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At least 847 records · Page 47Linked to original sources
PubMed1988

From aralu to ORS: Sinhalese perceptions of digestion, diarrhea, and dehydration.

This paper explores popular Sinhalese perceptions of diarrheal diseases and related health care behavior. Also addressed are cultural interpretations of dehydration and perceptions of oral rehydration solution (ORS). The social marketing of ORS is considered. It is suggested that the marketing of ORS be more closely linked to education programs which promote appropriate conceptualization of dehydration. The need to more closely integrate nutrition education and diarrheal management programs is discussed.

Child↗
PubMed1981

Inhibition of programmable demand pacemaker by pacemaker-induced myopotentials.

Pacemaker-induced myopotentials caused inhibition of a demand pacemaker in two cases in which the unipolar partially encapsulated pacemaker flipped over in its pocket and directly stimulated the muscles of the chest wall. This pacemaker-induced muscular stimulation, possibly combined with afterpotential sensing or T-wave sensing (or both), caused the rate of the demand pacemaker to fall when the output of the programmable pacemaker was set to deliver high energy charges. By programming the unit to deliver a lower charge (shorter width of pulse), the rate rose appropriately to the programmed rate. Likewise, manual rotation of the unipolar pacemaker into proper orientation with the active uninsulated surface directed towards the skin also solved the problem temporarily.

Aged↗
PubMed1991

A clinical evaluation of an emergency procedures training program.

An emergency skills training program was undertaken in a long-term care setting to increase nursing knowledge about appropriate interventions. The program incorporated readiness activities and a walk-through laboratory approach to learning. Pre- and postcourse knowledge scores revealed improvements, as did a 3-month follow-up assessment of knowledge. Most of all, the response of staff to the program was overwhelmingly positive.

Education, Nursing, Continuing↗
PubMed2003

Population-based screening or case detection for asthma: are we ready?

Asthma is a prevalent health problem for which there are effective treatments. By identifying people with asthma and treating them effectively, the burden of asthma in the United States should be reduced. Detecting people with asthma through screening programs seems a logical approach to the problem. This article assesses our readiness for population-based screening and case detection programs for asthma and examines these activities in relation to World Health Organization criteria for determining the appropriateness of screening programs. Given that, at this time, a number of the criteria have not been met, we conclude that population-based approaches to screening and case detection of asthma are of unproven benefit and need further research. A more appropriate focus may be to ensure that all people who are diagnosed with asthma receive appropriate medical care.

Asthma↗
PubMed1998

Using picture identification for research with preschool children.

Assessing preschool childrens' health knowledge and skill levels, and their recognition of health behavior, prove essential in developing and maintaining effective health education programs. However, the intent of the assessment process, and the methodology, must be carefully considered. Picture identification can be appropriately used to determine the status of a young child's health knowledge or skills and thus decide how the child might benefit from further learning experiences. Knowledge or skill assessment for young children primarily involves observing children while they demonstrate knowledge through an activity or behavior, although this assessment may be supplemented with a checklist or instrument, such as a picture identification instrument. This article 1) reviews the reliability of picture identification tools in previous studies; 2) provides recommendations for assessing health knowledge of preschool children; and 3) suggests ways health knowledge data can be used appropriately in early childhood education programs. The result of quality knowledge and skill assessment provides direction for program planners in developing appropriate health education programs for preschoolers.

Child, Preschool↗
PubMed1983

Standardized diagnosis and treatment of fluid, acid-base and electrolyte disorders in the surgical patient with the aid of a programmable pocket calculator.

The approach to fluid, acid-base and electrolyte disorders in the surgical patient has been standardized in a pocket calculator program that categorizes these disorders into formal diagnoses and subsequently uses these diagnoses to determine the appropriate therapy. The program was tested in 80 infusion regimens of patients in the intensive care and surgical wards. The advantages of a standardized approach to these disorders, using diagnostic and therapeutic algorithms, are briefly discussed.

Aged↗
PubMed1985

General hospital psychiatry: are its roles and functions adjunctive or pivotal?

General hospital psychiatric divisions are an important part of the mental health care delivery system; however, in Canada and the United States, their role and function have not been well defined. In most places, the general hospital is peripheral to the mental hospital, and is thus an adjunctive element in the resulting two-tier mental health care delivery system. The adjunctive type of general hospital psychiatric division provides brief treatment to highly selective types of patients, and is relatively inaccessible to a wide variety of patients. In contrast, the general hospital can be central to the mental health care delivery system--in a pivotal position to patients, other mental health facilities, and community agencies. Important features of the pivotal type are: defined catchment areas, broad admitting criteria and effective discharge planning, linkages with extramural and community programs, staff reorientation, appropriate architectural features, and the ability to hear and respond to the needs of the community. The pivotal type of general hospital psychiatric division can provide appropriate levels of inpatient care, as well as the linkages and backup to extramural and community programs for the long-term mentally ill. The mental hospital would no longer be used as a backup for general clinical disorders, involuntary patients, or patients usually rejected by adjunctive hospitals. There would be collaboration with other agencies in developing programs for special clinical groups (low prevalence disorders), as well as for alcoholism, psychogeriatrics, and adolescent disorders. This article reviews the current polemic on the role and function of the general hospital psychiatric division, as part of the mental health care delivery system.

Canada↗
PubMed1991

Selecting a systematic approach for educating hospitalized cancer patients.

Establishing cancer patient education programs for hospitalized cancer patients may follow a six-stage process that includes planning and strategy selection, selecting channels and materials, developing materials and pretesting, implementation, assessing effectiveness, and obtaining feedback to refine the program. The extent to which each of the stages is followed depends upon which stages are appropriate for the program and the consensus of hospital management.

Curriculum↗
PubMed1993

Project Safety Net: a health screening outreach and assessment program.

Although comprehensive geriatric assessment (CGA) has been conducted in many settings, its use in community-based outreach programs has been limited. We have developed Project Safety Net, a program that identifies low-income urban-dwelling frail elderly persons and provides CGA and appropriate referral. The program uses validated screening instruments and makes extensive use of a custom-designed computer program to provide information to the interdisciplinary team and for research purposes. During an 8 month period, 814 older persons were screened including high proportions who were widowed (51%) and who lived alone (66%). The effectiveness of this program remains to be determined in a randomized clinical trial.

Aged↗
PubMed1995

[The control of risk factors in cardiac rehabilitation programs].

Patients with ischaemic heart disease are at high risk of developing new clinical cardiac events and cardiac death in the following years. Appropriate Secondary Prevention Programs have proved to be useful both to slow the progression of coronary disease and to decrease the probability of new clinical events and the overall mortality. Cardiac rehabilitation programs constitute the best current approach directed to the modification of risk factors. The programs have not only significantly improved the risk profile of ischaemic patients but also have contributed to the acceptance of new healthy life style.

Age Factors↗
PubMed1979

Appropriateness of milk use in international supplementary feeding programs.

Recognition of lactose intolerance, debate over the limitedness of dietary energy and protein in specific settings, and the appreciation for the uniqueness and appropriateness of human milk during the 1st yr of life have prompted reexamination of the use of milk in international feeding programs. Substantial proportions of preschool and school-age children from expected populations are lactose intolerant. However, studies in this county indicate that lactose intolerant preschool and early school-age children can tolerate amounts of milk usually consumed. Older individuals with symptomatic responses to milk also will often have similarly mild symptomatic responses to hydrolyzed lactose milk. Appropriately controlled studies in developing countries are planned or are underway to assess milk tolerance. In feeding programs designed to provide a protein supplement, milk continues to be a very attractive option. The question of how much milk protein must be given and how often it should be provided to make a significant impact on a population's well-being depends on an evaluation of the data base describing protein intakes and needs for specific populations. These types of data for most populations are inadequate.

Adolescent↗
PubMed1993

Needs assessment for reducing infant mortality in Baltimore City: the Healthy Start Program.

Needs assessments are essential for policy formulation and the appropriate design of intervention programs. Recent nationwide data show that among large metropolitan areas of the United States, Baltimore has one of the highest infant mortality rates and ranks in the worst top 10 for blacks and the top 5 for whites for most indicators of poor pregnancy outcome. In this paper, we present the methods and results of a needs assessment that used multiple sources of routinely collected data and was conducted for the purpose of identifying intervention factors contributing to infant mortality in Baltimore City. This needs assessment was used by the Baltimore City Health Department to successfully secure funding for the federal Healthy Start Infant Mortality Prevention Initiative. We present the results of the analyses, along with some of the proposed interventions that resulted from the needs assessment. We also discuss the limitations of this type of needs assessment as well as suggestions for future needs assessments for the design of interventions to improve perinatal health.

Black or African American↗
PubMed1998

Group treatment for smoking cessation among persons with schizophrenia.

People with schizophrenia smoke more than the general population and more than other psychiatric diagnostic groups. The rate of smoking in the general population is 30 percent, and reported rates for people with schizophrenia range between 62 percent and 81 percent. The author briefly reviews evidence that nicotine's augmentation of dopamine release may account for the high prevalence of smoking in this group. The affective, cognitive, and social difficulties and the symptoms experienced by many patients with schizophrenia indicate that existing smoking cessation programs may not be appropriate for them. The author describes three programs developed for use with this population and reviews evidence of their effectiveness. Preliminary evidence suggests that transdermal nicotine patches are effective and that patients do not misuse them. The author concludes that stopping smoking is possible for individuals with schizophrenia, especially if the treatment is specifically designed for them.

Behavior Therapy↗
PubMed2001

Canadian research fellowship training programs in digestive sciences: achievements and challenges.

BACKGROUND: The Canadian Association of Gastroenterology (CAG) is committed to fostering the development of future Canadian investigators. Up to 1986, research fellowship support was obtained from the Medical Research Council (MRC) of Canada. Since that time, several peer-reviewed, industry-sponsored, CAG-supported research fellowships and a variety of independently funded awards have augmented this effort. In the same period, peer-reviewed operating grants (OGs) from the MRC and other agencies have been constrained. The aim of this study was to determine the success of CAG, MRC or any other Canadian research fellowships in the development of career investigators in digestive sciences and to identify factors influencing the outcomes of such training. METHODS: MRC records and the minutes of CAG annual meetings were reviewed to identify research fellowship support. Canadian program directors were requested to list research fellows affiliated with their groups between 1986 and 1997. Only fellowships providing at least 1 year of training were included. A 7-page questionnaire detailing biographic characteristics, the site and duration, and specific issues related to the quality of research training was sent to identified trainees. Significant associations between success in achieving an academic appointment or OG support and several variables of training were identified. RESULTS: Eighty-six research fellows were trained. Responses were obtained from 43 of them. The demographic characteristics of the whole group and the respondents were similar. Of the respondents, 81% of trainees obtained academic appointments. Fellowships longer than 1 year were associated with higher rates of academic posting, and MRC-funded fellows had greater success rates of academic appointments. Of eligible trainees 63% have obtained OG support. None of the other variables examined predicted success. Of the trainees responding, 85% valued the fellowship very highly. CONCLUSIONS: The establishment of the additional research fellowships has fostered the development of career investigators in digestive sciences. The high success rate of former trainees in obtaining academic appointments and OG support suggests that the fellowship programs are effective and appropriately oriented. The structure of the current programs does not require substantial revision. OG support for new investigators appears now to lag substantially.

Canada↗
PubMed1987

Financial analysis in the health administration curriculum: a survey of ACEHSA programs.

Among the continuing curriculum issues in health administration programs is the appropriate amount of financial analysis. This field covers economics and financial management, with both subjects being given importance in the ACEHSA accreditation guidelines. This paper reports on a national survey of health administration programs intending to discover the importance placed on the study of economics and financial management. A second survey gathered information from alumni and preceptors of a specific ACEHSA program (the University of Massachusetts at Amherst) on their perception of the appropriate curriculum content for financial analysis. The most important conclusion of this study is the discovery that the long-accepted schism between school of public health and school of management programs does not exist. There are far more similarities than differences, at least in terms of financial management and economics. Financial analysis is a broad area and at present a great amount of diversity among programs is acceptable. The accreditation process may require narrower standards for this important content area.

Curriculum↗
PubMed1985

Educational and exercise programs for asthmatic children.

We designed programs to teach appropriate exercises to asthmatic children and to educate their parents about their special needs. Each of 11 programs over a six-year period included a weekly two-hour session for four weeks. Lectures for parents dealt with the etiology and precipitating events of asthma, environmental control and drug therapy, family interaction with a psychiatrist, and hyposensitization therapy and food allergy. The 59 children, aged 4 to 13, played group games, learned breathing exercises, and were assisted by their parents in postural drainage. School absences decreased in 59%, emergency room visits decreased in 70%, medication usage decreased in 54%, and the number of attacks decreased in 70%. Greater understanding of asthma by both parents and children improved the quality of life and lessened the severity of the disease.

Asthma↗
PubMed2005

Food-for-work programs in Indonesia had a limited effect on anemia.

Indonesia's economic crisis of late 1990s lowered consumption of micronutrient-rich foods, which increased the prevalence of micronutrient deficiencies, including anemia. As a postcrisis response, 5 nongovernmental organizations (NGOs) implemented Food for Work (FFW) programs to protect food consumption levels and nutritional status by providing rice, sometimes combined with oil and/or pinto beans. An independent evaluation assessed the effect of the FFW programs on nutrition outcomes, particularly anemia. A quasi-experimental design was used in which 1500 beneficiary and 1500 control households were randomly selected and followed in each of 3 urban and 2 rural sites. Baseline data were collected before program implementation and subsequently at approximately 6-mo intervals for 2.5 y. The poor were found to be appropriately targeted, and program participation ranged from 4 to 18 mo. The proportion of households with debts ranged from 32 to 70%; although it was higher among beneficiaries than controls, it increased among controls, but not beneficiaries. However, only among urban poor mothers in Surabaya were the odds of anemia at endline lower when participating in the FFW program (0.60, 95%CI [0.40-0.89]). Other risk factors for anemia in mothers and children included nutritional status (anemia at baseline, low BMI, receipt of vitamin A capsule, child age) and socioeconomic status (maternal education, having official residency in the area, income level). Thus, postcrisis FFW programs had limited effect on anemia, the main identified nutritional problem. Closer attention is required to the potential for affecting nutritional outcomes through FFW, including food aid quality and quantity and complementary nonfood interventions. Micronutrient deficiencies should be addressed directly via supplements and fortified foods.

Adult↗
PubMed1997

Population and occupational screening for obstructive sleep apnea: are we there yet?

Several features of obstructive sleep apnea (OSA) suggest that it may be an appropriate disease for screening programs for general populations and more specific high-risk groups. Preliminary data suggest that OSA represents an important health problem in terms of high prevalence, increased levels of morbidity and mortality, and increased public safety risk. Furthermore, the chronicity of the disease and the relatively low levels of recognition of the disorder in the medical community suggest a potential for lead-time gains for screening programs. Specific groups that might be considered for screening programs include commercial vehicle operators, hazardous duty personnel, and certain groups of medical patients. The purpose of this clinical commentary is to consider the issues of population and specific group screening for OSA by reviewing the general principles of screening for chronic disease and then applying these principles specifically in the case of OSA. More extensive outcomes data relating levels of severity of the disorder to its potential adverse outcomes are needed and will assist in tailoring appropriate screening programs and determining the cost-effectiveness of screening various populations.

Chronic Disease↗