Oral Health Promotion Through an Online Training Program for Medical Students

The objective of this study was to compare the impact on knowledge and counseling skills of face-to-face and Internet-based oral health training programs on medical students. Participants consisted of 148 (82 percent) of the 180 invited students attending their fifth academic year at the Faculty of Medicine, University of Sao Paulo, Brasil, in 2007. The interventions took place during a three-month training period in the clinical Center for Health Promotion, which comprised part of a clerkship in Internal Medicine. The students were divided into four groups: 1) Control Group (Control), with basic intervention; 2) Brochure Group (Br), with basic intervention plus complete brochure with oral health themes; 3) Cybertutor Group (Cy), with basic intervention plus access to an Internet-based training program about oral health themes; and 4) Cybertutor + Contact Group (Cy+C), the same as Cy plus brief proactive contact with a tutor. The impact of these interventions on student knowledge was measured with pre- and post assessments, and student skills in asking and counseling about oral health were assessed with an objective structured clinical examination (OSCE). Multivariate logistic regression models were applied to identify the odds ratios of scoring above Control's medians on the final assessment and the OSCE. In the results, Cy+C performed significantly better than Control on both the final assessment (OR 9.4; 95% CI 2.7-32.8) and the OSCE (OR 5.6; 95% CI 1.9-16.3) and outperformed all the other groups. The Cy+C group showed the most significant increase in knowledge and the best skills in asking and counseling about oral health.

Use of web-based formative assessment to support student learning in metabolism/nutrition unit

In 2002, an integrated basic science course was introduced into the Bachelor of Dental Sciences programme at the University of Queensland, Australia. Learning activities for the Metabolism and Nutrition unit within this integrated course included lectures, problem-based learning tutorials, computer-based self-directed learning exercises and practicals. To support student learning and assist students to develop the skills necessary to become lifelong learners, an extensive bank of formative assessment questions was set up using the commercially available package, WebCT®. Questions included short-answer, multiple-choice and extended matching questions. As significant staff time was involved in setting up the question database, the extent to which students used the formative assessment and their perceptions of its usefulness to their learning were evaluated to determine whether formative assessment should be extended to other units within the course. More than 90% of the class completed formative assessment tasks associated with learning activities scheduled in the first two weeks of the block, but this declined to less than 50% by the fourth and final week of the block. Patterns of usage of the formative assessment were also compared in students who scored in the top 10% for all assessment for the semester with those who scored in the lowest 10%. High-performing students accessed the Web-based formative assessment about twice as often as those who scored in the lowest band. However, marks for the formative assessment tests did not differ significantly between the two groups. In a questionnaire that was administered at the completion of the block, students rated the formative assessment highly, with 80% regarding it as being helpful for their learning. In conclusion, although substantial staff time was required to set up the question database, this appeared to be justified by the positive responses of the students.

Personality, emotion, and mood in agent-based group decision making

Group decision making plays an important role in organizations, especially in the present-day economy that demands high-quality, yet quick decisions. Group decision-support systems (GDSSs) are interactive computer-based environments that support concerted, coordinated team efforts toward the completion of joint tasks. The need for collaborative work in organizations has led to the development of a set of general collaborative computer-supported technologies and specific GDSSs that support distributed groups (in time and space) in various domains. However, each person is unique and has different reactions to various arguments. Many times a disagreement arises because of the way we began arguing, not because of the content itself. Nevertheless, emotion, mood, and personality factors have not yet been addressed in GDSSs, despite how strongly they influence results. Our group’s previous work considered the roles that emotion and mood play in decision making. In this article, we reformulate these factors and include personality as well. Thus, this work incorporates personality, emotion, and mood in the negotiation process of an argumentbased group decision-making process. Our main goal in this work is to improve the negotiation process through argumentation using the affective characteristics of the involved participants. Each participant agent represents a group decision member. This representation lets us simulate people with different personalities. The discussion process between group members (agents) is made through the exchange of persuasive arguments. Although our multiagent architecture model4 includes two types of agents—the facilitator and the participant— this article focuses on the emotional, personality, and argumentation components of the participant agent.

Effects of a mental health training program on health care worker's knowledge and attitude and practice in Belize

ABSTRACT This study was conducted to assess mental health knowledge, attitude and practices among health care workers in Belize before and immediately after a competency based training program in mental health. A baseline Knowledge, Attitudes and Practices (KAP) survey was given to health personnel, mainly nurses, working primary and secondary care. The intervention was a 13-week face-to-face training course for health care professionals with the objective of increasing their competency in mental health and reducing stigma. After the training a post intervention KAP survey was conducted among the original respondents. 88 health care workers completed the baseline survey and 61 of those respondents completed the post-intervention questionnaire. The results showed that the level of knowledge of the participants had improved by the training intervention and that in general, the intervention was effective in correcting some misconceptions about mental illness and reducing stigmatizing attitudes among the participants.

Computer integrated testing for the transport refrigeration systems industry.

This is a study of a state of the art implementation of a new computer integrated testing (CIT) facility within a company that designs and manufactures transport refrigeration systems. The aim was to use state of the art hardware, software and planning procedures in the design and implementation of three CIT systems. Typical CIT system components include data acquisition (DAQ) equipment, application and analysis software, communication devices, computer-based instrumentation and computer technology. It is shown that the introduction of computer technology into the area of testing can have a major effect on such issues as efficiency, flexibility, data accuracy, test quality, data integrity and much more. Findings reaffirm how the overall area of computer integration continues to benefit any organisation, but with more recent advances in computer technology, communication methods and software capabilities, less expensive more sophisticated test solutions are now possible. This allows more organisations to benefit from the many advantages associated with CIT. Examples of computer integration test set-ups and the benefits associated with computer integration have been discussed.

Opioid maintenance therapy in Switzerland: an overview of the Swiss IMPROVE study.

BACKGROUND/AIMS: Switzerland's drug policy model has always been unique and progressive, but there is a need to reassess this system in a rapidly changing world. The IMPROVE study was conducted to gain understanding of the attitudes and beliefs towards opioid maintenance therapy (OMT) in Switzerland with regards to quality and access to treatment. To obtain a "real-world" view on OMT, the study approached its goals from two different angles: from the perspectives of the OMT patients and of the physicians who treat patients with maintenance therapy. The IMPROVE study collected a large body of data on OMT in Switzerland. This paper presents a small subset of the dataset, focusing on the research design and methodology, the profile of the participants and the responses to several key questions addressed by the questionnaires. METHODS: IMPROVE was an observational, questionnaire-based cross-sectional study on OMT conducted in Switzerland. Respondents consisted of OMT patients and treating physicians from various regions of the country. Data were collected using questionnaires in German and French. Physicians were interviewed by phone with a computer-based questionnaire. Patients self-completed a paper-based questionnaire at the physicians' offices or OMT treatment centres. RESULTS: A total of 200 physicians and 207 patients participated in the study. Liquid methadone and methadone tablets or capsules were the medications most commonly prescribed by physicians (60% and 20% of patient load, respectively) whereas buprenorphine use was less frequent. Patients (88%) and physicians (83%) were generally satisfied with the OMT currently offered. The current political framework and lack of training or information were cited as determining factors that deter physicians from engaging in OMT. About 31% of OMT physicians interviewed were ≥60 years old, indicating an ageing population. Diversion and misuse were considered a significant problem in Switzerland by 45% of the physicians. CONCLUSION: The subset of IMPROVE data presented gives a present-day, real-life overview of the OMT landscape in Switzerland. It represents a valuable resource for policy makers, key opinion leaders and drug addiction researchers and will be a useful basis for improving the current Swiss OMT model.

Uuden riskien arviointityökalun käyttöönotto metsäteollisuusyrityksessä

Vuonna 2003 uudistunut työturvallisuuslaki lisäsi yritysten vastuuta oman työympäristön riskien tunnistamisessa. Laki velvoittaa yritykset tunnistamaan, selvittämään ja arvioimaan työstä ja työolosuhteista johtuvat vaara- ja haittatekijät. Perinteisesti yritykset ovat suorittaneet riskien arviointia erilaisten tarkistuslistojen avulla, mutta nykyään tietotekniikan käytön lisääntyminen on tuonut tietotekniikan myös yhdeksi riskienhallinnan työvälineeksi. Tämän työn tavoitteena oli tutkia If Vahinkovakuutusyhtiön uuden riskien arviointiohjelman käyttöönottoa metsäteollisuuden yrityksessä, ja selvittää sen vaikutuksia turvallisuustoimenpiteiden hallintaan ja vastaavuutta sille ennakkoon asetettuihin käytettävyysvaatimuksiin. Riskien arviointiohjelmaa tutkittiin pilottikohteessa Stora Enson Anjalankoskentehtailla. Tietoa kerättiin mm. käyttäjäkoulutustilaisuuksien palautekyselyillä, haastattelemalla arvioijia ja osallistumalla riskien arviointikierroksille. Tutkimuksessa seurattiin mm. ohjelman avulla syntyneiden toimenpide-ehdotuksien määrää ja laatua, ja sitä kuinka hyvin ohjelmalle suunniteltu sisältö sopii käyttöön. Tämän tutkimuksen perusteella havaittiin, että riskien arviointiin tarkoitettu tietokoneohjelma voidaan suunnitella helppokäyttöiseksi ja toimivaksi. Myös ohjelman sisältö, joka oli tarkoitettu kattamaan työturvallisuuden eri osa-alueet, havaittiin tarkoitukseen sopivaksi. Riskien arvioinnin ongelmallisin alue, eli turvallisuustoimenpiteiden suunnittelu ja seuranta, havaittiin haasteelliseksi toteutettavaksi ohjelman avulla. Yritysten erilaisiin riskien arviointikäytäntöihinsopivan raportointijärjestelmän ja toimenpideseurannan kehittäminen tulee olemaan tulevaisuudessakin tärkeä osa-alue riskien arviointiohjelmien kehittämisessä.

Parallella, dynamiska representationer i gymnasiefysiken : implementering av ett interaktivt datorverktyg i didaktiska situationer och uppfattning av effektivt lärande

The computer is a useful tool in the teaching of upper secondary school physics, and should not have a subordinate role in students' learning process. However, computers and computer-based tools are often not available when they could serve their purpose best in the ongoing teaching. Another problem is the fact that commercially available tools are not usable in the way the teacher wants. The aim of this thesis was to try out a novel teaching scenario in a complicated subject in physics, electrodynamics. The didactic engineering of the thesis consisted of developing a computer-based simulation and training material, implementing the tool in physics teaching and investigating its effectiveness in the learning process. The design-based research method, didactic engineering (Artigue, 1994), which is based on the theoryof didactical situations (Brousseau, 1997), was used as a frame of reference for the design of this type of teaching product. In designing the simulation tool a general spreadsheet program was used. The design was based on parallel, dynamic representations of the physics behind the function of an AC series circuit in both graphical and numerical form. The tool, which was furnished with possibilities to control the representations in an interactive way, was hypothesized to activate the students and promote the effectiveness of their learning. An effect variable was constructed in order to measure the students' and teachers' conceptions of learning effectiveness. The empirical study was twofold. Twelve physics students, who attended a course in electrodynamics in an upper secondary school, participated in a class experiment with the computer-based tool implemented in three modes of didactical situations: practice, concept introduction and assessment. The main goal of the didactical situations was to have students solve problems and study the function of AC series circuits, taking responsibility for theirown learning process. In the teacher study eighteen Swedish speaking physics teachers evaluated the didactic potential of the computer-based tool and the accompanying paper-based material without using them in their physics teaching. Quantitative and qualitative data were collected using questionnaires, observations and interviews. The result of the studies showed that both the group of students and the teachers had generally positive conceptions of learning effectiveness. The students' conceptions were more positive in the practice situation than in the concept introduction situation, a setting that was more explorative. However, it turned out that the students' conceptions were also positive in the more complex assessment situation. This had not been hypothesized. A deeper analysis of data from observations and interviews showed that one of the students in each pair was more active than the other, taking more initiative and more responsibilityfor the student-student and student-computer interaction. These active studentshad strong, positive conceptions of learning effectiveness in each of the threedidactical situations. The group of less active students had a weak but positive conception in the first iv two situations, but a negative conception in the assessment situation, thus corroborating the hypothesis ad hoc. The teacher study revealed that computers were seldom used in physics teaching and that computer programs were in short supply. The use of a computer was considered time-consuming. As long as physics teaching with computer-based tools has to take place in special computer rooms, the use of such tools will remain limited. The affordance is enhanced when the physical dimensions as well as the performance of the computer are optimised. As a consequence, the computer then becomes a real learning tool for each pair of students, smoothly integrated into the ongoing teaching in the same space where teaching normally takes place. With more interactive support from the teacher, the computer-based parallel, dynamic representations will be efficient in promoting the learning process of the students with focus on qualitative reasoning - an often neglected part of the learning process of the students in upper secondary school physics.

PCR-based ribotyping of Staphylococcus aureus

Genotyping techniques are valuable tools for the epidemiologic study of Staphylococcus aureus infections in the hospital setting. Pulsed-field gel electrophoresis (PFGE) is the current method of choice for S. aureus strain typing. However, the method is laborious and requires expensive equipment. In the present study, we evaluated the natural polymorphism of the genomic 16S-23S rRNA region for genotyping purpose, by PCR-based ribotyping. Three primer pairs were tested to determine the size of amplicons produced and to obtain better discrimination with agar gel electrophoresis and ethidium bromide staining. The resolution of the typing system was determined using sets of bacteria obtained from clinical specimens from a large tertiary care hospital. These included DNA from three samples obtained from a bacteremic patient, six strains with known and diverse PGFE patterns, and 88 strains collected over a 3-month period in the same hospital. Amplification patterns obtained from samples from the same patient were identical, and PFGE from samples known to be different produced three genotypes. Amplification of DNA from 61 methicillin-resistant isolates produced only one pattern. Methicillin-sensitive strains yielded a diversity of patterns, pointing to a true polyclonal distribution throughout the hospital (22 unique patterns from 27 strains). Computer-based software can be used to differentiate among identifiable strains, given the low number of bands and good characterization of PCR products. PCR-based ribotyping can be a useful technique for genotyping methicillin-sensitive S. aureus strains, but is of limited value for methicillin-resistant strains.

Vancomycin-resistant enterococcus outbreak in a pediatric intensive care unit: report of successful interventions for control and prevention

The objective of this study is to retrospectively report the results of interventions for controlling a vancomycin-resistant enterococcus (VRE) outbreak in a tertiary-care pediatric intensive care unit (PICU) of a University Hospital. After identification of the outbreak, interventions were made at the following levels: patient care, microbiological surveillance, and medical and nursing staff training. Data were collected from computer-based databases and from the electronic prescription system. Vancomycin use progressively increased after March 2008, peaking in August 2009. Five cases of VRE infection were identified, with 3 deaths. After the interventions, we noted a significant reduction in vancomycin prescription and use (75% reduction), and the last case of VRE infection was identified 4 months later. The survivors remained colonized until hospital discharge. After interventions there was a transient increase in PICU length-of-stay and mortality. Since then, the use of vancomycin has remained relatively constant and strict, no other cases of VRE infection or colonization have been identified and length-of-stay and mortality returned to baseline. In conclusion, we showed that a bundle intervention aiming at a strict control of vancomycin use and full compliance with the Hospital Infection Control Practices Advisory Committee guidelines, along with contact precautions and hand-hygiene promotion, can be effective in reducing vancomycin use and the emergence and spread of vancomycin-resistant bacteria in a tertiary-care PICU.

The effects of computer assisted interactive fiction on the development of reading comprehension in grade five students

This study was undertaken in order to determine the effects of playing computer based text adventure games on the reading comprehension gains of students. Forty-five grade five students from one elementary school were randomly assigned to experimental and control groups, and were tested with regard to ability, achievement and reading skills. An experimental treatment, consisting of playing computer based interactive fiction games of the student's choice for fifteen minutes each day over an eight-week period, was administered. A comparison treatment engaged the control group in sustained silent reading of materials of the student's choice for an equal period of time. Following the experimental period all students were post-tested with an alternate form of the pre-test in reading skills, and gain scores were analysed. It was found that there were no significant differences in the gain scores of the experimental and control groups for overall reading comprehenSion, but the experimental group showed greater gains than the control group in the structural analysis reading sub-skill. Extreme variance in the data made generalization very difficult, but the findings indicated a potential for computer based interactive fiction as a useful tool for developing reading sl

Un outil d’évaluation neurocognitive des interactions humain-machine

De plus en plus de recherches sur les Interactions Humain-Machine (IHM) tentent d’effectuer des analyses fines de l’interaction afin de faire ressortir ce qui influence les comportements des utilisateurs. Tant au niveau de l’évaluation de la performance que de l’expérience des utilisateurs, on note qu’une attention particulière est maintenant portée aux réactions émotionnelles et cognitives lors de l’interaction. Les approches qualitatives standards sont limitées, car elles se fondent sur l’observation et des entrevues après l’interaction, limitant ainsi la précision du diagnostic. L’expérience utilisateur et les réactions émotionnelles étant de nature hautement dynamique et contextualisée, les approches d’évaluation doivent l’être de même afin de permettre un diagnostic précis de l’interaction. Cette thèse présente une approche d’évaluation quantitative et dynamique qui permet de contextualiser les réactions des utilisateurs afin d’en identifier les antécédents dans l’interaction avec un système. Pour ce faire, ce travail s’articule autour de trois axes. 1) La reconnaissance automatique des buts et de la structure de tâches de l’utilisateur, à l’aide de mesures oculométriques et d’activité dans l’environnement par apprentissage machine. 2) L’inférence de construits psychologiques (activation, valence émotionnelle et charge cognitive) via l’analyse des signaux physiologiques. 3) Le diagnostic de l‘interaction reposant sur le couplage dynamique des deux précédentes opérations. Les idées et le développement de notre approche sont illustrés par leur application dans deux contextes expérimentaux : le commerce électronique et l’apprentissage par simulation. Nous présentons aussi l’outil informatique complet qui a été implémenté afin de permettre à des professionnels en évaluation (ex. : ergonomes, concepteurs de jeux, formateurs) d’utiliser l’approche proposée pour l’évaluation d’IHM. Celui-ci est conçu de manière à faciliter la triangulation des appareils de mesure impliqués dans ce travail et à s’intégrer aux méthodes classiques d’évaluation de l’interaction (ex. : questionnaires et codage des observations).

Beyond Doing Good: An Interview with Dr. Kirsten Johnson on the Canadian Disaster and Humanitarian Response Training Program

Compte-rendu / Review

Selected Cardiovascular Studies Based on Photoplethysmography Technique

Photoplethysmography (PPG) is a simple and inexpensive optical technique that can be used to detect blood volume changes in the microvascular bed of tissues. There has been a resurgence of interest in the technique in recent years, driven by the demand for low cost, simple and portable technology for the primary care and community based clinical settings and the wide availability of low cost and small semiconductor components, and the advancement of computer-based pulse wave analysis techniques. The present research work deals with the design of a PPG sensor for recording the blood volume pulse signals and carry out selected cardiovascular studies based on these signals. The interaction of light with tissue, early and recent history of PPG, instrumentation, measurement protocol and pulse wave analysis are also discussed in this study. The effect of aging, mild cold exposure, and variation in the body posture on the PPG signal have been experimentally studied.

Econometrics as an Academic Discipline in Higher Education: An Exploratory Study of the Need, Relevance and Significance

Econometrics is a young science. It developed during the twentieth century in the mid-1930’s, primarily after the World War II. Econometrics is the unification of statistical analysis, economic theory and mathematics. The history of econometrics can be traced to the use of statistical and mathematics analysis in economics. The most prominent contributions during the initial period can be seen in the works of Tinbergen and Frisch, and also that of Haavelmo in the 1940's through the mid 1950's. Right from the rudimentary application of statistics to economic data, like the use of laws of error through the development of least squares by Legendre, Laplace, and Gauss, the discipline of econometrics has later on witnessed the applied works done by Edge worth and Mitchell. A very significant mile stone in its evolution has been the work of Tinbergen, Frisch, and Haavelmo in their development of multiple regression and correlation analysis. They used these techniques to test different economic theories using time series data. In spite of the fact that some predictions based on econometric methodology might have gone wrong, the sound scientific nature of the discipline cannot be ignored by anyone. This is reflected in the economic rationale underlying any econometric model, statistical and mathematical reasoning for the various inferences drawn etc. The relevance of econometrics as an academic discipline assumes high significance in the above context. Because of the inter-disciplinary nature of econometrics (which is a unification of Economics, Statistics and Mathematics), the subject can be taught at all these broad areas, not-withstanding the fact that most often Economics students alone are offered this subject as those of other disciplines might not have adequate Economics background to understand the subject. In fact, even for technical courses (like Engineering), business management courses (like MBA), professional accountancy courses etc. econometrics is quite relevant. More relevant is the case of research students of various social sciences, commerce and management. In the ongoing scenario of globalization and economic deregulation, there is the need to give added thrust to the academic discipline of econometrics in higher education, across various social science streams, commerce, management, professional accountancy etc. Accordingly, the analytical ability of the students can be sharpened and their ability to look into the socio-economic problems with a mathematical approach can be improved, and enabling them to derive scientific inferences and solutions to such problems. The utmost significance of hands-own practical training on the use of computer-based econometric packages, especially at the post-graduate and research levels need to be pointed out here. Mere learning of the econometric methodology or the underlying theories alone would not have much practical utility for the students in their future career, whether in academics, industry, or in practice This paper seeks to trace the historical development of econometrics and study the current status of econometrics as an academic discipline in higher education. Besides, the paper looks into the problems faced by the teachers in teaching econometrics, and those of students in learning the subject including effective application of the methodology in real life situations. Accordingly, the paper offers some meaningful suggestions for effective teaching of econometrics in higher education