Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Communication Methods, Total”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources
PubMed2006

Patients and health professionals' perspectives on the sociocultural influences on secondary cardiac behaviour: a qualitative study of the implications in policy and practice.

OBJECTIVES: To explore the similarities and differences between patients and health professionals' perspectives on the sociocultural influences on secondary cardiac behaviour, and the implications in policy and practice. METHODS: Qualitative study using grounded theory research. We used a linked, phased study to ascertain the factors which helped shape patients' views about their heart problems and how these influence secondary cardiac behaviour. We also explored health professionals' perspectives on patients' views and interpretations. A total of 70 participants, 56 patients and 14 health professionals, took part in individual and group interviews and focus groups. RESULTS: Patients seemed in control of their heart condition and communicated a sense of satisfaction in how they manage it. To interpret the sociocultural influences on secondary cardiac behaviour, patients used theirs and community knowledge of heart disease, personal constructions of cardiac illness, together with their individual belief systems, particularly relating to lay health beliefs. Individual interpretations were unique and contextual, but there were many common views which did not differ between patients. CONCLUSIONS: Patients and health professionals reported similar areas of influence but there were important differences in emphasis. Providers described the ambivalence between being positive about the future health of patients to boost their recovery process, and recognition that this positive outlook could be construed as a 'cure'.

Adult↗
PubMed1993

Enhancing clinical competence using a collaborative clinical education model.

BACKGROUND AND PURPOSE: The purpose of this study was to determine whether students in collaborative (two students to one Clinical Instructor [2:1]) learning placements differed on measures of clinical competence as compared with their peers in traditional (1:1) clinical placements. SUBJECTS: The population examined consisted of intermediate-level students in the physical therapy program at the University of Toronto. METHODS: The outcome measure of clinical competence in this study was a weighted score acquired from the university's Evaluation of Clinical Competence (ECC) form. Seven subgroup clinical competence scores as well as the total clinical competence score were analyzed. RESULTS: The collaborative learning group demonstrated significantly higher scores on all aspects of the ECC instrument. CONCLUSION AND DISCUSSION: This result suggests that achievement of clinical competence in patient evaluation, program planning, implementation of treatment, communication, management skills, professional behavior, and documentation were enhanced through collaborative learning.

Adult↗
PubMed2007

Effects of teamwork training on adverse outcomes and process of care in labor and delivery: a randomized controlled trial.

OBJECTIVE: To evaluate the effect of teamwork training on the occurrence of adverse outcomes and process of care in labor and delivery. METHODS: A cluster-randomized controlled trial was conducted at seven intervention and eight control hospitals. The intervention was a standardized teamwork training curriculum based on crew resource management that emphasized communication and team structure. The primary outcome was the proportion of deliveries at 20 weeks or more of gestation in which one or more adverse maternal or neonatal outcomes or both occurred (Adverse Outcome Index). Additional outcomes included 11 clinical process measures. RESULTS: A total of 1,307 personnel were trained and 28,536 deliveries analyzed. At baseline, there were no differences in demographic or delivery characteristics between the groups. The mean Adverse Outcome Index prevalence was similar in the control and intervention groups, both at baseline and after implementation of teamwork training (9.4% versus 9.0% and 7.2% versus 8.3%, respectively). The intracluster correlation coefficient was 0.015, with a resultant wide confidence interval for the difference in mean Adverse Outcome Index between groups (-5.6% to 3.2%). One process measure, the time from the decision to perform an immediate cesarean delivery to the incision, differed significantly after team training (33.3 minutes versus 21.2 minutes, P=.03). CONCLUSION: Training, as was conducted and implemented, did not transfer to a detectable impact in this study. The Adverse Outcome Index could be an important tool for comparing obstetric outcomes within and between institutions to help guide quality improvement. CLINICAL TRIAL REGISTRATION: (www.ClinicalTrials.gov), NCT00381056 LEVEL OF EVIDENCE: I.

Delivery, Obstetric↗
PubMed2003

[Factors associated with stages of behavior change in Cuban smokers].

OBJECTIVE: To describe the distribution of Cuban smokers in the first two stages of the process of behavior change (precontemplation (that is, no desire to quit smoking) and contemplation (thinking about quitting)), the characteristics of these smokers, and the relationship between these characteristics and some variables of interest. METHODS: The First National Survey of Risk Factors and Chronic Non-communicable Disease Prevention Activities was carried out in Cuba in 1996. As a part of that Survey, a probability sample was selected using three-stage clustering, with stratification of the primary units, which were the census districts in the 14 provinces and 169 municipalities that make up the country. The census districts were selected in proportion to their number of dwellings. A total of 4 835 smokers 15 years old or older were selected to answer a questionnaire on sociodemographic variables and smoking-related behaviors. The sociodemographic variables included age, sex, skin color, level of schooling completed, and work status (working, looking for work, retired, housewife, or student). The smoking-related behaviors included knowledge of tobacco's harmful effects on health, age when smoking began, number of cigarettes smoked daily, willingness to give up the habit, and the number of attempts made to quit smoking. The questionnaire information made it possible to place the smokers in one or the other of the two initial stages of smoking behavior change. The probability of being in the precontemplation stage was modeled through logistic regression. The standardized coefficients that the model produced were used to calculate the weight of the explanatory variables included in the model. To calculate the estimates and their errors, the SAS 6.12 and SUDAAN 7.5 statistical software packages were used, taking into account the complex design of the sample. The level of significance was set at 0.05. RESULTS: We found that 46.4% of the smokers surveyed were in the precontemplation stage, and 53.6% were in the contemplation stage. Women were more prepared to quit the habit than were men. The more formal the education that a person had, the stronger was the desire to quit smoking. Persons who were retired were the ones least likely to be considering giving up smoking. The probability of being in the precontemplation stage decreased with an increase in the age of beginning to smoke, the number of cigarettes smoked daily, and the number of attempts made to quit smoking. CONCLUSIONS: The proportion of Cuban smokers in the contemplation stage places the country in a favorable position for developing effective smoking prevention interventions. The majority of the factors identified (age when smoking began, number of cigarettes consumed daily, and number of attempts to give up the habit) can be modified through preventive actions. Identifying the stages in the process of change and the factors linked to them are necessary for designing and implementing effective smoking prevention and control programs.

Adolescent↗
PubMed2006

Clinical risk management in Dutch community pharmacies: the case of drug-drug interactions.

BACKGROUND: The prevention of drug-drug interactions requires a systematic approach for which the concept of clinical risk management can be used. The objective of our study was to measure the frequency, nature and management of drug-drug interaction alerts as these occur in daily practice of Dutch community pharmacies. METHODS: In total, 63 Dutch pharmacies collected all drug-drug interaction alerts during 153 research days (on average 2.4 days/pharmacy), as well as variables related to these alerts, such as involved medicines, first time or recurrent drug-drug interaction, same or different prescribers, patient data (age, sex) and information about the management of drug-drug interactions by the pharmacy. The latter was discriminated into internal procedures only and external action, such as communication with the patient, the prescriber or the anticoagulation clinic and prescription modification. All drug-drug interactions were classified into categories of clinical relevance (A-F) and available evidence (0-4). RESULTS: A total of 43,129 prescription-only medicines were dispensed during the study period. On average, 16.8 interaction alerts per day per pharmacy were collected. Approximately 6% of all prescriptions generated a drug-drug interaction alert. Of all alerts (n = 2572), 31.1% occurred for the first time and with 21% two different prescribers were involved. The 20 most frequently occurring drug-drug interaction alerts accounted for approximately 76% of all alerts. Cardiovascular drugs, NSAIDs, oral contraceptives and antibacterials were most frequently involved. External action was taken in response to 27.3% of the alerts, meaning either a modification of one of the concerned prescriptions (n = 65; 9.3%), communication with the prescriber or anticoagulation clinic (n = 90; 12.8%) or communication with the patient or a relative (n = 547; 77.9%). Where there was no external action (n = 1860; 72.3%), pharmacists concluded in about two-thirds of cases that the drug-drug interaction had been managed in the past. Other reasons not to intervene externally were for instance: incorrect alert; acceptable drug-drug interaction; or outcome of the interaction considered irrelevant. Adjusted for several variables, a first alert was found to be a main determinant for external action. After stratifying for first alerts no other significant determinants were found. CONCLUSIONS: A high frequency of drug-drug interaction alerts was found. Most concerned recurrent alerts, which were the main reason not to act externally. Concerning the assessment phase in the risk-management process, drug-drug interactions with no or low evidence/relevance should be reconsidered. Concerning the management of drug-drug interactions in pharmacies, the opportunity to actively suppress alerts for a certain period of time should be studied in more detail. There are indicators that the management of patient-orientated advice could be improved and a greater degree of consistency developed for the management of first and recurrent interaction alerts.

Adolescent↗
PubMed2005

Comparative evaluation of commonly used laboratory tests for post-mortem diagnosis of rabies.

Animal brain samples received at WHO Collaborating Centre laboratory at National Institute of Communicable Diseases (NICD) during the years 1991-2002 were tested by Seller's stain, Fluorescent Antibody Test (FAT) and Mouse Innoculation Test (MIT) as methods of rabies diagnosis. Negri bodies on Seller's staining could be detected in 52.5% of MIT positive brains, the concordance of this test with MIT was found to be 77.8%. FAT was positive in 91.5% of MIT positive brains, though it showed concordance of 95.7% with MIT results in the total samples. 12.2% of the samples were found positive by FAT of which 1/3rd also showed the presence of Negri bodies when MIT was negative i.e. showing that the virus is present in inactivated form. Thus emphasizing the need for timely and proper collection and transportation of specimens for testing. Seller's stain and FAT give reliable diagnosis of rabies in the brain samples in majority of the cases. MIT being time-intensive test, is of academic value only in decision making as regards initiation of Post Exposure Treatment (PET), it is recommended that in cases where Seller's stain and FAT have yielded negative results the decision to initiate PET should give due consideration to the nature and circumstances of the animal bite and other epidemiological features.

Animals↗
PubMed2006

Tobacco use among high school students in a remote district of Arua, Uganda.

INTRODUCTION: Tobacco smoking is a risk factor for several non-communicable public health problems including cancer, ischaemic heart disease and chronic obstructive airways disease. The prevalence of smoking among adolescents and the associated environment deserve attention. METHODS: A cross-sectional descriptive study was carried out in 2001 to determine the prevalence of tobacco smoking, exposure to advertisements, environmental tobacco smoke exposure, deterrents from smoking and perception about smoking among high school students in a remote district of Arua, north-western Uganda. RESULTS: In total 1528 high school students participated in the study of which 21.9% were current smokers and 33.1% had ever used tobacco products. When the data were stratified according to sex, 81/452 (17.9%) females and 337/871 (38.7%) males had ever smoked (p <0.05). With regard to current smoking, defined as having smoked at least once in the past 30 days, 12.2% of females (55/452) and 25.5% males were current smokers. Approximately one-tenth perceived themselves as likely to initiate smoking within the next 12 months. Just under half (47.3%) were exposed to environmental (passive) smoking in the home and 19.4% of current smokers usually smoked at home. Approximately 60% of smokers had obtained tobacco from grocery stores and they had never been prevented because of their age. Media exposure to tobacco advertisements was high. CONCLUSION: Many young people in Arua, Uganda, were current smokers and exposed to environments that seemed to facilitate uptake of tobacco smoking and other tobacco use. This could be explained in part, by the fact that the district relies heavily on tobacco farming and exposure to facilitating environments is common. A concerted public health response is urgently required that will effectively alter the home and societal environment so as to discourage uptake of tobacco use by young people.

Adolescent↗
PubMed1986

[Postoperative radiotherapy of supratentorial anaplastic glioma].

Between 1970 and 1983, 149 patients with high grade anaplastic supratentorial gliomas received a postoperative irradiation during primary treatment. 118 out of these patients had an anaplastic astrocytoma, 18 an anaplastic oligodendroglioma, and 13 an anaplastic ependymoma. Most of these patients were treated by irradiation of a great volume with 50 Gy within five weeks, the others by irradiation of the total brain with 50 Gy within five weeks and saturation with 10 Gy within one week. The one-year survival of the total group was 35.5% and the two-year survival 10.6%. Patients at an age of less than 40 years show a significantly longer survival than older patients (one-year survival rates 40% and 30.7%, respectively). Patients suffering from anaplastic tumors with astrocytic and oligodendrocytic differentiation have a comparable prognosis. Patients suffering from anaplastic tumors with ependymal differentiation, however, have prolonged survival times. The therapy results of different treatment methods are discussed using the communications of literature.

Adult↗
PubMed1981

[Studies on the cervical facet joints using arthrography of the cervical facet joint (author's transl)].

In order to elucidate the pathological changes of the cervical facet joint probably representing one of the causes of the neck and shoulder pain, the author developed the arthrography of the cervical facet joint and applied this method to 157 joints of 83 patients. Eight cadavers were also used to evaluate the method based on an anatomical basis. Cervical facet joints of patients with tenderness on the lateral side of the neck were studied. The technic used in this method using X-ray T.V. was described and the arthrograms obtained on the dissected specimens were compared with the anatomical findings. The arthrogram of the middle and lower cervical facet joint was classified into the type with regular joint margin, the type with slightly irregular one and the type with irregular one, or the type with sharp lateral margin and the type with unsharp one. In 80% of the 142 joints in total, a communicating pathway was found from the facet joint to the interlaminar portion, interspinous portion, contralateral facet joint, para-extradural space and cervical extradural space. These arthrograms were analyzed. The visualization of the atlanto-axial joint was also achieved. Even in normal subject, a communication to the contralateral side via the surface of the axial spine was demonstrated.

Adolescent↗
PubMed2004

The reliability of assessment criteria for undergraduate medical students' communication skills portfolios: the Nottingham experience.

INTRODUCTION: Some educators have argued that portfolios should not be assessed summatively because there is little evidence supporting the reliability of their assessment. This study aims to determine the reliability of assessment criteria used for a portfolio at the University of Nottingham. METHODS: Two independent analysts assessed a random sample of portfolios (n = 100, 49.5%) using criterion-referenced assessment. Students' performances were examined against subjective items in five areas: 1) portfolio structure, 2) level of critical reflection, 3) level of skills development, 4) use of documentary evidence, and 5) use of relevant literature. These subjective judgements were later converted into quantitative scales ranging from 0 to 3 so that interrater reliability could be established. The level of agreement between the two analysts for the total percentage score was established using an intraclass correlation coefficient and for the individual items using weighted kappa coefficients. RESULTS: The level of agreement between the two raters for the total percentage score was 0.771 (95% CI = 0.678, 0.840), as measured by an intraclass correlation coefficient. The levels of agreement between the two raters for the individual items of the assessment criteria ranged from kappa=0.359 (item 3) to kappa=0.693 (item 4). DISCUSSION: This study provides some support for the summative assessment of portfolios. The findings suggest that discussion and negotiation between independent assessors can enhance the reliability of assessment criteria. Therefore, medical educators are encouraged to use such procedures in the summative assessment of portfolios.

Clinical Competence↗
PubMed1989

Estimating the initial relative infection rate for a stochastic epidemic model.

Consider the problem of making inference about the initial relative infection rate of a stochastic epidemic model. A relatively complete analysis of infectious disease data is possible when it is assumed that the latent and infectious periods are non-random. Here two related martingale-based techniques are used to derive estimates and associated standard errors for the initial relative infection rate. The first technique requires complete information on the epidemic, the second only the total number of people who were infected and the population size. Explicit expressions for the estimates are obtained. The estimates of the parameter and its associated standard error are easily computed and compare well with results of other methods in an application to smallpox data. Asymptotic efficiency differences between the two martingale techniques are considered.

Communicable Diseases↗
PubMed1998

Metrifonate benefits cognitive, behavioral, and global function in patients with Alzheimer's disease.

OBJECTIVE: To evaluate the efficacy and safety of metrifonate, an acetylcholinesterase inhibitor, in patients clinically diagnosed with probable Alzheimer's disease (AD) of mild to moderate severity. METHODS: A prospective, 36-week, multicenter, double-blind, randomized, parallel group study of metrifonate in probable AD patients, including a 2-week screening period, a 26-week double-blind treatment period, and a follow-up visit at 8 weeks post-treatment. A total of 24 ambulatory clinics in the United States in a variety of settings, including contract research organizations, public health facilities, and universities. Patients met diagnostic criteria for probable AD as defined by the work group of the National Institute for Neurological and Communicative Diseases and Stroke and the Alzheimer's Disease and Related Disorders Association. Patients had Mini-Mental State Examination (MMSE) scores of 10 to 26 and Ischemic Scores (Rosen Modification) of <4. A total of 408 patients were enrolled. Percentages of patients completing double-blind treatment were 88% and 79% in the placebo and metrifonate groups, respectively. Rates of discontinuation due to adverse events were 4% in the placebo group and 12% in the metrifonate group. Placebo or metrifonate was administered once daily. Metrifonate-treated patients received a loading dose of 100 to 180 mg based on weight (2.0 mg/kg) for 2 weeks, followed by a maintenance dose of 30 to 60 mg based on weight (0.65 mg/kg) for 24 weeks. Primary efficacy variables were the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) and the Clinician's Interview-Based Impression of Change with Caregiver Input (CIBIC-plus). Secondary efficacy variables included the Neuropsychiatric Inventory (NPI), the Disability Assessment in Dementia, the Global Deterioration Scale (GDS), the ADAS-Noncognitive subscale (ADAS-Noncog), the MMSE, and the Clinician's Interview-Based Impression of Severity with Caregiver Input (CIBIS-plus). Outcome measures reflected changes from baseline at week 26 for all variables. Safety was assessed with incidences of premature termination, treatment-emergent events and mortality, and routine safety evaluations. RESULTS: After 26 weeks of metrifonate therapy, a 2.86-point treatment difference (p = 0.0001) was observed in the ADAS-Cog scores of the intent-to-treat AD patients. The treatment difference in the mean CIBIC-plus score at this time was 0.28 points (p = 0.0071). At week 26, treatment differences also were observed in the mean NPI total score (p = 0.0161). Analysis of the remaining secondary efficacy variables showed treatment differences that favored metrifonate but did not reach statistical significance. Metrifonate adverse events were predominantly mild in intensity. No hepatotoxicity was observed. CONCLUSIONS: Metrifonate was safe and well-tolerated. It enhanced not only the cognitive and global function, but also the behavioral function of patients diagnosed with mild to moderate AD. Therefore, metrifonate appears to be useful in the symptomatic treatment of AD.

Aged↗
PubMed1978

Voice, speech, and language habilitation in young children without laryngeal function.

We discuss aphonia in children, secondary to laryngeal obstruction, with regard to the development of a voice, speech, and language system that can be an effective and efficient means of communication while obstruction persists and a precursor to good voice and speech habits if and when the laryngeal function is reestablished. Several methods were considered. A technique of esophageal voice training for children was developed and implemented, which combined the aspects of normal language learning with the mechanical aspects of esophageal voice production. Results showed rapid learning in a 2 1/2-year-old child with severe juvenile laryngeal papillomatosis and normal speech and language at the age of 4 years when laryngeal function returned. A second technique, a communication board, was used with a 4-year-old child with total subglottic stenosis and brain damage.

Aphonia↗
PubMed2004

Fast fragments: the development of a parallel effective fragment potential method.

The Effective Fragment Potential (EFP) method for solvation decreases the cost of a fully quantum mechanical calculation by dividing a chemical system into an ab initio region that contains the solute plus some number of solvent molecules, if desired, and an "effective fragment" region that contains the remaining solvent molecules. Interactions introduced with this fragment region (for example, Coulomb and polarization interactions) are added as one-electron terms to the total system Hamiltonian. As larger systems and dynamics are just starting to be studied with the EFP method, more needs to be done to decrease the calculation time of the method. This article considers parallelization of both the EFP fragment-fragment and mixed quantum mechanics (QM)-EFP interaction energy and gradient computation within the GAMESS suite of programs. The iteratively self-consistent polarization term is treated with a new algorithm that makes use of nonblocking communication to obtain better scalability. Results show that reasonable speedup is achieved with a variety of sizes of water clusters and number of processors.

Journal Article↗
PubMed2005

Efficacy of biphasic insulin aspart in patients with type 2 diabetes.

BACKGROUND: It is estimated that 39% of people with diabetes worldwide who use insulin are prescribed premixes, largely because of the practical advantages of addressing both prandial and basal insulin needs with a single product. Rapid-acting premixed insulin analogues such as biphasic insulin aspart 30 (BIAsp 30 [30% soluble insulin aspart and 70% protamine-crystallized insulin aspart], NovoLog Mix 70/30, Novo Nordisk, Bagsvaerd, Denmark) have been developed recently to overcome the pharmacokinetic limitations of regular human insulin used in the most commonly prescribed premix, biphasic human insulin 30 (BHI 30, 30% human insulin and 70% neutral protamine Hagedorn [NPH] insulin). It would be expected that these pharmacokinetic improvements would enhance clinical performance. However, the efficacy of BIAsp 30 compared with other common treatment regimens has not yet been systematically reviewed. OBJECTIVE: The aim of this paper is to review current data on the efficacy of BIAsp 30 in comparison with other treatment strategies in type 2 diabetes, including oral antidiabetic drugs (eg, metformin, sulfonylureas, meglitinides, thiazolidinediones), conventional insulins (eg, BHI 30, NPH insulin), and other analogue insulins (eg, insulin glargine, biphasic insulin lispro 25 [Mix 25, 25% biphasic insulin lispro and 75% protaminated lispro]). The focus will be on comparative efficacy (ie, postprandial glucose [PPG], blood glucose profiles, and glycosylated hemoglobin [HbA1c]). METHODS: We identified human clinical studies published through February 2005 involving BIAsp 30 in patients with type 2 diabetes by performing a MEDLINE search (key words: biphasic insulin aspart, BIAsp 30, biphasic insulin, and premixed insulin). Additional papers were identified by assessing (1) the reference lists in these studies, (2) published conference proceedings, and (3) our reference files. A total of 21 relevant papers were retrieved: 13 were published as full manuscripts, 1 as a short communication, 5 as abstracts, and 1 as a poster. One paper is currently in press. Novo Nordisk supplied data from an unpublished trial (Study 1536, 2004), as well as data from a trial published in abstract form only (Study 1269, 2002). RESULTS: A regimen of BIAsp 30 BID, at breakfast and dinner, provides improved PPG control compared with BHI 30 BID, NPH BID, and insulin glargine OD for patients with type 2 diabetes. Fasting plasma glucose (FPG) with BIAsp 30 was not significantly different from FPG with insulin glargine; however, FPG was higher with BIAsp 30 than with NPH. BIAsp 30 prevented excessive PPG excursions whether it was injected at the beginning of a meal or < or =15 minutes after starting a meal. BIAsp 30 was not associated with an increased risk of major hypoglycemia compared with other insulin regimens used in the studies reviewed. The incidence of minor hypoglycemic events with BIAsp 30 varied across studies but occurred with frequency or risk similar to BHI 30, Mix 25, or NPH. Treat-to-target trials reported that BIAsp 30 can be used to intensify insulin therapy and to reach the glycemic target recommended by the American Diabetes Association (ie, HbA1c <7.0%). One study reported a greater lowering of postprandial triglyceride levels with BIAsp 30 than with BHI 30. CONCLUSIONS: BIAsp 30 BID can reduce PPG levels to a greater extent than other common treatment regimens, including basal insulin OD. Using BIAsp 30, even once daily, may allow some patients to reach glycemic targets with a degree of convenience and tolerability that may not be achievable with other treatment regimens.

Biphasic Insulins↗
PubMed2006

Situational therapy for Wernicke's aphasia.

Patients with Wernicke's or expressive aphasia are able to produce fluent speech, however, this speech may be complete gibberish sounds and totally incomprehensible, or even when comprehensible to a degree is often laced with severe errors and abnormalities such as verbal and phonemic paraphasias and neologisms. Furthermore, patient's with Wernicke's aphasia have poor to no understanding of speech or language. There is no proven method for rehabilitation of Wernicke's aphasia, or even much guidance for physicians or speech therapists to treat Wernicke's aphasia patients. In contrast to their poor to non-existent communication skills using speech or other forms of language, it has long been appreciated informally and formally that Wernicke's aphasia patients are able to communicate well, even normally, using non-verbal means such as actions, movements, props, gestures, facials expressions, and affect. Furthermore, in non-language domains Wernicke's aphasia patients can show normal memory and learning abilities. Thus, we here suggest that the non-language communication channels of Wernicke's aphasia patients be channeled and utilized in their functional rehabilitation: Specifically, we suggest that therapy for Wernicke's aphasia patients should consist of placing patients in real or simulated important functional situations--e.g., buying food, taking transport--and let the patients train and learn to use and hone their non-language communication means and skills for improved practical functioning.

Aphasia, Wernicke↗
PubMed1998

Teaching public health practitioners about health communication: the MPH curriculum experience.

The dissemination of health information to the public often occurs through the mass media. Media strategies as a component of behavior change assume knowledge of communication theories and methods by public health practitioners. We surveyed the curricula of 52 accredited graduate programs leading to the Master's in Public Health (MPH) degree to assess their communication component. Graduate bulletins for admission year 1996 were examined for public health mission statement, goals and objectives of the MPH training program, and for course titles. Courses were identified as having a communication focus if the terms communication, information, marketing or media were used in the title. There were a total of 82 communication courses offered, with 65 courses in 26 Schools of Public Health (SPH), 13 courses in 18 Community Health and Preventive Medicine departments (CHPM), and 4 courses in 8 Community Health Education departments (CHE). The difference in mean number of health communication courses was significant by type of MPH program (p < 0.003) with SPH offering an average of 3 courses, CHPM departments offering an average of 1 course, and CHE offering an average of 0.5 course. The distribution of communication courses ranged from 10 courses to 0 courses per program. Seven SPH offered 3 or more communication courses, whereas 5 SPH offered no health communication courses in the MPH curriculum. These data point to a shortcoming in the training of MPH students in health communication theory and skills as ascertained by course titles in graduate bulletins.

Communication↗
PubMed1999

Acupuncture for recurrent headaches: a systematic review of randomized controlled trials.

OBJECTIVE: To assess whether there is evidence that acupuncture is effective in the treatment of recurrent headaches. DESIGN: Systematic review. STUDY SELECTION: Randomized or quasi-randomized clinical trials comparing acupuncture with any type of control intervention for the treatment of recurrent headaches. DATA SOURCES: Electronic databases (Medline, Embase, Cochrane Field for Complementary Medicine, Cochrane Controlled Trials Register), personal communications and bibliographies. DATA COLLECTION AND ANALYSIS: Information on patients, interventions, methods, and results were extracted by at least two independent reviewers using a pretested form. A pooled estimate of the responder rate ratio (responder rate in treatment group/responder rate in control group) was calculated as a crude indicator of trial results as meta-analysis of more specific outcome data was impossible due to heterogeneity and insufficient reporting. RESULTS: Twenty-two trials, including a total of 1042 patients (median 36, range 10-150), met the inclusion criteria. Fifteen trials were in migraine patients, six in tension-headache patients, and in one trial patients with various headaches were included. The majority of the 14 trials comparing true and sham acupuncture showed at least a trend in favor of true acupuncture. The pooled responder rate ratio was 1.53 (95% confidence interval 1.11 to 2.11). The eight trials comparing acupuncture and other treatment forms had contradictory results. CONCLUSIONS: Overall, the existing evidence suggests that acupuncture has a role in the treatment of recurrent headaches. However, the quality and amount of evidence is not fully convincing. There is urgent need for well-planned, large-scale studies to assess effectiveness and efficiency of acupuncture under real life conditions.

Acupuncture Therapy↗