The behavior management skills training program improved CNAs' ability to interact with behaviorally disturbed nursing home residents and produced sustained reductions in agitation. The FSM system was more effective for maintaining communication skills 6 months after training.
The CNA-generated PPQ was a more sensitive measure of pain than the MDS for this sample. Although the MDS represents an important step toward systematic and standardized assessment of pain, more emphasis should be placed on multimodal assessment, including CNAs' perceptions and observations about pain experienced by cognitively impaired nursing home residents.
Nursing staff can be trained to improve and maintain communication skills during care without increasing the amount of time delivering care. The methodological advantages of including measures to assess treatment implementation are discussed.
To determine the completeness of reporting of human immunodeficiency virus (HIV) diagnoses to state surveillance systems, the authors used capture-recapture methods. The numbers of cases diagnosed in the areas were estimated using HIV diagnoses reported to nine surveillance programs by different sources (e.g., laboratories, health-care providers). To account for dependencies between reporting sources, the authors used log-linear models to estimate the number of cases that had been diagnosed but were not identified by any reporting sources. Completeness of reporting (observed cases/expected cases) was determined for two time frames: cases diagnosed within a 1-year period (from October 1, 2002, to September 30, 2003, for most US states) reported up to 6 months after that diagnosis period and cases diagnosed within a 6-month period reported up to 12 months after that diagnosis period. A total of 11,266 HIV diagnoses were reported for the 1-year period with 21,589 report documents. Completeness of reporting of HIV diagnoses was 76% (95% confidence interval: 66, 83) when allowing 6 months of reporting delay (range: 72-95%) and improved to 81% (95% confidence interval: 72, 88) with 12 months' follow-up. When reporting systems retain all relevant documents, capture-recapture is a feasible approach for assessing completeness of reporting of HIV diagnoses. Completeness should be measured by allowing 12-months' reporting delay.
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