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PubMedDate not supplied

Queensland public sector nurse executives: professional development needs.

In a time of health care reform and rapid change, nurse executives need effective leadership skills to be able to respond to a challenging environment, provide quality cost-effective care and promote the professional development of nursing. This research aimed to provide an understanding of nursing executives' roles and professional development needs and obtain concise information for the development of strategies and professional development programs to enhance the effectiveness of the present and future roles of nursing executives. A descriptive cross-sectional postal survey was sent to all public sector Level 4 and 5 nursing executives in Queensland (n = 281), with a response rate of 52.3% (n = 147). Financial management, human resource management and information technologies were identified as the areas where professional development was most needed. Structured educational activities such as short courses or seminars covering information technology, financial and budget management and general business management were identified as the type of activities best suited to nurse executives' needs. The most frequently reported barriers to professional development were difficulties obtaining relief staff, inadequate time, financial cost and inadequate district manager and regional support to enable access to professional development programs.

Attitude of Health Personnel↗
PubMed1995

The Occupational Health Partnership Program: a new paradigm for occupational health services.

For a variety of reasons, occupational health services at Army Material Command installations became severely strained during the 1980s. The Occupational Health Partnership Program, developed to improve this support, describes control, responsibility, and cost sharing between Army Materiel Command and Army Medical Command. This innovative approach is finding new solutions to challenging problems. The authors describe the history, principles, status, and possible future of the partnership program.

Health Plan Implementation↗
PubMed1990

From the parallel group design to the crossover design, and from the group approach to the individual approach.

The consequences of heterogeneity in response to antihypertensive drugs for the clinical development programs of new antihypertensive drugs and for the care of the individual hypertensive patient have not previously been sufficiently recognized. They play a role in the inappropriate choice of too-high daily doses of some antihypertensive drugs at the end of extensive international development programs. They are also implicated in the insufficient control of blood pressure observed in the long-term multicenter trials in hypertension, where some patients have been treated for several years with drugs that were not the most appropriate for their disease and which did not adequately control their blood pressure. In addition to the parallel group studies, the use of double-blind two-period or multiple period crossover designs can provide valid data for the dose-finding of new antihypertensive drugs and their comparative evaluation. At the end of the trial, these designs also offer each patient the opportunity to be treated with the right dose of the drug most appropriate for his or her disease.

Antihypertensive Agents↗
PubMedDate not supplied

An evaluation of I Can Cope. Insights into program design and implementation.

The I Can Cope program is an educational program developed to provide information on how to promote physical and emotional well-being to individuals with cancer, their families, and friends. Through focus group and individual interviews and a mailed survey, the effectiveness of the selection, marketing, implementation, and support processes associated with implementing the program in the central Arizona and greater Las Vegas, Nevada, regions was evaluated. Findings, recommendations, lessons learned, and use of findings are discussed.

Adaptation, Psychological↗
PubMed2001

The responsibilities and activities of internal medicine clerkship directors.

PURPOSE: To characterize the responsibilities, activities, and scholarly productivity of internal medicine clerkship directors (CDs). METHODS: In 1999, internal medicine CDs from 122 U.S. medical schools and one Canadian medical school were surveyed. The instrument asked about the CDs' demo-graphics, workloads, clerkship characteristics, and scholarly productivity. RESULTS: The response rate was 89%; 72% of the respondents were men. Mean age was 45 years, mean time as CD was 6.5 years, and 58% of the CDs had completed fellowship training. The CDs spent 28% of their professional time on the clerkship, three half days weekly in clinic, and three months on inpatient services. The CDs had published a mean of 2.2 (range 0-20) articles and received a mean of 0.7 (range 0-4) grants. Similar factors were associated with publishing articles and receiving grants; gender (men), < or = three clinic half days weekly, fellowship training, having a faculty development program, teaching other courses, and discussing expectations with their department chairs. In a multivariate analysis, fellowship training, clinic half days, teaching other courses, and discussing expectations explained 22% of the variance for papers published. For grants received, a model with gender, clinic half days, a faculty development program, discussing expectations, and teaching other courses explained 35% of the variance. CONCLUSIONS: An internal medicine CD invests significant effort administering the clerkship and contributing to clinical and educational activities. The factors associated with successful scholarship may be useful for fostering CDs' academic careers.

Analysis of Variance↗
PubMed1998

Dual approval of a residency program: ten years' experience and implications for postdoctoral training.

In 1985, the American Osteopathic Association (AOA) changed its educational policies to permit osteopathic postdoctoral programs in settings that were accredited by the Accreditation Council for Graduate Medical Education (ACGME). In response to this policy change, an existing ACGME-accredited emergency medicine residency was modified to create a combined osteopathic/allopathic residency program that meets the educational requirements of both the AOA and the ACGME. Our 10-year experience with this combined osteopathic/allopathic emergency medicine residency is described in terms of program development, governance structure involving key stakeholders, faculty distribution--equal numbers of allopathic and osteopathic faculty, and educational outcome of the total number of residents graduated (93 graduates, with 33 osteopathic physicians and 60 allopathic physicians). Lessons learned from the 10 years' experience of this combined residency program, as well as current issues, are explained. The future potential of such dual-approved programs on the supply of residency positions is discussed from the viewpoint of osteopathic postdoctoral education.

Accreditation↗
PubMed1998

Factorial validation of a widely disseminated educational framework for evaluating clinical teachers.

PURPOSE: To examine an instrument for evaluating clinical teaching using factor analysis and to refine the validated instrument to a practical length. METHOD: Factor analysis on a split sample of 1,581 student evaluations rating 178 teachers. The instrument was based on the seven-category Stanford Faculty Development Program's (SFDP's) clinical teaching framework and contained 58 Likert-scaled items, with at least seven items per category plus five items measuring "teacher's knowledge." Standard methodology for survey item reduction was used to remove items with low or complex factor loadings and iteratively remove items with low item-scale correlation. Results were replicated on the second sample. RESULTS: The seven original categories emerged and items originally categorized under "knowledge" statistically combined with "promoting self-directed learning." Over 73% of the variance was explained. Item reduction resulted in 25 items with overall internal consistency over .97 and internal consistency of constructs ranging from .82 to .95. CONCLUSIONS: Factor analysis of student ratings validated the seven-category SFDP framework. An abbreviated instrument to measure the seven categories is described. Results suggest that students may not systematically distinguish between their teachers' knowledge and their teachers' ability to promote self-directed learning, an important finding for both administrators and faculty development programs.

Adult↗
PubMed2003

Oligo Design: a computer program for development of probes for oligonucleotide microarrays.

Oligonucleotide microarrays have demonstrated potential for the analysis of gene expression, genotyping, and mutational analysis. Our work focuses primarily on the detection and identification of bacteria based on known short sequences of DNA. Oligo Design, the software described here, automates several design aspects that enable the improved selection of oligonucleotides for use with microarrays for these applications. Two major features of the program are: (i) a tiling algorithm for the design of short overlapping temperature-matched oligonucleotides of variable length, which are useful for the analysis of single nucleotide polymorphisms and (ii) a set of tools for the analysis of multiple alignments of gene families and related short DNA sequences, which allow for the identification of conserved DNA sequences for PCR primer selection and variable DNA sequences for the selection of unique probes for identification. Note that the program does not address the full genome perspective but, instead, is focused on the genetic analysis of short segments of DNA. The program is Internet-enabled and includes a built-in browser and the automated ability to download sequences from GenBank by specifying the GI number. The program also includes several utilities, including audio recital of a DNA sequence (useful for verifying sequences against a written document), a random sequence generator that provides insight into the relationship between melting temperature and GC content, and a PCR calculator.

Algorithms↗
PubMedDate not supplied

Emergency preparedness and bioterrorism response: development of an educational program for public health personnel.

Public health departments are under increasing pressure to provide emergency preparedness and bioterrorism response education to public health personnel. The challenge that health departments face is to provide cost-efficient, timely education to a large number of multidisciplinary personnel. This article describes an innovative strategy for providing this education to public health personnel using the health department's intranet system. The intranet system provided confidential information specific to the staff role and allowed for concurrent access to the program by multiple individuals at different service sites. Knowledge acquisition was tested through short multiple-choice questions that followed the specific information modules. The intranet system faced a number of challenges during the pilot-testing phase, primarily related to changes in the role of the public health nurse and limitations in funding and public health staff to maintain and monitor the bioterrorism response program and the intranet system. The design of the program may prove useful for other public health organizations when a need exists for quick delivery of information to a large number of personnel. It may especially be useful in providing basic emergency preparedness and bioterrorism education to new personnel in health departments.

Attitude of Health Personnel↗
PubMed1992

Bulletin boards for faculty development.

Within the faculty development program of a Department of Family Medicine at a major research university, bulletin boards offer an alternative method for communicating new information, reinforcing knowledge previously acquired, and stimulating faculty to think about new ideas. This paper describes a five-step strategy for integrating bulletin boards into a faculty development program.

Curriculum↗
PubMedDate not supplied

Peer power: how Dare County, North Carolina, is addressing chronic disease through innovative programming.

Peer Power is an innovative school-based program that trains high school students as health educators and mentors for middle school students. The program was designed to produce positive health behavior changes in youth and reduce long-term incidence of chronic diseases of the heart and lung. This program, developed at the Management Academy for Public Health, has been successful in receiving grant funds and has demonstrated positive behavioral changes in youth in the areas of physical activity, nutrition, and tobacco use. Peer Power has far exceeded the anticipated outcomes and proven to be a catalyst for improved health behaviors throughout the community. Positive unintended consequences of Peer Power include the development of an effective social marketing campaign, reduction in tobacco sales to minors, and an increase in smoke-free restaurants in Dare County. Benefits received by Management Academy participants are evident through improved business and administrative skills at the Dare County Department of Public Health, the number of new and innovative programs that have succeeded in securing grant funds, and the sustainability of the programs developed.

Adolescent↗
PubMed1992

Effects of early intervention on cognitive function of low birth weight preterm infants.

The Infant Health and Development Program is a randomized clinical trial to test the efficacy of educational and family support services and pediatric follow-up, offered during the first 3 years of life, in reducing the incidence of developmental delay in low birth weight preterm infants at eight clinical sites (N = 985). It was hypothesized that larger intervention effects would be found for the domains in which low birth weight preterm infants are known to have problems, specifically visual-motor and spatial skills and receptive language skills. These analyses explore the effects of the Infant Health and Development Program on different domains of cognitive functioning. Cognitive domains are identified by means of factor analysis of the intelligence tests used at 12, 24, and 36 months (Bayley Scales of Infant Development (including the Mental and Motor scales) at 12 and 24 months; the Stanford-Binet, Peabody Picture Vocabulary Test, and Beery Test of Visual Motor Intergration at 36 months). Our results reveal that, although intervention benefits accrue across cognitive domains at 24 and 36 months, gains are most pronounced for receptive language and visual-motor and spatial skills.

Child Development↗
PubMed2004

Overview of phase I/II pemetrexed studies.

Pemetrexed (Alimta) is an antifolate that is effective in the inhibition of multiple enzyme targets including thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyl transferase. The compound has been evaluated in several phase I trials, both as single agent and in combination with other cytotoxic agents. The initial schedule selected for further investigation in phase II trials was pemetrexed 600 mg/m2 as a 10-minute infusion on day 1 every 21 days. During the subsequent phase II development the dose of pemetrexed was adjusted to 500 mg/m2 due to bone marrow and gastrointestinal toxicities. The adjusted dose of pemetrexed was well tolerated throughout the late-phase drug development program. Preclinical evidence suggests that pemetrexed has additive or synergistic activity when combined with many other clinically important anticancer agents, including gemcitabine (Gemzar), fluorouracil, carboplatin (Paraplatin), oxaliplatin (Eloxatin), paclitaxel, and vinorelbine (Navelbine). Dose-limiting toxicities in these studies were primarily hematologic, and there was no evidence of cumulative hematologic toxicity. During the drug development program it was discovered that supplementation with folic acid and vitamin B12 profoundly increased the tolerability of pemetrexed. The studies discussed in this review demonstrate that pemetrexed is well tolerated as a single agent and will be an important contribution to combination chemotherapy regimens.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Formative research on smoking cessation program attributes preferred by smokers.

BACKGROUND: This article reports formative research procedures used to identify smoking cessation program attributes preferred by smokers. A theoretical rationale and a program development framework are presented. METHODS: Findings from a series of qualitative and small sample quantitative studies were used to evaluate smoker response to specific program materials, and to identify a comprehensive set of preferred smoking cessation program attributes. These findings guided the development of a telephone survey administered to a random sample of 205 smokers interested in quitting. RESULTS: The 205 smokers completing telephone interviews frequently indicated preferences for program features having little to do with specific cessation methods used. Low demand on time, endorsements by medical authorities, relaxation instructions, weight control techniques, and a substantial research base were often cited as being most preferred. Overall, chi-square analyses provided minimal support for significant relationships between preferences and sociodemographic or smoking history variables. DISCUSSION: The benefits of combining qualitative and quantitative research methods in cessation program development efforts are noted. Implications for further research are discussed, particularly those concerning multiattribute analysis of consumer preferences.

Adolescent↗
PubMed1986

Organization of screening programs in developing countries with reference to screening for cancer of the uterine cervix in India.

Cancer of the uterine cervix is the leading female malignancy in developing countries such as India. Efforts for early detection by cervical cytology smears have been few, restricted to special situations, or short-term. No measurement of impact in terms of decline in mortality or incidence rates has been possible in India. However, a study by the Cytology Research Centre, New Delhi, on the natural history and biological behaviour of dysplasias provides evidence of the usefulness of screening to detect malignancy at early stages; both routine follow-up by cervical smears of women with dysplasia as well as screening of women attending gynaecological out-patient departments were used. This paper reviews the magnitude of the problem of uterine cervical cancer, the epidemiological aspects of the present situation in India, the efforts made for its control in different parts of the country and the problems encountered in organizing cervical cancer screening programs. Models of the approaches adopted are described, and guidelines are suggested which include the utilization of several approaches, including institution-based programs, extension of services to peripheral areas through mobile units, links with maternal care services, and establishment of referral systems. The need to develop human resources in cytology, in both medical and paramedical categories, is highlighted.

Adult↗
PubMed1993

Early education as community intervention: assisting an ethnic minority to be ready for school.

An early education program designed for an ethnic minority of Native Hawaiians implemented at the community rather than the individual child level of intervention is described. The program development effort is theory driven and provides an opportunity to investigate the application of neo-Vygotskian theory to an applied community educational problem. Though not specifically derived from the work of O'Donnell, Tharp, and Wilson (1993), the project reported here shares a common intellectual heritage. This paper demonstrates the parallels between the early education program developed for Hawaiian children and the applicability of the theory presented in the work of O'Donnell et al.

Child, Preschool↗