Graduate program designed to prepare dentists to practice endodontics.
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Physical activity and sports-recreation experiences play an important part in the psychosomatic development of the multihandicapped. The importance of treating the multihandicapped individual as a whole and not keeping the motoric handicap in isolation is pointed out. Based on a theoretical framework for physical activity and sports programs, the complexity of issues in assessment, sports program design and sports competition is discussed. Some 200 multihandicapped individuals are assessed in their various ability levels and place into respective ability groups prior to the events. The competition events consist of track and field activities as well as a swimming event. The competition is open to manual as well as electric (12V; 24V) wheelchairs, respectively. Assessment procedures and results are described in detail for the track and field events. Assessment and participation in the swim event require the individual to swim a distance of 25 yards in two separate ability groups, 1) with adaptive floatation and, 2) without the aid. The sport events are organized for public school application as well as institutional settings without the need for a great amount of equipment. In designing programs and facilities to accommodate sports programs it is important to design for the functioning of the individual and not in such a way as to force the individual to function within the limits of the program design. If we are to make the multihandicapped comfortable in the mainstream of everyday life, it is the sports and recreation leader's responsibility to asses and present activities that aid in constantly excelling in physical and emotional development.
Designing and implementing an infection control program for home care poses many challenges. Some of these challenges stem from a long-standing lack of research and on-site expertise in the home care setting. Recent changes in health care and the proliferation of external regulations regarding home care practice further complicate the development of an effective and efficient infection control program.
OBJECTIVES: To describe a geriatric mental health outreach program based on a community development model and to review 4 years of experience with this program. DESIGN: Program model and description of implementation experience. SETTINGS: A geriatric mental health outreach program of a regional psychiatric hospital, serving a primarily non-urban area, with offices in the community it serves. PARTICIPANTS: The program targets community-dwelling or institutionalized older persons with late-onset mental health problems and/or behavioral disturbances, persons with long-standing psychiatric disorders with age-related changes, and their caregivers. INTERVENTION: The program is a geriatric mental health outreach and consultation service that emphasizes community development and caregiver education. Program components include an interprofessional consultation team, a specialized information and resource service, educational service initiatives, and an ongoing role in planning and coordination activity in the local health care system. MEASUREMENTS: Program monitoring, including a patient database and a description of program activities. RESULTS: Cognitive impairment, behavioral disturbance, physical/medical problems and depression are the most common reasons for referral to the outreach program. Referred patients (mean age 78; 65% female) have usually (almost 90% of cases) been managed at a similar or lower level of care. Program activities have included focused educational initiatives in community and institutional settings and have emphasized the involvement and development of community caregivers and other local resources. CONCLUSION: The program is a multifaceted effort to make efficient use of scarce specialized resources in a manner that is sensitive and responsive to local circumstances and needs. Experience to date has shown evidence of the feasibility and potential benefits of a comprehensive approach to community development and outreach in geriatric mental health.
To provide a forum for the exchange of ideas regarding the role of colleges of pharmacy in meeting the pharmaceutical industry's pharmacoeconomic needs, an invitational conference was conducted by the University of Arizona's Center for Pharmaceutical Economics on January 14 and 15, 1993, in Tucson, Arizona. This article represents the program design, program types, and consensus development portions of that conference. A description of current needs in pharmacoeconomics was obtained through transcripts of industry and university presentations, panel discussions, and question-and-answer sessions. Conference participants generally agreed that pharmacoeconomics holds great potential for making significant contributions to health care but that it will not flourish without deliberate and cooperative efforts. Participants from both industry and academia voiced the need for the two parties to work together to increase the visibility and understanding of pharmacoeconomics and to meet the training and staffing challenges facing the discipline.
The objectives of toxicokinetic (TK) studies are to evaluate systemic exposure of the toxicity species to drug and/or metabolite(s) and to relate exposure to dose level and toxicological findings. The tacit assumption is that such exposure can be related to target organ toxicity. Planning a TK program involves early development (often during discovery support) of an appropriate plasma assay, assurance that the studies conform to Good Laboratory Practices, evaluating exposure at steady state, and effective collaboration among toxicologists, kineticists, and other relevant disciplines. The 3 types of TK studies--prospective, concomitant, and retrospective--each have different goals. The various stages of TK program implementation range from those during drug discovery and selection to support of chronic toxicity studies. Exposure is best expressed as the area under the plasma concentration/time curve of drug and/or metabolite(s) and, for highly protein bound drugs, is based on the unbound fraction. Although the objectives of TK programs are generally standard and the Second International Conference on Harmonization has developed TK guidelines, the programs differ among pharmaceutical companies. Some variables in program design and implementation include properties of the drug, formulation used, characteristics of the target species, ability to develop a toxicokinetic-toxicodynamic relationship, strategies based on scientific/technical/philosophical considerations, dedicated resources, corporate support, and effectiveness of interdepartmental collaborations.