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A worksite smoking cessation intervention involving the media and incentives.

This study evaluated an attempt at 38 workplaces to help employees stop or reduce their levels of smoking. In past research, worksite support groups, in combination with a media smoking cessation program and self-help manuals, were found to be effective in helping employees quit smoking. Unfortunately, recidivism was found at the follow-up evaluations. The present study replicated the results of the previous worksite smoking cessation program with support groups, a television intervention, and self-help manuals. At this postpoint, 42% of employees provided groups plus incentives were abstinent compared to only 15% who were only provided self-help materials. An important difference in this study was that there were also monthly follow-up support groups and incentives. Work settings can be a source of stress and conflict, which can precipitate relapse. At a 12-month follow-up, 26% of those participants who were provided support and incentives were abstinent compared to 16% who were only provided the self-help materials.

Adult↗

How did it work? An examination of the mechanisms through which an intervention for the unemployed promoted job-search behavior.

Conducted process analysis of treatment mediation effects (Judd & Kenney, 1981) on longitudinal data from a large randomized field experiment with 928 recently unemployed persons. The experimental treatment included an intervention that succeeded in promoting quality reemployment outcomes, as described in earlier reports (Caplan et al., 1989; Vinokur et al., 1991). Using Ajzen's theory of planned behavior (Ajzen, 1985, 1988), the analyses examined the mediating effects of job-search self-efficacy, attitude, norms, and intention on job-search behavior. The results provided substantial support for the theory of planned behavior and demonstrated the mediational role of job-search self-efficacy. For both 1- and 4-month posttests, job-search self-efficacy was shown to mediate the effects of the intervention through its direct effects on job-search intention and on short term job-search behavior, as well as through its indirect effects on subjective norms and attitude. However, in the longer term 4-month posttest, exposure to the intervention had a direct effect on job-search behavior. This long-term direct effect of the intervention was hypothesized to reflect the influence of inoculation against setbacks which is essential for sustaining the long-term behavioral efforts involved in job seeking.

Adaptation, Psychological↗

Modifying the verbal expression of a child with autistic behaviors.

The Bell and Howell Language Master was used in conjunction with the Monterey Language Program to modify the verbal expression of a nine-year-old boy with autistic behaviors. The goal was to train the child to correctly name up to 10 pictures presented individually. Two training modes were used. For one, the therapist spoke at the time (live voice). For the other, she presented a tape recording of her voice via a Language Master. The results suggested that the child's responses to the Language Master were as good as, if not better than, his responses to the live-voice presentations. In addition, observation indicated that he responded more readily to the Language Master presentations. His spontaneous speech was also noted by independent observers to improve in his classroom and in his home. Possible reasons for the improvement in verbal expression are considered.

Auditory Perception↗

The index line as a new aid in clinical and forensic toxicology.

On behalf of the German Federal Ministry for Research and Technology, we investigated the use of electronic data processing for clinical toxicological purposes. Initially, sufficient funds were available for a comprehensive approach to the problem and programs covering the following areas were established: 1. A casuistic data program; 2. an identification program for wild fruits; 3. a program for the identification of tablets by their shapes. Due to a subsequent lack of funds, it was necessary to develop a partial solution: this solution is what we call the Index Line. The Index Line--limited data on poisonings--should enable the user to receive information by telex from the German Institute for Medical Documentation and Information, i.e., information on "who has what, where". As a first step the continuous Index Line registration of all cases of poisoning recorded at the poison control centers in Munich, Freiburg, Hamburg, and Nürnberg as well as at the State Institute for Food, Pharmaceutical and Forensic Chemistry in Berlin was founded in 1975. To participate in the program, complete instructions are necessary.

Computers↗

Compliance with medical regimens, self-management programs, and self-care in childhood asthma.

Compliance with medical regimens is as poor or poorer in childhood asthma than it is for other chronic illnesses. A spate of self-management programs for childhood asthma has been developed to counteract nonadherence and to enable patients to be more confident and competent in their ability to prevent or control asthmatic episodes. The programs offer promise and report some encouraging results, but the programs are still unproven, and they are neither widely available nor widely used. The individual physician remains the key player in mounting effective self-management programs; but if the physician is to function effectively in this role, drastic changes are called for in the way that both medical practice is conducted and patient-health care provider relationships are managed. Steps and strategies that would help providers establish effective individual self-management programs for asthmatic patients are outlined.

Asthma↗

[How effective and acceptable is a self-treatment manual with concomitant brief therapy in bulimia nervosa].

We compared 8 fortnightly sessions plus a self-care manual (guided self change, GSC) with 16 weekly individual sessions of cognitive behaviour therapy (CBT). There were 31 sufferers of DSM-III-R-bulimia nervosa (BN) in each group. Both treatments resulted in significant improvements regarding self and interviewer based measures of bulimia nervosa as well as depression, self-esteem, quality of life and knowledge about nutrition, weight and shape. There were no significant differences between therapies regarding drop-out rate, compliance with follow-up, and the number of patients receiving additional treatment. At none of the assessments was there a significant difference between GSC and CBT regarding severity of BN, Beck Depression Inventory-score, self-esteem, and quality of life. A significantly higher percentage of CBT-patients were abstinent from bingeing for at least one week at the end of treatment. Three months later, the GSC-group had caught up in this respect and knew more about nutition, weight and shape. Only the sum-scores on a BN self-rating scale were worse for GSC than CBT at the end of therapy and at follow-up. There were no significant differences between the two groups in general treatment satisfaction and judgement about the usefulness of the therapies. Thus, guided self change with a selfcare manual can save therapist time without impinging significantly on treatment satisfaction and effectiveness.

Adult↗

[Aspects of electronic patient records in radiology].

PURPOSE: The computerized patient record must provide patient- and problem-oriented access to all relevant patient data for health care professionals. The aspects of such systems will be analyzed in the light of the radiologist's needs. METHODS: Integration of the computerized patient record in a hospital communication network allows automated data exchange with the ancillary systems. Accessibility of electronic textbooks supports case-based learning during routine work. RESULTS: The computerized patient record not only supports routine clinical tasks but also training, education and research. The workflow in a hospital can be supported by the computerized patient record. Studying the tasks of a radiology department shows that both clinicians and radiologists will benefit from such a system. DISCUSSION: Current implementations of clinical computerized workstations offer only a fraction of these features. Advances in technology and increasing demands at the point of care will promote the development of new information systems of this kind.

Computer Systems↗

[Conservative nonpharmacological treatment of arthrosis].

There are different options for nonpharmacological therapies in osteoarthritis. An educational program and instruction of the patient are of major importance. There is evidence that manual physical therapy and exercise improve function and reduce pain in osteoarthritic joints. Thermal modalities are employed for short-term pain relief and change the intra-articular temperature. Electrotherapy, ultrasound, balneotherapy, and acupuncture show positive therapeutic effects. Orthotics, braces, and wedged insoles may be beneficial in selected cases. Based on the present findings, further investigations are needed to prove the effectiveness of various methods in physical therapy and nonpharmacological approaches to the management of osteoarthritis.

Exercise Therapy↗

Comparison of radiology residency programs in ten countries.

The purpose of our study was to compare various aspects of radiology training schemes in ten countries. A questionnaire was sent to senior residents in the UK, USA, Canada, Australia, New Zealand, Italy, Egypt, India, Malaysia and Greece. The questions concerned length of training, required pre-training experience, the organization of the training scheme, teaching, resources, stages at which residents can independently perform and report examinations, fellowships, and progression to jobs. A wide variety of training, ranging from highly scheduled programs with detailed aims and objectives, to self-learning occurs across the world. Examinations and assessments are also variable. There are lessons to be learned from varying practices; more exchanges of ideas should be encouraged. In view of the "internationalization" of radiology services and the variation in training styles an international qualification for quality assurance purposes may be desirable.

Asia↗

[Learning in old age: The importance of self-initiated structuring].

The purpose of the present study was to assess the role of memory, inhibition efficiency and self-initiated structuring of learning material in predicting age-related effects in learning performance. 47 young ( M = 23.3; SD = 3.8) and 52 old adults ( M = 64.5; SD = 5.2) took part in the current study. Tests assessing memory span, inhibition efficiency and a recall test requiring the participants to structure their learning material were administered. The results reveal that most of the age-related variance in learning performance can be explained by inhibition efficiency, memory span and-particularly-by the quality of structuring learning material. Furthermore, the results indicate that in order to recall the content of categories it is important to remember the categories formed during the learning period. The study emphasizes the importance of teaching strategies for organizing learning material in the context of cognitive trainings for the elderly.

Adult↗

Effects of an individual work system on the independent functioning of students with autism.

This study examined the effects of a work system on the independent work and play skills of students with autism. Work systems, an element of structured teaching developed by Division TEACCH, are organized sets of visual information that inform a student about participation in work or play areas. A single subject withdrawal of treatment design, with replications across three participants, was used to assess the on-task behavior and work completion skills of the students in classroom and employment settings as a result of the intervention. Observational data indicated that all students showed increases in on-task behavior, increases in the number of tasks completed or play materials utilized, and reduction of teacher prompts. The results were maintained through the 1-month follow-up.

Adult↗

Neuroanatomical term generation and comparison between two terminologies.

An approach and software tools are described for identifying and extracting compound terms (CTs), acronyms and their associated contexts from textual material that is associated with neuroanatomical atlases. A set of simple syntactic rules were appended to the output of a commercially available part of speech (POS) tagger (Qtag v 3.01) that extracts CTs and their associated context from the texts of neuroanatomical atlases. This "hybrid" parser. appears to be highly sensitive and recognized 96% of the potentially germane neuroanatomical CTs and acronyms present in the cat and primate thalamic atlases. A comparison of neuroanatomical CTs and acronymsbetween the cat and primate atlas texts was initially performed using exact-term matching. The implementation of string-matching algorithms significantly improved the identification of relevant terms and acronyms between the two domains. The End Gap Free string matcher identified 98% of CTs and the Needleman Wunsch (NW) string matcher matched 36% of acronyms between the two atlases. Combining several simple grammatical and lexical rules with the POS tagger ("hybrid parser") (1) extracted complex neuroanatomical terms and acronyms from selected cat and primate thalamic atlases and (2) and facilitated the semi-automated generation of a highly granular thalamic terminology. The implementation of string-matching algorithms (1) reconciled terminological errors generated by optical character recognition (OCR) software used to generate the neuroanatomical text information and (2) increased the sensitivity of matching neuroanatomical terms and acronyms between the two neuroanatomical domains that were generated by the "hybrid" parser.

Algorithms↗