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PubMed1984

[Dynamics of a latent epizootic process as evaluated by an incidence-of-infection index].

The index of infection (the number of positive samples to the total number of investigated samples ratio) was used to study the intensity of the inapparent epizootic process in avian salmonellosis. Two flocks of broiler birds were followed up for the presence of Salmonella organisms over the period of hatching up to the end of fattening. The study of samples taken from the cloaca revealed a high index of infection (15 to 31.7 per cent) among the clinically normal birds. Two laboratory tests were carried out to confirm the results. Sixteen, resp., 26 day-old, Salmonella-free birds were kept together with 2 (in each group) birds orally infected with S. isangi. Up to the 13th day (the end of the experiment) the percent of the infected contacts reached 92.3 and 100. This made it reasonable to believe that there was a chain of infections following one after an other among healthy birds maintained by sources of Salmonella organisms--an inapparent epizootic process.

Animals↗
PubMed1984

Physicians' and physical therapists' evaluations of cerebral-palsied children for Achilles tendon lengthening.

Ten orthopedic surgeons and 10 physical therapists working with spastic cerebral-palsied children were interviewed about the evaluation process they used to assess surgical lengthening of the achilles tendon. Objective and subjective considerations were described and wide variations in responses were found. No single evaluation criterion or subjective factor was mentioned by the majority of either group. In addition, the extent of interprofessional collaboration in presurgical assessment was described. Those respondents who consulted with other health professionals closely agreed about the purpose of the consultation. It is concluded clinicians need to identify more precisely the essential components of the evaluation process for this type of surgery.

Achilles Tendon↗
PubMed1982

Evaluating performance in writing drug information consultations.

A form for evaluating written drug information consultations was used to measure the performance of pharmacy students in a drug information service clerkship; the reliability of the evaluation process was also assessed. Drug consultations were written by 74 clerks during a four- or five-week rotation. A total of 147 consultations were written: Nine clerks wrote one consultation, 57 clerks wrote two, and eight clerks wrote three. The consultations were evaluated on 11 criteria by 18 different preceptors using an evaluation form. Performance on each criterion was rated on a four-level scale. Clerk improvement over time, reliability of the instrument, and inter-rater reliability for preceptors were analyzed statistically. The overall mean score for all consultations was 84 7%. Some improvement was observed between the first and second consultations completed by clerks, but the difference was not significant. Reliability of the evaluation process was good (coefficient of alpha = 0.666). There as no significant difference among preceptors. The authors concluded that the written drug information consultation evaluation form was a valid and reliable method for measuring individual and program competence.

Clinical Competence↗
PubMed1991

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

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

Curriculum↗
PubMed1988

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

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

Algorithms↗
PubMed1995

Effect of gender on the emergency department evaluation of patients with chest pain.

OBJECTIVE: To assess chest pain evaluation as reflected in the documentation of the evaluation process for women vs men in one emergency department (ED). METHODS: In this retrospective case series, patient charts were reviewed for documentation in accordance with a clinical policy for chest pain evaluation. Patient demographics and the frequencies of inclusion of the following items were determined: five descriptors of chest pain, associated symptoms, risk factors for coronary artery disease, receipt of physical examination, and receipt of ECG. RESULTS: Over a three-month period, 132 men and 150 women were evaluated for chest pain and entered in the study. There was no significant difference in age between men and women overall, but in the subgroup of patients who were admitted to the hospital, the women were significantly older than the men by an average of five years (p = 0.04). Fifty-five percent of all the patients were admitted to the hospital. The men were admitted to the hospital significantly more often than were the women (p = 0.01), with a relative risk of admission for women vs men 0.76 (95% CI = 0.62-0.94). There was no significant difference between the men and the women for any of the process of evaluation items in the overall group or in the hospital-admission and release-home subgroups. CONCLUSION: The authors' findings do not support the existence of a gender difference in ED chest pain evaluations, as reflected by documentation of the evaluation process. However, men were more likely to be admitted to the hospital for evaluation of coronary artery disease than were women.

Adult↗
PubMed1988

Evaluating the quality of education-practice relationships.

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

Career Mobility↗
PubMed1984

Species differences in oxidative drug metabolism: some basic considerations.

Perhaps one of the single most important developments in the past 20 years in the understanding of chemical toxicity has been the realisation of the importance of metabolic transformation in this process. It is now widely appreciated that the toxic effects of many chemicals is a function of their metabolism rather than the substance itself. Of central interest to the toxicologist therefore is an understanding of the metabolism of a toxic chemical and the significance of this in the toxic process. The metabolic process itself however can be highly variable both between and within animal species. For this reason the toxicologist may have to consider both species and strain differences in metabolism when attempting to extrapolate findings to man in the safety evaluation process. For the past twenty years, work on species differences in metabolism has been largely of a descriptive nature and the cataloguing of differences. However, developments in the last few years in the understanding of the genetic diversity of species, including man, in terms of biotransformation and the nature and substrate preferences of the various multiple forms of the drug-metabolizing enzymes now give a better insight into the nature of species differences of metabolism. Furthermore, an understanding of this problem tempers expectations in terms of what may be hoped for in the extrapolation from other species. For example, the search for a species that metabolizes like man will be seen to be ill-conceived and ill-advised. The presentation deals with some of the fundamental aspects of species and strain differences in oxidative metabolism in particular and the implications that this has for the toxicologist in the safety evaluation process.

Animals↗
PubMed1993

Repeated multiphasic screening examinations: evaluating the process.

There are sound clinical and epidemiological reasons to promote and emphasize early detection efforts and disease prevention services. A large body of scientific literature supports the notion that detection and intervention early in the course of many diseases is beneficial both to the afflicted individual and to society at large. Several publications deal with the evaluation of multiphasic screening examinations (MSE) as a tool for simultaneous early detection and prevention of multiple risk factors and various diseases. Usually, this technology is evaluated based on data from a single (cross-sectional) comprehensive screening study. However, frequently MSE are performed periodically, resulting in repeated test results of the same individuals. The health impact of such repeated (longitudinal) MSE has not been studied extensively. Similarly, many of the unique theoretical, technical, and epidemiological features characteristic of consecutive (periodical) comprehensive screening examinations are not well-documented. The purpose of this study was to compare the test results of two MSE, performed 3.5 years apart, in order to demonstrate certain characteristics of multiphasic health testing (MHT) technology related to repeated (longitudinal) multiphasic examination of the same individuals.

Humans↗
PubMed1992

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

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

Anxiety↗
PubMed1995

[Development and evaluation of self-study material for smoking prevention education].

A booklet for smoking prevention education was developed for junior high school students, which is a role-play activity book for self-study and discusses not only the harmful effects and dependency of smoking but also psychosocial factors affecting smoking behavior among students. The purpose of this material is to provide students with basic information needed to choose a non-smoking lifestyle even without a teacher's direct instruction. Process evaluation and impact evaluation studies were carried out between September 1991 and September 1992. Six hundred sixty-nine students and 9 teachers from three junior high schools in Osaka, Tokyo and Yamagata participated in the process evaluation study. More than 90% of the students were able to complete the material in one school hour and less than 4% students expressed difficulty in learning from the booklet. Nine hundred seventy-seven students from 2 junior high schools in Tokyo participated in an intervention study to evaluate the effectiveness of the material. There were 500 students in the experimental school and 477 students in the control school. All students were given a pretest and posttest, 2 months apart. Knowledge concerning smoking increased and attitudes toward smoking were modified significantly in the experimental school. However, intention to smoke and smoking behavior did not change significantly, due to the small numbers of students with intention to smoke at the time of pretest and because there was not enough time for their intention to change. This study demonstrates the effectiveness of the material in junior high school. However, teacher participation during the instruction is also seen to be necessary for greater effect.

Adolescent↗
PubMed1985

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

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

Attitude of Health Personnel↗
PubMedDate not supplied

[Quality assurance exemplified by perinatology and surgery].

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

Cesarean Section↗
PubMed1993

Human chromosomes: evaluation of processing techniques for scanning electron microscopy.

Methods for scanning electron microscopy (SEM) of chromosomes have been developed in the last two decades. Technical limitations in the study of human chromosomes, however, have hindered the routine use of SEM in clinical and experimental human cytogenetics. We compared different methodologies, including metal impregnation, air drying and specimen coating. SEM preparation of human chromosomes in which osmium impregnation is mediated by tannic acid, yielded more reproducible results when compared with osmium impregnation protocols previously described. The level of osmium impregnation was systematically evaluated by imaging chromosomes in the backscattering mode. Critical point drying and a light gold-palladium coating were essential for appropriate secondary electron imaging of chromosomes. With this method, and in a preliminary quantitative analysis, we show that our SEM technique is more sensitive than light microscopy for the detection of aphidicolin-induced fragile sites. This technical approach is useful for chromosomal studies requiring resolution higher than that obtained by light microscopy. Also, it allows the use of clinical and archival chromosomal samples prepared by routine cytogenetic techniques.

Adult↗