Sources of support for regular operating programs: state appropriations, tuition and fees, and endowment income.
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Economics, Medical↗
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Results for “Program Appropriateness”
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[Electrophysiologic studies on the peripheral part of the human ear, using appropriate computer programs].
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Action Potentials↗
Development of oral-motor skills in the neurologically impaired child receiving non-oral feedings.
Treatment of children with swallowing dysfunction requires a holistic approach based on a global view of their problems and needs. The connection of the swallowing mechanism with the sensorimotor organization of postural tone and movement throughout the body is a critical factor in the evaluation and treatment of children whose dysphagia is rooted in a neurologic disorder. An appropriate program includes work with the development of movement skills, sensory processing, learning, social skills, and communication. The initial focus is placed on oral-motor treatment, rather than direct work on oral feeding. The primary goal of the program is to develop the appropriate use of the mouth, respiratory, and phonatory systems in exploration, sound play, and as much oral feeding as possible. Oral feeding is the by-product of a total program, not its major goal.
Child↗
Managing patient length of stay better using an appropriateness tool.
A multidisciplinary group from two medical floors at the Royal Victoria Hospital chose the Managed Care Appropriateness Program (MCAP) to evaluate the appropriateness of the days of stay for their patients. Of 100 charts of consecutive patients examined by the nurse reviewer (comprising 1,095 patient days), 33 percent of the days were deemed inappropriate. The reasons for each of these inappropriate days were documented, and strategies were implemented to address the issues. The major outcome of the study was a change in the culture of the health professionals to a more positive approach to defining and carrying out efficient patient care.
Data Collection↗
Pursuing the course from research to practice.
Diffusion of Innovation Theory describes the typical course by which innovations become standard practice. Research-based prevention programs are one such innovation. These programs have passed through the early phases of diffusion-innovation development and adoption by progressive schools that seek out innovations. With one quarter of the nation's schools having adopted a research-based program, the field is currently in the early majority phase of diffusion. If the patterns of normal diffusion hold true, this phase is likely to be characterized by emerging tensions between program developers and adopting schools. There are several concerns that require attention from researchers and practitioners. Practitioners need to develop their capacity to implement programs with fidelity and to adapt programs appropriately to meet their circumstance. Program developers need to simplify and redesign programs to make them appealing and useful to teachers. Operational capacity to fulfill orders and provide training needs to be developed.
Diffusion of Innovation↗
HIV/AIDS prevention programs: methodologies and insights from the dynamic modeling literature.
Given the quickly changing landscapes of both global HIV infection and the HIV prevention literature, it has become increasingly difficult to identify or design an effective HIV prevention program. The authors discuss methods of selecting an appropriate program so that readers can critically evaluate the literature and create a suitable program for their unique setting. The intent of this article is to provide the reader with analytic modeling tools and methodology to search effectively the literature so that an appropriate and successful HIV prevention program can by selected by an organization or project team.
Acquired Immunodeficiency Syndrome↗
Web-based UMLS concept retrieval by automatic text scanning: a comparison of two methods.
The Web is increasingly the medium of choice for multi-user application program delivery. Yet selection of an appropriate programming environment for rapid prototyping, code portability, and maintainability remain issues. We summarize our experience on the conversion of a LISP Web application, Search/SR to a new, functionally identical application, Search/SR-ASP using a relational database and active server pages (ASP) technology. Our results indicate that provision of easy access to database engines and external objects is almost essential for a development environment to be considered viable for rapid and robust application delivery. While LISP itself is a robust language, its use in Web applications may be hard to justify given that current vendor implementations do not provide such functionality. Alternative, currently available scripting environments for Web development appear to have most of LISP's advantages and few of its disadvantages.
Artificial Intelligence↗
Programming of sensor driven pacemakers.
The chronotropic response is the most important means by which cardiac output is increased and oxygen delivery is maintained in response to increased oxygen consumption during exercise or stress. When the chronotropic response is suboptimal or absent, exercise intolerance results. This condition, called chronotropic incompetence can be treated effectively with a sensor-driven rate-responsive pacemaker. The effectiveness of this therapy assumes that the pacemaker is programmed appropriately. This article focuses on the programming of sensor-driven pacemakers and provides additional suggestions for follow-up testing to ensure maximal benefit from these devices.
Arrhythmias, Cardiac↗
An interdisciplinary effort to help patients with limited prescription drug benefits afford their medication.
BACKGROUND: Patients without prescription benefits present a significant challenge to health care providers. The inability of patients to afford medication may serve as a barrier to adherence and may ultimately result in poor patient outcomes. In this report, we describe the system used at a university-based adult internal medicine center to assist patients in affording medication. METHODS: Patients in need of prescription assistance are identified by any member of the interdisciplinary team, which consists of physicians, clinical pharmacists, nurses, a social worker, a financial counselor, and a dietitian. Medication profiles are reviewed to identify less expensive alternatives. State, federal, institutional, and pharmaceutical company assistance program eligibility is determined, and the appropriate program is accessed. RESULTS: The described approach is effective in assisting patients without prescription benefits with the procurement of medication. CONCLUSION: Use of this interdisciplinary approach is an innovative solution to a common problem encountered in the outpatient setting.
Adult↗
Effects of field-based training on teachers' knowledge and attitudes and the motor proficiency of their handicapped students.
The purpose of this study was to evaluate the effects of field-based training on the knowledge and attitudes of regular physical education teachers and the motor proficiency of their handicapped students. Twenty-four physical education teachers from a large, city school district completed a program in two phases, one on appropriate motor development for special populations followed by an implementation phase involving 46 handicapped students. An inventory was designed to measure teachers' knowledge, the Measurement of Attitudes Toward Disabled Persons scale measured teachers' attitudes, and the Bruininks-Oseretsky Test of Motor Proficiency measured handicapped students' motor ability. Analysis showed that teachers' knowledge increased significantly from pre- to midproject. Nonsignificant changes were noted for teachers' attitudes although positive increases occurred throughout the project. There was a significant increase in the motor ability of the handicapped students as a result of appropriate programming. Some change among teachers and students was encouraging.
Adolescent↗
[Status of the clinical laboratory in the mandatory postgraduate medical training system from the standpoint of the community hospital].
In city hospitals, it is difficult to develop an appropriate program for laboratory medicine. The ideal goal for the future on the basis of experience is that trainees study emergency tests, blood transfusion and microbiology as practical matters. In addition, it is effective to learn how to reply to consultations from physicians, to learn the laboratory flow, and to present interpretations of laboratory data with the laboratory physician at each case conference. The objectives of these training programs are to gain skills for appropriate laboratory utilization and interpretation, and develop communication and consultation with laboratory physician and medical technologists. The key points of success in training are that teaching divisions have confidence in the laboratory. Particularly, cooperation with medical technologists is necessary, and is essential medical practice for trainees because they will have to work together in the future. In addition, working with trainees increases the pride and dignity of medical technologists.
Education of Persons with Intellectual Disabilitie↗
Developing a culturally appropriate depression prevention program: the family coping skills program.
Depression is a disorder that can have particularly deleterious effects on individuals from racial/ethnic minority and low-income backgrounds. Culturally appropriate prevention programs offer a way to provide accessible and effective mental health services to these underserved populations. The authors introduce the Family Coping Skills Program (FCSP), a novel depression prevention program developed specifically for low-income Latina mothers. The authors present the theoretical underpinnings of the FCSP and describe their efforts to make the program culturally appropriate and to enhance recruitment and retention of participants. Initial outcome data from an uncontrolled trial were promising and support continued development and evaluation of the FCSP and other similar programs.
Adaptation, Psychological↗
Providing for the severely handicapped: a case for competency-based preparation of occupational therapists.
Recent court decisions that mandate the development of new instructional alternatives for severely handicapped children will have significant implications for occupational therapists. Focusing on such issues as mainstreaming, accountability, and certification standards, this paper places in perspective the problems and trends that have led to this new challenge. It also provides suggestions for the development and disposition of training programs that can ultimately result in more appropriate programming for the handicapped children in the new population to be served in the public schools. Illustrated with examples of competency components and behavioral objectives, competency-based occupational therapy preparation programs are emphasized.
Child↗
Cerebellar lesions impair context-dependent adaptation of reaching movements in primates.
To produce accurate movements when conditions change suddenly, the brain must be capable of learning multiple versions of a given motor task and must be able to access the appropriate program using sensory information linked to the context of the movement. The neural basis for context-dependent motor learning is uncertain, but the cerebellum is thought to play a fundamental role. In this study, we examined the effect of lesions of the dorsal vermal and paravermal cerebellar cortex on the adaptation of reaching movements produced by modified visual feedback and accessed with a visual cue. Two rhesus monkeys were trained to point to targets displayed on a video monitor while viewing monocularly with either eye. During the experimental sessions, visual information received by one eye (the "modified" eye) was displaced horizontally, while the information received by the other ("normal") eye remained unaltered. In the first set of experiments (noncontextual paradigm), the animals pointed to targets while viewing with the modified eye. This paradigm resulted in a gradual improvement in pointing accuracy when viewing with that eye, but also produced a shift in pointing responses of equivalent size when viewing with the normal eye. In the second set of experiments (contextual paradigm), the animals alternated six blocks of reaches while viewing monocularly with the modified eye with six blocks viewing with the normal eye. This paradigm improved the pointing accuracy when viewing with the modified eye, but produced only a small shift in pointing responses when viewing with the normal eye. After the dorsal vermal and paravermal cerebellar cortex were resected, no change occurred in the pattern of adaptation produced by the noncontextual paradigm. The contextual paradigm, however, no longer selectively adapted pointing responses for each eye, but rather produced a pointing shift of equivalent size when viewing with either eye. The results indicate that pointing responses can be differentially adapted for each viewing eye, which is a form of context-dependent motor learning. This capability was lost after focal lesions of the dorsal vermal and paravermal cerebellar cortex, suggesting that these regions of cerebellar cortex are required to learn or store multiple representations of a movement, or to retrieve the appropriate motor program in a given sensory context.
Adaptation, Physiological↗
An alternative baccalaureate curriculum plan for RNs.
It is a need of our times to improve the quality of baccalaureate programs for RN students. Professional pressures to secure the degree must be accompanied by the availability of appropriate programs. The yardstick of measure should not differ between generic or RN student. Care should be taken to assure that the competencies commensurate with a baccalaureate degree are attained by any graduate. It is inappropriate to extend the learning requirements for RNs beyond the basic degree requirements. In developing an alternative program for RNs, care should be taken to provide a program congruent with the philosophy, conceptual framework and objectives of the parallel program. Since the entering competencies of RNs differ from those of the basic student, curricular alternatives and course modification should address only that portion of knowledge that is unique. Clinical experiences should be planned to facilitate skill development in those areas that are needed. Registered nurse students should not be placed in clinical sections which fail to foster new skill development. Hopefully, as schools develop more appropriate BS(N) educational programs we will enjoy the success of assisting in the learning process and find the graduates not merely pleased by the degree obtained as a route to better employment opportunities but pleased with the knowledge and skills they have obtained by way of the degree.
Competency-Based Education↗
Computer-aided human modelling programs for workstation design.
In designing a workstation, computer-aided human modelling programs can be used advantageously to analyse human-fit to the workstation components. The analysis is performed within a three-dimensional computer graphics environment. To illustrate the current state of development, six representative programs were selected: CYBERMAN, COMBIMAN, CREW CHIEF, JACK, SAMMIE, and MANNEQUIN. The programs differ considerably in terms of system requirement, operating characteristics, applicability and the various ergonomic evaluation functions available in the human modelling programs. The comparative analysis of the programs will aid the user to select the appropriate program for a particular workstation design.
Anthropometry↗
Development of a distance-based interval throwing program for Little League-aged athletes.
We developed a distance-based interval throwing program for Little League-aged athletes (9 to 12 years) to be used in training and rehabilitation. The timing and repetition parameters were developed from data collected during 400 innings of organized baseball during a single season, and short toss distance from Little League rules for field dimensions. There were 1022 boys from organized baseball teams in the four studies. Maximal distance and speed measurements were recorded for 853 boys. We developed a mathematical model from these data to predict maximal throwing distance from maximal throwing speed. This model was then tested on a second sample of 114 players. We compared the predicted distance with the actual maximal throwing distance; the correlation coefficient was 0.92. Forty players aged 9 to 12 participated in a study to assess degradation of speed and distance. The average variability of the speed was small (< 5 mph), but the variability in distance was large (22.4 feet). Fifteen boys then threw the entire throwing program as designed. These results show that healthy young athletes can be expected to be able to throw the predicted value of this practical progressive interval throwing program for Little League-aged athletes. The appropriate program can be assigned from age and known preinjury pitch speed.
Adolescent↗
Keeping the program in-house.
The Scott and White Medical Institution identified a need to provide management development to its first-line, middle, and upper management personnel. What kind of program would have institution-wide appeal, application, controlled implementation, and maintenance, and at the same time could be delivered for a reasonable cost and enhance communication? Scott and White found the answer through an in-house, multi-level development program that utilizes available managers as speakers. From the beginning, managers throughout the institution became involved in the development of the program. Their early involvement ensured ease of implementation, appropriate program content, and evaluation. This effective management development program is an excellent model for a medical group seeking to further develop its team of managers.
Administrative Personnel↗