Public health interventions and behaviour change: reviewing the grey literature.

OBJECTIVES: This study identified and reviewed grey literature relating to factors facilitating and inhibiting effective interventions in three areas: the promotion of mental health and well-being, the improvement of food and nutrition, and interventions seeking to increase engagement in physical activity. STUDY DESIGN: Sourcing, reviewing and analysis of relevant grey literature. METHODS: Evidence was collected from a variety of non-traditional sources. Thirty-six pieces of documentary evidence across the three areas were selected for in-depth appraisal and review. RESULTS: A variety of approaches, often short-term, were used both as interventions and outcome measures. Interventions tended to have common outcomes, enabling the identification of themes. These included improvements in participant well-being as well as identification of barriers to, and promoters of, success. Most interventions demonstrated some positive impact, although some did not. This was particularly the case for more objective measures of change, such as physiological measurements, particularly when used to evaluate short-term interventions. Objective health measurement as part of an intervention may act as a catalyst for future behaviour change. Time is an important factor that could either promote or impede the success of interventions for both participants and facilitators. Likewise, the importance of involving all stakeholders, including participants, when planning health promoting interventions was established as an important indicator of success. DISCUSSION: Despite its limited scope, this review suggests that interventions can be more efficient and effective. For example, larger-scale, longer-term interventions could be more efficient, whilst outcomes relating to the implementation and beyond could provide a clearer picture of effectiveness. Additionally, interventions and evaluations must be flexible, evolve in partnership with local communities, and reflect local need and context.

Nurse managers in Australia: mentoring, leadership and career progression.

Identification of those leadership qualities which nurses believe led to their successful attainment of a nursing management position may help in understanding how to identify and foster leadership potential amongst nursing staff. This study asked nurse managers to indicate the important factors which influenced and facilitated their entry to management positions with a particular reference to the development of leadership characteristics. The results suggest that the leadership qualities we expect nurse managers to display evolve in a largely random way. Additionally, there is evidence that the development of leadership skills and attainment of management positions remains fragmented and random in nature. Because of this, individual nurse managers develop leadership skills almost by default using informal strategies to learn and develop. These findings should provide direction to educational providers and senior managers who seek to develop future leaders and managers.

Fingertip dermatitis in a retail florist.

Prevalence of plant contact dermatitis in retail florists varies with exposure, and the number of reports of contact allergy to cut tulips is rather small. Alpha-methylene-gamma-butyrolactone is better known as the cause of both Alstroemeria dermatitis in retail florists and tulip finger in wholesale floral workers who handle the bulbs. Our patient presented with prominent erythema, scaling, and peeling of the skin of the thumb, index, and middle fingers of his right hand. Results of a patch test to alpha-methylene-gamma-butyrolactone were strongly positive, and the patient determined that the exposure had occurred when he stripped leaves from the tulip stems to arrange cut flowers. Other natural sources of the antigen include Alstroemeria; Bomarea; Dioscorea hispida; Erythronium; Gagea; Fritillaria; and at least one species of onion, Allium triquetrum.

Profile of first-line nurse managers in New South Wales, Australia, in the 1990s.

AIMS: To determine a demographic profile, employment history and career plans of a sample of nursing unit managers (first-line managers) in New South Wales (NSW), Australia in 1999. To compare the profile of first-line nurse managers in 1999 with those in 1989. BACKGROUND: This study replicates another undertaken a decade earlier (see Duffield 1992). Tracking the changes to nurse manager positions is important, given changes to the educational preparation of nurses and restructuring within hospitals which have occurred in the past decade. METHOD: The same questionnaire was used in both studies, with minor amendments and the addition of two items to reflect changes to organizational structures, whereby nurse managers are now responsible for non-nursing staff. In 1999 all first-line nurse managers in the largest health service in NSW were invited to participate in the study. RESULTS: A response rate of 77% was achieved. There were few differences of note in the demographic profile from 1989 to 1999. However educationally, first-line nurse managers in 1999 were more highly qualified. A greater proportion had higher degrees and increasingly, in the management discipline. CONCLUSION: Perhaps reflecting these qualifications, more managers in 1999 indicated their intention to move to more senior management positions in the next decade. The mode for experience in this role of 1 year in both 1989 and 1999 reflects a worrying trend of high turnover and inexperience amongst this group of managers. While maternity relief might account for this result, further research needs to determine more precise reasons. The ad hoc bases on which expert clinicians (clinical nurse specialists) act as the manager in his/her absence need to be critically examined. Alternative strategies such as introducing a formal second- in-charge position may ensure more successful recruitment and retention of staff to these critical management positions.

The role of nursing unit managers in educating nurses.

This paper presents the findings of a work sampling study undertaken in New South Wales (Australia) to ascertain the amount of time spent by nursing unit managers directly educating nurses. The results indicate that they spend very little time in teaching, traditionally one of their role tasks. It is argued that their teaching at unit level should focus on their role as leader, mentor, preceptor and coach. This role shift needs to be articulated to managers and nurses to minimise confusion over the role and to ensure that direct teaching is placed into the hands of expert clinicians.

The role and preparation of first-line nurse managers in Australia: where are we going and how do we get there?

Organizational restructuring is impacting heavily on the first-line nurse managers' role. Given their critical role, it is important that the best and most talented are attracted to and prepared to be first-line managers. The authors provide an overview of the role of first-line nurse managers in Australia, proposing that nurse administrators take a more active role than has traditionally been the case in ensuring staff are appropriately educated and selected for management positions.

The role of the Advanced Casualty Management Team in St John Ambulance Australia (New South Wales District).

St John Ambulance is a household name synonymous with the teaching and provision of first aid. Recently the organisation has developed pre-hospital emergency care services through the introduction of the St John Ambulance Australia Advanced Casualty Management Team in New South Wales. The Advanced Casualty Management Team represents a move away from the practice of first aid by lay personnel and is a natural extension of the traditional work and principles of St John Ambulance. This article provides an overview of the Advanced Casualty Management Team and discusses its contribution to pre-hospital trauma care delivery.

Effective taper criterion for the full veneer crown preparation in preclinical prosthodontics.

PURPOSE: Effective taper criteria must define a realistic, measurable goal that the student can visualize and achieve. Six degrees is widely accepted as the taper criterion for the full veneer crown preparation. However, studies show the actual taper of most preparations to be greater than 12 degrees. The purpose of this study was to determine whether 12 degrees is an effective taper criterion for the full veneer crown preparation in preclinical prosthodontics instruction. MATERIALS AND METHODS: A group of 191 full veneer crown preparations with 6 degrees as the taper criterion, and a group of 130 full veneer crown preparations with 12 degrees as the taper criterion were evaluated. All preparations were accomplished by preclinical dental students working on typodonts under examination conditions. RESULTS: The overall mean taper for each group exceeded the targeted criterion. The overall mean taper for the 6 degrees group was 14,490. When 12 degrees was the criterion, the overall mean taper was 15,580. The t test results indicate significant differences (p < .0001) between the targeted criterion and the actual preparation mean taper in all samples except one: the faciolingual measurements in the 12 degrees group. The faciolingual measurement of 12,920 was not statistically significantly different (.0542) from the targeted criterion of 12 degrees. CONCLUSION: The use of a 12 degrees taper criterion did not result in preclinical students achieving the goal of a 12 degrees taper. However, a 12 degrees criterion is more realistic than a 6 degrees criterion for full veneer crown preparations.

Basal cell carcinoma treated with Mohs surgery. A comparison of 54 younger patients with 1050 older patients.

The average age of patients with basal cell carcinoma (BCC) is over 60 years, and fewer than 5% of patients with this tumor are under 30 years of age. A comparison of younger (15 to 30 years) and older (56 to 70 years) patients with BCC was conducted to identify specific tumor or host features associated with BCC occurring early in life. According to data collected over an 11-year period, 54 of 2728 (2%) BCCs occurred "de novo" in younger patients. In contrast to the predominantly male older group, most of the younger patients were female. An increased use of tanning booths and hair-dyes was associated with the younger patients (P less than .001). More overall sunlight exposure and actinic keratoses were associated with the older patients (P less than .01). Defect and lesion sizes were smaller (P less than .01) in the younger group. Location, histology, and clinical morphology did not differ appreciably between the two groups. De novo BCCs in younger and older patients are similar, although some differences do exist.

Timing in the movement of jaws, tongue, and hyoid during feeding in the hyrax, Procavia syriacus.

The anatomical structures used during mammalian feeding are morphologically linked by their connecting musculature, suggesting a predictable timing relationship among their movements. Cine-x-ray (100 frames per second) was used to record feeding behavior in four adult hyraxes (Procavia syriacus), herbivores. Movement of jaws, tongue, and hyoid bone was cyclic, and prior to the first swallow cycle, cycle duration was constant through time for all structures. Minimum gape, beginning of forward movement of the tongue and hyoid, and beginning of intrinsic tongue expansion occurred simultaneously over a large number of cycles. However, maximum gape, maximum protrusion of hyoid, and maximum forward position of the tongue happened at statistically different points in time. After the first swallow, cycle duration increased. Most of the variation in cycle duration can be explained by variation in the opening or forward phase of movement; the closing and return phases are constant in duration. These results are a quantitative description of the coordination that exists during different feeding behaviors (ingestion, intraoral transport, mastication, and swallowing) in normal, freely functioning hyraxes. The patterns of phase duration differ from some results obtained by using anesthetized animals.

Effect of monocyclic derivatives on DNA repair in human lymphocytes.

Several monocyclic compounds, widely used industrially, were observed to inhibit semiconservative DNA synthesis and DNA repair synthesis in human peripheral lymphocytes. The compounds were: anisole, rho-cresol, butylated hydroxytoluene, butylated hydroxyanisole, 2-tert-butyl-4-methylphenol,2,6-di-tert-butyl-4-nitrosophenol and rho-methoxyphenol.

Mechanism of intra-oral transport in a herbivore, the hyrax (Procavia syriacus).

Movements in the jaw, tongue and hyoid during feeding behaviour were recorded with cine-X-ray. Food was moved through the mouth by anterior/posterior motion of the tongue surface relative to the hard palate. This was true for both stage I transport, from the front of the mouth to the molar tooth row and stage II transport, from the molar tooth row to the vallecular area of the oropharynx. During a series of chew cycles, processed food collected in the oropharynx prior to a swallow. Swallows occurred as discrete events punctuating chew sequences and were characterized by coordinated movements of tongue and soft palate. Similar mechanisms of transport have been observed in the opossum and the cat, indicating a common mammalian behaviour. Differences between this herbivore and anthropoid primates can be attributed to differences in anatomy of the oral apparatus.

Mechanism of intraoral transport in macaques.

All mammals have the same divisions of cyclic movement of tongue and hyoid during mastication: a protraction or forward phase that begins at minimum gape, and a retraction or return phase. Nonanthropoid mammals transport food from the oral cavity to the oropharynx during the return phase; food on the dorsal surface of the tongue moves distally while the tongue is retracted. Macaques, however, transport food during the protraction phase of tongue/hyoid movement. Food is squeezed posteriorly by contact between the tongue surface and the palate anterior to the food. This mechanism of transport is occasionally seen in nonanthropoid mammals when they are transporting liquids from the oral cavity to the oropharynx. It has, however, not been seen when these mammals transport solid food. One morphological basis for this difference is the reduction in height of the rugae of the palate of macaques. In most mammals these rugae are pronounced ridges that are able to hold food in place during protraction as the tongue slides forward beneath the food. Anthropoids and other mammals differ in the way they store food prior to swallowing. When macaques transport food to the oropharynx, usually they swallow in the next cycle, but always in the next 2 or 3 cycles. Most mammals transport and store food in the oropharynx for several cycles before a swallow clears that region of food. This behavior is correlated with differences in morphology of the oropharynx; anthropoids have reduced valleculae, the area in which other mammals store food prior to swallowing.

Interaction between ethanol and antihistamines: 3. mebhydrolin.

We used 17 student volunteers in an experiment to investigate the effects of orally administered mebhydrolin (0.71 mg/kg), alone and in combination with ethanol (0.75 g/kg), on perceptual, cognitive and motor functions. Mebhydrolin did not significantly modify performance when given alone, but showed evidence of enhancing ethanol-induced performance deficits. Histamine challenge experiments indicated that the dose of mebhydrolin used exerted an antihistaminic effect over the period of the ethanol interaction study.

Yeast mitochondrial DNA characterization after ultraviolet irradiation.

Yeast mitochondrial (mtDNA) 3H-labelled was isolated from exponential phase cells after ultraviolet light irradiation. Both the size and amount of mtDNA were found to be reduced during a 40-h liquid-holding (LH) period in non-growth medium following irradiation as compared to the mtDNA recovered from nonirradiated cells under similar conditions. After the LH period, previously irradiated cells were resuspended in growth medium containing [14C]adenine. Double labelled mtDNA (3H and 14C) was isolated from cell samples removed during new growth. A recovery in the amount and size of mtDNA was observed in irradiated cells during new growth. These biochemical studies agree with the observed loss and recovery of mtDNA genetic markers in UV-irradiated exponential phase yeast after a period of LH and new growth resp.

The interaction between ethanol and antihistamines: 2. Clemastine.

Eighty paid student volunteers (35 male, 45 female) were used in an experiment to investigate the effects of a therapeutic dose of clemastine (1 mg) alone and in combination with a social dose of ethanol (0.54 g/kg) on perceptual, cognitive and motor functions. Both drugs were given orally. Clemastine did not significantly modify performance when given alone, and the performance decrements induced by ethanol were not enhanced by clemastine premedication.

The interaction between ethanol and antihistamines. 1: Dexchlorpheniramine.

Thirteen paid student volunteers (9 male, 4 female) were used in a double-blind crossover experiment to investigate the effects of a therapeutic dose of dexchlorpheniramine alone, and in combination with a social dose of ethanol on perceptual, cognitive and motor functions. Both ethanol (0.75 g/kg) and dexchlorpheniramine (4 mg/70 kg) were given orally. Although a synergistic effect of dexchlorpheniramine with ethanol was only observed in some of the tests, a delayed recovery from the effects of the combination was noted. Subjective data indicated that the sedative effects of dexchlorpheniramine were more pronounced in the presence of ethanol.

Ethanol and delta9-tetrahydrocannabinol interactive effects on human perceptual, cognitive and motor functions. II.

Fifteen paid student volunteers (10 male, five female) were used in a double-blind crossover experiment to further investigated the effects of delta9-tetrahydrocannabinol (THC), alone and in combination with ethanol, on perceptual, cognitive and motor functions. Both ethanol (0-54 g/kg) and THC (15 MG/70 KG) WERE GIVEN ORALLY. Ethanol was not very effective in in+uencing performance but this dose of THC produced marked decrements, predominantly in the latter part of the experiment. When they were given together, an early additive effect was apparent, but later, there was a suggestion of antagonism in that subjects who received the drug combination performed better than those who were given THC along. The interaction between THC and ethanol was considered to be complex.

The interaction of fructose, dextrose and ethanol on human performance.

1. The effects of orally administered fructose (1.2 g.kg-1) and dextrose (1.2 g.kg-1) on the performance decrement induced by ethanol (1.0 g.kg-1) in a series of perceptual, cognitive and motor tests were studied in twelve healthy, paid University student volunteers using a double-blind cross-over design. Ethanol was consumed at a constant rate over 20 min and the hexoses or placebo were given approximately 40 min later. 2. The peak blood ethanol concentration was attained earlier when the subjects also received either hexose than after placebo but although its rate of fall was unaffected, significantly lower ethanol concentrations were encountered in the hexose-treated groups in the latter part of the experiment. 3. In general, the subjects were impaired to a slightly lesser degree when they received a combination of hexose and ethanol than after ethanol alone. There were no differences between the effects of fructose and dextrose. 4. The results do not support contentions that fructose is able to accelerate a return to sobriety and observed differences between hexose and placebo-treated groups were attributed to an effect on the absorption of ethanol rather than its metabolism.