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A comparison of the use of adaptive microswitches by students with cerebral palsy.

This paper describes systematic procedures used to assess, train, and compare the use of adaptive microswitches for microcomputers used by adolescents with cerebral palsy. A comparison is made of three students with cerebral palsy using microswitches to increase their production rates as part of a vocational training program. Future uses of adaptive microswitches in vocational and educational training programs are also considered.

Adolescent↗

Workstation robotics: a pilot study of a Desktop Vocational Assistant Robot.

Rehabilitation robots are increasingly being viewed as an appropriate assistive technology interface for persons with disabilities. The Desktop Vocational Assistant Robot (DeVAR) system is a voice-controlled robotic workstation designed to enable persons with severe mobility impairments to function independently in a work environment. This study examined the overall efficacy of the DeVAR system, the level of expertise required for therapist and support personnel, routine maintenance requirements, and the readiness of the device for a multicenter evaluation. Two precommercial DeVAR workstations were installed at selected sites. The pilot study spanned 8 months in which staff members and four subjects with high-level quadriplegia evaluated the systems extensively. Responses were generally favorable regarding ease of use and overall training process. Subjects recommended modifications, including incorporation of a noise cancellation microphone, more effective use of workstation space, and addition of vocational tasks. All respondents thought that if the recommended changes were implemented, DeVAR would have potential as a vocational assistant. The small number of subjects was due to the limited subject pool available for the study. On the basis of pilot results, the Veterans Administration Rehabilitation Research and Development Service, Baltimore, Maryland, is conducting a national multicenter evaluation to determine the overall utility and commercial readiness of the DeVAR system.

Activities of Daily Living↗

Single-switch computer access for infants and toddlers.

Computer access was studied with children between the ages of 6 months and 18 months with no known handicapping conditions. The research focused on determining at what age young children can access a computer using a single-switch system to run a simple cause-and-effect program. The sample consisted of 80 children divided into four groups (6 to 8 months, 9 to 11 months, 12 to 14 months, and 15 to 17 months). Results demonstrated that some children as young as 6 months of age could control a computer-based, cause-and-effect program using a single-switch access system. Therefore, professionals who work with children with disabilities may consider introducing computers to children at this age or to children who are functioning near this cognitive developmental level.

Association Learning↗

Designing web-based education courses for nurses.

Maintaining lifelong learning in health care with its diversity and pressure on resources requires creative solutions to meet the needs of learners and organisations. As technology has evolved, web-based learning has been viewed as one solution. This article discusses the increasing use of online courses and activities in nursing education. It concludes that further research into what nurses want from web-based learning may better inform course design and the development of other web-based educational resources.

Attitude of Health Personnel↗

Continuing education needs of board members, administrators, and health care personnel.

Our society is becoming more aware of the basic fact that education is a lifelong process. The dynamic world in which we live requires that we continually update our knowledge and skills. Educational institutions that have traditionally viewed their mission as one of providing a sequence of courses leading to a specific degree are now expanding their role to include postgraduate nondegree offerings. The MIS area certainly ranks high among those fields that have a dynamic characteristic. Institutions with particular academic strength in this area can provide a needed service--and at the same time create a market niche for themselves--by developing and presenting continuing education programs in the area of MIS.

Computer Literacy↗

Expectations and outcome skills of a generalist health care administrator.

The question of the degree of technical versus managerial competence to be found in future graduates from health administration programs is not easily resolved. In the HIMSS 1988 survey of CIOs the attributes needed for success are listed in descending rank order as follows: leadership ability, vision/imagination, knowledge of hospital systems, business acumen, decisiveness, and technical competence. CIOs ranked technical competence as less important than other attributes associated with general management success. The expectations for attitudes, knowledge, and skills presented in this article support the greater importance of management abilities relative to pure technical competence. However, it is vital that an appropriate level of technical knowledge and skill be maintained to enable future alumni of health administration programs to function effectively as administrators. Depending on their role in a health care organization, greater or lesser technical knowledge may be needed. Those pursuing a career path toward CIO must, of necessity, have greater technical knowledge and skill. We have discussed necessary and expected attitudes, knowledge, and skills that will be needed by the generalist health administration graduate in the future. It will be important to develop and maintain an attitude that MIS is a strategic tool, that health care technology is a corporate asset, and that information is power. Graduates must recognize the necessity of maintaining and enhancing their knowledge and skills through continuing education. The knowledge base of MIS education should focus on determining information needs to support strategic goals, understanding of general systems theory, principles of systems analysis, design, implementation and maintenance, awareness and exposure to standard application software, and an awareness of external sources of data.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Literacy↗

The 1990s and beyond: determining the need for community health and primary care nurses for rural populations.

Increased numbers of primary care and advanced practice nurses with unique generalist skills will be required to meet the accelerating physiologic and sociocultural health care needs of rural populations. Several factors have been identified that will influence the demands and position of community-based nurses in rural practice settings during the next decade. A back-to-basics type of health care offered out of a growing elderly population; technological breakthroughs that make it possible for more chronically ill patients to live at home; serious substance abuse and other adolescent problems; AIDS; and high infant morbidity and mortality statistics are only some of the concerns that will demand nursing intervention. These changes speak to the need for improved nursing coordination, stronger collegial relationships, and better communication between physicians and nurses. Health care is moving in new directions to offer more efficient and technologically sophisticated care. These changes enhance the need for clinically expert educators who teach and jointly practice in programs with a rural focus. Telecommunications, and heightened computer literacy, will play a major role both in nursing education and clinical practice. The goals of kindergarten through 12th grade health promotion and disease prevention strategies in school health will be the norm and will require better prepared, and positions for, school nurses. More midwives and public health nurses will be needed to care for the growing population of sexually active adolescents who are in need of family planning and prenatal care. Underinsured and indigent populations will continue to fall within the purview of midlevel practitioners, as will providing anesthesia services in small rural hospitals. The transition of some rural hospitals into expanded primary care units (e.g., EACHs and RPCHs), and new models of case management will greatly influence nursing demands. This paper will further identify critical areas of advanced practice nursing within community settings, including new relationships with other health care providers, and will introduce strategies upon which rural health policy recommendations for the 1990s can be addressed.

Community Health Nursing↗

Being analog.

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Computer Literacy↗