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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.

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PubMed1995

Health promotion services and evaluation in the workplace: pragmatic issues.

1. Nurses in the workplace can positively affect employee health and wellness, which ultimately affects productivity and profit. 2. Evaluative research about health promotion services provides useful data about programs and cost effectiveness. 3. Knowing the issues and variables affecting the provision of health promotion services and the evaluation of program outcomes helps nurses plan appropriate services and programs as well as valid and reliable research projects. 4. Major issues include: system entry, management support and commitment, environmental context, ethical considerations, program variables, research design, instruments and equipment, program sites and times, type of program/services, and recordkeeping.

Health Promotion↗
PubMedDate not supplied

Pharmacist-managed intravenous to oral step-down program.

In an effort to provide cost-effective pharmaceutical care at a 650-bed community hospital, a pharmacist-managed intravenous to oral step-down program was developed and implemented. As part of this program, satellite pharmacists review daily the charts of patients receiving 1 or more of 10 targeted drugs given intravenously. Based on a predetermined set of criteria and their clinical judgment, pharmacists recommend that physicians switch to the oral formulation of the targeted drugs if appropriate. This program has been in place for 7 months, during which time 223 recommendations were made. Of these recommendations, 190 were accepted and implemented, resulting in a cost savings of $21,596.00. When annualized, the expected savings is $37,000.00 or nearly the salary of one full-time pharmacist. This program has been well accepted by physicians and pharmacists. It appears to be having a positive impact on physician awareness of using oral medications when appropriate.

Administration, Oral↗
PubMedDate not supplied

A comparative analysis of computer-based grading programs.

There are several elements to nursing students' course grades: quizzes, examinations, and presentations. There are several weights for the elements, which adds to the complexity of calculating grades. The accuracy and efficiency of calculating grades can be increased with the help of an appropriate computer program. Nursing faculty may have access to a variety of these computer software programs to aid them in calculating and maintaining students' course grades. These programs include spreadsheets, specific grading programs, and grading features included in online course programs. This article reviews selected computer-based grading programs and reviewers' evaluation of each program, based on the major features.

Education, Nursing↗
PubMed2005

Who's really hypertensive?--Quality control issues in the assessment of blood pressure for randomized trials.

The characterization of blood pressure in treatment trials assessing the benefits of blood pressure lowering regimens is a critical factor for the appropriate interpretation of study results. With numerous operators involved in the measurement of blood pressure in many thousands of patients being screened for entry into clinical trials, it is essential that operators follow pre-defined measurement protocols involving multiple measurements and standardized techniques. Blood pressure measurement protocols have been developed by international societies and emphasize the importance of appropriate choice of cuff size, identification of Korotkoff sounds, and digit preference. Training of operators and auditing of blood pressure measurement may assist in reducing the operator-related errors in measurement. This paper describes the quality control activities adopted for the screening stage of the 2nd Australian National Blood Pressure Study (ANBP2). ANBP2 is cardiovascular outcome trial of the treatment of hypertension in the elderly that was conducted entirely in general practices in Australia. A total of 54 288 subjects were screened; 3688 previously untreated subjects were identified as having blood pressure >140/90 mmHg at the initial screening visit, 898 (24%) were not eligible for study entry after two further visits due to the elevated reading not being sustained. For both systolic and diastolic blood pressure recording, observed digit preference fell within 7 percentage points of the expected frequency. Protocol adherence, in terms of the required minimum blood pressure difference between the last two successive recordings, was 99.8%. These data suggest that adherence to blood pressure recording protocols and elimination of digit preferences can be achieved through appropriate training programs and quality control activities in large multi-centre community-based trials in general practice. Repeated blood pressure measurement prior to initial diagnosis and study entry is essential to appropriately characterize hypertension in these elderly patients.

Aged↗
PubMed1979

Abnormal antepartum fetal heart rate tracings, failure to intervene, and fetal death: review of five cases reveals potential pitfalls of antepartum monitoring programs.

The goal of antepartum fetal heart rate monitoring is to identify which infants among high-risk obstetric patients are at risk for intrauterine death and which are not. Effective programs, by appropriately selecting cases for intervention and nonintervention, should contribute to lowering of perinatal morbidity and mortality rates. A review of five fetal deaths preceded by abnormal antepartum FHR tracings suggests effective programs require strict control. Individuals performing the testing should be experienced and knowledgeable in regard to instrumentation characteristics and recognition of normal and abnormal fetal heart rates. Dual responsibility of antepartum testing and providing primary patient care to labor and delivery patients is undesirable. Test interpretation should be based on strict criteria.

Adult↗
PubMed1994

An educational program for neonatal intensive care unit developmental care.

An innovative educational program on developmental care of the neonate was successfully implemented within the high-tech environment of a Level III NICU. Devised by a multidisciplinary team, the program provided appropriate levels of education to all personnel--from neonatologists to housekeeping staff--involved on a day-to-day basis with the infants. To assist those wishing to implement a similar program in their institution, details of program development, content, implementation, evaluation, and future goals are discussed.

Child Development↗
PubMed1995

Post-stroke rehabilitation: assessment, referral, and patient management. U.S. Department of Health and Human Services Public Health Service. Agency for Health Care Policy and Research.

This Quick Reference Guide for Clinicians contains highlights from Post-Stroke Rehabilitation, Clinical Practice Guideline No. 16, which was developed by a multidisciplinary, private-sector panel comprised of health care professionals and a consumer representative. The Quick Reference Guide for Clinicians is an example of how a clinician might implement the panel's findings and recommendations on the overall management of stroke patients who need post-stroke rehabilitation programs or services before returning to a family or other living environment. Topics include medical management of patients, systematic assessment and evaluation of patients throughout acute care and rehabilitation, referring patients to appropriate rehabilitation programs, managing the rehabilitation process, discharging patients from rehabilitation programs, and reintegrating patients into family and community environments.

Cerebrovascular Disorders↗
PubMed1997

Positive approaches to dementia care in the home.

Healthcare providers must select appropriate interventions for dementia patients as they assist families in the struggle to understand the changes in loved ones and to learn how to effectively manage the caregiving challenges. This Dementia Care Program prescribes appropriate strategies for the patient's remaining functional abilities as cognition declines. The interdisciplinary approach of nursing and occupational therapy allows for a careful assessment and the use of strategies designed to facilitate optimal function and prevent or reduce behavioral disturbances common in dementia patients. Use of the Allen Cognitive Levels provides a framework that permits more precise care plans and more successful interventions for both professionals and families who care for those with dementing disorders.

Alzheimer Disease↗
PubMed1979

Industrial hearing conservation.

Hearing conservation programs, when appropriate in industry, are now a necessity. Even though one may not wish to adopt an altruistic attitude toward the conservation of hearing, one must, like it or not, initiate a hearing conservation program because of both federal and state regulations. Since industrial noise exposure produced more hearing loss in more people than all other causes of hearing loss combined, it is incumbent on all industries with noise makers to do something about protecting human hearing. The tragedy is that nearly all industrial hearing loss can be prevented with proper hearing conservation measures. The cost of hearing conservation is far less than the cost of hearing loss in terms of human suffering and dollars in the compensation courts. Proper education of both managment and labor can result in successful hearing conservation programs. The method of choice is reduction of the noise at the source, but in many cases this is infeasible both technically and economically and therefore protection at the ear must be used. Experience has shown that with proper supervision ear protection programs can prevent the majority of instances of hearing loss in the majority of individuals exposed.

Acoustics↗
PubMed2001

A means to an end: an overview of a hyperlipidemia outcomes management program.

Quality management and improvement are increasingly important to managed care organizations (MCOs) as competition increases. One key area on which quality improvement programs can focus is MCO activity in helping patients remain healthy. Screening for and treatment of hyperlipidemia are important components of the preventive care of patients who are at risk for coronary heart disease (CHD). This article summarizes the methodology of a three-phase hyperlipidemia outcomes management program being implemented by 27 US health plans. Phase 1 identifies inefficiencies in the clinical management of hyperlipidemia by assessing patients' attainment rates of low-density lipoprotein cholesterol (LDL-C) targets. This information is then used to develop a multifactorial intervention program for CHD prevention in phase 2. The interventions for physicians include provision of treatment algorithms for patients with varying degrees of hyperlipidemia, education programs encouraging appropriate treatment of hyperlipidemia, and academic detailing summarizing phase 1 results and providing applicable literature. In phase 3, patient records are reassessed at least 6 months after the educational intervention. This three-phase program has the potential to improve patient care, reduce unnecessary treatment costs, provide a means of quality improvement, and increase plan value to potential purchasers.

Cholesterol, LDL↗
PubMed2005

Social support and the physical activity behaviours of people with a brain injury.

PRIMARY OBJECTIVE: To examine the influence of social support on the physical activity behaviours of individual's with a traumatic brain injury. MAIN OUTCOMES AND RESULTS: The paper defines social support as a multi-dimensional construct and reviews relevant literature describing how the type and source of social support changes post-brain injury. These findings are then applied to a physical activity domain with the use of a conceptual framework. Discussion finally focuses on research applications and appropriate measures of social support within a physical activity environment. CONCLUSIONS: This paper will provide physical activity programmers with an understanding of how social support influences physical activity participation, a conceptual framework to guide programming and appropriate measures of social support for research purposes.

Adolescent↗
PubMed2002

Violence against women: the state of batterer prevention programs.

While both men and women can be victims, domestic violence usually consists of assaults on women, and most violence against women occurs within an intimate relationship. In the past twenty years, numerous state and provincial programs to intervene in domestic violence cases have developed. The programs tend to focus on treating batterers, although they also offer counseling to domestic violence victims. The jury remains out on the effectiveness of these programs. A major issue is whether the programs use appropriate standards. After an overview of the prevalence and nature of domestic violence, this article provides a discussion of those standards--their nature, effectiveness, and limitations. Another section discusses use of a batterer intervention program in an urban setting. Yet another section explores the implications of intimate partner violence and looks again at the effectiveness of batterer treatment within intervention programs. The article closes with a look at the way one state addresses domestic violence and treats it as a crime. An inescapable conclusion to be drawn from the discussion is that violence against women has its roots in cultural assumptions that must undergo change if the incidence of that violence is to be reduced.

Battered Women↗
PubMed1989

Perceptions of case management services for elderly people.

Currently, case management is receiving considerable attention in the aging network as a means of coordinating and integrating services for elderly clients. However, social workers require additional data to better understand the use of this innovation. Formative data on how referral agents perceive one case management program for elderly people is provided. Most of the 137 referral agents who responded to questionnaires (259 questionnaires were mailed) viewed the program as appropriate in addressing basic social support needs of elderly people and inappropriate in addressing more complex physical and mental health problems. Although the referral agents perceived staff to be generally qualified, they also perceived the program to be understaffed and not building adequate awareness of its availability. Finally, perceptions of the adequacy of staffing and commitment of staff to serving elderly people were the strongest correlates of the program's perceived effectiveness.

Aged↗
PubMed2002

Advice on statistical analysis for Circulation Research.

Since the late 1970s when many journals published articles warning about the misuse of statistical methods in the analysis of data, researchers have become more careful about statistical analysis, but errors including low statistical power and inadequate analysis of repeated-measurement studies are still prevalent. In this review, several statistical methods are introduced that are not always familiar to basic and clinical cardiologists but may be useful for revealing the correct answer from the data. The aim of this review is not only to draw the attention of investigators to these tests but also to stress the conditions in which they are applicable. These methods are now generally available in statistical program packages. Researchers need not know how to calculate the statistics from the data but are required to select the correct method from the menu and interpret the statistical results accurately. With the choice of appropriate statistical programs, the issue is no longer how to do the test but when to do it.

Analysis of Variance↗
PubMed1983

A networking approach to rehabilitation service delivery in the developing nation/states of Micronesia.

The people of Micronesia , those inhabitants of a collection of over 2,000 islands and atolls encompassing three million square miles of Western Pacific Ocean, have developed by the establishment of three political entities, compacts of Free Association with the United States (United Nations Administrators of the area under the designation of the U.S. Trust Territory of the Pacific Islands). These emerging nations aim for self-sufficiency in all areas of national endeavor within specified periods of time. The University of Guam's Vocational Rehabilitation Training Program has addressed itself to the issue confronting not only these newly emerging nation/states of Micronesia , but indeed, those developing nations which currently struggle with the social, cultural and economic issues of providing for its citizenry , appropriate rehabilitation programming which meets criteria of high quality services to the largest number of people within an attainable cost structure. Initial findings suggest this Third World Rehabilitation community refrain from adopting a polarity of thinking approach in the design and delivery of Rehabilitation services. The logical extension of such either/or planning attempts seems only to limit current and future Rehabilitation programming effort. Rather, a comparative cost analysis of selected rehabilitation services and accompanying travel expenses related to providers from both sides and throughout the Pacific, demonstrates that an admixture approach, which includes all available sources of services, warrants further investigation as a viable programming model for the nation/states of Micronesia to utilize as they develop locally based Vocational Rehabilitation Service programs of their own.

Delivery of Health Care↗
PubMed2005

Training for best practices for agricultural programs.

As with other areas of animal research, ensuring the proper training and qualifications of the individuals working with agricultural animals for use in research, teaching, and testing is critical to both animal welfare and the successful outcome of the study or teaching exercise. The author provides guidance for the development of appropriate training programs for organizations that use agricultural animals in research.

Agriculture↗
PubMed1999

Assessment of quality of life in the younger child: the use of an animated computer program.

BACKGROUND: In the past, quality of life was primarily assessed using objective measurements of the condition of the patient. Today, most quality-of-life measurements include several aspects regarding the patient's opinions and feelings. There has been an extensive development of quality-of-life instruments particularly in adults, including those for people with inflammatory bowel disease (IBD). However, only a few instruments, mostly questionnaires, have been developed for the pediatric population. It has been noted, even in young patients with IBD, that there is reduced self-esteem and more anxiety and depression. Altogether, these are important aspects for early measurement of psychosocial functioning and possibly intervention during the treatment of children with IBD. METHODS: For the current study, an instrument was developed for young children aged 5 years or more in which a computer-based animated program was used to measure quality of life in children with inflammatory bowel disease. The instrument was designed to be similar for boys and girls with no reference to racial identity. In addition, it was culturally acceptable for all Dutch children. The program was in the form of a story of a bear and a clown playing in an attic of an old house where they come across many objects with which they play and where many adventures occur. All 35 questions were interwoven in this story. RESULTS: The animated computer program was well accepted and easily used by 16 children between the ages of 5 and 12 in a small pilot study. In those older than 11 years, another approach is probably necessary, using an age-appropriate animated program. CONCLUSIONS: The computer program can easily be used in an outpatient setting and thus ensures that quality-of-life measurement will become a routine part of a medical visit.

Child↗
PubMed2005

A comprehensive literature review of haplotyping software and methods for use with unrelated individuals.

Interest in the assignment and frequency analysis of haplotypes in samples of unrelated individuals has increased immeasurably as a result of the emphasis placed on haplotype analyses by, for example, the International HapMap Project and related initiatives. Although there are many available computer programs for haplotype analysis applicable to samples of unrelated individuals, many of these programs have limitations and/or very specific uses. In this paper, the key features of available haplotype analysis software for use with unrelated individuals, as well as pooled DNA samples from unrelated individuals, are summarised. Programs for haplotype analysis were identified through keyword searches on PUBMED and various internet search engines, a review of citations from retrieved papers and personal communications, up to June 2004. Priority was given to functioning computer programs, rather than theoretical models and methods. The available software was considered in light of a number of factors: the algorithm(s) used, algorithm accuracy, assumptions, the accommodation of genotyping error, implementation of hypothesis testing, handling of missing data, software characteristics and web-based implementations. Review papers comparing specific methods and programs are also summarised. Forty-six haplotyping programs were identified and reviewed. The programs were divided into two groups: those designed for individual genotype data (a total of 43 programs) and those designed for use with pooled DNA samples (a total of three programs). The accuracy of programs using various criteria are assessed and the programs are categorised and discussed in light of: algorithm and method, accuracy, assumptions, genotyping error, hypothesis testing, missing data, software characteristics and web implementation. Many available programs have limitations (eg some cannot accommodate missing data) and/or are designed with specific tasks in mind (eg estimating haplotype frequencies rather than assigning most likely haplotypes to individuals). It is concluded that the selection of an appropriate haplotyping program for analysis purposes should be guided by what is known about the accuracy of estimation, as well as by the limitations and assumptions built into a program.

Algorithms↗