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PubMed1988

Ministerial Resolution No. 379-8-SA/DM, 18 October 1988.

This Resolution approves the Regulations for the organization and functioning of the Autonomous Authority of the Special Project for Primary Attention and Basic Health Services created by Peru Supreme Decree No. 005-86-SA. The objectives of the Authority are 1) to implement basic health services; 2) to bring about the construction of health centers; 3) to give medical equipment and medicines to these centers, as well as to the people with the poorest levels of health within its jurisdiction; 4) to supply means of communication and transportation; 5) to obtain the participation of the community in all steps of the project; and 6) to train personnel. Further provisions of the Resolution deal with the directorate, the executive presidency, departments, and resources of the Authority, among other things.

Americas↗
PubMedDate not supplied

Innovations in reproductive health care: menstrual regulation policies and programs in Bangladesh.

Although abortion is legally restricted in Bangladesh, early menstrual regulation (MR) as a means of reducing female morbidity and mortality associated with indigenous abortion has been part of the government's health and family planning efforts since 1975. Approximately 3,000 doctors and 2,600 female family planning workers (Family Welfare Visitors) have been trained in techniques of MR in a program intended ultimately to serve rural populations in all areas of the country. This paper assesses MR training and service programs in Bangladesh for their capacity to provide high quality reproductive health care for very poor women who are trying to control their fertility. Among other advantages, MR programs serve as an entry point for many women to contraceptive services and to maternal health care.

Abortion, Induced↗
PubMed1997

Typology of local health departments based on maternal and child health core functions.

A survey of Missouri local health departments (LHDs) was conducted to measure core public health functions within maternal and child health (MCH). Measurement was based on a prior key informant study that defined each core function as a set of specific MCH activities, programs, and services. The 59 items in the survey operationalized these activities and enabled the creation of summary scores for assessment, policy development, and assurance. Participation included 93 of the 112 Missouri LHDs (83%) in 1995. Reliability coefficients for the summary scores ranged from .83 to .92. Cluster analysis produced six types of LHDs with differing core function patterns. By matching efforts to improve core function practice to LHD type, more efficient use of capacity building resources may result.

Female↗
PubMed1985

Community-based primary prevention of cardiovascular disease in Switzerland: methods and results of the National Research Program (NRP 1A).

The National Research Program 1A on Primary Prevention of Cardiovascular Disease in Switzerland was designed to determine whether community health education can reduce cardiovascular risk factors in whole population groups. Two towns (12,000 inhabitants each) in the French-speaking and two (16,000 inhabitants each) in the German-speaking part of the country were selected for either intervention or comparison. Following baseline screening in 1977 (stratified random samples) and the community intervention program (1978-1980), a final assessment on the initial participants was made at the end of 1980. In intervention towns, 26.2% of the regular smokers quit during this period compared with 18.1% in the reference towns. In addition, a significant net increase in the proportion of hypertensive patients under effective control was observed. A reduction in cholesterol levels was noted in both the intervention and the reference towns, with no difference between them. However, cholesterol levels in a subgroup of women participating in program activities as compared with those not participating were significantly reduced. The program, with extensive involvement of a diversity of community groups, has enjoyed continued support, even after the end of the research experience, thus demonstrating the viability and acceptability of community-oriented preventive action.

Blood Pressure↗
PubMed1997

Physical activity in the elderly: benefits and intervention strategies.

In spite of the well-documented evidence that physical activity is beneficial, only 30% of individuals over the age of 65 report exercising regularly. Regular physical activity can minimize and prevent chronic problems and increase functional ability in the elderly. Designing physical activity for the elderly requires initial assessment of functional ability, exercise tolerance, physical limitations, and psychologic and social support of the individual. The exercise prescription should address the intensity, frequency, and duration of the exercise. Several factors affect the elderly's initiation and adherence to a physical activity program. These include the elder's perception of factors preventing physical activity, individual goal setting, and personal and therapist support in the effort.

Aged↗
PubMed1978

Cardiovascular fitness program--a fringe benefit.

St. Marys Hospital Medical Center, Madison, WI, initiated an exercise counseling and activity program for its 1,400 employees. With professional guidance employees are encouraged to become involved in appropriate and enjoyable forms of exercise that will improve and maintain their cardiovascular health and overall well-being. The hospital believes that this is one of the first programs of its kind in a hospital setting.

Goals↗
PubMed1983

Medical student education for primary health care: who teaches what, when?

Since primary health care (PHC) is central to good doctoring and pervades all levels of medical services, a suitable system for teaching it must be developed. Whereas the traditional approach in teaching has been toward a set objective, PHC requires an approach that aims to meet urgent and changing needs. The PHC doctor must adapt to the prevailing requirements of his practice. Other teaching implications are those of organization and team training and continuing medical education. The conflict between different approaches is considered in an attempt to resolve the problem of who teaches what, when.

Curriculum↗
PubMed2000

Perceptions of sedentary African-American women about continuous versus intermittent walking.

To meet current physical activity recommendations, a person may chose to adopt a continuous or an intermittent physical activity program, as long as they accumulate 30 minutes of moderate-intensity physical activity most days of the week. Sixty-four sedentary African-American women were surveyed to assess whether perceptions about continuous and intermittent walking programs differed. Specifically, we assessed whether perceptions of self-efficacy, outcome expectations, social support, and the environment varied with respect to walking programs. Results indicated that the women perceived higher self-efficacy for the intermittent walking program and associated this program with more favorable environmental factors (p < .05). However, they expected greater benefits from the continuous walking program (p < .05). Overall, 65% of the women reported that they would prefer to adopt the continuous walking program.

Adult↗
PubMed1999

Caspase-independent programmed cell death with necrotic morphology.

Cell death is generally classified into two large categories: apoptosis represents active, programmed cell death, while necrosis represents passive cell death without underlying regulatory mechanisms. Recent progress revealed that caspases, a family of cysteine proteases, play a central role in the regulation of apoptosis. Unexpectedly, however, caspase inhibition occasionally turns the morphology of programmed cell death from apoptotic into necrotic without inhibiting death itself. In this article, we review different models of caspase-independent programmed cell death showing necrotic-like morphology, including our Ras-mediated caspase-independent cell death. Based on these findings, we suggest the existence of a necrotic-like cell death regulated by cellular intrinsic death programs distinct from that of apoptosis. Even though type 2 physiological cell death, or autophagic degeneration, has been recognized as a necrotic-like programmed cell death for a long time, the underlying molecular mechanisms have not been identified despite its physiological significance. This has been in part due to the previous absence of adequate caspase-independent cellular models to study, recent efforts may now help to elucidate these mechanisms.

Animals↗
PubMed1983

An organization-environment framework for assessing program implementation.

Evaluations of health programs are typically conducted from a rational bureaucratic framework in which client change and client outcome are seen as logical outcomes of program activity. This paper proposes a theoretical framework for examining organizational consequences of program implementation. Factors in the internal environment (e.g., the hospital) and the external environment (e.g., the community) which contribute to the program's success or failure, are considered. Observational and structured interview data are used to compare two state funded perinatal projects, one an organizational "success" and the other a costly failure. Attributes of external environments which may be important to successful implementation include demand for services, provider competition, access to information, social beliefs, and professional commitment. Important features of the internal environment include host organization commitment and conflict, and structural attributes: complexity, formalization, centralization, and coordination. The paper concludes with theoretically-based questions which serve as guidelines for process evaluation.

California↗
PubMed2003

Practice patterns for long-term follow-up of adult-to-adult right lobectomy donors at US transplantation centers.

Protocols used by transplant centers to care for donors after right hepatectomy for living donor liver transplantation are not well described in the medical literature. Our goal is to describe practice patterns for the long-term follow-up of adult-to-adult right lobectomy donors at US transplantation centers. All adult liver transplantation centers listed with the United Network for Organ Sharing were surveyed between October and November 2002. A transplant coordinator, hepatologist, or surgeon from each center completed a 10-item telephone questionnaire. Of 97 adult liver transplantation centers, 90 centers (92.8%) completed the survey. Ninety-six percent of participants were transplant coordinators; 2%, hepatologists; and 2%, surgeons. One thousand forty-four right lobectomies have been performed by 51 (56.7%) transplant programs (range, 1 to 101 per center). Thirty-eight percent of active programs have performed fewer than 10 donation right lobectomies. Fifty-one percent of programs have a transplant coordinator who works specifically with donors. Thirty-five programs (68.3%) have a formal follow-up protocol, and an additional 13 centers (14.4%) reported their usual follow-up patterns. Protocols ranged from no formal follow-up to visits every few weeks in the early postoperative period followed by evaluation every 6 months. Evaluation beyond 12 months is typically on an as-needed basis. Personal psychosocial support services after donation were unusual and included regular phone calls from the coordinator (5 centers), quality-of-life instruments (3 centers), scheduled follow-up with the psychologist (1 center), or a satisfaction survey (1 center). Several centers provided newsletters, combined donor-recipient support groups, recognitions parties, and certificates. There is significant variability in the long-term care of donors. Formal psychosocial support after donation is rare.

Adult↗
PubMed1992

Helping oneself by helping others: evaluation of a service credit banking demonstration.

Between 1987 and 1990, the Robert Wood Johnson Foundation funded six service credit banking demonstration programs among the elderly in which participants delivered services in return for credits, entitling them to later service. This evaluation of the demonstrations found that these six sites successfully attracted elders for the delivery of household support services to a relatively old, frail population with potentially limited social networks. Evidence on the significance of the "credit" in attracting volunteers was mixed, but the programs have attracted new volunteers, and have not substituted for other volunteer activities. Program development has entailed considerable staff investment in volunteer support; programs are better understood as community membership organizations than as mechanical exchanges.

Aged↗
PubMedDate not supplied

Evaluation of a culturally appropriate intervention to increase physical activity.

OBJECTIVE: To evaluate a culturally appropriate intervention to increase activity in overweight Mexican American women. METHODS: Participants were randomly assigned to a physical activity program or wait-list control. RESULTS: Treated participants were not more active than controls at 6 or 12 months. In addition, we found no significant differences in the proportion of individuals who met an objective criterion for physical activity from baseline to 6 months in the treatment or control groups. CONCLUSION: The intervention did not increase physical activity in this population. Differences in baseline activity and contamination of the control group may partially account for the outcome.

Adolescent↗