Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Integrated Programs”

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 937 records · Page 52Linked to original sources
PubMed1981

Night ventilation by body respirators for patients in chronic respiratory failure due to late stage Duchenne muscular dystrophy.

A program of respiratory muscle sparing in 9 patients with late stage Duchenne muscular dystrophy is presented. Results indicate that regular efficient night-time support by body respirator provides a constant significant improvement in daytime gas exchange for periods averaging up to 2 years following the occurrence of moderately severe respiratory failure. Until now, the longest survival is more than 4 years at the age of 28. the average PaCO2 and PaO2 before night ventilation were 60.8mmHg and 59.3mmHg, respectively. The levels after the program was begun were 45.5 (PaCO2) and 74.6 (PaO2). These arterial blood gas levels are acceptable for good cardiopulmonary homeostasis. There have been no deaths or episodes of cardiac failure since the program began. The ease of integrating the program into the patient's lifestyle and home are important advantages. Cost of equipment is discussed. The view that these patients are terminal must be qualified. A case is also made for early aggressive conservative measures including body respirators, postural drainage, chest physiotherapy with abdominal assisted coughing, intratracheal suctioning and bronchoscopy to combat respiratory infection, and decreasing the need of tracheostomy and volume ventilators which can be so disabling to the chronic restrictive lung disease (CRLD) patient. Research and development into better design of body respirators is vitally needed. Acute care hospitals must prepare themselves for such patients who now attain more independent living and longer lifespan. For this reason there is a growing need for these facilities to acquire tank ventilators for handling such patients who may need hospitalization for acute medical complications.

Adolescent↗
PubMed1995

Interdisciplinary and intersectoral approach: a challenge for integrated care.

Integrated care for health disorders, particularly chronic diseases, is a long-term and complex challenge, particularly because of the involvement of many individuals with different beliefs, attitudes, assumptions and reward structures. Two basic conceptual models of disease--the biomedical and psychosocial--underlie many of these differences. The biomedical model views humans as the sum of multiple individual 'subsystems,' and disease represents dysfunction of one or more of these subsystems. This model is 'reductionist' and 'individualistic' in nature in that if 'THE' defective subsystem can be identified, studied and improved, it is assumed that health would return. The biomedical model focuses primarily on the individual with ill-health and has added greatly to our basic understanding of disease processes. The psychosocial model is 'interactive' and dynamic, and sees the 'whole' as more than the sum of its parts. This model values elements outside of the individual, e.g. work and home environment, as important in maintaining or establishing health. Because of fundamental differences between these 2 models of health and disease, conflicts, e.g. efficacy vs. exposure; role of individual vs. environment; etc., may exist among varying professionals regarding the nature, purpose, targets, structure, and consequences of integrated care programs. These fundamental conflicts, if unrecognized and ignored, can significantly attenuate the benefits of well-intentioned prevention and treatment integrated care programs.

Chronic Disease↗
PubMed2003

Developing an integrated baccalaureate nursing education program infusing complementary/alternative therapies into critical care curricula.

Education of students within the holistic perspective of nursing should take place in an integrated curriculum that deliberately includes complementary and alternative therapies (CAT) content. A curricular model from the University of Minnesota School of Nursing outlining core CAT competencies and nursing-specific subcompetencies are presented as one planned method for integrating CAT content throughout a nursing curriculum, including an undergraduate critical care course. Suggestions for managing common patient symptoms in the critical care setting with selected CAT interventions and the importance of safely and effectively incorporating CAT into one's practice, including appropriate patient referral, are outlined. The significance of novice nurses learning life-long self-care practices as part of the curriculum is addressed.

Clinical Competence↗
PubMed1999

Visualisation and integration of G protein-coupled receptor related information help the modelling: description and applications of the Viseur program.

G Protein-Coupled Receptors (GPCRs) constitute a superfamily of receptors that forms an important therapeutic target. The number of known GPCR sequences and related information increases rapidly. For these reasons, we are developing the Viseur program to integrate the available information related to GPCRs. The Viseur program allows one to interactively visualise and/or modify the sequences, transmembrane areas, alignments, models and results of mutagenesis experiments in an integrated environment. This integration increases the ease of modelling GPCRs: visualisation and manipulation improvements enable easier databank interrogation and interpretation. Unique program features include: (i) automatic construction of 'Snake-like' diagrams or hyperlinked GPCR molecular models to HTML or VRML and (ii) automatic access to a mutagenesis data server through the Internet. The novel algorithms or methods involved are presented, followed by the overall complementary features of the program. Finally, we present two applications of the program: (i) an automatic construction of GPCR snake-like diagrams for the GPCRDB WWW server, and (ii) a preparation of the modelling of the 5HT receptor subtypes. The interest of the direct access to mutagenesis results through an alignment and a molecular model are discussed. The Viseur program, which runs on SGI workstations, is freely available and can be used for preparing the modelling of integral membrane proteins or as an alignment editor tool.

Algorithms↗
PubMed1996

Worker participation in an integrated health promotion/health protection program: results from the WellWorks project.

According to prior reports, blue-collar workers are less likely to participate in worksite health promotion programs than are white-collar workers. This study examined worker participation in the WellWorks worksite cancer prevention intervention, which integrated health promotion and health protection. Analyses were conducted to assess relationships among participation in health promotion and health protection programs, and workers' perceptions of management changes to reduce potential occupational exposures. Results indicate that blue-collar workers were less likely to report participating in health promotion activities than white-collar workers. A significant association was observed between participation in nutrition- and exposure-related activities, suggesting that participation in programs to reduce exposures to occupational hazards might contribute to blue-collar workers' participation in health promotion activities. Furthermore, when workers were aware of changes their employer had made to reduce exposures to occupational hazards, they were more likely to participate in both smoking control and nutrition activities, even when controlling for job category. These findings have clear implications for future worksite cancer prevention efforts.

Adult↗
PubMed1993

Diffusion of a school-based substance abuse prevention program: predictors of program implementation.

BACKGROUND: The present study addresses diffusion of a psychosocial-based substance abuse prevention program, including: (a) teacher adoption, implementation, and maintenance; (b) teacher characteristics associated with implementation; (c) the relationship between integrity of program delivery and program outcomes; and (d) the effectiveness of teacher training and school principal involvement in increasing implementation. METHODS: Participants were teachers (n = 60), school principals (n = 25), and fifth-grade students (n = 1147) from four Los Angeles area school districts. Districts were randomly assigned to an intensive or brief teacher training condition. Schools were randomly assigned to a principal-intervention or a no-principal-intervention condition. Assessments included teacher and principal self-reports, classroom observations of program delivery, and evaluation of immediate program outcomes. RESULTS: During the first year, 78% of trained teachers implemented one or more program lessons. During the second year, only 25% maintained implementation of the program. Implementors reported fewer years of teaching experience and stronger self-efficacy, enthusiasm, preparedness, teaching methods compatibility, and principal encouragement than did nonimplementors. The principal intervention increased rates of implementation, but the intensive teacher training did not. Integrity of program delivery was positively associated with immediate program outcomes. CONCLUSIONS: Program implementation was highly variable, suggesting that widespread teacher use of psychosocial-based programs cannot be taken for granted. Strategies for increasing implementation and maintenance need to be developed.

Alcoholism↗
PubMed2004

The availability of psychiatric programs in private substance abuse treatment centers, 1995 to 2001.

OBJECTIVE: The high rate of co-occurrence of substance abuse and mental disorders renders the availability of psychiatric programs, or integrated service delivery, a vital quality-of-care issue for substance abuse clients. This article describes the availability of psychiatric programs and integrated care for clients with severe mental illness in the private substance abuse treatment sector and examines these patterns of service delivery by profit status and hospital status. METHOD: S: Survey data from the National Treatment Center Study, which is based on a nationally representative sample of privately funded substance abuse treatment centers, were used to identify the proportion of centers that offered psychiatric programs in 1995-1996, 1997-1998, and 2000-2001. Centers reported whether they treated clients with severe mental illness on-site or referred them to external providers. Repeated-measures general linear models were used to test for significant changes over time and to assess mean differences in service availability by profit status and hospital status. RESULTS: About 59 percent of private centers offered a psychiatric program, and this proportion did not significantly change over time. The proportion of centers that referred clients with severe mental illness to external providers increased significantly from 57 percent to 67 percent. For-profit centers and hospital-based centers were significantly more likely to offer psychiatric programs and were less likely to refer severe cases to other providers. CONCLUSION: S: Although the importance of integrated care for clients with dual diagnoses is widely accepted, data from the private substance abuse treatment sector suggest that this pattern of service delivery is becoming less available.

Health Facilities, Proprietary↗
PubMed2006

An economic comparison of risperidone and olanzapine use within an integrated managed mental health program.

This study assessed differences in total mental health care costs for 1 year following initiation of risperidone or olanzapine in individuals within NorthSTAR, an integrated managed mental health pilot project. A retrospective database analysis of individuals with schizophrenia or schizoaffective disorder and newly started on either agent was conducted. Antipsychotic medication costs were significantly lower for individuals prescribed risperidone than olanzapine (1763 dollars versus 2582 dollars; p<0.001). Individuals prescribed risperidone had lower (but not significant) expenditures for mental health services (4714 dollars versus 5077 dollars; p=0.792), as well as total mental health care costs (7407 dollars versus 9011 dollars; p=0.255).

Antipsychotic Agents↗
PubMed1987

Personal computers: Rx for improving productivity.

The purpose of this article is to guide the computer-shy hospital pharmacy manager through the various choices concerning personal computer technology. The author discusses available computer programs that are easy to learn and can help pharmacists manage time and resources more efficiently. The Tandy 1000SX computer with the Deskmate integrated software program has been selected as one system that contains all basic computer systems. It is inexpensive and requires minimal learning time. Mastery of the computer and an integrated software program can facilitate improved productivity for interested pharmacists.

Computers↗
PubMed1986

The development of a freestanding adolescent partial-hospitalization program in a multimodal integrated-service system for high-risk youth.

At Three Rivers Youth in Pittsburgh, a freestanding adolescent partial-hospitalization program is a primary force in a multimodal integrated-treatment system for high-risk youth. Three barriers encountered in the development of the program (utilization, integration with other components, and staffing) are discussed and strategies successful in overcoming these barriers are presented. Features of the program which are believed to contribute to its success are outlined, including scheduling, clinical structures, educational services, case management, and staffing. Case illustrations from clinical practice in the program are also offered.

Adolescent↗
PubMedDate not supplied

Integrating health services into an MCH-FP program: lessons from Matlab, Bangladesh.

Since 1977 the International Centre for Diarrhoeal Disease Research, Bangladesh, has conducted a field experiment in family planning and MCH in its Matlab research station. The project began with an emphasis on family planning and MCH services were added in stages. This paper uses time series regression methods to address the question of whether the addition of health services contributed to family planning efficacy in Matlab in a program launched with minimal MCH services. The results show that some MCH interventions increased contraceptive prevalence, some decreased it, and others had no effect. The broader significance of these findings for implementing integrated programs is discussed.

Bangladesh↗
PubMed2000

Integrating a domestic violence education program into a medical school curriculum: challenges and strategies.

BACKGROUND: Domestic violence affects millions of women in the United States each year. Physicians are in a unique position to screen for violence in their patients' homes and refer individuals before they are injured or killed. All U.S. medical schools are expected to incorporate partner violence into their curricula. DESCRIPTION: The MCP Hahnemann School of Medicine has developed and integrated a domestic violence educational intervention program into the existing problem-based medical school curriculum. This educational intervention includes modification of an existing teaching case to include signs and symptoms specific to domestic violence, written learning objectives on domestic violence in the health care setting, relevant resource material, and a 3-hr training program conducted by an interdisciplinary teaching team. EVALUATION: Based on quantitative and qualitative data over a 3-year period, this domestic violence education program has been successfully integrated into an existing problem-based curriculum. Overall, the high student exam scores indicate the effectiveness of the teaching program. In addition, the students' evaluation of the program reflects a high level of student satisfaction with the curriculum presented on domestic violence. CONCLUSION: This article describes both the content of a domestic violence teaching program and the process used to integrate such a program into a medical school curriculum. Although medical schools and their teaching programs are uniquely structured, with slight modifications they are able to accommodate domestic violence teaching programs.

Curriculum↗
PubMed1986

A prospective short-term study of chronic low back pain patients utilizing novel objective functional measurement.

The present study utilized recently developed diagnostic tests that permit recognition of functional deficits in spine mobility, trunk strength, endurance, coordination, and dynamic lifting capacity. Changes in these tests were compared to changes in psychological functioning (e.g., self-report of pain) as well as to outcome criteria such as return-to-work and resolution of litigation. The study utilized these tests repeatedly during a new treatment approach to feed back objective information of the patient's functional capacity, not amenable to simple visual inspection, to both the patient and the surgeon. The program itself integrated a low back physical rehabilitation program with a multimodal pain management program and was guided by repeated functional capacity measurements. A total of 66 patients were evaluated. Results demonstrated significant improvement in physical function in these patients, which was also accompanied by changes in self-report of pain complaints. Moreover, an 82% return-to-work rate was achieved in this sample which was initially 92% unemployed. These results indicate that the physician dealing with chronic low back dysfunction can employ objective measures of functional capacity as an alternative to the sole reliance on pain patient self-report or structured tests, such as radiographic imaging, which merely document a universal, progressive degenerative process.

Adult↗
PubMed2006

Evaluation of efficacy expectations for novel and non-chemical helminth control strategies in ruminants.

The interest in novel methods of controlling helminth infections in ruminants is driven primarily by the development of parasite resistance to currently available anthelmintics. While the purpose of anthelmintics is to achieve high efficacy, i.e. >90% reduction of adult and/or larval parasites in the target host animal, the purpose of novel parasite control methods is rather to assist in maintaining parasite infections below the economic threshold. The ability to maintain parasite levels below the economic threshold is related not only to the efficacy of the control method, but also to the epidemiology of the parasites, climatic conditions, the livestock management program, and integration in a sustainable parasite control program. Because of this fundamental difference, novel parasite control methods need to be evaluated using efficacy criteria different from that adopted for anthelmintics. Although the efficacy of novel parasite control methods may be demonstrated in classic dose-confirmation studies, the impact on livestock production parameters can only be evaluated when tested on-farm. In this paper, the rationale for evaluating novel methods differently from anthelmintics is reviewed, potential performance expectations are presented, and four novel parasite control methods (vaccines, nematophagous fungi, condensed tannins, and immunonutrition) are assessed based on the potential performance criteria.

Animal Husbandry↗
PubMed2001

Short-term changes of cardiovascular risk factors after a non-pharmacological body weight reduction program.

OBJECTIVE: To test the short-term effectiveness of a 3 week hospital-based body weight reduction (BWR) program on selected coronary heart disease (CHD) risk factors in obese subjects. DESIGN: Intervention study to assess the modifications in CHD risk factor scores estimated according to Framingham risk factor categories (age, total cholesterol, high density lipoprotein (HDL) cholesterol, blood pressure, diabetes and smoking). SETTING: 3rd Division of Metabolic Diseases, Italian Institute for Auxology, Piancavallo (VB), Italy. SUBJECTS: Two-hundred and sixty-eight obese patients (43 men, 225 women, age range 19-81 y; body mass index (BMI) range 30-67). INTERVENTION: The BWR program consisted of a 3 week integrated energy-restricted diet (1200-1800 kcal/day), associated with moderate aerobic exercise, psychological counselling and educational lectures. RESULTS: Substantial reductions of total cholesterol (16.7%), HDL cholesterol (14.8%), systolic (11.2%) and diastolic blood pressure (8.7%) were observed at the end of the intervention, even with relatively moderate decrease in weight (4.1%) and in persistence of elevated BMI (over 40 kg/m2). The mean CHD Framingham score decreased by 16.1%, from 7.8 to 6.2. The BWR-induced changes were similar in both sexes, and across strata of age and BMI. CONCLUSIONS: The full-time participation of the patients in the hospital-based, integrated BWR program may explain the positive clinical outcome in all the subgroups considered, although the long-term results need to be quantified. SPONSORSHIPS: Partially supported by Progetti di Ricerca Corrente, Istituto Auxologico Italiano, IRCCS, Milan, Italy.

Adult↗