PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Informal learning”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources
PubMed2005

Effects of a peer-led behavioral intervention to reduce HIV transmission and promote serostatus disclosure among HIV-seropositive gay and bisexual men.

OBJECTIVES: To evaluate the effects of an enhanced peer-led intervention on transmission risk behavior and serostatus disclosure of HIV-seropositive gay and bisexual men. DESIGN: A randomized intervention trial. METHODS: HIV-seropositive gay and bisexual men were recruited from New York City and San Francisco and were randomly assigned to either a standard or an enhanced intervention. The standard intervention consisted of one session that provided safer sex information. The enhanced intervention consisted of six sessions and included safer sex information, interactive learning activities, and discussion groups that were facilitated by HIV-seropositive peers. Participants completed audio computer-assisted self interview (A-CASI) assessments at baseline and 3 and 6-month follow-ups. Optional testing for sexually transmitted infections was offered at baseline and the 6-month follow-up. RESULTS: A total of 811 participants met the inclusion criteria for outcome analyses. Of these, 85 and 90% were retained for the 3 and 6-month follow-ups, respectively. Compared with the standard intervention, fewer men assigned to the enhanced intervention reported unprotected receptive anal intercourse with a negative or unknown-serostatus partner at 3 months (21 versus 26%, P < 0.05). However, there were no other significant differences in transmission risk or serostatus disclosure at 3 or 6 months. CONCLUSION: The enhanced intervention was associated with only a limited reduction in transmission risk at 3 months relative to the standard intervention. The characteristics of the intervention that may have reduced its efficacy are identified and directions for future research are suggested.

Adult↗
PubMedDate not supplied

Genotype-phenotype correlation and frequency of the 3199del6 cystic fibrosis mutation among I148T carriers: results from a collaborative study.

PURPOSE: We expect that the mutation panel currently recommended for preconception/prenatal CF carrier screening will be modified as new information is learned regarding the phenotype associated with specific mutations and allele frequencies in various populations. One such example is the I148T mutation, originally described as a severe CF mutation. After implementation of CF population-based carrier screening, we learned that I148T exists as a complex allele with 3199del6 in patients with clinical CF, whereas asymptomatic compound heterozygotes for I148T and a second severe CF mutation were negative for 3199del6. METHODS: We performed reflex testing for 3199del6 on 663 unrelated specimens, including I148T heterozygotes, compound heterozygotes, and a homozygous individual. RESULTS: Less than 1% of I148T carriers were also positive for 3199del6. Excluding subjects tested because of a suspected or known CF diagnosis or positive family history, 0.6% of I148T-positive individuals were also positive for 3199del6. We identified 1 I148T homozygote and 6 unrelated compound heterozygous individuals with I148T and a second CF variant (2 of whom also carried 3199del6). In addition, one fetus with echogenic bowel and one infertile male were heterozygous for I148T (3199del6 negative). CONCLUSIONS: Reflex testing for 3199del6 should be considered whenever I148T is identified. Reflex testing is of particular importance for any symptomatic patient or whenever one member of a couple carries a deleterious CF mutation and the other member is an I148T heterozygote. Further population data are required to determine if I148T, in the absence of 3199del6, is associated with mild or atypical CF or male infertility.

Cystic Fibrosis↗
PubMed2004

Quality monitoring of nurse telephone triage: pilot study.

BACKGROUND: Nurse telephone triage is a popular way of managing workload in primary care and has been shown to be as safe as general practitioner (GP)-delivered alternatives. No studies have tested a routine method of assessing the quality of decision-making by triage nurses in primary care. AIMS: The aim of this paper is to describe a study to evaluate accuracy and utility of audiotaping telephone consultations to assess the quality of decisions made by practice nurses triaging same day appointment requests in routine practice. METHOD: An observational study was carried out using external assessment by GPs and nurse practitioners of triage quality in 218 audiotaped nurse telephone triage consultations. RESULTS: There were high levels of agreement between triage nurses and assessors on identifying the presenting problem. However, there were only moderate levels of agreement between GPs and nurse assessors both on level of information sought (kappa = 0.434) and appropriateness of outcome (kappa = 0.614). Assessors rated information-gathering as poor in 19.3% of calls (95% confidence interval 14.6 to 25.0), and seven (3.2%) consultations were rated as potentially dangerous (95% confidence interval 1.6 to 6.5). A 1% sample of all consultations would have a probability of 0.48 of identifying unsafe consultations and 0.99 probability of identifying consultations with poor information-gathering. CONCLUSIONS: External assessment of triage quality may be of only moderate accuracy and reliability. Nonetheless, considerable information can be gleaned from assessing audiotapes to assess consultation quality. Even where nurses are generally highly skilled and competent, a 1% review of triage consultations would be sufficient to identify their information-gathering learning needs in relation to patients' presenting problems. Audio-taped consultations could be an important part of clinical governance strategies.

Adult↗
PubMed2004

Personality differences between doctors and their patients: implications for the teaching of communication skills.

OBJECTIVE: To establish, as part of a wider study into specialty choice and job satisfaction, whether the personality profiles of a sample of doctors differed from those of the UK population at large, i.e. their potential patients, and the implications this might have for the doctor/patient consultation process. DESIGN: The Myers-Briggs Type Indicator (MBTI), which measures normal personality differences, was administered by post to five cohorts of doctors (n = 464) who had qualified from a London medical school during the 1980s. SETTING: United Kingdom. PARTICIPANTS: 313 (67.5%) of the medical graduates. MAIN OUTCOME MEASURES: Personality profiles of the respondents compared to those of the UK adult population norms, a proxy for their potential patients. RESULTS: The doctors in this sample differed significantly from the UK adult population norms on most of the dimensions of personality measured, including those which measure an individual's preferred mode of perception, i.e. how one likes to take in information and learn about things. This suggests potential points for miscommunication in the doctor/patient consultation process. CONCLUSIONS: This research should be replicated to see if the results are generalizable. Nevertheless, the findings do indicate that these doctors might benefit from education in the concept of psychological type differences and how these could affect communication with their patients. Training in how to "flex" their consultation style, when necessary, to take into account possible personality differences between themselves and their patients could enhance the outcome of the interaction for both parties.

Clinical Competence↗
PubMedDate not supplied

Zonisamide (CI-912) and cognition: results from preliminary study.

Nine patients with refractory partial seizures were evaluated in a pilot study of a new anticonvulsant compound, zonisamide (1,2-benzisoxazole-3-methanesulfonamide; CI-912). Cognitive functioning was evaluated prior to treatment with zonisamide and repeated after 12 and 24 weeks of treatment with zonisamide. At minimum steady-state plasma concentrations greater than 30 micrograms/ml, zonisamide appeared to affect specific cognitive functions such as acquisition and consolidation of new information. Previously learned material, such as vocabulary, and psychomotor performance were not affected. Verbal learning was affected, while visual-perceptual learning was unimpaired. These cognitive effects were observed in the absence of the usual clinical signs and symptoms of toxicity. A linear relationship was found between impairment of cognitive abilities and the minimum plasma concentration (r = -0.73; p less than 0.05). Findings also suggest the development of tolerance to the adverse cognitive effects.

Adult↗
PubMed1992

The impact of pacemaker implantation on cognitive functioning in elderly patients.

OBJECTIVE: To describe and quantify the impact of pacemaker implantation on cognitive functioning in the elderly. DESIGN: Prospective case-control, non-randomized trial. Data were collected from clinical and family interviews and from a psychological test battery. SETTING: Pacemaker clinic in a tertiary care hospital. PARTICIPANTS: Nineteen elderly (65+ years) patients undergoing new or replacement pacemaker implantation for dysrhythmias and volunteer controls matched for age, sex, and short Mental Status Questionnaire test results, without dysrhythmia or intervention. MAIN OUTCOME MEASURES: Subjective and clinical impressions based on family interviews; results of psychological test battery before and 6-12 months after pacemaker implantation. RESULTS: Prior to pacemaker implantation, three patients met DSM-III criteria for dementia and two for delirium. Paced patients demonstrated deficiency in immediate memory, language, memory for less structured information, and learning of abstract materials. These deficits were due primarily to the poor performance of patients with complete heart block. Despite clinical and subjective impressions of improvement, there was no change in psychologic test performance subsequent to pacemaker implantation. CONCLUSIONS: Impaired cognitive functioning is not always clinically apparent but appears common in patients with cardiac dysrhythmias; it is not altered 6-12 months after pacemaker implantation.

Aged↗
PubMedDate not supplied

Directed attention in normal and high-risk pregnancy.

OBJECTIVE: To compare the ability to direct attention in women having a high-risk pregnancy with those having an uncomplicated pregnancy. DESIGN: Descriptive comparative. SETTING: A tertiary-care hospital. PARTICIPANTS: Women in the 3rd trimester of pregnancy receiving care from perinatologists were recruited for this study and comprised the high-risk group (n = 67). Women in their 3rd trimester of pregnancy with uncomplicated pregnancies and enrolled in prenatal classes were the comparison group (n = 57). MAIN OUTCOME MEASURES: Objective measures of directed attention included digit span forward, digit span backward, Trailmaking A, and Trailmaking B. Subjective measures included the Attentional Function Index and Mental Effort in Tasks. RESULTS: Women having a complicated pregnancy had significantly more difficulty directing attention on all measures than women having normal pregnancies. When all covariates were considered, women having a high-risk pregnancy had significantly more difficulty directing attention as measured by Trailmaking A, Trailmaking B, and Mental Effort in Tasks. CONCLUSIONS: Women having high-risk pregnancies may have more difficulty with activities that require directed attention than women having normal pregnancies. Learning new information and skills, problem solving, and planning may require additional effort for women having complicated pregnancies.

Adaptation, Psychological↗
PubMed1986

Cognitive performance in early Parkinson's disease.

The cognitive, memory and psychomotor performance of 67 patients with Parkinson's disease who had not received any antiparkinson medication was compared with the performance of 43 healthy subjects matched by age and education. The principal impairments in the patients were motor ones, evident in various tests such as general motor slowness and delayed initiation of movement, and they correlated with clinical rigidity and hypokinesia but not with tremor. The performance of the patients was inferior to that of the controls in memory tests involving the processing of information and learning (logical memory, associative learning) but not in less demanding tasks such as the retrieval of numbers. The total disability was due to a combined effect of aging and disease. A decrease of about 15% in the psychomotor and cognitive performance, related to aging alone, can be expected to occur between the ages of 50 and 70. The performance of the patients in memory tests and other tests evaluating cognitive capacity did not correlate either with their motor disability or with their mood. A possibility therefore exists that biological processes behind the cognitive decline and the motor disability are separate, even if they may occur simultaneously.

Adult↗
PubMed2006

Turning policy into practice: more difficult than it seems. The case of breastfeeding education.

Breastfeeding is increasingly recognized as a health policy priority. To achieve real change in breastfeeding rates, those who advise and support childbearing women need to be appropriately educated and trained so that they do not disrupt breastfeeding. The aim of this study was to conduct a needs analysis about breastfeeding training among a range of people who advise and support breastfeeding women, including breastfeeding women themselves, to contribute to future provision of education. A qualitative, interview-based study was conducted in one northern UK city with practitioners who support breastfeeding, and breastfeeding women, selected using purposive sampling. Individual (n = 73) and group (n = 9) interviews were conducted. Detailed notes were returned to each respondent for checking. Information was organized into themes. Coding was charted to enable comparison by theme and case. Four main themes emerged: perspectives of breastfeeding women; feeling (un)prepared to support breastfeeding; fragmentation of knowledge; and provision of education about breastfeeding. A deficit in education and training for all professional groups was identified. There was little evidence of informal shared learning among professional groups, and no evidence of usual mechanisms to ensure education and practice standards. Doctors received very little formal education; most relied on other health professionals to provide this expertise. Students encountered a chaotic learning environment where it was not possible to observe sound, consistent practice. Voluntary breastfeeding supporters felt well-prepared. The results call into question the potential for health services to respond to policy recommendations that support increased rates of breastfeeding.

Breast Feeding↗
PubMed1990

First-order model for the analysis of stump stresses for below-knee amputees.

This study extends what had been a purely numerical model that used influence-factor matrices to relate the stump stresses to prosthesis loads for unilateral, below/knee amputees. Previously published influence-factor matrices are now factored into a coefficient matrix times the inverse of a stump geometry matrix. Using actual stump parameters, new information is learned about how the resistive moment of the stump balances the flexion-extension moment of the prosthesis and why certain normal stresses reach a maximum during a specific portion of the stance phase of the prosthesis.

Amputation Stumps↗
PubMed2005

How visual stimuli activate dopaminergic neurons at short latency.

Unexpected, biologically salient stimuli elicit a short-latency, phasic response in midbrain dopaminergic (DA) neurons. Although this signal is important for reinforcement learning, the information it conveys to forebrain target structures remains uncertain. One way to decode the phasic DA signal would be to determine the perceptual properties of sensory inputs to DA neurons. After local disinhibition of the superior colliculus in anesthetized rats, DA neurons became visually responsive, whereas disinhibition of the visual cortex was ineffective. As the primary source of visual afferents, the limited processing capacities of the colliculus may constrain the visual information content of phasic DA responses.

Animals↗
PubMed1999

Emergent properties of networks of biological signaling pathways.

Many distinct signaling pathways allow the cell to receive, process, and respond to information. Often, components of different pathways interact, resulting in signaling networks. Biochemical signaling networks were constructed with experimentally obtained constants and analyzed by computational methods to understand their role in complex biological processes. These networks exhibit emergent properties such as integration of signals across multiple time scales, generation of distinct outputs depending on input strength and duration, and self-sustaining feedback loops. Feedback can result in bistable behavior with discrete steady-state activities, well-defined input thresholds for transition between states and prolonged signal output, and signal modulation in response to transient stimuli. These properties of signaling networks raise the possibility that information for "learned behavior" of biological systems may be stored within intracellular biochemical reactions that comprise signaling pathways.

Animals↗
PubMed2000

A global geometric framework for nonlinear dimensionality reduction.

Scientists working with large volumes of high-dimensional data, such as global climate patterns, stellar spectra, or human gene distributions, regularly confront the problem of dimensionality reduction: finding meaningful low-dimensional structures hidden in their high-dimensional observations. The human brain confronts the same problem in everyday perception, extracting from its high-dimensional sensory inputs-30,000 auditory nerve fibers or 10(6) optic nerve fibers-a manageably small number of perceptually relevant features. Here we describe an approach to solving dimensionality reduction problems that uses easily measured local metric information to learn the underlying global geometry of a data set. Unlike classical techniques such as principal component analysis (PCA) and multidimensional scaling (MDS), our approach is capable of discovering the nonlinear degrees of freedom that underlie complex natural observations, such as human handwriting or images of a face under different viewing conditions. In contrast to previous algorithms for nonlinear dimensionality reduction, ours efficiently computes a globally optimal solution, and, for an important class of data manifolds, is guaranteed to converge asymptotically to the true structure.

Algorithms↗
PubMed2005

Cat dissection vs. sculpting human structures in clay: an analysis of two approaches to undergraduate human anatomy laboratory education.

Many human anatomy courses are taught using cat dissection. Alternatives are available, but information regarding learning outcomes is incomplete. In 2003, approximately 120 undergraduates enrolled in a human anatomy course were assigned to one of two treatment groups. In the control group, students performed cat dissections (emphasizing isolation and identification) of the muscular, digestive, and cardiovascular systems. In the experimental treatment group, students built clay sculptures of each human body system. Student learning was evaluated by using both low- and high-difficulty questions. On pre- and postexperiment control exams, there were no significant differences in student performance. On exams after a cat dissection vs. a human-clay sculpting experience, the students in the human-clay sculpting treatment group scored significantly higher than their classmates in the cat dissection group on both the low- and high-difficulty questions. Student attitudes toward dissection and taking future human anatomy courses were also measured. There were no differences in student attitudes at the beginning of the experiment; afterward, students exposed to a cat dissection experience viewed dissection more favorably than students in the human-clay sculpting treatment group. There were no treatment effects on student willingness to take future human anatomy courses. The experimental design makes it difficult to conclude precisely why students assigned to the human-clay sculpting experience performed better on exams, but as each method was performed in this particular human anatomy course, our data indicate that human-clay sculpting may be a viable alternative to cat dissection in an anatomy course in which the students focus on human anatomy.

Animals↗
PubMed2006

Large-scale analysis of neural stem cells and progenitor cells.

The past few years have seen remarkable progress in our understanding of stem cell biology. The wealth of genomic data and the multiplicity of sources have enabled researchers to begin to profile stem cells in detail. In this paper we describe the biological and technical controls necessary to obtain reliable data and the relative merits of various large-scale analytical techniques including microarray, expressed sequence tag enumeration, serial analysis of gene expression and massively parallel signature sequencing. We suggest that while much has been learned, additional information remains to be gleaned by meta-analysis of existing data.

Animals↗
PubMedDate not supplied

Senile dementia of extreme aging: a common disorder of centenarians.

To study dementia in the extremely aged, I evaluated 40 centenarians with a mean age of 101.6 years (range: 100-107). The group completed 5.8 years of education, on average. Bradyphrenia and bradykinesia were common and most had impaired awareness and concern. The Folstein Mini-Mental State Exam and Washington University's Clinical Dementia Rating Scale indicated moderately advanced dementia in more than half; 4 had a clinical pattern that suggested senile dementia of the Alzheimer's type. A common pattern of dementia emerged consisting of preserved awareness of the environment, normal participation in conversations, mild bradyphrenia and bradykinesia with normal latency to respond to questions and memory impairment with diminished ability to learn new information. They had a constricted universe with limited awareness of events outside their personal sphere; they repeated themes and topics endlessly. This study suggests senile dementia is common in centenarians.

Aged↗
PubMed1990

Comparison of a system of staff prompting with a programmable electronic diary in a patient with Korsakoff's syndrome.

The effect of a programmable electronic diary was compared with a system of staff prompting on the attendance at Occupational Therapy groups of a patient with Korsakoff's syndrome. Throughout the baseline period, the subject did not attend any groups. With the help of verbal prompting and other staff intervention, his attendance at groups increased significantly. By the fourteeth week he was attending all groups without verbal prompting apparently by using other environmental cues. The introduction of the electronic diary at this point was not found to increase the subject's attendance at groups further or to reduce the need for verbal prompting presumably due to a "ceiling effect". These findings suggest that despite severe memory impairment, the patient with Korsakoff's syndrome is able to learn new information. The potential of the electronic diary for reducing staff input and its use in a less predictable setting need to be evaluated further.

Alcohol Amnestic Disorder↗