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PubMed1985

Subjective symptoms among dental technicians exposed to the monomer methyl methacrylate.

Dental technicians, their technical aids, and the students of the State Institute for Dental Technicians during a single academic year were surveyed for their use of the acrylic ester monomer and subjective symptoms in a questionnaire study. The population under study included all the members of the trade union in the greater Helsinki area and all specially trained technical aids in Finland. Acrylic monomers were handled daily without skin protection by 81% of the 293 respondents. Current hand dermatitis, or previous local dermatological problems, was reported by 17% of the respondents. Frequent contact with the acrylic monomer increased the rate of the self-reported dermatitis. The symptoms were spontaneously reported to be associated with the monomer by 42% of the respondents. Previously experienced allergies seemed to predispose the subjects to these irritative reactions. Other finger symptoms, eg, whitening and feelings of numbness, coldness, and pain, were reported by 25% of the respondents. Students attending the four-year technical school reported an increasing frequency of finger symptoms as their studies advanced, and in their senior year they reported the same frequency of occurrence as the qualified dental technicians.

Adolescent↗
PubMedDate not supplied

[Training for rural matrons in Ouahigouya Hospital (Upper Volta) (author's transl)].

In Ouahigouya District (Upper Volta), more than eight pregnant women out of ten have no chance to be supervised or delivered by a midwife or a nurse. This situation is the consequence of the poor facilities of the Public Health Service whatever attempts have been made to improve it. Consequently, the Province Medical Authority has considered the value of matron(s) selected by the village community. Practical and technical training is given in Ouahigouya hospital and dispensaries. The education programme envolves basic information and learning know-how for pre, per and post-natal periods. The importance of an early diagnosis of risks of dystocia is emphasized. Further training sessions are scheduled, but the follow-up and the evaluation of the training already carried out is still to be done.

Burkina Faso↗
PubMed1985

[Historical development, current status and future perspectives of medical education in Chile].

This paper is a critical review in three parts. The first part reviews the past development of medical education in Chile in five stages (1833-1883, 1883-1933, 1933-1968, 1968-1973, and from 1973 to the present), in which the salient features and events are cited. The second part describes the present status of the five medical education programs; undergraduate medical training, graduate medical training, research, advanced training of teaching personnel, and planning and administration. The third part considers the prospects of medical education in each of those five programs. In this part the author presents his conclusions, for example, that it is necessary to review the number of vacancies for admission to the schools of medicine and to measure the academic and vocational aptitude of applicants; that the basic objectives of graduate training should be studied and formulated; that new course subjects should be added in response to the demands that will confront graduates in the future; that the objectives in areas of specialization should be revised; that it is urgent to assess the relationship of research to medical instruction; that pedagogical aspects should be incorporated into the advanced technical training of professionals, and, lastly, that the process of university planning in Chile needs to be refined.

Chile↗
PubMed1995

Graylyn Conference Report. Recommendations for reform of clinical pathology residency training. Conjoint Task Force of Clinical Pathology Residency Training Writing Committee.

The Graylyn Conference Report of the conjoint ACLPS, ASCP, APC, and CAP task force is prompted by the growing realization that without reform of the clinical pathology residency curriculum the future of clinical pathology practice may be in jeopardy. The conclusions reached at the ASCP-sponsored Colorado Springs IV Conference on Clinical Pathology Residency Training laid the groundwork for this report on curriculum reform. The goal is the creation of scientifically oriented clinical pathology practitioners capable of serving as consultants to other physicians of managing laboratory resources, and of playing leadership roles in an increasingly complex health-care system. Recommendations are described under the headings of patient care roles, graduated responsibility, analytical and technical training, laboratory management and informatics, and basic and applied research. In terms of reforming the structure and content of the curriculum, it is recommended that basic laboratory rotations be preceded by either a single didactic general 4- to 6-week orientation, or a series of shorter orientations incorporated into each rotation. The introductory and rotation phase should be 9 to 12 months in duration. It is further recommended that the remaining 6 to 9 months of the 18-month core be an integrated experience in which the resident practices Clinical Pathology by assuming service responsibilities for several laboratory sections simultaneously.

Clinical Laboratory Information Systems↗
PubMed2005

An overview to CERSSO's self evaluation of the cost-benefit on the investment in occupational safety and health in the textile factories: "a step by step methodology".

INTRODUCTION: The Pan American Health Organization (PAHO) and CERSSO collaborated to develop a new Tool Kit (TK), which became available in May 2002. PAHO already had a TK in place, and CERSSO requested that one be developed for their needs. CERSSO wanted to enable managers and line workers in garment factories to self-diagnose plant and workstation hazards and to estimate the costs and benefits of investing in occupational safety and health (OSH) as a way to improve productivity and competitiveness. METHODS: For consistency, the collaborating organizations agreed to construct the TK according to PAHO's methodology. The instrument was developed to be comprehensive enough that any user can collect the data easily. It integrates epidemiologic, risk assessment, clinic, engineering, and accountability issues, organized to include step-by-step training in: (a) performing risk assessments in the workplaces (risk factors); (b) making cause-effect relationships; (c) improving decision making on OSH interventions; (d) doing calculations of direct and indirect costs and savings; and (e) doing calculation of the overall cost-benefit of OSH interventions. RESULTS AND CONCLUSIONS: Since July 2002, about 2,400 employees and officials from 736 garment factories, Ministries of Labor, Health, Social Security Institutes, and Technical Training Institutions of Central America and the Dominican Republic have used this instrument. Systematically, they have calculated a positive relationship of the investment (3 to 33 times). Employers are now aware of the financial rewards of investing in OSH. The TK is available in Spanish, Korean, and English. In July 2003, a software program in Spanish and English was developed (180 persons have been trained in the region), which requires less time to execute with better reliability.

Central America↗
PubMed1981

Impact of new Food and Drug Administration regulations on college, university, and experiment station researchers.

The Good Laboratory Practice regulations adopted by the Food and Drug Administration describe specific procedures to assure the integrity of the research results. Those studies conducted with the intent to provide data on the safety of drugs and chemicals will be required to comply with the published relations. The process of bringing research laboratories into compliance with the regulations may be either arduous or fairly routine depending on the organization, goals, and type of research. Typically, the Good Laboratory Practice regulations will increase sharply the cost of health safety information. Hiring more and better trained technical and professional personnel will be much of this expense. If university and experiment station researchers choose to avoid compliance with these regulations, then agricultural research science may not continue to be recognized as an authority on the safety of products used for production of human food. Irrespective of whether universities choose to conduct regulated research or delegate this role to other segments of society, academic institutions must assume the role of training those individuals needed to conduct toxicity research.

Laboratories↗
PubMed2006

Cultivating systemic capacity: the Rhode Island tobacco control enhancement project.

This paper describes the Rhode Island Tobacco Control Enhancement Project (TCEP), a state-university-community technical assistance system. TCEP was developed under the auspices of the Rhode Island Department of Health's Tobacco Control program and was designed to build capacity among nine community-based organizations to mount comprehensive tobacco control interventions in five diverse communities within the state. This paper: (1) provides a description of community mobilization; (2) presents a logic model for planning and decision making used by state-university-community partners; (3) describes training, technical assistance services and implementation; and, (4) describes the evaluation and program improvement activities used to support on-going project development.

Comprehensive Health Care↗
PubMed2001

A comparison of operative times in arthroscopic ACL reconstruction between orthopaedic faculty and residents: the financial impact of orthopaedic surgical training in the operating room.

There is no published data regarding the financial impact of training orthopaedic residents in the operating room. No comparisons between orthopaedic faculty and residents in regard to operative time and costs are known. One hundred eleven cases of anterior cruciate ligament reconstruction with or without partial meniscectomy were evaluated from 1996 to 1997. Fifty-three cases met the selection criteria of times, documentation and identification of the surgeon. Twenty-one cases were performed by the orthopaedic attending (RCS) while 32 cases were performed by the senior orthopaedic resident. All procedures had the same faculty member present in the operating room either as the primary surgeon or as an assistant providing supervision and instruction as needed. In a two year period, comparisons were made between the attending and residents for the total anesthesia time and actual operative case time. Attending case time and anesthesia times averaged 94.62 minutes (range 60-125 min) and 128.1 minutes (range 84-185 min) respectively. Resident case and anesthesia times averaged 137.09 minutes (range 95-210 min) and 190.48 minutes (range 145-255 min) respectively. The anesthesia time was significantly less for the attending (p<.0001) as was the case time (p<.0001). The true costs of training orthopaedic surgery residents in the operating room is not known. The operative time and subsequent cost difference between experienced faculty and orthopaedic residents in certain arthroscopic procedures is not inconsequential. On average, the difference is equivalent to $228.73 per case for anesthesia costs. Based on increased operative times, operating room costs, on average, were increased by $661.85. The significant differences demonstrated between residents and faculty suggest the need to develop strategies and technical training facilities in order to improve orthopaedic residents' surgical skills and efficiency outside of the cost-central operating room.

Adult↗
PubMedDate not supplied

Incidence and mechanisms of acute ankle inversion injuries in volleyball. A retrospective cohort study.

In a retrospective cohort study of ankle inversion injuries performed after the 1991-1992 season in the top two divisions of the Norwegian Volleyball Federation, 63 injuries were found among 318 players during 60,612 hours of training and 928 matches. The study was limited to acute ankle inversion injuries that caused an absence of 1 or more days from training or match play. The total injury rate was 0.9 +/- 0.12 per 1000 player hours: 0.7 +/- 0.11 during training and 2.6 +/- 0.56 during match play. The relative risk of injury during match play versus training was 3.9 (P < 0.001). Women had an injury rate of 1.1 +/- 0.18, whereas that of men was 0.7 +/- 0.15 (relative risk = 1.47; not significant). Most of the players (78%) had suffered at least one previous injury of the affected ankle. Most injuries were mild to moderate. The majority of the injuries (86%) occurred at the net, mainly when landing after blocking (63%) or attacking (29%). We suggest that simple measures such as rule changes, technical training, and prophylactic taping or bracing may lead to a significant reduction in the incidence and severity of such injuries.

Acute Disease↗
PubMed1992

Evaluation of the operating room as a surgical teaching venue.

Surgical educators are facing changes in residency training that have a direct impact on the opportunity that surgeons and residents have for clinical teaching and learning. The knowledge required of residents continues to escalate. Further, as resident positions are reduced, the opportunity for inter-resident education is decreased. Increased service-to-education ratios may result in resident discontent unless surgeons take an active role in the resident's educational experience. The purpose of this study was to examine the educational activities that occur during the operating-room experience. Technical training in the procedure being done was the primary educational activity, but there were long periods when no form of education was taking place. The operating room provides the teacher and learner with uninterrupted time together, and this time can and should be used for clinical teaching and learning.

General Surgery↗
PubMed1955

Nomenclature and classification of health personnel.

Recognizing the widespread need to use partially-trained health personnel that exists in the under-developed countries today, the author discusses general principles for selecting the appropriate categories of auxiliary health workers to meet individual needs, together with ways of utilizing their services to the best advantage, bearing in mind always the ultimate goal of comprehensive health services, staffed by fully-trained professional workers.The value to be derived from establishing some degree of comparability in nomenclature and classification of health workers is self-evident. After analysing several types of such staff, the author advocates a departure from the more usual method of classification by function alone, in view of the fact that there is frequently a wide disparity from one country to another in the work done by similarly designated personnel. He suggests as a possible substitute, a method of classification by functional categories, at the same time taking account of general education and technical training. This method is likely to be more helpful for assessing a country's needs and for purposes of international comparison.

Developing Countries↗
PubMed2006

Follow-up comparisons of intervention and comparison schools in a state tobacco prevention and control initiative.

This study provides information about prevention and control practices in intervention and comparison secondary schools 2 years after the start-up of the Texas Tobacco Prevention Initiative. The intervention, which was funded through the Texas Department of State Health Services, consisted of guidance, training, technical assistance, and reimbursement of approximately 2000 dollars per year for program expenses. Self-administered written surveys for Principals and Health Coordinators, based on the School Health Education Profile Tobacco Module, were designed for periodic assessment of the status of school programs. Surveys were sent in 2002 to intervention (n = 74) and comparison (n = 60) schools. Response to the Principal Survey was received from 109 (81%) schools, and response to the Health Coordinator Survey was received from 84 (63%) schools. Survey analysis showed that intervention schools more frequently (p <or= .05) reported: (1) being extremely or moderately active in student cessation support, teacher training, policy development, family involvement, and assessment of the prevention program; (2) using recommended curricula, offering more tobacco-related lessons, involving more teachers, and using more recommended teaching methods such as role-playing, simulations or practice, and peer educators; and (3) having more interest in staff development and more funding to purchase release time. Similarities across schools are provided, as well as recommendations for future planning.

Data Collection↗
PubMed1978

Some problems--and their solutions--in the production of DTP (diphtheria, tetanus, pertussis) vaccine.

The desirability of choosing methods and equipment to meet local needs such as yield per cycle and ready availability of components of media and other reagents, and of simple equipment such as good quality glassware, of replacement parts for more complex equipment, and, most of all, of technical assistance is emphasised. Particular emphasis is given to ways of increasing yield from agar and static-liquid culture and to simple methods of separating bacteria from large volumes of culture using bacterial-precipitants. Designs are given for simple growth and mixing vessels, including magnetically-stirred units which require a minimum of servicing. It is strongly recommended that the basic production-unit should be a simple, multipurpose, high-quality stainless-steel vessel of appropriate size: such a unit has a working-life of at least 10 years. Regardless of the type of equipment used, simple or complex, the need, at all times, for well-trained technical staff is also stressed.

Bacterial Vaccines↗
PubMed2004

The coalition technical assistance and training framework: helping community coalitions help themselves.

Coalition staff, leaders, and members need training to promote coalition building and maintenance as well as ongoing technical assistance. The Coalition Technical Assistance and Training Framework uses a 6-step process to diagnose coalition strengths and challenges and provide a prescription for action. Re-evaluation after a specified time period helps determine whether a coalition adopted recommended changes in coalition participants, structures, and/or processes and progressed through stages of development. This empowerment approach helps coalition staff and members help themselves to be more effective and efficient. The framework was piloted with the Virginia Healthy Start Initiative from November 1997 to June 2001. Seven perinatal councils that focused on preventing low-weight births and infant mortality adopted 75% of the recommended actions within 1 year. Results from a pre and post-assessment tool after 3 years showed significant progress in the coalitions' ability to develop effective participants, processes, and structures

Community Participation↗
PubMed2003

Blinded multi-laboratory evaluation of an in-house dot-blot ELISA kit for diagnosis of human parastrongyliasis.

An in-house membrane dot-blot enzyme-linked immunosorbent assay kit, for the detection of specific antibody to a 31 kDa protein of Parastrongylus cantonensis was evaluated in a blinded multi-laboratory study. The kit was provided to technologists, who were trained in its use, from nine regional laboratories of Thailand. With an identical set of 20 coded serum samples and reference positive and negative controls, the kit was found to have a diagnostic sensitivity of 100% and a diagnostic specificity of 100% in all the laboratories. There was no obvious variation in quality among five lots of the antigen-coated nitrocellulose strips evaluated. The shelf life of the kit was > or = 6 months when the test components were stored at 4 degrees C and 18 months at -20 degrees C. The enzyme-linked immunoassay dot technique is easy to perform and does not require sophisticated electrical equipment; the result is available within 3 hours. If appropriate technical training is included, the application of this dot-blot ELISA kit in clinical laboratories throughout Thailand should be possible.

Angiostrongylus cantonensis↗
PubMed1984

An analysis of major errors and equipment failures in anesthesia management: considerations for prevention and detection.

Adaptations of the critical-incident technique were used to gather reports of anesthesia-related human error and equipment failure. A total of 139 anesthesiologists, residents, and nurse-anesthetists from four hospitals participated as subjects in directed or open-ended interviews, and 48 of them functioned as "trained observers." A total of 1,089 descriptions of preventable "critical incidents" were collected. Of these, 70 represented errors or failures that had contributed in some way to a "substantive negative outcome." From these incidents, ten potential strategies were developed for prevention or detection of incidents. Overall patterns observed in this wider study were similar to those of our earlier report. The incidents most frequently reported included breathing circuit disconnections, drug-syringe swaps, gas-flow control errors and losses of gas supply. Only 4% of the incidents with substantive negative outcomes involved equipment failure, confirming the previous impression that human error is the dominant issue in anesthesia mishaps. Among the broad categories of key strategies for mishap prevention were additional technical training, improved supervision, improved organization, equipment human-factors improvements, and use of additional monitoring instrumentation. The data also suggest that less healthy patients are more likely to be affected adversely by errors. It is suggested that, in future studies of anesthesia mortality and morbidity, untoward events should be classified according to preventive strategy rather than outcome alone as an aid to those who wish to apply the experience of others to lessen the risk in their individual practice.

Accident Prevention↗
PubMed2005

Neonatal mortality in rural Bangladesh: an exploratory study.

Bangladesh has a neonatal death rate that is substantially high and demands urgent attention. To assess the causes of neonatal mortality, 1,019 pregnant women were followed up in eight randomly-selected rural areas of the country. Trained female interviewers visited the households of the subjects at four-week intervals to record neonatal deaths (within 28 days after birth). For each death, they administered a structured verbal autopsy questionnaire to the mother and/or a close family member. Based on these field data, three neonatologists arrived at a consensus to assign two causes of death--an originating cause and a direct cause. The neonatal mortality rate was 53.5 per 1,000 livebirths. The originating causes of death were pre-maturity/low birth-weight (30%), difficult labour (16%), unhygienic birth practices (16%), others (4%), and unknown (34%). The direct causes were sepsis (32%), asphyxia (26%), tetanus (15%), respiratory distress (6%), others (6%), and unknown (14%). According to the prevailing causes of neonatal deaths, implementation of intervention programmes, often in the community, that do not depend on highly-technical training or sophisticated equipment should be implemented.

Adult↗
PubMed2005

Alcohol screening and brief intervention in primary care settings: implementation models and predictors.

OBJECTIVE: This study compared two different implementation strategies for Cutting Back, a primary care alcohol screening and brief intervention (SBI) program for hazardous and harmful drinkers. It also identified organizational factors contributing to the success or failure of SBI implementation. METHOD: Cutting Back was implemented in 10 primary care practices associated with managed care organizations (MCOs) in five states, through a system of planning, training, technical assistance and clinic feedback. Clinics were randomly assigned to one of two brief intervention systems: In the P Model, medical providers were responsible for delivering interventions, whereas in the S Model mid-level professionals (usually nurses) acted as the clinic specialists to provide that service. Data were collected to measure the performance of screening and delivery of interventions in each clinic. RESULTS: The S Model screened a higher percentage of patients than did the P Model during the best month of program operation (50% vs 44%) and over all months of operation (24% vs 19%). Of those patients who screened positive, more patients in the S condition received an intervention than in the P condition (73.1% vs 57.1%), but there was a considerable range of performance among the five sites within each condition. Results at the clinic level were mixed, with some MCOs performing alcohol SBI significantly better with the S model and others doing better with the P model. The ability of clinics to conduct SBI was significantly correlated with both provider characteristics and organizational factors (e.g., prior SBI experience, MCO stability, number of clinicians trained and the quality of the MCO coordinator's work). Lack of provider time, staff turnover and competing priorities correlated negatively with SBI performance. CONCLUSIONS: The extent to which a given delivery model is likely to work best within an MCO depends on complex provider and organizational characteristics.

Adolescent↗