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Public and professional aspects of the use of education in the control and prevention of cancer.

Studies of educational programs designed to encourage (i) regular systematic breast self-examination and (ii) participation in cervical screening programs demonstrate the necessity for precision in defining and evaluating cancer education aims and methods. Preteaching and postteaching and one-year follow-up data from both studies compare the immediate and longer-term effects of teaching on opinions and knowledge and relate these to behavior.

Attitude to Health

A systematic approach to continuing education for radiologic technologists.

As continuing education programs for radiologic technologists expand, it is important that needs be properly assessed and well-designed programs be developed. This reports on the step-by-step process of a regional medical education center to provide continuing education for technologists that would be most beneficial to them and indirectly to the patients they serve.

Curriculum

Case management and quality assurance to improve care of inner-city children with asthma.

Case management and quality assurance techniques were used in a program designed to improve the process and outcomes of care for inner-city children with asthma. The program had three major elements: assessment of the care of individual patients and feedback to their primary care providers, periodic contact with parents, and provision of educational materials about asthma to parents. Telephone interviews with parents were used to assess knowledge of home asthma care and the type of care prescribed by the child's physician. Medicaid and hospital records were used to measure acute care utilization. Eighty-eight children (aged 0 to 5 years) who had made more than two emergency room visits for asthma were recruited by telephone. Fifty-six prescribing errors were identified, 24 being failure to prescribe an additional drug for short-term use by children receiving continuous therapy. Acute care use dropped 50% compared with a control period. This type of program is feasible but may require in-person recruiting to reach high-risk families without telephones.

Asthma

Guidelines for the functioning of a helping service.

The purpose and the operation of an effective helping service are defined along the principles developed by R. R. Carkhuff. A functional operationalism directly linking each aspect of a helping service to the objective of servicing the needs of those people for whom the service exists is developed. The personal fitness of the staff as defined by their effectiveness at living is identified as the critical variable determining service effectiveness. The level of staff performance on the operational indices of physical, emotional, and intellectual functioning including, specifically, the interpersonal dimensions of empathy, respect, genuineness, concreteness, confrontation, and immediacy is designated as the operational basis for the organizational decisions of hiring, firing, promotion, and role assignment. Systematic programs designed to meet specific client needs serve to complete staff and service effectiveness.

Counseling

The Pawtucket Heart Health Program. Influencing adolescent eating patterns.

The Pawtucket Heart Health Program, a research effort testing a process of community activation for cardiovascular risk factor behavior change, risk factor change, and coronary heart disease event rate change, utilizes risk factor behavior change programs for the entire population of a northeastern city. A diversity of nutrition programs designed to teach new skills and to alter the nutrition environment have been delivered. These include group programs, highlighting restaurant menus, labeling grocery shelf items, screening for blood cholesterol levels accompanied by nutritional counseling, and provision of programs in schools. In addition to standard curricula, the Heart Healthy Cook-Off for both junior high school and high school students has been developed. Students select recipes, make substitutions to lower fat, saturated fat, and cholesterol content, analyze original and substitution recipe nutrient content using a microcomputer and nutrient analysis software, and prepare the food. A panel of judges assesses presentation, taste, and health-promoting characteristics. In one junior high school class, cholesterol measure before and after the cook-off decreased by 10.7% among those with elevated cholesterol. The Heart Healthy Cook-Off is an education program that influences the culinary practices of children in an enjoyable, challenging format.

Adolescent

Measuring the effectiveness of the Star Parenting Program with parents of young children.

This study evaluated the effectiveness of the STAR Parenting Program, designed specifically for parents with children between the ages of 1 and 5 yr. The 8-hr. program was completed by 35 parents. There was a significant increase in parents' favorability and a significant decrease in anxiety afterwards. Parents also significantly lowered their expectations, reduced the emotionality of their reactions to their child's problem behaviors, and increased their use of time-out and tangible rewards following training. These changes were maintained at a 6-wk. follow-up.

Adult

Psychological improvement in infertile women after behavioral treatment: a replication.

OBJECTIVE: To replicate previously reported psychological improvements in infertile women attending a group behavioral treatment program. DESIGN: Psychological and demographic data were collected before entering and again upon completion of a behavioral medicine program on a second cohort of patients. SETTING: The program was offered in the Division of Behavioral Medicine, an outpatient clinic of the Department of Medicine at New England Deaconess Hospital. All patients were receiving care from infertility specialists not affiliated with this hospital. PATIENTS: Fifty two self-referred women receiving medical treatment for infertility attended the program. INTERVENTION: A 10-week group behavioral treatment program. MAIN OUTCOME MEASURES: Three validated psychological instruments. RESULTS: Psychological improvement was statistically significant (Profile of Mood States Tension/Anxiety: P less than 0.0001; Depression/Dejection: P less than 0.0122; Vigor/Activity: P less than 0.0431; Confusion/Bewilderment: P less than 0.0057; Spielberger Anger Expression: P less than 0.0013; Spielberger State Anxiety: P less than 0.0037, and Trait Anxiety: P less than 0.0001). CONCLUSIONS: Behavioral treatment is associated with significant decreases in negative psychological symptoms.

Adult

Teaching physicians to teach: a three-year report.

To meet the needs for an expanded preceptor faculty, the Department of Family Medicine at the College of Medicine and Dentistry of New Jersey-Rutgers Medical School has for three years conducted yearly training programs designed to prepare practicing family physicians for the teaching role. Thirty-six physicians have completed the program, which consists of four group seminars and three individual learning site visits spent in the office of an experienced preceptor while a fourth year student is present. Many lessons were learned in the course of these yearly programs which may be useful to others who plan to undertake similar faculty development activities. Therefore, detailed, practical, experiential information is presented regarding recruitment, orientation, the educational program of seminars and individual learning experiences, evaluation, and required resources. Some problems proved to be particularly difficult, such as the uneven quality of the individual learning visits and the attrition of some participants from the program. Feedback from participating physicians has been extremely positive.

Faculty, Medical

Components in program development.

There has been a great deal of discussion and deliberation concerning the composition of program development. Nonetheless, the question still remains--what is program development? What are possible components in program development? In this paper the following components are described, differentiated, and integrated: Statement of Purpose, Curriculum Design, Program Competencies, Content, Content Competencies, and Practice Environments.

Curriculum

Evaluation and implementation of self-management programs for children with asthma.

We have reviewed the needs and problems associated with the evaluation and implementation of programs designed to assist children with asthma and their parents to manage the illness. To date, there are several programs that have been evaluated and found to be effective in terms of the objectives and dimensions described. Implementation has presented a larger problem because there are few implementors and because of the major barriers to be overcome by those who would make these programs available to the significant numbers of children and families who would benefit. Unless ways can be found to overcome the medical and reimbursement barriers, asthma self-management programs will not thrive. The growing number of individuals enrolled in some form of health maintenance organization, however, suggests a greater market for asthma self-management programs, under circumstances in which the costs of emergency room use and hospital services must be borne by physicians and hospitals, rather than by their patients.

Asthma

Automated classification of candidate structures for computer-assisted structure elucidation.

In computer-assisted structure elucidation, a large number of candidate structures for the unknown compound can be generated. A computer program designed to aid in the recognition of significant differences between these structures is described. The goal of the program is to group the candidates into meaningful classes with a minimum of input from the user; each class is distinguished by a substructure its members have in common. A computational approach is developed based on the combinatorial problem of set covering. The program evaluates its results using an information-theoretical criterion. An application of the program to a real-word structure problem is presented.

Chemical Phenomena

The culturally diverse student: a model for empowerment.

The student who is at a disadvantage due to race, educational background, or cultural background is often unsuccessful in higher education. Specific programs designed to assist the culturally diverse student can make a significant difference in the successful completion of a program of nursing and passing of the National Council Licensure Examination (NCLEX). The authors discuss a model that assists culturally diverse students' success in a program of nursing.

Cultural Characteristics

Student heart health knowledge, smoking attitudes, and self-esteem.

The Chicago Heart Health Curriculum Program (CHHCP) is a comprehensive, cardiovascular disease, risk-reduction program designed for a multiracial urban population of sixth-grade students and their families. The study showed strong program impact on student health knowledge, and found that independence of peers significantly influenced smoking attitudes and self-esteem. The latter was associated strongly with humanistic teacher attitudes and behavior as well. Smoking attitudes were found to be related significantly to general health attitudes. The results suggest that future programs conveying heart health knowledge should consider student learning in the affective context of self-esteem, independence of peers, and teacher humanism. Reinforcement through continual intervention over a prolonged period may produce more permanent change over time.

Attitude to Health

Nutritional status of black preschool children in Mississippi. Influence of income, mother's education, and food programs.

The nutritional status of 247 black preschoolers in two counties of Mississippi was studied by relating caloric and nutrient intakes and anthropometric measurements to homemaker's education, family income, and participation in Food Stamp and donated food programs..23AUTHOR Low intakes of calories, iron, calcium, vitamin A, and ascorbic acid were found in many of the children, regardless of the variable considered. These findings--in comparison with similar studies--imply that, as time passes, low education and income are having less impact on child nutrition. This ameliorating effect may be due to programs designed to educate parents and extend purchasing power of food dollars. Thus, it seems advisable to continue these programs.?23AUTHOR

Black or African American

A cost-effective, unit-based approach to computerized care planning education.

This article describes a grassroots approach to developing an educational program on nursing diagnosis and computerized care planning. The process involved staff nurses in program design, implementation, and evaluation. Using this process, staff development educators will be better able to successfully initiate grassroots programs that educate large numbers of nurses at minimal cost.

Computer User Training

Parallel computation and FASTA: confronting the problem of parallel database search for a fast sequence comparison algorithm.

We have parallelized the FASTA algorithm for biological sequence comparison using Linda, a machine-independent parallel programming language. The resulting parallel program runs on a variety of different parallel machines. A straight-forward parallelization strategy works well if the amount of computation to be done is relatively large. When the amount of computation is reduced, however, disk I/O becomes a bottleneck which may prevent additional speed-up as the number of processors is increased. The paper describes the parallelization of FASTA, and uses FASTA to illustrate the I/O bottleneck problem that may arise when performing parallel database search with a fast sequence comparison algorithm. The paper also describes several program design strategies that can help with this problem. The paper discusses how this bottleneck is an example of a general problem that may occur when parallelizing, or otherwise speeding up, a time-consuming computation.

Algorithms

A program to find regions of similarity between homologous protein sequences using dot-matrix analysis.

MATRIX is a program designed primarily to enable the user to visualize all regions of similarity between two proteins at a glance. The program helps the user to see where they are similar--at what relative positions in the amino acid sequences of the two proteins in question does the similarity exist; how they are similar--what functional characteristics the two similar sequences have in common; and to what extent they are similar--is the similarity significant, if so how significant relative to other similar sequences in the protein. This is achieved by constructing a diagram in which quantitative parameters of amino acids are used to compare every amino acid residue of the first protein with every amino acid residue of the second. Another function of the program is, given two sets of atomic coordinates--either of different proteins or for the same protein (for self-comparison)--to demonstrate which residues of the two proteins, when the two proteins are superimposed upon each other, appear in the same space (or are close to each other).

Amino Acid Sequence