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The integrated health professions education program seminar.

Powerful dynamics of change require practitioners from all disciplines to be prepared to work in interdisciplinary teams, competently access health and information technologies, and understand the multiple functions required for adequate healthcare provision. The University of Iowa's Integrated Health Professions Program is a state-funded effort designed to provide students with a common educational experience to enable them to work collaboratively in underserved or rural settings. Students take part in a series of team-building seminars including technology-based instruction and activities in conjunction with visits to community clinical sites. The authors discuss the experiential, collaborative, and cooperative forms of learning that take place during the seminar series.

Community Health Services↗

Effects of a 3-week integrated body weight reduction program on leptin levels and body composition in severe obese subjects.

The effects of short-term (3 weeks) integrated body weight reduction (BWR) program (including energy-restricted diet, aerobic and strength exercise (5 days/week), nutritional education and psychological counseling) on plasma leptin levels and body composition were investigated in 54 morbidly obese patients (38 females/16 males; mean BMI +/- SE: 41.8 +/- 0.1 kg/m2, range 35-58 kg/m2; mean age: 29.8 +/- 1.0 yr, age range: 18-46 yr). The BWR program induced a significant (p < 0.001) weight loss (BMI reduction: -4.8%) and a significant modification in body composition, consisting in a fat mass (FM) decrease (-7.0 +/- 0.4%, p < 0.001) with a concomitant fat-free (FFM) mass increase (1.8 +/- 0.3%, p < 0.001). On average, plasma leptin levels decreased significantly both in males (from 19.4 +/- 2.6 ng/ml to 11.6 +/- 1.3 ng/ml, p < 0.001) and in females (from 41.1 +/- 3.6 ng/ml to 29.9 +/- 3.0 ng/ml, p < 0.001). Both before and after weight loss, leptin levels were positively correlated (p < 0.001) with BMI and percent fat mass (FM) values. Weight changes after the BWR program were negatively correlated with baseline leptin concentrations both in absolute terms and expressed per unit FM. In conclusion, a short-term diet plus aerobic/strength training effectively induces body composition changes and reduces plasma leptin levels. Body FM reduction appears to be not the unique determinant of leptin levels regulation and the degree of leptin over-expression may negatively affect weight loss in morbidly obese patients.

Adipose Tissue↗

Evaluation and training of medication adherence counselors in a clinical trial: application of a skill inventory to video-recorded interviews.

This report describes the procedures and feasibility of an integrated evaluation and training program developed at the Baylor-Methodist Lipid Research Clinic to examine the skills used by the clinic's professional staff in conducting medication adherence interviews with participants in the Coronary Primary Prevention Trial (CPPT). The specific aims of this project were to evaluate the staff's interviewing and counseling skills, identify strengths and deficits, provide needed training, and reexamine the staff's skills following this training. Each of five staff members conducted two 20-minute video-recorded interviews with two different simulated CPPT participants. A trained observer reviewed the video-recordings and evaluated, by an Inventory for Interviewing and Counseling Skills for Adherence to Medication (IICS-AM), each staff member's possession and frequency of use of 17 interviewing skills and 10 counseling skills. The 27 skills on the IICS-AM were selected from the literature as being most frequently recommended for effective interviewing and counseling for medication adherence. These rating data were used to design a 14-week training program to acquire and promote the use of these skills. Following training, the video-recorded interview procedure was repeated and the data analyzed to identify the effects of the training program. The integrated evaluation and training procedures used in this project offer a practical, objective method for examining, improving, and monitoring the skills of the adherence counseling staff in a clinic participating in a multicenter clinical trial.

Audiovisual Aids↗

The Professional Transitions Workshop. Cornerstones of practice.

The Professional Transitions Workshop is a new program that integrates the Professional Advancement Program (clinical ladder) and the Professional Model of Practice (primary nursing). Together, these two programs provide the philosophical and structural foundations of professional practice and empower nurses to articulate the defining features of their clinical experiences. Educating staff members about these programs emphasizes critical thinking and storytelling as important skills for the professional nurse. The authors describe the advantages, processes, and outcomes of this change.

Career Mobility↗