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PubMed2004

Community exchange and training in the Suid Bokkeveld: a UNCCD pilot project to enhance livelihoods and natural resource management.

Community knowledge exchanges have played a key role in developmental processes in the Suid Bokkeveld community of South Africa. Two exchange visits were undertaken with the support of the Department of Agriculture and an NGO, the Environmental Monitoring Group, which have led to local economic development and enhanced capacity to manage natural resources in a sustainable manner. These pilot projects were undertaken within the framework of the Community Exchange and Training Programme of the Global Mechanism of the United Nations Convention to Combat Desertification (UNCCD). The methodology applied included facilitation to develop a community-based vision for development, in terms of which the community exchange process was designed. A Facilitation Team of service providers conducted preparatory workshops, and identified potential partner communities. Two exchange visits were carried out, one focused on Rooibos production and marketing, and the other on community-based eco-tourism. Following report-back and planning workshops, emerging community-driven initiatives were supported through their formative stages. The initiatives have not only resulted in enhanced livelihoods, but the methodology has also been applied widely in a number of different contexts.

Community Participation↗

PubMed2006

Assessing clinical competence: a pilot project to evaluate the feasibility of a standardized patient -- based practical examination as a component of the Swiss certification process.

PURPOSE: advances in the assessment of clinical competence have prompted medical schools and licensing authorities to complement written and oral tests with practical ones. The purposes of this project were to (1) determine how clinical competencies not effectively addressed on the present Swiss federal examinations can be assessed adequately on a standardised patient-based practical examination (SCE) and (2) evaluate the SCE validity, reliability and feasibility. METHOD: a bilingual, three-hour standardised patient-based clinical examination was pilot tested in 2003 with 48 volunteered fifth and sixth-year students from the five Swiss medical schools. All students took the same eight 15-minute patient cases. To ensure the test content validity, test cases were selected by a multi-disciplinary and -institutional committee of clinical faculty on the basis of predefined exam blueprint criteria and in reference to the Swiss catalogue of learning objectives. RESULTS: moderate correlations between the SCE and the existing Federal final written examinations (0.46) and the newly pilot-tested structured oral examination or SOE (0.56) [3] suggested that they were complementary to one another and that each might emphasise aspects of the clinical competence which others might not. The reliability (a coefficient) of the SCE scores ranged from 0.73 to 0.77. CONCLUSIONS: limited experiences gathered throughout the SCE pilot project demonstrated its feasibility. Preliminary results suggested that SCE scores had a good level of construct validity and reliability and seemed to complement scores obtained on the final certification written examinations and the newly tested SOE. These results, however, need to be further confirmed with larger samples studies.

Certification↗

PubMed2006

Comparison of tissue plasminogen activator administration management between Telestroke Network hospitals and academic stroke centers: the Telemedical Pilot Project for Integrative Stroke Care in Bavaria/Germany.

BACKGROUND AND PURPOSE: Systemic thrombolysis is the only therapy proven to be effective for ischemic stroke. Telemedicine may help to extend its use. However, concerns remain whether management and safety of tissue plasminogen activator (tPA) administration after telemedical consultation are equivalent in less experienced hospitals compared with tPA administration in academic stroke centers. METHODS: During the second year of the ongoing Telemedical Pilot Project for Integrative Stroke Care, all systemic thrombolyses in stroke patients of the 12 regional clinics and the 2 stroke centers were recorded prospectively. Patients' demographics, stroke severity (National Institutes of Health Stroke Scale), frequency of administration, time management, protocol violations, and safety were included in the analysis. RESULTS: In 2004, 115 of 4727 stroke or transient ischemic attack patients (2.4%) in the community hospitals and 110 of 1889 patients in the stroke centers (5.8%) received systemic thrombolysis. Prehospital latencies were shorter in the regional hospitals despite longer distances. Door to needle times were shorter in the stroke centers. Although blood pressure was controlled more strictly in community hospitals, symptomatic intracerebral hemorrhage rate (7.8%) was higher (P=0.14) than in stroke centers (2.7%) but still within the range of the National Institute of Neurological Disorders and Stroke trial. In-hospital mortality rate was low in community hospitals (3.5%) and in stroke centers (4.5%). CONCLUSIONS: Although with a lower rate of systemic thrombolysis, there was no evidence of lower treatment quality in the remote hospitals. With increasing numbers of tPA administration and growing training effects, the telestroke concept promises better coverage of systemic thrombolysis in nonurban areas.

Academic Medical Centers↗

PubMedDate not supplied

Translating research into MCH service: comparison of a pilot project and a large-scale resource mothers program.

This study examines the process and effect of translating a pilot research project into a large-scale service program. In a pilot resource mothers program for pregnant teenagers, participants had fewer low birth weight infants than teenagers in the comparison group. In the corresponding large-scale service program, a similarly positive effect on low birth weight was not seen. In an effort to understand how these differences occurred, the evaluation methodologies and key characteristics that describe the background, infrastructure, components, and service providers of the two projects were compared. Important differences between the pilot project and the service program were seen in funding stability, diversity of staff, community versus health department ownership of the program, caseloads, and levels of training and supervision. It seems probable that these differences brought about changes in the intensity and character of the intervention from the pilot to the service program, leading to a reduction of the intervention's efficacy in reducing the number of low birth weight infants. The implications of these findings for researchers and program planners are discussed.

Adolescent↗

PubMed1998

Preventing NIDDM among aboriginal people: is exercise the answer? Description of a pilot project using exercise to prevent gestational diabetes.

Rates of diabetes and its complications have reached epidemic proportions among North American Aboriginal peoples. This appears largely due to changes in diet and activity levels associated with a shift away from traditional lifestyles. Since exercise has been shown to be effective in preventing non-insulin-dependent diabetes mellitus (NIDDM), Aboriginal communities may be able to reduce their rates of the disease by incorporating exercise programs into their public health programs. We describe a pilot project in Saskatoon, Saskatchewan, whose ultimate purpose is to evaluate the effect of exercise in preventing gestational diabetes. If successful, this would reduce the risk of developing NIDDM for both women and their offspring.

Adolescent↗

PubMedDate not supplied

The Paris-Sud yeast structural genomics pilot-project: from structure to function.

We present here the outlines and results from our yeast structural genomics (YSG) pilot-project. A lab-scale platform for the systematic production and structure determination is presented. In order to validate this approach, 250 non-membrane proteins of unknown structure were targeted. Strategies and final statistics are evaluated. We finally discuss the opportunity of structural genomics programs to contribute to functional biochemical annotation.

Genomics↗

PubMed2001

[Intensive Psychiatric Support at the Setting in Lausanne: a pilot project].

While the hospital remains an important element of the psychiatric health-care system, the fact that it is always the best place to treat acute psychotic episodes is still debated. After a brief review of the literature relative to the main existing community care models, the authors describe the development in the Department Universitaire de Psychiatrie Adulte (DUPA), of an alternative to hospitalisation for patient going through a severe acute psychiatric episode. They present three clinical situations and the aims of the research project, which will follow this pilot phase.

Community Psychiatry↗

PubMed1998

AIDS education and intervention trials among youths in factories: a pilot project.

The project aimed to conduct a pilot study and intervention trials among youths in a factory of Khon Kaen. After contacting and obtaining agreement from owners/managers of factories, a survey using a self administered questionnaire, in-depth interview and focus group with workers to determine their level of knowledge and awareness of AIDS and high risk behaviour. A series of in-depth interviews with 16 workers and group discussion with 8 groups were conducted to find out their possible motivation for prevention and their acceptance of interventions/media. The data was used as a baseline for evaluating change after interventions and to modify the intervention education strategies and content. The study showed that the groups of factory workers which were not involved in the AIDS prevention had a different level of knowledge, attitudes, and behavior related to AIDS prevention than the groups which received the intervention and the methods used in the intervention achieved a level of success. The information we collected also showed that the best kinds of media for this purpose were videos and informational cartoons, which were also of special interest to the study group. It is hoped that the models will be adopted by relevant government and non-government agencies to be used in factories throughout the country.

Acquired Immunodeficiency Syndrome↗

PubMed2000

[Improving communication between ambulatory and inpatient care. A pilot project].

Medical care of our population has made dramatic progress during recent decades. However, problems arose from an increasing specialization and subspecialization on the one hand and from the complexity of care structures on the other hand. In light of scarce financial resources and of increasing demands regarding quality by both recipients and payers of medical care the analysis of diagnostic and treatment processes gained considerable attention. In this context, a lack of cooperation between ambulatory and in-patient care has been complained about for a long time. The aim of our pilot project introduced here was therefore to assess the cooperation between physicians in private practice and our psychiatric hospital by means of a random sample query. The results are communicated here.

Aged↗

PubMed2005

Wastewater planning in Djenné, Mali. A pilot project for the local infiltration of domestic wastewater.

The city of Djenné (Mali) is famous for its mosque which is the world's largest adobe building. Djenné is considered to be one of the most interesting cities in Western Africa from an architectural point of view. Since 1988, Djenné is listed as a UNESCO World Heritage Site. In the 1990s, a drinking water supply network was provided by foreign development organisations. However, no facilities were provided for the disposal of wastewater, resulting in an increase of waterborne diseases. This paper describes the urban drainage problem in Djenné and discusses the systematic evaluation of possible solutions and the subsequent pilot project for the local infiltration of sullage. The infiltration of sullage proved to be an appropriate technology for solving the urban drainage problem in Djenné.

Cities↗

PubMed2001

[Professional licensing examination. Innovative experience: the Integrated Multimedia Pilot Project of the Chieti University].

The Medical Licensing Examination (MLE) is governed, in Italy, by a law enacted in 1956. An ideal clinical competence assessment tool should effectively, reliably and objectively measure all the components of clinical competence: basic knowledge and clinical skills as history-taking, performing a physical examination, formulating the most likely diagnosis, establishing a management plan, communication and interpersonal relations. Since 1998 first session of the MLE, Chieti University implemented computer-based case simulations and standardized patients in the Multimedia Integrated Pilot Project (MIPP) administration. At the present time, we have examined 370 subjects during five sessions of MLE. This preliminary work shows results regarding the examinees in the first examination session of 1998 and 1999. The two groups of examinees are relatively homogeneous for number, age, gender, length of curriculum and country of University degree. In both groups the curriculum scores (preclinical, clinical and total) and the MIPP final score are reported for all subjects, first ten and last ten examinees. The MIPP final score is moderately correlated with the preclinical, clinical and total curriculum scores. Recently, the Federation of State Medical Boards and the National Board of Medical Examiners, sponsoring organisations of the United States Medical Licensing Examination (USMLE), have been planning the implementation of computer-based testing for the USMLE. It is important to point out that our MIPP-based MLE is not a mere didactic experiment, but a legal certifying examination valid for licensure.

Adult↗

PubMed1992

Mechanical behavior of three maxillofacial prosthetic adhesive systems: a pilot project.

The use of maxillofacial prosthetic adhesives remains controversial. A new machine for mechanical testing of adhesives was developed. This machine was used for in vivo testing of three adhesive systems to determine the adhesive joint strength of bonding silicone facial prosthetic elastomer to facial skin. Tensile, torsion, and combined tensile-torsion tests were carried out on two human subjects. The three adhesives tested were PSA1, Pros-Aide, and Dow Corning 355. All adhesives were applied according to the manufacturers' instructions. A 900 gm bonding load was applied for 20 seconds. The experimental design made use of two subjects, and the entire experiment was repeated on each subject. One test site on the cheek was used. Adhesive types were compared by means of the Student-Newman-Keuls method. Within the limitations of the design of this pilot study, the results showed that Dow Corning 355 adhesive was statistically significantly stronger than the other two adhesives evaluated by means of tensile and combined tensile-torsional tests. Although the results of the present pilot project are of interest, extrapolation to definitive conclusions of a clinical nature should be avoided.

Adhesives↗

PubMed2001

[A pilot project of the integration of oro-dental care into the primary health care system in Cameroon].

OBJECTIVE: The objective of this work is to analyse the situation of the Oral Health Care (OHC) of the population of operational district health unit in Primary Health Care (PHC) and finally integrate the component of OHC. Indeed in many countries in Africa, the World Health Organisation (WHO), in accord with the countries, have set up the policy of PHC. The agreement is that the component of OHC was neglected for quite sometimes in Cameroon. It's for this reason that a pilot project was initiated as a model so that it would be extended to all districts in this country. METHOD: The method consist in investigation into the prevalence by means of questionnaire and clinical examination of the population of varied age; 900 persons were examined in the Sangmelina health district in order to master the situation of OHC. RESULTS: Oral dental hygiene: 70.5% of the population had a tooth brush, 79% declared they brush their teeth, The state of periodontal tissue: 75% had debris, 70% calculus, 60.7% gingivitis, The prevalence of caries: 66.9% (91.9% had between 21 and 32 teeth), 44.8% follon teeth, 50.8% of this population needed artificial teeth. CONCLUSION: The situation of the OHC in the health district of Sangmelina requires an effective prevention, consequently the importance of including this situation in PHC program of the said district.

Adolescent↗

PubMed1993

[Investigations of the Berlin-Reinickendorf Health Office of salmonella infections, a pilot project in cooperation with the Robert von Ostertag Institute of the Federal Health Office].

According to the Federal Law on Epidemics, salmonelloses belong to the notifiable diseases. Even the suspicion of the disease is notifiable. However, only in very few cases the suspicion is notified, thus, the activity of the Public Health Office to clarify the infection routes is often too late. The rate of clarified cases from the total single cases is, therefore, very low. The different fields of responsibility of the Public Health Offices and the Veterinary Offices and Food Investigation Centres has a negative effect on the clarification rate as well. The Department of Health and Environment Protection has, in cooperation with the Robert von Ostertag-Institute, developed a pilot project: "Recording of suspected food infections and intoxications in private households--clarification of infection routes". The objective of the project is the improvement of cooperation of human and veterinary medicine, as well as of the investigation centres, the Federal Health Office and private physicians. Additionally, clinical data are to be collected to find out the reasons for the salmonellosis suspicion. Hypotheses on infection routes in households are to be verified or falsified by means of clutch and swab samples. Early investigations of the cases are to lead to a higher investigation rate of food samples in households and restaurants.

Animals↗

PubMed2005

Pilot project of mechanical-biological treatment of waste in Brazil.

By mechanical-biological treatment (MBT) of residual municipal solid waste the behaviour of landfills can be significantly improved. After MBT the organic content (COD and BOD5), total organic carbon, and total nitrogen in the leachate, as well as the gas production rate, are reduced to values lower than 90% of the fresh untreated waste. The volume of the stabilized material to be disposed on landfills decreases enormously, by up to 70%. The monitoring effort for a landfill constructed under these conditions is reduced to a minimum and the stabilized material can be used in other ways, as material for reforestation, for cover material or for thermal utilization to produce energy. Environmental conditions are important in MBT, as well as waste characteristics. This paper describes the results of a pilot project of MBT performed in Rio de Janeiro, Brazil. The results have shown that this technology can be used successfully in developing countries, with economy for the society and important results for the environment.

Air Pollution↗

PubMed2003

The Griffith area palliative care service: a pilot project.

In September 2000 the Commonwealth released, as part of its National Palliative Care Strategy under the Australian Health Care Agreements, a National Framework for Palliative Care Service Development. The new National Framework stressed an important set of values to guide models of palliative care delivery. It notes that the challenge is to secure the place of palliative care as an integral part of health care across Australia, routinely available within local communities to those people who need it. Care and support for people who are dying and their families need to be built not only into health care services, but also into the fabric of communities and their support networks. While few would disagree with this, little is known about how best to achieve it in rural Australia. The Griffith Area Palliative Care Service (GAPS) is a two-year pilot project delivering a palliative care service through a truly integrated approach to care for patients, their carers and families within the Griffith Local Government Area and Carrathool Shire areas. This paper describes how GAPS is successfully meeting the challenges of service provision to rural and remote areas.

Case Management↗

PubMed2002

Real-time influenza surveillance in Germany--results of a pilot project.

Real-time surveillance information is the prerequisite for accurate influenza diagnosis followed by appropriate treatment of acute influenza with neuraminidase inhibitors. With REALFLU trade mark Surveillance, Hoffmann-La Roche has developed an international early warning system for influenza. The feasibility of the newly developed real-time influenza surveillance in Germany was tested and the results were compared with those of the established German influenza sentinel system of Influenza Study Group (Arbeitsgemeinschaft Influenza, AGI). The evaluation of the REALFLU trade mark Surveillance was performed during the winters of 1999/2000 and 2000/2001. The percentage of influenza-like illnesses among patients seen by the reporting physicians and positives of the Roche Influenza A/B Rapid Test were reported daily by internet, evaluated and could be called up on dynamic internet web pages real-time. The group of project participants could at any time call up the evaluations of the current data on password-protected internet web pages. A retrospective comparison with data obtained by the AGI showed good agreement between the two systems. Even better agreement was obtained on comparing the data with the virus isolates of the National Reference Centers (NRZ). This confirms the reliability of the selected methodology. REALFLU trade mark Surveillance provided information about influenza outbreaks 1-2 weeks earlier than NRZ and the AGI. The results show that it is possible and reasonable to conduct influenza surveillance on a real-time basis. In an overall context of REALFLU trade mark Surveillance, the German pilot project was capable of reflecting the influenza situation on a real-time and regionalized basis during both winters. The Roche Influenza A/B Rapid test proved to be a useful surveillance tool.

Age Distribution↗

PubMed2000

[Innovative course concept for small group teaching in clinical methods. Results of a longitudinal, 2-cohort study in the setting of the medical didactic pilot project in Dusseldorf].

BACKGROUND AND OBJECTIVE: Medical students in Germany often criticize the anonymous and not practice-orientated way they are taught. It was the aim of this study to develop, try out and evaluate cost-effectiveness of practice-oriented interdisciplinary teaching in small groups. PATIENTS AND METHODS: The study was based on ca. 300 medical students/year, a practicable number in relation the average annual total intake by German medical schools. Between 1995 and 1998, 300 medical students annually, chosen by lot, were offered voluntary additional teaching of imaging methods (computed tomography, endoscopy and sonography), from a total of 2485 students (1276 females, 1209 males; mean age 25.8 years), the reminder serving as controls. After lecture-demonstration to all, the selected small groups were separately taught. They performed sonography on each other in small cohorts of 5 or they practised endoscopies on phantom models under supervision of a student tutor. In addition, lecturers circulated among the groups to answer additional questions and provide further help. All participants evaluated the course concept and the instructors on a questionnaire provided by the interdisciplinary centre for tertiary education. The effects of teaching on the participants were tested by a practical test in the form of an objective structured clinical examination (OSCE). RESULTS: Ca. 80% of course participants reached the intended aim and passed the OSCE examination. They gave the instructions in the pilot project highest marks, in all its criteria nearly one mark higher than those of other evaluated teaching sessions. Pre-clinical students judged the programme even more favourably than those in their clinical years. The additional cost incurred was moderately low at ca. DM 67 per year per student. CONCLUSION: Modern practice-oriented small group teaching will provide high quality results even with large numbers of students. The concept has already been taken over by other medical faculties.

Adult↗