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At least 955 records · Page 53Linked to original sources
PubMed1999

Computer-aided craniofacial surgical planning implemented in CAD software.

Accurate presurgical planning is imperative for successful cranial surgery. This article introduces a simulation program developed in a computer-aided design environment. The neurocranium is introduced as a mathematical surface, since this is the part on which the actual operation will be performed. The viscerocranium, which serves as reference, is visualized using small triangular surfaces. The development of the program commenced with a classification of the different surgical techniques mentioned in the literature into six basic actions. The use of mathematically described surfaces has the advantage that the program can simulate actions which change the shape of a surface and perform an on-line estimation of the fracture risk during bending. Three-point bending tests were carried out to provide the necessary data to perform the mathematical check, as these data are not available in the literature. A database with reference distances was introduced to guide the surgeon to obtain the best possible results. During one clinical trial, the computer was taken into the operating room so that the surgical plan developed with the simulation program could be applied to the actual operation.

Brain↗
PubMed1999

Strategies in disability management. Corporate disability management programs implemented at the work site.

Managers are challenged to demonstrate all programs as economically essential to the business, generating an appreciable return on investment. Further challenge exists to blend and integrate clinical and business objectives in program development. Disability management programs must be viewed as economically essential to the financial success of the business to assure management support for clinical interventions and return-to-work strategies essential for a successful program. This paper discusses a disability management program integrating clinical and business goals and objectives in return-to-work strategies to effect positive clinical, social-cultural, and business results. Clinical, educational, social, and economic challenges in the development, implementation, and continued management of a disability program at a large corporation with multiple global work sites are defined. Continued discussion addresses the effective clinical interventions and educational strategies utilized successfully within the workplace environment in response to each defined challenge. A multiple disciplinary team approach, clinical and business outcome measures, and quality assurance indicators are discussed as major program components. This article discusses a successful program approach focusing on business process and methodology. These parameters are used to link resources to strategy, developing a product for implementing and managing a program demonstrating economic value added through effective clinical medical case management.

Accidents, Occupational↗
PubMed1985

An approach to the collection and manipulation of time-based data using the IBM PC and BASICA.

With the advent of increasingly integrated, powerful and inexpensive digital electronics, relatively powerful computers have become available to the general public. Along with this technological boom there has been a concomitant increase in the availability of over-the-counter software packages which can be used by research scientists for program development. In the past, the development of computer programs for the collection of large amounts of time-based data was expensive and time consuming; however, the introduction of the current generation of 16-bit microcomputers and associated hardware and software packages has enabled investigators with only a rudimentary knowledge of computers and interfacing to begin to design programs. The schemes and algorithms, developed using BASICA on an IBM-Personal Computer, which are described in this article can serve other investigators as models for the assembly of their own programs for the collection, manipulation and plotting of time-based data. The incorporation of inexpensive computer graphics hardware and software, which provided a simple solution to the problem of analysis and presentation of large amounts of data, will also be discussed.

Algorithms↗
PubMed1997

Disease management: program design, development, and implementation.

Disease management is an emerging approach to patient management, customer satisfaction, and cost containment that comprises disease modeling; patient segmentation and risk assessment; clinical protocols; and wellness, self-management, and education. Implementing a disease management program poses significant challenges to healthcare organizations. To successfully implement a disease management program, a tightly integrated continuum of care, sophisticated information systems, and disease management support systems must be in place. Strategic partnerships with outside vendors may speed program implementation and provide opportunities to develop risk-sharing relationships.

Costs and Cost Analysis↗
PubMedDate not supplied

Analgesics for acute pain: Meeting the United States Food and Drug Administration's requirements for proof of efficacy.

OBJECTIVE: To examine the United States Food and Drug Administration's (FDA) standards for reviews of the scientific basis for efficacy claims for newly approved oral analgesics. METHODS: Comparison of the trial methodologies and results provided by the FDA's medical reviewer in the Summary Bases of Approval (SBA) for the 9 oral acute analgesics approved in the last 10 years: ketorolac, diclofenac potassium, bromfenac, tramadol, hydrocodone/ibuprofen fixed combination, celecoxib, rofecoxib, tramadol/acetaminophen, and valdecoxib. RESULTS: For all 9 new analgesics, studies were conducted in patients with postoperative dental pain and nondental surgical pain. The relief of gynecologic pain was examined for 5 of the new drugs. No studies in other pain models (such as infection, neuropathy, and nonsurgical trauma) supported claims of efficacy for any of the new drugs. The overall designs of the dental and nondental surgical studies, including timing of the single dose of trial drug, timing of evaluations, scales used for evaluations, and the use of both measured and derived outcome variables, were similar across the 8 development programs fully described in SBAs. Other characteristics of the trials, including choice of population for efficacy analyses, methods of carrying forward pain intensity and pain relief scores, and the length of time patients were encouraged to refrain from use of rescue medication differed across the development programs. CONCLUSION: The requirements for approval of new analgesics in the United States encourage the pharmaceutical industry to perform efficacy studies using stylized designs in dental and nondental surgical pain. Studies of the efficacy of new analgesics in other common clinical settings are rarely or never included in development programs.

Acute Disease↗
PubMed1977

College students as contingency managers for adolescents in a program to develop reading skills.

Behavior-modification procedures and an individualized tutorial program were used to remediate reading skill deficits in seventh-grade adolescent subjects. Forty-two college students were trained as reading tutors and contingency managers to use reading diagnostic and remedial materials, and to develop contracts and reinforce positive verbal responses toward reading. Significantly greater increases in reading scores of experimental groups, compared to control groups, substantial improvement in target behaviors, and significant changes in verbalizations toward reading were observed after 10 weeks of treatment. Six-month followup studies showed that all groups had consolidated their gains and that grade scores continued to improve. The improvement of the experimental subjects remained significantly ahead of the control subjects.

Adolescent↗
PubMed1998

[Tools and methods of developing educational programs in medical biophysics].

In this work various types of programs which can be used in a learning and teaching process are analysed. Also the procedure of creating software for CAL is studied and the procedure, that is the most suitable one for developing CAL is suggested here. Also recommended properties of software for teaching and learning medical biophysics are described. General characteristics and types of authoring tools are discussed in this work and a set of authoring tools is described in more details. Conclusions are documented and demonstrated by program Blood Circulation. For development of this program the authoring system Authorware 3.5 was selected. The program is organized as a hypertext with possibility to find words, with a list of the last visited pages, and with an on line help system. This program works with a text, graphics, interactive animated schemes and with interactive equations. In the program it is possible to test the level of knowledge by means of solving problems or multiply choice test.

Biophysics↗
PubMed1993

Developing community faculty. Principles, practice, and evaluation.

Medical education is increasingly emphasizing outpatient experiences in community settings, and, concurrently, the development and assessment of the teaching skills of community faculty. These skills can be addressed through a faculty development program focusing on (1) issues relevant to community education, (2) adult learning principles, and (3) logistics that facilitate the participation of community medical faculty. Using a series of 1- to 3-day seminars, the program described focused on clinical precepting and brief presentations, used interactional teaching and practicums, and actively involved participants in the evaluation and planning fo the seminars. Evaluation of the program suggested that it was successful in increasing participants' knowledge and application of educational principles taught. Such programs can result in the development of an effective and potentially abundant resource of faculty members for the medical education of students and residents.

Clinical Competence↗
PubMed1991

Program for training staff pharmacists in total parenteral nutrition.

A staff development program in total parenteral nutrition (TPN) is described. A 12-week education and training program was developed at a community hospital to enable staff pharmacists (those with B.S. degrees) to become involved in the pharmacy-based TPN service that has been in effect at the institution since 1978. Before 1987, the TPN pharmacist had always held a Pharm.D. degree. In the first four weeks of the program the trainee is allotted two hours per day for required reading. During the final eight weeks, the trainee accompanies a TPN pharmacist on daily rounds. A proficiency examination is given after week 10. Upon successful completion of the program, the pharmacist serves as a nutritional support therapy consultant to physicians who wish to have their patients evaluated, treated, and monitored by the TPN service. A quality assurance program was developed to enable the clinical coordinator in charge of the service to identify areas where further inservice education might be indicated and to satisfy requirements of the Joint Commission. Six staff pharmacists have completed the training program and are allowed to write TPN orders and conduct TPN rounds. The program has expanded the clinical roles of the staff pharmacists and has been well received by the medical staff. The quality assurance monitoring indicates that the service is excellent. A staff development program was successful in training staff pharmacists to participate in TPN therapy.

Education, Pharmacy, Continuing↗
PubMedDate not supplied

The role of staff development in promoting BSN programs.

Staff development is undergoing rapid change in the current health care environment. One issue of critical importance is providing access to credit courses for nurses who want to obtain a Bachelor of Nursing (BSN) degree. A university and hospital collaborated to provide learning opportunities jointly for nurses to work toward completion of a BSN using the off-campus concept.

Education, Continuing↗
PubMed2003

Transformative professional development of physicians as educators: assessment of a model.

PURPOSE: Medical education reform has been the clarion call of U.S. medical educators and policymakers for two decades. To foster change and seed reform, Harvard Medical School created a professional development program for physicians and scientists actively engaged in educating future physicians that sought to transform both participants and their schools. This study focused on identifying the long-term effects of a professional development program on physician educators. METHOD: A follow-up survey of the 1995-97 cohorts of the Harvard Macy Program for Physician Educators was conducted by sending the 99 program participants a questionnaire two years after their participation. Main outcome measures studied were individual changes as reflected in participants' self-reported shifts in teaching behaviors, academic productivity, career advancement, and sense of commitment. RESULTS: A total of 63 participants completed the questionnaire, for a response rate of 63.6%. Two years following participation in the program, a majority (88.8%) of respondents reported that participation had significantly affected their professional development, including long-term changes in teaching behaviors (77.8%), engagement in new educational activities from committee work (86%) to grant funding (52.4%), and renewed vitality/identification of themselves as educators. CONCLUSIONS: Long-term follow-up of participants enrolled in an intensive program for physician educators suggests that professional development programs that create an immersion experience designed in a high-challenge, high-support environment, emphasizing experiential and participatory activities can change behaviors in significant ways, and that these changes endure over time.

Education, Medical↗
PubMed1999

Reproductive physician-scientists for the twenty-first century.

As we enter a new century, departments of obstetrics and gynecology in American medical schools face a number of challenges. A primary concern is the relative dearth of physician-scientists to explore basic mechanisms of cell function and relate these to the diseases of women. The question arises, what can we do to revitalize the spirit of investigation in many of our academic departments? This report reviews three programs designed to develop academic investigators: the Reproductive Scientist Development Program, the American Gynecological and Obstetrical Society/American Association of Obstetricians and Gynecologists Foundation Fellowship Program, and the Women's Reproductive Health Research Career Development Centers. On the basis of a decade of experience with the first two of these programs, the prospects for the third are promising. Clearly, the opportunities for obstetrician-gynecologist basic and clinical scientists are considerable. The question remains: Will leaders in the specialty work together to meet the challenge?

Education, Medical↗
PubMed1980

The vocational integration of the mentally retarded: a program to develop vocational maturity.

In many countries there are minimum standards for entry into vocational training programs, but until now there has been no instrument for determining whether retarded applicants possess the motor skills required to enter and complete such programs. To construct such an instrument, experts representing most of the skilled vocations in West Germany were consulted about typical skills required during the vocational education in their fields. Based on their responses, a catalog of essential skills was compiled and testing procedures (Handwerklich-Motorischer Eignungstest HAMET) were developed to determine vocationally-oriented motor skills for use in diagnostic and remedial programs for the retarded. A test administered to more than 100 mentally retarded youth showed significant and typical deficiencies in motor skills compared with those of non-retarded individuals. By using a factor analysis of the HAMET-items, it was possible to isolate elementary motor functions which are common to all the skilled vocations. Knowledge of these factors made it possible to start one-year training courses to develop vocational maturity. With selected exercises based on the HAMET-items the courses were very successful. In contrast to traditional programs for the mentally retarded it could also be shown that frequent changes of workshops and of vocational education staff are not necessary and that the entire training program can be carried out in one equipped workshop.

Adolescent↗
PubMed2006

Type II translation: transporting prevention interventions from research to real-world settings.

This article summarizes research on Type II translation of prevention interventions aimed at enhancing the adoption of effective programs and practices in communities. The primary goal of Type II translation is to institutionalize evidence-based programs, products, and services. First, the authors describe theoretical frameworks that are useful to guide Type II translation research. Second, research on prevention program implementation, including fidelity of implementation and factors that are associated with successful program implementation, is summarized. The authors describe interventions designed to enhance the dissemination of preventive interventions in community and public health settings. Third, they describe strategies used by prevention program developers who have taken programs to scale. Fourth, they present a case example of Project Towards No Drug Abuse (TND), an empirically validated high school-based substance abuse prevention program. They describe ongoing research on the dissemination of Project TND. Finally, they provide suggestions for future Type II translation research.

Behavior↗
PubMed1994

[Organizational change by program and its impact].

The Pierre Janet Hospital Centre, a 110-bed short-term psychiatric treatment facility, reorganized its services based on a program-specific clientele. Operational functions are segmented according to client age. There are programs for children, teens, adults and seniors. Each program is responsible for developing, setting up and rendering a full spectrum of specialized services covering the following: reception, evaluation and orientation, treatment, re-adaptation, support to the community, research and development. Programs are managed by a team consisting of a clinical director, a psychiatrist and an administrative co-ordinator. The team reports directly to the director-general. The new structure has had a significant impact on the nursing profession: broadening of the scope of tasks, increase in professional freedom, professional recognition by the nursing community and a modified and enriched perception of the profession's practice.

Adolescent↗