Language acquisition: hesitations in the question/answer dialogic pair.

PURPOSE: (1) To verify the existence (or not) of hesitation marks in the beginning of utterances in children's discourse; and (2) to determine to what extent the presence/absence of these marks could be explained by retrievable facts in the production conditions of their discourses. METHODS: Interview situations with four children aged 5-6 years attending Kindergarten level II in a public preschool at the time of the data collection were analyzed. The interviews were recorded on audio and video, inside a soundproof booth, with high fidelity equipment. Afterwards, the recordings were transcribed by six transcribers that were specially trained for this task. Transcription rules that prioritized the analyses of hesitations were used. For the analysis of retrievable facts in the production conditions of children's discourse, the dialogic pair question-answer was adopted. RESULTS: A correlation between presence/absence of hesitation in the beginning of utterances in children and type of question (open/closed) made by the collocutor was observed. When the question was closed ended, the utterances were preferably initiated without hesitation marks, and when the question was open ended, the utterances were preferably initiated with hesitation marks. CONCLUSION: The presence/absence of hesitation marks in the beginning of utterances in children was found to be dependent on the production conditions of their discourses.

Language acquisition: hesitations in the question/answer dialogic pair / Aquisição da linguagem: hesitações no par dialógico pergunta/resposta

PURPOSE: (1) To verify the existence (or not) of hesitation marks in the beginning of utterances in children's discourse; and (2) to determine to what extent the presence/absence of these marks could be explained by retrievable facts in the production conditions of their discourses. METHODS: Interview situations with four children aged 5-6 years attending Kindergarten level II in a public preschool at the time of the data collection were analyzed. The interviews were recorded on audio and video, inside a soundproof booth, with high fidelity equipment. Afterwards, the recordings were transcribed by six transcribers that were specially trained for this task. Transcription rules that prioritized the analyses of hesitations were used. For the analysis of retrievable facts in the production conditions of children's discourse, the dialogic pair question-answer was adopted. RESULTS: A correlation between presence/absence of hesitation in the beginning of utterances in children and type of question (open/closed) made by the collocutor was observed. When the question was closed ended, the utterances were preferably initiated without hesitation marks, and when the question was open ended, the utterances were preferably initiated with hesitation marks. CONCLUSION: The presence/absence of hesitation marks in the beginning of utterances in children was found to be dependent on the production conditions of their discourses. .

OBJETIVOS: (1) Verificar a existência (ou não) de marcas hesitativas no início de enunciados no discurso de crianças; e (2) verificar em que medida a presença/ausência dessas marcas se explicaria por fatos recuperáveis na produção de seus discursos. MÉTODOS: Foram analisadas situações de entrevistas de quatro crianças com 5-6 anos de idade que frequentavam o nível II de uma escola pública de Educação Infantil na época da coleta dos dados. As entrevistas foram gravadas, em áudio e em vídeo, no interior de uma cabine acústica, com material de alta fidelidade. Posteriormente, as gravações foram transcritas por seis transcritores treinados para essa tarefa. Foram utilizadas normas de transcrição que priorizavam a análise das hesitações. Para a análise de fatos recuperáveis das condições de produção dos discursos das crianças, foi adotado o par dialógico pergunta-resposta. RESULTADOS: Foi observada correlação entre presença/ausência de hesitação em início de enunciados das crianças e tipo de pergunta (aberta/fechada) feita pelo interlocutor. Quando a pergunta era do tipo fechada, os enunciados iniciaram-se, preferencialmente, sem marca hesitativa; já quando a pergunta era do tipo aberta, os enunciados iniciaram-se, preferencialmente, com marcas hesitativas. CONCLUSÃO: A presença/ausência de marcas hesitativas em início de enunciados das crianças mostrou-se como dependente das condições de produção de seus discursos. .

Improving awareness of cancer clinical trials among Hispanic patients and families: audience segmentation decisions for a media intervention.

Clinical trials hold great promise for cancer treatment; yet, Hispanic cancer patients have low rates of clinical trial participation. Lack of awareness and knowledge of clinical trials and language barriers may account for low participation rates. Patient education through audiovisual materials can improve knowledge of and attitudes toward clinical trials among Hispanic populations. In this study, 36 Hispanic cancer patients/survivors and caregivers in Florida and Puerto Rico participated in focus groups to aid in developing a Spanish-language DVD and booklet intervention designed to increase knowledge about clinical trials. Focus group results showed (a) low levels of knowledge about clinical trials, (b) uncertainty about why a physician would expect a patient to make a choice about treatment, and (c) desire for family participation in decision making. Respondents expressed various preferences for aspects of the DVD such as showing extended family in the DVD and physician explanations about key terms. On the basis of these preferences, the authors developed a creative brief for a DVD. The content of the DVD was reviewed by Hispanic community leaders and key stakeholders. A final DVD was created, in Spanish, using Hispanic patients and physicians, which contained the information deemed important from the focus groups and stakeholder interviews. The DVD is complete with companion booklet and currently undergoing a randomized control trial.

E-learning used in a training course on atraumatic restorative treatment (ART) for Brazilian dentists.

The purpose of this study was to assess the benefits of using e-learning resources in a dental training course on Atraumatic Restorative Treatment (ART). This e-course was given in a DVD format, which presented the ART technique and philosophy. The participants were twenty-four dentists from the Brazilian public health system. Prior to receiving the DVD, the dentists answered a questionnaire regarding their personal data, previous knowledge about ART, and general interest in training courses. The dentists also participated in an assessment process consisting of a test applied before and after the course. A single researcher corrected the tests, and intraexaminer reproducibility was calculated (kappa=0.89). Paired t-tests were carried out to compare the means between the assessments, showing a significant improvement in the performance of the subjects on the test taken after the course (p<0.05). A linear regression model was used with the difference between the means as the outcome. A greater improvement on the test results was observed among female dentists (p=0.034), dentists working for a shorter period of time in the public health system (p=0.042), and dentists who used the ART technique only for urgent and/or temporary treatment (p=0.010). In conclusion, e-learning has the potential of improving the knowledge that dentists working in the public health system have about ART, especially those with less clinical experience and less knowledge about the subject.

Explanatory digital video disc with patients undergoing diagnostic cardiac catheterization.

The aim of this study was to evaluate knowledge of patients before outpatient diagnostic cardiac catheterization after viewing an explanatory Digital Video Disc, in a cardiology reference hospital. This cross-sectional study was carried out with patients undergoing their first cardiac catheterization and was performed from May to June 2009 in the hemodynamic sector. An instrument was used with questions (12) regarding the patients' understanding of the procedure. The intervention was a five-minute video prepared by the researchers. The sample was composed of 94 patients, divided into an intervention group (45) and a control group (49), with a mean age of 55 ± 9 years and predominantly male. The patients of the IG had a higher rate of correct answers (74.6 ± 17.1) compared to the CG (31.6 ± 18.8), P=.000. The results demonstrated the efficacy of the presentation of a guidance video for patients undergoing a hemodynamic procedure.

Explanatory digital video disc with patients undergoing diagnostic cardiac catheterization / Digital video disc explicativo em pacientes submetidos ao cateterismo cardíaco diagnóstico / Disco digital explicativo para pacientes sometidos al cateterismo cardiaco diagnóstico

The aim of this study was to evaluate knowledge of patients before outpatient diagnostic cardiac catheterization after viewing an explanatory Digital Video Disc, in a cardiology reference hospital. This cross-sectional study was carried out with patients undergoing their first cardiac catheterization and was performed from May to June 2009 in the hemodynamic sector. An instrument was used with questions (12) regarding the patients' understanding of the procedure. The intervention was a five-minute video prepared by the researchers. The sample was composed of 94 patients, divided into an intervention group (45) and a control group (49), with a mean age of 55±9 years and predominantly male. The patients of the IG had a higher rate of correct answers (74.6±17.1) compared to the CG (31.6±18.8), P=.000. The results demonstrated the efficacy of the presentation of a guidance video for patients undergoing a hemodynamic procedure.

O objetivo deste estudo foi avaliar o conhecimento dos pacientes pré-cateterismo cardíaco com diagnóstico ambulatorial, após digital video disc explicativo, em um hospital de referência em cardiologia. Usou-se o estudo transversal como metodologia, com pacientes submetidos ao primeiro cateterismo cardíaco, realizado de maio a junho de 2009, no setor de hemodinâmica. Foi utilizado instrumento com questões (12) referentes ao entendimento dos pacientes sobre o procedimento. A intervenção foi um vídeo com duração de cinco minutos, elaborado pelos pesquisadores. A amostra foi constituída por 94 pacientes, divididos em grupo intervenção-GI (45) e grupo controle-GC (49), com idade média de 55±9 anos e predominância do sexo masculino. Pacientes do GI apresentaram maior índice de acertos (74,6±17,1), quando comparados ao GC (31,6±18,8), p=0,000. Pode-se concluir, por meio dos resultados, que houve eficácia da apresentação de um vídeo de orientações para pacientes submetidos ao procedimento hemodinâmico.

El objetivo de este estudio fue evaluar el conocimiento de los pacientes sometidos a cateterismo cardiaco tipo diagnóstico en ambulatorio después de ser presentado un DVD explicativo, en un hospital de referencia en cardiología. Se trata de un estudio transversal, con pacientes sometidos al primer cateterismo cardiaco, realizado de mayo a junio de 2009, en el sector de hemodinámica. Fue utilizado un instrumento con 12 preguntas referentes a la atención de los pacientes sobre el procedimiento. La intervención fue un vídeo con duración de cinco minutos elaborado por los investigadores. La muestra constituida de 94 pacientes, fue dividida en grupo intervención (45) y grupo control (49); la edad promedio fue de 55±9 años con predominancia del sexo masculino. Los pacientes del GI presentaron un mayor índice de aciertos (74,6±17,1), cuando comparados al GC (31,6±18,8), P=0,000. Los resultados demostraron la eficacia de la presentación de un vídeo de orientaciones para pacientes sometidos al procedimiento hemodinámico.

Efeito na Ressuscitação Cardiopulmonar utilizando treinamento teórico versus treinamento teórico-prático / Effects of the use of theoretical versus theoretical-practical training on Cardiopulmonary Resuscitation / Efecto en la Resucitación Cardiopulmonar utilizando entrenamiento teórico versus entrenamiento teórico-prático

FUNDAMENTO: O conhecimento teórico e a habilidade de realizar ressuscitação cardiopulmonar (RCP) de qualidade são essenciais para a sobrevida do paciente vítima de morte súbita. OBJETIVO: Determinar se o ensino apenas teórico é capaz de promover o ensino da RCP de boa qualidade e conhecimento em profissionais da área da saúde comparado com curso teórico-prático de suporte básico de vida. MÉTODOS: Vinte enfermeiras voluntárias participaram do treinamento teórico de RCP e desfibrilação externa automática (DEA) utilizando aula teórica e vídeo usado nos cursos de Suporte Básico de Vida da American Heart Association (BLS-AHA; grupo A). Foram comparadas com 26 alunos profissionais da saúde que participaram de um curso regular teórico-prático de BLS-AHA (grupo B). Após os cursos, os participantes foram submetidos à avaliação teórica e prática como recomendado nos cursos do BLS-AHA. As avaliações práticas foram gravadas e posteriormente pontuadas por três instrutores experientes. A avaliação teórica foi um teste de múltipla escolha usada nos cursos regulares do BLS-AHA. RESULTADOS: Não houve diferença na avaliação teórica (p = ns), entretanto a avaliação prática foi consistentemente pior no grupo A, evidenciado pelos três examinadores (p < 0,05). CONCLUSÃO: A Utilização de vídeos de RCP e aulas teóricas não melhoraram a capacidade psicomotora em realizar RCP de boa qualidade, entretanto pode melhorar a capacidade cognitiva (conhecimento). Áreas críticas de atuação são o ABCD primário e o correto uso do DEA.

BACKGROUND: Theoretical knowledge and skill to perform good quality cardiopulmonary resuscitation (CPR) are essential for the survival of patients with sudden death. OBJECTIVE: To determine whether a theoretical course alone is sufficient to promote good quality CPR training and knowledge for health professionals in comparison to a theoretical-practical basic life support training. METHODS: Twenty volunteer nurses participated in the theoretical CPR and automated external defibrillation (AED) training by means of a theoretical class and video used in the Basic Life Support Training of the American Heart Association (BLS-AHA; group A). They were compared to other 26 health professionals who attended regular theoretical-practical BLS-AHA training (group B). After the training, the participants took theoretical and practical tests as recommended in BLS-AHA courses. The practical tests were recorded and were later scored by three experienced instructors. The theoretical test was a multiple choice test used in regular BLS-AHA courses. RESULTS: No difference was observed in the theoretical tests (p = ns). However, the practical tests were consistently worse in group A, as evaluated by the three examiners (p < 0.05). CONCLUSION: The use of CPR videos and theoretical training did not improve the individuals' psychomotor ability to perform good quality CPR; however, it may improve their cognitive ability (knowledge). Critical areas of intervention are the primary ABCD and the correct use of AED.

FUNDAMENTO: El conocimiento teórico y la habilidad de realizar resucitación cardiopulmonar (RCP) de calidad son esenciales para la sobrevida del paciente víctima de muerte súbita. OBJETIVO: Determinar si la enseñanza sólo teórica es capaz de promover la enseñanza de la RCP de buena calidad y conocimiento en profesionales del área de salud comparado con curso teórico-práctico de soporte básico de vida. MÉTODOS: Veinte enfermeras voluntarias participaron del entrenamiento teórico de RCP y desfibrilación externa automática (DEA) utilizando clase teórica y video usado en los cursos de Soporte Básico de Vida de la American Heart Association (BLS-AHA; grupo A). Fueron comparadas con 26 alumnos profesionales de la salud que participaron de un curso regular teórico-práctico de BLS-AHA (grupo B). Después de los cursos, los participantes fueron sometidos a evaluación teórica y práctica como es recomendado en los cursos del BLS-AHA. Las evaluaciones prácticas fueron grabadas y posteriormente puntuadas por tres instructores experimentados. La evaluación teórica fue un test de multiple choice usado en los cursos regulares del BLS-AHA. RESULTADOS: No hubo diferencia en la evaluación teórica (p = ns), mientras tanto la evaluación práctica fue consistentemente peor en el grupo A, evidenciado por los tres examinadores (p < 0,05). CONCLUSIÓN: La utilización de videos de RCP y aulas teóricas no mejoraron la capacidad psicomotora para realizar RCP de buena calidad, en cambio puede mejorar la capacidad cognitiva (conocimiento). Áreas críticas de actuación son el ABCD primario y el correcto uso del DEA.

Effects of the use of theoretical versus theoretical-practical training on CPR.

BACKGROUND: Theoretical knowledge and skill to perform good quality cardiopulmonary resuscitation (CPR) are essential for the survival of patients with sudden death. OBJECTIVE: To determine whether a theoretical course alone is sufficient to promote good quality CPR training and knowledge for health professionals in comparison to a theoretical-practical basic life support training. METHODS: Twenty volunteer nurses participated in the theoretical CPR and automated external defibrillation (AED) training by means of a theoretical class and video used in the Basic Life Support Training of the American Heart Association (BLS-AHA; group A). They were compared to other 26 health professionals who attended regular theoretical-practical BLS-AHA training (group B). After the training, the participants took theoretical and practical tests as recommended in BLS-AHA courses. The practical tests were recorded and were later scored by three experienced instructors. The theoretical test was a multiple choice test used in regular BLS-AHA courses. RESULTS: No difference was observed in the theoretical tests (p = ns). However, the practical tests were consistently worse in group A, as evaluated by the three examiners (p < 0.05). CONCLUSION: The use of CPR videos and theoretical training did not improve the individuals' psychomotor ability to perform good quality CPR; however, it may improve their cognitive ability (knowledge). Critical areas of intervention are the primary ABCD and the correct use of AED.

Associations between media viewing and language development in children under age 2 years.

OBJECTIVE: To test the association of media exposure with language development in children under age 2 years. STUDY DESIGN: A total of 1008 parents of children age 2 to 24 months, identified by birth certificates, were surveyed by telephone in February 2006. Questions were asked about child and parent demographics, child-parent interactions, and child's viewing of several content types of television and DVDs/videos. Parents were also asked to complete the short form of the MacArthur-Bates Communicative Development Inventory (CDI). The associations between normed CDI scores and media exposure were evaluated using multivariate regression, controlling for parent and child demographics and parent-child interactions. RESULTS: Among infants (age 8 to 16 months), each hour per day of viewing baby DVDs/videos was associated with a 16.99-point decrement in CDI score in a fully adjusted model (95% confidence interval = -26.20 to -7.77). Among toddlers (age 17 to 24 months), there were no significant associations between any type of media exposure and CDI scores. Amount of parental viewing with the child was not significantly associated with CDI scores in either infants or toddlers. CONCLUSIONS: Further research is required to determine the reasons for an association between early viewing of baby DVDs/videos and poor language development.

Image Engine: an object-oriented multimedia database for storing, retrieving and sharing medical images and text.

This paper describes Image Engine, an object-oriented, microcomputer-based, multimedia database designed to facilitate the storage and retrieval of digitized biomedical still images, video, and text using inexpensive desktop computers. The current prototype runs on Apple Macintosh computers and allows network database access via peer to peer file sharing protocols. Image Engine supports both free text and controlled vocabulary indexing of multimedia objects. The latter is implemented using the TView thesaurus model developed by the author. The current prototype of Image Engine uses the National Library of Medicine's Medical Subject Headings (MeSH) vocabulary (with UMLS Meta-1 extensions) as its indexing thesaurus.

Interactive video in health care: blending patient care, computer technology, and research results.

This article illustrates one method of combining research results and computer technology to produce a "high-tech" patient-education program that has demonstrated its applicability in clinical practice. A videodisc entitled The Story of Maria was produced as part of a large primary care research project along the southwestern U.S.-Mexico border. A needs assessment of approximately 200 Hispanic mothers preceded the scripting of the videodisc. The paper presents an overview of the production process, as well as a description of some special technological features, including the bilingual soundtrack, touchscreen control, and careful design of instructions to eliminate the need for literacy. Pilot testing of the interactive video program in two community health centers in the U.S.-Mexico border area indicates that the program is not only fulfilling its purpose, but also being enthusiastically received by the patients.

Microcomputers and biologists.

Microcomputers have now become a working tool of the biologist. This article explores some of the consequences of this revolution both in terms of the skills and working habits needed and of the range of uses which have been found. The primary consequence is that biologists must learn how to become computer managers. This does not mean learning BASIC and computer architecture, though this will usually prove valuable, but that we must be able to grasp from the flood of sales literature and computer specialists what tasks can or should be undertaken with the aid of microcomputers. Secondly it means being able to choose and maintain the right machinery for the tasks needed. An overview of applications shows four main areas of use. 1) The standard packages where one can expect the computer manufacturer to provide a complete working system. These are word-processing, database reference systems, spreadsheet calculations, graphics production and communications. 2) Specialist scientific programs such as statistics, data processing and model making. 3) The use of the microcomputer as a laboratory instrument for control or measurement. 4) Educational applications. Each of these areas has separate, often conflicting, requirements which can only be balanced by the user.