Baseline Knowledge (baseline + knowledge)

Distribution by Scientific Domains

Selected Abstracts

Evaluation of a training program to improve clinicians' assessment of patient stability

Abstract Introduction and Aims. Public clinics in New South Wales (NSW), Australia play a central role in inducting and stabilising opioid dependent clients onto treatment before transfer to a community pharmacy. Clinical assessment of stability is a vital skill in ensuring that clients are appropriately and effectively transferred. A two-hour clinical training program was delivered to staff at 31 public clinics, that aimed to improve staff confidence in assessing client stability, and skills in negotiating the transfer of clients to community pharmacies. Design and Methods. Pre- and post-training evaluation was conducted examining self-ratings of confidence and ability in the assessment of client stability, and the perceived utility of a clinical algorithm to improve assessments. Follow-up was conducted 3 to 6 months post-training assessing individual and clinic level changes in clinical practice. Results. 205 staff completed pre- and post-training questionnaires. Staff demonstrated a moderate level of self-reported baseline knowledge and skills in assessing client stability (mean = 6.5; 1 = poor; 10 = excellent) that improved when re-assessed following the training (mean = 8.0). 76 staff responded to the follow-up questionnaire. , 75% reported some level of improvement in their approach to clinical practice regarding stability assessment, and 59% reported being more effective in identifying clients appropriate for community pharmacy transfer. Of 19 public clinics, 14 reported an increased focus on stability assessment. Nine clinics reported barriers to achieving changes in clinical practice. Discussion and Conclusions. This evaluation demonstrates that it is possible to implement a targeted clinical training package to staff that translates into positive changes in clinical practice.[Winstock AR, Lea T. Evaluation of a training program to improve clinicians' assessment of patient stability. Drug Alcohol Rev 2009;28:353,359] [source]

Microbiological status of piggery effluent from 13 piggeries in the south east Queensland region of Australia

H.N. Chinivasagam
Abstract Aims:, To assist in the development of safe piggery effluent re-use guidelines by determining the level of selected pathogens and indicator organisms in the effluent ponds of 13 south-east Queensland piggeries. Methods and Results:, The numbers of thermotolerant coliforms, Campylobacter jejuni/coli, Erysipelothrix rhusiopathiae, Escherichia coli, Salmonella and rotavirus were determined in 29 samples derived from the 13 piggeries. The study demonstrated that the 13 final effluent ponds contained an average of 12 105 colony-forming units (CFU) 100 ml,1 of thermotolerant coliforms and 103 105 CFU 100 ml,1 of E. coli. The Campylobacter level varied from none detectable (two of 13 piggeries) to a maximum of 930 most probable number (MPN) 100 ml,1 (two of 13 piggeries). Salmonella was detected in the final ponds of only four of the 13 piggeries and then only at a low level (highest level being 51 MPN 100 ml,1). No rotavirus and no Erysip. rhusiopathiae were detected. The average log10 reductions across the ponding systems to the final irrigation pond were 177 for thermotolerant coliforms, 171 for E. coli and 104 for Campylobacter. Conclusions:, This study has provided a baseline knowledge on the levels of indicator organisms and selected pathogens in piggery effluent. Significance and Impact of the Study:, The knowledge gained in this study will assist in the development of guidelines to ensure the safe and sustainable re-use of piggery effluent. [source]

Fostering a culture of engagement: an evaluation of a 2-day training in solution-focused brief therapy for mental health workers

H. FERRAZ msc pg dip ed rmn
The focus of mental health care has changed considerably in recent years, from an almost exclusive inpatient system of care to one where the majority of care is being delivered within the community. Arguably this has contributed to a reduction in the length of inpatient admissions. Therefore, there is a need to understand the ramifications that shorter admissions have on inpatient care and nursing practice. This paper reports on a study designed to test the knowledge and skill acquisition and self-reported application of solution-focused brief therapy by staff following a 2-day training. The study adopted a repeated measures design where participants' baseline knowledge was measured prior to the 2-day training and then at 3 and 6 months post-training. This study has demonstrated that the 2-day training was effective in increasing participants' reported knowledge and understanding of solution-focused brief therapy and their self-reported use of the techniques in routine clinical practice. In conclusion, this study has established that staff from a variety of professional and non-professional backgrounds can make good skill acquisition from a fairly modest training. Additionally, the current study has also highlighted the need for well-conducted large-scale trials of this potentially important technology. [source]

Survival rate, abundance, and residency of long-finned pilot whales in the Strait of Gibraltar

P. Verborgh
Abstract Long-finned pilot whales in the Strait of Gibraltar are distributed over the main shipping routes. This exposes them to risks of collisions and probable acoustic and physical disturbance. This species is also the target of whale-watching operations. The aim of this study was to estimate the annual population size, survival rate, and population growth rate of pilot whales occurring in the Strait and their inter-annual variation using photo-identification. A robust design was used to estimate all three parameters. A total of 10,784 individual pilot whale fins were photographed and analyzed. The population size estimation in summer ranged from a low of 147 individuals in 1999 to a high of 265 individuals in 2003. The annual population growth rate was estimated from mark recapture models to be 5.5%. The survival rate of adults was estimated at 0.982 (95% CI: 0.955,0.993). The same individuals have been observed between years. This suggests that this population is resident in the Strait, at least during summer. This study provides baseline knowledge prior to a predicted increase in shipping traffic throughout the main foraging area due to the opening in 2007 of a major shipping harbor along the Moroccan coast of the Strait. [source]

Knowledge, Attitudes, Beliefs, and Personal Practices Regarding Colorectal Cancer Screening Among Health Care Professionals in Rural Colorado: A Pilot Survey

Sun Hee Rim MPH
ABSTRACT:,Purpose: This study reports the baseline knowledge, attitudes, beliefs, and personal practices of health care professionals regarding colorectal cancer (CRC) screening in the High Plains Research Network (HPRN) of rural Colorado prior to a community-based educational intervention. It also examines the association between health care staff members' knowledge, attitudes, beliefs, and personal practices for CRC screening and patient screening levels by practice. Methods: Surveys were mailed to health care professionals in the HPRN. Participating clinics (n = 21) distributed patient surveys on CRC screening to persons aged ,50 for a 2-week period in 2006. Results: The survey response rate was 81% for providers (n = 46) and 90% for nursing staff (n = 63). Only 54% of health care professionals knew CRC is a leading cause of cancer deaths. When surveyed on their attitudes toward colon cancer, 92%"strongly agreed" or "agreed" that colon cancer is preventable. About 99% (n = 107) of providers and nurses "strongly agreed" or "agreed" that testing could identify problems before colon cancer starts. Most health care professionals (61%) aged ,50 years had previously been tested and were up-to-date (52%) with screening. Provider knowledge was significantly associated with higher patient screening (P = .02), but provider attitudes and beliefs were not. Moreover, personal screening practices of health care professionals did not correlate with more patients screened. Conclusion: Background knowledge of CRC among HPRN health care professionals could be improved. The results of this pilot study may help focus effective approaches such as increasing provider knowledge to enhance CRC screening in the relevant population. [source]

44-55-66-PM, a Mnemonic That Improves Retention of the Ottawa Ankle and Foot Rules: A Randomized Controlled Trial

FRCPC, Jocelyn Gravel MD
ACADEMIC EMERGENCY MEDICINE 2010; 17:859,864 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, Studies have suggested that poor knowledge of the Ottawa Ankle Rules (OAR) limits its clinical impact. This study evaluated the ability of a mnemonic to improve knowledge of the OAR. Methods:, This was a single-blind randomized controlled trial performed among residents and medical students doing a pediatric emergency medicine rotation. At baseline, all participants were tested for their baseline knowledge of the OAR. The intervention was a standardized information sheet providing a mnemonic of the OAR (44-55-66-PM), while control subjects received its classic description. Block randomization (medical student vs. type of resident) was used. Each participant answered the same questionnaire at the end of rotation (3 weeks later) and via a Web-based survey 5 to 9 months postrandomization. Main outcome measures were knowledge of the components of the ankle rule based on a 13-item criterion grid and the foot rule based on a 10-item criterion grid. All questionnaires were marked at the end of the study by two reviewers blinded to the randomization. Discrepancies in final scores were resolved by consensus. Student's t-test was performed to compare mean scores on the evaluation between groups using an intention-to-treat approach. Results:, Among the 206 eligible participants, 96 medical students and 94 residents were recruited and agreed to participate. Primary outcomes were measured in 95% of the participants at 3 weeks postrandomization and in 72% on the long-term follow-up. Participants in both groups were similar with regard to baseline characteristics and prior knowledge of the OAR. Both groups showed improvement in their knowledge of the rule during the study period. At mid-term, knowledge of the OAR was similar for the ankle components (score for mnemonic 10.9; control 10.2; 95% confidence interval [CI] for difference = ,0.3 to 1.7) and for the foot (mnemonic 7.6 vs. control 7.5; 95% CI for difference = ,0.7 to 0.9). On the long term, randomization to the mnemonic was associated with a better knowledge of the OAR as demonstrated by a higher score for the ankle component (mnemonic 10.1 vs. control 8.9; 95% CI for difference = 0.6 to 1.8) and for the foot (mnemonic 7.8 vs. control 6.5; 95% CI for difference = 0.8 to 1.9). Conclusions:, Mid-term knowledge of the OAR drastically improved for all participants of the study. The use of the mnemonic 44-55-66-PM was associated with a better long-term knowledge of the OAR among medical students and residents. The improvement in knowledge of the OAR among the control group highlights the importance of using controlled trials for studies evaluating knowledge transfer. [source]

Population Ecology of the Riparian Frog Eleutherodactylus cuneatus in Cuba

BIOTROPICA, Issue 3 2010
Ansel Fong G.
ABSTRACT A population of the poorly known riparian frog Eleutherodactylus cuneatus was studied for 1 yr along a mountain stream in eastern Cuba. We examined population structure, seasonal and daily activity, growth, and habitat use using mark-recapture and call-point counts. Juveniles were observed during all survey periods with a spike in March. Higher numbers of adults were present in May,July, associated with longer day length, warmer temperatures, and the onset of the rainy season. This was coincident with higher calling activity away from the stream, suggesting an increase in both reproductive and nonreproductive activity in the warmer months between May and September. The number of individuals peaked at 2000,2200 h, but high numbers of individuals were visible throughout the night. Lower activity levels were observed throughout the day. Population size estimates were 84,131 adults and 124,304 juveniles, with averages of 110 and 236 individuals, survival rates were high but capture probabilities were low for a 5-d period in March 2004. Growth rate was negatively related to the size of recaptured individuals, although decreases in growth rate were slight. Frogs were found either in the water (49.7%), or in the banks and on the ground adjacent to the stream where most individuals were found on the ground under the cover of rocks, leaf litter, or large palm fronds. These results provide baseline knowledge of E. cuneatus population dynamics and ecology needed for a rapid detection of any decline this population may undergo in the future. Abstract in Spanish is available at [source]

Implications of Question Format in Emergency Department Preventive Health Knowledge Surveys

Roland C. Merchant MD
Objectives:To determine if respondents differed by their demography (age group, race or ethnicity, and insurance status) in their tendency to correctly answer knowledge-based questions when they were in an agree-disagree instead of a multiple-choice format. Methods:Women aged 18,55 years seeking treatment in the emergency department completed surveys of preventive health knowledge on three cancer screening tests (Pap smears, breast self-examinations, and mammograms) and two contraceptive measures (birth control pills and emergency contraception) that contained paired versions of questions in two different formats (agree-disagree format and multiple-choice format). Linear and ordinal regressions were used to determine demographic correlates of correctly answering the agree-disagree questions more often than the corresponding multiple-choice questions. Results:Of the 570 women included in this analysis, 64.6% were younger than 35 years, 62.1% were white, and 54.8% had private health care insurance. Older, white, and privately insured women demonstrated greater comprehension of all topics. Younger women, nonwhite women, and women without private health care insurance were more likely to respond to items correctly when they were in an agree-disagree format compared with a multiple-choice format. Conclusions:This study demonstrated that survey responses are influenced by the format of the questions, particularly in certain demographic groups. Policy makers and researchers might draw false conclusions about the baseline knowledge and need for education of patients, especially in these populations. The use of agree-disagree format questions in preventive health knowledge surveys should be avoided whenever possible. [source]