimer's disease and other dementia conditions are heading toward crisis levels, yet remain underdiagnosed and under-treated, according to the World Alzheimer Report 2011, published today.

18. Thyme to let nature help
NZ Herald - 26 Sept 2011
Herbalists offer some advice on the natural ways you can combat illness.

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