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At least 1,621 records · Page 90Linked to original sources
PubMed1993

The social validity of an argument supporting a ban on aversive procedures.

There is currently a controversy regarding the use of non-aversive and aversive procedures in the treatment of severe behaviour problems in individuals with mental retardation. One specific criticism directed at professionals who support the non-aversive position is that they have taken quotations from scientific articles out of context in order to give the impression of empirical support for their position. The present authors addressed this issue by assessing the social validity of references made to selected scientific articles in support of a specific argument in a monograph by Guess et al. (1987). Three groups of individuals were surveyed in this study: (1) psychologists working with individuals with mental retardation at six state schools in Texas (Group I); (2) selected professionals with expertise in the area of self-injurious behaviour and in the use of behaviour modification techniques with individuals who are mentally retarded (Group II); and (3) the authors of the six journal articles that were selected for the present study (Group III). The study focused on references made to journal articles in support of the 'depersonalization hypothesis' that aversive therapies serve to depersonalize the recipients of these treatments. Results indicate that the authors of the monograph were not completely accurate in their references to the six articles. Sixty per cent of the respondents from Group I, 71% of respondents from Group II, and two out of the three respondents from Group III rated the citations made in the monograph as inaccurate. In addition, the respondents rated the articles as not supportive of the depersonalization hypothesis for which they were cited. Over half of Group I respondents, and all respondents from Groups II and III rated the articles as non-supportive of the depersonalization hypothesis. These findings suggest that the authors of the monograph have used references selectively and incorrectly in support of their views in at least some instances. This emphasizes the importance of critical reading and hypotheses based on bodies of knowledge rather than selected sources. Furthermore, this study indicates the need for operationally defined hypotheses which may be examined empirically.

Attitude of Health Personnel↗
PubMed1989

Social desirability and questioning children in dental research.

The influence of social desirability on the results of a social dental investigation was examined in a survey of 320 15-yr-old children. Children with a lower level of schooling seemed to be more inclined to give social desirable answers. It appeared that the stronger the social desirability, the more satisfaction children tended to show with their dentist, the less they said they were afraid of him, but, surprisingly, the less responsible they felt for their dental health. Other measures were not influenced by social desirability: dental hygiene, perception of the quality of one's own teeth, knowledge about dental health, sources of information, and evaluation of the dentist's behavior. Also independent of social desirability were the measures of the amount of fluid sugar consumed, the child's obesity, and the actual dental health (DMFS, degree of treatment, P.H.P.). Several aspects of the meaning of social desirability in dental research are discussed.

Adolescent↗
PubMed1995

How is oral health education conducted in Finnish health centers?

The oral health education (OHE) given in Finnish health centers is mostly implemented by dental assistants and hygienists. However, there is no exact information concerning the distribution of OHE work and the working methods among individual health educators. The aims of this study were to assess 1) the time used for OHE by the dental professionals who bear most of the responsibility for OHE in health centers, and to evaluate 2) the collaboration between OH-educators and the parents of schoolchildren, school personnel and the other health care personnel and 3) the sources of the OHE knowledge and skills of these OH-educators and their methods according to their work load. The data for this study were collected from 323 OH-educators. About one fourth (28%) of the OH-educators used 40% or more of their working time for group OHE and one third (33%) used 40% or more of their time for individual OHE. These workers were considered to be full-time OH-educators. The mean age of the OH-educators was 36 yr. The mean length of the OHE career was 8 yr. The most common OHE methods were a usual type of school lesson or a lesson in which the audience was questioned. Slides, models, transparencies and leaflets were the most general visual aids used.

Adolescent↗
PubMed2002

Increasing awareness of asthma and asthma resources in communities on the southwest border.

PURPOSE: To provide outpatient asthma education for children and families along the southwest border of the U.S. and to study the effectiveness of a southwest border hospital's in-house asthma educational program. DATA SOURCES: (1) "Increasing the Knowledge Base of Asthmatics and Their Families through Asthma Clubs along the Southwest Border." (2) American Lung Association. (3) National Institutes of Health, National Heart, Lung and Blood Institute. (4) Referrals from a southwest border hospital. CONCLUSIONS: Only two of 23 patients referred for asthma follow-up were readmitted to hospital and/or emergency care during the following year. Large group teaching pretest-posttest score means for 3,429 fourth and fifth grade students revealed a 23% increase in asthma knowledge. Small follow-up groups of students received in-depth asthma education. IMPLICATIONS FOR PRACTICE: Effectiveness of hospital inpatient asthma education combined with outpatient family follow-up was supported. An additional finding was that southwest border families are more receptive to visits arranged with a school nurse in their children's school than to home visits from primary care clinic nurses.

Adolescent↗
PubMed2000

A two-step algorithm for predicting portal dose images in arbitrary detectors.

Recently, portal imaging systems have been successfully demonstrated in dosimetric treatment verification applications, where measured and predicted images are quantitatively compared. To advance this approach to dosimetric verification, a two-step model which predicts dose deposition in arbitrary portal image detectors is presented. The algorithm requires patient CT data, source-detector distance, and knowledge of the incident beam fluence. The first step predicts the fluence entering a portal imaging detector located behind the patient. Primary fluence is obtained through ray-tracing techniques, while scatter fluence prediction requires a library of Monte Carlo-generated scatter fluence kernels. These kernels allow prediction of basic radiation transport parameters characterizing the scattered photons, including fluence and mean energy. The second step of the algorithm involves a superposition of Monte Carlo-generated pencil beam kernels, describing dose deposition in a specific detector, with the predicted incident fluence. This process is performed separately for primary and scatter fluence, and yields a predicted dose image. A small but noticeable improvement in prediction is obtained by explicitly modeling the off-axis energy spectrum softening due to the flattening filter. The algorithm is tested on a slab phantom and a simple lung phantom (6 MV). Furthermore, an anthropomorphic phantom is utilized for a simulated lung treatment (6 MV), and simulated pelvis treatment (23 MV). Data were collected over a range of air gaps (10-80 cm). Detectors incorporating both low and high atomic number buildup are used to measure portal image profiles. Agreement between predicted and measured portal dose is better than 3% in areas of low dose gradient (<30%/cm) for all phantoms, air gaps, beam energies, and detector configurations tested here. It is concluded that this portal dose prediction algorithm is fast, accurate, allows separation of primary and scatter dose, and can model arbitrary detectors.

Air↗
PubMedDate not supplied

Measurement of activity yields for 12C(gamma, n)11C, 14N(gamma, n)13N, and 16O(gamma, n)15O reactions as a function of electron beam energy and angle from the electron beam using thick target produced bremsstrahlung.

The calculation of activity yields from practical photonuclear target systems designed to produce short-lived positron emitting radionuclides for nuclear medicine purposes requires certain basic information. These include a knowledge of the photon source (bremsstrahlung energy spectrum and intensity as a function of angle from the electron beam) and the gamma, n activation cross section of the secondary target element. A lack of adequate information concerning these parameters motivated the present study in which activity yields for the reactions 12C(gamma, n)11C, 14N(gamma, n)13N, and 16O(gamma, n)15O were measured as a function of energy of and angle from the electron beam between 16 and 30 MeV and 0 degree and 30.5 degrees, respectively. The data indicate highly complex relationships between the activity yield and the experimental variables. Also indicated are possible applications of the data to indicate the energy of an electron beam producing a given bremsstrahlung field in which activation measurements are made.

Carbon Radioisotopes↗
PubMed2002

Geoacoustic inversion of ambient noise: a simple method.

The vertical directionality of ambient noise is strongly influenced by seabed reflections. Therefore, potentially, geoacoustic parameters can be inferred by inversion of the noise. In this approach, using vertical array measurements, the reflection loss is found directly by comparing the upward- with the downward-going noise. Theory suggests that this simple ratio is, in fact, the power reflection coefficient-potentially a function of angle and frequency. Modeling and parameter searching are minimized, and the method does not require a detailed knowledge of the noise source distribution. The approach can handle stratified environments and is believed to tolerate range dependence. Experimental data from five sites, four in the Mediterranean, one on the New Jersey Shelf, are described. Most of the Mediterranean sites had temporally varying noise directionality, yet yielded the same reflection properties, as one would hope. One site was visited in conditions of very low surface noise. This paper concentrates on an experimental demonstration of the feasibility of the method and data quality issues rather than automatic search techniques for geoacoustic parameters.

Acoustics↗
PubMed1985

Influence of following context on perception of the voiced-voiceless distinction in syllable-final stop consonants.

This paper reports acoustic measurements and results from a series of perceptual experiments on the voiced-voiceless distinction for syllable-final stop consonants in absolute final position and in the context of a following syllable beginning with a different stop consonant. The focus is on temporal cues to the distinction, with vowel duration and silent closure duration as the primary and secondary dimensions, respectively. The main results are that adding a second syllable to a monosyllable increases the number of voiced stop consonant responses, as does shortening of the closure duration in disyllables. Both of these effects are consistent with temporal regularities in speech production: Vowel durations are shorter in the first syllable of disyllables than in monosyllables, and closure durations are shorter for voiced than for voiceless stops in disyllabic utterances of this type. While the perceptual effects thus may derive from two separate sources of tacit phonetic knowledge available to listeners, the data are also consistent with an interpretation in terms of a single effect; one of temporal proximity of following context.

Adult↗
PubMed1992

Strain delineation and epidemiology of Candida (Clavispora) lusitaniae.

Electrophoretic karyotype (EK) patterns, determined by using contour-clamped homogeneous pulsed-field electrophoresis, and isoenzyme (IZ) profiles were evaluated as methods for strain delineation among 35 isolates of Candida lusitaniae recovered from 15 patients. All isolates were identified to the species level by using conventional morphologic and physiologic criteria, and the identification was confirmed by gas-liquid chromatography analysis of the cellular fatty acids. The isolates were then typed without knowledge of the patient source. The IZ profiles showed all isolates to be closely related. Fifteen EK patterns were found; each pattern was restricted to isolates recovered from a single patient. In contrast, on the basis of heterogeneity in phosphatases, beta-glucosidases, esterases, and catalases, 10 IZ profiles were found; 4 were shared by isolates recovered from more than one patient. Multiple isolates from six patients were analyzed, and for each patient, a single EK- and IZ-defined type was found. The types of isolates obtained from two patients, after the emergence of resistance to amphotericin B, remained the same as the types of isolates obtained earlier. The data suggest that a patient becomes colonized by a single strain of C. lusitaniae which may disseminate to multiple sites, that the colonizing strain can persist during the patient's hospitalization, and that it may develop resistance to amphotericin B. Both EK patterns and IZ profiles can be used to delineate strains of C. lusitaniae, but the EK pattern provides more discriminatory power.

Amphotericin B↗
PubMed1992

Tracking laboratory contamination by using a Bacillus cereus pseudoepidemic as an example.

From 1 March to 31 May 1990, Bacillus cereus was recovered from 24 of 5,534 (0.49%) blood cultures and 22 of 1,088 (2.02%) other body fluid cultures. The rarity of this organism as a pathogen and comparison with previous baseline rates led to the conclusion that it was a pseudoepidemic involving some form of culture contamination. Generalized precautions taken without specific knowledge of the contaminant source reduced the recovery rate of the organism. Recovery rates for the organism returned to normal baseline prevalence after environmental cultures and epidemiological analysis led to the sterilization of a contaminated water bath used for boiling thioglycollate media. The problems encountered in this investigation are examined, and a systematic approach to clinical laboratory epidemiology is outlined.

Bacillus cereus↗
PubMed2006

The impact of internet use on the public perception of physicians: a perspective from the sociology of professions literature.

This study uses literature on the sociology of professions and explores the impact of Internet use on the degree to which patients believe doctors are the sole source of expert medical knowledge. A survey of 406 respondents was conducted to assess this question. Findings lend some support to the idea that the spread of Internet-based professional knowledge erodes the ability of professionals to control their knowledge. Specifically, findings suggest that increased access and use of online health information is related to the belief that doctors may be bypassed in the pursuit of medical information and diagnoses. Indirectly, age was found to be a significant factor, in that the younger the individual, the greater the use of online health information. This finding suggests that Internet use will likely continue to provide challenges to physician authority.

Data Collection↗
PubMedDate not supplied

Philosophy, knowledge and theory in the assessment of pain.

Pain is generally accepted to be an unpleasant sensory experience that can affect patients' quality of life if not addressed adequately. Pain assessment is a key aspect in the nursing management and delivery of care within the clinical environment. Effective pain management is thus reliant on a comprehensive assessment of the patient and his/her pain. It is though the assessment process that the skilled nurse utilizes many aspects of knowledge including that of the underlying pathophysiology, pharmacological knowledge of the drugs available for use, and knowledge of the patient being assessed. The use of these varying types of knowledge is essential when caring for a variety of patients. To ensure pain assessment is based on sound judgement, effective nurses will utilize their knowledge acquired through different sources, including any relevant theories or research, and their understanding of the philosophical dimensions of pain and its treatment. The ideology behind effective pain assessment and pain management is to achieve a pain-free status whenever possible. Although this sets the nurse a very difficult challenge, the aim is to ensure that the patient achieves the best possible treatment.

Clinical Competence↗
PubMedDate not supplied

Definition of medication therapy management: development of professionwide consensus.

OBJECTIVE: To describe events leading to development of a professionwide consensus definition of medication therapy management (MTM) and attendant programs and services and present the document (definition, services, and program requirements) resulting from the process. DATA SOURCES: Author's own knowledge and records of events. SUMMARY: Following the late 2003 passage of the Medicare Prescription Drug Improvement and Modernization Act, the pharmacy profession had a need to act quickly to define MTM so that a consensus definition would be available as regulations implementing the Medicare Part D benefit were being written. The American Pharmacists Association facilitated this process by convening a broad working group of members and other involved parties to draft a preliminary definition. The Pharmacy Practice Activity Classification was used to check elements of the definition for consistency with services being offered in a wide variety of settings. A professionwide stakeholders conference was then convened with representatives from each of 11 national pharmacy organizations. This group, following a daylong meeting in late May 2004 and several weeks of e-mail messages and conference calls, finalized the MTM definition, which was then approved by the chief executive officers of all 11 groups. CONCLUSION: Through the extraordinary efforts of the numerous organizations and participants, the MTM Services Definition is one that is applicable within diverse pharmacy practice segments, whose services are feasible for a majority of practitioners to implement, and whose elements are supported by a profession-wide consortium of 11 national professional pharmacy organizations. This historic achievement is the first step on a journey to find the best ways to effectively deliver MTM services to patients.

Chronic Disease↗
PubMed1998

[Prevention for speech-hearing therapists from the University of Valle in Cali, Colombia].

INTRODUCTION: Preventive activities in communication disorders treated by speech-hearing therapists of the Universidad del Valle in Cali Colombia, between January and April, 1995, are described. METHODOLOGY: Forty-five professionals to whom a self administered questionnaire with 13 questions was applied, were included in the study. RESULTS: For 67% the program of graduation is basic as source of their preventive knowledge. 47% used only one of nine strategic options and 29% report the use of only two of these preventive interventions. For all communication areas, on average nearly 60% of speech-hearing therapists never use preventive actions. CONCLUSION: The alumni of the Universidad del Valle do not exercise the practice of prevention in a systematic way it has been claimed by the curriculum of the school. Some determinants of social context and demand of professional services are suspected to induce a great reduction in the proportion and frequency of preventive practice in the professional role.

Colombia↗
PubMedDate not supplied

An ontology of quality initiatives and a model for decentralized, collaborative quality management on the (semantic) World-Wide-Web.

This editorial provides a model of how quality initiatives concerned with health information on the World Wide Web may in the future interact with each other. This vision fits into the evolving "Semantic Web" architecture - ie, the prospective that the World Wide Web may evolve from a mess of unstructured, human-readable information sources into a global knowledge base with an additional layer providing richer and more meaningful relationships between resources. One first prerequisite for forming such a "Semantic Web" or "web of trust" among the players active in quality management of health information is that these initiatives make statements about themselves and about each other in a machine-processable language. I present a concrete model on how this collaboration could look, and provide some recommendations on what the role of the World Health Organization (WHO) and other policy makers in this framework could be.

Internet↗
PubMed2006

eHealth Literacy: Essential Skills for Consumer Health in a Networked World.

Electronic health tools provide little value if the intended users lack the skills to effectively engage them. With nearly half the adult population in the United States and Canada having literacy levels below what is needed to fully engage in an information-rich society, the implications for using information technology to promote health and aid in health care, or for eHealth, are considerable. Engaging with eHealth requires a skill set, or literacy, of its own. The concept of eHealth literacy is introduced and defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. In this paper, a model of eHealth literacy is introduced, comprised of multiple literacy types, including an outline of a set of fundamental skills consumers require to derive direct benefits from eHealth. A profile of each literacy type with examples of the problems patient-clients might present is provided along with a resource list to aid health practitioners in supporting literacy improvement with their patient-clients across each domain. Facets of the model are illustrated through a set of clinical cases to demonstrate how health practitioners can address eHealth literacy issues in clinical or public health practice. Potential future applications of the model are discussed.

Computer Communication Networks↗
PubMed1992

Senior medical students as simulated patients in an objective structured clinical examination: motivation and benefits.

Third and fourth year medical students were recruited to participate as simulated patients and examiners in an Objective Structured Clinical Examination (OSCE) administered for second year medical students. Students reported they were motivated to participate, not only by the honorarium, but because they believed the OSCE would be fun and interesting and because they were interested in medical education and in improving clinical evaluation. The third and fourth year medical students benefitted academically and financially from participation. Faculty benefitted by having a readily available source of enthusiastic and knowledgeable simulated patients.

Education, Medical, Undergraduate↗
PubMed2006

Food and nutrition-related learning in collective kitchens in three Canadian cities.

PURPOSE: To determine what food and nutrition-related learning takes place in collective kitchens (CKs) in three Canadian cities. METHODS: Semi-participant observation and in-depth interviews were conducted with CK participants and leaders. Major nutrition-related themes that emerged were categorized and integrated to form a picture of how food-related knowledge and behaviours were affected as a result of CK involvement. RESULTS: In general, CKs were perceived as an important source of food-related knowledge and skills. Some behaviour changes that resulted from participation were an increased variety of foods in the diet, increased vegetable consumption, and decreased fat consumption. CONCLUSIONS: Collective kitchens can be important tools for nutrition education. However, the broader social conditions, such as poverty, that influence food-related behaviours should also be taken into account.

Canada↗