Paediatric prehospital care: postal survey of paramedic training managers. (1/67)

BACKGROUND: The process of prehospital care continues to develop in the UK. AIMS: To evaluate the availability of important paediatric resuscitation equipment in emergency ambulances and the extent of paramedic training in paediatric emergency medicine. METHODS: Postal survey of paramedic training managers. RESULTS: Completed questionnaires were returned by 41 (93%) training managers. No trust provided all of the equipment listed. Facemasks and self inflating bags (of appropriate sizes for all children) are provided by 32% and 42% of trusts respectively. Less than one third carry paediatric oximeter probes. Of the respondents, 16 (39%) trusts provide less than eight hours training in paediatric emergency medicine and five (12%) offer no training at all. Ongoing education varies from none to regular yearly updates. CONCLUSIONS: Paramedics seem ill prepared to deal with paediatric emergencies. Important deficiencies in the provision of equipment and training are noted. The results of this survey provide information against which improvements can be measured.  (+info)

Natural history of sensitization, symptoms and occupational diseases in apprentices exposed to laboratory animals. (2/67)

The natural history of the development of sensitization and disease due to high-molecular-weight allergens is not well characterized. This study describes the time-course of the incidence of work-related symptoms, skin reactivity and occupational rhinoconjunctivitis (RC) and asthma (OA); and assesses the predictive value of skin testing and RC symptoms in apprentices exposed to laboratory animals, in a 3-4-yr programme. Four-hundred and seventeen apprentices at five institutions were assessed prospectively with questionnaire, skin-testing with animal-derived allergens, spirometry and airway responsiveness (n=373). Depending on the school, students were seen 8 (n=136), 20 (n=345), 32 (n=355) and 44 (n=98) months after starting the programme. At all visits, the incidence was greater for work-related RC symptoms followed in order by skin reactivity, occupational RC, and, almost equally, OA and work-related respiratory symptoms. The incidence-density figures were comparable for each follow-up period and for most indices up to 32 months after entry into the study and then tended to decrease. The positive predictive values (PPVs) of skin reactivity to work-related allergens for the development of work-related RC and respiratory symptoms were 30% and 9.0%, respectively, while the PPVs of work-related RC for the development of OA was 11.4%. Sensitization, symptoms and diseases occur maximally in the first 2-3 yrs after starting exposure to laboratory animals. Skin reactivity to work-related allergens and rhinoconjuctivitis symptoms have low positive predictive values.  (+info)

Work-related research, education, and training in developing countries. (3/67)

Work-related research, education, and training (WRET) have not been widely recognised in many developing countries (DCs) as the most important factor for sustainable workplace improvement. There are many reasons why WRET is still neglected or remains unrecognised. Empirical research, advanced studies, and training abroad do not seem to be cost-effective for many people living in DCs because of enormous obstacles. Therefore, it is not easy to demonstrate that WRET result in workplace improvement in diverse situations in each DC. Taking into consideration poor health and safety in various workplaces, this paper aims to stimulate critical opinions and discussions on WRET, which are yet to be given high priority in the national agenda to ensure industrial production and social progress.  (+info)

An evaluation of a brief functional analysis format within a vocational setting. (4/67)

We conducted and compared both brief and extended functional analyses of disruptive behaviors for 3 individuals with developmental disabilities who attended a vocational training program. Results demonstrated that the brief assessment identified the function of 2 of the 3 participants' disruptive behavior compared to the extended assessment.  (+info)

CHILDREN WITH EPILEPSY. A STUDY OF THEIR NEEDS IN CALIFORNIA. (5/67)

The 1959 California Legislature directed the State Department of Public Health to conduct a study of the needs of California children with epilepsy and to determine the costs and feasibility of including medical services to such children under the Crippled Children Services program. A demonstration program of services was provided in Contra Costa and San Bernardino counties. Under these programs, children suspected of having epilepsy were referred for specialists' examinations, tests and recommendations for treatment. Private physicians provided the largest portion of a total of 236 referrals. Children referred were found to have complex medical, social and educational problems, and to be in need of comprehensive diagnostic and treatment services. About half of the children had mixed epilepsy and over one-third had focal seizures. Two-thirds had at least one other major additional handicap. At the time of referral one-fifth of these children had one or more seizures daily.Through specialized care and medications provided under this project, 58 per cent of those with seizures became seizure free, and an additional 24 per cent showed a considerable reduction of seizure frequency. This project provided a practical method of obtaining information necessary for program planning and has also demonstrated the value of such a program in helping private physicians to meet some of the multiple problems presented by these children.  (+info)

New strategies for higher professional education. (6/67)

Since the original recommendation in 1968 for a period of higher professional education, the development of this form of education has been slow. However, in 1990 a working party was established by the education division of the Royal College of General Practitioners to report on higher professional education. This paper describes some of the early work of the working party and its recommendations with particular emphasis on educational strategies, assessment and accreditation. A flexible, learner centred approach needs to be developed to encourage autonomy. Educational strategies are described which value previous experience and allow for a shift of responsibility for learning from the teacher to the learner.  (+info)

Evaluation of extended training for general practice in Northern Ireland: qualitative study. (7/67)

OBJECTIVE: To evaluate participants' perceptions of the impact on them of an additional six months' training beyond the standard 12 month general practice vocational training scheme. DESIGN: Qualitative study using focus groups. SETTING: General practice vocational training in Northern Ireland. PARTICIPANTS: 13 general practitioner registrars, six of whom participated in the additional six months' training, and four trainers involved in the additional six months' training. MAIN OUTCOME MEASURES: : Participants' views about their experiences in 18 month and 12 month courses. RESULTS: Participants reported that the 12 month course was generally positive but was too pressurised and focused on examinations, and also that it had a negative impact on self care. The nature of the learning and assessment was reported to have left participants feeling averse to further continuing education and lacking in confidence. In contrast, the extended six month component was reported to have restimulated learning by focusing more on patient care and promoting self directed learning. It developed confidence, promoted teamwork, and gave experience of two practice contexts, and was reported as valuable by both ex-registrars and trainers. However, both the 12 and 18 month courses left participants feeling underprepared for practice management and self care. CONCLUSIONS: 12 months' training in general practice does not provide doctors with the necessary competencies and confidence to enter independent practice. The extended period was reported to promote greater professional development, critical evaluation skills, and orientation to lifelong learning but does not fill all the gaps.  (+info)

Effects of in-school and tailored out-of-school smoking prevention among Dutch vocational school students. (8/67)

This paper evaluates a smoking prevention intervention aimed at vocational school students, consisting of an existing Dutch in-school program (three lessons each lasting 50 min) and a computer-based tailored out-of-school program (three tailored letters with smoking prevention messages mailed to students' homes). Nineteen schools that already participated in the in-school program were randomly assigned to the in-school or to the combined in-school and out-of-school condition. The remaining 17 schools were randomly assigned to the out-of-school condition or to the control group. Effect outcomes were assessed at 6, 12 and 18 months after a pre-test, and were based on initiation among never-smokers and continuation among ever-smokers. Twelve months after the pre-test (post-test 2), the in-school intervention was successful in preventing vocational school students from continuing to smoke, compared with students in the control condition [odds ratio (OR) = 0.49; 95% confidence interval (CI) = 0.29-0.84]. Eighteen months after the pre-test (post-test 3), the tailored out-of-school intervention was successful in preventing smoking initiation, compared with students in the control condition (OR = 0.42; 95% CI = 0.18-0.96). The effect of the combined approach was not larger than the sum of the effects of the in-school and the out-of-school effects.  (+info)