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At least 649 records · Page 36Linked to original sources
PubMed2005

Effects of using a computer in a doctor's office on patient attitudes toward using computerized prompts in routine care.

BACKGROUND: We undertook this investigation to understand the effect of using a computer in a primary care setting on attitudes toward using computers to improve health services delivery. METHODS: In this analysis, we compared the acceptability data from the group of primary care patients from 10 community-based practices who did not use a computer program, and answered the questions hypothetically, with data from a group of patients who actually used a program such as one proposed in the survey taken by the first group of patients. Attitudes toward three uses of the program, screening, counseling and changing treatments were measured, as well as attitudes toward specific aspects of the program, such as security. RESULTS: The great majority of patients who used the program believed that the program was not too long (80.1%), was easy to use (82.3%) and that the questions were not hard to answer (75.7%). Also, on average only 20% of patients had concerns about the privacy and confidentiality of using the program. Patients who had used the computer program were significantly less likely to favor its use for screening [odds ratio (OR)=0.09, 95% confidence interval (CI)=0.04-0.19], counseling [OR=0.13 (95% CI=0.05-0.31)] and changing treatments for chronic conditions, such as hypertension [OR=0.12 (95% CI=0.07-0.23)]. Patients who felt that the computer took too long to use were less likely to favor its use for each of the three uses. CONCLUSIONS: Despite acceptability ratings that were high and consistent with ratings observed in other studies, exposure to the program significantly diminished support for using it in routine care. These findings highlight the need for measuring overall program acceptability in the context of a realistic use scenario and for correlating overall acceptability with acceptability of individual program components and attitudes, as a means for identifying opportunities for program improvement.

Adult↗
PubMed1985

Administration for Children, Youth and Families child abuse and neglect research, demonstration and service improvement projects--DHHS. Announcements of availability of funds and request for application under the HDS' Discretionary Grants Program.

Applications are being accepted for new grants relating to the prevention, identification, treatment and remediation of child abuse and neglect, including child sexual abuse. Authority: Authority for this announcement is contained in Section 4(a), Pub. L. 93-247, as amended (42 U.S.C. 5103(a)). Approximately $2 million is available for additional grants in FY 1985. To the extent that worthy proposals exceed the amount available for funding in FY 1985, some proposals may be funded in FY 1986 subject to the availability of funds. Eligible applicants: In general, any State or local public, or nonprofit organization or agency may submit an application under this announcement. Applications developed jointly by State, local and community-based service agencies, professional organizations, such as, law enforcement, legal, educational, health, and other child serving agencies, foundations or universities are encouraged in order to promote comprehensive coordinated child protective service programs. Closing date: The closing date for receipt of applications is July 22, 1985. Application receipt point: Department of Health and Human Services, Office of Human Development Services, Discretionary Grants Management Branch, William J. McCarron, Chief, Hubert H. Humphrey Building, Room 345-F, 200 Independence Ave., SW., Washington, D.C. 20201. Attn: HDS-85-2.

Child↗
PubMed1991

Establishment of an oocyte donor program. Donor screening and selection.

IVF with donated oocytes, followed by embryo placement in the uterus of a recipient who has been primed with exogenous steroids, is a successful treatment for special cases of infertility. Preliminary results indicate that the success rate in this situation is even greater than that usually seen with normal IVF (with placement of the embryos back into the uteri of the women from whom the oocytes were recovered). Although different sources for donated oocytes have been identified, the use of "excess" oocytes from IVF cycles and the attempted collection of oocytes at the time of otherwise indicated pelvic surgery have ethical and practical problems associated with their use. We have herein described the establishment of a successful program relying on anonymous volunteers who go through ovarian stimulation, monitoring, and oocyte recovery procedures solely to donate oocytes. The potential donors go through an exhaustive screening and education process before they are accepted in the program. Psychological evaluation of our potential donors indicated a great degree of turmoil in their backgrounds and a wide variety of motivations for actually participating. Despite the extensive educational and screening process, a substantial percentage of the donors did not complete a donation cycle, having either voluntarily withdrawn or been dropped because of lack of compliance. Further investigation of the psychological aspects of participating in such a program is certainly warranted. The use of donated oocytes to alleviate specific types of infertility is quite successful, but the application of this treatment is likely to be limited by the relative unavailability of suitable oocyte donors.

Adult↗
PubMed2003

Prospects for controlling cervical cancer at the turn of the century.

Cervical cancer morbidity and mortality have decreased substantially during the last 50 years mostly due to successful organized or opportunistic screening with Pap cytology in high and middle income countries. In many low income countries Pap cytology screening is yet to be effectively implemented or has failed to reduce cervical cancer rates to an appreciable extent. The fact that infection with certain human papillomavirus (HPV) types is now recognized as a necessary cause of this disease has led to new research fronts on prevention of cervical cancer. Testing for HPV DNA has shown great promise as a screening tool with better sensitivity but somewhat lower specificity than Pap cytology. In combination with the latter, HPV testing has the potential to improve the negative predictive value of cytology, thus allowing for increased testing intervals, which would lower program costs with acceptable safety. Advances in cytology processing and automation have also led to new screening approaches that are increasingly gaining acceptance in high and middle income countries. For low income countries, visual inspection with acetic acid has proven to be an effective alternative to conventional Pap cytology, especially in settings where no screening programs have been implemented. Concerning primary prevention of cervical cancer, recent research on the safety and efficacy of candidate prophylactic vaccines against HPV have shown very promising results with nearly 100% efficacy in preventing persistent infections and development of cervical cancer precursors. However, policy makers are strongly cautioned to avoid deferring decisions concerning the implementation of cervical cancer screening under the expectation that a successful vaccine could obviate the need for secondary prevention strategies. This paper is available too at: http://www.insp.mx/salud/index.html.

Female↗
PubMed2004

Directly observed therapy for tuberculosis in New York City: factors associated with refusal.

OBJECTIVES: To describe patients who utilize hospital-based directly observed therapy (DOT) programs and to describe factors that influence refusal of DOT. METHODS: Retrospective analysis of patients diagnosed with tuberculosis through hospital admission in 1997 at 12 hospital sites with out-patient DOT programs. Data were obtained from hospital patient records and from the New York City Tuberculosis Case Registry. RESULTS: Of 443 patients diagnosed with tuberculosis in 1997 at the 12 hospital sites and available and/or eligible for DOT, 52 (12%) refused DOT. The two main reasons for DOT refusal were that the patients felt they could self-medicate (21%) and that their work schedule interfered with a DOT program (19%). White non-Hispanic race/ethnicity was associated with refusal of DOT (P = 0.001). Conversely, interview for DOT while in the hospital (P < 0.001) and enrollment in drug treatment were associated with acceptance of DOT (P = 0.05). The five hospitals with tuberculosis clinics on site had the lowest percentages (0-9%) of patients refusing DOT. CONCLUSION: To increase patient acceptance of DOT, programs need flexible hours that accommodate patients in the workforce. Patient education should focus on the difficulty of completing tuberculosis treatment on a self-administered regimen and the importance of the support offered through DOT.

Adolescent↗
PubMed1998

The effects of primary division, student-mediated conflict resolution programs on playground aggression.

This study examined the effects of a student-mediated conflict resolution program on primary school (junior kindergarten to grade 5) playground aggression. Mediation teams of grade 5 students (approximately age 10) participated in 15 hours of training according to the model developed by Cunningham, Cunningham, and Martorelli (1997). Following baseline observations, mediation was introduced onto the playgrounds of three schools according to a multiple baseline design. Mediators successfully resolved approximately 90% of the playground conflicts in which they intervened. Direct observations suggest that the student mediation program reduced physically aggressive playground behavior by 51% to 65%. These effects were sustained at 1-year follow-up observations. Teacher and mediator satisfaction questionnaires provided strong support for impact, feasibility, and acceptability of this program.

Aggression↗
PubMed2000

Effect of stimulation rate on cochlear implant recipients' thresholds and maximum acceptable loudness levels.

Clinically, speech processor programs are created using electrical thresholds and maximum acceptable loudness levels (MALs) at several different stimulation rates to determine what rate will provide cochlear implant recipients with the best speech recognition when using fast-rate speech coding strategies. This study was designed to determine the difference in thresholds and MALs (expressed in the clinical unit, Current Level [CL]) for pairs of six rates spanning those available with the Nucleus 24 device (i.e., 250 to 2,400 pps/ch) using monopolar, 25 microsec/phase stimulation. Test-retest measures of threshold and MAL for each rate were obtained from seven adult Nucleus 24 recipients on each of 11 electrodes. The difference in threshold and in MAL between pairs of rates was dependent on the absolute CL. Below approximately 190 CL, thresholds and MALs decreased with increasing rate; above 210 CL, there was little change in threshold or MAL with increasing rate. Based on these findings, an approach to estimating threshold and MAL from one rate to another is suggested, pending further research.

Adult↗
PubMed1993

Hepatitis B mass immunization of adolescents: a pilot study in a community.

The National Type Specific Hepatitis Surveillance System (SEIEVA) and seroepidemiological studies have shown that in addition to newborns from mothers who are carriers for hepatitis B surface antigen (HBsAg), adolescents are at high risk of acquiring type B hepatitis virus because of increasing importance of the heterosexual transmission of this virus. In order to evaluate logistic problems and acceptance rate of adolescents to mass vaccination against hepatitis B, a pilot study was carried out among all 7th grade children registered in the 9 schools of an hepatitis B endemic area located in the suburbs of Naples. After meetings held by the local health department with school teachers and parents, 1219 out of 1250 (97.5%) invited children received the first dose of hepatitis B vaccine; 1215 and 1209 received, respectively, the second and third doses. Anti-hepatitis B surface antigen (anti-HBs) values were studied in 406 subjects one month after the third dose, and 21 out of 406 (5.2%) had anti-HBs values less than 10 IU/L. We consider 95% of subjects with anti-HBs values greater than 9 IU/L a good achievement for a field vaccination program. The high acceptance rate of vaccination found in our study outlines the importance of active offer of vaccination combined with school involvement.

Adolescent↗
PubMedDate not supplied

[Smoking prevalence at the Federal University of São Paulo, 1996--preliminary data of an institutional program].

PURPOSE: To evaluate the prevalence of tobacco smoking among health workers, professores, nurses and students of Federal University of São Paulo and the acceptance of an institutional program for quitting smoking. METHODS: We analized the answers of a questionnairy with 51 questions, distributed to people from different categories. RESULTS: The total percentage of answered questionnaires was 48.6% (2613). The answers obtained from health workers were 37.3%, professors 49.0%, nurses 52.7% and students 76.5% The total percentage of smokers at UNIFESP was 15.5%:23.7% for health workers, 18% for professors, 16% for nurses and 8.6% for students. There was no significant statistical difference between the prevalence of smoking among females (17.3%) and males (16.3%). The age of major prevalence of smoking was between 31 to 40 years (26.6%). For all ages, people who have university level smoked less, independent of sex. Eighty three percent (83%) of the UNIFESP workers and students are worried of being passive smokers. Between the smokers, 55% were thinking of quiting and 42% declared that need some help to quit. CONCLUSION: We concluded that educational programs and help for cessation at institutional level are necessary and well accepted at UNIFESP, and the completion of these programs will contribute to the obeying of the prohibitive laws of no smoking within the community.

Adolescent↗
PubMed1989

Resources and limitations of medical centers in the United States.

A profile is provided of the range of opportunities and limitations for foreign nationals who seek access to the U.S. health care education and training system. The system is complicated, and entry depends on numerous variables. Facility in the English language is considered a prerequisite. Among opportunities, clinical training is probably most sought in the form of either residencies or clinical fellowships. Many major medical centers are eager to host earnest students and trainees from abroad. Yet such opportunities are limited, since most programs are unable to accept additional trainees once the first year of the program has been filled. Additional residency positions are not likely to be created and funded. In general, the larger academic medical centers tend to be the first to introduce new technologies and newer diagnostic and therapeutic modalities. Other settings may offer better, or at least equally good, environments for other kinds of post-M.D.-degree training. U.S. educational opportunities also exist in health policy and health systems education, nursing education, allied health and non-physician education, and research. All those seeking to study in the United States are urged to consult one of the several agencies that are knowledgeable about the opportunities and requirements for entering the programs offered.

Academic Medical Centers↗
PubMed2004

[Intervention program to improve secondary prevention of myocardial infarction. Results of the PRESENTE (early secondary prevention) study].

INTRODUCTION AND OBJECTIVES: Secondary prevention measures for myocardial infarction are inadequate. In Spain, the earlier PREVESE studies provided preliminary data. The aim of this study was to document the results of a simple intervention program for secondary prevention, implemented during the hospital stay. PATIENTS AND METHODS: We included 4174 patients (mean age 63.7 years, 73% men) discharged from 110 hospitals after myocardial infarction. Lipid profile was determined during the first 24 h after admission, and before discharge patients and relatives were informed about the disease and its prevention, and were given printed informative materials. The patients were seen again 6 months later. RESULTS: After 6 months, 82.9% of the patients were examined and 10% were lost to follow-up. Mean blood pressure, weight and body mass index of the sample were lower, and lifestyle variables had improved. At discharge 87% were prescribed statins, 59.4% beta blockers, 51.2% ACE inhibitors and angiotensin blockers, and 94.1% antiplatelet drugs. These prescriptions were still being used 6 months later. There were substantial improvements in lipid values. CONCLUSIONS: The implementation of a simple intervention program for patients with myocardial infarction and their relatives, and the determination of lipid levels within 24 hours of admission, improved the secondary prevention measures at discharge and during the 6-month follow-up period. Acceptance of the program among the patients was good.

Aged↗
PubMed1989

Basic issues in screening for oral cancer among male subpopulation.

The value of population screening for oral cancer among male adults as a method of oral cancer control is an issue of great controversy. Screening programs have different objectives, varying costs, undocumented benefits, and some may have harmful effects. Consequently, these programs are not unanimously accepted and with the many constraints in evaluating these programs, the future of screening as oral cancer prevention strategy is questionable. Basic issues in the prevalence of oral cancer include factors affecting the patient such as age, sex, exposure to carcinogens, plus the site or the type of the neoplasm. Oral cancer afflicts primarily middle-aged and older adults, particularly heavy users of tobacco and alcohol; long-term exposure to ultraviolet radiation may also be important in the initiation of the disease. Eighty percent of oral cancer patients are over 45 years of age. Exposure to tobacco and/or alcohol seems to be a critical factor in the transformation of normal cells to cancer-producing cells. In the U.S.A., 70-80 percent of oral cancers detected occurred in men. 27,000 new cases of oral cancer are found annually in the United States and at least 9,000 of the cases will result in death. Squamous cell carcinomas represent 90 percent of all oral soft tissue cancers. The most common sites are the floor of the mouth, and soft palate complex. Cancers of the lip and tongue show the greatest association with age while major salivary gland cancers show the least. An inexpensive test should be developed in the near future and subjects should be followed carefully.

Humans↗
PubMedDate not supplied

Health education for Ethiopian immigrants in Israel, 1991-92.

A health education program was developed to address the immediate needs of 20,000 Ethiopian immigrants to Israel in 1991. This modular program included: the use of health services, nutrition, prescription medication use, prevention of home accidents, first-aid and personal hygiene. Using an anthropological orientation, the program attempted to bridge the cultural gap regarding the health promotion skills of this population that had moved from a developing country to a new, Western society in Israel. The program was implemented throughout the country by specially trained veteran Ethiopian immigrants, some of whom were also health professionals, using newly developed visual tools. Over 4,300 adults participated in the program between August 1991 and August 1992. The program was positively accepted by the participants, who expressed their satisfaction with the content and materials. The tools developed were deemed successful in their cultural sensitivity, flexibility to local needs, and clarity. We suggest that various modules of the program continue to be implemented in order to address the rapidly changing health behavior needs of the Ethiopian immigrants in Israel, and that new modules be developed.

Cultural Deprivation↗
PubMed2005

[To assess the demands of community-based health care service among 717 elderly].

UNLABELLED: OBJECTIVE To understand the demands and influencing factors on the community-based health care service (CHS) among the elderly and to provide evidence of implementing health service for them METHODS: Cluster sampling method was used on 717 persons aged 60 and above in Yanjiao Developing Area. A survey was carried out, using questionnaire and focus group discussion approaches. RESULTS: Data showed that a two-week prevalence of diseases was 56.3% while the overall prevalence of chronic diseases was 92.1% with 70.0% of them suffering from more than two kinds of chronic diseases. The rates of ADL and IADL loss were 1.8% and 7.0% respectively with 37.0% of them sought medical consultation in the past two weeks. Major reason affecting the use of health service was low income. 57.7% of the elderly expressed their willingness of accepting CHS with the strongest demands as regular physical check-up, health education and consultation, specialized care services, home care service while major reasons hindering the acceptance of CHS could be referred to self-perception on good stamina and lack of awareness to CHS. CONCLUSION: The demands of CHS in the elderly were greater than those in general population that called for CHS programs to be acceptable and relevant to meet the different needs.

Aged↗
PubMedDate not supplied

Combined residency training in family practice and other specialties.

BACKGROUND AND OBJECTIVES: The University of California, Davis residencies in family practice and psychiatry are entering the third year of a combined training track. Graduates of the combined program will be eligible for board certification in both specialties. The combined program has created opportunities for collaborative training with other specialties, such as obstetrics and medical informatics. Barriers and challenges to collaborative training include issues of curriculum integration, establishment of an identity for residents and future graduates, resident stress, acceptance of combined programs, counting of generalist physicians, hospital privileges, fulfillment of unmet societal needs, and improved collaboration at academic health centers.

California↗
PubMed2007

[How to cope with the demands of the new "Approbation Regulation" (AR) by radiology-related interdisciplinary courses. The Erlangen model].

BACKGROUND: To create radiology-related interdisciplinary programs for the undergraduate education in terms of the new "Approbation Regulation". MATERIAL AND METHODS: Medical students developed in collaboration with radiologists and clinical partners virtual, radiology-related interdisciplinary training courses for different fields. Students and teachers evaluated the acceptance of the programs' structure and content as well as the possibility to replace the radiologist partly during interdisciplinary lessons. RESULTS: Six target group oriented virtual, radiology-related interdisciplinary training courses were developed which will relieve the implementation of the new AR's demands for more interdisciplinary education in small groups and the dreaded shortage of personnel. CONCLUSION: By the use of web- and CDRom-based interdisciplinary course models different fields of medicine and diagnostic radiology can be bridged in the sense of the new AR's demands as well as manpower in radiology can be saved.

CD-ROM↗
PubMed2002

Evaluation of osteopathic manipulative treatment training by practicing physicians in Ohio.

The authors mailed a survey designed to evaluate beliefs about osteopathic manipulative treatment (OMT) training to the 2318 osteopathic physicians registered with the Ohio Osteopathic Association. Responses were received from 871 osteopathic physicians (response rate, 38%). Fifty-three percent of the respondents had used OMT with patients at least once during the week before the survey. With regard to OMT training, 60% rated their experience during medical school as acceptable; during postgraduate training the acceptable rating dropped to 9%. Osteopathic manipulative treatment training through continuing medical education programs was rated as acceptable by 26% who had participated in these programs. Forty percent of the respondents reported that they were practicing less OMT now than when they originally entered practice, while 20% reported using OMT procedures more often. No significant correlation was observed between OMT training satisfaction during medical school and current use of OMT. However, a strong negative correlation was observed between satisfaction with postgraduate OMT training and OMT use. This survey did not detect any association between year of graduation and use of OMT.

Attitude of Health Personnel↗