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PubMed1978

[Preventive medical measures in the federal republic of germany. Present status and problems (author's transl)].

Following brief introductory remarks on the term "preventive medicine", an outline is presented of its evolvement during the last 20 years in the Health Services of the Federal Republic of Germany. Thereby, it becomes apparent that the development of single screening efforts, e.g. to detect unknown cases of diabetes and to make special model studies, especially in Baden-Württemberg, has led to comprehensive legal motherhood care, health care for young children, early detection of cancer, and detection of diabetes cases. Problems have arisen due to the generally very low utilization of preventive medical examinations and because of the question as to whether premorbid health conditions should be included in the preventive medical program additionally. Finally, indications are given for the necessity to examine possibilities of curtailing expenditures in the present preventive medical care program, or in some of its branches, without forfeiting the efficiency of the preventive measures. Thereby, it must be considered that these measures are benefiting only that part of the population which is socially insured. The claim to measures for health protection, however, should be available to the entire population as a basic human right.

Adolescent↗
PubMed1989

The New Zealand Glomerulonephritis Study: introductory report.

All patients 14 years and older seen between July 1972 and June 1983 in four of the five nephrological centers in New Zealand with biopsy-proven primary glomerulonephritis (GN), were enrolled in a central register. This study included 803 patients from 84% of the total New Zealand population in this age group. Polynesians (predominantly Maoris) were found to have a higher overall incidence of GN than New Zealanders of European descent, a higher incidence of postinfectious GN, mesangio-capillary GN and focal glomerulosclerosis and a reduced incidence of IgA nephropathy. The racial difference in the incidence of GN may account in part for the known higher rate of end-stage renal failure in Polynesians. Overall the incidence of GN in men was more than twice that in women, and this was particularly so for postinfectious GN, IgA nephropathy, antiglomerular basement membrane initiated GN and membranous nephropathy. An adverse outcome (entry into a dialysis-transplant program, death from renal failure, non-renal death), was more frequent for Polynesians than Europeans. Follow-up is continuing to define the long-term survival of patients with each histological category of GN and any potential prognostic factors.

Adolescent↗
PubMed1978

[Training and use of dental manpower resources in Mexico].

The introductory section describes the general situation of dental care in Mexico, analyzes the prevailing service model (including the kind of work done by the dental professional and the technology he employs), and briefly reviews the evolution of dentistry in the country. There follows an account of a series of new approaches to service and manpower training in experimental implementation since 1972 in the stomatology curriculum at the Xochimilco campus of the Metropolitan Autonomous University, at the National School of Professional Studies at Zaragoza, in the School of Dentistry of Nuevo León Autonomous University, Monterrey, and in the Dental Services at Ciudad Netzahualcóyotl. In each case, the background, characteristics, and objectives of the programs, and their evolution and prospects are described.

Dental Assistants↗
PubMed1992

SCORPIO: a system of medical teaching.

Reform in medical education is gaining momentum through the efforts of organizations such as the World Federation for Medical Education. Through the advocacy of such bodies, educational priorities have been redefined to widen the range of educational settings, upgrade evaluation systems and promote the training of teachers as educators. A system of medical teaching has been developed which addresses these issues. It is known by the acronym SCORPIO. The key elements of the system are that it is Structured, Clinical, Objective Referenced, Problem-based, Integrated and Organized. SCORPIO involves delivering a syllabus through a series of lecture-demonstrations at which students, teachers and patients gather at a defined area. Following a short introductory lecture, students rotate in small groups, through a series of teaching stations. These stations are structured to provide students with a problem-based, integrated learning experience. Assessment stations may be included before, during or after the teaching circuit. The teaching system has been formally evaluated over a period of time and now has an established place in the curriculum of this medical school.

Australia↗
PubMed1991

Introductory training in occupational health service. Report on the development and evaluation of nine preliminary courses, 1988-1989.

This compulsory course is open to all newly employed, including administrative personnel, at occupational health units. The goal of the course is to create a joint view of the aims and direction of occupational health service. All nine preliminary courses have given the participants distinct and homogeneous answers to questions such as: What is the aim of the occupational health services? Who is the client? How shall we work together?

Curriculum↗
PubMed1992

The problem of creating habits: establishing health-protective dental behaviors.

We describe three experiments testing treatments to promote the performance of health-protective dental behaviors. Subjects included 55 women from an introductory psychology course (Experiment 1), 45 men and women (Experiment 2), and 81 older-than-average students identified as at risk for gum disease (Experiment 3). The interventions, derived from social cognitive theory, included health education, skills training, and self-monitoring. In each study, we examined the contribution of additional treatment components, including social support (Experiment 1), intensive contact (Experiment 2), and flexible goal setting (Experiment 3). Across experiments, the behavioral results were remarkably similar: Subjects exhibited excellent adherence while in the study but, at follow-up, reported behavior that differed little from baseline. We discuss parallels between attempts to promote health-protective dental behaviors and other health-promotion programs, and we describe different perspectives from which to address the problem of creating healthy habits.

Adolescent↗
PubMed1979

Introduction to the theme--state intervention and the social wage: the politics of social services expansion.

State intervention in the consumption process has become increasingly critical to economic growth on the one hand and to real family income on the other. The social wage thus tends to become a conflictual political issue. As a result, the articulation of state intervention with the changing requirements of economic growth is subject to continuous political challenge. This special issue examines the problematic relationship between state intervention in social services and the organization of the capitalist economy. Some contributors study the ways in which state inter ventions are structured so as to be consonant with the requirements of economic growth and profitability, as well as the difficulties such structures pose. Feshbach's analysis of the Hill-Burton Hospital Construction Program and Mollenkopf's study of San Francisco's public transit system both reflect this concern. Other contributors study the ways in which the organization of the economy constrains the development of democratically responsive social services. Sbragia's study of the capital market and public housing in Italy and Taylor's study of free medical clinics in the U.S. both reflect this concern. Finally, contributors study macroscopic transformations in the relationship between state intervention and the organization of the capitalist economy. Esping-Andersen's study of the political logic of increasing state intervention in production and Hirschhorn's analysis of the defunctionalization of social services attendent upon the disaccumulative tendencies in capitalism both reflect this concern. This introductory paper reviews four theories which attempt to explain how state intervention is insulated from democratic controls. For each theory, the mechanisms specified to perform this function are subject to weaknesses. An attempt is made to position the contributions to this volume with respect to these theoretical traditions.

Conflict, Psychological↗
PubMed1991

Self-assessment and learning through GOSCE (group objective structured clinical examination).

The objective structured clinical examination (OSCE) was modified to serve as a means of self-assessment and learning, rather than as an examination. The main modifications were to adapt it for use by small groups instead of individuals, and to provide a correct answer or other feedback at each station. The resulting group OSCE (GOSCE) was used as an introductory session in two residential refresher courses for general practitioners. The 300 participants rated it highly as a method of self-assessment and as an enjoyable social event. Four potential applications of the GOSCE are suggested: as an assessment instrument for formative and informal summative assessment, as a resource for learning about interpersonal and interprofessional relationships, and as a framework for problem-based short courses.

Education, Medical, Graduate↗
PubMed1987

Two different approaches to computer-aided teaching of microbial genetics.

Two computer packages have been developed to teach bacterial genetics on an introductory genetics course for undergraduate students in biology. The first package, 'CONJUGACION', is designed to teach bacterial conjugation and its genetic outcomes. It includes four main parts. Firstly, a tutorial part presents a theoretical framework using screens of text and animated graphics. Secondly, an interactive concept application section requires students to carry out experiments for the determination of the correct sex and genotype of 10 bacterial strains. The third part uses the previously obtained data for simulating interrupted mating experiments and mapping the bacterial genome. Finally, an evaluation section allows the students to test their understanding through a series of multiple choice questions. The second package, 'LURIDEL', is intended for teaching the preadaptative character of mutation in bacterial populations on the basis of the fluctuation test of Luria and Delbrück. It simulates, graphically, the appearance of mutations in microbial cultures and gives results of simulated fluctuation experiments. Programs were written under the PCOS operating system in MBASIC extended to graphics for running on Olivetti M20 microcomputers.

Computer-Assisted Instruction↗
PubMed1989

Teaching microcomputing to student nurses: an evaluation.

This paper describes an introductory computer course designed for student nurses facing a career in nursing in which computers will play a major part. Questionnaires were given before and after the course. The purpose of the questionnaires were (a) initially to gain information about the students' previous computing experience, motivation and expectations of the course, and (b) to enable an evaluation to be undertaken. The course content, structure and results of the questionnaires are presented; modifications made to the course following the evaluation are mentioned and finally some of the issues which need to be considered when developing a computer course for nurses are raised.

Computer User Training↗
PubMed1991

Distance learning in a local setting: a structured learning course for the introduction of general practice to undergraduate students.

This paper describes the development and evaluation of a structured introductory course in general practice. Following some of the principles developed in distance education, the Department provides everything the student needs for the formal learning requirement as well as detailed assistance in how best to tackle the selected topics. The course was reported to be demanding, relevant and enjoyable. The major areas requiring attention were in reducing the amount of reading required, more help in learning to work in small student-run groups and more one-to-one supervision of physical examination skills. With further refinement the course should be applicable to other medical schools in developed countries.

Curriculum↗
PubMedDate not supplied

Preparing and presenting an introductory course on motor vehicle injury.

Health professionals are key to any progress in reducing motor vehicle injury and death, yet they have been slow to recognize their role in this important area. One factor contributing to this problem has been the absence of courses on motor vehicle injury from the curriculums of the health professions schools. A comprehensive course on motor vehicle injury and death was developed, presented, and evaluated at the University of Illinois at Chicago School of Public Health. The major course objectives were for students to (a) comprehend that highway injury is a major public health problem, (b) understand that this problem can be mitigated by proven public health techniques, and (c) understand and be able to implement multidisciplinary solutions. It was hoped that students would champion the prevention of motor vehicle injuries as a high priority for public health agencies and other professional and community organizations. The course has now been presented twice. A teaching guide was prepared and was reviewed by faculty at 13 schools of public health. This guide discusses practical aspects of introducing and implementing this type of course, overall course objectives, specific learning objectives, a model curriculum (with suggested readings) for nine topic areas, materials from which transparencies or slides could be made, and a geographic listing of resource persons. The objectives for the guide were for it to be a practical model for a motor vehicle injury course and to acquaint health professions faculty with the resources available to them for course development, as well as with a network of professionals who are willing to aid them in their efforts. The guide is not a programmed learning text or a collection of canned lectures, but rather it is intended to provide a framework and encouragement to those at other institutions who seek to develop such a course.

Accidents, Traffic↗
PubMed1990

The perceptions of students and teachers regarding the introductory module of an enrolled nurse conversion course.

This study sets out to explore the perceptions of students' and their teachers' regarding the Introductory Module of a course to convert Enrolled Nurses to Registered General Nurses. The course has been developed as a joint venture with two local Schools of Nursing as an experiment in joint course management. An illuminative evaluation approach has been adopted utilising the techniques of observation, questionnaires and interviews, in order to provide information by a variety of means upon which the course management team can base their future decisions regarding the course. The findings suggest that the introductory module was perceived by the students and teachers as a valuable learning experience. Issues specific to the course which were highlighted included the need for the involvement of the course teachers from each School of Nursing in the teaching programme, the introduction of negotiated student learning, a joint approach to the assessment of theory and practice and a modification of the maternity and community care experience. General issues related to the students as mature learners included the need for pre-course preparation for the students, the assessment of individual learning needs, the inclusion in the content of essay writing skills and stress management and the need for a comprehensive staff development programme for the teaching staff. The study highlighted the need for evaluation of nurse education programmes and teaching methods in order to provide professional accountability and to ensure nurse education practice is research-based.

Curriculum↗
PubMed1991

Nurse socialization: issues and problems.

A comparative study was conducted of the professional socialization process of student nurses in three nurse education centres in South Wales. Patterns and problem areas can be identified of relevance to issues in role theory and with practical implications for the more effective implementation of Project 2000. Three cohorts of students were interviewed using a semi-structured interview schedule whilst in the introductory block and at the end of the first year. The teaching and ward staff directly involved in the socialization process were also interviewed so that their views could be compared with those of the students. There were differences between the types of ward in the opportunities they offered for role modelling. It was doubtful whether the three categories of students, teaching staff and ward staff were all employing a single conception of 'the good nurse'. The student has to find her own pathway through the divergent and often conflicting values and philosophies of the teaching staff and those in authority on the wards. It is recommended that a more unified approach be adopted to reduce the conflict which learners experience. In accordance with Project 2000, the teaching staff should act as practitioners and thereby be perceived as a professional role model with clinical credibility.

Attitude of Health Personnel↗
PubMed1989

Bleeding patterns and acceptability among Norplant users in two Asian countries.

Changes in menstrual bleeding patterns are the most frequent reason for discontinuing NORPLANT during the first year of use. Although NORPLANT is used by more women in Asia than in any other region, the changes that occur among these women are not well documented. In pre-introductory clinical trials of NORPLANT in the Philippines and Sri Lanka, 175 women were enrolled with greater than 95% continuing the method after one year. Daily menstrual bleeding calendars were kept by 94% of subjects for nine months and by 66% for one year. In contrast to findings in previous studies which showed that approximately 60% of NORPLANT users had bleeding disruptions in the first year of use, almost all of these women experienced bleeding disruptions. In a one-year study of menstrual pattern changes, increased bleeding was found to occur with the same frequency as reduced bleeding. However, the changes experienced by the Asian women tended to be decreases, rather than increases, in menstrual bleeding.

Adult↗
PubMed1989

A practical approach to creative teaching: an experiment.

The purpose of this experiment was to see if creative teaching methods would prove effective when included in a school of nursing teaching programme. This would be demonstrated by significant differences in levels of achievement in assessments and a demonstration that the knowledge gained was applied to the clinical situation. Didactic teaching methods were exchanged for a more creative approach without alteration of the course structure. The quasi experimental method was used, with four introductory courses of 20 nursing students at two separate district schools as the sample, two groups acting as the control groups and two as the experimental groups. The teaching sessions introduced medical problems associated with poor oxygenation, particularly those consequent to heart disease. The teaching was supported by appropriate care planning within the Roper et al. (1981) theoretical framework. Three distinct areas were identified; fact learning, e.g. anatomy and physiology, problem identifications and planning for nursing, intervention and skill learning. Students in the experimental groups were given work sheets and facilities for self learning whilst those in the control groups continued with a traditional lecture/demonstration format. The results of the experiment were evaluated by testing all four groups using multiple choice objective tests, essays, problem solving and nursing intervention exercises and practical assessments. The findings showed that the experimental groups did no better in the multiple choice objective tests or in the essays than the control groups but they did do significantly better in the problem identification and planning for nursing intervention exercise. In the assessment of practical skills there was no difference between the groups in skill performance but the experimental groups were able to apply the theory significantly better than the control groups.

Creativity↗
PubMedDate not supplied

Evaluation of safety, efficacy, and acceptability of NORPLANT implants in Sri Lanka.

This paper presents findings based on a one-year pre-introductory clinical investigation concerning safety, efficacy, and acceptability of the new contraceptive NORPLANT implants in Sri Lanka. The study is based on 400 acceptors of the implants at two clinics in Sri Lanka. Acceptors' mean age was 27 years, mean number of children was about two, and average educational attainment was eight years. Nearly half of the acceptors did not want to have another child. Follow-up was conducted at one, three, six, and twelve months. The one-year termination rate due to medical problems was very low, and the one-year life-table pregnancy rate was 0.5. Menstrual pattern disruption was the most frequently reported complaint with the implants. Amenorrhea increased in the first three months of use, and intermenstrual bleeding was common among those menstruating. In spite of these changes and some significant variations between the acceptors in the two study center, the overall degree of satisfaction with the implants was very high. The features most important to the acceptability of the implants were low risk of pregnancy, the long duration of action, and the convenience of use. The results of the study suggest that NORPLANT implants are safe, effective, and highly acceptable to Sri Lankan women.

Adolescent↗