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ALERT: a clinical case simulator program for serious, communicable, and rare diseases.

ALERT is an intelligent Tutoring System (ITS) based on clinical case simulation. Its purpose is to assist in the training of general practitioners regarding the diagnosis and the control of serious, communicable, and rare diseases, such as anthrax, plague, and smallpox. ALERT provides both monitoring techniques and treatment protocols and is structured into two independent sections: one devoted to the simulation of the clinical case and the other to detailed description of disease.

Communicable Diseases↗

Role of health communications in Russia's diphtheria immunization program.

As part of a broader program in health communication assistance, project staff from Basic Support for Institutionalizing Child Survival worked with staff from Russia's oblast (regional) public health agencies to design and implement communication activities supporting local diphtheria immunization efforts. Because aggressive community outreach efforts and strong administrative sanctions had already achieved impressive adult coverage rates for first doses of diphtheria toxoid vaccine, communication interventions emphasized the need for second and third doses. Outcomes were assessed through vaccination coverage data and more qualitative measures. In one project site, the increase in adult coverage (two or more doses) was very modest. In a second site, with a stronger communications component, coverage increased significantly (from 20% to 80%). Although it is not possible to disentangle completely the effects of communications from other aspects of oblast immunization programs, these and other outcome data suggest that health communications can play an important role in Russia's ongoing mass immunization efforts.

Adult↗

[General aspects of the development of a program of non-verbal communication for nurses].

This study shows a program about nonverbal communication and is the continuation of a study of the failures in the perception of nonverbal communication in nurses who assist patients in nursing consultation. This study is one of the first to discuss the theme and describes the theoretical frameworks that legitimate its existence: LUFT & INGHAM (1961); BIRDWHISTELL (1970); HALL (1986); STEINBERG (1988); SILVA (1989) and GAGNE (1980).

Curriculum↗

A fast, portable desaccading program.

This short communication reports a program for detecting and removing saccades, quick phases and blink signals from eye movement records to allow determination of slow phase eye velocity (SPV) during vestibular stimulation. The program is written in C and is simple, fast, and independent of computer type.

Algorithms↗

Beyond hearing aid fitting: improving communication for older adults.

Many older adults with hearing impairment continue to have substantial communication difficulties after being fitted with hearing aids, and many do not choose to wear hearing aids. Two group communication education programs aimed at such older people are described. The 'Keep on Talking' program has a health promotion focus, and is aimed at maintaining communication for older adults living in the community. An experimental group (n = 120) attended the program, and a control group (n = 130) received a communication assessment but no intervention. Significant improvements were found in the experimental participants in terms of knowledge about communication changes with age and about strategies to maintain communication skills. At the follow-up evaluation at 1 year, 45% of the experimental group, compared to 10% of the control group, had acted to improve their communication skills. The 'Active Communication Education' program focuses on the development of problem-solving strategies to improve communication in everyday life situations. Preliminary outcomes have been assessed on a small scale (n = 14) to date. It is concluded that communication programs represent an important adjunct to, or supplement for, the traditional approach that focuses on hearing aid fitting.

Activities of Daily Living↗

Acquisition of spoken and signed English by profoundly deaf children.

A sample of 327 profoundly deaf children from oral/aural (OA) and total communication (TC) programs across the country was tested on the Grammatical Analysis of Elicited Language--Simple Sentence Level (GAEL-S), which measures production of selected English language structures. Results were analyzed separately for four different response modes: the oral productions of OA children, the oral productions of TC children, the manual productions of TC children, and the combined productions of TC children. Percentage correct scores for the oral productions of TC children were substantially below scores for their manual productions and below the scores of OA children in all grammatical categories sampled on the GAEL-S. The percentage correct scores of OA children were significantly higher than the manual and combined production scores of TC children in more than 50% of the grammatical categories. The manual scores of TC children significantly exceeded the scores of OA children in less than 20% of the categories. The gap between oral and manual production of the children in total communication programs indicates that spoken English did not develop simultaneously with manually coded English and that these children educated in programs using manually coded English did not develop competence with early developing English syntax at a rate faster than those not using signs.

Age Factors↗

[Life style: instrument in health promotion programs].

Non communicable diseases are increasing in third world countries, including Chile. Life style is one of the principal factors influencing this increase. Therefore programs and health strategies to modify the population life styles are needed. The programs developed to change life styles depend on the medical sociocultural scenery and the concept becomes outstanding when disease prevention is replaced by health promotion. The requirements for the application of the concept of life style in health promotion plans and fostering of healthy life styles are: 1) Training in behavioral epidemiology. 2) Election of a biopsychosocial concept of life style. 3) Identify the predominant scenery and target population. 4) Choose the appropriate educational methodologies to change behaviors. 5) Formalize strategies according to the boundaries where the program is applied. 6) Specify the qualifying requisites of the change agents, health promoters and program operators.

Health Behavior↗

The differential impact of work-oriented vs. communication-oriented juvenile correction programs upon recidivism rates in delinquent males.

This study examined recidivism rates in work-oriented (N = 30) and communication-oriented (N = 30) juvenile delinquency programs for males. Both groups were matched for age, ethnic origin, educational achievement, and reading scores. Chi-square analyses indicated significant differences in recidivism rates between groups in both residential (chi2 - 6.71, df = 1, p less than .01) and aftercare (chi2 = 3.89, df = 1, p less than .05) programs. In each phase of the treatment program, recidivism was highest in the work-oriented group. The results suggested that (a) facilitation of family interaction and communication is related closely to successful treatment of the delinquent and consequent recidivism; (b) group counseling that provides the youth and parents an opportunity to learn better communication skills appears to improve family cohesion and solidarity; and (c) newer therapeutic approaches in delinquency should concentrate on filial and family-type therapies.

Adolescent↗

Functional communication with AD patients: a caregiver training program.

The loss of functional communication in Alzheimer disease (AD) results from the disproportionate breakdowns in the pragmatic and semantic areas of language in these patients. Communication breakdown is regularly listed among the top four stressors in measures of stress and burden of AD caregivers. A caregiver training program designed around seven specific communication strategies can be used to alter communication interactions. As a pilot program, the acronym FOCUSED organized the seven strategies for easy recall (Face-to-face, Orientation, Continuity, Unsticking, Structure, Exchanges, and Direct). Significant differences in both attitude toward AD patients, knowledge of AD, and knowledge of communication strategies were shown in comparisons of pre- and posttraining assessments.

Adult↗