A project to improve the information seeking skills and increase the use of evidence-based research in public health practice

The ability of public health practitioners (PHPs) to work efficiently and effectively is negatively impacted by their lack of knowledge of the broad range of evidence-based practice information resources and tools that can be utilized to guide them in their development of health policies and programs. This project, a three-hour continuing education hands-on workshop with supporting resources, was designed to increase knowledge and skills of these resources. The workshop was presented as a pre-conference continuing education program for the Texas Public Health Association (TPHA) 2008 Annual Conference. Topics included: identification of evidence-based practice resources to aid in the development of policies and programs; identification of sources of publicly available data; utilization of data for community assessments; and accessing and searching the literature through a collection of databases available to all citizens of Texas. Supplemental resources included a blog that served as a gateway to the resources explored during the presentation, a community assessment workbook that incorporates both Healthy People 2010 objectives and links to reliable sources of data, and handouts providing additional instruction on the use of the resources covered during the workshop.^ Before- and after-workshop surveys based on Kirkpatrick's 4-level model of evaluation and the Theory of Planned Behavior were administered. Of the questions related to the trainer, the workshop, and the usefulness of the workshop, participants gave "Good" to "Excellent" responses to all one question. Confidence levels overall increased a statistically significant amount; measurements of attitude, social norms, and control showed no significant differences before and after the workshop. Lastly, participants indicated they were likely to use resources shown during the workshop within a one to three month time period on average. ^ The workshop and creation of supplemental resources served as a pilot for a funded project that will be continued with the development and delivery of four 4-week long webinar-based training sessions to be completed by December 2008. ^

Systems and technologies for objective evaluation of technical skills in laparoscopic surgery

Minimally invasive surgery is a highly demanding surgical approach regarding technical requirements for the surgeon, who must be trained in order to perform a safe surgical intervention. Traditional surgical education in minimally invasive surgery is commonly based on subjective criteria to quantify and evaluate surgical abilities, which could be potentially unsafe for the patient. Authors, surgeons and associations are increasingly demanding the development of more objective assessment tools that can accredit surgeons as technically competent. This paper describes the state of the art in objective assessment methods of surgical skills. It gives an overview on assessment systems based on structured checklists and rating scales, surgical simulators, and instrument motion analysis. As a future work, an objective and automatic assessment method of surgical skills should be standardized as a means towards proficiency-based curricula for training in laparoscopic surgery and its certification.

A Meta-analytic Review of Acceptance-Based Behavioral Interventions for the Treatment of Anxiety

The relative popularity of acceptance and commitment therapy (ACT) has grown in recent years, and inspired the development of contemporary acceptance-based treatment approaches. Acceptance-based therapies differ from traditional cognitive- behavior therapy (CBT) on pragmatic grounds, the import of which implicates the purpose of therapy. CBT utilizes exposure and cognitive change techniques primarily in service of symptom change outcomes; whereas, ACT utilizes exposure and acceptance for purposes of promoting psychological flexibility in the pursuit of personal values. The purpose of this meta-analytic study was to determine the relative efficacy of acceptance- based versus symptom-change behavioral approaches with anxiety disorders and to quantify this impact. A comprehensive literature search turned up 18 studies that met inclusion criteria for this analysis. An effect size was calculated using the standardized mean gain procedure for both the acceptance-based and symptom-change approaches, along with the waitlist control groups. The results demonstrate a large effect size for the acceptance-based approach (Weighted mean ES = .83) and a medium effect size for symptom-change approach (Weighted mean ES = .60). The waitlist control groups demonstrated a small effect size (Weighted mean ES = .24). Based on this review, it is suggested that graduate and internship programs in Clinical Psychology should promote evidence-based training in the use of acceptance-inspired behavioral therapies.

Does anticipation training affect drivers' risk taking?

Skill and risk taking are argued to be independent and to require different remedial programs. However, it is possible to contend that skill-based training could be associated with an increase, a decrease, or no change in fisk-taking behavior. In 3 experiments, the authors examined the influence of a skill-based training program (hazard perception) on the fisk-taking behavior of car drivers (using video-based driving simulations). Experiment 1 demonstrated a decrease in risk taking for novice drivers. In Experiment 2, the authors examined the possibilities that the skills training might operate through either a nonspecific reduction in risk taking or a specific improvement in hazard perception. Evidence supported the latter. These findings were replicated in a more ecological context in Experiment 3, which compared advanced and nonadvanced police drivers.

Progressive resistance training and stretching following surgery for breast cancer: study protocol for a randomised controlled trial

Background: Currently 1 in 11 women over the age of 60 in Australia are diagnosed with breast cancer. Following treatment, most breast cancer patients are left with shoulder and arm impairments which can impact significantly on quality of life and interfere substantially with activities of daily living. The primary aim of the proposed study is to determine whether upper limb impairments can be prevented by undertaking an exercise program of prolonged stretching and resistance training, commencing soon after surgery. Methods/design: We will recruit 180 women who have had surgery for early stage breast cancer to a multicenter single-blind randomized controlled trial. At 4 weeks post surgery, women will be randomly assigned to either an exercise group or a usual care ( control) group. Women allocated to the exercise group will perform exercises daily, and will be supervised once a week for 8 weeks. At the end of the 8 weeks, women will be given a home-based training program to continue indefinitely. Women in the usual care group will receive the same care as is now typically provided, i.e. a visit by the physiotherapist and occupational therapist while an inpatient, and receipt of pamphlets. All subjects will be assessed at baseline, 8 weeks, and 6 months later. The primary measure is arm symptoms, derived from a breast cancer specific questionnaire (BR23). In addition, range of motion, strength, swelling, pain and quality of life will be assessed. Discussion: This study will determine whether exercise commencing soon after surgery can prevent secondary problems associated with treatment of breast cancer, and will thus provide the basis for successful rehabilitation and reduction in ongoing problems and health care use. Additionally, it will identify whether strengthening exercises reduce the incidence of arm swelling. Trial Registration: The protocol for this study is registered with the Australian Clinical Trials Registry (ACTRN012606000050550).

Does high intensity resistance training maintain bone mass during moderate weight loss in older overweight adults with type 2 diabetes

The aim was to investigate whether the addition of supervised high intensity progressive resistance training to a moderate weight loss program (RT+WLoss) could maintain bone mineral density (BMD) and lean mass compared to moderate weight loss (WLoss) alone in older overweight adults with type 2 diabetes. We also investigated whether any benefits derived from a supervised RT program could be sustained through an additional home-based program. This was a 12-month trial in which 36 sedentary, overweight adults aged 60 to 80 years with type 2 diabetes were randomized to either a supervised gymnasium-based RT+WLoss or WLoss program for 6 months (phase 1). Thereafter, all participants completed an additional 6-month home-based training without further dietary modification (phase 2). Total body and regional BMD and bone mineral content (BMC), fat mass (FM) and lean mass (LM) were assessed by DXA every 6 months. Diet, muscle strength (1-RM) and serum total testosterone, estradiol, SHBG, insulin and IGF-1 were measured every 3 months. No between group differences were detected for changes in any of the hormonal parameters at any measurement point. In phase 1, after 6 months of gymnasium-based training, weight and FM decreased similarly in both groups (P < 0.01), but LM tended to increase in the RT+WLoss (n=16) relative to the WLoss (n = 13) group [net difference (95% CI), 1.8% (0.2, 3.5), P < 0.05]. Total body BMD and BMC remained unchanged in the RT+WLoss group, but decreased by 0.9 and 1.5%, respectively, in the WLoss group (interaction, P < 0.05). Similar, though non-significant, changes were detected at the femoral neck and lumbar spine (L2-L4). In phase 2, after a further 6 months of home-based training, weight and FM increased significantly in both the RT+WLoss (n = 14) and WLoss (n = 12) group, but there were no significant changes in LM or total body or regional BMD or BMC in either group from 6 to 12 months. These results indicate that in older, overweight adults with type 2 diabetes, dietary modification should be combined with progressive resistance training to optimize the effects on body composition without having a negative effect on bone health.

Approaches to training practitioners in the art and science of plant disease diagnosis

Allowing plant pathology students to tackle fictitious or real crop problems during the course of their formal training not only teaches them the diagnostic process, but also provides for a better understanding of disease etiology. Such a problem-solving approach can also engage, motivate, and enthuse students about plant pathologgy in general. This paper presents examples of three problem-based approaches to diagnostic training utilizing freely available software. The first provides an adventure-game simulation where Students are asked to provide a diagnosis and recommendation after exploring a hypothetical scenario or case. Guidance is given oil how to create these scenarios. The second approach involves students creating their own scenarios. The third uses a diagnostic template combined with reporting software to both guide and capture students' results and reflections during a real diagnostic assignment.

An evaluation of pharmacy education and pre-registration training

This thesis covers two major aspects of pharmacy education; undergraduate education and pre-registration training. A cohort of pharmacy graduates were surveyed over a period of four years, on issues related to undergraduate education, pre-registration training and continuing education. These graduates were the first-ever to sit the pre-registration examination. In addition, the opinions of pre-registration tutors were obtained on pre-registration training, during the year that competence-based assessment was introduced. It was concluded that although the undergraduate course provided a broad base of knowledge suitable for graduates in all branches of pharmacy, several issues were identified which would require attention in future developments of the course. These were: 1. the strong support for the expansion of clinical, social and practice-based teaching. 2. the strong support to retain the scientific content to the same extent as in the three-year course. 3. a greater use of problem-based learning methods. The graduates supported the provision of a pre-registration continuing education course to help prepare for the examination and in areas inadequately covered in the undergraduate course. There was also support for the introduction of some form of split branch training. There was no strong evidence to suggest that the training had been an application of undergraduate education. In general, competence-based training was well regarded by tutors as an appropriate and effective method of skill assessment. However, community tutors felt it was difficult to carry out effectively due to day-to-day time constraints. The assistant tutors in hospital pharmacy were found to have a very important role in provision of training, and should be adequately trained and supported. The study recommends the introduction of uniform training and a quality assurance mechanism for all tutors and assistants undertaking this role.

The Conception of Creation of Integrated Development Environment for Computer Training Systems

The various questions of creation of integrated development environment for computer training systems are considered in the given paper. The information technologies that can be used for creation of the integrated development environment are described. The different didactic aspects of realization of such systems are analyzed. The ways to improve the efficiency and quality of learning process with computer training systems for distance education are pointed.

An Approach for a more Objective Evaluation of Practical Projects, Used in the Training Process

Well–prepared, adaptive and sustainably developing specialists are an important competitive advantage, but also one of the main challenges for businesses. One option of the education system for creation and development of staff adequate to the needs is the development of pro jects with topics from real economy ("Practical Projects"). The objective assessment is an essential driver and motivator, and is based on a system of well-chosen, well-defined and specific criteria and indicators. An approach to a more objective evaluation of practical projects is finding more objective weights of the criteria. A natural and reasonable approach is the accumulation of opinions of proven experts and subsequent bringing out the weights from the accumulated data. The preparation and conduction of a survey among recognized experts in the field of project-based learning in mathematics, informatics and information technologies is described. The processing of the data accumulated by applying AHP, allowed us to objectively determine weights of evaluation criteria and hence to achieve the desired objectiveness. ACM Computing Classification System (1998): K.3.2.

Strategic Management Simulation as a Blended Learning Dimension: Campus Based Students’ Perspectives

Although business simulations are widely used in management education, there is no consensus about how to optimise their application. Our research explores the use of business simulations as a dimension of a blended learning pedagogic approach for undergraduate business education. Accepting that few best-practice prescriptive models for the design and implementation of simulations in this context have been presented, and that there is little empirical evidence for the claims made by proponents of such models, we address the lacuna by considering business student perspectives on the use of simulations. We then intersect available data with espoused positive outcomes made by the authors of a prescriptive model. We find the model to be essentially robust and offer evidence to support this position. In so doing we provide one of the few empirically based studies to support claims made by proponents of simulations in business education. The research should prove valuable for those with an academic interest in the use of simulations, either as a blended learning dimension or as a stand-alone business education activity. Further, the findings contribute to the academic debate surrounding the use and efficacy of simulation-based training [SBT] within business and management education.

Does a peer model’s task proficiency influence children’s solution choice and innovation?

The current study investigated whether 4- to 6-year-old children’s task solution choice was influenced by the past proficiency of familiar peer models and the children’s personal prior task experience. Peer past proficiency was established through behavioral assessments of interactions with novel tasks alongside peer and teacher predictions of each child’s proficiency. Based on these assessments, one peer model with high past proficiency and one age-, sex-, dominance-, and popularity-matched peer model with lower past proficiency were trained to remove a capsule using alternative solutions from a three-solution artificial fruit task. Video demonstrations of the models were shown to children after they had either a personal successful interaction or no interaction with the task. In general, there was not a strong bias toward the high past-proficiency model, perhaps due to a motivation to acquire multiple methods and the salience of other transmission biases. However, there was some evidence of a model-based past-proficiency bias; when the high past-proficiency peer matched the participants’ original solution, there was increased use of that solution, whereas if the high past-proficiency peer demonstrated an alternative solution, there was increased use of the alternative social solution and novel solutions. Thus, model proficiency influenced innovation.

Creating Partnerships: Computer Training with Assistive Technology for Senior Adults

Currently, at the SC Commission for the Blind, there is no opportunity for computer training for adults in the Older Blind Program. The Older Blind Program has to look for outside partners to make this service viable again. This project proposes that the OB Program partner with regional senior and recreation centers to establish a community-based training program that is both effective and is of minimal cost to the agency and to the partnering centers.

Matriz de capacita????o modelada por compet??ncias para atuar em programas de educa????o a dist??ncia: uma proposta para as escolas de governo

This study discusses distance learning (DL) as a corporate education strategy in the scope of National Policy on Staff Development. The purpose was to identify, along with managers and specialists of National Network of Schools of Government in Brazil (RNEG), demanded competencies for DL professionals acting in continued education to service public. Part of the research is based in official documents and in related capacity-building initiatives of Schools of Government in the last three years. Through questionnaire sent to managers of institutions of RNEG, we identified existing infrastructure, teams profile, actions developed in DL and training needs. The research allowed to map the critical competencies to work in DL programs and to create a proposal from a Competency-Based Training Matrix for school teams in order to leverage continuing education programs to public servants in three spheres of government. The results revealed the key technological, pedagogical, management and communication skills, as well as the critical activities and content to be included in the training plans. It was found that 88% of institutions have already implemented or are in the process of implementing DL, and the other 12% are deficient in qualified staff to make regulations on hiring personnel or in technology fluency. This corroborates the importance and the contribution of Competency-Based Training Matrix for RNEG

Jogos Sérios para a Saúde

Alguns jogos têm como objectivo a competição, outros a aprendizagem, uns jogam-se em grupo, outros individualmente. No entanto, todos têm um factor comum, ou seja, a experiência que se retira do momento é única. Seja esta experiência positiva ou negativa vai servir de aprendizagem nem que seja apenas das regras e mecânicas do dispositivo. Os Serious Games simulam situações ou processos do mundo real que são elaborados com o propósito de resolver um problema. Muitas vezes estes sacrificam o divertimento e o entretenimento com o objectivo de alcançar um tipo de progresso desejado para o jogador. Tal como no passado, e tendo em conta o desenvolvimento exponencial da tecnologia, os Serious Games podem agora ter um papel fundamental no desenvolvimento de novas terapias e ferramentas de saúde. É precisamente a olhar para o presente, e com os olhos no futuro dos Serious Games aplicados à saúde, que foi desenvolvida esta investigação. Como complemento, é também apresentado o projecto Typlife. Destinado a jovens com diabetes, é um projecto académico que tem como objectivo o desenvolvimento de uma aplicação para smartphone para o controlo da diabetes, enquanto envolve o utilizador numa experiência interactiva de recompensas pelas boas práticas no dia-a-dia.