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PubMed1998

Reducing teenage and unintended pregnancies through client-centered and family-focused school-based family planning programs.

Achievement of the national health goal to reduce teenage and unintended pregnancies through family planning requires a holistic approach to primary prevention. Building upon Rogers' Science of Unitary Human Being, Orem's Self-Care Theory, and Rosenstack's Health Belief Model, a client-centered and family-focused school-based family planning program is proposed as a means to achieve the health goal. FNPs play a pivotal role in development and successful implementation of such a program.

Adolescent↗

PubMed1997

Exact ART: A Complete Implementation of an ART Network.

In this article we introduce a continuous time implementation of adaptive resonance theory (ART). ART designed by Grossberg concerns neural networks that self-organize stable pattern recognition categories of arbitrary sequences of input patterns. In contrast to the current implementations of ART we introduce a complete implementation of an ART network, including all regulatory and logical functions, as a system of ordinary differential equations capable of stand-alone running in real time. This means that transient behavior is kept in tact. This implementation of ART is based on ART 2 and is called Exact ART. Exact ART includes an implementation of a gated dipole field and an implementation of the orienting sub-system. The most important features of Exact ART, which are the design principles of ART 2, are proven mathematically. Also simulation studies show that Exact ART self-organizes stable recognition codes that agree with the classification behavior of ART 2. Copyright 1997 Elsevier Science Ltd.

Journal Article↗

PubMed1999

High school genetics education and Alzheimer disease.

Improved and updated human genetics education, including Alzheimer disease (AD) awareness and education, is urgently needed. National, state, and local standards for science education agree that human genetics, biotechnology applications, and the social and ethical issues raised by modern technology need to be taught in high school science using hands-on and inquiry methods of teaching. High school science courses are the last opportunity for most individuals to learn human genetics. There are an increasing number of new and successful human genetics curriculum materials and inservice teacher education programs at the secondary school level aligned with national and state science education standards. These curricula and teacher education programs can be enhanced by collaborative partnerships of geneticists, genetics professionals, biotechnology scientists and technical personnel, and science educators, several of which are in successful operation. Because human genetics involves families and generations, genetics education tied to AD may provide a unique opportunity to educate two generations, both students and parents, to the many medical, personal, family, community, and cultural issues of human genetics and genetic conditions. Implementing human genetics and AD education provides a recipe for accurate, relevant, sustainable and exciting teaching and learning for all involved.

Adolescent↗

PubMed2006

Do self- reported intentions predict clinicians' behaviour: a systematic review.

BACKGROUND: Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice. Several interventions have been shown to be effective in changing health care professionals' behaviour, but heterogeneity within interventions, targeted behaviours, and study settings make generalisation difficult. Therefore, it is necessary to identify the 'active ingredients' in professional behaviour change strategies. Theories of human behaviour that feature an individual's "intention" to do something as the most immediate predictor of their behaviour have proved to be useful in non-clinical populations. As clinical practice is a form of human behaviour such theories may offer a basis for developing a scientific rationale for the choice of intervention to use in the implementation of new practice. The aim of this review was to explore the relationship between intention and behaviour in clinicians and how this compares to the intention-behaviour relationship in studies of non-clinicians. METHODS: We searched: PsycINFO, MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Science/Social science citation index, Current contents (social & behavioural med/clinical med), ISI conference proceedings, and Index to Theses. The reference lists of all included papers were checked manually. Studies were eligible for inclusion if they had: examined a clinical behaviour within a clinical context, included measures of both intention and behaviour, measured behaviour after intention, and explored this relationship quantitatively. All titles and abstracts retrieved by electronic searching were screened independently by two reviewers, with disagreements resolved by discussion. DISCUSSION: Ten studies were found that examined the relationship between intention and clinical behaviours in 1623 health professionals. The proportion of variance in behaviour explained by intention was of a similar magnitude to that found in the literature relating to non-health professionals. This was more consistently the case for studies in which intention-behaviour correspondence was good and behaviour was self-reported. Though firm conclusions are limited by a smaller literature, our findings are consistent with that of the non-health professional literature. This review, viewed in the context of the larger populations of studies, provides encouragement for the contention that there is a predictable relationship between the intentions of a health professional and their subsequent behaviour. However, there remain significant methodological challenges.

Journal Article↗

PubMed1995

Case study update. Arizona's UMC model of patient-center care thrives after four years. Three new features of redesign at University Medical Center, Tucson.

In January 1992, this publication introduced a promising one-year-old program of patient-centered care at 312-bed University Medical Center (UMC), Arizona Health Sciences Center, in Tucson. Since then, the groundbreaking program (dubbed the "Arizona Model" by admiring colleagues in other states) has continued to grow, even as the small teaching institution saw its environment evolve into "a war zone" of managed care competition. In the last year, three important enhancements have been implemented.

Academic Medical Centers↗

PubMed2002

Educational reform: problem-based learning at Chang Gung University, an overview.

Problem-based learning is an educational method characterized by utilization of problems involving patients as a context for students to learn problem-solving skills and acquire knowledge about basic and clinical science. It is a core curriculum in the new pathway of educational reform. Chang Gung University and Chang Gung Memorial Hospital began a program of educational reform in 1998. However, many difficulties were experienced at the very beginning including the capabilities of students, manpower resources, and a transition period of implementation. After a series of communication, education, practice, and system reforms, the problem-based learning curriculum is now performing quite smoothly. This paper reviews the history of and our experiences with educational reform including preparation, implementation, the content and range of reform, accompanying package, committee establishment, tutor training, assessment of tutors and students, etc. The fact that our education reform began from clinical aspects and then progressed to basic medicine is unique, and a hybrid curriculum with a model of parallel progress in traditional and new curricula was created using internal medicine as a reference for other departments. Finally, we hope that the effect of well-designed reforms in facilitating learning should not be underestimated.

Education, Medical↗

PubMed2003

A "systematics" tool for medical terminologies.

Finding the hierarchical relations amongst multiple terms within medical terminologies that support multiple parents to a term is a common task, especially for trainees and knowledge engineers implementing or maintaining medical logic modules or guidelines. Examples of such terminologies include the UMLS and the Medical Entity Dictionary (MED). In addition, the task of identifying and discriminating amongst some common ancestors to a list of terms is a recurrent theme. This is also a common concern in the science of classification (systematics). Some nearest common ancestors have distinct valuable properties for classification and simplification of lists. Although there exist some visualized navigating and editing tools for the UMLS and the MED, they are browsers that show a large number of unrelated and irrelevant relationships to the task at hand. While algorithms have been well studied in computer science to solve such a problem over semantic networks and trees, to our knowledge, they have not been used with a visualization tool in biomedicine. We developed a visualized tool that graphically displays the hierarchical relations of multiple terms, and helps identifying the nearest common ancestors of these terms.

Classification↗

PubMed2001

Tracing our roots: new opportunities and new challenges in clinical laboratory science (1977-1992).

OBJECTIVE: To describe new opportunities and challenges facing clinical laboratory science between 1977 and 1992. DESIGN: A survey of literature on the history of clinical laboratory science was conducted. References consulted include various books and professional journals. CONCLUSION: Between 1977 and 1992 the role of clinical laboratory scientist continued to evolve and expand as new tests and instruments were introduced. Over time, they began to assume greater responsibilities for analyzing and interpreting test results, evaluating and implementing quality assurance programs and new methodologies, and became involved, to a greater extent, in laboratory management and supervision, education, and research. A wide variety of career opportunities were opened to clinical laboratory scientists, providing them with employment opportunities beyond the milieu of the clinical laboratory. Federal regulations aimed at controlling cost of healthcare had a significant effect on the clinical laboratory and clinical laboratory personnel. Stricter guidelines for reimbursement of laboratory services by third-party payees and private insurers forced laboratories to scrutinize their costs and develop creative strategies to attract clients. Attrition, job satisfaction, salaries, and personnel shortages grew in importance during this period as well, prompting research in these areas.

Clinical Laboratory Techniques↗

PubMed2005

Selection of information resources for education in medical pharmacology.

Pharmacology is the foundation science of medical pharmacotherapy. Education in medical pharmacology (EP) requires the use of information resources (IR) to meet the challenge of the continuous introduction of new drugs and new educational, didactic and pedagogical theories to enhance knowledge. Hence criteria for selecting bibliographic material for EP should be clearly outlined and implemented. In this work we present a method to select IR for EP based on systems theory and focusing on the factors determining: (a) the integration of a list of recommended IR for EP; (b) the design of the acquisition list for faculty and students work; (c) the overall organization of the resources available for its optimal use and benefit in the educational process; and (d) a general strategy for assessing the impact of the bibliographic infrastructure. The proposal is based on information from: (i) lists of recommended readings in the academic program of the Pharmacology course given at the School of Medicine of UNAM in the last 30 years; (ii) the extent of discipline development measured by two indexes derived from the contents of Goodman and Gilman's "Pharmacological Basis of Therapeutics" (G & G); (iii) the number of texts currently found in the collection of FM-UNAM which are classified in the section of Pharmacology using the Library of Congress Classification System (LCCS); and (iv) the comparison of academic versus standardized classification of pharmacology topics, such as Medical Subject Heading (MESH) and LCCS The importance of this proposal relates to its usefulness for EP and for other medical disciplines.

Books↗

PubMed1991

New directions in migration research: perspectives from some North American regional science disciplines.

"This paper takes several surveys of the literature concerning migration research as its starting point and directs the reader toward a number of potentially fruitful lines for future research. Major sections include one on modeling migrant choice in which the pros and cons of using gross versus net migration measures are discussed. A second introduces and discusses the concept of a 'spatial' choice set, which has the potential to be implemented with laboratory experimental techniques. The third involves a wide-ranging discussion of new directions in modeling the interrelationships between employment and migration." The primary geographical focus is on the United States.

Americas↗

PubMed1997

Basic science of spinal instrumentation.

A wide variety of spinal implants are available to the clinician for the surgical treatment of spinal disorders. Most of the implants are associated with fusion--they are designed either to promote fusion, or, in the case of the newer devices such as artificial discs and disc implants, to offset the perceived disadvantages of fusion. The contributions of biomechanics to the improvement of spinal implant design and clinical implementation are detailed. Benchtop tests of device components and assemblies, in vitro studies of spinal constructs using osteoligamentous spinal segments, and analytical (finite element) and animal models are reviewed. Through these studies, the quantification of parameters such as stresses and strains within the spinal structures and within the fixation devices has permitted a better understanding of the relationship between the clinical observations after surgery and the mechanical factors. However, despite improvements in fusion techniques that have reduced the pseudarthrosis rate, there is still room for improvement. New concepts such as the biological enhancement of spinal fusion and alternatives to fusion such as the artificial disc are currently the subjects of intense, multidisciplinary study, but await the ultimate test of clinical trial with long term followup.

Animals↗

PubMed2003

Science and the major racket sports: a review.

The major racket sports include badminton, squash, table tennis and tennis. The growth of sports science and the commercialization of racket sports in recent years have focused attention on improved performance and this has led to a more detailed study and understanding of all aspects of racket sports. The aim here, therefore, is to review recent developments of the application of science to racket sports. The scientific disciplines of sports physiology and nutrition, notational analysis, sports biomechanics, sports medicine, sports engineering, sports psychology and motor skills are briefly considered in turn. It is evident from these reviews that a great deal of scientific endeavour has been applied to racket sports, but this is variable across both the racket sports and the scientific disciplines. A scientific approach has helped to: implement training programmes to improve players' fitness; guide players in nutritional and psychological preparation for play; inform players of the strategy and tactics used by themselves and their opponents; provide insight into the technical performance of skills; understand the effect of equipment on play; and accelerate the recovery from racket-arm injuries. Racket sports have also posed a unique challenge to scientists and have provided vehicles for developing scientific methodology. Racket sports provide a good model for investigating the interplay between aerobic and anaerobic metabolism and the effect of nutrition, heat and fatigue on performance. They have driven the development of mathematical solutions for multi-segment interactions within the racket arm during the performance of shots, which have contributed to our understanding of the mechanisms of both performance and injury. They have provided a unique challenge to sports engineers in relation to equipment performance and interaction with the player. Racket sports have encouraged developments in notational analysis both in terms of analytical procedures and the conceptualization of strategy and tactics. Racket sports have provided a vehicle for investigating fast interceptive actions, hand-eye coordination and perception-action coupling in the field of motor control. In conclusion, science has contributed considerably to our knowledge and understanding of racket sports, and racket sports have contributed to science by providing unique challenges to researchers.

Biomechanical Phenomena↗

PubMed2005

Post-migration dietary changes among african refugees in Geneva: a rapid assessment study to inform nutritional interventions.

OBJECTIVES: To conduct an assessment of perceived dietary changes and problems by African asylum seekers, in order to develop appropriate nutritional education interventions. METHODS: A cross-sectional qualitative study among a convenience sample. Analysis compared and contrasted reported dietary changes and migration-related difficulties. RESULTS: Nineteen interviews were analysed. After migration, main dietary changes were the decrease in different fruits and vegetables consumed weekly from 10 to 2 and 17 to 10 respectively. The number of respondents drinking sweetened beverages more than 3 times a week increased from 3 to 18. Reasons for changes were related to prices, taste, choice and accessibility. CONCLUSION: These dietary changes may have serious health consequences. Future remedial interventions based on suggestions of the respondents could easily be implemented.

Acculturation↗

PubMed2000

Doctor-patient communication about drugs: the evidence for shared decision making.

The traditional paternalistic model of medical decision-making, in which doctors make decisions on behalf of their patients, has increasingly come to be seen as outdated. Moreover, the role of the patient in the consultation has been emphasised, notably through the adoption of 'patient-centred' strategies. Models that promote patients' active involvement in the decision-making process about treatment have been developed. We examine one particular model of shared decision making [Charles, C., Gafni, A., Whelan, T, 1997. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Social Science & Medicine 44, 681-692.]. The model has four main characteristics. These are that (1) both the patient and the doctor are involved, (2) both parties share information, (3) both parties take steps to build a consensus about the preferred treatment and (4) an agreement is reached on the treatment to implement. Focusing on the first two of the four characteristics of the model, we use the findings from a study of 62 consultations, together with interviews conducted with patients and general practitioners, to consider participation in the consultation in terms of sharing information about, and views of, medicines. We found little evidence that doctors and patients both participate in the consultation in this way. As a consequence there was no basis upon which to build a consensus about the preferred treatment and reach an agreement on which treatment to implement. Thus even the first two of the four conditions said to be necessary for shared decision making were not generally present in the consultations we studied. These findings were presented in feedback sessions with participating GPs, who identified a number of barriers to shared decision making, as well as expressing an interest in developing strategies to overcome these barriers.

Decision Making↗

PubMedDate not supplied

Institutional collaboration not competition: preparing family nurse practitioners to serve rural areas.

In response to the need for an increased number of family nurse practitioners in rural Texas, The University of Texas at Tyler, Texas Tech University Health Sciences Center, and Midwestern State University entered into a collaborative arrangement to provide advanced education to nurses in outlying areas of the state. The catchment area for the project encompassed 72 counties, representing half the land mass in Texas. This article presents the development of the collaborative model, strategies used for implementation, and evaluation of this collaborative effort. The collaborative family nurse practitioner program is based on collegiality rather than competition to better meet the needs of students and communities in a cost-effective manner. Communication between the institutions and faculty has been a key factor in the success of the program. The addition of nurse practitioners from this project has the potential to greatly increase access to health care in large, underserved populations.

Education, Distance↗

PubMed2004

[100 years of Draeger Medical Technology (1902 - 2002) -- working for the applicability of oxygen].

This survey analyses the history of 100 years of Draeger Medical Technology. Between 1889 and 1902 a number of inventions on the field of pressure gas technology allowed to solve application problems, which until then proved major obstacles to the safe and efficient use of compressed gases such as oxygen, nitrous oxide or carbon dioxide for medical and industrial purposes. A special significance is to be awarded here to pressure reducing valves, but also reliable manometers, nozzles and valves for pressure tanks were not generally available until then. These were first successfully and on a really significant scale introduced into international medical and non-medical pressure-gas technology by Draeger Inc. (Luebeck/Germany), and proved particularly successful in anaesthesia and rescue-devices (e. g. in the "Roth-Draeger Anaesthesia Apparatus" (1902). Consequently, starting in 1902, Draeger Inc. increasingly put an emphasis on developing medical and rescue technology and -- by doing so -- gained an important influence on the history of the implementation of modern oxygen therapy and of inhalative anaesthesia. A survey of the historically most important Draeger-Developments is provided.

Anesthesiology↗

PubMed1987

A synthesis of research on nutrition education at the elementary school level.

This literature review emphasizes the importance of teacher training, teaching strategies, parental involvement, curricular concerns, administrative support, and social/cultural factors on the impact of nutrition education programs at the elementary school level. The characteristics, implementation, and effectiveness of selected elementary nutrition education programs are reviewed, and instructional methods and materials shown effective through research are identified and discussed.

Culture↗

PubMed1981

Changing priorities.

In the context of today's mounting global problems the relative demand for medical, educational, and related social benefits that derive from the neurosciences is diminished. At the same time the human value spin-offs of brain research are thrust into a strategic position of top concern because of their key role as criteria or policy priorities and decision-making guidelines. Recent conceptual developments in the mind-brain sciences rejecting reductionism and mechanistic determinism on the one side, and dualisms on the other, clear the way for a rational approach to the theory and prescription of values and to natural fusion of science and religion. Science can be upheld as the best route to an increased understanding and report with the forces that made and move the universe and created man. The outlines of the value-belief system emerge that include an ultimate respect for nature and the evolving quality of the biosphere, which, if implemented, would set in motion the kind of social change needed to lead us out of the viscious spirals of increasing population, pollution, poverty, energy demands, etc. The strategic importance of neuroscience and the central role of prevailing concepts of the mind-brain relation to all of the foregoing remain evident throughout, as does also the direct relevance of efforts to bring added insight and substantiation of these mind-brain concepts through further advances in brain research.

Animals↗