Development and implementation of an integrated, multi-modality, user-centered interactive dietary change program

Computer-tailored behavior change programs offer the potential for reaching large populations at a much lower cost than individual or group-based programs. However, few of these programs to date appear to integrate behavioral theory with user choice, or combine different electronic modalities. We describe the development of an integrated CD-ROM and interactive voice response dietary change intervention that combines behavioral problem-solving theory with a high degree of user choice. The program, WISE CHOICES, is being evaluated as part of an ongoing trial. This paper describes the program development, emphasizing how user preferences are accommodated, and presents implementation and user satisfaction data. The program was successfully implemented; the linkages among the central database, the CD-ROM and the automated telephone components were robust, and participants liked the program almost as well as a counselor-delivered dietary change condition. Multi-modality programs that emphasize the strengths of each approach appear to be feasible. Future research is needed to determine the program impact and cost-effectiveness compared with counselor-delivered intervention.     

The crying infant — an interdisciplinary approach

Crying in infancy is a complex phenomenon — we are trying to bring experiences of behavioural biology and human ethology together with pathophysiological and therapeutic pediatric considerations. Parent-child relationships, circadian rhythms, feeding methods and environmental stimuli are the most important factors for objective observation of the infant's behavioural patterns. We developed a special technique for analysing the parent-child-interaction and especially the crying behaviour by the use of so-called “crying-maps”.

Our clinical research was established by nurses' experiences in the coincidence of increased irritability, restlessness and chronic excessive crying on one hand, with feeding problems like spitting and vomiting in the infants on the other hand. By new recording-techniques, especially the 2-d-sonography of the esophago-gastric region and long-term-pH-metry in the distal esophagus, in most of these infants a relevant gastro-esophageal reflux [GER] can be proven. This was demonstrated in several clinical studies and various types of reflux were differentiated. Further we analysed anamnestic and clinical data of infants with GER and correlations with other clinical symptoms, especially neurological abnormalities. These clinical diagnoses have different influences on the treatment of the crying infants by feeding, carrying, drug-application and physiotherapy. Our experiences are combined in an open interdisciplinary concept about the origin and consequences of chronic excessive crying in which other concepts could be integrated.     

Evaluation of an interactive, Internet-based weight loss program: a pilot study

The Internet can access a large number of consumers in a more cost-effective manner than other information delivery channels. In this pilot study, we assessed whether an online weight reduction program including dietary advice plus exercise (ED) was more effective in reducing weight than an exercise-only program (EX) >12 weeks. Participants were randomized to either the ED or EX group and attended a center for anthropometric measurements and dietary assessment. Both groups wore a pedometer and set weekly goals to increase daily steps through an interactive Web site. The ED group set weekly dietary goals via the Web site and received tailored e-mail assistance. Seventy-three participants commenced and 53 (73%) completed the study [EX n = 26; ED n = 27; body mass index-mean (standard deviation): 29.7 (2.5) kg m(-2), age 46.3 (10.8); 21% male]. Percent weight changes were EX, 2.1 (0.6)% and ED, 0.9 (0.6)% (P = 0.15). Both groups increased their daily steps with no difference between groups. Only the ED group significantly reduced their energy intake. Despite a greater fall in energy intake reported by the ED group and a similar increase in physical activity in both groups, setting individual dietary goals did not enhance weight loss.     

Development of an interactive bioterrorism and emerging infections curriculum for medical students and internal medicine residents

While awareness of bioterrorism threats and emerging infectious diseases has resulted in an increased sense of urgency to improve the knowledge base and response capability of physicians, few medical schools and residency programs have curricula in place to teach these concepts. Public health agencies are an essential component of a response to these types of emergencies. Public health education during medical school is usually limited to the non-clinical years. With collaboration from our local public health agency, the Emory University School of Medicine developed a curriculum in bioterrorism and emerging infections. By implementing this curriculum in the clinical years of medical school and residency programs, we seek to foster improved interactions between clinicians and their local public health agencies.     

Mini-symposium — Public Health Observatories: Building public health skills and capacity in the English regions

Local public health departments have variable access to a public health intelligence function, and information skills are scarce. Public health observatories are supporting the development of professional standards for public health intelligence specialists and offer training opportunities for both defined public health specialists and generalist public health specialists. In addition observatories support public health practice through educational programmes in health impact assessment, health equity audit, public health intelligence, and the provision of toolkits and advice on methods. Observatories have a key role in supporting and developing networks, in particular public health analysts, and the use of interoperable websites is enhancing these opportunities.     

Economic and industrial understanding — The problems, opportunities and challenges

This article will examine the rationale for the introduction of Economic and Industrial Understanding (E.I.U.) in the 5 - 19 curriculum, and the problems, opportunities and challenges afforded by this curriculum initiative.     

Computers, children and teachers — where are we headed?

Almost a decade after the introduction of the microcomputer into classrooms, what conclusions can be drawn of its use and the effects of its use. Are we developing a new culture with new thought processes and approaches to education or are we involved in a 'treacherous deception'?     

Burden of Influenza-Associated Respiratory Hospitalizations,Vietnam, 2014–2016

Influenza burden estimates are essential to informing prevention and control policies. To complement recent influenza vaccine production capacity in Vietnam, we used acute respiratory infection (ARI) hospitalization data, severe acute respiratory infection (SARI) surveillance data, and provincial population data from 4 provinces representing Vietnam’s major regions during 2014–2016 to calculate provincial and national influenza-associated ARI and SARI hospitalization rates. We determined the proportion of ARI admissions meeting the World Health Organization SARI case definition through medical record review. The mean influenza-associated hospitalization rates per 100,000 population were 218 (95% uncertainty interval [UI] 197–238) for ARI and 134 (95% UI 119–149) for SARI. Influenza-associated SARI hospitalization rates per 100,000 population were highest among children <5 years of age (1,123; 95% UI 946–1,301) and adults >65 years of age (207; 95% UI 186–227), underscoring the need for prevention and control measures, such as vaccination, in these at-risk populations.     

Reading Difficulties and Optometry — A Review

Changing trends in the field of learning disabilities compel occupational therapists to keep up with trends and new approaches and to be able to view these objectively and scientifically. In this perspective, it is timely that the practice of optometry with learning disabled children is reviewed, as many occupational therapists refer children to optometrists for further assessment or to compliment their own treatment regimes. A review of the literature highlights definitional problems and conflicting findings. Although there is some support for the efficacy of optometric therapy, much of the published literature lacks an empirical scientific basis. It seems that vision training programmes are useful with some children, however visual or perceptual training techniques are not applicable to all types of reading difficulties.