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At least 217 records · Page 12Linked to original sources
PubMed1987

A clinical trial of Neo Sampoon vaginal tablets and Emko foam in Alexandria, Egypt.

Results are reported for a comparative 12-month study of Neo Sampoon foaming vaginal tablets containing 60 mg of the spermicide, menfegol, and Emko vaginal foam containing an 8.0% concentration of the spermicide, nonoxynol-9. Conducted in cooperation with the Family Planning Association in Alexandria, Egypt, the trial included 349 women who were randomly allocated to use one of the two contraceptive products. The twelve-month cumulative life-table rate for accidental pregnancy (per 100 women) was 2.8 for Neo Sampoon tablet users and 2.1 for Emko foam users. The 12-month continuation rates were 77.6 and 77.2 per 100 women for the tablet and foam groups, respectively. In both groups, the majority of discontinuations from the study were for personal reasons, including lack of confidence in the method, messiness, partner's objection and a burning sensation. Few women reported a product-related complaint while using their assigned contraceptive method. The most commonly reported complaint for both methods was that use of the product led to an uncomfortable burning sensation for the woman and/or her partner. This complaint, however, was cited by less than 5% of the women in each group. Thus, a combination of low pregnancy rates, few complications and complaints and high continuation rates confirm the relative acceptability, effectiveness and short-term safety of these methods of contraception among this sample of Egyptian women.

Administration, Intravaginal↗
PubMed2000

Curricular change in medical schools: how to succeed.

Society's changing needs, advancing knowledge, and innovations in education require constant changes of medical school curricula. But successful curricular change occurs only through the dedicated efforts of effective change agents. This study systematically searched and synthesized the literature on educational curricular change (at all levels of instruction), as well as organizational change, to provide guidance for those who direct curricular change initiatives in medical schools. The focus was on the process of planning, implementing, and institutionalizing curricular change efforts; thus, only those articles that dealt with examining the change process and articulating the factors that promote or inhibit change efforts were included. In spite of the highly diverse literature reviewed, a consistent set of characteristics emerged as being associated with successful curricular change. The frequent reappearance of the same characteristics in the varied fields and settings suggests they are robust contributors to successful change. Specifically, the characteristics are in the areas of the organization's mission and goals, history of change in the organization, politics (internal networking, resource allocation, relationship with the external environment), organizational structure, need for change, scope and complexity of the innovation, cooperative climate, participation by the organization's members, communication, human resource development (training, incorporating new members, reward structure), evaluation, performance dip (i.e., the temporary decrease in an organization's performance as a new program is implemented), and leadership. These characteristics are discussed in detail and related specifically to curricular change in medical school settings.

Communication↗
PubMedDate not supplied

[Eficiency, equity or eficacy? Is it nurses or health systems dilemma?].

Besides the increasing costs of health technologies and the epidemic and demographic transactions, the causes of the current inadequacy of resources in the health field are also to be ascribed to people changed expectations toward nursing and medicine. Such aspects have put in a critical position the working of the health services, which are incapable of facing the escalating and relentless health expenses. The evidence-based approach to the clinical practice and the following output of guidelines as a solution to the rationing of health services, may, in someone opinion, make headway towards the control of expenditure because it allows a synergy between optimal and basic principles. The reasoned use of the resources does not only presuppose that nurses can decide, as far as the patient is concerned, what is strictly necessary and at the same time most effective to the fulfillment of the nursing needs which have been pinpointed; nurses should also commit themselves to organise for the best, according to their level of responsibility, the scenario where clinic decisions are taken and to affect the guidance processes of the strategic choices of the institution they are part of. Nurses, as other professional do, have to honour also a commission which implies, on different levels, to take on an executive function, a teamwork function, an active and responsible cooperation in the working of health service. A superficial and cursory use of the guidelines as an allocation of resources might, on the other hand, raise objections in the name of ethics: health cannot be treated as a commodity, nor can health be subjected to market laws of supply and demand. The degree of legitimation of a health policy must therefore derive from the degree of harmonization and coherence between an evidence element and a social and cultural context where both have to be put a test.

Delivery of Health Care↗
PubMed1993

A system approach to reducing relapse in schizophrenia.

Successful treatment of schizophrenia depends on understanding the nature of the disorder and providing a system of care with the primary locus in the community. Care must be continuous and must fulfill a wide variety of needs required for patients to make a stable adjustment to the community. The Dane County, Wisconsin, integrated system of community-based care is a proven model. It is based on the above principles and has resulted in more patients living independently and working productively, with fewer hospitalizations. The majority of funding for the Dane County Mental Health System is allocated to community services making it possible to offer a comprehensive set of programs. These programs work cooperatively to do whatever is needed to help patients achieve a stable life, of decent quality, in the community. The conceptual framework for the treatment of persons with schizophrenia, the principles of treatment, and a system of care based on those principles is discussed.

Activities of Daily Living↗
PubMed1988

Danish Breast Cancer Cooperative Group (DBCG). A description of the register of the nation-wide programme for primary breast cancer.

An account of the criteria for protocol allocation and of the various treatments in the DBCG programme is given together with some numerical representations. Furthermore the article explains how the DBCG programme has been run, including its randomization. Finally there is a description of the calculation of recurrence-free survival and survival. It is concluded that in the nation-wide programme there are only minor methodological errors, and that the conclusions based on the therapeutic outcome of the different therapies are reliable.

Breast Neoplasms↗
PubMed1981

Chenodiol (chenodeoxycholic acid) for dissolution of gallstones: the National Cooperative Gallstone Study. A controlled trial of efficacy and safety.

A double-masked study was conducted to determine the efficacy and safety of randomly allocated chenodiol (chenodeoxycholic acid, 750 mg/d or 350 mg/d) or placebo administered for 2 years to 916 patients for dissolution of radiolucent gallstones. There was confirmed complete dissolution in 13.5% of patients (750 mg/d), 5.2% (375 mg/d), and 0.8% (placebo), p less than 0.0001. Partial (over 50%) or complete dissolution (by validated roentgenographic metrology) occurred in 40.8% (750 mg/d), 23.6% (375 mg/d), and 11.0% (placebo), p less than 0.0001. Dissolution occurred more frequently in women, thin patients, or patients with small or floating gallstones or serum cholesterol greater than or equal to 227 mg/dL. Clinically significant hepatotoxicity occurred in 3% of patients (750 mg/d), 0.4% (375 mg/d), and 0.4% (placebo), p less than 0.007, and always was reversible biochemically. Elevations of 10% or more of serum cholesterol, mostly low-density lipoproteins, occurred in 85.2% of patients (750 mg/d), 82.8% (375 mg/d), and 67.0% (placebo), p less than 0.001. Chenodiol, 750 mg/d for up to 2 years, is appropriate therapy for dissolution of gallstones in selected patients who are informed of the risks and benefits.

Chemical and Drug Induced Liver Injury↗
PubMedDate not supplied

Implementing performance management in the Irish Health Sector.

To realize the goals of successive health strategies, managers in the Irish Health Sector will have to proactively facilitate optimal employee performance in line with policy objectives. Along with developing employee and teams' capabilities, these managers have begun to implement performance management to achieve the latter. However, there typically are a variety of foundational organizational characteristics required for the successful implementation of performance management. These include providing top-down support for line management buy-in, providing ongoing managerial and performance management training so that trusting relationships and a culture of consensus and cooperation are developed, and appropriately managing expectations. Agreement on employee role definitions and provision of team-based conflict resolution training is also needed to facilitate performance management. There is a need for negotiated performance indicators that are of various types, specific, measurable, and aligned with strategy objectives. Associated reward systems need to be holistic and imaginative, and personal development plans need to have a broader focus than merely improving current job skills and performance. Performance review needs to be ongoing, conducted in a transparent manner, and allocated sufficient discussion time. Managers also need to be mindful of managing overperformance.

Cooperative Behavior↗
PubMed1983

An experimental study of covert extinction on smoking cessation.

Twenty-one subjects participated on a volunteer nonpaid basis in a smoking cessation treatment experiment. The subjects were randomly assigned to three groups: one receiving training in covert extinction, one in relaxation, and a waiting list group serving as a control group. Behavioral (number of cigarettes smoked), physiological (pulse rate during treatment sessions) and cognitive (craving for cigarettes) assessments were made during and between sessions. Analysis of variance showed the time variable to be significant for number of cigarettes. Tukey's HSD tests showed a significant decrease in smoking after treatment for all three groups, and also for the two treatment groups until the follow-up occasion, although smoking had returned to a higher level (though not the initial one) after one month. There were also significant differences between the control group and both treatment groups with regards to pulse rate changes in treatment sessions. There was no significant change in craving, although a tendency pointed in the same direction for pulse rates. A tentative conclusion is that covert extinction is not a specific effective treatment method surpassing other nonspecific treatment procedures.

Adult↗
PubMed2003

Backing up behaviors in teams: the role of personality and legitimacy of need.

In this article, the authors developed several hypotheses regarding both the main and interactive effects of 2 types of team inputs on backing up behaviors in teams: (a) team composition characteristics in terms of the personality of the members of the team and (b) team task characteristics in terms of the extent to which the nature of the task is one that legitimately calls for some members of the team to back up other members of the team. Results from a study of 71 4-person teams performing a computerized tactical decision-making task suggest that the legitimacy of the need for back up has an important main effect on the extent to which team members provide assistance to and receive assistance from each other. In addition, the legitimacy of the need for back up also has important interactive effects with both the personality of the back up recipient and the personality of the back up providers on backing up behaviors in teams.

Cooperative Behavior↗
PubMed2003

Groups perform better than the best individuals on letters-to-numbers problems: informative equations and effective strategies.

One-hundred 3-person groups and 300 individuals solved 2 letters-to-numbers problems, requiring identification of the coding of 10 letters to 10 numbers by proposing an equation in letters, receiving the answer in letters, proposing a hypothesis, and receiving feedback on the hypothesis on each trial. There were 5 instruction conditions: (a). standard, (b). use at least 3 letters on all equations, (c). use at least 4 letters on all equations, (d). number 1 known before beginning problem, and (e). number 9 known before beginning problem. The groups had fewer trials to solution, proposed more complex equations, and identified more letters per equation than the best individuals. Performance was best under instructions to use at least 4 letters and with the number 9 known.

Cooperative Behavior↗
PubMed2004

The emergent role of the link worker: a study in collaboration.

Partnership working is integral to New Labour's approach to modernising health and social care services for vulnerable groups such as children with complex needs. This paper draws on an initiative from Cornwall and the Isles of Scilly in which strategic and operational change have been promoted across the health and social care community in order to provide co-ordinated assessment and care for children with complex needs and their families. The introduction of link workers has been central, key contacts for families and professionals alike who are drawn from a wide range of backgrounds. The political imperative for partnership, combined with the commitment and commonality of purpose of front-line staff, has proved sufficient to facilitate inter-professional working without many of the enabling factors that are often regarded as important, such as co-location or parity of status. However, a number of organisational barriers to sustainability remain and the degree to which a strong operational lead can secure the necessary breadth of strategic resource allocation and support remains questionable.

Community Health Services↗
PubMed1993

Transplantation of organs: a European perspective.

The development of transplantation technology increasingly places before society a multitude of diverse, complex ethical and legal problems. The subject is the more complex because of the various divergent interests involved. There are the interests of the donor of organs, who has a right to protection of his legal position, and those of the patient in need of an often lifesaving organ. There are also the interests of the donor's relatives, after his death, and those of the transplantation surgeons. The international dimension of transplantation technology makes the picture even more complicated. Though this article is devoted to the European situation, the problems are similar all over the world.... These matters are solved primarily within the national context: answers are given in accordance with the national socio-cultural background. The overall European (legislative) picture is one of diversity.... This paper will, however, not present a comparative review of legislation in European countries. Instead, it concentrates on the European dimension of the various problems surrounding transplantation technology. First, some specific problems common to the majority of European countries will be presented. Following that, the European dimension will be reflected upon from the perspective of enlarging the potential donor pool.

Aborted Fetus↗