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PubMed2003

Neonatal hearing screening.

Neonatal hearing screening can be performed using reliable and reproducible methods. Intervention before the age of 6 months with hearing aids and appropriate educational support services will give the infant the best possible opportunity to develop language. Potential barriers to efficient implementation of a neonatal hearing screening program include access to appropriate and timely diagnostic and support services and insurance to cover the services. Without universal neonatal hearing screening, many children with hearing loss will be missed, which will have a direct negative impact on their speech, language, educational, and social development.

Hearing Disorders↗

PubMed1998

Fatal asthma in children: a nurse managed model for prevention.

In response to the rise in pediatric asthma-related deaths and the absence of guidance in the literature for prevention of such deaths, a nurse managed program was designed to prevent death in children at risk for death from asthma. Published guidelines for identification of children with life-threatening asthma were used to develop a comprehensive health care network designed to provide early, aggressive medical attention and rapid access to care for selected children. The program has been successful in assuring more aggressive and timely intervention for asthma attacks and there have been no deaths from lack of access to appropriate care since the program's inception.

Adolescent↗

PubMed1979

Height/weight disproportion in elementary school children.

This paper discusses the importance of studying physical growth patterns in children and presents the results of a survey of height and weight measurements collected on 1,953 children ages 5--11 from 12 schools in a city in the southeastern United States. Approximately 40% of the sample children had height/weight disproportion. Twenty-seven percent of the sample children weighed more than normal for their height. Physical and psychological consequences of childhood obesity are discussed as a basis for intervention with children. The investigators believe that the problems of elevated weight in childhood merits a great deal more study so that groups at risk can be predicted and more effective treatment programs developed. For persons who are overweight, control of weight requires a change in behavior which is essentially an educational process; therefore, it would appear appropriate to have such programs placed within the school setting.

Age Factors↗

PubMedDate not supplied

Falling through the cracks of the big cities: who is meeting the needs of HIV-positive youth?

BACKGROUND: Globally, half of all new HIV infections occur among youth under 25. As of June 30, 2002, more than 13,000 youth and young adults had tested positive for HIV in Canada. Despite this prevalence, there is a lack of resources for Canadian HIV-positive youth. OBJECTIVE: To investigate what can be done to better support the needs of HIV-positive youth in Canada. METHODS: A community-based participatory research approach was adopted. Thirty-four qualitative in-depth semi-structured interviews were conducted with youth (ages 12-24) living with HIV in Ontario. A stakeholder group of youth living with HIV, professionals and researchers collaboratively analyzed the data for emerging themes. RESULTS: When asked about areas in their lives where youth needed support, three major themes emerged: 1) Personal feelings about HIV: Youth identified a wide range of emotional response to their HIV status; however feelings of isolation, loneliness and hopelessness were dominant. 2) Barriers to full participation in society: Youth described a number of social and structural barriers to their full participation in society. 3) Specific support needs: Youth had difficulty accessing appropriate support services; they had very mixed feelings about both youth- and AIDS-serving organizations. INTERPRETATION: The youth we interviewed are interested in targeted programs, have difficulty accessing appropriate resources and would benefit greatly from increased social support. Specialized health and support services that are developmentally appropriate may be necessary. Where specialized services do exist, more research may be necessary to understand why they are underutilized and/or perceived as inappropriate. While this was a small exploratory study, our data suggest that better supporting the needs of HIV-positive youth might directly benefit this vulnerable population.

Adolescent↗

PubMed1991

Comparison of MS-DOS and Macintosh pharmacokinetic analysis programs using a two-compartment, two-infusion dosing scheme.

Pharmacokinetic values derived by three nonlinear least-squares regression computer programs for sets of serum drug concentration data were compared. The three programs selected for comparison were the MS-DOS-based programs PCNONLIN and ADAPT and the Macintosh program BOOMER. Data on serum recainam hydrochloride concentration in 10 patients given an i.v. loading dose followed by a maintenance infusion were fitted by the appropriate models in each program. Samples had been subjected to reverse-phase isocratic high-performance liquid chromatography with ultraviolet light detection; intraday and interday coefficients of variation were less than 8% over the range of concentrations measured. A two-compartment model was used for all regressions. Each program was given identical initial estimates, and the simplex minimization algorithm of each program was used to fit the model to the data. An identical weighting scheme was used for all three programs. The mean pharmacokinetic values estimated by each program for the 10 data sets were essentially identical. Slightly larger rate constants and smaller volume terms were derived by BOOMER. BOOMER yielded the lowest weighted sum of squares and the highest correlation coefficient. A mean concentration-time plot showed that the programs all produced values that described the data very well. The three computer programs used in this analysis derived essentially the same pharmacokinetic values to describe sets of serum drug concentration data. The BOOMER program provides an acceptable alternative to MS-DOS-based programs for pharmacokinetic analysis.

Chromatography, High Pressure Liquid↗

PubMed2006

Adherence to an occupational blood borne pathogens exposure management program among healthcare workers and other groups at risk in Argentina.

We conducted a retrospective review of 130 occupational blood borne pathogens exposure (BBP-OE) records at Centro de Estudios Médicos e Investigaciones Clínicas, a university hospital with an ongoing educational program and a postexposure management program for healthcare workers (HCWs) since 1995, in order to evaluate adherence to a hospital BBP-OE management program. We compared HCWs from our institution (Group 1) and HCWs from independent institutions that contract our postexposure management program (Group 2). Compliance with standard precautions in Group 1 was inadequate in 77%, 23%, and 16% of nurses, physicians, and others, respectively. A greater proportion of HCWs in Group 1 (74% vs. 40%) reported occupational accidents within two hours after exposure (p = 0.0001). No difference was observed regarding compliance with adherence to schedule, partial adherence, and loss at follow-up (14%, 33%, and 53%; p > 0.05). Adherence to the standard of care for BBP-OE, including postexposure prophylaxis, was low (HIV: 53% and HBV: 63%). Knowledge of the seropositive status of the source patient did not improve adherence. We conclude that postexposure programs do not guarantee appropriate behavior by HCWs. General interventions and ongoing personnel education to modify individual attitudes are needed, as are continued efforts to assess HCWs' experiences with these programs, as well as the identification of strategies to improve adherence.

Argentina↗

PubMed1984

Patterns of community-based prevention programs.

Prevention of dental caries is most effectively and efficiently achieved by community-based methods, whether in economically developed or developing countries. The role of the private practitioner is a dual one: to support the establishment of appropriate caries-preventive programs such as water fluoridation, salt fluoridation, supervised ingestion of fluoride tablets, and supervised programs of mouthrinsing with fluoride solutions and with such programs in place, to provide personal preventive care to that relatively small number of caries-susceptible people who will still need individual attention. The development of community-based programs is especially critical in those developing countries where the population is growing rapidly and caries is becoming more prevalent, for with their limited resources the only hope of controlling caries is with cost-effective community programs. Control of periodontal disease requires community education, but to be successful it will also require preventive care from practitioners. Even in the economically-developed countries there is a need for greater awareness of periodontal disease among both practitioners and the public. In many of these countries, now that caries is becoming better controlled, the time is ripe for considerably more prevention and treatment of periodontal disease. Its control, in the developing countries, poses special problems, and will have to depend heavily on public education for a considerable time yet. Both community-based programs and private practitioners have important roles to play in the prevention of the most prevalent oral diseases, but these roles need to be carefully defined to avoid wasteful duplication if maximum benefit is to be obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2001

Occurrence of anaerobic bacterial, clostridial, and Clostridium perfringens spores in raw goose livers from a poultry processing plant in Hungary.

Anaerobic bacterial, clostridial, and Clostridium perfringens spores were enumerated in raw goose liver samples taken after evisceration of the birds (EB) in the slaughterhouse and after removal of blood vessels from the liver (RBVL) in the cannery. The samples taken after RBVL had significantly higher (P < 0.05) spore counts than did those taken after EB, indicating contamination of livers during processing. The number of C. perfringens spores was one log cycle higher in the samples taken after RBVL than in those taken after EB (P < 0.05). The confirmation of C. perfringens according to the profiles of Rapid ID 32 A tests was carried out by means of the ATB Plus computer program. With an identification percentage of 99.9 and a T-value of 0.65, the suspect colonies proved to be C. perfringens. Therefore, the importance of an appropriate cleaning and sanitation program and of personnel hygiene should be emphasized in the industry.

Animals↗

PubMed1995

Impact of attitudes on maternal decisions regarding infant feeding.

It is essential that physicians and other health care professionals seeking to increase the rate of initiation and duration of breast-feeding build on the body of information concerning factors that influence a woman's attitudes about breast-feeding. The relation between positive attitudes concerning breast-feeding and its initiation is important to the development of programs targeting women before they become pregnant, and to the provision of active support for breast-feeding throughout the pregnancy, perinatal, and postnatal period. However, it is not sufficient for these programs to target only the mother or potential mother; members of a woman's social network must be considered as information targets. Educational programs must also be directed to the appropriate racial or ethnic group to develop programs that reach the individuals (father, female relative, or friend) most likely to influence the mother's breast-feeding decision. Physicians may be very knowledgeable about the nutritional and immune properties of human milk and yet not be supportive of the act of breast-feeding. This lack of support may be manifested by the lack of verbal support for women who intend to or are in the process of breast-feeding, the provision of infant formula before or at the time of birth of the baby, or encouragement to terminate breast-feeding should the mother encounter any difficulties with lactation. To increase physician awareness of the process of breast-feeding and the properties of human milk, information about the benefits should be integrated in both the basic science and the clinical curricula of medical schools. Primary care training programs, including obstetrics, should actively involve trainees in the management of breast-feeding women so that trainees become aware of the spectrum of circumstances that confront women seeking to establish and maintain successful breast-feeding. This type of involvement would provide a contextual base for physicians' understanding the attitudes and behaviors supportive of breast-feeding. Attitudes and behavior of women, although more complex then demographic factors, provide a powerful tool for meeting the Healthy People 2000 goals for the initiation and duration of breast-feeding. It is important to build on the base of research reviewed here to develop new and and more powerful interventions. Thus the emphasis on the known health advantages of human milk or the discovery of additional health benefits of breast-feeding should continue to be discussed because they may tip the balance in favor of breast-feeding for some women. Nevertheless, it may ultimately be more important to increase the amount of information provided to women (and girls and boys) about the practical aspects of the breast feeding process (e.g., ease of night feeding, fathers ability to feed mother's milk by bottle, lower cost, strategies to control leaking) then to rely solely on the positive health outcomes related to breast-feeding.

Adult↗

PubMed1984

Management of pacemaker circus movement tachycardias.

DDD pacemakers were implanted in 11 patients of whom 5 had the capacity to conduct retrogradely to the atrium. Methods to prevent or terminate pacemaker circus movement tachycardia ( PCMT ) were evaluated in these patients. V-A conduction was assessed before implantation by incremental right ventricular pacing while recording right atrial electrograms. Following implantation and at quarterly outpatient clinic visits, V-A conduction and ability to initiate and sustain PCMT were systematically assessed by non-invasive techniques. PCMT could be induced non-invasively in all 5 patients. The methods used to reduce and terminate the incidence of PCMT were: 1) decreasing the atrial sensitivity; 2) stressing the V-A conduction system by programming a high upper rate with an appropriately short A-V interval; 3) programming a low lower rate; 4) avoiding the Wenckebach response (by programming a high upper rate); 5) medication; and 6) occasionally by using a magnet. PCMT was controlled in all patients, in 2 patients by programming measures only and in 2 with the addition of medication. One patient who refused medication had to be programmed into another pacing mode. We conclude that: 1) the presence of V-A conduction is not an absolute contraindication to the use of a DDD pacing system; 2) pacing the ventricle early enough to cause V-A block was the most useful method to terminate PCMT ; 3) future generation DDD pacemakers should prevent initiation of PCMTs while maintaining the possibility to synchronize to exercise-induced high atrial rates.

Adult↗

PubMedDate not supplied

Ethnic/racial populations and worksite health promotion.

This chapter describes the health characteristics and health risks of ethnic-racial populations and the implications for planning and delivering health promotion programs at the worksite. Special consideration is given to occupational stratification, which separates these groups from their white counterparts, thus requiring special attention. Guidelines are given for designing culturally appropriate worksite health promotion programs.

Black or African American↗

PubMed2004

Assessment, prevention, and intervention activities in a school-based program for children experiencing homelessness.

Children who experience homelessness are at increased risk for a range of health and mental health problems. In spite of this increased risk, they are often less likely to receive appropriate services. School-based programs offer considerable potential to reduce the gap between needs and appropriate services for these youth; however, there are few examples of such programs in the published literature. This article provides information from a mental and physical health prevention program and needs assessment for at-risk children, who were experiencing homelessness or were from very low-income families, which was piloted during a summer camp program in an urban school. Results of the needs assessment indicated that children residing in homeless shelters reported less consistent access to medical and dental care than children residing with their families. It is interesting that children experiencing homelessness were more likely to report that they had participated in counseling than did children from low-income families. Satisfaction ratings of prevention activities conducted in the program were positive for students and teachers.

Adolescent↗

PubMed1995

The diversion of mentally ill persons from jails to community-based services: a profile of programs.

OBJECTIVES: A major proposal for appropriately treating persons with mental illnesses who have been arrested is to divert them from jail to community-based mental health programs. However, there are few available definitions, guidelines, and principles for developing effective diversion programs. The goal of this research was to determine the number and kinds of jail diversion programs that exist, how they are set up, and which types of programs are effective. METHODS: On the basis of information gathered during a national mail survey (n = 1263) and follow-up telephone survey of 115 responding jails, 18 sites were selected for on-site interviews based on perceived effectiveness and presence of a formal diversion program. RESULTS: Data are presented from a national sample of jail diversion programs (n = 18). Key factors for developing diversion programs and descriptors of effective programs are presented. CONCLUSIONS: It is clear that controlled, longitudinal studies of these programs' effectiveness, using client-based and organizational outcome measures, are badly needed.

Case Management↗

PubMed1988

A computer program to calculate mean skin temperature from measurements available from field trials.

Attempts to estimate mean skin temperature for subjects during prolonged experiments in field conditions are often made difficult because probes become disconnected or cease to function. There are several equations which allow estimation of mean skin temperature from a reduced number of functioning probes. The Fortran program described chooses the appropriate equation, calculates the mean skin temperature using whichever readings are available from the six selected sites and calculates mean body temperature using also rectal temperature. The organization of the program is such that it could easily be modified for use on results from a wide range of experimental conditions.

Electronic Data Processing↗

PubMed2005

Adverse drug reaction and medication error reporting by pharmacy students.

BACKGROUND: The reporting of adverse drug reactions (ADRs) and medication errors is the responsibility of all who are involved, particularly pharmacists. Since pharmacists are often privy to information surrounding ADRs and medication errors, it is of utmost importance that they are educated regarding the procedures of reporting. OBJECTIVE: To determine pharmacy students' knowledge of and ability to report ADRs and medication errors. METHODS: A total of 1322 students from 9 colleges of pharmacy were surveyed. RESULTS: The largest group of respondents was fifth-year pharmacy students (38%) followed by third-, fourth-, and sixth-year students (28%, 26%, and 8%, respectively). The majority of students reported learning about ADR and medication error reporting programs via didactic experiences. In comparison, fewer students cited alternative mechanisms of learning, including experiential rotations and work experience. Overall, respondents demonstrated the most experience with MedWatch and the least experience with the Vaccine Adverse Event Reporting System (VAERS). As students progressed through pharmacy curricula, there was a positive trend in the ability to locate and complete MedWatch forms. For VAERS and Medication Error Reporting (MER) program forms, however, this positive trend was broken at year 4. For all programs, significantly fewer students demonstrated appropriate use of the forms compared with those indicating familiarity with the programs. CONCLUSIONS: This study demonstrated that students are becoming familiar with ADR and MER programs via the college curriculum; however, there is opportunity for greater exposure and understanding. Colleges of pharmacy should continually seek methods to strengthen the education provided to pharmacy students regarding these programs.

Adverse Drug Reaction Reporting Systems↗

PubMed1990

Tobacco use cessation curricula in the U.S. dental schools and dental hygiene programs.

Tobacco-related health problems are the most preventable forms of illness in the United States. By assuming proactive tobacco use cessation counseling roles, dentists and dental hygienists can help reduce the number of people who currently use tobacco. The literature reports that many oral health professionals feel unprepared to assume such roles. To help combat the problem of tobacco-related illness and to help prepare dentists and dental hygienists to assume tobacco use cessation counseling roles, dental schools and dental hygiene programs need to develop appropriate didactic and clinical tobacco use cessation curriculum content. To date, there are limited national data addressing the extent of tobacco use cessation education in dental schools and dental hygiene programs. Studies of medical schools have revealed a need for increased curriculum content on tobacco use prevention and cessation. Further, tobacco use cessation training programs for medical students, practicing dentists, and dental hygienists have resulted in increased student and provider confidence when tobacco use cessation counseling roles were assumed. This study surveyed all dental schools and dental hygiene programs in the U.S. to determine if tobacco-related curriculum content exists, and if so, to what extent. Variables addressed included allocated hours, subject content, scope, department responsible, workplace smoking policy, importance, and future curricular directions. Questionnaires were mailed to all dental hygiene program directors and dental school academic deans. Study findings suggest that dental and dental hygiene students receive limited tobacco use cessation education, and respondent schools have no immediate plans for curriculum change in this area.(ABSTRACT TRUNCATED AT 250 WORDS)

Chi-Square Distribution↗

PubMed1973

Special programs in medical library education, 1957-1971. II. Analysis of the programs.

In this report, responses to a questionnaire to the directors of the sixteen past and present medical library education programs are presented. The questionnaires indicate a rather wide variety of training programs with emphases that vary from preparation of management personnel to preparation of subject specialists and those skilled in the techniques of information storage and retrieval. The content of the degree programs is fairly evenly divided among general retrieval and outside courses. The internship programs place more emphasis on the work experience than do the degree programs, supplementing this experience with appropriate courses in science, health sciences, management, and information storage and retrieval. Program directors indicated that new or expanded programs are needed in medical library education, although caution is reflected in comments concerning the limited job market. Most of the internship directors stated that they could not accommodate more individuals in their programs without expansion of staff and facilities.

Curriculum↗

PubMed1994

Perinatal mortality in Oklahoma.

OBJECTIVE: To identify areas of need in Oklahoma's perinatal care system by analysis of trends in perinatal mortality from 1939 through 1991. DATA: Derived from birth certificates and annual tabulation published by the Maternal Child Health Division, Oklahoma State Department of Health. RESULTS: Every measure of perinatal mortality has declined in the period studied. CONCLUSIONS: (1) Oklahoma's perinatal mortality rate is declining. (2) Preventable deaths still occur. (3) Programs are in place to appropriately deal with the problems that lead to preventable deaths. (4) These programs must be allowed to continue or expand their efforts to further reduce preventable perinatal death.

Cause of Death↗