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At least 883 records · Page 49Linked to original sources
PubMed1991

The Pawtucket Heart Health Program. Influencing adolescent eating patterns.

The Pawtucket Heart Health Program, a research effort testing a process of community activation for cardiovascular risk factor behavior change, risk factor change, and coronary heart disease event rate change, utilizes risk factor behavior change programs for the entire population of a northeastern city. A diversity of nutrition programs designed to teach new skills and to alter the nutrition environment have been delivered. These include group programs, highlighting restaurant menus, labeling grocery shelf items, screening for blood cholesterol levels accompanied by nutritional counseling, and provision of programs in schools. In addition to standard curricula, the Heart Healthy Cook-Off for both junior high school and high school students has been developed. Students select recipes, make substitutions to lower fat, saturated fat, and cholesterol content, analyze original and substitution recipe nutrient content using a microcomputer and nutrient analysis software, and prepare the food. A panel of judges assesses presentation, taste, and health-promoting characteristics. In one junior high school class, cholesterol measure before and after the cook-off decreased by 10.7% among those with elevated cholesterol. The Heart Healthy Cook-Off is an education program that influences the culinary practices of children in an enjoyable, challenging format.

Adolescent↗
PubMed1997

Emotional distress and substance abuse as risk factors for suicide attempts.

BACKGROUND: Both depression and hopelessness have been found to be closely related to suicide risk among adolescents and adults. Substance abuse has also been found to play a role in the suicide process with adults, but it is still unclear how much substance abuse influences suicide in adolescents. METHOD: The present study examined the relationship between substance abuse, emotional distress, and suicidal intent among 115 adolescent psychiatric inpatients who had attempted suicide. RESULTS: Measures of emotional distress, as well as the measures of substance abuse, were significantly intercorrelated. Correlations across domains (emotional distress versus substance abuse), however, varied by gender. Among adolescent females, both depression and hopelessness were significantly related to suicidal intent, whereas among adolescent males, only depression was related to suicidal intent. Also, alcohol abuse was significantly related to depression and hopelessness in adolescent males. CONCLUSIONS: Hopelessness may not be as useful an indicator of suicide risk among adolescent males as it is with adolescent females. Intervention and prevention programs designed for adolescent females should identify and address feelings of depression and hopelessness. New intervention and prevention programs may need to be developed for adolescent males.

Adolescent↗
PubMed1996

Aiding troubled employees: the prevalence, cost, and characteristics of employee assistance programs in the United States.

OBJECTIVES: Employee assistance programs (EAPs) are job-based programs designed to identify and assist troubled employees. This study determines the prevalence, cost, and characteristics of these programs in the United States by worksite size, industry, and census region. METHODS: A stratified national probability sample of more than 6400 private, nonagricultural US worksites with 50 or more full-time employees was contacted with a computer-assisted telephone interviewing protocol. More than 3200 worksites responded and were eligible, with a response rate of 90%. RESULTS: Approximately 33% of all private, nonagricultural worksites with 50 or more full-time employees currently offer EAP services to their employees, an 8.9% increase over 1985. These programs are more likely to be found in larger worksites and in the communications/utilities/transportation industries. The most popular model is an external provider, and the median annual cost per eligible employee for internal and external programs was $21.83 and $18.09, respectively. CONCLUSIONS: EAPs are becoming a more prevalent point of access to health care for workers with personal problems such as substance abuse, family problems, or emotional distress.

Adult↗
PubMed1991

Measuring the effectiveness of the Star Parenting Program with parents of young children.

This study evaluated the effectiveness of the STAR Parenting Program, designed specifically for parents with children between the ages of 1 and 5 yr. The 8-hr. program was completed by 35 parents. There was a significant increase in parents' favorability and a significant decrease in anxiety afterwards. Parents also significantly lowered their expectations, reduced the emotionality of their reactions to their child's problem behaviors, and increased their use of time-out and tangible rewards following training. These changes were maintained at a 6-wk. follow-up.

Adult↗
PubMed1993

The ongoing development of a problem-based surgery clerkship: year three.

The third-year clerkship at one college of medicine was modified to reflect an emphasis on adult learning principles and life-long learning habits. Problem-based learning was selected as the educational method, and the development of a cognitive knowledge base, clinical problem-solving skills, and appropriate clinical skills was stressed. At a yearly faculty education retreat, strengths and weaknesses of the clerkship were discussed. As a result of this meeting, several changes were made in the clerkship, including additional stress on students' usage of the medical library and computerized databases, a tutor development program, the addition of expert resource sessions, and more emphasis on students' development of clinical skills through a preceptor program. A comprehensive evaluation program designed to support the educational goals of the clerkship is in place. The major challenge of the program remains the proper synchronization of curricular, clinical, and student self-study activities essential for an ideal learning experience.

Clinical Clerkship↗
PubMed2001

Reparative changes and the false-positive/false-negative Papanicolaou test: a study from the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology .

CONTEXT: Reparative changes can be a diagnostic challenge on Papanicolaou tests and must be distinguished from epithelial cell abnormalities. Both squamous intraepithelial lesions (SIL) and carcinoma may be underdiagnosed as repair. This study examines laboratory and cytologist performance in the diagnosis of repair. OBJECTIVES: To determine if laboratories and cytologists can consistently distinguish reparative changes from SIL and carcinoma and to document how often SIL and carcinoma are mistaken for repair in a standardized educational slide program. DESIGN: Results for reparative changes, SIL, and carcinoma slides from the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology for 1998 were analyzed. Only results from validated referenced slide responses were used. RESULTS: The concordancy rate for reparative-change slides, that is, any response of within normal limits or benign cellular changes, ranged from 91% to 94% for cytotechnologist, pathologist, and laboratory responses. False-negative rates for squamous carcinoma and adenocarcinoma, high-grade SIL, and low-grade SIL ranged from 0.47% to 5.41%; the proportion of false-negative diagnoses of reparative changes ranged from 24% to 62% of all discordant responses. CONCLUSIONS: Of all benign cellular changes and within normal limits categories in the Interlaboratory Comparison Program in Cervicovaginal Cytology, repair most often elicits a false-positive laboratory response. Underdiagnosing epithelial abnormalities as repair is also a source of false-negative Papanicolaou test results.

Cervix Uteri↗
PubMed1994

Measuring and improving performance: a practical approach to implementing a productivity program.

Developing, implementing, and maintaining a productivity program are basic tenets of good management. While it does require time and commitment, a well-designed program is well worth the time investment. Increasingly, health information management professionals will be expected to monitor productivity and streamline work processes to help assure efficient, cost-effective support for patient care.

Abstracting and Indexing↗
PubMed2000

The effect of a teaching award on the quality of continuing medical education participant evaluations.

OBJECTIVE: To improve compliance with the completion of speakers' evaluation forms in a pediatric hospital continuing medical education program. DESIGN: Preintervention and postintervention analysis. SETTING: Pediatric hospital in Cincinnati, Ohio. PARTICIPANTS: Attendees at pediatric grand rounds programs. MAIN OUTCOME MEASURE: Analysis of speaker evaluation forms for each of 20 pediatric grand rounds programs were used as the basis for speakers' awards. RESULTS: Spontaneous written comments were found on a mean of 7.3 evaluations per preintervention program and 13.5 evaluations per postintervention program (P<.01). The distribution of objective scores in 3 items examined was wider postintervention than preintervention (P<.01). CONCLUSION: When participants in continuing medical education programs know that their evaluations of an activity are used as the basis for an educational award, they may be more reflective in completing such evaluations.

Awards and Prizes↗
PubMed2004

Enhancing community re-integration following spinal cord injury.

This study assessed the efficacy of a community-based program designed to provide Independent Living services (ILS) to people with new, traumatic spinal cord injuries (SCI). The program was implemented in six communities throughout the US served by Model SCI Care Systems where services are provided by Centers for Independent Living. Participants consisted of eighty-one people with new, traumatic SCI (38% intervention participants and 62% comparison group members). Each group was assessed with regard to ILS received, unmet needs for services, satisfaction with services and three outcomes: perceived control, quality of life and societal participation. Results show that program participants and comparison group subjects differed little in terms of either measures of ILS or the outcome measures. There were numerous associations between ILS and outcomes; those who felt that they did not need ILS tended to have superior outcomes to both those who received these services and those who said that they had unmet needs. Advocacy services had the strongest association with study outcomes. The study highlights the importance of minimizing the need for ILS. It also indicates that there is a need for improved communication among rehabilitation professionals working in large medical institutions and those working in community organizations.

Activities of Daily Living↗
PubMed1992

Psychological improvement in infertile women after behavioral treatment: a replication.

OBJECTIVE: To replicate previously reported psychological improvements in infertile women attending a group behavioral treatment program. DESIGN: Psychological and demographic data were collected before entering and again upon completion of a behavioral medicine program on a second cohort of patients. SETTING: The program was offered in the Division of Behavioral Medicine, an outpatient clinic of the Department of Medicine at New England Deaconess Hospital. All patients were receiving care from infertility specialists not affiliated with this hospital. PATIENTS: Fifty two self-referred women receiving medical treatment for infertility attended the program. INTERVENTION: A 10-week group behavioral treatment program. MAIN OUTCOME MEASURES: Three validated psychological instruments. RESULTS: Psychological improvement was statistically significant (Profile of Mood States Tension/Anxiety: P less than 0.0001; Depression/Dejection: P less than 0.0122; Vigor/Activity: P less than 0.0431; Confusion/Bewilderment: P less than 0.0057; Spielberger Anger Expression: P less than 0.0013; Spielberger State Anxiety: P less than 0.0037, and Trait Anxiety: P less than 0.0001). CONCLUSIONS: Behavioral treatment is associated with significant decreases in negative psychological symptoms.

Adult↗
PubMed1979

Teaching physicians to teach: a three-year report.

To meet the needs for an expanded preceptor faculty, the Department of Family Medicine at the College of Medicine and Dentistry of New Jersey-Rutgers Medical School has for three years conducted yearly training programs designed to prepare practicing family physicians for the teaching role. Thirty-six physicians have completed the program, which consists of four group seminars and three individual learning site visits spent in the office of an experienced preceptor while a fourth year student is present. Many lessons were learned in the course of these yearly programs which may be useful to others who plan to undertake similar faculty development activities. Therefore, detailed, practical, experiential information is presented regarding recruitment, orientation, the educational program of seminars and individual learning experiences, evaluation, and required resources. Some problems proved to be particularly difficult, such as the uneven quality of the individual learning visits and the attrition of some participants from the program. Feedback from participating physicians has been extremely positive.

Faculty, Medical↗
PubMed1983

Faculty development for clinical instructors in allied health: an inservice approach.

Allied health faculty in the clinical setting are traditionally practitioners with both service and teaching responsibilities. Much effort is expended on ensuring quality performance by the practitioner in his or her health care specialty with little emphasis on the faculty member's preparation for teaching. This article describes an inservice program designed to provide applied teaching techniques for clinical faculty members faced with such a situation. The inservice program addresses four areas of interest to clinical faculty: orientation to the educational process, development and implementation of behavioral objective, selection of the most effective clinical teaching method, and evaluation of student clinical performance. The effectiveness of the inservice program in meeting its objectives was estimated by use of gain scores between pre- and posttest performance.

Allied Health Personnel↗
PubMed1996

An aerobic exercise program for patients with haematological malignancies after bone marrow transplantation.

We describe the effects of an aerobic exercise program designed to improve the physical performance of patients undergoing bone marrow transplantation. Twenty patients entered the rehabilitation program, consisting of walking on a treadmill, and carried it out for 6 weeks. Patients started the training program 30 +/- 6 days (range 18-42) post-BMT. By the end of the program we observed a significant improvement in maximal physical performance and maximum walking distance, and a significant lowering of the heart rate with equivalent workloads (P for all significances < 0.001). All participants of the program reached a peak performance (calculated in metabolic equivalents, METs) more than sufficient for carrying out all basic activities of daily living. These results contrast with literature reports indicating that spontaneous recovery of physical functioning after BMT can take many months and that about 30% of patients experience long-lasting impairment of physical performance. We conclude that that fatigue and loss of physical performance in patients undergoing BMT can be corrected with adequate rehabilitative measures.

Adult↗
PubMed1976

Components in program development.

There has been a great deal of discussion and deliberation concerning the composition of program development. Nonetheless, the question still remains--what is program development? What are possible components in program development? In this paper the following components are described, differentiated, and integrated: Statement of Purpose, Curriculum Design, Program Competencies, Content, Content Competencies, and Practice Environments.

Curriculum↗
PubMed1994

Information technology enters the doctor's office: Part II--Six lessons about intended ... and unintended ... results.

Part I of this article ("Six Design and Implementation Lessons," Physician Executive, Sept.-Oct. 1993, pp. 46-50) described an ambulatory utilization review (AUR) program designed and implemented by Metropolitan Life Insurance Company and reviewed some of the lessons learned over the past five years. Those lessons pertained to the tasks of inventing a new information technology to measure and evaluate ambulatory care and some of the practical implementation issues associated with review of 30,000 small dollar value claims per day in 19 claim offices nationwide. This article turns to the basic purpose of AUR--to review the medical necessity and appropriateness of ambulatory utilization. One lesson learned about AUR in this context is that AUR works: savings from the program outweigh costs by almost 5:1. The more important lessons, however, stem from understanding how the savings are achieved, and what some of the other unintended benefits of the program are.

Ambulatory Care↗
PubMed2004

A practical method for increasing scholarly activity in an academic family medicine department.

BACKGROUND: Providing a stimulating environment designed to increase scholarly activity is becoming increasingly difficult in today's academic medicine departments. This article was written to communicate methods and results of a practical program designed to increase scholarly activities in an academic medicine department. DESCRIPTION: A straightforward program was developed and implemented with the objective of increasing scholarly activity in an academic medicine department. Concomitant departmental changes in scholarly activities including publications, lecturing, and research were determined over a 3-year period. EVALUATION: At Year 3 post program initiative, there was a significant increase in the number of faculty members publishing (from 15.8%-73.7%). The number of articles submitted to peer-reviewed journals increased from 5 to 44, and the number accepted increased from 8 to 10. The number of national lectures given by faculty increased from 1 to 17, whereas the number of local lectures did not increase. CONCLUSION: A straightforward program can be effectively used to increase scholastic endeavors such as writing and lecturing in an academic setting.

Academic Medical Centers↗
PubMed1995

Metal search: a computer program that helps design tetrahedral metal-binding sites.

We describe a computer program (Metal Search) that helps design tetrahedrally coordinated metal binding sites in proteins of known structure. The program takes as input the backbone coordinates of a protein and outputs lists of four residues that might form tetrahedral sites if wild-type amino acids were replaced by cysteine or histidine. The program also outputs the side chain dihedral angles of the amino acids and the coordinates of the predicted metal ion. The only function evaluated by Metal Search is the ability of side chains to meet simple geometric criteria for formation of a tetrahedral site, but these criteria are sufficient to produce a manageably small list that can then be evaluated by other means. The program has been used in the introduction of zinc binding sites in the designed four-helix bundle protein alpha 4 and in the B1 domain of streptococcal protein G, and in both cases the tetrahedral coordination of a bound metal ion has been confirmed (Klemba, M., Gardner, K. H., Marino, S., Clarke, N.D., and Regan, L., Nature: Structural Biology 2:368-373, 1995).

Amino Acids↗