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Results for “Program Appropriateness”

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At least 811 records · Page 45Linked to original sources
PubMed1985

Medical education reduces inappropriate use of cimetidine in a teaching hospital.

Before and after an education program to improve appropriate prescribing of cimetidine in an 810-bed teaching hospital, all new prescriptions written during a 4-week period were investigated, and information was obtained as to the indications for use, the dosage and concurrent drug therapy. The prescriptions were judged appropriate or inappropriate according to indications for cimetidine approved by the Department of National Health and Welfare's Health Protection Branch. After the program 63% of the prescriptions were deemed appropriate, compared with 40% before the program. The proportion of patients at risk of drug interactions, however, remained virtually unchanged. The results suggest that medical education can reduce the inappropriate use of cimetidine in teaching hospitals.

Canada↗
PubMedDate not supplied

Developing cancer control capacity in state and local public health agencies.

In 1986, the National Cancer Institute began a major grant program to enhance the technical capabilities of public health departments in cancer prevention and control. This effort, commonly referred to as "capacity building" for cancer control, provided funding to support eight State and one local health department. The program focused on developing the knowledge and skills of health department personnel to implement intervention programs in such areas as smoking cessation, diet modification, and breast and cervical cancer screening. The grants ranged from 2 to 5 years in length, with funding of $125,000 to $1.6 million per grant. The total for the program was $7.4 million. While the priorities set for these grants were nominally similar, their capacity building activities in cancer prevention and control evolved into unique interventions reflecting the individual needs and priorities of each State or locality. Their experiences illustrate that technical development for planning, implementing, and evaluating cancer prevention and control programs is a complex process that must occur at multiple levels, regardless of overall approach. Factors found to contribute to successful implementation of technical development programs include* commitment of the organization's leadership to provide adequate support for staff and activities and to keep cancer prevention and control on the organizational agenda,* the existence of appropriate data to monitor and evaluate programs,* appropriately trained staff,* building linkages with State and community agencies and coalitions to guide community action,* an established plan or process for achieving cancer control objectives,* access to the advice of and participation of individual cancer and health experts,* an informed State legislature,* diffusion of cancer prevention and control efforts,and* the ability to obtain funds needed for future activities.

Community Participation↗
PubMed1996

Skin diseases among adolescent boys in Abha, Saudi Arabia.

BACKGROUND: Adolescence is characterized by a sensitivity to issues of attractiveness. With dermatologic conditions, this may adversely affect early detection and compliance. METHODS: A cross-sectional study was carried out on a multistage stratified random sample of 647 adolescent schoolboys in Abha, Saudi Arabia, to determine the prevalence of skin diseases. The age of the boys ranged from 11 to 19 years with an average of 15.3 +/- 1.9 years. RESULTS: It was found that 19.8% of the children were affected by one form or another of transmissible skin diseases (TSD). The most common types were: pediculosis capitis (9.6%), verruca vulgaris (3.9%), and tinea pedis (1.9%). The prevalence of TSD increased significantly as the age decreased and as the crowding index increased. As for non-transmissible skin diseases, acne vulgaris was the most prevalent disease (56.3%). The prevalence and severity of acne increased significantly as the age increased. CONCLUSIONS: The findings indicate the need to develop regional intervention programs at the school level. Appropriate continuing medical education programs for school health workers in the region are mandatory to achieve this goal.

Adolescent↗
PubMed2001

Exercise as a modality in the treatment of childhood obesity.

In a review of the literature, Glenny et al determined that family therapy and lifestyle modification seem to be effective in the prevention and treatment of childhood but not necessarily adult obesity. Furthermore, research indicates that obese children are better able to maintain weight loss over a long-term period than are adults. Based on the limited research in the treatment of obesity in children, approaches should include family interventions with nutrition and physical activity education, structured exercise, and behavior modification. These interventions should be delivered by a team of health care experts in a nurturing, nonintimidating environment; however, obese children respond differently physiologically and emotionally to exercise than do normal-weight children. Therefore, obese children may experience negative consequences to participation in activities considered appropriate for normal-weight children. In clinical settings, specialized exercise programs based on appropriate theories that include specific recommendations for children with varied obese conditions have been shown to enhance safety, efficacy, and compliance during pediatric obesity treatment. Optimal results may be achieved by combining programs to reduce sedentary behaviors based on similar theories with specialized, structured exercise prescriptions. When used in conjunction with appropriate dietary prescriptions and consistent behavior modification, exercise serves as a promising modality that may reverse obese conditions during childhood and, perhaps, prevent the onset of adult obesity.

Adolescent↗
PubMed1994

Analysis of longitudinal data in craniofacial research: some strategies.

Although it is generally acknowledged that longitudinal data provide the most information on growth and development and other time-dependent phenomena, such data are often analyzed by conventional (cross-sectional) statistical methods. This widespread practice ignores the distinctive characteristics (e.g., covariance structure) of longitudinal data and may yield misleading results. The purpose of this article is to present some strategies and make available computer programs for the appropriate analysis of longitudinal data. User-friendly PC programs for the estimation of average growth curves, computation of tracking indices, prediction of future values, diagnosis, classification, clustering, estimation of missing values, and testing hypotheses concerning individual and group differences are presented. Benefits of these methods over the usual techniques are illustrated with the example of maxillary growth in the rhesus monkey.

Animals↗
PubMedDate not supplied

Pre-certification: lessons from diagnostic imaging.

Recently, managed care has received a great deal of criticism from the public and press, some of it richly deserved. One of the areas of greatest concern is pre-certification requirements and possible denial of services. Experience with programs of this sort in diagnostic imaging suggests that, implemented correctly, the consultative interface created by a pre-certification program can be of tremendous value in physician education. Appropriate behavior modification programs need to be crafted with an educational rather than economic bias and the methodology not be totally abandoned simply because it has been misused by some. The pre-certification process can be used as a vehicle to disseminate information about rapidly emerging new therapies and technologies.

Cost Control↗
PubMedDate not supplied

Emergency department airway management before and after an emergency medicine residency.

To determine whether the start of an Emergency Medicine (EM) training program affects the appropriateness, timeliness, and safety of Emergency Department (ED) intubations, all ED intubations performed 12 months before and after the start of an EM residency were reviewed. In addition, all patients intubated within 12 h after being admitted through the ED were reviewed. We found that all ED intubations before and after the start of a residency program were deemed appropriate. Of patients intubated after admission, 13 of 20 (65%) were felt to have warranted intubation while in the ED for the pre-residency group, compared with 9 of 29 patients (31%) for the post-residency group. There were no differences between the complication rates of these groups. We conclude that an EM residency program did not increase the number of inappropriate intubations or complications, and reduced the number of patients who required but did not receive intubation in the ED.

Adolescent↗
PubMedDate not supplied

A model for dual disorder treatment in acute psychiatry in a VA population.

One model for addressing the dual disorders of substance abuse and a concomitant mental disorder in an acute-psychiatry inpatient ward of a VA Medical Center utilized psychoeducation and ward policies to empower patients to make decisions affecting their recoveries. Existing staff shared responsibilities for implementing activities and creating ward milieu that supported psychiatric patients toward a life free of alcohol and drugs as they gained in acceptance of responsibility for the management of their mental disorders. Integrated programming assisted patients in constructing a meaningful path of recovery out of multiple treatment approaches and philosophies. Treatment principles, ward policies, and goals for an integrated acute-psychiatry model evolved over 4 years. Designed from a consumer-oriented "strengths perspective," patients responded to the new programming with satisfaction and gratitude. Recent adaptation of these policies, principles, and goals to a newly instituted continuous-care treatment program indicates the appropriateness of their application for outpatient dual disorder treatment and programming as well.

Anti-Anxiety Agents↗
PubMedDate not supplied

Using facilitators in mock codes: recasting the parts for success.

BACKGROUND: Members of the CHRISTUS Santa Rosa Children's Hospital staff development committee identified a need for a mock code program which would address a range of learning needs for nurses and other caregivers with varying levels of knowledge, skills, and experience. METHOD: We implemented a mock code program using experienced caregivers, usually emergency room and pediatric intensive care RNs and respiratory therapists to serve as facilitators to code participants during the mock code drills. Facilitators have dual roles of teaching and guiding the code participant as well as evaluating performance. RESULTS: Code participants and facilitators benefit from the design of this program. Debriefing session input and written program evaluations show that code participants value the opportunity to practice their skills in a nonthreatening situation in which they receive immediate feedback as needed. Facilitators learn to teach and coach and strengthen their own code knowledge and skills at the same time. CONCLUSION: This mock code program serves as a unique way to include novice and experienced nurses in mock codes together. The knowledge, skills, and confidence of the code participants and the facilitators have matured. The design of the program allows for immediate teaching/learning where needed, as well as appropriate evaluation. This program develops stronger, calmer, more efficient, and more confident nurses during codes. Practice and equipment changes can be based on findings from the mock codes. The program is invaluable to patients, staff, and hospital.

Cardiopulmonary Resuscitation↗
PubMed2006

Outpatient pain rehabilitation programs.

Outpatient pain rehabilitation programs that include an interdisciplinary approach have been shown to be effective treatments for patients with chronic pain. The objectives of this article are to describe the common interdisciplinary pain rehabilitation programs available, the appropriate indications for use, the components of typical pain rehabilitation programs, the short-term and long-term success rates, the costs of attending these programs, and the significant societal costs of those patients who do not complete these programs and do not return to work.

Chronic Disease↗
PubMed1997

Conceptual Design of a System for Selecting Appropriate Groundwater Models in Groundwater Protection Programs

/ An effective groundwater protection program requires understanding of water flow and contaminant transport processes in the subsurface. Although many mathematical models have been developed to simulate the processes, few actually are used in groundwater protection programs due to the difficulties in data collection, model selection, and model implementation. This study presents a conceptual design of a GIS-supported model selection system that evaluates available data and mathematical models to facilitate groundwater protection programs. Steady-state groundwater and contaminant transport models applied in isotropic aquifers are placed into four classes to simulate conservative or nonconservative contaminant transports in simple or complex geohydrological conditions. After analyzing specific study objectives, available data, and model requirements, the proposed system selects a class of models that can be used in simulation and recommends any need for additional data collection. This study initiates an effort to integrate GIS, mathematical models, and expert knowledge in one system to promote the application of appropriate groundwater models. The new technology of GIS and digital data-base management makes it possible to develop such a system in practice.KEY WORDS: Groundwater models; Geographic information systems

Journal Article↗
PubMedDate not supplied

An experimental analysis of response acquisition and elimination with positive reinforcers.

An 11 year old retarded child with a history of deviant behaviors underwent an extensive experimental-therapeutic program. This habilitation program was an extensive effort to decrease deviant behavior and to increase appropriate behavior. The program provided an experimental analysis of omission procedures for the reduction of deviant behaviors, and positive reinforcement for the acquisition and maintenance of appropriate play behavior. Response covariation of deviant behaviors was demonstrated. The study included a time period when the child was physically ill and under medical isolation. At the end of a two year follow-up, the child had significantly advanced her overall behavioral repertoire thus improving her physical health and living conditions.

Behavior Therapy↗
PubMed1997

Multiple von Neumann computers: an evolutionary approach to functional emergence.

A novel system composed of multiple von Neumann computers and an appropriate problem environment is proposed and simulated. Each computer has a memory to store the machine instruction program, and when a program is executed, a series of machine codes in the memory is sequentially decoded, leading to register operations in the central processing unit (CPU). By means of these operations, the computer not only can handle its generally used registers but also can read and write the environmental database. Simulation is driven by genetic algorithms (GAs) performed on the population of program memories. Mutation and crossover create program diversity in the memory, and selection facilitates the reproduction of appropriate programs. Through these evolutionary operations, advantageous combinations of machine codes are created and fixed in the population one by one, and the higher function, which enables the computer to calculate an appropriate number from the environment, finally emerges in the program memory. In the latter half of the article, the performance of GAs on this system is studied. Under different sets of parameters, the evolutionary speed, which is determined by the time until the domination of the final program, is examined and the conditions for faster evolution are clarified. At an intermediate mutation rate and at an intermediate population size, crossover helps create novel advantageous sets of machine codes and evidently accelerates optimization by GAs.

Algorithms↗
PubMed2004

Integrating smoking cessation into worker training among Latino immigrant workers: development of a program.

The prevalence of smoking among Latino immigrant workers needs to be addressed with culturally and linguistically appropriate smoking cessation programs. One innovative approach to reaching these workers is through worker health and safety training programs. These programs offer multiple opportunities to provide smoking cessation messages, a "teachable moment" to focus on health issues, and the likelihood that peers and family members will share these messages. A collaborative effort between an occupational health and safety training facility and a university utilizing Latino and non-Latino personnel developed a smoking cessation program integrated with worker health and safety training. Preliminary results of an evaluation of the program indicate that the program was able to reach a wide range of immigrant workers and improve their knowledge of the risks of smoking and the effectiveness of different methods of quitting smoking.

Journal Article↗
PubMedDate not supplied

Factors associated with melanoma incidence and prognosis.

Melanoma has a reputation as an unpredictable disease, but investigation has demonstrated a multiplicity of factors which are independently associated with melanoma incidence and prognosis. Major factors associated with melanoma incidence include those related to race and ethnicity, sunlight exposure, and genetic and familial predisposition. Major factors associated with melanoma prognosis include tumor thickness, ulceration, anatomic location, and patient's sex. These factors are clinically important in designing appropriate screening and prevention programs, as well as in selecting appropriate treatment and follow-up for the individual melanoma patient. There is an increasing need to identify the molecular mechanisms underlying these clinically defined etiologic and prognostic factors so that we may treat patients more effectively and more selectively. Available evidence indicates that the mechanisms of melanoma etiology include a loss of tumor suppressor genes. Mechanisms of melanoma progression include the accumulation of oncogene mutations, perhaps as a result of sun exposure, the development of autocrine and paracrine loops involving cytokines and growth factors, and alterations in cell-surface antigen expression. Finally, an antigen-specific immune response to melanoma appears to be important in the prognosis of some patients. Critical regulatory components of the melanoma immune response include antibodies, T-cells, and human leukocyte antigen (HLA) molecules.

Adult↗
PubMed1979

The transfer of selected image data to a computer using a conductive tablet.

The processing and analysis of images in a computer often requires the selection of particular features of a complex image for more detailed study. Sometimes such decisions are empirical, in which case it would be extremely difficult to describe a rigorous algorithm for detecting these features automatically in a computer. In this situation graphic tablets can be very useful as they allow an operator to use experience in deciding which features are to be transferred into a computer. A tablet is described which uses a conductive glass plate and pencil probe. A number of subroutines are available in a general purpose program for conventional processing, calculation and displays to be effected by simple option selection on the tablet for specific applications in cell growth, modeling and three dimensional reconstruction of serial sections, special programs were developed which could include appropriate subroutines. The categorisation of subsections by an operator was particularly useful in allowing different methods of analysis and display to be applied to each. For example they could be displayed separately or given different dentisy levels by choosing the appropriate option in the program.

Analog-Digital Conversion↗