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Results for “Program Appropriateness”

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PubMed2004

Seroepidemiologic study on pertussis, diphtheria, and tetanus in the Fukuoka area of southern Japan: seroprevalence among persons 0-80 years old and vaccination program.

In Japan, mass vaccination for diphtheria, pertussis, and/or tetanus has been mandated by the Vaccination Law since 1948. In order to evaluate the efficacy of this vaccination policy, we conducted seroepidemiological studies on pertussis, diphtheria, and tetanus among individuals aged 0 - 80 years. The pertussis toxin seropositive rates of the vaccine-eligible groups and vaccine-ineligible groups were 55.0 and 57.9%, respectively. The seropositive rate of each group for diphtheria antitoxin was 76.3 and 75.7%, respectively. The tetanus antitoxin seropositive rates were 91.7 and 10.5%, respectively, showing a significant difference between the two groups (P < 0.001). For the three diseases, variations were seen between age groups in the geometric mean antibody titers due to changes of the vaccination program. The results of this study show that natural Bordetella pertussis infection has occurred more frequently than expected. In order to establish the most appropriate vaccination program for the control of pertussis, diphtheria, and tetanus in Japan, further evaluation is necessary.

Adolescent↗
PubMed1993

For want of a flight surgeon....

In 1863, Captain John Randolph Bryan conducted the Confederate States Army's first military reconnaissance balloon flights. On his second flight, he survived a class "A" aviation mishap. This article discusses the probable contributing mishap factors stemming from the lack of an effective aviation medicine program with appropriate flight surgeon input and participation. Physical standards, flying duty medical examinations, the Acceptability Rating for Military Aeronautics (ARMA), crew rest regulations, unit safety programs, physiological training, aviation life support equipment (ALSE), night vision training, survival training, and aircraft accident investigation are explored.

Aerospace Medicine↗
PubMed1995

The demand for graduate education in health services administration: a case study.

This article documents research into the demand for graduate education in health services administration/management with a case study model. Research included background information on the profession, the history of graduate education in health services administration, health care administrator demographics and their perceptions of the demand for graduate-prepared professionals and their own educational needs, most appropriate degree to offer, and curriculum content. The findings support the trend toward a balance between specific and general health care business skills in graduate education. Other schools may benefit from the student profile, program delivery, appropriate degree information, and curriculum content findings as well as the research instrument design and methodology when assessing and planning graduate programs in health services administration/management.

Curriculum↗
PubMed1977

Physical medicine and rehabilitation in the elderly arthritic patient.

The basic conservative therapy programs for elderly patients with arthritis include adequate physical rest and mental relaxation, analgesics, aspirin, and physical rehabilitation consisting of occupational and physical therapy with a good home therapy program providing appropriate balance between rest and activity. Proper protection from trauma and overuse of the involved joints, and appropriate nutrition can afford optimal improvement in health status and general resistance. Proper orientation of the patient regarding the nature of his disease and treatment program usually is required to obtain his full cooperation. A kind, encouraging, and understanding approach is most helpful in the elderly patient. Physical rehabilitation can help to relieve pain, decrease edema and deformities, improve muscle weakness and incoordination, and increase stamina. Difficulties with gait, transfers, and self-care can be solved or improved. Physical medicine and rehabilitation measures are important components of the challenging treatment of patients of all age groups who are afflicted with severe arthritis. It is most important to tailor these components of the treatment program to the problem presented by geriatric arthritic patients.

Aged↗
PubMed2006

Case report: homicide by a 10-year-old girl with autistic disorder.

This case study presents a 10-year-old girl with a diagnosis of Autistic Disorder, who killed her 6-month-old sister by throwing her out of a window. Her aggressive-impulsive behavior had a persistent pattern. She had a history of epilepsy, and was frequently exposed to physical abuse. She never attended a structured treatment program. Here, we discuss the possible risk factors including history of epilepsy, unsupervised-disorganized home environment, existence of physical abuse-neglect and lack of appropriate treatment program leading to violent behavior.

Aggression↗
PubMed1998

Risk factors for Toxoplasma infection in a reproductive age female population in the area of Belgrade, Yugoslavia.

The contribution to Toxoplasma infection of known transmission risk factors such as consumption of undercooked meat, contact with soil, and contact with cats, as well as that of age, degree of education, residence in central vs. suburban city communities, and year of entry into the study, has been investigated in a group of 1157 female residents (age range 15 to 45 years) of a defined geographic area (Belgrade) during a 4-years period (1988-1991). The rate of infection increased with age, ranging from 57% to 93%, with an overall mean of 77%. However, it decreased significantly over the study period (p < 0.01). Of the potential risk factors examined, regression analysis showed that the following: age (relative risk (RR): 1.18, 95% confidence interval (CI): 1.02-1.37, p = 0.022), undercooked meat consumption (RR: 2.22, 95% CI: 1.2-2.86, p = 0.001), and the year of entry into the study (RR: 0.69, 95% CI: 0.6-0.8, p = 0.000) were significantly associated with infection. However, while the consumption of undercooked meat contributed to the frequency of infection in the whole group, its significance increased with the degree of education but decreased with age, and was greater in women residing in the suburbs. In addition, in women below age 20, exposure to soil (farming, gardening) was significantly associated with infection (RR: 1.38, 95% CI: 1.12-1.97, p = 0.037). Since cats are the single source of toxoplasma oocysts, the above finding indicates that cats are an epidemiologically significant source of environmental contamination in Belgrade. However, cat ownership itself as a criterion of contact with cats was not associated with infection (p = 0.326). In the absence of a general screening in pregnancy program in Yugoslavia, these data point out the groups of pregnant women at the highest risk of infection and provide a basis for a region-appropriate educational program to prevent congenital toxoplasmosis.

Adolescent↗
PubMed1999

Anterior cruciate ligament injury in female athletes: epidemiology.

OBJECTIVE: To present epidemiologic studies on anterior cruciate ligament (ACL) injuries in female athletes. DATA SOURCES: MEDLINE was searched from 1978 to 1998 with the terms "anterior cruciate ligament" and "female athlete" among others. Additional sources were knowledge base and oral, didactic, and video presentations. DATA SYNTHESIS: Epidemiologic studies have focused on level of participation, specific sports, sex differences and contributing factors, injury mechanism, prevention programs, and outcomes studies. Female athletes have a significantly increased risk of noncontact ACL injuries over male athletes in soccer and basketball. CONCLUSIONS/RECOMMENDATIONS: I believe that appropriate intervention programs can reduce these alarming rates of ACL injuries.

Journal Article↗
PubMedDate not supplied

Broadening the scope of nursing practice: federal programs for children.

Various social programs are available to support the family unit when a child with special needs enters the health care system. Nurses are challenged to link families with appropriate federal programs. An understanding of selected legislation and the programs designed to implement those laws better enables them to meet that challenge.

Adolescent↗
PubMedDate not supplied

Management of extremity metastatic bone cancer.

It is important to have an aggressive and appropriate treatment program for patients with metastatic cancer to bone. Metastasis to bone should no longer be considered the beginning of the end. It should be an invitation for appropriate orthopedic oncologic involvement and management. Impending pathologic fractures of the long bones can be quickly and relatively easily managed with intramedullary rod fixation. Patients with adenocarcinoma should be monitored periodically to identify the focus of metastatic lesions early. Patients with large lesions previously considered disastrous can be managed successfully using modular oncology systems. Patients with metastatic cancer to bone deserve evaluation and management by orthopaedic oncologists familiar with their treatment.

Bone Neoplasms↗
PubMedDate not supplied

Developing a community program on cancer pain and fatigue.

PURPOSE: The overall purpose of this project was to establish a community-based educational model on pain and fatigue management for individuals with cancer. The specific aims were: 1) to develop an appropriate educational program; 2) to pilot test this program in a community setting that supported a self-care approach; and 3) to evaluate the program process and outcomes. DESCRIPTION OF PROGRAM: The I Feel Better program was implemented through a two-session educational workshop taught by masters-prepared oncology nurses and was held at four Southern California sites of The Wellness Community. The focus of the sessions was to provide participants with general information about each symptom, assessment and management of those symptoms, and strategies for effectively communicating with their healthcare providers. Sessions of 2.5-hour duration were held on Saturday mornings and required preregistration. RESULTS: The participants were primarily female and White, with an average age of 58 years. Participants reported considerable pain and fatigue. They also lacked accurate information about pain management. Program evaluation revealed that the content and format were well received by the participants. They rated the program as extremely useful and reported positive outcomes after the first session. CLINICAL IMPLICATIONS: This pilot educational intervention program has strong implications for multidisciplinary educational approaches for patients with cancer. Limitations resulted from the setting selected and the possibility that participants were already active in their fight against cancer. Generalization to other community settings may not be as successful. Programs could be cosponsored by several collaborating institutions to share resources. Referral to community programs by physicians, nurses, and social workers can occur as needed when identified during patient interventions. The voluntary participation of health professionals in community education programs could provide a valuable service for patients and a rewarding experience for educators.

Adult↗
PubMed1997

Utilizing the ultraviolet (UV detect) camera to enhance the appearance of photodamage and other skin conditions.

BACKGROUND: Ultraviolet (UV) light (Wood's light) has been used since 1903 to document alterations in the pigment of the skin. The development of standard UV photographic methods has allowed better opportunities for patient education and the monitoring of their therapeutic progress. OBJECTIVE: To incorporate standardized UV photography into our cosmetic dermatology practice as a tool for patient teaching and monitoring therapeutic programs. METHODS: Patients with Fitzpatrick Type I to III skin types were photographed with visible and ultraviolet light. The resultant photographic prints were discussed with the patient. When appropriate, therapeutic programs to reverse the findings were instituted for these patients. Follow-up photographs were used to document changes. RESULTS: The UV camera became a useful tool in our practice. One picture was worth a thousand words. The UV camera documented pigment changes, melasma, vitiligo, and posttraumatic or postsurgical hypopigmentation. The UV camera was also useful to monitor treatment programs designed to redistribute the pigment. CONCLUSION: The UV camera should become an integral part of sun damage detection both in the physician's office and in the community. Not only does the camera document pigmentary changes but it also demonstrates improvement after therapeutic intervention.

Adolescent↗
PubMedDate not supplied

Nosocomial infection control: an overview.

Nosocomial infections are one of the most important public health problems in the world today. Although a great deal of attention is being directed toward the control and prevention of these infections, old problems continue to occur and new problems are constantly arising. The approximately 5% rate of nosocomial infections among patients admitted to acute-care hospitals has a significant impact on patients morbidity and morality and on the financial concerns of the patient, hospital, and community. An effective, efficient, and sensitive surveillance program developed to meet the needs of the individual hospital is absolutely necessary to obtain data on nosocomial infections from which controls and prevention programs can be developed. At the same time, lessons can be learned from the experience of other hospitals. The nosocomial infection control and prevention program must be under the general direction of a representative, interested, effective infection control committee. One area of importance under the committee's responsibility is that of an appropriate isolation program practiced by all persons within the hospital.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

An orientation program for new graduate nurses: the basis of staff development and retention.

The nursing shortage and an increased demand for obstetric nurses led a Central Texas hospital to hire new graduates for the Level Three obstetric unit. This change in hiring policy necessitated a reevaluation of the orientation program resulting in a new approach in staff development. A three-phase program was developed beginning with orientation and socialization of the new staff member, continuing with the development of advanced skills, and leading to assignments of complex cases after completing appropriate educational programs. The program has fostered autonomy in the experienced staff nurse and increased job satisfaction as measured by advancement in the career ladder and retention rate. The program is regularly monitored by chart and peer review audits, as well as by the orientees' six-week and six-month evaluations.

Education, Nursing, Continuing↗
PubMed2003

An open Internet platform to distributed image processing applied to dermoscopy.

Proprietary systems for dermoscopy images analysis are available to improve the diagnosis and follow-up of the pigmented skin lesions. Their performance seems comparable with that of a human expert. Progress in computer-aided classification of melanocytic lesions depends notably on judicious choices of the algorithms dedicated to the extraction of signs from the dermoscopy images and of the method which combines these signs to classify the lesions. To allow the researcher's community to benefit from their large set of elementary algorithms already available for dermoscopy, we set up a system accessible through the Internet which: allows the engineers to register their algorithms while preserving their secrecy: their programs run on their own server; lets a user to define its own sequence of image analysis and to apply it to its images: the system automatically calls the appropriate remote programs; makes possible and stimulates the synergy of worldwide researchers in order to validate algorithms of images analysis best suited to achieve the correct diagnosis and to track the malignant melanoma; makes these techniques available to the greatest number of users through the Web and thus to support a mass screening; reduces the maintenance of the system to the minimum: it requires users only an Internet browser and engineers to follow a simple widespread standardised interface for distributed programs. Various problems should be addressed: the lack of standardisation of images acquisition: algorithms based on relative colours are best suited to this system; the copyrights on images and algorithms; charging the use of remote computer resources. This system allows for an international collaborative work in the fight against the malignant melanoma by offering a conceptual and technical platform of teledermoscopy. It is intended to support synergy between the engineers and the users implied in the diagnosis and teaching of dermoscopy.

Algorithms↗
PubMed2004

Clinical, demographic, and psychological characteristics of new, asymptomatic participants in a transvaginal ultrasound screening program for ovarian cancer.

BACKGROUND: Attitudinal, mood, and personality variables have been identified as predictors of uptake of routine screening for a variety of cancers, including those of the breast, cervix, and colon. Little information exists, however, regarding characteristics of participants in ovarian cancer (OC) screening. METHOD: Asymptomatic women (n = 312; mean age = 57.45 years; range = 26-80) were assessed immediately before undergoing an initial transvaginal sonography (TVS) screening test for ovarian cancer (OCS group). Their responses were compared to identical information obtained from an age- and education-matched group of women with no history of screening for OC (HC group). All respondents completed measures of OC-related attitudes, knowledge, beliefs and risk perceptions, dispositional characteristics (informational coping style and dispositional optimism), and psychological distress. RESULTS: Analyses revealed the OCS group was characterized not only by more OC-specific distress and a more extensive family history of OC but also by less optimism and less knowledge of OC risk factors. Group membership was unrelated to beliefs about the efficacy of TVS screening. CONCLUSION: Results have implications for development of programs to increase appropriate participation in OC screening programs.

Adult↗
PubMed2001

IVF births and pregnancies: an exploration of two methods of assessment using life-table analysis.

PURPOSE: Our purpose was to explore two methods of expressing the performance of IVF programs. METHODS: Using life-table methods, hazard and cure rates and a "monthly fecundability rate" were calculated for an Ontario IVF clinic. The rates were evaluated for their meaningfulness as indicators of the clinic's performance. RESULTS AND CONCLUSIONS: While the hazard rate describes monthly fertility among those who will eventually become pregnant, the fecundability rate describes fertility for all patients who enter the program, making it the more appropriate index for program comparisons. However, from a prospective patient's perspective, both methods are valid indices for summarizing a program's performance.

Birth Rate↗
PubMed2005

Axotrophin and leukaemia inhibitory factor (LIF) in transplantation tolerance.

Immune self-tolerance is controlled by a subset of T lymphocytes that are regulatory (Treg) and epigenetically programmed to suppress auto-reactive immune effector cells in vivo. By extrapolation, donor-specific transplantation tolerance might be controlled by donor-specific Treg that have acquired the appropriate epigenetic program for tolerance. Although such tolerance has yet to be achieved in man, proof of concept comes from mouse models where regulatory transplantation tolerance can be induced within the complex micro-environment of the spleen or draining lymph node. By studying whole spleen cell populations in a murine model of transplantation tolerance we have incorporated a complexity of environmental factors when looking for specific features that characterize tolerance versus aggression. This approach has revealed unexpected patterns of gene activity in tolerance and most notably that a novel stem cell gene, axotrophin, regulates T lymphocyte responsiveness both in terms of proliferation and in release of leukaemia inhibitory factor (LIF). Since LIF is a regulator of stem cells in addition to being a key neuropoietic cytokine, these preliminary results linking both axotrophin and LIF to transplantation tolerance lead us to propose that regulatory pathways encoded during the epigenetic development of Treg cells are related to pathways that regulate fate determination of stem cells.

Cell Differentiation↗
PubMedDate not supplied

Design considerations for multidisciplinary continuing nutrition education programs.

A multidisciplinary group of nutritional care providers was surveyed to assess degree of agreement on the relative importance of various areas of nutrition knowledge. A 35-item nutrition content area survey was mailed to a stratified, random sample (n = 400) of the American Society for Parenteral and Enteral Nutrition (ASPEN) membership representing dietitians, nurses, pharmacists, and physicians. Through the use of modified Delphi survey, respondents rated each content area as 'essential,' 'useful,' or 'nonessential' for inclusion in a proposed test to assess nutrition knowledge. Respondents from all disciplines agreed that they should be knowledgeable in 22 of the 35 content areas. Chi square tests were used to assess significant response differences among disciplines. Systematic differences were primarily between dietitians and pharmacists. The study results provide direction to multidisciplinary continuing nutrition education program planners regarding appropriate content for combined discipline programs as well as for those more discipline-specific.

Animals↗