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PubMedDate not supplied

Community-based exercise intervention: Zuni Diabetes Project.

Non-insulin-dependent diabetes mellitus (NIDDM) is a serious health problem among the Zuni Indians of New Mexico. In July 1983, Indian Health Service personnel initiated a community-based exercise program designed to help control NIDDM in the community. To retrospectively evaluate the effects of the exercise program, the medical records of 30 participants with NIDDM were compared with the medical records of 56 nonparticipants with NIDDM matched by age, sex, health-care provider, and duration of NIDDM. From 1 July 1983 through 1 October 1985, participants had a mean weight loss of 4 kg, whereas nonparticipants had a mean weight loss of 0.9 kg (P less than .05). Participants' fasting blood glucose values dropped by a mean of 43 mg/dl, compared to a mean drop of 2 mg/dl among the nonparticipants (P less than .05). Participants were significantly more likely than nonparticipants to have stopped their hypoglycemic medication (relative risk 4.2) and to have decreased their medication dosage (relative risk 2.2). These results suggest that participation in a community-based exercise program can produce significant weight loss and improvement in glycemic control among a group of Native Americans with NIDDM.

Adolescent↗
PubMed1980

Utility of electromyographic biological feedback in chronic stuttering: a clinical study with follow-up.

A systematic case study is presented in which eight chronic adult stutterers underwent an electromyographic (EMG) biological feedback training program designed to reduce masseter muscle tension in an effort to improve fluency. All subjects mastered the program within 10 30-min. sessions. Measures of muscle tension and fluency indicated improvement at the end of treatment that were maintained at 3- to 6-mo. follow-up.

Adult↗
PubMed1992

SILMUT: a computer program for the identification of regions suitable for silent mutagenesis to introduce restriction enzyme recognition sequences.

We describe a set of IBM-compatible computer programs designed to selectively identify the potential sites for silent mutagenesis within a target DNA sequence. This program is based on a novel strategy of identifying amino acid motifs compatible with each restriction site (BioTechniques 12:382-384, 1991). The programs can be used to identify the suitability for the introduction of any 6-base nucleic acid sequences, such as restriction enzyme sites in cassette mutagenesis strategies. The Table program generates a table of multiple amino acid motifs for each restriction enzyme, obtained by translating each unique recognition sequence in all three reading frames. The Silmut program, which utilizes the features of Table, will further identify the presence of a match between any amino acid motif of each restriction enzyme and the input target sequence. Minor manipulations of the data base files will enable the individual researcher to identify the potential for introduction of any 6-base sequences by silent mutagenesis.

Base Sequence↗
PubMed1988

[Birth in the rural area: an evaluation of prevention of perinatal risk in rural areas].

A study was designed and implemented between 1983 and 1985 in order to evaluate the effectiveness of a personalized health education program designed for pregnant women in the specific context of rural areas. The action succeeded in increasing the proportion of women benefiting from a monthly antenatal surveillance but many other results underline the limitations of such prevention programs that would be restricted to the information of the general public and health professionals. Perinatal morbidity in the north-alpine rural area ranks very favourably compared to the regional or national figures.

Evaluation Studies as Topic↗
PubMed1979

Cognitive modifiability in retarded adolescents: effects of instrumental enrichment.

The Instrumental Enrichment program, designed to modify the cognitive structures of retarded, disadvantaged adolescents, was contrasted with a General Enrichment program both in a residential setting and a day center. This study is based on 57 matched pairs drawn from the total research sample of 218 adolescents. One group in a residential center (n = 24) and one group in a day center (n = 33) received Instrumental Enrichment; one group in a residential center (n = 24) and one group in a day center (n = 33) received General Enrichment. The Instrumental Enrichment program extended over 2 years, and the subjects were pre- and posttested on a battery of criterion measures: general and specific cognitive tests, scholastic achievement, classroom interaction, and self-concept. The results indicated significantly better performance by the groups receiving Instrumental Enrichment than by the groups receiving General Enrichment on the tests of specific cognitive functions and scholastic achievement and on some of the classroom interaction scales. Results for the residential groups compared with the day-center groups revealed significant differences on the tests of scholastic achievement, in favor of the residential groups and on the classroom interaction scales in favor of the day-center groups.

Achievement↗
PubMed1983

Public and professional aspects of the use of education in the control and prevention of cancer.

Studies of educational programs designed to encourage (i) regular systematic breast self-examination and (ii) participation in cervical screening programs demonstrate the necessity for precision in defining and evaluating cancer education aims and methods. Preteaching and postteaching and one-year follow-up data from both studies compare the immediate and longer-term effects of teaching on opinions and knowledge and relate these to behavior.

Attitude to Health↗
PubMed1995

Cumulative number and morphological score of embryos resulting in success: realistic expectations from in vitro fertilization-embryo transfer.

OBJECTIVE: To define statistical thresholds for the number and morphological score of embryos transferred that would be predictive of reproductive success in an IVF program. DESIGN: A retrospective review of patient records. SETTING: The Mount Sinai Medical Center Assisted Reproductive Technologies Program. PARTICIPANTS: One hundred women who underwent IVF-ET for a diagnosis of tubal occlusion and later delivered viable infants. RESULTS: The mean number of embryos transferred before achieving live birth was 10.7 +/- 7.9 (mean +/- SD), with one half of patients achieving success within the first seven embryos transferred, and 95% achieving success within 25 embryos. For high quality embryos, the numbers were 7.5 +/- 6.3, 5, and 17, respectively, and, for the cumulative embryo score, a measure of both embryo morphology and metabolic activity, were 114.2 +/- 86.0, 83, and 280, respectively. Greater than 50% of live births occurred within the first two ET attempts. CONCLUSIONS: Although more than half of patients achieved reproductive success within the first two ETs and the first five high quality embryos transferred, after this threshold, fecundity declined rapidly. The calculation of cumulative embryo scores offered additional prognostic information. While all prior attempts to define IVF-ET failure have done so by including patients who did not become pregnant, we have found an analysis of our successes to be a useful adjunct in counseling patients.

Adult↗
PubMed1994

Functional communication with AD patients: a caregiver training program.

The loss of functional communication in Alzheimer disease (AD) results from the disproportionate breakdowns in the pragmatic and semantic areas of language in these patients. Communication breakdown is regularly listed among the top four stressors in measures of stress and burden of AD caregivers. A caregiver training program designed around seven specific communication strategies can be used to alter communication interactions. As a pilot program, the acronym FOCUSED organized the seven strategies for easy recall (Face-to-face, Orientation, Continuity, Unsticking, Structure, Exchanges, and Direct). Significant differences in both attitude toward AD patients, knowledge of AD, and knowledge of communication strategies were shown in comparisons of pre- and posttraining assessments.

Adult↗
PubMedDate not supplied

A systematic approach to continuing education for radiologic technologists.

As continuing education programs for radiologic technologists expand, it is important that needs be properly assessed and well-designed programs be developed. This reports on the step-by-step process of a regional medical education center to provide continuing education for technologists that would be most beneficial to them and indirectly to the patients they serve.

Curriculum↗
PubMed1996

Residents' experiences of abuse, discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.

OBJECTIVE: To assess the prevalence of psychological abuse, physical assault, and discrimination on the basis of gender and sexual orientation, and to examine the prevalence and impact of sexual harassment in residency training programs. DESIGN: Self-administered questionnaire. SETTING: McMaster University, Hamilton, Ont. PARTICIPANTS: Residents in seven residency training programs during the academic year from July 1993 to June 1994. Of 225 residents 186 (82.7%) returned a completed questionnaire, and 50% of the respondents were women. OUTCOME MEASURES: Prevalence of psychological abuse, physical assault and discrimination on the basis of gender and sexual orientation experienced by residents during medical training, prevalence and residents' perceived frequency of sexual harassment. RESULTS: Psychological abuse was reported by 50% of the residents. Some of the respondents reported physical assault, mostly by patients and their family members (14.7% reported assaults by male patients and family members, 9.8% reported assaults by female patients and family members), 5.4% of the female respondents reported assault by male supervising physicians. Discrimination on the basis of gender was reported to be common and was experienced significantly more often by female residents than by male residents (p < 0.01). Ten respondents, all female, reported having experienced discrimination on the basis of their sexual orientation. Most of the respondents experienced sexual harassment, especially in the form of sexist jokes, flirtation and unwanted compliments on their dress or figure. On average, 40% of the respondents, especially women (p < 0.01), reported experiencing offensive body language and receiving sexist teaching material and unwanted compliments on their dress. Significantly more female respondents than male respondents stated that they had reported events of sexual harassment to someone (p < 0.001). The most frequent emotional reactions to sexual harassment were embarassment (reported by 24.0%), anger (by 23.4%) and frustration (20.8%). CONCLUSION: Psychological abuse, discrimination on the basis of gender and sexual harassment are commonly experienced by residents in training programs. A direct, progressive, multidisciplinary approach is needed to label and address these problems.

Adult↗
PubMed1988

Case management and quality assurance to improve care of inner-city children with asthma.

Case management and quality assurance techniques were used in a program designed to improve the process and outcomes of care for inner-city children with asthma. The program had three major elements: assessment of the care of individual patients and feedback to their primary care providers, periodic contact with parents, and provision of educational materials about asthma to parents. Telephone interviews with parents were used to assess knowledge of home asthma care and the type of care prescribed by the child's physician. Medicaid and hospital records were used to measure acute care utilization. Eighty-eight children (aged 0 to 5 years) who had made more than two emergency room visits for asthma were recruited by telephone. Fifty-six prescribing errors were identified, 24 being failure to prescribe an additional drug for short-term use by children receiving continuous therapy. Acute care use dropped 50% compared with a control period. This type of program is feasible but may require in-person recruiting to reach high-risk families without telephones.

Asthma↗
PubMed1980

Residential mobility and long-term treatment of hypertension.

Maintenance of long-term care of populations with high mobility patterns poses problems for programs designed to prevent and treat cardiovascular and other chronic diseases. The Hypertension Detection and Follow-up Program (HDFP)--a community-based screening and treatment program implemented in 1973--provided an opportunity to examine residential mobility among adults under long-term treatment in 13 communities. Whereas 11% of hypertensives included in the HDFP changed residence in the first two years of the study, only 4% moved outside the service areas of the programs. Although a higher proportion of blacks (to whites) moved within the service areas, a similar proportion moved outside the service areas. This low residential mobility, especially the low rate of movement outside the service areas of the treatment centers, suggests that mobility of cohorts under long-term treatment and observation may present lesser problems to continuous, long-term community health care programs than do other factors affecting adherence.

Community Health Services↗
PubMed1975

Guidelines for the functioning of a helping service.

The purpose and the operation of an effective helping service are defined along the principles developed by R. R. Carkhuff. A functional operationalism directly linking each aspect of a helping service to the objective of servicing the needs of those people for whom the service exists is developed. The personal fitness of the staff as defined by their effectiveness at living is identified as the critical variable determining service effectiveness. The level of staff performance on the operational indices of physical, emotional, and intellectual functioning including, specifically, the interpersonal dimensions of empathy, respect, genuineness, concreteness, confrontation, and immediacy is designated as the operational basis for the organizational decisions of hiring, firing, promotion, and role assignment. Systematic programs designed to meet specific client needs serve to complete staff and service effectiveness.

Counseling↗
PubMed1982

Software for linear and non-linear optimization in external radiotherapy.

The study presents a set of programs designed to determine optimum dose distribution either by calculation of beam intensities and field width (in linear programming) or, in addition, by calculation of beam geometry (non-linear optimization). Various optimization criteria can be selected: homogeneity, concentration on target, entire dose in a sensitive area. The optimization method used is the gradient projection method, and doses are calculated by Cunningham formulae. The article describes the program operating modes, the main subroutines and their functions and specifications, and outlines an example.

Computers↗
PubMed1997

Risk factors for adult paternity in births to adolescents.

OBJECTIVE: To examine the risk factors for adult (aged 20 years and older) paternity in births to teenagers (14-17 years of age). METHODS: This was a population-based, retrospective cohort analysis of 27,215 adolescent mothers residing in California who had a live singleton birth during 1993. Adjusted risks for adult paternity by paternal and maternal characteristics were derived from comparisons of adult-teen and teen-teen couples. RESULTS: Adult fathers, who were responsible for 49.2% of births to teenage mothers, were a mean of 6.4 years older than the mother. The most important risk factors for adult paternity were as follows: father's (odds ratio [OR] 5.19; 95% confidence interval [CI] 4.43, 6.08) or mother's (OR 1.33; 95% CI 1.14, 1.55) educational attainment of at least 3 years lower than expected for their age, two or more previous live births (OR 3.34; 95% CI 2.48, 4.53), mother's birthplace outside the United States (OR 2.33; 95% CI 2.11, 2.58), father's (OR 2.16; 95% CI 1.98, 2.36) or mother's (OR 1.28; 95% CI 1.15, 1.42) educational attainment 1-2 years lower than expected for their age, one previous live birth (OR 1.92; 95% CI 1.75, 2.12), and Asian (OR 1.29; 95% CI 1.04, 1.62) or African American race (OR 1.25; 95% CI 1.06, 1.46) of the father. CONCLUSIONS: Teenage pregnancy prevention programs must address adult paternity, which contributed to almost half of the births in our study. These programs should consider education adequacy, cultural beliefs and practices, previous live births, and race and ethnicity when designing programs to decrease the number of adults involved in teenage births.

Adolescent↗
PubMed1997

EasyMA: a program for the meta-analysis of clinical trials.

Meta-analysis of clinical trial data is an increasingly important method in clinical research, particularly in the field of therapeutic evaluation. This method uses some specific statistical techniques which are not all available on standard packages and therefore require specific developments. This paper describes a program designed to help medical researchers perform meta-analyses of clinical trial data with dichotomous outcomes. This program includes the various statistical methods of meta-analysis and enables cumulative meta-analysis and sub-groups to be performed. A robustness index can be determined and the results obtained in table and graphic formats. Data-editing and data-manipulating facilities are also possible. Much care has been taken to make the user interface as user-friendly as possible, so that the program is within the reach of all medical researchers.

Biometry↗
PubMed1997

A controlled trial of an educational program to prevent low back injuries.

BACKGROUND: Low back injuries are common and costly, accounting for 15 to 25 percent of injuries covered by workers' compensation and 30 to 40 percent of the payments made under that program. The high costs of injury, the lack of effective treatment. and the evidence that there are behavioral risk factors have led to widespread use of employee education programs that teach safe lifting and handling. The effectiveness of those programs, however, has received little rigorous evaluation. METHODS: We evaluated an educational program designed to prevent low back injury in a randomized, controlled trial involving about 4000 postal workers. The program, similar to that in wide use in so-called back schools, was taught by experienced physical therapists. Work units of workers and supervisors were trained in a two-session back school (three hours of training), followed by three to four reinforcement sessions over the succeeding few years. Injured subjects (from both the intervention and the control groups) were randomized a second time to receive either training or no training after their return to work. RESULTS: Physical therapists trained 2534 postal workers and 134 supervisors. Over 5.5 years of follow-up, 360 workers reported low back injuries, for a rate of 21.2 injuries per 1000 worker-years of risk. The median time off from work per injury was 14 days (range, 0 to 1717); the median cost was $204 (range, zero to $190,380). After their return to work, 75 workers were injured again. Our comparison of the intervention and control groups found that the education program did not reduce the rate of low back injury, the median cost per injury, the time off from work per injury, the rate of related musculoskeletal injuries, or the rate of repeated injury after return to work; only the subjects' knowledge of safe behavior was increased by the training. CONCLUSIONS: A large-scale, randomized, controlled trial of an educational program to prevent work-associated low back injury found no long-term benefits associated with training.

Adolescent↗
PubMed1991

The Pawtucket Heart Health Program. Influencing adolescent eating patterns.

The Pawtucket Heart Health Program, a research effort testing a process of community activation for cardiovascular risk factor behavior change, risk factor change, and coronary heart disease event rate change, utilizes risk factor behavior change programs for the entire population of a northeastern city. A diversity of nutrition programs designed to teach new skills and to alter the nutrition environment have been delivered. These include group programs, highlighting restaurant menus, labeling grocery shelf items, screening for blood cholesterol levels accompanied by nutritional counseling, and provision of programs in schools. In addition to standard curricula, the Heart Healthy Cook-Off for both junior high school and high school students has been developed. Students select recipes, make substitutions to lower fat, saturated fat, and cholesterol content, analyze original and substitution recipe nutrient content using a microcomputer and nutrient analysis software, and prepare the food. A panel of judges assesses presentation, taste, and health-promoting characteristics. In one junior high school class, cholesterol measure before and after the cook-off decreased by 10.7% among those with elevated cholesterol. The Heart Healthy Cook-Off is an education program that influences the culinary practices of children in an enjoyable, challenging format.

Adolescent↗