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PubMed1988

Quantitative immunocytochemistry using an image analyzer. I. Hardware evaluation, image processing, and data analysis.

In this review we describe how video-based image analysis systems are used to measure immunocytochemically labeled tissue. The general principles underlying hardware and software procedures are emphasized. First, the characteristics of image analyzers are described, including the densitometric measure, spatial resolution, gray scale resolution, dynamic range, and acquisition and processing speed. The errors produced by these instruments are described and methods for correcting or reducing the errors are discussed. Methods for evaluating image analyzers are also presented, including spatial resolution, photometric transfer function, short- and long-term temporal variability, and measurement error. The procedures used to measure immunocytochemically labeled cells and fibers are then described. Immunoreactive profiles are imaged and enhanced using an edge sharpening operator and then extracted using segmentation, a procedure which captures all labeled profiles above a threshold gray level. Binary operators, including erosion and dilation, are applied to separate objects and to remove artifacts. The software then automatically measures the geometry and optical density of the extracted profiles. The procedures are rapid and efficient methods for measuring simultaneously the position, geometry, and labeling intensity of immunocytochemically labeled tissue, including cells, fibers, and whole fields. A companion paper describes non-biological standards we have developed to estimate antigen concentration from the optical density produced by antibody labeling (Nabors et al., 1988).

Animals↗
PubMed1990

A new method to evaluate clinical performance and critical incidents in anaesthesia: quantification of daily comments by teachers.

We have found that the Clinical Anesthesia System of Evaluation (CASE) method provides information regarding clinical performance of residents and critical incidents that is not available from other sources. As a result, it expands the dimensions of the evaluation process and improves validity. In addition, the technique has helped address the concerns of many investigators. (1) It provides specific, real-time evaluations that permit early intervention, improve feedback and guide remediation; (2) it improves sampling techniques by increasing the breadth and volume of evaluators and settings; (3) it enhances the discriminatory power of the evaluation process; and (4) it improves documentation.

Anesthesia↗
PubMed1991

A process for developing a curriculum in ethics and human values.

This article describes the process and results of the deliberations of the group of authors at the 1989 spring meeting of the Northeast Group for Educational Affairs. The participants worked under the premise that someone had given an unlimited amount of money to fund a new medical school. They had to select and define what the educational goals would be and produce a plan to help students reach these goals. There had to be an evaluation process that documented progress toward the stated goals. This paper describes the ethics and human values curriculum, which should be of interest to cancer educators. The knowledge, skills, values, and attitudes are defined and the four-year process of implementing the teaching is described. This curriculum-planning process is applicable to any aspect of cancer education--first defining the outcome, then the evaluation process, and finally, how to get to that outcome.

Curriculum↗
PubMed1988

A simple method for predicting the secondary structure of globular proteins: implications and accuracy.

A method is presented for predicting the secondary structure of globular proteins from their amino acid sequence. It is based on a rigorous statistical exploitation of the well-known biological fact that the amino acid compositions of each secondary structure are different. We also propose an evaluation process that allows us to estimate the capacity of a method to predict the secondary structure of a new protein which does not have any homologous proteins whose structure is already known. This evaluation process shows that our method has a prediction accuracy of 58.7% over three states for the 62 proteins of the Kabsch and Sander (1983a) data bank. This result is better than that obtained by the most widely used methods--Lim (1974), Chou and Fasman (1978) and Garnier et al. (1978)--and also than that obtained by a recent method based on local homologies (Levin et al., 1986). Our prediction method is very simple and may be implemented on any microcomputer and even on programmable pocket calculators. A simple Pascal implementation of the method prediction algorithm is given. The interpretation of our results in terms of protein folding and directions for further work are discussed.

Algorithms↗
PubMed1988

Evaluating the quality of education-practice relationships.

Parameters for comprehensive evaluation of the education-practice collaboration project were evaluated. Cell six and nine were identified as being the most important foci for evaluating the process of collaboration. Groups that used the process to evaluate collaboration can use the information both for decision making and for data collection in the evaluation effort. Objectives of the project frame the purposes of the evaluation. In this case, the purposes were to evaluate effectiveness of the collaboration process/model for both education and practice, and to make recommendations for the next steps. In the best of circumstances, process evaluation should occur at the same time that the process is taking place. Sometimes this approach is not feasible when there is insufficient time or resources, and then alternative designs need to be developed. For example, it is conceivable that a retrospective descriptive survey could capture the essence of the communication, mutuality, and shared resources experience. Hypothetical statements or predictions assist in the process of maintaining clarity about what one really wants to measure or study to ensure that the focus and purposes are commonly understood, measureable, and worthwhile. Objective evaluation is facilitated when the level of measurement is appropriate and the results generated are in concert with the intended purposes. The use of this framework proved its worth after the data were collected and analyzed. It was found that the collaborative process was worthwhile, and that the outcomes of the collaboration were appropriate and meaningful and the goals had been achieved. Recommendations for follow-up flowed neatly from the data analysis and from a general discussion by participants.(ABSTRACT TRUNCATED AT 250 WORDS)

Career Mobility↗
PubMed1992

Auditing the clinical learning environment in West Glamorgan: evaluating the process.

The responsibility for auditing clinical learner areas was developed from the Welsh National Board to individual educational establishments in Wales in 1988. The West Glamorgan College of Nursing and Midwifery designed on audit tool, based on the National Board's guidelines, and have used it in clinical areas since 1990. This paper reports on an evaluation survey carried out after the tool had been in use for one year. The results suggest that the ward/area managers involved have been able to identify a range of benefits for their units with the introduction of the tool, and demonstrate an acceptance of the need to maintain standards of practice and education.

Anxiety↗
PubMed1985

Oral examinations: actual and perceived contributions to surgery clerkship performance.

Controversy persists regarding the validity, utility, and practicality of oral examinations. This study of a recent 3-year experience at the University of Michigan Medical School was undertaken to determine the value of the oral examination in the required junior year surgery clerkship. Multiple regression analysis of the relationship between the oral examination and ward grades, written examination grades, and the final grades for the clerkship years 1980 to 1981 (n = 198), 1981 to 1982 (n = 234), and 1982 to 1983 (n = 215) (classes of 1982, 1983, and 1984) revealed significant correlation between the oral examination and other evaluation parameters. Stepwise regression analysis revealed that the oral examination contributed unique information to final grade determination. Two surveys identified faculty and student opinion regarding the oral examination. The results were consistent during the 3-year period of study. Faculty and student opinion regarding the examination as an evaluation process and motivational device were positive, as was opinion regarding the breadth and depth of knowledge tested and the examination as a learning experience and an accurate reflection of students' performance. Both faculty and students agreed that the examination was worth the time and effort invested by faculty, was an appropriate evaluation process, and was a source of worthwhile faculty and student interaction.

Attitude of Health Personnel↗
PubMedDate not supplied

[Quality assurance exemplified by perinatology and surgery].

Quality assurance encompasses all activities which are necessary to obtain a demanded quality of medical care. Typically, a quality assurance process ("monitoring- and evaluation-process") includes the following steps: systematic observation of quality of medical care using quality indicators, assessment of quality by comparison with standards and recognizing problems, analysis of the most important problem, realization of appropriate problem solving strategies and evaluation, if the problem is successfully solved through the corrective action. The quality assurance programs in perinatology and surgery--established in all the states of the Federal Republic of Germany--support the hospitals in the application of this quality assurance process. Uniform documentation and preparation of quality relevant information (lists of complications, profiles, charts, etc.) help the hospitals to perform a self-evaluation, to recognize problems and to verify the elimination of the problems. Hence, comparisons with local results and with results of other hospitals are possible.

Cesarean Section↗
PubMed1992

Anticonvulsant drugs affect particular steps of verbal memory processing--an evaluation of 13 patients with intractable complex partial seizures of left temporal lobe origin.

Thirteen patients with intractable complex partial seizures of left temporal lobe origin were tested for verbal memory performance under the conditions of full and reduced anticonvulsant medication. As suggested by previous investigations memory performance improved significantly with the reduction of anticonvulsants. However, our observations refute assumptions that the effects of antiepileptic drugs act primarily by non-specific mechanisms affecting attention and/or memory diffusely. Our data rather suggest that very specific and circumscribed steps of verbal memory processing, particularly retrieval abilities after interference, are affected by anticonvulsants. The possible implications of these findings in relation to morphological and electrophysiological aspects in patients with temporal lobe epilepsy are discussed.

Adolescent↗
PubMedDate not supplied

Integrating occupational health into the medicine clerkship using problem-based learning.

OBJECTIVE: To improve medical students' ability and willingness to obtain occupational histories from their patients. PARTICIPANTS: General medicine faculty and internal medicine teaching residents, who participated as instructors, and medical students during their required internal medicine clerkships. SETTING: The primary teaching hospitals of two medical schools. DESIGN: During alternate months, students participated in problem-based sessions that included occupational health objectives (intervention) or attended the standard small-group didactic sessions (control). Process evaluations were collected from students and faculty in the intervention group following each session. Outcome evaluation was performed using chart audit and multiple-choice testing to compare the intervention and control groups. INTERVENTION: Intervention students participated in at least one problem-based session incorporating occupational aspects of disease into clinical internal medicine. Instructors received information packets and materials but had no other expertise in occupational medicine. MEASUREMENTS AND MAIN RESULTS: The great majority of ratings on the process evaluations showed that the students were "moderately" to "extremely" interested in the session attended. No student rated any session to be a "waste of time," and over 90% of students would recommend the session being evaluated to a friend. Chart audit showed that students in the intervention group recorded slightly more occupational information than did those in the control group (an average of 2.97 vs. 2.37 pieces of information, p = 0.06). When the most commonly documented data (employment status and job title) were ignored, the difference between group means (1.1 vs. 0.91) was significant (p = 0.03), suggesting that intervention students were more likely to probe further into a patient's occupational history. Both groups of students collected less occupational information from women than from men (t = 3.22, p = 0.0035). Multiple-choice tests revealed no difference between the two groups in overall medical knowledge or occupational medicine knowledge. CONCLUSIONS: Problem-based learning with specific occupational content is well accepted by students and modestly improves their occupational history taking.

Clinical Clerkship↗
PubMed1989

Primary prevention of coronary heart disease versus health promotion--a contradiction?

The German Cardiovascular Prevention Study is a multicentre community-based intervention study with the primary goal of reducing cardiovascular mortality by primary prevention measures. The intervention strategy comprises improving people's life styles as well as health promotion so as to modify cardiovascular risk factors (hypercholesterolemia, cigarette smoking, arterial hypertension, physical inactivity and over-weight). Design elements of the German Cardiovascular Prevention Study, now in its fifth year, were adopted from well known community intervention studies, including monitoring of mortality and morbidity, health examination surveys to assess distribution of cardiovascular risk factors, health attitudes and health behaviour in the community and use of formative and process evaluation to monitor the effects of intervention policies in the community. To identify risk factor profiles a cluster analysis was carried out from survey data. Four clusters were identified: a) people with none or few risk factors; b) those with high prevalence of smoking; c) those with high prevalence of hypercholesterolemia and hypertension; d) high risk factor exposure individuals. The clusters are different along social indicators like age, sex and social status. Process evaluation data show that special strategies like interventive blood pressure screenings reached a relatively high proportion of people from lower socioeconomic status. But they also indicate that there is a long way to go from publicity of intervention programs to lasting changes in behaviour.

Adult↗
PubMed1986

[Processing and evaluation of fish silage from accompanying fauna of shrimps].

Fish silage for animal feed was produced from a mixture of several fish species belonging to the shrimp by catch. All of them were ground and mixed with formic and sulfuric acids, 3.5% w/w at 1:2; 1:3 and 1:4, respectively, and stored at room temperature for 15 days, to complete liquefaction. The pH, exuded liquid, consistency, soluble nitrogen, total volatile bases, trimethylamine, lipid oxidation by thiobarbituric acid test and microbial count were measured during the 60 days of the storage period. Fish silage was dried and used for biological tests in chicken fed a diet with 6% of silage as a substitute of fish meal. Results of proximal analysis, amino acid profile and mineral content, as well as of the biological test with the dried product, indicated the feasibility of using fish silage as a substitute of traditional fish meal for the chicks included in the trial. This fact, coupled to its simple processing technology, make fish silage adequate for utilization as animal feed.

Animal Feed↗
PubMed1989

A quality assurance program for a state university student health center.

The New Mexico State University Student Health Center redesigned its quality assurance program to follow the Joint Commission's ten-step process for monitoring and evaluation. This article outlines the scopes of care in the Health Center's different units and provides case-study examples, including important aspects of care and indicators, to illustrate the monitoring and evaluation process as it is used for both retrospective studies and concurrent monitoring.

Data Collection↗