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At least 1,171 records · Page 65Linked to original sources
PubMed2002

Validity of total and segmental impedance measurements for prediction of body composition across ethnic population groups.

OBJECTIVES: To test the impact of body build factors on the validity of impedance-based body composition predictions across (ethnic) population groups and to study the suitability of segmental impedance measurements. DESIGN: Cross-sectional observational study. SETTINGS: Ministry of Health and School of Physical Education, Nanyang Technological University, Singapore. SUBJECTS: A total of 291 female and male Chinese, Malays and Indian Singaporeans, aged 18-69, body mass index (BMI) 16.0-40.2 kg/ m2. METHODS: Anthropometric parameters were measured in addition to impedance (100 kHz) of the total body, arms and legs. Impedance indexes were calculated as height2/impedance. Arm length (span) and leg length (sitting height), wrist and knee width were measured from which body build indices were calculated. Total body water (TBW) was measured using deuterium oxide dilution. Extra cellular water (ECW) was measured using bromide dilution. Body fat percentage was determined using a chemical four-compartment model. RESULTS: The bias of TBW predicted from total body impedance index (bias: measured minus predicted TBW) was different among the three ethnic groups, TBW being significantly underestimated in Indians compared to Chinese and Malays. This bias was found to be dependent on body water distribution (ECW/TBW) and parameters of body build, mainly relative (to height) arm length. After correcting for differences in body water distribution and body build parameters the differences in bias across the ethnic groups disappeared. The impedance index using total body impedance was better correlated with TBW than the impedance index of arm or leg impedance, even after corrections for body build parameters. CONCLUSIONS: The study shows that ethnic-specific bias of impedance-based prediction formulas for body composition is due mainly to differences in body build among the ethnic groups. This means that the use of 'general' prediction equations across different (ethnic) population groups without prior testing of their validity should be avoided. Total body impedance has higher predictive value than segmental impedance.

Adolescent↗
PubMed1998

Planning flexible learning to match the needs of consumers: a national survey.

The injection of market forces into the National Health Service (NHS) has led to nurse education being viewed as a commodity which educational institutions supply and NHS employers purchase. Conscious of the costs of paying for courses within this new consumer culture, NHS trusts and other health service employers are increasingly looking for cost-effective flexible training to educate their workforce quickly and efficiently. Parallel to this is the accelerated demand for continuing professional development (CPD) brought about by the inception of the UKCC's Post-Registration Education and Practice Project (PREPP). Both registered and enrolled nurses are finding they need professional updating and skills and thus increased access to courses. The increased demand for education and training brought about by these changes cannot be met through traditional methods alone, requiring educational institutions to re-appraise their methods of delivery and introduce more flexible approaches to learning. There is every evidence that this is now the case with open learning, distance learning and flexible approaches to learning ever growing in popularity as providers of nurse education recognize the benefits such approaches offer. The emphasis is on meeting the diverse needs of the health care employers and individuals by providing education that is flexible, learner-centred and customer focused. This paper presents the findings of a national survey to ascertain how providers of flexible education plan educational programmes to meet the needs of their customers. Based on data collected from 120 educational institutions within the higher education, health and social care and private sectors, it highlights: the ways in which flexible learning programmes and courses are delivered; what aspects of flexibility are considered important when designing programmes to meet the needs of prospective customers; and what approaches are used to assess demand for flexible education. The study stresses the need for providers of flexible education to take into account the dual perspectives of those who have a stake in the flexibility of nurse education; NHS employers as funders of students and individual healthcare professionals themselves.

Curriculum↗
PubMedDate not supplied

Virtual reality simulation of arthroscopy of the knee.

The virtual reality arthroscopic knee simulator (VR-AKS) consists of a computer platform, a video display, and two force-feedback (haptic) interfaces known as "PHANToMs" that also monitor the position of the instruments in the user's hands. The forces that the user would normally apply to the lower limb during arthroscopy are directed through an instrumented surrogate leg. Proprietary software provides the mathematical representation of the physical world and replicates the visual, mechanical, and behavioral aspects of the knee. This includes moderating the haptic interface and simultaneously executing a collision-detection algorithm that prevents the instruments from moving through "solid" surfaces. Modeling software interacts with this algorithm to send the appropriate images to the video display, including knee pathology such as meniscal tears and chondral defects as well as normal anatomy. Task-oriented programs monitor specific performance such as executing a proper examination of the knee or shaving a torn meniscus.

Arthroscopy↗
PubMed2001

Barriers and gateways: a study of nursing students' utilisation of learning support resources.

Many first year nursing students require additional academic support from both their lecturers and learning resources. Anecdotal evidence at an Australian university suggested that 'at risk' students did not follow up lecturer referral. This study identified what learning resources were accessed and what factors influenced students' decisions to follow up or not to follow up lecturer referral. First-year nursing students (n =150) were surveyed towards the end of their second semester regarding their use of learning support services. Twelve students were randomly selected and interviewed regarding their use of learning support and their first year learning experience. Demographic data were analyzed using descriptive statistics. Qualitative data were subjected to content analysis. Results revealed learning support utilisation was related to age and publicity but unrelated to gender or culture. Older students entering through non-traditional entry modes displayed a tendency to self refer to learning support. Younger students (<25 years) often lacked effective learning strategies and were reluctant to access on-campus learning support. For all students positive on and off campus support led to positive outcomes. Faculty and learning support lecturers need to foster integration of learning support for all students and encourage peer-learning partnerships within the foundation subjects.

Adult↗
PubMed2003

Validation of a computer-based colonoscopy simulator.

BACKGROUND: The computer-based colonoscopy simulator is intended to provide a realistic colonoscopic experience and feedback to operators regarding procedure skills. Advocates hope that computer-based colonoscopy simulators will enhance the mastery of colonoscopy by trainees. Before this hypothesis can be tested, the claims made for a simulator must be validated. The aims of this study were to answer the following: Does a computer-based colonoscopy simulator provide a "realistic" experience? Do computer-based colonoscopy simulators' performance parameters differentiate varying levels of experience? METHODS: Ten staff gastroenterologists, 6 gastroenterology fellows, and 6 residents each performed 2 computer-based colonoscopy simulator colonoscopies and performance parameters were recorded. Staff colonoscopists then completed a 6-item survey grading the "realism" of the simulation and procedure difficulty. Survey responses and performance scores were compared with the Wilcoxon rank-sum test. RESULTS: Faculty found the computer-based colonoscopy simulator experience to be realistic despite the "cases" being markedly easier than actual colonoscopy. The computer-based colonoscopy simulator distinguishes subjects according to endoscopic experience with 3 of its measured parameters (total procedure time, insertion time, time in "red-out"). No significant difference in the ability to distinguish among user types was found for the other 10 computer-based colonoscopy simulator measurements for which data were analyzable. CONCLUSION: The computer-based colonoscopy simulator provides a favorable degree of virtual realism with regard to visual simulation and colonoscope mechanics, although the "cases" were regarded as considerably easier than actual colonoscopy. The computer-based colonoscopy simulator has only limited capability for distinguishing varying levels of competence at actual colonoscopy. These findings suggest that a study to determine the role of computer-based colonoscopy simulators in the curriculum of trainees is warranted.

Clinical Competence↗
PubMed2003

Bilateral environmental and occupational health program with India.

In spite of considerable economic progress in recent years, India continues to face challenges dealing with poverty, unemployment, malnutrition, disease and disability. The governments of India and the United States have formed a collaborative effort to address outstanding issues in the fields of environmental and occupational health. The Joint Statement on Indo-U.S. Collaboration in Environmental and Occupational Health, which was approved by the Minister of the Indian Union of Health and Family Welfare and the Secretary of Health and Human Services of the United State in Geneva in May of 2002, formalizes the collaborative relationship and calls for the development of Implementation Guidelines. The Implementation Guidelines establish a Joint Working Group, which is responsible for identifying and implementing the collaborative projects. The collaborating organizations have identified three broad areas for collaboration: emergency preparedness and response; training, education, and technology transfer; and research. Within the three broad areas, the organizations have identified two subject areas for initiation: arsenicosis and asbestosis. Researchers and health officials in both India and the U.S. share interest in both research and interventions efforts in these subject areas. As many as 42 million people in the West Bengal area of India may be exposed to arsenic in drinking water at concentrations of health concern. Similarly, as many as 10 million industrial or mine workers in India may be exposed to asbestos or other dusts at concentrations of health concern. The first Joint Working Group meeting is scheduled for March 2003 in New Delhi and will consider these subject areas in developing collaborative projects. Other tasks being undertaken by the signatory agencies include expanding the relationship to include academic and nongovernmental organizations and obtaining funds for the various projects from governmental and nongovernmental sources.

Arsenic Poisoning↗
PubMed2000

Introducing computer-aided instruction into a traditional histology course: student evaluation of the educational value.

Both the World Health Organisation and the World Federation for Medical Education have endorsed integration of computer technology into medical education. In line with this and for more practical reasons, second-year medical students were introduced to commercial and in-house computer-aided instruction (CAI) packages in the traditional histology course. Although CAI was well received, light microscopy was still regarded as a valuable skill in the undergraduate curriculum. Its application was viewed to be important in future medical studies, as well as in general practice. It was also perceived to be a more self-directed form of learning than CAI. Students' use of CAI packages was related to CAI meeting course objectives and the level of interactivity.

Attitude of Health Personnel↗