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PubMed2003

Strangulation with intravenous tubing: a previously undescribed adverse advent in children.

Nonintentional strangulation in children is a widely recognized risk as a result of the vulnerability of their airway to occlusion by relatively low pressures. We describe 2 cases of strangulation by intravenous (IV) tubing in infants, 1 of which was fatal. This is the first documentation in the health science literature of this as a potential adverse consequence of IV therapy in young children. It is important that hospitals that care for such children recognize this potential risk and implement the appropriate strategies to minimize or eliminate it. Preventive interventions may include ongoing assessment of the need for continuous rather than intermittent IV infusions (saline or heparin locked IV sites), individualized level of supervision according to the child's age and behavior, and engineering modifications to the IV equipment.

Accidents↗
PubMed2006

[Referential of nursing competencies in the Democratic Republic of Congo within the framework of strengthening human resources for health].

This article describes the results of a participatory process aiming to design and develop a referential of competencies for nurses to be used in secondary professional training within the context of the global South, and more specifically in the Democratic Republic of Congo (DRC). Priority focus is given to the presentation of the final validated product. The competencies' referential is accompanied by a training referential as a pre-requisite guide, which outlines the course of study. Only the referential of competencies is described in this article. The result documents, in the first instance, the shape which this referential of competencies takes in reality, from which a school nurse can be brought to mobilise while practicing his/her profession. The referential's basis and presentation is founded on four key skill sets as a starting point. Each of the four key skills were further broken down and divided according to levels of competencies and minimal criteria for perfecting these skills per year of study. The presentation of the referential of competencies ends by regrouping "families of situations" for each year as well as with an adapted glossary. The discussion focuses on the results of the referential of competencies in its context but also on the use which should be made of this tool within the framework of the implementation of the education and training reform for nurses in DRC. Another point is the interest of this approach by skills for various types of professional training in the health sciences.

Competency-Based Education↗
PubMed2001

Production of the next-generation library virtual tour.

While many libraries offer overviews of their services through their Websites, only a small number of health sciences libraries provide Web-based virtual tours. These tours typically feature photographs of major service areas along with textual descriptions. This article describes the process for planning, producing, and implementing a next-generation virtual tour in which a variety of media elements are integrated: photographic images, 360-degree "virtual reality" views, textual descriptions, and contextual floor plans. Hardware and software tools used in the project are detailed, along with a production timeline and budget, tips for streamlining the process, and techniques for improving production. This paper is intended as a starting guide for other libraries considering an investment in such a project.

Computer Communication Networks↗
PubMed2000

Professional assessment of optimal nursing care intensity level. A new method for resource allocation as an alternative to classical time studies.

In the article a new method is presented for allocation of staff resources, 'Professional Assessment of Optimal Nursing Care Intensity Level' (PAONCIL). This method is presented as an alternative to classical time study, which has traditionally been considered to belong to systems for patient classification. By means of this method the optimal nursing care intensity level for individual wards can be established. The study comprised 8 wards, and the nurses working in these wards provided a total of 8,458 professional assessments of optimal nursing care intensity levels. The material was analysed by means of simple linear regression analysis. The nursing care intensity scores per nurse in a single ward were used as independent variables and the average PAONCIL score for the same calendar day was used as a dependent variable. The average determination coefficient for different wards were 0.37; the PAONCIL instrument thus explained 37% of the nursing care intensity/nurse variation. This corresponded to a linear correlation of 0.60. In five out of six wards for adults the optimal nursing care intensity/nurse scores were close to each other, ranging from 3.0 to 3.6. The advantage of the PAONCIL method is that it can be easily implemented in a ward, can be used time and again, is advantageous and is based on quality aspects. The PAONCIL method has been developed on the basis of a caring science perspective and can be seen as an administrative method for the nurse manager, with whose help 'good care' can become possible.

Clinical Nursing Research↗
PubMed1998

Treatment of pediatric obesity.

The primary goal of childhood obesity interventions is regulation of body weight and fat with adequate nutrition for growth and development. Ideally, these interventions are associated with positive changes in the physiologic and psychological sequelae of obesity. To contribute to long-term weight maintenance, interventions should modify eating and exercise behaviors such that new, healthier behaviors develop and replace unhealthy behaviors, thereby allowing healthier behaviors to persist throughout development and into adulthood. This overview of pediatric obesity treatment, using predominantly randomized, controlled studies, highlights important contributions and developments in primarily dietary, activity, and behavior change interventions, and identifies characteristics of successful treatment and maintenance interventions. Potential positive (eg, reduction in blood pressure, serum lipids, and insulin resistance) and negative (eg, development of disordered eating patterns) side effects of treatment also are described. Recommendations for improving implementation of childhood obesity treatments, including application of behavioral choice theory, improving knowledge of response extinction and recovery in regards to behavior relapse, individualization of treatment, and integration of basic science with clinical outcome research, are discussed.

Adolescent↗
PubMed2006

Institute of Medicine to overwhelmed ED managers: 'you're not alone'.

ED managers can make a difference, even though forces beyond your department impact your operations, according to just-released landmark reports from the Institute of Medicine. They suggest these changes to help offset the effects of those forces: Become involved in system design and communication issues. Performance indicators for EDs are coming. Make sure you have mechanisms in place for training, compliance, and evaluation. Consider implementing a clinical decision unit to combat overcrowding in your ED.

Emergency Service, Hospital↗
PubMed1991

Implementing a complex internetwork: a case study.

This paper concerns the implementation of a complex internetwork in late 1989 through early 1990. The purpose is to discuss the methods and approaches employed. The context is that as technology improves and computer science advances, the same problems are re-solved over and over for slightly different environments. The perspective is that the methods and approaches will remain viable while the hardware and software changes.

Local Area Networks↗
PubMed2005

The California active aging community grant program: translating science into practice to promote physical activity in older adults.

BACKGROUND: Attempts to study the translation of evidence-based physical activity interventions in community settings are scarce. PURPOSE: This project was an investigation of whether 13 diverse local lead agencies could effectively implement a choice-based, telephone-assisted physical activity promotion program for older adults based on intervention models proven efficacious in research settings. METHODS: At baseline, participants developed their own physical activity programs through an individualized planning session based on preference, health status, readiness to change, and available community resources. Thereafter, participants received regular telephone calls over a 1-year period from a trained staff member or volunteer support buddy. Additional program components consisted of health education workshops, newsletters, and group-based physical activities. Self-report data on caloric expenditure due to all and moderate or greater intensity physical activities were collected from 447 participants (M age = 68 +/- 8.6 years). RESULTS: A significant increase (p < or = .0001) from baseline to midintervention and intervention endpoint was observed for total weekly caloric expenditure (Mdn change = 644-707 kcal/week) and moderate or greater weekly caloric expenditure (Mdn change = 149-265 kcal/week), as well as for weekly physical activity duration and frequency. These changes were observed in participants across all sites. CONCLUSIONS: The increases in weekly caloric expenditure were commensurate with findings from several previous randomized clinical trials. The utilization of community agency staff and volunteers receiving basic training to implement essential program components proved feasible. Very favorable levels of program satisfaction expressed by community staff, volunteer support buddies, and participants, combined with the significant increases in physical activity, warrant further dissemination of the intervention model.

Aged↗
PubMed1996

Summary of track D: social science: research, policy and action.

SCOPE: This review summarizes the main issues discussed during Track D, which examined the societal impact of HIV/AIDS, and responses to the epidemic by individuals, families, communities and societies worldwide. Micro- and macrolevel issues addressed included the development, implementation and evaluation of programmes for prevention and care; policy development and implementation; structural issues such as the impact of gender relations, development and migration on the development of the epidemic; and the social and economic impact of HIV/AIDS on affected societies and communities. RECURRENT THEMES: Presentations provided strong evidence that peer-led, community-based programmes offer particularly effective ways of working, and that participatory research involving affected communities provides useful results for the design and evaluation of programmes and policies. This is the case across settings, issues, populations and countries. FUTURE DIRECTIONS: Emerging needs include how best to ensure sustainability of national and international responses, how best to scale up successful interventions for wider reach, and how best to work with systematically marginalized, neglected groups and populations. Research priorities include the characterization of the multiple determinants of HIV-related vulnerability, and the evaluation of interventions that take these complex determinants as their starting point. A more coherent and strategic response requires less separation between the different constituencies involved in AIDS work, and the more sustained involvement of people living with HIV/AIDS themselves.

Community Health Services↗
PubMed2005

The SUCOZOMA program: results and challenges.

The research program Sustainable Coastal Zone Management (SUCOZOMA), which was started in 1996 by the Swedish Foundation of Strategic Environmental Research, was motivated by the recognition of increasingly severe global, regional and national coastal problems. The program approached the complex issues of coastal eutrophication, fishing practices, and overexploited coastal resources, with a concerted effort involving multidisciplinarity, stakeholder cooperation, and a focus on the problems perceived as most serious by the public and decision-makers. As the program was concluded in 2004 it had resulted in the completion or near-completion of 22 doctoral dissertations and approximately one hundred publications. More than 40 scientists were involved in the program. Göteborg University was the host university, but important research teams have also been located at Stockholm University, the Beijer Institute, and the Kristineberg Marine Research Station of the Royal Swedish Academy of Sciences, and within the National Board of Fisheries. During the program, networks of stakeholders were established and SUCOZOMA had contributed to numerous political and administrative processes relevant for integrated coastal zone management (ICZM). SUCOZOMA program results can be grouped into different categories. Many of the projects in the two phases of the program produced results which can be defined as technical or practical and available for direct implementation in, e.g. mussel cultivation, restoration and safeguarding of spawning areas, seal-safe fishing gear or sustainable fishing of underexploited species. Other results can be characterized as policy oriented, and the impact of these can only be fairly evaluated as new policies are put into effect. SUCOZOMA resulted in important new knowledge regarding coastal science and management, but also concerning the organization required to conduct an end-user oriented multidisciplinary program effectively.

Animals↗
PubMed2005

First graduates' perceptions on a problem-based and task-based learning curriculum.

INTRODUCTION: Determination of graduates' perceptions and suggestions is essential in the evaluation of educational programmes. Dokuz Eylul University School of Medicine (DEUSM), the country's first medical school implementing a Problem-Based Learning (PBL) and Task-Based Learning (TBL) programme, graduated the first students of its new educational programme starting from the 2002-2003 academic year. The aim of the present study is to determine first graduates' perceptions on their self-efficacy and school's educational programme's efficacy. METHODS: In June 2003, 51 graduating students were asked to use five-point scales to evaluate: the content of the educational programme, the educational methods, communication with educators, assessment methods and instruments, the efficacy of each year of their undergraduate programme and the overall program, their satisfaction levels about educational programme regarding the acquisition of knowledge and skills, their self-efficacy and contentment level of being a physician. RESULTS: In the content of educational programme, the highest score was attributed to "acquisition of behavioural objectives" and the lowest score to "acquisition of basic science knowledge". Regarding the efficacy of educational programme, the highest score was attributed to "communication with educators". The highest scores regarding the satisfaction levels on the acquisition of knowledge and skills provided by the School were attributed to "implementing basic professional procedures" and "history taking" and the lowest score to "selecting appropriate treatment". CONCLUSION: The graduating students' mainly positive evaluations regarding the efficacy of DEUSM's new educational programme were considered as supportive reflections on the new educational programme. Further studies to monitor our graduates' future professional performances are being envisaged.

Clinical Competence↗
PubMed1993

Teaching bioethics as a new paradigm for health professionals.

In The Clouds by Aristophanes, Strepsiades brings his son before Socrates so that he could learn Philosophy for he has heard that this science teaches how to overcome the most difficult causes with reasons. And Strepsiades wants his son to learn the art of failing to pay debts. Regarding medical education in our time, Edmund Pellegrino has noted that the educational philosophy of medical schools determines what a "good" physician is. Thus, teaching bioethics to future health professionals makes us face old problems now: What teaching method to choose among all the possible various ones? What should teaching aim at? Which will be our educational philosophy? Therefore I shall introduce here the epistemological basis of our Bioethics teaching program in Argentina and its implementing strategies in the undergraduate curriculum and the post-graduate level.

Argentina↗
PubMedDate not supplied

The politics of physiological psychology. Ivan Pavlov's suppressed defense of scientific freedom and its consequences.

This statement, first presented at a plenary session of the Pavlovian Society on 9 October 1992, in Los Angeles, California, attempts to assess the recently released speech delivered by Ivan Pavlov in 1923, but publicly brought to light only in 1991, on the subject of "Communist Dogmatism and the Autonomy of Science." This speech, noteworthy for the courage of the delivery under adverse circumstances no less than the contents of its remarks, compels a new estimate of the place of science in a totalitarian system boasting an ideology of physiological psychology. It also sheds new light on the Russian Nobel laureate and pioneer in the areas of behavior modification induced by the functions of the higher nervous system. These remarks take an in-depth view of American radical and Marxian appraisals--how they followed the Soviet lead in harnessing Pavlov to the Communist cause, and in attempting to discredit the work of Sigmund Freud. This lethal combination of Communist political needs and ideological proclivities served to rationalize the implementation of slave labor as work therapy during the Stalinist era. The linkage of Pavlov to Makarenko in education and Michurin in biology serves as a case study in the manufacture of tradition. The collapse of the Soviet system permits a recasting of the history of science and Pavlov's place in Russian life. Such new conditions also provide a lesson in the distortive role of ideology in the evolution of modern science.

Communism↗
PubMed2002

An implementation framework for household and community integrated management of childhood illness.

This paper describes the development and recent history of the third component of the Integrated Management of Childhood Illness (IMCI) strategy, improving household and community practices (HH/C IMCI). An implementation framework for this third component, developed through review of experiences of non-governmental organizations (NGOs) working in community-based child health and nutrition programmes, is then presented. This Framework responds to demand from NGOs and their partners for a description of the different categories of community-level activities necessary for the implementation of a comprehensive child health and nutrition programme. These categories of activities facilitate the systematic cataloguing, synthesis and coordination of organizational activities and experience. It also serves as a reference tool for improving communication of related community child health activities, and a guide for designing appropriate behaviour change strategies. The Framework was endorsed by participants in an international workshop held in Baltimore, Maryland in January 2001, and specified three linked elements that are integral to HH/C IMCI, supported by a multi-sectoral platform that addresses constraints communities face in adopting practices that promote health and nutrition. The three programmatic Elements critical to HH/C IMCI programmes are (1). improving partnerships between health facilities or services and the communities they serve; (2). increasing appropriate and accessible care and information from community-based providers; and (3). integrating promotion of key family practices critical for child health and nutrition. The Framework presented in this paper is an ideal tool for describing, sharing and coordinating efforts in the field, and is purposely descriptive rather than prescriptive.

Child↗
PubMedDate not supplied

[Integration of nursing in science and technology policies].

Brazilian nursing is included in the national science and technology system, as part of the health knowledge area. Its scientific production is reknown but is yet to strengthen its position. Among the strategies to be used, we can emphasize: study different ways to promote a closer relationship between university and services; create or intensify interfacing between clinical and academic nurses; promote strategic research for the use of technological innovations, continuing education of human resources, and implement studies on Nursing care while integrating skills required by complex technological systems and intersubjectivity, acting in a therapeutic way.

Brazil↗
PubMed1996

Preceptorship, mentorship, and the adult learner in medical and health sciences education.

Preceptorship and mentorship are both based on principles of adult education and involve experiential, student-centered learning. Preceptorial relationships are especially useful in developing the practical skills of students. The preceptor works either with small groups of students or one-on-one with individual students, and serves as a teacher, role model, and evaluator. Preceptorial relationships between a teacher and a student are relatively short, and generally span the duration of a course or student rotation. Mentoring involves an intense, global, and long-term relationship between a mentor and a protégé/e, and-encompasses both professional and personal domains. It spans several years and may extend far beyond the period of the structured mentorship. The mentor serves as a teacher, role model, coach, and confidant for the protégé/e and works one-on-one with a protégé/e to achieve various outcomes. Both parties reap significant rewards as a result of the mentorship, and are transformed in the process. Preceptors and mentors must be appropriately selected and adequately trained. Comprehensive faculty development courses and workshops should be designed and implemented to enhance the requisite skills of both groups. The effectiveness of preceptorship and mentorship needs to be continually assessed and appropriate steps taken to further enhance these special educational options. Both options should be included in medical and health sciences education to train competent and well-rounded professionals for the future.

Clinical Competence↗
PubMed1999

A survey of cancer curricula in Australian and New Zealand medical schools in 1997. Oncology Education Committee of the Australian Cancer Society.

OBJECTIVE: To assess teaching about cancer in medical schools in Australia and New Zealand. DESIGN AND SETTING: Postal survey of all 12 Australian and New Zealand medical schools in 1997. PARTICIPANTS: The Dean (or a nominee) of each medical school and the representative of each university on the Oncology Education Committee (OEC) of the Australian Cancer Society. OUTCOME MEASURES: Curriculum content, clinical placements and forms of teaching and assessment related to cancer; presence and composition of cancer curriculum planning, and assessment groups. RESULTS: 22 responses were received from 10 medical schools (from nine Deans or nominees and 13 OEC representatives). Implementation of cancer teaching and overall course structure varied considerably between schools. Nine of these 10 schools had a "cancer planning group", and four were using problem-based learning. Only five schools could readily provide detailed curriculum maps. Courses covered most areas of basic and clinical sciences outlined in the ACS ideal curriculum; chemotherapy and palliative care were taught in all courses, but other subjects were covered less often (e.g., clinical staging, radiation oncology and pain management were taught in nine schools, critical evaluation of medical literature in seven, and economic evaluation in five). Teaching on cancer in clinical placements also varied considerably (e.g., one school devoted no time to palliative care). DISCUSSION: There has been some improvement in delivery of cancer education in medical schools since 1993, but considerable variation in teaching practice and implementation remains. Difficulty in determining details of course content led directly to difficulty in assessing the quality of teaching about cancer.

Australia↗