Online CME usage patterns.

The paper reports the findings of the analysis of a sample of 829 online Continuous Medical Education (CME) enrolments aimed at inspecting users' preferences and behaviours. The contents of the analyzed course are provided as online SCORM (Sharable Content Object Reference Model) resources together with the corresponding Pdf downloadable versions allowing different usage patterns (online only, Pdf only, online AND Pdf, mixed online OR Pdf). The results point out that there is not a specific preference for one of the four patterns and that most of the users access both navigable modules and Pdf documents. Demographic characteristics and initial knowledge level do not influence the choice of a specific usage pattern that probably depends on internal or context factors. From the point of view of knowledge acquisition, the four patterns are equivalent. As regards users' behaviour, the analysis has pointed out two issues: 1) the attitude to conclude the course in a short time and to reach good test scores, but not the excellence; 2) learning activity tracing data were not available for all the enrolments. Cues for discussion are proposed.

E-learning for occupational physicians' CME: a study case.

The present study reports the results of the evaluation of an e-learning CME course in the field of Occupational Medicine. In particular the following aspects have been investigated: If and how the course contents have met the educational users' needs; The effectiveness of the course in terms of knowledge improvement; Users' behaviour. Attendance data and results of a sample of 1128 attendees have been analyzed via ad hoc developed tools for direct inspection of Moodle CMS database. The results document the effectiveness of the e-learning course, as regards meeting the educational needs of physicians and also the improvement in terms of knowledge and problem solving skill acquisition. Users' behaviour has revealed a certain tendency for passing the tests, more than for pursuing the best possible result. Interaction with the tutor is low.

[Obesity and work: an emerging problem]. / Obesità e lavoro: un problema emergente.

In Italy, 42.5% of adult males is overweight and 10.5% obese, while 26.6% of the women is overweight and 9.1% obese. The economical consequences of a growing number of obese workers are relevant: obesity is associated to reduced participation to productive life, increased absenteeism, disability and need for health care, lower salaries, negative impact on productivity. The obese worker is characterized by reduced tolerance to effort, limited range of motion at spinal and joints level, reduced muscle strength normalized per body weight, lower tolerance to prolonged postures, reduced balance and overall reduced work capacity linear to the increase of body mass index. The present article reviews the most evident relationships between work factors (stress, musculoskeletal disorders, etc.) and obesity and speculates about possible interventions to prevent occupational issues for obese workers.

Earnings in e-learning: knowledge, CME credits or both? Hints from analysis of attendance dynamics and users' behaviour.

Many papers report and convey positive opinion about the use of e-learning in the healthcare sector. The issue is how to exploit at best such a powerful instrument. Starting from data regarding the usage of a CME e-learning course, attendance dynamics and users' behaviour have been inspected with the aim of getting some hints about how to improve the development and the delivery of e-learning courses for CME, and to promote knowledge acquisition at best. The different paths followed by 7811 users have been modeled, from enrolment to conclusion/drop-out, then the behaviour in terms of effort, elapsed time, achieved result have been analyzed. The obtained results point out: good acceptance (retention rate 83%) of a not basic educational model and effectiveness (success rate 79%). At the same time the inspection of behaviour has shown that there is a good margin of possible improvement in terms of knowledge acquisition. Conclusions provide a list of issues to keep in mind during system development, in order to provide CME e-learning meeting both credit and knowledge acquisition goals.

Usage and effectiveness of e-learning courses for continuous medical education.

The paper describes the results of an e-learning experimental project for Continuous Medical Education (CME) in Occupational Medicine in terms of: extent of the e-learning courses usage by the healthcare personnel, knowledge acquisition and satisfaction. 11 courses have been available for 11 months during which 2,034 users all over Italy enrolled in 5,183 courses with a success percentage of 72% and a significant difference between test scores performed before and after attending the e-learning courses. Also user's satisfaction, inspected through a questionnaire, has provided good results. Starting from the experience reported, the authors are confident that e-learning will gain ground and evolve as an effective and appreciated educational mean for CME.

Preliminary evaluation of an e-learning course for healthcare personnel.

Preliminary evaluation of an e-learning system for nurses and physiotherapists is presented. The results lead to positive conclusions, but traditional paper-based materials still play an important role in learning activity.

Development of an e-learning system for occupational medicine: usability issues.

The aim of the present paper is to describe the process of developing an e-learning system for continuous medical education in the field of occupational medicine, with special focus on usability. The following steps are described: the needs analysis of the potential users; the prototype of the system that has been set up; the usability evaluation of the prototype by a sample of ten users; the analysis of the potential improvements; the evaluation of the revised system. The results of the usability tests point out that investing in improving usability was useful, even when they have not been recommended as mandatory. Only data collected from real active users will provide a more exhaustive evaluation, nevertheless it can be considered that positive results can be expected.

[Polychlorinated biphenyl serum levels in two Italian population groups: sex pattern and correlation with age]. / Livelli serici di policlorobifenili in due gruppi di popolazione Italiana: distribuzione dei congeneri e correlazione con l'età.

OBJECTIVE: To examine the congener-specific concentrations and patterns of polychlorinated biphenyls in the Italian general population. DESIGN: Two population groups were selected and monitored for the determination of up to 60 congeners in human serum. A very detailed questionnaire was administered to each participant to collect information concerning demographic, lifestyle, and medical factors. Statistical analyses were performed to examine the relationships between PCB serum levels and age. SETTING: Northern and Central Italy. PARTICIPANTS: 162 subjects from Novafeltria, Central Italy and 164 subjects from Pavia, Northern Italy. MAIN OUTCOME MEASURE: Serum concentrations of both coplanar and non-coplanar PCB congeners. Relationship between PCB levels and age. RESULTS: The mean concentration of total PCBs was found to be 2.48 and 3.93 microg/l for Novafeltria and Pavia, respectively. As waited, the most abundant congeners were CB-153, CB-138, CB-180, and CB-170. Age resulted to be the most significant determinant of PCB levels. Slight differences in the congener profile were observed in the two population groups. CONCLUSIONS: As expected, a strong correlation between age and PCB levels has been observed. It is remarkable that the correlation increased with increasing chlorination in both the population groups. Associations with other variables, such as gender, food and alcohol consumption, and cigarette smoking, appeared to be inconsistent.

Reference values of coplanar and non-coplanar PCBs in serum samples from two Italian population groups.

The main goal of this study is to establish the reference values of individual Polychlorinated biphenyl (PCB) congeners in non-occupationally exposed subjects. Since the PCB pattern in human serum is related to the living area, two different population groups from North and Central Italy, were compared. Serum concentrations of both coplanar and non-coplanar PCB congeners were measured by using gas chromatography coupled with low-resolution mass spectrometry (HRGC-LRMS). A fast and reliable method for the determination of 60 congeners had been previously validated. Its reliability was further verified by using high-resolution mass spectrometry. Thirty-one congeners out of 60 were found at detectable concentrations in at least one sample. The mean value for total PCBs was found to be 2.48 and 3.93 microg/L for the two population groups. Eight dioxin-like PCBs were detected. In accordance with the findings from the literature, the most abundant congeners were found to be 153, 138, 180, and 170. Both univariate and multivariate analysis showed that age is a significant determinant of PCB concentrations. The correlation increased with increasing chlorination. Slight differences in the PCB pattern were observed in the two population groups.