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PubMed1983

A training pack. Field programme management: food and nutrition.

One of the main barriers to development is the lack of adequately trained field staff. It is now widely recognized that the field worker plays a crucial role in implementing community development programmes. National development plans may look promising on paper but without the staff in the field, capable of managing the programmes, there is little chance for substantial gain from development efforts. To help address the problem of training for field workers, the Food Policy and Nutrition Division has produced the Training Pack. Its aim is to help field workers develop simple management skills which can be used in their daily work. The material in the Pack stresses those management techniques required by all field workers, whether their primary responsibility is agriculture, health, nutrition or community development. The Pack uses aspects of food and nutrition to illustrate the basic management skills, without attempting to turn the field workers into nutritionists. The emphasis of the Course is on the planning, implementation and evaluation of community activities. The practical approach advocated by these training materials is described in detail here.

Community Health Workers↗

PubMedDate not supplied

RN students: unobtrusive cost-effective change agents.

A teaching learning project that empowers registered nurse (RN) to bachelor of science in nursing (BSN) senior nursing students to undertake cost containment and quality improvement pilot projects in the institutions where they work enables nursing education and nursing service to collaborate in promoting cost containment and quality improvement. Understanding how this process was implemented in one institution, as well as the outcomes, can help guide the application of this creative teaching strategy.

Cost Control↗

PubMed1995

Strengthening the links between health sciences information users and providers.

In 1994, the Hospital Library Service Program of the Central New York Library Resources Council conducted a study to evaluate the usefulness, impacts, and potential services of eleven hospital libraries in a four-county area in New York State; determine the degree to which the libraries comply with Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standard IM.9.2; and provide recommendations for improved services in the member libraries. Two research instruments were used: a survey for hospital-based health sciences professionals and a survey for hospital-based information providers. Results from the two surveys were compared to determine if users' needs were being filled, and to develop plans for improved information services and products. Fourteen recommendations are made that, if implemented, will support the creation of user-defined information products, enhance the library's profile within the hospital, and exploit resource sharing to reduce costs and enhance coordination.

Computer Communication Networks↗

PubMedDate not supplied

Changing how and what children learn in school with computer-based technologies.

Schools today face ever-increasing demands in their attempts to ensure that students are well equipped to enter the workforce and navigate a complex world. Research indicates that computer technology can help support learning, and that it is especially useful in developing the higher-order skills of critical thinking, analysis, and scientific inquiry. But the mere presence of computers in the classroom does not ensure their effective use. Some computer applications have been shown to be more successful than others, and many factors influence how well even the most promising applications are implemented. This article explores the various ways computer technology can be used to improve how and what children learn in the classroom. Several examples of computer-based applications are highlighted to illustrate ways technology can enhance how children learn by supporting four fundamental characteristics of learning: (1) active engagement, (2) participation in groups, (3) frequent interaction and feedback, and (4) connections to real-world contexts. Additional examples illustrate ways technology can expand what children learn by helping them to understand core concepts in subjects like math, science, and literacy. Research indicates, however, that the use of technology as an effective learning tool is more likely to take place when embedded in a broader education reform movement that includes improvements in teacher training, curriculum, student assessment, and a school's capacity for change. To help inform decisions about the future role of computers in the classroom, the authors conclude that further research is needed to identify the uses that most effectively support learning and the conditions required for successful implementation.

Adolescent↗

PubMed2001

How did we make the Interdisciplinary Generalist Curriculum Project work? School-level efforts to facilitate success.

This article examines how the schools funded by the Interdisciplinary Generalist Curriculum (IGC) Project handled the process of planning and implementing their proposals; incorporated the IGC requirements as templates for changes in educational programs and organizational infrastructures; and identified key educational and management issues that emerged over time. How collaboration flourished at each IGC school was the central functional ingredient for successful implementation. Shared power and support from the dean were essential for success. The need for excellent channels of communication among all constituencies in the process of curricular change cannot be overemphasized. The most common approach was the addition of the new interdisciplinary clinical curriculum to the existing, usually discipline-based, curriculum, with attempts to establish integrative horizontal connections among concurrent courses in years one and two. The integration, sequencing, and correlating of basic science and clinical material occupied much of the IGC course directors' time in the early stages. Several approaches were used to help ensure a beneficial initial clinical experience for medical students, while accepting that a uniform experience for all students was not attainable or necessary. Encouraging active learning on the part of students was a goal of IGC schools' planning in and of itself. The splash of establishing interdisciplinary communication structures and greater melding of disciplinary cultures that occurred at and among the IGC schools appeared to lead to ripple effects that were recognized within the first year of planning and early implementation.

Communication↗

PubMedDate not supplied

An overview of digital spectrometers for MR imaging. Instrumentation Subcommittee of the SMRI Basic Science Council.

Most magnetic resonance (MR) imaging systems were originally designed with analog spectrometers, since that was the "state of the art" in the late 1970s, when they were developed. Advances in technology have allowed the design of radio-frequency electronics with a much larger percentage of digital components while the cost of such components has decreased. This has given manufacturers the incentive to develop new spectrometers that incorporate these electronics for cost reduction and potentially better performance. Upgrades and new models of MR units have become available with these so-called "digital spectrometers." Because of the interest in the new systems, the Instrumentation Subcommittee of the Basic Science Council of the Society for Magnetic Resonance Imaging has produced this report to review the basic features of analog and digital spectrometers to help the MR imaging community better understand the similarities and differences of these systems. Some details of actual commercial implementations were left out to focus on the basic features. Regardless, the authors hope they have provided a readable introduction to this important topic.

Humans↗

PubMed1989

A qualitative analysis of examination questions set for students of nursing in Scotland.

The construction of essay-type questions for inclusion in nursing examination papers is a time consuming task for teachers. In this paper, the findings of the qualitative analysis of the examination systems in basic nursing education in Scotland are discussed, with specific reference to questions set in internal and external formal examinations. The form and type of questions which seemed to create difficulties for students are identified and discussed. Several issues are raised, including coverage of the syllabus content, the science base for nursing, and determining levels of question difficulty. The paper concludes with recommendations concerning the format of assessment, especially if the NBS were to delegate more responsibility to colleges and when the proposals on curriculum reform evisaged in Project 2000, are implemented.

Curriculum↗

PubMed1999

The 1999 Crafoord Prize lectures. Neo-Lamarckian experimentalism in America: origins and consequences.

The 1890s and the first decades of the twentieth century saw a vigorous debate about the mechanisms of evolutionary change. On one side, August Weismann defended the selectionist hypothesis; on the other, Herbert Spencer defended neo-Lamarckian theory. Supporters of Spencer, notably the American paleontologist and evolutionary theorist Henry Fairfield Osborn, recognized that the questions raised by Weismann and Spencer could only be settled experimentally. They called for the application of experimental methods, and the establishment of a new institution for the purpose of confirming the inheritance of acquired characters. To a great extent, the experimental program championed by Osborn and others was implemented and, although it failed to reveal soft inheritance and was soon eclipsed by Mendelian and chromosomal genetics, it did make significant and lasting contributions to evolutionary biology. Thus the importance of methodological and institutional innovation and theoretical pluralism to the progress of science is illustrated and underscored.

Animals↗

PubMed1990

Factors influencing the development of area health education centers with Texas-Mexico border populations.

Area Health Education Centers (AHECs) have been viewed as an appropriate vehicle for implementing new initiatives for training health professionals who will work along the U.S.-Mexico border. Perceptions about this program in Texas were evaluated from July 1988 to June 1989 to identify problems and formulate suggestions that might be of use to academic health science centers (HSCs)--and in particular medical schools--working with Hispanic populations. Interviews were conducted with 116 people: the presidents and/or deans of all eight Texas HSCs and/or medical schools, other deans and faculty, community leaders in five border counties, and state officials. The school and community perspectives about past and present AHEC activities were compared. Some of the barriers were: insufficient components of the health care delivery system to support medical education in severely underserved areas; differing school and community priorities; cultural differences between the school faculty and the community; and feeling among community physicians and dentists that AHECs were a source of competition. The school and community respondents agreed that the AHEC program needs more cooperative planning and training that emphasizes public health education for future AHEC-like activities with border populations.

Academic Medical Centers↗

PubMed2002

The profession of medicine: an integrated approach to basic principles.

OBJECTIVE: The University of South Florida College of Medicine developed and implemented an innovative three-week course entitled, "The Profession of Medicine: An Integrated Approach to Basic Principles" to introduce new medical students to topics and skills that are important to their successful study of medicine. Demonstrating the clinical relevance of the basic sciences, the importance of lifelong learning, and ethics and professionalism in medicine were emphasized. Basic physical examination techniques, searching the medical literature and evidence-based medicine, and study and computer skills were introduced in addition to traditional orientation topics. DESCRIPTION: Four interdisciplinary "state of the art" presentations demonstrated the importance of lifelong learning and the clinical relevance of basic science concepts. Lectures on acute myocardial infarction, breast cancer, duodenal ulcer, and pulmonary prematurity were presented as if the lectures were being given in 1980. Students attended lectures on basic science principles relevant to these topics, and then met in small groups with librarians, content experts, and small-group facilitators to begin investigating an assigned topic. For example, student groups researched the development of EMS and chest pain centers, thrombolysis and percutaneous coronary intervention, and the psychological implications of acute myocardial infarction for patients and families. Students were introduced to effective literature-searching techniques, the tenets of evidence-based medicine, and effective computer skills in the context of studying their assigned topics. Each group then selected a student presenter to deliver an eight-minute PowerPoint presentation of its 2001 "state of the art" findings, making particular note of scientific advances and new therapeutic protocols developed since 1980, such as the use of artificial surfactant in premature babies, the role of H. pylori in duodenal ulcers, and the discovery of the genetics of breast cancer. These projects as well as a series of small-group educational programs enabled students and faculty to develop a strong sense of team-work and cohesiveness. Students had opportunities to practice components of the history and physical examination on standardized patients relevant to the four clinical topic areas, such as cardiac and abdominal examinations with emphasis on anatomic principles. Basic ethical principles and their application to cases that pertained to the four clinical topics were introduced, and students participated in a small-group ethics case conference. Throughout the course, students and faculty were required to wear specially designed nametags. By the time the course concluded with the White Coat ceremony, the 75 participating faculty and 104 students knew one another, making the ceremony particularly meaningful. DISCUSSION: The pace at which scientific findings revolutionize the practice of medicine continues to accelerate. While it is important for undergraduate medical students to master the basic and clinical science foundations of medical practice, it may be even more important to teach students how to find and interpret medical information, form professional relationships with mentors and peers, and make a commitment to lifelong learning and professionalism. It is critical that students understand that the curricular program at any college of medicine is only the beginning of a life of study.

Education, Medical, Undergraduate↗

PubMed2005

Neuropsychiatric consequences of traumatic brain injury: a review of recent findings.

PURPOSE OF REVIEW: Behavioral and psychiatric disturbances are the more frequent consequences of traumatic brain injury and major determinants of the quality of life of patients. This review was designed to familiarize the reader with the more recent work published in this field. RECENT FINDINGS: We have now a more consistent view of the epidemiology of post-traumatic brain injury psychiatric disorders both in adult and pediatric populations. Mood disorders, anxiety disorders and substance use disorders are the more prevalent psychiatric diagnoses among traumatic brain injury patients. The phenomenological characteristics and clinical correlates of major depression, post-traumatic stress disorder, alcohol use disorders, and post-traumatic brain injury attention deficit hyperactivity disorder have been studied in more detail. Newer structural, metabolic and functional neuroimaging techniques help to clarify the pathogenesis of these disorders. In turn, this knowledge may lead to the implementation of more efficient therapeutic interventions. Unfortunately, controlled treatment studies have been the exception in the field, and treatment decisions usually lack adequate empirical support. SUMMARY: Recent advances in the basic neuroscience of traumatic brain injury as well as in behavioral genetics, social science and neuroimaging techniques should contribute to a better understanding of the pathophysiology of the psychiatric disorders occurring after the injury. There is a great need for randomized, double-blind, placebo-controlled trials to establish the most effective treatments for these disorders.

Journal Article↗

PubMed2002

Evaluation of quality improvement programmes.

In response to increasing concerns about quality, many countries are carrying out large scale programmes which include national quality strategies, hospital programmes, and quality accreditation, assessment and review processes. Increasing amounts of resources are being devoted to these interventions, but do they ensure or improve quality of care? There is little research evidence as to their effectiveness or the conditions for maximum effectiveness. Reasons for the lack of evaluation research include the methodological challenges of measuring outcomes and attributing causality to these complex, changing, long term social interventions to organisations or health systems, which themselves are complex and changing. However, methods are available which can be used to evaluate these programmes and which can provide decision makers with research based guidance on how to plan and implement them. This paper describes the research challenges, the methods which can be used, and gives examples and guidance for future research. It emphasises the important contribution which such research can make to improving the effectiveness of these programmes and to developing the science of quality improvement.

Evidence-Based Medicine↗

PubMed2002

Standards for hospital libraries 2002.

The Medical Library Association's "Standards for Hospital Libraries 2002" have been developed as a guide for hospital administrators, librarians, and accrediting bodies to ensure that hospitals have the resources and services to effectively meet their needs for knowledge-based information. Specific requirements for knowledge-based information include that the library be a separate department with its own budget. Knowledge-based information in the library should be directed by a qualified librarian who functions as a department head and is a member of the Academy of Health Information Professionals. The standards define the role of the medical librarian and the links between knowledge-based information and other functions such as patient care, patient education, performance improvement, and education. In addition, the standards address the development and implementation of the knowledge-based information needs assessment and plans, the promotion and publicity of the knowledge-based information services, and the physical space and staffing requirements. The role, qualifications, and functions of a hospital library consultant are outlined. The health sciences library is positioned to play a key role in the hospital. The increasing use of the Internet and new information technologies by medical, nursing, and allied health staffs; patients; and the community require new strategies, strategic planning, allocation of adequate resources, and selection and evaluation of appropriate information resources and technologies. The Hospital Library Standards Committee has developed this document as a guideline to be used in facing these challenges.

Consultants↗

PubMed2005

Dental education in Singapore--from the past to the future.

Dental education in Singapore has come a long way since the founding of the Dental School in 1929. With an initial intake of 7 students, the Faculty has over the years produced more than 1700 graduates. Its early years were fraught with physical constraints and recruitment problems. With a dedicated core of leaders and good planning, the dental school has overcome many of these shortcomings. The King Edward VII College of Medicine played a significant role in the early years of the school's development. Many a student of the past era has pleasant memories that bind and bond them to the SGH Sepoy Lines campus. Acquiring full Dental Faculty status in 1966, the progress of dental education took on a new urgency and stature. The basic medical science subjects were taught to the dental students by our medical colleagues at Sepoy Lines and now continue to be tutored at the Kent Ridge campus. With the shift of the Faculty in 1986 to Kent Ridge (NUS-NUH), together with the implementation of the changed curriculum in 1990 and 1997, the Faculty of Dentistry remains at the forefront of pedagogy and technology to train the future generation of dentists for Singapore.

Curriculum↗

PubMed2005

Promoting the oral health of older adults through the chronic disease model: CDC's perspective on what we still need to know.

The Centers for Disease Control and Prevention (CDC) has adopted a multicomponent approach to health promotion: the Chronic Disease Model. Among its underlying public health principles are 1) recognition of the universal preference for primary prevention of disease, 2) awareness that prevention often takes place outside of clinical settings and is influenced by behaviors that can be affected by social circumstances and institutional policies, 3) the need to base program efforts on the best available science, 4) the special responsibility of public health for at-risk populations, and 5) the need for population-based approaches. Such approaches require public health agencies to build programs that engage broad networks of partners; monitor diseases, risk factors, and behaviors; implement proven prevention strategies; and evaluate programs rigorously. If CDC is to implement comprehensive programs to promote the oral health of elderly people, more information is needed. In this short report we comment on gaps in knowledge concerning the components of programs, measurement of oral diseases and risk factors, and the effectiveness of preventive interventions at the self-care, clinical, and community levels for dental caries and oral and pharyngeal cancers.

Aged↗

PubMed1991

A collaborative institutional model for integrating computer applications in the medical curriculum.

The introduction and promotion of information technology in an established medical curriculum with existing academic and technical support structures poses a number of challenges. The UNC School of Medicine has developed the Taskforce on Educational Applications in Medicine (TEAM), to coordinate this effort. TEAM works as a confederation of existing research and support units with interests in computers and education, along with a core of interested faculty with curricular responsibilities. Constituent units of the TEAM confederation include the medical center library, medical television studios, basic science teaching laboratories, educational development office, microcomputer and network support groups, academic affairs administration, and a subset of course directors and teaching faculty. Among our efforts have been the establishment of (1) a mini-grant program to support faculty initiated development and implementation of computer applications in the curriculum, (2) a symposium series with visiting speakers to acquaint faculty with current developments in medical informatics and related curricular efforts at other institution, (3) 20 computer workstations located in the multipurpose teaching labs where first and second year students do much of their academic work, (4) a demonstration center for evaluation of courseware and technologically advanced delivery systems. The student workstations provide convenient access to electronic mail, University schedules and calendars, the CoSy computer conferencing system, and several software applications integral to their courses in pathology, histology, microbiology, biochemistry, and neurobiology. The progress achieved toward the primary goal has modestly exceeded our initial expectations, while the collegiality and interest expressed toward TEAM activities in the local environment stand as empirical measures of the success of the concept.

Academic Medical Centers↗

PubMedDate not supplied

[Mental health nursing in general clinical practice].

The nurse in the general clinical practice considers every person as a unique and indivisible bio-psycho-social human being and every disease as a psychosomatic phenomenon. In this perspective, she assesses not only the physical problems of each patient, but also his psychosocial adaptation to the stress of the physical illness. She plans and implements the necessary psychosocial interventions to strengthen the patient's mental health which will promote his cure, always practicing the holistic and personalized nursing care. Furthermore, she pursues her self-continuing education in matters of mental health as in matters of basic sciences and new hospital technology.

Holistic Health↗

PubMed2001

Outcomes of patients using a tiered trauma response protocol.

OBJECTIVES: This study evaluated processes of care and outcome for injured patients at a Level I trauma center who had been either treated as a full trauma team activation (FULL) or managed with a modified trauma team activation (MOD). METHODS: A retrospective methodology was used to evaluate all patients entered into the regional trauma system and transported from the scene to a Level I trauma center. Patients treated during a 2-year period of exclusively FULL trauma team protocols were compared with patients managed during a subsequent 2-year period after implementation of a two-tiered response. In the later era, trauma system patients were designated before hospital arrival as either FULL or MOD trauma team responses. An additional case-control analysis was conducted on a subset of MOD trauma team response patients who were undertriaged; that is, in retrospect, they met criteria for a FULL response. The outcomes in the case-control group were compared by chi2 tests and Mann-Whitney U tests. Statistical significance was assumed for p < 0.05. RESULTS: During the presystem period, 1,740 patients were transported as trauma system entries to Oregon Health Sciences University. During the postsystem period, 2,333 patients were transported to Oregon Health Sciences University as either MOD trauma system entries (1,272 [55%]) or as FULL trauma system entries (1,061 [45%]). Postsystem patients had longer time intervals in the emergency department compared with presystem patients. Death rates for patients who died in the emergency department or before hospital discharge were similar. Among patients who were designated as MOD trauma system entries and were subsequently categorized as meeting FULL trauma team criteria, mortality rate was low. CONCLUSION: Implementation of the tiered response protocol led to a substantial change in the operational response in the emergency department. Although processes of care were nominally prolonged, adverse consequences were not identified. We concluded from this quality improvement review that implementation of a tiered response protocol was satisfactory and improved efficiency. Further work is required to improve accuracy of the categorization of trauma system patients as either MOD or FULL trauma codes.

Adult↗