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PubMedDate not supplied

Developing a web-based data mining application to impact community health improvement initiatives: the Virginia Atlas of Community Health.

This article describes how a team from the Virginia Department of Health (VDH) and the Virginia Center for Healthy Communities (VCHC) attended the UNC Management Academy for Public Health to learn skills to address Virginia's commitment to using technology to improve the public's health. After creating a business plan for a food-safety information Web site, team members used that experience as well as Management Academy training in information technology, the management of data and finances, and strategic partnering to create a comprehensive tool with which to place customizable population data in the hands of anyone interested in pursuing population health improvement. The Virginia Atlas of Community Health, launched through the VCHC in 2003, places clear, compelling data in the hands of those who can influence decisions at the local level and create the most impact for health. Since the program's inception, more than 2,000 individuals have registered as ongoing users of the Virginia Atlas. Initially funded by a Turning Point grant from the Robert Wood Johnson Foundation, the program is sustained through a series of smaller grants and funding from the VDH.

Atlases as Topic↗
PubMed2002

Aplidin induces apoptosis in human cancer cells via glutathione depletion and sustained activation of the epidermal growth factor receptor, Src, JNK, and p38 MAPK.

We report that Aplidin, a novel antitumor agent of marine origin presently undergoing Phase II clinical trials, induced growth arrest and apoptosis in human MDA-MB-231 breast cancer cells at nanomolar concentrations. Aplidin induced a specific cellular stress response program, including sustained activation of the epidermal growth factor receptor (EGFR), the non-receptor protein-tyrosine kinase Src, and the serine/threonine kinases JNK and p38 MAPK. Aplidin-induced apoptosis was only partially blocked by the general caspase inhibitor benzyloxycarbonyl-VAD-fluoromethyl ketone and was also sensitive to AG1478 (an EGFR inhibitor), PP2 (an Src inhibitor), and SB203580 (an inhibitor of JNK and p38 MAPK) in MDA-MB-231 cells. Supporting a role for EGFR in Aplidin action, EGFR-deficient mouse embryo fibroblasts underwent apoptosis upon treatment more slowly than wild-type EGFR fibroblasts and also showed delayed JNK and reduced p38 MAPK activation. N-Acetylcysteine and ebselen (but not other antioxidants such as diphenyleneiodonium, Tiron, catalase, ascorbic acid, and vitamin E) reduced EGFR activation by Aplidin. N-Acetylcysteine and PP2 also partially inhibited JNK and p38 MAPK activation. The intracellular level of GSH affected Aplidin action; pretreatment of cells with GSH or N-acetylcysteine inhibited, whereas GSH depletion caused, hyperinduction of EGFR, Src, JNK, and p38 MAPK. Remarkably, Aplidin also induced apoptosis and activated EGFR, JNK, and p38 MAPK in two cell lines (A-498 and ACHN) derived from human renal cancer, a neoplasia that is highly refractory to chemotherapy. These data provide a molecular basis for the anticancer activity of Aplidin.

Animals↗
PubMed2006

Public health needs a strong, well-planned advocacy program.

Public health is the poor relation in the health system and attracted little additional funding from the 2006 Budget. A modest increase in the allocation to prevention would enable significant advances to be made across a wide range of public health activity and research areas. PHAA should take the lead in developing a planned and sustained advocacy program.

Australia↗
PubMed1993

Long-term recovery from alcoholism.

AA has demonstrated success in steadily increasing membership, with no loss of the proportion of those with over 5 years of sobriety. It has been recognized as effective long-term treatment for alcoholism by psychiatrists and psychoanalysts experienced in treatment of the addictions. The triennial membership surveys of AA have shown stability in 1. A 50% dropout rate within the first 3 months of starting AA. Only 41% of those in the first year will remain in the Fellowship for another year. 2. Roughly equal numbers of those with less than 1 year, 1 to 5 years, and over 5 years of sobriety, with an average length of sobriety of about 4 years. 3. Members having a sponsor (85%) and belonging to a home group (88%). 4. Attendance by members of about three meetings a week, regardless of duration of sobriety. 5. Members telling their doctor that they are in AA, but not helping him or her learn about the program. The survey data also indicate that AA is changing in the following ways: 1. The number of women members has increased to more than one third the total membership. 2. An increasing number of young people, under 30 years of age, to more than one fifth the total. 3. A decreasing number of older people, over 50 years of age, to just under one fourth the total. 4. An increasing number of members who were also addicted to other drugs (46%). Psychiatrists can use these data and knowledge of AA to 1. Increase the effectiveness of referrals of alcoholic patients to AA regardless of age, sex, race, or other characteristics. All are welcome and can benefit. 2. Deal with resistance, which occurs when patients begin to make contact with AA. 3. Help alcoholic patients through the difficult first year of sobriety. 4. Encourage their alcoholic patients to use AA as a program for personal growth and development. 5. Helping dually addicted patients use AA's singleness of purpose to facilitate their recovery. 6. Cooperate with alcohol and drug treatment programs in helping patients transfer to AA and work on an effective program of recovery. 7. Work with members of the local AA Treatment Facilities and Cooperation with the Professional Community Committees in helping alcoholic patients enter and use AA. 8. Provide psychiatric treatment for AA members in ways that support and sustain their program of recovery, especially by avoiding dependence-producing medications.

Alcoholics Anonymous↗
PubMed2026

Global reach and sustained engagement of a structured digital education program in medical mycology: an observational analysis of the 2025 ESCMID-EFISG webinar series.

OBJECTIVES: Evaluate the 2025 European Society of Clinical Microbiology and Infectious Diseases-European Fungal Infection Study Group webinar series to assess digital education as a scalable, equitable model for global professional development in medical mycology. METHODS: This observational study analyzed Zoom metadata across 17 webinars (January-December 2025). Metrics included registration, unique viewers, peak concurrent views, attendance rate, and duration. RESULTS: The series recorded 4631 registrations and 1372 unique participants. Median live attendance was 199 (interquartile range [IQR] 138-269), with a 39.3% attendance rate (IQR 33.7-47.5%) and peak concurrent viewership of 165 (IQR 106-229). Median session duration was 108 minutes. Webinars engaged a median of 60 countries (range 26-89) simultaneously, spanning 128 countries globally. Faculty comprised 67 unique experts from 23 countries with balanced gender representation (52.8% men, 47.2% women), of whom 16.4% (n = 11/67) were affiliated with institutions in low- and middle-income countries. CONCLUSION: Structured digital programs achieve wide global reach and sustained engagement. Strong participation in long-form sessions supports implementing Continuing Medical Education accreditation and unrestricted on-demand access to enhance global health equity.

Antimicrobial resistance↗
PubMed2004

WalkSafe: a school-based pedestrian safety intervention program.

OBJECTIVE: To evaluate the effectiveness of the WalkSafe program, an elementary school-based pedestrian safety program in a single high-risk district in Miami-Dade County. METHODS: Sixteen elementary schools were identified in a single high-risk district and enrolled in a one-year study. All schools implemented the WalkSafe program on the last week of January 2003. A pre, post, and three-month post testing of pedestrian safety knowledge was conducted. An observational component was also implemented at four schools that were randomly chosen. Engineering recommendations and law enforcement initiatives were also performed. RESULTS: A total of 6467 children from K-5th grade from 16 elementary schools participated in the program. Of these 5762 tests were collected over three different testing times. A significant difference (p-value < 0.001) was found between the pre and post testing conditions across all grade levels. There was no significant difference found between the post and three-month post testing conditions across all grade levels (p-value > 0.05). The observational data collected at four schools across the different testing times demonstrated a significant difference found between pre and post testing conditions for Group A (stop at the curb and look left, right, left) and also for Group B (midstreet crossing and darting out) (p-value < 0.05). There was no difference found between comparing the pre-test or post-test condition with the three-month post-test time. There were many environmental modifications that were recommended and actually performed. CONCLUSION: The WalkSafe program implemented in a single high-risk district was shown to improve the pedestrian safety knowledge of elementary school children. The observational data demonstrated improved crossing behaviors from pre-test to post-testing conditions. Future research will focus on sustaining the program in this district and expanding the program throughout our county.

Accidents, Traffic↗
PubMedDate not supplied

Diabetes self-management education program for Medicaid recipients: a continuous quality improvement process.

PURPOSE: Diabetes self-management education (DSME) is the cornerstone in effective management of diabetes. The continuous quality improvement process was used to identify the problem, collect and analyze data, and develop and implement a DSME program for Medicaid recipients, and subsequently, the program was evaluated to assess its effectiveness. METHODS: A DSME program consisting of a 1-hour initial assessment of individual needs followed by 12 hours of group education on nutrition and self-management was provided to 212 Arkansas Medicaid recipients over 1 year. Key clinical measures were assessed at the end of the period. RESULTS: Over 1 year, mean HbA1c declined by 0.45% among the DSME participants who completed the full program. Multivariate analyses found that after controlling for age, gender, race, preperiod diabetes drug use, and preperiod costs, DSME participants were found to have fewer hospital admissions, emergency department visits, and outpatient visits. Changes from baseline clinical values for DSME participants were used to project changes in diabetes-related costs using the Gilmer model. An estimated savings in diabetes-related cost over 3 years was $415 per program completer. Over 10 years, completers were estimated to experience 12% fewer coronary heart disease events and 15% fewer microvascular disease events using the United Kingdom Prospective Diabetes Study risk models. CONCLUSIONS: A DSME program for Medicaid recipients can reduce health care use among Medicaid recipients with diabetes within 1 year and over longer periods of time is likely to reduce costs associated with reduced use of health care. Plans are in place to explore the possibility of sustaining the program.

Diabetes Mellitus↗
PubMed2005

Local coverage initiatives: solution or band-aid for the uninsured?

This issue brief surveys health coverage expansion initiatives that are operating on the county or local level, often without the benefit of federal funding. The paper explores the circumstances that have made these initiatives possible and considers the ongoing barriers that local policymakers face in sustaining the programs. Descriptions of four initiatives illustrate the range and variety of programs in operation today and offer both best practices and lessons learned for other communities. The paper also includes a brief analysis of the key elements that make up a successful coverage initiative. Finally, this issue brief considers the role of local and county-based initiatives in the context of overall health care delivery in the national policy framework, highlighting the prospects for sustainability and replication on a broader scale.

California↗
PubMed1987

Comparison of the characteristics of nonsustained ventricular tachycardia on Holter monitoring and sustained ventricular tachycardia observed spontaneously or induced by programmed stimulation.

The characteristics of nonsustained ventricular tachycardias (VT) on Holter monitor recordings were compared with the characteristics of sustained VT noted spontaneously or induced by programmed stimulation in 50 patients with a history of spontaneous sustained VT. At baseline before antiarrhythmic therapy, all patients had nonsustained VT (triplets or longer) on Holter recordings and sustained VT inducible by programmed stimulation. The mean rate of the fastest nonsustained VT on Holter monitoring (150 +/- 52 beats/min) was significantly slower that that of induced sustained VT (246 +/- 56 beats/min) (p less than 0.001). Compared with nonsustained VT on Holter monitoring, sustained VT by programmed stimulation were faster in 45 of 50 patients, similar in 2 and slower in 3. There was a poor correlation between the rates of nonsustained VT and sustained VT (r = 0.2195). The duration of the longest nonsustained VT was fewer than 6 beats in 24 patients and 6 beats or more in 26. The mean rates of induced sustained VT were not significantly different between patients with shorter (fewer than 6 beats) and longer (6 or more beats) nonsustained VT. In 12 patients, the rate of spontaneous sustained VT was available. The rate of spontaneous sustained VT (217 +/- 59 beats/min) was similar to that of sustained VT by programmed stimulation (277 +/- 60 beats/min). There was a close correlation (r = 0.8036) between the rates of spontaneous and induced sustained VT. However, the rate of nonsustained VT on Holter monitoring (151 +/- 76 beats/min) was significantly slower than the rate of spontaneous sustained VT (p = 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Pacing, Artificial↗
PubMed2007

The effect of community based daycare on mental health and quality of life of elderly in rural south India: a community intervention study.

BACKGROUND: Sustainable cost-effective interventions to improve psychiatric morbidity and quality of life among the elderly have not been systematically evaluated in developing countries. METHOD: The most vulnerable elderly living in Pennathur, Vellore district, India, in terms of socioeconomic status and social supports, were invited to participate in a day-care program. Baseline assessments were done using the Mini Mental Status Examination, the Revised Clinical Interview Schedule and the World Health Organisation Quality of Life- Bref. Follow-up assessment was done at 3 months on subjects who took part and those who refused. RESULTS AND CONCLUSIONS: Forty-one (16.4%) were invited to take part. Twenty subjects took part in the program while 21 refused. There was a significant reduction in psychiatric morbidity and improvement in quality of life scores at 3 months for subjects who attended the program. The improvement in quality of life persisted after adjusting for gender, socioeconomic status and baseline scores. Costing of the program suggests sustainability.

Aged↗
PubMed2005

Impact of a homestead gardening program on household food security and empowerment of women in Bangladesh.

This paper assesses the additional benefits of a homestead gardening program designed to control vitamin A deficiency in Bangladesh. In February and March 2002, data were collected on the food security and social status of women from 2,160 households of active and former participants in the gardening program and from control groups in order to assess the impact and sustainability of the program. The proportions of active and former-participant households that gardened year-round were fivefold and threefold, respectively, higher than that of the control group (78% and 50% vs. 15%). In a three-month period, the households of active participants produced a median of 135 kg and consumed a median of 85 kg of vegetables, while the control households produced a median of 46 kg and consumed a median of 38 kg (p <.001). About 64% of the active-participant households generated a median garden income of 347 taka (US$1 = 51 taka), which was spent mainly on food, and 25% of the control households generated 200 taka in the same period (p < .001). The garden production and income levels of formerly participating households three years after withdrawal of program support were much higher than those of the control households, illustrating the sustainability of the program and its ability to increase household food security. Significantly more women in active- and former-participant households than in control households perceived that they had increased their economic contribution to their households since the time the program was launched in their subdistricts (> 85% vs. 52%). Similar results were found for the level of influence gained by women on household decision-making. These results highlight the multiple benefits that homestead gardening programs can bring and demonstrate that these benefits should be considered when selecting nutritional and development approaches targeting poor households.

Adult↗
PubMed1997

International HIV and AIDS prevention: Japan/United States collaboration.

As the epicenter of the HIV/AIDS pandemic shifts from Africa to Asia, Japan is becoming ever more aware of the importance of containing and preventing spread of the virus. International collaboration, particularly with the United States, is a logical approach because it allows utilization of expertise from countries in other stages of the pandemic, can prevent duplication of efforts, and complements efforts of the other countries. Further, both Japan and the United States can use their combined influence and prestige to encourage cooperation among all nations. In 1994, Japan established the Global Issues Initiative to extend cooperation to developing countries in the areas of population and AIDS control. It has disbursed more than $460 million (U.S.$) to promote active cooperation and stimulate international attention to the importance of addressing these health issues. Japan has established four main programs for international collaboration for control of HIV and AIDS, three operated by ministries and one by a Japanese nongovernmental organization. Japanese/United States collaboration is developing through the United States/Japan Cooperative Medical Sciences Program, the Common Agenda for Cooperation in Global Perspective, the Paris Summit, and the United Nations Joint Programme on AIDS. It is critical that Japan and the United States, as the two largest donors to international development, demonstrate, through their collaboration, ways to maximize the use of limited resources, reduce duplication, and promote sustainable development programs in which HIV prevention and AIDS care programs are systemically integrated.

Acquired Immunodeficiency Syndrome↗
PubMed2006

End of life issues action: impact of education.

There is an increased momentum to improve nurses' expertise in dealing with end of life issues via a standardized education program, ELNEC. This program has not been evaluated systematically. This quasi-experimental, longitudinal study's goal was to measure ELNEC Program's impact on registered nurses' death anxiety, death attitudes, and knowledge over time. General Systems Theory provided the foundation. Nurses completed surveys prior to and 3 times after the program. Research and control groups were similar. Research group's death anxiety scores increased immediately post- program, decreased 6 months later (t = -2.65, p = .02) and returned to pre-program levels at 12 months. Death attitudes varied. Knowledge levels improved significantly. The control group had steady increases in death anxiety scores. The program was associated with decreased death anxiety. Recommendations include timing evaluations after participants have time for reflection and planning "booster programs" to sustain effects. Future studies should include larger samples, incentives, and research method triangulation.

Anxiety↗
PubMed2005

Vitamin A deficiency and child survival in sub-Saharan Africa: a reappraisal of challenges and opportunities.

BACKGROUND: Children with vitamin A deficiency have higher risk of morbidity and mortality than vitamin A-sufficient children. Estimates on the potential child survival benefits of vitamin A deficiency control are needed for policy and program advocacy. OBJECTIVE: To determine the current prevalence of children at risk for vitamin A deficiency in sub-Saharan Africa in order to estimate the potential child-survival benefits of effective and sustained policies and programs for the control of vitamin A deficiency in this region. METHODS: Estimates of the prevalence of vitamin A deficiency generated in 1998, data from 11 nationally representative vitamin A deficiency surveys conducted in sub-Saharan Africa between 1997 and 2003, and the measured effects of vitamin A deficiency on child mortality were combined to estimate the prevalence of children at risk for vitamin A deficiency in sub-Saharan Africa and the potential child-survival benefits of effective and sustained policies and programs for the control of vitamin A deficiency in this region. RESULTS: Our analysis shows that in the absence of effective and sustained policies and programs for the control of vitamin A deficiency, an estimated 42.4% of children 0 to 59 months of age in sub-Saharan Africa (43.2 million children) are at risk for vitamin A deficiency. Such effective and sustained policy and program action for the control of vitamin A deficiency can bring about a potential 25% reduction in mortality in children 0 to 59 months with respect to 1995 mortality levels (i.e., before the onset of large-scale vitamin A supplementation programs in sub-Saharan Africa). CONCLUSIONS: Effective and sustained control of vitamin A deficiency has the potential to be among the most cost-effective and high-impact child-survival interventions in sub-Saharan Africa. A stronger political commitment and a more appropriate level of investment in the effective control of vitamin A deficiency could make a large contribution toward the attainment of the Millennium Development Goal for the reduction of child mortality rates by two-thirds between 1990 and 2015. Among the many challenges that Africa will need to face in the coming years, vitamin A deficiency is one that can be overcome. The need is urgent, and the solutions are known, effective, and affordable.

Africa South of the Sahara↗
PubMed1999

Prediction of sustained ventricular tachycardia inducible by programmed stimulation in patients with coronary artery disease. Utility of clinical variables.

BACKGROUND: Cardiologists often use clinical variables to determine the need for electrophysiological studies to stratify patients for risk of sudden death. It is not clear whether this is rational in patients with coronary artery disease, left ventricular dysfunction, and nonsustained ventricular tachycardia. METHODS AND RESULTS: We analyzed the first 1721 patients enrolled in the Multicenter UnSustained Tachycardia Trial to determine whether clinical variables could predict which patients would have inducible sustained monomorphic ventricular tachycardia. The rate of inducibility of sustained ventricular tachycardia was significantly higher in patients with a history of myocardial infarction and in men compared with women. There was a progressively increased rate of inducibility with increasing numbers of diseased coronary arteries. There was a significantly lower rate of inducibility in patients with prior coronary artery bypass surgery and in patients who also had noncoronary cardiac disease. The rate of inducibility was higher in patients of white race, patients with recent (</=6 weeks) angina, left ventricular dyskinesis, and in patients with greater numbers of fixed thallium defects. Inducibility was more likely in patients who had a prior myocardial infarction complicated by congestive heart failure, ventricular tachycardia, or fibrillation </=48 hours after the onset of infarction. Although these associations are statistically significant, the accuracy of the clinical variables in discriminating between patients with and those without inducible ventricular tachycardia is only modest (receiver operator characteristic area <0.70). CONCLUSIONS: Multiple clinical variables are independently associated with inducible sustained ventricular tachycardia. However, they have limited utility to guide clinical decisions regarding the use of electrophysiological testing for risk stratification in this patient population.

Aged↗
PubMed2004

The opportunities and obstacles to collaboration between the developing and developed countries in the field of occupational health.

The 2.4 billion working people in the developing countries often have to endure employment conditions, which do not meet even basic occupational safety and health (OSH) standards. The lack of work safety, excessive work loads, and occupational physical, chemical and biological exposures result in occupational diseases, injuries and as many as 1.2 million fatalities each year. Furthermore, as little as 15% of workers in the developing countries have access to occupational health and safety services. Some collaboration between the industrialized and developing countries in the field of OSH has been practiced for 30 years but its volume has been modest compared to other sectors of development assistance. The lessons learned from 30 years of experience are that the most important OSH improving factors in developing countries include legal and policy instruments, national OSH programs, infrastructure for OSH implementation, and OSH services. The establishment of OSH expert human resources, centers serving as engines for research, training, as well as information and registration systems can also be considered as key factors in any such collaboration. A convincing government OSH policy, and close cooperation between social partners and the government are also critical factors that guarantee sustainable OSH programs in a developing country over a long-term basis.

Accidents, Occupational↗
PubMed2006

Ongoing challenges of a global international patient assistance program.

The Glivec International Patient Assistance Program (GIPAP) that is supported by Novartis Oncology provides Glivec (imatinib), an innovative oral therapy for chronic myelogenous leukemia and gastrointestinal stromal tumours, at no cost to patients in developing countries who could otherwise not afford treatment. Using a novel direct-to-patient approach this program is currently successfully providing Glivec to underserved patients in 81 countries. A number of challenges were faced in the implementation of this program in countries where cancer is not a priority, and where the healthcare and other infrastructure can be very limited. By working within the existing healthcare system of each country, and with any national cancer control programme that may be in place, through careful selection of qualified institutions and physicians, while maintaining a global approach to ensure consistency and quality, GIPAP has become an efficient and sustainable access program. Novartis has made a long-term commitment to GIPAP, and is currently exploring new patient access programs for other drugs.

Administration, Oral↗
PubMed2026

Bioinformatics in crop research: using genomic data for crop improvement.

Sustainable crop development aims to maintain or increase yields while reducing environmental impact and managing the challenges imposed by climate change. As the global population grows and arable land becomes scarcer, the integration of molecular breeding with bioinformatics has emerged as an effective strategy for long-term crop improvement. Bioinformatics enables researchers to analyze and interpret the vast quantities of genetic data generated by high-throughput sequencing, making it possible to identify molecular markers, candidate genes, and regulatory networks linked to specific agronomic traits, which breeders then translate into focused, ecologically sustainable breeding programs. This approach has enabled major progress across several fronts: the identification of genes conferring resistance to biotic stressors (pests, pathogens) and abiotic stressors (drought, salinity, heat); the development of nutrient-efficient, low-input crop varieties; the improvement of agronomic performance and nutritional quality through identification of yield- and quality-related genes; and the conservation and deployment of genetic diversity to safeguard long-term breeding sustainability. By combining genomic data with precision breeding techniques, researchers are developing crops that are better adapted to a growing population and a changing climate, positioning the integration of molecular breeding and bioinformatics as a central pillar of future global food security.

bioinformatics↗