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PubMed2006

Development and implementation of a comprehensive faculty development program in PBL core skills.

Large curricular changes associated with changes in teaching and learning methods should be accompanied by faculty development programs linked to the new pedagogy. This article describes a framework for the development and implementation of a program designed to assist faculty with the transition of the dental curriculum to a problem-based learning (PBL) pedagogy. A faculty committee created a PBL core skills program based on experiential, developmentally appropriate approaches that resulted in constructive and social learning opportunities for the faculty participants. Nearly 70 percent of faculty members have participated in the facilitation preparation workshops and contributed to the D.D.S. curriculum as small-group, inquiry-based learning facilitators. Faculty development programs geared toward acquisition of specific teaching skills and based on adult learning principles can be devised locally and result in increased participation in a new curriculum.

Adult↗
PubMed2001

Planning of a community-based approach to injury control and safety promotion in a rural community.

This paper describes the planning of a community-based approach to injury control and safety promotion, the Kolan Injury Prevention Program. The process involved the establishment of a local steering committee, 11 months of injury surveillance, a critical review of the evidence base, community consultations and assessment of community resources. There were 412 recorded injury cases during the surveillance period, with higher rates among men, manual workers, those aged 15-34 years, sport/leisure activities and around the home and farm. Salient issues for residents included a lack of access to safety information and skills, particularly with regard to first aid and bush fire for isolated residents and rurally inexperienced new residents. While injury prevention was identified as an important issue for the community, the rapidly changing size and nature of the community and its infrastructure made this a particularly challenging issue. Challenges included limited availability of volunteers from key sectors, lack of formal data collection systems, difficulties in mobilising support for a broad issue like injury, limited communication networks and the negative impact of distance and role uncertainty on community ownership of the program. This case study illustrates the steps involved in an effective community-based needs assessment addressing injury prevention. Such an approach, if carried out systematically, will help ensure that the strategies and programs developed will be both appropriate and likely to obtain the support of the local community.

Adolescent↗
PubMed2001

A critical examination of community-based responses to household food insecurity in Canada.

Over the past two decades, household food insecurity has emerged as a significant social problem and serious public health concern in the "First World." In Canada, communities initially responded by establishing ad hoc charitable food assistance programs, but the programs have become institutionalized. In the quest for more appropriate and effective responses, a variety of community development programs have recently been initiated. Some are designed to foster personal empowerment through self-help and mutual support; others promote community-level strategies to strengthen local control over food production. The capacity of current initiatives to improve household food security appears limited by their inability to overcome or alter the poverty that under-pins this problem. This may relate to the continued focus on food-based responses, the ad hoc and community-based nature of the initiatives, and their origins in publicly funded health and social service sectors.

Canada↗
PubMed1989

Parenting education for employees.

Effective parenting is a skill that can be learned and developed through company supported programs for employees. The occupational health nurse is an appropriate professional within the corporation to facilitate parental support programs. The family unit is changing. Industry and community resources working together to provide support and education can make a positive impact on family life in America. The children of today will be the work force of tomorrow. An investment in the family is an investment in the future.

Humans↗
PubMed1985

Evaluation of the child with delayed speech or language.

Because of the relative frequency of speech/language delay, all infants and preschool children should undergo routine language screening as part of health care maintenance. Diagnostic evaluation of the child with speech or language delay should answer the following questions: What is the child's descriptive diagnosis (eg, hearing impaired, mentally retarded, DLD, etc.)? What is the child's etiologic diagnosis (eg, congenital viral infection, single gene disorder, birth asphyxia, etc.)? What is the appropriate intervention strategy (amplification, orally based speech therapy, total communication, "infant stimulation" program, etc.)? What is this child's long-term prognosis, to the extent that this is knowable? All children with speech or language delay should undergo formal audiologic testing, regardless of how well the child seems to hear in an office setting, and regardless of whether other disabilities are present which might independently explain the speech/language delay. Evaluation by a psychologist, a speech/language pathologist, or both should follow, with referral to an appropriate intervention program based upon the results of formal developmental testing. Additional medical evaluation (eg, CAT scan, EEG, karyotype), and genetic counseling must be determined on a case-by-case basis. Long-term follow-up should include an awareness that speech or language delay during the preschool years often signifies long-term developmental difficulties, warranting close follow-up of such children as they advance through the school age years.

Child, Preschool↗
PubMed2004

Evaluation of functional improvement in older patients with cognitive impairment, depression and/or delirium admitted to a geriatric convalescence hospitalization unit.

Cognitive impairment, depression and delirium are problems of high prevalence in older patients. The geriatric convalescence unit (GCU) is a hospitalization facility offering an interdisciplinary geriatric intervention program that may be more appropriate for these patients. This study intended to analyze the functional improvement (FI) in older patients with cognitive impairment, depression and/or delirium admitted to a GCU. A group of 107 patients received specific nurse care, habitually performed in GCU and they also were included in a rehabilitation program. Cognitive impairment, depression and delirium were diagnosed according to standardized protocols. The analyzed variables were: age, functional status (Barthel index) before admission (BBA), at admission (BA) and at discharge(BD), diagnostic categories, cognitive function (mini mental state examination: MMSE) and post-discharge destination. The corrected Heinemann index (CHI) was used to evaluate FI obtained during GCU-stay, where CHI = 100 x (BD-BA)/(BBA-BA), and the efficiency index(El) was used to analyze the relationship between FI and the length of stay in the GCU,where El = (BD-BA)/(days in GCU). According to CHI, patients were divided in three groups. Group I: CHI = 0 or negative (patients who lost functional capacity during hospitalization,those who died or were transferred to hospital owing to acute deterioration. Group II: CHI < 35 % (high FI). Mean age was 77.6 +/- 9.1 years, the diagnostic categories were: fractures/orthopedics 49 (45.7 %), neurological 27(25.2 %), pulmonary/cardiologic 6 (5.6 %) and other cases 25 (23.3 %). Mean MMSE and BA scores were 16.9 +/- 9.4 and 29.6 +/- 18.9, respectively. Post-discharge destinations were:63 patients (58.8 %) returned home, 28 (26.1 %) were definitively institutionalized, 11 (10.2%) died and finally 5 (4.6 %) were transferred to acute care hospital. In-Group I, there were 35 patients (32.7 %) with a mean value of the El = 0.12 +/-1.1; in Group II, 13 (12.1 %) and 0.26 +/- 0.38; in Group III, 59 (55.1 %) and 0.94 +/- 0.97, respectively. In spite of the presence of cognitive impairment, depression and/or delirium, a high proportion of patients (67.2 %)obtained a significant improvement in their functional capacity.35 % (moderate FI). Group III: CHI >/=

Aged↗
PubMed1981

An ecobehavioral examination of a simple strategy for increasing mealtime language in residential facilities.

Typically in large residential facilities for retarded person, meals are served in an institutional style that does not appear to encourage appropriate peer interactions. An ecological program alternative is serving meals in a family style. The present study was designed to examine both the feasibility of serving family style meals and the effects of family style meal service on mealtime language. Five retarded young adult male residents, who had some conversational skills and appropriate table manners, participated in this study. The experimental design involved a multiple baseline analysis across meals (dinner, lunch, and breakfast). Observers coded the youths' mealtime verbalizations according to the type, content, and direction of the verbalizations and they recorded the length of the meals. The analysis of the verbalization data indicated that during family style meals the participants spoke substantially more often than during institutional style meals. Increases in peer-directed conversation about the meals primarily accounted for the verbalization changes. Family style serving also resulted in the youths spending more time with their meals. In addition, social validation measures suggested that the family style procedures were preferred by the consumers (participants, staff, and concerned community members).

Adolescent↗
PubMed2001

[Implementation and evaluation of public relations activity in a community health program].

OBJECTIVE: This study evaluated public relations activity in a community health program in order to develop effective strategies to attract the public attention for the program. METHODS: An intervention study was conducted on public relations for "Nutrition Seminar for Citizens," sponsored by the Health Department of Machida City, Tokyo, in October, 1999. One ward in the city was selected as an intervention area, and another ward which had similar demographic and geographic characteristics was chosen as a control area. Two target populations were defined; one was women in their 20s to 60s (#1) and the other was those who had previously never utilized community health programs sponsored by the city (#2). Handbills were used as the medium for public relations for the seminar. These announced the time, place and content of the nutrition seminar and were designed by authors with special attention to catchphrases, colors and fonts. Handbills were distributed in the intervention area through elementary schools, local voluntary organizations and local health volunteers. In addition, the authors directly handed them out to people in front of two supermarkets in the town. The sources of seminar information were requested from the participants of the Nutrition Seminar with a self-administered questionnaire. RESULTS: 1. The percentage of participants who received the seminar information from handbills was higher than that of those who used monthly newsletters from the city as a source of information. 2. The percentage of participants from the intervention area was higher than that from the control area. 3. Regarding target populations #1 and #2, there were no differences in participation rates between the intervention and control area. 4. Among the four distribution routes, the local voluntary organization route was the most effective for attracting participants. CONCLUSIONS: The results show that handbills can be an effective medium for pubic relations to increase the number of participants in community health programs. Also, local voluntary organizations can play a crucial role in information transfer in the community because of their high credibility. On the other hand, we could not reach specified target populations with the medium. Further surveys are needed to establish optimal media and routes to reach appropriate target populations in health programs.

Adult↗
PubMed1993

Extended school year programs: a community-driven curriculum model.

Appropriate education guaranteed to children with disabilities under P.L. 94-142 has been translated by the courts to mean more than 180 days of education. There is now a strong legal precedent establishing the right to an extended school year (summer school) for students with severe disabilities. The courts have left open to interpretation, however, issues related to the program implementation. Descriptions of extended school year programs vary widely and include respite for parents, continuation of the regular school year curriculum, and remediation in skill areas. The only consensus seems to be that these programs should be tailored to individual needs. In the present article a systematic approach to curriculum development for students with severe disabilities enrolled in extended school year programs was described. This approach is (a) community driven, (b) consistent with each student's IEP objectives for the regular school year, (c) tailored to the individual student, and (d) consistent with current best practices of teaching functional skills performed by individuals without disabilities in a variety of integrated nonschool settings. Student progress data were presented.

Activities of Daily Living↗
PubMed1991

Quality assurance in the Connecticut Helicopter Emergency Medical Service.

Quality Assurance (QA) is a vital aspect of the Connecticut Helicopter Emergency Medical Service (HEMS). The program has three components: 1. scene flight audit, 2. random chart audit, and 3. biweekly patient care QA conferences. The scene flight audit identifies patients who, in retrospect, may not have required helicopter transportation. These patients are identified by the following criteria: trauma score greater than 12 and injury severity score less than 16, emergency department deaths, discharged within 24 hours, medical patients. Patient care QA involves review of all flights. A random chart audit is a method of peer review of the written flight record for completeness. The scene flight audit was from 6/85 to 12/87, with 17/107 (16%) in group one, 0/137 (0%) in group two, 5/29 (17%) in group three, and 8/54 (15%) in group four not justified. There were four audit review periods, each with a feedback mechanism to share results with providers. Each audit resulted in a decrease in the number of non-justified flights. There were 57 patient care QA conferences with 231 cases presented. Technical errors and policy issues decreased over time. Random review of five charts/month were reported quarterly. Omitted elements of standard documentation decreased over time. QA can be accomplished in HEMS. Monitored areas should include appropriateness of flights, proper documentation, and patient care review. A QA program improves appropriateness of flights, medical record keeping, and care given.

Aircraft↗
PubMed1989

Use of computer-assisted instruction in the prevention of alcohol abuse.

Recent critiques of and research with traditional alcohol prevention programs have revealed serious problems. Prevention programs typically increase knowledge and appropriate attitudes about alcohol while having little effect on drinking behavior. In this article several concepts are introduced in support of a technology which has the potential to revitalize alcohol education efforts. First, Bandura's self-efficacy theory offers a direction for re-conceptualizing the design of prevention programs as well as the measurement of their effects. Second, computer-assisted instruction (CAI) programs may provide a means for capturing attention, effectively educating about alcohol, and supplementing traditional approaches. One current CAI program is described in detail. Implications for research and practice and obstacles to effective CAI use are also discussed.

Alcoholism↗
PubMed2002

Anatomy of a successful K-12 educational outreach program in the health sciences: eleven years experience at one medical sciences campus.

The Department of Anatomy and Neurobiology, College of Medicine, University of Arkansas for Medical Sciences (UAMS) is the administrative home of a nationally recognized educational outreach program in the health sciences for K-12 teachers (includes school nurses, counselors, etc.) and students. This program is called the Partners in Health Sciences (PIHS) program. It began in the summer of 1991 and is based on an annual needs assessment of the state's teachers. PIHS is a program available to all teachers and students in the state. It has several different components: (1) a cafeteria of 21 days of mini-courses offered in the summer to meet the professional development needs of K-12 biology/health teachers and other school personnel; (2) weekly, interactive telecommunication broadcasts for students during the academic year; (3) intensive, 5-day workshops that train five selected teachers at a time (10 per year) to use an authoring software program to develop grade-appropriate interactive, computer-assisted, instructional (CAI) modules for Internet (http://k14education.uams.edu) use by teachers and students; (4) a monthly science night for students and their parents at a local science magnet high school; (5) field trips to the UAMS campus for teachers and their students; (6) community-requested presentations by program faculty; and (7) availability of earning undergraduate and graduate credit for science education majors in the College of Education, University of Arkansas at Little Rock. The data presented in this report span the period from 1991 through 2001. For all program activities, 14,084 different participants have consumed a total of 50,029 hours of education.

Academic Medical Centers↗
PubMed1998

The anaerobic threshold in cystic fibrosis: comparison of V-slope method, lactate turn points, and Conconi test.

Physical exercise can improve sputum clearance in patients with cystic fibrosis (CF). To set up individual training protocols it is desirable to know the anaerobic threshold (AT). Established methods such as blood lactate measurements and ergometry can only be performed in specialized centers. Conconi showed that the heart rate threshold (HRT), i.e., the deflection point from the linear relationship between work load and heart rate, correlated significantly with the AT in healthy adults. To assess the reliability of the HRT in CF, we performed ergometry in 32 CF patients (mean age, 21.0 +/- 5.5 years; mean Shwachman score, 77.8 +/- 12.0) according to the Conconi protocol. The HRT was compared with the aerobic threshold (AeT) as determined by the V-slope method and with two turn points in the lactate performance curve (LTP1, LTP2). An HRT could be obtained in only 17 of the 32 patients (53%). In these 17 patients there was a significant correlation between HRT and the other thresholds, but the absolute values for the AT differed considerably: The mean HRT was 132% higher than the AeT according to Beaver, 107% higher than LTP1, and 19% higher than LTP2. Exercise protocols that rely solely on the HRT in CF will lead to excessive exertion during exercise training programs in these patients. According to these results the HRT of Conconi is not a suitable method to determine appropriate exercise levels in CF training programs and might even be harmful in CF patients. These results also indicate the need to test the reliability of a diagnostic procedure that has been developed only for healthy people.

Adolescent↗
PubMed2001

Development of oral health training for rural and remote aboriginal health workers.

Research data exists that highlight the discrepancy between the medical/dental status experienced by Aboriginal people compared with that of their non-Aboriginal counterparts. This, coupled with a health system that Aboriginal people often find alienating and difficult to access, further exacerbates the many health problems they face. Poor oral health and hygiene is an issue often overlooked that can significantly impact on a person's quality of life. In areas where Aboriginal people find access to health services difficult, the implementation of culturally acceptable forms of primary health care confers significant benefits. The Aboriginal community has seen that the employment and training of Aboriginal health workers (AHW), particularly in rural and remote regions, is significantly beneficial in improving general health. In the present study, an oral health training program was developed and trialled. This training program was tailored to the needs of rural and remote AHWs. The primary objective was to institute a culturally appropriate basic preventative oral health delivery program at a community level. It is envisaged that through this dental training program, AHWs will be encouraged to implement long-term preventive measures at a local level to improve community dental health. They will also be encouraged to pursue other oral health-care delivery programs. Additionally, it is considered that this project will serve to strengthen a trust-based relationship between Aboriginal people and the health-care profession.

Adult↗
PubMed1979

The four basic types of evaluation: clinical reviews, clinical trials, program reviews, and program trials.

Four basic types of evaluation, each appropriate in a distinctive situation, are the clinical review and the clinical trial, which are concerned with the care of the individual patient, and the program review and program trial, which deal with programs or services directed at groups or populations. Evaluative reviews are primarily motivated by concern with the welfare of the specific population served, and they appraise specific activities in specific settings as a basis for decisions concerning these activities. Clinical and program trials aim to generate knowledge of more general applicability, especially concerning causal relationships between care and outcomes. The types of evaluation differ in the questions they pose and in the methods used to answer them. Failure to draw a distinction between program reviews and program trials is a frequent cause of wasteful or unhelpful evaluative studies.

Consumer Behavior↗
PubMed2005

VRVision: a new tool for the display of 3-D images in behavioral research.

Researchers using three-dimensional (3-D) scenes in their studies often spend a lot of time prerendering the scenes into a set of images for later presentations. To improve efficiency, we have developed a new plug-in program for MATLAB that eliminates this step. The program is able to manipulate and present 3-D scenes in real time. It allows fine control over numerous parameters, including the mode of projection, angular rotation, lighting, surface photo textures, and animation. Images can be presented with monoscopic or stereoscopic display. It can also dynamically track viewer position and update and display an appropriate 3-D projection. The program is fully compatible with existing MATLAB utilities such as the Psychophysics Toolbox (psychtoolbox.org). It is made freely available to the research community (www.hive.hull .ac.uk/software/vrvision).

Behavior↗
PubMed1996

Organ donation and recovery in Mississippi: update 1996.

Over the last 10 years, solid organ transplantation has become increasingly successful and, in 1996, is the recognized standard of care for many end-stage organ diseases. Unfortunately, as this therapy has become more desirable, the demand for transplants has far outpaced the available supply of transplantable organs. Advances in organ preservation, surgical recovery techniques, centralized placement services and communication systems, as well as increased public awareness of the need have helped to increase organ availability. In addition, many transplant programs are now willing to make use of organs from "marginal" or "expanded" donors, particularly in urgent settings for liver and heart transplant recipients. The primary source of organs for Mississippi patients awaiting transplants is Mississippi donors. The Mississippi Organ Recovery Agency, an independent, non-profit agency, is the federally designated recovery organization for the state of Mississippi. This agency and the wait-listed recipients of the University of Mississippi Medical Center's Transplant Programs are critically dependent on appropriate recognition and referral of potential donors by the health professionals of Mississippi. Historically, Mississippi has one of the lowest organ donation rates in the United States. This will only change if physicians make every effort to offer their patients the option of organ and tissue donation, and if the organ and tissue recovery programs are successful in ongoing educational projects for health professionals and the general public.

Aged↗
PubMed2002

Applicability of the ADA to "Ticket to Work" employment networks. Americans with Disabilities Act.

This article examines the applicability of the antidiscrimination provisions of the Americans with Disabilities Act (ADA) of 1990 to The Ticket to Work and Work Incentives Improvement Act (TWWIIA) passed in 1999. Among other policy changes, under the Ticket to Work program, eligible recipients of disability insurance (SSDI) and supplemental income (SSI) receive a voucher or "ticket" to obtain services from qualified employment networks (ENs). ENs provide employment services and supports to designated beneficiaries and must meet certain qualification requirements. The ADA is applicable to ENs in several ways: primarily, in the EN's responsibility to provide appropriate access and services to program participants. This article discusses application of the ADA to the Ticket Program as ENs begin to serve program beneficiaries.

Consumer Advocacy↗