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PubMedDate not supplied

Results of a focused scald-prevention program.

Scalds are a leading cause of burn injury for young children. A focused prevention program was developed in the zip code accounting for the majority of scald burns. This study investigated the effect of the program. Families in the high-risk area were identified at clinics, community centers, and schools. Parent workshops and home visits were the interventions used. A pretest was administered at the workshop to measure baseline knowledge. A post-test was administered at either the home visit or by telephone to measure change in knowledge. A survey was used to measure baseline scald risks in the home. Home visits were used to reinforce information from workshops, evaluate the home environment, and assist parents to make environmental changes. Changes to the home environments were made, with antiscald devices installed in the shower, sink, or bathtub depending on parent preference. The survey was repeated on a follow-up home visit to determine whether parents adhered to environmental changes and safety practices. The postmeasurements were performed from 6 to 12 months after the initial measurement. More than 900 parents attended the initial workshops, and 173 consented to participate in the follow-up study and took the pretest. Of these, 62 completed the post-test, and 48 participated in a home visit. The mean pretest score was 72 +/- 1%, and mean post-test score was 85 +/- 1% (P < .01). The initial home visit surveys revealed an average of 7 +/- 2 scald risks per household, whereas follow-up surveys showed an average of 2 +/- 1 risks (P < .01). Antiscald devices were installed in 37 households on the initial visit and remained in place and functioning in 22 households (60%) on the follow-up visit. Before the focused prevention program, the admission rate from the target zip code was 137 per 100,000 children ages 0 to 5 years. After the intervention, there was a greater than 2-fold reduction, to 59 per 100,000 (P < .01). In addition, there were no new scald burns in the homes in which the focused prevention program took place. This study demonstrates that a focused burn-prevention program can identify high-risk groups, decrease the number of scald risks per home, and decrease the rate of scald burns in the population. This straightforward program could be used to intervene in high-risk groups in other communities.

Accidents, Home↗
PubMed2006

Breast cancer screening in women surviving Hodgkin disease.

OBJECTIVE: To inform female Hodgkin disease (HD) survivors, younger than 35 at diagnosis, of their increased risk for breast cancer and encourage them to seek breast cancer screening. METHODS: An evidence-based intervention, telephone counseling, was used in a pre-post test design, randomized trial with the control group being offered the intervention following the post-test. Women treated at Stanford University who received thoracic irradiation before age 35, alive and HD-free at last contact, were referred to the project (n = 471). Of 261 eligible women who could be located, 157 completed the pretest and were randomized (60% response rate) and 133 completed the post-test (85% retention rate). RESULTS: There was a positive intervention effect on mammography maintenance: the odds of being in maintenance at post-test compared with pretest were greater in the intervention group than in the control group [odds ratio (OR) = 3.6]. Women were more likely to be in mammography maintenance at pre- or post-test if at pretest they were married (OR = 5.7), employed (OR = 2.3), more worried about breast cancer (OR = 1.4 per unit of scale), or received an annual physical examination (OR = 2.2). Women under age 40 were much less likely to be in maintenance than were those age 45 and over (age 35-39, OR = 0.2; under age 35, OR = 0.07). CONCLUSIONS: The findings indicate that providing risk information encourages cancer survivors to take health preventive actions. Telephone counseling is a method that can provide risk information and is easily transferable to settings where people seek health information, such as telephone information lines.

Adult↗
PubMed2005

Impact of direct-to-consumer advertising for hereditary breast cancer testing on genetic services at a managed care organization: a naturally-occurring experiment.

PURPOSE: To describe the impact of Myriad Genetics, Inc.'s direct-to-consumer advertising (DTC-ad) campaign on cancer genetic services within two Managed Care Organizations, Kaiser Permanente Colorado (KPCO), Denver, Colorado, where the ad campaign occurred, and Henry Ford Health System (HFHS), Detroit, Michigan, where there were no advertisements. METHODS: The main outcome measures were the changes in number and pretest mutation probability of referrals approved for cancer genetic services at KPCO and HFHS during the campaign versus the year prior, and mutation probability of those undergoing testing. RESULTS: At KPCO, referrals increased 244% during the DTC-ad compared to the same time period a year earlier (P value<0.001). The proportion of referrals at high pretest probability of a mutation (10% or greater) dropped from 69% the previous year to 48% during the campaign (P value<0.001). There was no significant change in pretest mutation probability among women who underwent testing between the two time periods. HFHS reported no significant change between the two time periods for numbers or mutation probability of referrals, or for mutation probability of women tested. CONCLUSION: The DTC-ad caused significant increase in demand for cancer genetic services. In the face of potential future DTC-ad for inherited cancer risk, providers and payers need to consider the delivery of genetic services and genetic education for persons of all risk levels.

Adult↗
PubMed2004

Preschool visual acuity screening with HOTV and Lea symbols: testability and between-test agreement.

PURPOSE: To compare the performance of 3- to 5-year-old children on visual acuity screening with HOTV letters vs. Lea symbols as optotypes. METHODS: Subjects included 1253 Head Start children who were aged either 3 or 4 years on September 1 of the school year of testing. The sample over-represented children who had not passed a Head Start screening. Binocular pretesting at 1 m demonstrated the child's ability to identify the optotypes verbally or by matching optotypes on a lap card. Acuity was tested monocularly at 3 m using crowded single lines of optotypes. Lines tested were based on age at the beginning of the school year (September 1) with 3-year-old children tested with lines 10/100, 10/32, 10/25, and 10/20 and 4-year-old children tested with 10/100, 10/25, 10/20, and 10/16. RESULTS: Overall, 99% of children were able to complete the binocular pretest for each test successfully, and there was no difference between the tests (p = 0.83). Children's ability to complete the pretest increased slightly with age. HOTV test scores were slightly worse than Lea symbols test scores (p = 0.047), primarily because more children were unable to pass the monocular 10/100 card for the HOTV test than for the Lea symbols test (2.6% vs. 1.3%). The percentage of identical results on HOTV vs. Lea overall was 67.3% and increased significantly with age. When the results were different, 3-year-old children, but not 4- and 5-year-old children, tended to have worse results on the HOTV letter test. CONCLUSIONS: The vision of nearly all 3- to 5-year-old children can be screened using either HOTV letters or Lea symbols. HOTV letters may be slightly more difficult than Lea symbols for 3- to 5-year-old children, with the largest difference between acuity results on the two tests occurring in 3-year-old children.

Aging↗
PubMed2005

Evaluation of age-appropriate firearm safety interventions.

OBJECTIVES: The purpose of this study was to determine if firearm safety training increased the knowledge of school-age children about gun safety. It was predicted that children's knowledge, attitudes, and feelings about firearm safety would be impacted by the method used to teach the key firearm safety constructs. The specific aim was to test the effects of 3 levels of firearm safety training on school-age children's knowledge about gun safety. The hypothesis was that children who attended a firearm injury prevention program that used a scripted discussion, psychomotor exercise, and a role-playing exercise about firearm safety would have greater knowledge about firearm safety. METHODS: A quasi-experimental pretest-posttest randomized complete block design was used. There were 57 participants, 58% were male and the mean age was 5.89 years. A pictorial tool was used to assess kindergarten and first-grade students' baseline and postintervention knowledge of firearm safety. RESULTS: Knowledge increased in all of the intervention groups [F(3,53) = 6.69, P = 0.001]. The greatest increase in knowledge occurred in the scripted discussion/psychomotor exercise group which exhibited an 81% increase in knowledge from the pretest to the posttest. There was no change in the control group's knowledge from pretest to posttest (P = 0.3). CONCLUSIONS: This study provides evidence that children do retain firearm safety training. The long-term objective of this research is to reduce the incidence of firearm injuries during childhood by teaching children how to be safe around guns.

Age Factors↗
PubMedDate not supplied

Impact of meditation on resting and ambulatory blood pressure and heart rate in youth.

OBJECTIVE: The purpose of this study was to evaluate the impact of a meditation program on resting and ambulatory blood pressure and heart rate in youth. METHODS: Data from 73 middle school students (age 12.3 +/- 0.6 years) randomly assigned by classroom to either meditation (N = 34) or health education control (N = 39) groups were analyzed. The meditation groups engaged in 10-minute sessions at school and at home after school each day for 3 months. Resting (seated) systolic blood pressure, diastolic blood pressure, and heart rate measurements were obtained pretest and posttest on three consecutive school days using Dinamap 1846SX monitors. Ambulatory systolic blood pressure, ambulatory diastolic blood pressure, and ambulatory heart rate were recorded over 24-hour periods at pretest and posttest every 20 minutes during self-reported normal waking hours and every 30 minutes during self-reported normal sleep hours using Spacelabs 90207 monitors. RESULTS: Significant (p < .05) differences in average change from pretest to posttest were found between the meditation and health education control groups for resting systolic blood pressure (-2.7 vs. 1.1 mm Hg), daytime ambulatory systolic blood pressure after school (-2.0 vs. 3.6 mm Hg), daytime ambulatory diastolic blood pressure after school (0.1 vs. 4.3 mm Hg), and daytime ambulatory heart rate after school (-5.3 vs. 0.3 bpm). CONCLUSION: These findings demonstrate the potential beneficial impact of meditation on blood pressure and heart rate in the natural environment in healthy normotensive youth.

Adolescent↗
PubMed1988

Epidermis and lymphocyte interactions during an allergic patch test reaction. Increased activity of ETAF/IL-1, epidermal derived lymphocyte chemotactic factor and mixed skin lymphocyte reactivity in persons with type IV allergy.

Recently, we have found an increased activity of epidermal-derived thymocyte-activating factor (ETAF/IL-1) and epidermal lymphocyte chemotactic factor (ELCF) in epidermis overlying a positive tuberculin skin reaction. In the present study, we investigated 20 patients with confirmed or suspected allergic contact dermatitis by using the suction blister technique before and during patch testing. The ETAF/IL-1 was found in epidermis before patch testing. Its presence increased 2.8-fold in epidermis overlying a positive patch test compared with pretesting values. This increase was statistically significant. Interestingly, nontested skin also showed a significant increase of ETAF/IL-1, which was 1.9-fold higher than pretest values. The ETAF/IL-1 activity in patch test areas was significantly correlated with the clinical response. ELCF is not present in epidermis from noneczematous persons. We observed a significant content of ELCF in three of seven patients with eczema prior to patch testing. After patch testing, all patients showed ELCF in epidermis. Nontested skin showed a 1.5-fold higher content of ELCF compared with pretest values, and in the test area ELCF was 1.8-fold higher. The increases were statistically significant. We performed mixed skin lymphocyte reactions in seven patients using epidermal cells from the patch test area. All patients with a positive patch test had an increased mixed skin lymphocyte reactivity compared with epidermis coming from a negative reaction.

Adult↗
PubMed2006

In the ventral tegmental area, cyclic AMP mediates the actions of progesterone at dopamine type 1 receptors for lordosis of rats and hamsters.

Progesterone-facilitated lordosis is enhanced by activation of, and inhibited by antagonism of, dopamine type 1 receptors (D1) in the ventral tegmental area (VTA). Given that D1 activation leads to increases in cyclic AMP (cAMP), we hypothesised that, in the VTA, progesterone's actions on lordosis that involve D1 are mediated, in part, by cAMP. In Experiment 1, naturally receptive rats and hamsters were pretested for lordosis, infused with the cAMP analogue 8-bromo-cAMP (200 ng) or vehicle to the VTA, and tested again 30 min later. In Experiments 2 and 3, ovariectomised, oestradiol (10 microg) + progesterone (0 or 100 microg)-primed rats and oestradiol (10 microg) + progesterone (0 or 200 microg)-primed hamsters were pretested for lordosis and infused with 8-bromo-cAMP (200 ng), the adenylyl cyclase inhibitor 2',5'-dideoxyadenosine (12 microM) or vehicle to the VTA. Subjects were tested again 30 min later. In Experiment 4, oestradiol + progesterone-primed rats and hamsters were pretested and infused with the D1 agonist SKF38393 (0 or 100 ng) to the VTA. Thirty minutes later, subjects were tested again and infused with 2',5'-dideoxyadenosine (12 microM) or vehicle. Subjects were tested again 30 min later. VTA infusions of 8-bromo-cAMP enhanced lordosis of naturally receptive or hormone-primed rats and hamsters and 2',5'-dideoxyadenosine decreased lordosis of oestradiol + progesterone-primed rats and hamsters. D1-mediated increases in progesterone-facilitated lordosis were reduced by 2',5'-dideoxyadenosine. These data suggest that progesterone-facilitated lordosis of rats and hamsters may be modulated by D1 and cAMP activity in the VTA.

Analysis of Variance↗
PubMed1993

Integration of the surgical specialties into an innovative undergraduate curriculum.

A dilemma exists concerning the most effective way to incorporate surgical specialty teaching into an innovative undergraduate curriculum. Should the specialties form part of the core curriculum or should they be available as electives? The aim of this study is to describe an educationally sound and time-effective way to give all students an exposure to the surgical specialties while maintaining the philosophy of an innovative curriculum. The SCORPIO method was used, on a trial basis, in 1992 to teach cardiothoracic surgery, neurosurgery, plastic surgery and urology to fourth-year medical students at a university teaching hospital. The teaching was evaluated by comparing group pretest performance with a posttest assessment given one month after each of the teaching sessions. Student perceptions were assessed by a questionnaire and a time analysis was carried out comparing SCORPIO with the traditional ward tutorial system. Students completed the sequence pretest, teaching and posttest on 169 occasions. Group performance increased from a pretest mean 28% (SD16) to a posttest mean 44% (SD13) P < 0.0001. Student acceptance was favourable, with high ratings given to the structured, problem-based style of teaching. The time to run the programme was one-eight that to teach by the ward tutorial system. This teaching model is a practical way to incorporate the surgical specialties into the core curriculum of a school moving towards a student centred, problem-based, integrated curriculum.

Australia↗
PubMed2005

Stroke Specific Quality of Life Scale: Danish adaptation and a pilot study for testing psychometric properties.

BACKGROUND AND PURPOSE: Stroke has an effect on many aspects of quality of life (QoL) and therefore it is important to measure the magnitude of the impact. Items in the American version of the Stroke Specific Quality of Life (SS-QoL) Scale are developed with help from patients with stroke and include even language impairments. AIMS: To translate and culturally adapt the American SS-QoL Scale, version 2.0, a stroke-specific instrument measuring health-related QoL, into a Danish version, and to perform a pilot testing of the psychometric properties of the instrument. METHODS: The guidelines recommended by Guillemin et al. (J Clin Epidemiol, 46, 1993, 1417) were followed including two independent forward and one back translation, inclusion of laymen, here patients with stroke and their spouses, pretest, and examining selected items with a probing technique. Four couples were included in the pretest, 14 in the pilot study. The patients for pretest and pilot study were selected strategically with regard to interest for participation, experience as stroke survivors, sufficient capacity of language perception and cohabitant status. RESULTS: In the Danish version instructions were made more distinct and formal than in the original American version. Explanatory examples within the items were excluded. One new item adjusted for Danish conditions replaced one in the original version, and the response categories concerning personality were adjusted for cultural differences. The pilot study resulted in a more explicit formulation of the instructions to mark each item only once and on the same line as the item. CONCLUSIONS: A Danish version of SS-QoL version 2.0 has been developed and content as well as format has proved relevant and acceptable to patients with stroke including those with impaired language production. The next step is testing the psychometric properties of the instrument.

Activities of Daily Living↗
PubMedDate not supplied

Effectiveness of breast self-examination teaching to women of low socioeconomic class.

To assess the effect of a breast self-examination (BSE) teaching program on retention of BSE knowledge and accuracy of BSE performance among women of low socioeconomic class, a pretest-posttest control group design with random assignment to groups was given to women at a Southeastern urban clinic. One hundred eighty women were pretested, after which the experimental group (N = 89) received one-to-one BSE instruction. Seventy of the subjects were given a posttest approximately two months later. All subjects were then asked to demonstrate BSE on themselves. The experimental group subjects showed a significantly greater increase in BSE knowledge from pretest to posttest and performed BSE with greater accuracy than the control group.

Breast Neoplasms↗
PubMed1995

A case-based emergency medicine curriculum for senior medical students.

OBJECTIVE: To determine the effects of a case-based, core content-oriented emergency medicine (EM) curriculum on the basic EM knowledge of senior medical students. METHODS: All senior medical students rotating through the Milwaukee County EM elective during the 1992-1993 academic year were assigned specific chapter readings from a case-oriented EM textbook. A course curriculum consisting of goals and objectives for each chapter and two to three representative cases for the discussion topic also was distributed to each student. Interspersed with the cases was a series of questions directed at pathophysiology, diagnosis, management, and disposition. The EM faculty and residents conducted case discussions three times per week. All students completing the rotation were given a pretest at the beginning and a final examination at the end of the rotation. In addition, the students rated the textbook, coursebook, and lecture series at the end of the rotation using a five-point Likert scale. RESULTS: Seventy-five students rotated through the elective. The students showed a significant improvement in their EM knowledge base as judged by improvement in final examination scores compared with pretest scores (pretest score 62.2 +/- 7.1%; final examination score 76.2 +/- 6.3%; p < 0.0001). The mean change in scores was 14.8%, with a range of -1.6% to 34%. The students also rated the textbook, coursebook, and lecture series as effective, as shown by high median scores on a Likert scale. CONCLUSIONS: A case-based EM curriculum coupled with ED clinical experience improves basic EM diagnostic and management knowledge of senior medical students.

Analysis of Variance↗
PubMed1997

The development and evaluation of a geriatric emergency medicine curriculum. The SAEM Geriatric Emergency Medicine Task Force.

OBJECTIVE: To summarize the processes used to develop a curriculum and model of care for the emergency medical treatment of elder patients and to assess the efficacy of the teaching material in a pilot course. METHODS: A survey of emergency medicine (EM) residency directors and geriatric fellowship directors was used to identify key topics for inclusion in the didactic material. An interdisciplinary consensus process was used to develop didactic as well as teaching material in geriatric EM. Pretests and posttests were administered to 46 participants in the initial course to assess knowledge gain. Subjective course evaluations were also done. RESULTS: Test scores significantly increased from 54% correct on the pretest to 77% correct on the posttest (p < 0.001). Significant improvement in knowledge as judged by pretest and posttest results occurred in 6 of the 7 teaching modules. Subjective evaluations demonstrated good to excellent ratings for each module as well as the overall workshop. CONCLUSIONS: The process of developing a curriculum for geriatric EM is described. The initial training of instructors was effective in improving participants' knowledge of geriatric issues in EM. Participants considered the training to be effective. The effect of the training on the emergency care of elder persons remains to be determined.

Aged↗
PubMed1983

Effects of dental health care instruction on knowledge, attitude, behavior and fear.

A field experiment was done to assess the effects of two methods of dental health instruction on knowledge, attitude, reported behavior and fear. Subjects (n=108) were male and female inhabitants of Abcoude, a suburban Dutch village of about 7000 inhabitants. There were three conditions, two experimental and one control. Subjects of experimental condition 1 were given a 30-min personal instruction on dental hygiene, subjects of experimental condition 2 received the same instruction preceded by a 10-min instructional film on dental hygiene. Subjects of the control condition received no instruction. Half of each group was pretested. All subjects were posttested 6-12 months after the dental health education. Mean postscores of control subjects were significantly lower than either mean postscores of condition 1 subjects (on attitude and three behavioral aspects) or mean postscores of condition 2 subjects(on knowledge, attitude and one behavioral aspect). There were no significant differences between the two experimental conditions or between the pretested and not-pretested groups.

Adolescent↗
PubMed1983

Primary prevention of tobacco smoking.

Sixth-grade students (N = 56) were assigned randomly to one of four experimental conditions: pretest and primary prevention; primary prevention; pretest; and neither pretest nor primary prevention. In eight group sessions, primary prevention students learned facts, problem solving, decision making, self-instructions and interpersonal skills to help keep them from using tobacco. All students completed posttests and a six-month follow-up. Compared with untrained controls, trained students had greater knowledge of smoking, more perspectives on tobacco problems, better linkages between problems and solutions, more insights on the consequences of nonsmoking decisions and greater nonverbal and verbal competence in tobacco use situations. Follow-up data showed trained students with stronger commitments to tobacco abstinence, more frequent refusals of tobacco, and less smoking than controls. Midway through seventh grade, 8% of trained students and 37.5% of controls had smoked in the most recent month.

Child↗
PubMed1984

A nutrition curriculum for health education: its effect on students' knowledge, attitude, and behavior.

The objective of the study was to determine the effect of nutrition instruction, using the curriculum guides, Nutrition In A Changing World, A Curriculum for Junior High Health, and A Curriculum for Senior High Health, on improving the nutrition knowledge, selected food/nutrition attitudes, and dietary behavior of students enrolled in secondary level health courses. Three groups of students were utilized including one experimental and two control groups at each level (junior high and senior high). The experimental group was pretested, taught the nutrition curriculum, and posttested. One control group was posttested only to measure the effect of the pretest on posttest performance. A second control group was pretested and posttested. Neither control group received nutrition instruction until after the study was completed. The three instruments used to collect data were a nutrition knowledge test, a food/nutrition attitude instrument, and a food frequency form. The results indicate that, at all grade levels, the experimental group had significantly improved knowledge scores. Little change in attitude scale scores was noted in grades seven and eight, while ninth grade experimental students scored significantly higher on the posttest for all attitude scales. Little improvement was seen in the posttest food frequency scores.

Adolescent↗
PubMed1984

Retention of emergency care knowledge.

This study provided data on the emergency care knowledge of students as measured by a pretest, posttest, and retention test. Fifty college students were the sample. The mean score for pretest was 62, posttest 86.75, and retention test 83.6. Pearson correlations were calculated for pretest, posttest, and retention test pairwisely. Data analyses revealed that all correlations were significantly greater than zero at the .05 level. A high relationship existed between students' posttest scores and retention test scores. ANOVA was used to gather information to determine if significant differences in students' first aid knowledge existed between the posttest and the retention test. Findings indicated that there was a significant difference between the emergency care knowledge scores of students when comparing the posttest to the retention test.

Analysis of Variance↗
PubMed1997

Evaluation of a third grade sexual abuse curriculum.

This paper presents results from a third grade sexual abuse prevention program. A 24-item questionnaire was administered as a pretest and post-test to an experimental group (n = 236) and a control group (n = 195) of third grade students. Those receiving the sexual abuse prevention program significantly increased their sexual abuse knowledge scores from pretest to post-test. In addition, differences in knowledge were significantly higher in the experimental compared to the control group. Students who received the sexual abuse curriculum significantly improved from pretest to post-test on their behavioral intention scores. Results from this evaluation indicated a modest improvement can be obtained through use of this two-hour sexual abuse prevention curriculum.

Child↗