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At least 307 records · Page 17Linked to original sources
PubMed1987

PEDA: a microcomputer program for parameter estimation and dosage adjustment in clinical practice.

PEDA, an integrated program in BASIC for implementation on microcomputers, has been developed for use in clinical practice to assist dosage adjustment for individual patients. A parameter optimization for individual patients is based on the principle of Bayes' theory and Maximum Likelihood Estimation, and utilizes a prior information on the distribution of population pharmacokinetic parameters, means and variances, as well as serum drug concentrations. The program can accommodate a one-compartment open linear model and a non-linear model at steady state (Michaelis-Menten model) and handle both uniform and non-uniform multiple dosage regimens mostly arising from clinical settings. Clinical examples which demonstrate the ability and the flexibility of the program are provided. The program may also be used as an aid for instruction in clinical pharmacokinetics.

Adult↗
PubMed2002

Informatics training in pathology residency programs.

Information management is crucial in pathology, and previous reports have stressed the needfor improved informatics training in pathology residency programs. We surveyed 150 US programs to assess informatics training with respect to types of training, proficiency expectations, and computing infrastructure. Seventy-two programs (48.0%) responded. Of the respondents, 67 (93%) reported offering informatics training; of these, 52 (78%) required it. Most programs integrated informatics into another rotation, usually management. In 37 programs (55%), the amount of informatics training has increased during the last 3 to 5 years. The most common instructional methods were hands-on training and self-study; 61 programs (91%) used multiple methods. In all but 2 programs, computers were designated for residents; 9 programs offered individual computers to residents. All programs provided productivity software. These data suggest progress in informatics training but that considerable room for improvement exists. Our data also document for the first time detailed computing resources available to residents.

Internet↗
PubMedDate not supplied

Educating students with mild disabilities in general education classrooms: Minnesota alternatives.

This article reports two major data collection efforts conducted during successive years. Study 1 examined the relationship between the school effectiveness variables identified in the Minnesota Educational Effectiveness Project (MEEP), and the attitudes and achievement of students in 31 MEEP schools. Study 2, which focused on 11 of the Study 1 schools, compared the instructional programs provided to students with mild disabilities in three integrated programs in these 11 schools, with those provided by conventional resource "pull-out" programs in three other schools. We not only contrasted program characteristics, but analyzed differences between program characteristics and cognitive and affective outcomes. Results do not provide a strong basis for concluding that general efforts at school improvement will provide the framework for improved outcomes among low-achieving students.

Achievement↗
PubMed1992

Moving Out Services for Education and Support (MOSES): a model program for individuals with spinal cord injury.

A comprehensive educational, social, and community integrated program for individuals with spinal cord injury (SCI) was established at Mount Sinai Medical Center. The need for this program was evident from patients' responses to mailed questionnaires and staff's direct observations of the difficulties encountered by SCI patients when they left the hospital's protected environment and began to cope with living in their communities. The program, Moving Out Services for Education and Support (MOSES), provides relevant information and support to individuals with spinal cord injury as they make the transition from patient to community member. The goal of the program is to foster independence and initiative and to develop leadership skills which enhance successful community reintegration. This article describes the program development, content and training requirements for implementation of these services.

Activities of Daily Living↗
PubMed2000

Behavioral medicine in medical education: report of a survey.

Behavioral medicine has become increasingly important in medical education over the past two decades, but adoption of its principles and methods has been slow. Behavioral medicine stresses the effects of human behavior on health and illness using a biopsychosocial approach. It also focuses on the use of the doctor-patient relationship, which, if developed using appropriate communication skills, can result in greater patient satisfaction and increased compliance. The authors surveyed all 124 American medical schools to assess both national trends and specific efforts in the teaching of behavioral medicine principles and methods. A review of the types of behavioral medicine programs offered reveals that eight percent of U.S. medical schools had integrated programs of behavioral medicine. Several successful and effective programs were identified, as were a number of specific curricular components. There are several options available to medical schools to integrate behavioral medicine into medical education. The authors conclude that medical education must include behavioral medicine in order to improve the health of the public and to meet the demands of a changing health care system.

Behavioral Medicine↗
PubMedDate not supplied

Policy issues for learning disability computer integration.

With the current expansion and development of educational computing in public and private schools across the country, policy issues for computer integration can be extremely important for educators. In the present article, research on a 3-year computer integration program at a private school for students with learning disabilities is used to illustrate integration issues. Problems and limitations in the computer program, ranging from lack of direction, support, and leadership from the administration to the lack of funds for maintenance or development, are identified and discussed. Policies and implications for the future of educational computing for students with learning disabilities as well as for private schools are examined.

Adolescent↗
PubMed1986

Patterns of otolaryngologic surgery utilization in Syracuse, NY.

Utilization of otolaryngologic surgical procedures performed in Syracuse, NY, during 1983 and 1984 was evaluated. Both inpatient and outpatient procedures were included; classification was according to diagnosis related groups. The system-wide portion of the analysis demonstrated that 62.5% of otolaryngologic operations carried out during the study were performed in outpatient settings. Total utilization was highest for myringotomies, tonsillectomies, and adenoidectomies, over 80% of which were performed on an outpatient basis. The program-specific portion of the analysis indicated that the highest volumes for these procedures were produced by a free-standing ambulatory surgery program with dedicated facilities and staff. However, a hospital-integrated program, which made use of inpatient resources, also served a majority of total hospital cases for several types of procedures.

Adenoidectomy↗
PubMedDate not supplied

A combined community strategy to reduce cholesterol and other risk factors.

Our primary objective was to conduct an integrated program to reduce coronary risk factors in the population of an Israeli kibbutz. The population-based objective was to reduce the mean community total cholesterol level. The individual-based objective was to provide counseling and treatment for individuals at high risk and to reduce individual total and low-density lipoprotein cholesterol levels. The intervention included food policy changes in the central kibbutz kitchen, health education programs aimed at all age groups, and health counseling for individuals at risk. Evaluation was by questionnaire at baseline and at the end of two years, blood lipoproteins, and monitoring of all food purchased by the kibbutz. Fifty-three percent of the adult population (100 of 187) had borderline to high baseline total cholesterol levels. At one year, 27% of these were in the normal category. Egg consumption dropped by 6%, liquid oil by 7%, and red meat by close to 19%. Consumption of fish, chicken meat, and vegetarian patties increased. Consumption of 1% milk increased by almost 300%. We conclude that an integrated health education program targeting individuals and the community together can be effective in reducing risk factors for coronary artery disease.

Adult↗
PubMed1986

Clinical oral medicine. An exciting facet of postdoctoral periodontic training.

This paper briefly reviews the historical relationship between oral medicine and periodontics. The reasons for including structured clinical oral medicine in a postdoctoral program in periodontics are discussed. Problems and solutions to such an integrated program are outlined. Guidelines for broadening the base of the field of periodontics by expanding the specialty more vigorously into the area of clinical oral medicine are provided.

Curriculum↗
PubMedDate not supplied

The benefits and challenges of a fitness and lifestyle enhancement program for correctional officers.

This paper documents the benefits and difficulties encountered in the development of an on-site exercise and lifestyle enhancement program for correctional officers. 25 male correctional officers participated in a 6.5-week strength and aerobic training program integrated with penitentiary duties. 21 officers were available for retesting. The program was associated with decreases in body weight, skinfold thickness, cholesterol levels and increases in HDL-cholesterol, chest girth, strength scores and muscular endurance. Resting heart rates and systolic blood pressures were reduced but there was no significant change in maximal oxygen consumption. Furthermore, there were favourable changes in smoking and alcohol consumption, sleeping patterns, nutritional habits and tolerance of stress. These results are probably typical of what can be expected from a program of this type. We conclude that a brief at-work exercise and health enhancement program can exert positive but modest influences on the fitness, health and lifestyle of correctional officers, without undermining security of the institution. However, if this type of program is to achieve beneficial effects on health and fitness, a number of difficulties must be addressed.

Adult↗
PubMed1987

Modeling: a method for program development.

Successful program development is crucial for nursing. The methodology of modeling systematically integrates program development strategies recommended in the nursing literature. In addition to guiding program planning and design, the series of diagrams which modeling generates can be used to guide program implementation, evaluation, refinement, and reformulation. The diagramming also facilitates communication with others about the program.

Health Services Needs and Demand↗
PubMedDate not supplied

[Evaluation of a supervision program of health centers at the district level in Madagascar].

Poor supervision and follow-up have long been recognized as major weaknesses in the development of primary health care in many countries. A program has therefore been specifically developed to strengthen the supervision activities of 18 rural health centers in Madagascar. District health officers were appropriately trained and then conducted two-monthly supervision visits. The emphasis of the training program was on problem solving, program integration and on-site training. The effects of the supervision program was assessed quantitatively and objectively. Various activities of each health center were scored before intervention, and one year after implementation of the supervision program. The improvement in most health centers was substantial, both in quantitative coverage and qualitative practice. Nevertheless, some centers appear to have been resistant to change.

Diarrhea↗
PubMed2004

Low back pain: an economic assessment in the United States.

Although it is clear that LBP imposes a grave economic cost on society, the lack of consensus on causes and appropriate treatments makes it difficult to develop explicit guidelines and best practices. To gain a greater understanding of the economic impact of the condition and to reduce the unnecessary procedures that patients undergo, a series of cost-effectiveness analyses on established treatment options and on proposed integrated programs of prevention, treatment, and counseling, would be not only informative but integral to the progress of LBP disease management.

Cost of Illness↗
PubMed1989

Strategies for improving services for the chronic mentally ill.

A central goal of policies aimed at improving care of the chronic mentally ill is better service coordination and integration. The author examines four current policy strategies--continuous care teams, local mental health authorities, integrated entitlement programs, and capitation payment systems--and discusses their incorporation in four model programs of integrated services. The programs differ in the degree to which they attempt to direct service coordination at the patient level, but all four programs have created local mental health authorities to oversee services. The success of any of the policy strategies depends on a system's capacity not only to regulate services but to ensure that presumed incentives to deliver cost-effective services filter down to well-trained and motivated front-line staff.

Chronic Disease↗
PubMedDate not supplied

[Status of day care treatment of elderly psychiatric patients in West Germany and West Berlin].

The possibilities as well as the limits of day-hospital treatment for elderly mentally ill patients are described, using as a basis a general survey on the situation of psychiatric day-hospitals in the Federal Republic of Germany and West Berlin. As of July 1, 1982, there were at least seven day-hospitals specializing in psychogeriatric patients, whereas a further eight institutions admitted elderly mentally ill patients as well as the usual patients. For all these day-hospitals a review of the current status is given regarding funds, size of program, integration into the existing network of psychiatric services, referral sources, the individual programs perceived mission, clientele, exclusionary criteria, duration of stay, therapeutic activities and staffing. Finally problems such as indication, clientele and delimitation of other ways of treatment are discussed. Questions are asked with regard to the purpose and the necessity of specialized psycho-geriatric partial hospitalization programs.

Aged↗
PubMed2004

Development and implementation of nonpharmacologic protocols for the management of patients with Alzheimer's disease and their families in a multiracial primary care setting.

PURPOSE: Most patients and families with dementia are cared for in primary care clinics. These clinics are seldom designed to provide the necessary comprehensive care. The purpose of this article is to describe nonpharmacologic protocols for the management of patients with Alzheimer's disease and their families that are administered as part of a multifaceted care-management intervention program in a multiracial primary care clinic. DESIGN & METHODS: The nonpharmacologic component for the integrated program of collaborative care was developed based on a literature review and previous clinical experience. The care is coordinated by a geriatric nurse practitioner who meets with patients, families, and the primary care physicians. The nonpharmacologic protocols included general educational guidelines about Alzheimer's disease. Specific protocols to treat the common behavioral disturbances associated with Alzheimer's disease also were developed. A major component of the intervention is a monthly psychoeducational support group for caregivers. RESULTS: The intervention has been well accepted by patients, families, and physicians. Approximately one-half of the treatment group has participated in the support group regularly. IMPLICATIONS: The integration of behavioral interventions and team care within the primary care environment has been successful.

Aged↗
PubMed1980

[Behavior therapy and communication theory as treatment for inpatients with anorexia nervosa (author's transl)].

A staged program for inpatient treatment of anorexia nervosa is presented. This program integrates behaviour-therapeutic and interactional models. Results show that five of seven patients completed the program successfully and maintained their stable condition after an average catamnestic period of 16 months. The necessity of integrating both models and the practical difficulties in a clinical setting are discussed.

Adolescent↗
PubMed1993

A curriculum based on systems theory.

This paper describes an entry-level curriculum based on systems theory that was designed to promote integrated thinking and a shared image of practice among all of the members of an educational community that included students, faculty, and clinicians. Initiated in 1983, the program integrates occupational therapy theory, critical thinking, and knowledge about person-environmental transactions with traditional medical, biological, psychological, and sociological course work to create a unique educational experience. The curriculum model is based on a spiral learning process that encourages integrated thinking. Furthermore, all concepts are systematically tied to the occupation core, the central theme of the program. Fieldwork is used to reinforce ideas presented in the classroom and features discrete learning experiences where students demonstrate their integration of knowledge and skills. In an evaluation of the program, responses from 78 clinician, 51 alumni, and 132 student questionnaires; feedback from 132 fieldwork supervisors; and longitudinal data from 33 alumni confirmed that graduates are critical thinkers who appreciate the diverse needs of clients while demonstrating an appreciation for the curative effect of meaningful, goal-directed activities.

Curriculum↗