Community education for stroke awareness: An efficacy study.
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BACKGROUND AND PURPOSE: This study examined the effectiveness of a slide/audio community education program aimed at increasing knowledge of stroke risk factors, stroke warning signs, and action needed when stroke warning signs occur. The program targets audiences at higher risk for stroke, especially individuals who are black or >50 years of age. METHODS: Subjects were 657 adults living in the community or in senior independent-living settings. The study examined the effectiveness of the program when presented alone and when accompanied by discussion (facilitation) led by a trained individual. Knowledge of stroke risk factors and warning signs was assessed using parallel pretests and posttests developed and validated specifically for the study. RESULTS: ANCOVA indicated that neither pretesting nor facilitation had a significant effect on posttest measures of knowledge. Paired t tests of groups receiving both the pretest and posttest demonstrated significant increase in knowledge (mean increase, 10.87%; P<0.001). ANCOVA indicated that these gains in knowledge were similar across subjects of different sex, race, age, and educational level. No significant differences could be ascribed to facilitation. CONCLUSIONS: The data indicate that the slide/audio program is effective in increasing knowledge of stroke risk factors, warning signs, and necessary action in subjects of varying ages, races, and education. Pretesting and facilitation did not significantly affect the short-term acquisition of information. The slide/audio program appears to offer a short, easily used educational experience for diverse communities, whether as a stand-alone program or with facilitated discussion. (+info)
Audiotapes and letters to patients: the practice and views of oncologists, surgeons and general practitioners.
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A range of measures have been proposed to enhance the provision of information to cancer patients and randomized controlled trials have demonstrated their impact on patient satisfaction and recall. The current study explored the practice and views of oncologists, surgeons and general practitioners (GPs) with regards to providing patients with consultation audiotapes and summary letters. In stage 1, 28 semi-structured interviews with doctors were conducted to provide qualitative data on which to base a questionnaire. In stage 2, 113 medical oncologists, 43 radiation oncologists, 55 surgeons and 108 GPs completed questionnaires. Only one-third of doctors had ever provided patients with a copy of the letter written to the oncologist or referring doctor, and one-quarter had provided a summary letter or tape. The majority of doctors were opposed to such measures; however, a substantial minority were in favour of providing a letter or tape under certain conditions. More surgeons and GPs (> two-thirds) were opposed to specialists providing a consultation audiotape than oncologists (one-third). Gender, years of experience and attitude to patient involvement in decision-making were predictive of doctors' attitudes. The majority of doctors remain opposed to offering patients personalized information aids. However, practice and perspectives appear to be changing. (+info)
Concentration and second-gas effects in the water analogue.
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The water analogue provides a visual model of the process of anaesthetic exchange. In the standard version, a single pipe connects the mouth container to the lung container and the conductance of this mouth-lung pipe is proportional to alveolar ventilation. This implies that inspired and expired ventilations are equal. In fact, with high inspired concentrations of nitrous oxide, early rapid uptake of gas by solution leads to a substantial difference between inspired and expired ventilation which in turn leads to concentration and second-gas effects. It is shown that by representing inspired and expired ventilations separately, and keeping one of them constant while varying the other to compensate for rapid uptake, concentration and second-gas effects are reproduced in the water analogue. Other means of reproducing the effects are reported but we believe that the first method is the most realistic and the most appropriate for teaching. (+info)
Explicit and implicit processing of words and pseudowords by adult developmental dyslexics: A search for Wernicke's Wortschatz?
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Two groups of male university students who had been diagnosed as dyslexic when younger, and two groups of control subjects of similar age and IQ to the dyslexics, were scanned whilst reading aloud and during a task where reading was implicit. The dyslexics performed less well than their peers on a range of literacy tasks and were strikingly impaired on phonological tasks. In the reading aloud experiment, simple words and pseudowords were presented at a slow pace so that reading accuracy was equal for dyslexics and controls. Relative to rest, both normal and dyslexic groups activated the same peri- and extra-sylvian regions of the left hemisphere that are known to be involved in reading. However, the dyslexic readers showed less activation than controls in the left posterior inferior temporal cortex [Brodmann area (BA) 37, or Wernicke's Wortschatz], left cerebellum, left thalamus and medial extrastriate cortex. In the implicit reading experiment, word and pseudoword processing was contrasted to visually matched false fonts while subjects performed a feature detection paradigm. The dyslexic readers showed reduced activation in BA 37 relative to normals suggesting that this group difference, seen in both experiments, resides in highly automated aspects of the reading process. Since BA 37 has been implicated previously in modality-independent naming, the reduced activation may indicate a specific impairment in lexical retrieval. Interestingly, during the reading aloud experiment only, there was increased activation for the dyslexics relative to the controls in a pre-motor region of Broca's area (BA 6/44). We attribute this result to the enforced use of an effortful compensatory strategy involving sublexical assembly of articulatory routines. The results confirm previous findings that dyslexic readers process written stimuli atypically, based on abnormal functioning of the left hemisphere reading system. More specifically, we localize this deficit to the neural system underlying lexical retrieval. (+info)
How to draw the skin ellipse for a mastectomy.
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The size of the skin ellipse for a mastectomy varies between patients and the accurate marking and tailoring of the skin flaps is often learnt by the surgical trainee only with increasing experience. Within the Breast Unit, a mathematical model was calculated to predict the required width of the skin ellipse for a successful mastectomy. Measurements of the straight-line distance from mid-clavicular point to the infra-mammary fold and maximum vertical height of the nipple above the infra-mammary fold were taken with the patient relaxed and supine. A close correlation (r = 0.85) was noted. Further analysis demonstrated a linear relationship between the pre-operative height to which the nipple could be suspended above the infra-mammary fold and the required maximum skin ellipse width (r = 0.87, P < 0.001). This linear relationship is easy to remember and is a useful check to ensure that the skin flaps intended will be just right. This same technique may be applicable to skin ellipses elsewhere. (+info)
An object-oriented taxonomy of medical data presentations.
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A variety of methods have been proposed for presenting medical data visually on computers. Discussion of and comparison among these methods have been hindered by a lack of consistent terminology. A taxonomy of medical data presentations based on object-oriented user interface principles is presented. Presentations are divided into five major classes-list, table, graph, icon, and generated text. These are subdivided into eight subclasses with simple inheritance and four subclasses with multiple inheritance. The various subclasses are reviewed and examples are provided. Issues critical to the development and evaluation of presentations are also discussed. (+info)
Elicited sequential presentation for low vision reading.
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This paper reports on a variant of the rapid serial visual presentation (RSVP) technique for low vision reading called elicited sequential presentation (ESP). In both techniques, words are presented sequentially at a constant screen location, but with ESP, the reader elicits presentation of each new word by means of a button press, rather than (as with RSVP) being presented with it automatically at fixed intervals. An experiment comparing reading speeds using, ESP, RSVP and a conventional closed-circuit television (CCTV) reading aid showed that for 15 slow readers who were customary CCTV users with low vision, ESP is superior to RSVP and yields reading speeds averaging 47% faster than RSVP--about the same as CCTV reading speed. The log of the ratio of ESP to RSVP reading speeds was significantly negatively correlated with the log of RSVP reading speed, showing that slower readers benefit more than faster readers; regression predicted no benefit for readers who read with RSVP at 133 wpm or greater. Finally, word length and word presentation duration chosen by subjects reading with ESP were significantly correlated, suggesting that part of the benefit of ESP is due to reader's ability to allocate time based on word length and difficulty. (+info)
Helping blind and partially sighted people to read: the effectiveness of low vision aids.
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AIMS: To substantiate the claim that low vision aids reduce the degree of disability associated with visual impairment. METHODS: An observational study of vision, ocular pathology, age, sex, and reading ability in new referrals to a low vision clinic. Reading ability was assessed both with the patients' own spectacles and with an appropriate low vision aid. RESULTS: The reading performance and biographical characteristics of new referrals to a low vision clinic were recorded. Data were collected for 168 people over a 6 month period. Upon arrival at the clinic the mean functional visual acuity equated to 6/36 and 77% of patients were unable to read newsprint (N8). After a low vision assessment and provision of a suitable low vision aid 88% of new patients were able to read N8 or smaller text. CONCLUSIONS: The degree of visual impairment observed in new referrals to a low vision clinic is sufficient to prevent the majority from performing many daily tasks. Low vision aids are an effective means of providing visual rehabilitation, helping almost nine out of 10 patients with impaired vision to read. (+info)