Evaluating an Employee Health Tobacco Cessation Program for Enhanced Success

Tobacco smoking is the number one cause of preventable death in the US. It increases risk for cardiovascular and respiratory disease, diabetes, and many types of cancer. When contrasted with nonsmoking employees, smokers have a greater amount of lost productivity, as well as cost of health and life insurance claims due to illness. The purpose of this evidence-based project was to identify current smokers and monitor the consistency of their progression through the 5 A’s framework within an employee health clinic. Data was collected over two years and 600 charts were reviewed. After the data was analyzed, it was estimated that 8% of employees smoke and that both asking and advising patients to quit smoking is being completed reliably. However, improvement in the assess, assist, and arrange categories of the 5 A’s is needed. Although utilization of each of the 5 A’s steps is needed for the program’s success, future focus on improving arrange utilization by the Nurse Practitioner (NP) will allow for repeated review of each smoker’s cessation progress and barriers

From 'form' to function and back again: a comparative analysis of form-based and function-based recognition of adult relationships in law.

This thesis explores the desirability and viability of a function-based as opposed to a form-based approach to adult relationship recognition in law. It explores the benefits and difficulties with both form-based and function-based approaches to determine whether either has any significant advantage over the other, both in relation to a need to provide a system of relationship recognition that is inclusive of the diversity of family relationships formed today, and in relation to the protective and symbolic functions of family law. To do this, the thesis will compare the English and Welsh approach to relationship recognition with that adopted in Australia. The thesis will show that form- and function-based approaches share many of the same benefits and both can be flexible because they can be used in ways that are inclusive of a variety of relationship types and both approaches have their disadvantages. On balance, function-based systems appear more principled than form-based systems because they focus on the quality of the relationship and not merely on its structure and function-based systems are better placed to protect the vulnerable partner in a relationship because there is no need to opt-in for legal recognition. But, form-based systems should not be abandoned because they have the benefit of being administratively efficient, and are better placed to serve family law’s symbolic function. Both form- and function-based approaches have the potential to be used in radical ways to respond to the needs of real families, but social reality and political will limits the development of both approaches to relationship recognition

Establishing priorities on the range of conditions managed by UK community practitioner nurse prescribers: A modified Delphi consensus study

Aim: To provide national consensus on the range of conditions community practitioner nurse prescribers manage, and for which it is considered important that they can prescribe. Background: Around 35,000 community practitioner nurse prescribers in the UK are able to prescribe from a limited formulary. Although prescribing is a key role for these nurses, there has been a decline in the numbers of community practitioner nurse prescribers who prescribe. It is evident that changing patterns of client and service delivery, changes the role of community nurses and the conditions they manage, however, little is known about the conditions community practitioner nurse prescribers manage. Design and methods: A modified Delphi approach comprising three on-line surveys delivered to a national Expert Panel of eighty-nine qualified community practitioner prescribers. Data collection took place between January and March 2017. Results: Panelists reached a consensus, with consistent high levels of agreement reached, on nineteen conditions for which it is believed community practitioner nurse prescribers should be able to prescribe. Conditions identified by school nurses (n=12) and health visitors (n=7) were mainly acutely focused, whereas those identified by district nurses (n=9) and community staff nurses (n=6) included both long-term and acute conditions. Conclusion: Given the high degree of consensus, this list of conditions should influence any decisions about the items community and public health nurses should be able to prescribe. The findings should also influence the education and training of these nurses

The Grizzly, March 27, 1987

Vandals Violate Student Property • Greek Week • Comprehensive Conflicts • Letter: Brothers Give Thanks • Future Changes for Ursinus • English Comprehensive Anxieties • Table Talk • Students Should Become Aware of Career Aid Opportunities • Lent, Wood Lead Ursinus at ECAC\u27s • Men\u27s Outdoor Track Upsets F&M • Lacrosse Opens Defense of National Crown • Golfers Win • Men Netters Split • Women\u27s Tennis Upsets Widener • Bears Leave Del. Val. Blue • Wentzel, Nelson Shut Down Widener • Wrestlers Lauded for Academics • O\u27Donohue Runs to All-American • WVOU Makes Waves • Hall Highlights Women\u27s Studies • Notes: Cub & Key Add Junior Members; Forum on Ethnic Writers; Richter Lectures to Community • The Bear Facts • Flamin\u27 Caucasians to Rock Ursinus • CAB Comedy Night a Laugh • Ursinus Receives Educational Grant • College Choir to Perform Elijahhttps://digitalcommons.ursinus.edu/grizzlynews/1186/thumbnail.jp

The effect of web based depression interventions on self reported help seeking: randomised controlled trial [ISRCTN77824516]

BACKGROUND: To date, there has been very little work investigating behaviour changes induced by interventions that are designed to increase help seeking. The present paper examines the effects of two Internet depression websites on help seeking. METHODS: 414 individuals with elevated scores on a depression assessment scale were randomly allocated to a depression information website, a cognitive-behavioural skills training website (CBT) or an attention control condition. Reports of help seeking for specific treatments, from specific sources and for categories of treatments were assessed. RESULTS: Relative to the control, the depression information site was associated with decreases in seeking support from friends and family, the use of music and of everyday treatments and no increase in seeking evidence based interventions. The CBT site was associated with the report of help seeking for CBT, massage and exercise. CONCLUSION: Methods to encourage the use of evidence-based treatments need further research to determine whether the assistance sought is evidence based and whether there are unintended effects

The Grizzly, April 10, 1987

Pfahler Hall Flooded • L.C.B. Visits a Second Time • Our Town Debuts • Letters: Director of Security at Sheraton Responds to Student Attack on Lorelei; Brothers of AXE Commended; Grizzly Dogged • Skunked Again • Students to Participate in Model UN Conference • Salamanca to Relate Experiences on Terrorism • Bard Graces Ursinus • Notes: UC / St. Joseph\u27s Host MBA Summer Session; Myrin Holds Semi-Annual Book Sale; New Resident Assistants Announced • Athlete of the Week: Kim Wentzel • Santangelo, O\u27Malley Jump Lady Bears to 6-0 Start • Women\u27s Tennis Served Tough Losses • Track\u27s Record: Record Breaking • Ursinus\u27 Champion Lacrosse Team: Vying for Fourth National Title • Opposition Unfavorable to Bears • Golf Team Drives Record to 8-0 • Softball Assumes First Place Position • Room Selection to Start • The Joshua Tree Rates an A • Young Democrats: Exhibiting New Challenges for the Future • Advanced TV Class Produces Ursinus Magazine For Cable Network • Arbor Day Trees Grow Money • Bear Facts: Ursinus Mascot Bearly Knownhttps://digitalcommons.ursinus.edu/grizzlynews/1187/thumbnail.jp

Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? : An individual participant data meta-analysis

BACKGROUND: Little is known about potential harmful effects as a consequence of self-guided internet-based cognitive behaviour therapy (iCBT), such as symptom deterioration rates. Thus, safety concerns remain and hamper the implementation of self-guided iCBT into clinical practice. We aimed to conduct an individual participant data (IPD) meta-analysis to determine the prevalence of clinically significant deterioration (symptom worsening) in adults with depressive symptoms who received self-guided iCBT compared with control conditions. Several socio-demographic, clinical and study-level variables were tested as potential moderators of deterioration. METHODS: Randomised controlled trials that reported results of self-guided iCBT compared with control conditions in adults with symptoms of depression were selected. Mixed effects models with participants nested within studies were used to examine possible clinically significant deterioration rates. RESULTS: Thirteen out of 16 eligible trials were included in the present IPD meta-analysis. Of the 3805 participants analysed, 7.2% showed clinically significant deterioration (5.8% and 9.1% of participants in the intervention and control groups, respectively). Participants in self-guided iCBT were less likely to deteriorate (OR 0.62, p < 0.001) compared with control conditions. None of the examined participant- and study-level moderators were significantly associated with deterioration rates. CONCLUSIONS: Self-guided iCBT has a lower rate of negative outcomes on symptoms than control conditions and could be a first step treatment approach for adult depression as well as an alternative to watchful waiting in general practice

Efficacy of Self-guided Internet-Based Cognitive Behavioral Therapy in the Treatment of Depressive Symptoms : A Meta-analysis of Individual Participant Data

IMPORTANCE Self-guided internet-based cognitive behavioral therapy (iCBT) has the potential to increase access and availability of evidence-based therapy and reduce the cost of depression treatment. OBJECTIVES To estimate the effect of self-guided iCBT in treating adults with depressive symptoms compared with controls and evaluate the moderating effects of treatment outcome and response. DATA SOURCES A total of 13 384 abstracts were retrieved through a systematic literature search in PubMed, Embase, PsycINFO, and Cochrane Library from database inception to January 1, 2016. STUDY SELECTION Randomized clinical trials in which self-guided iCBT was compared with a control (usual care, waiting list, or attention control) in individuals with symptoms of depression. DATA EXTRACTION AND SYNTHESIS Primary authors provided individual participant data from 3876 participants from 13 of 16 eligible studies. Missing data were handled using multiple imputations. Mixed-effects models with participants nested within studies were used to examine treatment outcomes and moderators. MAIN OUTCOMES AND MEASURES Outcomes included the Beck Depression Inventory, Center for Epidemiological Studies-Depression Scale, and 9-item Patient Health Questionnaire scores. Scales were standardized across the pool of the included studies. RESULTS Of the 3876 study participants, the mean (SD) age was 42.0 (11.7) years, 2531 (66.0%) of 3832 were female, 1368 (53.1%) of 2574 completed secondary education, and 2262 (71.9%) of 3146 were employed. Self-guided iCBT was significantly more effective than controls on depressive symptoms severity (ß =-0.21; Hedges g = 0.27) and treatment response (ß = 0.53; odds ratio, 1.95; 95% CI, 1.52-2.50; number needed to treat, 8). Adherence to treatment was associated with lower depressive symptoms (ß =-0.19; P =.001) and greater response to treatment (ß = 0.90; P <.001). None of the examined participant and study-level variables moderated treatment outcomes. CONCLUSIONS AND RELEVANCE Self-guided iCBT is effective in treating depressive symptoms. The use of meta-analyses of individual participant data provides substantial evidence for clinical and policy decision making because self-guided iCBT can be considered as an evidence-based first-step approach in treating symptoms of depression. Several limitations of the iCBT should be addressed before it can be disseminated into routine care