Maui dental program gets high praise, but access still remains a challenge.
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Dental Assistants↗
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Results for “Program Accessibility”
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.
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The DairyCHAMP program: a computerised recording system for dairy herds.
The DairyCHAMP program is an animal health and management software program that helps daily animal management, herd performance monitoring and problem analysis. Data entry to the program uses a data dictionary and includes an error-checking system that ensures the consistency and appropriateness of data entered. DairyCHAMP performs health management functions, provides a convenient user interface, ensures uniform data across farms by using a standard data dictionary, can be fully integrated with decision-making software programs like DairyORACLE, and is flexible enough to be useful for many types of dairy facilities. Data are entered via a menu-based system. Animal events are organised around reproduction and lactation cycles and health records. Farm records include inventories for drug, feed and semen. Farm parameters can be established which customize the program for an individual farm. The database system is an integration of three schemas: the individual user's view, the community view and the storage system. The individual user's view must be easy to use, while the storage system must be compact enough to fit within the disc storage space on a microcomputer. This conflict requires a translation from one schema to another. The DairyCHAMP program accomplishes this through a coding system which assigns a code number to each event. The program can add synonyms to this event dictionary by assigning the same code number to the synonym the user chooses. The DairyCHAMP program provides access to the large amounts of data required to aid in daily animal management, allow performance monitoring and analyse problems. Its highly integrated system is efficient and easy to use and maintain.
Animal Husbandry↗
Physician attitudes and family planning in Nigeria.
This study examines family planning attitudes and practices of 681 Nigerian physicians selected from cities in which large university teaching hospitals are located. About half of the physicians were practicing family planning; the method of choice was the IUD. Obstetrician/gynecologists and general practitioners were more likely to provide methods to their patients than were other types of physicians. The physicians were concerned about population growth and favored family planning, yet a substantial minority believed that family planning is foreign to the culture and that it promotes promiscuity. Physicians were reluctant to promote family planning on a wide scale; many disapproved of non-physicians providing oral contraceptives or IUDs.
Adult↗
Family planning in Jordan: 1983 survey data.
Data from the 1983 fertility survey in Jordan indicate that 26 percent of married women were using contraceptives, reflecting a very small relative increase in use in the seven years before the survey. Only 5 percent of nonusers stated that they desired to use a method. Other data from the same survey suggest a potential demand for contraception, for spacing as well as limiting births, among those not using. For example, many recent pregnancies were reported to be unplanned. Also, among nonusers who did not desire to use a method, many stated they did not desire to become pregnant, yet were exposed to the risk of pregnancy. A pool of potential users exists who can be considered in need of contraception (i.e., fecund, not pregnant or desiring pregnancy, and not using contraceptives)--20 percent of all currently married, childbearing-age women--who may become contraceptive users as attitudes toward contraception change.
Adolescent↗
The Health Information Register - instant access to community health care programs.
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Australia↗
The World Fertility Survey and Contraceptive Prevalence Surveys: a comparison of substantive results.
This paper deals with the findings of the World Fertility Survey (WFS) and Contraceptive Prevalence Surveys (CPSs) in five areas of common interest: fertility, contraceptive use, measuring the effect of the availability of contraceptives on levels of use, the unmet need for family planning services, and breastfeeding. The comparisons have several implications for those designing surveys of fertility and family planning in developing countries, among them, that women should be asked for the dates of at least their last two births (not just the last birth as in the CPSs) in order to ensure accurate estimates of fertility and duration of breastfeeding.
Adolescent↗
Contraceptive availability differentials in use and fertility.
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Adult↗
Exercise and the older person.
The enormous pleasure that older people derive from an exercise class to music or from an aquarobics group makes instant converts of any professionals involved in these health promotion activities. Irrefutable evidence now exists to show that regular physical activity slows the rate of decline of most of the physiological parameters that we associate with health and fitness--muscle strength, aerobic capacity, reaction time and joint flexibility. Master athletes at age 60 can perform considerably better than some sedentary men at age 30. The ideal is clearly to maintain a regular regimen of physical activity throughout adult life. It has now been shown that such exercise does not need to be heavy to maintain cardiovascular and musculoskeletal fitness. Walking and swimming are as good and much safer than jogging provided the regimen entails at least 30 minutes three to four times a week. The evidence is equally strong that sedentary older people can benefit from taking up an exercise program in later life. Significant gains in muscle strength and aerobic capacity can result from gentle exercise programs carried out at least three times a week. Improvements in balance, bone density and psychological health have yet to be confirmed. Exercise and fitness programs for older adults can attract large numbers and achieve high compliance rates if the programs are accessible, affordable and, above all, fun. Men tend to be more interested in monitoring fitness levels while women are satisfied to enjoy themselves and feel better. Older adults can also continue or take up competitive sports provided simple precautions are taken to ensure cardiovascular health and to minimise injury.(ABSTRACT TRUNCATED AT 250 WORDS)
Activities of Daily Living↗
Care of the hemodialysis patient with a new permanent vascular access: review of assessment and teaching.
Problems related to vascular access are the main reasons for admission to hospitals for hemodialysis patients today. Some patients develop vascular access problems prior to use and many require repeated surgery. This article addresses some of the key aspects of patient assessment and monitoring in the immediate preoperative/postoperative period. The focus is on the prevention of early vascular access failure. Approaches for patient teaching are included, as are strategies that should be part of a vascular access management program.
Arteriovenous Shunt, Surgical↗
Nurse academics' scholarly productivity: framed by the system, facilitated by mentoring.
The scholarly productivity of 65% of the 1,107 nurse academics employed full-time in Australian faculties of nursing and health sciences was investigated by means of a survey. This report describes respondents' demographic profile, the categories of their publications, their scholarship index ratings and the factors that framed (i.e. constrained) and facilitated their efforts to publish their work. The study found that overall the academics had a low level of scholarly productivity and that the scholarship of three quarters of those who had published in the year prior to the survey was not rated highly according to the university value system. Respondents' opportunities to publish were framed by job factors such as teaching commitments and the need to improve their academic qualifications and they were facilitated by mentoring, professional development leave and participating in research. The implications of the study are that there is an urgent need for nursing mentorship programs, increased access to professional development leave and encouragement to undertake research, the facilitators of the scholarly productivity which is the foundation of the discipline's body of knowledge.
Adult↗
Drug abuse treatment as AIDS prevention.
OBJECTIVE: As the acquired immunodeficiency syndrome (AIDS) epidemic among drug users enters its third decade in the United States, it is important to consider the role playing by substance abuse treatment in the prevention of human immunodeficiency virus (HIV) infection. METHODS: The authors review the research literature, examining findings from studies with behavioral and serologic measures on the association among treatment participation, HIV risk reduction, and HIV infection. RESULTS: Numerous studies have now documented that significantly lower rates of drug use and related risk behaviors are practiced by injecting drug users (IDUs) who are in treatment. Importantly, these behavioral differences, based primarily on self-report, are consistent with studies that have examined HIV seroprevalence and seroincidence among drug users. CONCLUSION: The underlying mechanism of action suggested by the collective findings of the available literature is rather simple-- individuals who enter and remain in treatment reduce their drug use, when leads to fewer instances of drug-related risk behavior. This lower rate of exposure results in fewer infections with HIV. The protective effects of treatment, however, can only be achieved when programs are accessible and responsive to the changing needs of drug users. Future research needs to be directed at developing a better understanding of the factors that enhance treatment entry and retention.
Epidemiologic Studies↗
Differences in mortality of black and white patients enrolled in the program of all-inclusive care for the elderly.
OBJECTIVES: To examine the relationship between race and mortality in frail community-dwelling older people with access to a program providing comprehensive access and coordination of services. DESIGN: A longitudinal cohort study. SETTING: Twelve nationwide demonstration sites of the Program of All-Inclusive Care for the Elderly (PACE) from 1990 to 1996. PACE provides comprehensive medical and long-term care services for nursing home-eligible older people who live in the community. PARTICIPANTS: Two thousand two white patients and 859 black patients. MEASUREMENTS: Patients were followed after enrollment until death or the end of the follow-up period. Time from enrollment to death was measured with adjustment of the Cox proportional hazards model for comorbid conditions, functional status, site, and other demographic characteristics. RESULTS: Black patients were younger than white patients (mean age 77 vs 80, P <.001) but had worse functional status (mean activity of daily living (ADL) score 6.5 vs 7.2, P <.001) on enrollment. Survival for black and white patients was 88% and 86% at 1 year, 67% and 61% at 3 years, and 51% and 42% at 5 years, respectively (unadjusted hazard ratio (HR) for black patients = 0.77; 95% confidence interval (CI) = 0.67-0.89). After adjustment for baseline comorbid conditions, functional status, site, and demographic characteristics, black patients still had a lower mortality rate (HR = 0.77; 95% CI =.65-0.93). The survival advantage for black patients did not emerge until about 1 year after PACE enrollment (HR for first year after enrollment = 0.97; 95% CI = 0.72-1.31; HR after first year = 0.67; 95% CI = 0.54-0.85, P-value for time interaction <.001). During the first year of enrollment, black patients were more likely to improve and less likely to decline in ADL function than white patients (P <.001). CONCLUSION: In PACE, a system providing access to and coordination of comprehensive medical and long-term care services for frail older people, black patients have a lower mortality rate than white patients. This survival advantage, which emerges approximately 1 year after PACE enrollment, may be related to the comprehensive access and coordination of services provided by the PACE program.
Black or African American↗
Effectiveness of the HomeSafe Pilot Program in reducing injury rates among residential construction workers, 1994-1998.
BACKGROUND: The construction industry typically has one of the highest fatal and non-fatal injury rates compared with other industries. Residential construction workers are at particular risk of injury (work is in remote sites with small crews, there are often many subcontractors, and they have limited access to safety programs). Difficulty accessing information specific to this group has made research more challenging, therefore, there are few studies. This study evaluated the effectiveness of the HomeSafe Pilot Program, a safety education and training program designed to reduce injuries among residential construction workers. METHODS: Researchers evaluated whether overall and severe injury incidence rates declined during the intervention period. Data were analyzed using incidence rates and Poisson regression to control for the effect of antecedent secular trend. RESULTS: Injury incidence rates declined significantly following HomeSafe; however, this effect was not statistically significant once temporal variation was controlled. CONCLUSIONS: The decline in injury rates following HomeSafe cannot be attributed solely to HomeSafe, however, programmatic and methodologic limitations contributed to the inconclusive results. Further research into the hazards faced by residential construction workers is needed. Am. J. Ind. Med. 45:210-217, 2004.
Accidents, Occupational↗
Position of the American Dietetic Association, Society for Nutrition Education, and American School Food Service Association--Nutrition services: an essential component of comprehensive school health programs.
It is the position of the American Dietetic Association (ADA), the Society for Nutrition Education (SNE), and the American School Food Service Association (ASFSA) that comprehensive nutrition services must be provided to all of the nation's preschool through grade twelve students. These nutrition services shall be integrated with a coordinated, comprehensive school health program and implemented through a school nutrition policy. The policy should link comprehensive, sequential nutrition education; access to and promotion of child nutrition programs providing nutritious meals and snacks in the school environment; and family, community, and health services' partnerships supporting positive health outcomes for all children. Childhood obesity has reached epidemic proportions and is directly attributed to physical inactivity and diet. Schools can play a key role in reversing this trend through coordinated nutrition services that promote policies linking comprehensive, sequential nutrition education programs, access to and marketing of child nutrition programs, a school environment that models healthy food choices, and community partnerships. This position paper provides information and resources for nutrition professionals to use in developing and supporting comprehensive school health programs. J Am Diet Assoc. 2003;103:505-514.
Adolescent↗
[Health care to HIV/AIDS patients in Brazil].
This study was intended to assess care provided to those living with HIV/AIDS in Brazil and the Brazilian Unified Health System (SUS) capacity of delivering interventions to cope with the epidemic as well as to discuss the sustainability of the Brazilian initiative of providing universal free access to antiretrovirals (ARVs). Original data from a study comprising 119 respondents on the potential capacity of delivering a prospective HIV vaccine in Brazil was used. Inpatient and pharmaceutical care was based on data from the SUS Hospital Information System and Drug Logistics Management Systems of the National Program for STD/AIDS. The study results indicate good performance of the Brazilian ARV Access Program but access to treatment of opportunistic infections was, however, unsatisfactory. The rates covered by SUS for AIDS hospital admissions remained very low, on average around R$700 in 2004. Health care to HIV/AIDS patients has been considered a citizen's right strongly supported by an effective joint action of the Brazilian government and civil society. The current challenges are fine monitoring of processes and program results and ensuring sustainability of universal free ARV access.
Acquired Immunodeficiency Syndrome↗
A comparison of perspectives on breastfeeding between two generations of black American women.
PURPOSE: To determine differences in breastfeeding perspectives between two generations of black American women with and without access to governmental food assistance programs (i.e., WIC). DATA SOURCES: Descriptive, comparative study of a convenience sample of 118 black American women in their childbearing years and beyond conducted in a primary rural health care clinic serving an indigent population. CONCLUSIONS: A significant difference was found between breastfeeding perceptions and rate among younger black American women on WIC program and their mothers without access to these programs. The availability of free formula through WIC programs has partially influenced the rate of breastfeeding among the young black American women. The other significant influencing factor was public embarrassment at breastfeeding. IMPLICATIONS FOR PRACTICE: An extensive educational campaign is needed in order to influence the public's perceptions of breastfeeding as an embarrassment. The success of programs such as WIC must be measured beyond the first six months of an infant's life.
Adolescent↗
Children's access to dental care in Connecticut's Medicaid managed care program.
OBJECTIVE: To describe dental care utilization and access problems in Connecticut's Medicaid managed care program, using quantitative and qualitative research methods. METHODS: Using Medicaid managed care enrollment and encounter data from Connecticut, utilization rates for preventive care and treatment services are determined for 87,181 children who were continuously enrolled in Medicaid managed care for 1 year in 1996-97. Sociodemographic and enrollment factors associated with utilization are identified using bivariate and multivariate methods. Dental providers and practices where children received services are described. Qualitative methods are used to characterize problems experienced by families seeking dental care during the study period. RESULTS: Only 30.5% of children continuously enrolled in Medicaid managed care for 1 year received any preventive dental services; 17.8% received any treatment services. Children who received preventive care were eight times more likely to have received treatment services. Utilization was higher among (a) younger children, (b) children who lived in Hartford and in other counties served by public dental clinics, and (c) children enrolled in health plans that did not subcontract for administration of dental services. Just 5% of providers, primarily those in public dental clinics, performed 50% of the services. Families whose children needed care encountered significant administrative and logistical problems when trying to find willing providers and obtain appointments. CONCLUSIONS: Access to dental care is a problem for children in Connecticut's Medicaid managed care program. Several features of managed care have negatively affected access. Public dental clinics served many children across the state and contributed to higher utilization of preventive care and treatment services among children living in Hartford.
Adolescent↗
Hemodialysis vascular access monitoring for stenosis.
A program evaluation of hemodialysis vascular access monitoring was undertaken to determine the effectiveness of serial, objective measurement, running venous dialysis pressures, in reducing access thrombosis in arterio-venous fistulae, as well as to assess the feasibility of long-term, routine monitoring for clients in a limited-care community hemodialysis unit. In all, 102 of 112 eligible patients participated in the study with a 98% compliance rate. Angiography confirmed stenosis in all eight performed for elevated venous pressures and 16 of 20 performed for clinical suspicion. Venous pressure frequency distributions indicated significantly lower venous pressures in lower arm arterio-venous fistulae than in upper arm arteriovenous fistulae or PTFE grafts. Running venous dialysis pressures are effective and feasible for predicting venous stenoses in arteriovenous fistulae in a limited care community hemodialysis unit. Lower and differentiated threshold pressures would increase the sensitivity of this screening tool; the effect on specificity would have to be evaluated.
Arteriovenous Shunt, Surgical↗