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PubMed1993

Maternal and child health in Indonesia.

AIIKU-HAN activity was initiated by the Imperial Gift Foundation BOSHI-AIIKU-KAI in Japan in 1936 and has been introduced and accepted to community-based maternal and child health development in Indonesia through the international cooperation project conducted by Japan International Cooperation Agency (JICA) in order to encourage community health activities carried out by Indonesian women volunteers. As AIIKU-HAN activity in Japan and Dasa Wisma health activity in Indonesia have much in common, transferring concepts, methods and experiences met less obstacles when Indonesian community health volunteers learned AIIKU-HAN activity. Experience gained while developed countries were less developed can be transferred by shifting the time-scale of history in developed countries.

Adult↗
PubMed1995

Promoting strategic learning by postsecondary students with learning disabilities.

The research described here investigated the effectiveness of an intervention model designed to promote self-regulated and strategic learning: Strategic Content Learning (SCL). In SCL, rather that focusing on teaching students specific cognitive strategies, instruction focuses on supporting students to develop a strategic approach to learning. The study comprised six parallel case studies embedded within a single-group, pre-post design. Each student chose a task of importance to current or future academic work, and individualized support was provided on those tasks. Participants were adults with learning disabilities (5 women and 1 man, ages 18 to 36 years) enrolled in postsecondary education programs. Results indicated, that students' task performance improved. Additionally, gains in metacognitive knowledge about tasks and strategies, increased perceptions of self-efficacy, and shifts in attributional patterns were observed. Most critically, the evidence suggested that students became more self-regulated in their learning: They were active in developing and modifying strategies, they transferred strategies across contexts, and they began to attack noninstructed tasks strategically. The particular suitability of SCL as an intervention for adults with learning disabilities is described, and implications of the findings for research and practice are discussed.

Adolescent↗
PubMed1998

Teaching and counselling behaviour: an applied study with community pharmacists.

Continuing education aims at improving practice. In this article, three main research questions are addressed: Which methodology is optimal to improve counselling behaviour? Are learning outcomes influenced by learning style? Does knowing imply doing? Four educational methods, transferring information on cough medicines, are assessed: a lecture, an interactive workshop, an audiocassette and a textbook. Attendants of the first three methods also received the textbook. Pharmacists completed a learning-style inventory in addition to a pretest. After the instruction phase, they were interviewed by telephone (post-test). We also evaluated the counseling behaviour by an 'incognito' visit to participants as well as to controls. Seventy-eight pharmacists participated. Their learning-style cannot be related to the results of pre- or posttest. Each educational method improved the level of knowledge significantly, but none of them proved to be better than the others. The pharmacists who in addition read the textbook, acquired more knowledge than those who did not. Self-study at home led to more fundamental rather than practical knowledge. Improving knowledge does not result in better counselling: 75% of the pharmacists asked only one question, especially concerning the type of cough. However 9 out of 10 mentioned how to use the drug. About half of the pharmacists told the patient about the action of the medicine. Other items were hardly ever mentioned. There was no difference in counselling behaviour between the intervention group and a group of pharmacists who did not attend the course. This investigation does not reveal any particular method of in-service training as being more efficient. Active use of self-study materials helps to improve pharmacological knowledge. Implementing educational strategies to improve counselling behaviour remains a future aim.

Belgium↗
PubMed1995

Ameliorating effects of histidine on learning deficits in an elevated plus-maze test in mice and the contribution of cholinergic neuronal systems.

We investigated the effects of histidine on scopolamine-induced learning deficits in the elevated plus-maze test in mice. In this test, transfer latency, the time mice took to move from the open arm to the enclosed arm, was used as an index of learning and memory. Intraperitoneal administration of scopolamine (0.5 mg/kg) prolonged the transfer latency on day 2 as compared with that in the saline-treated group. Histidine loading (500, 800 and 1600 mg/kg) reversed the prolongation of the transfer latency induced by scopolamine. This ameliorating effect of histidine was abolished by alpha-fluoromethylhistidine, an inhibitor of histidine decarboxylase, suggesting that histidine itself has no such ameliorating effect. Moreover, the ameliorating effect of histidine was antagonized by a histamine H1-receptor antagonist, pyrilamine, but not by zolantidine, a histamine H2-receptor antagonist. Thus, histamine, a decarboxylated product of histidine, elicited an ameliorating effect on scopolamine-induced learning deficit via histamine H1 receptors in mice. In the biochemical study, histidine significantly decreased acetylcholine (ACh) levels in the cerebral cortex and diencephalon of mice, and also significantly decreased them in the midbrain at a dose of 500 mg/kg. Histidine significantly increased and decreased levels of metabolites of noradrenaline and serotonin, respectively, in the brains of mice. Levels of dopamine and its metabolites were not very affected by histidine in the brains of mice. These findings clearly indicate that there is a close relationship between histaminergic and cholinergic system in the brain, and that histamine may play certain important roles in learning and memory.

Acetylcholine↗
PubMed1994

Artificial intelligence versus logistic regression statistical modelling to predict cardiac complications after noncardiac surgery.

The traditional approach to developing models predictive of cardiac events has been to perform logistic regression (LR) analysis on a variety of potential predictors. An alternative to use an artificial intelligence system called a neural network (NN) which simulates biological intelligence. To evaluate the potential applicability of the latter method, we compared the ability of LR and NN techniques to predict cardiac events after noncardiac surgery. A total of 200 patients (training group) underwent cardiac risk assessment before major noncardiac surgery using 17 clinical parameters and 7 quantitative indices based on dipyridamole-thallium imaging. There were 21 post-operative myocardial infarctions and/or cardiac deaths. Data from the training group were used to develop two predictive models: one based on backward stepwise LR multivariate statistical analysis and the other one using a neural network. Both models were then validated on a second group of 160 consecutive patients also referred for preoperative risk stratification (validation group). The NN consisted of 14 input, 29 hidden, and 1 output neurons and used a back-propagation algorithm (learning rate 0.2, training tolerance 0.5, sigmoid transfer function). The sensitivity, specificity, positive and negative predictive accuracies for the prediction of postoperative events in the validation group of 160 patients were, respectively, 67% (6/9), 82% (124/151), 18% (6/33), and 98% (124/127) for LR, and 67% (6/9), 96% (145/151), 50% (6/12), and 98% (145/148) for the NN, with a difference in specificity which attained statistical significance (p < 0.01). Artificial intelligence may provide a useful alternative to conventional LR statistical analysis for the purpose of preoperative cardiac risk assessment.

Artificial Intelligence↗
PubMed2000

Lateralized interhemispheric transfer of color cues: evidence for dynamic coding principles of visual lateralization in pigeons.

Visual feature discrimination tasks in pigeons reveal a right eye/left hemisphere dominance at the population level. Anatomical studies and lesion data show this visual lateralization to be related to asymmetries of the tectofugal system, which ascends from the tectum over the n. rotundus to the forebrain. Anatomically, this system is characterized by numerous morphological and connectional asymmetries which result in a bilateral visual representation in the dominant left hemisphere and a mostly contralateral representation in the subdominant right hemisphere. Ontogenetically, visual lateralization starts with an asymmetrical embryonic position within the egg, which leads to asymmetries of light stimulation. Differences in exposure to light stimulation between the eyes result in activity differences between the ascending tectofugal pathways of the left and the right hemisphere, which are transcribed during a critical time span into morphological asymmetries. The asymmetries established after this transient period finally start to determine the lateralized processes of the visual system for the entire life span of the individual. We now can show that these anatomical lateralizations are accompanied by asymmetries of interocular transfer, which enable a faster shift of learned color cues from the dominant right to the left eye than vice versa. In summary, our data provide evidence that cerebral asymmetries are based both on "static" anatomical and on "dynamic" process-dependent principles.

Animals↗
PubMed2001

Comparison of video trainer and virtual reality training systems on acquisition of laparoscopic skills.

Training on a video trainer or computer-based minimally invasive surgery trainer leads to improved benchtop laparoscopic skill. Recently, improved operative performance from practice on a video trainer was reported. The purpose of this study was three fold: (a) to compare psychomotor skill improvement after training on a virtual reality (VR) system with that after training on a video-trainer, (VT) (b) to evaluate whether skills learned on the one training system are transferable to the other, and (c) to evaluate whether VR or VT training improves operative performance. For the study, 50 junior surgery residents completed baseline skill testing on both the VR and VT systems. These subjects then were randomized to either a VR or VT structured training group. After practice, the subjects were tested again on their VR and VT skills. To assess the effect of practice on operative performance, all second-year residents (n = 19) were evaluated on their operative performance during a laparoscopic cholecystectomy before and after skill training. Data are expressed as percentage of improvement in mean score/time. Analysis was performed by Student's paired t-test. The VR training group showed improvement of 54% on the VR posttest, as compared with 55% improvement by the VT group. The VR training group improved more on the VT posttest tasks (36%) than the VT training group improved on the VR posttest tasks (17%) (p <0.05). Operative performance improved only in the VR training group (p <0.05). Psychomotor skills improve after training on both VR and VT, and skills may be transferable. Furthermore, training on a minimally invasive surgery trainer, virtual reality system may improve operative performance during laparoscopic cholecystectomy.

Animals↗
PubMed1986

Visual texture segmentation in cats.

The segmentation of visual images on the basis of textural discontinuity was studied in cats using two behavioural paradigms. The first task (Experiment 1) required the animals to detect the presence of a target square of one texture embedded in a background of a second texture. The second task (Experiment 2) required the cats to discriminate between two forms (square and triangle) both of which were defined by texture-texture boundaries. Both detection and discrimination tasks were presented in a transfer paradigm in which the animals first learned a luminance-based form of the same problem. The results indicate that cats are able to segment a visual array on the basis of textural discontinuity in the absence of global luminance differences between figure and ground, and that they are able to use the contour information provided by texture-texture boundaries as a basis for form discrimination.

Animals↗
PubMed2006

Assessing the predictive validity and efficacy of a multimodal training programme for laparoscopic radical prostatectomy (LRP).

OBJECTIVES: To assess the predictive validity (ability to correlate to real-life environment) and efficacy of a training programme for laparoscopic radical prostatectomy (LRP), based on a structured and progressive pelvitrainer component with hands-on clinical training in the operating room (OR). METHODS: Prospective data on 500 LRP cases were analysed with 80 excluded due to incomplete records. The operation was divided into multiple steps. Times for these steps were compared among 11 surgeons with different laparoscopic expertise (first-, second-, and third-generation surgeons in order of decreasing experience) and correlated to times for specific exercises on the pelvitrainer that simulated particular steps. Perioperative parameters were also evaluated among the three groups. RESULTS: Pelvitrainer times achieved by trainees (third-generation surgeons) did not differ significantly with times for corresponding steps of LRP. There was also no significant difference for total OR time between the second- and third-generation surgeons (205 and 207 min, respectively; p>0.05) although the time for the first-generation surgeons was faster than both (176 min). Short-term quality indicators for first, second, and third generations included transfusion rates (2.3%, 2.4%, and 2.6%, respectively), positive margin rates (20.3%, 21.5%, and 23.0%) and complications, which did not differ significantly among the generations although the first-generation surgeons had the lowest rates. CONCLUSIONS: A carefully designed training programme that incorporates both pelvitrainer and mentor-based operative training is essential for the effective and safe transfer of skills and knowledge required to learn LRP.

Adult↗
PubMed2006

Developmental asymmetries between horizontal and vertical tracking.

The development of the asymmetry between horizontal and vertical eye tracking was investigated longitudinally at 5, 7, and 9 months of age. The target moved either on a 2D circular trajectory or on a vertical or horizontal 1D sinusoidal trajectory. Saccades, smooth pursuit, and head movements were measured. Vertical tracking was found to be inferior to horizontal tracking at all age levels. The results also show that the mechanisms responsible for horizontal and vertical tracking mutually influence one another in the production of 2D visual pursuit. Learning effects were observed within-trials but no transfer between trials was found.

Child Development↗
PubMedDate not supplied

Sudden infant death syndrome: a cybernetic etiology.

The brain's processes, by hypothesis, involve information processing by an extraordinarily complex, highly sophisticated, self-organizing cybernetic system embedded in the central nervous system. This cybernetic system generates itself in successive stages. Breathing is, by default, an autonomous function, but breath control is learned. If there is not a smooth transfer of function at the time when a successor system (one that enables autonomous breathing to be overridden by voluntary control) takes over, breathing may cease, without any overt cause being detectable, even with a thorough postmortem examination. If conditions are such that, at that point, the infant's body lacks the strength to resume breathing again under autonomic control, Sudden Infant Death Syndrome may result. The theory explains why infants are at greater risk if they sleep face down.

Brain↗
PubMed2002

[The superior gluteal artery perforator flap (S-GAP-Flap)].

Superior gluteal artery perforator flap for breast reconstruction with autologous tissue (S-GAP-flap): With the introduction of perforator flaps for breast reconstruction with autologous tissue the gluteal region became again investigated as a possible donor site. With the S-GAP-flap breast reconstruction from the gluteal region is possible utilising skin and fat without muscle sacrifice. 52 S-GAP-flaps for autologous breast reconstruction with a flap loss rate of 7.7 % were performed at the Department of Plastic and Hand surgery, Behandlungszentrum Vogtareuth, Germany from 1997 till 2002. Although there is an obvious learning curve also with this free tissue transfer, the S-GAP-flap is a reliable alternative in autologous breast reconstruction, when tissue from the lower abdomen is not available.

Arteries↗
PubMed2002

Frame of reference and adaptation to directional bias in a video-controlled reaching task.

The present study (N=56) investigated spatio-temporal accuracy of horizontal reaching movements controlled visually through a vertical video monitor. Direct vision of the hand was precluded and the direction of hand trajectory, as perceived on the video screen, was varied by changing the angle of the camera. The orientation of the visual scene displayed on the fronto-parallel plane was thus congruent (0 degrees condition) or non-congruent (directional bias of 15 degrees, 30 degrees or 45 degrees counterclockwise) according to the horizontal working space. The goal of this study was to determine whether local learning of a directional bias can be transferred to other locations in the working space, but taking into account the magnitude of the directional bias (15 degrees, 30 degrees or 45 degrees ), and the position of the successive objectives (targets at different distances (TDD) or different azimuths (TDA)). Analysis of the spatial accuracy of pointing movements showed that when introducing a directional bias, terminal angular error was linearly related to the amount of angular perturbation (around 30%). Seven trials were, on average, necessary to eliminate this terminal error, whatever the magnitude of the directional bias and the position of the successive targets. When changing the location of the spatial objective, transfer of adaptation was achieved in the TDD condition but remained partial in the TDA condition. Furthermore, initial orientation of the trajectory suggested that some participants used a hand-centred frame of reference whereas others used an external one to specify movement vector. The adaptation process differed as a function of the frame of reference used, but only in the TDA condition. Adaptation for participants using a hand-centred frame of reference was more concerned with changes in the shape of the trajectory, whereas participants using an external frame of reference adapted their movement by up-dating the initial direction of hand trajectory. As a whole, these findings suggest that the processes involved in remote visual control of hand movement are complex with the result that tasks requiring video-controlled manipulation like video-controlled surgery require specific spatial abilities in actors and consequential plasticity of their visuo-motor system, in particular concerning the selection of the frame of reference for action.

Adaptation, Physiological↗
PubMed2004

Providing physicians with feedback on how they supervise students during patient contacts.

In this descriptive study an instrument is presented that has been developed to provide physicians with feedback about their strengths and weaknesses in facilitating student learning during patient contacts. The instrument is strongly theory based, i.e. it is based on current general theories of context-bound learning environments, and forms of facilitation promoting transfer of knowledge to actual professional practice. In addition, it has been developed in cooperation with physicians supervising students during patient contacts. The authors have shown how physicians can be provided with individualized feedback on their performance in supervising students during patient contacts.

Education, Medical, Undergraduate↗
PubMed1996

Treatment of autistic disorder.

OBJECTIVE: To present an overview of a variety of treatment approaches in individuals with autistic disorder. METHOD: Selected studies and articles are reviewed. RESULTS: In the past three decades, great progress has been made in the treatment of autistic disorder, particularly in the area of education and parental involvement, with the objective to transfer to home and in other situations learning acquired in school. A role for psychoactive agents, when combined with psychosocial treatments, has been identified. CONCLUSIONS: Although considerable advances have been made in a variety of interventions-educational, psychosocial, and biological-knowledge about the comparative and combined efficacy of the various treatment modalities is lacking. From the parents' perspective, particularly, support and continuity of services require improvement.

Antipsychotic Agents↗
PubMed1978

Involvement for learning in health programs.

Health educators are often required to transfer information, influence attitudes and change behavioral patterns. Whether communicating with an individual or a group, it is important to involve the participant in the educational process. Careful analyses of the goals to be accomplished and the techniques used in the educational process will result in significantly improved communications. Strategies are suggested which have been used successfully to break away from the mold which tends to guarantee passive participation on the part of the learner.

Communication↗
PubMedDate not supplied

Accreditation and nursing practice.

As part of a larger study (Conway, 1993) the literature relating to accreditation of prior learning (APL), accreditation of prior experiential learning (APEL), and the credit accumulation and transfer scheme (CATS) was examined. Significant influencing factors are identified and a general overview of the background to APEL is presented.

Accreditation↗
PubMed1994

Involving stakeholders in health services research: developing Alberta's resident classification system for long-term care facilities.

Little attention has been directed in Canada to identifying stakeholders at the administrative policy level to whom relevant health services research information can be targeted. This article describes a case study in which key stakeholders (long-term care facility owners, operators, and care providers) were explicitly defined not only as targets of original research information to inform administrative public policy but also as collaborators in the research process and dissemination of results. The research involved development of a classification system to measure resident care requirements in the province's nursing homes and auxiliary hospitals. The classification system formed the basis of a new government administrative policy for allocating public funds to these facilities based on levels of care. The authors describe the rationale for involving stakeholders in the research process, the role of stakeholders as collaborators, and lessons learned from the Alberta experience. Examples are presented of how stakeholders can contribute to the health services research process and outcome: by providing experiential knowledge related to the research outcome, anticipating and overcoming potential problems with policy implementation, facilitating policy-oriented learning across stakeholder groups, assisting in the transfer of research information to wider stakeholder audiences, and promoting acceptance for policy change.

Aged↗