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At least 595 records · Page 33Linked to original sources
PubMed1990

Hypertension research. The next five years.

Hypertension is both a disease and a risk factor. Long-term research objectives are to understand blood pressure homeostasis and the pathogeneses of the various forms of hypertension. Short-term research objectives center around enhancing methods for detection, evaluation, treatment, and control of high blood pressure because, even in the absence of precise knowledge of the etiology of hypertension, its control results in substantial reductions in morbidity and mortality. Therefore, a multifaceted national research strategy has been developed that includes basic science, applied research, clinical research, clinical trials, and demonstration and education research approaches. Complementing this research strategy is a congressionally mandated program to facilitate the application of the products of research to the clinical care setting by promoting educational activities aimed at health care providers, patients, and consumers.

Animals↗
PubMed2003

Toxicity characterization of environmental chemicals by the US National Toxicology Program: an overview.

The US National Toxicology Program (NTP) is an interagency program whose mission is to evaluate agents of public health concern by developing and applying the tools of modern toxicology and molecular biology. Chemicals substances or physical agents selected for toxicology and carcinogenesis evaluations by the NTP are usually studied in a series of subacute (14-day exposure), subchronic (90-day exposure) and chronic (2-year exposure) studies in rodents. The NTP has published more than 500 reports of the findings and conclusions from its toxicology and carcinogenesis studies. In more specialized studies, the NTP also evaluates adverse effects on the structure and function of the immune, reproductive, nervous, and respiratory systems. The program attempts to evaluate and appropriately incorporate new technologies to improve the way we study the toxicity of chemicals. For example, the program has extensively evaluated several transgenic mouse models for their potential use as short-term cancer screens and has been a full participant in an international effort to examine their usefulness in pharmaceutical registration. Toxicogenomics, an emerging scientific field that examines the expression of thousands of genes simultaneously in response to chemical exposure, holds promise for future application to better understand the underlying mechanisms of chemical toxicity. A number of public health issues being addressed by the NTP are not only of national importance but also have global impact, such as the potential for endocrine disruptors to influence development and carcinogenesis and the safety of herbal medicines and dietary supplements. The program participates in the preparation of national and international toxicity testing guidelines and the findings from NTP studies are widely used for risk assessments by international organizations and federal agencies. The NTP maintains databases that contain toxicity, and health and safety information on a large number of chemicals. These databases are available from the NTP web site (http://ntp-server.niehs.nih.gov) and are accessed over 100000 times a month from around the world.

Animals↗
PubMed2002

The Behavior Change Consortium: setting the stage for a new century of health behavior-change research.

The Behavior Change Consortium (BCC), a collective of 15 National Institutes of Health-funded behavior-change projects, was conceived with the goal of evaluating the efficacy and effectiveness of novel ways of intervening in diverse populations to reduce tobacco dependence, and improve physical activity, nutrition and other health behaviors. The purpose of this article is to provide a general introduction and context to this theme issue by: (1) reviewing the promises and challenges of past efforts related to promoting change for three key health behaviors; (2) reviewing successful intervention strategies and principles of health behavior change; (3) discussing major theoretical approaches for obtaining successful behavior change; (4) setting BCC activities within the context of recent recommendations for the behavioral and social sciences; and (5) providing an organizational framework for describing each of the projects within this consortium. In addition to the rich database on behavioral outcomes for tobacco dependence, physical activity and diet, the BCC represents a unique opportunity to share data and address cross-cutting intervention research issues critical for strengthening the field of behavior change research.

Health Behavior↗
PubMed1994

Public health and health care reform: the American Public Health Association's perspective.

This paper discusses the American Public Health Association's goals with regards to the current health care reform debate. By outlining the organization's historical context with regards to health care reform as well as the parameters of the current medical care and public health crises, the paper explains why APHA's advocacy efforts focused on two major issues: the adoption of a national health program that features universal coverage with a comprehensive set of benefits for all our nation's residents, and the enhancement of the federal, state, and local public health infrastructure. The paper argues that both medical care services and public health programs must be expanded if we are to improve the nation's overall health status.

Forecasting↗
PubMed1999

Integrated management of childhood illness: a summary of first experiences.

The strategy of Integrated Management of Childhood Illness (IMCI) aims to reduce child mortality and morbidity in developing countries by combining improved management of common childhood illnesses with proper nutrition and immunization. The strategy includes interventions to improve the skills of health workers, the health system, and family and community practices. This article describes the experience of the first countries to adopt and implement the IMCI interventions, the clinical guidelines dealing with the major causes of morbidity and mortality in children, and the training package on these guidelines for health workers in first-level health facilities. The most relevant lessons learned and how these lessons have served as a basis for developing a broader IMCI strategy are described.

Child↗
PubMed1994

Clinical trials in the community. The community clinical oncology program experience.

In 1983, the National Cancer Institute initiated the community clinical oncology program (CCOP), the goal of which was to hasten the adoption of state-of-the-art cancer medicine in community-based institutions. The strategy adopted was to link community oncologists to major cancer centers and research bases for the conduct of clinical trials. Since the program was initiated, a significant amount of literature has been developed, providing insight into the operation and success of the program. These reports have been combined with experience of the author, a principal investigator of an established CCOP, in an effort to characterize the critical features of the program. Experience to date indicates that CCOPs have been successful in accruing patients to cancer-treatment clinical trials, contributing approximately one third of patients placed in investigational protocols. Since 1987, CCOPs have been required to participate in nontreatment-related research in cancer prevention, detection, and mitigation of cancer symptoms, or cancer control research. After a slow beginning, both the research bases and CCOPs have accumulated experience in the development of and accrual of patients in cancer control protocols. This review suggests that CCOPs, as they mature, will fulfill their goal as an important mechanism for the transfer of technology and the conduct of clinical research.

Clinical Trials as Topic↗
PubMed1978

Role of diet and nutrition in cancer cause, prevention and treatment.

The roles of diet and nutrition as etiologic factors in cancer incidence is discussed. Diet and nutrition have recently been recognized as causative agents in other chronic diseases. Epidemiologic evidence supportive of the hypothesis that different diets rather than other environmental contaminants are important in the causation of certain forms of cancer is reviewed, including studies on several migrant populations and ethnic groups. Specific dietary components have been correlated with certain forms of cancer, such as bowel cancer and fat consumption, and a theory of the mechanism is set forth. The animal studies discussed strongly confirm the results of epidemiologic studies in man. Additionally, nutrition's important role in cancer therapy and rehabilitation is described. A variety of intervention techniques are available to maintain the nutrition status of the cancer patient. Finally, the research priorities and the Diet, Nutrition and Cancer Program (DNCP) of the National Cancer Institute are explained.

Adult↗
PubMed1990

Losing the war against cancer: who's to blame and what to do about it.

In 1971, the U.S. Congress launched a War on Cancer. Eighteen years and billions of dollars later, the United States is still in the grips of a cancer epidemic--and the number of victims grows every year. Much of the money has been squandered on a fruitless search for cancer "cures." Little has been done to prevent exposure to carcinogenic chemicals in the environment, despite ample evidence that chemical pollution of our air, water, food, and the workplace is the major cause of cancer. On the contrary, government, industry, and a small coterie of scientists have combined to stymie efforts to introduce preventive measures, such as strict pollution control standards. But cancer remains a preventable disease. It is up to citizens to push for action.

American Cancer Society↗
PubMed1992

Performance in quasi-firms: an example from the Community Clinical Oncology Program.

In this analysis, the authors examined the effects of different sets of process, structure, and environmental variables on the performance of the CCOP as a quasi-firm. Specifically, they distinguished between internal organizational processes, structural, and size characteristics of the CCOP and the organizational environment created by prior NCI program experience and the relationship within the quasi-firm. The analysis revealed that these sets of organizational and environmental characteristics have differential effects on treatment accrual. The strongest predictors are those associated with the quasi-firm relationship between the CCOP and its chosen research bases. Any definitive policy implications for the design of organizational network relationships--especially the CCOPs--will require further analysis. Particular attention needs to be given to the longitudinal nature of the relationships and the ability of these organizational and environmental factors to affect other aspects of performance. Several points have been made within this initial assessment. First, the structural character of the CCOP and its relationship to its organizational environment are important factors affecting accrual performance. The subtleties of this multivariate model are not as important as simply demonstrating that the various internal and external characteristics of these organizations as quasi-firms simultaneously affect their ability to accrue patients to clinical trials. Secondly, the importance of research base relations, and particularly the significant role of nurses, needs to be emphasized. While CCOPs were originally designed as a network of physicians and hospitals, it appears that an infrastructure of professionally active nurses working within a larger organizational environment is critical to success--at least as defined by accrual to treatment protocols. Finally, the failure of prior experience with other NCI community programs to affect CCOP accrual performance suggests that such experience does not assure "organizational learning" that may enhance performance. This suggests that CCOPs can be designated de novo to maximize performance without necessarily having to undergo a developmental or experiential phase involving community cancer programs to be effective. However, the authors suspect that another method of characterizing experience may produce different results. Further analyses of these data will test these results against other measures of CCOP performance. Specifically, attention will be given to whether this same set of characteristics is predictive of accrual to cancer control research protocols. Similarly, these same organizational characteristics may or may not be associated with other dimensions of CCOP performance such as changes in physician practice patterns and/or levels of institutionalization of the CCOP within its local community.(ABSTRACT TRUNCATED AT 400 WORDS)

Clinical Trials as Topic↗
PubMed1978

The political economy of federal health programs in the United States: an historical review.

In the 1960s the federal government of the United States added a wide range of new health programs--Medicare, Medicaid, health manpower training, occupational safety, and others--to its long-established support for biomedical research and hospital construction. Total federal health outlays rose from $5 billion in 1965 to almost $37 billion in 1975. This paper describes the legislative history of federal health programs and reports the recent trends in expenditures by functional category. The expenditures of major programs are related to the populations they serve and data are presented to document the enormous inflow of resources to medical care during the last 10 years. This inflow has been induced by the structural changes in the medical care market first set in motion by private health insurance, and accelerated by the new federal programs. Designing some way to control it is a major problem in health policy for the late 1970s.

Economics↗
PubMed2000

The National Cancer Program.

OBJECTIVES: To provide an understanding of the history, progress, and future of the National Cancer Program. DATA SOURCES: Published articles, reports, book chapters, and the National Cancer Institute (NCI) web site. CONCLUSIONS: The NCI is the largest agency for cancer research. The cancer incidence and burden remains significant in spite of many advances. Oncology nurses can contribute to the prevention and cure of cancer through an enhanced understanding of the NCI's program. IMPLICATIONS FOR NURSING PRACTICE: The NCI provides many opportunities for oncology nurses. Nurses can conduct NCI-sponsored research trials, serve on NCI advisory boards, and participate in clinical research. Nurses can advise patients and the public of the many resources available to patients from the NCI and assist patients with informed decision making.

Health Planning Councils↗