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PubMed1994

[AIDS-related knowledge, behavior and attitudes of workers in Israel].

Control of the AIDS pandemic depends largely on the success of educational programs designed to persuade the population at risk to use currently recommended methods of prevention. In Israel there are no regular national surveys on the health-related behavior of the population. The consequent lack of reliable data makes it difficult both to develop and to evaluate AIDS-related educational programs. A survey was therefore conducted among 536 employees of 3 workplaces in Dec. 1992, using anonymous questionnaires. The level of general knowledge of the disease was good, although in selected areas there were deficiencies: more than 20% of the men and 40% of the women believed that AIDS can be contracted through the use of public toilets. More than 50% of the subjects indicated that they would like more information on the disease, and believe that insufficient education is given youth regarding the use of the condom. Women tended to be more worried than men about the possibility of contracting AIDS, and were more likely to adopt preventive behavior and educate their children in this regard. These findings indicate the need to design separate educational programs for men and women. Further on-going surveys in representative samples of the general population are urgently needed to monitor trends in AIDS-related knowledge, attitudes and behavior.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Building research capacity in family medicine: evaluation of the Grant Generating Project.

OBJECTIVE: To evaluate the Grant Generating Project (GGP), a program designed to train and assist family medicine researchers to secure funding as part of an overall strategy to increase research capacity in family medicine. STUDY DESIGN: Cross-sectional mail survey. POPULATION: First- through fourth-year participants in the GGP program starting from 1995. Participants were faculty members of American and Canadian family medicine departments. OUTCOME MEASURED: We measured cardinal features of primary care quality including first-contact care (accessibility and utilization), longitudinality (strength of affiliation and interpersonal relationship), comprehensiveness (services offered and received), and coordination of care. RESULTS: Most (18 of 23) GGP participants completed the survey. A total of 58 grants/contracts were submitted by respondents, representing approximately US$19.3 million. Currently, 17 (29%) are pending, representing $10.8 million (including training grants). Given the current track record, $4.8 million additional grants funds could be generated. GGP strengths cited by respondents included an effort to enhance family medicine research; personal attention, guidance, motivation, and feedback from GGP faculty and mentors; development of grant-writing skills; encouragement to attend family medicine meetings; ability to meet and learn from peers; mock study section experience; and the ability to teach, mentor, and encourage others as the GGP experience did for them. Major challenges cited were a variable degree of commitment from mentors, lack of a long-term commitment to participants, and difficulty accommodating the research focus and skill level of participants. In general, most respondents regarded the GGP program as well worth the time and effort invested. CONCLUSIONS: One to 2 years after participating in the program, participants achieved a remarkable track record of grant submissions. Moreover, the GGP program has had a substantial impact on participants; many are now teaching and mentoring others in their department. If sustained, the program will greatly increase the research capacity of the discipline of family medicine.

Adult↗
PubMed1981

Self-designed continuing education for supervisors in community mental health.

This paper describes a continuing education program designed to meet the needs and interests of supervisors working in community mental health centers. As initial group of supervisors was recruited as consultants to design all aspects of their educational experience. The group used a modified nominal group technique to develop the curriculum. Subsequently 28 trainees in three separate groups participated in the training program; they represented 20 agencies and included directors, training coordinators, supervisory staff, and direct service workers. Methods employed were satisfaction measures, content retention measures, and interviews to evaluate program impact. Participants reported that they increased their knowledge and were satisfied with training, but that the program was only modestly effective in contributing to changes in their job and agency functioning. Training was most effective with agency directors, employees of private agencies, and workers with fewer years at a given work site.

Administrative Personnel↗
PubMed1999

Effects of a peer-mediated aerobic conditioning program on fitness levels of youth with mental retardation: two systematic replications.

The generality of a peer-mediated exercise program designed to enhance aerobic fitness of 17 children with moderate and severe cognitive disabilities was evaluated. Two systematic replications of the program were conducted. Participants' ages, disability levels, and school settings varied. Target participants were paired with peers without disabilities. These students encouraged their peers to maintain requisite levels of exercise intensity and monitored their heart rates. A between-group multiple-baseline design was used to evaluate program effects. Results replicated earlier findings. Aerobic fitness of participants, measured by exercise heart-rates, improved when the exercise program was introduced. Results for individual participants reflected more variability than combined group data. Implications for overcoming motivational barriers and obtaining valued outcomes correlated with the program are discussed.

Adolescent↗
PubMed1999

Premedical and predental enrichment program for minority students, 1969-1996, at Meharry Medical College.

From 1969 through 1996, Meharry Medical College offered the Biomedical Sciences Program, an eight-week summer premedical and predental enrichment program designed to increase the enrollment of minority students in health professions schools. The program focused on preparing undergraduates to pursue health professions careers by providing specially designed courses in biology, chemistry, mathematics, and scientific communications, as well as interactions with clinical faculty. The curriculum emphasized academic preparation, including structured course work in the classroom, assigned homework every night, and scheduled activities with clinicians. (The program merged with two other outreach programs in 1996 and is now part of the Health Careers Opportunity Pre-Baccalaureate Program.) From 1969 to 1996, 1,015 students participated in the program, and over the years 43% of them responded to tracking surveys. Of these 445 respondents, 70% (310) applied to professional schools, of whom 83% (257) applied to medical, 15% (46) to dental, and 2% (10) to graduate schools. Of the 257 who applied to medical schools, 70% (198) were admitted and all of them graduated. Of the 46 who applied to dental schools, all were admitted and graduated; and of the ten who applied to graduate schools, all were accepted and received PhD degrees in the biomedical sciences. Of particular note, 67% (172) of the applicants who were admitted to professional schools matriculated at Meharry Medical College. These data suggest that the Biomedical Sciences Program used effective strategies that increased the number of underrepresented-minority students entering health professions careers.

Education, Predental↗
PubMed1995

Inter-hospital transport of neonatal patients on extracorporeal membrane oxygenation: mobile-ECMO.

OBJECTIVE: To describe the equipment, personnel requirements, training, management techniques, and logistic problems encountered in the design and implementation of a mobile extracorporeal membrane oxygenation (ECMO) program. DESIGN: This is a report of a technique for the transport of patients on ECMO and a description of our retrospective case series. SETTINGS: The study was conducted at a regional referral children's hospital and ECMO unit. PATIENTS: Thirteen neonatal medical patients with acute respiratory failure were transported with mobile-ECMO. RESULTS: Over a 24-month period, we transported 13 neonatal patients with mobile-ECMO. The reason for transport with mobile-ECMO was inability to convert from high-frequency ventilation (4 of 13), patient already on ECMO (1 of 13), and patient deemed too unstable for conventional transport (8 of 13). Eleven of the 13 patients were transported from other ECMO centers. Of the 13, 9 survived. No major complications during transport were reported for any of the patients. Follow-up data were available on all nine survivors of neonatal mobile-ECMO. Eight of these had normal magnetic resonance imaging scans of the brain; the ninth had a small hemorrhage in the left cerebellum. CONCLUSION: Our limited series shows that patients can be safely transported with mobile-ECMO. This program does not replace the early appropriate transfer for ECMO-eligible patients to an ECMO center.

Arkansas↗
PubMed2004

Memory Club: a group intervention for people with early-stage dementia and their care partners.

PURPOSE: Diagnosis of dementia in its early stages presents a window of opportunity for examining the immediate and long-term consequences of the illness at a point when the individual with memory loss can still participate in decision making. DESIGN AND METHODS: Memory Club is a 10-session group program designed to provide information about memory loss and resources for coping with it in an emotionally supportive atmosphere for people with dementia and their care partners. Memory Club sessions are structured so that dyads meet together, as well as separately with other care partners and people with dementia, respectively. This approach allows for time for the dyad to talk together about issues in a supportive setting, and for the people in the same role (person with dementia or the care partner) to share experiences with one another. RESULTS: A preliminary evaluation indicated that people with dementia and their care partners rated Memory Club very positively. IMPLICATIONS: Facing an inevitable decline, persons with early-stage dementia and their care partners found it helpful to talk with one another and with peers in the same circumstances about the disease and its effects.

Aged↗
PubMed1996

PICDI, a simple program for codon bias calculation.

PICDI is a very simple program designed to calculate the Intrinsic Codon Deviation Index (ICDI). The program is available in Macintosh as well a PC format. Requirements for correct input of the sequences have been kept to a minimum and the analysis of sequences up to 2000 codons is very quick. The ICDI is very useful for estimation of codon bias of genes from species in which optimal codons are not known. The availability of a computer program for its calculation will increase its usefulness in the fields of Molecular Biology and Biotechnology.

Codon↗
PubMed2006

Parent-child development center follow-up project: child behavior problem results.

The long-term effectiveness of the Parent-Child Development Centers (PCDCs) as programs to prevent behavior problems in children was examined with follow-up data collected 6-13 years after program completion. Data were collected for 581 children who had been in the programs with their mothers (Ns: Birmingham, 151; New Orleans, 186; Houston, 244). Mothers and teachers were interviewed. There were few significant differences between program and control groups. Only the early cohorts of the Houston program showed significant differences between groups on the Child Behavior Checklist (CBCL). EDITORS' STRATEGIC IMPLICATIONS: This is a rare example of long-term longitudinal evaluation of a cross-site prevention program with a large sample size. Practitioners and program designers will be interested in the author's descriptions of cohort and site implementation differences. The absence of major effects at follow-up (despite significant short-term effects) in this well-designed study must caution us against thinking of early prevention programs as inoculations.

Adolescent↗
PubMed1995

Enhancing coverage and sustainability of vaccination programs: an explanatory framework with special reference to India.

The article addresses the question in what form and under what conditions vaccination programs can be expected to continue once the 'take off' period is over. This matter is of great importance because of the need to continuously vaccinate new cohorts of children with a high degree of coverage and in an appropriate manner. Using data from India, where vaccination programs are integrated in regular health care delivery, an explanatory framework is presented which, first, analyses the vaccination program in terms of different levels, organizational cultures and inner-level linkages and, second, addresses the relation between the program and its socio-cultural context. The analysis provides starting points for changes that could enhance coverage and sustainability. Such changes include alterations in program design and adjustments in the views of different categories of program staff. The article discusses strategies directed at achieving such changes.

Child↗
PubMed2004

Attrition from ophthalmology residency programs.

PURPOSE: To investigate the incidence of and reasons for voluntary resident attrition from ophthalmology training programs. DESIGN: Retrospective survey. METHODS: A survey was mailed to residency program directors of the 121 Accreditation Council for Graduate Medical Education-accredited ophthalmology residency programs asking them to report the number of residents who withdrew from training during 2001 to 2002 and the reasons for withdrawal. RESULTS: Of 102 responding programs, 13 (12.7%) had one resident withdraw from training in the academic year 2001 to 2002. These 13 residents represented 1.1% of all ophthalmology residents in training at the responding institutions during that academic year. The most frequent reason for withdrawing was to enter another medical specialty. CONCLUSIONS: Voluntary resident attrition from ophthalmology training programs is uncommon. The 1.1% attrition rate in this study is the lowest among published reports of attrition from other specialties.

Career Choice↗
PubMed2005

Dialysis water as a determinant of the adequacy of dialysis.

Hemodialysis patients are exposed to large volumes of water in the form of dialysate. Contaminants from the dialysate may cross the dialyzer membrane into the blood and have the potential to compromise the adequacy of dialysis. Several chemicals found commonly in drinking water have long been known to be toxic to hemodialysis patients. More recently, it has become apparent that even low levels of bacterial products in dialysate may adversely impact dialysis adequacy through their ability to stimulate an inflammatory response. Minimum levels of water and dialysate quality have been recommended to protect patients from chemical and microbiologic contaminants. Complying with these recommendations requires an appropriately designed water purification and distribution system, combined with a surveillance program designed to maintain dialysate quality.

Dialysis Solutions↗
PubMed2002

Behavior change outcomes in an outpatient cardiac rehabilitation program.

OBJECTIVE: To evaluate the effectiveness of nutrition education within an outpatient cardiac rehabilitation program. DESIGN: Subjects were assigned, according to participation in cardiac rehabilitation programs in two community hospitals within an integrated healthcare system, to either a treatment (n=54), or a control group (n=50). SUBJECTS/SETTING: One hundred four men and women, age range 35 to 85 years, participating in a 6-week cardiac rehabilitation program. Most were men (80%) and overweight. The majority presented with the diagnosis of myocardial infarction followed by coronary artery bypass surgery or percutaneous transluminal coronary angiography procedure. INTERVENTION: Subjects in the control group received usual nonindividualized nutrition education from cardiac rehabilitation therapists. Subjects in the treatment group attended two group nutrition education classes and one individual diet counseling session, all led by the same dietitian. MAIN OUTCOME MEASURES: Changes in fat, saturated fat, cholesterol, and carbohydrate intake, and restaurant eating habits as assessed by the Diet Habit Survey; changes in cardiac diet self-efficacy; and changes in health-related quality of life. Statistical analyses performed Group-by-time analysis of variance with repeated measures, chi2 test. RESULTS: The treatment group had greater improvement in Restaurant and Recipes scores on the Diet Habit Survey (2.6 vs 1.0) and a greater cardiac diet self-efficacy mean score (4.3) compared with the control group (3.8), with the greatest change in items related to eating in restaurants, away from home, or when alone. From entry into the program to discharge, the cholesterol-saturated fat index decreased significantly in the control group (from 57 to 48), and in the treatment group (from 51 to 42). The percent of energy from carbohydrate increased significantly in the control group (from 51% to 55%) and in the treatment group (from 53% to 57%). There were no differences between groups over the 3 time periods (baseline, 6 weeks, and 3-month follow-up) (n=39 for control group and n=47 for treatment group for all 3 time periods). APPLICATIONS/CONCLUSIONS: Nutrition education within an outpatient cardiac rehabilitation program can improve dietary choices at restaurants and boost self confidence in the ability to adhere to a lipid-lowering diet.

Adult↗
PubMed1999

Producer quality assurance programs.

Essentially all animal commodity organizations have established quality assurance programs designed to ensure food safety and quality. Most of these programs were originally implemented to address problems with veterinary drug residues. Many of the current programs have or plan to include food safety critical control points with specific guidelines on how to control or reduce pathogen load. The continued focus placed on food safety by today's consumer demands that American producers ensure that their commodities are wholesome, safe, and of high quality in order to remain competitive in the global marketplace. Veterinarians should recognize that it is important to encourage food animal producers to participate in quality assurance programs for their clients' economic health and for food safety and protection of public health. Commodities certified as being produced under good production practices or by producers certified as following a recognized and validated quality assurance program often bring a premium price. Also, some slaughter establishments are beginning to require producers to be certified as practicing under a recognized quality assurance program before animals are accepted for processing. This practice is being driven partially by the demands placed on slaughter establishments by the US Department of Agriculture's implementation of the Pathogen Reduction, Hazard Analysis and Critical Control Point Systems regulation. Regardless of why producer trade association quality assurance programs have come into existence, veterinarians should promote the programs as an excellent mechanism to help ensure everyone's goal of a safe, wholesome food supply.

Animals↗
PubMed1995

Spherical aberration and glare disability with intraocular lenses of different optical design.

We implanted several kinds of intraocular lenses (IOLs), calculated the spherical aberration using a computed ray-tracing system, and investigated the correlation between glare disability and spherical aberration and the difference in glare disability among the different IOL types. Type A IOLs (convex-plano), except for those with high power, had the smallest spherical aberration. Type B IOLs (biconvex, anterior more curved) had the smallest spherical aberration at high power. Type D IOLs (biconvex, posterior more curved) had the largest spherical aberration. The correlation between glare disability and spherical aberration was statistically significant for types A, B and C (equiconvex) IOLs. There was no correlation between glare disability and spherical aberration for Type D IOLs, although they showed the smallest glare disability of the four types. These results indicate that the spherical aberration of an IOL, which is calculated by an optical design program, may be a good criterion for selecting an IOL design.

Aged↗
PubMed1985

TWINAN: twin data analysis program for microcomputers.

A BASIC computer program designed to facilitate analysis of twin data is presented. The program estimates genetic parameters and tests their statistical significance based on the genetic and environmental hypothesis.

Computers↗
PubMed2001

The Institute on Human Values in Medicine: its role and influence in the conception and evolution of bioethics.

For ten years, 1971-1981, the Institute on Human Values in Medicine (IHVM) played a key role in the development of Bioethics as a field. We have written this history and analysis to bring to new generations of Bioethicists information about the development of their field within both the humanities disciplines and the health professions. The pioneers in medical humanities and ethics came together with medical professionals in the decade of the 1960s. By the 1980s Bioethics was a fully recognized discipline. We show the role that IHVM programs played in defining the field, training faculty and helping schools to develop programs. We review, the beginnings of the IHVM in the crucible of social and technological change that led to the establishment of the IHVM's parent organization, the Society for Health and Human Values. We then turn to the IHVM programs through which Faculty members received fellowships to explore new crossovers between the humanities and the health professions. We have not only described the Fellows Program as it existed in 1973-1980, but have completed a survey of the fellows a quarter of a century after they held their fellowships. We describe other IHVM programs designed to facilitate the initiation and development of new humanities programs, to explore conceptual issues between medicine and five humanities fields, to conduct issue driven or educational method conferences and to advance humanities programs into graduate education through the Directors of Medical Education.

Academies and Institutes↗
PubMed2004

Case studies of ergonomic interventions in automotive parts distribution operations.

Ergonomic job analysis, intervention design, and intervention implementation are essential components of an ergonomics program designed to reduce worker exposure to risk factors associated with musculoskeletal disorders. As part of a 4-year study to reduce overexertion injuries in the service parts division of a major automaker, intervention case studies were identified that could be used at multiple facilities across the division. Interventions were developed and implemented. The three case studies include 1) self-elevating powered vehicle for transporting parts throughout the facility and for reaching to high bin locations; 2) lift and tilt pallet jacks for packing small parts into large bin-like containers; and 3) single-level telescoping conveyor used for delivering hand-held totes for subsequent sorting operations. Several analysis methods were used to assess worker exposure before and after intervention implementation (biomechanical analysis, posture analysis, worker interviews, and activity analysis). Following implementation, a decrease in exposure to risk factors for musculoskeletal disorders was documented. Worker interviews revealed acceptance and agreement that risk factors associated with the targeted tasks were reduced. Each case study includes a description of the implementation hurdles and can serve as both primary and secondary prevention of musculoskeletal disorders. Future work should document worker health and/or symptom changes as well as changes in risk factor exposure.

Accidents, Occupational↗