J Health Serv Res Policy. <javascript:AL_get(this, 'jour', 'J Health
Serv Res Policy.');> 2010 Jan;15(1):47-55.
Community professionals' management of client care: a mixed-methods
systematic review.
Kolehmainen N
</pubmed?term=%22Kolehmainen%20N%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Francis J
</pubmed?term=%22Francis%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Duncan E
</pubmed?term=%22Duncan%20E%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Fraser C
</pubmed?term=%22Fraser%20C%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>.
Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
[log in to unmask]
OBJECTIVES: To review the literature on individual community
professionals' caseload management (behaviours related to assessment,
treatment and discharging of clients) to identify the main themes and
concepts, and to synthesize the findings to inform practice, policy and
research. METHODS: Publications were systematically identified from
electronic databases, hand searches of bibliographies, and contact with
professional organizations. There were no restrictions on language, the
nature of publications or publication year. Procedures were
systematically applied for quality appraisal and data extraction.
Qualitative and descriptive quantitative methods were used for data
analysis and synthesis. RESULTS: Search criteria yielded 2048 papers of
which 42 papers met the inclusion criteria. Thirty-five percent of these
were based on research, the rest on professionals' experiences. The
papers covered 16 professional and 20 client populations, and their
quality was generally poor. Analysis identified six broad themes:
definitions of caseload management, caseload measurement and 'tools',
models of caseload management practice, client-professional
relationship, discharging and professional guidance. Six papers
presented issues that related to but did not fit within these themes.
Current caseload management tools and models of caseload management
practice had a poor evidence base. Five papers described benefits of
team-based approaches. Professional guidance for caseload management is
limited in detail and relevance to daily practice. CONCLUSIONS: Although
there is a considerable literature on caseload management, it is not
possible to make summative conclusions. Policy-makers and professional
bodies should encourage and support development of research evidence
about the ways to achieve effective, efficient and equitable caseload
management. Health and social care services considering implementing
caseload management tools or models of practice should critically
appraise their basis, and consider their potential advantages as well as
disadvantages.
PMID: 20071502 [PubMed - in process]
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BMC Public Health. <javascript:AL_get(this, 'jour', 'BMC Public
Health.');> 2009 Dec 11;9:458.
The expressed needs of people with chronic fatigue syndrome/myalgic
encephalomyelitis: a systematic review.
Drachler Mde L
</pubmed?term=%22Drachler%20Mde%20L%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Leite JC
</pubmed?term=%22Leite%20JC%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Hooper L
</pubmed?term=%22Hooper%20L%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Hong CS
</pubmed?term=%22Hong%20CS%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Pheby D
</pubmed?term=%22Pheby%20D%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Nacul L
</pubmed?term=%22Nacul%20L%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Lacerda E
</pubmed?term=%22Lacerda%20E%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Campion P
</pubmed?term=%22Campion%20P%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Killett A
</pubmed?term=%22Killett%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
McArthur M
</pubmed?term=%22McArthur%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Poland F
</pubmed?term=%22Poland%20F%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>.
School of Allied Health Professions, University of East Anglia, Norwich,
NR4 7TJ, UK. [log in to unmask]
BACKGROUND: We aimed to review systematically the needs for support in
managing illness and maintaining social inclusion expressed by people
with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)
METHODS: We carried out a systematic review of primary research and
personal ('own') stories expressing the needs of people with CFS/ME.
Structured searches were carried out on Medline, AMED, CINAHL, EMBASE,
ASSIA, CENTRAL, and other health, social and legal databases from
inception to November 2007. Study inclusion, data extraction and risk of
bias were assessed independently in duplicate. Expressed needs were
tabulated and a conceptual framework developed through an iterative
process. RESULTS: Thirty two quantitative and qualitative studies,
including the views of over 2500 people with CFS/ME with mainly moderate
or severe illness severity, met the inclusion criteria. The following
major support needs emerged: 1) The need to make sense of symptoms and
gain diagnosis, 2) for respect and empathy from service providers, 3)
for positive attitudes and support from family and friends, 4) for
information on CFS/ME, 5) to adjust views and priorities, 6) to develop
strategies to manage impairments and activity limitations, and 7) to
develop strategies to maintain/regain social participation. CONCLUSIONS:
Although the studies were heterogeneous, there was consistent evidence
that substantial support is needed to rebuild lives. Gaining support
depends - most importantly - on the ability of providers of health and
social care, colleagues, friends and relatives, and those providing
educational and leisure services, to understand and respond to those needs.
PMID: 20003363 [PubMed - in process]
PMCID: PMC27994
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Acad Med. <javascript:AL_get(this, 'jour', 'Acad Med.');> 2009
Dec;84(12):1775-87.
Residents' and attending physicians' handoffs: a systematic review of
the literature.
Riesenberg LA
</pubmed?term=%22Riesenberg%20LA%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Leitzsch J
</pubmed?term=%22Leitzsch%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Massucci JL
</pubmed?term=%22Massucci%20JL%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Jaeger J
</pubmed?term=%22Jaeger%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Rosenfeld JC
</pubmed?term=%22Rosenfeld%20JC%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Patow C
</pubmed?term=%22Patow%20C%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Padmore JS
</pubmed?term=%22Padmore%20JS%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Karpovich KP
</pubmed?term=%22Karpovich%20KP%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>.
Christiana Care Health System, Newark, Delaware 19718, USA.
[log in to unmask]
PURPOSE: Effective communication is central to patient safety. There is
abundant evidence of negative consequences of poor communication and
inadequate handoffs. The purpose of the current study was to conduct a
systematic review of articles focused on physicians' handoffs, conduct a
qualitative review of barriers and strategies, and identify features of
structured handoffs that have been effective. METHOD: The authors
conducted a thorough, systematic review of English-language articles,
indexed in PubMed, published between 1987 and June 2008, and focused on
physicians' handoffs in the United States. The search strategy yielded
2,590 articles. After title review, 401 were obtained for further review
by trained abstractors. RESULTS: Forty-six articles met inclusion
criteria, 33 (71.7%) of which were published between 2005 and 2008.
Content analysis yielded 91 handoffs barriers in eight major categories
and 140 handoffs strategies in seven major categories. Eighteen articles
involved research on handoffs. Quality assessment scores for research
studies ranged from 1 to 13 (possible range 1-16). One third of the
reviewed research studies obtained quality scores at or below 8, and
only one achieved a score of 13. Only six studies included any measure
of handoff effectiveness. CONCLUSIONS: Despite the negative consequences
of inadequate physicians' handoffs, very little research has been done
to identify best practices. Many of the existing peer-reviewed studies
had design or reporting flaws. There is remarkable consistency in the
anecdotally suggested strategies; however, there remains a paucity of
evidence to support these strategies. Overall, there is a great need for
high-quality handoff outcomes studies focused on systems factors, human
performance, and the effectiveness of structured protocols and
interventions.
PMID: 19940588 [PubMed - indexed for MEDLINE]
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J Gen Intern Med. <javascript:AL_get(this, 'jour', 'J Gen Intern
Med.');> 2010 Jan;25(1):72-8. Epub 2009 Nov 19.
A systematic review of qualitative research on the meaning and
characteristics of mentoring in academic medicine.
Sambunjak D
</pubmed?term=%22Sambunjak%20D%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Straus SE
</pubmed?term=%22Straus%20SE%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Marusic A
</pubmed?term=%22Marusic%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>.
Croatian Medical Journal, Zagreb, Croatia.
BACKGROUND: Mentorship is perceived to play a significant role in the
career development and productivity of academic clinicians, but little
is known about the characteristics of mentorship. This knowledge would
be useful for those developing mentorship programs. OBJECTIVE: To
complete a systematic review of the qualitative literature to explore
and summarize the development, perceptions and experiences of the
mentoring relationship in academic medicine. DATE SOURCES: Medline,
PsycINFO, ERIC, Scopus and Current Contents databases from the earliest
available date to December 2008. REVIEW METHODS: We included studies
that used qualitative research methodology to explore the meaning and
characteristics of mentoring in academic medicine. Two investigators
independently assessed articles for relevance and study quality, and
extracted data using standardized forms. No restrictions were placed on
the language of articles. RESULTS: A total of 8,487 citations were
identified, 114 full text articles were assessed, and 9 articles were
selected for review. All studies were conducted in North America, and
most focused on the initiation and cultivation phases of the mentoring
relationship. Mentoring was described as a complex relationship based on
mutual interests, both professional and personal. Mentees should take an
active role in the formation and development of mentoring relationships.
Good mentors should be sincere in their dealings with mentees, be able
to listen actively and understand mentees' needs, and have a
well-established position within the academic community. Some of the
mentoring functions aim at the mentees' academic growth and others at
personal growth. Barriers to mentoring and dysfunctional mentoring can
be related to personal factors, relational difficulties and
structural/institutional barriers. CONCLUSIONS: Successful mentoring
requires commitment and interpersonal skills of the mentor and mentee,
but also a facilitating environment at academic medicine's institutions.
PMID: 19924490 [PubMed - in process]
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Acad Med. <javascript:AL_get(this, 'jour', 'Acad Med.');> 2009
Dec;84(12):1765-74.
"Renters" or "owners"? Residents' perceptions and behaviors regarding
error reduction in teaching hospitals: a literature review.
Padmore JS
</pubmed?term=%22Padmore%20JS%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Jaeger J
</pubmed?term=%22Jaeger%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Riesenberg LA
</pubmed?term=%22Riesenberg%20LA%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Karpovich KP
</pubmed?term=%22Karpovich%20KP%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Rosenfeld JC
</pubmed?term=%22Rosenfeld%20JC%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Patow CA
</pubmed?term=%22Patow%20CA%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>.
MedStar Health, Columbia, Maryland 21044, USA. [log in to unmask]
PURPOSE: Residents' attitudes, practices, and behaviors vary in response
to medical error within the context of the culture of their
institutions. The purpose of this study was to conduct a systematic
review of the literature focused on residents' attitudes and behaviors
regarding medical errors in teaching hospitals, including a qualitative
review of barriers and proposed countermeasures related to residents'
engagement in patient safety. METHOD: The electronic literature
databases of MEDLINE, CINAHL, and ERIC were searched for articles
published between January 1988 and June 2008. The search strategy
yielded 124 articles. A scoring system was developed to assess the
quality of the overall literature. RESULTS: Nineteen studies met
eligibility criteria, with 17 published since 2005. There were 12
cross-sectional, 5 qualitative, 1 cohort and 1 pre-post intervention
study. Quality assessment scores ranged from 5.5 to 12.5 (possible range
1.0-16.0). Three studies obtained a score of < or = 8.0, 5 obtained
scores of 8.5 to 10.5, and 11 studies had scores of 11.0 to 12.5.
Personal, environmental, and system barriers, and environmental and
system countermeasures, were identified. CONCLUSIONS: Although the
published literature on this topic is limited, those articles that exist
identify barriers that make residents reluctant to engage in
institutional error identification and/or reduction. Key factors
identified included a fear of retribution and the perception of
residents as transient care providers. Whereas several countermeasures
have been promulgated, the literature reveals scant evidence of their
effectiveness. Institutions should recognize and capitalize on the
unique experiences of residents and their potential to become owners in
patient safety initiatives.
PMID: 19940587 [PubMed - indexed for MEDLINE]
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JOURNAL OF CLINICAL NURSING VOL 19; NUMBER 3-4 (2010) pp. 447-460
A systematic review and meta-ethnography of the qualitative literature: experiences of the menarche
Chang, Y. T.; Hayter, M.; Wu, S. C.
KEYWORDS
adolescent health • menarche • nurses • reproductive health • school
nursing • systematic review
ABSTRACT
Aim. This article is a report of a systematic review and
meta-ethnography of women's experience of menarche.
Background. Adolescents may experience menarche at different ages, but
menarche remains an important milestone in the female maturation
process, representing the transition from childhood to womanhood.
Design. Systematic review and meta-ethnography.
Methods. Electronic databases were systematically searched and
supplemented with reference lists searching. Qualitative studies of
women's experience of menarche were purposely selected and questions
proposed by the critical appraisal skills programme was adapted and used
to assess papers prior to synthesis. Key themes and concepts were
extracted and synthesised using meta-ethnography.
Results. Fourteen studies on menarche experience were identified. The
majority of studies were descriptive. Five key concepts were identified
from all 14 papers as being descriptive of women's experience of
menarche. These included: menarche preparation, significant others'
response to menarche, physical experience of menarche, psychological
experience of menarche and social-cultural perspective of menarche.
Conclusions. Menarche experience had a major impact on women. Women went
through physical, psychological and social-culture changes when their
first menstrual flow came. Menarche preparation has been shown to have a
beneficial impact on the menarcheal woman. School nurses have accurate
knowledge about sexual health; they can and should provide appropriate
menstrual education.
Relevance to clinical practice. The findings can be used by school
nurses working with adolescents as the basis for a framework of
intervention strategies directed towards helping adolescents to better
accept their menarche and transition into womanhood.
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Int J Nurs Stud. <javascript:AL_get(this, 'jour', 'Int J Nurs Stud.');>.
[Epub ahead of print]
The user experience of critical care discharge: A meta-synthesis of
qualitative research.
Bench S
</pubmed?term=%22Bench%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Day T
</pubmed?term=%22Day%20T%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>.
Florence Nightingale School of Nursing and Midwifery, King's College,
James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, United
Kingdom.
OBJECTIVES: This review identifies the most significant factors, which
impact upon the user experience of progress and recovery from critical
illness during the first month after discharge from critical care, and
discusses these in relation to the development of effective critical
care discharge support strategies. DESIGN: Meta-synthesis of qualitative
primary research. DATA SOURCES: Qualitative research published in
English between 1990 and 2009 was identified using online databases:
CINAHL, MEDLINE, EMBASE, British Nursing Index, CDSR, ACP Journal Club,
Cochrane library, Social Policy and Practice and PsycInfo. Studies of
adult patients, relatives/carers/significant others, which focused on
experiences after discharge from an intensive care or high dependency
unit to a general ward were retrieved. REVIEW METHODS: Following
screening against inclusion/exclusion criteria, methodological appraisal
of studies was conducted using a published framework. Ten studies met
the criteria for inclusion. RESULTS: Five key themes emerged from the
meta-synthesis: physical and psychological symptoms; making progress;
the need to know; and safety and security. CONCLUSIONS: Findings from
this meta-synthesis and other related literature supports the existence
of physical and psychological problems in the immediate period following
discharge from critical care to the ward, and suggests that patients and
their families have a desire for more control over their recovery.
However, this desire is countered by a need to feel safe and protected,
culminating in an expression of dependence on healthcare staff. Any
effective support strategy needs to take account of these findings.
PMID: 20004396 [PubMed - as supplied by publisher]
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BMC Health Serv Res. <javascript:AL_get(this, 'jour', 'BMC Health Serv
Res.');> 2009 Dec 10;9:226.
Researching the mental health needs of hard-to-reach groups: managing
multiple sources of evidence.
Dowrick C
</pubmed?term=%22Dowrick%20C%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Gask L
</pubmed?term=%22Gask%20L%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Edwards S
</pubmed?term=%22Edwards%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Aseem S
</pubmed?term=%22Aseem%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Bower P
</pubmed?term=%22Bower%20P%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Burroughs H
</pubmed?term=%22Burroughs%20H%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Catlin A
</pubmed?term=%22Catlin%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Chew-Graham C
</pubmed?term=%22Chew-Graham%20C%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Clarke P
</pubmed?term=%22Clarke%20P%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Gabbay M
</pubmed?term=%22Gabbay%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Gowers S
</pubmed?term=%22Gowers%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,Hibbert
D
</pubmed?term=%22Hibbert%20D%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Kovandzic M
</pubmed?term=%22Kovandzic%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Lamb J
</pubmed?term=%22Lamb%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Lovell K
</pubmed?term=%22Lovell%20K%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Rogers A
</pubmed?term=%22Rogers%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Lloyd-Williams M
</pubmed?term=%22Lloyd-Williams%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Waheed W
</pubmed?term=%22Waheed%20W%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>;
AMP Group
</pubmed?term=%22AMP%20Group%22%5BCorporate%20Author%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>.
Primary Care Research Group, University of Manchester, Oxford Road,
Manchester, M13 9PL, UK. [log in to unmask]
BACKGROUND: Common mental health problems impose substantial challenges
to patients, carers, and health care systems. A range of interventions
have demonstrable efficacy in improving the lives of people experiencing
such problems. However many people are disadvantaged, either because
they are unable to access primary care, or because access does not lead
to adequate help. New methods are needed to understand the problems of
access and generate solutions. In this paper we describe our
methodological approach to managing multiple and diverse sources of
evidence, within a research programme to increase equity of access to
high quality mental health services in primary care. METHODS: We began
with a scoping review to identify the range and extent of relevant
published material, and establish key concepts related to access. We
then devised a strategy to collect - in parallel - evidence from six
separate sources: a systematic review of published quantitative data on
access-related studies; a meta-synthesis of published qualitative data
on patient perspectives; dialogues with local stakeholders; a review of
grey literature from statutory and voluntary service providers;
secondary analysis of patient transcripts from previous qualitative
studies; and primary data from interviews with service users and
carers.We synthesised the findings from these diverse sources, made
judgements on key emerging issues in relation to needs and services, and
proposed a range of potential interventions. These proposals were
debated and refined using iterative electronic and focus group
consultation procedures involving international experts, local
stakeholders and service users. CONCLUSIONS: Our methods break new
ground by generating and synthesising multiple sources of evidence,
connecting scientific understanding with the perspectives of users, in
order to develop innovative ways to meet the mental health needs of
under-served groups.
PMID: 20003275 [PubMed - in process]
PMCID: PMC2799397
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Harm Reduct J. <javascript:AL_get(this, 'jour', 'Harm Reduct J.');> 2009
Nov 20;6:32.
Integrated programs for women with substance use issues and their
children: a qualitative meta-synthesis of processes and outcomes.
Sword W
</pubmed?term=%22Sword%20W%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Jack S
</pubmed?term=%22Jack%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Niccols A
</pubmed?term=%22Niccols%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Milligan K
</pubmed?term=%22Milligan%20K%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Henderson J
</pubmed?term=%22Henderson%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Thabane L
</pubmed?term=%22Thabane%20L%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>.
School of Nursing, McMaster University, Hamilton, Ontario, Canada.
[log in to unmask]
BACKGROUND: There is a need for services that effectively and
comprehensively address the complex needs of women with substance use
issues and their children. A growing body of literature supports the
relevance of integrated treatment programs that offer a wide range of
services in centralized settings. Quantitative studies suggest that
these programs are associated with positive outcomes. A qualitative
meta-synthesis was conducted to provide insight into the processes that
contribute to recovery in integrated programs and women's perceptions of
benefits for themselves and their children. METHODS: A comprehensive
search of published and unpublished literature to August 2009 was
carried out for narrative reports of women's experiences and perceptions
of integrated treatment programs. Eligibility for inclusion in the
meta-synthesis was determined using defined criteria. Quality assessment
was then conducted. Qualitative data and interpretations were extracted
from studies of adequate quality, and were synthesized using a
systematic and iterative process to create themes and overarching
concepts. RESULTS: A total of 15 documents were included in the
meta-synthesis. Women experienced a number of psychosocial processes
during treatment that played a role in their recovery and contributed to
favourable outcomes. These included: development of a sense of self;
development of personal agency; giving and receiving of social support;
engagement with program staff; self-disclosure of challenges, feelings,
and past experiences; recognizing patterns of destructive behaviour; and
goal setting. A final process, the motivating presence of children,
sustained women in their recovery journeys. Perceived outcomes included
benefits for maternal and child well-being, and enhanced parenting
capacity. CONCLUSION: A number of distinct but interconnected processes
emerged as being important to women's addiction recovery. Women
experienced individual growth and transformative learning that led to a
higher quality of life and improved interactions with their children.
The findings support the need for programs to adopt practices that focus
on improving maternal health and social functioning in an environment
characterized by empowerment, safety, and connections. Women's
relationships with their children require particular attention as
positive parenting practices and family relationships can alter
predispositions toward substance use later in life, thereby impacting
favourably on the cycle of addiction and dysfunctional parenting.
PMID: 19930575 [PubMed]
PMCID: PMC2789048
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Int J Nurs Stud. <javascript:AL_get(this, 'jour', 'Int J Nurs Stud.');>
2010 Jan;47(1):89-107. Epub 2009 Oct 24.
Older people's and relatives' experiences in acute care settings:
systematic review and synthesis of qualitative studies.
Bridges J
</pubmed?term=%22Bridges%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Flatley M
</pubmed?term=%22Flatley%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Meyer J
</pubmed?term=%22Meyer%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>.
City University London, School of Community and Health Sciences, Philpot
Street, Whitechapel London E1 2EA, UK. [log in to unmask]
OBJECTIVE: To explore older people's and their relatives' views on and
experiences of acute health care. DESIGN: Systematic procedures were
used for study selection and data extraction and analysis. A comparative
thematic approach to synthesis was taken with a number of features
adopted from the literature on meta-ethnography. DATA SOURCES: Worldwide
grey and published literature written in English between January 1999
and June 2008 identified from databases: CINAHL, Medline, British
Nursing Index, EMBASE Psychiatry, International Bibliography of the
Social Sciences, PsychINFO, and AgeInfo. REVIEW METHODS: We conducted a
systematic review and synthesis of qualitative studies describing older
patients' and/or their relatives' experiences of care in acute hospital
settings. 42 primary studies and 1 systematic review met the inclusion
criteria. RESULTS: A number of themes emerged. The quality of technical
care is often taken for granted by older patients, and good or bad
experiences are described more in terms of relational aspects of care.
Older patients in hospital may feel worthless, fearful or not in control
of what happens, especially if they have impaired cognition, or
communication difficulties. Three key features of care consistently
mediated these negative feelings and were linked to more positive
experiences: "creating communities: connect with me", "maintaining
identity: see who I am" and "sharing decision-making: include me".
CONCLUSION: These findings highlight the perspectives of older people
and their relatives on the delivery of personalized and dignified care
in acute settings. They lend support to previous calls for
relationship-centred approaches to care and provide a useful
experience-based framework for practice for those involved in care for
older people.
PMID: 19854441 [PubMed - in process]
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BMJ. <javascript:AL_get(this, 'jour', 'BMJ.');> 2010 Jan 19;340:c112.
doi: 10.1136/bmj.c112.
The views of patients and carers in treatment decision making for
chronic kidney disease: systematic review and thematic synthesis of
qualitative studies.
Morton RL
</pubmed?term=%22Morton%20RL%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Tong A
</pubmed?term=%22Tong%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Howard K
</pubmed?term=%22Howard%20K%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Snelling P
</pubmed?term=%22Snelling%20P%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Webster AC
</pubmed?term=%22Webster%20AC%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>.
Sydney School of Public Health, University of Sydney, Sydney, NSW 2006,
Australia. [log in to unmask]
OBJECTIVE: To synthesise the views of patients and carers in decision
making regarding treatment for chronic kidney disease, and to determine
which factors influence those decisions. DESIGN: Systematic review of
qualitative studies of decision making and choice for dialysis,
transplantation, or palliative care, and thematic synthesis of
qualitative studies. DATA SOURCES: Medline, PsycINFO, CINAHL, Embase,
social work abstracts, and digital theses (database inception to week 3
October 2008) to identify literature using qualitative methods (focus
groups, interviews, or case studies). Review methods Thematic synthesis
involved line by line coding of the findings of the primary studies and
development of descriptive and analytical themes. RESULTS: 18 studies
that reported the experiences of 375 patients and 87 carers were
included. 14 studies focused on preferences for dialysis modality, three
on transplantation, and one on palliative management. Four major themes
were identified as being central to treatment choices: confronting
mortality (choosing life or death, being a burden, living in limbo),
lack of choice (medical decision, lack of information, constraints on
resources), gaining knowledge of options (peer influence, timing of
information), and weighing alternatives (maintaining lifestyle, family
influences, maintaining the status quo). CONCLUSIONS: The experiences of
other patients greatly influenced the decision making of patients and
carers. The problematic timing of information about treatment options
and synchronous creation of vascular access seemed to predetermine
haemodialysis and inhibit choice of other treatments, including
palliative care. A preference to maintain the status quo may explain why
patients often remain on their initial therapy.
PMID: 20085970 [PubMed - in process]
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Transplantation. <javascript:AL_get(this, 'jour', 'Transplantation.');>
2010 Jan 19. [Epub ahead of print]
Community Preferences for the Allocation of Solid Organs for
Transplantation: A Systematic Review.
Tong A
</pubmed?term=%22Tong%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Howard K
</pubmed?term=%22Howard%20K%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Jan S
</pubmed?term=%22Jan%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Cass A
</pubmed?term=%22Cass%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Rose J
</pubmed?term=%22Rose%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Chadban S
</pubmed?term=%22Chadban%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Allen RD
</pubmed?term=%22Allen%20RD%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>,
Craig JC
</pubmed?term=%22Craig%20JC%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>.
1Centre for Kidney Research, The Children's Hospital at Westmead,
Sydney, NSW, Australia. 2School of Public Health, Sydney Medical School,
The University of Sydney, Sydney, NSW, Australia. 3Renal Division, The
George Institute for International Health, Camperdown, Sydney, NSW,
Australia. 4The Poche Centre for Indigenous Health, The University of
Sydney, Sydney, NSW, Australia. 5Faculty of Economics and Business,
Institute of Transport and Logistics Studies, The University of Sydney,
Sydney, NSW, Australia. 6Central Clinical School, Bosch Institute, The
University of Sydney, Sydney, NSW, Australia. 7Department of Renal
Medicine, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, Australia.
BACKGROUND.: Organs for transplantation are a scarce community resource
but community preferences and how they are incorporated into allocation
policies are unclear. This systematic review aimed to ascertain
community preferences for organ allocation and the principles
underpinning these preferences. METHODS.: Medline, Embase, PsycINFO,
EconLit, and gray literature databases were searched. Quantitative data
were extracted, and a qualitative textual synthesis of the results and
conclusions reported in each included study was performed. RESULTS.:
Fifteen studies involving more than 5563 respondents were included.
Seven themes describing community preferences for organ allocation were
identified: (1) maximum benefit, to achieve maximum health gain in
recipient survival and quality of life; (2) social valuation, to base
preferences on societal gain; (3) moral deservingness, to consider the
"worthiness" of recipients based on their social standing and lifestyle
decisions; (4) prejudice, to make a judgement based on personal
ideologic viewpoints; (5) "fair innings," to provide an organ
preferentially to the younger recipient giving opportunity for a
"normal" life span and to those waiting for a first organ rather than a
retransplant; (6) "first come, first served," to allocate the organ to
recipients wait-listed the longest; and (7) medical urgency, to allocate
based on illness severity and saving life. CONCLUSIONS.: Community
preferences for organ allocation hinge on a complex balance of
efficiency, social valuation, morality, fairness, and equity principles.
Being a community-held resource, effective ways to identify and
incorporate community preferences into allocation algorithms for solid
organ transplantation are warranted.
PMID: 20090570 [PubMed - as supplied by publisher]
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CLINICAL PSYCHOLOGY REVIEW VOL 30; NUMBER 1 (2010) pp. 113-126
The impact of dementia on self and identity: A systematic review
Caddell, L. S.; Clare, L.
Abstract
There is much debate in the literature as to the extent to which self
and identity persist in people with dementia. The aim of this systematic
review was to examine methods currently used to investigate self and
identity in people with dementia, and the resulting evidence as to the
persistence of self and identity throughout the course of the disease.
Thirty-three studies were reviewed, which showed that many approaches
have been taken to studying aspects of self and identity in dementia,
including both quantitative and qualitative methods. This appears to be
partly due to the differing underlying concepts of self that have been
used as a basis for these studies. Consequently, results obtained from
these studies are somewhat disparate, although it is possible to draw
some tentative conclusions from the available evidence. Almost all of
the studies suggest that there is at least some evidence for persistence
of self in both the mild and moderate to severe stages of the illness,
although many studies record some degree of deterioration in aspects of
self or identity. Further research is required to clarify existing
evidence and to address outstanding questions regarding self and
identity in dementia.
*Keywords: *Alzheimer's disease; Vascular dementia; Fronto-temporal
dementia; Personhood; Self-concept; Selfhood
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JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS VOL 29; NUMB 4 (2009) pp. 235-241
UK health-care professionals experience of on-line learning techniques: A systematic review of qualitative data
Carroll, C.; Booth, A.; Papaioannou, D.; Sutton, A.; Wong, R.
INTRODUCTION: Continuing professional development and education is vital to the provision of better health services and outcomes. The aim of this study is to contribute to the evidence base by performing a systematic review of qualitative data from studies reporting health professionals' experience of e-learning. No such previous review has been published. METHOD: A systematic review of qualitative data reporting UK health professionals' experiences of the ways in which on-line learning is delivered by higher education and other relevant institutions. Evidence synthesis was performed with the use of thematic analysis grounded in the data. RESULTS: Literature searches identified 19 relevant studies. The subjects of the studies were nurses, midwives, and allied professions (8 studies), general practitioners and hospital doctors (6 studies), and a range of different health practitioners (5 studies). The majority of courses were stand-alone continuing professional development modules. Five key themes emerged from the data: peer communication, flexibility, support, knowledge validation, and course presentation and design. DISCUSSION: The effectiveness of on-line learning is mediated by the learning experience. If they are to enhance health professionals' experience of e-learning, courses need to address presentation and course design; they must be flexible, offer mechanisms for both support and rapid assessment, and develop effective and efficient means of communication, especially among the students themselves.
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EVIDENCE AND POLICY VOL 5; NUMB 4 (2009) pp. 399-428
Secondary school teachers' and pupils' definitions of bullying in the UK: a systematic review
O Brien, N.
**Abstract:
**The aim of the systematic review (SR) reported in this article was to compare how UK secondary school pupils and teachers define bullying, using the analytical framework proposed by Naylor et al (2006). Findings were drawn from five major studies - two quantitative, two qualitative and one using mixed methods - and suggest that teachers are much more likely than pupils to employ broader definitions and to include indirect forms of bullying. Possible additions to Naylor et al's framework are highlighted. The SR encompassed views from 3,283 pupils and 225 teachers, and a number of modest implications for policy and practice are identified.
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JOURNAL OF COMMUNITY PSYCHOLOGY VOL 38; NUMBER 1 (2010) pp. 99-114
Conceptualization and measurement of the neighborhood in rural settings: a systematic review of the literature
De Marco, A.; De Marco, M.
**Abstract:**
*I*nterest in the effects of neighborhood context on individual
wellbeing has increased in recent years. We now know that neighborhood
conditions, such as poverty and deprivation, negatively impact
residents. However, most of the extant work has taken an urban focus.
Less is known about these processes in rural settings. Neighborhood
conceptualizations, such as Census tracts and block groups, are standard
in the urban neighborhood effects literature. Yet, rural neighborhoods
differ from those in urban regions making it unclear how these
conceptualizations would fit. This systematic review seeks to summarize
how researchers have conceptualized and measured rural neighborhoods.
Keyword searches were performed in a variety of databases to compile all
relevant peer-reviewed articles. After examination, 19 articles fit the
review criteria. Conceptualizations fell into five categories:
administrative units, distance from home, town segments, local-actor
mapped regions, and nongeographical self-definitions. Discussion of the
merits of each for rural community research is provided.
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HEALTH POLICY AND PLANNING VOL 25; NUMBER 1 (2010) pp. 1-14
A systematic review of the evidence on integration of targeted health interventions into health systems
Atun, R.; de Jongh, T.; Secci, F.; Ohiri, K.; Adeyi, O.
*A* l*on*gst*a*nding deb*a*te *on* *health* *systems* org*a*niz*a*ti*on*
rel*a*tes^ to benefits *of*integr*a*ting *health* progr*a*mmes th*a*t
emph*a*size^ specific *interventions* *into*m*a*instre*a*m *health*
*systems* to incre*a*se^ *a*ccess *a*nd improve *health* outcomes. This
deb*a*te h*a*s l*on*g been^ ch*a*r*a*cterized by pol*a*riz*a*ti*on* *of*
views *a*nd ideologies, with^ prot*a*g*on*ists for *a*nd *a*g*a*inst
*integration* *a*rguing *the* rel*a*tive^ merits *of*
e*a*ch*a*ppro*a*ch. However, *a*ll too frequently *the*se *a*rguments^
h*a*ve not been b*a*sed *on*h*a*rd *evidence*. *The* presence *of* both
integr*a*ted^ *a*nd n*on*-integr*a*ted progr*a*mmes in m*a*ny countries
suggests *the*re^ m*a*y be benefits to ei*the*r*a*ppro*a*ch, but *the*
rel*a*tive merits^ *of* *integration* in v*a*rious c*on*texts *a*nd for
different *interventions*^ h*a*ve not been *systematic**a*lly
*a*n*a*lysed *a*nd documented. In this p*a*per we present findings *of*
*a* *systematic* *review* th*a*t^ explores *a* bro*a*d r*a*nge *of*
*evidence* *on*: (i) *the* extent*a*nd n*a*ture^ *of* *the*
*integration* *of* *targeted* *health* progr*a*mmes th*a*t emph*a*size^
specific *interventions* *into* critic*a*l* health* *systems*
functi*on*s,^ (ii) how *the* *integration* or n*on*-*integration* *of*
*health* progr*a*mmes^ *into* critic*a*l *health**systems* functi*on*s
in different c*on*texts^ h*a*s influenced progr*a*mme success, (iii) how
c*on*textu*a*l f*a*ctors^ h*a*ve *a*ffected *the*extent to which *the*se
progr*a*mmes were integr*a*ted^ *into* critic*a*l *health* *systems*
functi*on*s.Our *a*n*a*lysis shows few inst*a*nces where *the*re is full
*integration*^ *of* *a* *health* interventi*on* or where *a*n
interventi*on* is completely^ n*on*-integr*a*ted. Inste*a*d, *the*re
exists *a* highly heterogeneous^ picture both for *the* n*a*ture *a*nd
*a*lso for *the*extent *of* *integration*.^ *Health* *systems* combine
both n*on*-integr*a*ted *a*nd integr*a*ted *interventions*,^ but *the*
b*a*l*a*nce *of**the*se *interventions* v*a*ries c*on*sider*a*bly.
*Key Words:* *Health* *systems*, *targeted* progr*a*mmes, *integration*,
vertic*a*l progr*a*mmes, horiz*on*t*a*l progr*a*mmes
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WORK -ANDOVER MEDICAL PUBLISHERS INCORPORATED THEN IOS PRESS- VOL 34; NUMB 1 (2010) pp. 33-44
Disruption, disbelief and resistance: A meta-synthesis of disability in the workplace
Gewurtz, R.; Kirsh, B.
Abstract
This article presents the findings from a meta-synthesis of qualitative
research on the experiences of persons with disabilities in the
workplace. The purpose of this review was to explore how organizational
culture influences the experiences of people with disabilities in the
workplace, and the impact of disability on organizational culture.
Findings from seven qualitative peer-reviewed studies on the experiences
of people with disabilities at work and organizational culture published
between 1995 and 2006 were synthesized using the meta-ethnography
approach. The findings highlight how experiences of people with
disabilities and organizational culture intersect in the workplace.
Specifically, accessibility in the workplace involves more than removing
physical barriers. People with disabilities are affected by the degree
of acceptance and flexibility in the workplace, and relationships with
co-workers and supervisors. However, the presence of disability may be
perceived as disruptive to the organization, operation and structure of
the workplace, resulting in disbelief and resistance. The findings
suggest that attention and resources should be directed supporting the
implementation of disability and human rights legislation and increasing
tolerance for diversity in the workplace.
Keywords
Organizational culture, disability in the workplace, qualitative
research, meta-synthesis
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SOUTH AFRICAN JOURNAL OF EDUCATION VOL 29; NUMB 4 (2009) pp. 445-460
Meta-synthesis on learners' experience of aggression in secondary schools in South Africa
Myburgh, C.; Poggenpoel, M.
This meta-synthesis is on research conducted by different researchers in a team research project on learners’ experience of aggression in secondary schools in South Africa. The objective was to obtain a broader understanding of their experience of aggression in different contexts in South Africa, as well as possible ways to assist learners to address the experienced aggression. Eleven completed research projects were purposively sampled. Data were collected utilising the following headings: objectives, sampling, research design, research method,
and research results, and guidelines. At the end of the meta- synthesis process the results are described, with supporting direct quotations from participants and a literature control. Guidelines for learners to cope with aggression are described.
http://www.sajournalofeducation.co.za/index.php/saje/article/viewFile/290/174
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Andrew Booth BA Dip Lib MSc MCLIP<br>
Reader in Evidence Based Information Practice &<br>
Director of Information<br>
School of Health & Related Research (ScHARR)<br>
University of Sheffield, Regent Court,<br>
30 Regent Street, SHEFFIELD<br>
S1 4DA<br>
Tel: +44(0)114 244 3622<br>
Fax: +44(0)114 272 4095<br>
Email: [log in to unmask]<br>
<br>
<span class="Apple-style-span"
style="border-collapse: separate; color: rgb(0, 0, 0); font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;"><span
class="Apple-style-span"
style="font-family: arial,sans-serif; font-size: 12px; text-align: left;">First
you're an unknown, then you write one book and you move up to obscurity.<br>
-<span class="Apple-converted-space"> </span><b><span
style="color: rgb(28, 70, 128);">Martin Myers</span></b></span></span><br>
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