Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Program Sustainability”

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 919 records · Page 51Linked to original sources
PubMed2001

One-year follow-up evaluation of the sexually transmitted diseases/human immunodeficiency virus intervention program in a marine corps sample.

Although a substantial number of studies have been conducted to evaluate the impact of various human immunodeficiency virus (HIV) prevention programs, most of them have focused on civilian populations. There is a clear need to develop and evaluate sexually transmitted diseases (STD)/HIV prevention programs designed specifically for U.S. military populations. The objective of the present study was to determine whether a behavioral intervention known as the STD/HIV Intervention Program (SHIP) would have a sustained positive impact on the behavior of a sample of Marines. A 1-year follow-up telephone interview was administered to (1) Marines who participated in the SHIP course (intervention group), and (2) a quasi-control group of Marines who were not exposed to the SHIP course. The intervention and control groups differed significantly in the percentage of the time they had used condoms during the past year. The intervention participants reported using condoms a greater percentage of the time than the nonparticipants.

Adult↗
PubMed1983

Identifying patients at risk of sudden death after myocardial infarction: value of the response to programmed stimulation, degree of ventricular ectopic activity and severity of left ventricular dysfunction.

The ability of programmed ventricular stimulation to identify risk of sudden death after acute myocardial infarction (MI) was compared with 24-hour electrocardiographic assessment of ventricular ectopic activity and determination of left ventricular (LV) dysfunction. Forty-six patients underwent programmed stimulation 8 to 60 days (mean 22) after documented MI. Programmed stimulation consisted of single and double extrastimuli from the right ventricular apex at 2 times diastolic threshold during ventricular pacing and normal sinus rhythm. Of the 46 patients, 44 underwent electrocardiographic monitoring at least 6 days after MI. In 43 of the 46 patients, LV ejection fraction (EF) and the presence of LV aneurysm were determined. In response to programmed ventricular stimulation, 5 patients had sustained ventricular tachycardia (VT), 5 had nonsustained VT (greater than or equal to 4 beats), 13 had intraventricular reentrant repetitive responses, and 23 had either bundle branch reentrant repetitive responses or no extra responses to programmed ventricular stimulation (negative study). During a mean follow-up of 18 months, 10 patients died, 6 suddenly. One of the 10 patients with sustained or nonsustained VT died suddenly, compared with 3 of 13 patients with intraventricular reentrant responses and 2 of 23 patients with a negative study (difference not significant). Of 25 patients with Grade 0 to 2 ventricular ectopic activity, 3 died suddenly after MI, compared with 3 of 19 patients with Grade 3 or 4 activity (difference not significant). By comparison, the frequency of sudden death was greater in patients with an LVEF of less than 40% (5 of 16 versus 1 of 27 patients) or an LV aneurysm (5 of 13 versus 1 of 30 patients).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2006

A review of the Northern Ecosystem Initiative in Arctic Canada: facilitating arctic ecosystem research through traditional and novel approaches.

The Canadian Arctic is undergoing considerable social and environmental change. Anthropogenic stressors on this sensitive environment include climate change, contaminants, resource extraction, tourism and increasing human populations. The Northern Ecosystem Initiative (NEI) is a program aimed at supporting the sustainability of northern communities, and at improving our understanding of how northern ecosystems respond to these environmental stressors. A key element of the NEI is to establish partnerships between all levels of government, non-governmental environmental agencies, and northern residents. The NEI is an important source of financial support critical for social and environmental scientists as well as northern residents and their community and regional organizations. Initiated in 1998, the NEI has supported numerous northern scientific and capacity-building projects, and has evaluated the information gained from this work to refine and focus its future support to address key information gaps and northern needs.

Arctic Regions↗
PubMed2003

If HIV prevention works, why are rates of high-risk sexual behavior increasing among MSM?

Systematic reviews of HIV prevention research provide clear evidence that behavioral interventions can influence the sexual behavior of men who have sex with men (MSM). However, if HIV prevention works, why are rates of high-risk sexual behavior increasing among MSM in major European, Australian, Canadian, and U.S. cities? The evidence generated by systematic reviews alone may not provide a clear answer to this question. This is because (a) it is uncertain whether experimental interventions shown to be effective in one setting, place, or moment in time can be repeated successfully in another; (b) we have limited understanding of the processes that underlie the interventions; (c) interventions shown to work in an experimental study may not necessarily be effective in everyday life. To answer the question, we need to be alert to the changing risk environment in which men have sex with other men. We also need to develop a new program of research addressing the transferability, sustainability, and effectiveness of sexual health promotion among MSM. Randomized controlled trials will remain one of the optimal means of evaluating behavioral interventions in such a program. By further strengthening the evidence base, we may identify opportunities for innovative as well as effective HIV prevention initiatives.

Controlled Clinical Trials as Topic↗
PubMed1995

Serum cholesterol and triglyceride levels in weight reduction program dropouts.

Dropouts of a weight reduction program are not evaluated for the lasting effects of weight reduction. This study was an attempt to learn about the benefits of weight reduction received and sustained by the dropouts of the program. Ninety-seven males and females dropping out of a dietary weight management program after 16-18 weeks of treatment, and after 9-9.4kg weight loss and wishing to rejoin the program for a second time after at least 9 months' absence from it, were considered for the study. Their body weight, serum cholesterol, serum triglyceride, and blood sugar levels at the beginning of the second attempt, were compared with the respective values at the beginning of the first attempt. All patients had regained the weight lost during their first attempt when they reported for a second attempt. However, serum cholesterol and triglyceride values were 15% and 26% less for females, and 17% and 24% less for males, compared to their respective values on the first attempt, in the subgroup of patients with normal blood sugar levels. In the subgroup with above normal blood sugar levels, however, serum cholesterol and triglyceride values showed an increase by 12% and 17% respectively, for females, and by 2% and 7% respectively, for males, compared to their baseline values on their first attempt. The mechanism responsible for this observation was not uncovered. However, the observation that even an incomplete attempt at weight reduction appears to contribute in maintaining lower levels of serum cholesterol and triglyceride of at least those with normal blood sugar levels, is useful in nutritional counseling for emphasizing the health benefits of the weight reduction.

Adult↗
PubMed2005

Predicting participation and outcomes in out-of-school activities: similarities and differences across social ecologies.

The majority of research on out-of-school-time activity participation has focused on its relation to academic and social development, presumed to be consequences of participation, rather than on antecedents or predictors of participation. Understanding who participates in these programs can assist program directors in improving and sustaining youth involvement. This chapter uses data from two research study samples to examine differences in children's activity participation based on family social ecology and child gender and how the relations between participation and outcomes vary based on sample, gender, and activity type. Although children in both samples were of roughly the same age and were assessed for similar outcomes, their family incomes, socioeconomic status, ethnicity, and neighborhoods were very different. Findings suggest that participation in activities varies depending on the young person's social ecology, age, and gender. Furthermore, participation in activities was typically associated with positive youth outcomes, but these relations varied depending on the level of youth participation, type of activity, and social ecology.

Adolescent↗
PubMed1986

[Late potentials, myocardial kinetics and ventricular vulnerability as markers of sudden death after myocardial infarct].

The 1st myocardial infarction requires the identification of patients who are at high risk of malignant ventricular arrhythmias. Our study group included 55 consecutive patients (age less than 70): all had non-invasive "signal averaging" recording and 24 hour dynamic electrocardiogram at the post-acute phase of their 1st myocardial infarction (MI) and 3 months later. Wall motion abnormalities were evaluated in each patient but two. 24 randomized patients (without documented sustained ventricular tachycardia) underwent right programmed ventricular stimulation at the 3rd month after MI and pathological repetitive responses were evaluated (Table III); they were hemodynamically stable and without persistent ischemia. Late potentials have been compared to spontaneous and induced ventricular arrhythmias, wall motion abnormalities (Table II) and two-year follow-up (Table VI), in order to identify predictive markers of sudden death or malignant arrhythmias. Ventricular late potentials were identified in 28 patients (51%) 4-8 days after MI: mean duration was equal to 75 +/- 33 msec; they did not show any relationship to the site (Table I) and to the extension of necrosis (Table II). Ventricular late potentials had no significant association with myocardial dyskinesia (Table II) while their association with complex ventricular arrhythmias, detected on Holter monitoring within 8 days after MI, and with the induction of repetitive ventricular responses (greater than or equal to 2 complexes) showed significant correlations (respectively p = 0.02; p = 0.01). In regard of the recognition of spontaneous ventricular tachycardia (greater than or equal to 3 complexes) in the follow-up, the detection of late potentials showed 75% sensibility with predictive value equal to 32% (Table V); the combination of late potentials and ventricular dyskinesia exhibited the highest specificity (88%) and predictive value (54%). By the end of follow-up there had been 6 cardiac deaths (2 sudden, 4 from left ventricular failure): late potentials longer than 75 msec were recorded in all patients who had cardiac death; in the post acute phase of MI repetitive ventricular arrhythmias were detected in only 1 of the 2 case of sudden cardiac death and in none of the patients who developed sustained ventricular tachycardia in the follow-up (Table VI). Myocardial dyskinesia was present in each patient who developed non sudden cardiac death (Table VI).(ABSTRACT TRUNCATED AT 400 WORDS)

Arrhythmias, Cardiac↗
PubMed1999

Patient contact is the major determinant in incident leprosy: implications for future control.

Notwithstanding the elimination efforts, leprosy control programs face the problem of many leprosy patients remaining undetected. Leprosy control focuses on early diagnosis through screening of household contacts, although this high-risk group generates only a small proportion of all incident cases. For the remaining incident cases, leprosy control programs have to rely on self-reporting of patients. We explored the extent to which other contact groups contribute to incident leprosy. We examined retrospectively incident leprosy over 25 years in a high-endemic village of 2283 inhabitants in Sulawesi, Indonesia, by systematically reviewing data obtained from the local program and actively gathering data through interviews and a house-to-house survey. We investigated the contact status in the past of every incident case. In addition to household contact, we distinguished neighbor and social contacts. Of the 101 incident cases over a 25-year period, 79 (78%) could be associated to contact with another leprosy patient. Twenty-eight (28%) of these 101 cases were identified as household contacts, 36 (36%) as neighbors, and the remaining 15 (15%) as social contacts. Three patients had not had a traceable previous contact with another leprosy patient, and no information could be gathered from 19 patients. The median span of time from the registration of the primary case to that of the secondary case was 3 years; 95% of the secondary cases were detected within 6 years after the primary case. The estimated risk for leprosy was about nine times higher in households of patients and four times higher in direct neighboring houses of patients compared to households that had had no such contact with patients. The highest risk of leprosy was associated with households of multibacillary patients. The risk of leprosy for households of paucibacillary patients was similar to the risk of leprosy for direct neighboring houses of multibacillary patients, indicating that both the type of leprosy of the primary case and the distance to the primary case are important contributing factors for the risk of leprosy. Contact with a leprosy patient is the major determinant in incident leprosy; the type of contact is not limited to household relationships but also includes neighbor and social relationships. This finding can be translated into a valuable and sustainable tool for leprosy control programs and elimination campaigns by focusing case detection and health promotion activities not only on household contacts but also on at least the neighbors of leprosy cases.

Contact Tracing↗
PubMed1999

[Value of transesophageal programmed atrial stimulation in the evaluation of unexplained cerebrovascular accidents].

Certain embolic cerebrovascular accidents can be explained by the development of paroxysmal atrial fibrillation. When noninvasive complementary investigations are negative, programmed atrial stimulation can be proposed to detect increased atrial vulnerability. The objective of this study was to evaluate the reliability of this method performed via a transoesophageal approach in 59 subjects presenting with an embolic cerebrovascular accident and who were in sinus rhythm at the time of the accident. Seven of these patients had a history of paroxysmal atrial fibrillation (AF) or atrial tachycardia (AT) (group I). Three of these seven patients also presented AV nodal reentrant junctional tachycardia. The other 52 patients had no history of arrhythmia and their Holter recording did not reveal any episodes of sustained atrial tachycardia (group II). Transoesophageal programmed atrial stimulation used up to 2 extrastimuli under baseline conditions and during Isuprel infusion. The following results were obtained: sustained atrial tachycardia (> 1 min) was induced in all patients of group 1, 3 of them also presented inducible junctional tachycardias. 14 patients of group II (27%) presented inducible supraventricular tachycardia: atrial tachycardia in 7 cases. Patients in group II with inducible AT presented either heart disease (n = 3) or minor abnormalities on the Holter recording (runs of atrial premature complexes or sinus pauses (n = 3). Two of these patients subsequently developed sustained atrial fibrillation during follow-up. In 25 patients with normal Holter recording and no heart disease, programmed atrial stimulation induced junctional tachycardia in 4 cases. In conclusion, transoesophageal electrophysiological investigation is a useful way to identify various forms of supraventricular tachycardia able to explain an embolic cerebrovascular accident. The considerable incidence of inducible AV nodal reentrant junctional tachycardia must be emphasized, while the incidence of atrial fibrillation is much lower than during intracardiac investigations.

Adult↗
PubMed1986

[Programmed electric stimulation following acute myocardial infarct. Significance of stimulation timing].

To assess the influence of time on the inducibility by programmed electrical stimulation of ventricular arrhythmias after acute myocardial infarction, we studied 18 patients on the 5th and 24th day after infarction with a stimulation protocol employing a maximum of 3 right ventricular extrastimuli during sinus rhythm and at 3 paced cycle lengths. All patients were without documented sustained ventricular arrhythmias (sustained ventricular tachycardia or ventricular fibrillation) prior to the investigation. Sustained ventricular arrhythmias were induced in 2 patients on day 5, but in 9 on day 24 after infarction. This difference in incidence was statistically significant (p less than 0.05), as was the change in the distribution ratio of induced sustained ventricular arrhythmias from day 5 to day 24 (p less than 0.05). The types of arrhythmia induced on day 24 were sustained ventricular tachycardia with a mean cycle length of 207 ms in 6 cases (5 monomorphic, 1 polymorphic), and ventricular fibrillation in 3 cases. These 9 patients did not differ from the remaining 9 patients in maximal CPK, infarct site, number of stenosed coronary arteries, global left ventricular ejection fraction, and in the results of 24-hour Holter monitoring, but they had a significantly shorter right ventricular effective refractory period (223 +/- 10 ms versus 259 +/- 28 ms; p less than 0.05). During the follow-up period of 24 +/- 5 months no patient died, had syncopal attacks, or developed spontaneous episodes of sustained ventricular arrhythmia. The timing of programmed electrical stimulation with a maximum of 3 right ventricular extrastimuli strongly influences the inducibility of sustained ventricular arrhythmias after acute myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Differential effects of isoproterenol on sustained ventricular tachycardia before and during procainamide and quinidine antiarrhythmic drug therapy.

BACKGROUND: Autonomic modulation, especially increased sympathetic activity may play a role in the genesis of ventricular arrhythmias. The purpose of this study was to determine whether beta-sympathetic stimulation with isoproterenol would alter sustained ventricular tachycardia (VT) circuits similarly during the drug-free and antiarrhythmic drug-treated states. METHODS AND RESULTS: Twenty-five patients with repeatedly inducible, hemodynamically stable, sustained VT were evaluated by programmed ventricular stimulation. In the antiarrhythmic drug-free state, isoproterenol (0.03 microgram/kg per minute) shortened the following intervals (in milliseconds; mean +/- SEM; 25 patients; paired t test): sinus cycle length (792 +/- 37 to 568 +/- 18; (p < 0.001), ventricular paced QT interval (386 +/- 8 to 348 +/- 6; p < 0.001), ventricular paced QRS duration (185 +/- 4 to 182 +/- 4; p = 0.014), ventricular effective (238 +/- 5 to 208 +/- 4; p < 0.001) and functional (261 +/- 6 to 227 +/- 5; p < 0.001) refractory periods, and the VT cycle length (VTCL) (311 +/- 9 to 291 +/- 9; p < 0.001). Isoproterenol (0.03 microgram/kg per minute) was administered during 31 antiarrhythmic drug trials (procainamide, n = 18; quinidine, n = 13) in 22 patients. Isoproterenol shortened the sinus cycle length, QT interval during ventricular pacing, and ventricular effective and functional refractory periods before and during procainamide and quinidine therapy (ANOVA; isoproterenol effect, p < or = 0.0002 for all). The amount of decrease in these intervals with isoproterenol was the same before and during procainamide and quinidine therapy (ANOVA interaction, p = NS for all). The QRS duration during ventricular pacing and VTCL were also shortened by isoproterenol before and during procainamide (baseline, n = 17; QRS, 182 +/- 4 to 178 +/- 4 msec; VTCL, n = 18, 314 +/- 11 to 291 +/- 11 msec; during procainamide, QRS, 218 +/- 7 to 197 +/- 6 msec; VTCL, 422 +/- 15 to 359 +/- 11 msec) and quinidine (baseline, n = 13; QRS, 190 +/- 6 to 185 +/- 5 msec; VTCL, n = 12, 298 +/- 10 to 280 +/- 9 msec; during quinidine, QRS, 223 +/- 9 to 208 +/- 8 msec; VTCL, 415 +/- 14 to 355 +/- 10 msec) (isoproterenol effect p < or = 0.0003 for all). However, the amount of decrease in QRS duration and VTCL with isoproterenol was greater during procainamide and quinidine than in the drug-free state (ANOVA interaction, p < or = 0.02 for all). These changes continued to be significant when normalized for the initial QRS duration and VTCL (p < or = 0.03 for all). CONCLUSIONS: Isoproterenol affects presumed reentrant sustained VT circuits less in the absence of antiarrhythmic drugs but markedly attenuates the antiarrhythmic drug-induced slowing of sustained VT. To the extent that the change in QRS duration reflects a change in conduction within the VT circuit, these data imply that the attenuation of drug-induced slowing of VT by isoproterenol is due to a greater change in conduction rather than refractoriness.

Adult↗
PubMed1996

Village-based diagnosis and treatment of malaria.

Village-based volunteer workers have played an important role in malaria diagnosis and treatment in many different settings for more than 35 years. Two of these programs stand out in terms of their size and longevity: the Volunteer Collaborator Network of Latin America and the Village Voluntary Malaria Collaborator Program of Thailand. The success of these programs is based on a tradition of active community participation and sustained commitment and support from the national malaria control programs. As epidemiological conditions and program priorities change, these programs will have to be sufficiently flexible to keep pace. Perhaps the greatest challenge facing these single disease, vertical programs in the future is their integration into the general health services in a manner that will preserve their best features.

Community Health Workers↗
PubMed2004

Challenges and opportunities for promoting physical activity in the workplace.

Although there would appear to be considerable potential for improving the health, productivity and quality of life of the Australian workforce through workplace physical activity (PA) promotion programs, the scientific evidence that such programs are effective is limited. This review appraises the quality of intervention studies conducted since 1997. Most studies included volunteer participants, who were either sufficiently motivated to change their behaviour or already active. Interventions that focused on corporate-fitness type programs and the provision of generic health education programs were not effective in terms of adequate participation rates and sustained behaviour change. The more successful individually-based programs were those which tailored materials to individual needs. The greatest potential for influencing the overall workforce appeared to be programs that included less 'organised' approaches and promoted incidental PA within and around the workplace. Future programs should; incorporate contemporary theories of behaviour and organisational change; emphasise linkages between the workplace and external settings; expand the profile of programs to address workplace culture; and encourage management support for behavioural adjustments to the organisation. There is a need for greater understanding and evaluation of desirable employer-related outcomes, such as reduced absenteeism, job stress and turnover and improved productivity and job satisfaction, coupled with the exploration of how these factors may relate to PA promotion and adoption. Finally, more in-depth evaluation strategies and complete descriptions of intervention programs are required, in order to identify the most effective strategies.

Exercise↗
PubMed2005

Making it better: building evaluation capacity in community mental health.

This paper describes a province-wide initiative aimed at building the capacity of community mental health programs to participate in program evaluation and development by transferring knowledge, promoting discussion and developing resources. Active involvement of stakeholders and evaluation of the current capacity of the field informed the ongoing development of the initiative. Recovery served as a guiding framework for formulating and understanding community mental health outcomes. Despite the interest of the field in evaluation activities, programs were constrained by limited resources and accountability structures. Sustainability of the project would be enhanced by direct work with programs to facilitate application of Continuous Improvement.

Canada↗
PubMed1997

Food systems for improved health: linking agricultural production and human nutrition.

OBJECTIVES: Link traditional agricultural production disciplines to the food sciences and the various disciplines concerned with human nutrition and health in order to find sustainable solutions to malnutrition. DESIGN: Develop a new integrated program area within a university by forging explicit linkages within a wide array of disciplines concerned with food systems and human health. SETTING: The College of Agriculture and Life Sciences, the College of Human Ecology, the Division of Nutrition, and the Cornell International Institute for Food, Agriculture, and Development at Cornell University, Ithaca, New York, USA. INTERVENTIONS: Use food-based, system approaches to meet human nutrition goals. Current focus is on the provision of micronutrients (especially iron, vitamin A and iodine) for people globally. RESULTS: A new program area 'Food Systems for Health' has been developed at Cornell University. The program fosters effective interdisciplinary research, teaching and extension activities directed towards sustainable improvements in human nutrition and health. CONCLUSIONS: The old paradigms of agriculture, human nutrition, and public health must be shifted from current linear approaches to integrated and interactive approaches if effective long-term, food-based solutions to micronutrient malnutrition are to be found.

Agriculture↗
PubMed1989

Evaluation of a camp program for siblings of children with cancer.

In recent years, specialized camping programs for chronically ill children, members of their family, or both have proliferated. Although these programs are popular, little systematic evaluation of risk-benefit has been undertaken. In a naturalistic study we evaluated the effect of a 5-day residential camping program to determine the effect of the program on the level of medical knowledge, on the perceptions of how the cancer experience affected the individual, and on the participant's mood state. Analysis of questionnaire data from 90 campers before and after their participation in the program revealed that desirable changes occurred in each of these areas and were sustained for at least 3 months after the program. Siblings reported by parents to have behavioral problems with onset since the diagnosis of the cancer seemed to benefit particularly from this type of program. No substantial negative effects were found regardless of the camper age, adaptational status, or previous camp experience.

Adolescent↗
PubMed1992

National Head and Spinal Cord Injury Prevention Program of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.

Organized neurosurgery has developed and promoted a national educational program for adolescents to reduce the number of head and spinal cord injuries sustained by this group of young people. The program has been adopted widely, with over 1,000,000 teenagers exposed to it since its inception in 1986. Preliminary data suggest that the program has had a favorable impact on the knowledge and attitudes of young people regarding head and spinal cord injuries, risk-taking behavior, and incidence of injuries.

Child↗
PubMed1984

Facilitation of ventricular tachyarrhythmia induction by isoproterenol.

Ventricular tachyarrhythmia induction was facilitated during infusion of isoproterenol in 21 of 60 patients with ventricular tachycardia (VT) or ventricular fibrillation (VF) in whom programmed electrical stimulation alone failed to reproducibly induce sustained ventricular tachyarrhythmias. Of 44 patients with no ventricular tachyarrhythmias induced before isoproterenol infusion, 11 had a sustained ventricular tachyarrhythmia and 1 patient had unsustained VT induced by isoproterenol alone or by programmed stimulation during the infusion. In 9 of 16 patients in whom nonreproducible or unsustained ventricular tachyarrhythmias were induced before isoproterenol infusion, more reproducible or more sustained ventricular tachyarrhythmias were induced during the infusion. Tachyarrhythmia induction was facilitated by isoproterenol in 20 of 40 patients with sustained VT clinically, but in only 1 of 20 patients with unsustained VT or VF clinically. Among patients with sustained VT clinically, those with exercise-provoked VT and those who had not been tested with stimulation at a second right ventricular site or in the left ventricle were more likely to have induction facilitated by isoproterenol. Drugs effective against induction of isoproterenol-facilitated ventricular tachyarrhythmias were identified in 13 of 25 trials. These drugs were effective during a mean follow-up of 17 months in 7 of 9 long-term trials.

Anti-Arrhythmia Agents↗