Home About us Contact
|
Home About us Contact | ||
|
|
||
Educational Sessions (educational + session)
Selected AbstractsBuddhist nuns on the move: an innovative approach to improving breastfeeding practices in CambodiaMATERNAL & CHILD NUTRITION, Issue 1 2007Benjamin T. Crookston Abstract The benefits of initiating breastfeeding in the first hour of life and exclusively breastfeeding thereafter are well documented. However, little is known about how best to promote these practices. In this study, we assess the impact of Buddhist nuns and wat (pagoda) grannies on optimal breastfeeding behaviours in rural Cambodia. We did so by interviewing randomly selected mothers of infants less than 6 months of age. A total of 440 mothers in programme and control communities completed the baseline survey (before programme start-up), and 467 mothers responded 1 year later. Mothers' exposure to breastfeeding promotion activities was high. At follow-up, 76% of mothers in programme communities indicated that nuns had advised them about breastfeeding, 73% received a home visit and 72% reported attending an educational session. At baseline, mothers in programme communities were 11% more likely (RR = 1.11, CI: 0.74,1.68) than mothers in control communities to initiate breastfeeding in the first hour of life. At follow-up, they were 62% more likely (RR = 1.62, CI: 1.30,2.01) to do so. Similarly, at baseline, mothers in programme communities were 54% more likely (RR = 1.54, CI: 1.21,1.96) than mothers in control communities to breastfeed exclusively in the previous 24 h. At follow-up, they were 81% more likely (RR = 1.81, CI: 1.49,2.21) to do so. Programme planners may consider using community-based volunteers as one strategy to improve breastfeeding practices and child survival. [source] Impact of an exercise and walking protocol on quality of life for elderly people with OA of the kneePHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2003Rosāngela Corrźa Dias Abstract Background and Purpose The knee is the weight-bearing joint most commonly affected by osteoarthritis (OA). The symptoms of pain, morning stiffness of short duration and physical dysfunction in the activities of daily living (ADL) can have an effect on many aspects of health, affecting quality of life. Regular and moderate physical activity adapted to individuals' life-styles and education, and joint protection strategies have been advocated as conservative management. The purpose of the present study was to assess the impact of an exercise and walking protocol on the quality of life of elderly people with knee OA. Method The study design was a randomized controlled clinical trial. The subjects comprised 50 elderly people, aged 65 or more, with knee OA who had been referred to the geriatric outpatient unit for rehabilitation. Changes in severity of pain and quality of life were compared between a control group (CG) and an experimental group (EG). Both groups participated in an educational session and the EG also received a 12-week exercise and walking protocol. Both groups were assessed at baseline and after three and six months by an independent observer. The Lequesne Index of Knee OA Severity (LI), the Health Assessment Questionnaire (HAQ) and the Medical Outcomes Short-Form Health Survey (SF-36) were used as measurement instruments. Results In the CG, the measures of quality of life (SF-36), the HAQ and the LI between subjects did not yield statistically significant differences over the three measurement points. For the EG, there was a significant improvement in function, measured by HAQ, and decreasing OA symptom severity, measured by LI. For the SF-36 there were significant improvements in physical function, functional role limitation and pain. Comparisons between the groups showed statistically significant differences after three and six months for all measures, except for the SF-36 emotional domains. Conclusion The exercise protocol and walking programme had a positive effect on the quality of life of elderly individuals with knee OA. Copyright © 2003 Whurr Publishers Ltd. [source] Geriatric Emergency Medicine Educational Module: Abdominal Pain in the Older AdultACADEMIC EMERGENCY MEDICINE, Issue 2009Lowell Gerson The Society for Emergency Medicine (SAEM) Geriatrics Task Force has created an instructional tool to address the complaint of abdominal pain in older adults presenting to the emergency department (ED). This is the first module in a comprehensive, web-based geriatric emergency medicine curriculum that will address common syndromes in older adults presenting to the ED. There is no formal, residency-based curriculum in geriatric emergency medicine and there is a paucity of geriatric Continuing Medical Education (CME) opportunities for practicing emergency physicians. The amount, quality, and convenience of geriatrics training available to emergency physicians is insufficient. This educational gap is particularly concerning given the ever-growing volume of older adult emergency patients. The Task Force chose to focus first on geriatric abdominal pain because a survey of emergency physicians in the mid 1990s found that it is one of the most difficult complaints to evaluate and manage. The module comprises of six clinical cases with a pre- and post-test. Together, these cases encompass the broad differential diagnosis for geriatric abdominal pain and the core medical knowledge pertaining to the subject. The modules will expose the learner, through either content or modeling, to the six Accreditation Council for Graduate Medical Education (ACGME) core competencies and to the Principles of Geriatric Emergency Medicine including rapid evaluation of functional status, communication skills, and consideration of the effect of polypharmacy and co-morbidity on the presenting complaint. This module will be available to residency programs as an "asynchronous educational session" via the Council of Emergency Medicine Residency Directors (CORD) website as well as to practicing emergency physicians via the SAEM and American College of Emergency Physicians (ACEP) websites. [source] 16 A Novel Approach to "See One, Do One": Multimedia Presentations before Procedure Workshops and SimulationACADEMIC EMERGENCY MEDICINE, Issue 2008Amita Sudhir We propose that residents and medical students are likely to gain more from a simulation experience or procedure workshop if they are given educational materials conveying key concepts to review beforehand. Several multimedia formats are available to accomplish this task. Digital video and Powerpoint presentations can be converted to podcasts with or without audio tracks using programs like Profcast, GarageBand, Camtasia, and Keynote. There are also procedure videos available from sources like the New England Journal of Medicine. Participants are provided these instructional materials via a secure web server or email attachment several days prior to the educational session. These presentations are kept short in length (no greater than 10-15 minutes) to optimize compliance while delivering information efficiently. They can be reviewed at the learner's convenience on a personal computer or on an iPod with video capability. This method can significantly reduce the time required for didactic teaching in a procedure workshop; for example, when medical students review a video on basic suturing before attending a suturing workshop, they are prepared to begin practicing with minimal initial instruction. Furthermore, conveying the same information repeatedly through different instructional methods can help learners consolidate knowledge, as in the case of a presentation provided to residents before a simulation session containing the basic clinical teaching points of the case. Participant feedback regarding these resources has been favorable. [source] Web-based consultations for parents of children with atopic dermatitis: results of a randomized controlled trialACTA PAEDIATRICA, Issue 2 2009Trine S Bergmo Abstract Aim: To analyse how web-based consultations for parents of children with atopic dermatitis affect self-management behaviour, health outcome, health resource use and family costs. Methods: Ninety-eight children with atopic dermatitis were randomly assigned to intervention and control groups. The intervention group received remote dermatology consultations through a secure web-based communication system. The control group was encouraged to seek treatment through traditional means such as general practitioner visits and hospital care. Both groups received an extensive individual educational session prior to the intervention. Results: Thirty-eight percent of the intervention group used web-based consultations 158 times ranging from 1 to 38 consultations per patient. We found no change in self-management behaviour, health outcome or costs. The intervention group tended to have fewer visits to practitioners offering complementary therapies than the control group, and we found a positive correlation between emergency visits at baseline and messages sent. Both groups, however, reduced the mean number of skin care treatments performed per week and had fewer total health care visits after the intervention. Conclusion: We found no effect of supplementing traditional treatment for childhood dermatitis with web-based consultations. This study showed that web consultations is feasible, but more research is needed to determine its effect on self-management skills, health outcome and resource use. [source] An exploratory comparison of genetic counselling protocols for HNPCC predictive testingCLINICAL GENETICS, Issue 3 2005K Brain Most UK genetics centres offering predictive testing for hereditary non-polyposis colorectal cancer (HNPCC) use an extended counselling protocol originally developed for Huntington's disease. Shortened counselling may be more appropriate in the context of treatable genetic conditions such as HNPCC. Twenty-six high-risk individuals were randomized to extended genetic counselling (two sessions of education and reflection held 1 month apart) or shortened genetic counselling (a single educational session) prior to HNPCC testing. Prospective questionnaires, interviews and transcripts of counselling sessions were analysed. Participants were unsure what to expect prior to genetic counselling and had already decided to undergo genetic testing. There was no evidence of psychological harm caused by shortened genetic counselling, with a high level of satisfaction with the counselling received in both groups. Reflective counselling occurred in both groups but was framed in terms of practical action and information. Participants expressed differing preferences for the level of information received. This exploratory study indicates that shortened genetic counselling may be an appropriate means of supporting decisions already made by individuals about HNPCC testing. However, participants would benefit from preparatory information to help them reflect on issues not previously considered, which can then be explored more fully as part of a tailored counselling approach. [source] Effect of an interdisciplinary educational program on antipsychotic prescribing among nursing home residents with dementiaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2008Johanne Monette Abstract Objective To assess the effect of an interdisciplinary educational program in reducing the use of antipsychotics in nursing home residents with dementia. Methods We conducted a longitudinal pilot study to test the implementation of a 7-month interdisciplinary educational program in a fixed cohort of residents with dementia receiving antipsychotics. The program included consciousness-raising, educational sessions, and clinical follow-up. Administrators, physicians, pharmacists, nursing staff, and personal care attendants were involved. The effect of the program was assessed over a 6-month period, in terms of the proportion of discontinuations and dose reductions of antipsychotics. Repeated measures for use of other psychotropics and restraints, frequency of disruptive behaviors, and stressful events experienced by nursing staff and personal care attendants were simultaneously assessed. Results Among the 81 residents still present at the end of the program, there were 40 (49.4%) discontinuations and 11 (13.6%) dose reductions. No significant changes were found in the use of other psychotropics, the use of restraints, or in the number of stressful events experienced by nursing staff and personal care attendants. The frequency of disruptive behaviors decreased significantly over the 6-month period (p,<,0.001). Conclusions Our interdisciplinary educational program led to a substantial reduction in the number of residents receiving antipsychotics and to a decrease in the frequency of disruptive behaviors. Our findings suggest that implementation of recognized practice guidelines could be an effective way to target residents who might not benefit from antipsychotics or who may tolerate a dose reduction. Copyright © 2007 John Wiley & Sons, Ltd. [source] A Multifaceted Intervention to Implement Guidelines Improved Treatment of Nursing Home,Acquired Pneumonia in a State Veterans HomeJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2006Evelyn Hutt MD OBJECTIVES: To assess the feasibility of a multifaceted strategy to translate evidence-based guidelines for treating nursing home,acquired pneumonia (NHAP) into practice using a small intervention trial. DESIGN: Pre-posttest with untreated control group. SETTING: Two Colorado State Veterans Homes (SVHs) during two influenza seasons. PARTICIPANTS: Eighty-six residents with two or more signs of lower respiratory tract infection. INTERVENTION: Multifaceted, including a formative phase to modify the intervention, institutional-level change emphasizing immunization, and availability of appropriate antibiotics; interactive educational sessions for nurses; and academic detailing. MEASUREMENTS: Subjects' SVH medical records were reviewed for guideline compliance retrospectively for the influenza season before the intervention and prospectively during the intervention. Bivariate comparisons-of-care processes between the intervention and control facility before and after the intervention were made using the Fischer exact test. RESULTS: At the intervention facility, compliance with five of the guidelines improved: influenza vaccination, timely physician response to illness onset, x-ray for patients not being hospitalized, use of appropriate antibiotics, and timely antibiotic initiation for unstable patients. Chest x-ray and appropriate and timely antibiotics were significantly better at the intervention than at the control facility during the intervention year but not during the control year. CONCLUSION: Multifaceted, evidence-based, NHAP guideline implementation improved care processes in a SVH. Guideline implementation should be studied in a national sample of nursing homes to determine whether it improves quality of life and functional outcomes of this debilitating illness for long-term care residents. [source] Family violence prevention programs in immigrant communities: perspectives of immigrant menJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 7 2008Louise Simbandumwe The Strengthening Families in Canada Family Violence Prevention Project was aimed at engaging immigrant and refugee communities in family violence prevention. The project, which received support from the Community Mobilization Program, National Crime Prevention Strategy, involved a partnership of four community health and education organizations. The project had three streams: women's, youth, and men's. The women's and youth streams were composed of educational sessions on violence prevention. The third stream consisted of a qualitative research project examining immigrant and refugee men's views of family violence and their suggestions for prevention education. The authors present findings from this research and offer suggestions for future implementation of prevention programming for immigrant and refugee families. © 2008 Wiley Periodicals, Inc. [source] Sharing specialist skills for diabetes in an inner city: A comparison of two primary care organisations over 4 yearsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2006Abdu Mohiddin MFPHM Lecturer Abstract Objective, To evaluate the effects of organizational change and sharing of specialist skills and information technology for diabetes in two primary care groups (PCGs) over 4 years. Methods, In PCG-A, an intervention comprised dedicated specialist sessions in primary care, clinical guidelines, educational meetings for professionals and a shared diabetes electronic patient record (EPR). Comparison was made with the neighbouring PCG-B as control. In intervention and control PCGs, practice development work was undertaken for a new contract for family doctors. Data were collected for clinical measures, practice organizational characteristics and professional and patient views. Results, Data were analysed for 26 general practices including 17 in PCG-A and nine in PCG-B. The median practice-specific proportions of patients with HbA1c recorded annually increased in both areas: PCG-A from median 65% to 77%, while PCG-B from 53% to 84%. For cholesterol recording, PCG-A increased from 50% to 76%, and PCG-B from 56% to 80%. Organizational changes in both PCGs included the establishment of recall systems, dedicated clinics and educational sessions for patients. In both PCGs, practices performing poorly at baseline showed the greatest improvements in organization and clinical practice. Primary care professionals' satisfaction with access and communication with diabetes specialist doctors and nurses increased, more so in the intervention PCG. Only 16% of primary care professional respondents used the diabetes EPR at least monthly. Patient satisfaction and knowledge did not change. Conclusions, Improvements in practices' organizational arrangements were associated with improvements in clinical care in both PCGs. Sharing specialist skills in one PCG was associated with increased professional satisfaction but no net improvement in clinical measures. A shared diabetes EPR is unlikely to be used, unless integrated with practice information systems. [source] Improving Child Protection in the Emergency Department: A Systematic Review of Professional Interventions for Health Care ProvidersACADEMIC EMERGENCY MEDICINE, Issue 2 2010Amanda S. Newton PhD Abstract Objectives:, This systematic review evaluated the effectiveness of professional and organizational interventions aimed at improving medical processes, such as documentation or clinical assessments by health care providers, in the care of pediatric emergency department (ED) patients where abuse was suspected. Methods:, A search of electronic databases, references, key journals, and conference proceedings was conducted and primary authors were contacted. Studies whose purpose was to evaluate a strategy aimed at improving ED clinical care of suspected abuse were included. Study methodologic quality was assessed by two independent reviewers. One reviewer extracted the data, and a second checked for completeness and accuracy. Results:, Six studies met the inclusion criteria: one randomized controlled trial (RCT), one quasi-RCT, and four observational studies. Study quality ranged from modest (observational studies) to good (trials). Variation in study interventions and outcomes limited between-study comparisons. The quasi-RCT supported self-instructional education kits as a means to improve physician knowledge for both physical abuse (mean ± standard deviation [SD] pretest score = 13.12 ± 2.36; mean ± SD posttest score = 18.16 ± 1.64) and sexual abuse (mean ± SD pretest score = 10.81 ± 3.20; mean ± SD posttest score = 18.45 ± 1.79). Modest-quality observational studies evaluated reminder systems for physician documentation with similar results across studies. Compared to standard practice, chart checklists paired with an educational program increased physician consideration of nonaccidental burns in burn cases (59% increase), documentation of time of injury (36% increase), and documentation of consistency (53% increase) and compatibility (55% increase) of reported histories. Decisional flow charts for suspected physical abuse also increased documentation of nonaccidental physical injury (69.5% increase; p < 0.0001) and had a similar significant effect as checklists on increasing documentation of history consistency and compatibility (69.5 and 70.0% increases, respectively; p < 0.0001) when compared to standard practice. No improvements were noted in these studies for documentation of consultations or current status with child protective services. The introduction of a specialized team and crisis center to standardize practice had little effect on physician documentation, but did increase documentation of child protective services involvement (22.7% increase; p < 0.005) and discharge status (23.7% increase; p < 0.02). Referral to social services increased in one study following the introduction of a chart checklist (8.6% increase; p = 0.018). A recently conducted multisite RCT did not support observational findings, reporting no significant effect of educational sessions and/or a chart checklist on ED practices. Conclusions:, The small number of studies identified in this review highlights the need for future quality studies that address care of a vulnerable clinical population. While moderate-quality observational studies suggest that education and reminder systems increase clinical knowledge and documentation, these findings are not supported by a multisite randomized trial. The limited theoretical base for conceptualizing change in health care providers and the influence of the ED environment on clinical practice are limitations to this current evidence base. ACADEMIC EMERGENCY MEDICINE 2010; 17:117,125 © 2010 by the Society for Academic Emergency Medicine [source] Are nurses prepared for retirement?JOURNAL OF NURSING MANAGEMENT, Issue 6 2008JUDITH BLAKELEY BScN Aim, This study explored various factors and income sources that registered nurses believe are important in retirement planning. Background, In many countries worldwide, many registered nurses are approaching retirement age. This raises concerns related to the level of preparedness of retiring nurses. Methods, A mail-out questionnaire was sent to 200 randomly selected nurses aged 45 and older. SPSS descriptors were used to outline the data. Multiple t -tests were conducted to test for significant differences between selected responses by staff nurses and a group of nurse managers, educators and researchers. Results, Of 124 respondents, 71% planned to retire by age 60. Only 24% had done a large amount of planning. The top four planning strategies identified were related to keeping healthy and active, both physically and mentally; a major financial planning strategy ranked fifth. Work pensions, a government pension and a personal savings plan were ranked as the top three retirement income sources. No significant differences were found between the staff nurse and manager groups on any of the items. Implications for nursing managers/conclusions, The results of this study suggest that managers' preparation for retirement is no different from that of staff nurses. All nurses may need to focus more on financial preparation, and begin the process early in their careers if they are to have a comfortable and healthy retirement. Nurse managers are in a position to advocate with senior management for early and comprehensive pre-retirement education for all nurses and to promote educational sessions among their staff. Managers may find the content of this paper helpful as they work with nurses to help them better prepare for retirement. This exploratory study adds to the limited amount of research available on the topic. [source] A School-Community Partnership for At-Risk Students in PennsylvaniaJOURNAL OF SCHOOL HEALTH, Issue 2 2001Beth McMahon ABSTRACT: This four-year, school-community health improvement project addressed fragmentation and under-utilization of services of an at risk population in a county in central Pennsylvania. A population profile was developed that included demographic, attitudinal, and behavioral information as well as information related to liabilities and assets that affect resiliency and decrease or increase the likelihood of academic success. The profile was used in the planning and implementation of risk-reduction strategies that promote a healthy family and, in turn, a healthy community. More than 50 local, state, and national organizations as well as individuals volunteered or provided services at each school. The project produced a 22% increase in parental involvement in school activities; a 15% increase in parental involvement in educational sessions; a 22% increase in volunteers within the school; and a 75% decrease in truancy. (J Sch Health. 2001;71(2):53-55) [source] A comparison of the acceptance of immunochemical faecal occult blood test and colonoscopy in colorectal cancer screening: a prospective study among ChineseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2010M. C. S. Wong Aliment Pharmacol Ther 2010; 32: 74,82 Summary Background, Preferences to choose immunochemical faecal occult blood test (FIT) and colonoscopy as colorectal cancer (CRC) screening modalities among asymptomatic Chinese subjects remain unknown. Aim, To evaluate the preference of choosing colonoscopy vs. FIT among CRC screening participants. Methods, From a community-based CRC screening programme for asymptomatic Hong Kong Chinese aged 50,70 years, participants attended standardized educational sessions and chose the options of annual FIT for 5 years or direct colonoscopy once. Factors associated with choosing colonoscopy were evaluated by multivariate regression analysis. Results, Among 3430 participants [mean age 56.8 years (s.d. 5.0); female 55.1%, male 44.9%], 51.3% chose colonoscopy and 48.7% chose FIT. Older participants (65,70 years) were less likely to choose colonoscopy [adjusted odds ratio (aOR) 0.731, P = 0.041]. Subjects who chose colonoscopy were those disagreed screening would lead to discomfort (aOR 1.356, P < 0.001), had relatives or friends who had CRC (first degree relatives aOR 1.679, P < 0.001; second degree relatives aOR 1.304, P = 0.019; friends or others aOR 1.252, P = 0.026) and those who self-perceived their health as poor (aOR 1.529, P = 0.025). Conclusions, Faecal occult blood test and direct colonoscopy were equally preferable to Chinese. Colonoscopy was preferred among the younger subjects, those with positive family history of CRC and self-perceived poor health status. [source] | ||||||||||