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PubMed1995

Patient reactions to a program designed to facilitate patient participation in treatment decisions for benign prostatic hyperplasia.

Patients often want considerable information about their conditions, and enhanced patient participation might reduce unwanted practice variation and improve medical decisions. The authors assessed how men with benign prostatic hyperplasia reacted to an education program designed to facilitate participation in decisionmaking, and how strongly ratings of their symptom state and the prospect of complications predicted their treatment choice. A prospective cohort study was conducted in three hospital-based urology practices: two in prepaid group practices, and one Veterans Administration clinic. Four hundred twenty-one men with symptomatic benign prostatic hyperplasia without prior prostatectomy or benign prostatic hyperplasia complications were enrolled, and 373 provided usable ratings. Subjects participated in an interactive videodisc-based shared decisionmaking program about benign prostatic hyperplasia and its treatment options, prostatectomy, and "watchful waiting." They rated the length, clarity, balance, and value of the program and were followed for 3 months to determine if they underwent surgery. Patients rated the program as generally clear, informative, and balanced. Across all three sites, 77% of patients were very positive and 16% were generally positive about the program's usefulness in making a treatment decision. Logistic models predicting choice of surgical treatment documented the independent importance of negative ratings of the current symptom state (odds ratio 7.0, 95% confidence interval 2.9-16.6), as well as the prospect of postoperative sexual dysfunction (odds ratio 0.20, 95% confidence interval 0.08-0.48) in decisionmaking. Patients rated the Shared Decisionmaking Program very positively and made decisions consistent with their assessed preferences. These results suggest that patients can be helped to participate in treatment decisions, and support a randomized trial of the Shared Decisionmaking Program.

Aged↗
PubMed1975

Proceedings: Persepectives on adolescent medicine: concepts and program design.

The concepts and goals of a program in adolescent medicine should include development of a capability to focus on current health needs of youth in a variety of settings; to plan clinical services to meet those needs with the flexibility necessary to respond to changing future requirements; and to deliver service within such a context while simulataneously creating a milieu conducive to education and investigation into the very process and definition of adolescence. The Division of Adolescent Medicine at Montefiore Hospital and Medical Center was designed 7 years ago to fulfill these goals and consequently may serve others as a functional model for health care delivery to teenagers. The Division is comprised of: (1) a 37 bed in-patient unit; (2) a hospital-based ambulatory program including general diagnostic and follow-up services, as well as a speciality service capability in the areas of gynecology and family planning, cardiology, gastroenterology and nutrition; (3) primary care health services within teenage dentention and prison facilities; (4) addictive disease diagnostic and treatment programs; (5) school health programs from intermediate school through college levels, and (6) the division also performs supportive and consultative functions for a variety of community-based agencies. Within the programatic design approximately 70,000 adolescents have been served. The cornerstone of the educational and investigative efforts has been the concept that all the above six functional units are clinical laboratories and classrooms so that training and research activities are integral parts of each of the service areas. This program design is continually undergoing revision and refinement so as to remain ever-responsive to new and emerging problems to meet additional training demands and, most importantly, to permit and encourage creativity and growth patients and staff.

Adolescent↗
PubMedDate not supplied

Advance directives: a program design for home healthcare.

Home care agencies receiving Medicare and Medicaid reimbursement are now required to adhere to the regulations of the Patient Self-Determination Act of 1990. These regulations require all agencies to inform clients older than 18 years of their right to plan for their care in advance, and to provide clients with the agency's written policy respecting this right. It also requires that agencies educate their staff about the new provisions. This report presents a program designed to orient all new and continuing home care staff members with the requirements to ensure compliance with this important directive.

Advance Directives↗
PubMed2005

A very large diversity space of synthetically accessible compounds for use with drug design programs.

We have constructed a very large virtual diversity space containing more than 10(13) chemical compounds. The diversity space is built from about 400 combinatorial libraries, which have been expanded by choosing sizeable collections of suitable R-groups that can be attached to each link point of their scaffolds. These R-group collections have been created by selecting reagents that have drug-like properties from catalogs of available chemicals. As members of known combinatorial libraries, the compounds in the diversity space are in general synthetically accessible and useful as potential drug leads. Hence, the diversity space can be used as a vast source of compounds by a de novo drug design program. For example, we have used such a program to generate inhibitors of HIV integrase enzyme that exhibited activity in the micromolar range.

Algorithms↗
PubMed1990

Olga--oligonucleotide primer design program for the Atari ST.

A program to facilitate the design of oligonucleotide primers has been devised. Olga is written in draft ANSI standard 'C' and makes use of the implementation of Digital Research GEM (Graphics Environment Manager) on the Atari ST. Olga is specifically suited to the polymerase chain reaction (PCR) allowing simultaneous analysis of two primer sequences. The advantage of Olga is that it provides in one program analyses for direct repeats, secondary structures and primer dimerization as well as several useful 'finishing' tools for workers engaged in PCR optimization and oligonucleotide syntheses.

Drug Design↗
PubMed1988

The use of biofeedback in a behavioral program designed to teach an anxious child self-catheterization.

This paper presents a case study of a 7-year-old girl with a noncompliant bladder who was trained to self-catheterize using biofeedback and behavior therapy techniques. Initial attempts to train her to self-catheterize were unsuccessful owing to excessive amounts of fear, muscle tension, and refusal. After seven treatment sessions in which she was instructed in proper self-catheterization technique by a urology nurse clinician and coached in biofeedback-assisted relaxation by a clinical psychologist, the child successfully learned to self-catheterize. EMG readings showed a decrease in quadriceps muscle tension levels across sessions. Eight additional sessions were held in order to train the child's parents in proper technique and coaching procedures. Through the use of portable biofeedback equipment during actual training sessions, the biofeedback served as a cue--first to the child and coach, and later to the child and parents--for when the child needed to stop and relax. This case illustrates the usefulness of biofeedback in a comprehensive behavioral program designed to teach self-catheterization to fearful children.

Anxiety↗
PubMed1994

Reducing alcohol consumption among university students: recruitment and program design strategies based on Social Marketing Theory.

Recruitment of program participants and development of appealing comprehensive alcohol abuse prevention programs is an exigent priority for university campuses due to the serious physical and emotional consequences related to alcohol consumption. A sample of 67 students from a large midwestern university completed a survey based on Social Marketing Theory (SMT) which was developed to improve recruitment and enhance the design of comprehensive alcohol abuse prevention programs. The results indicate that recruitment may be optimized by providing a flexible, convenient, low-cost program that encourages friends' participation, communicates alcohol-related risks and offers university credit or refund as participation incentives. The design of alcohol abuse prevention programs may be enhanced by emphasizing the positive outcomes of reducing alcohol consumption, improving the quality and quantity of alternatives to the social atmosphere connected with drinking, and soliciting respected opinion leaders (physicians and parents) to communicate alcohol reduction messages. This project is a first initiative to 'fill the gap' in the social marketing research literature by providing formative information pertinent to recruitment and design of alcohol reduction programs specifically for college students.

Adolescent↗
PubMed1999

Ventricular assist device programs: design and function.

Ventricular assist device programs can be structured in a variety of models and can make use of personnel derived from a broad spectrum of clinical and hospital-based practice. When aggressively and proactively negotiated with payers, these programs can be cost-effective and thoroughly self-sustaining.

Animals↗
PubMedDate not supplied

[FARMAC: a program designed for monitoring the prescription of antimicrobials in hospitals].

INTRODUCTION: The use of computer programs for monitoring the prescription of antimicrobial agents in hospitals is of paramount importance in the incorporation of electronic databases developed and analyzed by several hospital committees, including the following: infection control; pharmacy; morbidity and mortality; and quality assurance committees, as well as other key areas or departments such as pathology, pharmacy, microbiology, radiology, or hospital administration. OBJECTIVE: To describe the development and use of an "information system" employed for monitoring the prescription of antimicrobial agents in hospitalized patients. MATERIAL AND METHODS: A printed format was developed in order for physicians to ask for authorization for the use of restricted antimicrobial agents (i.e. third-generation cephalosporins and other newly introduced beta lactams, fluoroquinolones, antifungals, antivirals, etc). A computer program, "FARMAC", was designed using the Dbase IV program. FARMAC contemplates the presentation on a screen of a main menu allowing for the use of several options: admissions; antibiotic changes; consultations; discharges; hospital transfers; reports, and distribution. The reports are generated from the menu and appear on the screen or are printed in representative tables and figures. Generally speaking, the system processes information on the use of antimicrobial agents, files information, allows for consultation, of the information and generates reports quickly and efficiently. RESULTS: The presentations were defined on screen, taking into account the space needed in order to avoid an inadequate distribution of the messages, therefore obtaining an optimal image. A database was created defining the necessary fields for storing information with reference to patients and usage patterns of restricted antimicrobial agents. DISCUSSION: The development of an information and surveillance system on the prescription of antibiotics allows for consulting updated information, making the data analysis easier for decision making. Its use will allow for surveying tendencies and usage patterns of controlled and non-controlled antimicrobial agents.

Anti-Infective Agents↗
PubMed2002

Theoretical basis and program design of a school-based mental health intervention for traumatized immigrant children: a collaborative research partnership.

This article describes a collaborative research model for school-based mental health services that targets children who are recent immigrants with violence-related mental health symptoms. The model describes a conceptual framework used in the establishment of an academic-community partnership during the development, evaluation, and implementation of the Mental Health for Immigrants Program (MHIP), a school-based mental health intervention. The article discusses the challenges that occurred and provides specific examples of how a participatory research partnership may work together through all program phases--design through implementation and program evaluation--to meet a specific community's needs and produce generalizable knowledge. The challenges and limitations of collaborative research approaches also are discussed, with particular emphasis on the role of participatory research in the development and evaluation of school-based mental health programs.

Behavioral Medicine↗
PubMedDate not supplied

An evaluation of I Can Cope. Insights into program design and implementation.

The I Can Cope program is an educational program developed to provide information on how to promote physical and emotional well-being to individuals with cancer, their families, and friends. Through focus group and individual interviews and a mailed survey, the effectiveness of the selection, marketing, implementation, and support processes associated with implementing the program in the central Arizona and greater Las Vegas, Nevada, regions was evaluated. Findings, recommendations, lessons learned, and use of findings are discussed.

Adaptation, Psychological↗
PubMed2005

A computer services program for residents of a continuing care retirement community: needs assessment and program design.

Preparatory to establishing a computer services program for residents, Presbyterian Homes, a multi-campus continuing care retirement community, conducted an assessment of residents' computer needs, ownership, and usage. Based on the results of the needs assessment, computer resource rooms were established at each facility, with computer hardware and software adapted for the use of seniors. We also deliver adapted computer education for residents, including small-group training in basic software skills; classes on software for computer accessibility; and workshops on themes motivating computer use. Ongoing evaluation shows that half of residents make use of computer resources, and that their computer skills have opened the door to other educational opportunities.

Aged↗
PubMed1984

The patients rights representative program: design of an ombudsman service for mental patients.

The article describes an experimental rights program operating in mental hospitals in one state's department of public welfare. The presentation of the program's internal/external design includes information on goals and objectives, structure, work activities, and reviews of the program to date. The program is linked to the general trend toward developing ombudsman services; several additional research needs are identified.

Follow-Up Studies↗
PubMed1974

Computer program designed to follow fluctuations in microbial populations and its application in a study of Chesapeake Bay microflora.

A computer program has been developed which performs cluster analysis of microorganisms using methods of numerical taxonomy. The program is designed to group related strains, identify the groups by reference to known strains, and calculate a hypothetical median organism (HMO) for each group. The HMO serves to condense taxonomic information and provides a tag for each strain cluster. Every strain in a group is compared with the HMO established for that group. A representative strain for the group is obtained by selection of the strain showing highest similarity to the HMO. New data sets can be compared with data sets of previous analyses. Hence, the occurrence of the same taxonomic groups within separate data sets can be determined. Quantitative or qualitative differences in distribution of taxonomic groups within or between data sets can be measured. The output from the computer is a graphical display, using an on-line plotter; thus, the investigator is provided with visual comparison of data sets. Results obtained from a study applying the computer program in an analysis of taxonomic data obtained for 43 bacterial strains isolated from Chesapeake Bay indicate the usefulness of this method of taxonomic analysis in microbial ecology.

Bacteria↗
PubMed1991

The evaluation of the Henry J. Kaiser Family Foundation's Community Health Promotion Grant Program: design.

The Kaiser Family Foundation's Community Health Promotion Grant Program (CHPGP) provides funding and technical assistance in support of community-based efforts to prevent major health problems. The first phase of the program was implemented in 11 communities in the western United States. This paper describes the evaluation design of the CHPGP in the West, the methods of data collection, and the baseline comparability of intervention and control communities. Major features of the evaluation design include: (1) the randomization of qualified communities making application into funded and unfunded comparison groups; (2) a second set of matched control communities for some intervention sites; (3) data gathering through repeated surveys of community residents (probability samples of adults and adolescents) and institutions (health-related organizations and randomly sampled grocery stores and restaurants); and (4) the use of secondary data to monitor health events. Selected baseline data show that intervention and control communities differ in racial/ethnic composition, but relevant health behaviors and ratings of community activation for health promotion appear comparable.

Adolescent↗
PubMed1978

Evaluation of programs designed to increase the protection of infants in cars.

Three in-hospital educational programs for postpartum women, designed to increase the crash protection of infants in cars, were evaluated in comparison to a group that received no education. The programs consisted of (1) literature, plus making infant carriers readily accessible and convenient to purchase; (2) literature, plus a personal discussion, plus making infant carriers readily accessible and convenient to purchase; and (3) literature, plus the offer of a free infant carrier. The programs increased the extent to which infant carriers were used to transport babies in cars, but had little or no effect on the key outcome measure: use of infant carriers fastened by the car seat belt so that crash protection is provided. Rates of such use were low in all groups. It is concluded that ways of providing increased crash protection to infant and child travelers in addition to use of restraint systems requiring the active, voluntary cooperation of parents must be encouraged. "Passive" (automatic) protection techniques, such as air bags and vehicle interior modifications, have great potential in this regard.

Accident Prevention↗