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At least 811 records · Page 45Linked to original sources
PubMed1997

Setting health priorities: community boards accurately reflect the preferences of the community's residents.

Setting priorities remains an important part of healthcare planning and program management. Local community input is often sought in government or publicly sponsored programs. Community policy/advisory boards are a common vehicle to represent the community's interests in program decisions and direction. Questions remain whether community boards accurately represent their communities' views. As part of a planning effort within Chicago and Cook County, Illinois, local District Health Councils (DHCs) have been created to provide assistance and leadership in systemization and improvement of the healthcare in communities with the poorest health status in the region. We sought to discover how closely the perceptions of health priorities of DHC members agreed with those of community members. A structured five-point Likert scale questionnaire of 22 of the most common diseases and conditions known to impact health were used for a random digit dialing telephone interview with a sample of 286 households from three under-served communities. The same interview was repeated with all DHC members (n = 80) representing those communities. Sociodemographic profiles and health-related behaviors were also collected. The results of this interview indicate a close and substantial agreement in priorities between community members and DHC members. Psychosocial conditions such as violence and substance abuse were ranked as the highest priorities by both groups. In contrast, sociodemographics and healthcare behavior differed significantly between DHC members and community's residents. This study demonstrates that these community policy/advisory boards can closely reflect the views of the communities they represent. Attention to their differences in sociodemographics and healthcare experiences with the community may strengthen their role even more.

Adult↗
PubMed1975

Family planning in Bali.

Despite low per capita income and little evidence of economic development, the response to the government-sponsored family planning program in Bali has been remarkably favorable. After five years of government involvement, a total of 29 percent of eligible women are estimated to be using program methods, including 25 percent who have accepted IUDs, and 4 percent more are estimated to be using nonprogram methods. This level of performance is higher than in most other developing areas of the world. A number of the factors that might help to explain the success of the program in Bali are identified, and the future prospects for continued success are assessed.

Adolescent↗
PubMed1997

Factors affecting specialty and location of practice of government-sponsored physicians in Taiwan.

Geographic and specialty maldistribution have created problems of physician supply in Taiwan. Previous small-scale government-sponsored physician (GSP) programs in Taiwan have had only limited effects. To solve this problem, the National Yang-Ming Medical College was established in 1975; it supplied its first government-sponsored physician graduates in 1982. Obligatory service in different specialties and geographic areas were assigned to graduates according to their personal preference and school performance. In this study, we evaluated the factors affecting the choice of specialty and location for these GSPs during the 6-year obligatory service period. Data on Department of Health-regulated GSPs who finished obligatory service prior to 1991 were obtained from the GSP files, medical student files, and the National Medical Manpower Information System for the years 1982 to 1985. Logistic regression was used to assess the effect of year of entry, age, gender, rank in class, and hometown of the GSPs on specialty choice upon entry into the obligatory service period. Both logistic regression and generalized estimating equations were used to analyze the effects of these parameters and location experiences during obligatory service on location selection after the obligatory service period. We found that rural experience during obligatory service was strongly associated with the choice of rural practice after the completion of the obligatory service. Male gender, a later year of entry to the program, and having a rural hometown were only moderately associated with the choice of rural practice. A more comprehensive evaluation and review of the effect of the GSP program on overall specialty and location distribution of physicians is needed to provide guidelines for improvement of current GSP program policies.

Adult↗
PubMed1988

Public education in East Java, comprehensively incorporated into the Family Welfare Program.

The establishment of a voluntary Cancer Society in East Java in 1969 has enabled the development of a program of public education, a counseling service, and a cervical cytology program. More recently the Cancer Society has begun to channel its work through the government-sponsored Family Welfare Program. That program includes a system of education directed to the needs and potential of the family as a unit. The Cancer Society plans to incorporate aspects of cancer control into all ten sections of the program. This paper describes these and the local organization of key people to promote and support the program in three pilot areas. In the long run it is hoped that through promoting changes in life-style, environmental factors/hygiene, and so forth, some carcinogenic factors may be eliminated, resulting in primary prevention.

Female↗
PubMed1991

Mass protection program of perinatal hepatitis B virus infection in Japan and impact of an optional booster vaccination on its efficacy.

We assessed the efficacy of a government-sponsored mass protection program in Osaka, Japan, for perinatal HBV infection in infants born to HBeAg positive HBV carrier mothers. We also evaluated the impact of optional follow-up procedures in such infants, including an evaluation of anti-HBs response and a booster dose of HBV vaccine for poor responders. The results demonstrated that this mass protection program protected 94.4% of the infants from perinatal HBV infection in the Osaka area. However, the proportion of infants with an unprotective level of anti-HBs was higher in the standard group than in the follow-up group both at 1.0 and 1.5 years of age, which was also the case for HBV events. Furthermore, the present study showed that a booster dose of vaccine in poor responders was very effective in promoting an anti-HBs response. In conclusion, we recommend that a follow-up blood test to confirm a response of anti-HBs to HBV vaccine should be performed at 4-8 weeks after the third injection of HBV vaccine in infants born to HBeAg positive HBV carrier mothers. We also recommend that a booster injection of HBV vaccine should be immediately given to poor responding infants who otherwise are at a considerable risk of developing HBV infection in late infancy.

Adult↗
PubMed2004

Dissemination of information on legislative mandates and consensus-based programs addressing payment of the costs of routine care in clinical trials through the World Wide Web.

BACKGROUND: Legislative and consensus-based programs that ensure payment for routine care costs in a trial have been enacted by a number of states and government-sponsored health benefits programs. To eliminate the potential for denial of payment by a health plan that can act as a barrier to participation, the public must be aware that these programs exist and what they entail. METHODS: World Wide Web sites are utilized by patients and their surrogates as a prime source of healthcare-related information. A review of cancer research organization and advocate group web sites was performed to document the degree to which these sites provided information on clinical trial coverage programs. The objective was to determine whether patients were being given sufficient information to overcome barriers to participation related to the existence of clinical trials, their potential benefits, and health plan payment. RESULTS: Fewer than 5% of the 373 sites reviewed provided sufficient information to communicate to a patient that 1) the institution participates in sponsored cancer clinical research, 2) patients can derive direct benefits by participating in a clinical trial, and 3) payment for treatment in a clinical trial is largely provided by their health plan. CONCLUSIONS: Sites on the World Wide Web are a key source of healthcare-related information for patients and their surrogates. Organizations involved in clinical cancer research should examine their web sites to ensure that the content it contains is sufficiently detailed, accessible, and readable to inform potential participants fully of the clinical trial options.

Clinical Trials as Topic↗
PubMed1994

Salmonella enteritidis control programs in the United States.

A sharply rising incidence of salmonellosis in humans caused by Salmonella enteritidis (SE) in the United States between 1985 and 1989 resulted in a government-sponsored outbreak traceback program which was started in 1990. Layer flocks considered the sources of egg-implicated outbreaks would be tested for SE and the eggs from these flocks would be diverted to pasteurization plants. A program to eliminate SE from primary and multiplier breeding flocks was started at the same time. A subsequent spent hen survey and a survey of prepasteurized liquid egg material revealed that SE was much more prevalent than had been suspected, and that the highest prevalence was found in the northeastern and middle Atlantic states. Since the SE rates did not decrease during the next 2 years, a pilot project was started in 1992 in Pennsylvania, in one of the most highly affected areas. The project was designed to reduce the number of SE outbreaks by diverting eggs from SE-affected flocks and at the same time attempting to delineate the epidemiology and control aspects of the disease. With the results generated during the fist 18 months of the Pilot Project, a much larger SE prevention program will start in the same area, in October 1993.

Animals↗
PubMed2003

Positive youth development: a pathway to healthy teens.

As part of its continuing mission to serve trustees and staff of health foundations and corporate giving programs, Grantmakers In Health (GIH) convened a group of experts from the fields of philanthropy, research, government, and health care to examine recent research on youth development and effective approaches for promoting healthy decision making by adolescents. This Issue Dialogue, Positive Youth Development: A Pathway to Healthy Teens-held June 13, 2002 in Washington, DC-provided an opportunity for grantmakers to explore how they can apply youth development principles and asset-based strategies to their grantmaking to promote healthy development and healthy decision making by the adolescents in their communities. This Issue Brief incorporates the information and ideas shared during the meeting into a background paper prepared for participants at the Issue Dialogue. It provides an introduction to positive youth development; describes the characteristics of effective services and programs; reviews the research in this area; and provides examples of programs sponsored by the government, national organizations, and foundations that are intended to support and promote positive youth development.

Adolescent↗
PubMedDate not supplied

A randomized trial of medical quality assurance. Improving physicians' use of pelvimetry.

The capacity of educational programs to improve physician performance remains doubtful despite many evaluative efforts. This is especially true for programs sponsored by the federal government. We tested the efficacy of an educational program conducted by Professional Standards Review Organizations in reducing the inappropriate use of x-ray pelvimetry. This procedure may cause harm to the fetus, and there is little evidence that it is efficacious. We randomly assigned 120 hospitals in six Professional Standards Review Organizations to study and control groups. Physicians with delivery privileges at each study hospital participated in an educational program that discussed acceptable indications for x-ray pelvimetry. Pelvimetry use was similar in study and control hospitals before the program. However, after the program, pelvimetry was performed by physicians at study hospitals less than one third as often as by physicians at control hospitals. We conclude that educational programs can improve physician performance substantially and that such programs can be effectively conducted by federally sponsored physician organizations.

Education, Medical, Continuing↗
PubMed2002

PCR as a diagnostic tool for brucellosis.

Numerous PCR-based assays have been developed for the identification of Brucella to improve diagnostic capabilities. Collectively, the repertoire of assays addresses several aspects of the diagnostic process. For some purposes, the simple identification of Brucella is adequate (e.g. diagnosis of human brucellosis or contamination of food products). In these cases, a genus-specific PCR assay is sufficient. Genus-specific assays tend to be simple, robust, and somewhat permissive of environmental influences. The main genetic targets utilized for these applications are the Brucella BCSP31 gene and the 16S-23S rRNA operon. Other instances require identification of the Brucella species involved. For example, most government-sponsored brucellosis eradication programs include regulations that stipulate a species-specific response. For epidemiological trace back, strain-specific identification is helpful. Typically, differential PCR-based assays tend to be more complex and consequently more difficult to perform. Several strategies have been explored to differentiate among Brucella species and strains, including locus specific multiplexing (e.g. AMOS-PCR based on IS711), PCR-RFLP (e.g. the omp2 locus), arbitrary-primed PCR, and ERIC-PCR to name a few. This paper reviews some of the major advancements in molecular diagnostics for Brucella including the development of procedures designed for the direct analysis of a variety of clinical samples. While the progress to date is impressive, there is still room for improvement.

Animals↗
PubMed2002

Clozapine use and risk of diabetes mellitus.

Recent reports have raised the concern that clozapine increases the risk for diabetes mellitus. Accurate pharmacoepidemiologic data on whether such a hazard exists and its magnitude are needed to enable clinicians and patients to make proper treatment decisions about clozapine. The authors performed a case-control study involving 7,227 cases of newly treated diabetes and 6,780 controls, all with psychiatric disorders. Cases and controls were older than 20 years and enrolled in government-sponsored drug benefit programs in New Jersey. The authors measured the use of clozapine or other antipsychotic medications and additional covariates. They developed logistic regression models adjusted for demographic, clinical, and health care use characteristics to identify whether clozapine users were at increased risk to begin treatment for diabetes. Clozapine use was not significantly associated with developing diabetes (adjusted odds ratio [OR], 0.98; 95% confidence interval [CI], 0.74-1.31). There was no suggestion of relationships between larger dosages or longer durations of clozapine use and increasing risks of diabetes. On the other hand, nonclozapine antipsychotic medication use was associated with a modest but significantly increased risk of developing diabetes (adjusted OR, 1.13; 95% CI, 1.05-1.22). Among individual nonclozapine antipsychotics, significantly elevated risks were observed for two phenothiazine agents: chlorpromazine (adjusted OR, 1.31; 95% CI, 1.09-1.56) and perphenazine (adjusted OR, 1.34; 95% CI, 1.11- 1.62). In contrast to earlier reports, these results provide some reassurance that clozapine does not increase the risk of developing diabetes. Additional data from pharmacoepidemiologic studies and randomized controlled trials are needed to exclude the possibility of residual confounding and ensure the appropriate use of this agent.

Adult↗
PubMedDate not supplied

Improving access to health care for children.

ISSUES AND PURPOSE: The number of uninsured children has been growing at an alarming rate. The most vulnerable children are those in lower-income families who are falling through the cracks between evolving government-sponsored health insurance programs. Recent policy initiatives may not be adequate to extend coverage to more children. CONCLUSIONS: Many low-income children actually are eligible for Medicaid but are not enrolled for a variety of reasons. The numbers of these children have risen due to welfare reform. Better outreach efforts are needed to ensure that new child health insurance programs and Medicaid expansions achieve their goals. IMPLICATIONS FOR PRACTICE: A comprehensive assessment of insurance status and referral to community agencies should be an integral part of patient care for all healthcare providers.

Child↗
PubMed1991

Prescribing patterns for older heavy drug users living in the community.

We report an analysis of prescription drugs claimed under a government-sponsored, universal Pharmacare program for community-dwelling adults aged greater than or equal to 50 years in Manitoba during 1975, 1978, 1981, and 1984. We limited our analysis to claimants who reported over six drugs in a year in order to control for effects of inflation and a changing deductible. The median number of prescribed drugs and the percent of claimants over age 50 years receiving prescriptions from multiple physicians decreased during the course of our study. In this sample of heavy drug users, age and sex did not consistently correlate with overall drug use, although there was correlation for specific drug groups. The relative ranking of prescribed drugs changed over the years, although benzodiazepines, thiazide diuretics, topical steroids, and codeine-containing analgesics remained near the top. Barbiturates and topical antibiotics showed the greatest drop in prescription rates; acetaminophen and beta-blockers increased the most. Using these community data, we project the prevalence of drug-related adverse events to be highest with beta-blockers, nonsteroidal antiinflammatory drugs, thiazide diuretics, and benzodiazepines.

Age Factors↗
PubMed1993

Condom use and the popular press in Nigeria.

The increased acceptability and use of condoms by men in southwestern Nigeria is reflected in joking references to condoms in the comic-style popular press. Yet these references display an ambivalence about condoms that is mirrored in survey data and in interviews regarding condom use by rural Ekiti Yoruba men. This ambivalence, which is often couched in terms of health, has implications for the acceptance of government-sponsored HIV/AIDS-related educational programs. Because of the irreverence of comic-style newspapers and the 'unofficial' nature of their authority which coincides with popular attitudes about health programs, they have a credibility that could be useful in educating adolescents about sexually-transmitted diseases and HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Epidemiologic factors, clinical findings, and vaccination status of rabies in cats and dogs in the United States in 1988. National Study Group on Rabies.

Despite the availability of rabies vaccination through private veterinarians and government-sponsored rabies control programs, rabies was reported in an average of 338 cats and dogs per year from 1980 through 1987 in the United States. Information was collected on 90% of the 183 cats and 97% of the 119 dogs that were reported to have rabies in the continental United States in 1988. The median age of rabid cats and dogs was 1 year, and 81% were from rural areas. Compared with rabid cats, rabid dogs were more likely to have been male (66 vs 42%, odds ratio = 2.6), to have been kept as pets (84 vs 43%, odds ratio = 6.8), and to have had reported contact with wildlife before onset of illness (38 vs 14%, odds ratio = 3.8). Rabid cats accounted for a greater proportion of human rabies postexposure prophylaxis, bites to people, and exposures to other animals than did rabid dogs. Although the clinical signs of rabies varied, rabid cats were more likely than dogs to have had aggressive behavior (55 vs 31%, odds ratio = 2.8). In contrast, rabid dogs were more likely than cats to have had an illness consistent with a paralytic process. The median period between onset of illness and death was 3 days (range, less than 1 to 10) in rabid cats and dogs that were allowed to die of rabies. Vaccine failures were documented in 3 (1%) rabid animals (2 cats and 1 dog). All animals had received only a single dose of vaccine in their lifetime and were vaccinated when they were between 3 and 6 months old.

Animals↗
PubMed1993

[Empirical studies of automobile driving fitness of patients treated with methadone-substitution].

The aim of this experimental study was to gain an impression on the driver fitness of heroin addicts which were at the moment substituted by methadone especially within a methadone program sponsored by the government of NRW. 21 out of 34 patients investigated were unfit to drive because they were at the time the tests were conducted under the effect of at least one additional psychotropic substance other than methadone or because at prior blood tests within 3 months they had been found at least twice under the effect of psychotropic drugs or they were known as concomitant drug users. The remaining 13 methadone patients were matched with 13 control subjects of the same sex, education and-within a range of +/- 2 years-also the same age. Testing short term memory, tracking, decision and reaction behavior, perception, sustained attention, speed estimation, peripheral attention with simultaneous central task, reactive loading, personality questionnaires including traffic specific questions and psychopathologic characteristics the patients yielded significant poorer results compared with the control group. When selecting 6 very good patients according to the decision of the physicians the significant differences concerning performance measures vanished but some differences concerning personality traits still remained. The results confirm the expert's opinion-called "disease and motor traffic"-that in general methadone substituted patients are unfit to drive. The driver fitness of the very few optimal patients depends on the amount of the personality disorders.

Adult↗
PubMed1983

The benefits of hospital sponsored home care programs.

Faced with increasing financial and government restraints, nursing administrators must search for effective ways to continue providing quality patient care. These authors believe that the relationships inherent within a hospital-sponsored home health care program benefit both the hospital and the home health care program as they try to meet patient and community needs.

Community Health Nursing↗