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106 records · Page 6Linked to original sources
PubMed2005

Use of insecticide-treated nets (ITNs) following a malaria education intervention in Piron, Mali: a control trial with systematic allocation of households.

BACKGROUND: Insecticide-treated nets (ITNs) reduce malaria morbidity and mortality, but use is limited. A barrier to ITN use may be lack of knowledge regarding malaria transmission and prevention. This study is a controlled trial comparing ITN use and malaria knowledge levels between households in Piron, Mali, undertaken in 2003. METHODS: Households received net impregnation services either with or without antecedent education. The main outcome measure was ITN use, defined as impregnation of at least one of the household's existing bednets with insecticide during the study. Knowledge about malaria and prevention practices was assessed pre- and post- educational intervention. Results were analysed by household and by individual. RESULTS: Forty-nine percent (34/70) of households who received the educational component impregnated their nets in comparison to 35% (22/62) of households who did not (OR = 1.6 CI = 0.8-3.3, P = 0.19). In individual analysis, ITN use was significantly greater in participants who had received the educational intervention (48%) vs. individuals who did not (33%, OR = 1.9, P = 0.012). Knowledge levels about malaria significantly increased for each individual pre- versus post- educational intervention (average change score = 2.13, standard deviation = 1.97, t = -17.78, P < 0.001), although there was no difference found between educational (change score = 2.14) and control groups (change score = 2.12). CONCLUSION: It is possible to educate individuals about malaria and to implement net impregnation services with limited resources. Greater accessibility to net-impregnation services is necessary but not sufficient to increase ITN use.

Adolescent↗
PubMedDate not supplied

Nursing education changes and reduced standards of quality care.

In acknowledging the evidence pointing to decreased standards of care, the authors accept the need to address identified problems. However, quality resolution will not occur by solely overhauling nurse education. The sum and substance of nursing requires that all key players influencing pre-registration nurse education must own their part in the problem. This paper addresses the main players, aims to define their roles and identifies the strategies necessary to address these serious concerns. National debate is required as is specific role identification. However, this will be to no avail if leadership, monitoring and the application of sanctions for non-compliance are not reinstated at both national and local levels.

Clinical Competence↗
PubMed1995

The Pawtucket Heart Health Program: community changes in cardiovascular risk factors and projected disease risk.

OBJECTIVES: Whether community-wide education changed cardiovascular risk factors and disease risk in Pawtucket, RI, relative to a comparison community was assessed. METHODS: Random-sample, cross-sectional surveys were done of people aged 18 through 64 years at baseline, during, and after education. Baseline cohorts were reexamined. Pawtucket citizens of all ages participated in multilevel education, screening, and counseling programs. RESULTS: The downward trend in smoking was slightly greater in the comparison city. Small, insignificant differences favored Pawtucket in blood cholesterol and blood pressure. In the cross-sectional surveys, body mass index increased significantly in the comparison community; a similar change was not seen in cohort surveys. Projected cardiovascular disease rates were significantly (16%) less in Pawtucket during the education program. This difference lessened to 8% posteducation. CONCLUSIONS: The hypothesis that projected cardiovascular disease risk can be altered by community-based education gains limited support from these data. Achieving cardiovascular risk reduction at the community level was feasible, but maintaining statistically significant differences between cities was not. Accelerating risk factor changes will likely require a sustained community effort with reinforcement from state, regional, and national policies and programs.

Adolescent↗
PubMed1979

Managing the change process.

Change is a normal and expected phenomenon in the 20th century, but how well are health professions educators prepared to deal with necessary educational change? This article presents a conceptual model for the change process, which provides a framework for adopting an innovation. Although a systems model is used, the human factors associated with change are emphasized. The model provides a basis for action, but the limitations of a static, inflexible viewpoint are discussed. The manager of the change process must be sensitive and responsive to human factors. To be successful, the manager must capitalize on his/her intuitive and creative capabilities. The phenomenon of change may be disruptive to an educational organization. The manager of change may not be in a comfortable position, but the manager who perseveres will see innovations adopted, experience personal growth and contribute to the professional development of others.

Faculty↗
PubMed1999

To improve pain management: measure, educate, change habits.

Healthcare organizations that have successfully implemented pain management programs started by unifying their care policies and building pain management into standing orders, protocols and patient charts. The greatest challenge, however, belongs to staff, pharmacists and physicians, who must measure pain routinely and seek effective treatment, see that the most appropriate and effective treatments are ordered and used, and incorporate pain management into the plan for each patient's recovery.

Hospital Administration↗
PubMed2001

[Basic assessment of needs for training in evidence-based medicine in Slovakia].

BACKGROUND: The health care reform in Slovakia produces a desire for greater responsibility for and control of strategic decisions and to be better able to evaluate international knowledge and experience in the specific national social and professional contexts. Evidence based medicine (EBM) provides an increasingly organised and accessible database of international knowledge in health and health care, capable of informing decisions at the macro and micro levels. AIM: The aim of this pilot study was to assess education, training and other capacity building needs in EBM and evidence based health care. METHODS: This study was primarily qualitative and based on a triangular approach, which included: (1) The analysis of the situation in pre- and postgraduate education in Slovakia aiming to the estimation of needs in EBM and critical appraisal skills training; (2) The analysis of questionnaires distributed in a sample of 50 medical doctors and university educated public health workers undergoing a postgraduate training; (3) The discussion in focused groups. RESULTS: The findings and analysis uncovered a gap in knowledge and experience of EBM approaches, particularly of searching for evidence, utilising information technology, of undertaking critical appraisals of the validity and quality of external evidence and of knowledge of English. On the other hand the findings revealed a high access to information including the Internet access at the workplace, an increasing awareness of the need for up-date information, a demand for training and potential opportunities for action. CONCLUSIONS AND RECOMMENDATIONS: The effective implementation introduction of EBM approach would require changes in broader political, cultural and behavioural contexts, including changes in pre- and postgraduate systems of professional and managerial education, changes in professional and managerial attitudes and changes in emphasis in skills and capacity building and improvements in knowledge management systems at the national level.

Education, Medical↗
PubMed2004

Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 2005 rates. Final rule.

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs to implement changes arising from our continuing experience with these systems; and to implement a number of changes made by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 that was enacted on December 8, 2003. In addition, in the Addendum to this final rule, we describe the changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs. These changes are applicable to discharges occurring on or after October 1, 2004. We also are setting forth rate-of-increase limits as well as policy changes for hospitals and hospital units excluded from the IPPS that are paid in full or in part on a reasonable cost basis subject to these limits. Among the policy changes that we are making are: Changes to the classification of cases to the diagnosis-related groups (DRGs); changes to the long-term care (LTC)-DRGs and relative weights; changes in the wage data, labor-related share of the wage index, and the geographic area designations used to compute the wage index; changes in the qualifying threshold criteria for and the approval of new technologies and medical services for add-on payments; changes to the policies governing postacute care transfers; changes to payments to hospitals for the direct and indirect costs of graduate medical education; changes to the payment adjustment for disproportionate share rural hospitals; changes in requirements and payments to critical access hospitals (CAHs); changes to the disclosure of information requirements for Quality Improvement Organization (QIOs); and changes in the hospital conditions of participation for discharge planning and fire safety requirements for certain health care facilities.

Humans↗
PubMed2005

Quantitative evaluation of counseling associated with HIV testing.

The purpose of the study was to demonstrate a quantitative evaluation of the educational impact of HIV pretest counseling. Two cohorts of clients exposed to different counseling methodologies were evaluated. The clients completed questionnaires before and after counseling. Responses were scored and compared, and a quantitative measure of educational impact reached. Quantitative educational change following counseling was demonstrated. The change was significantly greater in the more interactive and culturally sensitive counseling format. Quantitative measurement of educational change on focused HIV/AIDS counseling can be easily undertaken. Given that an ill informed population is unlikely to appropriately modify behavior, such educational evaluation should be considered as integral to national HIV/AIDS programs.

AIDS Serodiagnosis↗
PubMed1995

Physicians for the 21st century: implications for medical practice, undergraduate preparation, and medical education.

Changes in medical education and the practice of medicine have resulted from the push for both education and health care reforms. Undergraduates planning application to medical school should broaden their preparation to include communications, computers, economics, and multicultural educational experiences. To prepare graduates for medical practice in the new millennium, the University of Kentucky College of Medicine has implemented a new curriculum focusing on integration of basic and clinical sciences, primary care in ambulatory sites, health promotion and disease prevention, and attention to the ethical, social, psychologic, and financial impact of disease upon the patient, family, and society.

Curriculum↗
PubMed1998

Changes in gestational trophoblastic tumors over four decades. A Korean experience.

OBJECTIVE: To review changes that occurred in gestational trophoblastic tumor (GTT) patients treated over four decades and to identify factors leading to the changes. STUDY DESIGN: A retrospective study of 287 cases treated during 1961-1967, 1975-1979, 1980-1986 and 1990-1994. The method of diagnosis, incidence and outcome in each decade and factors that may have had an influence, on incidence, outcome or both, were reviewed. RESULTS: Diagnosis shifted from pathologic (1960s) to clinical (1990s). The incidence per 1,000 births decreased from 4.4 (1960s) to 1.6 (1990s). The incidence showed a 26-fold increase in women aged 40 and over and 13.4-fold increase in women para 3 and over. The obstetric population showed a decrease in the high-risk group of greater age and higher parity. Assessment by the 1983 World Health Organization prognostic score showed an increase in low-risk and decrease in high-risk disease. Prognostic score changes are related to a decrease in GTT in older women, increase in GTT with a short interval and increase in nonmetastatic disease. Overall mortality decreased from 32.6% to 2.6%. CONCLUSION: The decreased incidence and improved outcome of GTT in Korea are related to improved medical care and to social, economic and educational changes.

Adult↗
PubMed1998

Curriculum effect on nursing students' attitudes and knowledge towards organ donation and transplantation.

OBJECTIVE: To determine the impact of a nursing school's curriculum on student nurses' attitudes towards organ donation and whether specific educational directives could improve these attitudes. DESIGN: Quasi-experimental. SAMPLE/SETTING: First-, third-, and fourth-year nursing students at a Canadian University School of Nursing. METHODS: A questionnaire was developed to measure student's attitudes towards organ donation and transplantation. The questionnaire was administered to first- and fourth-year students to determine whether 4 years of nursing education changed the attitudes of the students. Third-year students responded to the questionnaire before and after attending a lecture or lecture and small group sessions on organ donation to determine whether instruction could improve attitudes and knowledge. RESULTS: No difference in attitudes were found between first- and fourth-year nursing students. The introduction of specific education strategies improved the attitudes and knowledge base of third year students. Discussion sessions in addition to lecture were the preferred strategy. CONCLUSIONS: The present curriculum does not significantly impact on nursing students. Given the importance of organ transplantation, nursing curricula should incorporate effective strategies to teach students the role of the nurse in organ donation.

Curriculum↗