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PubMed2001

[Restructuring of the specialized job market for people with disabilities through legislative reform of the Rehabilitation Act--consequences for the workshops for the disabled].

The legal basis for employment of people with disabilities in sheltered Workshops for the Disabled (Werkstätten für Behinderte, WfB) had hitherto been shaped by the 1961 Federal Social Assistance Act, the 1969 Employment Promotion Act, the 1974 Severely Disabled Persons Act with the related Workshop Ordinances of 1980 and 1996. The Act on Combating Unemployment of Severely Disabled Persons, effective as of Oct. 1, 2000 has now created a new legal foundation, which also is aimed at enhancing Workshop employees' horizontal mobility into the general job market, inter alia providing for access to Supported Employment arrangements and for availability of selective placement and support services (Integrationsfachdienste, IFD) throughout Germany. These Services also are intended as points of contact in the counselling of severely disabled school leavers in relation to placement opportunities in competitive jobs and/or integration projects or firms. Discussed from a legal perspective are the differences in sociolegal respects between such projects for severely disabled persons and employment in Workshops for the Disabled, as well as implications for the Workshops' own economic activity, also making reference to the forthcoming Book 9 of the Social Code.

Persons with Disabilities↗
PubMed2005

Priorities for clinical research in intracerebral hemorrhage: report from a National Institute of Neurological Disorders and Stroke workshop.

BACKGROUND AND PURPOSE: Spontaneous intracerebral hemorrhage (ICH) is one of the most lethal stroke types. In December 2003, a National Institute of Neurological Disorders and Stroke (NINDS) workshop was convened to develop a consensus for ICH research priorities. The focus was clinical research aimed at acute ICH in patients. METHODS: Workshop participants were divided into 6 groups: (1) current state of ICH research; (2) basic science; and (3) imaging, (4) medical, (5) surgical, and (6) clinical methodology. Each group formulated research priorities before the workshop. At the workshop, these were discussed and refined. RESULTS: Recent progress in management of hemorrhage growth, intraventricular hemorrhage, and limitations in the benefit of open craniotomy were noted. The workshop identified the importance of developing animal models to reflect human ICH, as well as the phenomena of rebleeding. More human ICH pathology is needed. Real-time, high-field magnets and 3-dimensional imaging, as well as high-resolution tissue probes, are ICH imaging priorities. Trials of acute blood pressure-lowering in ICH and coagulopathy reversal are medical priorities. The exact role of edema in human ICH pathology and its treatment requires intensive study. Trials of minimally invasive surgical techniques including mechanical and chemical surgical adjuncts are critically important. The methodologic challenges include establishing research networks and a multi-specialty approach. Waiver of consent issues and standardizing care in trials are important issues. Encouragement of young investigators from varied backgrounds to enter the ICH research field is critical. CONCLUSIONS: Increasing ICH research is crucial. A collaborative approach is likely to yield therapies for this devastating form of brain injury.

Animals↗
PubMed2000

Pulmonary artery catheterization and clinical outcomes: National Heart, Lung, and Blood Institute and Food and Drug Administration Workshop Report. Consensus Statement.

OBJECTIVE: The efficacy and safety of the pulmonary artery catheter are under scrutiny because of its association with increased morbidity and mortality in observational studies. In response, the National Heart, Lung, and Blood Institute (NHLBI) and the US Food and Drug Administration (FDA) conducted the Pulmonary Artery Catheterization and Clinical Outcomes workshop in Alexandria, Va, on August 25 and 26, 1997, to develop recommendations regarding actions to improve pulmonary artery catheter utility and safety. PARTICIPANTS: The NHLBI and FDA planning task force selected a workshop chairperson, subcommittee chairs, and participants. Approximately 85 participants were selected for their collective expertise in critical care, pulmonary medicine, cardiovascular medicine and surgery, pediatrics, nursing, biostatistics, and medical economics. The meeting was open to industry representatives and other government and lay observers. This workshop was funded by the NHLBI and the FDA's Division of Devices. EVIDENCE: Published reports relating to the efficacy and safety of the pulmonary artery catheter, especially consensus documents developed by professional societies. CONSENSUS PROCESS: The planning task force disseminated materials, held teleconferences, and developed draft position papers prior to the workshop. These were modified during the workshop and thereafter in the course of several teleconferences, and presented to the entire group for final modifications and approval. CONCLUSIONS: A need exists for collaborative education of physicians and nurses in performing, obtaining, and interpreting information from the use of pulmonary artery catheters. This effort should be led by professional societies, in collaboration with federal agencies, with the purpose of developing and disseminating standardized educational programs. Areas given high priority for clinical trials were pulmonary artery catheter use in persistent/refractory congestive heart failure, acute respiratory distress syndrome, severe sepsis and septic shock, and low-risk coronary artery bypass graft surgery. JAMA. 2000;283:2568-2572

Catheterization, Swan-Ganz↗
PubMed2000

Peripartum cardiomyopathy: National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) workshop recommendations and review.

OBJECTIVE: Peripartum cardiomyopathy (PPCM) is a rare life-threatening cardiomyopathy of unknown cause that occurs in the peripartum period in previously healthy women. In April 1997, the National Heart, Lung, and Blood Institute (NHLBI) and the Office of Rare Diseases of the National Institutes of Health (NIH) convened a Workshop on Peripartum Cardiomyopathy to foster a systematic review of information and to develop recommendations for research and education. PARTICIPANTS: Fourteen workshop participants were selected by NHLBI staff and represented cardiovascular medicine, obstetrics, immunology, and pathology. A representative subgroup of 8 participants and NHLBI staff formed the writing group for this article and updated the literature on which the conclusions were based. The workshop was an open meeting, consistent with NIH policy. EVIDENCE: Data presented at the workshop were augmented by a MEDLINE search for English-language articles published from 1966 to July 1999, using the terms peripartum cardiomyopathy, cardiomyopathy, and pregnancy. Articles on the epidemiology, pathogenesis, pathophysiology, diagnosis, treatment, and prognosis of PPCM were included. RECOMMENDATION PROCESS: After discussion of data presented, workshop participants agreed on a standardized definition of PPCM, a general clinical approach, and the need for a registry to provide an infrastructure for future research. CONCLUSIONS: Peripartum cardiomyopathy is a rare lethal disease about which little is known. Diagnosis is confined to a narrow period and requires echocardiographic evidence of left ventricular systolic dysfunction. Symptomatic patients should receive standard therapy for heart failure, managed by a multidisciplinary team. If subsequent pregnancies occur, they should be managed in collaboration with a high-risk perinatal center. Systematic data collection is required to answer important questions about incidence, treatment, and prognosis.

Cardiomyopathies↗
PubMed2003

Workshop in clinical anatomy for residents in gynecology and obstetrics.

A workshop in the clinical anatomy of the female pelvic viscera has been part of the training program for the first year residents in Gynecology and Obstetrics at the University of Padova since the 1999-2000 academic year. The purpose of the workshop is to offer a direct experience of practical anatomy despite a shortage of cadavers. It is designed for six residents who work in three teams on three specimens. The anatomical specimens are unembalmed, unfixed, female pelvic visceral blocs that are harvested from the cadavers 24 hr after death. They are stored at -12 degrees C and removed from the freezer 12 hr before the workshop. The workshop is 3 hr in length and has two parts: one on theory and one practical. In the theoretical section (30 min), the teacher presents the topographical anatomy of the specimens and the residents analyze a clinically oriented worksheet. In the practical section (2 hr), the residents identify viscera, vessels, and nerves through inspection and palpation, and then a step-by-step dissection is carried out. In the last section (30 min), the workshop includes presentations on the three specimens that illustrate anatomical variability and assess knowledge of topographical anatomy. For many residents, this is the first practical experience of the anatomy of the female pelvic viscera because the anatomical courses for medical students do not include direct dissection by students. The unfixed viscera preserves the natural characteristics of the different tissues that exhibit the aspects of living organs, such as color, softness, and pliability, enhancing the knowledge of anatomy. The worksheet is structured as a guide to the anatomical basis of physical examination through inspection and palpation of the viscera. It also introduces the residents to the surgical anatomy of the female pelvis through a brief and selective dissection focused on the relationship between the different regional systems.

Anatomy↗
PubMed2000

Evaluation of a problem-based learning workshop using pre- and post-test objective structured clinical examinations and standardized patients.

BACKGROUND: Osteoporosis is a health care issue in which family physicians play a major role. Although awareness of osteoporosis is high, recent studies suggest that application of recent advances in its treatment to the clinical setting may be low. We have developed a problem-based learning intervention for osteoporosis in which paired rheumatologists and family physicians developed nine problem-solving clinical scenarios. An educational matrix was used to link specific case scenarios with individual teaching objectives, developed via a previous needs assessment. Family physicians participated in the workshop, developing best practice responses to the clinical scenarios with a trained facilitator and content expert. METHODS: To assess the impact of this intervention, family physicians participated in a pre- and post-test evaluation, using objective structured clinical examinations and standardized patients. Objective structured clinical examination stations tested knowledge, skills, and judgment relating to osteoporosis with respect to risk factors, use of appropriate investigations including bone mineral densitometry (BMD), strategies for the prevention of osteoporosis (both pharmacologic and nonpharmacologic), treatment options for established osteoporosis (bisphosphonates and hormone replacement therapy), and management of recent osteoporosis fracture. Participants were evaluated using a predetermined score generated by their responses to objective structured clinical examinations and standardized patients (max. score = 101). Evaluations were conducted anonymously, although participants had access to their own pre- and post-test results for personal feedback. The impact of the workshop was assessed by comparing pre- and post-test responses by group, by individual, and by station. RESULTS: Participants demonstrated a significant improvement in their post-workshop scores. Of 40 participants, 26 showed improvement in score (> +10), 13 showed modest change (+1 to +10), and 1 showed a marked decrease (> -10). The greatest improvements were seen in the management of the male osteoporosis patient, determination of risk factors for osteoporosis, and the use and interpretation of bone mineral densitometry. Family physicians reported general satisfaction with the content and format of both the workshop and the evaluation process. IMPLICATIONS: We conclude that this type of problem-based learning intervention workshop results in improved knowledge, skills, and judgment in the management of osteoporosis by family physicians as objectively assessed using a pre- and post-test format including objective structured clinical examinations and standardized patients.

Clinical Competence↗
PubMed1989

Influence of continuing medical education workshops on participant learning.

The challenge of assessing the effectiveness of continuing medical education (CME) programs is formidable and intriguing. Two workshops on program factors affecting resident recruitment, conducted at annual meetings of the American Association of Directors of Psychiatric Residency Training, were evaluated for their influence on participant learning. Based on pre- and post-workshop questionnaires, participant perceptions and attitudes changed as a result of the workshop experience. The changes closely paralleled the planned and spontaneous discussion content. In describing the workshop-related changes, factors affecting residency program recruitment and aspects of CME program evaluation are discussed. A suggestion for enhancing workshop evaluations is incorporated.

Attitude of Health Personnel↗
PubMed2007

Evaluation of a pediatric palliative care educational workshop for oncology fellows.

BACKGROUND: Recent efforts have focused on improving pediatric palliative care to relieve physical and psychological suffering throughout the course of illness, as well as to improve care at the end-of-life (EOL). One area of attention has been medical training, as healthcare providers have often reported feeling ill-equipped to manage EOL issues. As a pilot study, we developed and evaluated a daylong educational workshop on pediatric palliative care for oncology fellows. PROCEDURE: Fellows (N = 32) from 20 hospitals participated in one of two workshops covering palliative care topics, such as pain/symptom management, communication, ethics, and bereavement. Training, knowledge, behavior, and attitudes regarding pediatric palliative care were assessed before the workshop, and knowledge was re-assessed immediately afterwards. RESULTS: Fellows reported a general lack of training in EOL care, and only 41% rated their education as at least "somewhat" adequate. Colleagues and personal experience were more often sources on EOL care, rather than formal classes or textbooks. Although fellows reported open attitudes toward palliative care, such as involving adolescents in decision-making, only half felt comfortable in the presence of a dying person. Fewer than half felt comfortable providing EOL care, managing families' expectations, or knowledgeable enough to discuss hospice with patients/families. Following the workshop, knowledge of palliative care increased significantly from 75 to 85% correct. CONCLUSIONS: Fellows reported open beliefs about palliative care, but acknowledged weaknesses in their training and level of competence. The workshop showed efficacy in improving knowledge, but additional research is needed to evaluate larger educational initiatives and their long-term impact on clinical services and family satisfaction.

Adult↗
PubMed1977

Research on control of craniofacial morphogenesis: an NIDR State-of-the-Art Workshop.

To assess the wide clinical ramifications of control of craniofacial morphogenesis, a State-of-the-Art Workshop was conducted by the National Institute of Dental Research at the initiative of Richard L. Christiansen, Chief of the Craniofacial Anomalies Program. In conjunction with the authors listed above, the format for the workshop was developed and participants were selected. The workshop was designed to provide an in-depth review of present knowledge and to identify future goals and directions for research on guiding, altering, and thus controlling growth and development of the cranofacial skeleton. The agenda for discussion ranged from molecular biology to clinical arts such as orthopedics and surgery. It was evident during the workshop that the mechanisms and procedures for controlling craniofacial morphogenesis must be derived from many biologic, physical, and clinical fields of knowledge. It is hoped that there will evolve an interdisciplinary clinical art which is aimed at preventing and correcting craniofacial deformities. Substantial biologic information has already been accumulated on the craniofacial skeleton. The clinical art of correcting malocclusion through mechanical forces is now applicable to the entire skull. The outstanding technical accomplishments of radical surgery in the correction of congenital craniofacial anomalies show that the needed surgical skills are now available. When these resources are combined, an area of knowledge and a clinical discipline which might be called "orthocephalics" is already identifiable. The workshop was held at the National Institutes of Health in Bethesda, Maryland, on Feb. 12 and 13, 1974. The ideas exchanged were integrated and summarized by the planning committee to produce this report.

Animals↗
PubMed1992

Transfer of staff training from workshops to group homes: a failure to generalize across settings.

Two experiments were conducted to assess acquisition and generalization of skills acquired in a workshop by trainees who were primary caregivers on the staffs of group homes for developmentally disabled clients. In Study 1, 31 staff trainees received an intensive, 1-week workshop in behavioral theory and treatment techniques. When assessed at the workshop site, these staff trainees showed increased treatment skills, relative to 18 staff trainees who did not participate in the workshop. In Study 2, pre- and postworkshop observations were taken on 53 developmentally disabled clients in group homes where the staff trainees worked. These observations provided no evidence that the workshop had any effect on group home client functioning. Future training programs for caregivers may be more successful if they occur in the group home, involve clients in the home, and enlist the support of supervisory staff, rather than focusing only on primary caregivers.

Activities of Daily Living↗
PubMed2005

The First International Collaborative Workshop on Seizure Prediction: summary and data description.

The First International Collaborative Workshop on Seizure Prediction was held at the Department of Epileptology, University of Bonn, in Bonn, Germany on April 24-28, 2002. Organized by the Universities of Pennsylvania and Bonn, and funded by grants from the American Epilepsy Society, the German Section of the International League against Epilepsy, and the German Section of the International Federation of Clinical Neurophysiology, the workshop was attended by 51 researchers from 16 centers in seven countries. There were four major goals for the workshop: (1) to host a one-day didactic session on the science of seizure prediction, with lectures by leaders in the field; (2) to assess the current state of the field by applying current methods used to predict seizures to a shared set of continuous intracranial EEG data and discussing the strengths and weaknesses of each approach; (3) to establish a consensus on minimal data requirements, a common nomenclature, and objective methods for comparing system performance across platforms and laboratories for seizure prediction research; and most importantly (4) to establish a multi-laboratory, international working group dedicated to understanding seizure generation and making on-line, prospective seizure prediction a reality. Following the didactic course, each participating group presented their results, after applying their seizure prediction methods to five common data sets agreed upon in advance and distributed before the meeting. What follows is a description of the shared data set used for analysis, a summary of the major discussion points from the workshop, and points of consensus among the group. The brief discussion serves as a common introduction to the research papers that follow in this issue, and the description of the shared data is referenced in each of these papers. Participants in the workshop are listed at the end of the Conclusions section, in alphabetical order.

Consensus↗
PubMed1999

Workshop on irradiated larval vaccines.

The development of anthelmintic resistance in gastrointestinal parasites of sheep and goats has meant that there is an urgent need for non-chemical control of these parasites. In order to investigate a potential alternative method of control, a workshop on irradiated larval vaccines (ILV) was held in conjunction with the Second International Conference on Novel Approaches to the Control of Helminth Parasites of Livestock. The objectives of the workshop were to: (1) Review knowledge of irradiated helminth vaccines through the presentation of invited and contributed papers. (2) Identify opportunities for an ILV and in which host/parasite/production systems. (3) Determine what are the gaps in knowledge required to produce and apply an ILV. The workshop concluded that ILVs could be useful as research tools in the further definition of immune responses to parasites and in stimulating the immune response in young sheep and goats to facilitate the estimating of heritability of faecal egg counts. Although the workshop identified some problems associated with a live attenuated vaccine, an ILV could be a useful control measure in the production systems identified by the workshop. Before an ILV could be used on farms, additional research is required into the period of protection afforded by an ILV especially under field conditions. The efficacy of an ILV could be improved by interaction between host genotype and nutritional status and is deserving of further investigation.

Animals↗
PubMed2001

NCI image archive management workshop: a preliminary report.

The National Cancer Institute organized a workshop entitled "Image Archive Management" that was presented on August 28 and 29, 2000, at the Natcher Conference Center on the National Institutes of Health (NIH) campus. The purpose of this workshop was to solicit expert input for the planned development of an archival system to make imaging databases readily accessible by the broad scientific community. The specific goals were to (a) define the technical requirements for a virtual archive of images used in oncology, (b) define the policy issues for access to these images, (c) recommend a process and phases for implementation of a robust imaging archival system, (d) review how this effort could be expanded and coupled with other ongoing efforts by NIH and other organizations interested in imaging, and (e) form an overall plan and policy to allow interoperability of image data archives. Representatives who attended the workshop came from academia, government agencies, and large and small businesses. A preliminary report was generated, as outlined herein, and additional reports are anticipated from the steering committee being organized as one of this workshop's recommendations, which is expected to be active by summer 2001. Additional information, including the list of participants in this workshop, is available at the Biomedical Imaging Program Web site (http://www.nci.nih.gov/bip/).

Humans↗
PubMed2002

Preclinical testing for aortic endovascular grafts: results of a Food and Drug Administration workshop.

BACKGROUND: Since their introduction into clinical trials in the United States, endovascular aortic grafts have shown various types of problems. Although details of design and construction vary between different endovascular grafts and failure modes have had a variety of causes and clinical effects, the inability of preclinical testing to predict these failures remains common to all endovascular grafts. The need to improve preclinical testing in an attempt to reduce clinical device failures resulted in a Food and Drug Administration-sponsored workshop on endovascular graft preclinical testing held in Rockville, Md, from July 31 to August 1, 2001. FORMAT: The workshop was not designed as a consensus conference. Instead, it provided a forum for bringing stakeholders together to define problems and identify areas of agreement and disagreement. The workshop had 34 invited participants who represented device manufacturers, the medical community, the Food and Drug Administration, and testing facilities, and international attendance was more than 120 people. OUTCOME: Discussion centered on: 1, defining the physiologic, anatomic, and morphologic characteristics of abdominal aortic aneurysms before and after endovascular graft treatment; 2, identifying the types of failures that have been observed clinically; and 3, determining which characteristics should be considered during preclinical modeling to better predict clinical performance. Attendees agreed to the need to better define and address anatomic characteristics and changes in the aneurysm after endograft treatment to optimize preclinical testing. Much discussion and little agreement occurred on the importance of flow-related forces on graft performance or the need or ability to define and model physiologic compliance during durability testing. The discussion and conclusions are summarized in this paper and are provided in detail at: http://www.fda.gov/cdrh/meetings/073101workshop.html. CONCLUSION: The workshop raised awareness of significant performance issues and the challenges of modeling the extremely variable and relatively undefined environment of abdominal aortic aneurysms. Through the interactive format of the workshop, participants identified areas of preclinical testing, device design, and aspects of the simulated environment that need further consideration.

Animals↗
PubMed2001

Improving teachers' skills in working with 'problem' residents: a workshop description and evaluation.

Working with 'problem' residents is a common challenge in medical education. This article describes a workshop designed to improve teachers' skills in this area as well as the results of an evaluation conducted to assess its effectiveness. Workshop modules focused on defining the problem, confirming the diagnosis, designing and implementing the intervention, and assuring residents' rights. Feedback on the workshop indicated that the participants were satisfied with the workshop content and format, and that they particularly valued the framework by which to analyze resident problems, gather relevant information, and design the intervention. Results on a self-assessment questionnaire indicated that the participants increased their knowledge in problem definition, data gathering, and the principles underlying an intervention strategy. This experience suggests that a two-day workshop focusing on the 'problem' resident can increase teachers' skills in working with 'problem' residents and can be adapted to diverse settings and disciplines.

Journal Article↗
PubMed2000

Critical appraisal workshops to promote evidence-based healthcare.

We evaluated the effect of literature appraisal workshops on participants views, attitudes and knowledge about evidence-based medicine in the West Midlands region in 1998. The performance of 55 practitioners was evaluated, before and after attending the workshop. After attending the workshop, participants paid more attention to the study design (81% vs. 98%, P=0.02), they did not find research evidence confusing (35% vs. 52%, P=0.05), and they felt more confident in assessing research evidence (26% vs. 59%, P=0.0001). Their mean knowledge scores improved from 47.3 (SD12.2) to 57.9 (SD 9.0) ( P=0.0001). Our critical appraisal skills workshops improved attitudes and knowledge needed for the provision of evidence-supported healthcare. Such workshops should be incorporated in postgraduate obstetrics and gynaecology training programmes.

Journal Article↗
PubMed2000

Is hands-on experience more effective than didactic workshops in postgraduate cancer pain education?

BACKGROUND: This study examined the nurse outcomes of a cancer pain education program for nurses of patients from 11 different ethnic groups. METHODS: Four hundred ninety six home, hospital, and hospice nurses participated in a one-day workshop or two half-day workshops on cancer pain assessment and management. Of these, 116 were randomized to participate in a bedside-precepted visit with an oncology nurse specialist with pain specialization and a focus group to discuss attitudinal issues. Eighty-six nurses served as controls. Pre-, post- and one-year follow-up tests were administered. RESULTS: Attitudes, knowledge, and application skills significantly improved for workshop-only and enriched-model nurses relative to controls. CONCLUSION: For postgraduate nurses, daylong cancer pain education workshops were, in the group studied, as effective as hands-on experience in improving cancer pain knowledge and changing attitudes. Both the workshop-only and the enriched-model nurses relative to controls had significantly improved knowledge and changed attitudes towards optimal pain management.

Adult↗
PubMed1999

Learning effects of a workshop in palliative cancer care for general practitioners.

BACKGROUND: Cancer patients may unnecessarily suffer from pain and other symptoms due to insufficient knowledge on the part of their doctors. In The Netherlands, the general practitioner is considered to be the key provider of palliative care for the cancer patient. Therefore, the authors developed and conducted workshops to teach symptom control to general practitioners. These workshops contained learning objectives from which they selected 18 items to form a questionnaire with five-point response scales. The goal of this study was to investigate changes in the knowledge and attitude scores of the participating general practitioners. METHODS: The participants were asked to complete the questionnaire at the start of the workshop and also four months later. RESULTS: Responses were obtained from 120 general practitioners for the pre-workshop and 96 for the post-workshop questionnaires. The majority of the scores increased toward the desired effect, and some items' scores improved by almost two points. CONCLUSION: The results suggest improvements in general practitioners' knowledge and attitude scores with regard to cancer pain and symptom management. Future studies should try to link these improvements with quality-of-life parameters of terminal cancer patients and their families.

Curriculum↗