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PubMed2000

National immunization day to assess nutritional status of underfives in Chandigarh.

National Immunization Days (NIDs) are an additional opportunity to reach a large number of children and can be used to undertake additional activities beside immunization. This study highlights an attempt to assess nutritional status of under five children by using a NID. Seven thousand four hundred and thirteen underfives were selected randomly from urban, rural and slums areas of Chandigarh. Nutritional status was assessed by using weight for age criteria. Prevalence of protein energy malnutrition (PEM) was found to be about 42% while 22.7%, 14.5%, 4.1% and 0.7% children had grade I, II, III and IV PEM respectively. The prevalence of PEM was significantly higher among females (47.6%), in 1-3 years age group (53.80%), in slum area (67%) and children of labour class (60.5%) (p < 0.001). With increase in family size, the prevalence of malnutrition also significantly increased, and decreased with high literacy rate in parents (p < 0.001). The prevalence of PEM in present study (42%) was comparable to a community based survey (51.6%) among pre-school children of an ICDS block of Chandigarh. National immunization days can be successfully used to assess nutritional status of children. This approach can be used by others for screening common childhood problems, preparing normogram for a region or country, administering Vitamin A and educating mothers.

Child, Preschool↗
PubMed2001

The effectiveness of a self-care management interactive multimedia module.

PURPOSE/OBJECTIVES: To develop and test an interactive multimedia module prototype designed to accommodate adults with limited literacy and without computer skills. DESIGN: Experimental, randomized, controlled, pretest, post-test. SETTING: Cancer treatment centers in California, Louisiana (pilot). New Hampshire, Pennsylvania, and Texas. SAMPLE: Outpatients who were at least 18 years old with a minimum fifth-grade reading level; 86 experimental treatment, 88 control. METHODS: Experimental treatment involved use of the interactive multimedia module; the control group received customary Instruction. FINDINGS: As compared to the control group, subjects in the experimental group had significant improvement (p = 0.0001; 257% gain) in self-care ability regardless of age, sex race, education, geographic location, reading ability, computer experience, or preferred learning style; a 6.515% increase in fatigue content covered and 16.775% Increase in instructional duration; and significantly greater benefit from sleep-related activities and a consistent, positive pattern of self-care behavior. CONCLUSIONS: The program is instructionally effective, appropriate for a wide and geographically diverse audience, and feasible for use in the ambulatory setting. IMPLICATIONS FOR NURSING PRACTICE: The interactive multimedia module is an effective, self-directed resource for individualized patient fatigue education.

Adaptation, Psychological↗
PubMed2006

CDC-funded intervention research aimed at promoting colorectal cancer screening in communities.

BACKGROUND: Although strong scientific evidence has shown that screening for colorectal cancer saves lives, most U.S. adults who are at the recommended age are not being screened. Prior studies suggest that barriers to routine screening vary by race, ethnicity, socioeconomic status, urban/rural residence, health insurance status, and factors related to health care providers and the health care environment. Relatively few studies, however, have identified and tested intervention approaches to promote routine colorectal cancer screening among diverse populations. METHODS: The Division of Cancer Prevention and Control at CDC has funded ongoing projects to develop and test interventions to promote routine colorectal cancer screening among medically underserved populations in Appalachia, the Lower Rio Grande Valley in Texas, the High Plains region of Colorado, and other U.S. communities. RESULTS: This article provides an overview of colorectal cancer screening intervention studies currently funded by CDC that focus on a wide range of populations, including medically underserved persons who live in predominately rural areas, Hispanic and non-Hispanic persons, urban African Americans, persons with low health literacy, and persons enrolled in managed care organizations. CONCLUSIONS: These CDC-funded intervention research projects are likely to contribute importantly to evidence about what works to promote colorectal cancer screening in diverse U.S. communities. .

Black or African American↗
PubMed2004

Exploring the self-learning experiences of patients with depression participating in a multimedia education program.

The purpose of the present study was to explore the self-learning experiences of depression patients on interactive multimedia education program. Qualitative in-depth interviews were employed. Fourteen patients with a first episode of major depression were recruited from a psychiatric outpatient department. Explanations of the purposes of the exercise and on-the-spot teaching were provided by the researcher before the study began. A tape-recorded, semi-structured interview format was employed after two weeks. Data analysis was performed in the framework of line-by-line content, contextual and thematic analysis. Eight subjects successfully completed the entire learning activities. Content analysis revealed 4 main aspects of successful self-learning experiences: the triggering of learning motivation, the enjoyment of self-paced learning, support for the effects of learning materials, and the gaining of self- awareness and changes. The factors influencing learning performance were related to: environmental impact, the degree of familiarity with traditional learning, possession or non-possession of the necessary computer operation skills, and good computer support. However, the findings provide a preliminary understanding of the application of interactive multimedia education programs in terms of self-learning outcomes and recognizing key elements of learning impediments among the study sample. A larger sample size with different clinical contexts is recommended to determine the effect and generalizability for future research. Furthermore, the creation of a computerized learning environment with different educational styles is crucial to patients' success in obtaining depression-related information and understanding effective adaptive skills.

Adaptation, Psychological↗
PubMedDate not supplied

The use of computers as cognitive tools to facilitate higher order thinking skills in nurse education.

Much of what has been written about computer use in nursing has been technocentric in nature. Nursing literature has focused on the intricacies of the technology, computer literacy, nurses' attitudes to computers and information systems, the implementation of these systems and, to a lesser degree, nursing information and its application in a computerized environment. Little, if any, attention has been given to the underlying cognitive processes required to use information technologies effectively. Can nursing stand accused of concentrating too heavily on the technology of information rather than on the cognitive processes involved in the acquisition, management, and use of information? This discussion will focus on the utilization of cognitive tools to facilitate the higher order thinking skills required for the effective use of information technologies. The concept of cognitive tools and cognitive residues will be defined. The role of these concepts within the broader context of nursing informatics will be illustrated using examples of how computer-based cognitive tools have been implemented in one undergraduate nursing program.

Cognition↗
PubMedDate not supplied

Paths of effects of early childhood intervention on educational attainment and delinquency: a confirmatory analysis of the Chicago Child-Parent Centers.

This study investigated the contributions of 5 mechanisms to the effects of preschool participation in the Child-Parent Centers for 1,404 low-income children in the Chicago Longitudinal Study. Based on a matched-group design, preschool participation was associated with significantly higher rates of educational attainment and lower rates of juvenile arrest. LISREL analysis revealed that the primary mediators of effects for both outcomes were attendance in high-quality elementary schools and lower mobility (school support hypothesis), literacy skills in kindergarten and avoidance of grade retention (cognitive advantage hypothesis), and parent involvement in school and avoidance of child maltreatment (family support hypothesis). The model accounted for 58% and 79% of the preschool links with school completion and juvenile arrest, respectively. The maintenance early intervention effects are influenced by many alterable factors.

Achievement↗
PubMed1998

Computer-assisted creation of psychiatric advance directives.

Results are reported from a project that involved design, production, and feasibility testing of the use of a multimedia computer program to: 1) educate MH consumers about psychiatric advance directives (ADs), and 2) assist them in creating ADs. The feasibility results, based on a random sample of 60 adults meeting criteria for having a serious and persistent mental illness, were positive. Sixty-five percent of the sample were able to complete their ADs. Educational level, presence of a learning disability, and minority-group membership, but not diagnosis, were related to completion rates. The results dispel several popular myths about psychiatric ADs.

Adult↗
PubMed2005

Differential improvement among countries in child stunting is associated with long-term development and specific interventions.

Stunting represents growth failure resulting from poor nutrition and health during the pre- and postnatal periods. Initiatives since 1980 have steadily reduced malnutrition and consequent retardation of child growth, but 1 of 3 preschool children worldwide remains stunted. Countries have varied substantially in progress achieved in reducing stunting. This study aimed to understand which underlying (i.e., proximal) and basic (i.e., distal) national factors have been most important in explaining this variation among countries, and the relation between the 2 sets of factors. Eighty-five developing countries with at least 2 surveys for stunting >4 y apart were included from the WHO Global Database on Child Growth. The analytic data set with independent variables from several sources was constructed to match closely by year for each country to initial and final stunting data. Full-information maximum likelihood estimated multiple linear regression models while accounting for missing data in independent variables. The final model explained 65.5% of the variance of change in stunting, and included both underlying and basic variables: initial and change in immunization rate, initial and change in safe water rate, initial female literacy rate, initial government consumption, initial income distribution, and the initial proportion of the economy devoted to agriculture. Although factors that were important for reducing stunting in the past may not necessarily be the ones that are important in the future, these results suggest that it possible for substantial progress to be made in reducing the current high prevalence of stunting by investing in both long-term development and in specific interventions.

Agriculture↗
PubMed2002

Quality of life assessment software for computer-inexperienced older adults: multimedia utility elicitation for activities of daily living.

Functional status as measured by dependencies in the Activities of Daily Living (ADLs) is an important indicator of overall health for older adults. Methodologies for outcomes-based medical-decision-making for public policy, such as decision modeling and cost-effectiveness analysis, require utilities for outcome health states. Utilities have been reported for many disease states, but have not been indexed by functional status, which is a strong predictor of outcome in geriatrics. We describe here a utility elicitation program developed specifically for use with computer-inexperienced older adults: Functional Limitation And Independence Rating (FLAIR1). FLAIR1 design features address common physical problems of the aged and computer attitudes of inexperienced users that could impede computer acceptance. We interviewed 400 adults ages 65 years and older with FLAIR1. In exit interviews with 154 respondents, 118 (76%) found FLAIR1 easy to use. Design features in FLAIR1 can be applied to other software for older adults

Activities of Daily Living↗
PubMed2006

Motivation for eating behaviour in adolescent girls: the body beautiful.

Body dissatisfaction is commonplace for teenage girls and is associated with dieting and unhealthy weight-control behaviours. The idealisation and pursuit of thinness are seen as the main drivers of body dissatisfaction, with the media prominent in setting thin body ideals. Television and consumer magazine production in the UK are extensive, annually releasing 1x10(6) h programming and >3000 magazine titles. Their engagement by adolescent girls is high, and in surveys girls identify thin and revealing body images as influential to the appeal of thinness and their pursuit of dieting. Experimental studies show a short-term impact of these images on body dissatisfaction, especially in teenagers who are already concerned about body image. Magazine images appear more influential than television viewing. For many adolescents selecting thin-image media is purposive, permitting comparison of themselves with the models or celebrities featured. Indeed, the impact of the media needs to be understood within a social context, as engagement is often a highly-social process. Media influence is uneven because of differences in its content and manner of communication, and individual differences in vulnerability to its content. Greater social responsibility on the part of the media and better media literacy by children would be beneficial. For those working in adolescent nutrition it is a reminder that adolescent food choice and intake are subject to many competing, contradictory and non-health-related determinants.

Adolescent↗
PubMed2001

Immunisation status of children in BIMARU states.

To assess the immunisation status of children in the states of Bihar, Madhaya Pradesh, Rajasthan and UP the evaluation covered BCG, DPT, OPV, Measles, Pulse Polio and Vitamin A. WHO 30 cluster survey methodology with certain modifications incorporating information on sex of the child, literacy of parents and distance of the village was used. Study covered 30 districts, 900 villages and 6300 children. About 48 per cent of children received all the vaccines (BCG, DPT, OPV, Measles) in these states as compared to 63 per cent at All India level. These states accounted for about 70 per cent of non-immunised children. The coverage levels were lower for children of illiterate mothers and in small, inaccessible and triple villages. The literacy of mother is the key to the success of the Universal Immunisation Programme (UIP). Information, Education and Communication (IEC) activities should specially be targeted to educate the moters in rural areas. The underserved areas of these four states should have special focus in the programme and hence the tribal, small and inaccessible villages in the coverage should be focused and targeted, immediate improvement in the coverage could also be achieved by better follow-up and reducing drop-out rate.

Child, Preschool↗
PubMed1998

Treatment efficacy: hearing loss in children.

This article provides a review of the topic of treatment efficacy for children with hearing loss. Efficacy is related to a wide range of treatment goals in the areas of sensory and perceptual skill development, language development (regardless of communication modality), speech-production skill development, academic performance, and social-emotional growth. Topics addressed in this article include (a) the definition of hearing loss in children; (b) incidence and prevalence data; (c) the effects of childhood hearing loss on daily life, including language and literacy, speech perception and production, socialization and family dynamics; (d) the role of audiologists and speech-language pathologists in managing children with hearing loss; and (e) a summary of pertinent efficacy research for children with hearing loss. The analysis of the available research suggests that (a) early intervention for children who are deaf or hard of hearing has long-term positive effects on overall development; (b) a variety of communication modalities exist for this population, and research to date has been more descriptive than prognostic on the choice of modality; (c) sensory aids (hearing aids, tactile aids, and cochlear implants) provide different degrees of benefit for children in the areas of speech perception, production, and language development, depending upon the extent of their hearing loss; (d) few studies have addressed rates of learning and long-term outcomes, but existing data suggest that enriched programs provide some children with hearing loss with the ability to overcome developmental lags in language and academic skills.

Child Language↗
PubMedDate not supplied

Clinicians and outcome measurement: what's the use?

The goal of this study was to learn more about clinicians' experiences with, and perceptions of the utility, validity, and feasibility of standardized outcome measures in practice. Fifty randomly selected clinicians from multiple disciplines and multiple service agencies in a large children's public mental health service system were interviewed individually (n = 30) or in focus groups (n = 20) using semistructured interviews. There was great variability across clinicians in attitudes about empirical methods of treatment evaluation. There was consensus regarding feasibility challenges of administering standardized measures, including time burden and literacy barriers. Although all participants had received scored assessment profiles for their clients, the vast majority reported that they did not use the scores in treatment planning or monitoring. Their suggestions for improved clinical utility of outcome measurement are included. With increased attention and resources devoted to performance outcome assessment, it is concerning that most clinicians perceive little clinical utility of outcome measurement.

Adolescent↗
PubMed2006

A systematic review of computer-based softwares for educating patients with coronary heart disease.

OBJECTIVE: To evaluate the use of computer-based softwares for educating patients with coronary heart disease. METHODS: A systematic electronic search for randomised controlled trials and comparison studies published from 1999 to the end of 2005 using the MEDLINE (1999-2005), EMBASE (1999-2005) and CINAHL (1999-2005) was carried out. Articles including the reference lists in the following journals were hand-searched: Patient Education and Counselling and Patient Counselling and Health Education. RESULTS: A total of 487 articles were identified. Based on a review of abstracts, five studies fulfilled the inclusion criteria of the review. A scoring sheet was used to assess the papers' quality. All studies reported significantly increased knowledge in patients using the educational software when compared to standard education. The difference in knowledge between the intervention and control groups remained high even at 6 months follow up. Furthermore, patients reported high satisfaction with the educational programs. CONCLUSION: Despite there only being five studies that met the inclusion criteria, this review supports the successful use of computer software to increase knowledge in patients with coronary heart disease. The reviewed articles reveal that computer-based education has an important role in increasing patients' knowledge about their condition. PRACTICAL IMPLICATIONS: It is commonly reported that patients want more information about their illness. This study shows that computer-based education can be a useful, acceptable to patients and effective way to deliver education about coronary heart disease.

Adult↗
PubMedDate not supplied

Optimizing computer-based system use in health professions' education programs.

The use of computer-based systems to support training in health profession education programs has been discussed and analyzed for more than 10 years. The literature is rich with examples of how using these systems can benefit programs by more effectively distributing human resources, by making the delivery of instruction more individual and more flexible, by expanding the professional and technical competence of trainees, and by improving the monitoring of trainee performance. Obstacles to and conventional recommendations for the broadened use of computer-based systems are discussed, and an additional set of system design characteristics are described that health care educators can use in their preview and specifications for procurement of more effective computer-based systems in their training settings.

Attitude to Computers↗
PubMedDate not supplied

Workforce literacy: do we have a choice?

Rapidly occurring demographic change and the demand for higher and higher skills in the workforce present a challenge for business and education. The investment the workplace makes in basic education for its employees will not only increase skills, but positively affect attitudes toward the employer, stimulate a desire for education and promotion and raise self-esteem. The rich mix of racial, ethnic and global experiences represented in today's workforce is a great potential advantage. We must face the question of best developing this potential for the future. Investment in personnel is not only worth-while--there is no other choice. We must not lose the opportunity.

Educational Status↗
PubMed2006

Use of diabetes resources in adults attending a self-management education program.

OBJECTIVE: To identify the types of resources used to acquire information or assistance in the management of diabetes, and to identify persons who are more or less likely to use a variety of diabetes resources. METHODS: Through the use of a questionnaire and review of patient records, sociodemographic, clinical, and health care service utilization characteristics were obtained for 267 individuals with type 2 diabetes from a culturally diverse diabetes education centre. Descriptive analyses were performed to provide information on the types of diabetes resources used by age, sex and primary language spoken. Multivariable Poisson regression was used to predict low from high users of a variety of diabetes resources. RESULTS: On average, most patients used four different resources. The most commonly cited were physicians or endocrinologists; diabetes educators; and magazines, newspapers, books or television. Those who did not speak English, were born outside of Canada, had a lower level of education, or who were older used fewer diabetes resources. CONCLUSION: Notably, the characteristics of individuals who are less likely to use resources or a variety of resources reflect the basic determinants of health (i.e., age, sex, ethnicity or primary language spoken, and education). PRACTICE IMPLICATIONS: We need to develop resources that are equitably accessible and of interest to all patients, particularly for individuals who do not speak English, who have lower education and literacy levels, and who are older. Furthermore, imparting the skills on how to find and utilize currently existing resources to assist in chronic disease self-management should be promoted as a core aspect of self-management education.

Adult↗
PubMedDate not supplied

Interactive computer-based cognitive training in patients with Alzheimer's disease.

The present paper presents data from ten patients suffering from mild to moderate Alzheimer's disease (AD), all of whom were trained to use an interactive computer-based program. Using photographs of the patient and his or her personal surroundings, an everyday task of relevance to the patient was simulated on a PC-touch screen, which the patient was trained to operate. After three weeks of training (three to four sessions a week), the patients needed less help in performing the programs, they became faster, and eight out of ten made fewer mistakes. The results were most pronounced in patients with a poor performance at the beginning, and there was no difference between early-onset (EO) and late-onset (LO) AD patients. Although the training was generally well received, there was no evidence of a general cognitive improvement, and it remains an open question whether the results achieved with PC training can be transferred to real-life situations.

Activities of Daily Living↗