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This paper describes the conditions for, and actually use of telematics in a regional Health Network in a Danish county. This paper gives an introductory view over the organisation of the Danish health care system, and the general practitioners place in it. The advantages experienced and the actual use of telematics in general practice today is described. Finally, the expectations for the near future is mentioned.
This article reports the results of a Saint Lucia survey, part of a larger program, that was the first to document the prevalence of suboptimal safety practices among vector control and farm workers using pesticides in the English-speaking Caribbean. Among other things, the survey found that many of 130 pesticide users surveyed were unaware that the skin and eyes were important potential routes of absorption. Over a quarter said they had felt ill at some point as a result of pesticide use. About half the respondents said they had received more than "introductory" training in safe pesticide use, and most said they always found labels or directions affixed to pesticide containers. However, about half said they never or only sometimes understood the labels, and many of those who said they understood did not always follow the instructions. About a quarter of the smokers said they smoked while using pesticides; about a sixth of the survey subjects said they ate food while using pesticides; and over 60% said they never wore protective clothing.
We present a simple application of the three-dimensional harmonic oscillator which should provide a very nice particle physics example to be presented in introductory undergraduate quantum mechanics course. The idea is to use the nonrelativistic quark model to calculate the spin-averaged mass levels of the charmonium and bottomonium spectra.
Service learning is becoming a requirement for many universities wanting to connect with the communities surrounding them while also instilling civic responsibility in their students. The process should benefit all involved. In the following case study, the authors describe their experience of initiating a service learning component in an introductory nursing course, from the design to the implementation of the project. Faculty concerns and student reactions are included.
The emerging concept of a clinical engineer is that of a practitioner of engineering science as it applies to hospital medical devices and the technology of health care delivery. Therefore, in addition to the theoretical and scientific aspects of the clinical engineer's education, there must also be some form of experiential education under proper guidance. For most university-based clinical engineering programs, this takes the form of a hospital internship. The transition between the academic environment to the hospital environment is not always a smooth one, as there is a type of "culture shock" brought on by the new and extremely demanding situation encountered in the hospital. In an effort to improve the transition from university to hospital and allow the student to focus more sharply on his or her professional goals, the concept of the clinical engineering practicum was developed. Its function is to be an introductory learning experience and half-way point between the hospital and the university.
OBJECTIVES: To gain experience with problem-based learning as a demonstration project in a medical school's curriculum renewal effort and determine if using a single facilitator to circulate among the small groups would yield positive results. DESIGN: We developed 16 cases around 4 ophthalmic problems that were used in 3-hour small-group sessions during the Introduction to Clinical Medicine semester of the second-year curriculum. A single faculty member facilitated the small groups of 4 students each that were created by self-division at each of 5 sessions. SETTING: A state-supported large Midwestern medical school. PARTICIPANTS: All students (N = 75) enrolled in the Introduction to Clinical Medicine course prior to their standard introductory ophthalmology lectures. MAIN OUTCOME MEASURES: A 5-item pretest, related to each of that day's clinical problems, was administered at the beginning and again at the end of the session as a posttest. A satisfaction questionnaire with Likert-type questions was also completed by the students at the close of the session. RESULTS: Knowledge scores showed statistically significant gains with a mean of 1.7 points. Student satisfaction was very positive--85% stated that they learned more than they would have in the traditional format and 93% agreed that they enjoyed the problem-based learning format. CONCLUSIONS: A single facilitator successfully managed small groups of students in a modified problem-based learning format that produced significant knowledge gains and high student satisfaction. This positive experience was one of the factors that led to adoption of problem-based learning into the curriculum.
Following a pretest, 11 participants who were naive with regard to various algebraic and trigonometric transformations received an introductory lecture regarding the fundamentals of the rectangular coordinate system. Following the lecture, they took part in a computer-interactive matching-to-sample procedure in which they received training on particular formula-to-formula and formula-to-graph relations as these formulas pertain to reflections and vertical and horizontal shifts. In training A-B, standard formulas served as samples and factored formulas served as comparisons. In training B-C, factored formulas served as samples and graphs served as comparisons. Subsequently, the program assessed for mutually entailed B-A and C-B relations as well as combinatorially entailed C-A and A-C relations. After all participants demonstrated mutual entailment and combinatorial entailment, we employed a test of novel relations to assess 40 different and complex variations of the original training formulas and their respective graphs. Six of 10 participants who completed training demonstrated perfect or near-perfect performance in identifying novel formula-to-graph relations. Three of the 4 participants who made more than three incorrect responses during the assessment of novel relations showed some commonality among their error patterns. Derived transfer of stimulus control using mathematical relations is discussed.
CONTEXT: There is a growing interest in and need for continuing education in medical informatics delivered by distance learning. OBJECTIVES: Implement and evaluate a distance learning introductory course in medical informatics. METHODS: A Web-based version of our on-campus "Introduction to Medical Informatics" course was implemented using streaming audio lectures, threaded discussion boards, and several other teaching modalities. Evaluation was performed using an adaptation of our on-campus course evaluation instrument. RESULTS: The course was implemented with no major technological or pedagogical problems. Student satisfaction with teaching modalities and other course modalities was high. CONCLUSIONS: The learning technologies used in this course were implemented successfully and a Graduate Certificate Program is planned to further meet educational needs in medical informatics.
This paper describes the general conditions of the social and economic dynamics of the rural area, with emphasis on the development of the factors that affect health in Mexico, and briefly analyzes the system for the education and training of manpower for health care. The author presents arguments in support of an alternative proposal for the training of the "community health technician" as a professional produced by four years of study following graduation from secondary school, and trained to take measures that contribute to the integral development of the community by acting upon the factors involved in the occurrence of pathological states, and to be the first contact for persons with medical problems. The course of training is described in terms of its ultimate purpose, which is improvement of the health status of a rural community, and of the general objectives in the "community development" and "medical care" areas. The course is administered in 25 modules as follows: four introductory modules to acquaint the student with the requirements for dealing with the areas, 11 modules on community development, eight modules on first-contact medical care, and the last two for practical exercises and community work, in which the student is required to bring all his knowledge to bear on a given community. Lastly, the course content of each semester is described together with the distribution of the theoretical and practical work in each module, and the outlook for its success, which points to the possibility of incorporating this resource into programs for extending coverage to rural areas.
Integrated gynaecological programmes play an extremely important role in total herd health control by ensuring the maintenance of optimal reproduction and production. The economic implications of reduced breeding efficiency manifest in, and are reflected by total lifetime milk production, the size of the calf drop, the availability of replacement animals and increased involuntary culling rate. Measured against production costs (feed, labour and veterinary expenses), lowered reproductive efficiency erodes the margin of profitability of the farming enterprise. Herd health programmes must be well planned, stringently implemented and regularly evaluated to ensure their effectiveness. To this end they must be based on simple and practical guidelines which can be adapted as required to cope with varied farming and management conditions. This paper outlines the setting of clear objectives, factors to consider during the introductory phasing in of an integrated gynaecological programme and details of each subsequent routine visit. Ideal objectives are presented and discussed in terms of the individual animal as well as the herd. Suggested figures for each parameter are given. The significance of oestrus observation is stressed as cardinal to the attainment of many of the set objectives. The significance of calf management as the nucleus of the production of a healthy heifer replacement herd is discussed. During the introductory phase, which can be a protracted period, the foundation for routine visits is laid. Herd structure is defined, facilities are evaluated, record systems are set up and the farmer is groomed as to his role in the successful implementation of the planned programme. The value of a control questionnaire is highlighted, and factors considered are set out. The method of the routine gynaecological programme is discussed in detail. The necessity for a standard examination list is set out and the various categories of cows to be examined on each routine visit is clearly outlined, with important factors relating to each being highlighted. Examples of the various forms used are given. Evaluation of the acquired data should be done immediately, and discussed with the farmer during the current visit. Findings can be compared with those of previous visits, analysed, and recommendations may be considered immediately in consultation with the farmer. Dairy farming is a highly complex farming enterprise involving large capital outlays, intensification of labour and astute management for optimal and economic production.(ABSTRACT TRUNCATED AT 400 WORDS)
We sought to develop a unique educational course for emergency medicine residents that provides the essential knowledge, the practical skills, and the motivation to complete a research project during the residency. A 5-day mandatory course was designed for first-year emergency medicine residents. Unique features of the curriculum include 1) didactic lectures paired with workshops teaching practical skills and 2) the use of a hypothetical research question ("mock project") that is utilized for practical experience at each step and results in an oral presentation of the completed research project. The course was evaluated with pre- and post-tests of general research knowledge, quality of the final presentations, and a post-course questionnaire. Following completion of the course, the 16 emergency medicine resident participants showed significant improvement in research knowledge, as evidenced by higher median post-test scores and an absolute increase in the pass rate of 50%. Residents' final course presentations were given ratings of "above average" to "superior" by all observing faculty members. Finally, 87.5% of the residents felt that developing a mock project during the course ("hands-on" experience) increased their confidence and interest in conducting future academic research. Thus, an introductory course in research methodology that utilizes didactic lectures paired with appropriate practical workshops and incorporates completion of a mock research project may provide an effective method for teaching emergency medicine residents to conduct research.
American Psychological Association graduate student affiliates (500) were sent surveys regarding their Rorschach training experiences and interests. From 254 valid surveys, 87% of students reported that they were offered an introductory course that included the Rorschach; only about one fourth of the students were offered an advanced course. Of the students (212) who had some Rorschach training, the majority (78%) indicated they would like to obtain more. Most students viewed the Rorschach as helpful for understanding a client's personality. More training is needed, however, in applying this understanding to treatment planning and client feedback. Students were more satisfied with their training when they (a) had more Rorschach experience (didactic, practical, and research familiarity), (b) were in a psychodynamic or eclectic versus cognitive-behavioral program, (c) were pursuing a clinical PsyD versus clinical PhD, and (d) perceived a more positive attitude toward the Rorschach in their training program. All of these variables (including training satisfaction) also were related to students' expected likelihood of using the Rorschach in their professional careers.
College students' attitudes about AIDS and people with AIDS (PWAs) were measured over a 15-year period. The AIDS Attitude Scale, designed by Shrum, Turner, and Bruce (1989; AIDS Education and Prevention, 1, 222-230), was administered to introductory psychology students (n = 1,571) at one midsized southeastern university, thus allowing direct comparison of attitudes over time. Overall tolerance about AIDS and PWAs has increased from 1986 to 2000 and robust gender differences in attitudes have been apparent over time, with females expressing more tolerant attitudes. Concerns about contagion from casual contact are diminishing as well and perceived knowledge about AIDS has increased over time. Perceptions about personal susceptibility to HIV remain low and show little relationship to attitudes about AIDS and PWAs. These data may be used to help refine HIV prevention programs for college students and provide an example of a useful approach to monitor changes in attitudes over time.
In 1998 a telemedicine network was established in South Australia and the Northern Territory to deliver educational material to professionals working in child and adolescent mental health in remote areas. The network involved a wide range of health professions, from psychiatrists to psychologists and social workers. The first 12 months of network activity were evaluated by quantitative and qualitative techniques. Four sources of data were used: an activity log, questionnaires, interviews and action research. A total of 36 telemedicine sessions were held, ranging in duration from 45 to 90 min (average 56 min) and involving a total of 45 different professionals, who participated an average of four times each (range 1-15). The most common types of session were case discussions (47%), followed by specialist seminars (36%) and administrative and introductory sessions (17%). The benefits of the network included: networking and peer support; improved efficiency and reduced travel costs; and improved efficiency of health services. The problems included: costs; lack of access to technical support; and the need for staff induction and training.
BACKGROUND: Hamot Health Foundation has been committed to and active in continuous quality improvement (CQI) since 1990. These activities have progressed from introductory quality education to application of practical CQI initiatives with the overall objective to improve the quality of patient care. During 1993, the CQI process began to focus on identifying processes requiring care at Hamot. It took shape as a five-step action planning process that focused on data to identify goals and areas for improvement. To accomplish our goal of improving the delivery of care by trimming unnecessary processes, educating Hamot's leaders in information management and decision support became a critical component in the quality improvement effort. CASE STUDY: This article describes the educational program established for vice presidents and service line managers who report to the executive vice president. It also describes how the program was designed to stimulate the use of decision support tools to meet organizational objectives. As a result of this program's success, all service lines are using decision support to support continuous quality improvement.
A project for the organisation of the new nursing degree program starting in Italy in 2001/02 is presented (national regulation published 5 June 2001). It is the fruit of the work of a group of nursing professors of the University of Insubria (Varese, Italy). After the explanation of the criteria which have led to the educative objectives construction, the choice of the scientific disciplines necessary to reach them has been made. The same educative objective have guided the amount of working hours assigned to each discipline and formative activity (according to the European credit transfer system). The characteristic elements of the project are: the presence of an introductory module among the so called "professionalising formative activities"; the centrality of these professionalising formative activities; the constant reference to a conceptual nursing model; the decision to keep the integrated courses modality beginning from the experience gained since 1992; the reduction in number of the integrated courses and therefore of the exams.
OBJECTIVE: To review the efficacy and safety of atorvastatin in the treatment of dyslipidemias. DATA SOURCES: A MEDLINE search (January 1960-April 1998), Current Contents search, additional references listed in articles, and unpublished data obtained from the manufacturer were used to identify data from scientific literature. Studies evaluating atorvastatin (i.e., abstracts, clinical trials, proceedings, data on file with the manufacturer) were considered for inclusion. STUDY SELECTION: English-language literature was reviewed to evaluate the pharmacology, pharmacokinetics, therapeutic use, and adverse effects of atorvastatin. Additional relevant citations were used in the introductory material and discussion. DATA EXTRACTION: Open and controlled animal and human clinical studies published in the English-language literature were reviewed and evaluated. Clinical trials selected for inclusion were limited to those in human subjects and included data from animals if human data were not available. DATA SYNTHESIS: Atorvastatin is a recent hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor for the treatment of primary hypercholesterolemia, mixed dyslipidemias, and homozygous familial hypercholesterolemia. In patients who have not met the low-density lipoprotein cholesterol (LDL-C) goal as recommended by the National Cholesterol Education Program Adult Treatment Panel II guidelines, atorvastatin 10-80 mg/d may be used as monotherapy or as an adjunct to other lipid-lowering agents and dietary modifications. In placebo-controlled clinical trials, atorvastatin 10-80 mg/d lowered LDL-C by 35-61% and triglyceride (TG) concentrations by 14-45%. In comparative trials, atorvastatin 10-80 mg/d showed a greater reduction of serum total cholesterol (TC), LDL-C, TG concentrations, and apolipoprotein B-100 (apo B) compared with pravastatin, simvastatin, or lovastatin. In comparison, currently available HMG-CoA reductase inhibitors (lovastatin, simvastatin, pravastatin, fluvastatin, cerivastatin) lower LDL-C concentrations by approximately 20-40% and TG concentrations by approximately 10-30%. In pooled placebo-controlled clinical trials of up to a duration of 52 weeks, atorvastatin in dosages up to 80 mg/d appeared to be well tolerated. The most common adverse effect of atorvastatin was gastrointestinal upset. The incidence of elevated serum hepatic transaminases may be greater at higher dosages of atorvastatin. The risk of myopathy and/or rhabdomyolysis is increased when an HMG-CoA reductase inhibitor is taken concomitantly with cyclosporine, gemfibrozil, niacin, erythromycin, or azole antifungals. CONCLUSIONS: Atorvastatin appears to reduce TC, LDL-C, TG concentrations, and apo B to a greater extent than do currently available HMG-CoA reductase inhibitors. Atorvastatin may be preferred in patients requiring greater than a 30% reduction in LDL-C or in patients with both elevated LDL-C and TG concentrations, which may obviate the need for combination lipid-lowering therapy. Adverse effects of atorvastatin appear to be similar to those of other HMG-CoA reductase inhibitors and should be routinely monitored. Long-term safety data (> 1 y) on atorvastatin compared with other HMG-CoA reductase inhibitors are still needed. Cost-effectiveness studies comparing atorvastatin with other HMG-CoA reductase inhibitors remain a subject for further investigation. Published clinical studies evaluating the impact of atorvastatin on cardiovascular morbidity and mortality are still needed. Additionally, clinical studies evaluating the impact of lipid-lowering therapy in a larger number of women, the elderly (> 70 y), and patients with diabetes for treatment of primary and secondary prevention of coronary heart disease are needed.
Many people think of plants as essentially sessile organisms that do not actively respond to their environment. What could be further from the truth! In fact, plants are capable of a variety of movements, including the dramatic nastic responses (such as Venus fly trap closure) and the less sensational tropisms. These latter movements are directed growth responses to some type of external stimulus such as gravity (gravitropism, formerly known as geotropism) or light (phototropism). This paper describes some interesting exercises that are derived from recent work, including research that has led to experiments performed on two Space Shuttle missions in 1997 (Kiss et al. 1998). The study of tropisms can be a useful way to introduce students to plant biology in high school and introductory college courses. In our experience, students are fascinated by plant movements when they are presented in lectures and find laboratory experiences on this topic quite engaging. Laboratory work on plant tropisms can also be used to introduce important concepts in science such as hypothesis testing, quantitative analysis, and the use of statistics. The laboratory exercises described in this paper involve the higher plant Arabidopsis thaliana, which has become an important organism in molecular biology research and is the focus of an international plant genome project. Based on the material presented here, a number of plant gravitropism laboratory exercises with Arabidopsis that are simple in terms of equipment/materials and procedures can be developed. These exercises are robust in that they work well even in the hands of introductory students, and they can be expanded according to the individual instructor's needs. This paper describes two exercises that have been performed by beginning college students, and these exercises can easily be performed in biology classes in most high school settings.