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PubMedDate not supplied

Nursing informatics in Australia.

The development of nursing informatics in Australia began around 1984 and has had a tortuous history. Nevertheless, it has helped create awareness of the discipline of informatics and the technology available. Nurses have been important in stimulating interest in health informatics throughout the country. This paper discusses nursing informatics in Australia in terms of historical roots, professional organizations, education, work experience, research, and government programs.

Australia↗
PubMed1997

Cancer screening and prevention in rural Wisconsin: the Greater Marshfield Experience.

BACKGROUND: Providing medical services to rural residents results in unique challenges to providers and patients. Cancer screening (CS) and early detection services (EDS) are frequently underutilized with rural residents often presenting with advanced cancer at diagnosis. A comprehensive approach to determine barriers and overcome them constitutes "The Greater Marshfield Experience." METHODS: Focus groups with rural residents determined the greatest barriers to receipt of CS and EDS were distance, cost, time from work and self-reliant behavior. Directives to address these concerns were to keep information simple and provide services at the workplace. In response, Marshfield Clinic and its research division developed a collaborative research partnership with public health agencies (PHA), federally funded government programs and volunteer agencies. RESULTS: In-house activities to remove barriers for providing CS and EDS included the development of a separate screening unit for these activities. Reminder systems were employed to notify patients of the need and availability of preventative services. Co-payments for health screening services were eliminated from the clinic owned health plan. Area residents near poverty level were encouraged to enroll in federally subsidized health plans that promoted and paid for CS and EDS. Federally funded cancer screening studies were implemented that funded breast and cervical cancer screening and evaluated the benefits of screening for prostate, lung, colorectal and ovarian cancers (PLCO). Outreach activities included developing partnerships with local PHA and minority groups and providing mobile screening services to remote areas. CONCLUSION: Concentrated, collaborative efforts to develop in-house systems and outreach activities resulted in delivery of CS and EDS in remote areas.

Adult↗
PubMed1998

A new measure of contemporary life stress: development, validation, and reliability of the CRISYS.

OBJECTIVE: To develop and validate a measure of contemporary life stressors. STUDY SETTING: Three interview studies: Study 1 (pilot), 32 caregivers receiving case management services for a child with chronic illness; Study 2 (validation), 311 caregivers of children receiving general pediatric care at a university clinic; Study 3 (reliability), 17 caregivers of children with a complex medical diagnosis. STUDY DESIGN: Study 1: item development via discussions with case managers; piloted with caregivers. Study 2 examined psychometric properties of the measure and correlated it with the CES-D, a measure of depressive symptomatology and the PRQ85-Part 2, a measure of perceived social support, to establish its convergent construct validity. Study 3 established the test-retest reliability of the measure over two weeks by correlating two administrations of the index. DATA COLLECTION: Face-to-face interviews in homes (Study 1) or in clinic waiting rooms (Studies 2 and 3) and by telephone (Study 3 retest). PRINCIPAL FINDINGS: The CRISYS is a flexible, multidimensional tool that demonstrates strong face, content, and construct validity, and excellent test-retest reliability. The format is easy to use and well accepted by respondents and is suitable for low-income populations. CONCLUSIONS: Researchers will find the CRISYS useful when evaluating the success of a clinical model or a healthcare system, and the effectiveness of an insurance plan or a government program. Clinicians may also find that the CRISYS is an effective screen for family needs.

Adult↗
PubMed1985

U.S. Government quality control program for Limulus amebocyte lysate and endotoxin.

The U.S. Government has licensed seven Limulus Amebocyte Lysate manufacturers. Each manufacturer must determine the sensitivity of each lot by using the U.S. Standard Endotoxin, EC-5 which is identical to the U.S. Pharmacopeia (USP) Endotoxin Standard (Lot F). A licensed firm must be inspected annually and submit a protocol along with potency testing results on each lot of lysate before it can be released. The FDA tests each lot for at least potency before releasing it to be marketed. The release criteria for both the gelation and chromogenic lysate tests are discussed.

Chromogenic Compounds↗
PubMed2004

International pediatric cardiac assistance in Croatia: results of the 10 year program.

AIM: In an effort to help alleviate the lack of an adequate pediatric cardiac surgical service that existed in Croatia following 1991 the International Childrens Heart Foundation (ICHF) was asked to provide the necessary surgery. Initially, this project was undertaken as a humanitarian program to provide pediatric cardiac operations. After 5 years, the Republic of Croatia financially sponsored the program. The intended purpose of the Government Sponsored Program was to provide staff education, clinical services, and the development of an organized pediatric cardiac service team in country. The surgical results of the humanitarian program and the educational and surgical results of the Government sponsored program are reported. METHODS: Review of 3 separate databases maintained in country and the database of the ICHF in Memphis, Tennessee, was undertaken. Risk classification of the operations performed was performed using the Risk Adjustment in Congenital Heart Surgery method. RESULTS: A total of 32 trips (11 during the Humanitarian Program, and 21 during the Government Sponsored Program) were made between April 1993 and July 2003. A total of 601 primary operations (151 - Humanitarian Program, 450 - Government Sponsored Program) were preformed. Overall mortality in the cardiac surgical department for the Government Sponsored Program was 11%, non-risk adjusted. There were 4 senior surgeons, 3 surgical residents, 6 cardiac anesthesiologists, 2 pediatric intensivists, and 3 pediatric cardiologists involved in the educational program. CONCLUSIONS: The combination of humanitarian and government sponsored pediatric cardiac surgical missions provided 601 Croatian children with operations. Substantial progress was made in the areas of anesthesia, perfusion, and postoperative care in the cardiac surgical intensive care unit. Despite these improvements a number of issues still exist that prevent the development of an independently functioning full service pediatric cardiac program.

Altruism↗
PubMed2001

The impact of Federal Alcohol and Drug Abuse block grants on state and local government substance abuse program expenditures: the role of federal oversight.

Are the federal Alcohol and Drug Abuse (ADA) block grant funds substituting for or supplementing state and local government spending on substance abuse? Using panel data on state and local government substance abuse programs, this study explores the fiscal effects of the ADA block grant money and the increased enforcement (after 1989) of federal restrictions on state spending of ADA block grants. The findings here reveal that for the current period, the federal ADA grant has no statistically significant effect on state and local government substance abuse spending both before and after 1989, and the increased enforcement of federal restrictions on the ADA grants after 1989 does not change this result. An additional finding is that lagged ADA grants have had a large effect on substance abuse spending both before and after 1989--a feature of the program not considered in previous studies.

Financing, Government↗
PubMed1995

[Feasibility of "well-aging facility" of "well-aging community promotion program"].

The government "Well-Aging Community Promotion Program" (WAC) defines a "Well-Aging Facility" (WAF) consisting of a gymnasium for the elderly, an education-center for the elderly, a service-center for handicapped elderly and their families, and a fee-for-service nursing home, and incorporated funding provisions for WAF. Because of economic reasons, with the exception of fee-for-service nursing home, there is only one WAF at present. An economic-feasibility study of WAF was conducted based on regional analysis of existing public facilities and the needs of the elderly, and proposals for promoting WAF and WAC were made. The results are as follows: 1. In large and middle-size cities, many types of public facilities exist within walking distance, but the number per capita of elderly is low. In small-size cities and towns the number per capita of elderly is high, but are rarely within walking distance. 2. Rather than investment in facilities, the role of private business in WAC can be described as investment in services such as management-services for public facilities and transportation among facilities. 3. As for economic feasibility of WAF, in large and middle-size cities the education-center is viable, but for the gymnasium facility it would be based on utilization of facilities not only for elderly but multi-generational. The feasibility for the service-center will be high in large cities but low in middle-size cities. 4. For small-size cities and towns, the management of the gymnasium, and the education-center will be feasible, but the service-center will be difficult. 5. To promote WAC in small-size cities and towns, the following will be needed. a. The development of transportation systems between homes and facilities. b. The promotion of multi-purpose use of facilities beyond the established purpose of each WAC public facility. c. The establishment of new multi-sectional management entities by both the public and private sectors to manage existing public facilities. d. Development of financial support program by the government for upgrading and remodeling of existing facilities to function as an alternative of the WAF.

Aged↗
PubMedDate not supplied

Beyond supply: the importance of female family planning workers in rural Bangladesh.

Using participant observation data on worker-client exchanges from Bangladesh, this article examines the interface between a government family planning program and the rural women it serves. Case material focuses first on the program function typically identified in the literature: meeting unmet demand for contraception by providing convenient supply. Functions that have been less recognized are then illustrated: (1) the worker's role in reducing fear of contraceptive technology; (2) her effort to address religious barriers, child mortality risks, and high fertility preferences; and (3) her role in mobilizing male support. The range of functions performed by the female family planning worker in the cases discussed here demonstrates that her role transcends the boundaries of what is conventionally implied by the concept of supply. She acts as an agent of change whose presence helps to shift reproductive decision-making away from passivity, exposing women long secluded by the tradition of purdah to the modern notion of deliberate choice.

Bangladesh↗
PubMed1995

Written patient information on prescription drugs. The evolution of government and voluntary programs in the United States.

This paper describes the evolution of written patient information on prescription drugs, FDA's patient package insert proposal and its revocation before its implementation in the early 1980s, the status of voluntary and government efforts since that time, and a review of current trends in this area. The burgeoning practice of direct-to-consumer advertising of prescription drugs in the lay press is viewed within the context of these efforts. This paper also reviews the current developments in certain FDA-regulated consumer products--over-the-counter drug labeling and nutrition labeling. The current state of patient information in the United States is reviewed in light of programs to improve prescription drug counseling, and current research in this area is discussed.

Consumer Advocacy↗
PubMed1980

Environmental Protection Agency--Hazardous waste and consolidated permit regulations, Parts X-XI. Final rule.

This rule establishes consolidated permit program requirements governing the Hazardous Waste Management program under the Resource Conservation and Recovery Act (RCRA), the Underground Injection Control (UIC) program under the Safe Drinking Water Act (SDWA), the National Pollutant Discharge Elimination System (NPDES) program and State Dredge on Fill ("404") programs under the Clean Water Act (CWA), and the Prevention of Significant Deterioration (PSD) program under the Clean Air Act, for three primary purposes: (1) To consolidate program requirements for the RCRA and UIC programs with those already established for the NPDES program. (2) To establish requirements for State programs under the RCRA, UIC, and Section 404 programs. (3) To consolidate permit issuance procedures for EPA-issued Prevention of Significant Deterioration permits under the Clean Air Act with those for the RCRA, UIC, and NPDES programs.

Government Agencies↗