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PubMed2004

An empowerment evaluation model for sexual assault programs: empirical evidence of effectiveness.

Using an empowerment evaluation approach, the Sexual Assault and Rape Prevention (SARP) Evaluation Project brought together university researchers, public health evaluators, state funders, and program staff to provide evaluation training and consultation to all state-funded rape prevention and victim services programs in Michigan. In this paper, the specific activities of the SARP project are described, and process and outcome data are presented that address the effectiveness of this empowerment evaluation approach. Based on subjective reports from program staff and objective data obtained from state funders, results suggest that this evaluation model was successful in helping 90% of the prevention programs and 75% of the victim services programs successfully develop and launch program evaluations. One-year follow-up data indicate that 90% of the programs had sustained their evaluation efforts after the formal work of the SARP project had ended.

Crime Victims↗
PubMed2004

Sustained low-efficiency daily diafiltration (SLEDD-f) for critically ill patients requiring renal replacement therapy: towards an adequate therapy.

BACKGROUND: Sustained low-efficiency daily dialysis (SLEDD) is an increasingly popular renal replacement therapy for intensive care unit (ICU) patients. SLEDD has been previously reported to provide good solute control and haemodynamic stability. However, continuous renal replacement therapy (CRRT) is considered superior by many ICU practitioners, due first to the large amounts of convective clearance achieved and second to the ability to deliver treatment independently of nephrology services. We report on a program of sustained low-efficiency daily diafiltration (SLEDD-f) delivered autonomously by ICU nursing personnel, and benchmark solute clearance data with recently published reports that have provided dose-outcome relationships for renal replacement therapy in this population. METHODS: SLEDD-f treatments were delivered using countercurrent dialysate flow at 200 ml/min and on-line haemofiltration at 100 ml/min for 8 h on a daily or at least alternate day basis. All aspects of SLEDD-f were managed by ICU nursing personnel. Clinical parameters, patient outcomes and solute levels were monitored. Kt/V, corrected equivalent renal urea clearance (EKRc) and theoretical Kt/V(B12) were calculated. RESULTS: Fifty-six SLEDD-f treatments in 24 critically ill acute renal failure patients were studied. There were no episodes of intradialytic hypotension or other complications. Observed hospital mortality was 46%, not significantly different from the expected mortality as determined from the APACHE II illness severity scoring system. Electrolyte control was excellent. Kt/V per completed treatment was 1.43+/-0.28 (0.96-2.0). Kt/V(B12) per completed treatment was 1.02+/-0.21 (0.6-1.38). EKRc for patients was 35.7+/-6.4 ml/min (25.0-48.2). CONCLUSION: SLEDD-f provides stable renal replacement therapy and good clinical outcomes. Logistic elements of SLEDD-f delivery by ICU nursing personnel are satisfactory. Small solute clearance is adequate by available standards for CRRT and intermittent haemodialysis, and larger solute clearance considerable. SLEDD-f is a viable alternative to CRRT in this setting.

Acute Kidney Injury↗
PubMed2004

Wired for success: stimulating excitement in nursing through a summer camp.

The seriousness of the nursing shortage has been addressed by both the public and professional media. The literature documents substantial support for strategies that focus on increasing the enrollment in nursing education programs and/or sustaining practice environments that contribute to higher nurse retention rates. A nursing camp is an example of an innovative strategy to stimulate excitement in a nursing career, and thus potentially limit the severity of the nursing shortage. The camp helps high school students enhance their discernment about being "wired" for nursing; learn selected basic nursing skills; job shadow; interact with current nursing students and practicing nurses; and develop themselves as educated consumers of information about nursing education programs and financial assistance for college. This article details the development and implementation of a summer residential nursing camp and describes associated outcomes for both the students and the nursing program.

Attitude to Health↗
PubMed2002

Tapping youth as agents for change: evaluation of a peer leadership HIV/AIDS intervention.

PURPOSE: To evaluate the impact of a community-based HIV/AIDS peer leadership prevention program on newly enrolled peer leaders and youth enrolled as peer educators for one or more years (repeat peer leaders). METHODS: Quasi-experimental nonrandomized design with two intervention groups (newly enrolled and repeat peer leaders) and one comparison group. The sample consisted of 235 adolescents, 164 peer leaders, and 71 comparison youth, drawn from nine communities in Massachusetts. The intervention consisted of a short course and ongoing group work with an adult advisor to plan and implement HIV/AIDS outreach activities for youth. A confidential questionnaire administered at baseline and postintervention measured change in (a) HIV/AIDS knowledge, (b) planning and presenting skills, (c) self-efficacy, (d) perception of one's self as a change agent in the community, and (e) sexual risk-taking behaviors. Information was collected from both groups of peer leaders on specific activities resulting from the program and perceived benefits. Data were analyzed by both descriptive and multivariate statistics. RESULTS: Over a 9-month period newly enrolled peer leaders had significantly higher mean scores for HIV/AIDS knowledge and perception of one's self as a change agent in the community than comparison youth. On all baseline outcome measures except risk-taking behaviors, repeat peer leaders reported higher scores than newly enrolled peer leaders. Post-intervention, HIV/AIDS knowledge continued to increase significantly more among repeat peer leaders compared with those newly enrolled in the program. Repeat peer leaders also reported more benefits from peer leadership training. CONCLUSIONS: A peer education program was found to have benefits to adolescent peer leaders. Benefits gained from the program were sustained and enhanced over time as evidenced by repeat peer leaders included in the study.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Effectiveness of continuing education in long-term care: a literature review.

PURPOSE: This review of the literature examines the effectiveness of continuing education programs in long-term care facilities. DESIGN AND METHODS: A comprehensive literature search was made for evaluation studies and included computerized bibliographic databases, manual searches of journals, the bibliographies of retrieved articles, and information from key informants. RESULTS: Forty-eight studies met our selection criteria. Rigorous research in this area has been limited. Because of the lack of follow-up evaluation, there is minimal evidence that knowledge gained from training programs is sustained in the long term. Most studies do not consider organizational and system factors when planning and implementing training initiatives. This may account for difficulties encountered in the sustained transfer of knowledge to practice. IMPLICATIONS: There is a need for further rigorous research on the effectiveness of continuing education in long-term care, with systematic attention to the role of organizational and system factors.

Education, Continuing↗
PubMed2006

Maternal programming of defensive responses through sustained effects on gene expression.

There are profound maternal effects on individual differences in defensive responses and reproductive strategies in species ranging literally from plants to insects to birds. Maternal effects commonly reflect the quality of the environment and are most likely mediated by the quality of the maternal provision (egg, propagule, etc.), which in turn determines growth rates and adult phenotype. In this paper we review data from the rat that suggest comparable forms of maternal effects on defensive responses stress, which are mediated by the effects of variations in maternal behavior on gene expression. Under conditions of environmental adversity maternal effects enhance the capacity for defensive responses in the offspring. In mammals, these effects appear to 'program' emotional, cognitive and endocrine systems towards increased sensitivity to adversity. In environments with an increased level of adversity, such effects can be considered adaptive, enhancing the probability of offspring survival to sexual maturity; the cost is that of an increased risk for multiple forms of pathology in later life.

Adaptation, Psychological↗
PubMedDate not supplied

The role of non-government organizations in supporting and integrating interventions to improve child health.

In Papua New Guinea there are many organizations providing sparsely spread and fragmented health services. Government health facilities are often relatively well functioning in urban and periurban areas, but sporadic or nonexistent in rural areas. In some remote areas churches are the major health service providers. Increasingly other community groups are providing village-based health services. Much financial support is now pledged by major international donors for community-based health services, but few people working at a district or community level have the management skills to access the funds or plan programs effectively, and few of the major donors have any significant presence in rural areas. Such a management skill gap also exists at the level of many provincial health offices and this seriously limits the effectiveness of all major donor projects. There is need for integration of health services to avoid replication and to extend services to areas where no effective services are currently provided. There is also a great need to train people at a community and district level in program planning and management. Non-government organizations (NGOs) working at a district or community level have the potential to bridge this skill gap and to help integrate community-based services with government institutions. This paper reports, as an example, the activities of Save the Children, an international NGO in Papua New Guinea. Essential for the success of community-based health projects is the development of local management skills, reliable funding, integration with established health institutions, objective evaluation and community support. Skilled NGOs working at a community, district or provincial level can have important roles in assisting local people to run effective and sustainable health programs.

Child↗
PubMedDate not supplied

Homelessness, substance misuse, and access to public entitlements in a soup kitchen population.

The study examined the effects of homelessness on access to public entitlements (Medicaid and food stamp programs) in a soup kitchen population. Data were collected between 1997 and 1999 from a sample of 343 adults at two soup kitchen sites in New York City. Five hypotheses, focusing on the effects of housing status (literal homelessness, unstable housing, and domiciled), frequency of drug/heavy alcohol use, drug/alcohol-user treatment history and childcare responsibilities on access to Medicaid and food stamp programs were tested. Multiple logistic regression analysis indicated that both literal homelessness and unstable housing were associated with less access to Medicaid and food stamps. Other significant findings were: current drug/alcohol-user treatment experience was associated with greater access to both Medicaid and food stamps, frequency of drug/heavy alcohol use was associated with less access to Medicaid only, and caring for children was associated with greater access to food stamps only. These findings support the crucial role of housing status in mediating access to entitlements, and the importance of drug/alcohol-user treatment involvement as a cue to seeking entitlements. The need to reduce health disparities through active and sustained outreach programs designed to enhance homeless persons' access to Medicaid and food stamp programs was discussed.

Adolescent↗
PubMedDate not supplied

Toward a science for and of the people: promoting civil society through the application of developmental science.

Applied developmental science (ADS) is scholarship that seeks to advance the integration of developmental research with actions-policies and programs-that promote positive development and/or enhance the life chances of vulnerable children and families. Through this integration ADS may become a major means to foster a science for and of the people. It may serve as an exemplar of the means through which scholarship, with community collaboration, may contribute directly to social justice. In so doing, ADS helps shift the model of amelioration, prevention, or optimization research from one demonstrating efficacy to one promoting outreach. When this contribution occurs in the context of university-community partnerships, ADS may serve also as a model of how higher education may engage policy makers, contribute to community capacity to sustain valued programs, and maintain and perpetuate civil society through knowledge-based, interinstitutional systems change.

Child↗
PubMed2005

An examination of knowledge, attitudes and practices related to HIV/AIDS prevention in Zimbabwean university students: comparing intervention program participants and non-participants.

OBJECTIVES: This study represents a comprehensive assessment of differences between participants in an HIV/AIDS prevention program (SHAPE: Sustainability, Hope, Action, Prevention, Education) and non-participants in knowledge, attitudes and practices with a focus on cultural, sociological and economic variables. METHODS: We developed an eight-page questionnaire that was administered to 933 randomly selected students at the University of Zimbabwe. Survey items addressed sexual decision-making, condom use, limiting sexual partners, cultural power dynamics and access to HIV testing. RESULTS: Results show participants are statistically more likely to report being sexually abstinent, and understand the prevention benefits of condom use. SHAPE members had fewer sexual partners in the previous year than non-SHAPE members (1.4 vs. 2.2). SHAPE members were significantly more likely (67%) than non-SHAPE respondents (48%) to indicate that they knew their HIV sero-status and to state that they knew their status because they had been tested (85% vs. 71%). DISCUSSION: Though we found differences between the groups suggesting that program participation increases awareness concerning gender equity, there continue to be many intractable cultural attitudes in this age group. Findings suggest that the attitudes and practices of young men and women are changing, but that progress in some areas does not assure progress in all areas.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Sustainability of a successful health and nutrition program in a remote aboriginal community.

OBJECTIVE: To assess the long term effect of a nutrition program in a remote Aboriginal community (Minjilang). DESIGN: Evaluation of nutritional outcomes over the three years before and the three years after a health and nutrition program that ran from June 1989 to June 1990. Turnover of food items at the community store was used as a measure of dietary intake at Minjilang and a comparison community. SETTING: A community of about 150 Aboriginal people live at Minjilang on Croker Island, 240 km north-east of Darwin. A similar community of about 300 people on another island was used as the comparison. RESULTS: The program produced lasting improvements in dietary intake of most target foods (including fruit, vegetables and wholegrain bread) and nutrients (including folate, ascorbic acid and thiamine). Sugar intake fell in both communities before the program, but the additional decrease in sugar consumption during the program at Minjilang "rebounded" in the next year. Dietary improvements in the comparison community were delayed and smaller than at Minjilang. CONCLUSIONS: The success of the program at Minjilang was linked to an ongoing process of social change, which in turn provided a stimulus for dietary improvement in the comparison community. When Aboriginal people themselves control and maintain ownership of community-based intervention programs, nutritional improvements can be initiated and sustained.

Diet↗
PubMed1994

Essential factors in the implementation of an Expanded Program on Immunization in an urban-periurban community in Nigeria.

The aim of this study was to identify some of the factors that affected the implementation of the Expanded Program on Immunization (EPI) in the Local Government Area (LGA). The study covered the three communities in Calabar LGA. Data on vaccine-eligible children and pregnant women were sought with questionnaires; other information on technical and community aspects of the EPI was gathered with specially designed checklists. EPI coverage for most antigens increased between 70-100% in response to highly-organized immunization campaigns initiated in 1985. In subsequent years, up to 1989, similar campaign-induced responses to national, state and local campaign efforts were observed. In contrast, coverage levels attributable to routine immunization remained unsatisfactory. When tested with the Z-statistic using 1985 as the base year (p < 0.05), there was a significant difference between the proportion of eligible children and pregnant women who did not receive their full dose of immunization. Socio-logistic variables found to be important in EPI implementations included scheduling, health staff attitude, intersectoral collaboration, and health education. Lack of community participation was also found to be a crucial constraining factor. As community participation/involvement is critical in sustaining health programs, social marketing techniques are suggested for future use.

Female↗
PubMed1999

Sharps injuries: defining prevention priorities.

OBJECTIVE: An institutional review of sharps injuries was conducted to assist in establishing priorities for resource allocation in a sharps prevention program. DESIGN: A retrospective review of 221 sharps injuries occurring during a 1-year period was conducted by a 4-member multidisciplinary team. Each injury was categorized as either moderate/high, low, or unknown risk for acquisition of bloodborne diseases by using modified provincial definitions of occupational risk for exposure to bloodborne pathogens. RESULTS: A total of 119 injuries were considered to be moderate/high risk, and 93 were at low risk for acquisition of bloodborne disease. Nine injuries could not be categorized. In 59% of high-risk injuries, education or changes in technique were identified as the primary preventive intervention. Passive devices such as needleless intravenous administration sets could theoretically address prevention of the majority of low-risk injuries. Known available safety devices could have prevented 33 (28%) high-risk injuries. CONCLUSION: Disposition of resources must take into consideration the risk of bloodborne disease acquisition and the efficiency and expense of the preventable methods employed. Institutional review of injuries combined with a cost analysis revealed that resources were best allocated to protective devices at source (eg, safety syringes) and on a comprehensive, multidisciplinary, and sustained educational program. Needleless intravenous infusion sets would mainly prevent low-risk injuries at significant cost.

British Columbia↗
PubMed1990

The medical importance of riceland mosquitoes and their control using alternatives to chemical insecticides.

The medical importance, ecology and control of riceland mosquitoes using alternative strategies is reviewed. Over 135 pest and vector anopheline and culicine mosquito species found in association with riceland habitats and their medical importance are presented. Malaria and Japanese encephalitis are the two most serious human diseases transmitted by riceland mosquitoes, but they have been incriminated as vectors of dozens of arboviruses and other parasites and pathogens including the causal agents of West Nile and Rift Valley Fevers and lymphatic filariasis. Control of vector and pest mosquitoes using chemical pesticides has generated several problems including: insecticide resistance, safety risks for humans and domestic animals, and other environmental concerns. These problems and the high cost and sustainability of programs based predominantly on conventional insecticides have stimulated increased interest in integrated control measures in ricelands. The integrated pest management (IPM) strategy for mosquito control, also known as integrated vector control (IVC), is an ecologically based approach that may involve several complementary interventions used in combination or singly. Environmental management, and chemical, biological and mechanical control, comprise the elements of IVC proposed for use in or near riceland habitats. Some of the elements of environmental management include the use of intermittent irrigation; flushing of fields; use of rice cultivars that require less water; shifting of planting schedules to avoid optimal mosquito breeding conditions; relocation of communities or use of dry belt farming around them; and zooprophylaxis and other personal protection methods, especially use of insecticide-impregnated bed nets. Biological control agents that have been used successfully in rice fields include several species of larvivorous fish, a mermithid nematode (Romanomermis culicivorax), a fungus (Lagenidium giganteum) and bacteria (Bacillus thuringiensis var. israelensis and Bacillus sphaericus). The mermithid and the entomopathogens have demonstrated little or no adverse effects on populations of vertebrate and invertebrate nontarget organisms. The successful use of any particular method or combination of interventions for the control of riceland mosquitoes will depend on in-depth ecological studies on the target species and nontarget organisms, sound geographic reconnaissance and effective routine sampling and evaluation. When biological control agents are considered, additional background on the environmental factors limiting their efficacy will also be needed. In addition to the technical components of the various interventions employed in integrated control, sustained suppression of riceland mosquitoes and the diseases they transmit will require a greater sociocultural supportive background, particularly in developing countries.(ABSTRACT TRUNCATED AT 400 WORDS)

Agriculture↗
PubMed2002

Progress in the prevention and control of viral hepatitis type B: closing remarks.

Hepatitis type B remains an important disease globally. Rapid advances have been made during the last two decades in the understanding of the biology of HBV, the complex interaction between the virus and the host, and the pathology and the clinical aspects of infection. Mass vaccination has been shown to be a safe and highly effective means for the control and prevention of hepatitis B. The presence of a large worldwide reservoir of carriers requires a continuous effort to develop new drugs for the treatment of persistent HBV infection. Efforts to sustain immunization programs and to make vaccines and drugs available to countries with limited resources, are the main challenges to the eradication of hepatitis B in the next few decades.

Adult↗
PubMed2026

De novo transcriptome meta-analysis reveals candidate genes involved in life-stage transitions for RNAi-mediated management of the citrus root weevil (Diaprepes abbreviatus).

BACKGROUND: The citrus root weevil, Diaprepes abbreviatus, is a destructive agricultural pest for which molecular control options remain limited due to historically sparse genomic resources. Leveraging a comprehensive de novo transcriptome, we investigated developmental gene regulation across larval, pupal, and adult stages and identified essential targets for RNA interference (RNAi)-based intervention. RESULTS: Stage-resolved transcriptomic analyses revealed extensive transcriptional reprogramming associated with metabolism, detoxification, cuticle biosynthesis, endocrine signaling, and sensory perception. Among these, chitin synthase (DaCHS) emerged as a critical developmental gene, exhibiting pronounced up-regulation during late larval and pupal stages corresponding to intensive cuticle synthesis. Phylogenetic and structural analyses demonstrated that DaCHS is highly conserved among insects and retains canonical catalytic domains and transmembrane topology. Alpha Fold-based structural modeling and molecular docking confirmed stable interaction of DaCHS with its substrate, N-acetylglucosamine, supporting functional conservation of enzymatic activity. Oral delivery of DaCHS double-stranded RNA induced robust transcript suppression, leading to significant mortality and severe developmental defects, including larval and pupal abnormalities, and adults with disrupted wing and abdominal morphogenesis. CONCLUSION: These findings establish DaCHS as an indispensable gene for D. abbreviates development and validate transcriptome-guided RNAi as a powerful framework for target discovery. This work provides a strong molecular foundation for developing RNAi-based strategies that can be integrated into sustainable management programs for citrus root weevil control. &#xa9; 2026 Society of Chemical Industry.

Animals↗
PubMed2002

Ensuring quality and sustainability in after-school programs.

The Charles Stewart Mott Foundation and the U.S. Department of Education are engaged in a unique public-private partnership that strives to integrate the assets and flexibility of philanthropy with the breadth of a major federal program to support meaningful after-school programs and school-community partnerships for children, youth, families, and communities.

Adolescent↗
PubMed2003

Measurement of hemoglobin in long-term fixed erythroid cells: application development for cell science experiments in microgravity.

Studying the effects of microgravity on cell differentiation will enhance our understanding of fundamental biology and is indispensable for a sustained space program. Rauscher murine erythroleukemic cells were chosen as a model system to study erythroid cell differentiation aboard the International Space Station because these cells undergo differentiation in response to the natural inducer, erythropoietin, as well as various chemical-inducers. We have now developed a method to quantify hemoglobin in Rauscher cells after weeks of fixation and storage required for such space biology experiments. By exploiting the pseudoperoxidase activity of hemoglobin and by using reagents that yield a soluble chromophore that freely passes out of fixed cells, we developed a highly specific and sensitive assay applicable to cells fixed as long as 4 months.

Animals↗