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PubMed1983

Health educational aspects of preventive dental programs for school-age children in 34 countries--final results of an FDI international survey.

The survey was conducted as part of a project of the Working Group on Oral Health Promotion of CORE, in order to provide a basis for the FDI to plan ways to assist its member associations in developing successful preventive dental programs for school-age children. Mail questionnaires were distributed through national dental associations and completed by dental program directors. A total of 119 responses from 34 countries has been analysed. The programs reported tended to be young, supported by public funds, carried out in schools and part of ongoing agency or organizational programs. Instructional activities were the most frequently mentioned service provided routinely for all children, followed by early detection and treatment services. Primary preventive services appeared to be provided least frequently. About 60 per cent of programs served children drinking water from central sources, but only 16 per cent of programs served children drinking optimally fluoridated water. Water fluoridation was the most frequently mentioned procedure that respondents would have liked to see added or extended if additional resources were to be made available. Program organization was the most frequently mentioned reason for program success. The five most frequently mentioned barriers were insufficient financial resources (most often cited), manpower limitations, low public acceptance, non-supportive attitudes among policy makers and inadequate facilities. As a result of the survey three major needs were identified: (1) the need for more efficient application of known effective primary protective methods, especially against dental caries; (2) the need to improve the correspondence between program objectives, the types of services provided and the evaluation methods used to assess and evaluate program achievements; and (3) the need for greater understanding of the scope of community health educational aspects of oral health, prevention and dental treatment. Specification of these and similar problems should lead the FDI working group to recommend priorities on the type of assistance to provide to member nations and the manner of its provision, perhaps in concert with the World Health Organization and the International Association for Dental Research.

Child↗
PubMed1993

OrthoGraphics. A two-dimensional surgical planning system.

Presurgical planning is a useful means of attaining consistent and predictable surgical results. The range of intraoperative errors is narrowed, and surgical time and materials are minimized. Computer-assisted presurgical planning is an extremely valuable tool for reconstructive foot surgery. A versatile, self-taught software program that permits longitudinal tracking of deformities and visualization of multiple surgical options, i.e., base wedge versus neck osteotomy, is effective in terms of cost, speed, accessibility, documentation, research, and education. The concept of CAD in presurgical planning is not new to other surgical specialties, but as of this date, it has not been implemented fully by podiatric surgeons. The cost factor for office computer use has decreased significantly over the years, and it is highly unusual to locate an office today that does not employ a computer in some aspect of office operation. The additional hardware and OrthoGraphics software at this date may represent between a $6000 and $20,000 investment, depending on how sophisticated an office operation is desired. It is of particular interest that one optical disk in the ICS can hold up to 1000 patient records with nearly 4000 radiographs. In addition, a 35-mm slide-creating interface is available along with the opportunity to modify existing programs to create custom software to meet special needs. It would appear that the teaching applications of this type of system are most compatible with the podiatric medical college clinical curriculum as a component of instructional programs in both biomechanics and surgery.

Computer Graphics↗
PubMed1996

Effectiveness of computer-assisted interactive videodisc instruction in teaching rheumatology to physical and occupational therapy students.

A computer-assisted interactive videodisc instructional program, HP-RHEUM was designed to teach clinical findings in arthritis to occupational and physical therapy students. Using the Rheumatology Image Library videodisc produced by the National Library of Medicine, HP-RHEUM consists of instructional modules which employ advance organizers, examples/nonexamples, summaries, and immediate feedback. To see if HP-RHEUM would be as effective as traditional classroom instruction, control data were collected in 1991 from 52 OT and PT students. Treatment data were collected from 61 students in 1992 when HP-RHEUM entirely replaced lectures. Identical pre- and post-tests consisted of 70 multiple choice questions, with 24 matched to slides. On the slide questions the HP-RHEUM group had significantly higher scores. Otherwise, there was no significant difference in performance between groups. HP-RHEUM provided an independent learning method and enhanced visual comprehension of rheumatologic disease concepts.

Analysis of Variance↗
PubMed2000

Using QuickTime virtual reality objects in computer-assisted instruction of gross anatomy: Yorick--the VR Skull.

QuickTime virtual reality (QTVR) is a software technology that creates, on a normal computer screen, the illusion of holding and turning a three-dimensional object. QTVR is a practical photo-realistic virtual reality technology that is easily implemented on any current personal computer or via the Internet with no special hardware requirements. Because of its ability to present dynamic photo-quality images, we reasoned that QTVR can provide a more realistic presentation of anatomic structure than two-dimensional atlas pictures and facilitate study of specimens outside the dissection lab. We created QTVR objects, using portions of the skull, and incorporated them into an instructional program for first-year medical students. To obtain images, the bones of the skull were mounted on a rotating table, and a digital camera was positioned on a swinging arm so that the focal point remained coincident with the rotational center of the object as the camera was panned through a vertical arc. Digital images were captured at intervals of 10 degrees rotation of the object (horizontal pan). The camera was then swung through an arc with additional horizontal pan sequences taken at 10 degrees intervals of vertical pan. The images were edited to place the object on a solid black background, then assembled into a linear QuickTime movie. The linear movie was processed to yield a QTVR object movie that can be manipulated on vertical and horizontal axes using the mouse. QTVR movies were incorporated into an interactive environment that provided labeling, links to text-based information and self-testing capabilities. This program, Yorick-the VR Skull, has been used in our first-year medical and graduate gross anatomy courses for the past two years. Results of student evaluation of the program indicate that this QTVR-based program is an effective learning tool that is well received by students.

Anatomy↗
PubMed1999

Feast or famine? Supplemental food programs and their impacts on two American Indian communities in California.

This article examines the use of supplemental food programs by two Native American populations and assesses some of the health and cultural impacts of these programs. A cross-sectional survey of 80 American Indian families, 40 families residing on the Round Valley Indian Reservation and 40 in Sacramento, California was conducted to determine access, use and appropriateness of supplemental feeding programs. Respondents at both the rural and urban geographic location showed considerable familiarity with available supplemental feeding programs. USDA Food Commodities were utilized most at Round Valley, raising the concern that provided staples which were highly processed and contained significant amounts of sodium, sucrose, and fat, could contribute to the problems of obesity and diabetes. Native Americans in Sacramento used food banks and food closets as their primary source of supplemental foods, and some expressed concern that the foods provided were highly sweetened and high in fat. While some nutrition advising was available at both geographical localities, access was inadequate. The study found that the foods provided by the supplemental food programs varied considerably in their nutritional quality and healthier foods such as fresh fruits, vegetables, and meats were either completely lacking or in short supply. In addition, culturally sensitive nutritional counseling and the development of education modules to instruct program recipients in the preparation of healthy meals and how to manage obesity and diabetes were needed and requested within the California Native American communities surveyed.

Adult↗
PubMed1991

Preparation for ambulatory surgery: a patient education program.

New experiences for patients and new role responsibilities for nurses emerge in the ambulatory surgical setting. Due to limited access to health care providers, individual patients must assume presurgical and postsurgical responsibility for their own well-being and self-care. Patient education that focuses on the perioperative experiences associated with ambulatory surgery is necessary to assist the patient's recovery efforts. This article will analyze the numerous steps involved in creating and evaluating a patient education program that prepares an adult patient for ambulatory surgery. The Systems Evaluation of Patient Education model developed by Rankin and Duffy will be used to illustrate how a PACU nurse systematically proceeded to examine needs, identify resources, implement the instructional program, and analyze outcomes.

Ambulatory Surgical Procedures↗
PubMed1985

Continuing education for hospice staff.

Hospice nursing is unique because of the philosophy and issues surrounding hospice care. Program planning for hospice staff follows basic principles. The real challenge in developing programs for orientation, continuing, and inservice education is using a format that will truly enable staff to meet the objectives. A lecture, programmed instruction, or video/slide format works well for the "nuts and bolts," but more creativity is needed for the other issues facing the hospice nurse--death, grief, symptom control, stress, team roles, and helping patients with options. Incorporating into the program some of the methods suggested will offer staff the opportunity to become involved in learning and make that learning more meaningful.

Curriculum↗
PubMedDate not supplied

Spatio-temporal patterns of velopharyngeal action in phonetic and phonological nasalization.

The aim of this paper is to differentiate between effects of phonetic implementation and effects of phonological structure in the adjustment of articulatory trajectories to varying speech rate. Cross-linguistic data on coarticulatory nasalization of vowels preceding a nasal consonant at different speech rates were analyzed in American English and Spanish. The two languages show different patterns of timing, magnitude, duration, and velocity of velopharyngeal movements. In Spanish the velocity of velar port (VP) opening and closing gestures is not affected by differences in speech rate, which suggests that these trajectories reflect the default articulatory movements automatically implemented by the phonetic component. In American English, VP closing velocity is not affected by speech rate whereas opening velocity adjusts to variations in speech rate to ensure vowel nasalization across rates. The careful regulation of VP opening velocity suggests that it is centrally controlled. Interarticulatory timing data support this interpretation: In Spanish, vowels are oral for most of their duration; onset of VP opening is timed relative to the following nasal consonant and peak VP size occurs at nasal consonant onset across rates, which suggests that the motor commands for opening the velar port are part of the instructions for the nasal consonant. In American English, on the other hand, VP opening onset coincides with vowel onset and peak VP size occurs in the middle of the vowel across rates, which indicates that opening movements are part of the programming instructions for the vowel. It is argued that, in Spanish, vowels followed by a nasal consonant are targeted as oral and are nasalized as a result of a coarticulatory effect, whereas, in American English, vowels are targeted as nasalized as a result of a phonological rule.

Female↗
PubMed2005

CAD-aided mammogram training.

RATIONALE AND OBJECTIVES: Although computer-aided detection (CAD) improves the diagnosis rate of early breast cancer, it has not been well integrated into radiology residency and technician training program. Moreover, CAD performance studies ignore the reader's training and experience with CAD. The purpose of this study was to investigate whether CAD training via a cognitive-perceptual based hypermedia program has effects on the performance studies of mammogram reading. MATERIALS AND METHODS: Three observers read a pretest set of 80 breast cancer cases (43 negative, 23 benign, and 14 malignant cancer cases). During 4 weeks' training, the observers used a hypermedia instructional program in CAD-aided mammography interpretation. The program includes modules of CAD attention-focusing schemes, CAD procedural knowledge, and case-based simulations in mammography interpretation in consensus with CAD. By the end of the fourth week of the training, they reviewed a posttest set of cases. Data were analyzed with multireader, multicase receiver operating characteristic methods. RESULTS: Three readers performed better in mammogram reading after training in CAD knowledge than they did before CAD training. CAD training and experience improved the performance of CAD-aided mammography interpretation. CONCLUSION: A statistically significant difference was found in each observer's performance in CAD-aided mammogram reading before and after the training. CAD training will influence the perception, recognition, and interpretation of early breast cancer and CAD performance studies. Furthermore, the young generation of radiologic professionals can have more training in various attention-focusing features, declarative knowledge, procedural knowledge, and conditional knowledge of CAD and incorporate them into their knowledge base and strategic processing for the purpose of improving the accuracy of mammography interpretation performance.

Breast Neoplasms↗
PubMed2006

IL-12-programmed long-term CD8+ T cell responses require STAT4.

Immunological adjuvants activate innate immune cells for Ag presentation and elicitation of cytokines like IL-12 that promote T cell expansion and effector differentiation. An important but elusive aim for most immunization strategies is to produce memory T cells that provide durable immunity. Recent evidence demonstrates that the context of Ag presentation instructionally programs T cells for short- and long-term responses. However, the role and mechanisms by which cytokines like IL-12 condition CD8 T cells for long-term responses remain relatively uncharacterized. In this study, we show that brief exposure (20 h) of naive TCR-transgenic CD8 cells to IL-12 during Ag stimulation leads to transient phosphorylation of STAT4 for robust effector differentiation. Moreover, the IL-12-induced STAT4 engenders greater clonal expansion of the Ag-activated CD8 cells by regulating the expression of the transcriptional factor Bcl3- and Bcl2-related genes that promote survival of Ag-activated CD8 cells. Remarkably, the IL-12-conditioned CD8 T cells demonstrate increased sensitivity to IL-7 and IL-15, whereby they are rendered "fit" for homeostatic self-renewal as well as augmented CD4-dependent recall responses that are effective at controlling Salmonella infection in vivo. This information provides new insights into mechanisms by which IL-12 conditions CD8 T cells for long-term immunity, which is likely to benefit development of new strategies for the use of IL-12 in infectious diseases and cancer.

Animals↗
PubMed1989

PharmaTrend as a management tool: evaluation of the program.

A critical evaluation of PharmaTrend, a personal computer-based program for the analysis of pharmacy workload and productivity, is presented. The use of PharmaTrend is facilitated by a number of support features. A tutorial program instructs first-time and infrequent users on how to negotiate PharmaTrend's data-entry screens. The manual is well written and organized, and a toll-free number is available should more technical questions arise. However, some of PharmaTrend's definitions are confusing, as is the program's method of capturing workload data on the preparation of intravenous solutions. Some of the data currently maintained in pharmacies will need considerable modification before they can be used as PharmaTrend entries. A few minor changes would transform PharmaTrend from a good to an exceptional program. In addition to clearer definitions, an option allowing the user to edit the definitions shown on the screen is needed. A line should be added to the data-entry screen to remind the user that F1 is the help key. Reporting would be facilitated if deadlines were changed to reflect standard quarters. PharmaTrend is advantageous for the analysis of departmental operations because it provides regional and national standards for comparison. It can also help justify proposals and defend existing services and staffing. The monthly and quarterly reports generated with PharmaTrend are useful in analyzing pharmacy operations, and the user can modify work-load times on the basis of local circumstances. These difficulties notwithstanding, the current cost of PharmaTrend appears to be a bargain. Although some aspects of PharmaTrend need refinement, its basic features make it a valuable management tool.

Database Management Systems↗
PubMed1996

Training older adults to use automatic teller machines.

The present study assessed the success of several instructional programs in teaching the use of automatic teller machines (ATMs). Fifty-six older adults (aged 61 to 81) participated in the study, randomly assigned to each of four, 14-member groups. The description group received only a general overview of an ATM; the text guide group received written instructions for performing various transactions on an ATM; the pictorial guide group received written instructions accompanied by pictures of corresponding ATM screens; and the online tutorial group completed a step-by-step tutorial on a simulated ATM. Participants practiced on an ATM simulator. They were tested after a 24-h interval on their ability to perform familiar transactions on an unfamiliar ATM simulator and to perform completely novel transactions. Accuracy was best for the online tutorial group, intermediate for the text and pictorial guide groups, and worst for the description group. These data demonstrate both the importance of providing older adults with ATM training and the fact that the type of training influences the level of performance. The online tutorial, which provided specific practice on the task components, best facilitated acquisition and transfer performance.

Age Factors↗
PubMed2001

[Evaluation of nutrition instruction in a group of Senegalese students at the secondary level].

BACKGROUND: In Senegal, nutrition instruction was implanted in 1981 in the national curriculum of biology and has never been evaluated since. METHODS: The purpose of this study, was to evaluate the effect of a six weeks nutrition instruction program on improving nutrition knowledge and nutrition attitudes in an experimental group including 81 subjects aged 16.7+/-1.2 years and a control group including 80 subjects aged 15.7+/-1.3 years. These subjects came respectively from third and fourth grade. A questionnaire on knowledge and one on attitudes were administered to the experimental group, before and after the nutrition instruction, while the control group, who did not received any nutrition instruction, also answered the questionnaires. RESULTS: Results indicate that the adjusted mean knowledge posttest scores did not significantly increase in the experimental group compared to the control group. In addition, the adjusted mean attitude postscores of the boys and girls of the experimental group on the attitude scale "Nutrition affects health" were significantly higher from that of the control group. CONCLUSION: An evaluation of the nutrition curriculum and the teaching methods is suggested in order to improve the effectiveness of this nutrition program.

Adolescent↗
PubMed1985

Psychological intervention for adults with cystic fibrosis.

This study assessed the effects of a stress management and life-style modification program on the physical and psychological well-being of young adults with cystic fibrosis. Four fibrocystic patients recently transferred to an adult rehabilitation centre completed this 6-week program. Instruction in stress management consisted of both behavioural (e.g. relaxation training) and cognitive techniques. Discussion on life-style included the topics of drug and alcohol abuse, leisure, and nutrition. Individual assessments were conducted before and after a 6-week non-intervention control period and after a 6-week training program. Assessments included a battery of psychometric inventories as well as electromyographic testing of trapezius muscle tension. At the end of the program, participants reported that they experienced fewer physical and psychological symptoms of stress. Electromyographic measures provided some suggestion of a trend toward greater stability at posttest.

Adult↗
PubMed1978

Training and continuing education for on-line searching.

Training of searchers of the National Library of Medicine's (NLM) computer system has evolved from an intensive eight-month programme on batch retrieval through a highly compressed three-week course on interactive searching to the current five-level programme. The five-level curriculum consists, in order, of a computer-assisted instruction program (*MEDLEARN*), the Initial Training course, a three to six month in-service practicum, the Advanced Training course, and continuing education. Each stage in the programme is intended for the more sophisticated user and deals with increasingly complex and refined searching techniques. Various types of media are incorporated into the instruction which seeks to tie together theoretical and rote material through an extensive amount of practical experience at the terminal. This modularized curriculum provides the flexibility required to teach the use of a dynamic system to a diverse student population. At the present time, approximately 400 students per year are availing themselves of NLM on-line training.

Curriculum↗