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PubMedDate not supplied

Use of exit examinations: a criterion for graduation?

This study sought to measure the use of exit examinations in nursing schools at Historically Black Colleges and Universities (HBCU). Fifteen participants from HBCU nursing schools throughout the United States were surveyed to determine current practices related to exit exams. Overall, fourteen schools (93.33%) used an exit exam at the end of their nursing program. However, 73.33% of the participants (11 schools) reported it was mandatory for students to pass the exam as a requirement for graduation. Almost 47% of the participants (7 schools) reported the use of the exit exam was related to NCLEX-RN pass rates, while others reported identification of student needs as the primary reason for using an exit exam. Most participants were very helpful by sharing their innovations. While this small study provided some information on the use of exit examinations, more research is needed to substantiate both the appropriateness and usefulness of their use in baccalaureate degree nursing programs.

Black or African American↗
PubMed2003

Enhancing resident training in abortion and contraception through hospital-community partnership.

OBJECTIVES: The study was undertaken to assess the efficacy of a hospital-community rotation in abortion and contraception. STUDY DESIGN: The program was developed and implemented by the Planned Parenthood League of Massachusetts (PPLM) and the Department of Obstetrics and Gynecology at Baystate Medical Center in November 2000. Abortion and contraceptive training is integrated into postgraduate year 3 and includes didactic presentations and 10 mandatory clinical sessions in first trimester abortion care. RESULTS: Five residents complete the program annually. Before rotation, residents report their competence in first-trimester abortion procedure as 2 on a scale of 1 to 5 (1=not at all comfortable, 5=very comfortable). After rotation, the reported competency rating is 4.5 on the same scale. Residents, trainers, and staff report high satisfaction with the program. CONCLUSION: A collaborative hospital-community rotation in abortion and contraception increases residents' clinical competence in these areas and is highly acceptable to residents, faculty, and staff.

Abortion, Induced↗
PubMed1983

Imipramine as treatment for depression in addicts.

This report describes the results of a placebo-controlled double-blind clinical trial evaluating imipramine hydrochloride, a tricyclic antidepressant, as treatment for depression in methadone-maintained opiate addicts. Forty-six subjects were assigned randomly to either the imipramine or placebo group for up to eight weeks. All patients also received mandatory once weekly group therapy as part of the methadone program. Outcome measures included attrition, depressive symptoms, global improvement, side effects, social functioning, and urine specimen results positive for illicit drugs. The therapeutic response in the two conditions was similar. Addicts receiving either imipramine or placebo experienced a substantial reduction of depressive symptoms during the eight weeks of the study. These findings are compared with other studies that treat depression in addicts and nonaddicts.

Adult↗
PubMed1993

Bone-lead analysis: development of analytical methodology for milligram samples.

A graphite platform-in-furnace atomic absorption spectrometric (GFAAS) method for determining micrograms/g levels of Pb in 10-20 mg cortical and trabecular primate bone samples is described. The GFAAS method is based on an ambient temperature nitric acid digestion of the sample, matrix modification with palladium nitrate, stabilized temperature platform furnace atomization, and a systematic evaluation of the temperature program of the atomizer. The method of standard additions is mandatory. The detection limit (3 standard deviations of the blank) is 0.19 micrograms Pb/g dry weight for a 10-mg sample taken up in a 1-mL volume. Data are presented on the degree of accuracy and precision. The accuracy of the proposed GFAAS method has been assessed using the IAEA bone reference material, H-5, and by comparing the values obtained in a bone sample with an isotope dilution mass spectrometric (IDMS) procedure. The GFAAS method can be applied to the determination of Pb in 10-20 mg bone samples and for concentrations which are > or = 10 x detection limit. The method is simple, fast, and contamination-free since the entire operation from weighing to GFAAS measurement is carried out in the same centrifuge tube. The method has been applied to the determination of total-Pb in some adult and fetal primate cortical and trabecular bone specimens.

Animals↗
PubMed1999

[Use of the DICOM standard in a heterogenous environment. Incompatibility or inoperability?].

PURPOSE: The DICOM standard, introduced in 1993, is now established in many of today's image modalities. Experiences with DICOM implementations and requirements for future developments are described. METHODS: First a brief summary of the development of the DICOM standard is given. Based on general observations, different problems with installation, programming and maintenance are outlined. RESULTS: The standard consists of mandatory and optional information models and functionalities to enable the use and development of a broad spectrum of applications. But the available options lead to specific applications not compatible with the basic idea of the standard. DISCUSSION: For functional communication distinct DICOM services are necessary. This includes DICOM Basic Worklist, Storage Commitment and Performed Procedure Step. A constructive way to achieve inter-operability through voluntary arrangements between manufactures and users will be shown.

Diagnostic Imaging↗
PubMed1998

Increasing employment of opioid dependent outpatients: an intensive behavioral intervention.

The impact of a new, mandatory employment requirement in a community-based methadone treatment program was evaluated. All patients who had been in the methadone substitution program for at least 1 year but who were not currently employed (n = 36) were required to enhance their treatment with 20 h of employment (paid or volunteer). Patients with significant psychiatric or medical disabilities were excluded from the routine treatment requirement. Patients were informed by counseling staff that they had 2 months to secure employment. Those who did not accomplish the goal within that time period were transferred to more intensive weekly counseling (i.e. up to 8 h/week) for 10 weeks, with the enhanced counseling focusing primarily on resistance to the employment goal. Patients who remained resistant to the treatment plan were eventually started on a 21 day methadone taper until employment was verified. Seventy-five percent of the patients secured employment and maintained the position for at least 1 month. Positions were found in an average of 60 days. Most patients (78%) continued working throughout the 6-month follow-up. Those who failed to find work or maintain employment engaged in more illicit drug use. These results demonstrate that behavioral contingencies can motivate many methadone maintenance patients to obtain verified employment in the community.

Adult↗
PubMed2002

[Obstetrics and gynecology--retrospect of 125 years in Basel].

The development of the discipline Obstetrics and Gynecology is reflected by the medical history at the University of Basel. At the very beginning of academic obstetrics, the cantonal government realised the need of a more practical teaching completing the tradition of theoretical lecturing (1865). Obstetrics was (and still is) a typical example for the turn from theoretical to hands-on-teaching in medicine. At the time, when the independent chair of obstetrics at the University of Basel was founded (1867, Bischoff [1841-1892]), the fight against puerperal fever was the most urgent aim. The battle against puerperal fever was ultimately won around the turn of the 19th to the 20th century (von Herff [1856-1916]) but not much earlier. Step by step the gynecology grew out of the classical surgery where it has been located previously. Surgically skilled obstetricians like Fehling [1847-1925] and Bumm [1868-1925] have enhanced that development. Clinical research started with better information about the lying-in patients (Fehling, Bumm, Labhardt). Bacteriology in close connection with obstetrics was seen important (Bumm). Some decades later, clinical laboratories (clinical chemistry) were founded accompanying the diagnostic approach to various disorders of pregnancy (Labhardt [1874-1949]). Exfoliative cytology became mandatory since 1950 and this was the start to screening programs for early diagnosis of cervical cancer (Koller [1899-1985]). The family planning exploded in the years from 1965 on as the pill has been available, replacing sterilisation-procedures (Labhardt). Endocrinology of pregnancy and cycle needed new biochemical methods. The laboratories were installed. Responding to the demands of a growing discipline, the building was enlarged and adapted in three major steps: 1896 new "Frauenspital", 1928 first enlargement, 1956-1968 constructing of two more storeys, of new surgical theatres and an entire tract for routine and scientific laboratories filling now the area between Klingelberg-, Schanzen- and Spitalstrasse. The hospital harboured in its peak time (1968-1970) more than 300 beds. In 1959 the hospital staff took care of 5000 deliveries (Koller). Fetal monitoring was introduced 1962, being the starting point for the development of "fetal medicine" in Basel. At that time, Otto Käser [1899-1995] was chairman. He was appreciated as one of the most brilliant pelvic surgeons in Europe. Soon, the surgery for breast cancer was added to the classical gynecologic surgery. At the same time, ultrasound started to dramatically influence diagnostic procedures in pregnancy. In the eighties, in-vitro-fertilization and embryo-transfer improved the possibilities to overcome unwanted childlessness (Ludwig [*1929]) and supplemented endocrinology. The scientific spectre spread heavily to reproductive medicine since then, in particular to the molecular biology and research on stem-cells, which was introduced by the present chairman (Holzgreve [*1955]). He has founded several research groups concentrating on the retrieval of floating fetal cells from cord and maternal blood, on other topics in fetal cell research, prenatal diagnosis and in ultrasound.

Female↗
PubMed1998

A review of journal clubs in postgraduate medical education.

OBJECTIVE: To review the goals, organization, and teaching methods of journal clubs, summarize elements of successful clubs, and evaluate their effect on reading habits, and effectiveness in meeting teaching goals. Examples of clubs that utilize principles of adult learning are reviewed. DATA SOURCES: English language articles identified through a MEDLINE search (1966-1997) using the MeSH terms "internship" and "residency," and text words "journal club" and "critical appraisal." STUDY SELECTION: Articles on learning goals and organization were included if they represented national or regional surveys with a response rate of 65% or greater. Articles that evaluated teaching effectiveness were included if they used a controlled, educational design, or if they exemplified important adult learning principles. DATA EXTRACTION: Data were manually extracted from selected studies and reviews. DATA SYNTHESIS: A major goal for most clubs is to teach critical appraisal skills. Clubs with high attendance and longevity are characterized by mandatory attendance, availability of food, and perceived importance by the program director. Residents who are taught critical appraisal report paying more attention to the methods and are more skeptical of the conclusions, and have increased knowledge of clinical epidemiology and biostatistics, but studies have failed to demonstrate that these residents read more, or read more critically. Reading guidelines may be useful for teaching critical appraisal skills, and may be associated with increased resident satisfaction. CONCLUSIONS: Journal club formats are educationally diverse, can incorporate adult learning principles, and are an adaptable format for teaching the "new basic sciences."

Adult↗
PubMed2000

A model intervention for elder abuse and dementia.

This article describes a 2-year collaborative project in Cleveland, OH, that improved the reporting and management of potential and suspected elder abuse situations involving persons with dementia. Educational curricula for cross-training, screening tools, and referral protocols were developed and tested for staff and volunteers in adult protective services and dementia care. A handbook for caregivers of persons with dementia was produced that enables caregivers to self-identify elder abuse risk and seek appropriate interventions to prevent abuse. Project organization, implementation, and evaluation are discussed along with strategies for replication in other communities.

Academies and Institutes↗
PubMed1998

Thunderstorm asthma due to grass pollen.

It is widely known and accepted that grass pollen is a major outdoor cause of hay fever. Moreover, grass pollen is also responsible for triggering allergic asthma, gaining impetus as a result of the 1987/1989 Melbourne and 1994 London thunderstorm-associated asthma epidemics. However, grass pollen is too large to gain access into the lower airways to trigger the asthmatic response and micronic particles <5 micro m are required to trigger the response. We have successfully shown that ryegrass pollen ruptures upon contact with water, releasing about 700 starch granules which not only contain the major allergen Lol p 5, but have been shown to trigger both in vitro and in vivo IgE-mediated responses. Furthermore, starch granules have been isolated from the Melbourne atmosphere with 50-fold increase following rainfall. Free grass pollen allergen molecules have been recently shown to interact with other particles including diesel exhaust carbon particles, providing a further transport mechanism for allergens to gain access into lower airways. In this review, implication and evidence for grass pollen as a trigger of thunderstorm-associated asthma is presented. Such information is critical and mandatory for patient education and training in their allergen avoidance programs. More importantly, patients with serum IgE to group 5 allergens are at high risk of allergic asthma, especially those not protected by medication. Therefore, a system to determine the total atmospheric allergen load and devising of an effective asthma risk forecast is urgently needed and is subject to current investigation.

Allergens↗
PubMed2000

Developing a safety protocol in qualitative research involving battered women.

Qualitative research involving battered women requires advanced planning to protect participants and the investigator from the risk of violence from an abusive partner. Domestic violence creates a potentially dangerous research environment that is seldom discussed in the literature. The use of a safety protocol has been advocated as a way to ensure that research is conducted with maximum safeguards for the participating women. In this article, the author presents a safety protocol developed for a study of battered women's perceptions of danger in their relationship. Issues that relate to safety contacting participants, conducting the interviews, and protecting data are discussed.

Attitude to Health↗
PubMed2002

Physical activity levels of Barbadian youth and comparison to a U.S. sample.

This is the first study to report on physical activity levels of young people in Barbados. The Self-Administered Physical Activity Checklist was administered to 1,579 children aged 8 to 18 years. The majority of youth (69%) reported at least 60 min of physical activity on the previous school day. Boys and younger students reported greater physical activity than girls and older students (p < .001). Participation in physical education was low among primary (30%) and secondary (18%) school students, and youth reported the majority of their physical activity took place after school (58%). Physical activity levels and patterns were similar to those of U.S. youth. Gender and grade differences in physical activity could put girls and older youth at higher risk for health problems such as obesity. Policy recommendations to support youth physical activity in Barbados include mandatory daily physical education and after-school physical activity programs.

Adolescent↗
PubMed2003

Drugs, prisons, and harm reduction.

The use of drugs in society raises important considerations for health and social policy. Critical health and social care issues arise when drugs are used inside prisons. This paper argues that there is an urgent need for prison drug policies to adopt the principles of harm reduction. However, current policy orthodoxy emphasises the control of drugs and punishment for drug taking. Key components of harm reduction are operationalised in this article by exploring the potential for harm reduction in prison within the context of English drug policy. Whilst the focus is on English policy debates, the discussion will have wider international resonance.

Community Health Services↗
PubMed1999

Applications of forensic identity testing in the clinical laboratory.

DNA analysis is becoming routine in the clinical laboratory for the diagnosis of human diseases using various tissue sources. Most clinical specimens are followed by tracking forms that include patient demographic data, accession number, and date and time of collection. As part of a thorough quality assurance program, proper documentation of test requisitions and tracking forms is mandatory. Despite these efforts, specimen mislabeling or other mix-ups can, and do, occur. We demonstrate the utility of the PM + DQA1 typing kit and STR analysis using the Visible Genetics automated DNA sequencing system in the proper identification of such clinical specimens as urine, blood, and paraffin-embedded tissues. In each case, sufficient DNA was extracted from these specimen types using a nonorganic extraction protocol for typing purposes. We conclude that DNA typing methods are feasible for distinguishing clinical laboratory specimens of questionable identity and compliment existing quality assurance techniques.

Blotting, Southern↗
PubMed1989

[Late results with hybrid dentures in low-income patients. An investigation at the Cantonal Public Dental Clinic of Zurich].

72 patients who had received overdentures at the Cantonal Public Dental Clinic of Zurich during a period of ten years (1970-1980) were called for re-examination. Results obtained were evaluated according to an analogous survey which had been conducted 12 years previously at the same public dental clinic (Wiesmann 1975): The test subjects of both studies belonged exclusively to the lower-income population and treatment was performed by post-graduate dentists employed at the clinic. A comparison with Wiesmann's findings demonstrated a definite improvement in the general oral health conditions of these wearers of hybrid prosthesis. Since 1972 a recall system has been successively introduced which, for the greatest part, offers the most probable explanation for these positive findings. Each patient was summoned for at least one dental examination per year, thereupon presenting better results in regard to average plaque index, carious lesions, degree of gingival inflammation, probing depth and functionality of the prosthetic appliance, a marked difference to those patients who did not participate in such a dental maintenance program. Therefore, the regular motivation and supervision of patients is mandatory for long-term success of overdenture treatment.

Aged↗
PubMed1979

The first year of operation under the new Patuxent law.

To summarize briefly, it can be said that the new Patuxent admissions are approximately in the same age range, but more often black and from urban areas. The seriousness of their crimes is significantly higher than in the old Patuxent population. It may be said with some assurance that the change of the law has been a positive step towards making the Patuxent Institution a more treatment-oriented place, since there is no more mandatory indeterminate incarceration of persons unwilling to participate in the program. On the other hand, a number of persons who could eventually be reached by the prolonged stay at the Institution under the indeterminate sentence are now lost to the treatment process and they will be eventually released as potentially dangerous persons into society.

Adolescent↗
PubMed1999

[An experimental quality assurance program for asbestos measurements performed with x-ray diffractometry in bulk samples].

A quality assurance program for the diffractometric determinations of asbestos in bulk samples is presented. The program, developed upon request of the Italian Health Ministry, includes two tests: the qualitative determination of the asbestos forms present in three samples and their quantitative measurements. The samples to be analyzed, the asbestos standards and the criteria for results evaluation are described in detail. The program will start in the year 2000. Compliance with the tests minimum requirements will be considered mandatory for a public or private laboratory be legally allowed to work in the field of asbestos determinations by X-ray diffractometry. The description of the program is preceded by an in-depth discussion on the definition of the terms "quality control" and "quality assurance", which are often confused, and on their operational meaning when they are applied to laboratory measurements. The analytical difficulties involved with the measurement procedures currently used are also discussed. Moreover, the results of a preliminary intercalibration test among fifteen Italian laboratories of proven experience are reported since they provided important information for the arrangement of the present quality assurance program.

Asbestos↗