Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Program Design”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 829 records · Page 46Linked to original sources
PubMed1999

The cost-effectiveness of varicella vaccine programs for Australia.

OBJECTIVE: to examine the cost-effectiveness of three different varicella vaccination programs compared with no vaccination program. DESIGN: cost-effectiveness study. Simulations of the costs and consequences of chickenpox and the vaccination programs over a 30-year period. Direct (health-care) costs only were used in the simulations. SETTING: Australia.Participants/subjects: annual birth cohorts of infants (12-months old) and adolescents (12 years old). INTERVENTIONS: strategy I (no vaccination) was compared with three different varicella vaccination programs: strategy II - all infants; strategy III - adolescents without a history of varicella; and strategy IV ('catch-up')- all infants plus, for the first 11 years, adolescents without a history. OUTCOME MEASURES: fatalities and hospitalisations for varicella and its complications (encephalitis, pneumonitis, long-term disability). RESULTS: the average cost per case of chickenpox averted was $64, $530 and $418 in the infant, adolescent and catch-up programs, respectively. The infant program was the most cost-effective of the three. This program could avert 4. 4 million cases, 13,500 hospitalisations and 30 fatalities for chickenpox over a 30-year period. RESULTS were sensitive to the price of the vaccine and the discount rate, but relatively insensitive to changes in vaccine efficacy, coverage rates or vaccine complication rates. Improved accuracy of a negative varicella history in adolescents would substantially reduce the costs of the adolescent and catch-up programs making these programs feasible. CONCLUSIONS: the infant vaccine program is the preferred program, but the direct costs of any of the vaccination programs considered here are greater than the direct costs of no vaccination program.

Adolescent↗
PubMedDate not supplied

Prevention strategies other than male condoms employed by low-income women to prevent HIV infection.

This study sought to determine HIV prevention strategies other than male condom use employed by low-income women who have sex with men (WSM) and to identify variables that predict use of these strategies. A cross-sectional survey of nearly 4,000 women receiving Women, Infants, and Children (WIC) benefits in 21 Missouri counties was conducted. The response rate was 58%, with 2,256 completed questionnaires returned. Women were asked to indicate one or more of nine methods they had ever used to prevent HIV infection. Women were also asked about their use of male condoms, preference for male condoms versus female condoms, and which partner usually made decisions about STD/HIV prevention. Of the 2,256 questionnaires returned, 1,325 WSM indicated use of at least one HIV prevention strategy other than condom use. Strategies were: being tested for HIV (68.2%), partner being tested for HIV (44.1%), asking partner about his sex history (41.1%), using oral contraceptives (18.8%), asking him if he has HIV (13.7%), douching (11.8%), withdrawal (9.4%), and having anal or oral sex (6.6%). Common predictors of these strategies were race, education, history of STD, condom use, and marital status. Basic misunderstandings about HIV prevention are common in specified subpopulations of low-income women. HIV prevention programs for low-income WSM should capitalize on women's efforts to prevent HIV by designing programs to help women replace ineffective prevention strategies with effective prevention strategies.

Adult↗
PubMed2006

The role of antimicrobial management programs in optimizing antibiotic prescribing within hospitals.

Managing serious infections is a balance between providing timely and appropriate broad-spectrum empirical therapy for individual patients, which has been consistently shown to improve outcomes, and reducing unnecessary use of antimicrobial agents, which may contribute to the development of antimicrobial resistance. To control the spread of antimicrobial resistance, hospitals commonly implement programs designed to optimize antimicrobial use, supported by infection-control measures. Hospital-based antimicrobial management programs--also called "antimicrobial stewardship programs"--are primarily based on education coupled with a "front-end" approach (i.e., restricting the availability of selected antimicrobial agents) or a "back-end" approach (i.e., reviewing broad-spectrum empirical therapy and then streamlining or discontinuing therapy, as indicated, on the basis of culture and susceptibility testing results and clinical response). Institutional efforts to optimize antimicrobial use should concentrate on patient outcomes, should have multidisciplinary support, and should use a combination of interventions customized to the needs, resources, and information technology infrastructure of the health care institution.

Anti-Bacterial Agents↗
PubMed1997

Visual BLAST and visual FASTA: graphic workbenches for interactive analysis of full BLAST and FASTA outputs under MICROSOFT WINDOWS 95/NT.

MOTIVATION: When routinely analysing protein sequences, detailed analysis of database search results made with BLAST and FASTA becomes exceedingly time consuming and tedious work, as the resultant file may contain a list of hundreds of potential homologies. The interpretation of these results is usually carried out with a text editor which is not a convenient tool for this analysis. In addition, the format of data within BLAST and FASTA output files makes them difficult to read. RESULTS: To facilitate and accelerate this analysis, we present for the first time, two easy-to-use programs designed for interactive analysis of full BLAST and FASTA output files containing protein sequence alignments. The programs, Visual BLAST and Visual FASTA, run under Microsoft Windows 95 or NT systems. They are based on the same intuitive graphical user interface (GUI) with extensive viewing, searching, editing, printing and multithreading capabilities. These programs improve the browsing of BLAST/FASTA results by offering a more convenient presentation of these results. They also implement on a computer several analytical tools which automate a manual methodology used for detailed analysis of BLAST and FASTA outputs. These tools include a pairwise sequence alignment viewer, a Hydrophobic Cluster Analysis plot alignment viewer and a tool displaying a graphical map of all database sequences aligned with the query sequence. In addition. Visual Blast includes tools for multiple sequence alignment analysis (with an amino acid patterns search engine), and Visual FASTA provides a GUI to the FASTA program.

Amino Acid Sequence↗
PubMed1994

Interdisciplinary team training in geriatrics: reaching out to small and medium-size communities.

Since 1989, six teams in the state of Michigan have been involved in a team training program designed to promote the development of geriatric services in small to medium-size communities. The program was enthusiastically received by participants, but after 18 months, only half of the teams had implemented clinical services for older adults. Monitoring the progress of the teams over 18 months and analyzing the activities of two teams revealed that financially stable and supportive sponsoring agencies and the community were critical factors in the implementation of interdisciplinary clinical services in geriatrics. Future team training programs trying to promote the development of geriatric services in small to medium-size communities should try to address these issues through community organization interventions.

Community Participation↗
PubMed2004

Covariates of current cigarette smoking among secondary school students in Budapest, Hungary, 1999.

To date, few studies have examined the relationship between health behavior risk factors and cigarette smoking in Hungary. From 1995 to 1999, the prevalence of current smoking increased from 35.9 to 46.0% among secondary students in Budapest, Hungary. The objective of the present study was to examine the association between smoking and other health behavior risk factors among secondary school students in Budapest. Surveys were administered during regular classes in 21 traditional and nine vocational/technical schools containing Grades 9-12; 2410 students aged 15-18 years were included in the analysis. Overall, 44.9% of males and 46.9% of females were current smokers. Smoking increased with age and was significantly higher among vocational/technical (60.2%) than traditional (43.1%) students. The likelihood of smoking was significantly higher among students who rarely or never used a seatbelt when riding in a car driven by someone else, currently used alcohol, had engaged in episodic heavy drinking, had had four or more sex partners during their lifetime or did not participate in vigorous physical activity. Health-risk behaviors are frequently interrelated. Findings suggest that programs designed to prevent smoking should consider related health-risk behaviors as part of a comprehensive program.

Adolescent↗
PubMed1985

United Kingdom Heart Disease Prevention Project: 12-year follow-up of risk factors.

Ten of the original 24 factories from the United Kingdom Heart Disease Prevention Project were resurveyed in 1983 to assess the long-term (12-year) effects of an education program on diet, smoking, and exercise. These 10 factories had previously been grouped into five pairs matched for size, location, and nature of industry, with one of each pair randomly chosen for intervention. Men in intervention factories were given advice on reduction of cholesterol in diet, stopping smoking, weight reduction, and regular exercise. High-risk workers (13%) received personal counseling in addition to the factory-wide education program. A total of 1,204 workers randomly selected from those still employed in 1978 were surveyed. There were significant differences observed in cigarette consumption, butter use, and several other dietary behaviors; however, the differences were small and insignificant for the proportion smoking and leisure-time exercise. The largest effects were in the high-risk group who had received personal counseling. This education program appears to have some lasting effects on behavior associated with coronary disease risk factors. Similarly designed programs may serve as models for community-wide coronary disease prevention programs.

Adult↗
PubMed1996

Outcome measures of a chronic pain program: a prospective statistical study.

OBJECTIVE: To provide outcome data measuring objective and subjective variables of an individualized, multidisciplinary, comprehensive pain management program. DESIGN: The study is a prospective evaluation of 50 consecutive patients who completed the pain management program. Objective measures were medication use and return to work. Subjective measures included self-reports of pain levels and completion of a Personal Concerns and Goals Assessment (PCGA) examining issues of lifestyle and emotional well-being. These measures were compared at program onset and completion by using appropriate statistical analyses. RESULTS: Objective measures: Medication use by the study subjects decreased overall by 72% within all drug categories. Opioid use was eliminated. Regarding return to work, the study subjects increased their work hours by twofold overall. Of patients working fewer than 30 h per week at program onset, representing 62% of the study population, a fivefold return to work was observed. Subjective measures: Overall pain levels improved by 33%, with an 18 to 47% improvement in all descriptors (average pain levels on good or bad days, average number of good or bad days). Of the PCGA factors, patients improved 24 to 46% in all categories concerning lifestyle and emotional well-being. Correlative analysis of the data produced prognostic information as well as insights into chronic pain development. CONCLUSIONS: This study of objective and subjective outcome measures demonstrates that a comprehensive program employing specific principles and methods produces an effective approach for the management of chronic pain. Patients disabled by chronic pain regain a quality of life that allows them to resume a functioning, productive role.

Adolescent↗
PubMed2002

The health effects of work-based welfare.

PURPOSE: To identify effects of work-based welfare on the health and well-being of participants. Data included the needs and experiences of people in the work-based welfare program. DESIGN: The population for this qualitative study was adults enrolled in the work-based welfare program in a large urban community in the U.S. Midwest. The sample was 34 women who were enrolled in this program. The interview settings were an inner-city adult education center, an inner-city church, a subsidized housing development, or homes of participants. Data were collected between July 1999 and June 2000. METHODS: Snowball sampling was used to identify participants. Instruments used for this report were a semi-structured interview guide, a demographic data sheet, and the General Well-being Schedule. FINDINGS: The human costs to people enrolled in work-based welfare included anxiety and depression as well as negative effects on health and well-being. Participants also reported positive effects on well-being and empowerment. CONCLUSIONS: The findings indicate the complex interplay of the socioeconomic environment, mental and physical health, and the well-being of families. The women's perceptions of the effects that welfare policy has had on them and their families indicate the need for a broader response to poverty than the largely economic response of work-based welfare.

Adult↗
PubMed1989

Alcohol and drug abuse prevention in Wisconsin public schools.

This survey assessed the status of Wisconsin public school district programs designed to prevent alcohol and other drug related problems among students. The assessment involved surveying prevention program directors of 102 school districts that received grants for prevention initiatives since 1981. Most districts (70%) implemented programs at the elementary, middle, and senior high school levels. Typical program strategies involved combining information dissemination with refusal skill and self-concept development. School programs predominantly were school-based and did not systematically involve community members or agencies. The greatest obstacles to providing effective prevention services include high rates of alcohol and other drug use in homes and communities, denial of alcohol and other drug related problems among students, parents, and community members, and lack of staff time for prevention activities. Project directors indicated a need for schools to initiate greater involvement of parents, nonschool alcohol and drug abuse prevention agencies, and other community organizations in school efforts.

Adolescent↗
PubMed2003

Comparison of two doses of oestradiol benzoate administered at a resynchronised oestrus on reproductive performance of dairy cows.

OBJECTIVE: To compare the effects of two doses of oestradiol benzoate (ODB) administered as part of a treatment designed to resynchronise returns to oestrus on the reproductive performance of cows in a controlled breeding program. DESIGN: Cohort study. PROCEDURE: Lactating dairy cows on two farms were treated to synchronise three successive oestrous cycles. An intravaginal progesterone releasing insert (IVP4) was used to synchronise the first oestrous cycle. The cows were then treated 15 days after the first treatment by reinsertion of an IVP4 that had been used to synchronise the first oestrus and administration of 1.0 mg of oestradiol benzoate (ODB) i.m. at device insertion. The IVP4 device was removed 8 days later and either 0.5 (n = 421) or 1.0 mg of ODB (n = 446) was administered 24 h later. Injections of (ODB) with or without the use of an IVP4 were used to synchronise the third oestrous cycle. Different synchronisation treatments were used to synchronise first and third oestrous cycles but differences were included in statistical models to account for variation in the data. This enabled examination of effects due to differences in the dose of ODB used to synchronise the second synchronised oestrus. RESULTS: The dose of ODB (0.5 or 1.0 mg) administered just before the second synchronised oestrus did not significantly (P > 0.10) affect the cumulative pregnancy rates over three successive rounds of artificial insemination, the mating start date to the conception intervals, the conception rates to the first or second insemination, the proportion of cows submitted for insemination at the second synchronised oestrus or the proportion of cows that were not pregnant yet failed to show signs of oestrous (phantom cows) identified within each herd. CONCLUSION: There was no difference in reproductive performance between cows receiving either 0.5 mg or 1.0 mg ODB after removal of used IVP4 devices that had been inserted to resynchronise them for a second insemination.

Administration, Intravaginal↗
PubMed2006

Reducing hazard related falls in people 75 years and older with significant visual impairment: how did a successful program work?

BACKGROUND: In a randomized controlled trial testing a home safety program designed to prevent falls in older people with severe visual impairment, it was shown that the program, delivered by an experienced occupational therapist, significantly reduced the numbers of falls both at home and away from home. OBJECTIVES: To investigate whether the success of the home safety assessment and modification intervention in reducing falls resulted directly from modification of home hazards or from behavioral modifications, or both. METHODS: Participants were 391 community living women and men aged 75 years and older with visual acuity 6/24 meters or worse; 92% (361 of 391) completed one year of follow up. Main outcome measures were type and number of hazards and risky behavior identified in the home and garden of those receiving the home safety program, compliance with home safety recommendations reported at six months, location of all falls for all study participants during the trial, and environmental hazards associated with each fall. RESULTS: The numbers of falls at home related to an environmental hazard and those with no hazard involved were both reduced by the home safety program (n = 100 participants) compared with the group receiving social visits (n = 96) (incidence rate ratios = 0.40 (95% confidence interval, 0.21 to 0.74) and 0.43 (0.21 to 0.90), respectively). CONCLUSIONS: The overall reduction in falls by the home safety program must result from some mechanism in addition to the removal or modification of hazards or provision of new equipment.

Accidental Falls↗
PubMed2001

Neuman systems model-based research: an integrative review project.

The project integrated Neuman systems model-based research literature. Two hundred published studies were located. This article is limited to the 59 full journal articles and 3 book chapters identified. A total of 37% focused on prevention interventions; 21% on perception of stressors; and 10% on stressor reactions. Only 50% of the reports explicitly linked the model with the study variables, and 61% did not include conclusions regarding model utility or credibility. No programs of research were identified. Academic courses and continuing education workshops are needed to help researchers design programs of Neuman systems model-based research and better explicate linkages between the model and the research.

Bibliometrics↗
PubMed2004

The role of the applied epidemiologist in armed conflict.

BACKGROUND: Applied epidemiologists are increasingly working in areas of insecurity and active conflict to define the health risks, suggest feasible means to reduce these risks and, monitor the capacity and reconstruction of the public health system. In 2001, The Carter Center and the United States Institute for Peace sponsored a conference within which "Violence and Health" was discussed and a working group on applied epidemiology formed. The group was tasked to describe the skills that are essential to effective functioning in these settings and thereby provide guidance to the applied epidemiology training programs. METHODS: We conducted a literature review and consultation of a convenience sample of practitioners of applied epidemiology with experience in conflict areas. RESULTS AND CONCLUSIONS: The health programs designed to prevent and mitigate conflict are in their early stages of implementation and the evaluation measures for success are still being defined. The practice of epidemiology in conflict must occur within a larger humanitarian and political context to be effective. The skills required extend beyond the normal epidemiological training that focuses on the valid collection and interpretation of data and fall into two general categories: (1) Conducting a thorough assessment of the conflict setting in order to design more effective public health action in conflict settings, and (2) Communicating effectively to guide health program implementation, to advocate for needed policy changes and to facilitate interagency coordination. These are described and illustrated using examples from different countries.

Journal Article↗
PubMed2000

Variability in performance of timed walk tests in pulmonary rehabilitation programs.

STUDY OBJECTIVE: To describe variability in the conduct of walk tests in pulmonary rehabilitation programs. DESIGN: : Analysis of information obtained by means of a structured written questionnaire. SETTING: Outpatient pulmonary rehabilitation programs in the United States and Canada. PARTICIPANTS: Clinical coordinators of 75 pulmonary rehabilitation programs. INTERVENTIONS: None RESULTS: Timed walk tests were obtained in 71 of 99 programs surveyed. Considerable variability in all aspects of testing practices was evident. Fifty-seven respondents (80%) based results on a single walk. Walk tests were completed in a hallway (73%), on a walking track (9%), and on a treadmill (7%). In 29 programs (44%), a walk supervisor carried or pulled the oxygen source, while in 25 programs (38%), the oxygen was carried or pulled by the patient. Informal nonstandardized instructions were provided to patients prior to walking in 41 programs (58%). In 53 programs (76%), the walk supervisor could direct a patient to speed up, to slow down, or to rest. Evaluations of breathlessness and perceived exertion were measured during the walk by 73% and 16% of programs, respectively. CONCLUSIONS: Practices regarding performance of timed walk tests are poorly standardized among pulmonary rehabilitation programs. Further research is needed to evaluate the impact of certain variations in testing practices on test results.

Exercise Test↗
PubMed1999

The prevention of unintentional injury among American Indian and Alaska Native children: a subject review. Committee on Native American Child Health and Committee on Injury and Poison Prevention. American Academy of Pediatrics.

Among ethnic groups in the United States, American Indian and Alaska Native (AI/AN) children experience the highest rates of injury mortality and morbidity. Injury mortality rates for AI/AN children have decreased during the past quarter century, but remain almost double the rate for all children in the United States. The Indian Health Service (IHS), the federal agency with the primary responsibility for the health care of AI/AN people, has sponsored an internationally recognized injury prevention program designed to reduce the risk of injury death by addressing community-specific risk factors. Model programs developed by the IHS and tribal governments have led to successful outcomes in motor vehicle occupant safety, drowning prevention, and fire safety. Injury prevention programs in tribal communities require special attention to the sovereignty of tribal governments and the unique cultural aspects of health care and communication. Pediatricians working with AI/AN children on reservations or in urban environments are strongly urged to collaborate with tribes and the IHS to create community-based coalitions and develop programs to address highly preventable injury-related mortality and morbidity. Strong advocacy also is needed to promote childhood injury prevention as an important priority for federal agencies and tribes.

Alaska↗
PubMedDate not supplied

Community-based exercise intervention: Zuni Diabetes Project.

Non-insulin-dependent diabetes mellitus (NIDDM) is a serious health problem among the Zuni Indians of New Mexico. In July 1983, Indian Health Service personnel initiated a community-based exercise program designed to help control NIDDM in the community. To retrospectively evaluate the effects of the exercise program, the medical records of 30 participants with NIDDM were compared with the medical records of 56 nonparticipants with NIDDM matched by age, sex, health-care provider, and duration of NIDDM. From 1 July 1983 through 1 October 1985, participants had a mean weight loss of 4 kg, whereas nonparticipants had a mean weight loss of 0.9 kg (P less than .05). Participants' fasting blood glucose values dropped by a mean of 43 mg/dl, compared to a mean drop of 2 mg/dl among the nonparticipants (P less than .05). Participants were significantly more likely than nonparticipants to have stopped their hypoglycemic medication (relative risk 4.2) and to have decreased their medication dosage (relative risk 2.2). These results suggest that participation in a community-based exercise program can produce significant weight loss and improvement in glycemic control among a group of Native Americans with NIDDM.

Adolescent↗
PubMed1980

Utility of electromyographic biological feedback in chronic stuttering: a clinical study with follow-up.

A systematic case study is presented in which eight chronic adult stutterers underwent an electromyographic (EMG) biological feedback training program designed to reduce masseter muscle tension in an effort to improve fluency. All subjects mastered the program within 10 30-min. sessions. Measures of muscle tension and fluency indicated improvement at the end of treatment that were maintained at 3- to 6-mo. follow-up.

Adult↗