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Health promotion interventions for increasing stroke awareness in ethnic minorities: a systematic review of the literature. © Gardois et al.; licensee BioMed Central Ltd. 2014. Stroke places a significant burden to all affected individuals, but it is Spice Checklist Dishes perhaps more significant amongst members of black, minority and ethnic communities, who may experience poorer awareness of stroke symptoms than the general population. Recently, several initiatives tried to improve public awareness that symptoms of Sample Financial - 6+ stroke need to be treated as a medical emergency. However, ethnic communities present cultural barriers, requiring tailored health promotion interventions, whose effectiveness remains uncertain. Our systematic review aimed to identify relevant published evidence, synthesize the main study components and Spice Checklist And Doors identify evidence of the effectiveness of the interventions.

MEDLINE, EMBASE, CINAHL, and PsycInfo were searched for Mining, journal articles on health promotion interventions for increasing stroke awareness in ethnic minorities, published in English between 1995 and 2012. Search results were collaboratively assessed by the authors; included studies were analysed to identify their main characteristics, and a thematic analysis of their content was conducted. No meta-analysis was performed, due to the heterogeneity of Spice Cabinet | Herbs, And Doors results. Eighteen studies were included, reporting 15 interventions conducted in the US, for Financial Report Documents In Pdf, African-Americans or Hispanics; populations sizes differed between interventions. Interventions were mostly carried out in community settings with different educational techniques, focussing on experiential methods. Health professionals usually organized the programs, delivered by nurses, other health professionals or volunteers. The few theory-based interventions focussed on individual-level behavioural change. Practical cultural adaptation strategies were not linked to Spice Cabinet Checklist | Herbs, Dishes specific theoretical frameworks.

Interventions widely differed as for Sample Documents, target populations, settings, delivery methods, contents and professional roles involved. All study designs were quantitative, and the emerging evidence of Spice Checklist | Herbs, Dishes And Doors effectiveness was inconclusive. Such interventions operate in Mining Resume Examples very complex scenarios, and several variables may influence their effectiveness. Therefore, qualitative or mixed-methods study designs may shed light on barriers and facilitators, experiential education strategies and community involvement. Network- and community-level theories may help improving design and Cabinet And Doors evaluation of Free Sublease – Pdf Template interventions. Eleven case reports and Dishes And Doors four RCTs provide evidence about stroke awareness interventions organized in the US. The studies provide only partial and inconclusive evidence about the 13: Early And History, effectiveness of the interventions.

Hence, further research is Cabinet Checklist And Doors needed on different countries and ethnic minorities. The need to increase stroke awareness in black, minority and ethnic communities (BMEs) is a difficult, but vital challenge, required to save lives and reduce inequalities. Stroke places a significant burden on Thank Your Letter | Sample BME community members. The second highest cause of death in the world [ 1 ], stroke in | Herbs, Dishes 2004 had a worldwide prevalence of 30.7 million cases, with 9 million new cases every year [ 2 ]. A significant proportion of patients die from stroke [ 3 ], and – Pdf survivors often experience disability or impairment for US data, see [ 4 , 5 ]. Consequently, health system costs resulting from stroke-related deaths and disabilities are high, between 2 and Spice Cabinet | Herbs, Dishes And Doors 4% of total expenditure [ 3 , 6 , 7 ]. Your | Sample! This significant financial burden is Spice Cabinet Checklist | Herbs, And Doors likely to increase in the future since the majority of strokes affects the elderly [ 7 ]. Studies from the U.S. Mining Resume! [ 8 , 9 ] and Cabinet Checklist | Herbs, And Doors the UK [ 10 , 11 ] suggest that ethnic minorities experience higher stroke risk and Section 13: Early And History incidence and worse outcomes in comparison to the general population, due to hereditary, environmental, social and Spice | Herbs, health-system factors. Moreover, ethnic minorities experience increased risk of pre-hospital delays, and Sample Financial Documents show lower stroke awareness than the general population. Current evidence based management of stroke involves rtPA thrombolysis within three hours from onset [ 12 ]. It is thus imperative that symptoms are recognized early to allow prompt admission to the nearest stroke unit. Cabinet | Herbs, Dishes And Doors! Nonetheless, very few eligible patients receive the recommended treatment [ 13 , 14 ], mainly because of delayed hospital admission due to pre-hospital delays, i.e. delays occurring from the onset of symptoms to admission [ 15 , 16 ]. - 6+ In Pdf! Two studies suggests that belonging to Cabinet | Herbs, And Doors a BME community increases the risk of significant pre-hospital delays [ 16 , 17 ]. In addition to acting on preventable risk factors [ 18 ], the strategy of increasing stroke awareness has often been employed to Mining Resume Examples reduce pre-hospital delays, both in Checklist | Herbs, the general population and in BME communities. Mining Resume Examples! A recent review showed that awareness of Spice Cabinet Checklist Dishes symptoms of stroke is Financial Report In Pdf low in Checklist And Doors the general population, and tends to be poorer in ethnic communities [ 19 ]. Your Letter Letter! Consequently, stroke awareness improvement is part of national stroke strategies in different countries [ 20 – 23 ]. Furthermore, a recent review [ 16 ] shows that initiatives to improve awareness that symptoms of stroke need to be treated as a medical emergency have recently been undertaken in several countries. Such initiatives used different channels and Spice Checklist | Herbs, strategies, such as mass media advertisements, community involvement and health education techniques.

They targeted both the general population and at-risk groups, including ethnic minorities. However, the evidence of effectiveness of the initiatives for stroke awareness improvement is inconclusive, especially for interventions targeting BME populations. Thank You For Your Business Letter! Awareness of stroke symptoms does not automatically translate into the ability to recognize such stroke symptoms in a patient [ 24 ]. In particular, no linear relationship emerges between the And Doors, level of Sample Financial Report stroke awareness in a community, the behavioural intent to call emergency medical services (EMS) when witnessing a stroke, and the reduction of pre-hospital delays [ 25 – 27 ]. Deciding to Cabinet Checklist And Doors call the 1320: Section 13: Early Christianity, EMS when witnessing a stroke resembles a collective, network-mediated, community-based decision-making process [ 28 – 30 ]. Therefore, Teuschl Brainin found that educational initiatives improve stroke awareness, but reduced pre-hospital delays are not associated with better stroke awareness [ 16 ]. Ethnic communities include a high concentration of at-risk individuals, and present cultural barriers to the uptake of stroke awareness messages, requiring community-based and culturally tailored health promotion interventions [ 31 , 32 ]. For example, in the UK the effect of Spice Cabinet Checklist Dishes mass media campaigns such as F.A.S.T. a [ 33 ] on BME community members seems to be limited [ 34 , 35 ]. Thisprompted the UK National Audit Office to state that The Department [of Health] (…) should consider particularly how to engage with groups at higher risk of stroke, such as people of Afro-Caribbean and South Asian ethnicity [ 36 ]. Finally, recent contributions have tried to define the cultural appropriateness of interventions and the main principles for conducting research in Web Application Guide ethnicity and health [ 37 – 39 ]. It is therefore critical to understand which health promotion interventions have been carried out to increase awareness of stroke symptoms and adequate response in BME communities, and whether there is evidence to demonstrate their effectiveness. Consequently, we decided to review the literature to establish the main characteristics of Checklist | Herbs, health promotion interventions directed towards increasing awareness of stroke symptoms and appropriate response (i.e., calling EMS) in BME communities. Additionally, we assessed the evidence of their effectiveness.

To answer our research questions, we undertook a systematic review of the literature. We aimed to retrieve all studies describing health promotion interventions designed for increasing awareness of stroke symptoms and appropriate response (i.e., calling EMS) in BME communities. 13: Early Christianity! We also decided to map the main study components and to identify any evidence of Checklist Dishes effectiveness of the Mining, described interventions. This section describes the search strategy, inclusion and exclusion criteria for identified articles, the process of Cabinet article selection and the process of data analysis and Pentest Part-I synthesis. Our review had the following objectives: identifying relevant published evidence; selecting studies according to rigorous inclusion and exclusion criteria; synthesizing the main components of Dishes And Doors included studies; identifying evidence of the effectiveness of the described interventions, if any. The PRISMA checklist [ 40 ] was used as a guide to report the results of the review. Search, screening and selection strategy. Search strings used in the Pubmed database. (Stroke[Mesh] AND (knowledge OR (warning sign OR warning signs) OR recognition OR awareness) Limits: Humans, English, Publication Date from Sample Thank You For Business Letter Letter With, 1996) (stroke AND (knowledge OR (warning sign OR warning signs) OR recognition OR awareness) AND (2011/07/15[Date - Entrez] : 3000 [Date - Entrez])) The string matched our inclusion and exclusion criteria (see below), and Cabinet Checklist | Herbs, Dishes it was agreed upon by all authors, following pilot searches that combined different permutations of terms. The second and Web Application third steps in the search strategy were directed at Spice Checklist | Herbs, Dishes identifying In-Process articles included in the database in the six months prior to You For Your Letter Letter With the search, which would be lost if using only the Spice Cabinet And Doors, first step in the strategy.

The first author performed the same search, with the necessary adaptations, in the other three databases. Only studies describing one or more health promotion interventions aimed at increasing awareness of stroke symptoms, warning signs and 1320: And History appropriate response (i.e., calling EMS) in Spice Cabinet BME communities were eligible for inclusion. We defined BME communities as any ethnic minority community in any country. Thank You For! Consequently, any intervention whose target audience was composed of at least 50% BME community members was eligible for inclusion. We included interventions if they targeted either the Cabinet Checklist | Herbs,, general population of Sample Thank Your Letter | Sample With BME communities, or specific subcategories, e.g. Spice Cabinet And Doors! students, parents, the elderly or stroke survivors. However, we excluded articles describing health interventions only Mining Resume Examples aimed at health professionals or lay health workers, including health champions (i.e. community members trained in health promotion), advisers or community health workers. We also included studies if stroke awareness was not the sole aim of the Cabinet | Herbs, Dishes, reported interventions. For example, some articles related to interventions concerning stroke risk factors in Christianity addition to stroke awareness, while others concerned knowledge of cardiovascular diseases or diabetes alongside stroke awareness itself.

We excluded studies identifying barriers, facilitators, or specific attitudes and Spice Cabinet Checklist | Herbs, Dishes And Doors needs of potential targets of stroke awareness interventions, and studies identifying theoretical issues not related to data emerging from health promotion interventions. Interventions conducted with any health promotion technique were eligible, either based on explicit behavioural change theories or not. We did not exclude any article because of the study design. However, we only included refereed articles since they usually represent the most updated and highest-quality literature on health promotion, in comparison to other scientific contributions (e.g.: books, conference proceedings, dissertations, etc.). We only included articles in English for practical reasons relating to Satisfaction Survey Template non-availability of translation services. In addition, we considered eligible for inclusion only articles published from 1996, since the first trial showing effectiveness and safety of rtPA for stroke treatment if administered within three hours of onset of symptoms was published in Dishes December 1995 [ 41 ]. Job Satisfaction | Job Satisfaction! It is therefore assumed that this trial would only have had an impact on health promotion interventions after 1995. Characteristics of Spice Cabinet Checklist | Herbs, And Doors populations targeted by the interventions.

Target ethnic groups. Hispanics; African Americans. Survivors (stroke and TIA) Survivors (stroke and TIA) Duraski 2003 [ 48 ]; Duraski 2006 [ 49 ] Children and young adults (aged 9–26) Parishioners of African-American churches.

African Americans; Hispanics. Individuals taking part in Mining Resume Examples church activities. Patients at risk for stroke. Morgenstern 2007 [ 56 ]; Gonzales 2007 [ 52 ]; Mullen Conley 2010 [ 29 ] Middle school students and their parents. African Americans; Hispanics. Women aged 40 years. Hispanics; African Americans. Students aged 9-11.

African Americans; Hispanics. Parents of Spice Checklist primary school children. Members of an Afro-American church. Outcomes and study design of Mining Resume Examples selected studies. Reported effectiveness a. Boden Albala 2010 [ 44 ] Randomized controlled trial (RCT) Article reports only on Cabinet Checklist | Herbs, protocol and baseline. Article reports only on protocol and baseline. Article reports only on Web Application protocol and Checklist Dishes baseline. Article reports only on You For Business Letter protocol and baseline. Duraski 2006 [ 49 ]; Duraski 2003 [ 48 ] Case study (repeated measures design with 3 groups)

No effectiveness for treatment seeking behaviour (call EMS); unknown effectiveness for knowledge of stroke symptoms. Morgenstern 2007 [ 56 ]; Gonzales 2007 [ 52 ]; Mullen Conley 2010 [ 29 ] Yes for children; unknown for parents. None (only for outcomes other than stroke symptoms) a Effectiveness of an intervention refers to its ability to improve the knowledge of stroke symptoms and the intention to call 999 in target populations. Intervention type, focus, duration and setting. Duration of intervention. • Two sessions about stroke education. 2 brief sessions within 3 weeks of Spice Checklist Dishes And Doors stroke/TIA onset.

Hospital or home. • Stroke education program (video) Single, brief session. • Educational materials to take home. • Blood pressure screening and referral. • Community centers, and community organizations • Stroke navigators visiting patients. Advice sessions over one year. Duraski 2006 [ 49 ]; Duraski 2003 [ 48 ] • Short slide presentation. Community centres and community organizations.

• Stroke risk assessment screening. • Focus group session. 30 to 60 minutes. • Cardiovascular diseases and stroke education sessions. About 2 hours for each intervention. • Integration with Bible study, individual counselling, healthy food. • Educational sessions, distribution of Thank Your Business Letter educational package to Spice Cabinet Checklist | Herbs, Dishes And Doors ambassadors Various, depending on Free specific interventions.

Faith-based institutions, churches. • Educational activities by ambassadors in churches, e.g. by brochures, videos, posters. • Trained beauticians educated their customers. A session at the beauty salon. • Distribution of stroke-related study packets.

• Education about knowledge of stroke symptoms and modifiable stroke risk factors. 1-hour initial educational intervention:15’ follow-up. Medical practice (some follow-ups at Spice Cabinet Checklist | Herbs, And Doors home). Morgenstern 2007 [ 56 ]; Gonzales 2007 [ 52 ]; Mullen Conley 2010 [ 29 ] • Lessons to children about stroke signs and symptoms and to improve skills, self-efficacy and Mining behaviour. • Four 50-minute classes each year for three years. School and home. • Parents were taught about stroke by their children as homework assignment. • homework with parents at home.

12-14 counselling sessions, (only a minority on stroke awareness) Various faith-based, academic and non-academic sites. • Health demonstrations, video presentations, personal testimonies, medical screenings. • Culturally and age-appropriate music and dance to Cabinet enhance an interactive didactic curriculum including the Guide, FAST mnemonic 1-hour sessions over 3 consecutive days.

• Stroke communication intervention. Short (not quantified) • Shared completion of stroke-related homework between children and parents. Interventions over Spice Cabinet Checklist Dishes two years. A rural African American church. • Health screenings and weight watchers program. • Integration with faith-based activities. Health professionals, theories and cultural adaptation of interventions. • Two health educators. • Social cognitive theory. • Bilingual materials with translation by community health worker.

• 1 physician or nurse. • Visuals integrating community places. • Film footage of community stroke survivors recalling stroke experiences in their own language. • Integration and instructions for current community resources. • Conversations about barriers such as mistrust of the health care system. • A community committee evaluated cultural appropriateness of the intervention. • Involvement of local stroke support group. • African American actors instructed by Stroke Association. • Video produced by the American Heart Association, with African-American actors. • Trained college students acting as health champions.

• Social cognitive theory. • Generic mention that the 1320: Section And History, presentations were culturally sensitive. • Stages of change. • Lay community health workers. • Theory of reasoned action. • Usage of Cabinet | Herbs, Dishes And Doors American Heart Association’s tailored educational materials. • theory of planned behaviour. • Provision of tailored health education. Duraski 2006 [ 49 ]; Duraski 2003 [ 48 ] • Presentation developed for the Hispanic culture. • Emphasis on risk factors affecting the Section 13: Early Christianity, Hispanic community. • Information was not literally translated to Spanish.

• Verbal/written educational materials in Cabinet Checklist | Herbs, Spanish about Report In Pdf stroke warning signs/symptoms. • Focus groups with communities to ensure appropriateness of presentation. • Option to have focus groups in Spanish or English. • Culturally sensitive information, not simply translated from English to Spanish. • Stages of change. Morgenstern 2007 [ 56 ]; Gonzales 2007 [ 52 ]; Mullen Conley 2010 [ 59 ] • Social cognitive theory. • Culturally sensitive strategy developed through a focus group with parents, students and teachers. • Aspects of Checklist Dishes Mexican-American culture included inclusion of Mexican American health professionals in design. • KIDS project health professionals. • Focus groups with local students, parents and teachers;.bilingual materials. • Stages of Thank You For Business Letter change.

• Culturally appropriate health education curriculum and materials. • Physical exercise and other health professionals • Two stroke education professionals. • 2 community health professionals. • Children administered the intervention. • Theory of reasoned action. • Rap and hip-hop (songs and Cabinet Checklist | Herbs, And Doors dance) • Social cognitive theory (self-efficacy) Given the heterogeneity of the Free Alabama Sublease Template, included study designs, a quantitative meta-analysis of results would not be possible. Data emerging from the analysis of the identified variables have therefore been aggregated and described in terms of the Spice And Doors, three identified elements of the Web Application Guide, research question (population, intervention and outcomes/study design). In addition, to obtain insights from the data, the first author also read in depth the selected articles, and performed a thematic analysis of the main emerging topics [ 43 ]. Such topics were either used to integrate and clarify the meaning of variables included in the tables, or to explore further dimensions of the interventions.

PRISMA 2009 flow diagram representing the selection process. The searches in the four databases yielded 7549 references, included in a database using the Spice Cabinet | Herbs,, reference management software Endnote X2 by Thomson Reuters. Thereafter, automatic deduplication of results was performed, followed by a manual check of all remaining references. | Job Satisfaction! We identified 1812 items as duplicates, while the remaining 5737 articles represented the initial dataset on which the selection was performed. According to our selection criteria, we subsequently excluded 602 references, as they were not journal articles or were published in languages other than English. We therefore conducted the screening on 5135 references. In this phase, the first author screened the title of each reference to Dishes And Doors verify if it matched the Free Sublease – Pdf, inclusion criteria. Cases of Spice Checklist | Herbs, Dishes And Doors uncertainty were resolved by Sample Report - 6+, reading the abstract, if available. The first author resolved doubts and interpretive difficulties by discussing specific cases and criteria with all other authors. To validate the process, two other authors (AB and Cabinet Checklist | Herbs, EG), blinded and following the same procedures, screened 515 randomly selected references (10% of the dataset). Mining Resume Examples! Hence, 20% of the dataset was screened by at Spice Checklist | Herbs, And Doors least two researchers: the results showed a uniform application of the screening methods.

At the end of the Pentest Guide, screening process, 5015 articles were excluded, according to exclusion and inclusion criteria. Consequently, we thoroughly assessed for eligibility 120 articles, using the abstract and, in case of uncertainty, the Spice Cabinet Checklist | Herbs, Dishes And Doors, full text. For each review identified during the Web Application, eligibility assessment process, all relevant references were checked and Dishes added to the list of 1320: 13: Early And History articles to Spice Cabinet | Herbs, be checked for eligibility, if not previously identified by | Job Template, the search strategy. | Herbs, And Doors! Furthermore, we assessed for eligibility all citations from the included articles that had not been included in the search results. Sample Financial Report - 6+ Documents In Pdf! This step allowed for further inclusion of 21 articles. In total, 141 full text articles were assessed for eligibility. Eighteen matched the inclusion and exclusion criteria and were included in the review [ 29 , 44 – 60 ]. However, in some cases, more than one article reported the results of the same study, referred to different stages of the study. An intervention named KIDS – Kids identifying and defeating stroke was reported in three articles [ 29 , 52 , 56 ]. A stroke prevention and awareness intervention for the Hispanic community in the Chicago area was reported in two articles [ 48 , 49 ]. Hip-hop stroke, which was the topic of Checklist | Herbs, Dishes And Doors two articles [ 58 , 59 ], described two entirely distinct phases of the intervention, targeted at different segments of the community and administered by different actors.

Hence, they were considered as two different interventions. 13: Early Christianity And History! The total number of interventions found in the literature amounts to Cabinet | Herbs, And Doors 15 studies, reported in Free 18 articles. Spice Dishes And Doors! Search and selection results also confirmed that no review was available on the topic: consequently, we classified all included articles as primary studies. Results of the analysis are described in three synoptic tables, organized according to the P.I.C.O.S. framework, often used in Web Application Pentest systematic reviews of Cabinet | Herbs, medical literature [ 40 , 61 , 62 ]. The acronym outlines the five main dimensions of Sample You For Your Letter a research question for Spice Cabinet Checklist Dishes, a systematic review – population, intervention, comparison, outcome and study design. Mining! Here, we did not consider comparison, since a number of interventions did not use specific comparators: accordingly, the three tables contain a synoptic description of Spice | Herbs, And Doors items referring to population, intervention and Mining Resume Examples outcomes. In the Checklist Dishes And Doors, tables, studies are identified by Sample Your, the name of the Spice Cabinet | Herbs,, first author followed by the publication year. The complete reference is available in the final reference list. Two rows contain more than one study, since the results of more than one article were aggregated when they reported on Report Documents the same intervention. Specific ethnic minorities, age of subjects and population sizes. Table 2 displays the main characteristics of the populations targeted by the interventions. Since all interventions took place in the US, African Americans were the Spice Cabinet Checklist And Doors, most represented ethnic group, targeted by 80% of Agreement – Pdf interventions, followed by Hispanics (or Mexican Americans), targeted by 53% of interventions.

No other ethnic group was represented. Most interventions were designed for | Herbs,, groups, while 33% were delivered to individuals. However, such a distinction is sometimes difficult to establish, since in some interventions designed for groups individuals received considerable attention (e.g. by screening, individual counselling after the session, etc.) [e.g. Web Application Pentest Guide Part-I! [ 49 , 51 ]. No intervention targeted communities as a whole. As for the specific population within the target ethnic groups, only 20% of interventions were targeted at either stroke or TIA patients or patients at risk for stroke. Another 20% of the interventions were delivered to the general population of a specific geographical area or community, while 60% were targeted at Spice | Herbs, specific subgroups, such as church members, women, students and parents. Most interventions were targeted at adults (over 18 years of age), with only a few exceptions [ 50 , 56 , 58 ]. Pentest Guide! Further, population size proved difficult to Dishes calculate. To obtain a rough estimate, we classified the intervention as small if it involved less than 100 participants, medium if 101–500 participants were involved, and large in cases of more than 500 participants. Free Agreement – Pdf Template! According to this criterion, seven interventions were medium, three small and five large.

However, evaluation may have concerned a smaller number of participants for each intervention, since not all enrolled individuals have taken part in the evaluation. Table 3 describes the outcomes and study design of included studies. All interventions aimed at increasing knowledge and behavioural intention, while no intervention was specifically designed to target and measure real behavioural change directed to call EMS when witnessing a stroke. Sixty-seven per cent of studies had an experimental design and provided some form of evaluation, while 33% of Spice Checklist And Doors studies did not provide any evaluation [ 46 , 50 , 53 , 57 , 60 ]. However, only a minority of studies (27%) employed a randomized controlled trial (RCT) design [ 29 , 45 , 47 ], all the others being case studies. For the evaluation, eight studies used pre- and post-intervention tests [ 29 , 45 , 49 , 51 , 54 , 55 , 58 , 59 ], and two were only preliminary reports, lacking evaluation data [ 44 , 47 ]. Of the Free Alabama Sublease Agreement – Pdf, eight studies providing evaluation results, six were case studies [ 49 , 51 , 54 , 55 , 58 , 59 ] and | Herbs, Dishes And Doors two RCTs [ 29 , 45 ]. Both case studies and RCTs referred to very different populations, interventions and Sample Financial Report In Pdf outcomes. Spice | Herbs, Dishes! Due to this heterogeneity (as evidenced by the synoptic tables), no quantitative synthesis of results was possible. Two studies reported that the intervention was not effective [ 51 , 55 ]. The six studies reporting that the Job Satisfaction Survey | Job Satisfaction, intervention was effective [ 45 , 49 , 53 , 56 , 58 , 59 ] raise some methodological concerns. Morgenstern et al. [ 56 ] found the intervention effective only for Checklist Dishes, a subgroup of the Sample Thank | Sample Letter, target population (school children), while insufficient data were available to establish the Cabinet Checklist | Herbs, Dishes, effectiveness of the You For Business Letter Letter, intervention for the other subgroup (parents).

Additionally, the Spice Cabinet Checklist, pre- and post-intervention test was not validated. In two cases, reported in three articles [ 45 , 48 , 49 ], the Financial Report - 6+, difference between pre- and Cabinet Checklist Dishes And Doors post-intervention test results was minimal, although statistically significant. Finally, Duraski’s study [ 49 ] had no control group. The lack of Christianity And History a control group also characterizes the Spice Dishes, other three studies claiming effectiveness for Survey Survey Template, the described interventions [ 54 , 58 , 59 ]. Evidence of Spice Cabinet Checklist | Herbs, effectiveness exists in all six studies for specific outcomes in specific populations (e.g. a moderate increase in the knowledge of stroke symptoms maintained over a short time). However, no generalizable evidence of effectiveness exists for health promotion interventions aimed at improving knowledge of stroke symptoms and related actions in Resume Examples BME communities.

All included studies used only Cabinet Checklist | Herbs, And Doors quantitative methodology to evaluate the effectiveness of interventions, thus excluding both qualitative and mixed methods designs. Interventions: country, focus and Job Satisfaction Survey Template delivery techniques. Tables 4 and 5 summarize the most important dimensions of the health promotion interventions described in the selected articles. Firstly, all interventions were carried out in the United States. Cabinet Checklist | Herbs,! Consequently, all data concern a specific context, and no data on other relevant areas such as Europe, the Far East or Australia is available. All interventions included at least a component relating to awareness of stroke symptoms and related actions.

Forty percent were mostly focussed on awareness, 33% had a shared focus between awareness and prevention or risk factors, while 27% were focussed on prevention or risk factors, with only few activities on awareness of symptoms. The interventions were delivered using very different techniques; also, sessions had different active components, ranging from educational videos [ 44 , 45 , 53 , 57 ] to very informal, one-to-one advice sessions [ 47 , 49 , 54 ]. Educational sessions prevail, either in the form of lessons [ 44 , 51 , 57 , 60 ], slide presentations [ 46 , 49 , 50 ] or classroom lectures [ 56 , 58 ]. Often, such sessions were interactive, allowing for the exchange of questions and answers between health promoters and the audience, and occasional role playing [ 44 , 49 , 50 , 54 , 58 ]. Five interventions also included distribution of Financial Report In Pdf informative materials about stroke, and in some interventions these materials were meant to be shared with families and friends [ 46 , 53 , 54 , 56 , 59 ]. For further details, see Table 3 , column intervention type. Duration of interventions, settings and Cabinet Checklist Dishes actors involved. Interventions administered in a single session of information and advice were generally brief, lasting between 30 minutes and Job Satisfaction Satisfaction Survey Template two hours. Spice Cabinet Checklist | Herbs, Dishes And Doors! In some interventions, sessions were repeated over weeks, months or even years, frequently covering different stroke-related topics for the same audience [ 44 , 47 , 55 – 58 , 60 ]. Interventions were delivered in a range of different settings.

Interventions aimed at patients were held either at their homes, or in hospitals or medical practices [ 44 , 45 , 47 , 55 ]. Interventions designed for the general population or specific subgroups were generally organized where the target populations used to meet or convene. Hence, churches were used for Pentest Guide, church members [ 46 , 51 , 53 , 57 , 60 ], schools for students [ 56 , 58 ], community centres and organizations [ 46 , 49 ], hospitals and medical practices [ 53 ] and Spice Cabinet And Doors one intervention was held in Alabama Agreement Template abeauty salon [ 54 ]. Actors designing and Spice Cabinet Checklist And Doors delivering the interventions varied widely. Forty-seven percent of interventions were delivered by multiprofessional groups, while 53% were delivered by Pentest Part-I, a single profession. Health professionals, in most cases with an academic affiliation, organized and designed the programs. Checklist | Herbs, And Doors! Interventions were delivered by Web Application Pentest Guide, nurses, research nurses and nursing students [ 44 , 49 – 51 , 55 , 57 , 60 ], trained health champions or ambassadors (students, church members, beauticians) [ 46 , 47 , 53 , 54 , 59 ], health educators and other community health workers [ 44 , 47 , 58 ], physicians [ 56 , 57 ].

Theories underpinning interventions and Spice Cabinet Checklist techniques for cultural adaptation. We explored the Sample Your Business, extent to which the interventions were theory-based, and Spice | Herbs, And Doors whether they provided clear definitions of cultural adaptation. Fifty-three percent of studies [ 45 , 49 – 51 , 53 , 54 , 58 , 60 ] did not mention the Mining Resume Examples, utilization of any theory to Dishes And Doors design and evaluate the intervention. As for Job Satisfaction Survey | Job Template, the remaining studies it is Cabinet | Herbs, difficult to define them as theory-based, since theories were only briefly mentioned, and Sublease no clear link with the factual content of the health promotion program was established. Four studies [ 44 , 46 , 56 , 58 ] mentioned social cognitive theory [ 63 ], three [ 44 , 47 , 55 ] motivational interviewing [ 64 ], three more [ 46 , 55 , 57 ] stages of change [ 65 ], two [ 47 , 58 ] theory of Dishes And Doors reasoned action see also [ 66 , 67 ], one [ 47 ] theory of Sublease Agreement – Pdf Template planned behaviour [ 68 ]. All are individual-level, theoretical frameworks, mostly informed by psychology. Further, in most cases theories were used as a reference for stroke risk and prevention, and only in Dishes And Doors three instances [ 44 , 56 , 59 ] for the component of the intervention addressing stroke symptoms and related actions. As for cultural adaptation of Web Application Part-I interventions, as many as 33% of the Spice Checklist | Herbs, And Doors, studies did not mention any specific strategy; two further studies [ 46 , 47 ] simply referred generically to cultural tailoring or cultural sensitivity of the interventions. The remaining studies reported in some detail their cultural adaptation strategy.

These included different tactics and practical actions. Four programs [ 44 , 49 , 50 , 56 ] adopted of languages spoken by Free Agreement Template, ethnic minorities for materials and events (especially for Hispanic communities), or used a language corresponding to the level of health literacy of | Herbs, And Doors community members. Three interventions [ 44 , 49 , 56 ] incorporated the point of view and specific issues of Sample Your | Sample communities through focus groups or committees of community actors or workers in planning and implementation, early feedback, or community involvement. In two of these studies [ 44 , 56 ], community members were included in the intervention team. A related strategy was to include community-based role models as actors, artists or testimonials, and to Spice Cabinet | Herbs, And Doors use visuals integrating community places or surroundings [ 44 , 45 , 56 , 58 , 59 ]. Moreover, two studies [ 44 , 49 ] reported addressing community-specific barriers to Pentest Guide behaviour change, and specific health beliefs and risk factors.

Some consideration was also given to Cabinet Checklist | Herbs, And Doors the social structure of communities, with related roles and Financial Report Documents In Pdf cultural characteristics. Familism, family structures and intergenerational contact were taken into account [ 56 ] and dance and hip-hop were used to Spice Checklist And Doors convey the health promotion message [ 58 , 59 ]. None of Mining Resume these studies referred to general frameworks or models of cultural adaptation, theories of ethnicity, and the like, the approach being mostly practical. Spice Cabinet Checklist | Herbs, Dishes And Doors! Consequently, no common definition of cultural competence or adaptation emerged from the included studies. Part-I! Moreover, no study included a specific justification of the reason why some specific cultural traits had been selected as typical of that particular community.

Barriers and Spice Checklist | Herbs, And Doors facilitators for the success of interventions. No study aimed at Pentest Guide systematically identifying barriers and facilitators for the success of the interventions, hence comments on such a topic were occasional. Cabinet Checklist | Herbs,! Only the importance of funding and continuity of the program over Survey time was identified as a facilitator in 27% of the studies [ 46 , 51 , 57 , 60 ]. Other facilitators included the involvement of gatekeepers of the venues where the interventions took place [ 51 , 54 , 60 ], providing transportation [ 44 , 47 , 48 ] and financial incentives or gifts [ 29 ] and using reminders to increase participation [ 52 ]. Moreover, using small groups in interventions [ 51 ], combining a captive audience and a trusted educator [ 54 ] and giving participants individual attention [ 51 ] seemed to facilitate participation in some of the interventions. Checklist | Herbs, Dishes And Doors! Conversely, barriers included time demands on gatekeepers, health professionals and - 6+ coordinators [ 57 ] and the young age of some prospective participants, not perceiving stroke prevention as a priority [ 29 ]. Community involvement: strategies and problems. All studies except two [ 50 , 55 ] outlined strategies to involve communities and ensure their buy-in of the intervention.

Such strategies were generally time-consuming and required considerable resources. Examples included the use of committees of advocates, gatekeepers and Spice Cabinet And Doors community members, to Your Business obtain advice on community involvement, program content and delivery techniques and channels and on | Herbs, Dishes And Doors the final evaluation. Focus groups were adopted for this purpose, alongside brief pilot interventions involving community members [ 44 , 49 , 52 , 59 ]. Particular care was taken in identifying community gatekeepers to Sample You For Business Letter With help or take the lead in organizing sessions [ 48 , 51 , 54 , 57 , 60 ], while some interventions explicitly adopted a train-the trainer approach [ 46 , 47 , 53 , 54 , 57 , 60 ]. In this case, health professionals and Cabinet Checklist Dishes campaigners provided stroke education to specific members of the community, such as school children, pastors, beauticians, who, in turn, played a relevant part in educating parents, customers or church attendants. In the case of a particularly sizeable and structured program, the whole organization of sessions in a community site (association, church, etc.) was devolved to previously instructed local leaders [ 57 ]. Sample Thank Letter | Sample Letter With! Other involvement strategies included fostering flexibility and community creativity [ 52 , 57 ], using community-based health professionals [ 29 , 57 ], and adopting multi-channel involvement strategies (word of mouth, gatekeepers, web site, advertising, community association meetings) [ 29 , 57 ]. No intervention was aimed at Cabinet Checklist | Herbs, Dishes And Doors specific social networks within communities. When sizeable groups were targeted, the main objective was still to increase the knowledge of individuals within the groups, without consideration for community or social network dynamics.

Six of the included articles made passing mention of social networks or social support [ 45 , 52 , 56 , 57 , 59 , 60 ]. Some studies mentioned the importance of using schoolchildren as trainers for Pentest, their parents, regarding stroke knowledge, and underlined the related difficulties [ 56 , 59 ]. Others generically mentioned the importance of improving stroke knowledge of relatives and other members of the support networks for stroke patients [ 45 , 52 ]. The most complex intervention stressed both the importance and the difficulty of Spice Checklist | Herbs, Dishes And Doors coordinating networks of different organizations involved [ 57 ]. In the Examples, same study social ties and networks were used to Cabinet Dishes And Doors recruit participants for the intervention, and to plan, test and implement it. Free Sublease – Pdf! Collaboration between networked actors with different roles was highlighted as important for the success of a further intervention [ 60 ]. Cabinet Checklist | Herbs, Dishes And Doors! However, none of the Section 13: Early Christianity And History, interventions put in place a systematic strategy for tapping social networks and Spice Cabinet | Herbs, Dishes social support resources. Educational strategies adopted in the interventions. Ten studies emphasized the value of active, interactive and experiential education strategies, but only some of Web Application these provided details of the educational methods. Small groups [ 29 , 57 ], role-plays and enactment of scenarios by participants [ 29 , 44 , 59 ], encouraging flexible discussion of stroke awareness [ 29 , 44 , 56 – 58 ], enabling self-efficacy [ 29 , 52 , 56 ] and interactive multimedia resources [ 29 , 52 , 56 , 58 ] were the most frequently cited methods. Exercises and assignments were used to promote involvement of participants in producing health promotion materials and spreading the message to their families [ 29 , 52 , 56 , 57 , 59 ]. Arts and music were also employed to involve community members in the educational activities, together with promoting the Cabinet Checklist | Herbs,, creativity of participants [ 29 , 52 , 56 , 58 , 59 ]. In long interventions [ 29 , 52 , 56 – 60 ], different methods were linked to Free Agreement – Pdf Template each other and produced positive feedback. For example, in Spice Checklist And Doors one circumstance, students interviewed their parents on stroke awareness and then produced information materials accordingly [ 29 , 56 ]. Community-based health promotion (CBHP) interventions are usually considered complex and Report - 6+ Documents In Pdf difficult to plan, perform, and evaluate. This is Cabinet Dishes And Doors due to the high number of variables involved, including complex behavioural factors, the influence of culture and norms on health behaviours and the simultaneous presence of several health promotion interventions [ 69 , 70 ]. This difficulty is clearly revealed by the studies included in our review.

Firstly, even in a relatively homogeneous context of Guide Part-I community-based health promotion interventions aimed at African Americans or Hispanics living in the US, planning and evaluation methods differed significantly. There is growing recognition that the Spice Cabinet Checklist | Herbs,, design and Sample You For Business Letter | Sample Letter With evaluation of Spice Checklist | Herbs, Dishes And Doors health promotion interventions need to be informed by theory [ 71 – 73 ]. Survey! However, theory-based health promotion interventions were in Spice Cabinet Checklist Dishes And Doors the minority in the sample used for our review. Consequently, clearly specifying the theoretical foundations of the design and evaluation methods of an Thank You For Your Letter With, intervention may considerably improve its implementation. Moreover, theories used in the included studies focussed on the individual level, while six studies have recently showed that community- and Checklist | Herbs, And Doors network-level theories may prove effective in designing and evaluating community-based health promotion interventions [ 74 – 79 ]. Hence, using community- or network-oriented theories may help health promoters to systematically take into account dimensions of an intervention that could have a significant impact on its effectiveness. Furthermore, no evidence was available for European countries, where minorities show cultural and social characteristics directly influencing health-related attitudes differing from Web Application Pentest Guide Part-I, US minorities.

For example, Scheppers et al. [ 80 ] show that ethnic minorities experience a number of Spice Checklist Dishes And Doors barriers to accessing health services, frequently linked with particular cultural, religious or social practices. Such practices are different between ethnic minorities: for example, UK Pakistanis and 13: Early Christianity And History US African-Americans are likely to Cabinet Checklist Dishes have very different health beliefs and ill health-attribution. Scheppers et al. also maintain [ 80 ], that the Examples, organization of health services in Cabinet Checklist | Herbs, Dishes And Doors different countries plays an important contextual role in Job Satisfaction | Job Satisfaction Template shaping health-related attitudes of ethnic minorities. Also, studies concerning the definition of cultural competence often emphasize the Spice Checklist, importance of specific, contextual aspects, rather than abstract definitions of ethnicity, in order to successfully conduct health promotion and health care initiatives [ 38 , 81 ]. Therefore, specific key factors (perception of health and illness, language, available community resources, specific barriers and facilitators) may greatly differ between different ethnic minorities living in different countries. For all these reasons, it seems difficult to generalize any results from the included studies to Job Satisfaction | Job Survey Template the UK or European situation. It would, however, be important to note that further research related to stroke awareness improvement is aimed at Spice Cabinet Checklist And Doors addressing non-US based ethnic minorities. Although in most studies cultural adaptation was considered as important, cultural adaptation was almost always linked to Web Application Pentest Guide Part-I practical or pragmatic strategies. Consequently, no intervention took into account the recent contributions that tried to define cultural appropriateness of interventions and the main principles for conducting research on ethnicity and health [ 37 – 39 ]. Checklist | Herbs, Dishes! Consequently, using theory and data from this specific literature may help in Mining designing interventions that are more congruent with specific characteristics of ethnic minorities. Furthermore, the evidence of effectiveness emerging from the Cabinet Checklist Dishes And Doors, included studies is inconclusive. Fifty-three percent of the studies provided evaluation results, and only 25% of Job Satisfaction Survey Survey these included a control group.

As a result, current available evidence of the effectiveness of such interventions seems inconclusive. Dishes And Doors! In addition, no qualitative study satisfied our inclusion criteria. Christianity! While acknowledging the importance of quantitative evidence, it seems that integrating a qualitative approach would be appropriate for complex health promotion interventions. In fact, such interventions involve different variables such as ethnicity, knowledge and behaviour change, and - most importantly – their success seems to heavily depend on complex contextual factors. Qualitative research is Spice Cabinet often advocated as an appropriate method in evaluating health promotion interventions [ 82 , 83 ] especially because it can provide an holistic perspective [ 84 , 85 ]. Qualitative research may therefore explore this under-researched topic and identify dimensions influencing the effectiveness of stroke awareness interventions for Web Application Pentest Guide, ethnic minorities. To the best of our knowledge, this was the first systematic review to Spice Checklist date on Financial Report - 6+ In Pdf health promotion interventions for stroke awareness in ethnic minorities.

The results outline the main characteristics of stroke awareness interventions for ethnic minorities in the US, alongside strength and limitations of both the interventions and the evaluation procedures. Review findings may therefore provide a useful starting point for academics and practitioners wishing to further analyse or plan similar health promotion initiatives in other parts of the world. Limitations include the Cabinet Dishes, fact that searches were restricted to peer-reviewed journal literature written in the English language. Although we searched the most relevant databases, broadening the Pentest, search to supplementary sources and Checklist | Herbs, Dishes including more languages may increase the number of retrieved studies. The same results might be obtained by the inclusion of 1320: conference proceedings, dissertations, books and book chapters and grey literature results.

Implications for further research. Since cultural adaptation seems important in this context, there is a critical need for studies on | Herbs, And Doors health promotion interventions for stroke awareness in ethnic minorities other than African Americans and Hispanics. Furthermore, such interventions operate in very complex scenarios, and several variables may have an impact on Examples their effectiveness. Qualitative or mixed-methods study designs may help to understand contextual factors influencing community-based health promotion, including barriers and facilitators, experiential education strategies and methods for involving communities. Finally, network- and community-level health promotion theories may contribute useful insights both in designing and Checklist | Herbs, Dishes And Doors evaluating health promotion interventions on Section stroke awareness for ethnic minorities. In this review we set out to find evidence about the effectiveness of interventions to Spice Cabinet | Herbs, Dishes increase stroke awareness in Sublease Agreement – Pdf ethnic minorities. Cabinet Checklist | Herbs, Dishes And Doors! Our results show that this is a particularly understudied area, and that all included studies refer to the US. Evidence of Sublease effectiveness from 11 case reports and four RCTs focussed on short- to medium-term knowledge improvement for individuals seems particularly weak and inconclusive. Spice | Herbs,! Therefore, we suggest that further research is conducted on different countries and Free Alabama Sublease Agreement – Pdf ethnic minorities. a The acronym of the Spice | Herbs, Dishes And Doors, campaign stands for Face, Arms, Speech, Time to Web Application Pentest Guide Part-I call EMS (the first three being distinctive stroke symptoms).

Paolo Gardois, Andrew Booth, Elizabeth Goyder and Tony Ryan contributed equally to Spice Cabinet Checklist | Herbs, Dishes this work. The author’s PhD was funded through a CLAHRC studentship as part of the Stroke Theme programme of the 1320: Section 13: Early Christianity, National Institute of Health Research (NIHR) CLAHRC for South Yorkshire. All views and Cabinet Checklist Dishes And Doors opinions expressed are those of the author, and not necessarily those of the NHS, the NIHR or the Department of Health. Further details of the CLAHRC for Part-I, South Yorkshire and the Stroke Theme can be found at . Authors' original submitted files for images. The authors declare that they have no competing interests. All authors contributed equally in designing the Spice, study and critically discussing the results. Job Satisfaction Template! PG carried out the bibliographic searches, selected the studies, analysed the data, contributed to the discussion and drafted the manuscript. Checklist | Herbs, And Doors! EG and TR contributed to the study design, selection of studies and interpreting the Mining Resume, results. AB contributed to | Herbs, design the search strategies, the selection process and the interpretation of results. Free Alabama Sublease – Pdf Template! EG, TR and AB critically revised the Cabinet Checklist, manuscript.

All authors read and approved the Thank Your Letter, final manuscript. The top 10 Causes of Cabinet | Herbs, Dishes Death. [ ], World Health Organization: The Global Burden of Disease: 2004 Update. Free Alabama Template! 2008, Geneva, Switzerland: World Health Organization Google Scholar Donnan GA, Fisher M, Macleod M, Davis SM: Stroke. Lancet. 2008, 371: 1612-1623. 10.1016/S0140-6736(08)60694-7. View ArticlePubMedGoogle Scholar Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Magid D, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, et al: Heart disease and stroke statistics—2013 update.

A report from the American heart association. Circulation. 2013, 127: e6-e245. 10.1161/CIR.0b013e31828124ad. Spice Cabinet | Herbs, Dishes And Doors! View ArticlePubMedGoogle Scholar Centers for Disease Control and Prevention: Prevalence and most common causes of Sample - 6+ Documents disability among adults--United States, 2005. MMWR Morb Mortal Wkly Rep. 2009, 58: 421-426. Google Scholar Moon L, Moise P, Jacobzone S, ARD-Stroke Experts Group: A Comparison of Spice Cabinet Checklist | Herbs, And Doors Treatment, Costs and Resume Outcomes in Checklist And Doors 17 Countries. 2003, Paris: OECD Google Scholar Demaerschalk BM, Hwang H-M, Leung G: US cost burden of ischemic stroke: a systematic literature review. | Job Satisfaction Survey Template! Am J Manag Care. Spice | Herbs, Dishes And Doors! 2010, 16: 525-533.

PubMedGoogle Scholar Liebson PR: Cardiovascular disease in special populations III: stroke. Prev Cardiol. Free Sublease Agreement! 2010, 13: 1-7. 10.1111/j.1751-7141.2009.00041.x. View ArticlePubMedGoogle Scholar Trimble BM: Stroke in minorities. Neurol Clin. 2008, 26: 1177-1190. 10.1016/j.ncl.2008.05.010. xi View ArticlePubMedPubMed CentralGoogle Scholar Gunarathne A, Patel JV, Gammon B, Gill PS, Hughes EA, Lip GYH: Ischemic stroke in South Asians: a review of the epidemiology, pathophysiology, and ethnicity-related clinical features. Stroke.

2009, 40: e415-e423. 10.1161/STROKEAHA.108.535724. Cabinet Checklist | Herbs, Dishes! View ArticlePubMedGoogle Scholar Heuschmann PU, Grieve AP, Toschke AM, Rudd AG, Wolfe CDA: Ethnic group disparities in 10-year trends in stroke incidence and vascular risk factors The South London Stroke Register (SLSR). Thank Business With! Stroke. Cabinet Checklist | Herbs,! 2008, 39: 2204-2210. 10.1161/STROKEAHA.107.507285.

View ArticlePubMedGoogle Scholar National Institute for Health and Clinical Excellence: Alteplase for the Treatment of Acute Ischaemic Stroke. Web Application! 2007, London: National Institute for Cabinet Dishes And Doors, Health and Clinical Excellence Google Scholar Reeves MJ, Arora S, Broderick JP, Frankel M, Heinrich JP, Hickenbottom S, Karp H, LaBresh KA, Malarcher A, Mensah G, Moomaw CJ, Schwamm L, Weiss P: Acute stroke care in the US: results from Sample Report - 6+ In Pdf, 4 pilot prototypes of the Paul Coverdell national acute stroke registry. Spice Cabinet Checklist! Stroke. 2005, 36: 1232-1240. View ArticlePubMedGoogle Scholar Fonarow GC, Smith EE, Saver JL, Reeves MJ, Bhatt DL, Grau-Sepulveda MV, Olson DM, Hernandez AF, Peterson ED, Schwamm LH: Timeliness of tissue-type plasminogen activator therapy in acute ischemic stroke. Clinical perspective patient characteristics, hospital factors, and Survey | Job outcomes associated with door-to-needle times within 60 minutes. Spice Dishes And Doors! Circulation. 2011, 123: 750-758. 10.1161/CIRCULATIONAHA.110.974675. View ArticlePubMedGoogle Scholar Kleindorfer D, Khoury J, Broderick JP, Rademacher E, Woo D, Flaherty ML, Alwell K, Moomaw CJ, Schneider A, Pancioli A, Miller R, Kissela BM: Temporal trends in public awareness of stroke: warning signs, risk factors, and treatment. Stroke.

2009, 40: 2502-2506. 10.1161/STROKEAHA.109.551861. Alabama Sublease Agreement! View ArticlePubMedPubMed CentralGoogle Scholar Teuschl Y, Brainin M: Stroke education: discrepancies among factors influencing prehospital delay and stroke knowledge. Cabinet! Int J Stroke. 2010, 5: 187-208.

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2012, London: Royal College of Physicians, 4 Google Scholar Haute Autorite de Sante: Stroke: Early Management (Alert, Prehospital Phase, Initial Hospital Phase, Indications for Thrombolysis). Spice Cabinet Checklist! Guidelines. 2009 Google Scholar National Stroke Foundation (Australia): Clinical Guidelines for Stroke Managemen. 2010, Melbourne: National Stroke Foundation Google Scholar Moreira E, Correia M, Magalhaes R, Silva MC: Stroke awareness in urban and Job Satisfaction rural populations from Northern Portugal: knowledge and Spice Cabinet Checklist action are independent. Neuroepidemiology. 2011, 36: 265-273.

10.1159/000328867. View ArticlePubMedGoogle Scholar Willey JZ, Williams O, Boden-Albala B: Stroke literacy in Web Application Pentest central Harlem: a high-risk stroke population. Dishes And Doors! Neurology. In Pdf! 2009, 73: 1950-1956. 10.1212/WNL.0b013e3181c51a7d. View ArticlePubMedPubMed CentralGoogle Scholar Lecouturier J, Murtagh MJ, Thomson RG, Ford GA, White M, Eccles M, Rodgers H: Response to symptoms of stroke in the UK: a systematic review. BMC Health Serv Res. 2010, 10: 157-10.1186/1472-6963-10-157. View ArticlePubMedPubMed CentralGoogle Scholar Lecouturier J, Rodgers H, Murtagh M, White M, Ford G, Thomson R: Systematic review of mass media interventions designed to Checklist | Herbs, Dishes And Doors improve public recognition of stroke symptoms, emergency response and early treatment. BMC Public Health.

2010, 10: 784-10.1186/1471-2458-10-784. View ArticlePubMedPubMed CentralGoogle Scholar Moloczij N, McPherson KM, Smith JF, Kayes NM: Help-seeking at the time of Job Satisfaction Survey | Job Satisfaction Template stroke: stroke survivors’ perspectives on their decisions. Dishes And Doors! Health Soc Care Community. 2008, 16: 501-510. 10.1111/j.1365-2524.2008.00771.x. View ArticlePubMedGoogle Scholar Mullen Conley K, Juhl Majersik J, Gonzales NR, Maddox KE, Pary JK, Brown DL, Moye LA, Espinosa N, Grotta JC, Morgenstern LB: Kids Identifying and Defeating Stroke (KIDS): development and implementation of a multiethnic health education intervention to increase stroke awareness among middle school students and In Pdf their parents. Checklist And Doors! Health Promot Pract. Web Application Pentest Part-I! 2010, 11: 95-103.

10.1177/1524839907309867. View ArticlePubMedGoogle Scholar Wein TH, Staub L, Felberg R, Hickenbottom SL, Chan W, Grotta JC, Demchuk AM, Groff J, Bartholomew LK, Morgenstern LB: Activation of emergency medical services for acute stroke in a nonurban population: the Checklist, T.L.L. Temple Foundation Stroke Project. Survey Satisfaction! Stroke. 2000, 31: 1925-1928.

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2012, 12: 410-415. 10.7861/clinmedicine.12-5-410. View ArticleGoogle Scholar Robinson TG, Reid A, Haunton VJ, Wilson A, Naylor AR: The face arm speech test: does it encourage rapid recognition of important stroke warning symptoms?. Checklist! Emerg Med J. 2013, 30: 467-471. 10.1136/emermed-2012-201471. Guide! View ArticlePubMedGoogle Scholar Department of Health: Progress in Spice | Herbs, Improving Stroke Care. 2010, London: The Stationery Office; National Audit Office Google Scholar Beach MC, Price EG, Gary TL, Robinson KA, Gozu A, Palacio A, Smarth C, Jenckes MW, Feuerstein C, Bass EB, Powe NR, Cooper LA: Cultural competence: a systematic review of health care provider educational interventions.

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2013, 23 (3): 504-510. 10.1093/eurpub/cks028. View ArticlePubMedGoogle Scholar Moher D, Liberati A, Tetzlaff J, Altman DG: Preferred reporting items for systematic reviews and | Herbs, And Doors meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009, 62: 1006-1012. 10.1016/j.jclinepi.2009.06.005. View ArticlePubMedGoogle Scholar The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group: Tissue plasminogen activator for acute ischemic stroke. Thank You For Letter | Sample With! N Engl J Med.

1995, 333: 1581-1587. View ArticleGoogle Scholar Cooper HM: Synthesizing research: a guide for literature reviews. 1998, Thousand Oaks, Cali: SAGE Google Scholar Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol. 2006, 3: 77-101. Cabinet Dishes And Doors! 10.1191/1478088706qp063oa. View ArticleGoogle Scholar Boden-Albala B, Stillman J, Perez T, Evensen L, Moats H, Wright C, Moon-Howard J, Doyle M, Paik MC: A stroke preparedness RCT in a multi-ethnic cohort: design and methods. Contemp Clin Trials. 2010, 31: 235-241.

10.1016/j.cct.2010.02.003. View ArticlePubMedGoogle Scholar Chan Y-F, Lavery R, Fox N, Kwon R, Zinzuwadia S, Massone R, Livingston D: Effect of an Sample Report - 6+ In Pdf, educational video on Spice Cabinet Checklist Dishes emergency department patient stroke knowledge. J Emerg Med. 2008, 34: 215-220. 10.1016/j.jemermed.2007.04.003. View ArticlePubMedGoogle Scholar Covington CF, King JA, Fennell I, Jones C, Hutchinson C, Evans A: Developing a community-based stroke prevention intervention course in minority communities: the DC Angels Project. J Neurosci Nurs. 2010, 42: 139-142. 10.1097/JNN.0b013e3181d4a3d3.

View ArticlePubMedGoogle Scholar Dromerick AW, Gibbons MC, Edwards DF, Farr DE, Giannetti ML, Sanchez B, Shara NM, Fokar A, Jayam?Trouth A, Ovbiagele B, Kidwell CS: Preventing recurrence of Mining Examples thromboembolic events through coordinated treatment in the District of Columbia. Spice Checklist | Herbs, Dishes! Int J Stroke. 2011, 6: 454-460. 10.1111/j.1747-4949.2011.00654.x. View ArticlePubMedPubMed CentralGoogle Scholar Duraski SA: Meeting the needs of the community: a project to prevent stroke in Hispanics. Top Stroke Rehabil.

2003, 9: 46-56. 10.1310/QE87-BTND-6K03-FY9F. View ArticlePubMedGoogle Scholar Duraski SA: Stroke prevention education in the Hispanic community. Rehabil Nurs. 2006, 31: 5-9. 10.1002/j.2048-7940.2006.tb00003.x. View ArticlePubMedGoogle Scholar Duraski SA: Do Hispanic children need to know about Sample Thank Business Letter | Sample Letter With stroke prevention?.

Top Stroke Rehabil. 2007, 14: 65-71. View ArticlePubMedGoogle Scholar Frank D, Grubbs L: A faith-based screening/education program for Spice Checklist Dishes, diabetes, CVD, and stroke in rural African Americans. Sample Thank Letter With! ABNF J. 2008, 19: 96-101. PubMedGoogle Scholar Gonzales NR, Brown DL, Maddox KE, Conley KM, Espinosa N, Pary JK, Karim AP, Moye LA, Grotta JC, Morgenstern LB: Kids Identifying and Spice Cabinet Checklist | Herbs, Defeating Stroke (KIDS): design of a school-based intervention to Sample Report improve stroke awareness. Ethn Dis. 2007, 17: 320-326. PubMedGoogle Scholar Kalenderian E, Pegus C, Francis C, Goodwin N, Jacques HS, Lasa D: Cardiovascular disease urban intervention: baseline activities and findings. J Community Health.

2009, 34: 282-287. 10.1007/s10900-009-9159-3. Checklist And Doors! View ArticlePubMedGoogle Scholar Kleindorfer D, Miller R, Sailor-Smith S, Moomaw CJ, Khoury J, Frankel M: The challenges of community-based research: the beauty shop stroke education project. Stroke. 2008, 39: 2331-2335. 10.1161/STROKEAHA.107.508812. View ArticlePubMedGoogle Scholar Miller ET, Spilker J: Readiness to change and Mining Examples brief educational interventions: successful strategies to reduce stroke risk.

J Neurosci Nurs. 2003, 35: 215-222. 10.1097/01376517-200308000-00009. View ArticlePubMedGoogle Scholar Morgenstern LB, Gonzales NR, Maddox KE, Brown DL, Karim AP, Espinosa N, Moye LA, Pary JK, Grotta JC, Lisabeth LD, Conley KM: A randomized, controlled trial to teach middle school children to recognize stroke and call 911: the | Herbs, And Doors, kids identifying and defeating stroke project. Section 13: Early Christianity And History! Stroke. Spice Cabinet | Herbs, Dishes And Doors! 2007, 38: 2972-2978. 10.1161/STROKEAHA.107.490078. View ArticlePubMedGoogle Scholar Villablanca AC, Arline S, Lewis J, Raju S, Sanders S, Carrow S: Outcomes of national community organization cardiovascular prevention programs for high-risk women. J Cardiovasc Transl Res. 2009, 2: 306-320. Sublease Agreement – Pdf Template! 10.1007/s12265-009-9118-5.

View ArticlePubMedPubMed CentralGoogle Scholar Williams O, Noble JM: Hip-Hop stroke: a stroke educational program for elementary school children living in Cabinet | Herbs, Dishes And Doors a high-risk community. Stroke. 2008, 39: 2809-2816. 10.1161/STROKEAHA.107.513143. Pentest Part-I! View ArticlePubMedGoogle Scholar Williams O, DeSorbo A, Noble J, Gerin W: Child-mediated stroke communication: findings from Hip Hop stroke. Stroke. Checklist | Herbs, Dishes And Doors! 2012, 43: 163-169. 10.1161/STROKEAHA.111.621029. View ArticlePubMedGoogle Scholar Williamson W, Kautz DD: Let’s get moving: let’s get praising: promoting health and Thank You For Your Letter | Sample hope in an African American church. ABNF J. 2009, 20: 102-105.

PubMedGoogle Scholar Armstrong EC: The well-built clinical question: the Cabinet Dishes And Doors, key to finding the best evidence efficiently. WMJ. 1999, 98: 25-28. PubMedGoogle Scholar University of York: Systematic reviews : CRD’s guidance for undertaking reviews in health care. Nhs Centre For Reviews And Dissemination. 2009, York: CRD, University of York Google Scholar Bandura A: Social Foundations of 1320: And History Thought and Action: A Social Cognitive Theory. 1986, Englewood Cliffs, N.J.: Prentice-Hall Google Scholar Miller WR, Rollnick S: Motivational Interviewing: Preparing People For Change. 2002, New York: Guilford Press Google Scholar Prochaska JO, DiClemente CC: Stages and | Herbs, processes of self-change of smoking: toward an integrative model of Free Agreement Template change. J Consult Clin Psychol.

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PubMedGoogle Scholar. The pre-publication history for this paper can be accessed here: This article is published under license to BioMed Central Ltd. Checklist | Herbs,! This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the Free, original work is properly credited. Share on Twitter Share on Cabinet Checklist Facebook Share on Sample You For Business Letter | Sample LinkedIn Share on Weibo Share on Google Plus Share on Reddit.

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Orwell#8217;s 1984: Privacy Issues and Public Manipulation. The links related to Spice And Doors, privacy issues taught me all of the negative things that come along with modern technology and 1320: Section Christianity, social websites. Spice Cabinet Checklist | Herbs, Dishes And Doors. In Tom Head’s Big Brother is Watching , he says that “as technology improves, privacy as we know it will inevitably evaporate; the best we can hope for is the Guide, power to watch the watchers.” By this he means that with the advancement of Spice Cabinet Checklist Dishes And Doors technology comes the decline of Your Letter | Sample individual privacy. This holds true in my opinion, because I believe that the use of Dishes modern technology is linked to the decline is personal relations, and the decline of personal relationships is linked to the weakening value associated with privacy. Mining Resume Examples. There are other ways that privacy is currently invaded other than the use of social media sites.

For starters, the CIFA has previously “exceeded its authority and | Herbs,, conducted unauthorized spying on innocent people and organizations,” (The Other Big Brother). Sample Report - 6+. They have even acknowledged that some reports may contain information on U.S. citizens and groups that “never should have been obtained.” Also, this same source states that the National Security Agency to monitor telephone conversations in the U.S. It has been proven, according to this source, that CIFA’s database has contained information that “may have violated regulations,” because the department isn’t allowed to retain information about citizens for more than 90 days unless there is a reasonable belief that the person is linked to Dishes, terrorism or foreign intelligence. This regulation has been violated. Also in use are video surveillance, face recognition software, GPS tracking, all of which go beyond the Web Application Guide Part-I, human eye and the evidence these technologies hold leaves an unsettling feeling to Cabinet Checklist And Doors, potential “victims,” (Tana Ganeva, Massive New Biometric Database ). The links related to public manipulation showed me that things aren’t always as they seem. There was one link that confirmed that the Mining Examples, portrait of Abraham Lincoln was actually Lincoln’s head painted atop of John Calhoun’s body.

The link “Orwell and March Madness” talked about an advertisement stating that African-American male student athletes are 10% more likely to graduate. A comparison of Cabinet college basketball players with other full-time student proves otherwise—that the athletes were 20% less likely to graduate than non-athletes. This link, (Orwell and March Madness) directly reminded me of the scene in 1984 where Winston overhears the Free Sublease – Pdf Template, telescreen state that the chocolate rations had been raised to 20g when he knew for a fact that the rations had just been dropped to 20g from 30g. In Oceania, the people believe whatever Big Brother tells them to believe. If the telescreen says rations of goods have been raised, then they have been raised. If the | Herbs, And Doors, telescreen says that conditions today are better than the conditions of the past, it is truth. If the telescreen reports that they are at war with Eurasia, they have always been at war with Eurasia and Eastasia has always been their allied country. The people of Sample Report - 6+ Documents Oceania are constantly manipulated by their government to believe that Big Brother is their provider, protector, and savior. Either they mask their realization and pretend to believe in the Party, they really don’t realize that they’re being manipulated, or they are punished and tortured in the Ministry of Cabinet Checklist And Doors Love like Winston is in the very end of the Report Documents, novel. The telescreens can always see and hear whatever is going on, both in public and private settings. There are no secrets and there is no privacy.

They have eyes and ears everywhere, in technological forms and in the form of undercover spies, like Mr. Charrington. If someone is acting or believed to be thinking suspiciously, that person is captured, tortured, and executed, then vaporized into an imaginary non-existence. All of this happens simply because the government, Big Brother, has some sort of inkling that one person is not thinking and behaving exactly like the rest. It could potentially be caused by nothing more than mere suspicion, suspicion that wouldn’t exist if it weren’t for the governmental spies—the Thought Police and the telescreens.

The technology of Oceania’s society is the core of its societal and Dishes, moral destruction. This brings me back to Tom Head’s statement: “As technology improves, privacy as we know it will inevitably evaporate; the best we can hope for is the power to watch the watchers.” In Oceania, their technology was so advanced that the people were continuously watched, leaving them no privacy. The best the people there could hope for Section 13: Early Christianity And History, was the existence of The Brotherhood—an organization conspiring to overthrow the unjust Big Brother—or a revolt against Big Brother himself. | Herbs, Dishes. The could only hope to free themselves by watching Big Brother watch them, see what he sees in Resume, order to do what he is incapable of seeing. While George Orwell’s ideas about governmental surveillance were far-fetched at the time, and Checklist And Doors, still seem over-the-top today, his underlying interpretation of the Job Satisfaction | Job Survey, future government holds true. We are watched and our activities are monitored by our government, though not to the severity assumed by | Herbs,, Orwell in 1984. Researching the privacy issues and the ways our government manipulates the Job Satisfaction Survey Template, public opinion by use of Cabinet advertisements makes me feel like I ought to Sample Report - 6+ Documents, be more cautious, especially when on the internet.

I have also learned that in order to know the Spice Cabinet Checklist And Doors, truth behind certain ads, I ought to research that ad, not just trust it for Sample Financial Documents In Pdf, what it is. Some may say the current state of government surveillance is minimal and doesn’t make much difference, and perhaps that is true, however, what level may it reach in Cabinet Checklist | Herbs, Dishes And Doors, the near future?

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Free Essays on The Causes Of Baby Dumping. BACKGROUND OF THE STUDY When we want to discuss about | Herbs,, baby dumping , firstly we must know about the definition. The baby dumping refers to discarding or leaving alone, for Christianity And History an extended period of time, a child younger than 12 months of age in a public or private setting with the intent to dispose of. This a part of my group survey and report about Baby Dumping Among Teenagers in Kuala Lumpur for our English Language subject. The part I do by my self is under title Factors influence of baby dumping and Spice Cabinet Checklist Dishes And Doors, Seven main causes of baby dumping among teenagers in Kuala Lumpur. But before doing presentation. Cause and Effects of Mining Resume Examples Baby Dumping. Causes of Baby Dumping One of the causes of baby dumping is teenagers are lack of sex education. Most of the parents failed to inject the Spice Cabinet Checklist | Herbs, And Doors knowledge of sex into the mind of their children when their children were small. They feel shy or uncomfortable when their children ask them about sex.

Besides that. Outline Template I. Introduction Hook: Baby Dumping Issue in Malaysia Background Information: It has becoming more popular among youngsters and heartbreaking to see this issue increasing. What is the Job Satisfaction | Job Satisfaction writher intends to do: Issue. In Malaysia, cabinet decides baby dumping cases investigated as murder or attempted murder to ensure that inhuman acts receive severe punishment (“Mixed reaction to classifying”, 2010). Some others said that they should given a new chance to repent on Spice what they have done. Our opinions, the punishment.

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