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At least 433 records · Page 24Linked to original sources
PubMed1981

Client participation in CMHC program evaluation: increasing incidence, inadequate involvement.

Client satisfaction surveys and client complaint systems are used by more CMHCs since the Amendments of 1975 required centers to evaluate "acceptability of service," but clients are seldom actively involved in designing or administering these evaluations. The authors argue that greater control by clients is merited on technical and political grounds, and would increase the likelihood that program improvements would result from assessments of acceptability.

Community Mental Health Centers↗
PubMed2003

Cost savings for a preferred provider organization population with multi-condition disease management: evaluating program impact using predictive modeling with a control group.

Disease management programs have historically had difficulty demonstrating the financial value of their programs using statistically rigorous methods. This preliminary study utilized a predictive model built from a control group that consisted of individual employer groups whose benefits managers did not purchase disease management. The purpose of this evaluation was to examine the cost savings associated with Health Management Corporation's disease management program for asthma, diabetes, and coronary artery disease. Study and control group members were identified with exactly the same selection criteria as self-insured employer groups (n = 76,194) with preferred provider organization health plans that offered the disease management program. The study group consisted of members (n = 1,009) who were identified as having any of the three conditions and were eligible for the disease management program, regardless of the extent of their participation. The control group included members (n = 2,491) who were identified as having any of the same three conditions. The control group data were used to develop a predictive model designed to calculate expected medical claims costs for the study group. The gross savings of the disease management program was measured by calculating the difference between the expected medical claims costs predicted by the model and the actual medical claims costs for the study group. Preliminary analyses indicate that Health Management Corporation's disease management program produced a return on investment of $2.84: $1.00 and $1.45 gross savings per member per month.

Adolescent↗
PubMed2001

Cerebrospinal fluid analysis: disease-related data patterns and evaluation programs.

Cerebrospinal fluid (CSF) analysis is a basic tool for diagnosis of neurological diseases. Knowledge regarding blood-CSF barrier function (molecular flux/CSF flow theory) and neuroimmunology is reviewed to aid understanding and evaluation of CSF data. Disease-related immunoglobulin patterns (IgG, IgA, IgM with reference to albumin) are described in CSF/serum quotient diagrams with the hyperbolic reference range for blood-derived protein fractions in CSF. Clinical relevance of complementary analyses (cytology, PCR, oligoclonal IgG, antibody detection and brain-derived proteins) is briefly discussed. Integrated CSF data reports are shown with numerical and graphical data representation, reference range-related interpretation and diagnosis-related comments. The principles and rationale of general CSF analysis reported in this review should enable the reader to accurately interpret CSF data profiles, and to plan a proper evaluation of new brain- or blood-derived analytes in CSF.

Albumins↗
PubMed1993

Development and implementation of a safety evaluation program for chemical fibers.

Polyester and acrylic fibers often have prolonged contact with human skin: the sucking of childrens' toys may lead to ingestion. During manufacture, occupational exposure to fiber components may occur. An evaluation of these possible hazards was undertaken by data appraisal, chemical analyses, and animal plus human testing. Occupational exposure limits have already been set for the chemicals used in polymer manufacture. Finishing agents (applied to the fibers) were examined in bacterial mutation and rat acute oral toxicity tests. Finished fibers were tested for acute toxicity and then for sensitizing potential (on guinea pig skin). Human volunteer trials for skin irritance and sensitization followed. No adverse reactions were seen. Only when fibers were burnt was toxicity seen: smoke from acrylic fiber proved more toxic than that from polyester fiber (due principally to hydrogen cyanide release). Migration tests showed that little material leached out from the fibers: < 1 mg/dm2 surface area in saline, 0.4 mg/dm2 from acrylic fibers in methanol, 3.6 mg/dm2 from polyester fibers in chloroform. Analysis showed only fiber polymer components and finish in saline and methanol leachates. Whilst further testing may be required for areas of special concern, since only a limited range of biological endpoints have been addressed, it is concluded that current and foreseeable future uses of these chemical fibers pose little or no toxicological hazard.

Acrylonitrile↗
PubMed2004

The National Pork Producers Council Maternal Line National Genetic Evaluation Program: a comparison of six maternal genetic lines for female productivity measures over four parities.

Litter (n = 8,424) and female performance records were collected in two breed-to-wean production units in order to evaluate genetic line differences for sow longevity and maternal performance over four parities. Lines evaluated were American Diamond Genetics, Danbred North America, Dekalb-Monsanto DK44, Dekalb-Monsanto GPK347, Newsham Hybrids, and National Swine Registry. Females within a line were derived from a minimum of 65 sires, 197 dams (three dams per sire), and a maximum of three daughters per dam, except in the GPK347, which were produced using semen from 12 Nebraska Index boars mated with Dekalb-Monsanto Line 34 females. All lines expressed 100% maternal heterosis. Mixed model statistical procedures were used with fixed effects including genetic line, parity, production unit, and two-way interactions. Random effects included a contemporary week of production and female for repeated records. Lactation length (average 15 d) was included as a linear covariate where appropriate. In total, 3,599 females entered as early-weaned pigs, 3,283 entered the breeding herd, 2,592 farrowed at least a single litter, and 1,656 and completed four parities. Line (P < 0.001) and parity (P < 0.001) effects were observed for virtually all traits measured. Ranges of genetic line differences averaged across parities were 1.76 pigs for total born, 1.45 pigs born alive, and 0.31 stillborn pigs per litter. Ranges of line differences in total and live litter weight were 1.4 and 1.3 kg, respectively. Ranges among lines, within Parities 1 through 4, for litter size at weaning were 0.56, 1.08, 0.91, and 0.64 pigs per litter, respectively. Line differences for weight (33.8 kg) and backfat depth (6.4 mm) at farrowing, lactation feed intake (8.7 kg), weight loss (5.0 kg), and backfat loss (0.87 mm) were observed. Extended wean-to-estrus interval was related to variation in weight, feed intake, and backfat loss in all lines except the GPK347. The GPK347 females farrowed and weaned the largest number of pigs, ate less feed in lactation, and lost more backfat and weight during lactation, yet they had the largest litters and the shortest wean-to-estrus intervals. Line x parity interactions existed for many traits due to small rank changes, but in general, the high- and low-ranked lines did not change. Genetic line differences in reproductive efficiency through four parities exist and must be recognized when choosing a female line.

Adipose Tissue↗
PubMed1986

ICWU cancer control education and evaluation program: research design and needs assessment.

The International Chemical Workers Union is implementing a 3-year nationwide field experiment in cancer prevention education. The educational program includes three stages: generalized cancer control education, education tailored to each local union, and an interactive monitoring system designed to provide ongoing communication and reinforcement for desired cancer control behaviors among local unions and their members. These alternative educational approaches will be systematically evaluated using a randomized factorial study design involving more than 120 local unions. The need for such a program is demonstrated by the results of a needs assessment survey of 690 union members. Respondents expressed strong concern regarding possible carcinogen exposures at the work site, combined with generally low ratings of co-worker knowledge of and adherence to appropriate cancer control behaviors. Engineering controls and personal protective equipment were reported to be inadequate in many work sites.

Attitude to Health↗
PubMedDate not supplied

Signs, symptoms, and ill-defined conditions in Persian Gulf War veterans: findings from the Comprehensive Clinical Evaluation Program.

OBJECTIVE: The purpose of this study was to analyze the type and frequency of signs, symptoms, and ill-defined conditions (SSID; International Classification of Diseases-9th Revision, Clinical Modification (ICD-9-CM) codes 780-799) identified by physicians evaluating Persian Gulf War veterans; to determine the influence of the extent of evaluation on the type and frequency of SSID diagnoses; and to search for evidence for a new illness, or illness related to wartime exposures, in veterans with ill-defined conditions. METHOD: Comprehensive examinations were provided for 21,579 consecutive Persian Gulf War veterans with symptoms or health concerns after the war. Data recorded on all individuals includes demographics, self-reported exposures, symptoms, and physician-assigned ICD-9-CM primary and secondary diagnoses. A detailed psychosocial history, including a multidisciplinary discussion, was incorporated for a subset of participants. RESULTS: SSID conditions were primary diagnoses for 17.2% of veterans, and either primary or secondary diagnoses for 41.8%. Although some SSIDs were objective conditions (eg, sleep apnea), most were simply symptoms. More comprehensive evaluation, especially the multidisciplinary discussion of findings, decreased the frequency of symptoms as diagnoses and increased the number of DSM-IV psychiatric diagnoses. Ill-defined conditions were not associated with particular self-reported exposures or demographic variables. CONCLUSIONS: Ill-defined conditions identified by physicians in Gulf War veterans are most often symptoms. More definitive, often psychological, diagnoses can be made by increasing the intensity of the evaluation and by multidisciplinary input. Evidence for a new or unique illness related to wartime exposures did not emerge from this analysis.

Adult↗
PubMed2003

[Evidence-based treatment and education programs--evaluation of complex interventions].

Patient education and treatment programmes are complex interventions that require a multiphased stepwise evaluation. The continuum of increasing evidence of effectiveness of structured treatment and teaching programmes for diabetes and hypertension as implemented in Germany is presented, and the indispensable components of the program and the conditions of their effective implementation are described.

Education, Medical↗
PubMedDate not supplied

A model drug usage evaluation program.

Following the ten step process discussed above should bring a program into compliance with the guidelines of JCAHO. However, each facility is unique and should design its own DUE program. Since quality assurance is a dynamic process, each facility must keep abreast of frequent changes. With sufficient time and resources devoted to DUE activities, DUE programs can produce beneficial findings and impact positively on the quality and appropriateness of patient care.

Drug Utilization↗
PubMed2003

Setting priorities and allocating resources in health regions: lessons from a project evaluating program budgeting and marginal analysis (PBMA).

BACKGROUND: Program budgeting and marginal analysis (PBMA) is a framework for setting priorities in health care, used internationally over the last 25 years in Britain, Australia and New Zealand. However, the framework has undergone limited evaluation, and insight into how such evaluation should even take place is not found in the literature. METHODS: Seven PBMA case studies were conducted in three Canadian health regions to examine the feasibility of applying the PBMA framework. Structured follow-up surveys with the users of the framework were carried out following the priority setting exercises. RESULTS: The PBMA framework was feasibly implemented in three regionalized contexts and was generally viewed favorably by managers and clinicians who participated in the case studies. Numerous methodological lessons were learned and it was found that successful implementation hinges on organizational context. An empirically derived model describing PBMA is outlined and put forth as an evaluation framework for future exercises. CONCLUSIONS: Comparisons to the health care management literature indicate that the derived PBMA model is a novel addition to this broader literature. Overall, managers in health organizations internationally would be well-served to consider PBMA to aid regional decision-making processes, but should do so with explicit consideration of the context in which such activity is to occur.

Alberta↗
PubMed1984

Environment and treatment: methodological notes on program evaluation and institutional culture.

This paper discusses the evaluation of a small regional children's rehabilitation centre. Several data sets were obtained including patient records and physical examinations of and interviews with Centre graduates. Originally, the project sought to describe the Centre's growth and determine successful programs. Design changes led to an examination of the relationship between institutional culture and the subsequent lifestyles of the graduates. The data strongly suggested that the institution's value orientation, which stressed successful accomplishment of daily living activities, life skills, had an impact upon an 'isolate lifestyle' apparent in the graduates. Standard statistical analysis are not able to support these conclusions. The methodological problems which lead to weaknesses in evaluation designs are discussed. It was concluded that researchers lack the methodological tools which would permit them to 'go beyond' simply reporting demographics, attitudes and opinions and making inferences into testing the relationships between institutional practices and subsequent behaviours.

Adolescent↗
PubMed2003

Determinants of satisfaction with an automated alcohol evaluation program.

High rates of untreated mental illness cause serious health problems in the United States and worldwide. The use of computer-administered therapy has the potential to increase access to mental health care for certain patient populations. An online version of an alcohol check-up was developed that guided subjects through a series of standardized questionnaires, and provided them with feedback designed to enhance their appreciation of the negative aspects of their alcohol use. Ratings of the helpfulness of the questionnaires were evaluated in order to determine the characteristics of individuals who would potentially benefit from an automated substance abuse intervention, and to learn which aspects of an automated program would be most useful. Over a period of 25 months, 1,455 individuals participated in the study, 83% of whom had an Alcohol Use Disorders Identification Test (AUDIT) score indicative of problem drinking. Subjects with alcohol problems found the on-line program more useful than other subjects. The questionnaire which compared subjects' alcohol use to national norms, provided the most helpful and also the most unexpected information. Alcohol abusers with high levels of ambivalence about their drinking and other measures of motivation for change found the program more helpful than those with lower motivation. Automated therapy made available to the general public via the Internet can be accessed by large numbers of individuals. The interaction can be useful to patients with significant levels of substance abuse.

Adult↗
PubMed1980

A court-mandated workshop for adolescent children of divorcing parents: a program evaluation.

This article provides a description and an empirical evaluation of a predivorce workshop established by the Family Court of Allen County, Indiana, for adolescent children (N = 48) of divorcing parents. Highlighted are the concerns of the adolescents, the approaches taken by the workshop staff, and the impact of the program on the participants. Viewpoints on the clinical, ethical, and legal issues involved in "required" predivorce counseling for adolescents are presented. The preventive nature of the program, its means of transforming initial resentment toward the workshop experience into positive feelings, and the implications for future practice and research are also discussed.

Adaptation, Psychological↗