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At least 775 records · Page 43Linked to original sources
PubMed2006

Mother's reactions to a skills-based breastfeeding promotion intervention.

We interviewed women who participated in a breast-feeding promotion intervention study about whether and how participation affected their infant feeding choices, and if they would recommend such an intervention to others. The larger study, a randomized controlled trial (RCT) of an individualized, pre- and post-natal lactation consultant (LC) intervention, enrolled 382 low-income primarily Black and Hispanic women in New York City. Twenty-one women completed qualitative exit interviews for this study (11 from the Intervention group and 10 Controls). Several of the Controls stated that the post-partum study interviews were a source of support, and made them more conscious of how they fed their infant. The Intervention Group was asked about contacts with the study 'Mother-Baby specialist' (i.e. LC), including what was and wasn't helpful. The Intervention Group participants described the Mother-Baby Specialist as key in their decision to initiate and maintain breastfeeding. They credit her direct skills and positive reinforcement with their confidence and perseverance to breastfeed. The success of the intervention is attributed to technical assistance from a trained lactation consultant within the context of a relationship built on encouragement, guidance and support.

Adult↗
PubMed2004

Diagnosis of schistosomiasis by reagent strip test for detection of circulating cathodic antigen.

A newly developed reagent strip assay for the diagnosis of schistosomiasis based on parasite antigen detection in urine of infected individuals was evaluated. The test uses the principle of lateral flow through a nitrocellulose strip of the sample mixed with a colloidal carbon conjugate of a monoclonal antibody specific for Schistosoma circulating cathodic antigen (CCA). The strip assay to diagnose a group of highly infected schoolchildren in Mwanza, Tanzania, demonstrated a high sensitivity and association with the intensity of infection as measured both by egg counts, and by circulating anodic antigen and CCA levels determined by enzyme-linked immunosorbent assay. A specificity of ca. 90% was shown in a group of schistosome-negative schoolchildren from Tarime, Tanzania, an area where schistosomiasis is not endemic. The test is easy to perform and requires no technical equipment or special training. The stability of the strips and the conjugate in the dry format lasts for at least 3 months at ambient temperature in sealed packages, making it suitable for transport and use in areas where schistosomiasis is endemic. This assay can easily be developed to an end-user format.

Adolescent↗
PubMed1993

Development of an internal quality assessment scheme in a clinical bacteriology laboratory.

AIM: To develop an internal quality assessment (IQA) scheme in a clinical bacteriology laboratory. METHODS: Over 24 months, 1230 diagnostic specimens, representing 0.42% of laboratory workload, were anonymised and resubmitted for analysis. Six hundred and twenty one (48.7%) of these gave positive culture results; 44 fecal and upper respiratory specimens were "spiked" (artificially inoculated) to increase the proportion of positive samples. RESULTS: Discrepancies between IQA and clinical sample results occurred in 188 cases (14.8%): 76.6% of these were in culture results, 13.3% in microscopy performance, and 10.1% in clerical recording. The culture discrepancy rate for each positive sample was lowest for wound (17.5%) and urine (18.1%) specimens, and highest for faeces (34.9%) and upper respiratory (37.7%) samples. Discrepancies in several areas responded to staff training and improvement in technical methods. CONCLUSIONS: An IQA programme of this type assesses the reproducibility of tests within a diagnostic laboratory when analysing common specimen types and organisms. It permits blind assessment of many areas of diagnostic work that are not readily amenable to other quality assurance methods, and it raises the awareness of all staff to the importance of quality in every aspect of specimen and data processing.

Bacteriological Techniques↗
PubMed2001

Future developments and perspectives in laparoscopy.

INTRODUCTION: As urologists head into the new millennium, it has become clear that laparoscopy will play a significant role in successful urologic practice. Issues that are addressed in this article include: (1) What are the new limits? (2) Technological advances. (3) Adequate training. (4) How to technically simplify the laparoscopic procedures? MATERIALS AND METHODS: To answer the stated questions a review of the literature has been undertaken together with interviews of the leading experts and laparoscopic working groups in urologic laparoscopy. The gathered information has been summarized and focussed with the aim of presenting the perspectives of laparoscopy in urology. RESULTS AND DISCUSSION: Standardized indications for laparoscopic urological surgery are benign nephrectomy, nephroureterectomy, cryptorchidism, adrenalectomy, renal cysts, lymphocele and bilateral or relapsing varicocele. Future indications might include living donor nephrectomy, partial nephrectomy and cyst decortication for adult polycystic kidney disease. Controversy exists about the laparoscopic treatment of malignancies in the urinary tract. Whereas pelvic lymph node dissection--even if performed with decreasing frequency--is accepted worldwide, retroperitoneal lymphadenectomy for low-stage testis cancer is currently performed only at few centers. The recent breakthrough in uro-oncological laparoscopic surgery has been laparoscopic radical prostatectomy changing our views on the limits of laparoscopic urology. Endoscopic suturing devices (i.e. Endostitch) are further being developed, and a prototype reapproximating micro-clips (VCS stapler) has been used to perform a uretero-ureterostomy laparoscopically in a porcine model. Nevertheless, the ability of endoscopic suturing using the standard equipment has still to be considered as a "conditio sine qua non". Improvements for tissue division and dissection include an electrosurgical snare to perform a partial nephrectomy, the development of a pneumodissector and hydrodissector. Robotics, including the AESOP 3000 and ZEUS represent a glimpse of the future. By positioning the optique in a voice-controlled full range motion mechanic arm, the image on the screen is very steady and the ergonomics of the surgeons is increased significantly. The da Vinci-System, however, is the first system that has translated all visions of telepresence surgery into clinical reality, recently also for laparoscopic radical prostatectomy. CONCLUSIONS: The future of laparoscopic urology is a two-tiered approach. On the first tier, the advancement of complex reconstructive and ablative surgery such as laparoscopic prostatectomy or, laparoscopic retroperitoneal node dissection, will be undertaken by referral centers of expertise. It is from these individuals that we will look to in order to separate what is feasible and what is reasonable. The second tier will be focusing on simplifying the procedure for the average urologist. As such, developments such as the pneumodissector, hydrodissection, and hand assistance will bring exstirpative laparoscopy into the realm of more urologists. What is critical is that the urologic community supports both groups of laparoscopists.

Education, Medical, Graduate↗
PubMed1992

Dietary habits of technical and vocational students in Riyadh, Saudi Arabia--Part II. Eating between meals.

Dietary habits of 452 young adult male students at 6 technical institutes and vocational training centres in Riyadh, Saudi Arabia were investigated as part of a nutritional assessment survey. The eating-between-meals habit was found to be common among the majority (72.3%) of those students. The association between this habit and age cohorts, marital status, accommodation status, self assessment of weight and exercising are discussed.

Adolescent↗
PubMed2000

The potential of a nursing education support system using videoconferencing.

Japan currently employs a total of 400,000 practical nurses, accounting for approximately 40% of the total number of nurses in the country. An education system for improving the skills of practical nurses and encouraging them to obtain certification as registered nurses is due to begin in 2001. In Hokkaido, 90 nursing schools are scheduled to be used as transitional education facilities. These, however, tend to be concentrated in large cities. We have examined the possibilities for an education support system for nurses using videoconferencing. The system will include theoretical lectures using television broadcasts and technical lectures conducted at training facilities. Given Hokkaido's geographical conditions, a support system using telecommunication is considered to be essential for the success of transitional education.

Communication↗
PubMed2005

Successfully developing a telemedicine system.

Successfully developing telemedicine systems is primarily about effective change management. The literature suggests that certain principles are likely to increase the chances of success in developing a telemedicine system. These are: (1) telemedicine applications and sites should be selected pragmatically, rather than philosophically; (2) clinician drivers and telemedicine users must own the systems; (3) telemedicine management and support should follow best-practice business principles; (4) the technology should be as user-friendly as possible; (5) telemedicine users must be well trained and supported, both technically and professionally; (6) telemedicine applications should be evaluated and sustained in a clinically appropriate and user-friendly manner; (7) information about the development of telemedicine must be shared. If telemedicine is to realize its full potential, it must be properly evaluated and the results of any evaluations published, whether the results are positive or negative. Since telemedicine is about communication with colleagues and patients across large distances, it should be possible for those involved in it to do the same with their experiences.

Delivery of Health Care↗
PubMed2005

Sowing the seeds of hope: providing regional behavioral health supports to the agricultural population.

In 1999, project leaders from seven states (i.e., Iowa, Kansas, Minnesota, Nebraska, North Dakota, South Dakota, and Wisconsin) began to share ideas and resources for providing behavioral health assistance (i.e., mental health counseling and addictions services) to stressed farmers, ranchers, farm workers, and their families. The seven states are among those most impacted by the farm crisis of the 1980s and again by low commodity prices and disasters such as droughts and floods in the 1990s. Project leaders conferred in monthly telephone conference calls and by 2001 began meeting in semi-annual face-to-face meetings to formally agree on a mission, program components, and management structure. Administrative functions were transferred from the Wisconsin Office of Rural Health and Wisconsin Primary Healthcare Association, to AgriWellness, Inc., a regional nonprofit corporation founded to provide technical assistance, grant writing, training of service providers, and other administrative supports. The Sowing the Seeds of Hope program has become a model for the provision of behavioral health supports for the agricultural population, including development of farm stress telephone hotlines, provision of confidential and affordable outpatient mental health and substance abuse counseling, training of professional providers in agricultural behavioral health, training of indigenous farm and rural residents as outreach workers who can respond to disasters of all types, and weekend educational retreats for farm residents. The program has achieved economy of scale by sharing expertise across state boundaries and the formation of a regional administrative structure. Yet, many challenges exist, the greatest of which is obtaining ongoing permanent support for the increasing numbers of uninsured and underinsured people involved in agriculture.

Community Mental Health Services↗
PubMed2004

A training psychotherapy elective for military psychiatry residents.

A Training Psychotherapy Elective (TPE) was developed to meet the special requirements of military medical education; but the model is generally applicable to all psychiatry training programs. It aims to demonstrate the technique of individual medical psychotherapy by offering residents and fellows an experience of this procedure in a patient role. It affords trainees an opportunity to address healthy curiosities about their mental functioning without the requirement of endorsing a complaint related to a mental disorder. Training psychotherapy follows the technical model that residents learn in their outpatient rotations. Transparent interventions allow trainees both to experience the impact of clarification and interpretation and to see how the therapist derived them from their associations. This facilitates the application of these interventions to work with patients. It also affords trainees an emotionally sheltered environment in which to explore attitudes and concerns associated with their service in military operations, fostering readiness for such assignments.

Adult↗
PubMedDate not supplied

[The home caregiver in Betim/MG].

This is a qualitative study about the care provided by "caregivers" enrolled in the Home Care Program in Betim, Minas Gerais. Interviews were held during home visits in order to identify characteristics of home care providers, analyze their perception about health care, verify factors which interfere in home care and relationships which are established between caregiver/person cared for/other family members. Discourse analysis (Fiorin, 1993) was used to build the empirical categories which revealed that most of the caregivers are family members, women, average age of 42 years, limited schooling, mostly housewives. The subjects sampled reported that the act of caring involves technique, duty and dedication. They referred to financial difficulties, physical and emotional stress. The relationships established during care involved feelings of pleasure, satisfaction and helplessness in the face of the needs and sufferings of the person cared for. The authors concluded that home care fosters more humane care, but requires technical guidance and emotional training for the caregivers and support from the health institution.

Adult↗
PubMed1998

[Perception of university teachers of their ability to teach nursing].

Teaching Administration Nursing Service we've been worried about several variables of the instructive process that affect the teachers and the students, as advantage, attitudes, thinking and acting manner, values, expectations, previous experiences, among some. These uneasiness take us to check the educational practice experience, considering the teaching's ability. In this study, we intend to reveal the teacher's understanding about the ability to teach nursing throw the education's reality recognition. So, we adopted a quality methodology that allow us a comprehensive analysis of the teaching's speech at a Public University in São Paulo city. According to the methodology it was possible to get back four meaning unities that allowed us to prescribe the emerging subjects; teaching's understanding about technical ability, teaching's understanding about scientific-theretical ability, teaching's understanding about pedagogical ability and the teaching identity. This study permitted us to reveal some points considered outstanding about the teacher's ability, getting it back as the result in a complex and continuous process of technical, theoretical and pedagogical training, contained in a several factors, psychological, social, ethical, economical, political and historical. We still understanding that the teacher's reflections about the teaching reality, in its totality, favouring the awareness and interfering positivly in their criticism formation. Finally there is a necessity to set up schools formation and up-dating centers and establish human political resources compatible with a renewed political of na educational action.

Attitude of Health Personnel↗
PubMed2006

Organization of a microsurgery laboratory.

Microsurgical techniques have been used in many surgical specialties as well as a broad application in surgical research.. It demands high technical skills and continued training. The microsurgical skills should be first mastered in the lab before to be employed in the clinical practice. The microsurgical lab has a dual role: the training of residents and specialized surgeons and the support for the high qualified scientific research in experimental surgery. Here, it is presented (showed) the organization of a microsurgical lab, including area and equipments, furthermore there is a proposal that school-hospitals that offer microsurgical procedures, should have a microsurgical laboratory.

Clinical Laboratory Techniques↗
PubMed1999

[Bioethics in the context of global health programs].

This work describes the Regional Program on Bioethics of the Pan American Health Organization (PAHO)/World Health Organization (WHO), as well as the Program's main achievements. The Program was established in 1994 under a three-way agreement with the University of Chile and the Government of Chile. The Program's objective is to thematically link the work of the PAHO/WHO units and representatives in each country, in close cooperation with local public and private organizations. The Program investigates such subjects as the health of poor people, priority-setting, the growth of the private sector, salaries and incentives in the public sector, investment in hospitals, health sector reform, professional education, and working together for development. Finally, the direction and heading of the Program are presented. Its efforts are carried out as promotional, support, and service activities. These activities take the form of technical assistance for personnel training, public information dissemination, ethical situation analysis in research and services, reviewing curricula and professional practice standards, and advising on specific plans and programs.

Adolescent↗
PubMed1994

Developing leaders vs training administrators in the health services.

In these difficult times, health care institutions need leaders, not simply managers. Leaders' breadth of skills and perspective come from understanding the values involved in health care delivery; managers know the right way to do things, but leaders know which are the right things to do. Schools of public health are moving away from their potential contribution to leadership development in health services administration. The result is a lack of accountability to the community. Leadership skills and an examination of values should be part of health services administration programs in schools of public health, which should see their mission as helping to identify and train leaders, not simply technical specialists in management.

Curriculum↗
PubMed2002

Effectiveness of a worksite intervention to reduce an occupational exposure: the Minnesota wood dust study.

OBJECTIVES: This study assessed the effectiveness of an intervention to reduce wood dust, a carcinogen, by approximately 26% in small woodworking businesses. METHODS: We randomized 48 businesses to an intervention (written recommendations, technical assistance, and worker training) or comparison (written recommendations alone) condition. Changes from baseline in dust concentration, dust control methods, and worker behavior were compared between the groups 1 year later. RESULTS: At follow-up, workers in intervention relative to comparison businesses reported greater awareness, increases in stage of readiness, and behavioral changes consistent with dust control. The median dust concentration change in the intervention group from baseline to follow-up was 10.4% (95% confidence interval = -28.8%, 12.7%) lower than the change in comparison businesses. CONCLUSIONS: We attribute the smaller-than-expected reduction in wood dust to the challenge of conducting rigorous intervention effectiveness research in occupational settings.

Adult↗
PubMedDate not supplied

Thoracoscopic anterior instrumentation and fusion for idiopathic scoliosis.

Thoracoscopically assisted surgery is a new approach to access the anterior spine to perform biopsies, anterior releases, diskectomies, and anterior instrumentation and fusion for idiopathic thoracic scoliosis. This approach compromises the chest wall less than an open thoracotomy does because it uses several small portal incisions. It has been suggested that this approach allows fusion of fewer motion segments and better correction of curvature than does posterior spinal fusion and instrumentation. The technique, which is still evolving, is technically demanding, requiring advanced training and special instrumentation and anesthesia techniques.

Female↗