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PubMed1990

Are Head Start effects sustained? A longitudinal follow-up comparison of disadvantaged children attending Head Start, no preschool, and other preschool programs.

This study investigates the sustained effects into kindergarten and grade 1 of Project Head Start for disadvantaged black children. Participation in generic Head Start programs was compared to both no preschool and other preschool experience for disadvantaged children in two American cities in 1969-1970. Incorporating both pretest/posttest and comparison group information, the study has advantages over other Head Start impact studies. Both preprogram background and cognitive differences were controlled in a covariance analysis design, using dependent measures in the cognitive, verbal, and social domains. Children who attended Head Start maintained educationally substantive gains in general cognitive/analytic ability, especially when compared to children without preschool experience. These effects were not as large as those found immediately following the Head Start intervention. Findings suggest an effect of preschool rather than of Head Start per se. Initial findings of greater effectiveness of Head Start for children of below average initial ability were reduced but not reversed. The diminution of effects over time, especially for low-ability children, may reflect differences in quality of subsequent schooling or home environment.

Achievement↗
PubMed1991

Creating changes in the corporate culture: case study.

The case study describes the experience of an OHN in starting a process of reorganization in a company. The concept was a "safety round" with a questionnaire created by safety officers and the OHS who also were responsible for getting the information to all employees, planning, carrying through, and evaluating the project. Last but not least, they should be aware of the consequences such a project could start. The results of the project were: a) the reorganization of the corporation should be evaluated for further development; b) the instruction plan should be reviewed with new employees, with better follow up and continuity; c) a survey should be done of future educational needs of the staff. Job rotation should be a priority; and d) a programmed schedule should be set for meetings in the line of production. The role of the OHN in the project was to support the changes and push for the follow up work after 1 year.

Humans↗
PubMed1994

Head Start. Only the best for America's children.

In March 1993 Senator Kassebaum introduced the Head Start Quality Improvement Act aimed at building on the success of Head Start by connecting a dramatically increased budget with measures designed to upgrade the quality of the program. The legislation provides the DHHS with the mandate, the resources, and the necessary legislative tools, using a five-part approach to (a) establish general performance measures for all grantees; (b) strengthen program accountability mechanisms, training, and technical assistance support systems; (c) provide more effective policy enforcement and instill more competition in the program; (d) expand the current Head Start Transition Project to assist children and their families in making a successful move from Head Start to elementary school; and (e) assist families entering or reentering the work force.

Adolescent↗
PubMed1994

Salmonella enteritidis control programs in the United States.

A sharply rising incidence of salmonellosis in humans caused by Salmonella enteritidis (SE) in the United States between 1985 and 1989 resulted in a government-sponsored outbreak traceback program which was started in 1990. Layer flocks considered the sources of egg-implicated outbreaks would be tested for SE and the eggs from these flocks would be diverted to pasteurization plants. A program to eliminate SE from primary and multiplier breeding flocks was started at the same time. A subsequent spent hen survey and a survey of prepasteurized liquid egg material revealed that SE was much more prevalent than had been suspected, and that the highest prevalence was found in the northeastern and middle Atlantic states. Since the SE rates did not decrease during the next 2 years, a pilot project was started in 1992 in Pennsylvania, in one of the most highly affected areas. The project was designed to reduce the number of SE outbreaks by diverting eggs from SE-affected flocks and at the same time attempting to delineate the epidemiology and control aspects of the disease. With the results generated during the fist 18 months of the Pilot Project, a much larger SE prevention program will start in the same area, in October 1993.

Animals↗
PubMed1997

[Scientific role of German ophthalmology in the European telecommunication project OPHTEL].

BACKGROUND: In Denmark, France, Germany, Great Britain and Italy, the OPHTEL project combines clinical centers of ophthalmology and internal medicine, an institute for medical informatics and health services research, a publishing company and different industrial partners in the EDP market. AIMS: With the aid of visual telecommunication and rapid data transfer, methods and conditions will be developed and proved so that any physician can very easily obtain sufficient information for treating his patient. Thus, the regional differences in the quality of structured health service (e.g., urban/ rural) will be overcome throughout Europe. SCIENTIFIC TASKS: A multilingual diagnostic and therapeutic thesaurus has to be worked out in order to create standards for communication and quality control. Based on literature, images and image analysis in a knowledge-based data bank, a monitoring system (containing watch-dog functions) and the basic aspects of an ophthalmological patient/disease register will be investigated. (In parallel, a technical development of synchronous and asynchronous telecommunication between eye physicians is taking place in close cooperation with the regional Bavarian project Teleopathalmology in Bavaria on-line). RESULTS: State of the art 6 months after starting the project:the knowledge-based image data bank has been founded and also an ophthalmological 8 language thesaurus and definition standard. All data transfer lines are installed. DISCUSSION: The project is taking place amid diverging sections of medicine: ophthalmology and internal medicine, health politics and data protection, individual treatment and common interest (health care), product management and office organization. Thus, the scientific quality of the transferred ophthalmological content must undergo sophisticated controls. FUTURE STEPS: Intense cooperation with the big German associations for ophthalmology (DOG, BVA) and the European ophthalmological societies concerning EDP, classification and quality control.

Computer Communication Networks↗
PubMed2004

Structural polarity and dynamics of male germline stem cells in the milkweed bug (Oncopeltus fasciatus).

The male germline stem cells (GSCs) of the milkweed bug present an extraordinary structural polarity that is, to our knowledge, unequalled by any other type of stem cells. They consist of a perikaryon and numerous projections arising from the cell pole directed toward the apical cells, the proposed niche of the GSCs. The projections can traverse a considerable distance until their terminals touch the apical cells. From hatching until death, the GSC projections undergo conspicuous changes, the sequence of which has been deduced from observations of all developmental stages. Projection formation starts from lobular cell protrusions showing trabecular ingrowths of the cell membrane. Finger-like projections result from a process of growth and "carving out". The newly formed projections contain mostly only free ribosomes other than a few mitochondria. A stereotyped degradation process commences in the projection terminals: profiles of circular, often concentric, cisternae of rough endoplasmic reticulum appear and turn into myelin bodies, whereas mitochondria become more numerous. The cytoplasm vesiculates, lysosomal bodies appear, and mitochondria become swollen. At the same time, the projection terminals are segregated by transverse ingrowths of the cell membrane. Finally, autophagic vacuoles and myelin bodies fill the segregated terminals, which then rupture. Simultaneously, new projections seem to sprout from the perikaryon of the GSCs. These dynamics, which are not synchronized among the GSCs, indicate that a novel type of signal exchange and transduction between the stem cells and their niche is involved in the regulation of asymmetric versus symmetric division of GSCs.

Animals↗
PubMed1987

Tax-exempt status is not a "sure thing" in long-term care.

Healthcare organizations sometimes mistakenly assume that their tax-exempt status will transfer to the long-term care facilities they are developing. Too late, they discover that the criteria for obtaining tax-exempt status are more extensive than anticipated. This problem can be avoided if a simple two-step process is followed: educate project managers about criteria for obtaining tax-exempt status and apply that education at the start of project development.

Aged↗
PubMed1989

[The Deinze pilot project for caries prevention, 1981-1988].

In 1981 a dental prevention pilot-project was started in Deinze with a group of 5-year-old school children. The aim of this project was to evaluate the effect of a preventive dental school-program. During a period of 7 years this program was carried out with 4 items: the motivation of the children; a daily teeth brushing; a weekly mouth rinsing with a 0.2% NaF solution; a trimonthly clinical examination. The effect of this prevention program can be summarized in four points: a reduction in caries prevalence of ca 40%; an increase in dental treatment; a reduction in the incidence of gingivitis in number and degree; a favourable effect on the dental attitude of the target group, the teachers and the immediate environment.

Belgium↗
PubMed1986

Four-year follow-up results of the smoking prevention program in the North Karelia Youth Project.

The North Karelia Youth Project was a 2-year intervention study aimed at preventing cardiovascular diseases risk factors among 13-year-old adolescents at the project's start. It was carried out during the years 1978 to 1980 in the county of North Karelia, Finland. The smoking prevention portion of the program was aimed at teaching children skills necessary to handle the social and psychological pressures associated with starting to smoke. During the 2-year program, 10 sessions were carried out in two schools by the project team and by specially trained peer leaders. In about half of the remaining 22 schools in North Karelia, a five-session program was carried out voluntarily by the teachers. After the program, 20% of the children in the two schools where the direct intervention was carried out reported smoking at least once a month. The same rate also was observed in two matched schools representative of the rest of the schools in North Karelia. In two other matched control schools in another county, 30% of the pupils reported to be smokers by the same criteria. Two years after the program (4 years after the beginning of the program), the reported smoking rates in the different school groups were 27, 26, and 37%, respectively. The results of this pilot study indicate that it is possible to reduce smoking onset by this kind of innovative program and that the beneficial effect can last several years.

Adolescent↗
PubMed1988

Combating severe malaria in African children.

An initiative to reduce childhood mortality due to malaria, diarrhoea and vaccine-preventable diseases, called the Africa Child Survival Initiative-Combatting Childhood Communicable Diseases (CCCD) project, was started in 1982 and is now operating in 13 African countries, 12 of which are endemic for malaria. The project's malaria control strategy relies on the use of drugs, mainly chloroquine, to prevent severe illness and death in children less than 5 years of age; chemoprophylaxis for pregnant women is also advised to prevent low birth weight in newborns. The strategy is based on WHO recommendations which focus on improved diagnosis and treatment of cases and chemoprophylaxis for pregnant women.In 9 out of the 13 CCCD countries the sensitivity of Plasmodium falciparum to chloroquine in children was investigated and a drug sensitivity surveillance network was established. In areas with chloroquine-resistant P. falciparum, treatment with chloroquine was found to decrease the temperature in febrile children and to greatly reduce the parasite density, thus preventing severe illness and possible death. Baseline surveys in 6 countries have shown a wide range of treatment practices, e.g., use of chloroquine in various doses without standard guidelines and the excessive use of quinine and chloroquine injections in some health units. As pregnant women are often not taking chemoprophylaxis, research has been started on alternative approaches to drug treatment to prevent the adverse effects of malaria on the fetus.Only 4 of the 12 malarious countries had malaria control units when their CCCD programme began and these were concerned mainly with vector control issues; 11 of 12 countries now have such units and a written CCCD malaria plan. These countries have now integrated malaria control activities into primary health care and have begun to implement standardized treatment and prevention practices that are described in their national CCCD malaria plans.

Adolescent↗
PubMed1992

Non-institutional care for the elderly. A Danish model.

A 4 year long Action Research Project including the reorganization and co-ordination of services and facilities for the elderly had been conducted in a Danish municipality. The project was started in June 1984 when a conceptual framework was developed to establish the foundation for the design of the project. The concept of self-care and WHO's strategy "Health for all by the year 2000" were central aspects of the framework. Self-care is the process of choosing and deciding over our own bodies and lives. In a more institutionalized health care system, citizens are often not able to take part in the decision-making process, or only with difficulty. A survey study was conducted to assess the social and health service needs and wishes of persons over 67 years of age. Comprehensive interdisciplinary training of staff was carried out. During the latter part of this period, a 24 hour service was planned, and the former nursing home was converted into a health care centre, with sheltered flats, guests flats and a day centre, open to all citizens, irrespectively of age. Out of consideration for both the inhabitants of the former nursing home and the staff, who were to test both the new ways of working together and the new working methods the changes were initiated slowly with careful preparation and coordination among the respective parties.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1989

Evaluation of factors influencing vaccine uptake in Mozambique.

A pulse immunization project was started in Mozambique to compensate for the decrease in routine immunization caused by destabilization. A study was conducted to evaluate the project and identify determinants of vaccination in urban and rural areas of Mozambique. Vaccine coverage based on a documented record, the 'Road to Health' card, was 53% in urban and 60% in rural project areas, and 12% higher if a verbal history of vaccination was considered. A further 17% of children would have received effective vaccination if the correct schedule had been followed for all vaccines given and all preventive health services contacts had been used for vaccination. Factors relating to the individual mother and child and factors relating to the clusters were investigated for their association with vaccine uptake. Those which showed a strong negative association included vaccination on offer at the nearest vaccination post for only a small number of days per week; cancellation of an outreach session; knowing a child with a post-vaccination abscess; child born at home; at least five children in the family; mother's inability to speak Portuguese and her inability to name at least two target diseases. Improving the supervision of health services and immunizing at least three days per week at permanent immunization clinic sites may be the most important measures to improve coverage further.

Adult↗
PubMed1996

[Laboratory operations in general practice--where do we stand, concerning quality assurance projects?].

In 1992 a project was started by the Norwegian Medical Association to secure the quality of laboratory work performed on physicians' own premises in Norway. The project is now well established in all 19 counties and more than 90% of the practices participate on a voluntary basis. In each county a central clinical chemistry laboratory with a specially engaged laboratory adviser is responsible for assisting the general practitioners and specialists with the laboratory work performed on their own premises. The assistance includes visits, telephone contacts and education courses. An external quality control scheme is carried out by a national centre, which distributes samples of unknown concentrations to all the participants. The whole project is coordinated by a steering committee, which arranges national meetings annually. Working groups have been appointed to elucidate more complicated and time-consuming subjects, such as guidelines for internal quality control, evaluation of equipment and education programmes. A set of written manuals for all kinds of working procedures has recently been prepared and adjusted individually to each physician's premises.

Chemistry, Clinical↗
PubMed1996

A Cross-Task Comparison of False Belief Understanding in a Head Start Population

This research had two main goals: to compare different methods of assessing understanding of false belief and to extend the study of false belief to the population served by Project Head Start. Across two experiments the participants were ninety 3-, 4-, and 5-year-old children, drawn from low-income, primarily African-American families. Each child responded to a battery of false belief tasks that varied in the type of belief in question (contents tasks versus locations tasks), the target for the belief ascription (own belief versus other's belief), the method of presenting the reality information (visual versus verbal), and the presence or absence of a deception context. Performance was better on locations tasks than on contents tasks and among older children compared to younger children; the other comparisons resulted in smaller and less consistent effects. Despite the improvement with age, the level of performance fell short of that typically reported in the literature. Although correlations among tasks were significant, fewer than half of the children performed consistently across the problems.

Journal Article↗
PubMed1988

A nation-wide collaborative study on the long-term effects of bromocriptine in patients with Parkinson's disease. First interim report in Japan.

Two prospective projects were started in May 1985 to evaluate the long-term effects of bromocriptine in patients with Parkinson's disease. One of the projects is to see if combination therapy with levodopa and bromocriptine is superior to levodopa alone with regard to the prevention of late side effects of levodopa therapy. The other is to see the long-term effects of bromocriptine monotherapy. Patients with Parkinson's disease were allocated randomly to either combination or levodopa group in the first project. Parkinsonian symptoms, disabilities of daily life and severity of late side effects of long-term levodopa therapy were evaluated by a semiquantitative rating scale. This communication represents the first interim report. Methods of the studies and synopsis of the results at the end of the 12th month are described. A total of 702 patients was enrolled in the study (combination therapy, n = 216; levodopa therapy, n = 200, bromocriptine monotherapy, n = 286). At the end of the 12th month, the numbers of patients who dropped out from the study were 19, 16 and 55 in the three groups, respectively. It appears to be too early to make any definite conclusion with regard to which mode of treatment is superior, however, some evidence suggesting a superiority of the combination therapy over levodopa alone was noted in managing wearing-off phenomenon and dyskinesia. As many patients are sticking to the originally intended mode of treatment, it appears to be possible to obtain more meaningful data in several years.

Adult↗
PubMed2006

Assessment of Internet-based tele-medicine in Africa (the RAFT project).

The objectives of this paper on the Réseau Afrique Francophone de Télémédecine (RAFT) project are the evaluation of feasibility, potential, problems and risks of an Internet-based tele-medicine network in developing countries of Africa. The RAFT project was started in Western African countries 5 years ago and has now extended to other regions of Africa as well (i.e. Madagascar, Rwanda). A project for the development of a national tele-medicine network in Mali was initiated in 2001, extended to Mauritania in 2002 and to Morocco in 2003. By 2006, a total of nine countries are connected. The entire technical infrastructure is based on Internet technologies for medical distance learning and tele-consultations. The results are a tele-medicine network that has been in productive use for over 5 years and has enabled various collaboration channels, including North-to-South (from Europe to Africa), South-to-South (within Africa), and South-to-North (from Africa to Europe) distance learning and tele-consultations, plus many personal exchanges between the participating hospitals and Universities. It has also unveiled a set of potential problems: (a) the limited importance of North-to-South collaborations when there are major differences in the available resources or the socio-cultural contexts between the collaborating parties; (b) the risk of an induced digital divide if the periphery of the health system in developing countries is not involved in the development of the network; and (c) the need for the development of local medical content management skills. Particularly point (c) is improved through the collaboration between the various countries as professionals from the medical and the computer science field are sharing courses and resources. Personal exchanges between partners in the project are frequent, and several persons received an education at one of the partner Universities. As conclusion, we can say that the identified risks have to be taken into account when designing large-scale tele-medicine projects in developing countries. These problems can be mitigated by fostering South-South collaboration channels, by the use of satellite-based Internet connectivity in remote areas, the appreciation of local knowledge and its publication on-line. The availability of such an infrastructure also facilitates the development of other projects, courses, and local content creation.

Africa↗
PubMed2001

The national health demonstration projects.

The White Paper Towards a Healthier Scotland pledged 15 million Pounds to support four national health demonstration projects to lead the way in achieving sustained improvement in child health, young people's sexual health, coronary heart disease and cancer. The Starting Well project aims to demonstrate that child health in Glasgow can be improved by a programme of activities which both supports families and provides them with access to enhanced community-based resources. The Healthy Respect project aims to help young people in Lothian develop a positive attitude to their own sexuality and that of others, and a healthy respect for their partners, in order to reduce unplanned teenage pregnancies and sexually transmitted infections. The Have a Heart Paisley project is targeting coronary heart disease among the population of Scotland's largest town. The Cancer Challenge project is piloting a screening programme in the North East of Scotland for the detection of colorectal cancer. Though each project has specific objectives, appropriate to its own topic, all share underlying principles. The projects will act as test beds for action and a learning resource for the rest of Scotland.

Cardiovascular Diseases↗
PubMed2004

Density-independent population projection trajectories of chromosome-substituted lines resistant and susceptible to organophosphate insecticides in Drosophila melanogaster.

BACKGROUND: Seasonal fluctuations in susceptibility to organophosphate insecticides were observed in the Katsunuma population of Drosophila melanogaster for two consecutive years; susceptibility to three organophosphates tended to increase in the fall. To examine the hypothesis that variation in fitness among resistant and susceptible genotypes could trigger the change of genetic constitution within the fall population, we investigated density-independent population projection trajectories starting from single adult females with characteristics of chromosome-substituted lines resistant and susceptible to the three organophosphates. RESULTS: Density-independent population projection trajectories, expressed as the ratios of the number of each chromosome-substituted line to that of line SSS, for which all chromosomes were derived from the susceptible line, showed significant declines in numbers with time for all the resistant chromosome-substituted lines. CONCLUSION: The declining tendency in the density-independent population projection trajectories of the resistant chromosome-substituted lines could explain the simultaneous decline in the levels of resistance to the three organophosphates, observed in the Katsunuma population in the fall.

Age Factors↗