Online Science Instruction Can Promote Adolescents' Autonomy Need Satisfaction: a Latent Growth Curve Analysis.

This research examined the differential motivational effects of a pre-college science enrichment program delivered in both online and in-person learning formats. Using self-determination theory as a guiding framework, we hypothesized that (a) students would exhibit growth in their perceived satisfaction of needs for autonomy, competence, and relatedness, (b) online learning would be associated with greater growth in autonomy, and (c) in-person learning would be associated with greater growth in both competence and relatedness. Using a sample of 598 adolescent participants, results of latent growth curve modeling indicated that satisfaction of the three needs grew unconditionally over the course of the program. However, format type was unrelated to growth in need satisfaction. Rather, this effect was found to be conditional upon the type of science project undertaken by students: astrophysics students exhibited significantly greater autonomy growth when receiving online instruction than did biochemistry students. Our findings suggest that online science learning can be just as effective in motivating students as in-person learning provided that the learning tasks are conducive to remote instruction.

Glove Use and Glove Education in Workers with Hand Dermatitis.

BACKGROUND: Occupational skin diseases are common. The occurrence of occupational skin diseases represents a failure of primary prevention strategies that may include the use of personal protective equipment, most commonly gloves. OBJECTIVE: The objective of this study was to describe current glove use and education practices related to gloves in workers being assessed for possible work-related hand dermatitis. METHODS: Participants included consecutive patients being assessed for possible work-related hand dermatitis. A self-administered questionnaire obtained information on demographics, workplace characteristics and exposures, glove use, and education regarding gloves. RESULTS: Ninety percent of the 105 participants reported using gloves. Only 44% had received training related to glove use in the workplace. Major gaps in training content included skin care when using gloves, warning signs of skin problems, and glove size. If the worker indicated no glove training received, the majority reported they would have used gloves if such training was provided. CONCLUSIONS: Although the majority of workers being assessed wore gloves, the minority had received training related to glove use. Particular gaps in training content were identified. Those who had not received training noted they would likely have used gloves if training had been provided.

Promoting advance directives among elderly primary care patients.

OBJECTIVE: To determine efficient ways of promoting advance directives among heterogeneous populations of elderly ambulatory patients. DESIGN: One-year quasi-experimental trial. SETTING: Five suburban and urban health centers in one region of a large managed care organization. One additional suburban center served as a control site. PARTICIPANTS: Individuals ages 65 and older (N= 2,120) who were continuously enrolled and had a health maintenance visit with their primary care provider during the study year. INTERVENTION: Physician education (oral and written) and physician and patient prompts to discuss advance directives. MAIN RESULTS: Sixty-six (7.8%) of patients at the intervention centers completed new advance directives, versus 9 of 1,277 (<1%) at the comparison center (P <.001). Patients 75 and older were twice as likely (odds ratio [OR], 2.0; 95% confidence limits [CL], 1.2 to 3.3) as those 65 to 74 to file a new advance directive, and the odds were twice as great (OR, 2.6; 95% CL, 1.4 to 4.6) at centers serving communities with median household income over the state median. Gender, recent hospitalization, emergency room visits, and number of chronic conditions were not related to making new directives nor was predominant ethnicity of the center community (African-American versus white). Adjusted for these factors, the intervention resulted in a 20-fold increase (95% CL, 10.4 to 47.8) in the odds of creating a new advance directive. Doctors reported barriers of time and unwillingness to press discussions with patients. CONCLUSIONS: A replicable intervention largely targeting doctors achieved a modest increase in advance directives among elderly ambulatory patients. Future interventions may need to target lower-income patients, "younger" elderly, and more specifically address doctors' attitudes and comfort discussing advance directives.