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PubMed2001

Reintegrating women leaving jail into urban communities: a description of a model program.

Women are the fastest-growing population in the criminal justice system, and jails reach more people than any other component of the correctional system. About 1 million women pass through US jails each year. Most return to their communities within a few weeks of arrest, and few receive help for the substance abuse, health, psychological or social problems that contribute to incarceration. We describe a model program, Health Link, designed to assist drug-using jailed women in New York City to return to their communities, reduce drug use and HIV risk behavior, and avoid rearrest. The program operates on four levels: direct services, including case management for individual women in the jail and for 1 year after release; technical assistance, training, and financial support for community service providers that serve ex-offenders; staff support for a network of local service providers that coordinate services and advocate for resources; and policy analysis and advocacy to identify and reduce barriers to successful community reintegration of women released from jail. We describe the characteristics of 386 women enrolled in Health Link in 1997 and 1998; define the elements of this intervention; and assess the lessons we have learned from 10 years of experience working with jailed women.

Adult↗
PubMed2001

Practical implementation of the medical exposure directive (97/43) in Luxembourg.

The medical exposure Directive of 1984 was updated in 1997 (EURATOM 97/43) and should be implemented into national legislation before May 2000. Need for harmonisation exists in Europe, as differences in the application of ionising radiation exist throughout European countries and social mobility of the population is increasing. The context of the justification/optimisation process as well as specific characteristics of national health legislation and Social Security legislation and their impact on radiation protection of the patient, are presented. Existing differences in the justification process throughout Europe are: (i) prescribing process of the X ray examination, training of the prescriber, (ii) auto-referral; (iii) economic situation in the member states. The optimisation process is mainly sensitive to: (i) 'culture' of radiation protection in each national medical community; (ii) training; (iii) technical and clinical audits; (iv) quality assurance.

European Union↗
PubMed2002

A whole body counting facility in a remote Enewetak Island setting.

The U.S. Department of Energy (DOE) has recently implemented a series of strategic initiatives to address long-term radiological surveillance needs at former U.S. test sites in the Marshall Islands. The plan is to engage local atoll communities in developing shared responsibilities for implementing radiation protection programs for resettled and resettling populations. As part of this new initiative, DOE agreed to design and construct a radiological laboratory on Enewetak Island, and help develop the necessary local resources to maintain and operate the facility. This cooperative effort was formalized in August 2000 between the DOE, the Republic of the Marshall Islands (RMI), and the Enewetak/Ujelang Local Atoll Government (EULGOV). The laboratory facility was completed in May 2001. The laboratory incorporates both a permanent whole body counting system to assess internal exposures to 137Cs, and clean living space for people providing 24-h void urine samples. DOE continues to provide on-going technical assistance, training, and data quality review while EULGOV provides manpower and infrastructure development to sustain facility operations on a full-time basis. This paper will detail the special construction, transportation and installation issues in establishing a whole body counting facility in an isolated, harsh environmental setting.

Body Burden↗
PubMedDate not supplied

A conceptual model for understanding effective coalitions involved in health promotion programming.

Funding agencies are increasingly focused on community coalitions as effective entities for promoting public health programs. Yet, there has been no conceptual model for understanding how effective coalition infrastructure works to facilitate a learning environment, wherein coalition members and leaders receive ongoing training and technical assistance needed to accomplish their external programming goals. This article presents a conceptual model for measuring the internal effectiveness of coalitions [Internal Coalition Outcome Hierarchy (ICOH)]. The ICOH model served as the basis for development of the evaluation instrument, Internal Coalition Effectiveness, which measures internal coalition effectiveness based on achievement of organizational outcomes at each of the model's seven hierarchical levels. The ICOH conceptual model has broad application for public health nurses who are frequently called on to serve as evaluators for community coalitions engaged in health programming. The model has implications for evaluators to use in teaching coalition members and leaders about their internal strengths and areas for improvement, so that coalitions can develop more effective internal structures and thereby promote long-term sustainability.

Community Participation↗
PubMed1991

Nationwide faculty development: a model for a shift from diploma to baccalaureate education.

Many countries are in the process of moving nursing education from 2-year or 3-year diploma programmes to institutions of higher education. This paper reports on a national project in Israel in which diploma school faculties were retooled for baccalaureate teaching. Among many issues associated with this shift are two addressed by this paper: what are the essential differences between diploma and baccalaureate education and how can faculty be developed so that the change is substantive and not the same type of education with a different label? The authors propose: (a) more radical changes must occur in the preparation of faculty for there to be substantive differences in the graduates; (b) the objectives curriculum model widely exported from the USA promotes training for technical levels of nursing and inhibits true education for professional practice; (c) there are six types of learning, not one, and the difference between technical and professional nursing education lies in the types of learning emphasized by faculty.

Curriculum↗
PubMed1988

A role for computers in the management of dental education.

The dental educator confronts increasing demands for technically demanding training against a background of factors working to reduce the clinical experience of students: less dental disease, new educational emphases and greater cost-consciousness. A computer system is described which has run successfully for 7 years in the Department of Conservative Dentistry at Manchester University. This system enables better use to be made of declining teaching resources; it allows the department to make more accurate and timely assessments of student progress; it can also provide information on current workload and clinical commitments. Some possible lines of future development are discussed, including use of the system to collect Korner data-sets and to support a more integrated approach to treatment.

Computers↗
PubMed2003

Technical skills in paediatrics: a qualitative study of acquisition, attitudes and assumptions in the neonatal intensive care unit.

PURPOSE: While the effective acquisition of technical skills is essential for excellent paediatric care, little is known about how technical skills are learned in the paediatric setting. This study sought to describe and theorise the variables influencing technical skills acquisition in a tertiary care neonatal intensive care unit (NICU) inpatient setting. METHODOLOGY: Using non-participant field methodology, paediatric residents and their teachers (nurses, respiratory therapists, neonatal staff and fellows) were observed at various times in the NICU for 8 weeks. Thirteen semistructured interviews with these teachers and learners and 1 focus group of additional learners were conducted and used to triangulate observational findings. Using a constant comparative process, field notes, interview and focus group transcripts were analysed by 2 researchers for emergent themes in the grounded theory tradition. RESULTS: Data sourced from over 90 hours of observation and 21 observed technical procedures, and both individual and group interviews are presented thematically. Dominant themes include: the nature, timing and purpose of feedback about technical procedures; opportunities to learn technical skills; multiple demands that intersect with technical procedure attempts; competing priorities, and teachers' and learners' differing perceptions. These themes interact to affect the learning environment. CONCLUSION: The NICU learning environment represents a complex interplay between competing priorities, learning opportunities and attributions about learners. This interplay must be understood if improvements to technical skills training in this domain are to be developed.

Attitude of Health Personnel↗
PubMed2007

Injuries in Swedish skydiving.

OBJECTIVE: To create a basis for prevention of modern skydiving injuries. DESIGN: Descriptive epidemiological study. SETTING: National total material. PATIENTS: Data on all reported injury events (n = 257) in Swedish skydiving 1999-2003 (total 539,885 jumps) were retrieved from the Swedish Parachute Association. Non-fatally injured skydivers were sent a questionnaire asking for event and injury details (response rate 89%), and supplementary hospital records were retrieved for the most serious injuries (n = 85). Human, equipment and environmental factors were assessed for risk. MAIN OUTCOME MEASUREMENTS: Frequency and severity of injuries. RESULTS: Incidence of non-fatal injury events was 48 per 100,000 jumps. The lower extremities, spine and shoulders were important regions of injury. The most serious injuries were experienced by licensed skydivers, but students in training had a higher injury rate and more often left the sport because of the injury. Of two student-training systems, one had an incidence less than half that of the other. CONCLUSIONS: A basis for prevention was created, showing a potential for reduction of frequency and severity of injuries with training and technical interventions.

Athletic Injuries↗
PubMed1994

Teaching laparoscopic surgery: the need for guidelines.

There is a risk that minimally invasive surgery will fall into disrepute unless adequate steps are taken to reassure the public. Some form of accreditation after a recognised training scheme would go a long way towards allaying these fears. The cost of training surgeons must be addressed. Adequate training will probably pay dividends in reduced litigation. The royal colleges should be responsible for maintaining standards of teaching on recognised courses, setting criteria for accreditation, and supervising a national audit of all laparoscopic procedures.

Accreditation↗
PubMed1984

Training rural health staff for oral rehydration therapy in southern Sudan.

From February 1980 to August 1982 a very definite change occurred in the treatment pattern for diarrhoea among the rural health staff in Torit and Kapoeta districts in Eastern Equatoria Province in Sudan. This paper describes a training and supervision programme for promoting use of ORT in diarrhoeal diseases and at the same time discouraging the use of sulphonamides in simple diarrhoea. In the training programme emphasis is put on increasing the knowledge of the health staff both about the medical facts and about communication with their communities. ORS as treatment for diarrhoea has been well accepted by the public, who consider the sugar/salt solution as "good medicine". The use of sulphonamides for diarrhoea has decreased from 75% to 22% of the diarrhoea cases, while use of ORS has increased from 7% to 72% of the diarrhoea cases.

Adult↗
PubMed1992

A computerized intensive care unit order-writing protocol.

OBJECTIVE: To present a computerized intensive care unit order-writing protocol. DESIGN: Descriptive report. SETTING: Eight-bed surgical intensive care unit, Department of Surgery, Department of Veterans Affairs Medical Center, Bronx, NY. METHODS: IBM-based, computer network program that provides user-friendly, logical, and comprehensive organ-system order sequences for patient management. RESULTS: Since July 1988, an order program that stresses (1) improved and more efficient patient care, (2) the use of program-integrated automatic safety features, (3) the substitution of computer entry for handwriting, and (4) the assurance that physicians deliver obligatory care in a logical organ-system-based progression has been implemented. CONCLUSIONS: The order protocol system presented is simple to introduce and operate, has minimal training and technical requirements, and is demonstrably reliable.

Computer Security↗
PubMed2006

Evaluation and community prevention coalitions: validation of an integrated Web-based/technical assistance consultant model.

Community coalitions (CCs) have labored with some difficulty to demonstrate empirical evidence of effectiveness in preventing a wide range of adolescent problem behaviors. Training and technical assistance (TA) have been identified as important elements in promoting improved functioning of CCs. A reliable, valid, and inexpensive method to assess functioning of CCs has been developed and is tested in this article in the context of Pennsylvania's Communities That Care (CTC) model. A CC Web-based questionnaire was developed and administered to more than 79 communities (867 participants) and the validity and reliability were assessed through multiple means, including the use of a companion TA implementation feedback questionnaire completed by TAs assigned to each of the sites. Results indicated adequate to good psychometric properties on internal reliability of the Web-based questionnaire, moderate construct validity across different reports of functioning, and relative stability throughout the course of 1 year. Implications for a variety of community prevention coalitions interested in a relatively low-cost, user friendly, and suitable methodology for evaluating coalition functioning are discussed. In addition, areas of application for future research including linking coalition functioning with the quality and nature of technical assistance, levels of risk and protective factors, and large data sets of youth risk factor and problem behavior data are highlighted.

Adolescent↗
PubMedDate not supplied

Fragmented services, unmet needs: building collaboration between the mental health and domestic violence communities.

The Domestic Violence and Mental Health Policy Initiative (DVMHPI) is an innovative project to address the unmet mental health needs of domestic violence survivors and their children and to develop models that integrate clinical and advocacy concerns. Overseeing a network of more than fifty community-based mental health, domestic violence, substance abuse, and social service agencies, as well as city and state officials, the DVMHPI promotes collaboration and provides training and technical assistance to improve the capacity of local service systems to address the traumatic effects of abuse. This report highlights the importance of generating funding streams that promote collaboration.

Battered Women↗