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At least 397 records · Page 22Linked to original sources
PubMed1975

[The Caceres-USPHS (version HP-3) computer program. Evaluation of automatic analysis of 40,000 ECG (author's transl)].

The main features of Caceres-USPHS (version HP-3) program for automatic analysis of the ECG are reviewed. Our experience at the Ospedale Regionale di Udine has now reached a total of 40,000 tracings analyzed by such a program and with an HP 1530-A computer system. In a detailed study of 1,000 consecutive computer-analyzed tracings reviewed by three experienced cardiologists, 534 were normal and 466 abnormal. A high degree of specificity was detected in the normal group (only 1.5% of false negatives) while the sensivity was rather low. In the abnormal group there were 18.1% of false positives and while the agreement was 100% in complete bundle branch block and some types of infarction, it was 56% in atrial fibrillation and 47% in incomplete right bundle branch block. Program errors were more common in measurements and pattern recognition; they were unusual in the program logic (0.3%). A significant improvement over comparable data obtained one year previously was attributed to a better quality control in data recording and to increase physician acceptance of the program diagnostic criteria. On the current and past figures of accuracy, it is concluded that the version HP-3 of Caceres-USPHS program represents a step forward in computer-derived ECG interpretation. However more progress is still needed for a larger and more profitable clinical application of this ECG computer program.

Computers↗
PubMed2002

Characteristics of Mexican-American elders with dementia presenting to a community-based memory evaluation program.

OBJECTIVE: To determine sociodemographic characteristics associated with the initial presentation of Mexican-American elders to a community-based memory evaluation clinic. METHODS: Retrospective review of the charts of 89 Mexican Americans presenting consecutively to an outpatient memory evaluation clinic in San Antonio, Texas. PRINCIPAL FINDINGS: Mexican Americans presented for evaluation with more moderate-to-severe cognitive impairment than previously reported. They also tended to have high levels of IADL (83.1%) and gait/balance (52.3%) impairment, as well as high levels of depressive symptoms (63.1%). CONCLUSIONS: Mexican Americans present for initial evaluation for memory decline with moderate-to-severe cognitive decline and significant dementia-associated co-morbidities. In Mexican Americans, caregiver burden, fall risks, depressive symptoms, and need for IADL support should be addressed on the initial visit for memory decline.

Aged↗
PubMed1989

Supported employment program evaluation: evaluating degree of implementation and selected outcomes.

The relation between the degree to which adult service agencies implemented supported employment and selected program outcomes was examined. Supported employment programs developed by adult vocational service agencies in Illinois served as the subject pool for data collection. Results indicated that clients with higher IQs received less complete support services but earned higher wages. Vocational service agencies that spent more time developing jobs seemed better at matching job requirements with clients' skills.

Employment↗
PubMed1995

Recruitment to a university alcohol program: evaluation of social marketing theory and stepped approach model.

BACKGROUND: This study was a first initiative to evaluate the application of social marketing theory (SMT) to increase attendance at an alcohol abuse education program for university residence hall students and to ascertain whether aggressive recruitment strategies are necessary as part of the stepped approach model (SAM) of service delivery. METHOD: SMT and public health strategies that include focus groups, in-depth interviews, and intercept interviews were used to develop recruitment materials in a Test Hall. These new recruitment materials were introduced to the residents in the Treatment Hall (N = 727) and were compared to the Usual Care, Control Hall (N = 706) which received the recruitment materials normally provided to residents as well as to three Historical Halls separately and combined which had used the Usual Care recruitment materials in the past. RESULTS: The Treatment Hall percentage attendance was significantly superior (0.001 < p < 0.05) in all comparisons. The percentage attendance did not differ significantly from marketing literature expectations. The projections for campus-wide attendance for residence hall students were between 207 and 243 participants and for nationwide attendance, 36,900 +/- 8,185. CONCLUSIONS: The results suggest that the SMT and public health methods used are helpful in developing recruitment strategies and are an important initial step of the SAM and that a "minimal intervention" recruitment strategy is a cost-effective approach that can have a dramatic impact.

Adolescent↗
PubMed1996

Pediatric drug development: a perspective from the Cancer Therapy Evaluation Program (CTEP) of the National Cancer Institute (NCI).

Well-designed and carefully conducted pediatric phase 1 trials are critical to the process of evaluating new agents for potential benefit in children with cancer, and the National Cancer Institute (NCI) has for a number of years sponsored pediatric phase I trials. The development of new agents for children with cancer differs in important ways from drug development for adults with cancer, primarily necessitated by the smaller number of children eligible for phase I trials in comparison to adults. Pediatric drug development is characterized by a greater need to prioritize new agents for evaluation, since many more agents can be evaluated in adults than can be evaluated in children. Pediatric phase I trials are also commonly conducted as multi-institutional collaborations, since most single institutions do not have enough eligible patients to complete phase I trials within a reasonable time. In addition, pediatric phase I trials begin at doses close to the adult maximum tolerated dose, thereby minimizing the number of patients required to complete pediatric phase I trials. While pediatric phase I trials have traditionally evaluated conventional cytotoxic agents, new classes of agents with distinctive mechanisms of action are entering clinical evaluation. These agents target specific cellular proteins (e.g., protein tyrosine kinases, protein kinase C isoforms, enzymes involved in controlling progression through the cell cycle). Determining whether these agents with specificity for critical cellular proteins will be effective anti-cancer agents will be an important objective of pediatric clinical investigations in the coming years.

Antineoplastic Agents↗
PubMed1996

Evaluation of live attenuated influenza vaccines in children 6-18 months of age: safety, immunogenicity, and efficacy. National Institute of Allergy and Infectious Diseases, Vaccine and Treatment Evaluation Program and the Wyeth-Ayerst ca Influenza Vaccine Investigators Group.

Live attenuated, cold-adapted (ca) monovalent and bivalent influenza A vaccines were evaluated in seronegative infants (ages 6-18 months) in a double-blind placebo-controlled trial to assess safety and immunogenicity. A total of 182 seronegative subjects received a single intranasal dose (10(6.2) TCID50) of ca A/Kawasaki/9/86 (H1N1) or ca A/Los Angeles/2/87 (H3N2), both as a bivalent vaccine, or placebo. Respiratory and systemic symptoms did not differ between groups after vaccination. Hemagglutination antibody seroconversions (> or = 1:8) to H3N2 exceeded 90%. In contrast, seroconversions to A/Kawasaki/9/86 (H1N1) were significantly less frequent in bivalent ca vaccine recipients (31%) than in monovalent ca H1N1 recipients (83%) (P < .002). During a subsequent H3N2 epidemic, nasal washes were cultured for viruses from any subject with respiratory illness. H3N2 infections documented by virus isolation were reduced by 65% in ca H3N2 recipients compared with placebo or ca HIM recipients (P = .01).

Adaptation, Physiological↗
PubMed2001

Background and framework for ILSI's collaborative evaluation program on alternative models for carcinogenicity assessment. International Life Sciences Institute.

The willingness of the agencies involved in the regulation of pharmaceuticals to accept data from newly proposed models for carcinogenicity testing (eg, transgenic animals, neonatal rodent models, initiation-promotion models) has stimulated international interest in gaining experience and a greater understanding of the strengths and limitations of the specific models. Over a 4-year period, the International Life Sciences Institute (ILSI) Health and Environmental Science Institute (HESI) has coordinated a large-scale collaborative research program to help to better characterize the responsiveness of several models proposed for use in carcinogenicity assessment. The overall objective of this partnership among industry, government, and academic scientists was to evaluate the ability of these new models to provide useful information for human cancer risk assessment. This research program reflected a commitment of nearly US$35 million by over 50 industrial, govemment, and academic laboratories from the United States, Europe, and Japan. Evaluation of the models required the development of standardized protocols to allow reproducibility and comparability of data obtained across multiple laboratories. Test compounds were selected on the basis of mechanistically meaningful carcinogenic activity or noncarcinogenicity in the rodent bioassay as well as humans. Criteria were established for dose selection, pathology review, quality control, and for evaluation of study outcome. The database from these studies represents an important contribution to the future application of new models for human cancer risk assessment. Beyond the data, the collaborative process by which the models were evaluated may also represent a prototype for assessing new methods in the future.

Academies and Institutes↗
PubMed2001

[How external quality evaluation programs affect the quality of laboratory results in routine practice in the Czech Republic].

Goals of our study were: 1. to assess quality of our analytical work and application of concepts of good laboratory practice using different EQA surveys, 2. to evaluate performance and efficiency of systems for internal quality control using EQA program that is independent on local subjective and objective influences and 3. to observe how single EQA programs differ and how they contribute the ability of laboratories to manage their overall quality. Using one-way ANOVA, we compared our 1999 results in the local EQA survey AKS (SEKK s r.o., Czech Republic) to our results in CN3 Comprehensive Chemistry Survey (College of American Pathologists, USA) for analyses provided in CN3 with the definitive method correlated target values, the design of which assures accuracy of the field methods on patient specimens. In 4 out of 9 methods, the material AKS predicted target values that were significantly different from that of CN3; calcium sodium, uric acid and cholesterol. The CN3 survey provided link of our results of internal quality control and national EQA to the largest proficiency testing available worldwide in clinical chemistry. Out data suggest that a possibility exists to improve the design of target values for materials used for small national EQA surveys as well as the program administration so that local characteristics of field method on patient specimens could be better monitored.

Clinical Chemistry Tests↗
PubMed2002

Targeting dental sealants in school-based programs: evaluation of an approach.

Several guidelines have been published in the United States to promote the appropriate use of sealants in both individual care and public health programs. Targeting sealants to children and teeth at high risk for dental caries has been accepted as a desirable strategy in school-based programs. However, there is little evidence to show that programs are complying with these guidelines. This report examined the extent to which sealants were targeted to high-risk children at 11 different school-based programs in New York State. Data on 3357 children ages seven to nine were analyzed. The percent of children receiving sealants ranged from 41% to 88%. While in two sites (St. Lawrence & Onondaga) fewer than 52% of the children received sealants; more than 73% received sealants in the remaining nine sites (P < 0.05). The results suggest that there was a wide variation in the implementation of the guidelines for sealant use. Some reasons for not adhering to the guidelines were: difficulty in assuring parents and local dentists that some children were not at risk for caries; lack of confidence in the risk-assessment method; uncertainty regarding what constitutes deep pits and fissures; fear of misclassifying children and requests by school administrators, parents and local dentists that all children should benefit from preventive measures.

Chi-Square Distribution↗
PubMed1985

Response of general practitioners to a national dental office evaluation program. Office of Quality Assurance.

The methods used and the results achieved in an effort to solicit 300 volunteers to test the feasibility of a dental office assessment instrument have been described. In response to personal letters to general practitioners in 14 states, 13.9% returned a card indicating a willingness to consider participation. The response rate from different states ranged from 8% to 21.7% with the response being more favorable from states with fewer dentists. Year of graduation from dental school had little effect on the rate of response. Rural dentists responded at a slightly more favorable rate. Of dentists responding, 71% did so within 2 weeks and 90% within the first month after receiving the solicitation. Mail solicitation can be used successfully in recruiting private practitioners for participation in an in-office practice assessment program.

Adult↗
PubMed1985

[A conceptual framework for the evaluation of health programs].

Evaluation can have three distinct goals: to help plan and develop programs, to provide information which will improve programs and to determine the outcomes and impact of programs. Evaluation questions flow from each of these goals. Described in this paper are different types of evaluation useful in answering these questions. Whatever type of evaluation is chosen, the evaluator must attempt to assess its validity. This validity concerns the equivalence between answers to evaluation questions and the "true value" of the program. It is just as concerned with measurement strategy and instruments as it is with the designs and techniques of analysis used, and the population studied.

Evaluation Studies as Topic↗
PubMed1990

Children's self-selection into prevention programs: evaluation of an innovative recruitment strategy for children of alcoholics.

Systematically evaluated the efficacy of a self-selection strategy to recruit elementary-aged children into a school-based prevention program for children of alcoholics. Recruitment involved: a film about parental alcoholism, a follow-up meeting, and an invitation to participate in a prevention program. Of the 844 4th-6th graders exposed to recruitment, 67% showed no interest in the program, 26% attended the follow-up meeting, and 11% obtained parental permission. Analyses focused on group differences according to selection classification on measures of symptomatology and resources available to the child. Significant differences were noted on level of concern about parents' drinking, depression, conduct disorder, and self-worth. Children interested in the program tended to score higher on measures of symptomatology. The potential of a self-selection model for identifying children at risk and areas for future research are discussed.

Alcohol Drinking↗