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PubMed1997

How the occupational physician works with the unions.

A few attitudinal and behavioural principles will bring about a productive liaison between the occupational physician and trade unions. An effective working relationship with these organizations and employee associations can be developed, provided the occupational health care professionals are impartial in their practice, the loyalty to medicine replacing any bias toward the favouring of a managerial view. Respect must be given union officials, for in their organization they have status and can advance or defeat various health programs. Union representation on an occupational health committee will gain union support and minimize the filing of health-based grievances. The presentation of occupational health information at union meetings will communicate the goals of in-plant programs and familiarize workers, through their accustomed channels, with the objectives of health care policies and procedures.

Health Education↗
PubMed2004

Behavioral interventions to reduce incidence of HIV, STD, and pregnancy among adolescents: a decade in review.

PURPOSE: To review adolescent sexual risk-reduction programs that were evaluated using quasi-experimental or experimental methods and published in the 1990s. We describe evaluated programs and identify program and evaluation issues for health educators and researchers. METHODS: We systematically searched seven electronic databases and hand-searched journals to identify evaluations of behavioral interventions to reduce sexual risk behaviors among adolescents. Articles were included if they were published in the 1990s, provided a theoretical basis for the program, information about the interventions, clear aims, and quasi-experimental or experimental evaluation methods. We identified 101 articles, and 24 met our criteria for inclusion. RESULTS: We reviewed these evaluations to assess their research and program characteristics. The majority of studies included randomized controlled designs and employed delayed follow-up measures. The most commonly measured outcomes were delay of initiation of sexual intercourse, condom use, contraceptive use, and frequency of sexual intercourse. Programs ranged from 1 to 80 sessions, most had adult facilitators, and commonly included skills-building activities about sexual communication, decision-making, and problem solving. The programs included a wide range of strategies for content delivery such as arts and crafts, school councils, and community service learning. CONCLUSIONS: Analysis of these programs suggest four overall factors that may impact program effectiveness including the extent to which programs focus on specific skills for reducing sexual risk behaviors; program duration and intensity; what constitutes the content of a total evaluated program including researchers' assumptions of participants' exposure to prior and concurrent programs; and what kind of training is available for facilitators.

Adolescent↗
PubMed1994

Video home training (the Orion project): a short-term preventive and treatment intervention for families with young children.

Developed in Holland and based on short-term, home-centered, filmed video feedback of family interactions, an experimental Orion project was conducted in Israel to determine whether it could be provided through local welfare departments as a routine treatment alternative. This article summarizes an evaluation of 52 families (with problems in parent-child interaction) and 64 control families that participated in the Orion Video Home-Training Project. Only the Orion families showed significant gains in all the eight areas of positive parent-child communication that are the focus of the program, which is based on reinforcing potential family strengths. These gains were generally sustained 6 months after program completion. There were several background variables, such as family status, income, health, education, and employment, that influenced the extent of family gains.

Adolescent↗
PubMed2002

Writing effective consultation letters: 12 tips for teachers.

Written correspondence is the standard mode of communication between healthcare providers. Despite the importance of this skill and increased emphasis on ambulatory care, communication skills and professionalism in training programs, there has been very little written on the teaching and evaluation of consultation letter writing. Consultation letter writing is an essential skill that cannot be learned simply by reading others' letters and should be taught in a formal manner. This article describes the authors' experience in teaching the skill of writing effective consultation letters to residents and describes strategies for evaluating this skill.

Canada↗
PubMed2004

Clinical education of ethicists: the role of a clinical ethics fellowship.

BACKGROUND: Although clinical ethicists are becoming more prevalent in healthcare settings, their required training and education have not been clearly delineated. Most agree that training and education are important, but their nature and delivery remain topics of debate. One option is through completion of a clinical ethics fellowship. METHOD: In this paper, the first four fellows to complete a newly developed fellowship program discuss their experiences. They describe the goals, structure, participants and activities of the fellowship. They identify key elements for succeeding as a clinical ethicist and sustaining a clinical ethics program. They critically reflect upon the challenges faced in the program. RESULTS: The one-year fellowship provided real-time clinical opportunities that helped them to develop the necessary knowledge and skills, gain insight into the role and scope of practice of clinical ethicists and hone valuable character traits. CONCLUSION: The fellowship enabled each of the fellows to assume confidently and competently a position as a clinical ethicist upon completion.

Bioethics↗
PubMed1997

Design, development, and evaluation of visual aids for communicating prescription drug instructions to nonliterate patients in rural Cameroon.

In this study, culturally sensitive visual aids designed to help convey drug information to nonliterate female adults who had a prescription for a solid oral dosage form of antibiotic medications were developed and evaluated. The researchers conceptualized the educational messages while a local artist produced the visual aids. Seventy-eight female ambulatory patients were evaluated for comprehension and compliance with antibiotic prescription instructions. The study was conducted in three health centers in Cameroon, West Africa and followed a pre-test, post-test, and follow-up format for three groups: two experimental, and one control. All participants were randomly assigned to either experimental or control groups, 26 patients to each group. Subjects in the experimental groups received visual aids alone or visual aids plus an Advanced Organizer. A comparison of the three groups showed that subjects in the experimental groups scored significantly higher than the control group in both the comprehension and compliance measures.

Adolescent↗
PubMed2000

Teaching children about health: an example of secondary gain in an academic-community partnership.

CONTEXT: The Partners in Health Education (PHE) program is an elective that pairs first and second year medical students with local classroom teachers to promote health messages to students in kindergarten through grade eight. Designed with the primary goal of helping medical students improve their communication skills through the process of teaching children about health, the PHE program has secondary goals of supporting community teachers in their efforts to promote health and of teaching children about health and the prevention of disease and injury. This report contains the results of the assessment of program impact on the school children. METHODS: A total of 327 elementary grade students in 14 experimental classrooms and 13 comparison classrooms comprised the participants for the study. Students were individually interviewed twice over an eight-week period using a structured interview form designed to capture self-report information about health and healthy living. Repeated measures analysis of variance was conducted. The effect of interest in each case was the treatment x time interaction. RESULTS: There were significant treatment x time interactions for several measures of children's reported knowledge and attitudes about health. DISCUSSION: Although designed primarily to help medical students improve their communication skills, the PHE program produced a secondary gain such that elementary students in participating classrooms reported learning more about health than did students in comparison classrooms. Programs such as PHE can provide ways to meet the goal of helping children become empowered to take charge of their own health and to make healthy choices.

Journal Article↗
PubMed1991

A parallel computing approach to genetic sequence comparison: the master-worker paradigm with interworker communication.

We have implemented a parallel version of a dynamic programming biological sequence comparison algorithm to study the potential applicability of using parallel computers for genetic sequence comparisons. Our parallel program is built using C-Linda, a machine-independent parallel programming language, and was tested on both a 10 CPU Sequent Symmetry and a 64 CPU Intel Hypercube. C-Linda implements a shared associative memory model, "tuple space," through which multiple processes can communicate and coordinate control. In our master-worker (MW) parallel implementation, a master process creates several worker processes, extracts a test sequence and multiple library sequences from a database and stores them in tuple space. Each worker reads the test sequence and then repeatedly extracts library strings from tuple space, performs pairwise sequence comparison using a local comparison algorithm to generate a similarity score, and returns the similarity scores to tuple space. The master collects the scores from tuple space and identifies the best match over all library sequences. We also implemented a method of global interworker communication to reduce the total search time by stopping those string comparisons that had no chance of improving on the current best match. Comparisons of the total run time, speedup, and efficiency were made for parallel and sequential versions of a basic MW implementation as well as versions with the global abort threshold.

Algorithms↗
PubMed2003

Effect of nutrition education of mothers on infant feeding practices.

OBJECTIVE: To assess current infant feeding practices (IFP) in a relocated slum, to identity the lacunae, to outline, implement, and evaluate the gain in awareness and IFP followed by mothers. METHODS: Thirty-five mothers of infants aged 5-19 months were interviewed. Based on lacunae, Nutrition Education (NE) was imparted to mothers over two months. Tools used were individual counseling, participatory learning methods, positive deviance and early adopters approach aided with existing information education communication materials. Monthly weight and length of infants was also taken. Awareness and practices on infant feeding (IF) were reviewed at mid and post NE. RESULTS: Areas of concern at baseline were (i) discarding colostrum (77.0%), (ii) feeding prelacteals (80.0%), (iii) initiation of breast-feeding (BF) after 3 days (54.3%), (iv) absence of exclusive breast-feeding (86.3%), (v) delayed complementary feeding (CF) and (vi) feeding CF grossly inadequate in quality, quantity, frequency and consistency. Post NE results revealed an improved awareness about IF amongst the mothers. An improvement was seen in variety, quantity and consistency of CF fed. Active feeding behaviours were adopted (6.6% pre-NE vs 66.6% post-NE). Early adopters (24%) served as motivators. Weight for age and weight for length showed improvement. CONCLUSION: NE programs of shorter duration using a 'communication mix' of channels with repeated reinforcement can bring about improvement not only in awareness but also in IFP.

Adult↗
PubMed1999

Customer focus: patient, organization and EQuIP in collaboration. Evaluation and Quality Improvement Program.

The Australian Council on Healthcare Standards (ACHS) Evaluation and Quality Improvement Program (EQuIP) calls on healthcare organizations to increase their focus on patients by using leadership to coordinate, and continuous improvement to guide, care delivery. At a large acute care private facility in Melbourne, a program has been developed to create a 'care partnership', characterized by shared decision making, collaboration and conciliation. This program enhances patient care through the coordination of three strategies, a patient communication strategy, an evaluation strategy and a quality improvement strategy. The program has resulted in patient guided reforms such as redesign of a patient information booklet, a hospital-wide discharge planning improvement initiative and a hospital-wide strategy to improve pain management. Through the creation of a care partnership, this program helps an acute care hospital focus its services and processes on one of its key customer groups, patients.

Australia↗
PubMed2005

Patient-physician communication in oncology: past, present, and future.

PURPOSE OF REVIEW: Contemporary oncology practice acknowledges the importance of partnering with the patient and family in dealing with the illness. Patients also value their physicians as important sources of support when they provide information about the illness, encouragement, and hope, discuss treatment options, and address their concerns. For this reason outcomes associated with the quality of the physician-patient relationship have received increasing recognition. This review highlights relevant studies bearing on important outcomes of communication with the cancer patient and discusses the implication for training oncologists of the future. RECENT FINDINGS: Evidence is mounting that effective and empathic communication with the cancer patient and family can influence desirable outcomes in cancer care, which affect patient quality of life, satisfaction with care, and medical outcomes. Evidence also exists that communication and interpersonal skills can be taught and learned. Oncology training programs traditionally do not offer experience in this aspect of care although communication skills have now been defined as a core competency for oncology trainees. Finding motivated faculty to teach and providing time and structure in the curriculum are also major obstacles to be overcome. SUMMARY: Communication skills are the cornerstone of comprehensive cancer care. Learning this aspect of patient care can expand the supportive role of the oncologist especially at crucial times for the patient and family such as diagnosis, disease recurrence, and transition to palliative care.

Communication↗
PubMed1997

Evaluate and communicate health care benefits.

Both employers and employees need appropriate information to make intelligent decisions about health care benefits. For employers, analysis of health care data offers an approach to monitoring quality care and can provide a tool for controlling costs. For employees, an education and communication strategy is probably the single most important factor influencing both program utilization and employee acceptance.

Communication↗
PubMedDate not supplied

The role of information, education, and communication in family planning service delivery in Tunisia.

In an effort to measure the value of outreach, a prospective study using an experimental comparison group design was implemented in a rural region of Tunisia, where an outreach program had been implemented in 1981 to increase contraceptive prevalence. The main components of the program included the improvement and expansion of rural health care services through mobile clinics, and the implementation of an information, education, and communication (IEC) outreach program. While the program tended to focus on the implementation of the mobile clinics, service statistics suggested that the IEC outreach component in fact accounted for much of the success of the program. The study shows that the addition of outreach to existing services more than doubles the number of new family planning acceptors, and that outreach has a more positive impact on service output than does the creation of new services.

Communication↗
PubMed2006

Targeted selective treatment for worm management--how do we sell rational programs to farmers?

Seriously escalating global anthelmintic resistance in gastrointestinal nematodes of small ruminants has spawned a variety of alternatives to anthelmintics for worm management, based on the need for sustainable Integrated Parasite Management (sIPM). Pivotal to the sIPM approach is the concept of refugia, the proportion of a given parasite population that escapes exposure to control measures. By balancing drug applications with the maintenance of refugia, the accumulation of anthelmintic resistance alleles in worm populations can be considerably delayed, while still providing good levels of control. The over-dispersed nature of parasitic infections provides an opportunity to achieve this balance, by targeting treatments to the members of a flock or herd that are least tolerant to nematode infection. However, implementation of this strategy has only recently become feasible, with the development of the FAMACHA((c)) system for clinical evaluation of anaemia due to haemonchosis. Subsequently, the use of milk yields has proven an effective indicator in dairy goats infected predominantly with nematodes other than Haemonchus contortus. In addition, short-term weight changes and perhaps also body condition scoring may provide indices of parasitism, permitting the rapid identification of animals likely to benefit from treatment. However, sIPM and refugia-based approaches are more complex than whole-flock treatments in conventional programs, and adoption by farmers is most likely where the theoretical basis is understood. As close communication with informed advisors is generally limited, there is a danger that sIPM will remain a theoretical concept without alternative modes of communication. The development of computer-based decision support programs, which use epidemiological, seasonal and clinical information to provide recommendations for specific situations, should be accorded high priority in the future development of worm management systems.

Animal Husbandry↗
PubMedDate not supplied

Tribal education: reflections from the Pine Ridge Indian Reservation.

Attracting and retaining Native American students in tribal nursing programs is crucial to the health and well-being of Native American populations. The authors share their experiences teaching nursing in the associate degree program at the Oglala Lakota College on the Pine Ride Reservation in South Dakota. The authors communicate the importance of the work of tribal nursing programs and illustrate the experience as an opportunity for nurses who are interested in cross-cultural development.

Cultural Characteristics↗
PubMed1991

Maximizing communication skills in graduate and postgraduate health-care education through medical writing.

Graduate and postgraduate health-care professional training and postdoctoral fellowship programs that deny trainees opportunities to practice both oral and written communication skills produce an incompletely trained health-care provider unable to compete for faculty positions at university hospitals and affiliated staffs. Therefore, it is imperative that program directors make medical writing a prerequisite to successful completion of postgraduate training programs. To make trainees as well as administrators and faculty aware of the importance of oral and written communication skills, a variety of oral abilities needed for presenting medical findings prior to publication are detailed. The use of 2 x 2 slides to support a presentation as well as transparencies, movies, and videotapes are considered. The poster session/scientific exhibit, now becoming more visible because of increasing attendance at professional meetings, is also explained. Written communication abilities are discussed. Consideration is given to the writing of professional manuscripts for publication in a refereed journal. Other types of written communication include case reports, clinicopathological conferences, letters to the editor, book reviews, books, and book contributions. The opportunity to learn needed skills must be offered in the postgraduate health-care curriculum. Mandatory medical writing will maximize the marketability of black health-care professionals for faculty staff placement. Moreover, the establishment of a "track record" early in a professional career will increase the likelihood that black health providers are awarded grants for research.

Audiovisual Aids↗