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PubMed1992

The level and focus of geriatric nursing content in ADN and BSN programs.

The didactic and clinical focus of geriatric curriculum content within both associate (ADN) and baccalaureate (BSN) schools of nursing in California was reviewed. Geriatric nursing content experts confirmed the detail of a geriatric nursing curriculum, then determined which of the content items were basic to both educational levels, and which might be appropriately deferred to programs of baccalaureate preparation. Nurse educators may use the results of this study to guide curriculum development in both depth and breadth of content.

California↗
PubMed1994

Caring for the indigent patient: resources to improve care.

Numerous resources can be used to meet the needs of indigent persons with cancer. Most pharmaceutical companies have professional information hotlines and programs to help patients obtain medications when they are unable to pay for them. Most communities provide numerous informational and support services. In order to provide optimal patient care, oncology nurses must be able to make referrals to appropriate community agencies. Programs are also available that provide financial assistance and lodging.

Community Health Services↗
PubMed1984

Maximizing patient care services to improve funding in a family medicine residency.

The authors discuss ways to increase the funding base of a family medicine residency program through the appropriate use of procedures related to patient care and the provisions of service. Following a commitment of cooperation by residents and faculty members, certain principles of a business practice management curriculum were expanded and applied to a residency program. A written procedure manual describing the intricacies of the fee-for-service system was prepared for interns. Mechanisms for the review of patient care productivity and educationally productive incentives were developed. All of these steps were helpful in achieving improvement in the funding base for the residency. Areas for potential expansion in training programs and financial and staffing strategies to increase revenues are discussed. Although administrative decisions regarding fees and collection mechanisms are mentioned, this discussion focuses on educational and patient care activities that also produce revenue.

California↗
PubMed1985

Data discrepancies and their origins. An evaluation of a family practice residency program using a naturalistic inquiry paradigm.

The results of an evaluation of a family practice residency program are presented. The program evaluation employed a naturalistic inquiry paradigm and a variety of qualitative methods to ensure credibility of results. An important outcome of the data collection and analysis was the identification of significant discrepancies between data collected from interviews with residents and from direct observations of a variety of the educational components of the program. Two major explanations are proposed for interpreting these discrepancies: variations in standards and variations in definition of goals and clients. The discussion supports the position that naturalistic inquiry promotes expansionist rather than reductionist outcomes, which are particularly appropriate for formative program evaluation goals.

Data Collection↗
PubMed1998

Medically induced gingival hyperplasia.

Gingival hyperplasia or gingival overgrowth is a common occurrence in patients taking phenytoin, cyclosporine, or calcium channel blockers. Speech, mastication, tooth eruption, and aesthetics may be altered. Controlling the inflammatory component through an appropriate oral hygiene program may benefit the patient by limiting the severity of the gingival overgrowth. In patients in whom gingival overgrowth is present or may be anticipated, recognition of this condition and referral to a general dentist or periodontist are appropriate steps to management. The physician's awareness of the potential for development of overgrowth and the dental practitioner's role in attempting to prevent or minimize this problem are important aspects. In this article, we discuss the medications associated with gingival hyperplasia and describe appropriate recommendations.

Anticonvulsants↗
PubMedDate not supplied

Guidelines for community-based screening for chronic health conditions.

Preventive measures for many chronic diseases depend upon identification of asymptomatic individuals who have the disease or who may be at risk for developing it. A screening biochemical test can identify such individuals. Mass screening for biochemical markers or risk factors for chronic conditions, especially for elevated serum cholesterol and blood glucose, has been advocated in recent years and has become increasingly common in various nonmedical community settings. Although generally well intentioned, such programs may fall short of their goals and may even be counterproductive. In recognition of the use of biochemical screening in nonmedical community settings, and in an attempt to make such efforts as productive as possible, the California Department of Health Services (CDHS) has developed state guidelines for these screening programs. These guidelines make recommendations regarding: (1) the criteria for judging the effectiveness of biochemical screening tests; (2) the qualifications and training of screening program staff; (3) the proper use and maintenance of equipment used in screening programs and other quality control measures; (4) referral procedures for persons with abnormal test results; and (5) the lawful implementation of screening programs. Optimally, as pointed out by these guidelines, all community-based screening programs should complement a larger health education or risk-reduction program that guarantees appropriate medical follow-up and management. Preventive medicine practitioners and organizations embarking on such activities should be familiar with the issues addressed by these guidelines and may find adherence to them useful in developing effective community screening programs.

California↗
PubMed1999

Biomonitoring of air pollution as exemplified by recent IAEA programs.

Biomonitoring is an appropriate tool for assessing the levels of atmospheric pollution, having several advantages compared with the use of direct measurements of contaminants (e.g., in airborne particulate matter, atmospheric deposition, precipitation), related primarily to the permanent and common occurrence of the chosen organisms in the field, the ease of sampling, and trace element accumulation. Furthermore, biomonitors may provide a measure of integrated exposure over an extended period of time and are present in remote areas and no expensive technical equipment is involved in collecting them. They accumulate contaminants over the exposure time and concentrate them, thus facilitating analytical measurements. Based on large-scale biomonitoring surveys, polluted areas can be identified, and by applying appropriate statistical tools, information can be obtained on the type of pollution sources and on the transboundary transport of atmospheric pollutants. The International Atomic Energy Agency is including the research on biomonitors in its projects on health-related environmental studies. Biomonitoring activities from several coordinated research projects on air pollution are presented, and results from an international workshop are discussed. In addition, activities in supporting improvement quality in the participating laboratories are outlined.

Air Pollutants↗
PubMed1993

Recent advances in the social and behavioral aspects of filariasis.

Despite an increased awareness of the significance of social and behavioral influences upon various aspects of filariasis, there has been a relative lack of research that has specifically attempted to assess such factors from the outset. Instead, the norm has been to indirectly discover social and behavioral patterns primarily as a byproducts of epidemiological and clinical surveys. The exception to this has been a recent surge of research interest in this domain that was initiated by a commitment by the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), although it is clear that more research is needed. The results of those few studies that have been conducted concerning the roles of behavioral (knowledge, attitudes, beliefs, practice) and socio-cultural factors are reviewed in this paper, highlighting how an acknowledgement of such factors contributes of a greater understanding of the relevant issues, thus allowing for more relevant and feasible health education/intervention programs. Finally, recent research conducted by two of the present authors in Nakhon Si Thammarat Province in Southern Thailand, which is noted for having the highest filariasis morbidity rate in the country, is presented and discussed. This is followed by recommendations for appropriate health education programs, and suggestions for future research.

Animals↗
PubMed2002

Inner-city African American women who failed to receive cancer screening following a culturally-appropriate intervention: the role of health insurance.

Culturally-appropriate health promotion programs are thought to be more effective among minority groups than those designed for the population at large. We investigated factors associated with failure to obtain cervical and breast cancer screening among inner-city African American women who received a culturally-appropriate educational intervention. Women who completed the intervention, but did not obtain a Pap smear, a clinical breast examination, and/or a mammogram at follow-up were compared with those who did obtain these tests. Women with private health insurance were more likely to be screened following the intervention than those covered by Medicaid or Medicare or those who were not insured (P < 0.001). Post-intervention screening was not associated with age, education, income, employment, or marital status. The effectiveness of a culturally-appropriate intervention is likely to be reduced if women's ability to respond is limited by inadequate insurance coverage.

Adolescent↗
PubMedDate not supplied

Sustaining a diabetes in pregnancy program: a continuous quality improvement process.

Education regarding diabetes management is of utmost importance, especially during pregnancy when there are 2 patients being managed at the same time, a mother and a fetus. The level of education the mother receives affects both patients. The constant reevaluation and change in treatment plans based on those evaluations positively affects the outcomes for each of them. There are a number of complications associated with having uncontrolled diabetes during pregnancy. A diabetes in pregnancy management program can offer education, provide continuous evaluation of management options, decrease hospitalizations for glucose control, and decrease complications associated with uncontrolled diabetes. All programs must have a goal, a benchmark by which to measure themselves. Plans must be formulated using current and acceptable standards of care. Once implemented, there must be ongoing evaluation of outcomes to determine whether goals are being met. With implementation of the appropriate quality tools, programs can learn to formulate their plans, implement them, measure the results, improve outcomes, and sustain themselves.

Diabetes Complications↗
PubMedDate not supplied

Designing career development programs through understanding of nurses' career needs.

A nurse's career can be divided into the exploration, establishment, maintenance, and disengagement stages. Because nurses have varied career needs at different career stages, this article uses literature review and in-depth interviews with nurses to understand the features of career stages. The authors detail nurses' career needs in different stages and infer appropriate career development programs in the hospital system.

Age Factors↗
PubMedDate not supplied

A primary intervention program (pilot study) for Mexican American children at risk for type 2 diabetes.

Many chronic diseases that are leading causes of morbidity and mortality can be prevented or controlled by primary or secondary interventions. Type 2 diabetes with its complications constitutes a major health problem, especially among Mexican Americans. The purpose of this pilot study was to develop an age- and culturally appropriate primary intervention program for Mexican American children at risk of type 2 diabetes. The sample included 37 Mexican American children ages 7 to 12 years who had at least one parent or grandparent with type 2 diabetes. A health screen of physiologic risk factors, a nutritional assessment, and a diabetes knowledge test were administered before and after the program. The eight-session activity oriented educational program focused on nutrition, exercise, and diabetes knowledge. Due to small sample size and limited study time, changes in physiologic factors and diet were not analyzed for statistical significance. Analysis of individual factors showed a trend toward more normal values. Results of this pilot program indicated that health intervention projects may be effective in helping children at risk of type 2 diabetes adopt healthier lifestyles.

Child↗
PubMed1991

Can intensive campaigns dynamize front line health services? The evaluation of an immunization campaign in Thiès health district, Senegal.

With the aid of UNICEF, Senegal has implemented an intensive national vaccination campaign, the first phase of which extended over 4.5 months in 1986 and 1987, the second and third phases being held exactly 1 and 2 years later. The present article evaluates its effects in Thiès health district. It seeks to establish; whether the objectives of the campaign were achieved and maintained beyond the intensive phase; whether the organization of the campaign was appropriate and did dynamize the first-line health services. The low sustainability, the interference with other activities of the services and some technical deficiencies are shown. They are related to the managerial characteristics of an intensive campaign. The conclusions of this evaluation question (1) the possibility of developing basic health services under one or two programs, (2) the appropriateness of 'Universal Child Immunization in 1990' and (3) the value of accelerating immunization activities when no epidemics occur. Two types of alternatives are suggested: technical options to improve UCI sustainability, and a reorientation of health policy that advocates district management and the administrative as well as operational integration of vertical programs.

BCG Vaccine↗
PubMed1999

A framework for doctoral education in health administration and policy.

The fundamental building block upon which the whole edifice of education for health services administration rests is doctoral education. Programs can be no better than the quantity and quality of doctoral graduates available to them. In turn, these graduates can be no better than the programs in which they were trained. The purpose of the present paper is to propose a framework for analyzing five different types of doctoral programs in health services administration and policy. First, five models of doctoral education in health services administration and policy are proposed and described. Second, the advantages and disadvantages of each of these models are described fro the viewpoint of the producer. Third, the most appropriate matches of program types and customer orientations are outlined. The basic premise of the paper is that the employers of doctoral graduates occupy (implicitly or explicitly) a limited set of market niches. No single doctoral program can meet the needs of all potential employers. Nor should the potential employer expect that all program types will produce graduates equally capable of meeting their needs.

Curriculum↗
PubMed1990

[Evaluation of FCR (Fuji Computed Radiography) images applied to standard radiography for the diagnosis of chest diseases].

FCR (Fuji Computed Radiography) was added to plain chest radiography in order to evaluate its image characteristics and to determine the best image characteristics and to determine the best image processing program by comparing the visibility of shadows on conventional X-rays and on six FCR hard copy images processed by six mutually different image processing program. FCR showed excellent ability to visualize abnormal lung shadows as well as normal chest structures when processed by a moderate spatial frequency enhancement (spatial frequency 0.11 cycle/mm, level of enhancement). FCR also proved superior to the conventional film-screen system in the visualization of hilar and mediastinal structure as well as lung shadows. The effects of the image processing program on the visibility of shadow, granular and linear shadows were clearly demonstrated when a more intense spatial frequency enhancement (spatial frequency 0.18 cycle/mm, level of enhancement) was performed. The same results were obtained in terms of reticular and linear shadows and calcified lesions. On the contrary, low density shadows with poorly defined margins the lung field and infiltrates from mycoplasma pneumonia were well depicted by a program with a slightly steeper gradation (gamma; 1.0) and minimal frequency enhancement. Accordingly, FCR was found to be useful for the screening of abnormal chest X-ray shadows whereas it was also likely to demonstrate the best image when processed by the most appropriate image processing programs, depending on the characteristics of the shadows.

Adult↗
PubMed2001

Satisfaction with services in innovative managed care programs for groups of traditionally underserved individuals with HIV/AIDS: empirical models.

As the number of people with HIV/AIDS receiving services in managed care models increases, concerns over quality of care and satisfaction with services have grown. This article examined data from three national demonstration projects that were funded to enroll traditionally underserved individuals and provide innovative medical services in programs developing models appropriate for managed care funding. Assessments of patient satisfaction were related to indicators of traditionally underserved status including demographic characteristics, behaviors, and other risk factors using the data modeling method of Exhaustive CHAID (Chi-squared Automatic Interaction Detector). Overall patient satisfaction levels with these programs were very high. Through the modeling methods, the groups most likely to experience the greatest program satisfaction are identified. In general, all groups were highly satisfied with the programs.

Adult↗
PubMed1957

Treatment of mental illness; the use and misuse of sedation and the seclusion room.

Nine hundred and thirty-nine patients admitted to the locked receiving ward in the psychiatric service of the U. S. Naval Hospital, Oakland, over a ten-month period, many of them psychotic and in an acute initial episode, were treated with an intensive group therapy program, which more appropriately should be called a therapeutic community. During this time, the ward medical officer did not put any patients in a seclusion room. Patients who did not require a locked ward were quickly transferred to the open receiving ward which was established five months after this program began. It was possible to greatly diminish the quantity of sleeping medicine prescribed and practically to eliminate the use of barbiturates given parenterally. Restraints were never used. To be dealt with in this atmosphere of candor and relative freedom seemed to evoke a responsive attitude in the patients and many of them benefited from it.

Barbiturates↗