Head Start Teaching Center: Differential Training Effects for Head Start Personnel

Driven by research findings regarding the positive relationship between training and enhancement of services, as well as literature on adult learning, the New England Head Start Teaching Center (NEHSTC) was created in 1992 to test the efficacy of participatory, hands-on training. The purpose of this paper is to examine the outcome evaluation results from 4 years of training at the NEHSTC, 1 of 14 federally funded sites, as well as to discuss the implications for delivering this type of participatory training throughout Head Start. Findings suggest that the NEHSTC was successful in implementing high quality, participatory training within the context of an ongoing Head Start program. Head Start staff who participated in the NEHSTC trainings demonstrated gains in knowledge, skills, and expertise compared to similar Head Start employees who did not receive training. Results also reveal a sustained effect of training over time, with NEHSTC participants continuing to demonstrate enhanced knowledge and skills 6 months after training. Similar positive outcomes of training were found for staff with varying levels of experience and holding different Head Start positions. Thus the participatory, hands-on training implemented by the NEHSTC was found to produce positive and lasting outcomes for diverse Head Start staff. An effective and cost efficient model of training Head Start personnel is particularly relevant and timely as Head Start strives to establish universal quality and expansion of services in the 21st Century. The findings are also relevant for improving the quality of all early care and education programs.     

经鼻蝶窦手术动物模型神经内镜手术训练

目的建立一种活体动物的神经内镜经鼻蝶手术模拟训练方法。方法选择大鼠，建立一套训练计划，完成内镜图像导引下的内镜操作，电凝止血、冲洗和吸引、活检等神经内镜经鼻蝶手术的基本技巧。结果利用大鼠颅脑进行模仿内镜经鼻蝶手术，如在内镜图像导引下操作内镜的方法；熟悉内镜系统、电凝系统、冲洗和吸引设备的使用；熟悉了神经内镜经鼻蝶手术的步骤。结论作为神经内镜实验室训练的重要组成部分，通过利用大鼠颅脑进行模拟神经内镜手术，训练者可以从中获得神经内镜操作基本技巧的练习。     

Development and evaluation of an allocation committee to distribute community placements on an equitable basis between universities: Our experience with the University Placement Allocation Committee

The present paper outlines the development and evaluation of an allocation committee to distribute community placements on an equitable basis between universities. Although based on our experience in South Australia with the University Placement Allocation Committee (UPAC), the primary goal is to outline the steps that would be useful if placement coordinators at other universities in Australia decided to establish and maintain an allocation committee. A survey of field supervisors was also conducted and field supervisors endorsed UPAC as a constructive mechanism for allocating community placements.     

Laparoscopic colorectal surgery in Great Britain and Ireland – Where are we now?

OBJECTIVE: We aimed to gather information from the members of the Association of Coloproctology of Great Britain and Ireland (ACPGBI) to assess trends in the current practice of laparoscopic colorectal surgery. METHODS: A postal questionnaire survey of the members of ACPGBI. RESULTS: The response rate was 37% (200/540). Only 45 surgeons currently perform laparoscopic colorectal work in Great Britain and Ireland mainly right hemicolectomy and laparoscopic stoma formation, of these about one third practiced laparoscopy for benign colorectal conditions only. The majority (68%) of surgeons had enough resources at their place of work, but further training seemed to be a major issue. Nearly 22% of surgeons had not had any formal training. Only 50% of surgeons trained their specialist registrars. The incidence of conversion rate was not different for benign or malignant conditions and also did not appear to be related to the duration of experience. Only four surgeons had noted port a site recurrence during the past 10 years. Seventy-five percent (150/200) felt that laparoscopic colorectal work could be carried out safely in a District General Hospital. CONCLUSION: Laparoscopic colorectal surgery was being performed by a small minority of members of the ACPGBI although more surgeons had started to work in this field in recent years. The main areas of concern appeared to be a wide variation in the range of experience as indicated by the number of operations performed and limited formal training for consultants.     

Recognition and management of patients with high-risk vesicovaginal fistulas: Implications for teaching and research

Vesicovaginal fistulas (VVFs) occurring as a result of obstetric trauma are a vast problem in Nigeria and Ghana, where at least 20 000 women await repair, and fewer than 50 physicians have the necessary expertise. Through a series of conferences those VVFs that are at high risk and those at low-risk for repair failure, were identified. A clinic was established where repair of low-risk VVFs was done on an ongoing basis in a remote region of Ghana. A visiting surgical team was utilized to repair the difficult, or high-risk, VVFs, which included 4–6 cm VVFs (3), recurrent VVF (1), combined VVF and RVF (rectovaginal fistula), a large 5 cm juxtacervical VVF (1), and a vesicouterine fistula (1). Management of these patients and others with VVF repair complications is discussed.     

Skeletal Muscle Adaptations to Physical Training in Type II (Non-insulin-dependent) Diabetes Mellitus

Seven middle-aged men with manifest type II diabetes mellitus underwent an endurance training programme for 10–15 weeks. The maximal aerobic capacity, as well as the endurance capacity, was improved by 10% (p<0.05). The intramuscular glycogen store increased by more than 80% (p<0.05) from 350 μmol/g dw (dry weight), and the activities of citrate synthase and 3-hydroxy-acyl-CoA dehydrogenase increased by more than 50% (p<0.05) and 30% (p<0.05). The activity of glycogen synthase was decreased by approximately 20% (p<0.05), whereas lactate dehydrogenase remained unchanged. Capillaries/fibre and fibre area increased by more than 50% (p<0.05) and 30% (p<0.05) leaving the area of supply constant. Training did not influence fasting blood lipids and glucose, glycosylated hemoglobin, oral glucose tolerance, and insulin response to an oral glucose load measured 72 hours post-exercise. It is concluded that patients with manifest type II diabetes, as normoglycaemic individuals, adapt to physical training. However, no persistent effect on glucohomeostasis and lipaemia is produced by short-term training in the diabetic patients.     

Short utterance recognition using a network with minimum training

A feedforward network is used to recognize short, digitized, isolated utterances. A high, multispeaker recognition rate is achieved with a small vocabulary with a single training utterance. This approach makes use of the pattern recognition property of the network architecture to classify different temporal patterns in the multidimensional feature space. The network recognizes the utterances without the need of segmentation, phoneme identification, or time alignment. We train the network with four words spoken by one single speaker. The network is then able to recognize 20 tokens spoken by 5 other speakers. We repeat the above training and testing procedure using a different speaker's utterances for training each time. The overall accuracy is 97.5%. We compare this approach to the traditional dynamic programming (DP) approach, and find that DP with slope constraints of 0 and 1 achieve 98.5% and 85% accuracies respectively. Finally we validate out statistics by training and testing the network of a four-word subset of the Texas Instruments (Tl) isolated word database. The accuracy with this vocabulary exceeds 96%. By doubling the size of the training set, the accuracy is raised to 98%. Using a suitable threshold, we are able to raise the accuracy of one network from 87% to 98.5%. Thresholding applied to all networks would then raise the overall accuracy to well over 99%.

This technique is especially promising because of the low overhead and computational requirements, which make it suitable for a low cost, portable, command recognition type of application.     

Development of the Diploma in Clinical Dentistry (Conscious Sedation and Pain Control) Faculty of Dentistry, University of Sydney

The Diploma in Clinical Dentistry (Conscious Sedation and Pain Control) of the Faculty of Dentistry, University of Sydney, is the first dedicated programme devoted to this field in Australia. Its development followed a decision by the Dental Board of New South Wales to require a formal qualification from the University of Sydney before dental practitioners could offer sedation and pain management in practice.
The programme is conducted at Westmead Hospital in conjunction with the Department of Anaesthetics, and satisfies the guidelines developed by the Royal Australasian College of Dental Surgeons and the Royal Australasian College of Surgeons.
The course is conducted either over one or two years, with block sessions requiring attendance at Westmead Hospital, together with assignments which are completed outside the block sessions. In this way, a dental practitioner enrolled in the programme is able to continue practice.
The block sessions need not be completed over one year, but must be completed within two years.