High-fidelity simulation in post-graduate training and assessment: an Irish perspective.

BACKGROUND: Lack of financial resources was internationally ranked as the greatest limitation to the application of human physiological simulation in clinical teaching. The Beaumont Simulation Centre in the Republic of Ireland is solely funded by once-off grant payments. Attracting a range of health care specialties through course diversity can offset costs. AIMS: This survey of simulator course evaluations aimed to determine attitudes of an array of Irish health care professionals towards full-scale simulation. METHODS: Anaesthetists (n = 51), nurses (n = 48) and dentists (n = 12) rated simulator-based courses and use of simulation for competency assessment with a self-reporting questionnaire with a five-point scale (1 = poor, 5 = excellent). RESULTS: Participants rated the courses from very good to excellent and were of the opinion that full-scale simulation is acceptable and appropriate for both education and competency assessment. CONCLUSIONS: This study demonstrates successful post-graduate course development in a simulation centre with narrow budgetary restrictions. In addition, it is the first to examine Irish anaesthetists', nurses' and dentists' attitudes towards full-scale simulation as an assessment tool.

Effect of exercise and medium-chain fatty acids on postprandial lipemia.

The purpose of this study was to evaluate the effect of medium-chain triglycerides (MCT) with and without exercise on postprandial lipemia (PPL). Subjects were 25 young men and women. Each subject performed three trials: 1) control (fat meal only, 1.5 g fat/kg) 2) MCT (substitution of MCT oil, 30% of fat calories), and 3) MCT + Ex (exercise 12 h before the MCT meal). Before each trial, the subject underwent consistent dietary preparation. Blood was collected on 2 separate days for baseline measurements of postheparin lipases and, in each trial, at 0 h (premeal), at 2, 4, 6, and 8 h after the fat meal for triglycerides and cholesterol ester transfer protein (CETP), and at 8 h for postheparin lipoprotein lipase (LPL) and hepatic lipase activities (HL). ANOVA indicated that the partial substitution of MCT oil to the fat meal did not affect the PPL response. However, the PPL was significantly lower after the MCT + Ex trial vs. the other trials. LPL activity was significantly elevated after all trials compared with baseline, whereas HL was lower in the MCT + Ex trial only. CETP mass was significantly lower at 4 and 8 h than 0 h during all trials but relatively higher in the MCT + Ex trial vs. the nonexercise trials. These results suggest that MCT does not affect the TG response to a fat meal. LPL and CETP are affected by a fat meal with or without exercise, but HL is affected only when exercise is included.

Smoking cessation. Pulling out the stops.

The launch of smoking-cessation drug Zyban in June last year greatly increased demand on a local smoking-cessation service. It is important to use local media to increase awareness of local services. Health authorities and pharmaceutical companies should work with the media when new drugs may put extra strain on local services.

LPN role advancement: from blueprints to ribbon cutting.

The role of the Licensed Practical Nurse (LPN) in an acute care setting has been a point of debate for many years. Increasing LPN job responsibility has not been widely reported. In this article, the authors describe the process used to advance the LPN role. Emphasized here is the educators' contribution to the process from inception to implementation.

Chile: perspectives in school health.

The leading health problems of children and adolescents in Chile is reviewed. The Chilean educational system and how the system addresses its principal health problems are described. A school health program is described as well as other educational programs designed and developed by nongovernmental institutions which have a smaller coverage. Current research studies regarding growth and development, child morbidity, nutritional level, and mental health studies are reviewed. In addition, principal challenges that include developing more efficient ways of referring children, enriching the curriculum and teacher training, assigning school hours for health teachers, and enlarging coverage of the health care evaluation programs are outlined. Of special importance is developing prevention programs for parents and children using school and community leaders to prevent health problems in areas such as human sexuality education, decision-making, social abilities, and alcohol and drug abuse. Main efforts should be directed toward low-income families and children to improve life conditions.

PIP: The leading health problems of children and adolescents in Chile is reviewed. The Chilean educational system and how the system addresses its principal health problems are described. A school health program is described as well as other educational programs designed and developed by nongovernmental institutions which have a smaller coverage. Current research studies regarding growth and development, child morbidity, nutritional level, and mental health studies are reviewed. In addition, principal challenges that include developing more efficient ways of referring children, enriching the curriculum and teacher training, assigning school hours for health teachers, and enlarging coverage of the health care evaluation programs are outlined. Of special importance is developing prevention programs for parents and children using school and community leaders to prevent health problems in areas such as human sexuality education, decision making, social abilities, and alcohol and drug abuse. Main effort should be directed toward low-income families and children to improve life conditions. The Chilean school health program includes health screenings for high-risk schools. These are defined as those located in low socioeconomic communities. There are medical clinics for problems detected by the school health evaluation through anthropometric tests. If necessary, the student is hospitalized. Immunization is carried out in every Chilean elementary school (grades 1-8). Local health programs consist of health promotion programs, disease prevention programs, and mental health programs (including substance addiction). The greatest challenge now is to implement local, regional, and national policies, adapting the program to regional differences; creating new educational areas, and providing human resources and materials.

WHO Collaborative Study on Alcohol Education and Young People: outcomes of a four-country pilot study.

In 1985 the Division of Mental Health, World Health Organization, Geneva, convened a group of investigators from centers in four countries--Australia, Chile, Norway, Swaziland--to participate in a pilot study on the efficacy of school-based alcohol education. The goal of the educational program was to delay onset and minimize involvement of alcohol use among 13- to 14-year-old adolescents. Twenty-five schools in the four countries, representing middle- and lower-class populations, were randomly assigned to peer-led education, teacher-led education, or a control condition. The educational program was derived from social-psychological theory and etiological research on adolescent alcohol use. The program focused on the social and environmental influences to drink alcohol and skills to resist those influences. It consisted of five lessons over 2 months. Baseline and posttest data measured alcohol use knowledge, attitudes, skills, and friends' drinking patterns. Data were collected immediately prior to and 2 months following the educational program. The data converge on the finding that peer-led education appears to be efficacious in reducing alcohol use across a variety of settings and cultures.