Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Project START”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 325 records · Page 18Linked to original sources
PubMed1998

The last month of life: continuity, care site and place of death.

A hospice ward was opened in 1991 at the Orebro Medical Centre Hospital (OMCH) in Sweden. Shortly afterwards, a research project was started, which aimed to describe different aspects of the final period of life of a group of cancer patients. This exploratory study is part of this project and aims to assess continuity in the site of care for a group of severely ill cancer patients during the final stages of their lives, and their place of death within different cultures of care. This prospective study involved 56 adults with cancer who had been admitted to six specialized departments at OMCH. Demographic and diagnostic data, documentation of when the patients changed from one care form to another, as well as place of death were obtained. The analysis of continuity in terms of care site involved care-oriented cultures (hospice ward, hospital-based home care, primary care-based home care and nursing home) and cure-oriented cultures (acute hospital wards). Considered as a group, the patients spent one-third of their time at home during their final month of life, with or without formal caregivers. For individual patients, however, there were great variations with regard to continuity of care site and care form. A pattern was found for the type of cancer the patients had and where they were during their final month. Ten patients died in their own homes, and of the 46 who died in an institution, approximately the same number died in a care-oriented culture as in a cure-oriented culture.

Adult↗
PubMedDate not supplied

Implementing community-oriented primary care projects in an urban family practice residency program.

BACKGROUND: Clinics interested in pursuing community-oriented primary care (COPC) have struggled with the implementation of its theory. Although we are still early in the COPC transformation process, the HealthPartners Family Practice Residency Program has had several successful COPC projects during our 10 years of experience. This article describes these projects and the 8 lessons learned, including some that differ from traditional COPC teaching and practice. In our experience, clinics should select a topic or problem that creates a passion within their clinic. Projects can start small within the clinic and expand outward into larger portions of the urban community. Partnerships begin the process of extending into the community and increasing the project's impact. The evaluation of projects should begin with clinic-based data. A physician champion and a nonphysician staff person increase the success of the project. Resident involvement is enhanced with concrete tasks and community connections. Ultimately, the project needs to be institutionalized within the clinic to survive. The whole COPC endeavor is a long, slow process that requires time, energy, and committed individuals. In our experience, COPC is a journey, not an end, and there are many rich rewards to be found along the way.

Adolescent↗
PubMed2004

[Primary prevention of non-communicable diseases. Experiences from population based intervention in Finland for the global work of WHO].

Globally most people die from noncommunicable diseases. Especially in developing countries noncommunicable diseases are on the rise, effecting especially poorer societal segments. The noncommunicable diseases contribute greatly to societal and economic losses and inequities in health status. The North Karelia Project was started in Finland to prevent noncommunicable diseases and with the main aim to curb the high mortality from cardiovascular diseases. In collaboration with the community, the health sector, the food industry and mass media, initiatives were started to promote a healthy diet, physical activity and reduce smoking. Over the last 25 years, the age adjusted mortality rate among men of 25-64 years of age from cardiovascular diseases fell by 73%, from lung cancer by 71% and total mortality fell 49%. Each country should plan and implement its own prevention programs, but lessons can be learned from the North Karelia Project. The paper discusses some key lessons and recommendation from the project for countries and for global work. In the last few years WHO has started to up-grade its work to fight noncommunicable diseases. Some initiatives are presented and discussed.

Adult↗
PubMedDate not supplied

Health status and school achievement of children from Head Start and Free School Lunch Programs.

School health records of 332 children through the eighth grade were examined in a retrospective comparative analysis of physical health status and school achievement of children from Head Start and Free School Lunch Programs. The objective was to determine if nutrition early in the lives of children as a part of a comprehensive health and education program such as Head Start produces greater or different benefits for disadvantaged children than nutrition intervention later through free lunches when the child enters school. Cross-sectional longitudinal, and case-study approaches were used in the analysis. A group of no-food-program disadvantaged children and a group of advantaged children served as comparisons. Results showed that advantaged children performed better on all parameters of school achievement and health status compared with the disadvantaged children, regardless of the form of intervention. Measures of school achievement of Head Start and Free Lunch children did not differ from those of the disadvantaged comparison group, but there were significant differences in measures of health status between the disadvantaged groups. Fewer boys from Project Head Start fell below the 25th percentile for height compared with boys in the Free Lunch Program. Head Start children also scored higher in physical fitness and had fewer reported absences from school due to illness.

Achievement↗
PubMed2006

[Sealing of percutaneous nephrolithotomy access after complete stone removal with a hemostyptic gelatin powder (Spongostan)].

PURPOSES: Parallel to the pilot project of Lee et al. which was published in February 2004, we also considered the possibility to seal the percutaneous nephrolithotomy (PCNL) access after complete stone removal via the local amplatz sheath. We started our project with the aims of increasing postoperative patient comfort, minimizing the risk of bleeding, and reducing postoperative cost and length of the hospital stay by performing this minimally invasive technique in 7 patients with medium stone burden. MATERIALS AND METHODS: All patients were treated by removing stones via a working channel passing through the lower pole calix. After complete stone removal a hemostyptic gelatin powder (Spongostan, Johnson & Johnson) was prepared to a doughy paste, some drops of contrast medium were added and the whole material was introduced through the amplatz sheath into the working channel under imaging control. Imaging-controlled insertion of the doughy gelatin clot through the amplatz sheath into the parenchymal part of the channel alone resulted in immediate hemostasis in all patients. The amplatz sheath was retracted over a 28 Fr. rectal tube which was used to push the gelatin forward. There was no need for an additional tamponade of the renal fat capsule or the abdominal wall. After 2 minutes when no channel bleeding was apparent, the skin sutures were placed. RESULTS: Bleeding of the nephrostomy tract did not occur in any of the 7 patients. Average operating time was 50 minutes which was not significantly reduced by performing the new procedure. However, the hospital stay was reduced by 2 days. Two of the patients showed a single fever episode during the second postoperative evening. All patients presented with steady postoperative laboratory values without evidence of bleeding. Free urinary flow from the collecting system was controlled by means of ultrasound and urography. CONCLUSIONS: Similar to the recent usage of FloSeal/Baxter reported by Lee et al. we can confirm very reliable and immediate hemostasis using a pasty preparation of Spongostan (Johnson and Johnson) gelatin powder which was classified as being less toxic by the FDA in 2003 due to the lack of glutaraldehyde and bovine thrombin. Therefore, tubeless PCNL can be used for complete percutaneous clearance of stones without bleeding.

Administration, Topical↗
PubMed1999

Comparative genomics: the key to understanding the Human Genome Project.

The sequencing of the human genome is well underway. Technology has advanced, such that the total genomic sequence is possible, along with an extensive catalogue of genes via comprehensive cDNA libraries. With the recent completion of the Saccharomyces cerevisiae sequencing project and the imminent completion of that of Caenorhabditis elegans, the most frequently asked question is how much can sequence data alone tell us? The answer is that that a DNA sequence taken in isolation from a single organism reveals very little. The vast majority of DNA in most organisms is noncoding. Protein coding sequences or genes cannot function as isolated units without interaction with noncoding DNA and neighboring genes. This genomic environment is specific to each organism. In order to understand this we need to look at similar genes in different organisms, to determine how function and position has changed over the course of evolution. By understanding evolutionary processes we can gain a greater insight into what makes a gene and the wider processes of genetics and inheritance. Comparative genomics (with model organisms), once the poor relation of the human genome project, is starting to provide the key to unlock the DNA code.

Animals↗
PubMed2001

[Surveillance of drinking water supply with a geographic information system: a pilot project of the of the Iogd NRM and the Hoxter district].

Drinking water surveillance includes the use of spatial data. A geographic information system (GIS) is a practicable tool for work with spatial data in the health sector as well. Co-operation between the Institute of Public Health for North Rhine Westphalia, the local health authority of the Hoexter district and the Institute for Geoinformatics of the University of Muenster started a project testing the use of GIS for drinking water surveillance. A special application was programmed. It includes functions of retrieval and classification of the measured values of drinking water wells, in order to show time trends in a diagram and to visualise the location of the wells and the analysis data in a map. The members of the Public Health Office accepted the method and started using it regularly. In addition, the collaboration between the health authority and other local authorities was strengthened. Several data sets were included in the GIS, such as wells and results of water analysis, water protection areas, land use data, and topographical maps. Basing on to the experiences with this project, the development of a standard application is planned that is supposed to be communicated to all local health authorities in North Rhine Westphalia.

Germany↗
PubMed2005

[Domestic violence against women and health care demands. Results of a female emergency department patient survey].

Domestic violence (DV) is a serious risk for women's health. So far, little attention has been paid to this area in research and medical care in Germany. Acknowledging this deficit, the S.I.G.N.A.L.-Intervention Project has started to develop a program to improve the medical care for victimized women. For the first time in Germany, data on the health care needs of victimized women have been collected within the S.I.G.N.A.L.-Evaluation Research Project. This article presents the results of a female patient survey (n=806) on DV conducted in the emergency department (ED) of a university hospital in Berlin. The results demonstrate that 36.6% of women reported at least one episode of DV after the age of 16. A total of 4.6% were victims of DV over the past year, and 1.5% of women came to the ED for treatment of injuries caused by violence. A total of 57% of the victims of at least one episode of DV in their lifetime after the age of 16 described a negative impact on their health. The most frequently reported sequelae were head injuries, haematomas and fractures, gastrointestinal disorders, headache/migraine and heart disease. The psychological symptoms were anxiety, depression and suicide/self-mutilation attempts. Some 52% of the victims who reported health consequences had received medical care. In case of DV occurring, 67% of all women said that they would discuss it with their physicians. Approximately 80% of all respondents favoured a routine inquiry for DV as part of the medical history protocol of the ED.

Adolescent↗
PubMed2003

Intergenerational interaction in health promotion: a qualitative study in Brazil.

OBJECTIVE: In 1994 a pilot intergenerational project was started in the city of Taguatinga, Brazil, to promote the well-being of both elderly and adolescent populations using reminiscence processes as a means of interaction. The purpose of the study is to evaluate the project from the participants' viewpoint and to improve the contribution of those age groups in building up social capital. METHODS: From November 1999 to April 2000 a qualitative study using focus groups technique was conducted. Using a discussion guide, 9 groups of students, ranging in age from 13 to 19 years old, and 3 groups of elderly aged 60 years and over were interviewed to collect data regarding their interaction before and after an intergenerational program. RESULTS: The main findings suggested a change in attitude of young people toward old age and elderly people. Participating elderly people reported improvement in their health status. For both age groups the findings suggested a better understanding between generations. CONCLUSIONS: It seems that reminiscence intergenerational activity contributes to building up mutual trust and reciprocity. These results seem to indicate this is an alternative for investing in social capital and improving participants' well-being. However, further work is needed to support these findings.

Adolescent↗
PubMed2005

Implementation of a professional program in Finnish community pharmacies in 2000-2002.

The aim was to assess implementation of a national 4-year project to promote professional strategy in Finnish community pharmacies during the 2.5 years of program's action in 2000-2002. A survey of random sample of 734 community pharmacists in Finland was conducted in 2002 (response rate 51%, n = 376). The questionnaire included an implementation scale and two open-ended questions on patient counselling. Many of the actions were not optimally implemented 2.5 years after starting the project. Some individual actions may have been taken, but the systematic long-term development process has not yet been started in many pharmacies. Future challenges in implementation will be a better commitment of the pharmacy owners to the goals of the national professional strategy and a better access to Internet-based drug information sources while counselling patients.

Adult↗
PubMedDate not supplied

Implementation of a hypertension control program in the county of North Karelia, Finland.

A hypertension control program was established as part of the more comprehensive North Karelia Project. This project was started in 1972 in response to a petition from the population of North Karelia, a county in Finland, asking for national assistance to reduce the exceptionally high cardiovascular disease mortality and morbidity in the area. The North Karelia Project was carried out from 1972 to 1977.The hypertension control program was implemented mainly in local health centers by physicians and public health nurses, who followed guidelines issued by the project staff and worked under its supervision.Although the target population for the North Karelia Project was the entire population of North Karelia, the project focused on middle-aged men. The hypertension subprogram was introduced in steps. Its objectives included the training of health personnel, establishment of an information system in the county to educate people about hypertension, and organization of the detection, treatment, and followup of hypertensives. A hypertension dispensary was established in each of the 12 health centers in the county. Continuous training of the local public health nurses and physicians faciliated integration of the hypertension program into the operations of the health centers.A central hypertension register and the hypertension control clinics at the health centers were the essential tools in the systematic followup of hypertensives. Some 17,000 hypertensives were on the register by the end of the 5-year project.The main aim in providing health education about hypertension, as well as in treating hypertension itself, was to prevent severe cardiovascular diseases as a whole. Therefore the hypertension control program was integrated into the comprehensive cardiovascular disease control program, and hypertensives received advice concerning smoking and dietary changes as well as about high blood pressure.A survey of health care personnel in North Karelia and in a reference area showed that the care of hypertensives was more systematic in North Karelia and that its health care personnel were more satisfied with the cardiovascular disease care that was provided.

Adult↗
PubMed1989

[Evaluation of the basic health care pilot project of the Turnhout area].

A primary health care project was started two years ago by the PIH in collaboration with the health councils of ten municipalities in the region of Turnhout. The objective was to promote actions on better health that were beyond the capacity of existing regional health care facilities. The project is managed by representatives of the province and of the ten municipalities. The first subject for coordinated action was healthy eating. Three practical projects were developed: a salt concentration analysis of bread from 150 bakeries; a quality evaluation of the deep fat from 110 french fry stands and a secondary school programme entitled "Eat Healthy". A new concept of project development was proposed after the first study. 4 steps have to be considered in the future, which are: first to quantify the amount of the suspected health care problem in the region; secondly to activate an intervention strategy which tends to limit to suggest and initiate long term policy actions. Findings of the to suggest and initiate long term policy actions. Findings of the first project show that to obtain the desired results a well conceived information campaign is essential.

Belgium↗
PubMed1998

[How I treat a diabetes type 2 patient: the DREAM project for better general practitioner-specialist collaboration. Diabetes Reinforcement of Adequate Management].

Type 2 diabetes is an important public health problem because of its high prevalence and morbidity rate which both are associated with a considerable social and human cost. The general practitioner should play a central role in the management of patients with type 2 diabetes and try to meet the therapeutic objectives. Main goals include reinforcement of early diagnosis, by a better screening of individuals at risk for type 2 diabetes, achievement of a good glycaemic control, through an optimized antidiabetic treatment, correction of associated risk factors as well as detection and treatment of disease complications. DREAM ("Diabetes Reinforcement of Adequate Management") is a pilot project which started in Liege area end 1997 for at least 2 years. It aims at improving the management of type 2 diabetic patients through a better free collaboration between general practitioners and diabetologists and the adhesion to an optimized therapeutic strategy. This ambitious project benefits from the valuable support of three pharmaceutical companies.

Aged↗
PubMed1990

The Bassett Farm Safety and Health Project.

The Bassett Farm Safety and Health Project was started in 1980 when Drs. May and Pratt made clinical observations on respiratory illnesses in farmers. The initial work involved the investigation of clinical syndromes associated with dust exposures and, from there, environmental dust studies. The current scope of work of The Farm Safety and Health Project includes three major components: research, education, and patient care. The research activities currently include studies into the analysis of injuries on farms, hearing loss in a randomly selected population, and estimating the annual incidence of Silo Filler's Disease in New York State. Educational activities currently include a statewide hearing conservation project, and the provision of numerous education materials for farmers and farm workers. The clinical activities include the establishment of an occupational medicine clinic in the fall of 1988, designed specifically for evaluation and treatment of agricultural workers with occupation-related illness and injuries.

Accidents, Occupational↗
PubMed1993

Analytical quality goals and assessment to ensure transferability of laboratory results.

About 3 years ago NORDKEM started a project entitled 'Medical Need for Quality Specifications in Clinical Laboratories'. This communication describes the general approach of this project and a subproject oriented towards problems of transferability of clinical laboratory data. Attempts are made to estimate clinical goals for analytical measurements--either used alone or in combinations with other measurements or observations--in defined clinical situations. Various methodologies are used for the assessment of the clinical goals, starting, e.g., from clinical situations or biological reference data. The analytical quality specifications are expressed as total allowable errors. It is necessary to complement specifications of 'clinical goals' with data describing characteristics of the measurement procedure, preanalytical errors and internal and external quality assurance procedures in order to establish the laboratory quality specification guaranteed by the laboratory. Problems of transferability of clinical laboratory results occur both within a laboratory/hospital and between laboratories/hospitals/health care units, problems that sometimes make communication of laboratory results difficult or even meaningless. In order to study the transferability of clinical laboratory data within a health care region, so called 'transformation functions' could be used to characterize each laboratory in a strict quality assessment/proficiency testing procedure on the basis of analytical quality specifications. Under certain conditions, e.g. for analytical procedures with high specificity and documented stable analytical performance, numerical correction of analytical bias could be performed to decrease interlaboratory variation to a level specified by medical needs.

Cholesterol↗
PubMed2001

Multiple metal contamination from house paints: consequences of power sanding and paint scraping in New Orleans.

Power sanding exterior paint is a common practice during repainting of old houses in New Orleans, Louisiana, that triggers lead poisoning and releases more than Pb. In this study we quantified the Pb, zinc, cadmium, manganese, nickel, copper, cobalt, chromium, and vanadium in exterior paint samples collected from New Orleans homes (n = 31). We used interior dust wipes to compare two exterior house-painting projects. House 1 was measured in response to the plight of a family after a paint contractor power sanded all exterior paint from the weatherboards. The Pb content (approximately 130,000 microg Pb/g) was first realized when the family pet died; the children were hospitalized, the family was displaced, and cleanup costs were high. To determine the quantity of dust generated by power sanding and the benefits of reducing Pb-contaminated dust, we tested a case study house (house 2) for Pb (approximately 90,000 microg/g) before the project was started; the house was then dry scraped and the paint chips were collected. Although the hazards of Pb-based paints are well known, there are other problems as well, because other toxic metals exist in old paints. If house 2 had been power sanded to bare wood like house 1, the repainting project would have released as dust about 7.4 kg Pb, 3.5 kg Zn, 9.7 g Cd, 14.8 g Cu, 8.8 g Mn, 1.5 g Ni, 5.4 g Co, 2.4 g Cr, and 0.3 g V. The total tolerable daily intake (TTDI) for a child under 6 years of age is 6 microg Pb from all sources. Converting 7.4 kg Pb to this scale is vexing--more than 1 billion (10(9)) times the TTDI. Also for perspective, the one-time release of 7.4 x 10(9) microg of Pb dust from sanding compares to 50 x 10(9) microg of Pb dust emitted annually per 0.1 mile (0.16 km) from street traffic during the peak use of leaded gasoline. In this paper, we broaden the discussion to include an array of metals in paint and underscore the need and possibilities for curtailing the release of metal dust.

Air Movements↗
PubMed1997

Review by a local medical research ethics committee of the conduct of approved research projects, by examination of patients' case notes, consent forms, and research records and by interview.

OBJECTIVE: To monitor the conduct of medical research projects that have already been approved by the local medical research ethics committee. DESIGN: Follow up study of ethically approved studies (randomly selected from all the studies approved in the previous year) by examination of patients' case notes, consent forms, and research records and by interview of the researchers at their workplace. SETTING: Tayside, Scotland (mixed rural and urban population). SUBJECTS: 30 research projects approved by Tayside local medical research ethics committee. MAIN OUTCOME MEASURES: Adherence to the agreed protocol, particularly for recruitment (obtaining and recording informed consent) and for specific requirements of the ethics committee, including notification of changes to the protocol and of adverse events. RESULTS: In one project only oral consent had been obtained, and in a quarter of the studies one or more consent forms were incorrectly completed. Inadequate filing of case notes in five studies and of consent forms in six made them unavailable for scrutiny. Adverse events were reported, but there was a general failure to report the abandoning or non-starting of projects in two studies the investigators failed to notify a change in the responsible researcher. CONCLUSIONS: Monitoring of medical research by local medical research ethics committees promotes and preserves ethical standards, protects subjects and researchers, discourages fraud, and has the support of investigators. We recommend that 10% of projects should undergo on-site review, with all others monitored by questionnaire. This would require about six person hours of time and a salary bill of 120 pounds per study monitored.

Consent Forms↗
PubMed1996

Recruitment and enrollment for Project HeartBeat! Achieving the goals of minority inclusion.

OBJECTIVE: The inclusion of women and minorities in health research supported by the National Institutes of Health (NIH) has received increasing attention since the adoption of related guidelines by NIH in 1990. Investigators in population-based and clinical research may need to identify and recruit research participants from community settings in which little is known by investigators of the dynamics and day-to-day needs of the community. This was the case at the start of Project HeartBeat!, an intensive longitudinal study of the development of cardiovascular risk factors against the background of growth and maturation. This paper identifies those elements found essential when recruiting and enrolling minority participants for Project HeartBeat! METHODS: No prior experience had existed in the community from which the majority of Black participants were recruited to the Project. Therefore, recruitment methods were based on previous experience of the investigators as well as on the published reports of others. RESULTS: Immediate costs were substantially greater than projected, and the recruitment period was two years rather than one-a circumstance with longer-term implications as well. However, with the support of a community-based advisory committee, the school district, and a local recruitment staff, the recruitment goal was obtained. CONCLUSIONS: Recruitment and enrollment of minority participants can be especially challenging; however, many of those challenges are common to any target population. Elements that need to be adequately addressed include the researchers' involvement with the community in which the participants live, a tracking system to assess recruitment efforts, flexibility in the methods of recruitment, and adequate resources in time, money and personnel.

Adolescent↗