Effectiveness of locomotion training in a home visit preventive care project: one-group pre-intervention versus post-intervention design study.

PubMed

Ito, Shinya; Hashimoto, Mari; Aduma, Saori; Yasumura, Seiji

2015-11-01

Locomotion training in a home visit-type preventive-care program has been reported elsewhere. However, continuation of appropriate exercises in a home setting is difficult, and few reports are available on locomotion training in a home setting. The objective of this study was to evaluate the effectiveness of locomotion training over 3 months in a home visit-type preventive-care program for improvement of motor function among elderly people. Nine hundred and fifty-eight elderly people in Tendo City in Japan who were not currently attending any preventive-care program were invited to participate in the study, and 87 were enrolled. In the pre-intervention and post-intervention assessments, we administered an interview survey (the Kihon Checklist), the timed one-leg standing test with eyes open and the sit-to-stand test, at the participants' homes. The intervention involved one set of training exercises with the participants standing on each leg for 1 min and squatting five or six times. The participants were asked to repeat one set of the exercises three times a day at home. In addition, the participants were regularly asked over the telephone about their performance of the exercises. Physical strength, cognitive function, and total scores of the Kihon Checklist were significantly lower after the intervention than before. In addition, the one-leg standing test time was significantly longer after the intervention (mean ± SD, 23.9 ± 35.4) than before (15.7 ± 20.5), and the sit-to-stand test time was significantly shorter after the intervention (13.0 ± 6.2) than before (14.8 ± 8.3). Locomotion training in a home-visit preventive-care program with telephone support effectively improved the motor function of elderly people who were not currently attending any preventive-care program organized by the long-term care insurance system.

Effective Home Visiting Training: Key Principles and Findings to Guide Training Developers and Evaluators.

PubMed

Schultz, David; Jones, Shelby S; Pinder, Wendy M; Wiprovnick, Alicia E; Groth, Elisabeth C; Shanty, Lisa M; Duggan, Anne

2018-06-23

Purpose Home visiting programs have produced inconsistent outcomes. One challenge for the field is the design and implementation of effective training to support home visiting staff. In part due to a lack of formal training, most home visitors need to develop the majority of their skills on the job. Home visitors typically receive training in their agency's specific model (e.g., HFA, NFP) and, if applicable, curriculum. Increasingly, states and other home visiting systems are developing and/or coordinating more extensive training and support systems beyond model-specific and curricula trainings. To help guide these training efforts and future evaluations of them, this paper reviews research on effective training, particularly principles of training transfer and adult learning. Description Our review summarizes several meta-analyses, reviews, and more recent publications on training transfer and adult learning principles. Assessment Effective training involves not only the introduction and modeling of concepts and skills but also the practice of, evaluation of, and reflection upon these skills. Further, ongoing encouragement of, reward for, and reflection upon use of these skills, particularly by a home visitor's supervisor, are critical for the home visitor's continued use of these skills with families. Conclusion Application of principles of adult learning and training transfer to home visiting training will likely lead to greater transfer of skills from the training environment to work with families. The involvement of both home visitors and their supervisors in training is likely important for this transfer to occur.

Characteristics and Outcomes of an Innovative Train-in-Place Residency Program.

PubMed

Green-McKenzie, Judith; Emmett, Edward A

2017-10-01

Physicians who make a midcareer specialty change may find their options for formal training are limited. Here, we describe a train-in-place program, with measureable outcomes, created to train midcareer physicians who desire formal training in occupational medicine. We evaluated educational outcomes from a novel residency program for midcareer physicians seeking formal training and board certification in occupational medicine. Physicians train in place at selected clinical training sites where they practice, and participate in 18 visits to the primary training site over a 2-year period. Program components include competency-based training structured around rotations, mentored projects, and periodic auditing visits to train-in-site locations by program faculty. Main outcome measures are achievement of Accreditation Council for Graduate Medical Education Occupational Medicine Milestones, American College of Occupational and Environmental Medicine competencies, performance on the American College of Preventive Medicine examinations, diversity in selection, placement of graduates, and the number of graduates who remain in the field. Since inception of this program in 1997, there have been 109 graduates who comprise 7.2% of new American Board of Preventive Medicine diplomates over the past decade. Graduates scored competitively on the certifying examination, achieved all milestones, expressed satisfaction with training, and are geographically dispersed, representing every US region. Most practice outside the 25 largest standard metropolitan statistical areas. More than 95% have remained in the field. Training in place is an effective approach to provide midcareer physicians seeking comprehensive skills and board certification in occupational medicine formal training, and may be adaptable to other specialties.

Involving Employers in Training: Case Studies. Research and Evaluation Report Series 97-J.

ERIC Educational Resources Information Center

Isbell, Kellie; Trutko, John W.; Barnow, Burt S.; Nightengale, Demetra; Pindus, Nancy

This document contains in-depth descriptions and assessments of 17 exemplary employer-based training (EBT) programs that were studied as part of an examination of EBT programs. The case studies are based on site visits to each firm, during which interviews were conducted with company management, supervisors of workers in training, individuals…

Effect of Home Visit Training Program on Growth and Development of Preterm Infants: A Double Blind Randomized Controlled Trial

PubMed Central

Edraki, Mitra; Moravej, Hossian; Rambod, Masoume

2015-01-01

Background: Home visit program can be effective in infants’ growth and development. The present study aimed to investigate the effect of home visit program on preterm infants’ growth and development within 6 months. Methods: It was a double-blind clinical trial study. The study was conducted in Hafez, Hazrat-e-Zeinab, and Namazee Hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from 2010 to 2011. Preterm infants were divided into intervention (n=30) and control groups (n=30) through blocked randomization. The intervention group received home visit training program for 6 months, while the control group only received the hospital’s routine care. Then, the infants’ growth indexes, including weight, height, and head circumference, and development criteria were compared on the first day of admission in Neonatal Intensive Care Unit, and then first, second, third, and sixth months. The data were analyzed using Chi-square, independent t-test, and repeated measures ANCOVA. Results: The mean weight of the intervention and control group infants was 7207.3±1129.74 and 6366.7±922.26 gr in the sixth month. Besides, the intervention group infants’ mean weight was higher compared to the control group after six months (t=-3.05, P=0.03). Also, a significant difference was found between the two groups regarding development indexes, such as following moving objects with the head, keeping the head stable when changing the position from lying to sitting,  producing “Agha” sound, and taking objects by hand (P<0.05) during six months of age. Conclusion: The results showed that the home visit program was effective in preterm infants’ weight gain and some development indexes at the sixth month. Considering the importance of infants’ growth and development, healthcare staff is recommended to incorporate home visit training into their programs, so that steps can be taken towards improvement of preterm infants’ health. Trial Registration Number: IRCT2014082013690N3  PMID:25553330

Effect of home visit training program on growth and development of preterm infants: a double blind randomized controlled trial.

PubMed

Edraki, Mitra; Moravej, Hossian; Rambod, Masoume

2015-01-01

Home visit program can be effective in infants' growth and development. The present study aimed to investigate the effect of home visit program on preterm infants' growth and development within 6 months. It was a double-blind clinical trial study. The study was conducted in Hafez, Hazrat-e-Zeinab, and Namazee Hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from 2010 to 2011. Preterm infants were divided into intervention (n=30) and control groups (n=30) through blocked randomization. The intervention group received home visit training program for 6 months, while the control group only received the hospital's routine care. Then, the infants' growth indexes, including weight, height, and head circumference, and development criteria were compared on the first day of admission in Neonatal Intensive Care Unit, and then first, second, third, and sixth months. The data were analyzed using Chi-square, independent t-test, and repeated measures ANCOVA. The mean weight of the intervention and control group infants was 7207.3±1129.74 and 6366.7±922.26 gr in the sixth month. Besides, the intervention group infants' mean weight was higher compared to the control group after six months (t=-3.05, P=0.03). Also, a significant difference was found between the two groups regarding development indexes, such as following moving objects with the head, keeping the head stable when changing the position from lying to sitting,  producing "Agha" sound, and taking objects by hand (P<0.05) during six months of age. The results showed that the home visit program was effective in preterm infants' weight gain and some development indexes at the sixth month. Considering the importance of infants' growth and development, healthcare staff is recommended to incorporate home visit training into their programs, so that steps can be taken towards improvement of preterm infants' health. IRCT2014082013690N3 

An Attempt to Target Anxiety Sensitivity via Cognitive Bias Modification

PubMed Central

Clerkin, Elise M.; Beard, Courtney; Fisher, Christopher R.; Schofield, Casey A

2015-01-01

Our goals in the present study were to test an adaptation of a Cognitive Bias Modification program to reduce anxiety sensitivity, and to evaluate the causal relationships between interpretation bias of physiological cues, anxiety sensitivity, and anxiety and avoidance associated with interoceptive exposures. Participants with elevated anxiety sensitivity who endorsed having a panic attack or limited symptom attack were randomly assigned to either an Interpretation Modification Program (IMP; n = 33) or a Control (n = 32) condition. During interpretation modification training (via the Word Sentence Association Paradigm), participants read short sentences describing ambiguous panic-relevant physiological and cognitive symptoms and were trained to endorse benign interpretations and reject threatening interpretations associated with these cues. Compared to the Control condition, IMP training successfully increased endorsements of benign interpretations and decreased endorsements of threatening interpretations at visit 2. Although self-reported anxiety sensitivity decreased from pre-selection to visit 1 and from visit 1 to visit 2, the reduction was not larger for the experimental versus control condition. Further, participants in IMP (vs. Control) training did not experience less anxiety and avoidance associated with interoceptive exposures. In fact, there was some evidence that those in the Control condition experienced less avoidance following training. Potential explanations for the null findings, including problems with the benign panic-relevant stimuli and limitations with the control condition, are discussed. PMID:25692491

An attempt to target anxiety sensitivity via cognitive bias modification.

PubMed

Clerkin, Elise M; Beard, Courtney; Fisher, Christopher R; Schofield, Casey A

2015-01-01

Our goals in the present study were to test an adaptation of a Cognitive Bias Modification program to reduce anxiety sensitivity, and to evaluate the causal relationships between interpretation bias of physiological cues, anxiety sensitivity, and anxiety and avoidance associated with interoceptive exposures. Participants with elevated anxiety sensitivity who endorsed having a panic attack or limited symptom attack were randomly assigned to either an Interpretation Modification Program (IMP; n = 33) or a Control (n = 32) condition. During interpretation modification training (via the Word Sentence Association Paradigm), participants read short sentences describing ambiguous panic-relevant physiological and cognitive symptoms and were trained to endorse benign interpretations and reject threatening interpretations associated with these cues. Compared to the Control condition, IMP training successfully increased endorsements of benign interpretations and decreased endorsements of threatening interpretations at visit 2. Although self-reported anxiety sensitivity decreased from pre-selection to visit 1 and from visit 1 to visit 2, the reduction was not larger for the experimental versus control condition. Further, participants in IMP (vs. Control) training did not experience less anxiety and avoidance associated with interoceptive exposures. In fact, there was some evidence that those in the Control condition experienced less avoidance following training. Potential explanations for the null findings, including problems with the benign panic-relevant stimuli and limitations with the control condition, are discussed.

Implementation of Reach Up early childhood parenting program: acceptability, appropriateness, and feasibility in Brazil and Zimbabwe.

PubMed

Smith, Joanne A; Baker-Henningham, Helen; Brentani, Alexandra; Mugweni, Rose; Walker, Susan P

2018-05-01

Young children need nurturing care, which includes responsive caregiver-child interactions and opportunities to learn. However, there are few extant large-scale programs that build parents' abilities to provide this. We have developed an early childhood parenting training package, called Reach Up, with the aim of providing an evidence-based, adaptable program that is feasible for low-resource settings. Implementation of Reach Up was evaluated in Brazil and Zimbabwe to inform modifications needed and identify challenges that implementers and delivery agents encountered. Interview guides were developed to collect information on the program's appropriateness, acceptability, and feasibility from mothers, home visitors, and supervisors. Information on adaptation was obtained from country program leads and Reach Up team logs, as well as quality of visits from observations conducted by supervisors. The program was well accepted by mothers and visitors, who perceived benefits for the children; training was viewed as appropriate, and visitors felt well-prepared to conduct visits. A need for expansion of supervisor training was identified and the program was feasible to implement, although challenges were identified, including staff turnover; implementation was less feasible for staff with other work commitments (in Brazil). However, most aspects of visit quality were high. We conclude that the Reach Up program can expand capacity for parenting programs in low- and middle-income countries. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of New York Academy of Sciences.

Delivering services to incarcerated teen fathers: a pilot intervention to increase the quality of father-infant interactions during visitation.

PubMed

Barr, Rachel; Morin, Marisa; Brito, Natalie; Richeda, Benjamin; Rodriguez, Jennifer; Shauffer, Carole

2014-02-01

The absence of a father figure has been linked to very poor developmental outcomes for the child. During incarceration, there are limited opportunities for visitation between fathers and their children. The Baby Elmo Program provides incarcerated teen fathers with parenting training and visitation with their children with the stated goal of enhancing father-child interactional quality. Forty-one incarcerated teen fathers and their infants ranging from 1 to 15 months of age participated in the present study. During individual sessions, a trained facilitator prepared fathers for visits with their children by introducing key concepts such as following the child's lead, using developmentally appropriate media to illustrate those concepts. After each training session, the incarcerated teen father interacted with his infant and the visit was video recorded. Analysis of the visit sessions focused on father's time use on different activities, the quality of father-infant interactions, and father's integration of target skills introduced in the intervention. The time-use analysis revealed that time use changed as a function of infant age. Growth linear modeling indicated that there were significant positive increases in the amount of parent support and infant engagement as a function of the number of sessions. Follow-up analyses indicated that changes between specific sessions mapped onto the target skills discussed during specific training sessions. This study's preliminary findings suggest that an intervention integrating visitation and appropriate media may be effective for incarcerated teen fathers. Due to the lack of a randomized control group, the present findings are exploratory and are discussed with a focus on further program development. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Analysis of Manning Options for Visit, Board, Search, and Seizure Teams

DTIC Science & Technology

2015-06-01

operations in urban terrain, tactical formations, and continue to advance in the Marine Corps Martial Arts Program (“Recruit Training,” n.d.). About 1100...response. Space onboard a deployed ship is in high commodity, and Marines must find space to conduct their close combat training and martial arts ...order combat training and Marine Corps Martial Arts Program could be integrated more easily with VBSS training. B. CONCLUSIONS AND RECOMMENDATIONS

Predictors of Treatment Response in Depressed Mothers Receiving In-Home Cognitive-Behavioral Therapy and Concurrent Home Visiting

ERIC Educational Resources Information Center

Ammerman, Robert T.; Peugh, James L.; Putnam, Frank W.; Van Ginkel, Judith B.

2012-01-01

Home visiting is a child abuse prevention strategy that seeks to optimize child development by providing mothers with support, training, and parenting information. Research has consistently found high rates of depression in mothers participating in home visiting programs and low levels of obtaining mental health treatment in the community.…

Relationship work in an early childhood home visiting program.

PubMed

Heaman, Maureen; Chalmers, Karen; Woodgate, Roberta; Brown, Judy

2007-08-01

A significant component of the work of public health nurses and paraprofessional home visitors who provide home visits to families with young children involves establishing relationships to effectively deliver the visiting program. The purpose of this qualitative and descriptive study was to describe the relationships among participants in a home visiting program in one regional health authority in the Canadian province of Manitoba. Interviews were carried out with 24 public health nurses, 14 home visitors, and 20 parents. The findings related to establishing, maintaining, and terminating relationships as well as factors influencing relationship work are described. Public health nurses and home visitors put significant effort into the work of establishing relationships with each other and their clients and require adequate training, sufficient human resources, and support from the program's administration to sustain these relationships.

Family risk as a predictor of initial engagement and follow-through in a universal nurse home visiting program to prevent child maltreatment.

PubMed

Alonso-Marsden, Shelley; Dodge, Kenneth A; O'Donnell, Karen J; Murphy, Robert A; Sato, Jeannine M; Christopoulos, Christina

2013-08-01

As nurse home visiting to prevent child maltreatment grows in popularity with both program administrators and legislators, it is important to understand engagement in such programs in order to improve their community-wide effects. This report examines family demographic and infant health risk factors that predict engagement and follow-through in a universal home-based maltreatment prevention program for new mothers in Durham County, North Carolina. Trained staff members attempted to schedule home visits for all new mothers during the birthing hospital stay, and then nurses completed scheduled visits three to five weeks later. Medical record data was used to identify family demographic and infant health risk factors for maltreatment. These variables were used to predict program engagement (scheduling a visit) and follow-through (completing a scheduled visit). Program staff members were successful in scheduling 78% of eligible families for a visit and completing 85% of scheduled visits. Overall, 66% of eligible families completed at least one visit. Structural equation modeling (SEM) analyses indicated that high demographic risk and low infant health risk were predictive of scheduling a visit. Both low demographic and infant health risk were predictive of visit completion. Findings suggest that while higher demographic risk increases families' initial engagement, it might also inhibit their follow-through. Additionally, parents of medically at-risk infants may be particularly difficult to engage in universal home visiting interventions. Implications for recruitment strategies of home visiting programs are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

A Study of the Extent and Effect of English Language Training for Refugees. Phase II: Classroom Observation and Community Survey.

ERIC Educational Resources Information Center

Reder, Stephen; Cohn, Mary

The second phase of a study of the impact of English language training programs on adult Southeast Asian refugees involved on-site visits to 22 intensive programs in eight metropolitan areas: San Diego, Seattle, Minneapolis/St. Paul, New Orleans, Oklahoma City, Northern Virginia/Washington, DC, and Stockton, California. Programs represented a wide…

An Attachment-Based Home Visiting Program for Distressed Mothers of Young Infants

ERIC Educational Resources Information Center

Kaitz, Marsha; Tessler, Naomi; Chriki, Miriam

2012-01-01

Mom2Mom is an attachment-based home visiting project for distressed mothers of young infants, based in Israel. Home visitors, who are volunteer mothers from the community, are trained and supervised by professionals. Home visits occur weekly for 1-2 hours and continue until the infant is 1 year old. The project was founded in Jerusalem in year…

Whale Hunting is Different There -- A Report on the Alaska Rural Teacher Training Corps (ARTTC). COP [Career Opportunities Program] Bulletin 8.

ERIC Educational Resources Information Center

Gartner, Alan

The result of a week long visit to the ARTTC program, this report identifies program strengths and weaknesses. The basic premise behind this 4 year college program is identified as "belief that persons native to a community and trained in that community are best prepared to teach in it", since these students learn while they teach in 10…

A Study of English Language Training for Refugees. Public Report.

ERIC Educational Resources Information Center

Reder, Stephen; And Others

The final report of a study on the impact of English language training on adult Southeast Asian refugees in the United States summarizes the findings of the study's three phases, which include (1) a mail survey of local, regional, and state program administrators; (2) 22 program site visits and four community surveys; and (3) a six-month…

Continued Development of Curriculum for Interpreter Training Programs in Vocational Education. Final Report, July 1, 1980 - June 30, 1981.

ERIC Educational Resources Information Center

Texas State Technical Inst., Waco.

A project was undertaken to continue development of a curriculum for training interpreters for deaf persons enrolled in vocational education programs in Texas. Utilizing field consultants for specialized course development, project staff completed 11 interpreting modules and accompanying audiovisual prototypes. In addition, on-site visits were…

Impact of educational outreach visits on smoking cessation activities performed by specialist physicians: a randomized trial.

PubMed

Etter, Jean-François

2006-07-01

To find out whether educational visits by a nurse to specialist physicians improved their self-reporting of smoking cessation activities; whether these visits increased the percentage of physicians who were aware of and recommended a computer-tailored smoking cessation program and who participated in a training workshop on tobacco dependency treatment. Specialist private practice physicians (n = 523) working in Geneva, Switzerland were randomly assigned to either receiving (n = 261) or not receiving (n = 262) a single 40-minute visit by a trained nurse in 2003. The physicians answered a postal questionnaire 5 months after the visits indicating the percentage of their patients they counselled or treated for tobacco dependency and we recorded whether physicians took part in the workshop. Only half (53%) of the physicians agreed to receive a visit. At follow-up more physicians in the intervention group than in the control group were aware of the computer-tailored program (73% vs. 39%, p < 0.001) and more physicians in the intervention group said they recommended the use of this program to more patients (20% vs. 10%, p = 0.009). Among non-smoking physicians only, the proportion of patients who were advised to quit smoking was higher in the intervention than in the control group (69% vs. 54%, p = 0.019, as reported by physicians). The intervention had no impact on physicians' participation in the workshop. Visits by a nurse increased the proportion of physicians who recommended to their patients the use of a computer-tailored smoking cessation program. Among non-smoking physicians only, the intervention increased the proportion of patients who received the advice to quit smoking, as reported by physicians.

Smoking cessation and its predictors: results from a community-based pharmacy tobacco cessation program in New Mexico.

PubMed

Khan, Nasreen; Anderson, Joe R; Du, Juan; Tinker, Dale; Bachyrycz, Amy M; Namdar, Rocsanna

2012-09-01

The New Mexico Pharmaceutical Care Foundation received funding through the Tobacco Use Prevention and Control Program (TUPAC) to provide support for pharmacist-delivered tobacco cessation services. The goal of the program was to increase the availability of tobacco cessation services to residents of New Mexico. Program outcomes are presented, using data from the first 2 fiscal years. To assess tobacco quit rates among smokers who participated in the community pharmacist-based program and identify the predictors of quitting at the end of a 6-month program. Pharmacists, who had received Rx for Change training, provided tobacco cessation services. Patients were scheduled for an initial visit and then were seen at regularly scheduled follow-up visits at 1 month, 3 months, and 6 months from the initial visit. Data collected at the initial visit included demographics, smoking history, and readiness for quitting. Smoking status was collected at each of the follow-up visits. Data were analyzed using SAS (SAS Institute) and STATA (StataCorp LP) statistical software. Tobacco quit rates were calculated at 1, 3, and 6 months. Multivariate regression analysis was performed to assess predictors of quitting. Standard errors were adjusted for repeated observation. Data were available for 346 participants. The average quit rate at the end of 6 months was 25%. Significant predictors of quitting were high confidence levels in quitting at baseline, individuals who had first cigarettes at least 30 minutes after waking up, first cessation attempt, and nonwhite patients. A smoking cessation program delivered through trained community pharmacists with prescriptive authority is an effective approach to reducing smoking. Further research should be conducted to compare the effectiveness of pharmacists with that of other providers of tobacco cessation services.

Ecotourism, sustainable development, and conservation education: Development of a tour guide training program in Tortuguero, Costa Rica

NASA Astrophysics Data System (ADS)

Jacobson, Susan K.; Robles, Rafael

1992-11-01

A tour guide training program was developed for rural communities near Costa Rica's Tortuguero National Park to respond to the impacts of the 24-fold increase in park visitation in the past decade, to involve local communities in resource management, and to provide regional environmental education. The development of the training course involved a survey of scientists and park managers to ascertain resource management needs, priorities for information to be disseminated, and impacts of tourism on the resource base. Current and potential tour guides were surveyed to identify their information needs, solicit their input in the training program, and to determine their knowledge and skills. Written questionnaires were developed and given to 400 tourists to determine their activities and environmental information needs, and hotel owners were censused to examine the economic feasibility of a local guide program. A pilot training course and guide program involving 12 Tortuguero residents demonstrated that a tour guide program: (1) helped mitigate negative tourism impacts on Tortuguero National Park's natural resources, particularly by regulating tourists on the park's 35-km beach used for nesting by endangered sea turtles; (2) provided environmental education to an important segment of the local community not traditionally reached through school or government development projects; (3) provided environmental information to tourists, thus enhancing their visit; and (4) provided local economic benefits through lucrative part-time employment, thereby allowing local people to participate more fully in the tourism system. An extended training course is being planned to provide further environmental education programming and to increase year-round employment opportunities for the tour guides.

Injuries in women associated with a periodized strength training and running program.

PubMed

Reynolds, K L; Harman, E A; Worsham, R E; Sykes, M B; Frykman, P N; Backus, V L

2001-02-01

Forty-five women participated in a 24-week physical training program designed to improve lifting, load carriage, and running performance. Activities included weightlifting, running, backpacking, lift and carry drills, and sprint running. Physicians documented by passive surveillance all training-related injuries. Thirty-two women successfully completed training program. Twenty-two women (48.9%) suffered least 1 injury during training, but only 2 women had to drop out of the study because of injuries. The rate of injury associated with lost training time was 2.8 injuries per 1,000 training hours of exposure. Total clinic visits and days lost from training were 89 and 69, respectively. Most injuries were the overuse type involving the lower back, knees, and feet. Weightlifting accounted for a majority of the lost training days. A combined strength training and running program resulted in significant performance gains in women. Only 2 out of 45 participants left the training program cause of injuries.

How People Choose Vocational Education and Training Programs: Social, Education and Personal Influences on Aspiration.

ERIC Educational Resources Information Center

Maxwell, Graham; Cooper, Maureen; Biggs, Neville

The reasons why Australians choose to enroll in vocational education and training (VET) programs were examined through a questionnaire survey and site visits. The questionnaire yielded responses from 1,501 VET students of a target sample of 3,000 students who were equally representative of the following fields of study: business, engineering,…

Vocational Outreach Program.

ERIC Educational Resources Information Center

Benne, Larry L.

A manpower study was conducted by Indian Hills Community College (IHCC) to gather local labor market information, determine training needs, and assess the effectiveness of IHCC's vocational programs. IHCC instructors from 20 vocational programs visited and conducted interviews with 347 private and public sector employers. Study findings included…

Home-based bimanual training based on motor learning principles in children with unilateral cerebral palsy and their parents (the COAD-study): rationale and protocols.

PubMed

Schnackers, Marlous; Beckers, Laura; Janssen-Potten, Yvonne; Aarts, Pauline; Rameckers, Eugène; van der Burg, Jan; de Groot, Imelda; Smeets, Rob; Geurts, Sander; Steenbergen, Bert

2018-04-18

Home-based training is considered an important intervention in rehabilitation of children with unilateral cerebral palsy. Despite consensus on the value of home-based upper limb training, no evidence-based best practice exists. Promoting compliance of children to adhere to an intensive program while keeping parental stress levels low is an important challenge when designing home-based training programs. Incorporating implicit motor learning principles emerges to be a promising method to resolve this challenge. Here we describe two protocols for home-based bimanual training programs, one based on implicit motor learning principles and one based on explicit motor learning principles, for children with unilateral spastic cerebral palsy aged 2 through 7 years. Children receive goal-oriented, task-specific bimanual training in their home environment from their parents for 3.5 h/week for 12 weeks according to an individualized program. Parents will be intensively coached by a multidisciplinary team, consisting of a pediatric therapist and remedial educationalist. Both programs consist of a preparation phase (goal setting, introductory meetings with coaching professionals, design of individualized program, instruction of parents, home visit) and home-based training phase (training, video-recordings, registrations, and telecoaching and home visits by the coaching team). The programs contrast with respect to the teaching strategy, i.e. how the parents support their child during training. In both programs parents provide their child with instructions and feedback that focus on the activity (i.e. task-oriented) or the result of the activity (i.e. result-oriented). However, in the explicit program parents are in addition instructed to give exact instructions and feedback on the motor performance of the bimanual activities, whereas in the implicit program the use of both hands and the appropriate motor performance of the activity are elicited via manipulation of the organization of the activities. With the protocols described here, we aim to take a next step in the development of much needed evidence-based home-based training programs for children with unilateral cerebral palsy.

77 FR 44675 - Agency Information Collection Activities; Submission for OMB Review; Comment Request: Site Visit...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-30

... Reinvestment Act Funded Grants; Job Training Evaluations ACTION: Notice. SUMMARY: The Department of Labor (DOL... Act funded Grants; Job Training Evaluations,'' to the Office of Management and Budget (OMB) for review... Green Jobs training programs. The overall aim of these evaluations is to determine the extent to which...

Migrant Education Administrative Guide.

ERIC Educational Resources Information Center

North Carolina State Dept. of Public Instruction, Raleigh. Div. of Compensatory Education.

Relating specifically to the North Carolina migrant education program's administrative responsibilities, this guide is designed to aid administrators in program management, monitoring project activities, project evaluation, self-assessment, determining needs for training and staff development, site-visit preparation, policy development, and…

Nutrition component in a comprehensive child development program. I. The home visitor's role in the prenatal intervention phase.

PubMed

Snowman, M K; Dibble, M V

1979-02-01

Nutritional services were integrated in a comprehensive child development program for sixty-eight disadvantaged urban families in an attempt to promote maximum cognitive and psychosocial functioning in their children. Child development trainers made weekly home visits beginning in pregnancy, which combined data gathering, direct nutritional counseling, and early sensory excercises for infants. This paper describes the prenatal home visit program, the training of the home visitors, how the 24-hr. food recall method was adapted for their use, the nature of the home visits, and the complex role of the home visitor. The group whose families participated in the prenatal home visits and were also followed for six months after the infants' birth scored higher on six-month Cattell Scales than did a control group who entered the program at six months of age. There were no stillbirths or neonatal deaths. The incidence of low-birth-weight infants was lower than the national averages. Participation in the program was high.

Implementation of a Cognitive Skills Training Program in ROTC: The Leadership Enrichment Program

DTIC Science & Technology

1987-03-01

IMPLEMENTATION ..................... B-i C. LEP BRIDGING MANUAL . ............... ..... C-I D. ROTC INSTRUCTORS TRAINED IN IE ............... D-1 E. BASIC...cognitive ability. The importance of thinking ability is em- phasized throughout the leadership field manual , FM-22-100, particularly in the sections...haplamtation * Qonfeaumos Calls, * Gonctmetr Site Visits * instrutor 4-5/85 questionnaires Got Feeback an * Conference Camll * Ref ruskur Session 2/85 Frolow

Reserve Component Programs, Fiscal Year 1992: Annual Report of the Reserve Forces Policy Board

DTIC Science & Technology

1993-01-01

serve components. (q 66 Reserve IFrmes Polut , i(oard k’e’re (, 0inmpontt PJatwrnm.s I 9’)𔃼 Ot!!S Training and Mobilization Readiness9 "trained people...requested for use. Additionally, activities enforcing command compliance. Each program are now required to perform a self- audit on a is subject to...visits, Environmental Compliance Assessment and coordination and cooperation with other Management Program audits performed by the agencies, policy and

Systemwide Aviation/Aerospace Education Program Review. Aviation/Aerospace Task Force's Report to the Oklahoma State Regents for Higher Education.

ERIC Educational Resources Information Center

Oklahoma State Regents for Higher Education, Oklahoma City.

A program review was done of all aviation/aerospace-related higher education programs in Oklahoma. A team of nine experts reviewed statistics on the state's public and private programs, conducted a survey of institutions on industry status and projected training needs, and visited all 10 program locations. The project applied guidelines to…

When Reading Gets Ruff: Canine-Assisted Reading Programs

ERIC Educational Resources Information Center

Lane, Holly B.; Zavada, Shannon D. W.

2013-01-01

Canine-assisted reading programs show promise as an innovative method for engaging reluctant readers and motivating them to practice. In such programs, specially trained dogs visit classrooms and libraries, and children read to them. Children who struggle with reading may be motivated to read more because they find dogs to be calming and…

Update on child abuse prevention.

PubMed

Krugman, Scott D; Lane, Wendy G; Walsh, Christina M

2007-12-01

Child abuse remains a significant problem in the United States with 2.9 million reports and 825 000 indicated cases in 2005. This report will highlight recent efforts toward child abuse prevention, focusing on home visiting programs, abusive head trauma primary prevention, parent training programs, sexual abuse prevention, and the effectiveness of laws banning corporal punishment. Most home visitation programs have demonstrated a lack of effectiveness in recent randomized trials. One exception is the Nurse Family Partnership, which remains the most effective and longest enduring intervention for high-risk families. Child sexual abuse prevention programs and parent training programs need further evaluation with more rigorous methodology and outcome measures. Providing universal parent education about coping with crying infants appears to be effective in lowering the incidence of abusive head trauma. Although advocated for, further study will determine the effectiveness of laws banning corporal punishment or mandating abusive head trauma education to parents of newborns. Pediatricians play an important role in the prevention of child maltreatment. Their knowledge of the effectiveness of different programs can help guide parents toward appropriate services.

78 FR 19711 - Center for Devices and Radiological Health: Experiential Learning Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... Program (ELP). The ELP provides a formal training mechanism for regulatory review staff to visit research... medical device establishments, including, research, manufacturing, academia, and health care facilities.... Clinical use of orthopedic bone void Observation of surgical filler devices. procedures (posterolateral...

[Sportsmanship.

ERIC Educational Resources Information Center

CRF Sports and the Law, 1993

1993-01-01

This publication is part of the Sports and the Law program sponsored by the Constitutional Rights Foundation. The program draws on young people's natural interest in sports to stimulate their involvement in education, and provides teacher training, lesson plans, a textbook and accompanying videotape, an annual conference, and classroom visits by…

Transfer of communication skills to the workplace during clinical rounds: impact of a program for residents.

PubMed

Liénard, Aurore; Merckaert, Isabelle; Libert, Yves; Bragard, Isabelle; Delvaux, Nicole; Etienne, Anne-Marie; Marchal, Serge; Meunier, Julie; Reynaert, Christine; Slachmuylder, Jean-Louis; Razavi, Darius

2010-08-26

Communication with patients is a core clinical skill in medicine that can be acquired through communication skills training. Meanwhile, the importance of transfer of communication skills to the workplace has not been sufficiently studied. This study aims to assess the efficacy of a 40-hour training program designed to improve patients' satisfaction and residents' communication skills during their daily clinical rounds. Residents were randomly assigned to the training program or to a waiting list. Patients' satisfaction was assessed with a visual analog scale after each visit. Transfer of residents' communication skills was assessed in audiotaped actual inpatient visits during a half-day clinical round. Transcripted audiotapes were analyzed using content analysis software (LaComm). Training effects were tested with Mann-Whitney tests and generalized linear Poisson regression models. Eighty-eight residents were included. First, patients interacting with trained residents reported a higher satisfaction with residents' communication (Median=92) compared to patients interacting with untrained residents (Median=88) (p=.046). Second, trained residents used more assessment utterances (Relative Risk (RR)=1.17; 95% Confidence intervals (95%CI)=1.02-1.34; p=.023). Third, transfer was also observed when residents' training attendance was considered: residents' use of assessment utterances (RR=1.01; 95%CI=1.01-1.02; p=.018) and supportive utterances (RR=0.99; 95%CI=0.98-1.00; p=.042) (respectively 1.15 (RR), 1.08-1.23 (95%CI), p<.001 for empathy and 0.95 (RR), 0.92-0.99 (95%CI), p=.012 for reassurance) was proportional to the number of hours of training attendance. The training program improved patients' satisfaction and allowed the transfer of residents' communication skills learning to the workplace. Transfer was directly related to training attendance but remained limited. Future studies should therefore focus on the improvement of the efficacy of communication skills training in order to ensure a more important training effect size on transfer.

Job Training Partnership Act: Participants, Services, and Outcomes. Statement before the Committee on Education and Labor, United States House of Representatives.

ERIC Educational Resources Information Center

Thompson, Lawrence H.

The U.S. General Accounting Office studied the characteristics of individual participants in training provided by the Job Training Partnership Act (JTPA), the kinds and intensity of services they received, and the occupations in which they were employed after leaving the program. Visits to 63 randomly selected service delivery areas provided…

Short-term Evaluation of a Comprehensive Education Program Including Inhaler Training and Disease Management on Chronic Obstructive Pulmonary Disease.

PubMed

Yoo, Kwang Ha; Chung, Wou Young; Park, Joo Hun; Hwang, Sung Chul; Kim, Tae Eun; Oh, Min Jung; Kang, Dae Ryong; Rhee, Chin Kook; Yoon, Hyoung Kyu; Kim, Tae Hyung; Kim, Deog Kyeom; Park, Yong Bum; Kim, Sang Ha; Yum, Ho Kee

2017-10-01

Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. The outcomes of 127 COPD patients were analyzed. CAT scores (19.6±12.5 vs. 15.1±12.3) improved significantly after this program (p<0.05). Patients with improved CAT scores of 4 points or more had a better understanding of COPD management and the correct technique for using inhalers than those who did not have improved CAT scores (p<0.05). A comprehensive education program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management. Copyright©2017. The Korean Academy of Tuberculosis and Respiratory Diseases

Peer supporter experiences of home visits for people with HIV infection

PubMed Central

Lee, Han Ju; Moneyham, Linda; Kang, Hee Sun; Kim, Kyung Sun

2015-01-01

Purpose This study’s purpose was to explore the experiences of peer supporters regarding their work in a home visit program for people with HIV infection. Patients and methods A qualitative descriptive study was conducted using focus groups. Participants were 12 HIV-positive peer supporters conducting home visits with people living with HIV/AIDS in South Korea. Thematic analysis was used to analyze the data. Results Six major themes emerged: feeling a sense of belonging; concern about financial support; facing HIV-related stigma and fear of disclosure; reaching out and acting as a bridge of hope; feeling burnout; and need for quality education. The study findings indicate that although peer supporters experience several positive aspects in the role, such as feelings of belonging, they also experience issues that make it difficult to be successful in the role, including the position’s instability, work-related stress, and concerns about the quality of their continuing education. Conclusion The findings suggest that to maintain a stable and effective peer supporter program, such positions require financial support, training in how to prevent and manage stress associated with the role, and a well-developed program of education and training. PMID:26445560

Evaluation of LEAA Funded Courts Training Programs. Volume I.

ERIC Educational Resources Information Center

McManis Associates, Inc., Washington, DC.

An impact evaluation of eight courts training project (CTP) institutes funded by the Law Enforcement Assistance Administration was conducted. After a literature search and visits to potential evaluation sites in all fifty states, twelve sites were selected from a random stratified sample of court systems. Data were obtained from 1047 respondents…

A comprehensive palliative care program at a tertiary cancer center in Jordan.

PubMed

Shamieh, Omar; Hui, David

2015-03-01

The palliative care program in King Hussein Cancer Center (KHCC) is growing rapidly to serve the needs of patients with cancer and their families. To describe the KHCC palliative care program and its integration into the oncology care. Narrative review of our palliative care program. Patients with cancer at KHCC have access to an interprofessional palliative care at different settings. In 2012, the inpatient team saw 400 consultations and 979 referrals and admissions. The outpatient clinic had a total of 1133 patient visits. The home care program provided a total of 1501 visits. Our program is a regional center for education and training and actively conducts research. Our palliative care program may be a model for successful delivery of comprehensive cancer care in the Middle East. © The Author(s) 2013.

Open Campus: Strategic Plan

DTIC Science & Technology

2016-05-01

The formal and informal interactions among scientists, engineers, and business and technology specialists fostered by this environment will lead...pathways for highly trained graduates of science, technology, engineering, and mathematics (STEM) academic programs, and help academic institutions...engineering and mathematics (STEM) disciplines relevant to ARL science and technology programs. Under EPAs, visiting students and professors

A Model for Integrating Low Vision Services into Educational Programs.

ERIC Educational Resources Information Center

Jose, Randall T.; And Others

1988-01-01

A project integrating low-vision services into children's educational programs comprised four components: teacher training, functional vision evaluations for each child, a clinical examination by an optometrist, and follow-up visits with the optometrist to evaluate the prescribed low-vision aids. Educational implications of the project and project…

A real-life study on acquired skills from using an adrenaline autoinjector.

PubMed

Topal, Erdem; Bakirtas, Arzu; Yilmaz, Ozlem; Ertoy, Ilbilge Hacer; Arga, Mustafa; Demirsoy, Mehmet Sadik; Turktas, Ipek

2013-01-01

Training programs performed by allergists have increased the ability of patients' recognition and management of anaphylaxis. We aim to investigate the permanence of effect of an anaphylaxis training program and to determine the factors affecting it beyond training given by allergists. Children and/or their caregivers who had been prescribed an adrenaline autoinjector at least 1 year before were invited to take part in the study. The knowledge about anaphylaxis was assessed using a questionnaire and the skills were practically tested. Sixty-four (50 caregivers/14 children >12 years of age) of 80 patients who accepted the invitation were included in the study. Fifty-nine patients obtained the autoinjector after initial prescription. Among them, 42 (71%) still had the device at the time of the study. The most common reason for not having the autoinjector was no longer feeling it was necessary (54.6%). Of the cases, 39.4% were competent in autoinjector use. There was a significant relation between adrenaline autoinjector competency and regular allergy visits (p = 0.010), believing that it is necessary (p = 0.04), having an adrenaline autoinjector (p = 0.003), and previous history of severe anaphylaxis (p = 0.010). Autoinjector competency score decreased as time elapsed from the last visit (rho = -0.382; p = 0.002) and the first instruction (rho = -0.317; p = 0.01). Regular visits (p = 0.009) and history of severe anaphylaxis (p = 0.007) were found as independent factors having an effect on adrenaline autoinjector competency. Training of patients/caregivers by allergists does not guarantee the permanence of acquired skills on anaphylaxis in the long run. Regular follow-up visits should be fostered. Copyright © 2012 S. Karger AG, Basel.

Effects of a video feedback parent training program during child welfare visitation☆

PubMed Central

Nese, Rhonda N.T.; Anderson, Cynthia M.; Ruppert, Traci; Fisher, Philip A.

2017-01-01

Behavioral parent training programs have documented efficacy for improving behaviors among parents and their children and are frequently used by child welfare agencies to prevent removal of a child from the parental home or to facilitate reunification. Although an ideal time for parent training might be during supervised visits where parents may practice skills with their children under the guidance and support of a therapist or caseworker, this is not typically the case. Most often, parents within the child welfare system receive parent training in small groups without their children present, and to date, few studies have examined effects of behavioral parent training interventions during supervised visitation. In this study, concurrent multiple baseline across behaviors design was used to examine effects of a behavioral parent training program, Filming Interactions to Nurture Development (FIND), on parental skill acquisition with four mothers who had lost custody of their children but were being considered for reunification. Children emitted little or no problem behaviors during baseline or intervention, so parenting behavior was the primary dependent variable. Results obtained across participants documented a clear functional relation between implementation of the FIND intervention and increases in developmentally supportive parenting behaviors. Results of social validity and contextual fit measures suggest the intervention was perceived by mothers to be positive, feasible, and appropriate within the child welfare context. Practical and conceptual implications, limitations of this study, and directions for future research are discussed. PMID:28936018

Prenatal and infancy home visiting by nurses: from randomized trials to community replication.

PubMed

Olds, David L

2002-09-01

This paper summarizes a 25-year program of research that has attempted to improve the early health and development of low-income mothers and children and their future life trajectories with prenatal and infancy home visiting by nurses. The program has been tested in two separate large-scale randomized controlled trials with different populations living in different contexts. The program has been successful in improving parental care of the child as reflected in fewer injuries and ingestions that may be associated with child abuse and neglect; and maternal life-course, reflected in fewer subsequent pregnancies, greater work force participation, and reduced use of public assistance and food stamps. In the first trial, the program also produced long-term effects on the number of arrests, convictions, emergent substance use, and promiscuous sexual activity of 15-year-old children whose nurse-visited mothers were low-income and unmarried when they registered in the study during pregnancy. Since 1996, the program has been offered for public investment outside of research contexts. Careful attention has been given to ensuring that the program is replicated with fidelity to the model tested in the scientifically controlled studies by working with community leaders to ensure that organization and community contexts are favorable for the program; by providing the nurses with excellent training and technical assistance and detailed visit-by-visit guidelines; and by providing organizations with a web-based clinical information system that creates a basis for monitoring program performance and continuous quality improvement.

Pediatric Asthma

MedlinePlus

... Asthma (Pediatric) Find a Doctor Appointments & Questions Patient Education & Support Visiting Us Tests & Procedures Ways to Give National Jewish Health ... Programs Health Information Doctors & Departments Clinical Research & ... Training Contact Us Make a Donation Make an Appointment Patient Portal ...

Can symptom relief be provided in the home to palliative care cancer patients by the primary caregivers? An Indian study.

PubMed

Chellappan, Sheeba; Ezhilarasu, Punitha; Gnanadurai, Angela; George, Reena; Christopher, Solomon

2014-01-01

A large proportion of cancer deaths occur in the developing world, with limited resources for palliative care. Many patients dying at home experience difficult symptoms. The objective of this study was to assess the feasibility of a structured training program on symptom management along with an acute symptom management kit for primary caregivers of cancer patients receiving home care. Descriptive design was used. Thirty primary caregivers of cancer patients attending the palliative care clinic in Vellore, South India, were provided training on the administration of drugs for acute symptoms. A plastic box with partitions for drugs specific to symptom was provided. On follow-up visits, the usage of the kit, drugs used, and routes of administration were noted. A structured questionnaire with a 4-point scale was used to assess primary caregiver views and satisfaction. Of primary caregivers, 96.7% used a kit. The common medications used were morphine, metoclopramide, dexamethasone, and benzodiazepines. Seventy-three percent of primary caregivers administered subcutaneous injections at home. Hospital visits for acute symptoms reduced by 80%; 90% were satisfied with the training received; 73% stated it was not a burden to treat the patient at home. The training program and acute symptom management kit were favorably received and appropriately used by caregivers of diverse backgrounds. Rural backgrounds and illiteracy were not barriers to acceptance. Healthcare professionals should train caregivers during hospital visits, empowering them to manage acute symptoms and provide simple nursing care. This is doubly important in countries where resources are limited and palliative care facilities scarce.

Impact of a Home-Based Physical and Nutritional Intervention Program Conducted by Lay-Volunteers on Handgrip Strength in Prefrail and Frail Older Adults: A Randomized Control Trial.

PubMed

Haider, Sandra; Dorner, Thomas E; Luger, Eva; Kapan, Ali; Titze, Sylvia; Lackinger, Christian; Schindler, Karin E

2017-01-01

A randomized controlled trial was performed to compare the effects of a home-based physical and nutritional intervention program carried out by lay-volunteers to home visits with social support alone. Buddies visited 80 prefrail or frail older persons at home twice a week for 12 weeks. The physical training and nutrition group (PTN, n = 39) performed two sets of six strength exercises, discussed nutritional topics and received social support. The social support group (SoSu, n = 41) received home visits with social support only. In the PTN group, handgrip strength increased significantly by 2.4 kg (95% CI: 1.0-3.8). In the SoSu group we did not see a significant improvement. However, no significant between-group difference was found. Physical performance increased in both groups, although with a higher increase of 1.0 point (95% CI: 0.1-2.0) in the PTN group. In none of the groups muscle mass changed. Further results showed that frail individuals benefit more from the intervention than prefrail individuals (OR: 2.78; 95% CI: 1.01-7.66). Handgrip strength in the intervention group increased by a clinically relevant value and this effect is comparable to that obtained by health-care professionals. Therefore, home visits with a physical training and nutritional program could offer a new perspective in the care of community-dwelling prefrail and frail older persons.

Information Technology Curriculum Development for Participation and Equity Programs.

ERIC Educational Resources Information Center

Post, Maarten; And Others

A study explored ways in which training in information technology could be included in Participation and Equity Programs (PEP) in the areas of hospitality/tourism, retailing, and business and finance. The research team conducted a literature search, obtained completed questionnaires from 10 colleges offering a total of 22 PEPs, visited an…

Care of newborn in the community and at home.

PubMed

Neogi, S B; Sharma, J; Chauhan, M; Khanna, R; Chokshi, M; Srivastava, R; Prabhakar, P K; Khera, A; Kumar, R; Zodpey, S; Paul, V K

2016-12-01

India has contributed immensely toward generating evidence on two key domains of newborn care: Home Based Newborn Care (HBNC) and community mobilization. In a model developed in Gadchiroli (Maharashtra) in the 1990s, a package of Interventions delivered by community health workers during home visits led to a marked decline in neonatal deaths. On the basis of this experience, the national HBNC program centered around Accredited Social Health Activists (ASHAs) was introduced in 2011, and is now the main community-level program in newborn health. Earlier in 2004, the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) program was rolled out with inclusion of home visits by Anganwadi Worker as an integral component. IMNCI has been implemented in 505 districts in 27 states and 4 union territories. A mix of Anganwadi Workers, ASHAs, auxiliary nursing midwives (ANMs) was trained. The rapid roll out of IMNCI program resulted in improving quality of newborn care at the ground field. However, since 2012 the Ministry of Health and Family Welfare decided to limit the IMNCI program to ANMs only and leaving the Anganwadi component to the stewardship of the Integrated Child Development Services. ASHAs, the frontline workers for HBNC, receive four rounds of training using two modules. There are a total of over 900 000 ASHAs per link workers in the country, out of which, only 14% have completed the fourth round of training. The pace of uptake of the HBNC program has been slow. Of the annual rural birth cohort of over 17 million, about 4 million newborns have been visited by ASHA during the financial year 2013-2014 and out of this 120 000 neonates have been identified as sick and referred to health facilities for higher level of neonatal care. Supportive supervision remains a challenge, the role of ANMs in supervision needs more clarity and there are issues surrounding quality of training and the supply of HBNC kits. The program has low visibility in many states. Now is the time to tap the missed opportunity of miniscule coverage of HBNC; that at least half of the country's birth cohort should be covered by this program by 2016, coupled with rapid scale up of the community-based treatment of neonates with pneumonia or sepsis, where referral is not possible.

Care of newborn in the community and at home

PubMed Central

Neogi, S B; Sharma, J; Chauhan, M; Khanna, R; Chokshi, M; Srivastava, R; Prabhakar, P K; Khera, A; Kumar, R; Zodpey, S; Paul, V K

2016-01-01

India has contributed immensely toward generating evidence on two key domains of newborn care: Home Based Newborn Care (HBNC) and community mobilization. In a model developed in Gadchiroli (Maharashtra) in the 1990s, a package of Interventions delivered by community health workers during home visits led to a marked decline in neonatal deaths. On the basis of this experience, the national HBNC program centered around Accredited Social Health Activists (ASHAs) was introduced in 2011, and is now the main community-level program in newborn health. Earlier in 2004, the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) program was rolled out with inclusion of home visits by Anganwadi Worker as an integral component. IMNCI has been implemented in 505 districts in 27 states and 4 union territories. A mix of Anganwadi Workers, ASHAs, auxiliary nursing midwives (ANMs) was trained. The rapid roll out of IMNCI program resulted in improving quality of newborn care at the ground field. However, since 2012 the Ministry of Health and Family Welfare decided to limit the IMNCI program to ANMs only and leaving the Anganwadi component to the stewardship of the Integrated Child Development Services. ASHAs, the frontline workers for HBNC, receive four rounds of training using two modules. There are a total of over 900 000 ASHAs per link workers in the country, out of which, only 14% have completed the fourth round of training. The pace of uptake of the HBNC program has been slow. Of the annual rural birth cohort of over 17 million, about 4 million newborns have been visited by ASHA during the financial year 2013–2014 and out of this 120 000 neonates have been identified as sick and referred to health facilities for higher level of neonatal care. Supportive supervision remains a challenge, the role of ANMs in supervision needs more clarity and there are issues surrounding quality of training and the supply of HBNC kits. The program has low visibility in many states. Now is the time to tap the missed opportunity of miniscule coverage of HBNC; that at least half of the country's birth cohort should be covered by this program by 2016, coupled with rapid scale up of the community-based treatment of neonates with pneumonia or sepsis, where referral is not possible. PMID:27924109

[Structured residency training program for otolaryngology: a trendsetting principle].

PubMed

Meyer, J E; Wollenberg, B; Schmidt, C

2008-09-01

A concept for an ORL residency training program is necessary because of personnel bottlenecks, quality assurance and benchmarkings. We have created a 2.5 years' program, which is based on 6 pillars: 1. Acquisition of the necessary specialist knowledge by the resident in self-study. 2. Weekly attendance of training lectures according to a study timetable, a monthly specialist seminar to discuss case examples. 3. Weekly presentation by the resident on an article from the current literature, alternating with a presentation on cases and a morbidity and mortality conference. 4. Annual 60 min learning target test. 5. Definition of a surgical training calendar oriented to the new national ORL training regulations. 6. Internal operation course with preparative exercises in anatomy and visit to an operations course at a renowned otolaryngology clinic each year. After 2.5 years of the training time a revision course is introduced. In this way a basic training will be guaranteed for all residents, which can be assessed by the annual test. Finally, the construction of a further training curriculum should lead to an improved transparent training, a higher standard of quality and improved staff satisfaction.

Does investment in home visitors lead to better psychological health for HIV-affected families? Results from a quasi-experimental evaluation in South Africa.

PubMed

Thurman, Tonya R; Kidman, Rachel; Taylor, Tory M

2014-01-01

Children and families affected by HIV are at considerable risk for psychological distress. Community-based home visiting is a common mechanism for providing basic counseling and other services to HIV-affected families. While programs emphasize home visitor training and compensation as means to promote high-quality service delivery, whether these efforts result in measurable gains in beneficiaries' well-being remains largely unanswered. This study employs a longitudinal quasi-experimental design to explore whether these kinds of investments yield concomitant gains in psychological outcomes among beneficiaries. Baseline and follow-up data were collected over a two-year period from children aged 10-17 at the time of program enrollment and their caregivers, with 80% retention. In this sample of 1487 children and 918 caregivers, the psychological health outcomes of those enrolled in programs with home visitors who receive intensive training, organizational support, and regular compensation (termed "paraprofessional") were compared to those enrolled in programs offering limited home visiting services from lay volunteers. Applying multilevel logistic regression, no measurable improvements were found among paraprofessional enrollees, and three outcomes were significantly worse at follow-up regardless of program model. Children's behavior problems became more prevalent even after adjusting for other factors, increasing from 29% to 35% in girls and from 28% to 43% in boys. Nearly one-quarter of girl and boys reported high levels of depression at follow-up, and this was a significant rise over time for boys. Rates of poor family functioning also significantly worsened over time, rising from 30% to 59%. About one-third of caregivers reported high levels of negative feelings at follow-up, with no improvements observed in the paraprofessional group. Results highlight that children's and caregivers' psychological outcomes may be relatively impervious to change even in paraprofessional home visiting models. Findings underscore the need for programs serving HIV-affected families to add focused evidence-based psychological interventions to supplement traditional home visiting.

A Tobacco-Free Campus Ambassador Program and Policy Compliance

ERIC Educational Resources Information Center

Ickes, Melinda. J.; Rayens, Mary Kay; Wiggins, Amanda T.; Hahn, Ellen J.

2015-01-01

Objective: Assess impact and feasibility of a Tobacco-Free Ambassador Program on campus policy compliance. Participants: Trained Ambassadors made 253 visits to campus sites over 15 months to observe and/or approach violators. Methods: Policy violators were observed at 23 locations during Wave 1 (April-June 2012) and/or Wave 2 (April-June 2013).…

Herniated Cervical Disc

MedlinePlus

... doctor, with the help of a nurse or physical therapist, may also begin education and training on specific exercises to strengthen your neck. These exercises may be performed at home or you may visit a physical therapist for a more specific program to meet ...

Maternal relationship security as a moderator of home visiting impacts on maternal psychosocial functioning.

PubMed

McFarlane, Elizabeth; Burrell, Lori; Crowne, Sarah; Cluxton-Keller, Fallon; Fuddy, Loretta; Leaf, Philip J; Duggan, Anne

2013-02-01

There is variability in home visiting program impacts on the outcomes achieved by high risk families. An understanding of how effects vary among families is important for refining service targeting and content. The current study assessed whether and how maternal attributes, including relationship security, moderate short- and long-term home visiting impacts on maternal psychosocial functioning. In this multisite RCT of home visiting in a population-based, ethnically-diverse sample of families at risk for maltreatment of their newborns (n = 643), families were randomly assigned to home visited (HV) and control groups. HV families were to receive intensive services by trained paraprofessionals from birth-3 years. Outcome data were collected when children were 1, 2, and 3 years old and 7, 8, and 9 years old. Overall, short- and long-term outcomes for HV and control mothers did not differ significantly. Demographic attributes, a general measure of overall maternal risk, and partner violence did not moderate program impact on psychosocial functioning outcomes. Maternal relationship security did moderate program impact. Mothers who scored high on relationship anxiety but not on relationship avoidance showed the greatest benefits, particularly at the long-term follow-up. Mothers scoring high for both relationship anxiety and avoidance experienced some adverse consequences of home visiting. Further research is needed to determine mediating pathways and to inform and test ways to improve the targeting of home visiting and the tailoring of home visit service models to extend positive home visiting impacts to targeted families not benefiting from current models.

Home Visiting Programs: What the Primary Care Clinician Should Know.

PubMed

Finello, Karen Moran; Terteryan, Araksi; Riewerts, Robert J

2016-04-01

Responsibilities for primary care clinicians are rapidly expanding ascomplexities in families' lives create increased disparities in health and developmental outcomes for young children. Despite the demands on primary care clinicians to promote health in the context of complex family and community factors, most primary care clinicians are operating in an environment of limited training and a shortage of resources for supporting families. Partnerships with evidence-based home visiting programs for very young children and their families can provide a resource that will help to reduce the impact of adverse early childhood experiences and facilitate health equity. Home visiting programs in the United States are typically voluntary and designed to be preventative in nature, although families are usually offered services based on significant risk criteria since the costs associated with universal approaches have been considered prohibitive. Programs may be funded within the health (physical orbehavioral/mental health), child welfare, early education, or early intervention systems or by private foundation dollars focused primarily on oneof the above systems (e.g., health), with a wide range of outcomes targeted by the programs and funders. Services may be primarily focused on the child, the parent, or parent-child interactions. Services include the development of targeted and individualized intervention strategies, better coaching of parents, and improved modeling of interactions that may assist struggling families. This paper provides a broad overview ofthe history of home visiting, theoretical bases of home visiting programs, key components of evidence-based models, outcomes typically targeted, research on effectiveness, cost information, challenges and benefits of home visiting, and funding/sustainability concerns. Significance for primary care clinicians isdescribed specifically and information relevant for clinicians is emphasized throughout the paper. Copyright © 2016 Mosby, Inc. All rights reserved.

[Effects of an Individual Breast-feeding Promotion Program for Married Immigrant Women].

PubMed

Park, Mi Kyoung; Moon, So Hyun

2016-02-01

This study was designed to evaluate the effects of an individual breast-feeding promotion program to address breast-feeding knowledge, attitude, method and rate of practice for married immigrant women. A non-equivalent control group quasi-experimental design was used (experimental group=16, control group=17). The intervention consisted of 3 phases: (1) Within 2 hours of delivery - individual breast-feeding training through video/verbal/practical training education and demonstration (2) After 1~2 days - group training using video, model doll, and breast models (3) After 7 days - family visit, counseling, retraining and reinforcement training. The data were analyzed using non-parametric tests with the SPSS program. Married immigrant women who participated in the individual breast-feeding program scored high in knowledge, attitude, method and rate of practice compared to the control group. The results indicate that the individual breast-feeding program is very effective in increasing breast-feeding knowledge, attitude, method and rate of practicing breast feeding for married immigrant women. So, nurses are encouraged to aggressively utilize individual breast-feeding programs to help married immigrant women, who are exposed to vulnerability due to various situations.

A Community-Based Sensory Training Program Leads to Improved Experience at a Local Zoo for Children with Sensory Challenges.

PubMed

Kong, Michele; Pritchard, Mallory; Dean, Lara; Talley, Michele; Torbert, Roger; Maha, Julian

2017-01-01

Sensory processing difficulties are common among many special needs children, especially those with autism spectrum disorder (ASD). The sensory sensitivities often result in interference of daily functioning and can lead to social isolation for both the individual and family unit. A quality improvement (QI) project was undertaken within a local zoo to systematically implement a sensory training program targeted at helping special needs individuals with sensory challenges, including those with ASD, Down's syndrome, attention-deficit/hyperactivity disorder, and speech delay. We piloted the program over a 2-year period. The program consisted of staff training, provision of sensory bags and specific social stories, as well as creation of quiet zones. Two hundred family units were surveyed before and after implementation of the sensory training program. In this pilot QI study, families reported increased visitation to the zoo, improved interactions with staff members, and the overall quality of their experience. In conclusion, we are able to demonstrate that a sensory training program within the community zoo is feasible, impactful, and has the potential to decrease social isolation for special needs individuals and their families.

A Community-Based Sensory Training Program Leads to Improved Experience at a Local Zoo for Children with Sensory Challenges

PubMed Central

Kong, Michele; Pritchard, Mallory; Dean, Lara; Talley, Michele; Torbert, Roger; Maha, Julian

2017-01-01

Sensory processing difficulties are common among many special needs children, especially those with autism spectrum disorder (ASD). The sensory sensitivities often result in interference of daily functioning and can lead to social isolation for both the individual and family unit. A quality improvement (QI) project was undertaken within a local zoo to systematically implement a sensory training program targeted at helping special needs individuals with sensory challenges, including those with ASD, Down’s syndrome, attention-deficit/hyperactivity disorder, and speech delay. We piloted the program over a 2-year period. The program consisted of staff training, provision of sensory bags and specific social stories, as well as creation of quiet zones. Two hundred family units were surveyed before and after implementation of the sensory training program. In this pilot QI study, families reported increased visitation to the zoo, improved interactions with staff members, and the overall quality of their experience. In conclusion, we are able to demonstrate that a sensory training program within the community zoo is feasible, impactful, and has the potential to decrease social isolation for special needs individuals and their families. PMID:28966920

Tanzania benefits from inter-organizational cooperation.

PubMed

1998-08-01

This article describes observations of a monitoring mission by JOICFP, the IPPF Regional Africa Office, and JICA in Tanzania, during June 7-13, 1998. The team visited the Morogoro region to review and assess the current major Integrated Program (IP) activities. The community-based distribution agents have been successful in gaining the trust of the community and contributing to social change. Agents are motivated to work and receive additional training, even though they do not receive a salary. Communities recognize the agents as their representatives. Training agents at the grass roots level has been cost effective. The visiting doctor scheme has been successful in maximizing use of health personnel. In one example, 92 patients from 3 villages were treated by a visiting doctor, who had an adequate supply of basic drugs. Service fees paid by patients cover the cost of medicine. Women receive reproductive health and sexually transmitted disease check-ups. The Income Generation Activities (IGA) program strengthens income generation and women's organizations. IGA also provides tools for masonry and carpentry to encourage male participation in the program. The IP has cooperative support from UMATI, the Ministry of Health, UNFPA, and the Japanese government. Essential drugs and equipment are procured by JICA, and delivered through the UMATI-JOICFP distribution channels to government health centers and dispensaries and UMATI's clinics. The experience has confirmed the ability of nongovernmental organizations to supply a multi-bilateral project. Grassroots staff are most appreciative.

Development and Pilot Testing of a Standardized Training Program for a Patient-Mentoring Intervention to Increase Adherence to Outpatient HIV Care

PubMed Central

Mignogna, Joseph; Stanley, Melinda A.; Davila, Jessica; Wear, Jackie; Amico, K. Rivet; Giordano, Thomas P.

2012-01-01

Abstract Although peer interventionists have been successful in medication treatment-adherence interventions, their role in complex behavior-change approaches to promote entry and reentry into HIV care requires further investigation. The current study sought to describe and test the feasibility of a standardized peer-mentor training program used for MAPPS (Mentor Approach for Promoting Patient Self-Care), a study designed to increase engagement and attendance at HIV outpatient visits among high-risk HIV inpatients using HIV-positive peer interventionists to deliver a comprehensive behavioral change intervention. Development of MAPPS and its corresponding training program included collaborations with mentors from a standing outpatient mentor program. The final training program included (1) a half-day workshop; (2) practice role-plays; and (3) formal, standardized patient role-plays, using trained actors with “real-time” video observation (and ratings from trainers). Mentor training occurred over a 6-week period and required demonstration of adherence and skill, as rated by MAPPS trainers. Although time intensive, ultimate certification of mentors suggested the program was both feasible and effective. Survey data indicated mentors thought highly of the training program, while objective rating data from trainers indicated mentors were able to understand and display standards associated with intervention fidelity. Data from the MAPPS training program provide preliminary evidence that peer mentors can be trained to levels necessary to ensure intervention fidelity, even within moderately complex behavioral-change interventions. Although additional research is needed due to limitations of the current study (e.g., limited generalizability due to sample size and limited breadth of clinical training opportunities), data from the current trial suggest that training programs such as MAPPS appear both feasible and effective. PMID:22248331

A Qualitative Exploration of Co-location as an Intervention to Strengthen Home Visiting Implementation in Addressing Maternal Child Health.

PubMed

Kellom, Katherine S; Matone, Meredith; Adejare, Aderinola; Barg, Frances K; Rubin, David M; Cronholm, Peter F

2018-06-01

Objectives The aim of this paper is to explore the process and impact of co-locating evidence-based maternal and child service models to inform future implementation efforts. Methods As part of a state-wide evaluation of maternal and child home visiting programs, we conducted semi-structured interviews with administrators and home visitors from home visiting agencies across Pennsylvania. We collected 33 interviews from 4 co-located agencies. We used the Consolidated Framework for Implementation Research (CFIR) to describe the key elements mitigating implementation of multiple home visiting models. Results A primary advantage of co-location described by participants was the ability to increase the agency's base of eligible clients through the implementation of a model with different program eligibility (e.g. income, child age) than the existing agency offering. Model differences related to curriculum (e.g. content or intensity/meeting frequency) enabled programs to more selectively match clients to models. To recruit eligible clients, new models were able to build upon the existing service networks of the initial program. Co-location provided organizational opportunities for shared trainings, enabling administrative efficiencies and collaborative staff learning. Programs implemented strategies to build synergies with complementary model features, for instance using the additional program option to serve waitlisted clients and to transition services after one model is completed. Conclusions for Practice Considerable benefits are experienced when home visiting models co-locate. This research builds on literature encouraging collaboration among community agencies and provides insight on a specific facilitative approach. This implementation strategy informs policy across the social services spectrum and competitive funding contexts.

Disseminating Comparative Effectiveness Research Through Community-based Experiential Learning.

PubMed

Hansen, Richard A; Williamson, Margaret; Stevenson, Lynn; Davis, Brandy R; Evans, R Lee

2017-02-25

Objectives. To launch and evaluate a comparative effectiveness research education and dissemination program as part of an introductory pharmacy practice experience (IPPE). Methods. First- through third-year PharmD students received training on comparative effectiveness research and disseminated printed educational materials to patients in the community who they were monitoring longitudinally (n=314). Students completed an assessment and initial visit documentation form at the first visit, and a follow-up assessment and documentation form at a subsequent visit. Results. Twenty-three diabetes patients, 29 acid-reflux patients, 30 osteoarthritis patients, and 50 hypertension patients received materials. Aside from the patient asking questions, which was the most common outcome (n=44), the program resulted in 38 additional actions, which included stopping, starting, or changing treatments or health behaviors, or having additional follow-up or diagnostic testing. Small but positive improvements in patient understanding, confidence, and self-efficacy were observed. Conclusions. Dissemination of comparative effectiveness research materials in an IPPE program demonstrated a positive trend in markers of informed decision-making.

Developing a Sustainable Need-Based Pediatric Acute Care Training Curriculum in Solomon Islands.

PubMed

Yu, Daniel Ta Yo; Gillon, Jason T; Dickson, Raymond; Schneider, Karen A; Stevens, Martha W

2017-01-01

The Johns Hopkins Hospital Pediatric Emergency Department (PED) was invited to collaborate with the National Referral Hospital (NRH), Solomon Islands, to establish an acute care pediatric education program for the country's inaugural class of national medical graduate trainees. To develop and evaluate a sustainable, need-based post-graduate training curriculum in pediatric acute care, resuscitation, and point-of-care ultrasound. A need-based training curriculum was developed utilizing the ADDIE model and was implemented and revised over the course of 2 years and two site visits. Implementation followed a train-the-trainer model. The curriculum consisted of high-yield didactics including workshops, simulations, hands-on ultrasound sessions, and lectures at the NRH. A mixed-methods design was used to evaluate the curriculum, including pre/posttesting, qualitative group discussions, and individual surveys. The curriculum was revised in response to ongoing learner evaluations and needs assessments. Continuing educational sessions after the site visit demonstrated sustainability. The curriculum included 19 core topics with 42 teaching sessions during the two site visits. A total of 135 pre/posttests and 366 individual surveys were collected from 46 trainees. Completion rates were 78.2% for surveys and 71.3% for pre/posttests. Pre/posttest scores increased from 44 to 63% during the first site visit and 69.6 to 77.6% during the second. Learners reported a mean 4.81/5 on a standard Likert scale for curriculum satisfaction. Group discussions and surveys highlighted key areas of knowledge growth, important clinical care advances, and identified further needs. Initial sustainability was demonstrated by continued ultrasound sessions led by local graduate trainees. A collaborative team including Johns Hopkins PED staff, Solomon Islands' graduate trainees, and NRH administration initiated a professional education curriculum for the first class of Solomon Islands' medical graduates. Knowledge growth and positive impacts of the program were reflected in learner survey and test scores. Graduate trainees were identified as local champions to continue as course instructors. This innovative curriculum was developed, revised, and initially sustained on site. It has been successful in introducing life-saving pediatric acute care and graduate training in Solomon Islands.

A Volunteer Program to Connect Primary Care and the Home to Support the Health of Older Adults: A Community Case Study.

PubMed

Oliver, Doug; Dolovich, Lisa; Lamarche, Larkin; Gaber, Jessica; Avilla, Ernie; Bhamani, Mehreen; Price, David

2018-01-01

Primary care providers are critical in providing and optimizing health care to an aging population. This paper describes the volunteer component of a program (Health TAPESTRY) which aims to encourage the delivery of effective primary health care in novel and proactive ways. As part of the program, volunteers visited older adults in their homes and entered information regarding health risks, needs, and goals into an electronic application on a tablet computer. A total of 657 home visits were conducted by 98 volunteers, with 22.45% of volunteers completing at least 20 home visits over the course of the program. Information was summarized in a report and electronically sent to the health care team via clients' electronic medical records. The report was reviewed by the interprofessional team who then plan ongoing care. Volunteer recruitment, screening, training, retention, and roles are described. This paper highlights the potential role of a volunteer in a unique connection between primary care providers and older adult patients in their homes.

A Volunteer Program to Connect Primary Care and the Home to Support the Health of Older Adults: A Community Case Study

PubMed Central

Oliver, Doug; Dolovich, Lisa; Lamarche, Larkin; Gaber, Jessica; Avilla, Ernie; Bhamani, Mehreen; Price, David

2018-01-01

Primary care providers are critical in providing and optimizing health care to an aging population. This paper describes the volunteer component of a program (Health TAPESTRY) which aims to encourage the delivery of effective primary health care in novel and proactive ways. As part of the program, volunteers visited older adults in their homes and entered information regarding health risks, needs, and goals into an electronic application on a tablet computer. A total of 657 home visits were conducted by 98 volunteers, with 22.45% of volunteers completing at least 20 home visits over the course of the program. Information was summarized in a report and electronically sent to the health care team via clients’ electronic medical records. The report was reviewed by the interprofessional team who then plan ongoing care. Volunteer recruitment, screening, training, retention, and roles are described. This paper highlights the potential role of a volunteer in a unique connection between primary care providers and older adult patients in their homes. PMID:29536010

Impact of the training on the compliance and persistence of weekly bisphosphonate treatment in postmenopausal osteoporosis: a randomized controlled study.

PubMed

Tüzün, Şansın; Akyüz, Gülseren; Eskiyurt, Nurten; Memiş, Asuman; Kuran, Banu; İçağasıoğlu, Afitap; Sarpel, Tunay; Özdemir, Ferda; Özgirgin, Neşe; Günaydın, Rezzan; Cakçı, Aytül; Yurtkuran, Merih

2013-01-01

Long-term patient adherence to osteoporosis treatment is poor despite proven efficacy. In this study, we aimed to assess the impact of active patient training on treatment compliance and persistence in patients with postmenopausal osteoporosis. In the present national, multicenter, randomized controlled study, postmenopausal osteoporosis patients (45-75 years) who were on weekly bisphosphonate treatment were randomized to active training (AT) and passive training (PT) groups and followed-up by 4 visits after the initial visit at 3 months interval during 12 months of the treatment. Both groups received a bisphosphonate usage guide and osteoporosis training booklets. Additionally, AT group received four phone calls (at 2(nd), 5(th), 8(th), and 11(th) months) and participated to four interactive social/training meetings held in groups of 10 patients (at 3(rd), 6(th), 9(th), and 12(th) months). The primary evaluation criteria were self-reported persistence and compliance to the treatment and the secondary evaluation criteria was quality life of the patients assessed by 41-item Quality of Life European Foundation for Osteoporosis (QUALEFFO-41) questionnaire. Of 448 patients (mean age 62.4±7.7 years), 226 were randomized to AT group and 222 were randomized to PT group. Among the study visits, the most common reason for not receiving treatment regularly was forgetfulness (54.9% for visit 2, 44.3% for visit 3, 51.6% for visit 4, and 43.8% for visit 5), the majority of the patients always used their drugs regularly on recommended days and dosages (63.8% for visit 2, 60.9% for visit 3, 72.1% for visit 4, and 70.8% for visit 5), and most of the patients were highly satisfied with the treatment (63.4% for visit 2, 68.9% for visit 3, 72.4% for visit 4, and 65.2% for visit 5) and wanted to continue to the treatment (96.5% for visit 2, 96.5% for visit 3, 96.9% for visit 4, and 94.4% for visit 5). QUALEFFO scores of the patients in visit 1 significantly improved in visit 5 (37.7±25.4 vs. 34.0±14.6, p<0.001); however, the difference was not significant between AT and PT groups both in visit 1 and visit 5. In conclusion, in addition to active training, passive training provided at the 1(st) visit did not improve the persistence and compliance of the patients for bisphosphonate treatment.

[Psychological effects of preventive voice care training in student teachers].

PubMed

Nusseck, M; Richter, B; Echternach, M; Spahn, C

2017-07-01

Studies on the effectiveness of preventive voice care programs have focused mainly on voice parameters. Psychological parameters, however, have not been investigated in detail so far. The effect of a voice training program for German student teachers on psychological health parameters was investigated in a longitudinal study. The sample of 204 student teachers was divided into the intervention group (n = 123), who participated in the voice training program, and the control group (n = 81), who received no voice training. Voice training contained ten 90-min group courses and an individual visit by the voice trainer in a teaching situation with feedback afterwards. Participants were asked to fill out questionnaires (self-efficacy, Short-Form Health Survey, self-consciousness, voice self-concept, work-related behaviour and experience patterns) at the beginning and the end of their student teacher training period. The training program showed significant positive influences on psychological health, voice self-concept (i.e. more positive perception and increased awareness of one's own voice) and work-related coping behaviour in the intervention group. On average, the mental health status of all participants reduced over time, whereas the status in the trained group diminished significantly less than in the control group. Furthermore, the trained student teachers gained abilities to cope with work-related stress better than those without training. The training program clearly showed a positive impact on mental health. The results maintain the importance of such a training program not only for voice health, but also for wide-ranging aspects of constitutional health.

Does clinical exposure matter? Pilot assessment of patient visits in an urban family medicine residency program.

PubMed

Iglar, Karl; Murdoch, Stuart; Meaney, Christopher; Krueger, Paul

2018-01-01

To determine the number of patient visits, patient demographic information, and diagnoses in an urban ambulatory care setting in a family medicine residency program, and assess the correlation between the number of patient visits and residents' in-training examination (ITE) scores. Retrospective analysis of data from resident practice profiles, electronic medical records, and residents' final ITE scores. Family medicine teaching unit in a community hospital in Barrie, Ont. Practice profile data were from family medicine residents enrolled in the program from July 1, 2013, to June 30, 2014, and electronic medical record and ITE data were from those enrolled in the program from July 1, 2010, to June 30, 2015. Number of patient visits, patient characteristics (eg, sex, age), priority topics addressed in clinic, resident characteristics (eg, age, sex, level of residency), and residents' final ITE scores. Between July 1, 2013, and June 30, 2014, there were 11 115 patient visits. First-year residents had a mean of 5.48 patient visits per clinic, and second-year residents had a mean of 5.98 patient visits per clinic. A Pearson correlation coefficient of 0.68 was found to exist between the number of patients seen and the final ITE scores, with a 10.5% difference in mean score between residents who had 1251 or more visits and those who had 1150 or fewer visits. Three diagnoses (ie, epistaxis, meningitis, and neck pain) deemed important for Certification by the College of Family Physicians of Canada were not seen by any of the residents in clinic. There is a moderate correlation between the number of patients seen by residents in ambulatory care and ITE scores in family medicine. It is important to assess patients' demographic information and diagnoses made in resident practices to ensure an adequate clinical experience. Copyright© the College of Family Physicians of Canada.

Evaluation of a continuing professional development training program for physicians and physician assistants in hospitals in Laos based on the Kirkpatrick model

PubMed Central

2016-01-01

Purpose: Medical professionals from Korea and Laos have been working together to develop a continuing professional development training program covering the major clinical fields of primary care. This study aimed to evaluate the effectiveness of the program from 2013 to 2014 using the Kirkpatrick model. Methods: A questionnaire was used to evaluate the reaction of the trainees, and the trainers assessed the level of trainees’ performance at the beginning and the end of each clinical section. The transfer (behavioral change) of the trainees was evaluated through the review of medical records written by the trainees before and after the training program. Results: The trainees were satisfied with the training program, for which the average score was 4.48 out of 5.0. The average score of the trainees’ performance at the beginning was 2.39 out of 5.0, and rose to 3.88 at the end of each section. The average score of the medical records written before the training was 2.92 out of 5.0, and it rose to 3.34 after the training. The number of patient visits to the district hospitals increased. Conclusion: The continuing professional development training program, which was planned and implemented with the full engagement and responsibility of Lao health professionals, proved to be effective. PMID:27246494

Evaluation of a peer consultation program for burn inpatients. 2000 ABA paper.

PubMed

Williams, Rhonda M; Patterson, David R; Schwenn, Clay; Day, Jeanette; Bartman, Mark; Engrav, Loren H

2002-01-01

A burn survivor may provide unique psychological support to patients who have been burned more recently and enhance their adjustment to burn injury. The purpose of this study was to describe the peer consultation/burn survivor support program at a large regional burn center in the Northwest United States. Over the course of 17 months, three specially trained peer consultants who had survived their own burn injuries in the past made 167 visits to 108 patients, who, in turn, completed evaluation forms for each visit. Findings indicated that patients reported that the peer consultants approached them in an appropriate manner, answered their questions, and provided useful support and information.

School site visits for community-based participatory research on healthy eating.

PubMed

Patel, Anisha I; Bogart, Laura M; Uyeda, Kimberly E; Martinez, Homero; Knizewski, Ritamarie; Ryan, Gery W; Schuster, Mark A

2009-12-01

School nutrition policies are gaining support as a means of addressing childhood obesity. Community-based participatory research (CBPR) offers an approach for academic and community partners to collaborate to translate obesity-related school policies into practice. Site visits, in which trained observers visit settings to collect multilevel data (e.g., observation, qualitative interviews), may complement other methods that inform health promotion efforts. This paper demonstrates the utility of site visits in the development of an intervention to implement obesity-related policies in Los Angeles Unified School District (LAUSD) middle schools. In 2006, trained observers visited four LAUSD middle schools. Observers mapped cafeteria layout; observed food/beverage offerings, student consumption, waste patterns, and duration of cafeteria lines; spoke with school staff and students; and collected relevant documents. Data were examined for common themes and patterns. Food and beverages sold in study schools met LAUSD nutritional guidelines, and nearly all observed students had time to eat most or all of their meal. Some LAUSD policies were not implemented, including posting nutritional information for cafeteria food, marketing school meals to improve student participation in the National School Lunch Program, and serving a variety of fruits and vegetables. Cafeteria understaffing and costs were obstacles to policy implementation. Site visits were a valuable methodology for evaluating the implementation of school district obesity-related policies and contributed to the development of a CBPR intervention to translate school food policies into practice. Future CBPR studies may consider site visits in their toolbox of formative research methods.

Listening with care: Using narrative methods to cultivate nurses’ responsive relationships in a home visiting intervention with teen mothers

PubMed Central

SmithBattle, Lee; Lorenz, Rebecca; Leander, Sheila

2012-01-01

Effective public health nursing relies on the development of responsive and collaborative relationships with families. While nurse-family relationships are endorsed by home visitation programs, training nurses to follow visit-to-visit protocols may unintentionally undermine these relationships and may also obscure nurses’ clinical understanding and situated knowledge. With these issues in mind, we designed a home visiting intervention, titled Listening with Care, to cultivate nurses’ relationships with teen mothers and nurses’ clinical judgment and reasoning. Rather than using protocols, the training for the intervention introduced nurses to narrative methods and therapeutic tools. This mixed-method pilot study included a quasi-experimental design to examine the effect of the intervention on teen mothers’ depressive symptoms, self-silencing, repeat pregnancy, and educational progress compared to teens who received usual care. Qualitative data was collected from the nurses to evaluate the feasibility and acceptability of the intervention and therapeutic tools. The nurses endorsed the therapeutic tools and expected to continue using them in their practice. Despite the lack of statistically significant differences in outcomes between groups, findings suggest that further study of the intervention is warranted. Future studies may have implications for strengthening hidden aspects of nursing that make a difference in the lives of teen mothers. PMID:22713121

A new corps of trained Grand-Aides has the potential to extend reach of primary care workforce and save money.

PubMed

Garson, Arthur; Green, Donna M; Rodriguez, Lia; Beech, Richard; Nye, Christopher

2012-05-01

Because the Affordable Care Act will expand health insurance to cover an estimated thirty-two million additional people, new approaches are needed to expand the primary care workforce. One possible solution is Grand-Aides®, who are health care professionals operating under the direct supervision of nurses, and who are trained and equipped to conduct telephone consultations or make primary care home visits to patients who might otherwise be seen in emergency departments and clinics. We conducted pilot tests with Grand-Aides in two pediatric Medicaid settings: an urban federally qualified health center in Houston, Texas, and a semi-rural emergency department in Harrisonburg, Virginia. We estimated that Grand-Aides and their supervisors averted 62 percent of drop-in visits at the Houston clinic and would have eliminated 74 percent of emergency department visits at the Virginia test site. We calculated the cost of the Grand-Aides program to be $16.88 per encounter. That compares with current Medicaid payments of $200 per clinic visit in Houston and $175 per emergency department visit in Harrisonburg. In addition to reducing health care costs, Grand-Aides have the potential to make a substantial impact in reducing congestion in primary care practices and emergency departments.

76 FR 76168 - Regulatory Site Visit Training Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0824... routine manufacturing practices and to give CBER staff a better understanding of the biologics industry... quality of its regulatory efforts and interactions, by providing CBER staff with a better understanding of...

Exploring patients' reasons for participation in a medical education home visit program: a qualitative study in Malaysia.

PubMed

Tan, Chai-Eng; Jaffar, Aida; Tohit, Noorlaili; Hamzah, Zuhra; Hashim, Syahnaz Mohd

2017-06-01

Direct contact with patients for medical education is essential in healthcare professional training. Patients who were recruited for a medical education home visit program in Malaysia did so on a voluntary basis without remuneration. This paper aims to explore their reasons for participation in this program. An exploratory qualitative study was conducted on patients who had been visited during the 2012/2013 academic session. Purposive sampling was done to select adult participants from varying ethnicities and ages from the list of patients. In-depth interviews were conducted at the participants' homes and were audio recorded. The transcripts of these interviews were analyzed using thematic analysis. A total of nine in-depth interviews were conducted. Four main themes were identified from thematic analysis: 1) Perceived meaning of the visit; 2) Perceived benefits and risks; 3) Past healthcare experiences; 4) Availability for visits. The home visits meant different things to different participants, including a teaching-learning encounter, a social visit, a charitable deed or a healthcare check-up. The benefits and risks of accepting unknown students to their homes and sharing their health issues with them had been weighed prior to participation. Prior experience with healthcare services such as gratitude to healthcare providers or having a relative in the healthcare profession increased their receptivity for involvement. Lastly, enabling factors such as availability of time would determine their acceptance for home visits. Patients agree to participate in medical education activities on a voluntary basis for various reasons. Providing good healthcare service and sufficient preparation are crucial to increase patient receptivity for such activities.

Cognitive remediation training improves performance in patients with chronic fatigue syndrome.

PubMed

McBride, Richard L; Horsfield, Sarah; Sandler, Carolina X; Cassar, Joanne; Casson, Sally; Cvejic, Erin; Vollmer-Conna, Uté; Lloyd, Andrew R

2017-11-01

Neurocognitive disturbance with subjectively-impaired concentration and memory is a common, disabling symptom reported by patients with chronic fatigue syndrome (CFS). We recently reported preliminary evidence for benefits of cognitive remediation as part of an integrated cognitive-behavioral therapy (CBT)/ graded exercise therapy (GET) program. Here, we describe a contemporaneous, case-control trial evaluating the effectiveness of an online cognitive remediation training program (cognitive exercise therapy; CET) in addition to CBT/GET (n=36), compared to CBT/GET alone (n=36). The study was conducted in an academic, tertiary referral outpatient setting over 12 weeks (11 visits) with structured, home-based activities between visits. Participants self-reported standardized measures of symptom severity and functional status before and after the intervention. Those in the CET arm also completed standardized neurocognitive assessment before, and following, treatment. The addition of formal CET led to significantly greater improvements in self-reported neurocognitive symptoms compared to CBT/GET alone. Subjective improvement was predicted by CET group and lower baseline mood disturbance. In the CET group, significant improvements in objectively-measured executive function, processing speed, and working memory were observed. These subjective and objective performance improvements suggest that a computerized, home-based cognitive training program may be an effective intervention for patients with CFS, warranting randomized controlled trials. Copyright © 2017 Elsevier B.V. All rights reserved.

Postgraduate Emergency Medicine Training in India: An Educational Partnership with the Private Sector.

PubMed

Douglass, Katherine; Pousson, Amelia; Gidwani, Shweta; Smith, Jeffrey

2015-11-01

Emergency medicine (EM) is a recently recognized specialty in India, still in its infancy. Local training programs are developing, but remain very limited. Private, for-profit hospitals are an important provider of graduate medical education (GME) in India, and are partnering with United States (US) universities in EM to expand training opportunities. Our aim was to describe current private-sector programs affiliated with a US university providing postgraduate EM training in India, the evolution and structure of these programs, and successes and challenges of program implementation. Programs have been established in seven cities in India in partnership with a US academic institution. Full-time trainees have required didactics, clinical rotations, research, and annual examinations. Faculty members affiliated with the US institution visit each program monthly. Regular evaluations have informed program modifications, and a local faculty development program has been implemented. Currently, 240 trainees are enrolled in the EM postgraduate program, and 141 physicians have graduated. A pilot survey conducted in 2012 revealed that 93% of graduates are currently practicing EM, 82% of those in India; 71% are involved in teaching, and 32% in research. Further investigation into programmatic impacts is necessary. Challenges include issues of formal program recognition both in India and abroad. This unique partnership is playing a major early role in EM GME in India. Future steps include official program recognition, expanded numbers of training sites, and a gradual transition of training and education to local faculty. Similar partnership programs may be effective in other settings outside of India. Copyright © 2015 Elsevier Inc. All rights reserved.

A Determination of the Change in Dietary Levels of Families Participating in the Expanded Foods and Nutrition Program in Choctaw County, Mississippi.

ERIC Educational Resources Information Center

Walton, Billy Doyle

The purpose of this study was to determine changes made in the dietary levels of families participating in the Expanded Foods and Nutrition Program in Choctaw County, Mississippi. The educational work was done by county professionals who were trained by the home economist and who then taught the homemakers through individual home visits. Data were…

Nonformal Continuing Education in Rural Brazil.

ERIC Educational Resources Information Center

Chesterfield, Ray; Schutz, Paulo

1978-01-01

The authors describe a nonformal adult vocational education program developed in Rio Grande do Sul, a rural Brazilian state, which offers in-school vocational education as well as adult continuing education. Truck trailers with vocational equipment and trained personnel visit rural communities to provide learning experiences both in and out of the…

Active Motor Training Has Long-term Effects on Infants’ Object Exploration

PubMed Central

Wiesen, Sarah E.; Watkins, Rachel M.; Needham, Amy Work

2016-01-01

Long-term changes in infants’ behavior as a result of active motor training were studied. Thirty-two infants completed three visits to the laboratory. At the first visit, infants were 3 months old and completed an object exploration assessment. Then the experimenter demonstrated the motor training procedures appropriate for the infant’s experimental condition, and parents took home custom infant mittens (either sticky or non-sticky) and a bag of lightweight toys to practice with their infants. Over the course of the following 2 weeks, infants participated in 10 sessions of either active (sticky) or passive (non-sticky) mittens training at home with their parents. Infants who participated in active mittens training wore mittens with the palms covered in Velcro, allowing them to pick up and move around small toys. Infants who participated in passive mittens training wore non-sticky mittens, and their parents moved the toys through their visual fields on their behalf. After completing the training, infants returned to the lab for the second visit. At visit two, infants participated in another object exploration assessment as well as a reaching assessment. Parents returned the training materials to the lab at the second visit, and were told not to continue any specific training regimen from this point forward. Two months later, when infants were about 5.5 months of age, they returned to the lab for a third visit. At the third visit, infants completed the same two assessments as during the second visit. The results of this study indicate that infants who participated in active motor training engaged in more sophisticated object exploration when compared to infants who received passive training. These findings are consistent with others in the literature showing that active motor training at 3 months of age facilitates the processes of object exploration and engagement. The current results and others reveal that the effects of early experience can last long after training ceases. PMID:27199833

Interventionist training and intervention fidelity monitoring and maintenance for CONNECT, a nurse-led primary palliative care in oncology trial.

PubMed

Robbins-Welty, Gregg A; Mueser, Lisa; Mitchell, Chandler; Pope, Nicole; Arnold, Robert; Park, SeoYoung; White, Doug; Smith, Kenneth J; Reynolds, Charles; Rosenzweig, Margaret; Bakitas, Marie; Schenker, Yael

2018-06-01

Intervention fidelity is a critical component of behavioral research that has received inadequate attention in palliative care studies. With increasing focus on the need for palliative care models that can be widely disseminated and delivered by non-specialists, rigorous yet pragmatic strategies for training interventionists and maintaining intervention fidelity are needed. (1) Describe components of a plan for interventionist training and monitoring and maintaining intervention fidelity as part of a primary palliative care trial (CONNECT) and (2) present data about perceived training effectiveness and delivery of key intervention content. Post-training evaluations, visit checklists, and visit audio-recordings. Data were collected from June, 2016 through April, 2017. We include procedures for (1) identification, training and certification of oncology nurses as CONNECT interventionists; (2) monitoring intervention delivery; and (3) maintaining intervention quality. All nurses (N = 14) felt prepared to deliver key competencies after a 3-day in-person training. As assessed via visit checklists, interventionists delivered an average of 94% (SD 13%) of key content for first intervention visits and 85% (SD 14%) for subsequent visits. As assessed via audio-recordings, interventionists delivered an average of 85% (SD 8%) of key content for initial visits and 85% (SD 12%) for subsequent visits. We present a 3-part strategy for training interventionists and monitoring and maintaining intervention delivery in a primary palliative care trial. Training was effective in having nurses feel prepared to deliver primary palliative care skills. As assessed via nursing checklists and visit audio-recordings, intervention fidelity was high.

Reaching Mothers and Babies with Early Postnatal Home Visits: The Implementation Realities of Achieving High Coverage in Large-Scale Programs

PubMed Central

Sitrin, Deborah; Guenther, Tanya; Murray, John; Pilgrim, Nanlesta; Rubayet, Sayed; Ligowe, Reuben; Pun, Bhim; Malla, Honey; Moran, Allisyn

2013-01-01

Background Nearly half of births in low-income countries occur without a skilled attendant, and even fewer mothers and babies have postnatal contact with providers who can deliver preventive or curative services that save lives. Community-based maternal and newborn care programs with postnatal home visits have been tested in Bangladesh, Malawi, and Nepal. This paper examines coverage and content of home visits in pilot areas and factors associated with receipt of postnatal visits. Methods Using data from cross-sectional surveys of women with live births (Bangladesh 398, Malawi: 900, Nepal: 615), generalized linear models were used to assess the strength of association between three factors - receipt of home visits during pregnancy, birth place, birth notification - and receipt of home visits within three days after birth. Meta-analytic techniques were used to generate pooled relative risks for each factor adjusting for other independent variables, maternal age, and education. Findings The proportion of mothers and newborns receiving home visits within three days after birth was 57% in Bangladesh, 11% in Malawi, and 50% in Nepal. Mothers and newborns were more likely to receive a postnatal home visit within three days if the mother received at least one home visit during pregnancy (OR2.18, CI1.46–3.25), the birth occurred outside a facility (OR1.48, CI1.28–1.73), and the mother reported a CHW was notified of the birth (OR2.66, CI1.40–5.08). Checking the cord was the most frequently reported action; most mothers reported at least one action for newborns. Conclusions Reaching mothers and babies with home visits during pregnancy and within three days after birth is achievable using existing community health systems if workers are available; linked to communities; and receive training, supplies, and supervision. In all settings, programs must evaluate what community delivery systems can handle and how to best utilize them to improve postnatal care access. PMID:23874816

Beyond Watches and Chocolate-Global Mental Health Elective in Switzerland.

PubMed

Schneeberger, Andres R; Weiss, Andrea; von Blumenthal, Suzanne; Lang, Undine E; Huber, Christian G; Schwartz, Bruce J

2016-08-01

Despite increasing interest in global mental health training opportunities, only a few psychiatry residency programs offer global mental health training experiences in developing countries and even fewer programs offer it in other first-world countries. The authors developed a global mental health elective giving US psychiatry residents the opportunity to visit Switzerland to study and experience the mental health care system in this European country. This elective focuses on four major learning objectives: (1) the system of training and curriculum of postgraduate psychiatry education in Switzerland, (2) clinical and organizational aspects of Swiss mental health, (3) administrative aspects of Swiss mental health care delivery, and (4) scholarly activity. This program was uniquely tailored for psychiatry residents. The preliminary experiences with US psychiatry residents show that they value this learning experience, the opportunity to access a different mental health care system, as well as the potential to build international connections with peers.

The role of professional education in building capacity for health promotion in the global South: a case study from Norway.

PubMed

Mittelmark, Maurice B

2003-01-01

The capacity to train public health professionals is far from sufficient to meet urgent global needs. Foreign aid programs hold much promise to deal with this challenge. A case study from Norway illustrates the possibilities. Since the early 1960s, Norwegian universities have offered English-taught masters and doctoral degree programs, with sufficient financial support that all Third World students have the resources to complete training, regardless of their personal financial circumstances. This facet of the program is its main distinguishing factor, compared to many educational opportunities that are available in other countries. Since the first visiting students were awarded degrees in 1968, almost 10,000 students have participated at more than 25 Norwegian institutions, including many offering public health training. Many eligible applicants have been turned away due to lack of resources, indicating a level of interest that cannot be met with existing resources. Similar programs in more countries could help alleviate the need.

School Site Visits for Community-Based Participatory Research on Healthy Eating

PubMed Central

Patel, Anisha I.; Bogart, Laura M.; Uyeda, Kimberly E.; Martinez, Homero; Knizewski, Ritamarie; Ryan, Gery W.; Schuster, Mark A.

2010-01-01

Background School nutrition policies are gaining support as a means of addressing childhood obesity. Community-based participatory research (CBPR) offers an approach for academic and community partners to collaborate to translate obesity-related school policies into practice. Site visits, in which trained observers visit settings to collect multilevel data (e.g., observation, qualitative interviews), may complement other methods that inform health promotion efforts. This paper demonstrates the utility of site visits in the development of an intervention to implement obesity-related policies in Los Angeles Unified School District (LAUSD) middle schools. Methods In 2006, trained observers visited four LAUSD middle schools. Observers mapped cafeteria layout; observed food/beverage offerings, student consumption, waste patterns, and duration of cafeteria lines; spoke with school staff and students; and collected relevant documents. Data were examined for common themes and patterns. Results Food and beverages sold in study schools met LAUSD nutritional guidelines, and nearly all observed students had time to eat most or all of their meal. Some LAUSD policies were not implemented, including posting nutritional information for cafeteria food, marketing school meals to improve student participation in the National School Lunch Program, and serving a variety of fruits and vegetables. Cafeteria understaffing and cost were obstacles to policy implementation. Conclusions Site visits were a valuable methodology for evaluating the implementation of school district obesity-related policies and contributed to the development of a CBPR intervention to translate school food policies into practice. Future CBPR studies may consider site visits in their toolbox of formative research methods. PMID:19896033

Prospects for Vascular Access Education in Developing Countries: Current Situation in Cambodia.

PubMed

Naganuma, Toshihide; Takemoto, Yoshiaki

2017-01-01

We report our activities training doctors on vascular access procedures at International University (IU) Hospital in Cambodia through a program facilitated by Ubiquitous Blood Purification International, a nonprofit organization that provides medical support to developing countries in the field of dialysis medicine. Six doctors from Japan have been involved in the education of medical personnel at IU, and we have collectively visited Cambodia about 15 times from 2010 to 2016. In these visits, we have performed many operations, including 42 for arteriovenous fistula, 1 arteriovenous graft, and 1 percutaneous transluminal angioplasty. Stable development and management of vascular access is increasingly required in Cambodia due to increased use of dialysis therapy, and training of doctors in this technique is urgently required. However, we have encountered several difficulties that need to be addressed, including (1) the situation of personnel receiving this training, (2) problems with facilities, including medical equipment and drugs, (3) financial limitations, and (4) problems with management of vascular access. © 2017 S. Karger AG, Basel.

Developing a health and human rights training program for french speaking Africa: lessons learned, from needs assessment to a pilot program

PubMed Central

2009-01-01

Background The importance of human rights education has widely been recognized as one of the strategies for their protection and promotion of health. Yet training programs have not always taken into account neither local needs, nor public health relevance, nor pedagogical efficacy. The objectives of our study were to assess, in a participative way, educational needs in the field of health and human rights among potential trainees in six French-speaking African countries and to test the feasibility of a training program through a pilot test. Ultimately the project aims to implement a health and human rights training program most appropriate to the African context. Methods Needs assessment was done according to four approaches: Revue of available data on health and human rights in the targeted countries; Country visits by one of the authors meeting key institutions; Focus group discussions with key-informants in each country; A questionnaire-based study targeting health professionals and human rights activists. Pilot training program: an interactive e-learning pilot program was developed integrating training needs expressed by partner institutions and potential trainees. Results Needs assessment showed high public health and human rights challenges that the target countries have to face. It also showed precise demands of partner institutions in regard to a health and human rights training program. It further allowed defining training objectives and core competencies useful to potential employers and future students as well as specific training contents. A pilot program allowed testing the motivation of students, the feasibility of an interactive educational approach and identifying potential difficulties. Conclusion In combining various approaches our study was able to show that training needs concentrate around tools allowing the identification of basic human rights violations in the health system, the analysis of their causes and coordinated responses through specific intervention projects. PMID:19703303

Developing a health and human rights training program for french speaking Africa: lessons learned, from needs assessment to a pilot program.

PubMed

Chastonay, Philippe; Klohn, Axel Max; Zesiger, Véronique; Freigburghaus, Franziska; Mpinga, Emmanuel Kabengele

2009-08-24

The importance of human rights education has widely been recognized as one of the strategies for their protection and promotion of health. Yet training programs have not always taken into account neither local needs, nor public health relevance, nor pedagogical efficacy.The objectives of our study were to assess, in a participative way, educational needs in the field of health and human rights among potential trainees in six French-speaking African countries and to test the feasibility of a training program through a pilot test. Ultimately the project aims to implement a health and human rights training program most appropriate to the African context. Needs assessment was done according to four approaches: Revue of available data on health and human rights in the targeted countries; Country visits by one of the authors meeting key institutions; Focus group discussions with key-informants in each country; A questionnaire-based study targeting health professionals and human rights activists.Pilot training program: an interactive e-learning pilot program was developed integrating training needs expressed by partner institutions and potential trainees. Needs assessment showed high public health and human rights challenges that the target countries have to face. It also showed precise demands of partner institutions in regard to a health and human rights training program. It further allowed defining training objectives and core competencies useful to potential employers and future students as well as specific training contents.A pilot program allowed testing the motivation of students, the feasibility of an interactive educational approach and identifying potential difficulties. In combining various approaches our study was able to show that training needs concentrate around tools allowing the identification of basic human rights violations in the health system, the analysis of their causes and coordinated responses through specific intervention projects.

The POSNA-COUR International Scholar Program. Results of the First 7 Years.

PubMed

Fornari, Eric D; Sabharwal, Sanjeev; Schwend, Richard M

2017-12-01

The Pediatric Orthopedic Society of North America (POSNA)-Children's Orthopedics in Underserved Regions (COUR) International Scholar Program was initiated in 2007 to provide educational opportunities for emerging leaders who treat children with orthopaedic conditions in resource-challenged environments worldwide. Financial support is available each year for 4 to 6 orthopaedic surgeons to attend either the POSNA Annual Meeting or the International Pediatric Orthopedic Symposium. The scholars are also encouraged to visit selected centers for observerships during their trip. Since 2007 there have been 41 international scholars who have participated in the program. We wished to assess the impact of the program and to obtain feedback to improve the experience for future participants. A 23-question web-based survey was created and sent to 38 past scholars from 22 countries who have participated in the program by July 2013. The responses were gathered online and the data were analyzed for the 24 (62%) respondents from 18 countries who completed the survey. Of the respondents, 16/24 (66%) reported that their current practice is comprised of at least 75% pediatrics. Twelve of 24 (52%) were fellowship trained in pediatric orthopaedics, typically outside of North America. All scholars found the meeting they attended to be very useful and have subsequently made changes to their clinical practice. Nineteen of 24 (82%) did a premeeting or postmeeting observership. Twenty-two of 24 (92%) participants have remained in contact with POSNA members they met at the meeting, with 86% of respondents stating that they have subsequently consulted POSNA members on management of patients. Sixty-two percent of the scholars had a POSNA member visit them following the scholarship and 29% have since returned to visit POSNA members for further clinical observerships. Twenty-one of 24 (91%) have had the opportunity to share the knowledge they gained with others in their region through lectures, surgical demonstrations, and/or clinical training. A common response from the scholars was that the scholarship program was a truly transformative life experience that provided them with an opportunity to receive the highest quality of professional education. The main challenges that these scholars report are lack of available fellowship/subspecialty training in their region, patients' inability to pay, and excessive physician workload. All of the respondents expressed interest in arranging a POSNA cosponsored regional meeting. Since 2007, the POSNA-COUR international scholar program has been a fruitful resource for orthopaedists practicing in resource-challenged environments worldwide. It has provided unique training for the scholars and has further enabled them to teach others in their region. The program has thus far succeeded in fostering lasting relationships that have led to continued educational exchanges. Level IV-case series.

Cultural Adaptation of Second Language Soldiers.

DTIC Science & Technology

1981-07-05

such training in any of the programs visited. There appears to be no coordinated plan to develop such training. Many people express great interest in and...language soldiers. 9. That all plans , data and conclusions resulting from this or other studies be liberally shared with pertinent DOD agencies in order...ought to know?" TAKE NOTES. PROBE. 8."Thank you very much. I’ve learned a lot. My plans are to study what I find out here and at other places and then

European School-to-Work Systems: A View from the American States. Issue Brief.

ERIC Educational Resources Information Center

National Governors' Association, Washington, DC.

Representatives of the School-to-Work Roundtable studied education systems and work force training programs in Denmark and Germany. The group visited vocational schools, technical colleges, and firms sponsoring apprentices in Copenhagen and Munich and spoke with students, teachers, and mentors in apprenticeships in metalworking, textiles,…

Chronic Pulmonary Disease in Children and Young Adults. Community Visitation Training Program.

ERIC Educational Resources Information Center

New Mexico Regional Medical Program, Albuquerque.

This curriculum guide outlines the subject matter, techniques, and demonstrations presented to medical and paramedical personnel in a 1-week course offered at the New Mexico Pulmonary Center on the diagnostic evaluation of and the use of the most recent therapeutic techniques for children with chronic respiratory disorders. The manual's five…

Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial.

PubMed

Haider, Sandra; Grabovac, Igor; Winzer, Eva; Kapan, Ali; Schindler, Karin Emmi; Lackinger, Christian; Titze, Sylvia; Dorner, Thomas Ernst

2017-01-01

The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35) conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23) received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2) to 3.0 pg/l (min-max = 2.0-20.8), and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9) to 0.3 mg/dl (min-max = 0.1-3.0) after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45) were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

Promoting patient participation in healthcare interactions through communication skills training: A systematic review.

PubMed

D'Agostino, Thomas A; Atkinson, Thomas M; Latella, Lauren E; Rogers, Madeline; Morrissey, Dana; DeRosa, Antonio P; Parker, Patricia A

2017-07-01

To present literature on training patients in the use of effective communication skills. Systematic searches were conducted in six databases. References were screened for inclusion through several phases. Extracted data included intervention study design, sample characteristics, content and structure of training programs, outcomes assessed, and findings reported. A total of 32 unique intervention studies were included. Most targeted primary care or cancer patients and used a randomized controlled study design. Interventions used a variety of training formats and modes of delivering educational material. Reported findings suggest that communication training is an effective approach to increase patients' total level of active participation in healthcare interactions and that some communication behaviors may be more amenable to training (e.g., expressing concerns). Trained patients do not have longer visits and tend to receive more information from their providers. Most studies have found no relationship between communication training and improved health, psychosocial wellbeing, or treatment-related outcomes. Findings reinforce the importance and potential benefits of patient communication training. Additional research is warranted to determine the most efficacious training programs with the strongest potential for dissemination. Copyright © 2017 Elsevier B.V. All rights reserved.

Organizational impact of evidence-informed decision making training initiatives: a case study comparison of two approaches.

PubMed

Champagne, François; Lemieux-Charles, Louise; Duranceau, Marie-France; MacKean, Gail; Reay, Trish

2014-05-02

The impact of efforts by healthcare organizations to enhance the use of evidence to improve organizational processes through training programs has seldom been assessed. We therefore endeavored to assess whether and how the training of mid- and senior-level healthcare managers could lead to organizational change. We conducted a theory-driven evaluation of the organizational impact of healthcare leaders' participation in two training programs using a logic model based on Nonaka's theory of knowledge conversion. We analyzed six case studies nested within the two programs using three embedded units of analysis (individual, group and organization). Interviews were conducted during intensive one-week data collection site visits. A total of 84 people were interviewed. We found that the impact of training could primarily be felt in trainees' immediate work environments. The conversion of attitudes was found to be easier to achieve than the conversion of skills. Our results show that, although socialization and externalization were common in all cases, a lack of combination impeded the conversion of skills. We also identified several individual, organizational and program design factors that facilitated and/or impeded the dissemination of the attitudes and skills gained by trainees to other organizational members. Our theory-driven evaluation showed that factors before, during and after training can influence the extent of skills and knowledge transfer. Our evaluation went further than previous research by revealing the influence--both positive and negative--of specific organizational factors on extending the impact of training programs.

Merging universal and indicated prevention programs: the Fast Track model. Conduct Problems Prevention Research Group.

PubMed

2000-01-01

Fast Track is a multisite, multicomponent preventive intervention for young children at high risk for long-term antisocial behavior. Based on a comprehensive developmental model, this intervention includes a universal-level classroom program plus social-skill training, academic tutoring, parent training, and home visiting to improve competencies and reduce problems in a high-risk group of children selected in kindergarten. The theoretical principles and clinical strategies utilized in the Fast Track Project are described to illustrate the interplay between basic developmental research, the understanding of risk and protective factors, and a research-based model of preventive intervention that integrates universal and indicated models of prevention.

Feasibility of Internet-based Parent Training for Low-income Parents of Young Children.

PubMed

McGoron, Lucy; Hvizdos, Erica; Bocknek, Erika L; Montgomery, Erica; Ondersma, Steven J

2018-01-01

Parent training programs promote positive parenting and benefit low-income children, but are rarely used. Internet-based delivery may help expand the reach of parent training programs, although feasibility among low-income populations is still unclear. We examined the feasibility of internet-based parent training, in terms of internet access/use and engagement, through two studies. In Study 1, 160 parents recruited from Women, Infants, and Children (WIC) centers completed a brief paper survey regarding internet access and use (all parents received government aid). We found high levels of access, openness, and comfort with the internet and internet-enabled devices. In Study 2, a pilot study, we assessed use of an online parenting program in a project with a sample of 89 predominately low-income parents (75% received government aid). Parents learned about a new, online parenting program (the "5-a-Day Parenting Program") and provided ratings of level of interest and program use 2-weeks and 4-weeks later. Local website traffic was also monitored. At baseline, parents were very interested in using the web-based program, and the majority of parents (69.6%) reported visiting the website at least once. However, in-depth use was rare (only 9% of parents reported frequent use of the online program). Results support the feasibility of internet-based parent training for low-income parents, as most parent were able to use the program and were interested in doing so. However, results also suggest the need to develop strategies to promote in-depth program use.

Commercial Crew Astronauts Visit Kennedy on This Week @NASA – August 12, 2016

NASA Image and Video Library

2016-08-12

Two of the NASA astronauts training for the first flight tests for the agency’s Commercial Crew Program visited with employees during an Aug. 11 event at Kennedy Space Center. Astronauts Eric Boe and Suni Williams, alongside Commercial Crew Program Manager Kathy Lueders, responded to questions during a panel discussion, moderated by Kennedy Director Robert Cabana. NASA has contracted with Boeing and SpaceX to develop crew transportation systems and provide crew transportation services to and from the International Space Station. The agency will select the commercial crew astronauts from the group that includes Boe, Williams, Bob Behnken and Doug Hurley The first flight tests are targeted for next year. Also, Air Quality Flight over California Wildfire, CYGNSS Media Day, Putting NASA Earth Science to Work, and more!

Helpers program: A pilot test of brief tobacco intervention training in three corporations.

PubMed

Muramoto, Myra L; Wassum, Ken; Connolly, Tim; Matthews, Eva; Floden, Lysbeth

2010-03-01

Quitlines and worksite-sponsored cessation programs are effective and highly accessible, but limited by low utilization. Efforts to encourage use of cessation aids have focused almost exclusively on the smoker, overlooking the potential for friends, family, co-workers, and others in a tobacco user's social network to influence quitting and use of effective treatment. Longitudinal, observational pilot feasibility study with 6-week follow-up survey. Employees of three national corporations, with a combined target audience of 102,100 employees. The Helpers Program offers web-based, brief intervention training to activate social networks of tobacco users to encourage quitting and use of effective treatment. Helpers was offered from January 10 to March 31, 2008, as a treatment engagement strategy, together with Free & Clear's telephone/web-based cessation services. Website utilization, training completion, post-training changes in knowledge and self-efficacy with delivery of brief interventions, referrals to Free & Clear, and use of brief intervention training. There were 19,109 unique visitors to the Helpers website. Of these, 4727 created user accounts; 1427 registered for Helpers Training; 766 completed training. There were 445 visits to the referral page and 201 e-mail or letter referrals generated. There were 67 requests for technical support. Of follow-up survey respondents (n=289), 78.9% reported offering a brief intervention. Offering the Helpers Program website to a large, diverse audience as part of an employer-sponsored worksite health promotion program is both feasible and well accepted by employees. Website users will participate in training, encourage quitting, and refer smokers to quitline services. 2010. Published by Elsevier Inc.

System looks outside its own walls to find innovative way to cut kids' asthma admissions.

PubMed

1999-10-01

Atlanta children's hospital system initiates outpatient pediatric asthma disease management program to reduce inpatient admissions and ER visits while reducing costs. Children's Healthcare of Atlanta turned to the primary care physician community for front-line support in keeping mild asthma cases out of the hospital. By offering evidence-based practice guidelines, training for staff, and educational materials for patients and their families, the Partnership to ACE Asthma program is off to a running start. Learn how to set up a similar program.

Patient-specific academic detailing for smoking cessation

PubMed Central

Jin, Margaret; Gagnon, Antony; Levine, Mitchell; Thabane, Lehana; Rodriguez, Christine; Dolovich, Lisa

2014-01-01

Abstract Objective To describe and to determine the feasibility of a patient-specific academic detailing (PAD) smoking cessation (SC) program in a primary care setting. Design Descriptive cohort feasibility study. Setting Hamilton, Ont. Participants Pharmacists, physicians, nurse practitioners, and their patients. Interventions Integrated pharmacists received basic academic detailing training and education on SC and then delivered PAD to prescribers using structured verbal education and written materials. Data were collected using structured forms. Main outcome measures Five main feasibility criteria were generated based on Canadian academic detailing programs: PAD coordinator time to train pharmacists less than 40 hours; median time of SC education per pharmacist less than 20 hours; median time per PAD session less than 60 minutes for initial visit; percentage of prescribers receiving PAD within 3 months greater than 50%; and number of new SC referrals to pharmacists at 6 months more than 10 patients per 1.0 full-time equivalent (FTE) pharmacist (total of approximately 30 patients). Results Eight pharmacists (5.8 FTE) received basic academic detailing training and education on SC PAD. Forty-eight physicians and 9 nurse practitioners consented to participate in the study. The mean PAD coordinator training time was 29.1 hours. The median time for SC education was 3.1 hours. The median times for PAD sessions were 15 and 25 minutes for an initial visit and follow-up visit, respectively. The numbers of prescribers who had received PAD at 3 and 6 months were 50 of 64 (78.1%) and 57 of 64 (89.1%), respectively. The numbers of new SC referrals at 3 and 6 months were 11 patients per FTE pharmacist (total of 66 patients) and 34 patients per FTE pharmacist (total of 200 patients), respectively. Conclusion This study met the predetermined feasibility criteria with respect to the management, resources, process, and scientific components. Further study is warranted to determine whether PAD is more effective than conventional academic detailing. PMID:24452574

[International collaboration to develop a nurse practitioner master's program].

PubMed

Tang, Woung-Ru

2007-12-01

Because of the shortage of resident doctors and in order to raise standards, hospitals and medical centers have trained their own nurse practitioners (NPs). Given the absence of standard training criteria and an unevenness of faculty quality, however, many NPs play the role of medical substitute, which is far from the independent role performed by NPs in foreign countries. It is therefore necessary to include NP training within higher education. The Graduate Institute of Nursing at Chang Gung University established the first NP in-service training program in 2003 through international collaboration, with the purpose of cultivating advanced clinical nursing talents. The program emphasizes the importance of clinical reasoning and practical training, in order to enable students to perform the multiple roles of treatment and caring undertaken by NPs. Experts in advanced nursing and clinical medicine from Taiwan and abroad were invited to serve as lecturers. The students also had the opportunity to take NP courses at Oregon Health and Science University (USA) and participate in clinical visits. The results have been widely praised. International collaboration is built upon the mutual trust of the parties, and its success is determined by the measures that it involves, as well as by the global vision and competence of participants. This paper shares the advantages and disadvantages of the NP master's program through international collaboration.

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR FIELD PERSONNEL TRAINING--GENERAL (UA-T-3.0)

EPA Science Inventory

The purpose of this SOP is to describe basic pre- and post-field visit activities and standards which are expected of every field team member. This procedure was followed to ensure consistent data retrieval during the Arizona NHEXAS project and the Border study. Keywords: traini...

Course on Early Childhood Education, September 22-December 22, 1982. Report.

ERIC Educational Resources Information Center

Mount Carmel International Training Centre for Community Development, Haifa (Israel).

The topics and issues brought forth in this report are the result of a 3-month training course on early childhood education that included lectures, discussions, and field visits. Nineteen participants representing 11 countries lived together for 3 months during 1982, exchanging views and ideas. A list of program participants, staff, and sponsors…

Katu Kalpa: Report on the Inquiry into the Effectiveness of Education and Training Programs for Indigenous Australians.

ERIC Educational Resources Information Center

Australia Parliament, Canberra. Senate Employment, Workplace Relations, Small Business and Education References Committee.

An inquiry into Indigenous education by an Australian Senate committee examined government reports produced in 1989-99 and conducted school site visits and public hearings. During the inquiry, it became clear that educational equity for Indigenous people had not been achieved, and Indigenous participation and achievement rates lagged behind those…

Columbia University Public Outreach: Looking Beyond the Bright Lights in the Big City

NASA Astrophysics Data System (ADS)

Ash, Summer; Agueros, Marcel A.

2015-01-01

Columbia University astronomers have been inviting the public to come and share in our love of the skies for several decades now, but only within the last ten years has this program become a sustained tool for public outreach and professional development. Columbia's Public Outreach engages with multiple audiences, from the general public to teachers to students of all ages, year-round. In the last three years alone, we have interacted with approximately 7500 people via school visits, teacher-training events, and our public lecture and stargazing series. Our outreach efforts are unique in that they are staffed entirely by graduate students and undergraduate majors who volunteer their time, and coordinated by a dedicated science-trained staff member in the department. Our program is particularly suited to be a vehicle for graduate-student training in science communication and public speaking. We describe the various components of our program and provide an analysis of the populations reached.

Integrative Medical Care Plus Mindfulness Training for Patients With Congestive Heart Failure: Proof of Concept.

PubMed

Kemper, Kathi J; Carmin, Cheryl; Mehta, Bella; Binkley, Phillip

2016-10-01

Congestive heart failure (CHF) has a high rate of morbidity and mortality. It is often accompanied by other medical and psychosocial comorbidities that complicate treatment and adherence. We conducted a proof of concept pilot project to determine the feasibility of providing integrative group medical visits plus mindfulness training for patients recently discharged with CHF. Patients were eligible if they had been discharged from an inpatient stay for CHF within the 12 months prior to the new program. The Compassionate Approach to Lifestyle and Mind-Body (CALM) Skills for Patients with CHF consisted of 8 weekly visits focusing on patient education about medications, diet, exercise, sleep, and stress management; group support; and training in mind-body skills such as mindfulness, self-compassion, and loving-kindness. Over two 8-week sessions, 8/11 (73%) patients completed at least 4 visits. The patients had an average age of 57 years. The most common comorbidities were weight gain, sleep problems, and fatigue. After the sessions, 100% of patients planned to make changes to their diet, exercise, and stress management practices. Over half of the patients who met with a pharmacist had a medication-related problem. Improvements were observed in depression, fatigue, and satisfaction with life. Integrative group visits focusing on healthy lifestyle, support, and skill-building are feasible even among CHF patients and should be evaluated in controlled trials as a patient-centered approach to improving outcomes related to improving medication management, depression, fatigue, and quality of life. © The Author(s) 2015.

EBCOG Hospital Recognition: where do we stand?

PubMed Central

Wladimiroff, J.; Hornnes, P.

2010-01-01

Hospital Recognition for general Ob/Gyn training programmes was started by EBCOG (European Board & College of Obstetrics & Gynaecology) in 1996 and for subspecialty Ob/Gyn training programmes in 2005, the latter jointly with the four European scientific organisations representing the subspecialties. So far, 85 Audits/Visits have been conducted by EBCOG for general Ob/Gyn training and a good start has been made for subspecialty training, in particular Gynaecological Oncology. EBCOG Visits are conducted by two EBCOG representatives and one trainee appointed by ENTOG (European Network for Trainees in Obstetrics & Gynaecology) for general Ob/Gyn training programmes and by two subspecialty specialists and an EBCOG representative for subspecialty programmes. Each Visit lasts one day. Accredition is granted by the EBCOG Executive Board depending on the Visiting report. Ultimately, EBCOG would like to see the introduction of an auditing and accreditation system for general and subspecialty Ob/Gyn training programmes in each country in Europe PMID:25206968

To evaluate if increased supervision and support of South African Government health workers' home visits improves maternal and child outcomes: study protocol for a randomized control trial.

PubMed

Rotheram-Borus, Mary Jane; Le Roux, Karl; Le Roux, Ingrid M; Christodoulou, Joan; Laurenzi, Christina; Mbewu, Nokwanele; Tomlinson, Mark

2017-08-07

Concurrent epidemics of HIV, depression, alcohol abuse, and partner violence threaten maternal and child health (MCH) in South Africa. Although home visiting has been repeatedly demonstrated efficacious in research evaluations, efficacy disappears when programs are scaled broadly. In this cluster randomized controlled trial (RCT), we examine whether the benefits of ongoing accountability and supervision within an existing government funded and implemented community health workers (CHW) home visiting program ensure the effectiveness of home visiting. In the deeply rural, Eastern Cape of South Africa, CHW will be hired by the government and will be initially trained by the Philani Programme to conduct home visits with all pregnant mothers and their children until the children are 2 years old. Eight clinics will be randomized to receive either (1) the Accountable Care Condition in which additional monitoring and accountability systems that Philani routinely uses are implemented (4 clinics, 16 CHW, 450 households); or (2) a Standard Care Condition of initial Philani training, but with supervision and monitoring being delivered by local government structures and systems (4 clinics, 21 CHW, 450 households). In the Accountable Care Condition areas, the CHW's mobile phone reports, which are time-location stamped, will be monitored and data-informed supervision will be provided, as well as monitoring growth, medical adherence, mental health, and alcohol use outcomes. Interviewers will independently assess outcomes at pregnancy at 3, 6, 15, and 24 months post-birth. The primary outcome will be a composite score of documenting maternal HIV/TB testing, linkage to care, treatment adherence and retention, as well as child physical growth, cognitive functioning, and child behavior and developmental milestones. The proposed cluster RCT will evaluate whether routinely implementing supervision and accountability procedures and monitoring CHWs' over time will improve MCH outcomes over the first 2 years of life. ClinicalTrials.gov registration #NCT02957799 , registered on October 26, 2016.

A Study of the Effects of Automation on the Nature of the Work of the Draftsman in Industry, and the Innovative Programs of Instruction for Automated Drafting in Selected Junior Colleges in California to be Used for Curricular Revision. Final Report.

ERIC Educational Resources Information Center

Husung, William T., Jr.

Visits to 35 industries and professional offices throughout California and interviews of 219 draftsmen and supervisors were conducted to determine: (1) the effects of automation on the needs of industry for draftsmen with general versus specialized training, and (2) the curricular revisions in vocational drafting programs in junior colleges to…

KSC-03pd1204

NASA Image and Video Library

2003-04-23

KENNEDY SPACE CENTER, FLA. - JoAnn Morgan, director, External Relations and Business Development, speaks to the students of MESA, the New Mexico Mathematics, Engineering and Science Achievement Program. The students are visiting KSC, touring facilities and meeting with mentors. MESA students, high school seniors who hold grade-point averages of at least 3.2 and who tutor other students in math and science, have made the spring trip for the past 14 years. The MESA program has close ties to the NASA Training Project at the University of New Mexico.

KSC-03pd1203

NASA Image and Video Library

2003-04-23

KENNEDY SPACE CENTER, FLA. - JoAnn Morgan, director, External Relations and Business Development, speaks to the students of MESA, the New Mexico Mathematics, Engineering and Science Achievement Program. The students are visiting KSC, touring facilities and meeting with mentors. MESA students, high school seniors who hold grade-point averages of at least 3.2 and who tutor other students in math and science, have made the spring trip for the past 14 years. The MESA program has close ties to the NASA Training Project at the University of New Mexico.

KSC-03pd1205

NASA Image and Video Library

2003-04-23

KENNEDY SPACE CENTER, FLA. - JoAnn Morgan, director, External Relations and Business Development, speaks to the students of MESA, the New Mexico Mathematics, Engineering and Science Achievement Program. The students are visiting KSC, touring facilities and meeting with mentors. MESA students, high school seniors who hold grade-point averages of at least 3.2 and who tutor other students in math and science, have made the spring trip for the past 14 years. The MESA program has close ties to the NASA Training Project at the University of New Mexico.

KSC-03PD-1203

NASA Technical Reports Server (NTRS)

2003-01-01

KENNEDY SPACE CENTER, FLA. - JoAnn Morgan, director, External Relations and Business Development, speaks to the students of MESA, the New Mexico Mathematics, Engineering and Science Achievement Program. The students are visiting KSC, touring facilities and meeting with mentors. MESA students, high school seniors who hold grade-point averages of at least 3.2 and who tutor other students in math and science, have made the spring trip for the past 14 years. The MESA program has close ties to the NASA Training Project at the University of New Mexico.

KSC-03PD-1205

NASA Technical Reports Server (NTRS)

2003-01-01

KENNEDY SPACE CENTER, FLA. - JoAnn Morgan, director, External Relations and Business Development, speaks to the students of MESA, the New Mexico Mathematics, Engineering and Science Achievement Program. The students are visiting KSC, touring facilities and meeting with mentors. MESA students, high school seniors who hold grade-point averages of at least 3.2 and who tutor other students in math and science, have made the spring trip for the past 14 years. The MESA program has close ties to the NASA Training Project at the University of New Mexico.

KSC-03PD-1201

NASA Technical Reports Server (NTRS)

2003-01-01

KENNEDY SPACE CENTER, FLA. -- Gregg Buckingham, University Affairs officer, External Relations and Business Development Directorate, addresses students of MESA, the New Mexico Mathematics, Engineering and Science Achievement Program. The students are visiting KSC, touring facilities and meeting with mentors. MESA students, high school seniors who hold grade-point averages of at least 3.2 and who tutor other students in math and science, have made the spring trip for the past 14 years. The MESA program has close ties to the NASA Training Project at the University of New Mexico.

KSC-03PD-1202

NASA Technical Reports Server (NTRS)

2003-01-01

KENNEDY SPACE CENTER, FLA. - Gregg Buckingham, University Affairs officer, External Relations and Business Development Directorate, addresses students of MESA, the New Mexico Mathematics, Engineering and Science Achievement Program. The students are visiting KSC, touring facilities and meeting with mentors. MESA students, high school seniors who hold grade-point averages of at least 3.2 and who tutor other students in math and science, have made the spring trip for the past 14 years. The MESA program has close ties to the NASA Training Project at the University of New Mexico.

KSC-03PD-1204

NASA Technical Reports Server (NTRS)

2003-01-01

KENNEDY SPACE CENTER, FLA. - JoAnn Morgan, director, External Relations and Business Development, speaks to the students of MESA, the New Mexico Mathematics, Engineering and Science Achievement Program. The students are visiting KSC, touring facilities and meeting with mentors. MESA students, high school seniors who hold grade-point averages of at least 3.2 and who tutor other students in math and science, have made the spring trip for the past 14 years. The MESA program has close ties to the NASA Training Project at the University of New Mexico.

Effectiveness of supportive supervision on the consistency of integrated community cases management skills of the health extension workers in 113 districts of Ethiopia.

PubMed

Ameha, Agazi; Karim, Ali Mehryar; Erbo, Amano; Ashenafi, Addis; Hailu, Mulu; Hailu, Berhan; Folla, Abebe; Bizuwork, Simret; Betemariam, Wuleta

2014-10-01

Consistency in the adherence to integrated Community Case Management (iCCM) protocols for common childhood illnesses provided by Ethiopia's Health Extension Program (HEP) frontline workers. One approach is to provide regular clinical mentoring to the frontline health workers of the HEP at their health posts (HP) through supportive supervision (SS) following the initial training. To Assess the effectiveness of visits to improve the consistency of iCCM skills (CoS) of the HEWs in 113 districts in Ethiopia. We analyzed data from 3,909 supportive supervision visits between January 2011 and June 2013 in 113 districts in Ethiopia. From case assessment registers, a health post was classified as consistent in managing pneumonia, malaria, or diarrhea cases if the disease classification, treatment, and follow-up of the last two cases managed at the health posts were consistent with the protocol. We used regression models to assess the effects of SS on CoS. All HPs (2,368) received at least one supportive supervision visit, 41% received two, and 15% received more than two. During the observation period, HP management consistency in pneumonia, malaria, and diarrhea increased by 3.0, 2.7 and 4.4-fold, respectively. After controlling for secular trend and other factors, significant dose-response relationships were observed between number of SS visits and CoS indicators. The SS visits following the initial training were effective in improving the CoS.

Organizational impact of evidence-informed decision making training initiatives: a case study comparison of two approaches

PubMed Central

2014-01-01

Background The impact of efforts by healthcare organizations to enhance the use of evidence to improve organizational processes through training programs has seldom been assessed. We therefore endeavored to assess whether and how the training of mid- and senior-level healthcare managers could lead to organizational change. Methods We conducted a theory-driven evaluation of the organizational impact of healthcare leaders’ participation in two training programs using a logic model based on Nonaka’s theory of knowledge conversion. We analyzed six case studies nested within the two programs using three embedded units of analysis (individual, group and organization). Interviews were conducted during intensive one-week data collection site visits. A total of 84 people were interviewed. Results We found that the impact of training could primarily be felt in trainees’ immediate work environments. The conversion of attitudes was found to be easier to achieve than the conversion of skills. Our results show that, although socialization and externalization were common in all cases, a lack of combination impeded the conversion of skills. We also identified several individual, organizational and program design factors that facilitated and/or impeded the dissemination of the attitudes and skills gained by trainees to other organizational members. Conclusions Our theory-driven evaluation showed that factors before, during and after training can influence the extent of skills and knowledge transfer. Our evaluation went further than previous research by revealing the influence—both positive and negative—of specific organizational factors on extending the impact of training programs. PMID:24885800

Tailoring communication in cancer genetic counseling through individual video-supported feedback: a controlled pretest-posttest design.

PubMed

Pieterse, Arwen H; van Dulmen, Alexandra M; Beemer, Frits A; Ausems, Margreet G E M; Bensing, Jozien M

2006-03-01

To assess the influence of a 1-day individual video-feedback training for cancer genetic counselors on the interaction during initial visits. Feedback was intended to help counselors make counselees' needs more explicit and increase counselors' sensitivity to these. In total 158 counselees, mainly referred for breast or colon cancer and visiting 1 of 10 counselors, received a pre- and post-visit questionnaire assessing needs (fulfillment). Visits were videotaped, counselor eye gaze was assessed, and verbal communication was analyzed by Roter Interaction Analysis System (RIAS) adapted to the genetic setting. Halfway the study, five counselors were trained. Trained counselors provided more psychosocial information, and with trained counselors emotional consequences of DNA-testing was more often discussed. Counselees seen by a trained counselor considered their need for explanations on (emotional) consequences of counseling as better fulfilled. Unexpectedly, counselees' contribution to the interaction was smaller with trained counselors. Feedback appeared to result in greater emphasis on psychosocial issues, without lengthening the visit. However, counselors did not become more verbally supportive in other ways than by providing information. A 1 day individual training appears effective to some extend; increased opportunities for watching and practicing behavioral alternatives and arranging consolidating sessions may improve training results.

Training the trainers: beyond providing a well-received course.

PubMed

Blitz, Julia; Edwards, Jill; Mash, Bob; Mowle, Steve

2016-09-01

The Royal College of General Practitioners in partnership with the South African Academy of Family Physicians obtained funding to run a series of 'Training the Trainers' courses for trainers of family medicine registrars, with a view to strengthening clinical supervision of postgraduate registrars. The authors wanted to establish whether it was worthwhile for the course to be provided on an ongoing basis after the funded project was completed. Development of a pilot tool for evaluation visits after a faculty development course. The authors developed a pre-visit pack and conducted five site visits to registrar trainers who had been on the course between 12 and 24 months earlier. Before the series of visits and after each visit we debriefed and modified our approach. Optimising the use of the pre-visit pack will require greater orientation of the trainer. Administrative support for the visits will be vital. The visits were experienced very positively. However, in a context in which these visits are not the norm, the trainers need support and encouragement to participate in an activity which made them feel quite vulnerable. The tool enabled course participants to show evidence of their behaviour change, enabled their colleagues to report on the impact on their own teaching practices, and enabled registrars to voice their opinions of their trainer's supervision skills. A post-course formative evaluation visit has the potential to catalyse the impact of the training course. It will be necessary to train the family physicians who conduct these visits.

Knock, Knock, May I Come In? An Integrative Perspective on Professional Development Concerns for Home Visits Conducted by Teachers

ERIC Educational Resources Information Center

Jiles, Tywanda

2015-01-01

This article address home visits and the professional development needs of teachers who perform visits. The author writes from a practitioner's point of view, focusing on training needs for providers. The author argues that training and preparation for conducting home visits is needed to equip professionals with the skills needed to execute this…

Identifying gaps, barriers, and solutions in implementing pressure ulcer prevention programs.

PubMed

Jankowski, Irene M; Nadzam, Deborah Morris

2011-06-01

Patients continue to suffer from pressure ulcers (PUs), despite implementation of evidence-based pressure ulcer (PU) prevention protocols. In 2009, Joint Commission Resources (JCR) and Hill-Rom created the Nurse Safety Scholar-in-Residence (nurse scholar) program to foster the professional development of expert nurse clinicians to become translators of evidence into practice. The first nurse scholar activity has focused on PU prevention. Four hospitals with established PU programs participated in the PU prevention implementation project. Each hospital's team completed an inventory of PU prevention program components and provided copies of accompanying documentation, along with prevalence and incidence data. Site visits to the four participating hospitals were arranged to provide opportunities for more in-depth analysis and support. Following the initial site visit, the project team at each hospital developed action plans for the top three barriers to PU program implementation. A series of conference calls was held between the site visits. Pressure Ulcer Program Gaps and Recommendations. The four hospitals shared common gaps in terms of limitations in staff education and training; lack of physician involvement; limited involvement of unlicensed nursing staff; lack of plan for communicating at-risk status; and limited quality improvement evaluations of bedside practices. Detailed recommendations were identified for addressing each of these gaps. these Recommendations for eliminating gaps have been implemented by the participating teams to drive improvement and to reduce hospital-acquired PU rates. The nurse scholars will continue to study implementation of best practices for PU prevention.

Preparation for Encounter; Training Peace Corps Volunteers for Community Involvement Through Community Exploration.

ERIC Educational Resources Information Center

Ruopp, Phillips; Wrobel, Paul

A result of two years' experience at the Virgin Islands Training Center, this handbook on Peace Corps volunteer training for community involvement covers types of activities used (one-day community visits, small discussion groups on communities visited, group consultations to develop community exploration methods, field training and its…

Helpers Program: A Pilot Test of Brief Tobacco Intervention Training in Three Corporations

PubMed Central

Muramoto, Myra L.; Wassum, Ken; Connolly, Tim; Matthews, Eva; Floden, Lysbeth

2014-01-01

Background Quitlines and worksite-sponsored cessation programs are effective and highly accessible, but limited by low utilization. Efforts to encourage use of cessation aids have focused almost exclusively on the smoker, overlooking the potential for friends, family, coworkers and others in a tobacco user’s social network to influence quitting and use of effective treatment. Methods Longitudinal, observational pilot feasibility study with six-week follow-up survey. Setting/Participants Employees of three national corporations, with a combined target audience of 102,100 employees. Intervention The Helpers Program offers Web-based brief intervention (BI) training to activate social networks of tobacco users to encourage quitting and use of effective treatment. Helpers was offered from 1/10/08 to 3/31/08, as a treatment engagement strategy, together with Free and Clear’s (F&C) telephone/Web-based cessation services. Main outcome measures web-site utilization, training completion, post-training changes in knowledge and self-efficacy with delivery of BIs, referrals to F&C, and use of BI training. Results There were 19,109 unique visitors to the Helpers Web-site. Of these, 4727 created user accounts; 1427 registered for Helpers Training; 766 completed training. There were 445 visits to the referral page and 201 e-mail or letter referrals generated. There were 67 requests for technical support. Of follow-up survey respondents (n=289), 78.9% reported offering a BI. Conclusions Offering the Helpers Program Web-site to a large, diverse audience as part of an employer-sponsored worksite health promotion program is both feasible and well accepted by employees. Website users will participate in training, encourage quitting, and refer smokers to quitline services. PMID:20176303

Adult Literacy: Skills for the American Work Force. Research and Development Series No. 265B.

ERIC Educational Resources Information Center

Hull, William L.; Sechler, Judith A.

A study examined the nature and extent of adult literacy needs in the American labor force. Data for the study were collected from a review of the literature, site visits to nine industry-based training programs, and consultation with a technical panel of experts. Input from company managers, instructors, and trainers familiar with the…

Perceptions of Pregnant Teens and Teen Mothers Entering a Training Program on Parenting Skills and Knowledge about Infants.

ERIC Educational Resources Information Center

Boals, Beverly G.; And Others

Project REAL was designed to address Goal 1 of the Educate America Act. Four major components were: (1) the identification of pregnant and/or parenting teens; (2) the enrollment of those identified into parental services, life skills and parenting classes; (3) weekly visits in the home to provide assistance with developmentally appropriate needs…

Determining the Influence of a Science Exhibition Center Training Program on Elementary Pupils' Interest and Achievement in Science

ERIC Educational Resources Information Center

Bozdogan, Aykut Emre; Yalcin, Necati

2009-01-01

This research aimed to examine the effects of visiting exhibitions and participating in the activities offered by science centers on raising the interest of second level students of primary education in science and improving their academic achievements. Thirty one 8th grade students chosen randomly from primary schools participated in the research…

The Association Between Residency Training and Internists’ Ability to Practice Conservatively

PubMed Central

Sirovich, Brenda E.; Lipner, Rebecca S.; Johnston, Mary; Holmboe, Eric S.

2014-01-01

IMPORTANCE Growing concern about rising costs and potential harms of medical care has stimulated interest in assessing physicians’ ability to minimize the provision of unnecessary care. OBJECTIVE To assess whether graduates of residency programs characterized by low-intensity practice patterns are more capable of managing patients’ care conservatively, when appropriate, and whether graduates of these programs are less capable of providing appropriately aggressive care. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional comparison of 6639 first-time takers of the 2007 American Board of Internal Medicine certifying examination, aggregated by residency program (n = 357). EXPOSURES Intensity of practice, measured using the End-of-Life Visit Index, which is the mean number of physician visits within the last 6 months of life among Medicare beneficiaries 65 years and older in the residency program’s hospital referral region. MAIN OUTCOMES AND MEASURES The mean score by program on the Appropriately Conservative Management (ACM) (and Appropriately Aggressive Management [AAM]) subscales, comprising all American Board of Internal Medicine certifying examination questions for which the correct response represented the least (or most, respectively) aggressive management strategy. Mean scores on the remainder of the examination were used to stratify programs into 4 knowledge tiers. Data were analyzed by linear regression of ACM(or AAM) scores on the End-of-Life Visit Index, stratified by knowledge tier. RESULTS Within each knowledge tier, the lower the intensity of health care practice in the hospital referral region, the better residency program graduates scored on the ACM subscale (P < .001 for the linear trend in each tier). In knowledge tier 4 (poorest), for example, graduates of programs in the lowest-intensity regions had a mean ACM score in the 38th percentile compared with the 22nd percentile for programs in the highest-intensity regions; in tier 2, ACM scores ranged from the 75th to the 48th percentile in regions from lowest to highest intensity. Graduates of programs in low-intensity regions tended, more weakly, to score better on the AAM subscale (in 3 of 4 knowledge tiers). CONCLUSIONS AND RELEVANCE Regardless of overall medical knowledge, internists trained at programs in hospital referral regions with lower-intensity medical practice are more likely to recognize when conservative management is appropriate. These internists remain capable of choosing an aggressive approach when indicated. PMID:25179515

A Pilot Study of Perceptual-Motor Training for Peripheral Prisms

PubMed Central

Houston, Kevin E.; Bowers, Alex R.; Fu, Xianping; Liu, Rui; Goldstein, Robert B.; Churchill, Jeff; Wiegand, Jean-Paul; Soo, Tim; Tang, Qu; Peli, Eli

2016-01-01

Purpose Peripheral prisms (p-prisms) shift peripheral portions of the visual field of one eye, providing visual field expansion for patients with hemianopia. However, patients rarely show adaption to the shift, incorrectly localizing objects viewed within the p-prisms. A pilot evaluation of a novel computerized perceptual-motor training program aiming to promote p-prism adaption was conducted. Methods Thirteen patients with hemianopia fitted with 57Δ oblique p-prisms completed the training protocol. They attended six 1-hour visits reaching and touching peripheral checkerboard stimuli presented over videos of driving scenes while fixating a central target. Performance was measured at each visit and after 3 months. Results There was a significant reduction in touch error (P = 0.01) for p-prism zone stimuli from pretraining median of 16.6° (IQR 12.1°–19.6°) to 2.7° ( IQR 1.0°–8.5°) at the end of training. P-prism zone reaction times did not change significantly with training (P > 0.05). P-prism zone detection improved significantly (P = 0.01) from a pretraining median 70% (IQR 50%–88%) to 95% at the end of training (IQR 73%–98%). Three months after training improvements had regressed but performance was still better than pretraining. Conclusions Improved pointing accuracy for stimuli detected in prism-expanded vision of patients with hemianopia wearing 57Δ oblique p-prisms is possible and training appears to further improve detection. Translational Relevance This is the first use of this novel software to train adaptation of visual direction in patients with hemianopia wearing peripheral prisms. PMID:26933522

Home Visiting for Adolescent Mothers: Effects on Parenting, Maternal Life Course, and Primary Care Linkage

PubMed Central

Barnet, Beth; Liu, Jiexin; DeVoe, Margo; Alperovitz-Bichell, Kari; Duggan, Anne K.

2007-01-01

PURPOSE Adolescent mothers are at risk for rapidly becoming pregnant again and for depression, school dropout, and poor parenting. We evaluated the impact of a community-based home-visiting program on these outcomes and on linking the adolescents with primary care. METHODS Pregnant adolescents aged 12 to 18 years, predominantly with low incomes and of African American race, were recruited from urban prenatal care sites and randomly assigned to home visiting or usual care. Trained home visitors, recruited from local communities, were paired with each adolescent and provided services through the child’s second birthday. They delivered a parenting curriculum, encouraged contraceptive use, connected the teen with primary care, and promoted school continuation. Research assistants collected data via structured interviews at baseline and at 1 and 2 years of follow-up using validated instruments to measure parenting (Adult-Adolescent Parenting Inventory) and depression (Center for Epidemiologic Studies Depression). School status and repeat pregnancy were self-reported. We measured program impact over time with intention-to-treat analyses using generalized estimating equations (GEE). RESULTS Of 122 eligible pregnant adolescents, 84 consented, completed baseline assessments, and were randomized to a home-visited group (n = 44) or a control group (n = 40). Eighty-three percent completed year 1 or year 2 follow-up assessments, or both. With GEE, controlling for baseline differences, follow-up parenting scores for home-visited teens were 5.5 points higher than those for control teens (95% confidence interval, 0.5–10.4 points; P = .03) and their adjusted odds of school continuation were 3.5 times greater (95% confidence interval, 1.1–11.8; P <.05). The program did not have any impact on repeat pregnancy, depression, or linkage with primary care. CONCLUSIONS This community-based home-visiting program improved adolescent mothers’ parenting attitudes and school continuation, but it did not reduce their odds of repeat pregnancy or depression or achieve coordination with primary care. Coordinated care may require explicit mechanisms to promote communication between the community program and primary care. PMID:17548850

The "nuts and bolts" of implementing shared medical appointments: the Harvard Vanguard Medical Associates experience.

PubMed

Berger-Fiffy, Jill

2012-01-01

Harvard Vanguard Medical Associates (Harvard Vanguard) decided to develop a Shared Medical Appointment (SMA) program in 2007 for a variety of reasons. The program has launched 86 SMAs in 17 specialties at 12 sites and has exceeded 13 000 patient visits. Currently, the practice offers 54 SMAs and is believed to be the largest program in the country. This article provides an overview regarding staffing, space and equipment, project planning, promotional materials, training programs, workflow development, and the use of quality improvement (ie, LEAN) tools used to monitor the work to be completed and the metrics to date.

Journey Through the Universe

NASA Astrophysics Data System (ADS)

Harvey, J.

2005-12-01

Journey through the Universe held its first Journey Week January 21-28, 2005 in Hilo, Hawaii. This ambitious program uses the fi elds of space, earth science and exploration to engage communities with long-term connections to science, mathematics and technology. All content is aligned to state and national education standards. Last year, the Hawaii-based program trained 135 teachers, visited more than 120 classrooms, talked to more than 5,000 students and hosted three family science events for more than 2,500 people. In 2006 the program seeks to reach an additional 8,000 students in public, private and charter schools in North Hawaii.

Training for cervical cancer prevention programs in low-resource settings: focus on visual inspection with acetic acid and cryotherapy.

PubMed

Blumenthal, P D; Lauterbach, M; Sellors, J W; Sankaranarayanan, R

2005-05-01

The modern approach to cervical cancer prevention, characterized by use of cytology and multiple visits for diagnosis and treatment, has frequently proven challenging and unworkable in low-resource settings. Because of this, the Alliance for Cervical Cancer Prevention (ACCP) has made it a priority to investigate and assess alternative approaches, particularly the use of visual screening methods, such as visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI), for precancer and cancer detection and the use of cryotherapy as a precancer treatment method. As a result of ACCP experience in providing training to nurses and doctors in these techniques, it is now widely agreed that training should be competency based, combining both didactic and hands-on approaches, and should be done in a clinical setting that resembles the service-delivery conditions at the program site. This article reviews ACCP experiences and perceptions about the essentials of training in visual inspection and cryotherapy and presents some lessons learned with regard to training in these techniques in low-resource settings.

A randomized trial of effects of health risk appraisal combined with group sessions or home visits on preventive behaviors in older adults.

PubMed

Dapp, Ulrike; Anders, Jennifer A M; von Renteln-Kruse, Wolfgang; Minder, Christoph E; Meier-Baumgartner, Hans Peter; Swift, Cameron G; Gillmann, Gerhard; Egger, Matthias; Beck, John C; Stuck, Andreas E

2011-05-01

To explore effects of a health risk appraisal for older people (HRA-O) program with reinforcement, we conducted a randomized controlled trial in 21 general practices in Hamburg, Germany. Overall, 2,580 older patients of 14 general practitioners trained in reinforcing recommendations related to HRA-O-identified risk factors were randomized into intervention (n = 878) and control (n = 1,702) groups. Patients (n = 746) of seven additional matched general practitioners who did not receive this training served as a comparison group. Patients allocated to the intervention group, and their general practitioners, received computer-tailored written recommendations, and patients were offered the choice between interdisciplinary group sessions (geriatrician, physiotherapist, social worker, and nutritionist) and home visits (nurse). Among the intervention group, 580 (66%) persons made use of personal reinforcement (group sessions: 503 [87%], home visits: 77 [13%]). At 1-year follow-up, persons in the intervention group had higher use of preventive services (eg, influenza vaccinations, adjusted odds ratio 1.7; 95% confidence interval 1.4-2.1) and more favorable health behavior (eg, high fruit/fiber intake, odds ratio 2.0; 95% confidence interval 1.6-2.6), as compared with controls. Comparisons between intervention and comparison group data revealed similar effects, suggesting that physician training alone had no effect. Subgroup analyses indicated favorable effects for HRA-O with personal reinforcement, but not for HRA-O without reinforcement. HRA-O combined with physician training and personal reinforcement had favorable effects on preventive care use and health behavior.

The impact of disease management on outcomes and cost of care: a study of low-income asthma patients.

PubMed

Rossiter, L F; Whitehurst-Cook, M Y; Small, R E; Shasky, C; Bovbjerg, V E; Penberthy, L; Okasha, A; Green, J; Ibrahim, I A; Yang, S; Lee, K

2000-01-01

An asthma disease management program designed specifically for low-income patients experiencing significant adverse events can improve health outcomes substantially, while lowering costs. The Virginia Health Outcomes Partnership aimed to help physicians in a fee-for-service primary care case management program manage asthma in Medicaid recipients. Approximately one-third of physicians treating asthma in an area designated as the intervention community volunteered to participate in training on disease management and communication skills. This large-scale study discovered that the rate of emergency visit claims for patients of participating physicians who received feedback reports dropped an average of 41% from the same quarter a year earlier, compared to only 18% for comparison community physicians. Although only a third of the intervention community physicians participated in the training, emergency visit rates for all intervention community physicians nonetheless declined by 6% relative to the comparison community among moderate-to-severe asthma patients when data for participating and nonparticipating physicians were combined. At the same time, the dispensing of some reliever drugs recommended for asthma increased 25% relative to the comparison community. A cost-effectiveness analysis projected direct savings to Medicaid of $3 to $4 for every incremental dollar spent providing disease management support to physicians. The results of this study demonstrate the potential this program offers, especially for Medicaid programs in other states that want to improve the care of their primary care case management networks and, at the same time, manage costs.

Establishing a health information workforce: innovation for low- and middle-income countries.

PubMed

Ledikwe, Jenny H; Reason, Letitia L; Burnett, Sarah M; Busang, Lesego; Bodika, Stephane; Lebelonyane, Refeletswe; Ludick, Steven; Matshediso, Ellah; Mawandia, Shreshth; Mmelesi, Mpho; Sento, Baraedi; Semo, Bazghina-Werq

2013-07-18

To address the shortage of health information personnel within Botswana, an innovative human resources approach was taken. University graduates without training or experience in health information or health sciences were hired and provided with on-the-job training and mentoring to create a new cadre of health worker: the district Monitoring and Evaluation (M&E) Officer. This article describes the early outcomes, achievements, and challenges from this initiative. Data were collected from the district M&E Officers over a 2-year period and included a skills assessment at baseline and 12 months, pre- and post-training tests, interviews during stakeholder site visits, a survey of achievements, focus group discussions, and an attrition assessment. An average of 2.7 mentoring visits were conducted for M&E Officers in each district. There were five training sessions over 18 months. Knowledge scores significantly increased (p < 0.05) during the three trainings in which pre/post tests were administered. Over 1 year, there were significant improvements (p < 0.05) in self-rated skills related to computer literacy, checking data validity, implementing data quality procedures, using data to support program planning, proposing indicators, and writing M&E reports. Out of the 34 district M&E Officers interviewed during site visits, most were conducting facility visits to review data (27/34; 79%), comparing data sets over time (31/34; 91%), backing up data (32/34; 94%), and analyzing data (32/34; 94%). Common challenges included late facility reports (28/34; 82%), lack of transportation (22/34; 65%), inaccurate facility reports (10/34; 29%), and colleagues' misunderstanding of M&E (10/34; 29%). Six posts were vacated in the first year (6/51; 12%). A total of 49 Officers completed the achievements survey; of these, common accomplishments related to improvements in data management (35/49; 71%), data quality (31/49; 63%), data use (29/49; 59%), and capacity development (26/49; 53%). The development of a cadre of district M&E Officers has contributed positively to the health information system in Botswana. In the absence of tertiary training related to health information, on-the-job training and mentoring of university graduates can be an effective approach for developing a new professional cadre of M&E expertise and for strengthening capacity within a national health system.

Establishing a health information workforce: innovation for low- and middle-income countries

PubMed Central

2013-01-01

Background To address the shortage of health information personnel within Botswana, an innovative human resources approach was taken. University graduates without training or experience in health information or health sciences were hired and provided with on-the-job training and mentoring to create a new cadre of health worker: the district Monitoring and Evaluation (M&E) Officer. This article describes the early outcomes, achievements, and challenges from this initiative. Methods Data were collected from the district M&E Officers over a 2-year period and included a skills assessment at baseline and 12 months, pre- and post-training tests, interviews during stakeholder site visits, a survey of achievements, focus group discussions, and an attrition assessment. Results An average of 2.7 mentoring visits were conducted for M&E Officers in each district. There were five training sessions over 18 months. Knowledge scores significantly increased (p < 0.05) during the three trainings in which pre/post tests were administered. Over 1 year, there were significant improvements (p < 0.05) in self-rated skills related to computer literacy, checking data validity, implementing data quality procedures, using data to support program planning, proposing indicators, and writing M&E reports. Out of the 34 district M&E Officers interviewed during site visits, most were conducting facility visits to review data (27/34; 79%), comparing data sets over time (31/34; 91%), backing up data (32/34; 94%), and analyzing data (32/34; 94%). Common challenges included late facility reports (28/34; 82%), lack of transportation (22/34; 65%), inaccurate facility reports (10/34; 29%), and colleagues’ misunderstanding of M&E (10/34; 29%). Six posts were vacated in the first year (6/51; 12%). A total of 49 Officers completed the achievements survey; of these, common accomplishments related to improvements in data management (35/49; 71%), data quality (31/49; 63%), data use (29/49; 59%), and capacity development (26/49; 53%). Conclusions The development of a cadre of district M&E Officers has contributed positively to the health information system in Botswana. In the absence of tertiary training related to health information, on-the-job training and mentoring of university graduates can be an effective approach for developing a new professional cadre of M&E expertise and for strengthening capacity within a national health system. PMID:23866794

The dynamics of CRM attitude change: Attitude stability

NASA Technical Reports Server (NTRS)

Gregorich, Steven E.

1993-01-01

Special training seminars in cockpit resource management (CRM) are designed to enhance crew effectiveness in multicrew air-transport cockpits. In terms of CRM, crew effectiveness is defined by teamwork rather than technical proficiency. These seminars are designed to promote factual learning, alter aviator attitudes, and motivate aviators to make use of what they have learned. However, measures of attitude change resulting from CRM seminars have been the most common seminar evaluation technique. The current investigation explores a broader range of attitude change parameters with specific emphasis on the stability of change between recurrent visits to the training center. This allows for a comparison of training program strengths in terms of seminar ability to effect lasting change.

A simulation and video-based training program to address adverse childhood experiences.

PubMed

Wen, Frances K; Miller-Cribbs, Julie E; Coon, Kim A; Jelley, Martina J; Foulks-Rodriguez, Kristin A

2017-05-01

Adverse childhood experiences (ACEs) are 10 categories of childhood abuse and maltreatment, which have a dose-response relationship with common adult health concerns seen in primary care including health risk behaviors, chronic disease, and mental illness. Many of the ACEs-associated biopsychosocial risk factors are modifiable. However, physicians may not address these issues for fear of opening "Pandora's Box", that is, a source of extensive problems for which they are not sufficiently prepared with training, resources, or time. Residents need training in how to conduct trauma-focused conversations within the limited scope of an office visit. To address this need, a 4-hour simulation and video-based training program was developed for primary care residents about how to conduct brief interventions connecting their patients' current health concerns with their experiences of ACEs. Resident participants have evaluated this program as preparatory for real-life encounters and as being designed to allow for educational mastery. This article describes a workshop presenting this training program which was given at the 37th Annual Behavioral Science Forum in Family Medicine. Five skills targeted in the program were presented and a demonstration was made of the components, that is, didactics, provider and patient videos, simulated patient encounters, trainee feedback, and facilitated discussion that encompasses targeted skills, clinical implementation, and self-care. Companion tools were shared, including the syllabus, evaluation rubric, and provider and patient resources. Participants practiced trainee feedback and discussed the challenges in implementation.

Characteristics of effective family medicine faculty development programs.

PubMed

Bland, C J; Stritter, F T

1988-01-01

Five federally funded family medicine faculty development programs were site visited from December 1985 to June 1986 to collect from experienced project directors, staff, and faculty their thoughts on training practices and future funding. The sites selected were the Faculty Development Center of Texas in Waco (McLennan County Medical Education and Research Foundation), the National Center for Faculty Development at the University of Miami, and programs at Michigan State University, the University of North Carolina-Chapel Hill, and Duke University. Since the late 1970s these programs have trained 259 fellows and 3,284 other participants. In total, $7,515,350 in federal dollars were spent. A variety of program formats and strategies were used to recruit faculty, and to prepare them in teaching, research, and other skill areas. Interviews (as well as phone conversations and letters) with key personnel at each site resulted in a summary of 30 critical elements identified for effective faculty development. Additionally, respondents made 11 specific recommendations to the Federal Faculty Development Grant Program that concern funding and future programs.

Effect of Educational Outreach Timing and Duration on Facility Performance for Infectious Disease Care in Uganda: A Trial with Pre-Post and Cluster Randomized Controlled Components

PubMed Central

Burnett, Sarah M.; Mbonye, Martin K.; Naikoba, Sarah; Zawedde-Muyanja, Stella; Kinoti, Stephen N.; Ronald, Allan; Rubashembusya, Timothy; Willis, Kelly S.; Colebunders, Robert; Manabe, Yukari C.; Weaver, Marcia R.

2015-01-01

Background Classroom-based learning is often insufficient to ensure high quality care and application of health care guidelines. Educational outreach is garnering attention as a supplemental method to enhance health care worker capacity, yet there is little information about the timing and duration required to improve facility performance. We sought to evaluate the effects of an infectious disease training program followed by either immediate or delayed on-site support (OSS), an educational outreach approach, on nine facility performance indicators for emergency triage, assessment, and treatment; malaria; and pneumonia. We also compared the effects of nine monthly OSS visits to extended OSS, with three additional visits over six months. Methods This study was conducted at 36 health facilities in Uganda, covering 1,275,960 outpatient visits over 23 months. From April 2010 to December 2010, 36 sites received infectious disease training; 18 randomly selected sites in arm A received nine monthly OSS visits (immediate OSS) and 18 sites in arm B did not. From March 2011 to September 2011, arm A sites received three additional visits every two months (extended OSS), while the arm B sites received eight monthly OSS visits (delayed OSS). We compared the combined effect of training and delayed OSS to training followed by immediate OSS to determine the effect of delaying OSS implementation by nine months. We also compared facility performance in arm A during the extended OSS to immediate OSS to examine the effect of additional, less frequent OSS. Results Delayed OSS, when combined with training, was associated with significant pre/post improvements in four indicators: outpatients triaged (44% vs. 87%, aRR = 1.54, 99% CI = 1.11, 2.15); emergency and priority patients admitted, detained, or referred (16% vs. 31%, aRR = 1.74, 99% CI = 1.10, 2.75); patients with a negative malaria test result prescribed an antimalarial (53% vs. 34%, aRR = 0.67, 99% CI = 0.55, 0.82); and pneumonia suspects assessed for pneumonia (6% vs. 27%, aRR = 2.97, 99% CI = 1.44, 6.17). Differences between the delayed OSS and immediate OSS arms were not statistically significant for any of the nine indicators (all adjusted relative RR (aRRR) between 0.76–1.44, all p>0.06). Extended OSS was associated with significant improvement in two indicators (outpatients triaged: aRR = 1.09, 99% CI = 1.01; emergency and priority patients admitted, detained, or referred: aRR = 1.22, 99% CI = 1.01, 1.38) and decline in one (pneumonia suspects assessed for pneumonia: aRR: 0.93; 99% CI = 0.88, 0.98). Conclusions Educational outreach held up to nine months after training had similar effects on facility performance as educational outreach started within one month post-training. Six months of bi-monthly educational outreach maintained facility performance gains, but incremental improvements were heterogeneous. PMID:26352257

Region-wide assessment of the capacity for human nutrition training in West Africa: current situation, challenges, and way forward.

PubMed

Sodjinou, Roger; Fanou, Nadia; Deart, Lucie; Tchibindat, Félicité; Baker, Shawn; Bosu, William; Pepping, Fré; Delisle, Hélène

2014-01-01

There is a dearth of information on existing nutrition training programs in West Africa. A preliminary step in the process of developing a comprehensive framework to strengthen human capacity for nutrition is to conduct an inventory of existing training programs. This study was conducted to provide baseline data on university-level nutrition training programs that exist in the 16 countries in West Africa. It also aimed to identify existing gaps in nutrition training and propose solutions to address them. Participating institutions were identified based on information provided by in-country key informants, UNICEF offices or through internet searches. Data were collected through semi-structured interviews during on-site visits or through self-administered questionnaires. Simple descriptive and bivariate analyses were performed. In total, 83 nutrition degree programs comprising 32 B.Sc. programs, 34 M.Sc. programs, and 17 Ph.D. programs were identified in the region. More than half of these programs were in Nigeria. Six countries (Cape Verde, Guinea-Bissau, Liberia, Mali, The Gambia, and Togo) offered no nutrition degree program. The programs in francophone countries were generally established more recently than those in anglophone countries (age: 3.5 years vs. 21.4 years). Programs were predominantly (78%) run by government-supported institutions. They did not provide a comprehensive coverage of all essential aspects of human nutrition. They were heavily oriented to food science (46%), with little emphasis on public health nutrition (24%) or overnutrition (2%). Annual student intakes per program in 2013 ranged from 3 to 262; 7 to 40; and 3 to 10, respectively, for bachelor's, master's, and doctoral programs while the number of graduates produced annually per country ranged from 6 to 271; 3 to 64; and 1 to 18, respectively. External collaboration only existed in 15% of the programs. In-service training programs on nutrition existed in less than half of the countries. The most important needs for improving the quality of existing training programs reported were teaching materials, equipment and infrastructures, funding, libraries and access to advanced technology resources. There are critical gaps in nutrition training in the West Africa region. The results of the present study underscore the urgent need to invest in nutrition training in West Africa. An expanded set of knowledge, skills, and competencies must be integrated into existing nutrition training curricula. Our study provides a basis for the development of a regional strategy to strengthen human capacity for nutrition across the region.

A randomized trial of treatments for high-utilizing somatizing patients.

PubMed

Barsky, Arthur J; Ahern, David K; Bauer, Mark R; Nolido, Nyryan; Orav, E John

2013-11-01

Somatization and hypochondriacal health anxiety are common sources of distress, impairment, and costly medical utilization in primary care practice. A range of interventions is needed to improve the care of these patients. To determine the effectiveness of two cognitive behavioral interventions for high-utilizing, somatizing patients, using the resources found in a routine care setting. Patients were randomly assigned to a two-step cognitive behavioral treatment program accompanied by a training seminar for their primary care physicians, or to relaxation training. Providers routinely working in these patients' primary care practices delivered the cognitive behavior therapy and relaxation training. A follow-up assessment was completed immediately prior to treatment and 6 and 12 months later. Eighty-nine medical outpatients with elevated levels of somatization, hypochondriacal health anxiety, and medical care utilization. Somatization and hypochondriasis, overall psychiatric distress, and role impairment were assessed with well-validated, self-report questionnaires. Outpatient visits and medical care costs before and after the intervention were obtained from the encounter claims database. At 6 month and 12 month follow-up, both intervention groups showed significant improvements in somatization (p < 0.01), hypochondriacal symptoms (p < 0.01), overall psychiatric distress (p < 0.01), and role impairment (p < 0.01). Outcomes did not differ significantly between the two groups. When both groups were combined, ambulatory visits declined from 10.3 to 8.8 (p = 0.036), and mean ambulatory costs decreased from $3,574 to $2,991 (pp = 0.028) in the year preceding versus the year following the interventions. Psychiatric visits and costs were unchanged. Two similar cognitive behavioral interventions, delivered with the resources available in routine primary care, improved somatization, hypochondriacal symptoms, overall psychiatric distress, and role function. They also reduced the ambulatory visits and costs of these high utilizing outpatients.

Success of Solar Dynamics Observatory (SDO) Education & Public Outreach (E/PO) in Montana

NASA Astrophysics Data System (ADS)

Freed, M. S.; Lowder, S. C.; McKenzie, D. E.

2013-03-01

The Space Public Outreach Team (SPOT) program at Montana State University (MSU) is the main component of SDO E/PO efforts in Montana. SPOT brings energetic presentations of recent science & NASA missions to students in primary & secondary schools. Presenters are university undergraduates that visit a diverse group of K-12 students from both rural & urban areas of Montana. This program is extremely cost effective, a valuable service-learning experience for undergraduates at MSU and has repeatedly received praise from both teachers and students. A complementary effort for training schoolteachers entitled NASA Education Activity Training (NEAT) is also employed. NEAT illustrates to teachers inexpensive and highly effective methods for demonstrating difficult science concepts to their students. We will highlight the successes and lessons learned from SPOT & NEAT, so that other E/PO programs can use it as a template to further science literacy in our nation's schools.

Evaluation of the impact of collaborative work by teams from the National Medical Residency Committee and the Brazilian Society of Neurosurgery. Retrospective and prospective study.

PubMed

Santos, Renato Antunes Dos; Snell, Linda; Nunes, Maria do Patrocínio Tenório

2016-04-01

Training for specialist physicians in Brazil can take place in different ways. Closer liaison between institutions providing this training and assessment and health care services may improve qualifications. This article analyzes the impact of closer links and joint work by teams from the National Medical Residency Committee (Comissão Nacional de Residência Médica, CNRM) and the Brazilian Society of Neurosurgery (Sociedade Brasileira de Neurocirurgia, SBN) towards evaluating these programs. Retrospective and prospective study, conducted in a public university on a pilot project developed between CNRM and SBN for joint assessment of training programs across Brazil. The literature in the most relevant databases was reviewed. Documents and legislation produced by official government bodies were evaluated. Training locations were visited. Reports produced about residency programs were analyzed. Only 26% of the programs were immediately approved. The joint assessments found problems relating to teaching and to functioning of clinical service in 35% of the programs. The distribution of programs in this country has a strong relationship with the Human Development Index (HDI) of the regions and is very similar to the distribution of specialists. Closer collaboration between the SBN and CNRM had a positive impact on assessment of neurosurgery medical residency across the country. The low rates of direct approval have produced modifications and improvements to the quality of teaching and care (services). Closer links between the CNRM and other medical specialties have the capability to positively change the structure and function of specialty training in Brazil.

The proposed EROSpace institute, a national center operated by space grant universities

USGS Publications Warehouse

Smith, Paul L.; Swiden, LaDell R.; Waltz, Frederick A.

1993-01-01

The "EROSpace Institute" is a proposed visiting scientist program in associated with the U.S. Geological Survey's EROS Data Center (EDC). The Institute would be operated by a consortium of universities, possible drawn from NASA's Space Grant College and Fellowship Program consortia and the group of 17 capability-enhancement consortia, or perhaps from consortia though out the nation with a topical interest in remote sensing. The National Center for Atmospheric Research or the Goddard Institute for Space Studies provide models for the structure of such an institute. The objectives of the Institute are to provide ready access to the body of data housed at the EDC and to increase the cadre of knowledgeable and trained scientists able to deal with the increasing volume of remote sensing data to become available from the Earth Observing System. The Institute would have a staff of about 100 scientists at any one time, about half permanent staff, and half visiting scientists. The latter would include graduate and undergraduate students, as well as faculty on temporary visits, summer fellowships, or sabbatical leaves. The Institute would provide office and computing facilities, as well as Internet linkages to the home institutions so that scientists could continue to participate in the program from their home base.

The Early Childhood Obesity Prevention Program (ECHO): an ecologically-based intervention delivered by home visitors for newborns and their mothers.

PubMed

Cloutier, Michelle M; Wiley, James; Wang, Zhu; Grant, Autherene; Gorin, Amy A

2015-06-24

Obesity is a major problem in the United States, particularly among socio-economically disadvantaged Latino and Black children. Effective interventions that can be disseminated to large numbers of at-risk children and their families are needed. The goals of the Early Childhood Obesity Prevention Program (ECHO) are to examine the 12-month efficacy of a primary obesity prevention program targeting the first year of life that is delivered by home visitors and that engages mothers as agents of change to modify their own behavior and their infant's behavior through education and skill-building around nutrition, physical activity, and wellness, and then "echoes" her training with linkages to neighborhood programs and resources. Six family centers located in low-income neighborhoods in Hartford, CT were randomized into control and intervention neighborhoods. Fifty-seven mothers were recruited either prenatally or shortly after delivery into the Nurturing Families Network home visitation program; 27 lived in a control neighborhood and received the standard home visitation program and 30 lived in an intervention neighborhood and received both the standard home visitation program and the ECHO intervention. The intervention increases maternal skills in goal-setting, stimulus control and problem-solving, engages family members to support changes, links mothers to neighborhood resources and is embedded in the standard home visitation program. ECHO targets include breastfeeding, solids, juice and sugar-sweetened beverages, routines for sleep and responding to infant cues, television/screen time, and maternal diet and physical activity. We hypothesize that infants in ECHO will have been breastfed longer and exclusively, will have delayed introduction of solids and juice, have longer sleep duration, decreased television/screen time and a lower weight for length z-score at 12 months, and their mothers will have greater fruit and vegetable consumption and higher levels of physical activity. ECHO will provide important information about whether an enhanced behavior change curriculum integrated into an existing home visitation program, focused on the mother as the agent of change and linked to neighborhood resources is effective in changing energy balance behaviors in the infant and in the mother. If effective, the intervention could be widely disseminated to prevent obesity in young children. ClinicalTrials.gov NCT02052518 January 30, 2014.

Knowledge, experience, and anxieties of young classical singers in training.

PubMed

Kwak, Paul E; Stasney, C Richard; Hathway, Jeremy; Minard, Charles G; Ongkasuwan, Julina

2014-03-01

Young classical singers in training have a wide variety of knowledge about the anatomy and physiology of the voice and vocal pathology and harbor anxiety about treatment of vocal fold disorders. This study aimed to examine differences in knowledge, experience, and anxiety across levels of training at elite conservatories and young artist programs in the United States. Prospective cohort questionnaire. Undergraduate (50), master's (35), and doctoral/young artist (25) singers (n = 110) were given an 80-point questionnaire assessing experience with vocal pathology, otolaryngologists, speech pathologists, and participation in choir or teaching. Participants were asked questions to test their medical knowledge in vocal anatomy, physiology, and care. They were also asked questions about their anxiety about medical visits and vocal pathology and about their habits in the care of their own voices. There was no statistically significant difference in test scores for vocal knowledge across the three levels of training (P = 0.47). Mean scores were just above 50% with standard deviations around 12-13 points. The lowest score was 26% and the highest score was 84%. Doctoral/young artist-level participants were more anxious regarding general office visits to an otolaryngologist compared with undergraduate and master's level participants. There were no other significant differences by level of training regarding anxiety about vocal pathology, scope examinations, or visits to a speech pathologist. There were no significant differences in self-reported levels of knowledge. All groups of young singers expressed marked interest in expanding their knowledge of anatomy and physiology, speech pathology, care of the vocal mechanism, and vocal disorders. More advanced singers do not have significantly greater knowledge of vocal form and function and are more anxious about visits to otolaryngologists and vocal pathology; a clear majority of singers indicate interest in knowing more. There is thus ample opportunity for innovation in the development of medical curricula in the instruction of young singers and clear interest in more knowledge on their part. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Personal Selling at Bournesworth College: A Simulation Exercise. Information Bank Simulation Exercise 2435A-F.

ERIC Educational Resources Information Center

Scribbins, Keith

This simulation is designed to train further education college salespersons in making effective sales presentations to firms' training officers. The exercise is divided into the following four parts: preparing for a sales visit (allotted time, 1 hour 15 minutes); carrying out the visit (45 minutes); reflecting on the visit and drafting…

Partners in Leadership for Pearl River

NASA Technical Reports Server (NTRS)

2007-01-01

Members of the 2007 class of Partners in Leadership toured NASA Stennis Space Center in Hancock County, Miss., on Jan. 11. They visited the center's B Test Stand, part of the center's rocket engine test complex. The Partners in Leadership training program is designed to teach Pearl River County leaders about their county's government, economic development, health and human services, history and arts, environment and education during a 10-month period. The program, sponsored by the Partners for Pearl River County, helps fulfill the mission of the economic and community development agency.

Partners in Leadership for Pearl River

NASA Image and Video Library

2007-01-11

Members of the 2007 class of Partners in Leadership toured NASA Stennis Space Center in Hancock County, Miss., on Jan. 11. They visited the center's B Test Stand, part of the center's rocket engine test complex. The Partners in Leadership training program is designed to teach Pearl River County leaders about their county's government, economic development, health and human services, history and arts, environment and education during a 10-month period. The program, sponsored by the Partners for Pearl River County, helps fulfill the mission of the economic and community development agency.

The mother and child in Bangladesh. A view from the People's Health Centre (Gonoshasthaya Kendra).

PubMed

Chowdhury, Z

1976-01-01

2 stories of children in misery in Bangladesh are recounted, and the Gonoshasthaya Kendra project begun in January 1972 is described. In 1972 it was found in Bangladesh that 3.8 million children under 10-years-old suffer from malnutrition, and 26% of all children die before age 5 from diarrhea, whooping cough, measles, diptheria, smallpox, and malnutriation. In rural Bangladesh the ratio is 30,000 people to 1 doctor, but a well-trained paramedic can meet rural needs. The Gonoshasthaya Kendra project is a cooperative health program integrating itself with a rural development program. 1st paramedics are trained, and the village midwife is trained and returned to the village. An insurance scheme costs patients 2 taka (14 U.S. cents) per month for the entire family and includes visits and medicine. A corps of village-recruited, paraprofessional agriculture development workers is being developed, and efforts are being made to increase and improve the food supply. A woman's vocational program has been developed to provide women with economic independence.

A Community-Oriented Approach to Breast Cancer in a Low-Resource Setting: Improving Awareness, Early Detection and Treatment of Breast Cancer in Tajikistan.

PubMed

Talib, Zohray; Shukurbekova, Irina; Sadonshoeva, Guldarbogh; Alibekov, Alibek; Jamshedov, Nekruz; Moloo, Zahir; Welji, Almas; Amersi, Farin; Muhammad, Aliya Amin; Jiwani, Aliya; Rais, Sheliza; Nazrishoeva, Akoyat; Ilnazarova, Surayo; Nuridinova, Shifo; Ukani, Hafiza; Alwani, Shireen; Saleh, Mansoor

2016-05-01

Breast cancer is one of the most common cancers and causes of death in females in Tajikistan; yet less than half of the adult women in Tajikistan have heard of breast cancer. Limited access to health care contributes to late stage presentation. We developed a public-private partnership to implement a breast cancer awareness intervention in a low-resource community in Khorog, Tajikistan. We trained local health professionals in clinical breast care and conducted a breast cancer screening and treatment program. The partnership involved visiting USA-based health professionals working alongside local health care providers (HCP) in the continuum of breast care-from education to the diagnostic evaluation and management of detected breast abnormalities. Patient data were collected using a web-based program (VirtualDoc). Twenty-four HCP received didactic and clinical breast examination training. 441 women underwent clinical breast evaluation. 74 (17%) had abnormal exams and underwent additional diagnostic procedures. We identified six (1.4%) cases of breast cancer (all locally advanced) and two women had benign fibroadenomas. All women with cancer underwent modified radical mastectomy, while the fibroadenomas were treated by cosmetically appropriate lumpectomy. Five of six subjects with cancer were previously aware of their breast lump and three had recently seen a family medicine (FM) doctor. Health systems assessment revealed availability of diagnostic equipment but lack of well-trained operators and clinician interpreters. We were successful in integrating clinical breast exams into the routine care of female patients by local FM doctors and in the process, achieved a better understanding of existing risk factors and barriers to breast cancer care. This public-private partnership, leveraging the technical expertise of visiting health professionals, demonstrates how a focused onsite training and awareness program can provide sustained improvements in breast care in a low-resource environment. © 2016 Wiley Periodicals, Inc.

Development of a diabetes care management curriculum in a family practice residency program.

PubMed

Nuovo, Jim; Balsbaugh, Thomas; Barton, Sue; Davidson, Ellen; Fox-Garcia, Jane; Gandolfo, Angela; Levich, Bridget; Seibles, Joann

2004-01-01

Improving the quality of care for patients with chronic illness has become a high priority. Implementing training programs in disease management (DM) so the next generation of physicians can manage chronic illness more effectively is challenging. Residency training programs have no specific mandate to implement DM training. Additional barriers at the training facility include: 1) lack of a population-based perspective for service delivery; 2) weak support for self-management of illness; 3) incomplete implementation due to physician resistance or inertia; and 4) few incentives to change practices and behaviors. In order to overcome these barriers, training programs must take the initiative to implement DM training that addresses each of these issues. We report the implementation of a chronic illness management curriculum based on the Improving Chronic Illness Care (ICIC) Model. Features of this process included both patient care and learner objectives. These were: development of a multidisciplinary diabetes DM team; development of a patient registry; development of diabetes teaching clinics in the family practice center (nutrition, general management classes, and one-on-one teaching); development of a group visit model; and training the residents in the elements of the ICIC Model, ie, the community, the health system, self-management support, delivery system design, decision support, and clinical information systems. Barriers to implementing these curricular changes were: the development of a patient registry; buy-in from faculty, residents, clinic leadership, staff, and patients for the chronic care model; the ability to bill for services and maintain clinical productivity; and support from the health system key stakeholders for sustainability. Unique features of each training site will dictate differences in emphasis and structure; however, the core principles of the ICIC Model in enhancing self-management may be generalized to all sites.

Integration of cognitive-behavioral therapy with gait training for a 58-year-old male with a fear of falling: a case report.

PubMed

Vendrely, Ann; Messmer, Eric; Moseley, Jennifer

2012-04-01

Fear of falling is a common concern among adults over age 65, which results in decreased activity levels. Cognitive-behavioral therapy (CBT) uses psychological techniques to redirect negative cognitive, emotional, or behavioral affects for improvement of self-efficacy and reduced fear of falling. The purpose of this case study is to describe the integration of CBT into the physical therapy (PT) management of a middle-aged male with fear of falling and difficulty walking. The single subject was a 58-year-old male with complaints of frequently losing his balance, feeling unstable while walking, and requiring the use of a walker to ambulate. During the initial PT examination his primary impairment was difficulty ambulating in open spaces. Dynamic Gait Index (DGI) was 8/24 and the Modified Falls Efficacy Score (MFES) was 6.36/10. The interventions began with a general lower extremity strengthening program, balance exercises, and gait training. At visit 9, CBT techniques of cognitive restructuring were added. Visualization of correct gait patterns was added to the program during visit 10, which continued until discharge after visit 14. Measurements on the DGI improved to 23/24 and MFES improved to 9.43/10 at discharge. Gait pattern improved with the ability to ambulate indoors without an assistive device and using only a straight cane for community ambulation. The use of CBT is well documented as a group intervention for older adults with fear of falling, but CBT techniques may also be helpful for younger adults with fear of falling.

Performance Evaluation of Community Health Workers: Case Study in the Amazon of Peru.

PubMed

Westgard, Christopher; Naraine, Renuka; Paucar Villacorta, Diego Mauricio

2018-03-26

A shortage in human resources for health is a growing crisis that has led to an inability to provide adequate health services to impoverished populations. By "task-shifting", health systems can delegate certain activities, such as health promotion and referral, to trained community members to help fill the human resource gap. An effective community health agent program can improve maternal and child health and overall effectiveness of rural health systems. Such a program is most effective when the community health agents receive supervision and evaluation of their performance. There is a shortage of literature that provides instruction and example on how to conduct a performance evaluation in the developing world to improve maternal and child health outcomes. The current study provides a case study of a performance evaluation in the Amazon region of Peru and how the findings can be used to make program adjustments. A set of instruments to measure the performance of CHWs was adapted from the literature and then implemented in the field. The instruments were used to measure the quality of home visits by the CHWs, their knowledge of the health topics, and structural activities. Three communities with an active CHW program in Loreto, Peru were chosen to receive the evaluation. All CHWs in the communities were evaluated. The scores from the evaluation were compared internally to identify strengths and weaknesses of the program and within the population of CHWs. The evaluation was completed on 52 home visits and 27 CHWs in three communities. The CHWs were found to be most effective at creating good relationships with caregivers and delivering health messages, and least effective at interacting with the child during the home visit and using material to deliver health messages. The evaluation instruments were well suited for the CHW program that utilizes home visits to teach about child health and development.

Student-Teacher Astronomy Resource (STAR) Program

NASA Astrophysics Data System (ADS)

Gaboardi, M.; Humayun, M.; Dixon, P.

2006-12-01

Our NASA-funded E/PO program, the Student-Teacher Astronomy Resource (STAR) Program, designed around the Stardust and Genesis Missions, focuses on the reciprocal relationship between technological progress and advances in scientific understanding. We work directly with the public, teachers, classrooms, and individual school students. Both formal and informal evaluations suggest that our four-step approach to outreach has been effective. This annual program may serve as a model for the partnership between a national research institution, local scientists, and local teachers. The program has four components: 1."Space Stations" developed around the technology and science of the Genesis and Stardust Missions, are offered as child-friendly booths at the annual National High Magnetic Field Laboratory (NHMFL) Open House. The stations allow for direct interaction between the scientists and the public (over 3000 visitors). 2. STAR teachers (15) receive training and supplies to lead their classrooms through "Technology for Studying Comets". After attending a one-day in-service at the NHMFL, teachers can bring to their students an inquiry-based space science unit about which they are knowledgeable and excited. 3. We offer "Comet Tales," an informal education experience based on the NASA classroom activity "Comet Basics," to 15 local classrooms. We visit local classrooms and engage students with inquiry about comets, sampling of Wild 2, and what scientists hope to learn from the Stardust Mission. Visits occur during the two-week "Technology for Studying Comets" unit taught by each STAR teacher. 4. The "Stellar Students" component involves 15 high-achieving students in research activities. From each classroom visited during "Comet Tales," one student is selected to visit the NHMFL for a day. Parents and teachers of the students are invited for an awards ceremony and student presentations. Evaluation consisted of focus groups, informal observation, and questionnaires. Responses were overwhelmingly positive. This format allows us to continuously improve the design of our program and ensure that we meet the needs of our local school district.

The development and implementation of a theory-informed, integrated mother-child intervention in rural Uganda.

PubMed

Singla, Daisy R; Kumbakumba, Elias

2015-12-01

A randomised cluster effectiveness trial of a parenting intervention in rural Uganda found benefits to child development among children 12-36 months, relevant parenting practices related to stimulation, hygiene and diet, and prevented the worsening of mothers' depressive symptoms. An examination of underlying implementation processes allows researchers and program developers to determine whether the program was implemented as intended and highlight barriers and facilitators that may influence replication and scale-up. The objectives of this study were to describe and critically examine (a) perceived barriers and facilitators related to implementation processes of intervention content, training and supervision and delivery from the perspectives of delivery agents and supervisors; (b) perceived barriers and facilitators related to enactment of practices from the perspective of intervention mothers participating in the parenting program; and c) whether the program was implemented as intended. Semi-structured interviews were conducted at midline with peer delivery agents (n = 12) and intervention mothers (n = 31) and at endline with supervisors (n = 4). Content analysis was used to analyze qualitative data in terms of barriers and facilitators of intervention content, training and supervision, delivery and enactment. Additionally, mothers' recall and enactment of practices were coded and analyzed statistically. Monitoring of group sessions and home visits were examined to reveal whether the program was implemented as intended. Among the program's five key messages, 'love and respect' targeting maternal psychological well-being was the most practiced by mothers, easiest to implement by delivery agents, and mothers reported the most internal facilitators for this message. A detailed manual and structured monitoring forms were perceived to facilitate training, intervention delivery, and supervision. Interactive and active strategies based on social-cognitive learning theory were reported as facilitators to intervention delivery. Only program attendance, but not barriers, facilitators or message recall, was significantly positively related to message enactment. Monitoring of group sessions and home visits showed that the program was largely implemented as intended. This implementation assessment revealed a number of important barriers and facilitators from the perspectives of delivery agents, supervisors and program participants. The methods and results are useful to examining and informing the content, delivery, and scaling up of the current program as well as future mother-child interventions in LMIC settings. Copyright © 2015 Elsevier Ltd. All rights reserved.

Challenger Center's Window on the Universe

NASA Astrophysics Data System (ADS)

Livengood, T. A.; Goldstein, J. J.; Smith, S.; Bobrowsky, M.; Radnofsky, M.; Perelmuter, J.-M.; Jaggar, L.

2001-11-01

Challenger Center for Space Science Education's Window on the Universe program aims to create a network of under-served communities across the nation dedicated to sustained science, math, and technology education. Window communities presently include Broken Arrow, OK; Muncie, IN; Moscow, ID; Nogales, AZ; Tuskegee, AL; Marquette, MI; Altamont, KS; Washington, D.C.; and other emerging sites. Window uses themes of human space flight and the space sciences as interdisciplinary means to inspire entire communities. Practicing scientists and engineers engaged in these disciplines are invited to volunteer to become a part of these communities for a week, each visitor reaching roughly 2000 K-12 students through individual classroom visits and Family Science Night events during an intense Window on the Universe Week. In the same Window Week, Challenger Center scientists and educators present a workshop for local educators to provide training in the use of a K-12 educational module built around a particular space science and exploration theme. Window communities follow a 3-year development: Year 1, join the network, experience Window Week presented by Challenger Center and visiting researchers; Year 2, same as Year 1 plus workshop on partnering with local organizations to develop sources of visiting researchers and to enhance connections with local resources; Year 3 and subsequent, the community stages its own Window Week, with Challenger Center providing new education modules and training workshops for "master educators" from the Window community, after which the master educators return home to conduct training workshops of their own. Challenger Center remains a resource and clearinghouse for Window communities to acquire experience, technical information, and opportunities for distance collaboration with other Window communities. Window on the Universe is dedicated to assessing degree of success vs. failure in each program component and as a whole, using pre- and post-assessment questionnaires to develop a sound basis for continual improvement. Window on the Universe is funded by NASA's Office of Space Flight and the Office of Space Science.

Student science enrichment training program. Progress report, June 1, 1991--May 31, 1992

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sandhu, S.S.

1992-04-21

Historically Black Colleges and Universities wing of the United States Department of Energy (DOE) provided funds to Claflin College, Orangeburg, S.C. To conduct a student Science Enrichment Training Program for a period of six weeks during 1991 summer. Thirty participants were selected from a pool of applicants, generated by the High School Seniors and Juniors and the Freshmen class of 1990-1991 at Claflin College. The program primarily focused on high ability students, with potential for Science, Mathematics and Engineering Careers. The major objectives of the program were W to increase the pool of well qualified college entering minority students whomore » will elect to go in Physical Sciences and Engineering and (II) to increase the enrollment in Chemistry and Preprofessional-Pre-Med, Pre-Dent, etc.-majors at Claflin College by including the Claflin students to participate in summer academic program. The summer academic program consisted of Chemistry and Computer Science training. The program placed emphasis upon laboratory experience and research. Visits to Scientific and Industrial laboratories were arranged. Guest speakers which were drawn from academia, industry and several federal agencies, addressed the participants on the future role of Science in the industrial growth of United States of America. The guest speakers also acted as role models for the participants. Several videos and films, emphasizing the role of Science in human life, were also screened.« less

Protocol for a randomized controlled trial of piano training on cognitive and psychosocial outcomes.

PubMed

Bugos, Jennifer

2018-05-09

Age-related cognitive decline and cognitive impairment represent the fastest growing health epidemic worldwide among those over 60. There is a critical need to identify effective and novel complex cognitive interventions to promote successful aging. Since piano training engages cognitive and bimanual sensorimotor processing, we hypothesize that piano training may serve as an effective cognitive intervention, as it requires sustained attention and engages an executive network that supports generalized cognition and emotional control. Here, I describe the protocol of a randomized controlled trial (RCT) to evaluate the impact of piano training on cognitive performance in adulthood, a period associated with decreased neuroplasticity. In this cluster RCT, healthy older adults (age 60-80) were recruited and screened to control for confounding variables. Eligible participants completed an initial 3-h assessment of standardized cognitive and psychosocial measures. Participants were stratified by age, education, and estimate of intelligence and randomly assigned to one of three groups: piano training, computer brain training, or a no-treatment control group. Computer brain training consisted of progressively difficult auditory cognitive exercises (Brain HQ; Posit Science, 2010). Participants assigned to training groups completed a 16-week program that met twice a week for 90 minutes. Upon program completion and at a 3-month follow-up, training participants and no-treatment controls completed a posttest visit lasting 2.5 hours. © 2018 New York Academy of Sciences.

The nurse-family partnership: An evidence-based preventive intervention.

PubMed

Olds, David L

2006-01-01

Pregnancy and the early years of the child's life offer an opportune time to prevent a host of adverse maternal, child, and family outcomes that are important in their own right, but that also reflect biological, behavioral, and social substrates in the child and family that affect family formation and future life trajectories. This article summarizes a 27-year program of research that has attempted to improve early maternal and child health and future life options with prenatal and infancy home visiting by nurses. The program is designed for low-income mothers who have had no previous live births. The home-visiting nurses have three major goals: to improve the outcomes of pregnancy by helping women improve their prenatal health, to improve the child's health and development by helping parents provide more sensitive and competent care of the child, and to improve parental life course by helping parents plan future pregnancies, complete their education, and find work. The program has been tested in three separate large-scale, randomized controlled trials with different populations living in different contexts. Results from these trials indicate that the program has been successful in achieving two of its most important goals: (a) the improvement of parental care of the child as reflected in fewer injuries and ingestions that may be associated with child abuse and neglect and better infant emotional and language development; and (b) the improvement of maternal life course, reflected in fewer subsequent pregnancies, greater work-force participation, and reduced dependence on public assistance and food stamps. The impact on pregnancy outcomes is equivocal. In the first trial, the program also produced long-term effects on the number of arrests, convictions, emergent substance use, and promiscuous sexual activity of 15-year-old children whose nurse-visited mothers were low-income and unmarried when they registered in the study during pregnancy. In general, the impact of the program was greater on those segments of the population at greater risk for the particular outcome domain under examination. Since 1996, the program has been offered for public investment outside of research contexts. Careful attention has been given to ensuring that organizational and community contexts are favorable for development of the program, to providing excellent training and guidance to the nurses in their use of the program's visit-by-visit guidelines, to monitoring the functioning of the program with a comprehensive clinical information system, and to improving the performance of the programs over time with continuous improvement strategies. Copyright © 2006 Michigan Association for Infant Mental Health.

Evaluation of a statewide dissemination and implementation of physical activity intervention in afterschool programs: a nonrandomized trial.

PubMed

Beets, Michael W; Glenn Weaver, R; Turner-McGrievy, Gabrielle; Saunders, Ruth P; Webster, Collin A; Moore, Justin B; Brazendale, Keith; Chandler, Jessica

2017-12-01

In 2015, YMCA-operated afterschool programs (ASPs) across South Carolina pledged to achieve the national standard that calls for every child to accumulate 30 min/day of moderate-to-vigorous physical activity (MVPA) during program time. This study shares the first-year findings related to the dissemination, implementation, and outcomes associated with the statewide intervention to achieve the MVPA Standard. Twenty ASPs were sampled from all YMCA-operated ASPs (N = 97) and visited at baseline (spring 2015) and first-year follow-up (spring 2016). Programs were provided standardized professional development training to increase the MVPA children accumulated while attending ASPs. The training focused on extending the scheduled time for activity opportunities and modifying commonly played games to increase MVPA. The RE-AIM framework was used to evaluate the statewide intervention. Accelerometer-derived MVPA was the primary outcome. Implementation was evaluated via direct observation. Intent-to-treat (ITT) and as-treated comparisons were conducted in summer 2016. Reach/adoption was variable, with attendance at trainings ranging from 0 to 100% across ASPs. Effectiveness of the intervention using ITT models indicated no changes from baseline in the percentage of programs meeting the MVPA standard for boys or girls. Implementation levels also varied and were related to increases in both boys' and girls' MVPA for moderate and high implementers. Findings indicate improvements in MVPA can be made from attending the trainings and implementing some or all of the training components. Additional work is necessary to identify ways to ensure staff attend trainings to implement strategies and to identify which specific factors contributed to increases in MVPA.

Using the AIDA--www.2aida.org--diabetes simulator. Part 2: recommended training requirements for health-carers planning to teach with the software.

PubMed

Lehmann, Eldon D; Tatti, Patrizio

2002-01-01

The purpose of this article is to document some recommended training requirements for health-carers planning to teach using the AIDA interactive educational diabetes simulator. AIDA is a diabetes computer program that permits the interactive simulation of plasma insulin and blood glucose profiles for teaching, demonstration, and self-learning purposes. It has been made freely available, without charge, on the Internet as a noncommercial contribution to continuing diabetes education. Since its launch in 1996 over 200,000 visits have been logged at the AIDA Website--www.2aida.org--and over 40,000 copies of the AIDA program have been downloaded free-of-charge. This report describes various training requirements that are recommended for health-care professionals who are interested in teaching with the software. Intended goals of this article are to answer possible questions from teachers using the program, highlight some minimum recommended training requirements for the software, suggest some "hints and tips" for teaching ideas, explain the importance of performing more studies/trials with the program, overview randomised controlled trial usage of the software, and highlight the importance of obtaining feedback from lesson participants. The recommendations seem to be straightforward and should help in formalising training with the program, as well as in the development of a network of teachers "accredited" to give lessons using the software. This report, together with the previous article (Part 1, Diabetes Technol Ther 2002;4:401-414), highlights the utility of providing guidelines and suggesting recommended training requirements for health-carers planning to make use of educational medical/diabetes software.

An Occupational Therapy Fall Reduction Home Visit Program for Community-Dwelling Older Adults in Hong Kong After an Emergency Department Visit for a Fall.

PubMed

Chu, Mary Man-Lai; Fong, Kenneth Nai-Kuen; Lit, Albert Chau-Hung; Rainer, Timothy Hudson; Cheng, Stella Wai-Chee; Au, Frederick Lap-Yan; Fung, Henry Kwok-Kwong; Wong, Chit-Ming; Tong, Hon-Kuan

2017-02-01

To investigate the effects of an occupational therapy fall reduction home visit program for older adults admitted to the emergency department (ED) for a fall and discharged directly home. Single-blind, multicenter, randomized, controlled trial. EDs in three acute care hospitals in Hong Kong. Individuals aged 65 and older who had fallen (N = 311). After screening for eligibility, 204 consenting individuals were randomly assigned to an intervention group (IG) and received a single home visit from an occupational therapist (OT) within 2 weeks after discharge from the hospital or a control group (CG) and received a well-wishing visit from a research assistant not trained in fall prevention. Both groups were followed for 12 months through telephone calls made every 2 weeks by blinded assessors with a focus on the frequency of falls. Another blinded assessor followed up on their status with telephone calls 4, 8, and 12 months after ED discharge. Prospective fall records on hospital admissions were retrieved from electronic databases; 198 individuals were followed for 1 year on an intention-to-treat basis. The percentage of fallers over 1 year was 13.7% in the IG (n = 95) and 20.4% in the CG (n = 103). There were significant differences in the number of fallers (P = .03) and the number of falls (P = .02) between the two groups over 6 months. Significant differences were found in survival analysis for first fall at 6 months (log-rank test 5.052, P = .02) but not 9 or 12 months. One OT visit after a fall was more effective than a well-wishing visit at reducing future falls at 6 months. A booster OT visit at 6 months is suggested. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Counselling quality in community pharmacies: implementation of the pseudo customer methodology in Germany.

PubMed

Berger, K; Eickhoff, C; Schulz, M

2005-02-01

To investigate a new method for evaluating counselling performance of staff in community pharmacies and to assess the quality of patient counselling. Trained pseudo customers, instructed to play their role according to two different self-medication scenarios, visited voluntarily participating community pharmacies in Berlin. After documenting the counselling process, immediately after each visit, outside the pharmacy on an assessment form, the pseudo customer re-entered the pharmacy and gave detailed performance feedback to the counsellor and the pharmacist in charge in order to provide support for improving counselling skills and practice behaviour, when appropriate. This was followed with a written summary of the general performance of all participating pharmacies and additional individual feedback and suggestions for improvement. Educational needs were identified for subsequent performance-based educational strategies such as group-workshops, team-training and on-site team-coaching. Forty-nine community pharmacies in Berlin volunteered to participate in this pilot study. Ninety-eight per cent of the participating pharmacies offered advice. However, in 36% of the cases, advice was only given on request. The different types of scenarios--presentation of a symptom or request for a specific product--made a great difference to the spontaneity of questions and advice. At least one question to check on accuracy of self-diagnosis was asked in 95% of the cases of symptom presentation but in only 47% of the cases of specific product request. Information on appropriate self-medication was provided on at least one item in 74% of pseudo customer visits, but most of the time the information was not sufficient. Communication skills (nonverbal elements, comprehensibility etc.) were very good or good in 54% of the visits. Potential for improvement was mainly in relation to the use of open-ended questions to gain more information and on counselling about appropriate self-medication. Direct feedback was given in 96% of the pharmacies (one person refused to accept feedback and one feedback had to be postponed because of time shortage). All of the participants regarded counselling as an important subject in pharmacy practice. The pseudo customer method was successfully used in this study of German community pharmacies. It was shown that pseudo customer visits and performance feedback following the counselling process, were feasible in daily practice and well accepted by the participants. A training program, focussing on areas in most need of improvement, has been developed. The promising results have led to the Federal Chamber of Pharmacists in Germany adopting this method as part of a continuous quality improvement program in community pharmacies.

How we used a patient visit tracker tool to advance experiential learning in systems-based practice and quality improvement in a medical student clinic.

PubMed

Chen, Chen Amy; Park, Ryan J; Hegde, John V; Jun, Tomi; Christman, Mitalee P; Yoo, Sun M; Yamasaki, Alisa; Berhanu, Aaron; Vohra-Khullar, Pamela; Remus, Kristin; Schwartzstein, Richard M; Weinstein, Amy R

2016-01-01

Poorly designed healthcare systems increase costs and preventable medical errors. To address these issues, systems-based practice (SBP) education provides future physicians with the tools to identify systemic errors and implement quality improvement (QI) initiatives to enhance the delivery of cost-effective, safe and multi-disciplinary care. Although SBP education is being implemented in residency programs and is mandated by the Accreditation Council for Graduate Medical Education (ACGME) as one of its core competencies, it has largely not been integrated into undergraduate medical education. We propose that Medical Student-Faculty Collaborative Clinics (MSFCCs) may be the ideal environment in which to train medical students in SBPs and QI initiatives, as they allow students to play pivotal roles in project development, administration, and management. Here we describe a process of experiential learning that was developed within a newly established MSFCC, which challenged students to identify inefficiencies, implement interventions, and track the results. After identifying bottlenecks in clinic operations, our students designed a patient visit tracker tool to monitor clinic flow and implemented solutions to decrease patient visit times. Our model allowed students to drive their own active learning in a practical clinical setting, providing early and unique training in crucial QI skills.

A program of symptom management for improving self-care for patients with HIV/AIDS.

PubMed

Chiou, Piao-Yi; Kuo, Benjamin Ing-Tiau; Chen, Yi-Ming; Wu, Shiow-Ing; Lin, Li-Chan

2004-09-01

The purpose of this study was to investigate the effect of a symptom management program on self-care of medication side effects among AIDS/HIV-positive patients. Sixty-seven patients from a sexually transmitted disease control center, a medical center, and a Catholic AIDS support group in Taipei were randomly assigned to three groups: one-on-one teaching, group teaching, and a control group. All subjects in each teaching group attended a 60- or 90-minute program on highly active antiretroviral therapy (HAART) side effect self-care education and skill training once per week for 3 weeks; subjects also underwent counseling by telephone. A medication side effect self-care knowledge questionnaire, Rosenberg's Self-Esteem Scale (RSES), and unscheduled hospital visits were used to evaluate the effectiveness of the symptom management program. The results revealed there were significant differences in mean difference of knowledge and unscheduled hospital visits between baseline and post-testing at 3 months for symptom management in the two groups. The mean difference of the self-esteem scale was not significant between the two groups. In summary, the symptom management program effectively increased the ability of AIDS/HIV-positive patients to self-care for medication side effects. We recommend that this program be applied in the clinical nursing practice.

Teacher decision-making in implementing a new environmental education curriculum: A qualitative study

NASA Astrophysics Data System (ADS)

Winther, Austin A.

This was a qualitative study of teacher decision-making during the first year of implementation of a new environmental education curriculum. Eight teachers were included in the study: three high school teachers, two middle school teachers and three elementary teachers. These teachers received summer training in the program, and were chosen at random from those who volunteered for the study. The teachers were interviewed at the close of training, at midyear during implementation, and during the spring. In addition to interview data other data sources were used to verify findings. These additional sources included interviews with high school students, visits to all the schools, examination of teacher prepared and student prepared materials, informal discussions with teacher peers at the schools, and implementation reports from the teachers. Among the factors examined were teachers' perceptions of training, teachers' perceptions of administrative and peer support, and the manner in which the program was implemented in each classroom. It was found that support from administrative and peer was important, but that neither of these were as critical as might have been expected. Administrators were perceived as supporting the program because the program helped to facilitate goals that had already been established in the school. Peer support was social and largely passive. Participants perceived that neither administrators nor peers really understand how the program worked. Participants initially found the training difficult and confusing. As they continued training and implementation some participants found that the program was substantially different from what they were accustomed to doing in their classrooms. Some participants were reluctant to implement the program, either implementing the program late in the year, or limiting implementation in some way. Others implemented the program fully, and were extremely enthusiastic about what their students were doing and learning. The researcher found that teachers' perceptions of training, administrative and peer support, and of the program itself stemmed from cognitive changes that the program stimulated. Comments from all of the teachers reflected reactions to these changes. Some teachers resisted the changes, while others enjoyed the process. Both programmatic and research recommendations were made.

The Mother and Infant Home Visiting Program Evaluation: Early Findings on the Maternal, Infant, and Early Childhood Home Visiting Program. A Report to Congress. OPRE Report 2015-11

ERIC Educational Resources Information Center

Michalopoulos, Charles; Lee, Helen; Duggan, Anne; Lundquist, Erika; Tso, Ada; Crowne, Sarah Shea; Burrell, Lori; Somers, Jennifer; Filene, Jill H.; Knox, Virginia

2015-01-01

"The Mother and Infant Home Visiting Program Evaluation: Early Findings on the Maternal, Infant, and Early Childhood Home Visiting Program--A Report to Congress" presents the first findings from the Mother and Infant Home Visiting Program Evaluation (MIHOPE), the legislatively mandated national evaluation of the Maternal, Infant, and…

Emergency department patient satisfaction: customer service training improves patient satisfaction and ratings of physician and nurse skill.

PubMed

Mayer, T A; Cates, R J; Mastorovich, M J; Royalty, D L

1998-01-01

Customer service initiatives in healthcare have become a popular way of attempting to improve patient satisfaction. This study investigates the effect of clinically focused customer service training on patient satisfaction in the setting of a 62,000-visit emergency department and level I trauma center. Analysis of patient complaints, patient compliments, and a statistically verified patient-satisfaction survey indicate that (1) all 14 key quality characteristics identified in the survey increased dramatically in the study period; (2) patient complaints decreased by over 70 percent from 2.6 per 1,000 emergency department (ED) visits to 0.6 per 1,000 ED visits following customer service training; and (3) patient compliments increased more than 100 percent from 1.1 per 1,000 ED visits to 2.3 per 1,000 ED visits. The most dramatic improvement in the patient satisfaction survey came in ratings of skill of the emergency physician, likelihood of returning, skill of the emergency department nurse, and overall satisfaction. These results show that clinically focused customer service training improves patient satisfaction and ratings of physician and nurse skill. They also suggest that such training may offer a substantial competitive market advantage, as well as improve the patients' perception of quality and outcome.

Transforming the Primary Care Training Clinic: New York State's Hospital Medical Home Demonstration Pilot.

PubMed

Angelotti, Marietta; Bliss, Kathryn; Schiffman, Dana; Weaver, Erin; Graham, Laura; Lemme, Thomas; Pryor, Veronica; Gesten, Foster C

2015-06-01

Training in patient-centered medical home (PCMH) settings may prepare new physicians to measure quality of care, manage the health of populations, work in teams, and include cost information in decision making. Transforming resident clinics to PCMHs requires funding for additional staff, electronic health records, training, and other resources not typically available to residency programs. Describe how a 1115 Medicaid waiver was used to transform the majority of primary care training sites in New York State to the PCMH model and improve the quality of care provided. The 2013-2014 Hospital Medical Home Program provided awards to 60 hospitals and 118 affiliated residency programs (training more than 5000 residents) to transform outpatient sites into PCMHs and provide high-quality, coordinated care. Site visits, coaching calls, resident surveys, data reporting, and feedback were used to promote and monitor change in resident continuity and quality of care. Descriptive analyses measured improvements in these areas. A total of 156 participating outpatient sites (100%) received PCMH recognition. All sites enhanced resident education using PCMH principles through patient empanelment, development of quality dashboards, and transforming resident scheduling and training. Clinical quality outcomes showed improvement across the demonstration, including better performance on colorectal and breast cancer screening rates (rate increases of 13%, P≤.001, and 11%, P=.011, respectively). A 1115 Medicaid waiver is a viable mechanism for states to transform residency clinics to reflect new primary care models. The PCMH transformation of 156 sites led to improvements in resident continuity and clinical outcomes.

[The strategies of the symbolic struggle for the training of the visiting nurse in the early twentieth century].

PubMed

Ayres, Lílian Fernandes Arial; Amorim, Wellington Mendonça de; Piva, Teresa Cristina de Carvalho; Porto, Fernando Rocha

2012-09-01

Based on the historical and social perspective, the scope of this documentary study were the strategies of the symbolic struggle for the training of agents in home visitation in the Courses for Visiting Nurses of the Brazilian Red Cross and the National Department of Public Health in Rio de Janeiro (Federal District), with repercussions in the Department of Health and Welfare of the State of Pernambuco between 1920 and 1926. We adopted the thinking of sociologist Pierre Bourdieu as a theoretical benchmark, showing the symbolic struggle in the field of public health between sanitarians Amaury de Medeiros and José P. Fontenelle and public health nurse Ethel Parsons, to analyze who was responsible for the scientific authority and competence of the training of visiting nurses.

COS NUV Target Acquisition Monitor

NASA Astrophysics Data System (ADS)

Penton, Steven V.

2017-08-01

Visits PA, BA, & BB of this program verify all ACQ/IMAGE mode co-alignments by bootstrapping from PSA+MIRRORA. The assumption, which should be tested at some point, is that the PSA+MIRRORA WCA-to-PSA FSW offsets are still as accurate in defining the center of the PSA relative to the WCA as there were in SMOV. The details of the observations are given is the observing section.Visit PB was an on-hold contingency visit in case, for whatever reason, visit 2A of 14452, did not execute as planned in the fall of 2017. This program was replaced with a better program for aligning the FGGs so we needed to activate this visit to obtain the PSA/MIRRORA to PSA/MIRRORB ACQ/IMAGE alignment. Visit BA of this program takes back-to-back PSA/MIRRORB & BOA/MIRRORA ACQ/Images and images (with flashes) and also takes G230L, G285M as well as FUV LP3 G130M and G140L spectra to test the WCA-to-PSA offsets.Visit BB of this program takes back-to-back BOA/MIRRORA & BOA/MIRRORB ACQ/Images and images (with flashes) and also takes G225M, G185M, and FUV LP3 G160M spectra to test the WCA-to-PSA offsets. Visit BA of this program bootstraps off VIsit PB to co-align the PSA+MIRRORB ACQ/IMAGE mode to the BOA+MIRRORA. Visit BB of this program follows the style of Visit BA and bootstraps from the BOA+MIRRORA mode to the BOA+MIRRORB TA imaging mode. In all visits, lamp+target images are taken before and after the TA imaging mode that is being co-aligned (the second ACQ/IMAGE of the program.)All visits in this program are single orbit visits. This program is very similar to the NUV portion of the C24 version (14857). This program differs from the Cycle 23 version in that Visit PB (the old Visit 03) has been permanently upgraded from contingency to operational status. NOTE: Beginning with Cycle 25. ALL FUV exposures in this program have been moved to a separate monitoring program. This program will sequentially test the XD accuracy of FUV LP4 spectra. As needed, NUV ACQ/IMAGEs will reset the centering between grating tests.

Supporting families in challenging contexts: the CAPEDP project.

PubMed

Saïas, Thomas; Greacen, Tim; Tubach, Florence; Dugravier, Romain; Marcault, Estelle; Tereno, Susana; Tremblay, Richard E; Guédeney, Antoine

2013-06-01

Although France has one of the most generous health and social care systems for infant and maternal well-being in the Western world, professionals have been increasingly concerned by the rising number of children being referred for mental health problems. The present article describes the first home-visiting program in France to specifically target mental health questions in families living in vulnerable contexts. The CAPEDP project, involving 440 women and their families, took place in Paris and its inner suburbs from 2006 to 2011. To be eligible for inclusion, women had to be (i) under 26 years old, (ii) less that 27 weeks pregnant, (iii) sufficiently fluent in French to give truly informed consent to participate in the study and benefit from the intervention and (iv) presenting with one or more of the following social vulnerability factors: low income, low educational level, and/or intending to bring up the child without the child's father. The intervention consisted of 44 home visits from the third trimester of pregnancy through to the child's second birthday. The aim of the intervention was to promote infant mental health and reduce the incidence of infant mental health problems at the age of two years. The intervention paid particular attention to postnatal maternal depression and promoting parenting skills and attachment security, particularly through the use of video during home-visits. A major issue was that of adapting international best practice recommendations with regard to home-visiting programs to the particularities of the existing French social and health care system. An original aspect of the intervention was to use trained clinical psychologists to conduct all home visits.

Does Physician Education on Depression Management Improve Treatment in Primary Care?

PubMed Central

Lin, Elizabeth H B; Simon, Gregory E; Katzelnick, David J; Pearson, Steven D

2001-01-01

OBJECTIVE To assess the effect of physician training on management of depression. DESIGN Primary care physicians were randomly assigned to a depression management intervention that included an educational program. A before-and-after design evaluated physician practices for patients not enrolled in the intervention trial. SETTING One hundred nine primary care physicians in 2 health maintenance organizations located in the Midwest and Northwest regions of the United States. PATIENTS/PARTICIPANTS Computerized pharmacy and visit data from a group of 124,893 patients who received visits or prescriptions from intervention and usual care physicians. INTERVENTIONS Primary care physicians received education on diagnosis and optimal management of depression over a 3-month training period. Methods of education included small group interactive discussions, expert demonstrations, role-play, and academic detailing of pharmacotherapy, criteria for urgent psychiatric referrals, and case reviews with psychiatric consultants. MEASUREMENTS AND MAIN RESULTS Pharmacy and visit data provided indicators of physician management of depression: rate of newly diagnosed depression, new prescription of antidepressant medication, and duration of pharmacotherapy. One year after the training period, intervention and usual care physicians did not differ significantly in the rate of new depression diagnosis (P = .95) or new prescription of antidepressant medicines (P = .10). Meanwhile, patients of intervention physicians did not differ from patients of usual care physicians in adequacy of pharmacotherapy (P = .53) as measured by 12 weeks of continuous antidepressant treatment. CONCLUSIONS After education on optimal management of depression, intervention physicians did not differ from their usual care colleagues in depression diagnosis or pharmacotherapy. PMID:11556942

Connecting for Health Literacy: Health Information Partners

PubMed Central

Pomerantz, Karyn L.; Muhammad, Abdul-Ali; Downey, Stacey; Kind, Terry

2010-01-01

This article describes a community-based health information partnership to address health literacy and health information inequalities in marginalized communities. Public health, medical, literacy, and library practitioners promote health literacy through outreach, training, and professional development activities in community settings. They create learning environments for people to develop the necessary knowledge and skills to better understand health information and health policy so they can make decisions concerning personal and community health. Outreach activities focus on visits to neighborhood health centers, health fairs, health exhibits at union meetings and conferences; training programs involve hands-on, peer-led computer classes for people living with HIV and for the general public; and professional development programs connect librarians, health providers, public health workers, and literacy teachers in joint planning and learning. Several learners currently participate in and lead community health education programs and HIV advocacy. The coalition's strength develops from strongly shared objectives, an absence of territoriality, and a core active leadership group. PMID:18544664

Influences on Faculty Willingness to Mentor Undergraduate Students from Another University as Part of an Interinstitutional Research Training Program

PubMed Central

Morales, Danielle X.; Grineski, Sara E.; Collins, Timothy W.

2016-01-01

In 2014, the National Institutes of Health invested $31 million in 10 primary institutions across the United States through the Building Undergraduate Infrastructure Leading to Diversity (BUILD) program; one requirement of BUILD is sending undergraduate trainees from those primary institutions to partner institutions for research experiences. Mechanisms like BUILD are designed to broaden research opportunities for students, especially those from underrepresented backgrounds. However, to our knowledge, no studies have examined faculty willingness to mentor undergraduates from other institutions through structured training programs. Survey data from 536 faculty members at 13 institutions were collected in Fall 2013 and analyzed using multiple statistical techniques. Results show that faculty who valued the opportunity to increase diversity in the academy and those who believed that mentoring undergraduates benefited their own research expressed greater willingness to serve as research mentors to visiting undergraduates, and faculty who perceived that they did not have the ability to accommodate additional students expressed less willingness to do so. Most respondents viewed student and faculty incentives as motivating factors in their willingness to mentor, but their perspectives on different types of incentives varied based on faculty career stage, discipline, and research funding status. Results have important implications for designing multi-institutional undergraduate research training programs. PMID:27521237

International Power Institute`s quarterly technical progress report, July--September 1998

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coles, J.E.

1998-10-30

The International Power Institute (IPI) at Morehouse College has organized a team to design and create a Short Term Training Program for ESKOM Union Leaders which will last four weeks and take place at a location in South Africa to be designated by ESKOM. This proposal envisions a group of no more than 25 union leaders to be trained at the same time but the program could be expanded to accommodate up to 40 trainees. The program is designed around interactive training with lectures followed by discussion, case studies, trainee work groups, homework assignments and two field study visits. Also,more » the program is designed to have a number of ESKOM management people join the course for one day in the second week and one day at the end, in each case after a half day of preparation in separate sessions from the union leaders, to share with the trainees expectations and, at the end of the program, their course experiences. In addition, IPI has prepared a follow on proposal for a Long Term Training Program. This LT program is specified in less detail but can be expanded based on future discussions with ESKOM management. The training program is designed with the following objectives: determine and identify the most pressing problems facing ESKOM Union Leadership in their relationship with management; instill in the union leadership a heightened sense of purpose and willingness to take ownership of a process that will increase effective outcomes of meaningful, good faith bargaining; develop skills and experience leading to improved union administration; enhance realistic expectations and improve process knowledge to facilitate future labor negotiations and grievance proceedings; and provide participants with enhanced skills and knowledge to develop and/or strengthen a functioning, democratic work culture and structure internal to the union.« less

Design and implementation of an integrated, continuous evaluation, and quality improvement system for a state-based home-visiting program.

PubMed

McCabe, Bridget K; Potash, Dru; Omohundro, Ellen; Taylor, Cathy R

2012-10-01

To describe the design and implementation of an evaluation system to facilitate continuous quality improvement (CQI) and scientific evaluation in a statewide home visiting program, and to provide a summary of the system's progress in meeting intended outputs and short-term outcomes. Help Us Grow Successfully (HUGS) is a statewide home visiting program that provides services to at-risk pregnant/post-partum women, children (0-5 years), and their families. The program goals are to improve parenting skills and connect families to needed services and thus improve the health of the service population. The evaluation system is designed to: (1) integrate evaluation into daily workflow; (2) utilize standardized screening and evaluation tools; (3) facilitate a culture of CQI in program management; and, (4) facilitate scientifically rigorous evaluations. The review of the system's design and implementation occurred through a formative evaluation process (reach, dose, and fidelity). Data was collected through electronic and paper surveys, administrative data, and notes from management meetings, and medical chart review. In the design phase, four process and forty outcome measures were selected and are tracked using standardized screening and monitoring tools. During implementation, the reach and dose of training were adequate to successfully launch the evaluation/CQI system. All staff (n = 165) use the system for management of families; the supervisors (n = 18) use the system to track routine program activities. Data quality and availability is sufficient to support periodic program reviews at the region and state level. In the first 7 months, the HUGS evaluation system tracked 3,794 families (7,937 individuals). System use and acceptance is high. A successful implementation of a structured evaluation system with a strong CQI component is feasible in an existing, large statewide program. The evaluation/CQI system is an effective mechanism to drive modest change in management of the program.

Evaluation Study of the Exploratory Visit: An Innovative Outreach Activity of the ILGWU's Friendly Visiting Program

ERIC Educational Resources Information Center

Wright, Holly; And Others

1977-01-01

The exploratory visit to recent retirees, an outreach component of the International Ladies Garment Workers Union Friendly Visiting Program, was evaluated. A post-test only control group effect study revealed exploratory visits were effective in establishing a link between the program and the retiree. (Author)

An integrative approach to cultural competence in the psychiatric curriculum.

PubMed

Fung, Kenneth; Andermann, Lisa; Zaretsky, Ari; Lo, Hung-Tat

2008-01-01

As it is increasingly recognized that cultural competence is an essential quality for any practicing psychiatrist, postgraduate psychiatry training programs need to incorporate cultural competence training into their curricula. This article documents the unique approach to resident cultural competence training being developed in the Department of Psychiatry at the University of Toronto, which has the largest residency training program in North America and is situated in an ethnically diverse city and country. The authors conducted a systematic review of cultural competence by searching databases including PubMed, PsycINFO, PsycArticles, CINAHL, Social Science Abstracts, and Sociological Abstracts; by searching government and professional association publications; and through on-site visits to local cross-cultural training programs. Based on the results of the review, a resident survey, and a staff retreat, the authors developed a deliberate "integrative" approach with a mindful, balanced emphasis on both generic and specific cultural competencies. Learning objectives were derived from integrating the seven core competencies of a physician as defined by the Canadian Medical Education Directions for Specialists (CanMEDS) roles framework with the tripartite model of attitudes, knowledge, and skills. The learning objectives and teaching program were further integrated across different psychiatric subspecialties and across the successive years of residency. Another unique strategy used to foster curricular and institutional change was the program's emphasis on evaluation, making use of insights from modern educational theories such as formative feedback and blueprinting. Course evaluations of the core curriculum from the first group of residents were positive. The authors propose that these changes to the curriculum may lead to enhanced cultural competence and clinical effectiveness in health care.

Perceptions of telecare training needs in home healthcare services: a focus group study.

PubMed

Guise, Veslemøy; Wiig, Siri

2017-02-23

The implementation and use of telecare requires significant changes to healthcare service organisation and delivery, including new ways of working for staff. Competency development and training for healthcare professionals is therefore required to enable necessary adaptation of clinical practice and ensure competent provision of telecare services. It is however unclear what skills healthcare staff need when providing care at a distance and there is little empirical evidence on effective training strategies for telecare practice. Training should however emphasise the experiences and preferences of prospective trainees to ensure its relevance to their educational needs. The aim of this study was to explore healthcare professionals' perceptions of training related to the general use of telecare, and to identify specific training needs associated with the use of virtual visits in the home healthcare services. Six focus group interviews were held with a total of 26 participants working in the home healthcare services in Norway, including registered nurses, enrolled nurses, physiotherapists, occupational therapists, social workers, health workers, and healthcare assistants. The data material was analysed by way of systematic text condensation. The analysis resulted in five categories relevant to telecare training for healthcare professionals: Purposeful training creates confidence and changes attitudes; Training needs depend on ability to cope with telecare; The timing of training; Training must facilitate practical insight into the patients' perspective; and Training content must focus on the telecare process. Findings are discussed in light of implications for the form and content of a training program for healthcare professionals on how to undertake virtual home healthcare visits. Appropriate preparation and training for telecare use is important for healthcare professionals and must be taken seriously by healthcare organisations. To facilitate the knowledge, skills and attitudes required for new ways of working and enable quality and safety in telecare practice, staff should be provided with training as part of telecare implementation processes. Telecare training should be hands-on and encourage an overall patient-centred approach to care to ensure good patient-professional relationships at a distance.

COMPARE/Radiology, an interactive Web-based radiology teaching program evaluation of user response.

PubMed

Wagner, Matthias; Heckemann, Rolf A; Nömayr, Anton; Greess, Holger; Bautz, Werner A; Grunewald, Markus

2005-06-01

The aim of this study is to assess user benefits of COMPARE/Radiology, a highly interactive World Wide Web-based training program for radiology, as perceived by its users. COMPARE/Radiology (http://www.idr.med.uni-erlangen.de/compare.htm), an interactive training program based on 244 teaching cases, was created by the authors and made publicly available on the Internet. An anonymous survey was conducted among users to investigate the composition of the program's user base and assess the acceptance of the training program. In parallel, Web access data were collected and analyzed using descriptive statistics. The group of responding users (n = 1370) consisted of 201 preclinical medical students (14.7%), 314 clinical medical students (22.9%), 359 residents in radiology (26.2%), and 205 users of other professions (14.9%). A majority of respondents (1230; 89%) rated the interactivity of COMPARE/Radiology as good or excellent. Many respondents use COMPARE/Radiology for self-study (971; 70%) and for teaching others (600; 43%). Web access statistics show an increase in number of site visits from 1248 in December 2002 to 4651 in April 2004. Users appreciate the benefits of COMPARE/Radiology. The interactive instructional design was rated positively by responding users. The popularity of the site is growing, evidenced by the number of network accesses during the observation period.

National trends in IPPE programs at US schools of pharmacy from 2008-2013.

PubMed

Devine, Patricia S; Darbishire, Patricia L

2015-04-25

To determine trends and challenges in introductory pharmacy practice experience (IPPE) programs from 2008-2013. In 2013, a web-based survey was sent to IPPE program administrators at 107 fully accredited colleges and schools of pharmacy. The survey addressed administrative personnel, program structure, and quality assurance issues. Sixty-nine IPPE administrators responded to the survey (64.5% response rate). Within the past 5 years, 4 significant trends occurred in the area of administrative personnel, 7 trends in program structure, and 6 in quality assurance. Clarifications of ACPE Standards through new guidelines and policy statements likely influence many of the 17 trends. Understaffed programs, competition for institutional sites, difficulty conducting site visits, preceptor training, program assessment, documentation maintenance, and individual site requirements are all challenges. The results of this study can be used as a stimulus to address ongoing issues and to enhance the quality of IPPE programs.

Implementing the patient-centered medical home in residency education.

PubMed

Doolittle, Benjamin R; Tobin, Daniel; Genao, Inginia; Ellman, Matthew; Ruser, Christopher; Brienza, Rebecca

2015-01-01

In recent years, physician groups, government agencies and third party payers in the United States of America have promoted a Patient-centered Medical Home (PCMH) model that fosters a team-based approach to primary care. Advocates highlight the model's collaborative approach where physicians, mid-level providers, nurses and other health care personnel coordinate their efforts with an aim for high-quality, efficient care. Early studies show improvement in quality measures, reduction in emergency room visits and cost savings. However, implementing the PCMH presents particular challenges to physician training programs, including institutional commitment, infrastructure expenditures and faculty training. Teaching programs must consider how the objectives of the PCMH model align with recent innovations in resident evaluation now required by the Accreditation Council of Graduate Medical Education (ACGME) in the US. This article addresses these challenges, assesses the preliminary success of a pilot project, and proposes a viable, realistic model for implementation at other institutions.

Mobile Integrated Health Care and Community Paramedicine: An Emerging Emergency Medical Services Concept.

PubMed

Choi, Bryan Y; Blumberg, Charles; Williams, Kenneth

2016-03-01

Mobile integrated health care and community paramedicine are models of health care delivery that use emergency medical services (EMS) personnel to fill gaps in local health care infrastructure. Community paramedics may perform in an expanded role and require additional training in the management of chronic disease, communication skills, and cultural sensitivity, whereas other models use all levels of EMS personnel without additional training. Currently, there are few studies of the efficacy, safety, and cost-effectiveness of mobile integrated health care and community paramedicine programs. Observations from existing program data suggest that these systems may prevent congestive heart failure readmissions, reduce EMS frequent-user transports, and reduce emergency department visits. Additional studies are needed to support the clinical and economic benefit of mobile integrated health care and community paramedicine. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Musculoskeletal education in physical medicine and rehabilitation residency programs.

PubMed

Smith, Jay; Krabak, Brian J; Malanga, Gerard A; Moutvic, Margaret A

2004-10-01

To characterize current musculoskeletal (MSK) education experiences in physical medicine and rehabilitation residency programs and to identify perceived barriers to providing more extensive MSK education experiences. In addition, to establish utilization patterns for the PASSOR Physical Examination Core Competencies List. Between March and November 2003, all 81 physical medicine and rehabilitation residency program directors were asked to complete an MSK education survey developed by the authors. A total of 69 of 81 program directors (86%) responded after multiple contacts. The most frequently utilized MSK education formats were MSK lecture series, MSK departmental conferences, and physical examination workshops. Potential barriers to expanded MSK education included money, time, and staff number. Given unlimited resources, most residency programs would greatly increase utilization of visiting lecturers, CD-ROMs/DVDs, objective structured clinical examinations, and physical examination videos. Of the 30 program directors who recalled receiving the Core Competencies List, only 40% (12 of 30) have formally integrated the list into their residency training. Barriers to implementation included logistical challenges and lack of direction regarding implementation. Residency program directors indicate a strong interest in expanding resident MSK education through the use of CD-ROMs/DVDs, physical examination videos, objective structured clinical examinations, and visiting lecturer programs. CD-ROMs/DVDs and videos represent particularly attractive educational formats for supplementing resident MSK education due to the advantages of central production, nominal costs, widespread distribution, multimedia capabilities, and accessibility. These educational formats should be considered for targeted educational initiatives to enhance resident MSK education, regardless of residency program size or resources.

Consumer-Operated Service Programs: monetary and donated costs and cost-effectiveness.

PubMed

Yates, Brian T; Mannix, Danyelle; Freed, Michael C; Campbell, Jean; Johnsen, Matthew; Jones, Kristine; Blyler, Crystal R

2011-01-01

Examine cost differences between Consumer Operated Service Programs (COSPs) as possibly determined by a) size of program, b) use of volunteers and other donated resources, c) cost-of-living differences between program locales, d) COSP model applied, and e) delivery system used to implement the COSP model. As part of a larger evaluation of COSP, data on operating costs, enrollments, and mobilization of donated resources were collected for eight programs representing three COSP models (drop-in centers, mutual support, and education/advocacy training). Because the 8 programs were operated in geographically diverse areas of the US, costs were examined with and without adjustment for differences in local cost of living. Because some COSPs use volunteers and other donated resources, costs were measured with and without these resources being monetized. Scale of operation also was considered as a mediating variable for differences in program costs. Cost per visit, cost per consumer per quarter, and total program cost were calculated separately for funds spent and for resources donated for each COSP. Differences between COSPs in cost per consumer and cost per visit seem better explained by economies of scale and delivery system used than by cost-of-living differences between program locations or COSP model. Given others' findings that different COSP models produce little variation in service effectiveness, minimize service costs by maximizing scale of operation while using a delivery system that allows staff and facilities resources to be increased or decreased quickly to match number of consumers seeking services.

The Relationship of Repeated Technical Assistance Support Visits to the Delivery of Positive Health, Dignity, and Prevention (PHDP) Messages by Healthcare Providers in Mozambique: A Longitudinal Multilevel Analysis.

PubMed

Gutin, Sarah A; Amico, K Rivet; Hunguana, Elsa; Munguambe, António Orlando; Rose, Carol Dawson

Positive health, dignity, and prevention (PHDP) is Mozambique's strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training. We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers. With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors. Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.

Home Visiting Family Support Programs: Benefits of the Maternal, Infant, and Early Childhood Home Visiting Program. Fact Sheet

ERIC Educational Resources Information Center

Home Visiting Campaign, 2015

2015-01-01

The federally funded, locally administered Maternal, Infant, and Early Childhood Home Visiting Program sponsors family support programs that are often called "home visiting" because they take place in the homes of at-risk families. These families often lack support, experience, and knowledge of basic parenting skills. Because children…

Short-Term Absenteeism and Health Care Utilization Due to Lower Extremity Injuries Among Novice Runners: A Prospective Cohort Study.

PubMed

Smits, Dirk-Wouter; Huisstede, Bionka; Verhagen, Evert; van der Worp, Henk; Kluitenberg, Bas; van Middelkoop, Marienke; Hartgens, Fred; Backx, Frank

2016-11-01

To describe absenteeism and health care utilization (HCU) within 6 weeks after occurrence of running-related injuries (RRIs) among novice runners and to explore differences relating to injury and personal characteristics. Prospective cohort study. Primary care. One thousand six hundred ninety-six novice runners (18-65 years) participating in a 6-week running program ("Start-to-Run"). Injury characteristics were assessed by weekly training logs and personal characteristics by a baseline questionnaire. Data on absenteeism and HCU were collected using questionnaires at 2 and 6 weeks after the RRI occurred. A total of 185 novice runners (11%) reported an RRI during the 6-week program. Of these injured novice runners, 78% reported absence from sports, whereas only 4% reported absence from work. Fifty-one percent of the injured novice runners visited a health care professional, mostly physical therapists (PTs) rather than physicians. Absenteeism was more common among women than men and was also more common with acute RRIs than gradual-onset RRIs. As regards HCU, both the variety of professionals visited and the number of PT visits were higher among runners with muscle-tendon injuries in the ankle/foot region than among those with other RRIs. Among novice runners sustaining an RRI during a 6-week running program, over three quarters reported short-term absence from sports, whereas absence from work was very limited, and over half used professional health care. Both absence and HCU are associated with injury characteristics. In future running promotion programs (eg in Start-to-Run programs), specific attention should be paid to acute injuries and to muscle-tendon injuries in the ankle/foot region.

Determinants of pediatric cataract program outcomes and follow-up in a large series in Mexico.

PubMed

Congdon, Nathan G; Ruiz, Sergio; Suzuki, Maki; Herrera, Veronica

2007-10-01

To report determinants of outcomes and follow-up in a large Mexican pediatric cataract project. Hospital Luis Sanchez Bulnes, Mexico City, Mexico. Data were collected prospectively from a pediatric cataract surgery program at the Hospital Luis Sanchez Bulnes, implemented by Helen Keller International. Preoperative data included age, sex, baseline visual acuity, type of cataract, laterality, and presence of conditions such as amblyopia. Surgical data included vitrectomy, capsulotomy, complications, and use of intraocular lenses (IOLs). Postoperative data included final visual acuity, refraction, number of follow-up visits, and program support for follow-up. Of 574 eyes of 415 children (mean age 7.1 years +/- 4.7 [SD]), IOLs were placed in 416 (87%). At least 1 follow-up was attended by 408 patients (98.3%) (mean total follow-up 3.5 +/- 1.8 months); 40% of eyes achieved a final visual acuity of 6/18 or better. Children living farther from the hospital had fewer postoperative visits (P = .04), while children receiving program support had more visits (P = .001). Factors predictive of better acuity included receiving an IOL during surgery (P = .04) and provision of postoperative spectacles (P = .001). Predictive of worse acuity were amblyopia (P = .003), postoperative complications (P = .0001), unilateral surgery (P = .0075), and female sex (P = .045). The results underscore the importance of surgical training in reducing complications, early intervention before amblyopia (observed in 40% of patients) can develop, and vigorous treatment if amblyopia is present. The positive impact of program support on follow-up is encouraging, although direct financial support may pose a problem for sustainability. More work is needed to understand reasons for worse outcomes in girls.

Establishing Pulmonary and Critical Care Medicine in China: 2016 Report on Implementation and Government Recognition: Joint Statement of the Chinese Association of Chest Physicians and the American College of Chest Physicians.

PubMed

Qiao, Renli; Marciniuk, Darcy; Augustyn, Nicki; Rosen, Mark J; Dai, Huaping; Chen, Rongchang; Wu, Sinan; Wang, Chen

2016-08-01

This article provides an update on progress toward establishing pulmonary and critical care medicine (PCCM) fellowship training as one of the first four subspecialties to be recognized and supported by the Chinese government. Designed and implemented throughout 2013 and 2014 by a collaborative effort of the Chinese Thoracic Society (CTS) and the American College of Chest Physicians (CHEST), 12 leading Chinese hospitals enrolled a total of 64 fellows into standardized PCCM training programs with common curricula, educational activities, and assessment measures. Supplemental educational materials, online assessment tools, and institutional site visits designed to evaluate and provide feedback on the programs' progress are being provided by CHEST. As a result of this initial progress, the Chinese government, through the Chinese Medical Doctor's Association, endorsed the concept of subspecialty fellowship training in China, with PCCM as one of the four pilot subspecialties to be operationalized nationwide in 2016, followed by implementation across other subspecialties by 2020. This article also reflects on the achievements of the training sites and the challenges they face and outlines plans to enhance and expand PCCM training and practice in China. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Medical students as hospice volunteers: reflections on an early experiential training program in end-of-life care education.

PubMed

Mott, Melissa L; Gorawara-Bhat, Rita; Marschke, Michael; Levine, Stacie

2014-06-01

Despite an increase in the content of palliative medicine curricula in medical schools, students are rarely exposed to end-of-life (EOL) care through real-patient experiences during their preclinical education. To evaluate the utility and impact of exposure to EOL care for first year medical students (MS-1s) through a hospice volunteer experience. Patients and Families First (PFF), a hospice volunteer training program in EOL care, was piloted on three cohorts of MS-1s as an elective. Fifty-five students received 3 hours of volunteer training, and were then required to conduct at least two consecutive hospice visits on assigned patients to obtain course credit. Students' reflective essays on their experiences were analyzed using qualitative methodology and salient themes were extracted by two investigators independently and then collaboratively. The following five themes were identified from students' reflective essays: perceptions regarding hospice patients; reactions regarding self; normalcy of EOL care at home; impact of witnessing death and dying; and suggestions for improving EOL care education for medical students. Hospice volunteering during preclinical years may provide valuable experiential training for MS-1s in caring for seriously ill patients and their families by fostering personal reflection and empathic skills, thereby providing a foundation for future patient encounters during clinical training.

Acción Mutua (Shared Action): a multipronged approach to delivering capacity-building assistance to agencies serving Latino communities in the United States.

PubMed

Ayala, George; Chión, Miguel; Díaz, Rafael M; Heckert, Andrea L; Nuño, Monica; del Pino, Homero E; Rodríguez, Claudia; Schroeder, Kurt; Smith, Terry

2007-01-01

Culturally appropriate, theory-based capacity-building assistance can serve a vital role in helping HIV prevention providers remain up-to-date, effective, and responsive to those they serve. Funded by the Centers for Disease Control and Prevention (CDC), AIDS Project Los Angeles, in collaboration with San Francisco State University's César E. Chávez Institute, conducted full-day site visits and qualitative interviews in 2005 with mid-level management staff of CDC-funded community-based organizations delivering HIV prevention services to Latino communities in the western region of the United States. We found that agencies we visited (1) had not yet adapted the evidence-based interventions they were using at the time of our visit and (2) requested technical assistance and training in the areas of program development, evaluation, group facilitation techniques, consumer recruitment, client retention, intervention adaptation, and materials development. Findings from this needs assessment were used to inform our seven-pronged approach to delivering capacity-building assistance entitled "Acción Mutua" (Shared Action). The approach emphasizes strategic partnerships, stakeholder involvement, organizational self-assessment, culturally appropriate materials development, interactive training, tailored onsite technical assistance, and professional networking opportunities. This article describes our approach in detail, the assessment process we used to develop it, and its implications for capacity-building practice.

A randomized controlled trial of home visits by neighborhood mentor mothers to improve children's nutrition in South Africa

PubMed Central

le Roux, Ingrid M.; le Roux, Karl; Mbeutu, Kwanie; Comulada, W. Scott; Desmond, Katherine A.; Rotheram-Borus, Mary Jane

2011-01-01

Malnourished children and babies with birth weights under 2500 g are at high risk for negative outcomes over their lifespans. Philani, a paraprofessional home visiting program, was developed to improve nutritional outcomes for young children in South Africa. One “mentor mother” was recruited from each of 37 neighborhoods in Cape Town, South Africa. Mentor mothers were trained to conduct home visits to weigh children under six years old and to support mothers to problem-solve life challenges, especially around nutrition. Households with underweight children were assigned randomly on a 2:1 ratio to the Philani program (n = 500) or to a standard care condition (n = 179); selection effects occurred and children in the intervention households weighed less at recruitment. Children were evaluated over a one-year period (n = 679 at recruitment and n = 638 with at least one follow-up; 94%). Longitudinal random effects models indicated that, over 12 months, the children in the intervention condition gained significantly more weight than children in the control condition. Mentor mothers who are positive peer deviants may be a viable strategy that is efficacious and can build community, and the use of mentor mothers for other problems in South Africa is discussed. PMID:22299019

[Healthy heart: Results of a community education program on cardiovascular health].

PubMed

Madridejos Mora, Rosa; Majem Fabres, Lourdes; Puig Acebal, Helena; Sanz Latorre, Inma; Llobet Traveset, Eva; Arce Casas, Mar; Ruiz Morilla, Dolors; Mercadal Dalmau, Angel; Pañart Sánchez, Dani

2014-11-01

To improve the knowledge of the population about heart-healthy habits through a training program supplemented by a web site and community activities. A controlled clinical trial with intervention done through participation in the Cardiovascular Health Training Classroom (CHTC) LOCATION: A town of 80,000 inhabitants. both sexes, aged 55 to 70 years, with at least one cardiovascular risk factor (CVRF). The intervention group (IG) consisted of patients who participated in the CHTC. Intervention was carried out through a 20-hour presential group course in which a support web site was offered and complementary activities were organized. Classes were taught by three Primary Care nurses. The primary endpoint was knowledge of CVRF. The secondary variables were age, sex, CVRF, lifestyle, visits to health centers, pharmaceutical use adherence, and satisfaction with the program. Data from patients in the first 10 courses (n=150) were evaluated. A statistically significant improvement was observed in overall knowledge of CVRF in the IG (87.3% to 100%) compared with control group (GC) (84.5% to 92.7%), p<.001, as well as an improvement in physical activity is (IG: 71.2% to 83.1% versus CG: 72.6% to 78.2%), p=.05. The total number of Primary Care visits (medical and nursing) decreased in the IG more than in the CG. The satisfaction rate of the course was very high. This experience is effective in improving cardiovascular health knowledge and promoting some healthy habits. Copyright © 2012 Elsevier España, S.L.U. All rights reserved.

Cost analysis of large-scale implementation of the 'Helping Babies Breathe' newborn resuscitation-training program in Tanzania.

PubMed

Chaudhury, Sumona; Arlington, Lauren; Brenan, Shelby; Kairuki, Allan Kaijunga; Meda, Amunga Robson; Isangula, Kahabi G; Mponzi, Victor; Bishanga, Dunstan; Thomas, Erica; Msemo, Georgina; Azayo, Mary; Molinier, Alice; Nelson, Brett D

2016-12-01

Helping Babies Breathe (HBB) has become the gold standard globally for training birth-attendants in neonatal resuscitation in low-resource settings in efforts to reduce early newborn asphyxia and mortality. The purpose of this study was to do a first-ever activity-based cost-analysis of at-scale HBB program implementation and initial follow-up in a large region of Tanzania and evaluate costs of national scale-up as one component of a multi-method external evaluation of the implementation of HBB at scale in Tanzania. We used activity-based costing to examine budget expense data during the two-month implementation and follow-up of HBB in one of the target regions. Activity-cost centers included administrative, initial training (including resuscitation equipment), and follow-up training expenses. Sensitivity analysis was utilized to project cost scenarios incurred to achieve countrywide expansion of the program across all mainland regions of Tanzania and to model costs of program maintenance over one and five years following initiation. Total costs for the Mbeya Region were $202,240, with the highest proportion due to initial training and equipment (45.2%), followed by central program administration (37.2%), and follow-up visits (17.6%). Within Mbeya, 49 training sessions were undertaken, involving the training of 1,341 health providers from 336 health facilities in eight districts. To similarly expand the HBB program across the 25 regions of mainland Tanzania, the total economic cost is projected to be around $4,000,000 (around $600 per facility). Following sensitivity analyses, the estimated total for all Tanzania initial rollout lies between $2,934,793 to $4,309,595. In order to maintain the program nationally under the current model, it is estimated it would cost $2,019,115 for a further one year and $5,640,794 for a further five years of ongoing program support. HBB implementation is a relatively low-cost intervention with potential for high impact on perinatal mortality in resource-poor settings. It is shown here that nationwide expansion of this program across the range of health provision levels and regions of Tanzania would be feasible. This study provides policymakers and investors with the relevant cost-estimation for national rollout of this potentially neonatal life-saving intervention.

Exploration of Factors Predictive of At-risk Fathers' Participation in a Pilot Study of an Augmented Evidence-Based Parent Training Program: A Mixed Methods Approach.

PubMed

Rostad, Whitney L; Self-Brown, Shannon; Boyd, Clinton; Osborne, Melissa; Patterson, Alexandria

2017-08-01

There has been burgeoning parenting intervention research specifically addressing fathers in recent decades. Corresponding research examining their participation and engagement in evidence-based parent training programs, which have almost exclusively targeted mothers, is just emerging. The current study used mixed methods to examine factors that influenced completion of an augmented version of an evidence-based child maltreatment prevention program developed for male caregivers called SafeCare Dad to Kids (Dad2K) in a pilot study. The current sample comprised 50 male caregivers ( M age = 29.42 years, SD = 8.18) of a child between the ages of 2 and 5 years. Fathers participated in a baseline assessment and were considered program completers (n = 27) if they participated in the program's six home visiting sessions. A subsample of completers (n = 11) was recruited to participate in qualitative interviews that provided in-depth information about fathers' experiences in Dad2K. Logistic regression indicated that, in the context of other demographic predictors, fathers with an education beyond high school were over 5 times more likely to complete Dad2K program compared to fathers with a high school education or less. Qualitative analyses revealed that interviewed father completers were motivated to enroll and participate in a fathering program because of an interest to learn and obtain skills to make them a better parent. Fathers with a high school education or less may require additional engagement strategies to help proactively encourage their enrollment and completion of parent training programs.

KSC-2014-4111

NASA Image and Video Library

2014-09-25

CAPE CANAVERAL, Fla. – NASA Kennedy Space Center Director and former astronaut Bob Cabana, right, introduces astronaut Rick Mastracchio to the audience at a post-flight presentation on the Expedition 38 mission to the International Space Station. The Space Flight Awareness Program hosted Mastracchio's presentation for employees in the KSC Training Auditorium. An Expedition 38/39 crew member, Mastracchio launched to the station from the Baikonur Cosmodrome in Kazakhstan on Nov. 6, 2013, and returned to Earth on May 13, 2014, after 188 days in space. Following Mastracchio's remarks, employees were given the opportunity to ask questions and to meet him in person. To read Mastracchio's biography, visit http://www.jsc.nasa.gov/Bios/htmlbios/mastracc.html. For more information on Expedition 38, visit http://www.nasa.gov/mission_pages/station/expeditions/expedition38. Photo credit: NASA/Daniel Casper

KSC-2014-4113

NASA Image and Video Library

2014-09-25

CAPE CANAVERAL, Fla. – NASA astronaut Rick Mastracchio makes his opening remarks to the audience at a post-flight presentation on the Expedition 38 mission to the International Space Station. The Space Flight Awareness Program hosted Mastracchio's presentation for employees in the KSC Training Auditorium at NASA's Kennedy Space Center in Florida. An Expedition 38/39 crew member, Mastracchio launched to the station from the Baikonur Cosmodrome in Kazakhstan on Nov. 6, 2013, and returned to Earth on May 13, 2014, after 188 days in space. Following Mastracchio's remarks, employees were given the opportunity to ask questions and to meet him in person. To read Mastracchio's biography, visit http://www.jsc.nasa.gov/Bios/htmlbios/mastracc.html. For more information on Expedition 38, visit http://www.nasa.gov/mission_pages/station/expeditions/expedition38. Photo credit: NASA/Daniel Casper

KSC-2014-4114

NASA Image and Video Library

2014-09-25

CAPE CANAVERAL, Fla. – NASA astronaut Rick Mastracchio discusses the highlights of the Expedition 38 mission to the International Space Station with the audience at a post-flight presentation. The Space Flight Awareness Program hosted Mastracchio's presentation for employees in the KSC Training Auditorium at NASA's Kennedy Space Center in Florida. An Expedition 38/39 crew member, Mastracchio launched to the station from the Baikonur Cosmodrome in Kazakhstan on Nov. 6, 2013, and returned to Earth on May 13, 2014, after 188 days in space. Following Mastracchio's remarks, employees were given the opportunity to ask questions and to meet him in person. To read Mastracchio's biography, visit http://www.jsc.nasa.gov/Bios/htmlbios/mastracc.html. For more information on Expedition 38, visit http://www.nasa.gov/mission_pages/station/expeditions/expedition38. Photo credit: NASA/Daniel Casper

KSC-2014-4110

NASA Image and Video Library

2014-09-25

CAPE CANAVERAL, Fla. – NASA Kennedy Space Center Director and former astronaut Bob Cabana, right, welcomes astronaut Rick Mastracchio to the center for a post-flight presentation on the Expedition 38 mission to the International Space Station. The Space Flight Awareness Program hosted Mastracchio's presentation for employees in the KSC Training Auditorium. An Expedition 38/39 crew member, Mastracchio launched to the station from the Baikonur Cosmodrome in Kazakhstan on Nov. 6, 2013, and returned to Earth on May 13, 2014, after 188 days in space. Following Mastracchio's remarks, employees were given the opportunity to ask questions and to meet him in person. To read Mastracchio's biography, visit http://www.jsc.nasa.gov/Bios/htmlbios/mastracc.html. For more information on Expedition 38, visit http://www.nasa.gov/mission_pages/station/expeditions/expedition38. Photo credit: NASA/Daniel Casper

KSC-2014-4112

NASA Image and Video Library

2014-09-25

CAPE CANAVERAL, Fla. – NASA Kennedy Space Center Director and former astronaut Bob Cabana, right, introduces astronaut Rick Mastracchio to the audience at a post-flight presentation on the Expedition 38 mission to the International Space Station. The Space Flight Awareness Program hosted Mastracchio's presentation for employees in the KSC Training Auditorium. An Expedition 38/39 crew member, Mastracchio launched to the station from the Baikonur Cosmodrome in Kazakhstan on Nov. 6, 2013, and returned to Earth on May 13, 2014, after 188 days in space. Following Mastracchio's remarks, employees were given the opportunity to ask questions and to meet him in person. To read Mastracchio's biography, visit http://www.jsc.nasa.gov/Bios/htmlbios/mastracc.html. For more information on Expedition 38, visit http://www.nasa.gov/mission_pages/station/expeditions/expedition38. Photo credit: NASA/Daniel Casper

KSC-2014-4109

NASA Image and Video Library

2014-09-25

CAPE CANAVERAL, Fla. – NASA Kennedy Space Center Director and former astronaut Bob Cabana, left, greets astronaut Rick Mastracchio before the start of a post-flight presentation on the Expedition 38 mission to the International Space Station. The Space Flight Awareness Program hosted Mastracchio's presentation for employees in the KSC Training Auditorium. An Expedition 38/39 crew member, Mastracchio launched to the station from the Baikonur Cosmodrome in Kazakhstan on Nov. 6, 2013, and returned to Earth on May 13, 2014, after 188 days in space. Following Mastracchio's remarks, employees were given the opportunity to ask questions and to meet him in person. To read Mastracchio's biography, visit http://www.jsc.nasa.gov/Bios/htmlbios/mastracc.html. For more information on Expedition 38, visit http://www.nasa.gov/mission_pages/station/expeditions/expedition38. Photo credit: NASA/Daniel Casper

Medication therapy disease management: Geisinger's approach to population health management.

PubMed

Jones, Laney K; Greskovic, Gerard; Grassi, Dante M; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R; Murray, Michael F; Manickam, Kandamurugu; Nathanson, Douglas C; Wright, Eric A; Evans, Michael A

2017-09-15

Pharmacists' involvement in a population health initiative focused on chronic disease management is described. Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS). Over a 15-year period, Geisinger Health Plan (GHP)-insured patients with AF whose warfarin therapy was managed by the MTDM program had, on average, 18% fewer emergency department (ED) visits and 18% fewer hospitalizations per year than GHP enrollees with AF who did not receive MTDM services, with 23% lower annual total care costs. Over a 2-year period, GHP-insured patients with MS whose pharmacotherapy was managed by pharmacists averaged 28% fewer annual ED visits than non-pharmacist-managed patients; however, the mean annual total care cost was 21% higher among MTDM clinic patients. The Geisinger MTDM program has evolved over 20 years from a single pharmacist-run anticoagulation clinic into a large program focused on managing the health of an ever-growing population. Initial challenges in integrating pharmacists into the Geisinger patient care framework as clinical experts were overcome by demonstrating the MTDM program's positive impact on patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Neuroscientists’ Classroom Visits Positively Impact Student Attitudes

PubMed Central

Fitzakerley, Janet L.; Michlin, Michael L.; Paton, John; Dubinsky, Janet M.

2013-01-01

The primary recommendation of the 2010 President’s Council of Advisors on Science and Technology report on K-12 education was to inspire more students so that they are motivated to study science. Scientists’ visits to classrooms are intended to inspire learners and increase their interest in science, but verifications of this impact are largely qualitative. Our primary goal was to evaluate the impact of a longstanding Brain Awareness classroom visit program focused on increasing learners understanding of their own brains. Educational psychologists have established that neuroscience training sessions can improve academic performance and shift attitudes of students from a fixed mindset to a growth mindset. Our secondary goal was to determine whether short interactive Brain Awareness scientist-in-the-classroom sessions could similarly alter learners’ perceptions of their own potential to learn. Teacher and student surveys were administered in 4th-6th grade classrooms throughout Minnesota either before or after one-hour Brain Awareness sessions that engaged students in activities related to brain function. Teachers rated the Brain Awareness program as very valuable and said that the visits stimulated students’ interest in the brain and in science. Student surveys probed general attitudes towards science and their knowledge of neuroscience concepts (particularly the ability of the brain to change). Significant favorable improvements were found on 10 of 18 survey statements. Factor analyses of 4805 responses demonstrated that Brain Awareness presentations increased positive attitudes toward science and improved agreement with statements related to growth mindset. Overall effect sizes were small, consistent with the short length of the presentations. Thus, the impact of Brain Awareness presentations was positive and proportional to the efforts expended, demonstrating that short, scientist-in-the-classroom visits can make a positive contribution to primary school students’ attitudes toward science and learning. PMID:24358325

Neuroscientists' classroom visits positively impact student attitudes.

PubMed

Fitzakerley, Janet L; Michlin, Michael L; Paton, John; Dubinsky, Janet M

2013-01-01

The primary recommendation of the 2010 President's Council of Advisors on Science and Technology report on K-12 education was to inspire more students so that they are motivated to study science. Scientists' visits to classrooms are intended to inspire learners and increase their interest in science, but verifications of this impact are largely qualitative. Our primary goal was to evaluate the impact of a longstanding Brain Awareness classroom visit program focused on increasing learners understanding of their own brains. Educational psychologists have established that neuroscience training sessions can improve academic performance and shift attitudes of students from a fixed mindset to a growth mindset. Our secondary goal was to determine whether short interactive Brain Awareness scientist-in-the-classroom sessions could similarly alter learners' perceptions of their own potential to learn. Teacher and student surveys were administered in 4(th)-6(th) grade classrooms throughout Minnesota either before or after one-hour Brain Awareness sessions that engaged students in activities related to brain function. Teachers rated the Brain Awareness program as very valuable and said that the visits stimulated students' interest in the brain and in science. Student surveys probed general attitudes towards science and their knowledge of neuroscience concepts (particularly the ability of the brain to change). Significant favorable improvements were found on 10 of 18 survey statements. Factor analyses of 4805 responses demonstrated that Brain Awareness presentations increased positive attitudes toward science and improved agreement with statements related to growth mindset. Overall effect sizes were small, consistent with the short length of the presentations. Thus, the impact of Brain Awareness presentations was positive and proportional to the efforts expended, demonstrating that short, scientist-in-the-classroom visits can make a positive contribution to primary school students' attitudes toward science and learning.

ASTP 15th Anniversary Clip-Media Release

NASA Technical Reports Server (NTRS)

1990-01-01

This release is comprised of 5 separate clips, including the following: CL 762 Astronauts/Cosmonauts Visit to KSC and Walt Disney World; CL 739 ASTP Joint Crew Activities; CL 748 ASTP Astronauts/Cosmonauts Horlock Ranch Visit; CL 758 T-21 ASTP Training - US/USSR; and CL 743 ASTP Joint Crew Training in the Soviet Union.

A Study of Operator and Mechnaic Training Needs in the Transit Industry. Volume II, Appendices. Final Report.

ERIC Educational Resources Information Center

Henderson, Harold L.; And Others

Surveys of 188 transit properties and on-site visits were conducted to determine the training needs of operators and mechanics in the urban mass transportation industry. The appendices include listings of respondents and sample copies of the survey questionnaires and visit reports. (NTIS)

Equally able, but unequally accepted: Gender differentials and experiences of community health volunteers promoting maternal, newborn, and child health in Morogoro Region, Tanzania.

PubMed

Feldhaus, Isabelle; Silverman, Marissa; LeFevre, Amnesty E; Mpembeni, Rose; Mosha, Idda; Chitama, Dereck; Mohan, Diwakar; Chebet, Joy J; Urassa, David; Kilewo, Charles; Plotkin, Marya; Besana, Giulia; Semu, Helen; Baqui, Abdullah H; Winch, Peter J; Killewo, Japhet; George, Asha S

2015-08-25

Despite emerging qualitative evidence of gendered community health worker (CHW) experience, few quantitative studies examine CHW gender differentials. The launch of a maternal, newborn, and child health (MNCH) CHW cadre in Morogoro Region, Tanzania enlisting both males and females as CHWs, provides an opportunity to examine potential gender differences in CHW knowledge, health promotion activities and client acceptability. All CHWs who received training from the Integrated MNCH Program between December 2012 and July 2013 in five districts were surveyed and information on health promotion activities undertaken drawn from their registers. CHW socio-demographic characteristics, knowledge, and health promotion activities were analyzed through bi- and multivariate analyses. Composite scores generated across ten knowledge domains were used in ordered logistic regression models to estimate relationships between knowledge scores and predictor variables. Thematic analysis was also undertaken on 60 purposively sampled semi-structured interviews with CHWs, their supervisors, community leaders, and health committee members in 12 villages from three districts. Of all CHWs trained, 97% were interviewed (n = 228): 55% male and 45% female. No significant differences were observed in knowledge by gender after controlling for age, education, date of training, marital status, and assets. Differences in number of home visits and community health education meetings were also not significant by gender. With regards to acceptability, women were more likely to disclose pregnancies earlier to female CHWs, than male CHWs. Men were more comfortable discussing sexual and reproductive concerns with male, than female CHWs. In some cases, CHW home visits were viewed as potentially being for ulterior or adulterous motives, so trust by families had to be built. Respondents reported that working as female-male pairs helped to address some of these dynamics. Male and female CHWs in this study have largely similar knowledge and health promotion outputs, but challenges in acceptance of CHW counseling for reproductive health and home visits by unaccompanied CHWs varied by gender. Programs that pair male and female CHWs may potentially overcome gender issues in CHW acceptance, especially if they change gender norms rather than solely accommodate gender preferences.

Evaluation of an emergency department-based enrollment program for uninsured children.

PubMed

Mahajan, Prashant; Stanley, Rachel; Ross, Kevin W; Clark, Linda; Sandberg, Keisha; Lichtenstein, Richard

2005-03-01

We evaluate the effectiveness of an emergency department (ED)-based outreach program in increasing the enrollment of uninsured children. The study involved placing a full-time worker trained to enroll uninsured children into Medicaid or the State Children's Health Insurance Program in an inner-city academic children's hospital ED. Analysis was carried out for outpatient ED visits by insurance status, average revenue per patient from uninsured and insured children, proportion of patients enrolled in Medicaid and State Children's Health Insurance Program through this program, estimated incremental revenue from new enrollees, and program-specific incremental costs. A cost-benefit analysis and breakeven analysis was conducted to determine the impact of this intervention on ED revenues. Five thousand ninety-four uninsured children were treated during the 10 consecutive months assessed, and 4,667 were treated during program hours. One thousand eight hundred and three applications were filed, giving a program penetration rate of 39%. Eighty-four percent of applications filed were resolved (67% of these were Medicaid). Average revenue from each outpatient ED visit for Medicaid was US135.68 dollars, other insurance was US210.43 dollars, and uninsured was US15.03 dollars. Estimated incremental revenue for each uninsured patient converted to Medicaid was US120.65 dollars. Total annualized incremental revenue was US224,474 dollars, and the net incremental revenue, after accounting for program costs, was US157,414 dollars per year. A program enrolling uninsured children at an inner-city pediatric ED into government insurance was effective and generated revenue that paid for program costs.

APSIC Guidelines for environmental cleaning and decontamination.

PubMed

Ling, Moi Lin; Apisarnthanarak, Anucha; Thu, Le Thi Anh; Villanueva, Victoria; Pandjaitan, Costy; Yusof, Mohamad Yasim

2015-01-01

This document is an executive summary of APSIC Guidelines for Environmental Cleaning and Decontamination. It describes best practices in routine cleaning and decontamination in healthcare facilities as well as in specific settings e.g. management of patients with isolation precautions, food preparation areas, construction and renovation, and following a flood. It recommends the implementation of environmental hygiene program to keep the environment safe for patients, staff and visitors visiting a healthcare facility. Objective assessment of cleanliness and quality is an essential component of this program as a method for identifying quality improvement opportunities. Recommendations for safe handling of linen and bedding; as well as occupational health and safety issues are included in the guidelines. A training program is vital to ensure consistent adherence to best practices.

Chinese IP expands with self-reliance.

PubMed

1999-05-01

In 1999, program officers from JOICFP visited five of 10 projects where JOICFP has provided direct assistance during 1993-95 to enhance health education in China's integrated family planning, maternal-child health programs. The JOICFP team and three members of the Chinese National Steering Committee of the Integrated Projects visited project areas in remote and mountainous areas that are characterized by underdevelopment, low income rates, low rates of hospital deliveries, and high rates of parasitic infection. The monitoring team found that all project areas continued the projects after completion of the 3-year period and even expanded efforts to cover other areas. By 1998, more than a million people had been served, which is quadruple the initial target number. The team found that the program could benefit from additional assistance in training new staff to interact with the public and to use IEC (information, education, communication) materials appropriately. One project area, Shaowu City, opened a new Family Health Service Center in August 1998 with a grant from the Japanese Grant Assistance for Grassroots Projects and assistance from its provincial and local government. This Center serves women and children and adolescents on a fee-charged basis and hopes to expand its service area.

CULTURAL ADAPTATIONS OF EVIDENCE-BASED HOME-VISITATION MODELS IN TRIBAL COMMUNITIES.

PubMed

Hiratsuka, Vanessa Y; Parker, Myra E; Sanchez, Jenae; Riley, Rebecca; Heath, Debra; Chomo, Julianna C; Beltangady, Moushumi; Sarche, Michelle

2018-05-01

The Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) Program provides federal grants to tribes, tribal consortia, tribal organizations, and urban Indian organizations to implement evidence-based home-visiting services for American Indian and Alaska Native (AI/AN) families. To date, only one evidence-based home-visiting program has been developed for use in AI/AN communities. The purpose of this article is to describe the steps that four Tribal MIECHV Programs took to assess community needs, select a home-visiting model, and culturally adapt the model for use in AI/AN communities. In these four unique Tribal MIECHV Program settings, each program employed a rigorous needs-assessment process and developed cultural modifications in accordance with community strengths and needs. Adaptations occurred in consultation with model developers, with consideration of the conceptual rationale for the program, while grounding new content in indigenous cultures. Research is needed to improve measurement of home-visiting outcomes in tribal and urban AI/AN settings, develop culturally grounded home-visiting interventions, and assess the effectiveness of home visiting in AI/AN communities. © 2018 Michigan Association for Infant Mental Health.

University-level nutrition training in West Africa: cost and financing issues.

PubMed

Sodjinou, Roger; Bosu, William; Fanou, Nadia; Zagre, Noel; Tchibindat, Félicité; Baker, Shawn; Delisle, Helene

2015-01-01

There is a serious shortage of skilled nutrition professionals in West Africa. Investing in nutrition training is one of the strategies for strengthening the human resource base in nutrition. However, little is known about how nutrition training in the region is financed and the levels of tuition fees charged. The purpose of this study was to provide a comprehensive assessment about the levels of tuition fees charged for nutrition training in the West Africa region and to determine to what extent this is of reach to the average student. The data for this study were obtained from 74 nutrition degree programs operating in nine West African countries in 2013 through semi-structured interviews during on-site visits or through self-administered questionnaires. They included the age of the programs, school ownership, tuition fees, financial assistance, and main sources of funding. Tuition fees (in 2013 US$) were expressed per program to enable uniformity and comparability. Simple descriptive and bivariate analyses were performed. Results from 74 nutrition training programs in nine countries showed a wide variation in tuition fees within and between countries. The tuition fees for bachelor's, master's, and doctoral programs, respectively, ranged from 372 to 4,325 (mean: 2,353); 162 to 7,678 (mean: 2,232); and 369 to 5,600 (mean: 2,208). The tuition fees were significantly higher (p<0.05) in private institutions than in public institutions (mean: US$3,079 vs. US$2,029 for bachelor's programs; US$5,118 vs. US$1,820 for master's programs; and US$3,076 vs. US$1,815 for doctoral programs). The difference in the tuition fees between Francophone and Anglophone countries was not statistically significant (mean: US$2,570 vs. US$2,216 for bachelor's programs; US$2,417 vs. US$2,147 for master's programs; US$3,285 vs. US$2,055 for doctoral programs). In most countries, the tuition fees appeared to be out of reach of the average student. Recent master's programs appeared to charge higher fees than older ones. We found a significant negative correlation between tuition fees and the age of the program, after controlling for school ownership (r=-0.33, p<0.001). Our findings underscore the urgent need for national governments in the region to establish benchmarks and regulate nutrition training costs. In a region where the average annual gross national income (GNI) per capita is barely 890$, the rising cost of tuition fees is likely to hinder access of students from poor background to nutrition training. Governments should institute financing mechanisms such as scholarships, public-private partnerships, credit facilities, and donor funding to facilitate access to tertiary-level nutrition training in the region.

A pilot study evaluating a one-session attention modification training to decrease overeating in obese children.

PubMed

Boutelle, Kerri N; Kuckertz, Jennie M; Carlson, Jordan; Amir, Nader

2014-05-01

There are a number of neurocognitive and behavioral mechanisms that contribute to overeating and obesity, including an attentional bias to food cues. Attention modification programs, which implicitly train attention away from specific cues, have been used in anxiety and substance abuse, and could logically be applied to food cues. The purpose of this study was to evaluate the initial efficacy of a single session attention modification training for food cues (AMP) on overeating in overweight and obese children. Twenty-four obese children who eat in the absence of hunger participated in two visits and were assigned to an attention modification program (AMP) or attentional control program (ACC). The AMP program trained attention away 100% of the time from food words to neutral words. The ACC program trained attention 50% of the time to neutral and 50% of the time to food. Outcome measures included the eating in the absence of hunger free access session, and measures of craving, liking and salivation. Results revealed significant treatment effects for EAH percent and EAH kcal (group by time interactions p<.05). Children in the ACC condition showed a significant increase over time in the number of calories consumed in the free access session (within group t=3.09, p=.009) as well as the percent of daily caloric needs consumed in free access (within group t=3.37, p=.006), whereas children in the AMP group demonstrated slight decreases in these variables (within group t=-0.75 and -0.63, respectively). There was a trend suggesting a beneficial effect of AMP as compared to ACC for attentional bias (group by time interaction p=.073). Changes in craving, liking and saliva were not significantly different between groups (ps=.178-.527). This is the first study to demonstrate that an AMP program can influence eating in obese children. Larger studies are needed to replicate and extend these results. Copyright © 2014. Published by Elsevier Ltd.

Training supervisors of primary health workers.

PubMed

Bennett, F J

1982-01-01

This article draws on experience gained working with an international agency that provides assistance to primary health care programs, and deals briefly with some of the issues involved in training of supervisors of primary health workers (PHWs). The job of supervising PHWs is best described by the word "support," which takes the form of technical guidance, assistance with problems and referrals, provision of supplies, continuing education, monitoring of activities, checking and analysis of records, and discussion and coordinaiton of health care management with the community. A list of the duties of a supervisor is provided, all of which are based on the ability to form a helping relationship. Training requires field work, team work, and multisectorial exposure, and probably the best way to gain some ideas of the PHWs role in the community is to participate in the training program of the PHW. Supervisors also need some knowledge and skills in community diagnosis, simple field epidemiology, and statistical determinations in addition to managerial skills and a broad outlook on community problems. In training supervisors, the emphasis should be as practical as possible, remembering that the reality for which most supervisors are needed is rural primary health care. The content of training is summarized and a list of items to monitor in supervisory visits is given. This training requires considerable thought as to content and method, as it must shape not only cognitive skills for a disciplinary-administrative role, but also communicative skills for a counseling-educational role.

Assessing the Deployment of Home Visiting: Learning from a State-Wide Survey of Home Visiting Programs.

PubMed

Fischer, Robert L; Anthony, Elizabeth R; Lalich, Nina; Nevar, Ann; Bakaki, Paul; Koroukian, Siran

2016-03-01

Large-scale planning for health and human services programming is required to inform effective public policy as well as deliver services to meet community needs. The present study demonstrates the value of collecting data directly from deliverers of home visiting programs across a state. This study was conducted in response to the Patient Protection and Affordable Care Act, which requires states to conduct a needs assessment of home visiting programs for pregnant women and young children to receive federal funding. In this paper, we provide a descriptive analysis of a needs assessment of home visiting programs in Ohio. All programs in the state that met the federal definition of home visiting were included in this study. Program staff completed a web-based survey with open- and close-ended questions covering program management, content, goals, and characteristics of the families served. Consistent with the research literature, program representatives reported great diversity with regard to program management, reach, eligibility, goals, content, and services delivered, yet consistently conveyed great need for home visiting services across the state. Results demonstrate quantitative and qualitative assessments of need have direct implications for public policy. Given the lack of consistency highlighted in Ohio, other states are encouraged to conduct a similar needs assessment to facilitate cross-program and cross-state comparisons. Data could be used to outline a capacity-building and technical assistance agenda to ensure states can effectively meet the need for home visiting in their state.

[The educational program for modern military surgeons].

PubMed

Willy, C; Gutcke, A; Klein, B; Rauhut, F; Friemert, B; Kollig, E W; Weller, N; Lieber, A

2010-02-01

Casualties in military conflict produce patterns of injuries that are not seen in routine surgical practice at home. In an era of increasing surgical sub-specialization the deployed surgeon needs to acquire and maintain a wide range of skills from a variety of surgical specialties. Improvised explosive devices (IEDs) have become the modus operandi for terrorists and in the current global security situation these tactics can be equally employed against civilian targets. Therefore, knowledge and training in the management of these injuries are relevant to both military and civilian surgeons. To create this kind of military surgeon the so-called "DUO-plus" model for the training of surgical officers (specialization general surgery plus a second specialization either in visceral surgery or orthopedics/trauma surgery) has been developed in the Joint Medical Service of the German Bundeswehr. Other relevant skills, such as emergency neurotraumatology, battlefield surgery with integrated oral and craniomaxillofacial surgery and emergency gynecology, are integrated into this concept and will be taught in courses. Log books will be kept in accordance with the training curricula. On successful completion of the program medical officers will be officially appointed as Medical Officer "Einsatzchirurg" by their commanding officers for a maximum of 5 years and it will be necessary to renew it after this period. These refresher programs will require participation in visiting physicians programs in the complementary surgical disciplines in order to retain the essential specific skills.

Computer Based Training - A Report of a NATO Study Visit to America. A.P. Report 91.

ERIC Educational Resources Information Center

Patrick, J.

This report describes some of the research projects encountered on a 1979 study visit which investigated the nature and availability of computer-based training (CBT) systems in the United States and Canada, particularly within industrial, occupational and military contexts. An overview of the trip itinerary includes the names of the organizations…

A Study of Operator and Mechanic Training Needs in the Transit Industry. Volume I, Findings and Conclusions. Final Report.

ERIC Educational Resources Information Center

Henderson, Harold L.; And Others

Surveys of 188 transit properties and on-site visits were conducted to determine training needs of operators and mechanics in the urban mass transportation industry. Volume I presents findings and conclusions of the study with reference to survey methodology, site visit interviews and observations, questionnaire results, and specific…

VOCATIONAL EDUCATION AND TRAINING IN THE SOVIET UNION, REPORT OF THE BACIE DELEGATIONS VISIT, 5-23 MAY, 1963.

ERIC Educational Resources Information Center

PERRY, PETER

A SUMMARY OF INDUSTRIAL AND COMMERCIAL TRAINING INFORMATION SECURED BY A DELEGATION OF FIVE BRITISH EDUCATORS WHO VISITED 19 VOCATIONAL TECHNICAL SCHOOLS, INDUSTRIAL ESTABLISHMENTS, INSTITUTES OF HIGHER EDUCATION, AND VARIOUS LEVELS OF MINISTRIES AND GOVERNMENT DEPARTMENTS IN MOSCOW, LENINGRAD, AND TBILISC (GEORGIA) IS PRESENTED. IN 45 YEARS, THE…

Pollution Prevention through Peer Education: A Community Health Worker and Small and Home-Based Business Initiative on the Arizona-Sonora Border

PubMed Central

Moreno Ramírez, Denise; Ramírez-Andreotta, Mónica D.; Vea, Lourdes; Estrella-Sánchez, Rocío; Wolf, Ann Marie A.; Kilungo, Aminata; Spitz, Anna H.; Betterton, Eric A.

2015-01-01

Government-led pollution prevention programs tend to focus on large businesses due to their potential to pollute larger quantities, therefore leaving a gap in programs targeting small and home-based businesses. In light of this gap, we set out to determine if a voluntary, peer education approach led by female, Hispanic community health workers (promotoras) can influence small and home-based businesses to implement pollution prevention strategies on-site. This paper describes a partnership between promotoras from a non-profit organization and researchers from a university working together to reach these businesses in a predominately Hispanic area of Tucson, Arizona. From 2008 to 2011, the promotora-led pollution prevention program reached a total of 640 small and home-based businesses. Program activities include technical trainings for promotoras and businesses, generation of culturally and language appropriate educational materials, and face-to-face peer education via multiple on-site visits. To determine the overall effectiveness of the program, surveys were used to measure best practices implemented on-site, perceptions towards pollution prevention, and overall satisfaction with the industry-specific trainings. This paper demonstrates that promotoras can promote the implementation of pollution prevention best practices by Hispanic small and home-based businesses considered “hard-to-reach” by government-led programs. PMID:26371028

Pollution Prevention through Peer Education: A Community Health Worker and Small and Home-Based Business Initiative on the Arizona-Sonora Border.

PubMed

Ramírez, Denise Moreno; Ramírez-Andreotta, Mónica D; Vea, Lourdes; Estrella-Sánchez, Rocío; Wolf, Ann Marie A; Kilungo, Aminata; Spitz, Anna H; Betterton, Eric A

2015-09-09

Government-led pollution prevention programs tend to focus on large businesses due to their potential to pollute larger quantities, therefore leaving a gap in programs targeting small and home-based businesses. In light of this gap, we set out to determine if a voluntary, peer education approach led by female, Hispanic community health workers (promotoras) can influence small and home-based businesses to implement pollution prevention strategies on-site. This paper describes a partnership between promotoras from a non-profit organization and researchers from a university working together to reach these businesses in a predominately Hispanic area of Tucson, Arizona. From 2008 to 2011, the promotora-led pollution prevention program reached a total of 640 small and home-based businesses. Program activities include technical trainings for promotoras and businesses, generation of culturally and language appropriate educational materials, and face-to-face peer education via multiple on-site visits. To determine the overall effectiveness of the program, surveys were used to measure best practices implemented on-site, perceptions towards pollution prevention, and overall satisfaction with the industry-specific trainings. This paper demonstrates that promotoras can promote the implementation of pollution prevention best practices by Hispanic small and home-based businesses considered "hard-to-reach" by government-led programs.

School personnel experiences in notifying parents about their child’s risk for suicide: lessons learned

PubMed Central

Nadeem, Erum; Santiago, Catherine DeCarlo; Kataoka, Sheryl H.; Chang, Vickie Y.; Stein, Bradley D.

2015-01-01

BACKGROUND Schools across the nation are increasingly implementing suicide prevention programs that involve training school staff and connecting students and their families to appropriate services. However, little is known about how parents are engaged in such efforts. METHODS This qualitative study examined school staff perspectives on parent involvement in the implementation of a district-wide suicide prevention program by analyzing focus group and interview data gathered on the program implementation processes. Participants included middle school teachers, administrators, and other school personnel. RESULTS Study results revealed that in the immediate wake of a crisis or concern about suicide, school staff routinely contacted parents. However, substantial barriers prevent some students from receiving needed follow-up care (eg, lack of consistent follow-up, financial strain, parental stress, availability of appropriate services). Despite these challenges, school staff identified strategies that could better support parents before, during, and after the crisis. In particular, school-based services increased the success of mental health referrals. CONCLUSIONS Our study suggests that systematic post-crisis follow-up procedures are needed to improve the likelihood that students and families receive ongoing support. In particular, school-based services and home visits, training and outreach for parents, and formal training for school mental health staff on parent engagement may be beneficial in this context. PMID:26645415

School Personnel Experiences in Notifying Parents About Their Child's Risk for Suicide: Lessons Learned.

PubMed

Nadeem, Erum; Santiago, Catherine DeCarlo; Kataoka, Sheryl H; Chang, Vickie Y; Stein, Bradley D

2016-01-01

Schools across the nation are increasingly implementing suicide prevention programs that involve training school staff and connecting students and their families to appropriate services. However, little is known about how parents are engaged in such efforts. This qualitative study examined school staff perspectives on parent involvement in the implementation of a district-wide suicide prevention program by analyzing focus group and interview data gathered on the program implementation processes. Participants included middle school teachers, administrators, and other school personnel. Study results revealed that in the immediate wake of a crisis or concern about suicide, school staff routinely contacted parents. However, substantial barriers prevent some students from receiving needed follow-up care (eg, lack of consistent follow-up, financial strain, parental stress, availability of appropriate services). Despite these challenges, school staff identified strategies that could better support parents before, during, and after the crisis. In particular, school-based services increased the success of mental health referrals. Our study suggests that systematic postcrisis follow-up procedures are needed to improve the likelihood that students and families receive ongoing support. In particular, school-based services and home visits, training and outreach for parents, and formal training for school mental health staff on parent engagement may be beneficial in this context. © 2015, American School Health Association.

Impact of the University of Colorado's Advanced Clinical Training and Service (ACTS) Program on dental students' clinical experience and cognitive skills, 1994-2006.

PubMed

Berg, Rob; Call, Richard L; Maguire, Kerry; Berkey, Douglas B; Karshmer, Bernard A; Guyton, Brad; Tawara-Jones, Karen

2010-04-01

The University of Colorado Denver School of Dental Medicine has operated a community-based dental education program for all of its students since 1985. A database of student productivity has been maintained in a standardized format, capable of multiyear compilation, since 1994. This study utilizes twelve years of these data to profile the type and amount of clinical treatment that can be provided by a typical fourth-year dental student during a 100-day community-based training experience. Between 1994 and 2006, the school's 423 graduates provided a mean of 922 treatment procedures per student at a mean of 498 patient visits per student. During a typical four-week clinical affiliation, each student provided a mean of approximately twenty-seven restorations on permanent teeth, sixteen restorations on primary teeth, and twenty-four oral surgery procedures (extractions). Students also gained considerable experience in periodontics, fixed and removable prosthodontics, and endodontics. Self-assessed competency ratings tended to increase after completing the program, as did willingness to treat underserved populations after graduation. About 16 percent of graduates reported planning to practice in the public sector after completing dental school. A community-based experience such as this appears to offer an opportunity to substantially augment dental students' clinical training experiences.

Stingless bees (Melipona scutellaris) learn to associate footprint cues at food sources with a specific reward context.

PubMed

Roselino, Ana Carolina; Rodrigues, André Vieira; Hrncir, Michael

2016-10-01

Foraging insects leave chemical footprints on flowers that subsequent foragers may use as indicators for recent flower visits and, thus, potential resource depletion. Accordingly, foragers should reject food sources presenting these chemical cues. Contrasting this assumption, experimental studies in stingless bees (Apidae, Meliponini), so far, demonstrated an attractive effect of footprints. These findings lead to doubts about the meaning of these chemical cues in natural foraging contexts. Here, we asked whether foragers of stingless bees (Melipona scutellaris) use footprints according to the previously experienced reward level of visited food sources. Bees were trained to artificial flower patches, at which the reward of a flower either decreased or, alternatively, increased after a visit by a forager. Individuals were allowed a total of nine foraging bouts to the patch, after which their preference for visited or unvisited flowers was tested. In the choice tests, bees trained under the decreasing reward context preferred unvisited flowers, whereas individuals trained under the increasing reward context preferred visited flowers. Foragers without experience chose randomly between visited and unvisited flowers. These results demonstrate that M. scutellaris learns to associate unspecific footprint cues at food sources with differential, specific reward contexts, and uses these chemical cues accordingly for their foraging decisions.

Dermatologic emergencies in a tertiary hospital: A descriptive study.

PubMed

Bancalari-Díaz, D; Gimeno-Mateos, L I; Cañueto, J; Andrés-Ramos, I; Fernández-López, E; Román-Curto, C

2016-10-01

Dermatology in-house call is uncommon in the Spanish national health system. The objective of the present study was to define the groups of dermatologic diseases and conditions most frequently seen in the emergency department and to evaluate the need for dermatology in-house call in the training of medical residents. We performed a descriptive study of all patients who attended the emergency department with a skin complaint during a 1-year period (June 2013 to May 2014) and were assessed by 9 dermatology residents. The study variables were date/day, sex, age, diagnosis, special surgical procedures, additional laboratory tests, and need for hospitalization and/or follow-up. We also evaluated patients attending their first scheduled visit to the dermatologist between January and June 2014 in order to compare the most frequent conditions in both groups. A total of 3084 patients attended the emergency room with a skin complaint (5.6% of all visits to the emergency department), and 152 different diagnoses were made. The most frequent groups of diseases were infectious diseases (23%) and eczema (15.1%). The specific conditions seen were acute urticaria (7.6%), contact dermatitis (6.1%), and drug-induced reactions (4.6%). By contrast, the most frequent conditions seen in the 1288 patients who attended a scheduled dermatology appointment were seborrheic keratosis (11.9%), melanocytic nevus (11.5%), and actinic keratosis (8%). A follow-up visit was required in 42% of patients seen in the emergency department. Fourth-year residents generated the lowest number of follow-up visits. We found that infectious diseases and eczema accounted for almost 40% of all emergency dermatology visits. Our results seem to indicate that the system of in-house call for dermatology residents is very useful for the hospital system and an essential component of the dermatology resident's training program. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

An Early Look at Families and Local Programs in the Mother and Infant Home Visiting Program Evaluation-Strong Start: Third Annual Report. OPRE Report 2016-37

ERIC Educational Resources Information Center

Lee, Helen; Crowne, Sarah; Faucetta, Kristen; Hughes, Rebecca

2016-01-01

The Mother and Infant Home Visiting Program Evaluation-Strong Start (MIHOPE-Strong Start) is the largest random assignment study to date to examine the effectiveness of home visiting services on improving birth outcomes and infant and maternal health care use for expectant mothers. The study includes local home visiting programs that use one of…

77 FR 47855 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-10

... development outcomes for at- risk children through evidence-based home visiting programs. Under this program...: Proposed Project: Maternal, Infant and Early Childhood Home Visiting Program FY 2012 Non-Competing... Maternal, Infant, and Early Childhood Home Visiting Program, ( http://frwebgate.access.gpo.gov/cgi-bin...

Work-Related Stressors Among Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Home Visitors: A Qualitative Study.

PubMed

Alitz, Paige J; Geary, Shana; Birriel, Pamela C; Sayi, Takudzwa; Ramakrishnan, Rema; Balogun, Omotola; Salloum, Alison; Marshall, Jennifer T

2018-05-31

Background The Florida Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program delivers evidence-based home visiting services to over 1400 families each year. Home visitors are integral in providing resources for families to promote healthy pregnancy, child development, family wellness, and self-sufficiency. Due to the nature of this work, home visitors experience work-related pressures and stressors that can impact staff well-being and retention. Objectives The purpose of this study was to understand primary sources of work-related stress experienced by home visitors, subsequent effects on their engagement with program participants, and to learn of coping mechanisms used to manage stress. Methods In 2015, Florida MIECHV program evaluators conducted ten focus groups with 49 home visitors during which they ranked and discussed their top sources of work-related stress. Qualitative analysis was conducted to identify emergent themes in work-related stressors and coping/supports. Results Across all sites, the burden of paperwork and data entry were the highest ranked work-related stressors perceived as interfering with home visitors' engagement with participants. The second-highest ranked stressors included caseload management, followed by a lack of resources for families, and dangerous environments. Home visitors reported gratification in their helping relationships families, and relied on coworkers or supervisors as primary sources of workplace support along with self-care (e.g. mini-vacations, recreation, and counseling). Conclusions for practice Florida MIECHV home visitors across all ten focus groups shared similar work-related stressors that they felt diminished engagement with program participants and could impact participant and staff retention. In response, Florida MIECHV increased resources to support home visitor compensation and reduce caseloads, and obtained a competitive award from HRSA to implement a mindfulness-based stress reduction training statewide.

Promoting Healthy Behaviors among Egyptian Mothers: A Quasi-Experimental Study of a Health Communication Package Delivered by Community Organizations.

PubMed

Brasington, Angela; Abdelmegeid, Ali; Dwivedi, Vikas; Kols, Adrienne; Kim, Young-Mi; Khadka, Neena; Rawlins, Barbara; Gibson, Anita

2016-01-01

Decisions made at the household level, for example, to seek antenatal care or breastfeed, can have a direct impact on the health of mothers and newborns. The SMART Community-based Initiatives program in Egypt worked with community development associations to encourage better household decision-making by training community health workers to disseminate information and encourage healthy practices during home visits, group sessions, and community activities with pregnant women, mothers of young children, and their families. A quasi-experimental design was used to evaluate the program, with household surveys conducted before and after the intervention in intervention and comparison areas. Survey questions asked about women's knowledge and behaviors related to maternal and newborn care and child nutrition and, at the endline, exposure to SMART activities. Exposure to program activities was high in intervention areas of Upper Egypt: 91% of respondents reported receiving home visits and 84% attended group sessions. In Lower Egypt, these figures were 58% and 48%, respectively. Knowledge of danger signs related to pregnancy, delivery, and newborn illness increased significantly more in intervention than comparison areas in both regions (with one exception in Lower Egypt), after controlling for child's age and woman's education; this pattern also occurred for two of five behaviors (antenatal care visits and consumption of iron-folate tablets). Findings suggest that there may have been a significant dose-response relationship between exposure to SMART activities and certain knowledge and behavioral indicators, especially in Upper Egypt. The findings demonstrate the ability of civil society organizations with minimal health programming experience to increase knowledge and promote healthy behaviors among pregnant women and new mothers. The SMART approach offers a promising strategy to fill gaps in health education and counseling and strengthen community support for behavior change.

Promoting father involvement in early home visiting services for vulnerable families: Findings from a pilot study of "Dads matter".

PubMed

Guterman, Neil B; Bellamy, Jennifer L; Banman, Aaron

2018-02-01

Despite mounting evidence on the importance of fathers in children's development, evidence-based perinatal home visitation programs have largely overlooked fathers in the design and delivery of services. This paper describes the design, development, and pilot testing of the "Dads Matter" enhancement to standard home visiting services. Dads Matter is a manualized intervention package designed to fully incorporate fathers into perinatal home visiting services. Twenty-four families were enrolled in a pilot study to assess the feasibility, acceptability, and preliminary outcomes of the intervention. Using a quasi-experimental time-lagged design, 12 families received standard home visiting services and completed baseline and four-month post-tests. Home visitor staff were then trained and supervised to implement the Dads Matter enhancement in addition to standard services. Twelve additional families were then enrolled and completed baseline and four-month post-tests. Implementation data indicated that Dads Matter was implemented as planned. Cohen's d scores on outcome measures indicate positive trends associated with Dads Matter in the quality of the mother-father relationship, perceived stress reported by both parents, fathers' involvement with the child, maltreatment indicators, and fathers' verbalizations toward the infant. Effect sizes generally ranged from moderate to large in magnitude and were larger than overall effect sizes of home visitation services alone reported in prior meta-analyses. Dads Matter appears to be a feasible, acceptable, and promising approach to improving fathers' engagement in home visiting services and promoting family and child well-being. Copyright © 2017. Published by Elsevier Ltd.

Patient access and clinical efficiency improvement in a resident hospital-based women's medicine center clinic.

PubMed

Bush, Stephen H; Lao, Michael R; Simmons, Kathy L; Goode, Jeff H; Cunningham, Steve A; Calhoun, Byron C

2007-12-01

To apply the Six Sigma tools of Change Acceleration Process and Work-Out and to improve patient access in an outpatient clinic in a hospital-based residency training program. Observational study. Comparison of productivity in an obstetrics and gynecology clinic after implementation of the Six Sigma principles, with a comparable internal medicine clinic as a control group. Productivity from January 1 through December 31, 2005, was assessed in both clinics. After applying the Six Sigma tools to obstetrics and gynecology, outputs from both clinics from January 1 through December 31, 2006, were analyzed. Wait times for new obstetrical visits decreased from 38 to 8 days. The patient time spent in the clinic dropped from 3.2 to 1.5 hours. Initial gynecologic visits increased by 87% (from 453 to 850 per year), return gynecologic visits increased by 66% (from 1392 to 2311 per year), initial obstetrical visits increased by 55% (from 520 to 808 per year), repeat obstetrical visits increased by 45% (from 2239 to 3243 per year), and the mean patient satisfaction scores increased from 5.75 to 8.54 (on a 10-point scale). The gross clinic revenue increased by 73% in the first 6 months of 2006 over that of the previous year. By contrast, internal medicine patient wait times for new patients and for revisits, patient satisfaction scores, total number of clinic visits, and revenues remained unchanged. Application of the Six Sigma principles resulted in a team approach to solving the clinic's productivity issues.

Delivery of Health Coaching by Medical Assistants in Primary Care

PubMed Central

Djuric, Zora; Segar, Michelle; Orizondo, Carissa; Mann, Jeffrey; Faison, Maya; Peddireddy, Nithin; Paletta, Matthew; Locke, Amy

2017-01-01

Background Health coaching is potentially a practical method to assist patients in achieving and maintaining healthy lifestyles. In health coaching, the coach partners with the patient, helping patients discover their own strengths, challenges, and solutions. Methods Two medical assistants were provided with brief training. The 12-week program consisted of telephone coaching with in-person visits at the beginning and end of the program. Coaching targeted improvements in diet, physical activity, and/or sleep habits using a self-care planning form. Results A total of 82 subjects enrolled in the program, 72% completed 8 weeks and 49% completed 12 weeks. Subjects who completed assessments at 12 weeks had significant weight loss despite the fact that weight loss was not a study goal. There also were improvements in diet and physical activity. Subject who completed the study were highly satisfied with the program and felt that health coaching should be available in all family medicine clinics. The main barrier providers voiced was remembering to refer patients. The medical providers indicated high satisfaction with the study and valued having coaching available for their patients. Conclusions Medical assistants can be trained to assist patients with lifestyle changes that are associated with improved health and weight control. PMID:28484068

The current medical education system in the world.

PubMed

Nara, Nobuo; Suzuki, Toshiya; Tohda, Shuji

2011-07-04

To contribute to the innovation of the medical education system in Japan, we visited 35 medical schools and 5 institutes in 12 countries of North America, Europe, Australia and Asia in 2008-2010 and observed the education system. We met the deans, medical education committee and administration affairs and discussed about the desirable education system. We also observed the facilities of medical schools.Medical education system shows marked diversity in the world. There are three types of education course; non-graduate-entry program(non-GEP), graduate-entry program(GEP) and mixed program of non-GEP and GEP. Even in the same country, several types of medical schools coexist. Although the education methods are also various among medical schools, most of the medical schools have introduced tutorial system based on PBL or TBL and simulation-based learning to create excellent medical physicians. The medical education system is variable among countries depending on the social environment. Although the change in education program may not be necessary in Japan, we have to innovate education methods; clinical training by clinical clerkship must be made more developed to foster the training of the excellent clinical physicians, and tutorial education by PBL or TBL and simulation-based learning should be introduced more actively.

Presidential address: The origins and evolution of the Mayo Clinic from 1864 to 1939: a Minnesota family practice becomes an international "medical Mecca".

PubMed

Fye, W Bruce

2010-01-01

This paper describes the origins and international impact of the Mayo Clinic through 1939. Multispecialty group practice was invented at the clinic a century ago. A visiting Canadian physician wrote in 1906, "Specialization and cooperation, with the best that can be had in each department, is here the motto. Cannot these principles be tried elsewhere?" Mayo Clinic's major (and underappreciated) role in the development of rigorous postgraduate (specialty) training is addressed. Unlike traditional academic medical centers that emphasize research, Mayo's main mission has always been patient care. This activity has been undertaken in an environment enriched by extensive programs devoted to specialty training and clinical research.

Personnel training experience in the radioactive waste management: 10 years of Moscow SIA 'RADON' international education training centre

DOE Office of Scientific and Technical Information (OSTI.GOV)

Batyukhnova, Olga; Dmitriev, Sergey; Arustamov, Artur

Available in abstract form only. Full text of publication follows: The education service for specialists dealing with radioactive waste was established in Russia (former USSR) in 1983 and was based on the capabilities of two organisations: the Moscow Scientific and Industrial Association 'Radon' (SIA 'Radon') and the Chemical Department of Lomonosov's Moscow State University. These two organizations are able to offer training programs in the science fundamentals, applied research and in practical operational areas of the all pre-disposal activities of the radioactive waste management. Since 1997 this system was upgraded to the international level and now acts as International Educationmore » Training Centre (IETC) at SIA 'Radon' under the guidance of the IAEA. During 10 years more than 300 specialists from 26 European and Asian countries enhanced their knowledge and skills in radioactive waste management. The IAEA supported specialized regional training courses and workshops, fellowships, on-the-job training, and scientific visits are additional means to assure development of personnel capabilities. Efficiency of training was carefully analysed using the structural adaptation of educational process as well as factors, which have influence on education quality. Social-psychological aspects were also taken into account in assessing the overall efficiency. The analysis of the effect of individual factors and the efficiency of education activity were carried out based on attestation results and questioning attendees. A number of analytical methods were utilised such as Ishikawa's diagram method and Pareto's principle for improving of training programs and activities. (authors)« less

"Know Your Well" A Groundwater Quality Project to Inform Students and Well-Owners

NASA Astrophysics Data System (ADS)

Olson, C.; Snow, D.; Samal, A.; Ray, C.; Kreifels, M.

2017-12-01

Over 15 million U.S. households rely on private, household wells for drinking water, and these sources are not protected under the Safe Drinking Water Act. Data on private well water quality is slowly being collected and evaluated from a number of different agencies, sources and projects. A new project is designed both for training high school students and to help assess the quality of water from rural domestic wells in Nebraska. This "crowd sourced" program engaging high school agricultural education programs, FFA chapters, and science classes with students sampling and testing water sampling from rural domestic wells from 12 districts across the state. Students and teachers from selected school were trained through multiple school visits, both in the classroom and in the field. Classroom visits were used to introduce topics such as water quality and groundwater, and testing methods for specific analytes. During the field visit, students were exposed to field techniques, the importance of accuracy in data collection, and what factors might influence the water in sampled wells. High school students learn to sample and test water independently. Leadership and initiative is developed through the program, and many experience the enlightenment that comes with citizen science. A customized mobile app was developed for ease of data entry and visualization, and data uploaded to a secure website where information was stored and compared to laboratory tests of the same measurements. General water quality parameters, including pH, electrical conductivity, major anions are tested in the field and laboratory, as well as environmental contaminants such as arsenic, uranium, pesticides, bacteria. Test kits provided to each class were used by the students to measure selected parameters, and then duplicate water samples were analyzed at a university laboratory. Five high schools are involved in the project during its first year. Nitrate, bacteria and pesticides represent major concerns for private well owners across the U.S. and preliminary results indicate that nitrate concentrations can range up to 70 mg/L, while detections of bacteria and traces of pesticide residues are consistent with other studies. This project will help both high school students and private well owner become better-informed about water quality in Nebraska.

Outcomes assessment of on-site communication skills education in a companion animal practice.

PubMed

Shaw, Jane R; Barley, Gwyn E; Broadfoot, Kirsti; Hill, Ashley E; Roter, Debra L

2016-08-15

OBJECTIVE To evaluate veterinarian-client communication and veterinarian and client satisfaction with veterinary visits before and after veterinarians underwent a 6-month communication skills training program in a practice setting. DESIGN Case-based pretest-posttest intervention study. SAMPLE 1 purposely selected companion-animal practice. PROCEDURES The practice team (3 veterinarians, 5 veterinary technicians, 1 receptionist, and 1 office manager) participated in a 6-month educational program (intervention) that included interactive communication modules, individual coaching, and a communication laboratory. For each of the veterinarians, 6 appointments were video recorded and 30 additional clients completed a visit satisfaction survey both before and after the intervention. The Roter interaction analysis system was used to analyze the video-recorded appointments. RESULTS After the intervention, appointments were 5.4 minutes longer and veterinarians asked 60% fewer closed-ended lifestyle-social questions, provided 1.4 times as much biomedically related client education, and used 1.5 and 1.25 times as much facilitative and emotional rapport communication, respectively, compared with before the intervention. Clients provided veterinarians with 1.3 times as much biomedically related information and engaged in twice as much social conversation. After the intervention, veterinarians perceived their clients as complaining less and being more personable and trusting, and clients felt more involved in the appointment and reported that the veterinarian expressed greater interest in their opinion. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the intervention resulted in veterinarians who spent more time educating and building rapport with their clients and facilitating client input in an unhurried environment, which enhanced overall veterinarian visit satisfaction and various aspects of client visit satisfaction.

Who let the dogs out? Infection control did: utility of dogs in health care settings and infection control aspects.

PubMed

DiSalvo, Heidi; Haiduven, Donna; Johnson, Nancy; Reyes, Valentine V; Hench, Carmen P; Shaw, Rosemary; Stevens, David A

2006-06-01

Research has substantiated that animals improve human health, both psychologically and physiologically. Therefore, healthcare facilities have begun to implement programs, such as the "Furry Friends Foundation," that bring animals into the facility to improve the quality of life of patients. When implementing these programs, consideration must be given to potential adverse events such as phobias, allergies, and particularly the possibility of zoonotic disease transmission. Santa Clara Valley Medical Centre (SCVMC), a 600-bed county teaching hospital with specialized units (e.g., for burns, rehabilitation, and pediatric care), has implemented programs that incorporate animals into the healthcare setting. This facility allows three categories of dogs to interact with their patients: service dogs, therapy dogs, and pet visitation dogs by the "Furry Friends Foundation." A blurring of the roles of the three categories of dogs occurred when these programs were put into place at SCVMC. The American with Disabilities Act (ADA) states that service animals cannot be prohibited from any area. For example, a "no pet allowed" policy could not apply to these animals. Proof of a person's disability or proof of the service animal's health or training cannot be required. The purpose of this project was to maintain these programs by clarifying the policies regarding animals, specifically dogs, in the healthcare setting. This had to take place to provide a safe and enjoyable environment for the patients and the staff. A comprehensive table was developed to delineate the three categories of dogs and the corresponding policies. Therapy dogs and the visitation animals are more restricted than service dogs. Both therapy dogs and visitation dogs require identification and certification of health and are excluded from certain areas of the facility, including intensive care units and isolation rooms. By complying with the current policies and regulations, the risks from these programs can be minimized. Staff should be educated on the proper terminology and procedures to prevent a blurring of the categories and roles of these animals.

Billing by residents and attending physicians in family medicine: the effects of the provider, patient, and visit factors.

PubMed

Al Achkar, Morhaf; Kengeri-Srikantiah, Seema; Yamane, Biniyam M; Villasmil, Jomil; Busha, Michael E; Gebke, Kevin B

2018-06-13

Medical billing and coding are critical components of residency programs since they determine the revenues and vitality of residencies. It has been suggested that residents are less likely to bill higher evaluation and management (E/M) codes compared with attending physicians. The purpose of this study is to assess the variation in billing patterns between residents and attending physicians, considering provider, patient, and visit characteristics. A retrospective cohort study of all established outpatient visits at a family medicine residency clinic over a 5-year period was performed. We employed the logistic regression methodology to identify residents' and attending physicians' variations in coding E/M service levels. We also employed Poisson regression to test the sensitivity of our result. Between January 5, 2009 and September 25, 2015, 98,601 visits to 116 residents and 18 attending physicians were reviewed. After adjusting for provider, patient, and visit characteristics, residents billed higher E/M codes less often compared with attending physicians for comparable visits. In comparison with attending physicians, the odds ratios for billing higher E/M codes were 0.58 (p = 0.01), 0.56 (p = 0.01), and 0.63 (p = 0.01) for the third, second, and first years of postgraduate training, respectively. In addition to the main factors of patient age, medical conditions, and number of addressed problems, the gender of the provider was also implicated in the billing variations. Residents are less likely to bill higher E/M codes than attending physicians are for similar visits. While these variations are known to contribute to lost revenues, further studies are required to explore their effect on patient care in relation to attendings' direct involvement in higher E/M-coded versus their indirect involvement in lower E/M-coded visits.

IMIA Educational Recommendations and Nursing Informatics.

PubMed

Mantas, John; Hasman, Arie

2017-01-01

The updated version of the IMIA educational recommendations has given an adequate guidelines platform for developing educational programs in Biomedical and Health Informatics at all levels of education, vocational training, and distance learning. This chapter will provide a brief introduction of the recommendations pinpointing aspects for developing and assessing educational programs. We will provide a review of the existing feedback we have acquired during the IMIA site visits of accrediting educational programs at a worldwide level and discuss implementations issues. A brief overview of existing academic programs in Europe, North America and in other regions, especially for programs related to Nursing and to Nursing Informatics is provided. Finally, we will draw conclusions as how the IMIA recommendations may be required to be fitted into the specific needs of the Nursing Informatics and the needs of the Nursing professionals when they apply the recommendations to their academic and/or hospital/professional environments.

Pelvic floor muscle training program increases muscular contractility during first pregnancy and postpartum: electromyographic study.

PubMed

Marques, Joseane; Botelho, Simone; Pereira, Larissa Carvalho; Lanza, Ana Helena; Amorim, Cesar Ferreira; Palma, Paulo; Riccetto, Cassio

2013-09-01

The aim of this study was to evaluate the effect of a training program over both pelvic floor muscles contractility and urinary symptoms in primigravid pregnant and postpartum primiparous women. A clinical, prospective and blinded trial was conducted with 33 women divided into three groups: (G1) 13 primigravid pregnant women; (G2) 10 postpartum primiparous women (49.3 ± 5.84 days), after vaginal delivery with right mediolateral episiotomy; (G3) 10 postpartum primiparous women (46.3 ± 3.6 days), after cesarean section delivery. The evaluation was carried out using digital palpation (Modified Oxford Grading Scale), pelvic floor electromyography and, for the investigation of urinary symptoms, validated questionnaires (International Consultation on Incontinence Questionnaire-short form-ICIQ-UI SF and International Consultation on Incontinence Questionnaire Overactive Bladder-ICIQ-OAB). The protocol consisted of 10 individual sessions carried out by the physiotherapist through home visits, three times a week, with 60 min duration each. The statistical analysis was performed using ANOVA and Spearman's correlation coefficient. The pelvic floor muscle contractility increased after the training program (P = 0.0001) for all groups. Decreases in the scores of both ICIQ-UI SF (P = 0.009) and ICIQ-OAB (P = 0.0003) were also observed after training. Pelvic floor muscle training is an effective means for the increase in its own contractility in both primigravid pregnant and primiparous postpartum women, accompanied with a concomitant decrease in urinary symptoms. Copyright © 2012 Wiley Periodicals, Inc.

Effectiveness of a training package for implementing a community-based occupational therapy program in dementia: a cluster randomized controlled trial.

PubMed

Döpp, Carola M E; Graff, Maud J L; Teerenstra, Steven; Olde Rikkert, Marcel G M; Nijhuis-van der Sanden, Maria W G; Vernooij-Dassen, Myrra J F J

2015-10-01

Evaluate the effectiveness of a training package to implement a community occupational therapy program for people with dementia and their caregiver (COTiD). Cluster randomized controlled trial. A total of 45 service units including 94 occupational therapists, 48 managers, 80 physicians, treating 71 client-caregiver couples. Control intervention: A postgraduate course for occupational therapists only. A training package including the usual postgraduate course, additional training days, outreach visits, regional meetings, and access to a reporting system for occupational therapists. Physicians and managers received newsletters, had access to a website, and were approached by telephone. The intended adherence of therapists to the COTiD program. This was assessed using vignettes. clients' daily functioning, caregivers' sense of competence, quality of life, and self-perceived performance of daily activities of both clients and caregivers. Between-group differences were assessed using multilevel analyses with therapist and intervention factors as covariates. No significant between-group differences between baseline and 12 months were found for adherence (1.58, 95% CI -0.10 to 3.25), nor for any client or caregiver outcome. A higher number of coaching sessions and higher self-perceived knowledge of dementia at baseline positively correlated with adherence scores. In contrast, experiencing more support from occupational therapy colleagues or having conducted more COTiD treatments at baseline negatively affected adherence scores. The training package was not effective in increasing therapist adherence and client-caregiver outcomes. This study suggests that coaching sessions and increasing therapist knowledge on dementia positively affect adherence. NCT01117285. © The Author(s) 2014.

Outpatient nursing clinic for congenital heart disease patients: Copenhagen Transition Program.

PubMed

Berg, Selina Kikkenborg; Hertz, Pernille Grarup

2007-01-01

Adolescents with congenital heart disease need support transitioning from childhood to adulthood. To become independent, adolescents need to possess knowledge about the disease and how to handle life with congenital heart disease. Outpatient nursing clinics can address issues relevant for adolescents. Creating an environment in which worries and questions can be discussed better prepares adolescents to meet the struggles of living with congenital heart disease. The Copenhagen Transition Program was established in 2004. This outpatient nursing clinic was established by (1) defining the target group, (2) conducting a literature review, (3) collaborating with interdisciplinary colleagues, (4) scheduling visits to the transition-nursing clinic, (5) arranging clinic visits, (6) charting, and (7) testing and evaluating the clinic. Adolescents with congenital heart disease are invited to a consultation with a specially trained nurse, and it is the patients themselves who decide the content of the consultation. Topics such as knowledge about the disease, endocarditis, acute situations, nutrition, contraception, alcohol/drugs, smoking, physical activity, sleep/rest, and education may be discussed. Parents are asked not to participate.

Partnered Research Experiences for Junior Faculty at Minority-Serving Institutions Enhance Professional Success

PubMed Central

Campbell, Andrew G.; Leibowitz, Michael J.; Murray, Sandra A.; Burgess, David; Denetclaw, Wilfred F.; Carrero-Martinez, Franklin A.; Asai, David J.

2013-01-01

Scientific workforce diversity is critical to ensuring the realization of our national research goals and minority-serving institutions play a vital role in preparing undergraduate students for science careers. This paper summarizes the outcomes of supporting career training and research practices by faculty from teaching-intensive, minority-serving institutions. Support of these faculty members is predicted to lead to: 1) increases in the numbers of refereed publications, 2) increases in federal grant funding, and 3) a positive impact on professional activities and curricular practices at their home institutions that support student training. The results presented show increased productivity is evident as early as 1 yr following completion of the program, with participants being more independently productive than their matched peers in key areas that serve as measures of academic success. These outcomes are consistent with the goals of the Visiting Professorship Program to enhance scientific practices impacting undergraduate student training. Furthermore, the outcomes demonstrate the benefits of training support for research activities at minority-serving institutions that can lead to increased engagement of students from diverse backgrounds. The practices and results presented demonstrate a successful generalizable approach for stimulating junior faculty development and can serve as a basis for long-term faculty career development strategies that support scientific workforce diversity. PMID:24006388

Partnered research experiences for junior faculty at minority-serving institutions enhance professional success.

PubMed

Campbell, Andrew G; Leibowitz, Michael J; Murray, Sandra A; Burgess, David; Denetclaw, Wilfred F; Carrero-Martinez, Franklin A; Asai, David J

2013-01-01

Scientific workforce diversity is critical to ensuring the realization of our national research goals and minority-serving institutions play a vital role in preparing undergraduate students for science careers. This paper summarizes the outcomes of supporting career training and research practices by faculty from teaching-intensive, minority-serving institutions. Support of these faculty members is predicted to lead to: 1) increases in the numbers of refereed publications, 2) increases in federal grant funding, and 3) a positive impact on professional activities and curricular practices at their home institutions that support student training. The results presented show increased productivity is evident as early as 1 yr following completion of the program, with participants being more independently productive than their matched peers in key areas that serve as measures of academic success. These outcomes are consistent with the goals of the Visiting Professorship Program to enhance scientific practices impacting undergraduate student training. Furthermore, the outcomes demonstrate the benefits of training support for research activities at minority-serving institutions that can lead to increased engagement of students from diverse backgrounds. The practices and results presented demonstrate a successful generalizable approach for stimulating junior faculty development and can serve as a basis for long-term faculty career development strategies that support scientific workforce diversity.

Feasibility of a clinical trial of vision therapy for treatment of amblyopia.

PubMed

Lyon, Don W; Hopkins, Kristine; Chu, Raymond H; Tamkins, Susanna M; Cotter, Susan A; Melia, B Michele; Holmes, Jonathan M; Repka, Michael X; Wheeler, David T; Sala, Nicholas A; Dumas, Janette; Silbert, David I

2013-05-01

We conducted a pilot randomized clinical trial of office-based active vision therapy for the treatment of childhood amblyopia to determine the feasibility of conducting a full-scale randomized clinical trial. A training and certification program and manual of procedures were developed to certify therapists to administer a standardized vision therapy program in ophthalmology and optometry offices consisting of weekly visits for 16 weeks. Nineteen children, aged 7 to less than 13 years, with amblyopia (20/40-20/100) were randomly assigned to receive either 2 hours of daily patching with active vision therapy or 2 hours of daily patching with placebo vision therapy. Therapists in diverse practice settings were successfully trained and certified to perform standardized vision therapy in strict adherence with protocol. Subjects completed 85% of required weekly in-office vision therapy visits. Eligibility criteria based on age, visual acuity, and stereoacuity, designed to identify children able to complete a standardized vision therapy program and judged likely to benefit from this treatment, led to a high proportion of screened subjects being judged ineligible, resulting in insufficient recruitment. There were difficulties in retrieving adherence data for the computerized home therapy procedures. This study demonstrated that a 16-week treatment trial of vision therapy was feasible with respect to maintaining protocol adherence; however, recruitment under the proposed eligibility criteria, necessitated by the standardized approach to vision therapy, was not successful. A randomized clinical trial of in-office vision therapy for the treatment of amblyopia would require broadening of the eligibility criteria and improved methods to gather objective data regarding the home therapy. A more flexible approach that customizes vision therapy based on subject age, visual acuity, and stereopsis might be required to allow enrollment of a broader group of subjects.

Feasibility of a Clinical Trial of Vision Therapy for Treatment of Amblyopia

PubMed Central

Lyon, Don W.; Hopkins, Kristine; Chu, Raymond H.; Tamkins, Susanna M.; Cotter, Susan A.; Melia, B. Michele; Holmes, Jonathan M.; Repka, Michael X.; Wheeler, David T.; Sala, Nicholas A.; Dumas, Janette; Silbert, David I.

2013-01-01

Purpose We conducted a pilot randomized clinical trial of office-based active vision therapy for the treatment of childhood amblyopia to determine the feasibility of conducting a full-scale randomized clinical trial. Methods A training and certification program and manual of procedures were developed to certify therapists to administer a standardized vision therapy program in ophthalmology and optometry offices consisting of weekly visits for 16 weeks. Nineteen children, 7 to less than 13 years of age, with amblyopia (20/40–20/100) were randomly assigned to receive either 2 hours of daily patching with active vision therapy or 2 hours of daily patching with placebo vision therapy. Results Therapists in diverse practice settings were successfully trained and certified to perform standardized vision therapy in strict adherence with protocol. Subjects completed 85% of required weekly in-office vision therapy visits. Eligibility criteria based on age, visual acuity, and stereoacuity, designed to identify children able to complete a standardized vision therapy program and judged likely to benefit from this treatment, led to a high proportion of screened subjects being judged ineligible, resulting in insufficient recruitment. There were difficulties in retrieving adherence data for the computerized home therapy procedures. Conclusions This study demonstrated that a 16-week treatment trial of vision therapy was feasible with respect to maintaining protocol adherence; however, recruitment under the proposed eligibility criteria, necessitated by the standardized approach to vision therapy, was not successful. A randomized clinical trial of in-office vision therapy for the treatment of amblyopia would require broadening of the eligibility criteria and improved methods to gather objective data regarding the home therapy. A more flexible approach that customizes vision therapy based on subject age, visual acuity, and stereopsis, might be required to allow enrollment of a broader group of subjects. PMID:23563444

Changes in smoke alarm coverage following two fire department home visiting programs: what predicts success?

PubMed

Gielen, Andrea C; Perry, Elise C; Shields, Wendy C; McDonald, Eileen; Frattaroli, Shannon; Jones, Vanya

2014-12-01

Door-to-door canvassing and installation of smoke alarms have been found to be effective at increasing the number of homes protected. This analysis reports on how smoke alarm coverage changes six months after a home visiting program in a large urban sample, and how this change varies by characteristics of the residents and characteristics of the services delivered during the home visit. Fire department Standard and Enhanced home visiting programs were compared. During the home visit, fire fighters installed lithium battery smoke alarms. Residents in the Enhanced program received tailored education about fire safety. Six months after the home visit, participating residences were visited to complete a follow-up survey and to have the installed alarms checked. 81% of the 672 homes that had a working smoke alarm on every level of the home at the end of the home visit remained safe at follow-up, and 87% of the residents found the home visit was very useful, and these rates did not differ between the Enhanced and Standard programs. The degree to which firefighters delivered their services varied, although households in which the resident's engagement with the fire department team was rated as excellent were 3.96 times as likely to be safe at follow-up compared to those with poor or fair resident engagement (p=0.03). There is a need to better understand how to maximize the time spent with residents during smoke alarm home visiting programs. This study helps with the development of methods needed for implementing and evaluating such programs in real-world settings.

Impact of training on pharmacists' counseling of patients starting antidepressant therapy.

PubMed

Liekens, Sophie; Vandael, Eline; Roter, Debra; Larson, Susan; Smits, Tim; Laekeman, Gert; Foulon, Veerle

2014-01-01

To measure the impact of a one-day depression-related training program on pharmacists' counseling of unannounced "mystery shoppers" (MS) starting antidepressant therapy. Clustered RCT pharmacies; intervention group pharmacists received communication skills training related to depression (n=21); control pharmacists did not (n=19). Eight months after training, the 40 community pharmacies were visited by MS with a first prescription for antidepressants. The pharmacy interactions were recorded and analyzed using the Roter Interaction Analysis System (RIAS). Mann-Whitney U tests were used to evaluate the impact of training on pharmacy interactions and MS evaluations of the pharmacists' skills and attitudes. Interactions of intervention group pharmacists were significantly longer and consisted of more education and counseling statements about lifestyle and psychosocial concerns. Intervention group pharmacists asked more questions about medical condition and therapeutic regimen, as well as socioemotional concerns. MS gave more socioemotional information to intervention group pharmacists and were more positive in their assessment of these pharmacists' skills and attitudes (p values<0.05). Pharmacist training in depression care can positively affect the quality of patient care. Postgraduate training in depression related services is a worthwhile approach to improve the quality of pharmaceutical care. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Student science enrichment training program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sandhu, S.S.

1994-08-01

This is a report on the Student Science Enrichment Training Program, with special emphasis on chemical and computer science fields. The residential summer session was held at the campus of Claflin College, Orangeburg, SC, for six weeks during 1993 summer, to run concomitantly with the college`s summer school. Fifty participants selected for this program, included high school sophomores, juniors and seniors. The students came from rural South Carolina and adjoining states which, presently, have limited science and computer science facilities. The program focused on high ability minority students, with high potential for science engineering and mathematical careers. The major objectivemore » was to increase the pool of well qualified college entering minority students who would elect to go into science, engineering and mathematical careers. The Division of Natural Sciences and Mathematics and engineering at Claflin College received major benefits from this program as it helped them to expand the Departments of Chemistry, Engineering, Mathematics and Computer Science as a result of additional enrollment. It also established an expanded pool of well qualified minority science and mathematics graduates, which were recruited by the federal agencies and private corporations, visiting Claflin College Campus. Department of Energy`s relationship with Claflin College increased the public awareness of energy related job opportunities in the public and private sectors.« less

Challenges and promises for nurse education curriculum development in Kosovo: results of an "accidental ethnography".

PubMed

Goepp, Julius G; Johnson, Tiesha D; Maddow, Charles L

2008-05-01

Kosovo's infrastructure was devastated by armed conflict through the 1990s; in 1999 a visiting inter-disciplinary team described healthcare services as being in "disarray". Several collaborative programs were initiated to enhance delivery of emergency medical (EM) services. Our inter-disciplinary team traveled to Kosovo in 2004 to evaluate EM physician education and training. A brief renewed outbreak of hostilities created a mass casualty incident. An "accidental ethnography" focused on nurse education was conducted by team members during and after the event. Results indicated low levels of professionalization of nurses as indicated by expressions of professional self-identity and self-esteem, autonomy, and submission to patriarchal attitudes. Undergraduate nurse education is restricted to a diploma program and one foreign training project, one graduate degree program exists abroad, and no national board examination exists. Nurses' social location is described as marginalized and disenfranchised, and retention of nurses is a persistent problem. Based on these observations we outline an inter-professional curriculum development program to foster professionalization of Kosovar nurses through a synthesis of participatory action research with elements of grounded theory and standard curriculum development methodologies. The collaborative, emancipatory, and empowering nature of PAR is described in the context of professionalizing nurse education programs.

Using MSD prevention for cultural change in mining: Queensland Government/Anglo Coal Industry partnership.

PubMed

Tilbury, Trudy; Sanderson, Liz

2012-01-01

Queensland Mining has a strong focus on safety performance, but risk management of health, including Musculoskeletal Disorders (MSDs) continues to have a lower priority. The reliance on individual screening of workers and lower level approaches such as manual handling training is part of the coal mining 'culture'. Initiatives such as the New South Wales and Queensland Mining joint project to develop good practice guidance for mining has allowed for a more consistent message on participatory ergonomics and prevention of MSD. An evidence based practice approach, including the introduction of participatory ergonomics and safe design principles, was proposed to Anglo American Coal operations in Queensland. The project consisted of a skills analysis of current health personnel, design of a facilitated participatory ergonomics training program, site visits to identify good practice and champions, and a graduated mentoring program for health personnel. Early results demonstrate a number of sites are benefiting from site taskforces with a focus on positive performance outcomes.

Farm and management variables linked to fecal shedding of Campylobacter and Salmonella in commercial squab production.

PubMed

Jeffrey, J S; Atwill, E R; Hunter, A

2001-01-01

A cross-sectional study was performed to determine the relationship of farm variables and management practices to fecal shedding of Campylobacter or Salmonella on commercial squab (young pigeon) farms. A detailed survey provided information on biosecurity, cleaning and disinfection, bird health, vector control, and loft and pen. Twenty pigeons on each of 12 farms were cultured before and after the producers completed a voluntary quality assurance training program (QAP), based on principles of hazard analysis critical control point (HACCP). The prevalence of positive samples for Salmonella and C. jejuni was 1/480 (0.21%) and 19/480 (3.96%), respectively. Campylobacter was present on one farm during both visits; three farms during the first visit, and three farms during the second visit. Analysis by fixed-effects logistic regression showed the probability of having a positive C. jejuni culture was increased by not using dry manure in the nesting material, not cleaning shipping crates, cleaning landing boards, and by increased frequency of chemical disinfection of water. Having a positive parent and higher numbers of squab per pen (density) were also associated with higher odds of being positive for C. jejuni. Factors not associated with a positive C. jejuni culture included, other avian species on the farm, type of shipping crate, covered drinkers, fly problems, bird age, level of nest box within the loft, and QAP training. Prevalence of food safety pathogens was extremely low on the squab facilities tested as compared with reports from commercial broiler or turkey flocks. This observation suggests that one or more farm variables or management practices were effectively reducing infection, or possibly a species-related difference existed in carriage rates and shedding of pathogens. These results emphasize critical control points for food safety pathogens may vary widely, and the formulation of effective QAP programs are dependent on science-based knowledge of diverse animal production systems.

Effect of intense military training on body composition.

PubMed

Malavolti, Marcella; Battistini, Nino C; Dugoni, Manfredo; Bagni, Bruno; Bagni, Ilaria; Pietrobelli, Angelo

2008-03-01

Individuals in a structural physical training program can show beneficial changes in body composition, such as body fat reduction and muscle mass increase. This study measured body composition changes by using 3 different techniques-skinfold thickness (SF) measurements, air displacement plethysmography (BOD-POD), and dual-energy x-ray absorptiometry (DXA)-during 9 months of intense training in healthy young men engaged in military training. Twenty-seven young men were recruited from a special faction of the Italian Navy. The program previewed three phases: ground combat, sea combat, and amphibious combat. Body composition was estimated at the beginning, in the middle, and at the end of the training. After the subjects performed the ground combat phase, body composition variables significantly decreased: body weight (P < 0.05), fat-free mass (FFM) (P < 0.001), and fat mass (FM) (P < 0.03). During the amphibious combat phase, body weight increased significantly (P < 0.01), mainly because of an increase in FFM (P < 0.001) and a smaller mean decrease in FM. There was a significant difference (P < 0.05) in circumferences and SF at various sites after starting the training course. Bland-Altman analysis did not show any systematic difference between FM and FFM measured with the 3 different techniques on any occasion. On any visit, FFM and FM correlation measured by BOD-POD (P = 0.90) and DXA was significantly greater than measured by SF. A significant difference was found in body mass index (BMI) measured during the study. BOD-POD and SF, compared with DXA, provide valid and reliable measurement of changes in body composition in healthy young men engaged in military training. In conclusion, the findings suggest that for young men of normal weight, changes in body weight alone and in BMI are not a good measure to assess the effectiveness of intense physical training programs, because lean mass gain can masquerade fat weight loss.

Sustainable Development of Pathology in Sub-Saharan Africa: An Example From Ghana.

PubMed

Stalsberg, Helge; Adjei, Ernest Kwasi; Owusu-Afriyie, Osei; Isaksen, Vidar

2017-11-01

- Pathology services are poorly developed in Sub-Saharan Africa. Komfo Anokye Teaching Hospital in Kumasi, Ghana, asked for help from the pathology department of the University Hospital of North Norway, Tromsø. - To reestablish surgical pathology and cytology in an African pathology department in which these functions had ceased completely, and to develop the department into a self-supporting unit of good international standard and with the capacity to train new pathologists. - Medical technologists from Kumasi were trained in histotechnology in Norway, they were returned to Kumasi, and they produced histologic slides that were temporarily sent to Norway for diagnosis. Two Ghanaian doctors received pathology training for 4 years in Norway. Mutual visits by pathologists and technologists from the 2 hospitals were arranged for the introduction of immunohistochemistry and cytology. Pathologists from Norway visited Kumasi for 1 month each year during 2007-2010. Microscopes and immunohistochemistry equipment were provided from Norway. Other laboratory equipment and a new building were provided by the Ghanaian hospital. - The Ghanaian hospital had a surgical pathology service from the first project year. At 11 years after the start of the project, the services included autopsy, surgical pathology, cytopathology, frozen sections, and limited use of immunohistochemistry, and the department had 10 residents at different levels of training. - A Ghanaian pathology department that performed autopsies only was developed into a self-supported department with surgical pathology, cytology, immunohistochemistry, and frozen section service, with an active residency program and the capacity for further development that is independent from assistance abroad.

Visiting Mom: A pilot evaluation of a prison-based visiting program serving incarcerated mothers and their minor children.

PubMed

Schubert, Erin C; Duininck, Megan; Shlafer, Rebecca J

2016-01-01

We describe an evaluation of a prison visiting program, Extended Visiting (EV), for incarcerated mothers and their children. Mothers ( N = 24) and caregivers ( N = 19) were interviewed regarding experiences with the program. Mothers identified benefits including maintaining a relationship with children, physical contact, motivation, privacy, peer support, and personal growth. Caregivers echoed mothers' appreciation for the opportunity to maintain mother-child relationships and physical contact. Mothers identified barriers including desire for overnight visits and more age-appropriate activities. Caregivers perceived travel time and costs and children's adverse reactions as barriers. When comparing EV to typical visiting, participants unanimously preferred EV.

Innovative asthma health promotion by rural community pharmacists: a feasibility study.

PubMed

Kritikos, Vicky; Saini, Bandana; Bosnic-Anticevich, Sinthia Z; Krass, Ines; Shah, Smita; Taylor, Susan; Armour, Carol

2005-04-01

Asthma awareness in a rural community and the involvement of the community pharmacist in proactive health promotion. Between September 2002 and May 2003, seven community pharmacists from Orange, a rural town in New South Wales, were trained to provide two asthma outreach programs: one targeting adolescents in high schools (Year 11 students) using Triple A training; and a public forum on asthma for the wider community. There was a significant increase in the mean asthma knowledge scores of Year 11 students in each high school after Triple A training. From the multivariate analysis, although there was a significant increase in mean asthma knowledge scores over time (F=101.09, df=1, p<0.001), there were no differences between high schools (F=2.79, df=2, p>0.05). There was a significant increase in the proportion of asthma-related pharmacy visits involving requests for information on asthma and on asthma devices at the four different time points. The study provided a unique opportunity for community pharmacists to increase asthma awareness in a rural setting. The study demonstrated that it is feasible for rural community pharmacists to become involved in proactive health promotion and effectively provide asthma outreach programs.

What do health coaches do? Direct observation of health coach activities during medical and patient-health coach visits at 3 federally qualified health centers.

PubMed

Johnson, Christopher; Saba, George; Wolf, Jessica; Gardner, Heather; Thom, David H

2018-05-01

To examine activities of health coaches during patient medical visits and when meeting one-on-one with patients at 3 urban federally qualified health centers. Encounters were videotaped and transcribed. Data was analyzed using a matrix analysis approach that allowed a priori identification of expected categories of activity, based on the health coach training model and previously developed conceptual framework, which were modified based on activities observed. A total of 10 medical visits (patient, clinician and health coach), and 8 patient-coach visits were recorded. We identified 9 categories common to both medical and patient-coach visits and 2 categories unique to the medical visit. While observed activities were generally consistent with expected categories, some activities were observed infrequently or not at all. We also observed additional activity categories, including information gathering and personal conversation. The average amount of time spent on some categories of coaching activities differed substantially between medical visits and patient-coach visits. Health coaching activities observed differed in several respects to those expected, and differed between medical visits and coaching only visits. These results provide insights into health coaching behaviors that can be used to inform training and improve utilization of health coaches in practice. Copyright © 2017 Elsevier B.V. All rights reserved.

Development, implementation, and evaluation of a community pharmacy-based asthma care model.

PubMed

Saini, Bandana; Krass, Ines; Armour, Carol

2004-11-01

Pharmacists are uniquely placed in the healthcare system to address critical issues in asthma management in the community. Various programs have shown the benefits of a pharmacist-led asthma care program; however, no such programs have previously been evaluated in Australia. To measure the impact of a specialized asthma service provided through community pharmacies in terms of objective patient clinical, humanistic, and economic outcomes. A parallel controlled design, where 52 intervention patients and 50 control patients with asthma were recruited in 2 distinct locations, was used. In the intervention area, pharmacists were trained and delivered an asthma care model, with 3 follow-up visits over 6 months. This model was evaluated based on clinical, humanistic, and economic outcomes compared between and within groups. There was a significant reduction in asthma severity in the intervention group, 2.6 +/- 0.5 to 1.6 +/- 0.7 (mean +/- SD; p < 0.001) versus the control group, 2.3 +/- 0.7 to 2.4 +/- 0.5. In the intervention group, peak flow indices improved from 82.7% +/- 8.2% at baseline to 87.4% +/- 8.9% (p < 0.001) at the final visit, and there was a significant reduction in the defined daily dose of albuterol used by patients, from 374.8 +/- 314.8 microg at baseline to 198.4 +/- 196.9 microg at the final visit (p < 0.015). There was also a statistically significant improvement in perceived control of asthma and asthma-related knowledge scores in the intervention group compared with the control group between baseline and the final visit. Annual savings of $132.84(AU) in medication costs per patient and $100,801.20 for the whole group, based on overall severity reduction, were demonstrated. Based on the results of this study, it appears that a specialized asthma care model offers community pharmacists an opportunity to contribute toward improving asthma management in the Australian community.

Case Study of Home-School Visits

ERIC Educational Resources Information Center

Aguerrebere, Yolanda

2009-01-01

This case study evaluated one site of a California teacher home visit program. Home visits have been an important means of connecting families and schooling. In 1999, California inaugurated a statewide home visit program to promote effective partnership between home and school for low-achieving schools. At this site, families in 3 kindergarten…

Effects of Pet and/or People Visits on Nursing Home.

ERIC Educational Resources Information Center

Hendy, Helen M.

1987-01-01

Compared effects of different visiting programs (people, people and pets, pets, no visit) on behaviors of nursing home residents. Found all three visiting programs increased behaviors of smiling and alertness in comparison to control conditions. Close proximity to person-alone visitor was associated with greatest number of positive resident…

77 FR 47856 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-10

... and development outcomes for at risk children through evidence-based home visiting programs. Under...: Proposed Project: Maternal, Infant and Early Childhood Home Visiting Program FY 2012 Competitive Grant Non... the Maternal, Infant, and Early Childhood Home Visiting Program, ( http://frwebgate.access.gpo.gov/cgi...

78 FR 53150 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

... and Services Administration Advisory Committee on the Maternal, Infant and Early Childhood Home... Maternal, Infant and Early Childhood Home Visiting Program Evaluation (MIECHVE). Authority: Section 10(a)(2... meeting: Name: Advisory Committee on the Maternal, Infant, and Early Childhood Home Visiting Program...

Assessing Quality in Home Visiting Programs

ERIC Educational Resources Information Center

Korfmacher, Jon; Laszewski, Audrey; Sparr, Mariel; Hammel, Jennifer

2013-01-01

Defining quality and designing a quality assessment measure for home visitation programs is a complex and multifaceted undertaking. This article summarizes the process used to create the Home Visitation Program Quality Rating Tool (HVPQRT) and identifies next steps for its development. The HVPQRT measures both structural and dynamic features of…

The Collins Center Update. Volume 1, Issue 3, December 1999

DTIC Science & Technology

1999-12-01

CDN), devel oped and executed the FORO DE ESTRATEGIA NACIONAL 2005 Hon­ du ras en el Siglo XXI (FEN 2005) {Na tional Strategy Forum 2005 Hon du­ ras...tools and processes used to make strate gic leaders. Im­ pressed with this program, Gover nor Pat ton requested a return visit with his en tire...wide command post and field train ing exer cise which tests and vali­ dates nuclear command and control, and exe cu tion proce dures. It is based on a

KSC-2012-3032a

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – At the NASA Railroad Yard at NASA’s Kennedy Space Center in Florida, preparations are under way for the departure of a train made up of tank cars. The train will pass by Kennedy’s 525-foot-tall Vehicle Assembly Building in the background. The train is headed for the Florida East Coast Railway interchange in Titusville, Fla., where the train’s helium tank cars, a liquid oxygen tank car, and a liquid hydrogen dewar or tank car will be transferred for delivery to the SpaceX engine test complex outside McGregor, Texas. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

Short- and Long-Term Outcomes of Student Field Research Experiences in Special Populations.

PubMed

Soliman, Amr S; Chamberlain, Robert M

2016-06-01

Global health education and training of biomedical students in international and minority health research is expending through U.S. academic institutions. This study addresses the short- and long-term outcomes of an NCI-funded R25 short-term summer field research training program. This program is designed for MPH and Ph.D. students in cancer epidemiology and related disciplines, in international and minority settings (special populations) in a recent 7-year period. Positive short-term outcome of 73 students was measured as publishing a manuscript from the field research data and having a job in special populations. Positive long-term outcome was measured as having a post-doc position, being in a doctoral program, and/or employment in special populations at least 3 years from finishing the program. Significant factors associated with both short- and long-term success included resourcefulness of the student and compatibility of personalities and interests between the student and the on-campus and off-campus mentors. Short-term-success of students who conducted international filed research was associated with visits of the on-campus mentor to the field site. Short-term success was also associated with extent of mentorship in the field site and with long-term success. Future studies should investigate how field research sites could enhance careers of students, appropriateness of the sites for specific training competencies, and how to maximize the learning experience of students in international and minority research sites.

Can typical US home visits affect infant attachment? Preliminary findings from a randomized trial of Healthy Families Durham.

PubMed

Berlin, Lisa J; Martoccio, Tiffany L; Appleyard Carmody, Karen; Goodman, W Benjamin; O'Donnell, Karen; Williams, Janis; Murphy, Robert A; Dodge, Kenneth A

2017-12-01

US government-funded early home visiting services are expanding significantly. The most widely implemented home visiting models target at-risk new mothers and their infants. Such home visiting programs typically aim to support infant-parent relationships; yet, such programs' effects on infant attachment quality per se are as yet untested. Given these programs' aims, and the crucial role of early attachments in human development, it is important to understand attachment processes in home visited families. The current, preliminary study examined 94 high-risk mother-infant dyads participating in a randomized evaluation of the Healthy Families Durham (HFD) home visiting program. We tested (a) infant attachment security and disorganization as predictors of toddler behavior problems and (b) program effects on attachment security and disorganization. We found that (a) infant attachment disorganization (but not security) predicted toddler behavior problems and (b) participation in HFD did not significantly affect infant attachment security or disorganization. Findings are discussed in terms of the potential for attachment-specific interventions to enhance the typical array of home visiting services.

Promoting Sustained Breastfeeding of Infants at Risk for Asthma: Explaining the “Active Ingredients” of an Effective Program Using Intervention Mapping

PubMed Central

Mesters, Ilse; Gijsbers, Barbara; Bartholomew, L. Kay

2018-01-01

Infants whose parents and/or siblings have a history of asthma or allergy may profit from receiving exclusive breastfeeding during the first 6 months of life. This is expected to diminish the chance of developing childhood asthma and/or atopic disease. Ongoing breastfeeding for 6 months seems challenging for many women. An educational program was developed using Intervention Mapping as a logic model to guide development and was found successful in improving breastfeeding rates at 6 months postpartum, improving knowledge and beliefs about breastfeeding for 6 months, after exposure to the program compared to controls. Intervention elements included an evidence- and theory-based booklet addressed during pre- and postnatal home visits by trained assistants. This paper elucidates the inner workings of the program by systematically describing and illustrating the steps for intervention development. PMID:29616209

Promoting Sustained Breastfeeding of Infants at Risk for Asthma: Explaining the "Active Ingredients" of an Effective Program Using Intervention Mapping.

PubMed

Mesters, Ilse; Gijsbers, Barbara; Bartholomew, L Kay

2018-01-01

Infants whose parents and/or siblings have a history of asthma or allergy may profit from receiving exclusive breastfeeding during the first 6 months of life. This is expected to diminish the chance of developing childhood asthma and/or atopic disease. Ongoing breastfeeding for 6 months seems challenging for many women. An educational program was developed using Intervention Mapping as a logic model to guide development and was found successful in improving breastfeeding rates at 6 months postpartum, improving knowledge and beliefs about breastfeeding for 6 months, after exposure to the program compared to controls. Intervention elements included an evidence- and theory-based booklet addressed during pre- and postnatal home visits by trained assistants. This paper elucidates the inner workings of the program by systematically describing and illustrating the steps for intervention development.

Connecting Socially Isolated Older Rural Adults with Older Volunteers through Expressive Arts.

PubMed

MacLeod, Ann; Skinner, Mark W; Wilkinson, Fay; Reid, Heather

2016-03-01

Employing a participatory arts-based research approach, we examined an innovative program from rural Ontario, Canada, designed to address social isolation among older people. Older socially isolated adults were matched to trained volunteers, where in dyads, the eight pairs created expressive art in their home setting over the course of 10 home visits. With thematic and narrative inquiry, we analysed the experiences and perceptions of the program leader, older participants, and older volunteers via their artistic creations, weekly logs, evaluations, and field notes. The findings reveal a successful intervention that positively influenced the well-being of older adult participants and older volunteers, especially in regards to relationships, personal development, and creating meaning as well as extending the intervention's impact beyond the program's duration. We also discuss opportunities for similar programs to inform policy and enable positive community-based health and social service responses to rural social isolation.

Interventions to Increase Male Attendance and Testing for Sexually Transmitted Infections at Publicly-Funded Family Planning Clinics.

PubMed

Fine, David; Warner, Lee; Salomon, Sarah; Johnson, David M

2017-07-01

We assessed the impact of staff, clinic, and community interventions on male and female family planning client visit volume and sexually transmitted infection testing at a multisite community-based health care agency. Staff training, clinic environmental changes, in-reach/outreach, and efficiency assessments were implemented in two Family Health Center (San Diego, CA) family planning clinics during 2010-2012; five Family Health Center family planning programs were identified as comparison clinics. Client visit records were compared between preintervention (2007-2009) and postintervention (2010-2012) for both sets of clinics. Of 7,826 male client visits during the time before intervention, most were for clients who were aged <30 years (50%), Hispanic (64%), and uninsured (81%). From preintervention to postintervention, intervention clinics significantly increased the number of male visits (4,004 to 8,385; Δ = +109%); for comparison clinics, male visits increased modestly (3,822 to 4,500; Δ = +18%). The proportion of male clinic visits where chlamydia testing was performed increased in intervention clinics (35% to 42%; p < .001) but decreased in comparison clinics (37% to 33%; p < .001). Subgroup analyses conducted among adolescent and young adult males yielded similar findings for male client volume and chlamydia testing. The number of female visits declined nearly 40% in both comparison (21,800 to 13,202; -39%) and intervention clinics (30,830 to 19,971; -35%) between preintervention and postintervention periods. Multilevel interventions designed to increase male client volume and sexually transmitted infection testing services in family planning clinics succeeded without affecting female client volume or services. Copyright © 2017 Society for Adolescent Health and Medicine. All rights reserved.

Effects of a Home-Based and Volunteer-Administered Physical Training, Nutritional, and Social Support Program on Malnutrition and Frailty in Older Persons: A Randomized Controlled Trial.

PubMed

Luger, Eva; Dorner, Thomas Ernst; Haider, Sandra; Kapan, Ali; Lackinger, Christian; Schindler, Karin

2016-07-01

The aim of this study was to examine the effects of a home-based and volunteer-administered physical training and nutritional intervention program compared with social support intervention on nutritional and frailty status in prefrail and frail community-dwelling older persons. This was a randomized controlled trial in which community-dwelling persons (mean age = 83 years) were recruited and randomly assigned to the physical training and nutritional intervention group (PTN, n = 39) and the social support group (SoSu, n = 41). The study was conducted by trained lay nonprofessionals. The community-dwelling older persons in both groups were visited twice a week by trained nonprofessional volunteers (buddies) in Vienna, Austria. Eighty prefrail and frail adults aged 65 years or older. In the PTN group, both the buddies and older persons performed 6 strength exercises within a circuit training session and discussed nutrition-related aspects. The active control group (SoSu) had the opportunity to perform cognitive training in addition to the social contact. Outcome measures as nutritional (Mini Nutritional Assessment long form [MNA-LF]) and frailty status (Frailty Instrument for Primary Care of the Survey of Health, Ageing and Retirement in Europe [SHARE-FI]) were obtained at baseline and after 12 weeks. Significant improvements in the MNA-LF score (1.54 points, 95% confidence interval [CI] 0.51-2.56; P = .004) and the SHARE-FI score (-0.71 discrete factor score values, 95% CI -1.07, -0.35; P < .001) were observed in the PTN group after 12 weeks. In both groups, the prevalence of impaired nutritional status and frailty decreased significantly over time. The prevalence of impaired nutritional status decreased by 25% in the PTN group and by 23% in the SoSu group. Moreover, the prevalence of frailty decreased by 17% in the PTN group and by 16% in the SoSu group. The presence of impaired nutritional status at baseline was independently associated with greater changes in the nutritional (adjusted odds ratio [OR] 3.18, 95% CI 1.26-7.98; P = .014) and frailty status (adjusted OR 3.16, 95% CI 1.01-9.93; P = .049) after 12 weeks. The results indicate that a home-based physical training, nutritional, and social support intervention conducted by nonprofessionals is feasible and can help to tackle malnutrition and frailty in older persons living at home. Furthermore, social support alone also can result in improvement. In particular, older adults with impaired nutritional status at baseline can benefit more from the intervention. Such a home visit program might also have the potential to prevent future health risks and could allay isolation and loneliness. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Visiting Mom: A pilot evaluation of a prison-based visiting program serving incarcerated mothers and their minor children

PubMed Central

Schubert, Erin C.; Duininck, Megan; Shlafer, Rebecca J.

2016-01-01

We describe an evaluation of a prison visiting program, Extended Visiting (EV), for incarcerated mothers and their children. Mothers (N = 24) and caregivers (N = 19) were interviewed regarding experiences with the program. Mothers identified benefits including maintaining a relationship with children, physical contact, motivation, privacy, peer support, and personal growth. Caregivers echoed mothers’ appreciation for the opportunity to maintain mother-child relationships and physical contact. Mothers identified barriers including desire for overnight visits and more age-appropriate activities. Caregivers perceived travel time and costs and children’s adverse reactions as barriers. When comparing EV to typical visiting, participants unanimously preferred EV. PMID:27867281

Characteristics of workplace violence prevention training and violent events among home health and hospice care providers.

PubMed

Vladutiu, Catherine J; Casteel, Carri; Nocera, Maryalice; Harrison, Robert; Peek-Asa, Corinne

2016-01-01

In the rapidly growing home health and hospice industry, little is known about workplace violence prevention (WVP) training and violent events. We examined the characteristics of WVP training and estimated violent event rates among 191 home health and hospice care providers from six agencies in California. Training characteristics were identified from the Occupational Safety and Health Administration guidelines. Rates were estimated as the number of violent events divided by the total number of home visit hours. Between 2008 and 2009, 66.5% (n = 127) of providers reported receiving WVP training when newly hired or as recurrent training. On average, providers rated the quality of their training as 5.7 (1 = poor to 10 = excellent). Among all providers, there was an overall rate of 17.1 violent events per 1,000 visit-hours. Efforts to increase the number of home health care workers who receive WVP training and to improve training quality are needed. © 2015 Wiley Periodicals, Inc.

Design and Implementation of a postgraduate curriculum to support Ethiopia's first emergency medicine residency training program: the Toronto Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM).

PubMed

Meshkat, Nazanin; Teklu, Sisay; Hunchak, Cheryl

2018-04-06

To design and implement an emergency medicine (EM) postgraduate training curriculum to support the establishment of the first EM residency program at Addis Ababa University (AAU). In response to the Ethiopian Federal Ministry of Health mandate to develop EM services in Ethiopia, University of Toronto EM faculty were invited to develop and deliver EM content and expertise for the first EM postgraduate residency training program at AAU. The Toronto Addis Ababa Academic Collaboration-EM (TAAAC-EM) used five steps of a six-step approach to guide curriculum development and implementation: 1. Problem identification and general needs assessment, 2. Targeted needs assessment using indirect methods (interviews and site visits of the learners and learning environment), 3. Defining goals and objectives, 4. Choosing educational strategies and curriculum map development and 5. The needs assessment identified a learning environment with appropriate, though limited, resources for the implementation of an EM residency program. A lack of educational activities geared towards EM practice was identified, specifically of active learning techniques (ALTs) such as bedside teaching, simulation and procedural teaching. A curriculum map was devised to supplement the AAU EM residency program curriculum. The TAAAC-EM curriculum was divided into three distinct streams: clinical, clinical epidemiology and EM administration. The clinical sessions were divided into didactic and ALTs including practical/procedural and simulation sessions, and bedside teaching was given a strong emphasis. Implementation is currently in its seventh year, with continuous monitoring and revisions of the curriculum to meet evolving needs. We have outlined the design and implementation of the TAAAC-EM curriculum; an evaluation of this curriculum is currently underway. As EM spreads as a specialty throughout Africa and other resource-limited regions, this model can serve as a working guide for similar bi-institutional educational partnerships seeking to develop novel EM postgraduate training programs.

Feasibility of a combined aerobic and strength training program and its effects on cognitive and physical function in institutionalized dementia patients. A pilot study.

PubMed

Bossers, Willem J R; Scherder, Erik J A; Boersma, Froukje; Hortobágyi, Tibor; van der Woude, Lucas H V; van Heuvelen, Marieke J G

2014-01-01

We examined the feasibility of a combined aerobic and strength training program in institutionalized dementia patients and studied the effects on cognitive and physical function. Thirty-three patients with dementia, recruited from one nursing home, participated in this non-randomized pilot study (25 women; age = 85.2±4.9 years; Mini Mental State Examination = 16.8±4.0). In phase 1 of the study, seventeen patients in the Exercise group (EG) received a combined aerobic and strength training program for six weeks, five times per week, 30 minutes per session, in an individually supervised format and successfully concluded the pre and posttests. In phase 2 of the study, sixteen patients in the Social group (SG) received social visits at the same frequency, duration, and format and successfully concluded the pre and posttests. Indices of feasibility showed that the recruitment and adherence rate, respectively were 46.2% and 86.3%. All EG patients completed the exercise program according to protocol without adverse events. After the six-week program, no significant differences on cognitive function tests were found between the EG and SG. There was a moderate effect size in favor for the EG for the Visual Memory Span Forward; a visual attention test. There were significant differences between groups in favor for the EG with moderate to large effects for the physical tests Walking Speed (p = .003), Six-Minute Walk Test (p = .031), and isometric quadriceps strength (p = .012). The present pilot study showed that it is feasible to conduct a combined aerobic and strength training program in institutionalized patients with dementia. The selective cognitive visual attention improvements and more robust changes in motor function in favor of EG vs. SG could serve as a basis for large randomized clinical trials. trialregister.nl 1230.

Alumni survey of Masters of Public Health (MPH) training at the Hanoi School of Public Health

PubMed Central

Le, Linh Cu; Bui, Quyen Tu; Nguyen, Ha Thanh; Rotem, Arie

2007-01-01

Background 1) To elicit the opinions of the Public Health alumni of the MPH program; 2) To assess the applicability of the knowledge and skills acquired; 3) To identify the frequency of the public health competencies that the alumni performed. Methods We requested 187 graduates to complete a self-administered questionnaire and conducted in-depth interviews with 8 alumni as well as a focus group discussion with 14 alumni. Results In total 79.1% (148) of the MPH graduates completed and returned the questionnaire. Most alumni (91%) agreed that the MPH curriculum corresponded with the working requirements of public health professionals; and nearly all were satisfied with what they have learnt (96%). Most respondents said that the MPH program enabled them to develop relevant professional skills (95%) and that they were satisfied with the curriculum (90%). Notably fewer respondents (73%) felt that the MPH program structure was balanced and well designed. Most alumni (64.3%) were satisfied with Hanoi School of Public Health (HSPH) full-time lecturers; but even more (83%) were satisfied with visiting lecturers. The most commonly selected of the 34 pre-identified public health competencies were: applying computer skills (66.4%), planning and managing health programs (47.9%), communicating with the community and/or mobilizing the community to participate in health care (43.2%). Overall, the MPH alumni felt that HSPH emphasized research methods at the expense of some management and operational competencies. The most important challenges at work identified by the alumni were insufficient skills in: data analysis, decision making, inter-sectoral cooperation development, English language and training. Conclusion The training program should be reviewed and revised to meet the needs of its graduates who enter diverse situations and positions. English language skills were identified as top priority for further emphasis. The training program should comply with a more advanced accreditation system and standards. PMID:17949491

76 FR 12978 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-09

... Administration for Children and Families Advisory Committee on the Maternal, Infant and Early Childhood Home...: Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation. Date and... and Early Childhood Home Visiting Program Evaluation will meet for its first session on Wednesday...

Theory! The Missing Link in Understanding the Performance of Neonate/Infant Home-Visiting Programs to Prevent Child Maltreatment: A Systematic Review

PubMed Central

Segal, Leonie; Sara Opie, Rachelle; Dalziel, Kim

2012-01-01

Context Home-visiting programs have been offered for more than sixty years to at-risk families of newborns and infants. But despite decades of experience with program delivery, more than sixty published controlled trials, and more than thirty published literature reviews, there is still uncertainty surrounding the performance of these programs. Our particular interest was the performance of home visiting in reducing child maltreatment. Methods We developed a program logic framework to assist in understanding the neonate/infant home-visiting literature, identified through a systematic literature review. We tested whether success could be explained by the logic model using descriptive synthesis and statistical analysis. Findings Having a stated objective of reducing child maltreatment—a theory or mechanism of change underpinning the home-visiting program consistent with the target population and their needs and program components that can deliver against the nominated theory of change—considerably increased the chance of success. We found that only seven of fifty-three programs demonstrated such consistency, all of which had a statistically significant positive outcome, whereas of the fifteen that had no match, none was successful. Programs with a partial match had an intermediate success rate. The relationship between program success and full, partial or no match was statistically significant. Conclusions Employing a theory-driven approach provides a new way of understanding the disparate performance of neonate/infant home-visiting programs. Employing a similar theory-driven approach could also prove useful in the review of other programs that embody a diverse set of characteristics and may apply to diverse populations and settings. A program logic framework provides a rigorous approach to deriving policy-relevant meaning from effectiveness evidence of complex programs. For neonate/infant home-visiting programs, it means that in developing these programs, attention to consistency of objectives, theory of change, target population, and program components is critical. PMID:22428693

Theory! The missing link in understanding the performance of neonate/infant home-visiting programs to prevent child maltreatment: a systematic review.

PubMed

Segal, Leonie; Sara Opie, Rachelle; Dalziel, Kim

2012-03-01

Home-visiting programs have been offered for more than sixty years to at-risk families of newborns and infants. But despite decades of experience with program delivery, more than sixty published controlled trials, and more than thirty published literature reviews, there is still uncertainty surrounding the performance of these programs. Our particular interest was the performance of home visiting in reducing child maltreatment. We developed a program logic framework to assist in understanding the neonate/infant home-visiting literature, identified through a systematic literature review. We tested whether success could be explained by the logic model using descriptive synthesis and statistical analysis. Having a stated objective of reducing child maltreatment-a theory or mechanism of change underpinning the home-visiting program consistent with the target population and their needs and program components that can deliver against the nominated theory of change-considerably increased the chance of success. We found that only seven of fifty-three programs demonstrated such consistency, all of which had a statistically significant positive outcome, whereas of the fifteen that had no match, none was successful. Programs with a partial match had an intermediate success rate. The relationship between program success and full, partial or no match was statistically significant. Employing a theory-driven approach provides a new way of understanding the disparate performance of neonate/infant home-visiting programs. Employing a similar theory-driven approach could also prove useful in the review of other programs that embody a diverse set of characteristics and may apply to diverse populations and settings. A program logic framework provides a rigorous approach to deriving policy-relevant meaning from effectiveness evidence of complex programs. For neonate/infant home-visiting programs, it means that in developing these programs, attention to consistency of objectives, theory of change, target population, and program components is critical. © 2012 Milbank Memorial Fund.

Evaluation of patient compliance, quality of life impact and cost-effectiveness of a "test in-train out" exercise-based rehabilitation program for patients with intermittent claudication.

PubMed

Malagoni, Anna Maria; Vagnoni, Emidia; Felisatti, Michele; Mandini, Simona; Heidari, Mahdi; Mascoli, Francesco; Basaglia, Nino; Manfredini, Roberto; Zamboni, Paolo; Manfredini, Fabio

2011-01-01

Patients with intermittent claudication (IC) could benefit from low-cost, effective rehabilitative programs. This retrospective study evaluates compliance, impact on Quality of Life (QoL) and cost-effectiveness of a hospital prescribed, at-home performed (Test-in/Train-out) rehabilitative program for patients with IC. Two-hundred and eighty-nine patients with IC (71 ± 10.1 years, M = 210) were enrolled for a 2-year period. Two daily 10-min home walking sessions at maximal asymptomatic speed were prescribed, with serial check-ups at the hospital. Compliance with the program was assessed by assigning a score of 1 (lowest compliance) to 4 (highest compliance). The SF-36 questionnaire and a constant-load treadmill test were used to evaluate QoL and Initial/Absolute Claudication Distance, respectively. Both direct and indirect costs of the program were considered for cost-effectiveness analysis. Two-hundred and fifty patients (70.5 ± 9.2 years, M = 191), at Fontaine's II-B stage (86%), were included in the study. No adverse events were reported. The average compliance score was 3.1. At discharge, both SF-36 domains and walking performance significantly increased (P < 0.0001). A total of 1,839 in-hospital check-ups (7.36 /patient) were performed. Direct and indirect costs represented 93% and 7% of the total costs, respectively. The average costs of a visit and of a therapy cycle were C68.93 and C507.20, respectively. The cost to walk an additional meter before stopping was C9.22. A Test-in/Train-out program provided favourable patient compliance, QoL impact and cost-effectiveness in patients with IC.

GO-FAAR Program | CTIO

Science.gov Websites

Program PIA Program GO-FAAR Program Other Opportunities Tourism Visits to Tololo Astro tourism in Chile Tourism in Chile Information for travelers Visit Tololo Media Relations News Press Release Publications

Implementation of the court visitor program in a clinical nursing curriculum.

PubMed

Stowell, Jane M; Pihlak, Mary Rose; Matzke, Amanda; O'Keefe, Mary

2013-12-01

The State of Texas has more than 19,000 individuals who lack the physical or mental ability to provide for their need for shelter, financial management, or physical care. These individuals have been designated as wards of the court and placed under guardianship. Texas probate courts appoint individuals known as court visitors to make annual visits to wards of the court to assess their well-being under guardianship. Although the 10 statutory probate courts have court visitor programs, many county courts do not. This article describes the details of a service-learning experience using an online distance educational program to train undergraduate nursing students in a mental health course to become court visitors. This information may be useful to others looking for nontraditional clinical experiences and service-learning opportunities for undergraduate nursing students.

Preventing child maltreatment: Examination of an established statewide home-visiting program.

PubMed

Chaiyachati, Barbara H; Gaither, Julie R; Hughes, Marcia; Foley-Schain, Karen; Leventhal, John M

2018-05-01

Although home visiting has been used in many populations in prevention efforts, the impact of scaled-up home-visiting programs on abuse and neglect remains unclear. The objective of this study was to assess the impact of voluntary participation in an established statewide home-visiting program for socially high-risk families on child maltreatment as identified by Child Protective Services (CPS). Propensity score matching was used to compare socially high-risk families with a child born between January 1, 2008 and December 31, 2011 who participated in Connecticut's home-visiting program for first-time mothers and a comparison cohort of families who were eligible for the home-visiting program but did not participate. The main outcomes were child maltreatment investigations, substantiations, and out-of-home placements by CPS between January 1, 2008 and December 31, 2013. In the unmatched sample, families who participated in home-visiting had significantly higher median risk scores (P < .001). After matching families on measured confounders, the percentages of families with CPS investigations (21.1% vs. 20.9%, P = .86) were similar between the two groups. However, there was a 22% decreased likelihood of CPS substantiations (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.64-0.95) for families receiving home visiting. First substantiations also occurred later in the child's life among home-visited families. There was a trend toward decreased out-of-home placement (HR 0.73, 95% CI 0.53-1.02, P = .06). These results from a scaled-up statewide program highlight the potential of home visiting as an important approach to preventing child abuse and neglect. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Training Process of the Organization Development and Training Office

NASA Technical Reports Server (NTRS)

Johnson, Melissa S.

2004-01-01

The Organization Development and Training Office provides training and development opportunities to employees at NASA Glenn Research Center, as a division of the Office of Human Resources and Workforce Planning. Center-wide required trainings, new employee trainings, workshops and career development programs are organized by the OD&TO staff. They also arrange all academic, non-academic, headquarters, fellowship and learning center sponsored courses. They also service organizations wishing to work more effectively by facilitating teambuilding exercises. Equal Opportunity programs and upward mobility programs such as the STEP and GO programs for administrative staff. In working with my mentor I am very involved with Cuyahoga Community College classes, mandatory supervisory training and administrative staff workshops. My largest tasks are in the secretarial training category. The Supporting Organizations And Relationships workshop for administrative personnel, commonly known as SOAR, began last year and continued this summer with follow-up workshops. Months before a workshop or class is brought to Glenn, a need has to be realized. In this case, administrative staff did not feel they had an opportunity to receive relevant training and develop skills through teambuilding, networking and communication. A Statement of work is then created as several companies are contacted about providing the training. After the company best suited to meet the target group s needs is selected, the course is announced with an outline of all pertinent information. A reservation for a facility is made and applications or nominations, depending on the announcement s guidelines, are received from interested employees. Confirmations are sent to participants and final preparations are made but there are still several concluding steps. A training office staff member also assists the facilitator with setting up the facility and introducing the class. After the class, participants evaluations are read and summarized to determine the effectiveness of the class and instructor. In addition to the SOAR workshops, I have several projects and daily tasks to complete. Coding training applications, which require me to be familiar with Glenn s budgetary allocations and policies on training, is an ongoing process. It also requires verifying information reported by an employee via her C-478 form, more commonly known as the training application. I am also the point of contact for the Cuyahoga Community College Advising Sessions held here at NASA Glenn which involves coordinating counselors visits with employees schedules. Two databases had to be created. The first database holds information on administrative staff, and the other tracks supervisors training histories. Through these assignments I gained experience in Microsoft Access 2002 and spreadsheet creation, communicating with co-workers, and successfully facilitating a training to serve specific purposes. With trainings and evaluations to assessment them, the Organization Development and Training Office can assure a quality product and continued customer satisfaction.

Crisis Nursery and Respite Care Programs: Site Visit Results of Staff and Family Interviews (Winter and Spring of 1991).

ERIC Educational Resources Information Center

Huntington, Gail S.; And Others

Visits were made to selected respite care and crisis nursery programs in order to describe the programs and services they offered to families of young children with special needs and to learn more about the families who used the services and the staff who provided them. The visits to 10 crisis nurseries and 24 respite care programs resulted in…

Advocating for the Future of Science on Capitol Hill

NASA Astrophysics Data System (ADS)

Paczkowski, Karen

2013-05-01

Students make great science lobbyists. That was the message from AGU at the annual Science, Engineering, and Technology Congressional Visits Day (SET-CVD) on 12-13 March. As students, we exist at the intersection of research and education and are an exuberant and visual example of the positive outcomes of funding SET programs. As the future practitioners and beneficiaries of science, we also have a lot at stake. In the midst of current budget battles, it is more important than ever that we take the opportunity to remind our legislators that SET programs play a unique and important role in the education and training of our nation's citizens as well as in the scientific discoveries that benefit society and fuel our economy.

An emergency room decision-support program that increased physician office visits, decreased emergency room visits, and saved money.

PubMed

Navratil-Strawn, Jessica L; Hawkins, Kevin; Wells, Timothy S; Ozminkowski, Ronald J; Hartley, Stephen K; Migliori, Richard J; Yeh, Charlotte S

2014-10-01

The objective of this study was to evaluate an Emergency Room having a Decision-Support (ERDS) program designed to appropriately reduce ER use among frequent users, defined as 3 or more visits within a 12-month period. To achieve this, adults with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company (for New York residents, UnitedHealthcare Insurance Company of New York) were eligible to participate in the program. These included 7070 individuals who elected to enroll in the ERDS program and an equal number of matched nonparticipants who were eligible but either declined or were unreachable. Program-related benefits were estimated by comparing the difference in downstream health care utilization and expenditures between engaged and not engaged individuals after using propensity score matching to adjust for case mix differences between these groups. As a result, compared with the not engaged, engaged individuals experienced better care coordination, evidenced by a greater reduction in ER visits (P=0.033) and hospital admissions (P=0.002) and an increase in office visits (P<0.001). The program was cost-effective, with a return on investment (ROI) of 1.24, which was calculated by dividing the total program savings ($3.41 million) by the total program costs ($2.75 million). The ROI implies that for every dollar invested in this program, $1.24 was saved, most of which was for the federal Medicare program. In conclusion, the decrease in ER visits and hospital admissions and the increase in office visits may indicate the program helped individuals to seek the appropriate levels of care.

Co-Analysis of Work in the Triadic Supervision of Preservice Teachers Based on Neo-Vygotskian Activity Theory: Case Study from a French University Institute of Teacher Training

ERIC Educational Resources Information Center

Cartaut, Solange; Bertone, Stefano

2009-01-01

The goal of this study was to evaluate the effects of the joint training activities of a cooperating teacher and a university supervisor during an advisory visit on (a) the professional development of a preservice teacher's activity and (b) the reorganization of mentoring activity following this visit. The results are considered from a theoretical…

My Most Memorial Meeting - The June, 1997, San Diego Meeting

NASA Astrophysics Data System (ADS)

Philip, A. G. Davis

1999-05-01

At the June, 1997 AAS meeting in San Diego I arranged a topical session on the Shapley Visiting Lectureships Program. There were poster papers and speakers from the early days of the program, going back to the Visiting Lectureships Program of the AAS. Then the three past directors and the present director described their activities in running the program from 1979 to 1997. We had other speakers who described their many visits to institutions over the years and representatives from two institutions which had received many visits. This session provided much interesting information about the Shapley Program and its history. At the end of the program several people pledged, and then gave, a substantial sum to the Shapley Endowment Fund. Because of all these events and happenings, the San Diego Meeting was a highlight meeting for me. A second meeting with significance to the Shapley Program was the June, 1996 meeting in Madison, Wisconsin. At this meeting certificates were awarded to 31 lecturers who had made 15 or more Shapley visits and 18 lecturers who had made 25 or more visits. A dinner was held at which those lecturers in these two groups who were present at the meeting were personally awarded their certificates. The remaining certificates were mailed after the meeting. The success of the Shapley Program is directly related to the devotion of its group of lecturers who spend considerable time and effort in making the two day visits to host institutions.

Who Drops out of Early Head Start Home Visiting Programs?

ERIC Educational Resources Information Center

Roggman, Lori A.; Cook, Gina A.; Peterson, Carla A.; Raikes, Helen H.

2008-01-01

Research Findings: Early Head Start home-based programs provide services through weekly home visits to families with children up to age 3, but families vary in how long they remain enrolled. In this study of 564 families in home-based Early Head Start programs, "dropping out" was predicted by specific variations in home visits and certain family…

Welcome Home and Early Start: An Assessment of Program Quality and Outcomes

ERIC Educational Resources Information Center

Daro, Deborah, Howard, Eboni; Tobin, Jennifer; Harden, Allen

2005-01-01

Chapin Hall Center for Children at the University of Chicago, in collaboration with Westat Associates, designed and implemented a comprehensive evaluation of the Early Childhood Initiative's (ECI) two home visitation programs: Welcome Home, a universal home visitation program that provides a single home visit to all first-time and teen parents,…

SUMMARY REPORT FOR THE NATIONAL ATMOSPHERIC DEPOSITION PROGRAM/NATIONAL TRENDS NETWORK (NADP/NTN) SITE VISITATION PROGRAM FOR THE PERIOD OCTOBER 1987 THROUGH SEPTEMBER 1988

EPA Science Inventory

The U.S Environmental Protection Agency (EPA) provides technical assistance to the NADP/NTN network through a site visitation program. esearch Triangle Institute, as contractor to EPA, conducts these visits. f deficiencies or nonstandard procedures are noted, the site operator an...

Evaluation of a peer assessment approach for enhancing the organizational capacity of state injury prevention programs.

PubMed

Hunter, Wanda M; Schmidt, Ellen R; Zakocs, Ronda

2005-01-01

To conduct a formative and pilot impact evaluation of the State Technical Assessment Team (STAT) program, a visitation-based (visitatie) peer assessment program designed to enhance the organizational capacity of state health department injury prevention programs. The formative evaluation was based on observational, record review, and key informant interview data collected during the implementation of the first 7 STAT visits. Pilot impact data were derived from semi-structured interviews with state injury prevention personnel one year after the visit. Formative evaluation identified 6 significant implementation problems in the first visits that were addressed by the program planners, resulting in improvements to the STAT assessment protocol. Impact evaluation revealed that after one year, the 7 state injury prevention programs had acted on 81% of the recommendations received during their STAT visits. All programs reported gains in visibility and credibility within the state health department and increased collaboration and cooperation with other units and agencies. Other significant program advancements were also reported. Specific program standards and review procedures are important to the success of peer assessment programs such as STAT. Early impact evaluation suggests that peer assessment protocols using the visitatie model can lead to gains in organizational capacity.

A Randomized Control Trial: Supplementing Hearing Aid Use with Listening and Communication Enhancement (LACE) Auditory Training.

PubMed

Saunders, Gabrielle H; Smith, Sherri L; Chisolm, Theresa H; Frederick, Melissa T; McArdle, Rachel A; Wilson, Richard H

2016-01-01

To examine the effectiveness of the Listening and Communication Enhancement (LACE) program as a supplement to standard-of-care hearing aid intervention in a Veteran population. A multisite randomized controlled trial was conducted to compare outcomes following standard-of-care hearing aid intervention supplemented with (1) LACE training using the 10-session DVD format, (2) LACE training using the 20-session computer-based format, (3) placebo auditory training (AT) consisting of actively listening to 10 hr of digitized books on a computer, and (4) educational counseling-the control group. The study involved 3 VA sites and enrolled 279 veterans. Both new and experienced hearing aid users participated to determine if outcomes differed as a function of hearing aid user status. Data for five behavioral and two self-report measures were collected during three research visits: baseline, immediately following the intervention period, and at 6 months postintervention. The five behavioral measures were selected to determine whether the perceptual and cognitive skills targeted in LACE training generalized to untrained tasks that required similar underlying skills. The two self-report measures were completed to determine whether the training resulted in a lessening of activity limitations and participation restrictions. Outcomes were obtained from 263 participants immediately following the intervention period and from 243 participants 6 months postintervention. Analyses of covariance comparing performance on each outcome measure separately were conducted using intervention and hearing aid user status as between-subject factors, visit as a within-subject factor, and baseline performance as a covariate. No statistically significant main effects or interactions were found for the use of LACE on any outcome measure. Findings from this randomized controlled trial show that LACE training does not result in improved outcomes over standard-of-care hearing aid intervention alone. Potential benefits of AT may be different than those assessed by the performance and self-report measures utilized here. Individual differences not assessed in this study should be examined to evaluate whether AT with LACE has any benefits for particular individuals. Clinically, these findings suggest that audiologists may want to temper the expectations of their patients who embark on LACE training.

KSC-2012-3057

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – The drawbridge span of the NASA Railroad’s Jay Jay Railroad Bridge over the Indian River north of Launch Complex 39 at NASA’s Kennedy Space Center in Florida is reopened following the passage of a NASA Railroad train. The permanent configuration of the bridge is open the span is lowered only for a train to cross. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

Delivery of Health Coaching by Medical Assistants in Primary Care.

PubMed

Djuric, Zora; Segar, Michelle; Orizondo, Carissa; Mann, Jeffrey; Faison, Maya; Peddireddy, Nithin; Paletta, Matthew; Locke, Amy

2017-01-01

Health coaching is potentially a practical method to assist patients in achieving and maintaining healthy lifestyles. In health coaching, the coach partners with the patient, helping patients discover their own strengths, challenges, and solutions. Two medical assistants were provided with brief training. The 12-week program consisted of telephone coaching with in-person visits at the beginning and end of the program. Coaching targeted improvements in diet, physical activity, and/or sleep habits using a self-care planning form. A total of 82 subjects enrolled in the program, 72% completed 8 weeks and 49% completed 12 weeks. Subjects who completed assessments at 12 weeks had significant weight loss despite the fact that weight loss was not a study goal. There also were improvements in diet and physical activity. Subject who completed the study were highly satisfied with the program and felt that health coaching should be available in all family medicine clinics. The main barrier providers voiced was remembering to refer patients. The medical providers indicated high satisfaction with the study and valued having coaching available for their patients. Medical assistants can be trained to assist patients with lifestyle changes that are associated with improved health and weight control. © Copyright 2017 by the American Board of Family Medicine.

Developing a longitudinal cancer nursing education program in Honduras.

PubMed

Sheldon, Lisa Kennedy; Wise, Barbara; Carlson, Julie R; Dowds, Cynthia; Sarchet, Vanessa; Sanchez, Jose Angel

2013-12-01

The present paper is a longitudinal study which aims to develop and deliver cancer nursing education conferences in Honduras using volunteer nurse educators. This program intends to (1) perform site assessments of work environments and resources for cancer care in Honduras, (2) develop cancer nursing education programs, (3) survey conference participants continuing education needs, (4) deliver cancer nursing education conferences, and (5) share data with local and global partners for future cancer programs. The study draws on a longitudinal program development with site assessments, data collection, and educational conferences at two time points. Assessments and surveys were used for conference development and delivery by volunteer nurse educators. Site assessments and conferences were delivered twice. Data were collected regarding assessments and surveys to inform program development. Survey data revealed that <4 % had formal training in cancer care and >65 % had internet access. Participants desired more information about handling of chemotherapy, symptom management, and palliative care. Volunteer nurse educators perform site assessments and develop educational programming for cancer nurses. Local and global partners should explore internet-based programs between site visits to create sustainable education programs.

The African Laser Centre: Transforming the Laser Community in Africa

NASA Astrophysics Data System (ADS)

Mtingwa, Sekazi

2012-02-01

We describe the genesis and programs of the African Laser Centre (ALC), which is an African nonprofit network of laser users that is based in Pretoria, South Africa. Composed of over thirty laboratories from countries throughout the continent of Africa, the ALC has the mission of enhancing the application of lasers in research and education. Its programs include grants for research and training, equipment loans and donations, student scholarships, faculty grants for visits to collaborators' institutions, conferences, and technician training. A long-term goal of the ALC is to bring a synchrotron light source to Africa, most probably to South Africa. One highly popular program is the biennial conference series called the US-Africa Advanced Studies Institute, which is funded by the ALC in collaboration with the U.S. National Science Foundation and the International Center for Theoretical Physics in Trieste. The Institutes typically bring about thirty faculty and graduate students from the U.S. to venues in Africa in order to introduce U.S. and African graduate students to major breakthroughs in targeted areas that utilize lasers. In this presentation, we will summarize the ALC achievements to date and comment on the path forward.

Using Long-Distance Scientist Involvement to Enhance NASA Volunteer Network Educational Activities

NASA Astrophysics Data System (ADS)

Ferrari, K.

2012-12-01

Since 1999, the NASA/JPL Solar System Ambassadors (SSA) and Solar System Educators (SSEP) programs have used specially-trained volunteers to expand education and public outreach beyond the immediate NASA center regions. Integrating nationwide volunteers in these highly effective programs has helped optimize agency funding set aside for education. Since these volunteers were trained by NASA scientists and engineers, they acted as "stand-ins" for the mission team members in communities across the country. Through the efforts of these enthusiastic volunteers, students gained an increased awareness of NASA's space exploration missions through Solar System Ambassador classroom visits, and teachers across the country became familiarized with NASA's STEM (Science, Technology, Engineering and Mathematics) educational materials through Solar System Educator workshops; however the scientist was still distant. In 2003, NASA started the Digital Learning Network (DLN) to bring scientists into the classroom via videoconferencing. The first equipment was expensive and only schools that could afford the expenditure were able to benefit; however, recent advancements in software allow classrooms to connect to the DLN via personal computers and an internet connection. Through collaboration with the DLN at NASA's Jet Propulsion Laboratory and the Goddard Spaceflight Center, Solar System Ambassadors and Solar System Educators in remote parts of the country are able to bring scientists into their classroom visits or workshops as guest speakers. The goals of this collaboration are to provide special elements to the volunteers' event, allow scientists opportunities for education involvement with minimal effort, acquaint teachers with DLN services and enrich student's classroom learning experience.;

[Programmes against depression].

PubMed

Taleb, M; Rouillon, F; Hegerl, U; Hamdani, N; Gorwood, Ph

2006-01-01

Depressive disorders represent a major public health concern, regarding their high frequency and their important cost. Depression impair the quality of life more than any other disease, sometimes leading to suicidal ideas or behavior. Indeed, 50% of patients with severe major depression commit suicide. Numerous studies showed that depressive disorders are frequently not recognised, and regularly untreated. In France, where at least 3 millions of inhabitants are concerned, 38% of depressed patients are not using any health system. When they are asking for care, the majority of depressed patients visit their general practitioner (51%), whereas less than 10% visit a psychiatrist. Even when the diagnostic is correct, the treatment prescribed is not systematically relevant. The treatment is, for example, frequently proposed for a too short period, and sometimes the prescribed product does not have proven antidepressive efficacy. Furthermore, as incorrect informations are frequently given to patients, and as there is a general biased judgement about psychotropic drugs in the general population, the compliance is usually poor for antidepressive treatment. Therefore, only a small minority of depressed patients benefits from an adequate care. Public health information methodological asserts. To improve this situation, delivering simple and clear-cut recommendations cannot be considered as sufficiently effective, and public health interventions are required. Different programs improving the recognition of depressive disorders have already been tested in some countries with encouraging results. These programs are based on information campaigns given to the public, and the training of general practitioners about the management of depressive disorders. The "Defeat Depression" campaign in Great-Britain and the "National Depression Screening Day" in the United-States of America may represent informative examples. Restricting these programs to general practitioners only is frequently criticized, as this may reduce efficacy. A multilevel approach is crucial for the success of action programmes against depression, because synergistic effects can be expected. In Germany, the "Nürnberger Bündnis gegen Depression" project was based on four levels, and effectively reduced the suicide rate. These levels of action included "cooperation with GPs", such as training sessions based on video, and presence of a phone hotline, "public relations activities", "training sessions for multipliers", such as priests, social workers and media, and "special offers for high risk groups and self-help activities". In France, such a program is clearly required.

NOAO-S EPO Program team | CTIO

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Program PIA Program GO-FAAR Program Other Opportunities Tourism Visits to Tololo Astro tourism in Chile Tourism in Chile Information for travelers Visit Tololo Media Relations News Press Release Publications

The AAS Visiting Professor Programs: Three Anniversaries

NASA Astrophysics Data System (ADS)

Philip, A. G. Davis

2003-05-01

The AAS Program of Visiting Professors was started in 1958 with three astronomers as lecturers. They were Paul Merrill (Mt. Wilson and Palomar Observatories), Seth Nicholson (Mt. Wilson and Palomar Observatories) and Harlow Shapley (Harvard College Observatory). The program was run by a Committee on Visiting Professors from 1958 through 1963. The program was funded by grants from the National Science Foundation. The Executive Officer of the AAS, Paul Routley headed the program from the 1963 - 64 academic year through the 1968 - 69 academic year. Larry Fredrick headed the program for 1969 - 70 and then Hank Gurin headed it through 1973 -74, the last year of the program. At the end of this summer meeting, the combined Visiting Professors Program and the Shapley Program will be starting their 47th year. The Shapley Visiting Lectureships in Astronomy Program was started in the 1974 - 75 academic year under the leadership of Hank Gurin. The original funding came from the Perkin Fund and a three year grant from the Research Corporation. In 1975 the Shapley Endowment fund was set up to help pay the expenses of the program. In 1976 there was support from the Slipher fund which lasted through the 1978 - 79 academic year. From 1979 to the present the program is financed by the Shapley Endowment Fund and by the contributions made by institutions which host the visits. In the fall of 1998 the fee that Institutions pay to the AAS in support of their Shapley visits was reduced from 300 to 250 to make it easier for them to apply for visits. Members of the AAS have made contributions to the program over the years and we are very appreciative of this support. In 1974 there were 42 lecturers in the program, of whom four are still active giving lectures (George Carruthers, Larry Fredrick, Arlo Landolt and Davis Philip). After the summer meeting, the Shapley Program will be embarking on its 30th year. Now there are 82 astronomers in the program and we get from 40 to 60 requests a year. Shapley visits have been made to Canadian institutions since 1976 and to Mexican institutions since 1998. After the summer meeting it will be the start of the 10th year of my directing the program. On May 26 there will be a Shapley Dinner at Dyer Observatory in Nashville for the Shapley lecturers who are attending the AAS meeting and we will celebrate these three anniversaries.

The Plastic Surgery Match: A Quantitative Analysis of Applicant Impressions From the Interview Visit.

PubMed

Frojo, Gianfranco; Tadisina, Kashyap Komarraju; Pressman, Zachary; Chibnall, John T; Lin, Alexander Y; Kraemer, Bruce A

2016-12-01

The integrated plastic surgery match is a competitive process not only for applicants but also for programs vying for highly qualified candidates. Interactions between applicants and program constituents are limited to a single interview visit. The authors aimed to identify components of the interview visit that influence applicant decision making when determining a final program rank list. Thirty-six applicants who were interviewed (100% response) completed the survey. Applicants rated the importance of 20 elements of the interview visit regarding future ranking of the program on a 1 to 5 Likert scale. Data were analyzed using descriptive statistics, hierarchical cluster analysis, analysis of variance, and Pearson correlations. A literature review was performed regarding the plastic surgery integrated residency interview process. Survey questions were categorized into four groups based on mean survey responses:1. Interactions with faculty and residents (mean response > 4),2. Information about the program (3.5-4),3. Ancillaries (food, amenities, stipends) (3-3.5),4. Hospital tour, hotel (<3).Hierarchical item cluster analysis and analysis of variance testing validated these groupings. Average summary scores were calculated for the items representing Interactions, Information, and Ancillaries. Correlation analysis between clusters yielded no significant correlations. A review of the literature yielded a paucity of data on analysis of the interview visit. The interview visit consists of a discrete hierarchy of perceived importance by applicants. The strongest independent factor in determining future program ranking is the quality of interactions between applicants and program constituents on the interview visit. This calls for further investigation and optimization of the interview visit experience.

[Educating health workers is key in congenital syphilis elimination in Colombia].

PubMed

Garcés, Juan Pablo; Rubiano, Luisa Consuelo; Orobio, Yenifer; Castaño, Martha; Benavides, Elizabeth; Cruz, Adriana

2017-09-01

Colombia promotes the diagnosis and treatment of gestational syphilis in a single visit using rapid diagnostic tests to prevent mother-to-child transmission. Additionally, integrated health programs pursue the coordinated prevention of mother-to-child transmission of syphilis/HIV. To identify knowledge gaps among health workers in the prevention of mother-to-child transmission of syphilis/HIV and to provide recommendations to support these programs. We conducted a descriptive study based on 306 surveys of health workers in 39 health institutions in the city of Cali. Surveys inquired about planning, management and implementation of services for pregnant women, clinical knowledge of HIV/syphilis rapid diagnostic tests, and prior training. Knowledge deficits in the management of gestational syphilis were detected among the surveyed health workers, including physicians. Rapid tests for syphilis are currently used in clinical laboratories in Cali, however, procedural deficiencies were observed in their use, including quality control assurance. During the two years prior to the survey, training of health workers in the prevention of mother-to-child transmission of syphilis/HIV had been limited. Health workers are interested in identifying and treating gestational syphilis in a single event, in using rapid diagnostic tests and in receiving training. Intensive training targeting health workers, policy/decision makers and academic groups is needed to ensure adequate implementation of new strategies for the prevention of mother-to-child transmission of syphilis/HIV.

Hands-on workshops as an effective means of learning advanced technologies including genomics, proteomics and bioinformatics.

PubMed

Reisdorph, Nichole; Stearman, Robert; Kechris, Katerina; Phang, Tzu Lip; Reisdorph, Richard; Prenni, Jessica; Erle, David J; Coldren, Christopher; Schey, Kevin; Nesvizhskii, Alexey; Geraci, Mark

2013-12-01

Genomics and proteomics have emerged as key technologies in biomedical research, resulting in a surge of interest in training by investigators keen to incorporate these technologies into their research. At least two types of training can be envisioned in order to produce meaningful results, quality publications and successful grant applications: (1) immediate short-term training workshops and (2) long-term graduate education or visiting scientist programs. We aimed to fill the former need by providing a comprehensive hands-on training course in genomics, proteomics and informatics in a coherent, experimentally-based framework. This was accomplished through a National Heart, Lung, and Blood Institute (NHLBI)-sponsored 10-day Genomics and Proteomics Hands-on Workshop held at National Jewish Health (NJH) and the University of Colorado School of Medicine (UCD). The course content included comprehensive lectures and laboratories in mass spectrometry and genomics technologies, extensive hands-on experience with instrumentation and software, video demonstrations, optional workshops, online sessions, invited keynote speakers, and local and national guest faculty. Here we describe the detailed curriculum and present the results of short- and long-term evaluations from course attendees. Our educational program consistently received positive reviews from participants and had a substantial impact on grant writing and review, manuscript submissions and publications. Copyright © 2013. Production and hosting by Elsevier Ltd.

Client-centered counseling improves client satisfaction with family planning visits: evidence from Irbid, Jordan

PubMed Central

Kamhawi, Sarah; Underwood, Carol; Murad, Huda; Jabre, Bushra

2013-01-01

ABSTRACT Background: High levels of unmet need for family planning and high contraceptive discontinuation rates persist in Jordan, prompting the Jordan Health Communication Partnership (JHCP) to initiate a client-centered family planning service program called “Consult and Choose” (CC), together with community-based activities to encourage women with unmet need to visit health centers. Methods: We held exit interviews with 461 family planning clients between November–December 2011 to assess, from the clients' perspective, whether trained providers followed the CC protocol and used the CC tools, as well as to measure client satisfaction. We also tracked referral card information from community-based activities to health centers and examined service statistics to explore trends in family planning use. Results: On average, clients reported that providers performed 5.6 of the 7 steps outlined in the CC protocol. Nearly 83% of respondents were very satisfied with their clinic visits. Logistic regression analysis found that the odds of being “very satisfied” increases by 20% with each additional counseling protocol step performed and by 70% with each increase in the number of CC materials used. Between June 2011 and August 2012, 14,490 referral cards from community-based activities were collected in health centers, 59% of which were for family planning services. Service statistic trends indicate an increase in the number of new family planning users and in couple-years of protection after starting the CC program. Conclusions: Implementation of the CC program at health centers nationally, in tandem with community-based interventions, could play a key role in attaining Jordan's goal of reducing its total fertility rate to 2.1 by 2030. Although this initiative would likely be replicated most readily in other middle-income countries, lower-resource countries could also adapt the tested CC approach. PMID:25276531

Florida Panhandle Healthy Start: A Randomized Trial of Prenatal Home Visitation.

ERIC Educational Resources Information Center

Stabile, Isabel; Graham, Mimi

Noting prenatal and early childhood home visitation by nurses has had positive effects on birth outcomes in several at-risk populations, this study examined the impact of weekly home visits by systematically trained visitors on birth outcomes of high-risk pregnant women within the context of a Florida Healthy Start project. Participating were…

Use of the emergency department for less-urgent care among type 2 diabetics under a disease management program

PubMed Central

2009-01-01

Background This study analyzed the likelihood of less-urgent emergency department (ED) visits among type 2 diabetic patients receiving care under a diabetes disease management (DM) program offered by the Louisiana State University Health Care Services Division (LSU HCSD). Methods All ED and outpatient clinic visits made by 6,412 type 2 diabetic patients from 1999 to 2006 were extracted from the LSU HCSD Disease Management (DM) Evaluation Database. Patient ED visits were classified as either urgent or less-urgent, and the likelihood of a less-urgent ED visit was compared with outpatient clinic visits using the Generalized Estimating Equation methodology for binary response to time-dependent variables. Results Patients who adhered to regular clinic visit schedules dictated by the DM program were less likely to use the ED for less urgent care with odds ratio of 0.1585. Insured patients had 1.13 to 1.70 greater odds of a less-urgent ED visit than those who were uninsured. Patients with better-managed glycated hemoglobin (A1c or HbA1c) levels were 82 times less likely to use less-urgent ED visits. Furthermore, being older, Caucasian, or a longer participant in the DM program had a modestly lower likelihood of less-urgent ED visits. The patient's Charlson Comorbidity Index (CCI), gender, prior hospitalization, and the admitting facility showed no effect. Conclusion Patients adhering to the DM visit guidelines were less likely to use the ED for less-urgent problems. Maintaining normal A1c levels for their diabetes also has the positive impact to reduce less-urgent ED usages. It suggests that successful DM programs may reduce inappropriate ED use. In contrast to expectations, uninsured patients were less likely to use the ED for less-urgent care. Patients in the DM program with Medicaid coverage were 1.3 times more likely to seek care in the ED for non-emergencies while commercially insured patients were nearly 1.7 times more likely to do so. Further research to understand inappropriate ED use among insured patients is needed. We suggest providing visit reminders, a call centre, or case managers to reduce the likelihood of less-urgent ED visit use among DM patients. By reducing the likelihood of unnecessary ED visits, successful DM programs can improve patient care. PMID:19968871

Use of the emergency department for less-urgent care among type 2 diabetics under a disease management program.

PubMed

Chiou, Shang-Jyh; Campbell, Claudia; Horswell, Ronald; Myers, Leann; Culbertson, Richard

2009-12-07

This study analyzed the likelihood of less-urgent emergency department (ED) visits among type 2 diabetic patients receiving care under a diabetes disease management (DM) program offered by the Louisiana State University Health Care Services Division (LSU HCSD). All ED and outpatient clinic visits made by 6,412 type 2 diabetic patients from 1999 to 2006 were extracted from the LSU HCSD Disease Management (DM) Evaluation Database. Patient ED visits were classified as either urgent or less-urgent, and the likelihood of a less-urgent ED visit was compared with outpatient clinic visits using the Generalized Estimating Equation methodology for binary response to time-dependent variables. Patients who adhered to regular clinic visit schedules dictated by the DM program were less likely to use the ED for less urgent care with odds ratio of 0.1585. Insured patients had 1.13 to 1.70 greater odds of a less-urgent ED visit than those who were uninsured. Patients with better-managed glycated hemoglobin (A1c or HbA1c) levels were 82 times less likely to use less-urgent ED visits. Furthermore, being older, Caucasian, or a longer participant in the DM program had a modestly lower likelihood of less-urgent ED visits. The patient's Charlson Comorbidity Index (CCI), gender, prior hospitalization, and the admitting facility showed no effect. Patients adhering to the DM visit guidelines were less likely to use the ED for less-urgent problems. Maintaining normal A1c levels for their diabetes also has the positive impact to reduce less-urgent ED usages. It suggests that successful DM programs may reduce inappropriate ED use. In contrast to expectations, uninsured patients were less likely to use the ED for less-urgent care. Patients in the DM program with Medicaid coverage were 1.3 times more likely to seek care in the ED for non-emergencies while commercially insured patients were nearly 1.7 times more likely to do so. Further research to understand inappropriate ED use among insured patients is needed. We suggest providing visit reminders, a call centre, or case managers to reduce the likelihood of less-urgent ED visit use among DM patients. By reducing the likelihood of unnecessary ED visits, successful DM programs can improve patient care.

Study on Students' Impression Data in Practical Training Using Text Mining Method-Analysis of Considerable Communication.

PubMed

Teramachi, Hitomi; Sugita, Ikuto; Ino, Yoko; Hayashi, Yuta; Yoshida, Aki; Otsubo, Manami; Ueno, Anri; Katsuno, Hayato; Noguchi, Yoshihiro; Iguchi, Kazuhiro; Tachi, Tomoya

2017-09-01

We analyzed impression data and the scale of communication skills of students using text mining method to clarify which area a student was conscious of in communication in practical training. The results revealed that students tended to be conscious of the difference between practical hospital training and practical pharmacy training. In practical hospital training, specific expressions denoting relationships were "patient-visit", "counseling-conduct", "patient-counseling", and "patient-talk". In practical pharmacy training, specific expressions denoting relationships were "patient counseling-conduct", "story-listen", "patient-many", and "patient-visit". In practical hospital training, the word "patient" was connected to many words suggesting that students were conscious of a patient-centered communication. In practical pharmacy training, words such as "patient counseling", "patient", and "explanation" were placed in center and connected with many other words and there was an independent relationship between "communication" and "accept". In conclusion, it was suggested that students attempted active patient-centered communication in practical hospital training, while they were conscious of listening closely in patient counseling in practical pharmacy training.

Benchmarks for Reducing Emergency Department Visits and Hospitalizations Through Community Health Workers Integrated Into Primary Care: A Cost-Benefit Analysis.

PubMed

Basu, Sanjay; Jack, Helen E; Arabadjis, Sophia D; Phillips, Russell S

2017-02-01

Uncertainty about the financial costs and benefits of community health worker (CHW) programs remains a barrier to their adoption. To determine how much CHWs would need to reduce emergency department (ED) visits and associated hospitalizations among their assigned patients to be cost-neutral from a payer's perspective. Using a microsimulation of patient health care utilization, costs, and revenues, we estimated what portion of ED visits and hospitalizations for different conditions would need to be prevented by a CHW program to fully pay for the program's expenses. The model simulated CHW programs enrolling patients with a history of at least 1 ED visit for a chronic condition in the prior year, utilizing data on utilization and cost from national sources. CHWs assigned to patients with uncontrolled hypertension and congestive heart failure, as compared with other common conditions, achieve cost-neutrality with the lowest number of averted visits to the ED. To achieve cost-neutrality, 4-5 visits to the ED would need to be averted per year by a CHW assigned a panel of 70 patients with uncontrolled hypertension or congestive heart failure-approximately 3%-4% of typical ED visits among such patients, respectively. Most other chronic conditions would require between 7% and 12% of ED visits to be averted to achieve cost-savings. Offsetting costs of a CHW program is theoretically feasible for many common conditions. Yet the benchmark for reducing ED visits and associated hospitalizations varies substantially by a patient's primary diagnosis.

Expanding the Operational Use of Total Lightning Ahead of GOES-R

NASA Technical Reports Server (NTRS)

Stano, Geoffrey T.; Wood, Lance; Garner, Tim; Nunez, Roland; Kann, Deirdre; Reynolds, James; Rydell, Nezette; Cox, Rob; Bobb, William R.

2015-01-01

NASA's Short-term Prediction Research and Transition Center (SPoRT) has been transitioning real-time total lightning observations from ground-based lightning mapping arrays since 2003. This initial effort was with the local Weather Forecast Offices (WFO) that could use the North Alabama Lightning Mapping Array (NALMA). These early collaborations established a strong interest in the use of total lightning for WFO operations. In particular the focus started with warning decision support, but has since expanded to include impact-based decision support and lightning safety. SPoRT has used its experience to establish connections with new lightning mapping arrays as they become available. The GOES-R / JPSS Visiting Scientist Program has enabled SPoRT to conduct visits to new partners and expand the number of operational users with access to total lightning observations. In early 2014, SPoRT conducted the most recent visiting scientist trips to meet with forecast offices that will used the Colorado, Houston, and Langmuir Lab (New Mexico) lightning mapping arrays. In addition, SPoRT met with the corresponding Center Weather Service Units (CWSUs) to expand collaborations with the aviation community. These visits were an opportunity to learn about the forecast needs of each office visited as well as to provide on-site training for the use of total lightning, setting the stage for a real-time assessment during May-July 2014. With five lightning mapping arrays covering multiple geographic locations, the 2014 assessment has demonstrated numerous uses of total lightning in varying situations. Several highlights include a much broader use of total lightning for impact-based decision support ranging from airport weather warnings, supporting fire crews, and protecting large outdoor events. The inclusion of the CWSUs has broadened the operational scope of total lightning, demonstrating how these data can support air traffic management, particularly in the Terminal Radar Approach Control Facilities (TRACON) region around an airport. These collaborations continue to demonstrate, from the operational perspective, the utility of total lightning and the importance of continued training and preparation in advance of the Geostationary Lightning Mapper.

Impact of a Kentucky Maternal, Infant, and Early Childhood Home-Visitation Program on Parental Risk Factors

ERIC Educational Resources Information Center

Ferguson, Jonnisa M.; Vanderpool, Robin C.

2013-01-01

As public health organizations continue to implement maternal and child health home-visitation programs, more evaluation of these efforts is needed, particularly as it relates to improving parental behaviors. The purpose of our study was to assess the impact of families' participation in a home-visitation program offered by a central Kentucky…

Tololo and Tourism | CTIO

Science.gov Websites

Program PIA Program GO-FAAR Program Other Opportunities Tourism Visits to Tololo Astro tourism in Chile Tourism in Chile Information for travelers Visit Tololo Media Relations News Press Release Publications ‹› You are here CTIO Home » Outreach » Tololo and Tourism Tololo and Tourism Visits to Cerro

The Role of the Campus Visit and Summer Orientation Program in the Modification of Student Expectations about College.

ERIC Educational Resources Information Center

Singer, Wren

2003-01-01

Studied the messages being conveyed to prospective students in campus visits and summer orientation sessions at the University of Wisconsin-Madison. Findings for 497 prospective students show that the visit and orientation program may be effective, but programs are trying to communicate too much. Findings also show the importance of the campus…

A cost analysis of a smoke alarm installation and fire safety education program.

PubMed

Parmer, John E; Corso, Phaedra S; Ballesteros, Michael F

2006-01-01

While smoke alarm installation programs can help prevent residential fire injuries, the costs of running these programs are not well understood. We conducted a retrospective cost analysis of a smoke alarm installation program in 12 funded communities across four states. Costs included financial and economic resources needed for training, canvassing, installing, and following-up, within four cost categories: (a) personnel, (b) transportation, (c) facility, and (d) supplies. Local cost per completed home visit averaged 214.54 dollars, with an average local cost per alarm installed of 115.02 dollars. Combined state and local cost per alarm installed across all four states averaged 132.15 dollars. For every 1% increase in alarm installation, costs per alarm decrease by 1.32 dollars. As more smoke alarms are installed, the average installation cost per alarm decreases. By demonstrating effective economies of scale, this study suggests that smoke alarm programs can be implemented efficiently and receive positive economic returns on investment.

Translation to Primary Care of an Effective Teen Safe Driving Program for Parents.

PubMed

Shope, Jean T; Zakrajsek, Jennifer S; Finch, Stacia; Bingham, C Raymond; O'Neil, Joseph; Yano, Stephen; Wasserman, Richard; Simons-Morton, Bruce

2016-10-01

Addressing teen driver crashes, this study adapted an effective Checkpoints(TM) program for parents of teen drivers for dissemination by primary care practitioners (PCPs) and the web; distributed the PCP/web program through pediatric practices; and examined dissemination to/implementation by parents. The website, youngDRIVERparenting.org, and brief intervention protocol were developed. PCPs delivered interventions and materials to parents, referred them to the website, and completed follow-up surveys. Google Analytics assessed parents' website use. Most PCPs reported delivering interventions with fidelity, and thought the program important and feasible. Brief interventions/website referrals, averaging 4.4 minutes, were delivered to 3465 (87%) of 3990 eligible parents by 133 PCPs over an 18-week average. Website visits (1453) were made by 42% of parents, who spent on average 3:53 minutes viewing 4.2 topics. This program costs little (its website, training and promotional materials are available) and could be one component of a comprehensive approach to reducing teen driver crashes. © The Author(s) 2016.

Transition from grant funding to a self-supporting burn telemedicine program in the western United States.

PubMed

Russell, Katie W; Saffle, Jeffrey R; Theurer, Louanna; Cochran, Amalia L

2015-12-01

Many Americans have limited access to specialty burn care, and telemedicine has been proposed as a means to address this disparity. However, many telemedicine programs have been founded on grant support and then fail once the grant support expires. Our objective was to demonstrate that a burn telemedicine program can be financially viable. This retrospective review from 2005 to 2014 evaluated burn telemedicine visits and financial reimbursement during and after a Technology Opportunities Program grant to a regional burn center. In 2005, we had 12 telemedicine visits, which increased to 458 in 2014. In terms of how this compares to in-person clinic visits, we saw a consistent increase in telemedicine visits as a percentage of total clinic visits from .26% in 2005 to 14% in 2014. Median telemedicine reimbursement has been equivalent to in-person visits. Specialty telemedicine programs can successfully transition from grant-funded enterprises to self-sustaining. The availability of telemedicine services allows access to specialty expertise in a large and sparsely populated region without imposing an undue financial burden. Copyright © 2015 Elsevier Inc. All rights reserved.

Impact of a brief patient and provider intervention to improve the quality of communication about medication adherence among HIV patients.

PubMed

Beach, Mary Catherine; Roter, Debra L; Saha, Somnath; Korthuis, P Todd; Eggly, Susan; Cohn, Jonathan; Sharp, Victoria; Moore, Richard D; Wilson, Ira B

2015-09-01

Medication adherence is essential in HIV care, yet provider communication about adherence is often suboptimal. We designed this study to improve patient-provider communication about HIV medication adherence. We randomized 26 providers at three HIV care sites to receive or not receive a one-hour communication skills training based on motivational interviewing principles applied to medication adherence. Prior to routine office visits, non-adherent patients of providers who received the training were coached to discuss adherence with their providers. Patients of providers who did not receive the training providers were not coached. We audio-recorded and coded patient-provider interactions using the roter interaction analysis system (RIAS). There was more dialogue about therapeutic regimen in visits with intervention patients and providers (167 vs 128, respectively, p=.004), with the majority of statements coming from providers. These visits also included more brainstorming solutions to nonadherence (41% vs. 22%, p=0.026). Intervention compared with control visit providers engaged in more positive talk (44 vs. 38 statements, p=0.039), emotional talk (26 vs. 18 statements, p<0.001), and probing of patient opinion (3 vs. 2 statements, p=0.009). A brief provider training combined with patient coaching sessions, improved provider communication behaviors and increased dialogue regarding medication adherence. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Outreach to Scientists and Engineers at the Hanford Technical Library

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buxton, Karen A.

Staff at the Hanford Technical Library has developed a suite of programs designed to help busy researchers at the Pacific Northwest National Laboratory (PNNL) make better use of library products and services. Programs include formal training classes, one-on-one consultations, and targeted email messages announcing new materials to researchers in specific fields. A staple of outreach has been to teach classes to library clients covering research tools in their fields. These classes started out in the library classroom and then expanded to other venues around PNNL. Class surveys indicated that many researchers desired a practical approach to learning rather than themore » traditional lecture format. The library instituted “Library Learning Day” and hosted classes in the PNNL computer training room to provide lab employees with a hands-on learning experience. Classes are generally offered at noon and lab staff attends classes on their lunch hour. Many just do not have time to spend a full hour in training. Library staff added some experimental half-hour mini classes in campus buildings geared to the projects and interests of researchers there to see if this format was more appealing. As other programs have developed librarians are teaching fewer classes but average attendance figures has remained fairly stable from 2005-2007. In summer of 2004 the library began the Traveling Librarian program. Librarians call-on groups and individuals in 24 buildings on the Richland Washington campus. Five full-time and two part-time librarians are involved in the program. Librarians usually send out email announcements prior to visits and encourage scientists and engineers to make appointments for a brief 15 minute consultation in the researcher’s own office. During the meeting lab staff learn about products or product features that can help them work more productively. Librarians also make cold calls to staff that do not request a consultation and may not be making full use of the library. Scientists and engineers who require longer sessions can arrange half-hour training appointments in the researcher’s own office or at the library. Since the program was implemented staff made 165 visits to 1249 laboratory staff including some repeat consultation requests. New acquisitions lists are sent to individuals and groups that would be interested in recent journal, database, and books purchases. These lists are topic specific and targeted to groups and individuals with an interest in the field. For example newly acquired engineering resources are targeted at engineering groups. The new acquisitions list for engineering began mid year in 2005. An analysis of circulation statistics for engineering books in fiscal year 2005, 2006, and 2007 show that circulation increased each year with 2007 circulation nearly double that of 2005. This took place when overall circulation rose in FY06 but fell slightly in FY07. Outreach strategies tailored and individualized can be effective. Offering multiple outreach options offers researchers different ways to interact with library staff and services.« less

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Pseudo-drunk-patron evaluation of bar-staff compliance with Western Australian liquor law.

PubMed

Rydon, P; Stockwell, T; Lang, E; Beel, A

1996-06-01

Compliance of bar staff with the Western Australian liquor law prohibiting service to drunk patrons was assessed through the deployment of actors trained to behave in a drunken manner. The serving practices of 23 licensed premises (19 hotels and four nightclubs) were examined. During 120 visits to hotel and nightclub bars, more than 350 drink orders were placed by pairs of pseudo-drunk actors who ordered up to three drinks each on each visit. On placing these drink orders, pseudo-drunks were refused service by bar staff on only 12 occasions. The rate of refusal of service across all premises was 10 per cent of visits. Partial interventions by servers, such as offering food or low-alcohol or nonalcoholic drinks, occurred in only four instances of the 120 visits. Qualitative observations and results obtained from a separate study examining a subsample of the servers who trained in responsible service of alcohol are discussed.

Effect of Planned Follow-up on Married Women's Health Beliefs and Behaviors Concerning Breast and Cervical Cancer Screenings.

PubMed

Kolutek, Rahsan; Avci, Ilknur Aydin; Sevig, Umit

2018-04-01

The objective of this study was to identify the effect of planned follow-up visits on married women's health beliefs and behaviors concerning breast and cervical cancer screenings. The study was conducted using the single-group pre-test/post-test and quasi-experimental study designs. The sample of the study included 153 women. Data were collected using a Personal Information Form, the Health Belief Model (HBM) Scale for Breast Cancer Screening, the HBM Scale for Cervical Cancer Screening, and a Pap smear test. Data were collected using the aforementioned tools from September 2012 to March 2013. Four follow-up visits were conducted, nurses were educated, and telephone reminders were utilized. Friedman's test, McNemar's test, and descriptive statistics were used for data analyzing. The frequency of performing breast self-examination (BSE) at the last visit increased to 84.3 % compared to the pre-training. A statistically significant difference was observed between the pre- and post-training median values in four subscales except for the subscale of perceived seriousness of cervical cancer under "the Health Belief Model Scale for Cervical Cancer and the Pap Smear Test" (p < 0.001). The rate of performing BSE significantly increased after the training and follow-up visits. Also, the rate of having a Pap smear significantly increased after the follow-up visits.

Development of a Portable Gait Rehabilitation System for Home-Visit Rehabilitation

PubMed Central

Yano, Hiroaki; Tanaka, Naoki; Kamibayashi, Kiyotaka; Saitou, Hideyuki; Iwata, Hiroo

2015-01-01

This paper describes the development of a gait rehabilitation system with a locomotion interface (LI) for home-visit rehabilitation. For this purpose, the LI should be compact, small, and easy to move. The LI has two 2 degree-of-freedom (DOF) manipulators with footpads to move each foot along a trajectory. When the user stands on the footpads, the system can move his or her feet while the body remains stationary. The footpads can have various trajectories, which are prerecordings of the movements of healthy individuals walking on plane surfaces or slopes. The homes of stroke patients may have not only flat surfaces but also some slopes and staircases. The quadriceps femoris muscle is important for walking up and down slopes and staircases, and the eccentric and concentric contractions of this muscle are, in particular, difficult to train under normal circumstances. Therefore, we developed a graded-walking program for the system used in this study. Using this system, the user can undergo gait rehabilitation in their home, during visits by a physical therapist. An evaluation of the results of tests showed that the vastus medialis muscles of all the subjects were stimulated more than by walking on real slopes. PMID:25945364

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Effects of a pulmonary rehabilitation program on physical capacity, peripheral muscle function and inflammatory markers in asthmatic children and adolescents: study protocol for a randomized controlled trial.

PubMed

Reimberg, Mariana Mazzuca; Castro, Rejane Agnelo Silva; Selman, Jessyca Pachi Rodrigues; Meneses, Aline Santos; Politti, Fabiano; Mallozi, Márcia Carvalho; Wandalsen, Gustavo Falbo; Solé, Dirceu; De Angelis, Kátia; Dal Corso, Simone; Lanza, Fernanda Cordoba

2015-08-13

Individuals with chronic lung disease are more susceptible to present reduction in exercise tolerance and muscles strength not only due to pulmonary limitations but also due systemic repercussions of the pulmonary disease. The aim of this study is to assess the physical capacity, peripheral muscle function, physical activity in daily life, and the inflammatory markers in children and adolescents with asthma after pulmonary rehabilitation program. This is a study protocol of randomized controlled trial in asthmatic patients between 6 to 18 years old. The assessments will be conducted in three different days and will be performed at the beginning and at the end of the protocol. First visit: quality of life questionnaire, asthma control questionnaire, pre- and post-bronchodilator spirometry (400 μcg salbutamol), inflammatory assessment (blood collection), and cardiopulmonary exercise test on a cycle ergometer to determine aerobic capacity. Second visit: assessment of strength and endurance of the quadriceps femoris and biceps brachii muscles with concomitant electromyography to assess peripheral muscle strength. Third visit: incremental shuttle walk test (ISWT) and accelerometer to evaluate functional capacity and physical activity in daily life during 7 days. Then, the volunteers will be randomized to receive pulmonary rehabilitation program (intervention group) or chest physiotherapy + stretching exercises (control group). Both groups will have a supervised session, twice a week, each session will have 60 minutes duration, with minimum interval of 24 hours, for a period of 8 weeks. Intervention group: aerobic training (35 minutes) intensity between 60 to 80 % of the maximum workload of cardiopulmonary exercise testing or of ISWT; strength muscle training will be applied to the quadriceps femoris, biceps brachii and deltoid muscles (intensity: 40 to 70 % of maximal repetition, 3 x 8 repetition); finally the oral high-frequency oscillation device (Flutter®) will be used for 5 minutes. The control group: oral high-frequency oscillation device (Flutter®) for 10 minutes followed by the stretching of upper and lower limbs for 40 minutes. It is expected to observe the improvement in aerobic capacity, physical activity in daily life, muscle strength and quality of life of patients in the intervention group, and reduction in inflammatory markers. NCT02383069. Data of registration: 03/03/2015.

Heliophysics

NASA Astrophysics Data System (ADS)

Austin, M.; Guhathakurta, M.; Schrijver, C. J.; Bagenal, F.; Sojka, J. J.

2013-12-01

Title: Heliophysics Presentation Type: Poster Current Section/Focus Group: SPA-Solar and Heliosphere Physics (SH) Current Session: SH-01. SPA-Solar and Heliosphere Physics General Contributions Authors: Meg Austin1, Madhulika Guhathakurta2, Carolus Schrijver3, Frances Bagenal4, Jan Sojka5 1. UCAR Visiting Scientist Programs 2. NASA Living With a Star Program 3. Lockheed Martin Advanced Technology Center 4. Laboratory for Atmospheric and Space Physics, University of Colorado 5. Utah State University Abstract: Heliophysics is a developing scientific discipline integrating studies of the Sun's variability, the surrounding heliosphere, and climate environments. Over the past few centuries our understanding of how the Sun drives space weather and climate on the Earth and other planets has advanced at an ever-increasing rate. NASA Living With a Star and the UCAR Visiting Scientist Progams sponsor the annual Heliophysics Summer Schools to build the next generation of scientists in this emerging field. The highly successful series of the summer schools (commencing 2007) trains a select group of graduate students, postdoctoral fellows and university faculty to learn and develop the science of heliophysics as a broad, coherent discipline that reaches in space from the Earth's troposphere to the depths of the Sun, and in time from the formation of the solar system to the distant future. The first three years of the school resulted in the publication of three textbooks now being used at universities worldwide. Subsequent years have also developed the complementary materials that support teaching of heliophysics at both graduate and undergraduate levels. The textbooks are edited by Carolus J. Schrijver, Lockheed Martin, and George L. Siscoe, Boston University. The books provide a foundational reference for researchers in heliophysics, astrophysics, plasma physics, space physics, solar physics aeronomy, space weather, planetary science and climate science. The Jack Eddy Postdoctoral Fellowship Program matches newly graduated postdoctorates with hosting mentors for the purpose of training the next generation researchers needed in heliophysics. The fellowships are for two years, and any U.S. university or research lab may apply to host a fellow. Two major topics of focus for the program are the science of space weather and of the Sun-climate connection. Since the goal of this fellowship program is to train Sun-Earth system researchers, preference is also given to research projects that cross the traditional heliophysics subdomains of the Sun, heliosphere, magnetosphere, and ionosphere/upper atmosphere, as well as Sun-climate investigations. Host mentors plan critical roles. Potential hosts may enter information about their research on a central database.

[Cognitive impairment in earthquake brain injury treated with comprehensive program of acupuncture and rehabilitation: a randomized controlled trial].

PubMed

Zhou, Jian-Wei; Zhang, An-Ren; Qiu, Ling; Huang, Shu; Wang, Wen-Chun; Hu, Yong-He; Zhang, Zhao; Xie, Hui-Jun; Zhao, Jing-Jing; Zhai, Jia-Li; Jiang, Yue; Tian, Tian; Liu, Di; Zheng, Xu; Wang, Min

2014-02-01

To explore the comprehensive program of integrated Chinese and western medicine in the treatment of cognitive impairment in earthquake brain injury. The multi-central randomized controlled trial was adopted. The qualified subjects were randomized into an acupuncture + rehabilitation group (38 cases) and a rehabilitation group (35 cases). In the acupuncture + rehabilitation group, acupuncture, hyperbaric oxygen (HBO) and cognitive rehabilitation training were combined as the comprehensive program of integrated Chinese and western medicine in the treatment. In the rehabilitation group, HBO and cognitive rehabilitation training were adopted. The efficacy and safety were assessed. (1) After treatment of 2 months, the intelligent state, cognitive function and activity of daily life of patients were improved in the both groups (all P < 0.01). (2) After treatment of 2 months, the score of MMSE and the score of activity of daily life were (24.11 +/- 4.08) and (75.45 +/- 13.95) in the acupuncture + rehabilitation group, which were more significant as compared with (17.05 +/- 43.84), (66.06 +/- 12.75) in the rehabilitation group, respectively (both P < 0.01). In 6-month follow-up visit after treatment, the cognitive function and activity of daily life were improved continuously in the acupuncture + rehabilitation group, which was more significant as compared with the rehabilitation group (P < 0.01, P < 0.05). The integrated Chinese and western medicine of acupuncture, HBO and cognitive rehabilitation training is safe and effective in the treatment of cognitive impairment in earthquake brain injury. The therapeutic effect is more advantageous as compared with the simple rehabilitation program of western medicine.

KSC-2012-3055

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – A NASA Railroad train crosses the railroad’s Jay Jay Railroad Bridge north of Launch Complex 39 at NASA’s Kennedy Space Center in Florida. The train is on its way to the Florida East Coast Railway interchange in Titusville, Fla., where the train’s helium tank cars, a liquid oxygen tank car, and a liquid hydrogen dewar or tank car will be transferred for delivery to the SpaceX engine test complex outside McGregor, Texas. The helium tank cars are positioned in the front and rear of the train. The long, thin tank car in the middle was used for liquid hydrogen, followed by a much larger tank car used for liquid oxygen. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

KSC-2012-3054

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – A NASA Railroad train crosses the railroad’s Jay Jay Railroad Bridge north of Launch Complex 39 at NASA’s Kennedy Space Center in Florida. The train is on its way to the Florida East Coast Railway interchange in Titusville, Fla., where the train’s helium tank cars, a liquid oxygen tank car, and a liquid hydrogen dewar or tank car will be transferred for delivery to the SpaceX engine test complex outside McGregor, Texas. The helium tank cars are positioned in the front and rear of the train. The long, thin tank car in the middle was used for liquid hydrogen, followed by a much larger tank car used for liquid oxygen. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

For support of USAMRMC Biological Weapons Convention, treaty and statement implementation activities. Final report, 1 March 1996-28 February 1997

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fox, J.

Program of work to provide support to the Biological Arms Control Treaty Office (BACTO) of the U.S. Army Medical Research and Material Command (USAMRMC), in the development of Army and U.S. Government negotiation, implementation and compliance policies and preparations regarding potential verification and confidence measures for the 1975 Biological Weapons Convention (BWC) and related biological weapons agreements. Support services provided included the preparation of Army installations and commands for implementation of visits pursuant to the U.S./UK/Russian Trilateral Statement on BW. Support included site assistance visit, development of required facility documentation and briefings, identification of additional facilities potentially subject to access,more » and support to DOD development of guidelines, procedures, documentation, and other materials for the conduct of visits. Specific tasks under this contract included: identification and delineation of `Military Biological Facilities` and related activities at Army installations; development of visit implementation documentation for the Army; assessment of potentially at-risk equities and sensitivities at relevant facilities; facility staff training and preparation; and review and modification of facility inputs to annual BWC Confidence Building Measure Declarations. Also supported the provision of timely and critical technical support to the Joint Staff and OSD in the development of DoD negotiation biological arms control positions.« less

Initial Impact of the Fast Track Prevention Trial for Conduct Problems: I. The High-Risk Sample

PubMed Central

2009-01-01

Fast Track is a multisite, multicomponent preventive intervention for young children at high risk for long-term antisocial behavior. Based on a comprehensive developmental model intervention included a universal-level classroom program plus social skills training, academic tutoring, parent training, and home visiting to improve competencies and reduce problems in a high-risk group of children selected in kindergarten. At the end of Grade 1, there were moderate positive effects on children's social, emotional, and academic skills; peer interactions and social status; and conduct problems and special-education use. Parents reported less-physical discipline and greater parenting satisfaction/ease of parenting and engaged in more appropriate/consistent discipline, warmth/positive involvement, and involvement with the school. Evidence of differential intervention effects across child gender, race, site, and cohort was minimal. PMID:10535230

Mothers’ experiences in the Nurse-Family Partnership program: a qualitative case study

PubMed Central

2012-01-01

Background Few studies have explored the experiences of low income mothers participating in nurse home visiting programs. Our study explores and describes mothers' experiences participating in the Nurse-Family Partnership (NFP) Program, an intensive home visiting program with demonstrated effectiveness, from the time of program entry before 29 weeks gestation until their infant's first birthday. Methods A qualitative case study approach was implemented. A purposeful sample of 18 low income, young first time mothers participating in a pilot study of the NFP program in Hamilton, Ontario, Canada partook in one to two face to face in-depth interviews exploring their experiences in the program. All interviews were digitally recorded and transcribed verbatim. Conventional content analysis procedures were used to analyze all interviews. Data collection and initial analysis were implemented concurrently. Results The mothers participating in the NFP program were very positive about their experiences in the program. Three overarching themes emerged from the data: 1. Getting into the NFP program; 2. The NFP nurse is an expert, but also like a friend providing support; and 3. Participating in the NFP program is making me a better parent. Conclusions Our findings provide vital information to home visiting nurses and to planners of home visiting programs about mothers' perspectives on what is important to them in their relationships with their nurses, how nurses and women are able to develop positive therapeutic relationships, and how nurses respond to mothers' unique life situations while home visiting within the NFP Program. In addition our findings offer insights into why and under what circumstances low income mothers will engage in nurse home visiting and how they expect to benefit from their participation. PMID:22953748

Accelerating Commercial Remote Sensing

NASA Technical Reports Server (NTRS)

1995-01-01

Through the Visiting Investigator Program (VIP) at Stennis Space Center, Community Coffee was able to use satellites to forecast coffee crops in Guatemala. Using satellite imagery, the company can produce detailed maps that separate coffee cropland from wild vegetation and show information on the health of specific crops. The data can control coffee prices and eventually may be used to optimize application of fertilizers, pesticides and irrigation. This would result in maximal crop yields, minimal pollution and lower production costs. VIP is a mechanism involving NASA funding designed to accelerate the growth of commercial remote sensing by promoting general awareness and basic training in the technology.

KSC-04PD-1459

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. In the Space Station Processing Facility, Center Director Jim Kennedy (second from left) presents a framed photo to Mary Harney , Tanaiste (deputy prime minister) and Minister for Enterprise, Trade and Employment of Ireland. Harney is visiting KSC to support a Memorandum of Understanding between Florida Spaceport Authority and the Irish governments training and employment authority (FAS). The joint initiative enables Irish students to work with science and engineering experts during a six-week program in Florida. At far left is FSA Director Capt. Winston Scott. Next to Harney is Paul Haran, secretary to the deputy prime minister.

KSC-04pd1459

NASA Image and Video Library

2004-07-09

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Center Director Jim Kennedy (second from left) presents a framed photo to Mary Harney , Tanaiste (deputy prime minister) and Minister for Enterprise, Trade and Employment of Ireland. Harney is visiting KSC to support a Memorandum of Understanding between Florida Spaceport Authority and the Irish government’s training and employment authority (FAS). The joint initiative enables Irish students to work with science and engineering experts during a six-week program in Florida. At far left is FSA Director Capt. Winston Scott. Next to Harney is Paul Haran, secretary to the deputy prime minister.

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Military Training Time and Cost Should Be Reduced Through Improved Management.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

The report on the management of recruit and initial skill training identifies delays in training cycles, their causes, and resultant costs. In visits to four recruit training centers, eight initial skill training schools, and various headquarters offices, the General Accounting Office (GAO) identified 1,979,000 man-days per year that new members…

Corrosion Program

DTIC Science & Technology

2010-02-01

April 2010 8-10 June 2010 3-5 August 2010 5 Corrosion Assistance Team ( CAT ) Visits Classroom Briefing • General Corrosion Theory • Preventive Maintenance...MD DC CAT Visit 2009 CAT Visit 2008 CAT Visit 2007 CAT Visit 2006 CAT Visit 2005 CAT Visits (calendar year) ME HI Germany ROK Honduras Egypt Japan DE 8

Approaches to systematic assessment of environmental exposures posed at hazardous waste sites in the developing world: the Toxic Sites Identification Program.

PubMed

Ericson, Bret; Caravanos, Jack; Chatham-Stephens, Kevin; Landrigan, Philip; Fuller, Richard

2013-02-01

In the developing world, environmental chemical exposures due to hazardous waste sites are poorly documented. We describe the approach taken by the Blacksmith Institute's Toxic Sites Identification Program in documenting environmental chemical exposures due to hazardous waste sites globally, identifying sites of concern and quantifying pathways, populations, and severity of exposure. A network of local environmental investigators was identified and trained to conduct hazardous waste site investigations and assessments. To date, 2,095 contaminated sites have been identified within 47 countries having an estimated population at risk of 71,500,000. Trained researchers and investigators have visited 1,400 of those sites. Heavy metals are the leading primary exposures, with water supply and ambient air being the primary routes of exposure. Even though chemical production has occurred largely in the developed world to date, many hazardous waste sites in the developing world pose significant hazards to the health of large portions of the population. Further research is needed to quantify potential health and economic consequences and identify cost-effective approaches to remediation.

Community oriented interprofessional health education in Mozambique: one student/one family program.

PubMed

Ferrão, L J; Fernandes, Tito H

2014-01-01

In the remote northern region of Mozambique the ratio of doctors to patients is 1:50,000. In 2007, Lúrio University initiated an innovative, "One Student/One Family" program of teaching and learning for health professions students, to complement their traditional core curriculum. All students of each of the school's six health degree programs complete a curriculum in "Family and Community Health" in each year of their training. Groups of six students from six different health professions training programs make weekly visits to communities, where each student is allocated to a family. Students learn from their families about community life and health issues, within a community where 80% of the population still lacks access to modern health care and rely on indigenous doctors and traditional remedies. In turn, students transmit information to families about modern health care and report to the faculty any major health problems they find. The educational/experiential approach is interprofessional and community-oriented. The main perceived advantages of the program are that it is applied and problem-based learning for students, while simultaneously providing needed healthcare services to the community. The major disadvantages include the complexity of coordinating multidisciplinary groups, the time and distance required of students in traveling to communities, and interpretation of multiple reports with variable data. This community-oriented education program involving students from six disciplines uses nontraditional teaching/learning methods is the basis of the ex libris of Lúrio University.

Barriers and Facilitators to Implementing a Change Initiative in Long-Term Care Using the INTERACT® Quality Improvement Program.

PubMed

Tappen, Ruth M; Wolf, David G; Rahemi, Zahra; Engstrom, Gabriella; Rojido, Carolina; Shutes, Jill M; Ouslander, Joseph G

Implementation of major organizational change initiatives presents a challenge for long-term care leadership. Implementation of the INTERACT® (Interventions to Reduce Acute Care Transfers) quality improvement program, designed to improve the management of acute changes in condition and reduce unnecessary emergency department visits and hospitalizations of nursing home residents, serves as an example to illustrate the facilitators and barriers to major change in long-term care. As part of a larger study of the impact of INTERACT® on rates of emergency department visits and hospitalizations, staff of 71 nursing homes were called monthly to follow-up on their progress and discuss successful facilitating strategies and any challenges and barriers they encountered during the yearlong implementation period. Themes related to barriers and facilitators were identified. Six major barriers to implementation were identified: the magnitude and complexity of the change (35%), instability of facility leadership (27%), competing demands (40%), stakeholder resistance (49%), scarce resources (86%), and technical problems (31%). Six facilitating strategies were also reported: organization-wide involvement (68%), leadership support (41%), use of administrative authority (14%), adequate training (66%), persistence and oversight on the part of the champion (73%), and unfolding positive results (14%). Successful introduction of a complex change such as the INTERACT® quality improvement program in a long-term care facility requires attention to the facilitators and barriers identified in this report from those at the frontline.

Effective Implementation of Collaborative Care for Depression: What is Needed?

PubMed Central

Whitebird, Robin R.; Solberg, Leif I.; Jaeckels, Nancy A.; Pietruszewski, Pamela B.; Hadzic, Senka; Unützer, Jürgen; Ohnsorg, Kris A.; Rossom, Rebecca C.; Beck, Arne; Joslyn, Ken; Rubenstein, Lisa V.

2014-01-01

Objective To identify the care model factors that were key for successful implementation of collaborative depression care in a statewide Minnesota primary care initiative. Study Design We used a mixed-methods design incorporating both qualitative data from clinic site visits and quantitative measures of patient activation and 6-month remission rates. Methods Care model factors identified from the site visits were tested for association with rates of activation into the program and remission rates. Results Nine factors were identified as important for successful implementation of collaborative care by the consultants who had trained and interviewed participating clinic teams. Factors correlated with higher patient activation rates were: strong leadership support (0.63), well-defined and implemented care manager roles (0.62), a strong primary care physician champion (0.60), and an on-site and accessible care manager (0.59). However, remission rates at six months were correlated with: an engaged psychiatrist (0.62), not seeing operating costs as a barrier to participation (0.56), and face-to-face communication (warm handoffs) between the care-manager and primary care physician for new patients (0.54). Conclusions Care model factors most important for successful program implementation differ for patient activation into the program versus remission at six months. Knowing which implementation factors are most important for successful implementation will be useful for those interested in adopting this evidence-based approach to improve primary care for patients with depression. PMID:25365745

COS/FUV Mapping of Stray PtNe Lamp Light Through FCA

NASA Astrophysics Data System (ADS)

Oliveira, Cristina

2010-09-01

This program determines which cross-dispersion locations lead to wavecal lamp {PtNe} light leaking through the flat-field calibration aperture {FCA}. This unexpected effect, observed initially in program 12096, led to a shut down of the COS/FUV detector due to a global count rate violation in Segment A of the G140L/1230 setting. Detector? threshold ?is ?600,000 ?FEC ?counts ?in? 10 seconds ?on each ?segment. ?If ?this ?level? is ?exceeded, ?the? detector? shuts ?down? the ?HV.In program 12096, for the G140L/1230 setting, at +6" from the nominal position in the cross-dispersion direction, 180,000 cts/sec were observed through the FCA in Segment A, and 49,000 cts/sec in Segment B {PtNe/FCA}. The corresponding wavecal count rate {PtNe/WCA} is 685 cts/sec in Segment A, implying that there is a scale factor of 263 between the FCA and WCA count rates. This scale factor could not be verified for Segment B, given that the PtNe lamp does not produce counts at the short wavelengths seen by G140L/1230/FUVB. However, this scaling factor is expected to be the same for both segments.The scaling factor derived from program 12096 is then used to predict the FCA count rates seen with all the gratings, in off-nominal positions where light might leak through the FCA in the current program.There is no light leak between the nominal position and positions up to and including +3" {at least not in Mar 2010 when program 12096 executed}, but somewhere above +3" and certainly at +6" the PtNe light starts leaking through the FCA.Light is not predicted to leak at negative POS-TARG positions from the nominal, and the purpose of this program is to verify that as well.Visits 1N to 6N take data at positions from +1.0" to +6.0", while visits 1S to 6S take data at positions from -1.0" to -6.0". Visits 10 through 13 take data at the nominal position, 0.0".At each position in the detector data is taken with the following settings:G130M/1055/1291/1327, G160M/1577/1623, and G140L/1280/1105, in this order.LAMP2 with CURRENT=LOW is used in all of these visits. In addition, at each position, one exposure with LAMP1 CURRENT=MED is also taken with the G130M/1055 setting, which leads to total counts in 10 sec more than a factor of 10 below the 600,000 limit. This exposure is used so that the ratio of LAMP1/MED to LAMP2/LOW can be calculated for the FCA at each position {in conjunction with the data obtained in visits 11, 12, and 13; see below}. In addition, the G130M/1055 exposures with LAMP1/MED and LAMP2/LOW will be used to determine if the lamp spot size is changing at each position.Depending on the total counts estimated for each setting, either a typical wave exposure is taken or special flash commands are used. Details are given in each visit.Exposures obtained with LAMP1/CURRENT=LOW are expected to have a 20% smaller count rate than exposures obtained with LAMP1/CURRENT=MED. Exposures obtained with LAMP2/CURRENT=MED are expected to have count rates similar to those obtained with LAMP1/CURRENT=MED, and exposures obtained with LAMP2/CURRENT=LOW are expected to have a count rate which is 1/7 of that obtainedwith LAMP2/CURRENT=MED.VISIT 10 OBTAINS LAMP1/CURRENT=MED+ LOW SPECTRA AT ALL THE M SETTINGS USED IN THIS PROGRAM, AT THE NOMINAL POSITION {0.0"}.VISIT 11 OBTAINS LAMP2/CURRENT=MED SPECTRA AT ALL THE M SETTINGS USED IN THIS PROGRAM, AT THE NOMINAL POSITION {0.0"}.VISIT 12 OBTAINS LAMP2/CURRENT=LOW SPECTRA AT ALL THE M SETTINGS USED IN THIS PROGRAM, AT THE NOMINAL POSITION {0.0"}.VISIT 13 OBTAINS LAMP1/CURRENT=MED, LOW AND LAMP2/CURRENT=MED, LOW SPECTRA AT ALL OF THE L SETTINGS USED IN THIS PROGRAM, AT THE NOMINAL POSITION {0.0"}.THE GOAL OF THESE VISITS IS TO DETERMINE THE RATIOS OF THE DIFFERENT LAMP SETTINGS AT DIFFERENT WAVELENGTHS, TO HELP IN ANALYZING THE DATA OBTAINED IN VISITS WHERE ONLY LAMP2/LOW IS USED.ALSO, THESE DATA WILL BE USED TO PREDICT WHAT THE COUNTS WOULD BE WITH G140L/1280/LAMP1/MED AT THE +6.0" POSITION {VIS6N, WHERE LAMP2/LOW IS USED}. THESE COUNTS WILL BE COMPARED WITH THE COUNTS OBTAINED IN PROGRAM 12096 WITH G140L/1230/LAMP1/MED, MORE THAN ONE YEAR AGO, TO LOOK FOR VARIABILITY, POSSIBLY INDICATING CHANGES TO THE LAMP SPOT SIZE.Visits 10 through 13, all executed at the nominal position, pose no safety concerns.CONSTRAINTS:- Visits 1N, 2N, 3N can be executed back to back as no light is expected to leak through the FCA. Visit 1N should execute before visit 2N, which should execute before visit 3N.- Visits 1S, 2S, and 3S can be executed back to back and do not have constraints relative to the other visits. Visit 1S should execute before visit 2S, which should execute before visit 3S- Visits 10, 11, 12, and 13 {data obtained at nominal position}, can also be executed back to back and have no constraints relative to other visits. However, these visits should be scheduled as soon as possible, because results of data anaysis will be used to inform execution of program 12678.- There should be an interval of at least two days between any of the visits mentioned above and the other visits in this program {4N, 5N, 6N, 4S, 5S, 6S} which could see light leaking through the FCA.- Visits 4S and 4N can be scheduled in the same week, but they don't need to be.- Visits 5S and 5N can be scheduled in the same week, but they don't need to be.- There should be an interval of at least 3 weeks between visit 4N and visit 5N.- Visits 6S and 6N can be scheduled in the same week, but they don't need to be.- There should be an interval of at least 3 weeks between visit 5N and visit 6N.- Visits 1S through 5S should be scheduled as soon as possible, the same is true for visits 1N to 4N.

Visiting Scholars Program | FNLCR Staging

Cancer.gov

The Visiting Scholars Program (VSP) is a scientific partnership program that offers extramural scientists access to the intellectual capital and state-of-the-art facilities of the Frederick National Laboratory for Cancer Research (FNLCR), the only na

Telescopes on Cerro Tololo & Cerro Pachon | CTIO

Science.gov Websites

Program PIA Program GO-FAAR Program Other Opportunities Tourism Visits to Tololo Astro tourism in Chile Tourism in Chile Information for travelers Visit Tololo Media Relations News Press Release Publications

Victor Blanco 4-m Telescope | CTIO

Science.gov Websites

Program PIA Program GO-FAAR Program Other Opportunities Tourism Visits to Tololo Astro tourism in Chile Tourism in Chile Information for travelers Visit Tololo Media Relations News Press Release Publications

Otolaryngology workforce analysis.

PubMed

Hughes, Charles Anthony; McMenamin, Patrick; Mehta, Vikas; Pillsbury, Harold; Kennedy, David

2016-12-01

The number of trained otolaryngologists available is insufficient to supply current and projected US health care needs. The goal of this study was to assess available databases and present accurate data on the current otolaryngology workforce, examine methods for prediction of future health care needs, and explore potential issues with forecasting methods and policy implementation based on these predictions. Retrospective analysis of research databases, public use files, and claims data. The total number of otolaryngologists and current practices in the United States was tabulated using the databases of the American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Board of Otolaryngology, American College of Surgeons, Association of American Medical Colleges, National Center for Health Statistics, and Department of Health and Human Services. Otolaryngologists were identified as surgeons and classified into surgical groups using a combination of AMA primary and secondary self-reported specialties and American Board of Medical Specialties certifications. Data gathered were cross-referenced to rule out duplications to assess total practicing otolaryngologists. Data analyzed included type of practice: 1) academic versus private and 2) general versus specialty; and demographics: 1) urban versus rural, 2) patient age, 3) reason for visit (referral, new, established, surgical follow-up), 4) reason for visit (diagnosis), and 5) payer type. Analysis from the above resources estimates the total number of otolaryngologists practicing in the United States in 2011 to be 12,609, with approximately 10,522 fully trained practicing physicians (9,232-10,654) and 2,087 in training (1,318 residents and 769 fellows/others). Based on 2011 data, workforce projections would place the fully trained and practicing otolaryngology workforce at 11,088 in 2015 and 12,084 in 2025 unless changes in training occur. The AAO-HNS Physicians Resource Committee performed an extensive analysis of collated data from multiple sources in 2014 and identified 10,800 practicing otolaryngologists and 2,087 in training. It is estimated that the current attrition rate is approximately 306 otolaryngologists per year. Percentage distribution of office visits by patient age was found to be 20% <15 years old, 7% 15 to 24 years old, 21% 25 to 44 years old, 32% 45 to 64 years old, 11% 65 to 74 years old, and 10% ≥75 years old. Reason for visit was 34% new, 29% chronic, 17% chronic with exacerbation, and 15% pre- or postsurgical follow-up. The top diagnoses consisted of otitis media, chronic sinusitis, and impacted cerumen. Payer mix consisted of 59% private insurance, 19% Medicare, and 12% Medicaid/Children's Health Insurance Program. Despite past findings and predictions of 8,000 to 8,500 otolaryngologists practicing in the United States, collated data from above resources places the total at 12,887, with 10,800 fully trained and practicing in 2014. This 30% to 50% underestimation of the otolaryngology workforce has an impact on future predictions and resource utilization analysis. Even when this correction is considered, the available trained otolaryngologists required to serve the otolaryngologic health care needs of the US population are still insufficient and understaffed. The impact of an aging population and the estimated 30 to 47 million newly insured citizens under the 2010 Patient Protection and Affordable Care Act are also unprecedented variables that must be considered. Further analysis of differences in physician productivity and geographic population density, and model formation of current otolaryngology workforce utilization, are needed to predict future public health needs. NA Laryngoscope, 126:5-11, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

An NGO-Implemented Community-Clinic Health Worker Approach to Providing Long-Term Care for Hypertension in a Remote Region of Southern India.

PubMed

Sankaran, Sujatha; Ravi, Prema S; Wu, Yichen Ethel; Shanabogue, Sharan; Ashok, Sangeetha; Agnew, Kaylan; Fang, Margaret C; Khanna, Raman A; Dandu, Madhavi; Harrison, James D

2017-12-28

Poor blood pressure control results in tremendous morbidity and mortality in India where the leading cause of death among adults is from coronary heart disease. Despite having little formal education, community health workers (CHWs) are integral to successful public health interventions in India and other low- and middle-income countries that have a shortage of trained health professionals. Training CHWs to screen for and manage chronic hypertension, with support from trained clinicians, offers an excellent opportunity for effecting systemwide change in hypertension-related burden of disease. In this article, we describe the development of a program that trained CHWs between 2014 and 2015 in the tribal region of the Sittilingi Valley in southern India, to identify hypertensive patients in the community, refer them for diagnosis and initial management in a physician-staffed clinic, and provide them with sustained lifestyle interventions and medications over multiple visits. We found that after 2 years, the CHWs had screened 7,176 people over age 18 for hypertension, 1,184 (16.5%) of whom were screened as hypertensive. Of the 1,184 patients screened as hypertensive, 898 (75.8%) had achieved blood pressure control, defined as a systolic blood pressure less than 140 and a diastolic blood pressure less than 90 sustained over 3 consecutive visits. While all of the 24 trained CHWs reported confidence in checking blood pressure with a manual blood pressure cuff, 4 of the 24 CHWs reported occasional difficulty documenting blood pressure values because they were unable to write numbers properly. They compensated by asking other CHWs or members of their community to help with documentation. Our experience and findings suggest that a CHW blood pressure screening system linked to a central clinic can be a promising avenue for improving hypertension control rates in low- and middle-income countries. © Sankaran et al.

The rehabilitation of attention in patients with mild cognitive impairment and brain subcortical vascular changes using the Attention Process Training-II. The RehAtt Study: rationale, design and methodology.

PubMed

Salvadori, Emilia; Poggesi, Anna; Valenti, Raffaella; Della Rocca, Eleonora; Diciotti, Stefano; Mascalchi, Mario; Inzitari, Domenico; Pantoni, Leonardo

2016-10-01

Cerebral small vessel disease (SVD) may cause attentional and executive cognitive deficits. No drug is currently available to improve cognitive performance or to prevent dementia in SVD patients, and cognitive rehabilitation could be a promising approach. We aimed to investigate: (1) the effectiveness of the Attention Process Training-II program in the rehabilitation of patients with mild cognitive impairment (MCI) and SVD; (2) the impact of the induced cognitive improvement on functionality and quality of life; (3) the effect of training on brain activity at rest and the possibility of a training-induced plasticity effect. The RehAtt study is designed as a 3-year prospective, single-blinded, randomized clinical trial. Inclusion criteria were: (1) MCI defined according to Winblad et al. criteria; (2) evidence of impairment across attention neuropsychological tests; (3) evidence on MRI of moderate/severe white matter hyperintensities. All enrolled patients are evaluated at baseline, and after 6 and 12 months, according to an extensive clinical, functional, MRI and neuropsychological protocol. The baseline RehAtt cohort includes 44 patients (66 % males, mean ± SD age and years of education 75.3 ± 6.8 and 8.3 ± 4.3, respectively). After baseline assessment, patients have been randomly assigned to 'attention training' or 'standard care'. Treatments and follow-up visits at 6 months are completed, while follow-up visits at 12 months are ongoing. This study is the first attempt to reduce attention deficits in patients affected by MCI with SVD. The results of this pilot experience will represent an essential background for designing larger multicenter, prospective, double-blinded, randomized and controlled clinical trials. NCT02033850 (ClinicalTrials.gov Identifier).

Home Visitations for Delivering an Early Childhood Obesity Intervention in Denver: Parent and Patient Navigator Perspectives.

PubMed

Knierim, Shanna Doucette; Moore, Susan L; Raghunath, Silvia Gutiérrez; Yun, Lourdes; Boles, Richard E; Davidson, Arthur J

2018-06-23

Objective This qualitative study explored parent and patient navigator perspectives of home visitation as part of a childhood obesity program in a low-income, largely Latino population. Methods Three patient navigators and 25 parents who participated in a home-based, childhood obesity program participated in focus groups or interviews. Emergent themes were identified through content analysis of qualitative data. Results Three overall themes were identified. Patient navigators and parents perceived: (1) enabling characteristics of home-based program delivery which facilitated family participation and/or behavior change (i.e., convenience, increased accountability, inclusion of household members, delivery in a familiar, intimate setting, and individualized pace and content); (2) logistic and cultural challenges to home-based delivery which reduced family participation and program reach (i.e., difficulties scheduling visits, discomfort with visitors in the home, and confusion about the patient navigator's role); and (3) remediable home-based delivery challenges which could be ameliorated by additional study staff (e.g., supervision of children, safety concerns) or through organized group sessions. Both patient navigators and participating parents discussed an interest in group classes with separate, supervised child-targeted programming and opportunities to engage with other families for social support. Conclusions for Practice A home visitation program delivering a pediatric obesity prevention curriculum in Denver was convenient and held families accountable, but posed scheduling difficulties and raised safety concerns. Conducting home visits in pairs, adding obesity prevention curriculum to existing home visiting programs, or pairing the convenience of home visits with group classes may be future strategies to explore.

The Shapley Program 1985 - 1990: The Virginia Years

NASA Astrophysics Data System (ADS)

Tolbert, C. R.

1998-05-01

The Shapley Program moved to the University of Virginia from the University of Delaware in the summer of 1985. Prior to moving to Charlottesville the program had been run by Harry Shipman. 1985 - 1986 was the year of Comet Halley, and it was also the year that the program reached its peak of visits made by the astronomical community. We scheduled 135 visits that year. Luckily, I was new on the job and didn't realize the effort that would be involved in coordinating that many visiting astronomers. One way or the other we got through the "big" year and, after consultation with the Council, established a maximum number of visits to be scheduled per year at 80. We maintained that number every year through the Virginia period. It was during this time that the office purchased its first computer and computerized the mailing list. We sent brochures to some 2,000 plus colleges and junior colleges throughout the US, Canada and Mexico. (regrettably, we never received a request form a Mexican school.) The fee charged to the school for each visit was \\75 per visit in the beginning and rose to \\200 per school by the end of the period. The rest of the costs of the program were borne by the Shapley Endowment Fund and the AAS Education Office. We waived the fee from a number of schools on request. In addition to being a Shapley Lecturer myself, I had the great pleasure during this period of receiving the many compliments about the program. There is no question that the Shapley Visiting Lectureships Program provides an excellent service to small colleges in both the US and Canada. Based on the reports of our success, the American Physical Society re-instituted their lecture program as did the American Optical Society.

Nonpharmacological treatment of tics in Tourette syndrome adding videotape training to self-hypnosis.

PubMed

Lazarus, Jeffrey E; Klein, Susan K

2010-01-01

This case series examines the practicality of using a standardized method of training children in self-hypnosis (SH) methods to explore its efficiency and short-term efficacy in treating tics in patients with Tourette syndrome. The files of 37 children and adolescents with Tourette syndrome referred for SH training were reviewed, yielding 33 patients for analysis. As part of a protocol for SH training, all viewed a videotape series of a boy undergoing SH training for tic control. Improvement in tic control was abstracted from subjective patient report. Seventy-nine percent of the patients trained in this technique experienced short-term clinical response, defined as control over the average 6-week follow-up period. Of the responders, 46% achieved tic control with SH after only 2 sessions and 96% after 3 visits. One patient required 4 visits. Instruction in SH, aided by the use of videotape training, augments a protocol and probably shortens the time of training in this technique. If SH is made more accessible in this way, it will be a valuable addition to multi-disciplinary management of tic disorders in Tourette syndrome.

Development and outcomes of a program to translate the evidence for spinal manipulation into physical therapy practice

PubMed Central

Kramer, Christopher D; Koch, William H; Fritz, Julie M

2013-01-01

Objectives: To describe a program to translate evidence into practice for the use of manipulation with a sub-group of patients with low back pain and report the program's outcomes following implementation. We compared outcomes based on appropriate inclusion in the program and compliance with the evidence being translated. Methods: The evidence translation program was based on evidence that patients meeting two criteria (duration of symptoms <16 days, no symptoms distal to knee) were likely to respond to a physical therapy that included manipulation in the first two visits. Implementation addressed potential barriers with referring physicians, physical therapists, and scheduling staff to this evidence. Outcomes for patients in the program were tracked following implementation. Process outcomes were appropriateness of inclusion (met both criteria), compliance with evidence for providing thrust manipulation in the first two visits, and number of physical therapy visits. Clinical outcomes were based on Oswestry scores from the first, interim (after two to three visits), and final visit. Results: A total of 577 patients entered the evidence translation program (mean age  =  43.0, 56.8% female); 79.5% were appropriate inclusions and 83.0% received manipulation. The use of manipulation was associated with fewer visits (mean difference  =  0.54 visits, 95% CI: 0.037, 1.04, P  =  0.035), and appropriate inclusion was associated with greater Oswestry change (mean difference at the final visit  =  6.6 points, 95% CI: 1.6, 11.6; P  =  0.010). Discussion: Implementing evidence into practice is difficult; however, barriers can be anticipated and overcome. Tracking the outcomes of an implementation program is critical to evaluating its benefit to patients. Additional research using experimental designs are necessary to evaluate the effectiveness of various treatments implemented in physical therapy practice. PMID:24421630

Impact of a Community Dental Access Program on Emergency Dental Admissions in Rural Maryland.

PubMed

Rowland, Sandi; Leider, Jonathon P; Davidson, Clare; Brady, Joanne; Knudson, Alana

2016-12-01

To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP's impact on dental-related visits to a regional emergency department (ED). We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015. The CDP served approximately 1600 unique clients across 2700 visits during FYs 2011 through 2015. The model suggested that if the CDP had not provided services during that time period, about 670 more dental-related visits to the ED would have occurred, resulting in $215 000 more in charges. Effective ED dental diversion programs can result in substantial cost savings to taxpayers, and more appropriate and cost-effective care for the patient. Community dental access programs may be a viable way to patch the dental safety net in rural communities while holistic solutions are developed.

Impact of a Community Dental Access Program on Emergency Dental Admissions in Rural Maryland

PubMed Central

Rowland, Sandi; Davidson, Clare; Brady, Joanne; Knudson, Alana

2016-01-01

Objectives. To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP’s impact on dental-related visits to a regional emergency department (ED). Methods. We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015. Results. The CDP served approximately 1600 unique clients across 2700 visits during FYs 2011 through 2015. The model suggested that if the CDP had not provided services during that time period, about 670 more dental-related visits to the ED would have occurred, resulting in $215 000 more in charges. Conclusions. Effective ED dental diversion programs can result in substantial cost savings to taxpayers, and more appropriate and cost-effective care for the patient. Policy Implications. Community dental access programs may be a viable way to patch the dental safety net in rural communities while holistic solutions are developed. PMID:27736218

Association of mandated language access programming and quality of care provided by mental health agencies.

PubMed

McClellan, Sean R; Snowden, Lonnie

2015-01-01

This study examined the association between language access programming and quality of psychiatric care received by persons with limited English proficiency (LEP). In 1999, the California Department of Mental Health required county Medicaid agencies to implement a "threshold language access policy" to meet the state's Title VI obligations. This policy required Medi-Cal agencies to provide language access programming, including access to interpreters and translated written material, to speakers of languages other than English if the language was spoken by at least 3,000, or 5%, of the county's Medicaid population. Using a longitudinal study design with a nonequivalent control group, this study examined the quality of care provided to Spanish speakers with LEP and a severe mental illness before and after implementation of mandatory language access programming. Quality was measured by receipt of at least two follow-up medication visits within 90 days or three visits within 180 days of an initial medication visit over a period of 38 quarter-years. On average, only 40% of Spanish-speaking clients received at least three medication follow-up visits within 180 days. In multivariate analyses, language access programming was not associated with receipt of at least two medication follow-up visits within 90 days or at least three visits within 180 days. This study found no evidence that language access programming led to increased rates of follow-up medication visits for clients with LEP.

A Cost-Benefit Analysis of a State-Funded Healthy Homes Program for Residents With Asthma: Findings From the New York State Healthy Neighborhoods Program.

PubMed

Gomez, Marta; Reddy, Amanda L; Dixon, Sherry L; Wilson, Jonathan; Jacobs, David E

Despite considerable evidence that the economic and other benefits of asthma home visits far exceed their cost, few health care payers reimburse or provide coverage for these services. To evaluate the cost and savings of the asthma intervention of a state-funded healthy homes program. Pre- versus postintervention comparisons of asthma outcomes for visits conducted during 2008-2012. The New York State Healthy Neighborhoods Program operates in select communities with a higher burden of housing-related illness and associated risk factors. One thousand households with 550 children and 731 adults with active asthma; 791 households with 448 children and 551 adults with asthma events in the previous year. The program provides home environmental assessments and low-cost interventions to address asthma trigger-promoting conditions and asthma self-management. Conditions are reassessed 3 to 6 months after the initial visit. Program costs and estimated benefits from changes in asthma medication use, visits to the doctor for asthma, emergency department visits, and hospitalizations over a 12-month follow-up period. For the asthma event group, the per person savings for all medical encounters and medications filled was $1083 per in-home asthma visit, and the average cost of the visit was $302, for a benefit to program cost ratio of 3.58 and net benefit of $781 per asthma visit. For the active asthma group, per person savings was $613 per asthma visit, with a benefit to program cost ratio of 2.03 and net benefit of $311. Low-intensity, home-based, environmental interventions for people with asthma decrease the cost of health care utilization. Greater reductions are realized when services are targeted toward people with more poorly controlled asthma. While low-intensity approaches may produce more modest benefits, they may also be more feasible to implement on a large scale. Health care payers, and public payers in particular, should consider expanding coverage, at least for patients with poorly controlled asthma or who may be at risk for poor asthma control, to include services that address triggers in the home environment.

Early predictors of need for remediation in the Australian general practice training program: a retrospective cohort study.

PubMed

Magin, Parker; Stewart, Rebecca; Turnock, Allison; Tapley, Amanda; Holliday, Elizabeth; Cooling, Nick

2017-10-01

Underperforming trainees requiring remediation may threaten patient safety and are challenging for vocational training programs. Decisions to institute remediation are high-stakes-remediation being resource-intensive and emotionally demanding on trainees. Detection of underperformance requiring remediation is particularly problematic in general (family) practice. We sought to establish early-training assessment instruments predictive of general practice (GP) trainees' subsequently requiring formal remediation. We conducted a retrospective cohort study of trainees from a large Australian regionally-based GP training organization. The outcome factor was requirement for formal remediation. Independent variables were demographic factors and a range of formative assessments conducted immediately prior to or during early-stage training. Analyses employed univariate and multivariate logistic regression of each predictor assessment modality with the outcome, adjusting for potential confounders. Of 248 trainees, 26 (10.5 %) required formal remediation. Performance on the Colleague Feedback Evaluation Tool (entailing feedback from a trainee's clinical colleagues on clinical performance, communication and probity) and External Clinical Teaching Visits (half-day sessions of the trainee's clinical consultations observed directly by an experienced GP), along with non-Australian primary medical qualification, were significantly associated with requiring remediation. There was a non-significant trend for association with performance on the Doctors Interpersonal Skills Questionnaire (patient feedback on interpersonal elements of the consultation). There were no significant associations with entry-selection scores or formative exam or assessment scores. Our finding that 'in vivo' assessments of complex behaviour, but not 'in vitro' knowledge-based assessments, predict need for remediation is consistent with theoretical understanding of the nature of remediation decision-making and should inform remediation practice in GP vocational training.

The effect of a telephone-based health coaching disease management program on Medicaid members with chronic conditions.

PubMed

Lin, Wen-Chieh; Chien, Hung-Lun; Willis, Georgianna; O'Connell, Elizabeth; Rennie, Kate Staunton; Bottella, Heather M; Ferris, Timothy G

2012-01-01

Despite the growing popularity of disease management programs for chronic conditions, evidence regarding the effect of these programs has been mixed. In addition, few peer-reviewed studies have examined the effect of these programs on publicly insured populations. To examine the effect of a telephone-based health coaching disease management program on healthcare utilization and expenditures in Medicaid members with chronic conditions. Using a difference-in-differences analysis, we examined changes in hospitalizations, emergency department (ED) visits, ambulatory care visits, and Medicaid expenditures among program members for 1 year before and 2 years after their enrollment compared with a matched comparison group. Medicaid members aged 18 to 64 with a diagnosis of qualifying chronic conditions and 2 acute health service events of hospitalizations and/or ED visits within a 12-month period. Changes in acute hospitalizations, ambulatory care visits, and Medicaid expenditures before and after program enrollment were similar between the 2 study groups. However, during the second year after enrollment, program members had a significantly smaller decrease in ED visits than the comparisons (8% in program members and 23% in comparisons, P value=0.03). Compared with a matched comparison group, the telephone-based health coaching disease management program did not demonstrate significant effects on healthcare utilization and expenditures in Medicaid members with chronic conditions.

Training Trainers on a Tight Budget.

ERIC Educational Resources Information Center

Schoonmaker, Robert L.

1979-01-01

Presents training budget ideas which meet these criteria: (1) minimal cost, (2) minimal time consumption, and (3) convey skill or concept. Ideas include learning from attendance at free training demonstrations, sales meetings, professional groups, college/university courses, staff and division trainer meetings, visitations, cotraining sessions,…

The Nippon Foundation / GEBCO Indian Ocean Bathymetric Compilation Project

NASA Astrophysics Data System (ADS)

Wigley, R. A.; Hassan, N.; Chowdhury, M. Z.; Ranaweera, R.; Sy, X. L.; Runghen, H.; Arndt, J. E.

2014-12-01

The Indian Ocean Bathymetric Compilation (IOBC) project, undertaken by Nippon Foundation / GEBCO Scholars, is focused on building a regional bathymetric data compilation, of all publically-available bathymetric data within the Indian Ocean region from 30°N to 60° S and 10° to 147° E. One of the objectives of this project is the creation of a network of Nippon Foundation / GEBCO Scholars working together, derived from the thirty Scholars from fourteen nations bordering on the Indian Ocean who have graduated from this Postgraduate Certificate in Ocean Bathymetry (PCOB) training program training program at the University of New Hampshire. The IOBC project has provided students a working example during their course work and has been used as basis for student projects during their visits to another Laboratory at the end of their academic year. This multi-national, multi-disciplinary project team will continue to build on the skills gained during the PCOB program through additional training. The IOBC is being built using the methodology developed for the International Bathymetric Chart of the Southern Ocean (IBCSO) compilation (Arndt et al., 2013). This skill was transferred, through training workshops, to further support the ongoing development within the scholar's network. This capacity-building project is envisioned to connect other personnel from within all of the participating nations and organizations, resulting in additional capacity-building in this field of multi-resolution bathymetric grid generation in their home communities. An updated regional bathymetric map and grids of the Indian Ocean will be an invaluable tool for all fields of marine scientific research and resource management. In addition, it has implications for increased public safety by offering the best and most up-to-date depth data for modeling regional-scale oceanographic processes such as tsunami-wave propagation behavior amongst others.

Best Practices in Mentoring in NOAA Scholarship Programs

NASA Astrophysics Data System (ADS)

Kaplan, M.; Sarvis, S.; Dancy, V.

2015-12-01

Through established scholarship programs, NOAA hosts 125 - 175 undergraduate students each summer to participate in internship opportunities at agency facilities. In order to host a scholar, NOAA labs and offices must designate a mentor who develops a project and oversees activities of the student throughout the summer. NOAA implements best practices in mentoring in the following ways: mentor and intern responsibilities are clearly defined in a manual; mentors are required to take an online mentor training class; mentors and scholars are matched through an online system and scholars conduct a site visit prior to beginning the internship; proposed internship projects are reviewed by scholarship program managers to assure they are sufficiently analytical and will advance the student in their future academic and career goals; and mentors are surveyed at the midpoint, allowing scholarship program managers to identify problems and intervene if possible. These practices have resulted in strong results. Students identify the mentor relationship, hands-on experience and networking with professionals as the three most important outcomes of the internship experience.

Assessing the Efficiency of HIV Prevention around the World: Methods of the PANCEA Project

PubMed Central

Marseille, Elliot; Dandona, Lalit; Saba, Joseph; McConnel, Coline; Rollins, Brandi; Gaist, Paul; Lundberg, Mattias; Over, Mead; Bertozzi, Stefano; Kahn, James G

2004-01-01

Objective To develop data collection methods suitable to obtain data to assess the costs, cost-efficiency, and cost-effectiveness of eight types of HIV prevention programs in five countries. Data Sources/Study Setting Primary data collection from prevention programs for 2002–2003 and prior years, in Uganda, South Africa, India, Mexico, and Russia. Study Design This study consisted of a retrospective review of HIV prevention programs covering one to several years of data. Key variables include services delivered (outputs), quality indicators, and costs. Data Collection/Extraction Methods Data were collected by trained in-country teams during week-long site visits, by reviewing service and financial records and interviewing program managers and clients. Principal Findings Preliminary data suggest that the unit cost of HIV prevention programs may be both higher and more variable than previous studies suggest. Conclusions A mix of standard data collection methods can be successfully implemented across different HIV prevention program types and countries. These methods can provide comprehensive services and cost data, which may carry valuable information for the allocation of HIV prevention resources. PMID:15544641

New Research Strengthens Home Visiting Field: The Pew Home Visiting Campaign

ERIC Educational Resources Information Center

Doggett, Libby

2013-01-01

Extensive research has shown that home visiting parental education programs improve child and family outcomes, and they save money for states and taxpayers. Now, the next generation of research is deepening understanding of those program elements that are essential to success, ways to improve existing models, and factors to consider in tailoring…

Team Training (Training at Own Facility) versus Individual Surgeon's Training (Training at Trainer's Facility) When Implementing a New Surgical Technique: Example from the ONSTEP Inguinal Hernia Repair

PubMed Central

Laursen, Jannie

2014-01-01

Background. When implementing a new surgical technique, the best method for didactic learning has not been settled. There are basically two scenarios: the trainee goes to the teacher's clinic and learns the new technique hands-on, or the teacher goes to the trainee's clinic and performs the teaching there. Methods. An informal literature review was conducted to provide a basis for discussing pros and cons. We also wanted to discuss how many surgeons can be trained in a day and the importance of the demand for a new surgical procedure to ensure a high adoption rate and finally to apply these issues on a discussion of barriers for adoption of the new ONSTEP technique for inguinal hernia repair after initial training. Results and Conclusions. The optimal training method would include moving the teacher to the trainee's department to obtain team-training effects simultaneous with surgical technical training of the trainee surgeon. The training should also include a theoretical presentation and discussion along with the practical training. Importantly, the training visit should probably be followed by a scheduled visit to clear misunderstandings and fine-tune the technique after an initial self-learning period. PMID:25506078

KSC-2012-3053

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – A NASA Railroad train crosses the railroad’s Jay Jay Railroad Bridge north of Launch Complex 39 at NASA’s Kennedy Space Center in Florida. The train is on its way to the Florida East Coast Railway interchange in Titusville, Fla., where the train’s helium tank cars, a liquid oxygen tank car, and a liquid hydrogen dewar or tank car will be transferred for delivery to the SpaceX engine test complex outside McGregor, Texas. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

KSC-2012-3052

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – A NASA Railroad train crosses the railroad’s Jay Jay Railroad Bridge north of Launch Complex 39 at NASA’s Kennedy Space Center in Florida. The train is on its way to the Florida East Coast Railway interchange in Titusville, Fla., where the train’s helium tank cars, a liquid oxygen tank car, and a liquid hydrogen dewar or tank car will be transferred for delivery to the SpaceX engine test complex outside McGregor, Texas. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

KSC-2012-3034a

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – Engineers board a NASA Railroad train in preparation for its departure from the NASA Railroad Yard at NASA’s Kennedy Space Center in Florida. The train is headed for the Florida East Coast Railway interchange in Titusville, Fla., where the train’s helium tank cars, a liquid oxygen tank car, and a liquid hydrogen dewar or tank car will be transferred for delivery to the SpaceX engine test complex outside McGregor, Texas. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

KSC-2012-3039a

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – A NASA Railroad train passes in front of the 525-foot-tall Vehicle Assembly Building at NASA’s Kennedy Space Center in Florida. At the far right is the Orbiter Processing Facility. The train is on its way to the Florida East Coast Railway interchange in Titusville, Fla., where the train’s helium tank cars, a liquid oxygen tank car, and a liquid hydrogen dewar or tank car will be transferred for delivery to the SpaceX engine test complex outside McGregor, Texas. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

KSC-2012-3036a

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – A NASA Railroad train passes in front of the twin bays of the Orbiter Processing Facility at NASA’s Kennedy Space Center in Florida. The train is on its way to the Florida East Coast Railway interchange in Titusville, Fla., where the train’s helium tank cars, a liquid oxygen tank car, and a liquid hydrogen dewar or tank car will be transferred for delivery to the SpaceX engine test complex outside McGregor, Texas. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

KSC-2012-3035a

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – A NASA Railroad train passes in front of the twin bays of the Orbiter Processing Facility at NASA’s Kennedy Space Center in Florida. The train is on its way to the Florida East Coast Railway interchange in Titusville, Fla., where the train’s helium tank cars, a liquid oxygen tank car, and a liquid hydrogen dewar or tank car will be transferred for delivery to the SpaceX engine test complex outside McGregor, Texas. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

KSC-2012-3056

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – A NASA Railroad train has crossed the Indian River on the railroad’s Jay Jay Railroad Bridge north of Launch Complex 39 at NASA’s Kennedy Space Center in Florida. The train is on its way to the Florida East Coast Railway interchange in Titusville, Fla., where the train’s helium tank cars, a liquid oxygen tank car, and a liquid hydrogen dewar or tank car will be transferred for delivery to the SpaceX engine test complex outside McGregor, Texas. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

KSC-2012-3050

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – A NASA Railroad train crosses the railroad’s Jay Jay Railroad Bridge north of Launch Complex 39 at NASA’s Kennedy Space Center in Florida. The train is on its way to the Florida East Coast Railway interchange in Titusville, Fla., where the train’s helium tank cars, a liquid oxygen tank car, and a liquid hydrogen dewar or tank car will be transferred for delivery to the SpaceX engine test complex outside McGregor, Texas. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

KSC-2012-3051

NASA Image and Video Library

2012-05-23

CAPE CANAVERAL, Fla. – A NASA Railroad train crosses the railroad’s Jay Jay Railroad Bridge north of Launch Complex 39 at NASA’s Kennedy Space Center in Florida. The train is on its way to the Florida East Coast Railway interchange in Titusville, Fla., where the train’s helium tank cars, a liquid oxygen tank car, and a liquid hydrogen dewar or tank car will be transferred for delivery to the SpaceX engine test complex outside McGregor, Texas. The railroad cars were needed in support of the Space Shuttle Program but currently are not in use by NASA following the completion of the program in 2011. Originally, the tankers belonged to the U.S. Bureau of Mines. At the peak of the shuttle program, there were approximately 30 cars in the fleet. About half the cars were returned to the bureau as launch activity diminished. Five tank cars are being loaned to SpaceX and repurposed to support their engine tests in Texas. Eight cars previously were shipped to California on loan to support the SpaceX Falcon 9 rocket launches from Space Launch Complex-4 on Vandenberg Air Force Base. SpaceX already has three helium tank cars previously used for the shuttle program at Space Launch Complex-40 on Cape Canaveral Air Force Station in Florida. For more information, visit http://www.nasa.gov/spacex. Photo credit: NASA/Jim Grossmann

Behavioral changes following participation in a home health promotional program in King County, Washington.

PubMed Central

Leung, R; Koenig, J Q; Simcox, N; van Belle, G; Fenske, R; Gilbert, S G

1997-01-01

This study examined behavioral changes in households after participation in a home environmental assessment. Home assessment visits by a trained coach, which involved a walk-through in the home with the home residents, were conducted in 36 homes. The walk-through included a list of recommended behavioral changes that the residents could make to reduce their exposures to home pollutants in areas such as dust control, moisture problems, indoor air, hazardous household products, and hobbies. Recruited households were surveyed 3 months after the home assessment to evaluate their implementation of the recommendations. Following the home visits, 31 of 36 households reported making at least one behavioral change, and 41% of the recommendations made by the volunteer coaches were implemented. In conclusion, this study found that the majority of the households who participated in the home assessment reported implementing at least one recommendation. This home health promotional method was effective in influencing behavioral changes. PMID:9349831

Is Matching Innate?

PubMed Central

Gallistel, C.R; King, Adam Philip; Gottlieb, Daniel; Balci, Fuat; Papachristos, Efstathios B; Szalecki, Matthew; Carbone, Kimberly S

2007-01-01

Experimentally naive mice matched the proportions of their temporal investments (visit durations) in two feeding hoppers to the proportions of the food income (pellets per unit session time) derived from them in three experiments that varied the coupling between the behavioral investment and food income, from no coupling to strict coupling. Matching was observed from the outset; it did not improve with training. When the numbers of pellets received were proportional to time invested, investment was unstable, swinging abruptly from sustained, almost complete investment in one hopper, to sustained, almost complete investment in the other—in the absence of appropriate local fluctuations in returns (pellets obtained per time invested). The abruptness of the swings strongly constrains possible models. We suggest that matching reflects an innate (unconditioned) program that matches the ratio of expected visit durations to the ratio between the current estimates of expected incomes. A model that processes the income stream looking for changes in the income and generates discontinuous income estimates when a change is detected is shown to account for salient features of the data. PMID:17465311

Is matching innate?

PubMed

Gallistel, C R; King, Adam Philip; Gottlieb, Daniel; Balci, Fuat; Papachristos, Efstathios B; Szalecki, Matthew; Carbone, Kimberly S

2007-03-01

Experimentally naive mice matched the proportions of their temporal investments (visit durations) in two feeding hoppers to the proportions of the food income (pellets per unit session time) derived from them in three experiments that varied the coupling between the behavioral investment and food income, from no coupling to strict coupling. Matching was observed from the outset; it did not improve with training. When the numbers of pellets received were proportional to time invested, investment was unstable, swinging abruptly from sustained, almost complete investment in one hopper, to sustained, almost complete investment in the other-in the absence of appropriate local fluctuations in returns (pellets obtained per time invested). The abruptness of the swings strongly constrains possible models. We suggest that matching reflects an innate (unconditioned) program that matches the ratio of expected visit durations to the ratio between the current estimates of expected incomes. A model that processes the income stream looking for changes in the income and generates discontinuous income estimates when a change is detected is shown to account for salient features of the data.

Let's Talk About Breastfeeding: The Importance of Delivering a Message in a Home Visiting Program.

PubMed

McGinnis, Sandra; Lee, Eunju; Kirkland, Kristen; Miranda-Julian, Claudia; Greene, Rose

2018-05-01

To examine the potential impact of paraprofessional home visitors in promoting breastfeeding initiation and continuation among a high-risk population. A secondary analysis of program data from a statewide home visitation program. Thirty-six Healthy Families New York sites across New York State. A total of 3521 pregnant mothers at risk of poor child health and developmental outcomes. Home visitors deliver a multifaceted intervention that includes educating high-risk mothers on benefits of breastfeeding, encouraging them to breastfeed and supporting their efforts during prenatal and postnatal periods. Home visitor-reported content and frequency of home visits, participant-reported breastfeeding initiation and duration, and covariates (Kempe Family Stress Index, race and ethnicity, region, nativity, marital status, age, and education). Logistic regression. Breastfeeding initiation increased by 1.5% for each 1-point increase in the percentage of prenatal home visits that included breastfeeding discussions. Breastfeeding continuation during the first 6 months also increased with the percentage of earlier home visits that included breastfeeding discussions. Additionally, if a participant receives 1 more home visit during the third month, her likelihood of breastfeeding at 6 months increases by 11%. Effect sizes varied by months postpartum. Delivering a breastfeeding message consistently during regular home visits is important for increasing breastfeeding rates. Given that home visiting programs target new mothers least likely to breastfeed, a more consistent focus on breastfeeding in this supportive context may reduce breastfeeding disparities.

Development of a Multisystemic Parent Management Training Intervention for Incarcerated Parents, Their Children and Families

PubMed Central

Eddy, J. Mark; Martinez, Charles R.; Schiffmann, Tracy; Newton, Rex; Olin, Laura; Leve, Leslie; Foney, Dana M.; Shortt, Joann Wu

2008-01-01

The majority of men and women prison inmates are parents. Many lived with children prior to incarceration, and most have at least some contact with their children and families while serving their sentences. As prison populations have increased in the United States, there has been a renewed interest in finding ways not only to reduce recidivism, but also to prevent incarceration in the first place, particularly amongst the children of incarcerated parents. Positive family interaction is related to both issues. The ongoing development of a multisystemic intervention designed to increase positive family interaction for parents and families involved in the criminal justice system is described. The intervention package currently includes a prison-based parent management training program called Parenting Inside Out (PIO); a prison-based therapeutic visitation program; and complimentary versions of PIO designed for jail and probation and parole settings. Work on other components designed for justice-involved parents, children and for caregivers during reunification from prison is ongoing. Program development has occurred within the context of strong support from the state department of corrections and other key governmental and non-profit sector groups, and support systems have been established to help maintain the interventions as well as to develop complimentary interventions, policies and procedures. PMID:19885365

World Presidents Organization

NASA Technical Reports Server (NTRS)

2010-01-01

Members of the World Presidents' Organization enjoy a buffet luncheon during a Jan. 26 visit to NASA's John C. Stennis Space Center. WPO members from several states toured Stennis facilities during a daylong visit that included a river ride with Special Boat Team 22, the U.S. Navy's elite boat warriors group that trains at Stennis. Visiting president also had an opportunity to learn about the ongoing work of the nation's premier rocket engine testing site.

World Presidents Organization

NASA Image and Video Library

2010-01-26

Members of the World Presidents' Organization enjoy a buffet luncheon during a Jan. 26 visit to NASA's John C. Stennis Space Center. WPO members from several states toured Stennis facilities during a daylong visit that included a river ride with Special Boat Team 22, the U.S. Navy's elite boat warriors group that trains at Stennis. Visiting president also had an opportunity to learn about the ongoing work of the nation's premier rocket engine testing site.

Quality assurance of research protocols conducted in the community: the National Institute on Drug Abuse Clinical Trials Network experience.

PubMed

Rosa, Carmen; Campbell, Aimee; Kleppinger, Cynthia; Sampson, Royce; Tyson, Clare; Mamay-Gentilin, Stephanie

2009-04-01

Quality assurance (QA) of clinical trials is essential to protect the welfare of trial participants and the integrity of the data collected. However, there is little detailed information available on specific procedures and outcomes of QA monitoring for clinical trials. This article describes the experience of the National Institute on Drug Abuse's (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) in devising and implementing a three-tiered QA model for rigorous multi-site randomized clinical trials implemented in community-based substance abuse treatment programs. The CTN QA model combined local and national resources and was developed to address the unique needs of clinical trial sites with limited research experience. The authors reviewed internal records maintained by the sponsor, a coordinating site (Lead Nodes), and a local site detailing procedural development, training sessions, protocol violation monitoring, and site visit reporting. Between January 2001 and September 2005, the CTN implemented 21 protocols, of which 18 were randomized clinical trials, one was a quality improvement study and two were surveys. Approximately 160 community-based treatment programs participated in the 19 studies that were monitored, with a total of 6560 participants randomized across the sites. During this time 1937 QA site visits were reported across the three tiers of monitoring and the cost depended on the location of the sites and the salaries of the staff involved. One study reported 109 protocol violations (M = 15.6). Examples are presented to highlight training, protocol violation monitoring, site visit frequency and intensity and cost considerations. : QA data from the entire network were not easily available for review as much of the data were not electronically accessible. The authors reviewed and discussed a representative sample of internal data from the studies and participating sites. The lessons learned from the CTN's experience include the need for balancing thoroughness with efficiency, monitoring early, assessing research staff abilities in order to judge the need for proactive, focused attention, providing targeted training sessions, and developing flexible tools. The CTN model can work for sponsors overseeing studies at sites with limited research experience that require more frequent, in-depth monitoring. We recommend that sponsors not develop a rigid monitoring approach, but work with the study principal investigators to determine the intensity of monitoring needed depending on trial complexity, the risks of the intervention(s), and the experience of the staff with clinical research. After careful evaluation, sponsors should then determine the best approach to site monitoring and what resources will be needed.

Quality assurance of research protocols conducted in the community: The National Institute on Drug Abuse Clinical Trials Network Experience

PubMed Central

Rosa, Carmen; Campbell, Aimee; Kleppinger, Cynthia; Sampson, Royce; Tyson, Clare; Mamay-Gentilin, Stephanie

2009-01-01

Background: Quality assurance (QA) of clinical trials is essential to protect the welfare of trial participants and the integrity of the data collected. However, there is little detailed information available on specific procedures and outcomes of QA monitoring for clinical trials. Purpose: This article describes the experience of the National Institute on Drug Abuse's (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) in devising and implementing a three-tiered QA model for rigorous multi-site randomized clinical trials implemented in community-based substance abuse treatment programs. The CTN QA model combined local and national resources and was developed to address the unique needs of clinical trial sites with limited research experience. Methods: The authors reviewed internal records maintained by the sponsor, a coordinating site (Lead Nodes), and a local site detailing procedural development, training sessions, protocol violation monitoring, and site visit reporting. Results: Between January 2001 and September 2005, the CTN implemented 21 protocols, of which 18 were randomized clinical trials, one was a quality improvement study and two were surveys. Approximately 160 community-based treatment programs participated in the 19 studies that were monitored, with a total of 6560 participants randomized across the sites. During this time 1937 QA site visits were reported across the three tiers of monitoring and the cost depended on the location of the sites and the salaries of the staff involved. One study reported 109 protocol violations (M = 15.6). Examples are presented to highlight training, protocol violation monitoring, site visit frequency and intensity and cost considerations. Limitations: QA data from the entire network were not easily available for review as much of the data were not electronically accessible. The authors reviewed and discussed a representative sample of internal data from the studies and participating sites. Conclusions: The lessons learned from the CTN's experience include the need for balancing thoroughness with efficiency, monitoring early, assessing research staff abilities in order to judge the need for proactive, focused attention, providing targeted training sessions, and developing flexible tools. The CTN model can work for sponsors overseeing studies at sites with limited research experience that require more frequent, in-depth monitoring. We recommend that sponsors not develop a rigid monitoring approach, but work with the study principal investigators to determine the intensity of monitoring needed depending on trial complexity, the risks of the intervention(s), and the experience of the staff with clinical research. After careful evaluation, sponsors should then determine the best approach to site monitoring and what resources will be needed. PMID:19342468

Working with community health workers to improve maternal and newborn health outcomes: implementation and scale-up lessons from eastern Uganda.

PubMed

Namazzi, Gertrude; Okuga, Monica; Tetui, Moses; Muhumuza Kananura, Rornald; Kakaire, Ayub; Namutamba, Sarah; Mutebi, Aloysius; Namusoke Kiwanuka, Suzanne; Ekirapa-Kiracho, Elizabeth; Waiswa, Peter

2017-08-01

Preventable maternal and newborn deaths can be averted through simple evidence-based interventions, such as the use of community health workers (CHWs), also known in Uganda as village health teams. However, the CHW strategy faces implementation challenges regarding training packages, supervision, and motivation. This paper explores knowledge levels of CHWs, describes the coverage of home visits, and shares lessons learnt from setting up and implementing the CHW strategy. The CHWs were trained to conduct four home visits: two during pregnancy and two after delivery. The aim of the visits was to promote birth preparedness and utilization of maternal and newborn health (MNH) services. Mixed methods of data collection were employed. Quantitative data were analyzed using Stata version 13.0 to determine the level and predictors of CHW knowledge of MNH. Qualitative data from 10 key informants and 15 CHW interviews were thematically analyzed to assess the implementation experiences. CHWs' knowledge of MNH improved from 41.3% to 77.4% after training, and to 79.9% 1 year post-training. However, knowledge of newborn danger signs declined from 85.5% after training to 58.9% 1 year later. The main predictors of CHW knowledge were age (≥ 35 years) and post-primary level of education. The level of coverage of at least one CHW visit to pregnant and newly delivered mothers was 57.3%. Notably, CHW reports complemented the facility-based health information. CHWs formed associations, which improved teamwork, reporting, and general performance, and thus maintained low dropout rates at 3.6%. Challenges included dissatisfaction with the quarterly transport refund of 6 USD and lack of means of transportation such as bicycles. CHWs are an important resource in community-based health information and improving demand for MNH services. However, the CHW training and supervision models require strengthening for improved performance. Local solutions regarding CHW motivation are necessary for sustainability.

What if pediatric residents could bill for their outpatient services?

PubMed

Ng, M; Lawless, S T

2001-10-01

We prospectively studied the potential of billing and coding practices of pediatric residents in outpatient clinics and extrapolated our results to assess the financial implications of billing inaccuracies. Using Medicare as a common measure of "currency," we also used the relative value unit (RVU) and ambulatory payment class methodologies as means of assessing the productivity and financial value of resident-staffed pediatric clinics. Residents were asked to submit voluntarily shadow billing forms and documentation of outpatient clinic visits. Documentation of work was assessed by a blinded reviewer, and current procedure terminology evaluation and management codes were assigned. Comparisons between resident codes and calculated codes were made. Financial implications of physician productivity were calculated in terms of dollar amounts and RVUs. Resource intensity was measured using the ambulatory payment class methodology. A total of 344 charts were reviewed. Coding agreement for health maintenance visits was 86%, whereas agreement for acute care visits was 38%. Eighty-three percent of coding disagreement in the latter group was resulting from undercoding by residents. Errors accounted for a 4.79% difference in potential reimbursement for all visit types and a 19.10% difference for acute care visits. No significant differences in shadow billing discrepancies were found between different levels of training. Residents were predicted to generate $67 230, $87 593, and $96 072 in Medicare revenue in the outpatient clinic setting during each successive year of training. On average, residents generated 1.17 +/- 0.01 and 0.81 +/- 0.02 work RVUs for each health maintenance visit and office visit, respectively. Annual productivity from outpatient clinic settings was estimated at 548, 735, and 893 work RVUs in the postgraduate levels 1, 2, and 3, respectively. When pediatric residents are not trained adequately in proper coding practices, the potential for billing discrepancies is high and potential reimbursement differences may be substantial. Discussion of financial issues should be considered in curriculum development.

Increasing Use of Postpartum Family Planning and the Postpartum IUD: Early Experiences in West and Central Africa.

PubMed

Pleah, Tsigue; Hyjazi, Yolande; Austin, Suzanne; Diallo, Abdoulaye; Dao, Blami; Waxman, Rachel; Karna, Priya

2016-08-11

A global resurgence of interest in the intrauterine device (IUD) as an effective long-acting reversible contraceptive and in improving access to a wide range of contraceptive methods, as well as an emphasis on encouraging women to give birth in health care facilities, has led programs to introduce postpartum IUD (PPIUD) services into postpartum family planning (PPFP) programs. We describe strategic, organizational, and technical elements that contributed to early successes of a regional initiative in West and Central Africa to train antenatal, maternity, and postnatal care providers in PPFP counseling for the full range of available methods and in PPIUD service delivery. In November 2013, the initiative provided competency-based training in Guinea for providers from the main public teaching hospital in 5 selected countries (Benin, Chad, Côte d'Ivoire, Niger, and Senegal) with no prior PPFP counseling or PPIUD capacity. The training was followed by a transfer-of-learning visit and monitoring to support the trained providers. One additional country, Togo, replicated the initiative's model in 2014. Although nascent, this initiative has introduced high-quality PPFP and PPIUD services to the region, where less than 1% of married women of reproductive age use the IUD. In total, 21 providers were trained in PPFP counseling, 18 of whom were also trained in PPIUD insertion. From 2014 to 2015, more than 15,000 women were counseled about PPFP, and 2,269 women chose and received the PPIUD in Benin, Côte d'Ivoire, Niger, Senegal, and Togo. (Introduction of PPIUD services in Chad has been delayed.) South-South collaboration has been central to the initiative's accomplishments: Guinea's clinical centers of excellence and qualified trainers provided a culturally resonant example of a PPFP/PPIUD program, and trainings are creating a network of regional trainers to facilitate expansion. Two of the selected countries (Benin and Niger) have expanded their PPFP/PPUID training programs to additional sites. Inspired after learning about the initiative at a regional meeting, Togo has outperformed the original countries involved in the initiative by training more providers than the other countries. Challenges to scale-up include a lack of formal channels for reporting PPFP and PPIUD service delivery outcomes, inconsistent coordination of services across the reproductive health continuum of care, and slow uptake in some countries. Continued success will rely on careful recordkeeping, regular monitoring and feedback, and strategic data use to advocate scale-up. © Pleah et al.

Increasing Use of Postpartum Family Planning and the Postpartum IUD: Early Experiences in West and Central Africa

PubMed Central

Pleah, Tsigue; Hyjazi, Yolande; Austin, Suzanne; Diallo, Abdoulaye; Dao, Blami; Waxman, Rachel; Karna, Priya

2016-01-01

ABSTRACT A global resurgence of interest in the intrauterine device (IUD) as an effective long-acting reversible contraceptive and in improving access to a wide range of contraceptive methods, as well as an emphasis on encouraging women to give birth in health care facilities, has led programs to introduce postpartum IUD (PPIUD) services into postpartum family planning (PPFP) programs. We describe strategic, organizational, and technical elements that contributed to early successes of a regional initiative in West and Central Africa to train antenatal, maternity, and postnatal care providers in PPFP counseling for the full range of available methods and in PPIUD service delivery. In November 2013, the initiative provided competency-based training in Guinea for providers from the main public teaching hospital in 5 selected countries (Benin, Chad, Côte d’Ivoire, Niger, and Senegal) with no prior PPFP counseling or PPIUD capacity. The training was followed by a transfer-of-learning visit and monitoring to support the trained providers. One additional country, Togo, replicated the initiative’s model in 2014. Although nascent, this initiative has introduced high-quality PPFP and PPIUD services to the region, where less than 1% of married women of reproductive age use the IUD. In total, 21 providers were trained in PPFP counseling, 18 of whom were also trained in PPIUD insertion. From 2014 to 2015, more than 15,000 women were counseled about PPFP, and 2,269 women chose and received the PPIUD in Benin, Côte d’Ivoire, Niger, Senegal, and Togo. (Introduction of PPIUD services in Chad has been delayed.) South–South collaboration has been central to the initiative’s accomplishments: Guinea’s clinical centers of excellence and qualified trainers provided a culturally resonant example of a PPFP/PPIUD program, and trainings are creating a network of regional trainers to facilitate expansion. Two of the selected countries (Benin and Niger) have expanded their PPFP/PPUID training programs to additional sites. Inspired after learning about the initiative at a regional meeting, Togo has outperformed the original countries involved in the initiative by training more providers than the other countries. Challenges to scale-up include a lack of formal channels for reporting PPFP and PPIUD service delivery outcomes, inconsistent coordination of services across the reproductive health continuum of care, and slow uptake in some countries. Continued success will rely on careful recordkeeping, regular monitoring and feedback, and strategic data use to advocate scale-up. PMID:27540120

Post-Interview Communication During Application to Orthopaedic Surgery Residency Programs.

PubMed

Brooks, Jaysson T; Reidler, Jay S; Jain, Amit; LaPorte, Dawn M; Sterling, Robert S

2016-10-05

Post-interview communication from residency programs to applicants is common during the U.S. residency match process. The goals of this study were to understand the frequency and type of post-interview communication, how this communication influences applicants' ranking of programs, whether programs use "second-look" visits to gauge or to encourage applicant interest, and the financial costs to applicants of second-look visits. A post-match survey was sent to 1,198 applicants to one academic orthopaedic residency program over 2 years. The response rates were 15% in 2014 and 31% in 2015, totaling 293 responses used for analysis. Sixty-four percent of applicants reported having post-interview communication with one or more programs. Seventeen percent said that communication caused them to rank the contacting program higher or to keep the program ranked as number 1. Twenty percent felt pressured to reveal their rank position, and 8% were asked to rank a program first in exchange for the program's promise to rank the applicant first. Applicants who received post-interview communication had odds that were 13.5 times higher (95% confidence interval, 6.2 to 30 times higher) of matching to the programs that contacted them. Ninety percent of applicants said that communication from a program did not change how they ranked the program with which they eventually matched. Seventeen percent were encouraged to attend second-look visits, incurring a mean cost of $600 (range, $20 to $8,000). Orthopaedic residency programs continue to communicate with applicants in ways that violate the National Resident Matching Program's Match Communication Code of Conduct, and they continue to encourage second-look visits. To improve the integrity of the match, we suggest that programs use no-reply e-mails to minimize influence and pressure on applicants, interviewers and applicants review the Code of Conduct on interview day and provide instructions on reporting violations to the National Resident Matching Program, all post-interview communication be directed to a standardized or neutral third party, and programs actively discourage second-look visits and stop requiring second-look visits. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Development of a Curriculum in Laser Technology. Final Report.

ERIC Educational Resources Information Center

Wasserman, William J.

A Seattle Central Community College project visited existing programs, surveyed need, and developed a curriculum for a future program in Laser-Electro-Optics (LEO) Technology. To establish contacts and view successful programs, project staff made visits to LEO technology programs at San Jose City College and Texas State Technical Institute, Center…

A Home Visiting Asthma Education Program: Challenges to Program Implementation

ERIC Educational Resources Information Center

Brown, Josephine V.; Demi, Alice S.; Celano, Marianne P.; Bakeman, Roger; Kobrynski, Lisa; Wilson, Sandra R.

2005-01-01

This study describes the implementation of a nurse home visiting asthma education program for low-income African American families of young children with asthma. Of 55 families, 71% completed the program consisting of eight lessons. The achievement of learning objectives was predicted by caregiver factors, such as education, presence of father or…

Multidisciplinary rehabilitation program in recently hospitalized patients with heart failure and preserved ejection fraction: rationale and design of a randomized controlled trial.

PubMed

Koifman, Edward; Grossman, Ehud; Elis, Avishay; Dicker, Dror; Koifman, Bella; Mosseri, Morris; Kuperstein, Rafael; Goldenberg, Ilan; Kamerman, Tamir; Levine-Tiefenbrun, Nava; Klempfner, Robert

2014-12-01

Heart failure with preserved ejection fraction (HFpEF) comprises a large portion of heart failure patients and portends poor prognosis with similar outcome to heart failure with reduced ejection fraction (HFrEF). Thus far, no medical therapy has been shown to improve clinical outcome in this common condition. The study is a randomized-controlled, multicenter clinical trial aimed to determine whether early posthospitalization comprehensive cardiac rehabilitation (CR) including exercise training (ET) in recently hospitalized HFpEF patients reduces the composite end point of all-cause mortality and hospitalizations in comparison with usual care (UC). After undergoing baseline evaluation, patients are randomized to either UC or to ambulatory comprehensive CR program. Patients in the CR arm will participate in a 6-month biweekly ET program according to a predefined protocol, in addition to a complementary home exercise prescribed by a specialist in CR. Exercise training will include endurance and low-intensity resistance training. Patients in the UC arm will be followed up at the outpatient clinic, with management according to current heart failure guidelines. Physician follow-up visits will be conducted at 3, 6, and 12 months for assessment of adherence to therapy and ET, functional status, quality of life, and clinical events. Secondary end points will include quality-of-life questionnaire, economic end points, blood pressure, and hemoglobin A1C levels. Cardiac rehabilitation and ET are relatively inexpensive and accessible and can be beneficial in HFpEF patients. Our trial is designed to evaluate the impact of early posthospitalization comprehensive rehabilitation program on clinical end points of mortality, hospitalization, and quality of life in HFpEF patients. Copyright © 2014 Elsevier Inc. All rights reserved.

The virtual practice: using the residents' continuity clinic to teach practice management and systems-based practice.

PubMed

Perez, Jose A; Faust, Cheryl; Kenyon, Angie

2009-09-01

Education in systems-based practice is a required component of all postgraduate medical education programs in the United States. Competency in this area requires that trainees have an understanding of the health care system sufficient to provide optimal care to patients. Most trainees in residency programs have little understanding of the complexities and challenges of present-day practice in the current system of care and consider themselves unprepared to undertake this activity following completion of training. Training in practice management in residency programs has not been emphasized as an important component of systems-based practice. Historically, practice management training in residency programs has been done using a fully didactic model, and residents have expressed a desire to learn this skill by becoming more directly involved in the operations and management of a practice. The patient visit touches many aspects of the health care system, including clinic operations, insurance, quality, and finances. At our institution, we used the residents' continuity clinic practices as a vehicle to provide education in practice management and systems-based practice by creating a curriculum that included the residents' perceived gaps in knowledge regarding going into practice. This is known as the virtual practice. This curriculum is taught using data obtained from residents' practice to illustrate concepts in many areas, including primary practice operations, malpractice insurance, financial benchmarks, and career planning. Resident self-assessed knowledge of these areas increased after participating in the curriculum, and resident testimonials indicate satisfaction with the project. In addition, residents have become engaged and interested in how their effort translates into performance and how they participate in the health care system.

A neonatal nurse training program in kangaroo mother care (KMC) decreases barriers to KMC utilization in the NICU.

PubMed

Hendricks-Munoz, Karen D; Mayers, Roslyn M

2014-11-01

This study assessed the impact of a nurse simulation training program on perception of kangaroo mother care (KMC) value and transfer skill competency. An 8-item Likert scale skill survey tool and a 24-item Likert developmental care survey tool were used in a prospective cohort study to analyze perceptions of 30 neonatal nurses who underwent a comprehensive KMC simulation-based training program. Competency skills were evaluated pretraining and tracked by direct observation for 6 months posttraining. Pre- and postsurvey data were analyzed and KMC utilization for preterm infants born at ≤ 34 weeks' gestation was determined. Nurses' competency in infant transfer improved, especially in infants receiving nasal continuous positive airway pressure or ventilator support, from 30 to 93% or 10 to 50%, respectively, p < 0.0001. Neonatal nurses' perceived KMC value increased from 50 to 100%, p < 0.001, and parent KMC utilization increased from 26.5 to 85.9%, p < 0.0001. Nurses' support for parental visitation improved from 38 to 73%, p < 0.001; discussion of KMC with parents on the 1st day increased from 5 to 45%, p < 0.001; and initial day of KMC provision improved from 18.0 ± 2.7 to 5.6 ± 1.2 days, p < 0.001. A comprehensive simulation-based KMC education program improved nurses' perception of KMC value, their competency and comfort in infant transfer for KMC care, and successfully promoted KMC parent utilization for the preterm infant in the neonatal intensive care unit. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Influences on Faculty Willingness to Mentor Undergraduate Students from Another University as Part of an Interinstitutional Research Training Program.

PubMed

Morales, Danielle X; Grineski, Sara E; Collins, Timothy W

2016-01-01

In 2014, the National Institutes of Health invested $31 million in 10 primary institutions across the United States through the Building Undergraduate Infrastructure Leading to Diversity (BUILD) program; one requirement of BUILD is sending undergraduate trainees from those primary institutions to partner institutions for research experiences. Mechanisms like BUILD are designed to broaden research opportunities for students, especially those from underrepresented backgrounds. However, to our knowledge, no studies have examined faculty willingness to mentor undergraduates from other institutions through structured training programs. Survey data from 536 faculty members at 13 institutions were collected in Fall 2013 and analyzed using multiple statistical techniques. Results show that faculty who valued the opportunity to increase diversity in the academy and those who believed that mentoring undergraduates benefited their own research expressed greater willingness to serve as research mentors to visiting undergraduates, and faculty who perceived that they did not have the ability to accommodate additional students expressed less willingness to do so. Most respondents viewed student and faculty incentives as motivating factors in their willingness to mentor, but their perspectives on different types of incentives varied based on faculty career stage, discipline, and research funding status. Results have important implications for designing multi-institutional undergraduate research training programs. © 2016 D. X. Morales et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

The effect of scopolamine on matching behavior and the estimation of relative reward magnitude.

PubMed

Leon, Matthew I; Rodriguez-Barrera, Vanessa; Amaya, Aldo

2017-10-01

We investigated the behavioral effects of scopolamine on rats that bar pressed for trains of electrically stimulating pulses under concurrent variable interval schedules of reward. For the first half of the session (30 min) a 1:4 ratio in the programmed number of stimulation trains delivered at each option was in effect. At the start of the second half of the session, an unsignaled reversal in the relative train number (4:1) occurred. We tracked the relative magnitude of reward estimated for each contiguous pair of reinforced visits to competing options. Scopolamine hydrobromide led to a reduction in the relative magnitude of reward. A similar result was obtained in a follow-up test in which relative magnitude was manipulated by varying the pulse frequency of stimulation, while equating the train number at each option. The effect of scopolamine hydrobromide could not be attributed to undermatching, side bias, nor to an effect of scopolamine on the reward integration process. When the same rats were treated with scopolamine methylbromide, no effects on matching behavior were observed. Our results suggest a cholinergic basis for the computation of choice variables related to matching behavior. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Modified Directly Observed Therapy to Facilitate Highly Active Antiretroviral Therapy Adherence in Beira, Mozambique

PubMed Central

Pearson, Cynthia R.; Micek, Mark; Simoni, Jane M.; Matediana, Eduardo; Martin, Diane P.; Gloyd, Stephen

2016-01-01

Summary As resource-limited countries expand access to highly active antiretroviral therapy (HAART) treatment, innovative programs are needed to support adherence in the context of significant health system barriers. Modified directly observed therapy (mDOT) is one such strategy, but little is known about the process of designing and implementing mDOT programs for HAART in resource-limited settings. In this descriptive study, we used a mixed-methods approach to describe the process of implementing mDOT for an ongoing randomized control trial (RCT) in Beira, Mozambique. Interviews with clinic staff, mDOT peers, and participants provided information on design elements, problems with implementation, satisfaction, and benefits. Acceptability and feasibility measures were obtained from the RCT. Most (81%, N = 350) eligible persons agreed to participate, and of those randomized to mDOT (n = 174), 95% reported that their time with peers was beneficial. On average, participants kept 93% of the 30 required daily mDOT visits. Key components of the intervention’s success included using peers who were well accepted by clinic staff, adequate training and retention of peers, adapting daily visit requirements to participants’ work schedules and physical conditions, and reimbursing costs of transportation. This study identified aspects of mDOT that are effective and can be adopted by other clinics treating HIV patients. PMID:17133197

Demographics of cleft care providers in Africa and reported experience in training and practice: direct analysis of continent-based practitioners.

PubMed

Adetayo, Oluwaseun A; Martin, Mark C

2012-05-01

To elucidate the impact of several geographic, cultural, and socioeconomic variables on cleft care delivery in Africa, and to investigate the current status of cleft care delivery in Africa. Survey of practitioners attending the second Pan-African Congress on Cleft Lip and Palate (PACCLIP). The annual PACCLIP conference in Ibadan, Nigeria, West Africa, February 2007. To provide an analysis of the demographics and training experience of cleft care providers in Africa by collating information directly from the continent-based practitioners. Plastic surgeons and oral and maxillofacial surgeons provide the majority of cleft care. Most of the participants reported availability of formal training programs in their respective countries. The predominant practice settings were university and government-based. During training, half of the providers had encountered up to 30 cleft cases, and a quarter had managed more than 100 cases. Representation of visiting surgeons were equally distributed between African and non-African countries. This study provides initial and detailed analysis crucial to understanding the underlying framework of cleft care composition teams, demographics of providers, and training and practice experience. This awareness will further enable North American and other non-African plastic surgeons to effectively partner with African cleft care providers to have a further reaching impact in the region.

Enhancing the routine health information system in rural southern Tanzania: successes, challenges and lessons learned.

PubMed

Maokola, W; Willey, B A; Shirima, K; Chemba, M; Armstrong Schellenberg, J R M; Mshinda, H; Alonso, P; Tanner, M; Schellenberg, D

2011-06-01

To describe and evaluate the use of handheld computers for the management of Health Management Information System data. Electronic data capture took place in 11 sentinel health centres in rural southern Tanzania. Information from children attending the outpatient department (OPD) and the Expanded Program on Immunization vaccination clinic was captured by trained local school-leavers, supported by monthly supervision visits. Clinical data included malaria blood slides and haemoglobin colour scale results. Quality of captured data was assessed using double data entry. Malaria blood slide results from health centre laboratories were compared to those from the study's quality control laboratory. The system took 5 months to implement, and few staffings or logistical problems were encountered. Over the following 12 months (April 2006-March 2007), 7056 attendances were recorded in 9880 infants aged 2-11 months, 50% with clinical malaria. Monthly supervision visits highlighted incomplete recording of information between OPD and laboratory records, where on average 40% of laboratory visits were missing the record of their corresponding OPD visit. Quality of microscopy from health facility laboratories was lower overall than that from the quality assurance laboratory. Electronic capture of HMIS data was rapidly and successfully implemented in this resource-poor setting. Electronic capture alone did not resolve issues of data completeness, accuracy and reliability, which are essential for management, monitoring and evaluation; suggestions to monitor and improve data quality are made. © 2011 Blackwell Publishing Ltd.

KSC-2014-3147

NASA Image and Video Library

2014-07-08

CAPE CANAVERAL, Fla. -- In the KSC Training Auditorium at NASA's Kennedy Space Center in Florida, Yves Lamothe, transition manager for the Ground Systems Development and Operations Program, is the master of ceremonies at a special event marking the 50th anniversary of the Civil Rights Act of 1964. Center Director Robert Cabana made the opening remarks. Dr. Mary Frances Berry, an award-winning civil rights activist and former member of the U.S. Commission on Civil Rights, was the guest speaker. The event was presented by Kennedy's Office of Diversity and Equal Opportunity. For more information on Kennedy Space Center, visit http://www.nasa.gov/kennedy. Photo credit: NASA/Kim Shiflett

KSC-2014-3146

NASA Image and Video Library

2014-07-08

CAPE CANAVERAL, Fla. -- In the KSC Training Auditorium at NASA's Kennedy Space Center in Florida, Center Director Robert Cabana addresses the audience at a special event marking the 50th anniversary of the Civil Rights Act of 1964. Yves Lamothe, on stage, transition manager for the Ground Systems Development and Operations Program, was the master of ceremonies. Dr. Mary Frances Berry, an award-winning civil rights activist and former member of the U.S. Commission on Civil Rights, was the guest speaker. The event was presented by Kennedy's Office of Diversity and Equal Opportunity. For more information on Kennedy Space Center, visit http://www.nasa.gov/kennedy. Photo credit: NASA/Kim Shiflett

An open cluster-randomized, 18-month trial to compare the effectiveness of educational outreach visits with usual guideline dissemination to improve family physician prescribing

PubMed Central

2014-01-01

Background The Portuguese National Health Directorate has issued clinical practice guidelines on prescription of anti-inflammatory drugs, acid suppressive therapy, and antiplatelets. However, their effectiveness in changing actual practice is unknown. Methods The study will compare the effectiveness of educational outreach visits regarding the improvement of compliance with clinical guidelines in primary care against usual dissemination strategies. A cost-benefit analysis will also be conducted. We will carry out a parallel, open, superiority, randomized trial directed to primary care physicians. Physicians will be recruited and allocated at a cluster-level (primary care unit) by minimization. Data will be analyzed at the physician level. Primary care units will be eligible if they use electronic prescribing and have at least four physicians willing to participate. Physicians in intervention units will be offered individual educational outreach visits (one for each guideline) at their workplace during a six-month period. Physicians in the control group will be offered a single unrelated group training session. Primary outcomes will be the proportion of cyclooxygenase-2 inhibitors prescribed in the anti-inflammatory class, and the proportion of omeprazole in the proton pump inhibitors class at 18 months post-intervention. Prescription data will be collected from the regional pharmacy claims database. We estimated a sample size of 110 physicians in each group, corresponding to 19 clusters with a mean size of 6 physicians. Outcome collection and data analysis will be blinded to allocation, but due to the nature of the intervention, physicians and detailers cannot be blinded. Discussion This trial will attempt to address unresolved issues in the literature, namely, long term persistence of effect, the importance of sequential visits in an outreach program, and cost issues. If successful, this trial may be the cornerstone for deploying large scale educational outreach programs within the Portuguese National Health Service. Trial registration ClinicalTrials.gov number NCT01984034. PMID:24423370

Surgery Website as a 24/7 Adjunct to a Surgical Curriculum.

PubMed

Jyot, Apram; Baloul, Mohamed S; Finnesgard, Eric J; Allen, Samuel J; Naik, Nimesh D; Gomez Ibarra, Miguel A; Abbott, Eduardo F; Gas, Becca; Cardenas-Lara, Francisco J; Zeb, Muhammad H; Cadeliña, Rachel; Farley, David R

Successfully teaching duty hour restricted trainees demands engaging learning opportunities. Our surgical educational website and its associated assets were assessed to understand how such a resource was being used. Our website was accessible to all Mayo Clinic employees via the internal web network. Website access data from April 2015 through October 2016 were retrospectively collected using Piwik. Academic, tertiary care referral center with a large general surgery training program. Mayo Clinic, Rochester, MN. A total of 257 Mayo Clinic employees used the website. The website had 48,794 views from 6313 visits by 257 users who spent an average of 14 ± 11 minutes on the website. Our website houses 295 videos, 51 interactive modules, 14 educational documents, and 7 flashcard tutorials. The most popular content type was videos, with a total of 30,864 views. The most popular visiting time of the day was between 8 pm and 9 pm with 6358 views (13%), and Thursday was the most popular day with 17,907 views (37%).  A total of 78% of users accessed content beyond the homepage. Average visits peaked in relation to 2 components of our curriculum: a 240% increase one day before our biannual intern simulation assessments, and a 61% increase one day before our weekly conducted Friday simulation sessions. Interns who rotated on the service of the staff surgeon who actively endorses the website had 93% more actions per visit as compared to other users. The highest clicks were on the home banner for our weekly simulation session pre-emptive videos, followed by "groin anatomy," and "TEP hernia repair" videos. Our website acted as a "just-in-time" accessible portal to reliable surgical information. It supplemented the time sensitive educational needs of our learners by serving as a heavily used adjunct to 3 components of our surgical education curriculum: weekly simulation sessions, biannual assessments, and clinical rotations. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Children visiting family and friends on adult intensive care units: the nurses' perspective.

PubMed

Clarke, C M

2000-02-01

Recent surveys show that children are still restricted from visiting their critically ill family and friends on many adult intensive care units throughout the country. The purpose of this small-scale exploratory pilot study was to examine and describe the experiences and perceptions of trained nurses towards children visiting within this setting. The aim of the study was to gain greater insight and understanding into the reason why, despite evidence to support the benefits to children of visiting their critically ill family and friends, they remain discouraged and restricted. It is hoped that the study will act as an initial enquiry to generate themes and further research questions. A qualitative research approach was adopted and in-depth focused interviews used as a method of data collection. The participants of the study were trained nurses working on an adult intensive care unit in a district general hospital in England. A total of 12 individual interviews were conducted which were audiotaped in full and analysed using a method of thematic content analysis. The value of the research is to promote family-centred care within an adult intensive care environment to meet the neglected needs of the well children of the critically ill person. The findings suggest that the participants in the study attempted to offer valuable support to children visiting their critically ill family and friends, but, despite an open visiting policy, children rarely visited within this setting. The desire of the well parent to protect and shield the child from the crisis of critical illness was perceived by the participants to be the main reason why they did not visit. To provide family-centred care within an adult intensive care setting has many implications for practice and several of these important issues are discussed. These include the educational and training needs of nursing staff and the importance of adopting a collaborative team approach to providing care for the critically ill person and their family. The need to generate research and literature from within the United Kingdom's health care system has also been identified and recommendations for further studies are proposed.

An Evaluation of the Individual Training Account/Eligible Training Provider Demonstration. Final Interim Report.

ERIC Educational Resources Information Center

D'Amico, Ronald; Martinez, Alexandria; Salzman, Jeffrey; Wagner, Robin

In March 2000, thirteen grants were awarded as part of the Individual Training Account/Eligible Training Provider (ITA/ETP) Demonstration. In summer and fall of 2000, the grant recipients' activities were subjected to an interim evaluation. Site visits were made to each grantee to determine what ITA policies and practices were being formulated,…

A prehabilitation program for physically frail community-living older persons.

PubMed

Gill, Thomas M; Baker, Dorothy I; Gottschalk, Margaret; Gahbauer, Evelyne A; Charpentier, Peter A; de Regt, Paul T; Wallace, Sarah J

2003-03-01

To describe the development and implementation of a preventive, home-based physical therapy program (PREHAB) and to provide evidence for the safety and interrater reliability of the PREHAB protocol. Demonstration study. General community. Ninety-four physically frail, community-living persons, aged 75 years or older, who were randomized to the PREHAB program in a clinical trial. The PREHAB program built on the physical therapy component of 2 previous home-based protocols. A total of 223 assessment items were linked to 28 possible interventions, including progressive balance and conditioning exercises, by using detailed algorithms and decisions rules that were automated on notebook computers. The percentages of participants who were eligible for and who completed each intervention, the extent of progress noted in the balance and conditioning exercises, adherence to the training program, and adverse events. Participants who completed the PREHAB program and those who ended it prematurely received an average of 9.7 and 7.2 interventions during an average of 14.9 and 9.5 home visits, respectively. With few exceptions, the completion rate and interrater reliability for the specific interventions were high. Despite high self-reported adherence to the training program, the majority of participants did not advance beyond the initial Thera-Band level for the upper- and lower-extremity conditioning exercises, and only about a third advanced to the highest 2 levels of the balance exercises. Adverse events were no more common in the PREHAB group than in the educational control group. Our results support the feasibility and safety of the PREHAB program, but also show the special challenges and pitfalls of such a strategy when it is implemented among persons of advanced age and physical frailty. Copyright 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

[A cross-sectional survey of the prevalence of depressive-anxiety disorders among general hospital outpatients in five cities in China].

PubMed

He, Yan-ling; Ma, Hong; Zhang, Lan; Liu, Zhe-ning; Jia, Fu-jun; Zhang, Ming-yuan

2009-09-01

To find the prevalence of depressive and anxiety disorders among general hospital outpatients and to evaluate the diagnoses and treatment provided by physicians in China. A multi-center, hospital-based cross-sectional study was conducted. A total of 8478 subjects were screened by using HADS and PHQ-15 together with medical history review list and were followed by regular clinical visit process. Physician's diagnoses and management were recorded. Mini International Neuropsychiatric Interview (MINI) was used to evaluate by psychiatrists afterwards for 4172 subjects scored >or= 8 on HADS. The adjusted prevalence rates of MINI-diagnosed depressive disorder, anxiety disorder, depression and anxiety, depression or anxiety disorders were 12.0%, 8.6%, 4.1% and 16.5%, respectively. The prevalence of depressive and/or anxiety disorder in outpatients visiting department of neurology and digestive diseases were higher than that in patients visiting departments of cardiovascular diseases and gynecology with statistical significance (P < 0.0001). High prevalence and low identification and treatment rate of depressive and/or anxiety disorders were found in the general hospitals. In order to improve the status quo, training program for physicians and specialists other than psychiatric professionals in general hospitals should be enhanced together with psychiatric consultation.

An Alternative Approach for Supportive Supervision and Skill Measurements of Health Workers for Integrated Management of Neonatal and Childhood Illnesses Program in 10 Districts of Haryana.

PubMed

Aggarwal, Arun K; Gupta, Rakesh; Das, Dhritiman; Dhakar, Anar S; Sharma, Gourav; Anand, Himani; Kaur, Kamalpreet; Sheoran, Kiran; Dalpath, Suresh; Khatri, Jaidev; Gupta, Madhu

2018-01-01

"Integrated Management of Neonatal and Childhood Illnesses" (IMNCI) needs regular supportive supervision (SS). The aim of this study was to find suitable SS model for implementing IMNCI. This was a prospective interventional study in 10 high-focus districts of Haryana. Two methods of SS were used: (a) visit to subcenters and home visits (model 1) and (b) organization of IMNCI clinics/camps at primary health center (PHC) and community health center (CHC) (model 2). Skill scores were measured at different time points. Routine IMNCI data from study block and randomly selected control block of each district were retrieved for 4 months before and after the training and supervision. Change in percentage mean skill score difference and percentage difference in median number of children were assessed in two areas. Mean skill scores increased significantly from 2.1 (pretest) to 7.0 (posttest 1). Supportive supervisory visits sustained and improved skill scores. While model 2 of SS could positively involve health system officials, model 1 was not well received. Outcome indicator in terms of number of children assessed showed a significant improvement in intervention areas. SS in IMNCI clinics/camps at PHC/CHC level and innovative skill scoring method is a promising approach.

Implementation Differences of Two Staffing Models in the German Home Visiting Program "Pro Kind"

ERIC Educational Resources Information Center

Brand, Tilman; Jungmann, Tanja

2012-01-01

As different competencies or professional backgrounds may affect the quality of program implementation, staffing is a critical issue in home visiting. In this study, N = 430 women received home visits delivered either by a tandem of a midwife and a social worker or by only one home visitor (primarily midwives, continuous model). The groups were…

A Solid Foundation: Key Capacities of Construction Pre-Apprenticeship Programs

ERIC Educational Resources Information Center

Helmer, Matt; Blair, Amy; Gerber, Allison

2012-01-01

This publication shares research from site visits conducted to construction pre-apprenticeship programs in Baltimore, Hartford, Milwaukee and Portland (OR). Findings from the site visits, which included interviews and focus groups with pre-apprenticeship program staff, public officials, philanthropic leaders, construction industry leaders and…

Using a Geriatric Mentoring Narrative Program to Improve Medical Student Attitudes towards the Elderly

ERIC Educational Resources Information Center

Duke, Pamela; Cohen, Diane; Novack, Dennis

2009-01-01

This study examined first-year medical student attitudes concerning the elderly before and after instituting a geriatric mentoring program. The program began and ended with a survey designed to assess students' attitudes toward the elderly. During the mentoring program, students visited the same senior for four visits throughout the academic year.…

Mobile health care operations and return on investment in predominantly underserved children with asthma: the breathmobile program.

PubMed

Morphew, Tricia; Scott, Lyne; Li, Marilyn; Galant, Stanley P; Wong, Webster; Garcia Lloret, Maria I; Jones, Felita; Bollinger, Mary Elizabeth; Jones, Craig A

2013-08-01

Underserved populations have limited access to care. Improved access to effective asthma care potentially improves quality of life and reduces costs associated with emergency department (ED) visits. The purpose of this study is to examine return on investment (ROI) for the Breathmobile Program in terms of improved patient quality-adjusted life years saved and reduced costs attributed to preventable ED visits for 2010, with extrapolation to previous years of operation. It also examines cost-benefit related to reduced morbidity (ED visits, hospitalizations, and school absenteeism) for new patients to the Breathmobile Program during 2008-2009 who engaged in care (≥3 visits). This is a retrospective analysis of data for 15,986 pediatric patients, covering 88,865 visits, participating in 4 Southern California Breathmobile Programs (November 16, 1995-December 31, 2010). The ROI calculation expressed the cost-benefit ratio as the net benefits (ED costs avoided+relative value of quality-adjusted life years saved) over the per annum program costs (∼$500,000 per mobile). The ROI across the 4 California programs in 2010 was $6.73 per dollar invested. Annual estimated emergency costs avoided in the 4 regions were $2,541,639. The relative value of quality-adjusted life years saved was $24,381,000. For patients new to the Breathmobile Program during 2008-2009 who engaged in care (≥3 visits), total annual morbidity costs avoided per patient were $1395. This study suggests that mobile health care is a cost-effective strategy to deliver medical care to underserved populations, consistent with the Triple Aims of Therapy.

Beyond coverage: improving the quality of antenatal care delivery through integrated mentorship and quality improvement at health centers in rural Rwanda.

PubMed

Manzi, Anatole; Nyirazinyoye, Laetitia; Ntaganira, Joseph; Magge, Hema; Bigirimana, Evariste; Mukanzabikeshimana, Leoncie; Hirschhorn, Lisa R; Hedt-Gauthier, Bethany

2018-02-23

Inadequate antenatal care (ANC) can lead to missed diagnosis of danger signs or delayed referral to emergency obstetrical care, contributing to maternal mortality. In developing countries, ANC quality is often limited by skill and knowledge gaps of the health workforce. In 2011, the Mentorship, Enhanced Supervision for Healthcare and Quality Improvement (MESH-QI) program was implemented to strengthen providers' ANC performance at 21 rural health centers in Rwanda. We evaluated the effect of MESH-QI on the completeness of danger sign assessments. Completeness of danger sign assessments was measured by expert nurse mentors using standardized observation checklists. Checklists completed from October 2010 to May 2011 (n = 330) were used as baseline measurement and checklists completed between February and November 2012 (12-15 months after the start of MESH-QI implementation) were used for follow-up. We used a mixed-effects linear regression model to assess the effect of the MESH-QI intervention on the danger sign assessment score, controlling for potential confounders and the clustering of effect at the health center level. Complete assessment of all danger signs improved from 2.1% at baseline to 84.2% after MESH-QI (p <  0.001). Similar improvements were found for 20 of 23 other essential ANC screening items. After controlling for potential confounders, the improvement in danger sign assessment score was significant. However, the effect of the MESH-QI was different by intervention district and type of observed ANC visit. In Southern Kayonza District, the increase in the danger sign assessment score was 6.28 (95% CI: 5.59, 6.98) for non-first ANC visits and 5.39 (95% CI: 4.62, 6.15) for first ANC visits. In Kirehe District, the increase in danger sign assessment score was 4.20 (95% CI: 3.59, 4.80) for non-first ANC visits and 3.30 (95% CI: 2.80, 3.81) for first ANC visits. Assessment of critical danger signs improved under MESH-QI, even when controlling for nurse-mentees' education level and previous training in focused ANC. MESH-QI offers an approach to enhance quality of care after traditional training and may be an approach to support newer providers who have not yet attended content-focused courses.

Feasibility of new simulation technology to train novice drivers

DOT National Transportation Integrated Search

1996-12-01

This project examined the feasibility of using existing simulation and other electronic device technology with the potential for the safety training of novice drivers. Project activities included: a literature review; site visits and telephone inquir...

77 FR 27781 - Agency Information Collection Activities: Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... progress towards a high-quality home visiting program or embedding their home visiting program into a comprehensive, high-quality early childhood system. Thirteen States were awarded Development Grants, and nine...

Using Information Communication Technologies in Remote School Communities

ERIC Educational Resources Information Center

Lock, Graeme; Forlin, Chris

2006-01-01

In 2003 the authors visited four schools in the Western Australian Department of Education and Training's Kimberley Education District to investigate the use of Information Communication Technologies (ICT) in the curriculum for students who have diverse needs. The visits also provided an opportunity to investigate how teachers in remote school…

"My Daddy's Number Is C-92760."

ERIC Educational Resources Information Center

Hughes, James E.

1982-01-01

Specially trained inmates in a maximum security prison supervised a play area in the prison visiting room where children could play in a safe and structured way with materials appropriate to their developmental needs. Children were thus able to master, in age-appropriate ways, the circumstances of the visiting room. (Author/CMG)

Development and implementation of a quality assurance infrastructure in a multisite home visitation program in Ohio and Kentucky.

PubMed

Ammerman, Robert T; Putnam, Frank W; Kopke, Jonathan E; Gannon, Thomas A; Short, Jodie A; Van Ginkel, Judith B; Clark, Margaret J; Carrozza, Mark A; Spector, Alan R

2007-01-01

As home visitation programs go to scale, numerous challenges are faced in implementation and quality assurance. This article describes the origins and implementation of Every Child Succeeds, a multisite home visitation program in southwestern Ohio and Northern Kentucky. In order to optimize quality assurance and generate new learning for the field, a Web-based system (eECS) was designed to systematically collect and use data. Continuous quality assurance procedures derived from business and industry have been established. Findings from data collection have documented outcomes, and have identified clinical needs that potentially undermine the impact of home visitation. An augmented module approach has been used to address these needs, and a program to treat maternal depression is described as an example of this approach. Challenges encountered are also discussed.

Enhancing fire department home visiting programs: results of a community intervention trial.

PubMed

Gielen, Andrea C; Shields, Wendy; Frattaroli, Shannon; McDonald, Eileen; Jones, Vanya; Bishai, David; O'Brocki, Raymond; Perry, Elise C; Bates-Hopkins, Barbara; Tracey, Pat; Parsons, Stephanie

2013-01-01

This study evaluates the impact of an enhanced fire department home visiting program on community participation and installation of smoke alarms, and describes the rate of fire and burn hazards observed in homes. Communities were randomly assigned to receive either a standard or enhanced home visiting program. Before implementing the program, 603 household surveys were completed to determine comparability between the communities. During a 1-year intervention period, 171 home visits took place with 8080 homes. At baseline, 60% of homes did not have working smoke alarms on every level, 44% had unsafe water temperatures, and 72% did not have carbon monoxide alarms. Residents in the enhanced community relative to those in the standard community were significantly more likely to let the fire fighters into their homes (75 vs 62%). Among entered homes, those in the enhanced community were significantly more likely to agree to have smoke alarms installed (95 vs 92%), to be left with a working smoke alarm on every level of the home (84 vs 78%), and to have more smoke alarms installed per home visited (1.89 vs 1.74). The high baseline rates of home hazards suggest that fire department home visiting programs should take an "all hazards" approach. Community health workers and community partnerships can be effective in promoting fire departments' fire and life safety goals. Public health academic centers should partner with the fire service to help generate evidence on program effectiveness that can inform decision making about resource allocation for prevention.

Improving Primary Care Provider Practices in Youth Concussion Management.

PubMed

Arbogast, Kristy B; Curry, Allison E; Metzger, Kristina B; Kessler, Ronni S; Bell, Jeneita M; Haarbauer-Krupa, Juliet; Zonfrillo, Mark R; Breiding, Matthew J; Master, Christina L

2017-08-01

Primary care providers are increasingly providing youth concussion care but report insufficient time and training, limiting adoption of best practices. We implemented a primary care-based intervention including an electronic health record-based clinical decision support tool ("SmartSet") and in-person training. We evaluated consequent improvement in 2 key concussion management practices: (1) performance of a vestibular oculomotor examination and (2) discussion of return-to-learn/return-to-play (RTL/RTP) guidelines. Data were included from 7284 primary care patients aged 0 to 17 years with initial concussion visits between July 2010 and June 2014. We compared proportions of visits pre- and post-intervention in which the examination was performed or RTL/RTP guidelines provided. Examinations and RTL/RTP were documented for 1.8% and 19.0% of visits pre-intervention, respectively, compared with 71.1% and 72.9% post-intervention. A total of 95% of post-intervention examinations were documented within the SmartSet. An electronic clinical decision support tool, plus in-person training, may be key to changing primary care provider behavior around concussion care.

Transfer of knowledge in international cooperation: the Farmanguinhos - SMM case.

PubMed

Silva, Samuel Araujo Gomes da; Duarte, Roberto Gonzalez; Castro, José Márcio de

2017-01-01

To analyze the influence of four mechanisms of knowledge transfer (training, technical visits, expatriation, and standard operating procedures) on the different dimensions (potential and realized) of absorptive capacity in international technical cooperation. We examine the case of implementation of the Sociedade Moçambicana de Medicamentos. Data have been collected using semi-structured interviews (applied to 21 professionals of the Sociedade Moçambicana de Medicamentos, Farmanguinhos, FIOCRUZ, and Itamaraty) and official documents. The data of the interviews have been submitted to content analysis, using the software NVivo. Training and technical visits directly influenced the acquisition and, partly, the assimilation of knowledge. Expatriation contributed with the transformation of this knowledge from the development and refinement of operational routines. Finally, the definition of standard operating procedures allowed the Mozambican technicians to be the actors of the transformation of the knowledge previously acquired and assimilated and, at the same time, it laid the foundations for a future exploration of the knowledge. Training and technical visits mainly influence the potential absorptive capacity, while expatriation and standard operating procedures most directly affect the realized absorptive capacity.

Psychiatry Residents' Use of Educational Websites: A Pilot Survey Study.

PubMed

Torous, John; Franzan, Jamie; O'Connor, Ryan; Mathew, Ian; Keshavan, Matcheri; Kitts, Robert; Boland, Robert

2015-12-01

Psychiatry residents have numerous online educational resources readily available to them although currently there are no data regarding residents' use and perception of such websites. A survey was offered to 62 residents from all four years of training as well as recent graduates of a single psychiatry residency training program. Residents reported utilizing online resources on average 68 % of the time, in comparison to 32 % on average for printed materials. Residents reported UpToDate, PubMed, and Wikipedia as the most visited websites and ranked each highly but for different purposes. Thirty-five percent of residents felt that insufficient faculty guidance was a barrier to use of these educational websites. Pilot data indicate psychiatry residents use online resources daily for their education in various settings. Resident perceptions of individual website's trustworthiness, ease of use, and sources of clinical decision-making and personal learning suggest potential opportunities for educators to better understand the current use of these resources in residency training. Reported barriers including lack of faculty guidance suggest opportunities for academic psychiatry. Further study is necessary at multiple sites before such results may be generalized.

When and Why Parents Seek Dental Care for Children under 36 Months.

PubMed

Volpato, Luiz Evaristo Ricci; Palti, Dafna Geller; Lima, Jose Eduardo de Oliveira; Machado, Maria Aparecida de Andrade Moreira; Aranha, Andreza Maria Fabio; Bandeca, Matheus Coelho; Pedro, Fabio Luis Miranda; Borges, Alvaro Henrique

2013-08-01

The aim was to analyze an infant preventive program determining at what age parents take their children for their first dental visit and the reasons why they do it. A total of 844 children aged from 0 to 36 months, enrolled in the program of oral health maintenance of the Baby Clinic, participated in this study. During the first dental visit, the parents were inquired about the reasons that led them to enroll their children in the program. One trained investigator identified this reasons on the records and classified them according to the following scores: orientation/prevention, caries treatment, malpositioned teeth, dental trauma, tooth color alterations and others. Orientation/prevention was the most prevalent reason from 0-6 months to 25-30 months of age, and at the age 30-36 months, the reason caries/treatment overcame orientation/prevention, becoming the most prevalent reason in that age group. The third place was occupied by dental trauma. The mean age parents seek for dental care to their children was 14, 92 months. This study showed a preferentially preventive/educational profile for the children. However, lots of parents still take children to the dentist preferentially for curative instead of preventive treatment. How to cite this article: Volpato LE, Palti DG, Lima JE, Machado MA, Aranha AM, Bandeca MC, Pedro FL, Borges AH. When and Why Parents Seek Dental Care for Children under 36 Months. J Int Oral Health 2013; 5(4):21-25.

Reducing adverse self-medication behaviors in older adults with the Next Generation Personal Education Program (PEP-NG): Design and methodology

PubMed Central

Neafsey, Patricia J; Anderson, Elizabeth; Coleman, Craig; Lin, Carolyn A; M’lan, Cyr E; Walsh, Stephen

2009-01-01

A randomized controlled efficacy trial targeting older adults with hypertension is providing a tailored education intervention with a Next Generation Personal Education Program (PEP-NG) in primary care practices in New England. Ten participating advanced practice registered nurses (APRNs) completed online knowledge and self-efficacy measures pre-onsite training and twice more after completing a continuing education program. Patient participants self-refer in response to study recruitment brochures and posters. Twenty-four participants from each APRN practice (total N = 240) are randomly assigned by the PEP-NG software to either control (data collection and four routine APRN visits) or tailored intervention (PEP-NG interface and four focused APRN visits) conditions. Patients access the PEP-NG interface via wireless tablet and use a stylus to answer demographic, knowledge, and self-efficacy questions as well as prescription and over-the-counter self-medication practice questions. The PEP-NG analyzes patient-reported information and delivers tailored educational content. Patients’ outcome measures are self-reported antihypertensive medication adherence, blood pressure, knowledge and self-efficacy concerning potential adverse self-medication practices, adverse self-medication behavior “risk” score and satisfaction with the PEP-NG and APRN provider relationship. APRN outcome measures are knowledge and self-efficacy concerning adverse self-medication practices, self-efficacy for communicating with older adults and satisfaction with the PEP-NG. Time–motion and cost–benefit analyses will be conducted. PMID:20016796

Training of the midwife in Senegal.

PubMed

Ndiaye, D F

1982-01-01

The profession of midwifery continues to hold a prominent place in the health manpower structure of many developing countries. The training program at the School of Midwifery in Senegal lasts for 3 years and is based on the teaching in French midwifery schools. Because of the special conditions in Senegal, the objective of the teaching is to train midwives to be multiskilled workers who can deliver health care services in preventive as well as in curative medicine, in both rural and urban settings, and in the maternity clinic as well as in the community. The following proposals for revising the training were developed: 1) the level of admission will become the baccalaureate; 2) the nursing training will be strengthened and the length of rural field practice will be extended to at least 3 months, including provisions for practical application of primary health care; 3) in pediatrics, more stress will be placed on diet counseling, home visits, and the treatment of infectious and parasitic diseases; 4) training will cover administration, supervision, evaluation, and maintenance of materials and facilities. The midwife in Senegal also plays a primary role in family planning, and in family planning centers should be reponsible for gynecological examinations; giving assistance in the choice of contraceptive methods; placement, follow-up, and removal of IUDs; and detection of sterility, genital and mammary cancers, and sexually transmissible diseases.

Home hemodialysis education during postdoctoral training: Challenges and innovations.

PubMed

Glickman, Joel D; Seshasai, Rebecca Kurnik

2018-03-01

Inadequate education in home hemodialysis (HHD) fellowship training might contribute to underutilization of this modality in the United States. Most graduates of nephrology fellowships do not grade themselves as competent in HHD suggesting that fellowship training in HHD is inadequate. An essential component for fellow education is at least one faculty member with expertise in HHD who is passionate about promoting the use of this modality. At a minimum, fellow training should utilize a curriculum that includes both lectures about HHD and outpatient clinical exposure to this modality over a period of at least 6-12 months. Fellows benefit from the opportunity to transition at least three patients to a home modality to gain experience with modality education, access placement, initial prescriptions, and home dialysis training. They should spend time with HHD training nurses to learn more about modality education, observe nurse intake interviews with patients in order to learn the criteria for entrance into the home dialysis program as well as recognize how to identify potential barriers to successful home dialysis therapy. To expose fellows to problems that do not occur during clinic visits fellows are encouraged to take first call during the day for HHD patients. There are many opportunities to do research and quality improvement projects which might also propel some fellows into an academic career as a home dialysis nephrologist. © 2018 Wiley Periodicals, Inc.

[Pediatrician-parent interaction and early prevention : A review about the limits in addressing psychosocial risks during well-child visits].

PubMed

Barth, Michael

2016-10-01

Pediatricians can be a door opener to early prevention for families at risk. The German well-child program is well-established, but there is a gap between the structural possibilities and the observed placements. The aim of this review is to show how pediatricians and parents talk about psychosocial risks under the very structured conditions of well-child visits. The challenges and traps of the framed interactions will be described and options for early prevention will be shown. The review is primarily based on the work of conversational and ethnomethodological studies reconstructing the pediatrician's discussion with parents about psychosocial issues in the family. Well-child visits are a highly routinized practice. Talking about family issues for both partners is a difficult task. Discussions about psychosocial issues are seldom and vague . Predominantly, they work cooperatively on reciprocal normalization of the child's development. Based on this shared orientation, pediatricians make an early, mostly general, prescription of parental tasks, supporting the child in the next developmental step. This kind of routine anticipatory counselling puts some pressure on the parents. Parents under unknown stress could be overburdened with this advice. In the script of well-child visits, there are no slots that indicate to pediatricians and parents when, which, how and for what purpose psychosocial issues can be discussed and negotiated. For implementing such slots in well-child visits, three steps are necessary: a structured and regular assessment of psychosocial issues, a trained pediatrician in motivational interviewing and a social worker guiding the family in the network of early prevention.

Home-based Reach-to-Grasp training for people after stroke is feasible: a pilot randomised controlled trial.

PubMed

Turton, A J; Cunningham, P; van Wijck, F; Smartt, Hjm; Rogers, C A; Sackley, C M; Jowett, S; Wolf, S L; Wheatley, K; van Vliet, P

2017-07-01

To determine feasibility of a randomised controlled trial (RCT) of home-based Reach-to-Grasp training after stroke. single-blind parallel group RCT. Residual arm deficit less than 12 months post-stroke. Reach-to-Grasp training in 14 one-hour therapist's visits over 6 weeks, plus one hour self-practice per day (total 56 hours). Usual care. Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), pre-randomisation, 7, 12, 24 weeks post-randomisation. Forty-seven participants (Reach-to-Grasp=24, usual care=23) were randomised over 17 months. Reach-to-Grasp participants received a median (IQR) 14 (13,14) visits, and performed 157 (96,211) repetitions per visit; plus 30 minutes (22,45) self-practice per day. Usual care participants received 10.5 (5,14) therapist visits, comprising 38.6 (30,45) minutes of arm therapy with 16 (6,24) repetitions of functional tasks per visit. Median ARAT scores in the reach-to-grasp group were 8.5 (3.0,24.0) at baseline and 14.5 (3.5,26.0) at 24 weeks compared to median of 4 at both time points (IQR: baseline (3.0,14.0), 24 weeks (3.0,30.0)) in the usual-care group. Median WMFT tasks completed at baseline and 24 weeks were 6 (3.0,11.5) and 8.5 (4.5,13.5) respectively in the reach-to-grasp group and 4 (3.0,10.0), 6 (3.0,14.0) in the usual care group. Incidence of arm pain was similar between groups. The study was stopped before 11 patients reached the 24 weeks assessment. An RCT of home-based Reach-to-Grasp training after stroke is feasible and safe. With ARAT being our preferred measure it is estimated that 240 participants will be needed for a future two armed trial.

Annual Report of the Chief, National Guard Bureau for the Fiscal Year 1970

DTIC Science & Technology

1970-06-30

visited were Alpena . Michigan and Savan- nah, Georgia. National Guard Bureau CEMT surveys of field training sites will be performed on a continuing basis...this training will be acquired and maintained at the ANC Field Training Site. Alpena , Michigan. Survival radios (ACR/RT-10) continue to be in

Evaluation of the Mobile Training Team Projects (1996-2003): Final Report

ERIC Educational Resources Information Center

Online Submission, 2005

2005-01-01

Background: For more than 30 years since 1972, the Government of Japan has contributed funds to UNESCO for implementation of the Mobile Training Team (MTT) projects. The MTT assists Member States enhance their capacity in development oriented educational innovation through intra-country study visits, training courses, workshops and technical…

Old Dogs, New Tricks: Training Mature-Aged Manufacturing Workers

ERIC Educational Resources Information Center

Smith, Erica; Smith, Andrew; Smith, Chris Selby

2010-01-01

Purpose: This paper aims to examine the employment and training of mature-aged workers, so that suggestions for improving training for mature-aged workers may be offered. Design/methodology/approach: Six expert interviews were carried out by telephone, and three case studies involving company site visits were completed. Each company case study…

Environmental Education and Training in Brazil. Discussion Paper No. 84.

ERIC Educational Resources Information Center

Bruan, Ricardo

Brazilian environmental education and training experience is recent but has a concrete base of generating awareness among all levels of the population and also aims to train people to protect, control and manage the use of environmental resources. Several visits were made by the author to organizations, enterprises and institutions from federal,…

Parent Involvement Affects Children's Cognitive Growth.

ERIC Educational Resources Information Center

Irvine, David J.; And Others

As part of a longitudinal study of the New York State Experimental Prekindergarten Program, the effect of degree of parental involvement in the program on children's cognitive development was examined. Parent involvement included employment in the program, school visits, home visits by school personnel, group meetings, and incidental contacts such…

Library | CTIO

Science.gov Websites

Program PIA Program GO-FAAR Program Other Opportunities Tourism Visits to Tololo Astro tourism in Chile Tourism in Chile Information for travelers Visit Tololo Media Relations News Press Release Publications , and books, most of which can be found at CTIO's La Serena library branch. Electronic Resources Access

Preparing for the Validation Visit--Guidelines for Optimizing the Experience.

ERIC Educational Resources Information Center

Osborn, Hazel A.

2003-01-01

Urges child care programs to seek accreditation from NAEYC's National Academy of Early Childhood Programs to increase program quality and provides information on the validation process. Includes information on the validation visit and the validator's role and background. Offers suggestions for preparing the director, staff, children, and families…

Toward Population Impact from Home Visiting

ERIC Educational Resources Information Center

Dodge, Kenneth A.; Goodman, W. Benjamin; Murphy, Robert; O'Donnell, Karen J.; Sato, Jeannine M.

2013-01-01

Although some home visiting programs have proven effective with the families they serve, no program has yet demonstrated broader impact on an entire county or state population. This article describes the Durham Connects program, which aims to achieve broad county-level effects by coalescing community agencies to serve early-intervention goals…

Skier and Snowboarder Motivations and Knowledge Related to Voluntary Environmental Programs at an Alpine Ski Area

NASA Astrophysics Data System (ADS)

Little, Christopher M.; Needham, Mark D.

2011-11-01

Many alpine ski areas have recently adopted voluntary environmental programs (VEPs) such as using recycling, renewable energy, and biofuels to help reduce their environmental impacts. Studies have addressed the performance of these VEPs in mitigating environmental impacts of this industry, but little is known about visitor awareness and perceptions of these programs. This article addresses this knowledge gap by exploring skier and snowboarder knowledge of VEPs at a ski area and the influence of these programs on their motivations to visit this area currently and behavioral intentions to visit again in the future. Data were obtained from an onsite survey at the Mt. Bachelor ski area in Oregon, USA ( n = 429, 89.7% response rate). Few skiers and snowboarders were knowledgeable of VEPs at this area and fewer than 20% were motivated to visit on their current trip because of these programs. Other attributes such as scenery, snow conditions, and access were more important for influencing visitation. Up to 38% of skiers and snowboarders, however, intend to visit this ski area more often if it adopts and promotes more VEPs. Managers can use these results to inform communication and marketing of their environmental programs and performance to visitors. Additional implications for management and future research are discussed.

Skier and snowboarder motivations and knowledge related to voluntary environmental programs at an alpine ski area.

PubMed

Little, Christopher M; Needham, Mark D

2011-11-01

Many alpine ski areas have recently adopted voluntary environmental programs (VEPs) such as using recycling, renewable energy, and biofuels to help reduce their environmental impacts. Studies have addressed the performance of these VEPs in mitigating environmental impacts of this industry, but little is known about visitor awareness and perceptions of these programs. This article addresses this knowledge gap by exploring skier and snowboarder knowledge of VEPs at a ski area and the influence of these programs on their motivations to visit this area currently and behavioral intentions to visit again in the future. Data were obtained from an onsite survey at the Mt. Bachelor ski area in Oregon, USA (n = 429, 89.7% response rate). Few skiers and snowboarders were knowledgeable of VEPs at this area and fewer than 20% were motivated to visit on their current trip because of these programs. Other attributes such as scenery, snow conditions, and access were more important for influencing visitation. Up to 38% of skiers and snowboarders, however, intend to visit this ski area more often if it adopts and promotes more VEPs. Managers can use these results to inform communication and marketing of their environmental programs and performance to visitors. Additional implications for management and future research are discussed.

Assessing the Benefits of a Geropsychiatric Home-Visit Program for Medical Students

ERIC Educational Resources Information Center

Roane, David M.; Tucker, Jennifer; Eisenstadt, Ellen; Gomez, Maria; Kennedy, Gary J.

2012-01-01

Objective: Authors assessed the benefit of including medical students on geropsychiatric home-visits. Method: Medical students, during their psychiatry clerkship, were assigned to a home-visit group (N=43) or control group (N=81). Home-visit participants attended the initial visit of a home-bound geriatric patient. The Maxwell-Sullivan Attitude…

The impact of universal access to dental care on disparities in caries experience in children.

PubMed

Ismail, A I; Sohn, W

2001-03-01

The authors investigated the association between socioeconomic status and the severity of dental caries in 6- and 7-year-old children who had had access to dental care throughout their lives. The children had lived since birth in Nova Scotia, Canada, a province with a universal publicly financed dental care program. The authors selected a representative sample of first-grade children using a stratified multistage sampling method of primary schools (n = 1,614). The response rate was 78.8 percent. Two dentists were trained to diagnose dental caries using modified World Health Organization criteria. Intra- and interexaminer reliability was excellent (kappa > or = 0.88). Of the children who were examined (n = 1,271), 955 were lifelong residents of Nova Scotia, Canada, and so were included in this analysis. Data were weighted and adjusted for clustering (design) effects. Only 8.4 percent of the children had visited a dental office before the age of 2 years, and 88.5 percent of the children had their first dental visit between the ages of 2 and 5 years. Children whose parents had completed a university education had a significantly lower mean number of decayed, missing and filled surfaces, or dmfs, in their primary teeth than did children whose parents had a lower education level. A Poisson regression model indicated that parents' high education status, optimal fluoride concentration in schools' water supplies, daily toothbrushing and dental visits for checkup were significantly associated with low dmfs scores. Having access to a universal publicly financed dental insurance program since birth did not eliminate the disparities in caries experience. This analysis of a highly utilized universal dental insurance program suggests that disparities in oral health status cannot be reduced solely by providing universal access to dental care. Focused efforts by professional and governmental organizations should be directed toward understanding the socioeconomic, behavioral and community determinants of oral health disparities.

77 FR 33225 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

... progress towards a high-quality home visiting program or towards embedding their home visiting program into a comprehensive, high-quality early childhood system. Of State applicants to the competitive grant...

Rethinking multifamily resets and cutouts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jablonski, F.

In multifamily applications, where heating bills often run into thousands of dollars, reset-cutout combinations appear to be very attractive retrofits because, when properly operated, they meet owners' needs for very quick returns on energy saving investments. Unfortunately, the author's observation of resets and cutouts operating under conditions the author typically found in residential multifamily buildings indicates that adjustable controls, such as most resets and cutouts, will often be defeated through poor installation and maladjustment. This appears to be true even when programs incorporate mechanisms aimed at training building operators to manage the controls correctly, and reinforce that training with writtenmore » instructions and periodic reminders. Despite the massive and frequently reinforced education effort for control operators, his post-installation site visits revealed that resets and cutouts were still routinely defeated. Out of curiosity, he conducted a survey of cutout controls in spring 1990. The author has found that 19 of 19 cutout controls surveyed, all of which had been installed under the enhanced program, were rendered functionally inoperable because they were turned off or set far too high. Because this preliminary survey showed such poor results, additional research is now underway to assess the maintenance or disablement of these adjustable resets and cutouts.« less

Social Support Perspectives on Programs for Parents: Lessons from the Child Survival/Fair Start Home Visiting Programs.

ERIC Educational Resources Information Center

Larner, Mary

This paper discusses home visiting programs for low income parents and infants and describes five such programs known collectively as the Child Survival/Fair Start (CS/FS) projects, funded by the Ford Foundation. It describes a conceptual model which links risk factors and intervention activities to effects on mothers and children and explains how…

Training addiction professionals in empirically supported treatments: perspectives from the treatment community.

PubMed

Hartzler, Bryan; Rabun, Carl

2014-01-01

Large-scale dissemination efforts seek to expand opportunities for the addiction treatment community to receive training in empirically supported treatments (ESTs). Prospective consumers of such training are valuable sources of input about content of interest, preferences for how training events are structured, and obstacles that deter receipt of training. In this mixed-method study, data were collected in 64 semistructured individual interviews with personnel during site visits to 16 community opioid treatment programs (OTPs). At each OTP, interviews were completed with the executive director, a clinical supervisor, and 2 direct-service clinicians. Topical interests were analyzed qualitatively in a cultural domain analysis. Likert ratings of training event preferences were analyzed via generalized linear mixed models (GLMMs), and unstructured interviewee comments were analyzed via narrative analysis. Obstacles to training receipt were analyzed qualitatively with both content coding and narrative analysis. Based on topics of reported interest, cultural domain analysis suggests as ESTs of note: Multidimensional Family Therapy, Motivational Enhancement Therapy, Relapse Prevention Therapy, "Seeking Safety," and broad addiction-focused pharmacotherapy. Regarding training event preferences, GLMMs and narrative analysis revealed clear preferences for time-distributed trainings and use of participatory activities (e.g., trainer demonstrations, role plays, small group exercises). Content coding identified cost as the primary obstacle to receipt of EST trainings, followed by lack of time, logistical challenges, and disinterest, and narrative analysis elaborated on contextual issues underlying these obstacles. As primary consumers of EST technologies, the treatment community has valuable input to offer. Dissemination efforts may be enhanced by greater consideration of their preferences for training content and event structure, as well as practical obstacles that challenge their receipt of training.

Adherence to evidence based care practices for childbirth before and after a quality improvement intervention in health facilities of Rajasthan, India.

PubMed

Iyengar, Kirti; Jain, Motilal; Thomas, Sunil; Dashora, Kalpana; Liu, William; Saini, Paramsukh; Dattatreya, Rajesh; Parker, Indrani; Iyengar, Sharad

2014-08-13

After the launch of Janani Suraksha Yojana, a conditional cash transfer scheme in India, the proportion of women giving birth in institutions has rapidly increased. However, there are important gaps in quality of childbirth services during institutional deliveries. The aim of this intervention was to improve the quality of childbirth services in selected high caseload public health facilities of 10 districts of Rajasthan. This intervention titled "Parijaat" was designed by Action Research & Training for Health, in partnership with the state government and United Nations Population Fund. The intervention was carried out in 44 public health facilities in 10 districts of Rajasthan, India. These included district hospitals (9), community health centres (32) and primary health centres (3). The main intervention was orientation training of doctors and program managers and regular visits to facilities involving assessment, feedback, training and action. The adherence to evidence based practices before, during and after this intervention were measured using structured checklists and scoring sheets. Main outcome measures included changes in practices during labour, delivery or immediate postpartum period. Use of several unnecessary or harmful practices reduced significantly. Most importantly, proportion of facilities using routine augmentation of labour reduced (p = 0), episiotomy for primigravidas (p = 0.0003), fundal pressure (p = 0.0003), and routine suction of newborns (0 = 0.0005). Among the beneficial practices, use of oxytocin after delivery increased (p = 0.0001) and the practice of listening foetal heart sounds during labour (p = 0.0001). Some practices did not show any improvements, such as dorsal position for delivery, use of partograph, and hand-washing. An intervention based on repeated facility visits combined with actions at the level of decision makers can lead to substantial improvements in quality of childbirth practices at health facilities.