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PubMed1993

A survey of university health centers in western Canada.

A survey of 11 universities in the four provinces of western Canada in July 1991 found that only 1 of the institutions had no student health service. The survey asked for information about general operations, staff, finances, and services at the centers. The 10 universities that had health services were found to vary widely in their programs, funding, and compensation to physicians, with two distinct types of health service: those that serve the entire university community and others that provide care for students only. Psychiatry, preventive medicine, immunization, and sports medicine were the common services, and all centers were open throughout the year. Patient visits to the centers had increased during the preceding 5 years, although physicians working in university health services experienced approximately the same number of annual patient visits as did community physicians in private practice. The author contrasts services at the Canadian institutions with those reported by colleges and universities in the United States.

Adult↗
PubMed1999

Education of the trauma team: video evaluation of the compliance with universal barrier precautions in resuscitation.

OBJECTIVE: To assess the effectiveness of an educational symposium designed to improve compliance with universal barrier precautions by the use of video analysis of resuscitations. DESIGN: Prospective single blind analysis of data. SETTING: Hospital Trauma Unit, Johannesburg, South Africa. SUBJECTS: 100 severely injured patients who presented to the emergency room, divided into two study periods. INTERVENTIONS: An educational symposium held between the study periods, which focused on universal barrier precautions and the risk of occupational transmission of HIV. MAIN OUTCOME MEASURES: Compliance with items of universal precautions; mechanism; Injury Severity Score and Revised Trauma Score. RESULTS: There was a significant improvement in compliance from 48% to 74% after the symposium (p = 0.007), with specific improvement in the wearing of masks and visors. Initially there was poor compliance with universal precautions in severely injured patients, which significantly improved to 83% compliance (p = 0.0004). CONCLUSION: Video analysis of resuscitations is an effective audit and educational tool that allows analysis of compliance with protocol. The education symposium was effective in altering attitudes and behaviour towards universal barrier precautions.

Education, Medical, Continuing↗
PubMed2003

Graduate health professions education: an interdisciplinary university - community partnership model 1996 - 2001.

INTRODUCTION: In 1996, East Tennessee State University (ETSU) reinforced its historical commitment to multidisciplinary community engagement by developing a graduate level community partnerships program in the Division of Health Sciences. While the university's earlier health partnership efforts relied primarily on curricular innovation, the approach to graduate health professions education was to seed a series of curricular enhancements and interdisciplinary, community-based learning experiences and service into traditional curricula. This paper presents the experience of one school in crafting a regional network that became the basis of a division-wide graduate level teaching and learning initiative. INNOVATIONS AND EVALUATION: Carefully selected planning and implementation techniques enabled multidisciplinary practitioners and community members from across a 20-county region to participate with university faculty in training ETSU learners in community-based medical care. By year four of the project, curricular "enhancements" were institutionalized in over five departments across the Division and engaged 1160 medical residents and graduate learners in a give - get model of health education. Programme evaluation methodology was collaboratively defined and documentation of programme effort and outcomes regularly reported and strategically reviewed. CONCLUSIONS: Programme evaluation demonstrates mutual benefit to community and university. Faculty involvement in programme activity increased fourfold and community involvement in training of health professions graduate learners increased threefold by year four. Educational innovations were adopted into traditional curricula, thousands of hours of clinical services were provided to underserved communities and the university-community team forged by network links continues to promote multidisciplinary interests through joint public policy endeavors.

Appalachian Region↗
PubMed2005

Colds and influenza-like illnesses in university students: impact on health, academic and work performance, and health care use.

BACKGROUND: Upper respiratory tract illnesses (URIs) are a major cause of morbidity among adults, with substantial direct and indirect costs to society, but their impact among university students has not been well described. We sought to assess the impact of URIs (colds and influenza-like illnesses [ILIs]) on the health, academic and work performance, and health care use of university students. METHODS: This was a cohort study of college students at the University of Minnesota, Twin Cities campus (Minneapolis-St. Paul), who were recruited during October 2002 and followed up from November 2002 through April 2003. All 42,000 registered students were invited via e-mail to participate. Baseline information was obtained in October 2002. Monthly follow-up information about colds or ILIs was obtained for the period of November 2002 through April 2003. Data were collected by use of Internet-based questionnaires. RESULTS: Of 4919 volunteers, 3249 completed all follow-up surveys. The mean age was 22.7 years; 68% of the volunteers were female. Ninety-one percent had > or = 1 URI (83% had > or = 1 cold, and 36.7% had > or = 1 ILI). These URIs caused 6023 bed-days, 4263 missed school days, 3175 missed work days, and 45,219 days of illness. Of the cohort, 22.2% had > or = 1 health care visit, and 15.8% used antibiotics to treat a URI; 27.8% did poorly on a test and 46.3% did poorly on a class assignment. ILIs versus colds had a much greater impact on all parameters (e.g., general health level was 55%-60% lower with ILI vs. no URI and 33%-39% lower for colds vs. no URI; P < .001 for each). CONCLUSION: Colds and ILIs were common and associated with substantial morbidity in university students. Enhanced efforts to prevent and control URIs, especially influenza vaccination, could improve the health and well-being of the 17 million college and university students in this country.

Adult↗
PubMed1992

Healthcare workers' risk of contact with body fluids in a hospital: the effect of complying with the universal precautions policy.

OBJECTIVE: To test whether healthcare workers' knowledge of and compliance with the basic principle of the Universal Precautions policy (i.e., that all patients should be treated equally regarding contact with body fluids) influenced the rate of contact with patient blood. DESIGN: Survey based on anonymous questionnaires. SETTING: A 380-bed secondary and tertiary care hospital receiving emergency and elective patients. PARTICIPANTS: All employees having any contact with patients. Nine hundred one of 1,308 (69%) of the questionnaires were returned. RESULTS: Twelve percent of the respondents (95% confidence interval [CI95] = 10.0%-14.4%) had experienced any contact with patient blood in the week preceding their answer. Physicians had the highest rate of contact with blood followed by nurses. In the five groups--physicians, nurses, laboratory technicians and phlebotomists, nursing aides, and student nurses--contact with blood was less frequent in the subgroup that did know and comply with the basic principle of the Universal Precautions policy, compared with the subgroup that did not. When adding the results for the 5 groups, contact with blood was experienced by 91 of 571 (15.9%, CI95 = 13%-19%) of the personnel who did not know and comply with Universal Precautions. The personnel who did know and comply with Universal Precautions had a significantly lower (9 of 111 [8.1%], p < .05, CI95 = 3.8%-15%) rate of contact with blood. CONCLUSIONS: The healthcare workers who knew and complied with Universal Precautions had a significant lower rate of contact with patient blood than those who did not.

Blood↗
PubMed1998

Wide-area network connecting a hospital drug informatics center with a university.

A wide-area network (WAN) connecting a new drug informatics center in a university-affiliated hospital with the university's campus-based computer network is described. In 1994 a pharmacy school developed a drug informatics center in an affiliated hospital. The center was originally designed around a local-area network (LAN) to be located at the hospital and planned to provide clients with easy access to typical productivity software and various electronic information resources. Only occasional modem connections to the university network were envisioned. However, large price increases in information retrieval systems and decreases in the cost of a frame relay connection (T1 line) to the campus network led to the installation of a WAN when the drug informatics center was established. Technical, political, and legal problems were overcome, and the connection was made. The WAN gave faculty and students at the hospital access to many of the university's computing and Internet resources. In addition, the faculty and students have access to various files and programs available only on the drug informatics center's file server at the affiliated hospital. It cost about $6500 to install all WAN equipment and maintain the frame relay for the first year, or a third of what would have been necessary for information retrieval software had a separate LAN been established at the hospital. A WAN connecting a drug informatics center and a university's computer network gave the center access to more electronic information resources at lower cost than would have been possible with a separate LAN.

Computer Communication Networks↗
PubMed1997

Tobacco control programmes for universities: a feasibility study.

BACKGROUND: University may be a good time for smoking cessation, because younger, lighter smokers are more successful at stopping. METHODS: An initial survey of 4141 students at Cambridge and Anglia Polytechnic universities identified the prevalence of smoking; questionnaires were given to smokers asking about desire to stop. Some respondents were invited to a discussion, but very few came. Those wanting to quit were sent a second questionnaire about what help they wanted. On National No Smoking Day, 101 students were interviewed about "stop smoking' advertisements, and those wanting to stop smoking were offered different forms of help. Lastly, student union welfare officers at 54 universities in the United Kingdom were interviewed over the telephone, about what motivation and support they provide for students to stop smoking, and what more they would consider providing. RESULTS: Prevalence of smoking varied according to university, subject studied and sex. Desire to quit varied with subject studied, duration of habit and amount smoked. Some "stop smoking' TV adverts were widely remembered, but their motivational impact remains unclear. Most of those wanting to stop found it difficult, but few requested help unless approached directly. Only books were widely used, and innovative ones seemed most popular. Few student unions provided effective encouragement or help for students to stop smoking. Most said they would consider doing more. CONCLUSIONS: There is a need for smoking cessation programmes at universities. More research is needed on ways of motivating those who do not want to stop. "Direct marketing' of books seems the best way of reaching those who want to stop. The effectiveness of different books needs to be evaluated. There is great potential for improving the quality, quantity and availability of cessation aids through student unions.

Adolescent↗
PubMed1993

Senior medical students' knowledge of universal precautions.

BACKGROUND: Few data exist concerning the assessment of medical students' knowledge of universal precautions. The purpose of this study was to assess what students know--immediately before they graduate--about universal-precautions procedures. METHOD: The 151 fourth-year students of the class of 1992 at the University of Washington School of Medicine were given a questionnaire one week before graduation. They were asked to indicate the protective equipment required to safely complete ten common clinical procedures. For each procedure, the proportion of students who correctly indicated the protective equipment was calculated. RESULTS: The questionnaires were completed by 137 (91%) of the students. The mean percentage of correct answers by the responding students was 67%. For five of the ten procedures, from 104 to 123 (76-90%) of the students reported the proper levels of protection. For the remaining five procedures, from 58 to 75 (42-55%) of the students knew the proper levels of protection. CONCLUSION: The results of the survey are worrisome, because many students--immediately before they graduated--lacked adequate knowledge of universal precautions regarding the ten common clinical procedures. More emphasis on universal precautions during undergraduate medical education is needed.

Health Knowledge, Attitudes, Practice↗
PubMed1995

What medical schools and universities can learn from one another.

Colleges and universities devoted to undergraduate education and non-medical graduate education (hereafter called "universities") have much to teach medical schools and much to learn from them. Universities and medical schools differ significantly in their sources of revenue, cultures of promotion and tenure, academic values, and decision-making processes. Yet from the experience of universities, medical schools can learn innovative techniques of curriculum assessment and teaching, how to handle diversity issues, and ways to expand the definition of scholarship. In turn, medical schools can help teach universities the importance of fiscal and regulatory accountability, the benefits of interdisciplinary efforts, the practical benefits of problem-based learning, and techniques for adjusting to rapid change. The authors, all with medical school faculty backgrounds, developed the views reported in this article when they were Fellows in a leadership training program sponsored by the American Council on Education (ACE). They urge their colleagues to reach out beyond their specialties and departments and learn from higher education institutions that are grappling with problems analogous to those faced by medical schools.

Schools, Medical↗
PubMed2006

Addressing global health through the marriage of public health and medicine: developing the University of Washington department of global health.

Widespread interest in global health issues is a common characteristic of students and faculty in schools of public health and schools of medicine. Building on strong university-based and community-based programs in global health, the University of Washington has created a unique Department of Global Health that is housed jointly in its School of Public Health and Community Medicine and its School of Medicine. The creation of this department has generated significant enthusiasm throughout the university and the Seattle community as a new paradigm for addressing global health education, research, and service. Placing the new Department of Global Health in two university schools and finding the appropriate niche for the department among the university's many global health initiatives presented challenges, as well as opportunities. This article describes the goals of the department, the process by which it was created, and what it expects to accomplish.

Education, Medical↗
PubMed1994

An analysis of nursing's performance in the 1992 assessment of research in British universities.

Nursing was rated as lowest of all 72 subjects reviewed in the 1992 assessment of research in British universities. Of the 29 academic nursing departments assessed, 17 received the lowest possible rating and only five were given an average or above average rating. Immediate coverage of these results in the nursing press was slow and superficial, and sometimes misleading. This paper explains how the Research Assessment Exercise (RAE) was carried out. It is argued that academic nursing departments are crucial to the profession in its current pursuit of an improved research capability and productivity and, therefore, that the results of the RAE should be of interest and concern to nurses. The analysis presented of nursing's results shows that the larger, longer-established departments based in research-strong 'old' universities have more research-active staff, and it was these departments that received the best ratings in the RAE. In contrast, most of the nursing departments assigned the lowest possible rating were small, recently established departments in 'new' universities that could not have been expected to distinguish themselves in their first research assessment. It is suggested, however, that any new academic nursing departments should be strategically placed in research-strong universities. Although this paper is concerned with nursing in British universities, the general notion of research funding being allocated on the basis of performance is (or is likely to become) pertinent to other countries, especially those in Europe, North America and Australasia.

Education, Medical↗
PubMed2000

Epidemic of cesarean section at the general, private and university hospitals in Thailand.

OBJECTIVE: To undertake a survey of cesarean section in the general, private and university hospitals in Thailand. METHODS: Postal questionnaires were sent to all the general, private and university hospitals with 200 beds or more. The questionnaires were prepared to find out the percentage, the indications and the trend of cesarean delivery, the measures taken to decrease cesarean section rate, and the practice of external cephalic version (ECV) and vaginal birth after cesarean section (VBAC) in the hospitals. RESULTS: The overall response rate was 88%. Mean cesarean section rates were 24, 48, and 22% in the general, private and university hospitals, respectively. Cesarean section rates in most of the hospitals were increased in the past 5 years namely 78% in the general hospitals, 50% in the private hospitals, 66% in the university hospitals. However, only 38% of the hospitals had measures to regulate this operation. Repeated cesarean section was the most common indication in the private (63%) and the university hospitals (88%) while failure to progress was the most common indication in the general hospitals (55%). ECV and VBAC were performed in 26 and 12% of the hospitals. They were, however, not the standard practices. CONCLUSION: Rising of cesarean section rate without any measure to regulate it is the problem in the developing countries. Standardised labor management and reduction of unnecessary primary cesarean section will automatically reduce repeated operation and overall cesarean section.

Cesarean Section↗
PubMed1968

Research and development at the university. The direction of federal support and opportunities for response by consortia are changing.

In summary then, the growing call from government for the universities to do applied research in the civilian sector has many disturbing elements. It asks the university to provide more policy advice. In addition, it calls upon the university to become an advocate for that policy research. One can hardly be a part of the university tradition in this country without being initially appalled. Yet the demand is clearly there and it is hard to disagree with Perkins when he says, "The University-as the most sophisticated and, let us hope, independent agency now at work advancing, transmitting and applying knowledge-has come too far to retreat before what may be its finest hour" (8, p. 24).

Financing, Government↗
PubMed1974

University research and the new federalism.

In this brief article we have touched on some of the solutions to problems universities are encountering in working with the expanding "new federalism." These arrangements will bring faculties into new kinds of relationships, which they can find stimulating if they are prepared ahead of time to accept the kind of public scrutiny that they have not encountered at the national level and to learn about the political system and the politician (13). Universities will find advantages for their academic programs if they involve faculty and students in programs that promote the advancement of public good provided that caution is exercised to prevent the development of arrangements that restrict academic freedom, push the university into the political arena, and drain its financial resources. Faculties need to work closely with their university administrations to make sure that valid academic principles are upheld. The exercise will be time-consuming and frustrating, but vital to the objective and the high quality support the public expects from universities.

Costs and Cost Analysis↗
PubMed1993

Investor-owned psychiatric hospitals and universities: can their marriage succeed?

Economic and competitive pressures have spurred a growing number of affiliations between university medical centers and for-profit health care corporations. University facilities can benefit from such partnerships through strengthened financial support, increased marketing and administrative expertise, and economies of scale. The university connection gives the investor-owned hospital enhanced status, sends a message of clinical excellence, and involves the hospital in educational and research programs that aid in physician recruitment and further enhance its reputation. However, the university's goals of education, research, and public service are not always compatible with the investor-owned hospital's goal of maximizing profits. The authors review the benefits and problems that result from affiliations between university medical centers and investor-owned corporations and discuss principles to be considered in structuring such partnerships.

Cost-Benefit Analysis↗
PubMed2001

Step to college. Moving from the high school career academy through the 4-year university.

This study addresses the question "Do school-to-work programs, as embodied by career academies, facilitate postsecondary education?" The author conceptualizes postsecondary education as a series of steps through the university and examines the high school career academy's influence on entrance into, route through, and outcomes from a 4-year university. Data are drawn from applicant and student records at a comprehensive, urban university for all individuals originating from a single district's high schools. The findings suggest that students from career academies have higher academic achievement upon leaving high school, less need for remediation in English at the university, and a 4-percentage-point increase in graduation from the university than students who are not from academies. These findings suggest that school-to-work programs could facilitate positive outcomes in postsecondary education. However, the continued high rates of remediation and the low rates of graduation, even for students from career academics, suggest that their influence might not be enough to ensure success in postsecondary education. This analysis therefore suggests that further research should identify program components that increase postsecondary education and determine how these components can be institutionalized and built on in subsequent reforms.

Achievement↗
PubMed1990

The differential effects of a change in reimbursement on public and private university hospitals.

The primary purpose of the government's prospective payment system was to decrease the rate of federal spending for Medicare patients by paying fixed prices for services and by transferring the financial risk for the care provided to the hospital. While PPS certainly has affected all hospitals, this article has attempted to identify some of the expected and unexpected consequences of the change in reimbursement on publicly and privately owned university hospitals. Of importance is the discussion that has analyzed the specific effects of PPS on the components of the UHs' missions. The implementation of PPS may exaggerate the effects of the payment change on both types of UHs. The provision of broadly based primary and specialty care services may be in question as institutions find themselves potentially unable to deliver these services on a price-competitive yet profitable basis. The costs associated with educational, research, and community service programs can no longer be subsidized by excess patient care revenues as payers streamline payments to reflect only the costs of clinical care. Thus, university hospitals may be forced to reexamine their missions and change their operating plans to reflect the current fiscal environment. If taken to an extreme, it is likely that the local society may be negatively affected by these actions. Clinical and community services that increase access, assure continuity of care, or provide needed but costly (public) health services may be eliminated or reduced in scope in an effort to contain costs. Even those services that are cost beneficial from a societal perspective may be eliminated without some form of subsidy or direct payment as institutions are forced to reallocate their limited funds from these types of public health services to support nonprofitable, but critical clinical or academic programs. The potential impact on access, continuity of care, and morbidity and mortality will not be known for many years. Although it is not known how these changes will eventually affect university hospitals, two outcomes seem clear. University hospitals with different governance and management structures may not change their missions and means for achieving institutional goals as much as might have been expected. The interdependence of the university hospitals' goals and the role they play in their local communities may force them to begin to explore new ways to achieve their missions. Public-private sector cooperation is suggested as one approach to use in response to the demands of payers and patients while the institution remains true to its historical mission.(ABSTRACT TRUNCATED AT 400 WORDS)

Community-Institutional Relations↗
PubMed1999

Nigerian university students' knowledge, perceptions, and behaviours about HIV/AIDS: are these students at risk?

The purpose of the study was to determine the knowledge level of undergraduate students of a Nigerian university about HIV/AIDS, their perception of risk of contracting HIV/AIDS based on their sexual behaviour, and to assess how students acquire information about HIV/AIDS. The sample consisted of 380 students from five faculties of the university who volunteered to participate in the study. Participants completed a survey asking about their knowledge about transmission, symptomatology and prevention of HIV/AIDS. The survey included questions about their sexual orientation, past and present sexual practices as well as sources of information about HIV/AIDS. The results indicated that the students were knowledgeable about transmission and symptomatology but there were some misconceptions about the mode of transmission of HIV. Few students identified themselves to be at high risk even though majority of them (92%) were sexually experienced. The study also showed that even though these students are knowledgeable and concerned about contracting HIV/AIDS from their partners, this did not prevent them from engaging in unprotected sexual intercourse. It appears, however, that students are exercising caution when negotiating new sexual relationships, as they are likely to discuss (and insist on) using condoms and ask to have a monogamous relationship. Students obtained information about HIV/AIDS primarily from the media rather than from school classrooms and homes, which suggests a need to increase educational efforts at the university. Many students of this university may be at risk of becoming HIV-infected due to their age bracket, level of sexual activity and past/present sexual behaviors. University faculty can be actively involved in developing and implementing HIV/AIDS education and prevention strategies on their campuses. Health educators must go beyond providing accurate and gender-specific information about HIV/AIDS; they must also help students realistically assess their own risk of infection, and develop communication processes which enable them to negotiate safer sexual practices.

Acquired Immunodeficiency Syndrome↗