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The LeMoyne-Owen College--UTCHS cooperative educational program: a model for minority recruitment.

A program of cooperative education between LeMoyne-Owen College and the University of Tennessee Center for the Health Sciences (UTCHS) was designed to attract students from the undergraduate institution to the various health professional schools at UTCHS. The program was initiated by a black faculty member at UTCHS. It involved a faculty exchange between the two institutions and the implementation of several changes in the pre-health science curriculum at the undergraduate institution. Other components of the program included: the gift of equipment and supplies to LeMoyne-Owen College by UTCHS; counseling of LeMoyne-Owen students by UTCHS faculty members; the generation of private funds by the faculty and staff at UTCHS for the support of LeMoyne-Owen students participating in the cooperative education program; and broad exposure of LeMoyne-Owen students to the laboratories and clinical facilities at UTCHS.

Black or African American↗

On organizational models for clinical education.

For reasons more epistemological than pedagogical, the preclinical, theoretical part of allied health education can be provided by a relatively small number of faculty in a centralized educational institution. Clinical education, however, is pluralistic, requiring a variety of clinical teachers, who use a variety of clinical approaches, in various clinical settings. Three models for the organization of clinical education are explored: 1) the external model, in which theory teaching is offered in an educational institution relatively divorced from clinical teaching provided in clinical service settings; 2) the internal model, in which both theory and clinical teaching are provided in the same institution; and 3) the bridging model, in which educational and clinical service institutions remain organizationally separate but with bridging arrangements to facilitate the clinical education. The advantages and disadvantages of each model are considered.

Allied Health Personnel↗

The effectiveness of physical activity counseling in a work-site setting. A randomized, controlled trial.

Voluntary employees (N = 155) from nine different companies were screened by questionnaire for the study. They were randomized into three study groups: counseling (n = 52), counseling + fitness testing (n = 51) and control group (n = 52). The counseling was based on a goal-oriented conversation session for each participant and three follow-up appointments with an occupational nurse over a period of 1 year. The fitness tests were adapted from the UKK Health-related Fitness Test Battery. The outcome measures were the changes in the amount of leisure-time physical activity (LTPA) assessed by diary, pedometer and questionnaire at baseline and at 6 and 12 month follow-up visits. As a result, no statistically significant differences were detected between the three groups at either of the follow-up visits. It seemed, thus, that the two PA counseling methods implemented had no direct mid- or long-term effects on the LTPA of voluntary employees with no specific disease-related indication to increase LTPA.

Adult↗

Promoting responsible conduct in research through "survival skills" workshops: some mentoring is best done in a crowd.

For graduate students to succeed as professionals, they must develop a set of general "survival skills". These include writing research articles, making oral presentations, obtaining employment and funding, supervising, and teaching. Traditionally, graduate programs have offered little training in many of these skills. Our educational model provides individuals with formal instruction in each area, including their ethical dimensions. Infusion of research ethics throughout a professional skills curriculum helps to emphasize that responsible conduct is integral to succeeding as a researcher. It also leads to the consideration of ethical dimensions of professional life not covered in traditional ethics courses.

Education↗

Health promotion in a changing world: preparing for the genomics revolution.

All health professionals must become actively engaged in preparing for the genomics revolution. Healthy lifestyles will continue to be of utmost importance, and we must maintain a balance between health promotion activities and genomic-based tests and therapies. We must understand the specific changes likely to occur as advances in genomics are developed and applied to medicine, as well as their ethical, social, and legal implications. We must develop new, Web-based systems and new educational models to most appropriately incorporate these changes into routine practice. Finally, we must offer timely, useful advice and guidance to the public as well as to policymakers in order to maintain realistic expectations and to ensure adequate and balanced funding for health promotion initiatives and research.

Confidentiality↗

Health care workers' hand decontamination practices: an Irish study.

The primary purpose of this quasi-experimental research is to observe health care workers' compliance with hand-hygiene guidelines during patient care in an intensive care unit in Ireland before (pretest) and after (posttest) implementation of a multifaceted hand-hygiene program. Health care workers' attitudes, beliefs, and knowledge in relation to compliance with handwashing guidelines were also investigated. A convenience sample of nurses, doctors, physiotherapists, and care assistants (n = 73 observational participants, n = 62 questionnaire respondents) was used. Data (N = 314 observations, 62 questionnaires) were analyzed descriptively and cross-tabulated using chi-square (Pearson's) and Mann-Whitney statistical tests. Results revealed that a significant shift (32%) occurred in health care workers' compliance with handwashing guidelines (pretest 51%, posttest 83%, p < .001) following the interventional hand-hygiene program. Significant changes were also found in relation to health care workers' attitudes, beliefs, and knowledge (p < .05).

Attitude of Health Personnel↗

A needs assessment for a palliative care curriculum.

To ensure the success of a new curriculum at an institution, information about the educational needs of learners, available resources, and potential obstacles needs to be systematically collected and analyzed prior to the development and implementation of the actual curriculum. This process, known as needs assessment, is important in the development of palliative care training for internal medicine residents, because internal medicine has only recently begun to address these issues in a formalized way and palliative care is a relatively new topic in medical education and clinical medicine. Therefore, institutional issues and resistance, lack of knowledge and appropriate attitudes among trainees and faculty, and a paucity of educational models for individual internal medicine training programs present potential obstacles. Although curricula that have been developed by national organizations can serve as "guideposts, " these documents are unable to address the specific needs and culture of an individual institution. This paper outlines a systematic methodology of needs assessment for palliative care curricula at individual institutions that could be applied to the development and implementation of palliative care training for different groups of learners. An institution-specific needs assessment was developed based upon the findings of a systematic literature review and interviews with experts in palliative medicine and medical education. The following methods were utilized: 1) an anonymous survey; 2) focus groups; 3) topic rankings; and 4) individual interviews. The needs assessment revealed the following educational, clinical, and institutional information: 1) interns had very little exposure to palliative care in medical school; 2) there was no formalized system formal education and clinical exposure; 3) tremendous interest in palliative care education existed; 4) patients, families, physicians, and nurses perceived a need to improve the quality of palliative care; and 5) there are several political, logistical, and resource (time and financial) obstacles that needed to be addressed. An institution-specific needs assessment is an important part of the successful development and implementation of any new curriculum for medical residents and was specifically necessary for our palliative care program. As a result of the needs assessment process, a curriculum consisting of ten units of case-based and problem-based teaching was successfully implemented.

Curriculum↗

A prospective population-based study of the predictors of undergoing total joint arthroplasty.

OBJECTIVE: To examine prospectively the predictors of time to total joint arthroplasty (TJA). METHODS: This was a prospective cohort study with a median followup time of 6.1 years. We included participants from an existing population-based cohort of 2,128 individuals, ages 55 years and older with disabling hip and/or knee arthritis and no prior TJA, from 2 regions of Ontario, Canada, 1 urban with low TJA rates and 1 rural with high rates. The main outcome measure was the occurrence of a TJA based on procedure codes in the hospital discharge abstract database. RESULTS: At baseline, the mean age of the patients was 71.5 years, 67.9% had a high school education or higher, 73.4% were women, the mean arthritis severity (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) score was 41.1 (maximum possible score 100), and 20.0% were willing to consider TJA. Greater probability of undergoing TJA was associated with higher (worse) baseline WOMAC scores (hazard ratio [HR] 1.22 per 10-unit increase, P < 0.001), age (compared with age or=82 years; P < 0.05 for all), better health (HR 1.14 per 10-unit increase in Short Form 36 general health survey score, P < 0.001), and willingness to consider TJA (HR 4.92, P < 0.001). When willingness was excluded from the model, education level, but not sex or income, became a significant predictor of TJA receipt. CONCLUSION: Willingness to consider TJA was the strongest predictor of the time to first TJA. Given that previous research indicates that willingness is largely explained by perceptions of the indications for and risks associated with TJA and not disease severity, this finding supports the need for population education about arthritis treatments, including TJA.

Aged↗

Oral health education and promotion in maternal and child health: a position paper.

Oral health education and promotion are the connecting mechanisms among prevention, policy development and program implementation, maintenance and evaluation. Given the preventive procedures available today, all focus populations of women and children should have access to accurate information about such procedures as well as access to the procedures themselves. Furthermore, appropriate methodologies need to be utilized for community oral health education and these methods differ from those commonly used for individual education. In the context of maternal and child health there are unprecedented opportunities for new accomplishments in oral health. The health education model most appropriate for these groups is the public health model, an approach designed to empower as well as inform, and one that fosters shared decision making among community members and health professionals. Dental professionals have the responsibility to address this challenge, and to help correct the health information inequities that prevail, especially among the traditionally informationally disenfranchised subfocus populations discussed in this paper.

Child↗

Metabolic control of adults with type 2 diabetes mellitus through education and counseling.

PURPOSE: To test the efficacy of a controlled nursing intervention focused on education and counseling to improve metabolic control of adults diagnosed with diabetes mellitus type 2 in (DMT2) ambulatory care. DESIGN: A quasi-experimental design with repeated measures was selected. A sample of 45 subjects participated, of which 25 were in the experimental group, and 20 in the comparison group. Measures were taken at 0, 3, 6, 9, and 12 months, including glycosylated hemoglobin (HbAlc), psychosocial, and clinical variables. FINDINGS: Results showed a significant decrease in HbAlc in the experimental group, as well as positive effects of self-care agency, adaptation, and barriers to treatment (plus one interaction) on the HbA1c levels and on the scores of self-care actions. CONCLUSIONS: The counseling and educational model applied in the intervention was effective to improve the metabolic control of diabetic patients in the experimental group. Self-care agency, adaptation, and barriers were predictors of self-care measures and level of HbA1c.

Adult↗

The process and outcome of a programme for preventing early childhood caries in Thailand.

OBJECTIVE: To evaluate the process and outcomes of a participatory dental health education (DHE) programme for preventing early childhood caries (ECC). DESIGN: A one-year intervention programme. SETTING: 21 health centres. PARTICIPANTS: 520 mothers/caregivers of 6-19 month-old children who lived in a rural area of Thailand. INTERVENTION: Small group discussion with active involvement in the intervention group and the national teaching DHE programme in the control group. MAIN OUTCOME MEASURES: Health centre staff impact evaluation, children's dental cavitated carious increment and stated changes in oral health behaviour. RESULTS: After one-year, the percent of subjects using a toothbrush and tooth brushing with fluoride toothpaste was 93% and 87% respectively in the intervention group, significantly higher (p<0.01) than the control group (73% and 58% respectively). Night time bottle-feeding, falling asleep with a bottle and sweet snack diet behaviour appeared the same in both groups. The net cavitated carious increment was 3.5 (SD=3.4) teeth in the intervention and 3.2(SD=3.5) in the control group. Health centre staff were very supportive of the programme and suggested extending the participatory format to other child health topics. CONCLUSIONS: The participatory dental health education model was shown to be a practical and effective method for increasing oral hygiene practice, but was not sufficient to prevent the development of ECC. This single intervention in the short term is not seen as sufficient to prevent the development of ECC.

Adult↗

Incorporating a behavioral model in health education.

Understanding the concept of behavior formation is vital in facilitating health education effectively in any setting. Traditionally, the health education process was predicated on the cognitive domain. Consequently, other behavioral influences such as attitudes and intentions were not respectively addressed. Several multidimensional behavior models have been used by health educators to favorably influence human behavior. One specific model, based on one's knowledge (beliefs), attitudes, and intentions is particularly suited for educational settings. This model can be used to assess the validity of individual beliefs, nature of attitude, specificity of intentions and associated personal health behaviors. This assessment can serve as a major motivating factor to encourage persons to identify the quality of their current lifestyle and assume personal responsibility for their welfare.

Attitude to Health↗

Improving quality of life in patients with heart failure: an innovative behavioral intervention.

Nurses play a major role in assisting patients with chronic diseases manage their symptoms, adhere to treatment, and change behavior. This article describes an innovative behavioral intervention for patients with heart failure. The rationale and theoretical basis for the intervention, implementation, and evaluation of the intervention and its implications for use in clinical practice and further research are presented.

Activities of Daily Living↗

Clinical immersion: a residency model for nursing education.

The education of future generations of nurses is in need of philosophic and programmatic transformation in keeping with the rapidly changing health care delivery system. The Nurse Residency Model is one baccalaureate nursing program's response to calls for reform. Rooted in a spirit of collegiality and lifelong learning, the three facets of its philosophy include enhanced socialization, improved transition to practice, and increased student accountability. Students gain increased competency and demonstrate increased accountability with each progressive semester in the program, which culminates in clinical immersion in the senior year. Unique programmatic features of this model include field experiences, the simulation lab, and a work requirement. Additional benefits include resource efficiency and patient safety. Implementation remains an ongoing process. Outcome indicators are expected to yield valuable data on which to develop an evidence base in support of the model.

Attitude of Health Personnel↗

Prevention of child sexual abuse.

Child sexual abuse prevention programs are a growing phenomenon addressing an expanding number of topics raised by a variety of violent and perverse acts. Currently programs tend to focus on a fairly narrow age group and use an educational model for children. There is a need for broad-based programs with a strong focus on the adults around children. Perinatal prevention programs require an adult focus and must take advantage of a special time in child and family development to address lesson of health and intimacy in a way that may decrease the incidence of future child sexual abuse.

Child↗