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Outcomes results from the evaluation of the APA/HRSA Faculty Scholars Program.

BACKGROUND: The goal of the Ambulatory Pediatric Association/Health Resources and Services Administration National Faculty Development Scholars Program was to improve primary care education in the pediatric setting. The program evaluation focused on four stake-holder objectives: 1) increase the educational skills of community and generalist faculty; 2) create pediatric leadership focused on changing the culture within the medical community to support primary care education; 3) develop an infrastructure that supports sustained faculty development efforts at the local, regional, and national level; and 4) include content areas consistent with Health Resources and Services Administration contract requirements. METHODS: A multimethod evaluation plan, focused on the 107 completing scholars, was implemented utilizing six evaluation instruments. RESULTS: Key outcomes from both quantitative and qualitative outcome measures reveal that all evaluation objectives were achieved. Scholars presented 438 local workshops and 161 regional/national workshops focused on pediatric education with a combined attendance of 7939 participants. More than half of the scholars have now assumed a leadership position in education associated with program participation. Ninety-three percent of the scholars reported organizational/infrastructure changes associated with their program participation ranging from increased numbers of community teaching sites to specific resource allocations to support of faculty development. CONCLUSIONS: The outcomes of this evaluation reveal that the faculty development program achieved its objectives, with participants leading workshops, impacting faculty development infrastructure, advancing their own careers, and being strategically positioned in leadership roles with the skills to improve primary care education in the ambulatory setting.

Ambulatory Care↗
PubMed2005

Gascoyne Growers Market: a sustainable health promotion activity developed in partnership with the community.

OBJECTIVE: To explore the social, health and economic impact of a farmers' market on a small rural community in the north of Western Australia. DESIGN: Qualitative and quantitative research using a random structured intercept survey, and focus group interviews around four domains of social capital: economic impact, governance and capacity building, healthy public places and social and civic participation. SETTING: The Gascoyne Growers Markets in Carnarvon. SUBJECTS: One hundred consumers and 28 market stallholders. RESULTS: Consumers demonstrated community pride and an increase in fruit and vegetable consumption since they commenced shopping at the markets. The stallholders appear to have gained economically, professionally and socially from the market experience. CONCLUSIONS: The Gascoyne Growers Markets demonstrate a sustainable health promotion activity developed in partnership with the community. It has contributed to the local economy, providing local quality fruit and vegetables directly to the community while also increasing social capital and creating a healthy public space.

Community-Institutional Relations↗
PubMed2002

Development and in-vitro evaluation of sustained release poloxamer 407 (P407) gel formulations of ceftiofur.

The objective of this study was to develop sustained release Poloxamer 407 (P407) gel formulations of ceftiofur for treating foot infections in cattle. The formulations contained 25-35% (w/v) P407 alone or with polyvinyl pyrrolidone (PVP), carboxy methylcellulose (CMC), or hydroxylpropyl methylcellulose (HPMC) as an additive. The in-vitro release profiles of ceftiofur from the P407 formulations and the gel dissolution profiles were obtained simultaneously. Ceftiofur release followed zero order kinetics and correlated well with the weight percentage of P407 dissolved, indicating that the overall rate of release of ceftiofur is controlled by dissolution of the P407. An increase in P407 content from 25 to 35% resulted in a decrease in the rate of ceftiofur release. However, it appears that other factors may have also affected the drug release rate. Inclusion of PVP, CMC, and HPMC in the gel decreased the rate of release of ceftiofur to some extent. A decrease in the temperatures of the release medium decreased the release rate of ceftiofur, but not the rate of gel dissolution. The pH of the release medium showed a very slight effect on the release of ceftiofur and did not affect gel dissolution due to the non-ionic nature of P407.

Cephalosporins↗
PubMed2002

Dams, environment and regional development--harnessing the "elixir of life: water" for overall development.

Water--the Elixir of Life--has the potential to sustain human life and also to develop it further, and that is why various international instruments have aptly recognized its role in sustainable development. This paper reviews the global and Indian water scenario before presenting the case of Gujarat State, where perennial water scarcity has raised serious threats to the existence of millions of people and cattle and has led to environmental degradation and constrained economic development. More than 13,000 villages out of 18,028 villages of the State are facing scarcity in terms of crop failure this year. Drinking water supply is maintained by transporting water by road tankers, "water special" trains and even by ships via a sea route. Lack of access to safe and clean water for domestic use has a detrimental effect on the social fabric, and even incidences of migration and water riots are recorded. The paper discusses the efficacy of available options including rain water harvesting. The efforts of the State to harness the untapped waters of Narmada for the survival of millions and sustainable development of western India, are discussed adjudging socioeconomic and environmental impacts. The paper concludes that assured water supply is essentially critical for overall development.

Agriculture↗
PubMed2002

Environmental sustainability in an agricultural development project: a system dynamics approach.

Regional agricultural projects based on water resource development have many potential impacts on social and natural environments. In this research, potential long-term environmental problems of the Southeastern Anatolian Project (GAP) related to water resources, land use, land degradation, agricultural pollution and demography are analysed from a systems perspective. The analysis focuses on the totality of environmental, social and economic issues. For this purpose, a system dynamics simulation model (GAPSIM) has been developed as an experimental platform for policy analysis. GAPSIM was validated, first 'structurally', using the tests suggested by the literature and then the model 'behaviour' was tested and calibrated with respect to available data. The reference behaviour of GAPSIM reveals that, as the irrigated lands are developed, GAP faces significant water scarcity because of the increased intensity of cotton, the crop with the highest demands for water. Simulation results also indicate that two key environmental factors, pesticide and fertilizer consumption may reach undesirable levels. Alternative irrigation water release strategies, development rates of irrigated fields and farm rotation practices appear as important policy tools in achieving long-term environmental sustainability. GAPSIM promises to be not only a useful laboratory for policy makers of GAP, but also a useful generic structure applicable to other similar regional development projects.

Agriculture↗
PubMed2004

Use of ibutilide in cardioversion of patients with atrial fibrillation or atrial flutter treated with class IC agents.

OBJECTIVES: We sought to assess the efficacy and safety of ibutilide cardioversion for those with atrial fibrillation (AF) or atrial flutter (AFL) receiving long-term treatmentwith class IC agents. BACKGROUND: Attenuation of ibutilide-induced QT prolongation has been observed in a small number of patients pretreated with class IC agents. The clinical significance of the interaction between ibutilide and class IC agents is unknown. METHODS: Seventy-one patients with AF (n = 48) or AFL (n = 23), receiving propafenone 300 to 900 mg/day (n = 46) or flecainide 100 to 300 mg/day (n = 25), presented for ibutilide (2.0 mg) cardioversion. RESULTS: The mean durations of arrhythmia episode and arrhythmia history were 25 +/- 48 days and 4.4 +/- 6.4 years, respectively. Sixty-five patients (91.5%) had normal left ventricular systolic function. Twenty-three of 48 patients (47.9%; 95% confidence interval, 33.3% to 62.8%) with AF and 17 of 23 patients (73.9%; 95% confidence interval, 51.6% to 89.8%) with AFL converted with mean conversion times of 25 +/- 14 min and 20 +/- 12 min, respectively. There was a small increase in corrected QT interval after ibutilide (from442 +/- 61 ms to 462 +/- 59 ms, p = 0.006). One patient developed non-sustained polymorphous ventricular tachycardia and responded to intravenous magnesium. Another developed sustained torsade de pointes and was treated effectively with direct-current shock and intravenous dopamine. CONCLUSIONS: Our observations suggest that the use of ibutilide in patients receiving class IC agents is as successful in restoring sinus rhythm and has a similar incidence of adverse effects as the use of ibutilide alone.

Aged↗
PubMed1986

Use of chitosan and hydroxypropylchitosan in drug formulations to effect sustained release.

This study was an attempt to develop implantable sustained release forms of drugs, based on formulations containing chitosan, a biodegradable polymer from a natural source, and hydroxypropylchitosan (HP-chitosan), its water-soluble derivative. The possibilities were explored using uracil as a model for anticancer drugs. Enzymatic degradation of chitosan and HP-chitosan was first confirmed in vitro (using lysozyme) and in vivo by implanting both materials subcutaneously into the backs of rats. Then, using an in vitro dissolution test, we found that the release rate of uracil from chitosan membranes could be altered by the addition of HP-chitosan. Film- and stick-type implantable dosage forms of chitosan containing uracil were prepared by the 'Extrusion-in-Air' method. These gave rise to sustained release of uracil in vitro and in vivo. We conclude that chitosan and HP-chitosan have a potential as biocompatible and biodegradable vehicles in the preparation of implantable sustained release dosage forms of anticancer drugs.

Chemical Phenomena↗
PubMed1979

[Plasma levels, renal excretion and metabolism of orciprenaline after administration in sustained-release form (author's transl)].

A newly developed sustained-release form of orciprenaline-sulfate (Alupent) was tested in 13 patients. Determination of 3H-radioactivity in blood, urine and faeces was used to elucidate its pharmacokinetic properties. Maximum plasma levels of radioactivity were obtained between 8 and 12 h after administration. 10.7 +/- 2.5% of the administered radioactivity were excreted in urine over a period of 72 h. Orciprenaline was mainly excreted as the sulfate-conjugate. Approximately five percent of the radioactivity were excreted as 4,6,8-trihydroxy-N-isopropyl-tetrahydroisoquinoline--the condensation product of formaldehyde and orciprenaline.

Biotransformation↗
PubMed2006

Management matters: sustaining funds for youth development programs.

Drawing on data collected through evaluations of youth development (YD) programs, including those offered in community-and school-based after-school programs, this article describes practices that support program managers' quests for funds that will sustain programs. Designing YD activities to incorporate skills building (including educational) and recreational and fun activities for adolescents can enlarge the resource pool to include funds for educational activities and youth engagement. Strong behavioral management of programs encourages youth attendance and provides a safe environment to develop positive peer and adult relationships, both of which are crucial to YD. Strong attendance, in turn, can keep program costs in line with expectations and reduce the marginal costs for additional participants. Faithful implementation of previously tested program models increases the likelihood that the program will be effective, and positive outcomes are essential to sustained funding.

Adolescent↗
PubMed2006

Development of a respirable, sustained release microcarrier for 5-fluorouracil II: In vitro and in vivo optimization of lipid coated nanoparticles.

The release rate of 5-fluorouracil (5-FU) from lipid-coated nanoparticles (LNPs) was determined to develop a respirable delivery system for use as adjuvant (postsurgery) therapy for lung cancer. LNPs were prepared by spray drying, and the in vitro release was measured by microdialysis. The composition of the core and shell affected the release rate. Increasing the core diameter at constant shell thickness and increasing shell thickness at constant core diameter reduced the release rate, suggesting that the lipid shell is the rate limiting step for the release of 5-FU. A model consisting of a sequential zero-order/first-order dependence on time from polydispersed cores within polydispersed shells was developed to describe the release. Based on studies of the effect of geometry of the layered particles, the optimal formulation was identified as a 600-nm diameter 5-FU/poly-(glutamic acid) core with a 200-nm thick tripalmitin/cetyl alcohol shell. This system is readily aerosolized by ultrasonic atomization, which did not change the release properties. Preliminary instillation and inhalation delivery studies to the hamster resulted in lung levels of the particles and 5-FU that were near the desired values. Through this effort, a sustained-release, respirable delivery system for adjuvant therapy of lung cancer in humans may ultimately be realized.

Administration, Inhalation↗
PubMed2003

[Workflow involving preventive health care promotes the economic development of a company].

Today's working society obviously develops from industrial production to knowledge-intensive service. In service-oriented working conditions, the importance of the human being as a main performer of economic success increases. Thus, the development leads to a changing spectrum of occupational health risks. Together with socio-demographic developments, individual strain-oriented health disorders connected to one's occupation might endanger an enterprise's capacity of performance and innovation as well as its sustainable enterprise development. Only healthy, motivated and qualified employees are able and ready to keep their creative and customer-oriented potential harnessed and thereby work to the best of their ability. Consequently, occupational health gains a more important role within the enterprise. Although in many enterprises the benefit contribution of preventive work design has not yet been considered that relevant, enterprises have realised that a preventive health-oriented work design might help to better manage current business challenges. An up-to-date definition of health includes the goals of health improvement, personality development as well as a comprehensive well-being. Health is a prerequisite and result of a productive reflection upon the conditions and challenges of work. Business practice shows that a preventive work design should involve an economic benefit for the enterprise. If occupational health is seen as a characteristic of quality and a prerequisite for sustainable enterprise development, economic potentials of preventive work designs will expand considerably.

Humans↗
PubMed2006

Signaling pathways mediating VEGF165-induced calcium transients and membrane depolarization in human endothelial cells.

Cytosolic calcium and membrane potential were monitored simultaneously in quiescent human umbilical vein endothelial cells (HUVEC) exposed to vascular endothelial growth factor (VEGF)165 using the fluorescent indicators indo-1 AM and DiSBAC2(3), respectively. Application of VEGF165 to cells elicits a rapid rise in cytosolic calcium followed by a slower decline toward control values. Peak calcium is associated with a slight membrane hyperpolarization; however, as calcium falls toward control, a strong depolarization develops and is sustained throughout a 10-min period of VEGF165 stimulation. Both the VEGF165-mediated rise in cytosolic calcium and membrane depolarization are eliminated by inhibitors of VEGFR-2, tyrosine kinase, src kinase and inositol-1,4,5 triphosphate-operated calcium channels. Calcium entry, which is initially facilitated by transient hyperpolarization, is restricted by a substantial, sustained depolarization that developed during the downstroke of the calcium spike. Inhibition of plasmalemmal calcium channels diminished the magnitude and duration of the calcium spike, suggesting that extracellular calcium influx, secondary to stores release, is a significant component of the calcium transient. Inhibition of chloride channels substantially reduced membrane depolarization. In addition, the depolarization is modulated by PI3 kinase in a ras-independent manner. In summary, intracellular calcium and membrane potential are influenced by several key signaling cascades of VEGFR-2 activation in HUVEC.

Calcium Signaling↗