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PubMedDate not supplied

Innovative strategies for incorporating gerontology into BSN curricula.

To prepare nurses in providing competent care to older adults, schools of nursing at the Otterbein College and the Florida International University, supported by American Association of Colleges of Nursing/John A. Hartford Foundation, developed innovative strategies for incorporation of gerontological content into their BSN curricula. Both nursing programs integrated these innovative gerontological learning experiences into sophomore-, junior-, and senior-level baccalaureate courses; developed independent gerontology courses, including online courses; supported the development of faculty expertise and sensitivity in elder care; and established new and/or enhanced existing community partnerships. The program objectives, planning, and implementation procedures for each of the two schools evolved similarly. Faculty development strategies and examples of community and international partnerships are presented. Finally, lessons learned from the implementation of these projects and recommendations based on these initiatives are presented.

Aged↗

PubMed2001

State child health; implementing regulations for the State Children's Health Insurance Program. Health Care Financing Administration (HCFA), HHS. Final rule.

Section 4901 of the Balanced Budget Act of 1997 (BBA) amended the Social Security Act (the Act) by adding a new title XXI, the State Children's Health Insurance Program (SCHIP). Title XXI provides funds to States to enable them to initiate and expand the provision of child health assistance to uninsured, low-income children in an effective and efficient manner. To be eligible for funds under this program, States must submit a State plan, which must be approved by the Secretary. This final rule implements provisions related to SCHIP including State plan requirements and plan administration, coverage and benefits, eligibility and enrollment, enrollee financial responsibility, strategic planning, substitution of coverage, program integrity, certain allowable waivers, and applicant and enrollee protections. This final rule also implements the provisions of sections 4911 and 4912 of the BBA, which amended title XIX of the Act to expand State options for coverage of children under the Medicaid program. In addition, this final rule makes technical corrections to subparts B, and F of part 457.

Child↗

PubMed2002

Fast and sensitive alignment of large genomic sequences.

Comparative analysis of syntenic genome sequences can be used to identify functional sites such as exons and regulatory elements. Here, the first step is to align two or several evolutionary related sequences and, in recent years, a number of computer programs have been developed for alignment of large genomic sequences. Some of these programs are extremely fast but often time-efficiency is achieved at the expense of sensitivity. One way of combining speed and sensitivity is to use an anchored-alignment approach. In a first step, a fast heuristic identifies a chain of strong sequence similarities that serve as anchor points. In a second step, regions between these anchor points are aligned using a slower but more sensitive method. We present CHAOS, a novel algorithm for rapid identification of chains of local sequence similarities among large genomic sequences. Similarities identified by CHAOS are used as anchor points to improve the running time of the DIALIGN alignment program. Systematic test runs show that this method can reduce the running time of DIALIGN by more than 93% while affecting the quality of the resulting alignments by only 1%. The source code for CHAOS is available at http://www.stanford.edu/~brudno/chaos/ An integrated program package containing CHAOS and DIALIGN is available at http://bibiserv.techfak.uni-bielefeld.de/dialign/

Algorithms↗

PubMed1990

The City of Toronto's geriatric dental program.

The past four years have witnessed the development of a comprehensive dental program for the seniors of the City of Toronto. This program is based upon the principles of dental health promotion and prevention. It recognizes the distinct needs of seniors who are institutionalized. It also addresses the needs of those low-income seniors living in the community. The overall result is an integrated program aimed at improving the dental health of all seniors in Toronto.

Aged↗

PubMed2006

Innovative safety valve selection techniques and data.

The new valve data resources and modeling tools that are available today are instrumental in verifying that that safety levels are being met in both current installations and project designs. If the new ISA 84 functional safety practices are followed closely, good industry validated data used, and a user's maintenance integrity program strictly enforced, plants should feel confident that their design has been quantitatively reinforced. After 2 years of exhaustive reliability studies, there are now techniques and data available to support this safety system component deficiency. Everyone who has gone through the process of safety integrity level (SIL) verification (i.e. reliability math) will appreciate the progress made in this area. The benefits of these advancements are improved safety with lower lifecycle costs such as lower capital investment and/or longer testing intervals. This discussion will start with a review of the different valve, actuator, and solenoid/positioner combinations that can be used and their associated application restraints. Failure rate reliability studies (i.e. FMEDA) and data associated with the final combinations will then discussed. Finally, the impact of the selections on each safety system's SIL verification will be reviewed.

Accident Prevention↗

PubMed1984

Integrating cardiovascular health education with an English curriculum in a secondary school.

The purpose of this study was to assess the impact on cognitive and attitude retention of a cardiovascular (CV) health education unit that was integrated within high school English classes. The integrated program was an extension of previous research on the Cardiovascular School Health Curriculum that was developed by the National Heart and Blood Vessel Research and Demonstration Center, Baylor College of Medicine. The results of this study supported the hypotheses that CV health education can be successfully integrated within the English curriculum of secondary schools. This joint effort between health education and a liberal art assisted students in retaining important facts related to CV disease and in maintaining more positive attitudes toward their abilities to control their CV risks.

Adolescent↗

PubMed1987

The efficacy of the ROM Dance Program for adults with rheumatoid arthritis.

This study examined the efficacy of an exercise and relaxation program for adults with rheumatoid arthritis. The program integrates principles of occupational therapy and T'ai-Chi Ch'uan and was expected to be more effective than traditional exercise and rest regimens because of its expressive and pleasurable elements. There were significant differences between 17 experimental and 16 control subjects on two categories of dependent variables after the former group's participation in the experimental program. These dependent variables were range of motion measures and subject self-reports of frequency, enjoyment, and benefits of home exercise and rest routines. Pretest, posttest, and 4-month follow-up data were analyzed. Program participants showed significantly greater upper extremity range of motion 4 months after completing the program although the reported frequency of exercise and rest was greater in the control group. Postprogram reports of enjoyment were significantly higher for experimental than for control subjects. If these initial results are confirmed in further studies, the efficacy of the use of purposeful activity for exercise and rest will be supported. This study also supports the integration of Eastern and Western frames of reference in the treatment of patients with chronic illness.

Adult↗

PubMed2007

Integrating and promoting medical podcasts into the library collection.

Podcasts offer a way for medical professionals to listen to current information in medicine from an iPod, MP3 player, handheld device, or computer. As podcasts become more popular, libraries may be interested in integrating programs into the library collection. South Pointe Medical Library evaluated medical podcasts relevant to the scope of the library collection and explored methods for finding and organizing such programs in ways that are efficient for both the librarian and the patron. doi:10.1300/J115v26n01_03.

Access to Information↗

PubMed1987

Workplace health promotion: a commentary on the evolution of a paradigm.

Reports of workplace health promotion programs are reviewed in light of Kuhn's views on paradigmatic advances in science. Such reports fall into two categories: those which describe single health-habit interventions (e.g., smoking cessation, weight control, or stress management) and those which describe comprehensive efforts to incorporate many single health-habit interventions into integrated programs. Common to virtually all of these programs in their focus on the modification of the health behavior of individuals. Consideration of such organizational-level factors as work design or climate which are beyond the control of the individual, yet may contribute heavily to illness and absenteeism of employees, is typically omitted. It is concluded that workplace health promotion in the United States has achieved the status of a paradigm and that this paradigm is associated with several limitations and ethical problems in light of the programs' objectives: to reduce organizations' medical-care costs and improve productivity.

Environment↗

PubMed1995

[Results of integrated inpatient detoxification and motivation treatment of alcohol dependent patients].

During the course of the disease many alcoholic patients are detoxified on an inpatient basis. Detoxification lasts for some days to 2 or 3 weeks. The treatment goal of abstinence usually cannot be achieved by detoxification alone. Therefore a qualified detoxification should consist of a medical treatment, a careful (psychiatric) diagnostic process and a psychotherapeutic treatment aiming at motivation for further treatment. The described program integrates these components. The psychotherapeutic approach is emphatic and directive, trying to convince all patients to apply for further alcoholism treatment. Follow-up data of 120 of the initial 130 patients eight months after detoxification showed, that 68 patients (57%) started further treatment, most of them as inpatients. In the group of prognostic unfavourable patients, who had not received any disease related counseling before detoxification (77% of the sample), 47% started further alcoholism treatment.

Adult↗

PubMed2026

Integrated Telehealth Rehabilitation and Quality of Life in Mechanically Ventilated Adults: A Randomized Clinical Trial.

IMPORTANCE: Whether integrated rehabilitation strategies spanning intensive care unit (ICU), hospital, and postdischarge phases improve quality of life after acute respiratory failure is uncertain. OBJECTIVE: To evaluate the effect of an integrated multicomponent telehealth-based rehabilitation intervention on health-related quality of life at 90 days after hospital discharge among adults with acute hypoxemic respiratory failure requiring invasive mechanical ventilation. DESIGN, SETTING, AND PARTICIPANTS: This stepped-wedge cluster randomized clinical trial in ICUs of 20 public hospitals in Brazil enrolled adults with acute hypoxemic respiratory failure requiring invasive mechanical ventilation between June 2024 and May 2025, with follow-up through September 2025. INTERVENTIONS: A multicomponent telehealth-based rehabilitation program integrating an ICU telehealth-based rehabilitation intervention focused on ventilator liberation; a ward telehealth-based rehabilitation intervention targeting risk stratification and initiation of individualized rehabilitation plans; and a postdischarge telehealth-based rehabilitation intervention consisting of a 2-month personalized centralized telerehabilitation program. MAIN OUTCOMES AND MEASURES: Health-related quality of life at 90 days after hospital discharge, measured using the EuroQol 5-Dimension 3-Level (EQ-5D-3L) utility score (range, -0.17 [worse than death] to 1 [best health state], with 0 representing death). RESULTS: Among 1916 enrolled patients (mean [SD] age, 60.6 [17.3] years; 43.6% female), 1063 were assigned to the intervention and 853 to usual care per local protocols. At 90 days after hospital discharge, mean (SD) EQ-5D-3L utility scores were higher in the intervention group than in the usual care group (0.16 [0.31] vs 0.12 [0.28]; adjusted difference, 0.049; 95% CI, 0.0002 to 0.098; P = .04) but did not differ among survivors (0.60 [0.32] vs 0.59 [0.32]; adjusted difference, -0.045; 95% CI, -0.138 to 0.045; P = .34). Compared with usual care, the intervention resulted in lower 90-day all-cause mortality (71.8% [676 of 941] vs 78.3% [584 of 746]; adjusted difference, -7.6%; 95% CI, -14.7% to -0.6%; P = .03) and shorter mean (SD) mechanical ventilation duration (9.9 [10.3] vs 15.5 [15.9] days; adjusted difference, -6.2 days; 95% CI, -8.5 to -3.9; P < .001). CONCLUSIONS AND RELEVANCE: In this study, an integrated telehealth-based rehabilitation strategy delivered across ICU, hospital, and postdischarge phases improved 90-day health-related quality of life, potentially influenced by reduced mortality. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06343545.

Humans↗

PubMedDate not supplied

Spindle polarity in S. cerevisiae: MEN can tell.

Spatial coordination between the axis of the spindle and the division plane is critical in asymmetric cell divisions. In the budding yeast S. cerevisiae, orientation of the mitotic spindle responds to two intertwined programs dictating the position of the spindle poles: one providing the blueprint for built-in pole asymmetry, the other sequentially confining microtubule-cortex interactions to the bud and the bud neck. The first program sets a temporal asymmetry to limit astral microtubules to a single pole prior to spindle pole separation. The second enforces this polarity by allowing these early formed microtubules to undergo capture at the bud cell cortex while stopping newly formed microtubules once cortical capture shifts to the bud neck. The remarkable precision of this integrated program results in an invariant pattern of spindle pole inheritance in which the "old" spindle pole is destined to the bud. An additional layer of asymmetry is superimposed to couple successful chromosomal segregation between the mother and the bud with mitotic exit. This is based on the asymmetric localization to the committed daughter-bound pole of signaling components of the mitotic exit network. This system operates irrespective of intrinsic spindle polarity to ensure that it is always the pole translocating into the bud that carries the signal to regulate mitotic exit.

Chromosome Segregation↗

PubMed1998

Mental health and substance abuse treatment services for dually diagnosed clients: results of a statewide survey of county administrators.

Finding are presented from a survey of administrators of county departments of mental health and alcohol and drug programs in California regarding services for individuals with co-occurring mental and substance abuse disorders. A total of 47 counties responded (84% response rate). The survey findings indicate that collaboration across county mental health and alcohol and drug services primarily occurs through information sharing, coordination of services, and joint projects. Fewer than one-half of the counties responding provide integrated programs, and the most frequently provided services are outpatient counseling and case management. Administrators cited historical differences between the two service systems and societal stigma as the greatest barriers to service delivery. Two opposing strategies for state action were suggested, either establishing specific funding set-asides or blending funding for services. Counties varied widely in their ability to estimate unmet service needs. Implications for policy development related to the dually diagnosed are discussed.

Adult↗

PubMed1997

Utility of the Inventory of Suicide Orientation-30 (ISO-30) for adolescent psychiatric inpatients: linking clinical decision making with outcome evaluation.

This report describes a study that integrates program evaluation with clinical practice. The subjects were 139 adolescent psychiatric inpatients who were tested with the Inventory of Suicide Orientation-30 (ISO-30) at admission and retested six days after admission. Aggregate analyses showed statistically significant changes in the direction of decreased suicidality on all ISO-30 indices. Further analyses compared the data with normative data from the ISO-30 manual, and also evaluated the relationships between ISO-30 scores and length of stay. Implications of the results and also methods of integrating outcome with clinical practice are discussed.

Adolescent↗

PubMed1996

Program development and integrated treatment across systems for dual diagnosis: mental illness, drug addiction, and alcoholism (MIDAA).

Numerous bureaus of mental health, drug addiction, and alcoholism are designated to provide service to persons who have discrete singular disorders of mental illness, drug addiction, or alcoholism. Mental health and substance abuse programs (nationally and internationally) have evolved with this singular limited-service capacity. Contrasting incompatible philosophies and treatment methods across the systems have resulted in minimal services for persons with dual diagnoses. The project the authors have outlined is an example of the development of a dual/multiple-disorder program that integrates these diverse systems and provides comprehensive services within each of the programs of each delivery system. These programs are cost-effective, use existing facilities, train and cross-train existing staff, correct the issues of incompatible treatment interventions, and end the dilemma of gaps in services systems and limited referral resources. As a result, the availability and quality of care for persons with dual diagnoses is greatly improved.

Alcoholism↗

PubMed2004

Enhancing the dining experience in long-term care: Dining with Dignity program.

Nursing home residents nationwide are at nutritional risk as the result of physical, social and environmental factors. The Dining with Dignity program integrates long-term care residents, staff, community volunteers and occupational therapy students to improve residents' nutritional intake. Volunteers are trained to provide one-on-one assistance during meals and to promote a positive dining experience as organized by the theory of Social Support. Resident satisfaction with meals and improved nutritional status are important outcomes as is volunteer commitment to the program.

Aged↗

PubMed2005

Post-transcriptional control of gene expression: a genome-wide perspective.

Gene expression is regulated at multiple levels, and cells need to integrate and coordinate different layers of control to implement the information in the genome. Post-transcriptional levels of regulation such as transcript turnover and translational control are an integral part of gene expression and might rival the sophistication and importance of transcriptional control. Microarray-based methods are increasingly used to study not only transcription but also global patterns of transcript decay and translation rates in addition to comprehensively identify targets of RNA-binding proteins. Such large-scale analyses have recently provided supplementary and unique insights into gene expression programs. Integration of several different datasets will ultimately lead to a system-wide understanding of the varied and complex mechanisms for gene expression control.

Gene Expression Profiling↗

PubMedDate not supplied

Development of interactive patient-based multimedia computer programs in veterinary orthopedic radiology.

Three computerized multimedia programs on large and small animal veterinary orthopedic radiology were developed and implemented for the radiology curriculum as an alternative to traditional film-based laboratory learning. Programs utilized "hot words" (colored text words that displayed an overlaid image label that highlighted lesions) and interactive quizzes which responded appropriately to selected answers. "Hot words" helped students develop confidence in accurate lesion detection and the interactive quizzes transformed learning from a passive to an active process. Multiple examples were provided for reinforcement and concepts were incorporated from other clinical disciplines for curriculum integration. Programs were written using a presentation software program, Toolbook for DOS based platform, and contained radiographic images made by laser-scanning digitization. Multiple students could simultaneously access the programs through a network server. These pilot programs were implemented successfully and computerized multimedia presentation proved to be well suited to teaching radiology. Development of the programs required attention to a number of hardware, software, time and cost factors.

Computer Communication Networks↗