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At least 919 records · Page 51Linked to original sources
PubMed2002

An integrated child nutrition intervention improved growth of younger, more malnourished children in northern Viet Nam.

Integrated nutrition programs are widely used to prevent and/or reverse childhood malnutrition, but rarely rigorously evaluated. The impact of such a program on the physical growth of young rural Vietnamese children was measured. We randomized six communes to receive an integrated nutrition program implemented by Save the Children. We matched six communes to serve as controls. Our sample consisted of 238 children (n = 119 per group) who were 5 to 25 months old on entry. Between December 1999 and December 2000, we measured weight and height monthly for seven months and again at month 12. Principle outcomes were weight-for-age Z score (WAZ), height-for-age Z score (HAZ), and weight-for-height Z score (WHZ), and the changes among these measures. As expected, anthropometric indicators relative to international references worsened as the children aged. Overall, children in the intervention communes who were exposed to the integrated nutrition program did not show statistically significant better growth than comparison children. Intervention children who were younger (15 months or less) and more malnourished (less than-2 Z) at baseline, however, deteriorated significantly less than their comparable counterparts. Between baseline and month four, for example, intervention children who were malnourished and less than 15 months old at entry lost on average 0.05 WAZ while similar comparison children lost 0.25 WAZ (p = .02). Lack of overall impact on growth may be due to a lower than expected prevalence of malnutrition at baseline and/or deworming of comparison children. Targeting nutrition interventions at very young children will have the maximum impact on growth.

Age Factors↗
PubMed1993

[Early severe malnutrition and psychomotor development. Effects of a rehabilitation program].

This study evaluates the psychomotor development of 228 undernourished infants submitted to an integral rehabilitation program in Nutritional Recovery Centers. At admission these children present a moderate retardation of their developmental quotient: mean 0.59 +/- 0.17, improving significantly to mean 0.79 +/- 0.4 (p < 0.001) after an average period of 178.2 +/- 63.9 days of intervention. As regards areas of development, rehabilitation only demonstrates a significant change in coordination and language, not so in the social and motor areas. Those children presenting the most severe developmental delays are also those who obtain the greater benefits from this integral rehabilitation program.

Developmental Disabilities↗
PubMed1996

Informatics integration in a medical residency program: early experiences.

In 1992, Informatics training was integrated into the medical residency program at Norwalk Hospital. The program objective was to familiarize the residents with clinical applications of information technology that could enhance their productivity in clinical practice. In its first year, the curriculum was theory oriented. Evaluation of the program at the end of the first year led to a significant restructuring of the program format and curriculum. The trainees did not find theory to be of immediate clinical value, in the second year the program emphasis was redirected toward the development of practical skills. Next year, in 1993, 'Informatics Clinics' were initiated to develop practical Informatics skills that would be useful in a clinical setting. This approach was more successful but did not offer a complete solution. The degree to which the concepts and methods learned are clinically utilized by residents will depend upon the degree of reinforcement provided in the clinical residency years. In addition, there is a need for the development of assessment standards for the evaluation of Informatics literacy levels. In the absence of assessment standards the level of Informatics literacy in medical graduates remains undetermined Consequently, it is difficult to determine whether the training received has transformed expectations into reality.

Connecticut↗
PubMed1998

Planning an integrated population-based program.

Social, economic, and political pressures demand that hospitals focus on ways to provide cost-effective, population-based care. As a member of the hospital executive staff, nurse administrators need to have a method for analyzing, planning, implementing, and evaluating prospective programs and be able to articulate their potential and relative worth in terms of cost, quality, and value. The author presents a template model for integrated population-based program planning. Children's Home-Based Asthma Management and Prevention Service (CHAMPS) is presented to illustrate application of the model.

Adolescent↗
PubMed2006

Promotion of service integration among home visiting programs and community coalitions working with low-income, pregnant, and parenting women.

This study assessed service integration promoted by home visitors and community coalitions in Baltimore's Comprehensive Family Support Strategy. The study first assessed home visitors' coordination of services for their clients. Two yearly home visitors surveys (n = 32) assessed changes in their perceptions of 11 community resources' availability, service quality, and referrals made to those resources. There were statistically significant increases in the percentage of home visitors who (a) reported availability of seven resources, (b) gave high service quality ratings for six resources, and (c) referred clients to all 11 resources. The study also assessed six community coalitions' actions to promote service integration during 1 year through observation of coalition meetings. Coalitions discussing more service integration exhibited greater increases in home visitors' perceptions of high service quality and referrals. Home visiting practitioners should consider including coalitions as part of their program models in order to better link clients to appropriate community resources.

Adult↗
PubMed1993

Customer satisfaction planning and industrial engineering move hospital towards in-house stockless program.

By integrating customer satisfaction planning and industrial engineering techniques when examining internal costs and efficiencies, materiel managers are able to better realize what concepts will best meet their customers' needs. Defining your customer(s), applying industrial engineering techniques, completing work sampling studies, itemizing recommendations and benefits to each alternative, performing feasibility and cost-analysis matrixes and utilizing resources through productivity monitoring will get you on the right path toward selecting concepts to use. This article reviews the above procedures as they applied to one hospital's decision-making process to determine whether to incorporate a stockless inventory program. Through an analysis of customer demand, the hospital realized that stockless was the way to go, but not by outsourcing the function--the hospital incorporated an in-house stockless inventory program.

Consumer Behavior↗
PubMed2006

Twelve-year blood pressure dynamics in adults in Ljubljana area, Slovenia: contribution of WHO Countrywide Integrated Noncommunicable Diseases Intervention Program.

AIM: To determine 12-year dynamics of the average value of arterial blood pressure and arterial hypertension prevalence among adult residents of Ljubljana area in Slovenia, and to assess the probable contribution of World Health Organization's Countrywide Integrated Noncommunicable Diseases Intervention Program (CINDI) to observed dynamics. METHODS: A total of 4409 adults aged 25-64 participated in three successive cross-sectional surveys performed in Ljubljana area from late autumn to early spring 1990/1991, 1996/1997, and 2002/2003 (n(1990/91)=1692, n(1996/97)=1342, n(1990/91)=1375). Standardized measurements of systolic and diastolic blood pressure were performed. The subjects were considered to have hypertension if systolic/diastolic blood pressure was > or =140/90 mm Hg. The dynamics of average values of systolic and diastolic blood pressures and arterial hypertension was statistically assessed with multiple linear or logistic regression. RESULTS: After the adjustment for the effects of sex, age, and education, the average value of systolic blood pressure remained almost the same between 1990/1991 and 1996/1997 (130.6+/-20.3 and 130.6+/-19.6 mm Hg, respectively; P=0.728), whereas it significantly decreased to 127.6+/-17.8 mm Hg in 2002/2003 (P<0.001). The average value of diastolic blood pressure was not significantly different in 1990/1991, 1996/1997, and 2002/2003 (83.4+/-11.6 mm Hg, 84.1+/-11.4 mm Hg, and 83.5+/-11.2 mm Hg, respectively; P=0.059). The odds ratio for arterial hypertension increased significantly between 1990/1991 and 1996/1997 (P=0.001), but decreased between 1996/1997 and 2002/2003 (P=0.135). CONCLUSIONS: The values of blood pressure remained unchanged or increased during the first half of 12-year period, but decreased during the second half. The favorable decrease in average blood pressure could be attributed to systematic intervention promoted by CINDI program activities in Slovenia, which started in the late 1990s.

Adult↗
PubMed1994

Cholesterol intervention in the workplace: successful integration with other risk reduction programs.

1. Despite substantial progress in reducing cardiovascular disease in the United States, 52 million Americans with elevated cholesterol still require dietary intervention and another 12.7 million may require drug intervention. 2. Only one third of the population who need lipid management receive it; 40% of people who have seen a physician in the past 2 years have never been screened for cholesterol. Therefore, screening at the worksite may provide an opportunity for cholesterol awareness and follow up evaluation. 3. It is important to understand the different behavioral models which help motivate individuals to make lifestyle changes. Generally, a combination of these models can be used successfully at the worksite in promoting health behavior changes. 4. Because the employer benefits from health promotion programs, it should be an integral part of the occupational health nurse's role. The most successful programs offer information about making lifestyle changes and provide individual and group support.

Health Promotion↗
PubMedDate not supplied

[Curricular integration in nursing undergraduate programs].

This paper discusses a few lessons drawn from the curricular reform process, in which integration is a major challenge. The main transformations and problems arising from the concept of an integrated education system are approached. We have noticed that coping with daily problems, recognizing the existing diversity among individuals and power sharing are the main challenges to be conquered for the adoption of an integrated curriculum.

Brazil↗
PubMed2002

Integrating quantitative and qualitative methods to assess the impact of child survival programs in developing countries: the case of a program evaluation in Ceara, Northeast Brazil.

In evaluating public health programs, the tradition has been to design quantitative approaches, relying on epidemiological and statistical techniques to determine if and to what extent a program has an effect on a predetermined targeted population. More recently, however, qualitative methods such as rapid ethnographic assessments and focus groups have been implemented more frequently. This article describes an outcome evaluation of a community health workers program that integrated quantitative and qualitative methods to assess the impact of child survival interventions in reducing infant mortality and inadequate weight gain in children among municipalities in the state of Ceara, Northeast Brazil. By using multiple methods that combine quantitative and qualitative components, researchers can broaden their understanding of complex public health issues and direct use of data for decision making.

Adult↗
PubMed2006

Sensors and signals: a coactivator/corepressor/epigenetic code for integrating signal-dependent programs of transcriptional response.

A decade of intensive investigation of coactivators and corepressors required for regulated actions of DNA-binding transcription factors has revealed a network of sequentially exchanged cofactor complexes that execute a series of enzymatic modifications required for regulated gene expression. These coregulator complexes possess "sensing" activities required for interpretation of multiple signaling pathways. In this review, we examine recent progress in understanding the functional consequences of "molecular sensor" and "molecular adaptor" actions of corepressor/coactivator complexes in integrating signal-dependent programs of transcriptional responses at the molecular level. This strategy imposes a temporal order for modifying programs of transcriptional regulation in response to the cellular milieu, which is used to mediate developmental/homeostatic and pathological events.

Allosteric Regulation↗
PubMed1997

Treating prison inmates with co-occurring disorders: an integrative review of existing programs.

The tremendous growth in state and federal correctional populations has focused greater attention on the needs of mentally ill and substance abusing inmates. Although an estimated 3-11% of prison inmates have co-occurring mental health (psychotic and major mood) disorders and substance abuse disorders, few treatment programs are described in the literature and there is little available information regarding effective treatment strategies for this population. The current study provides an integrative review of seven 'dual diagnosis' treatment programs that recently have been developed in state and federal prisons. Many of these have evolved from existing substance abuse treatment programs and approaches. Key program components include an extended assessment period, orientation/motivational activities, psychoeducational groups, cognitive-behavioral interventions such as restructuring of 'criminal thinking errors', self-help groups, medication monitoring, relapse prevention, and transition into institution or community-based aftercare facilities. Many programs use therapeutic community approaches that are modified to provide (a) greater individual counseling and support, (b) less confrontation, (c) smaller staff caseloads, and (d) cross-training of staff. Research is underway in three of the seven sites to examine the effectiveness of these new programs.

Adult↗
PubMed2006

U.S. Department of Energy policies, directives, and guidance for radiological control and release of property.

U.S. Department of Energy (U.S. DOE) regulates its operations with a system of rules, directives, and guidance under the Atomic Energy Act. U.S. DOE's policy is to conduct its radiological operations in a manner that ensures the health and safety of its employees, contractors, and the public. U.S. DOE uses an annual dose limit of 100 mrem (1 mSv) with an "as low as reasonably achievable" (ALARA) process to achieve radiological protection. The primary directive for radiation protection of the public and the environment is DOE Order 5400.5. It contains requirements for the protection of the public and the environment from routine operations, including controlling and releasing property. Since the publication of Order 5400.5 in 1990, U.S. DOE has issued guidance for meeting requirements under it; Guide G 441.1-xx consolidates this guidance. DOE applies a dose constraint of 25 mrem y (0.25 mSy y(-1)), plus ALARA, for the release of real property, and 1 mrem y(-1), plus ALARA, for release of personal property. Models and guidance to develop the needed documentation for release of property are easily available and user-friendly. While achieving protection of human health and the environment, U.S. DOE's dose-based release process has resulted in significant cost savings. U.S. DOE has recently adopted a management systems approach for general environmental and public protection programs. The integration of the radiation protection program into this new approach is a high priority.

Decision Making↗
PubMed2005

Legislating "sound science": the role of the tobacco industry.

In the late 1990s, in an effort to dispute the link between secondhand smoke and lung cancer, Philip Morris initiated a campaign to legislate "sound science." The campaign involved enacting data access and data quality laws to obtain previously confidential research data in order to re-analyze it based on industry-generated data quality standards. Philip Morris worked with other corporate interests to form coalitions and work-groups, develop a "data integrity" outreach program, sponsor symposia on "research integrity," and draft language for the new acts. The tobacco industry played a role in establishing laws that increase corporate influence on public health and regulatory policy decisions.

Expert Testimony↗
PubMed2004

Undernutrition as an underlying cause of malaria morbidity and mortality in children less than five years old.

Undernutrition is highly prevalent in many areas in which morbidity and mortality from malaria is unacceptably high. That undernutrition exacerbates diarrhea and respiratory infections is widely demonstrated; however, research suggests that it may exacerbate, palliate, or have little effect on malaria outcomes. This review examines the global burden of malaria associated with various nutrient deficiencies as well as underweight status in children 0-4 years of age. Although the association is complex and requires additional research, improved nutritional status lessens the severity of malaria episodes and results in fewer deaths due to malaria. Deficiencies in vitamin A, zinc, iron, folate, as well as other micronutrients are responsible for a substantial proportion of malaria morbidity and mortality. It is recommended that nutrition programs be integrated into existing malaria intervention programs.

Anemia, Iron-Deficiency↗
PubMed1979

Independent living programs: the role of the able-bodied professional.

The Independent Living Program movement was created by the disabled community. It has established a broad coalition of diverse disabilities functioning to provide services on a broader scale than has been traditionally offered by the rehabilitation community. The effectiveness and the strength of the movement lies in consumer control. The able-bodied professional can provide expertise, balance and a vital link with established rehabilitation programs. The integrity of the independent living program movement can only be maintained and developed if these basic concepts are respected.

Humans↗