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At least 1,243 records · Page 69Linked to original sources
PubMed2005

A home education program for older adults with hearing impairment and their significant others: a randomized trial evaluating short- and long-term effects.

This paper addresses the development and effectiveness of a home education program. The program, designed for hearing-impaired elders and their significant others (SO), deals with communication strategies and speech reading. Participants were randomly assigned to a training group (hearing aid fitting+home education program) or a control group (hearing aid fitting). The training group included 24 hearing-impaired subjects and 24 SO's. Controls were 24 affected individuals and 22 SO's. Questionnaires addressing emotional response, communication strategies and the IOI-HA, IOI-AI and IOI-SO were used. A repeated measures analysis of variance was applied to test group differences between pre, post, and 6-months follow-up measures. Increased awareness of benefits of speech reading and improved interaction with the SO were observed in the training group only (p < 0.05). No group difference on 'emotional response' was found. IOI-AI and IOI-SO demonstrated favorable attitudes towards the program. Follow-up measures showed improved quality of life and satisfaction in the training group, while a decrease was observed among the controls (p < 0.05). Some effects differed between first-time and experienced hearing aid users. Addition of services to amplification and involvement of the SO are relevant in aural rehabilitation.

Aged↗
PubMed2004

Preventing alcohol-related harm in college students: Alcohol-related Harm Prevention program effects on hypothesized mediating variables.

The Alcohol-related Harm Prevention (AHP) program is a normative education and skill-acquisition program designed to reduce serious, long-term alcohol-related harm in college students. Without admonishing students not to drink, which is likely to fail in many student populations, the AHP program attempts to give students the necessary perceptions, motivation and skills to intervene within their peer group, and to make proactive harm-avoidance plans with friends prior to social occasions that involve using alcohol. The AHP program is a two-session, in-class intervention that corrects misperceived norms regarding levels of alcohol use, caring about friends, acceptability of risky behaviors and willingness to intervene. The program also makes use of interactive discussions with students and a graded, peer interview assignment to identify and promote harm-prevention strategies. The AHP program was implemented during fall 1999 at a large northeastern university. The program was received very well by students and showed significant effects on the proximal outcomes hypothesized to mediate more distal health-relevant outcomes.

Alcoholism↗
PubMed1982

Recidivism and drug use among school-age children.

This paper is the result of an investigation of recidivism rates among teenaged children who completed a program designed to improve communication between the children and their parents. A sample of 62 children from 13 to 18 years old was utilized. All had been referred to a mental health program by juvenile courts for therapeutic intervention because of drug offenses. The intervention program stressed family communication and communication techniques and required both the child and parents to attend. Three types of rates of recidivism were then obtained from juvenile court records for each sample member including all referrals, adjusted referrals, (excluding such referrals for truancy, fighting, traffic offenses, etc.), and those referrals for drug offenses only. These were analyzed for both pre- and post- intervention length of time. Analysis of data revealed significant (p v .001) decrease for all three categories of referral. Notable was that the recidivism rate for drug offenses declined significantly. While this data is encouraging some considerations are necessary. First, the degree of experimental control was limited. The use of a control group would perhaps have been beneficial. Secondly, one must consider the effect of the "arrest experience" and its relationship to learning how to avoid getting caught for the same offense twice. This could be examined further if the pre- and post-intervention periods could be lengthened. A final consideration would be the effect of other intervention programs on recidivism. since many of the children were receiving more than one type of therapy. The question of which intervention program most effected the decline of recidivism would have to be answered before one could accept the conclusion that the communication program was indeed responsible for the significant decrease in recidivism.

Adolescent↗
PubMed1995

Interventional procedures of the breast: medicolegal considerations.

Interventional procedures of the breast are increasing in frequency both because of screening programs designed to detect large numbers of nonpalpable lesions and the advent of new technologies. These procedures afford the radiologist new opportunities to participate in patient care. Those radiologists involved in interventional programs need to be familiar with the legal ramifications of such procedures, many of which have not been historically important outside of the treating clinical community. The high frequency of legal exposure associated with breast cancer evaluation should prompt the development of risk management guidelines for the performance of interventional procedures of the breast.

Biopsy, Needle↗
PubMed2006

Enhancing diversity in science: is teaching science process skills the answer?

The Biology Fellows Program at the University of Washington aims to enhance diversity in science by helping students succeed in the rigorous introductory biology classes and motivating them to engage in undergraduate research. The composite Scholastic Achievement Test scores and high school grade point averages of the Biology Fellows are comparable to those of students who are not in the program; however, they earn, on average, higher grades in introductory biology classes than non-Biology Fellows. Underrepresented minorities and disadvantaged students in the program also earn higher grades in the introductory biology classes than do their non-Biology Fellows counterparts. Analysis of the performance of Biology Fellows shows that the program assists students who are not proficient in certain science process skills and that students who lack these skills are at risk for failing introductory biology. This evaluation provides insight for designing programs that aim to enhance the performance of beginning students of biology, particularly for underrepresented minorities, who want to obtain a life science degree.

Attitude↗
PubMed1995

Educating African-Americans about cancer prevention and detection: a review of the literature.

The high incidence of cancer mortality and morbidity among African-Americans has led to a need for cancer education and detection programs designed for this underserved population. This review of the literature focuses on key cancer-related health beliefs, barriers to utilization, and methods of intervention that should be considered in developing programs for African-Americans. Implications for social work practice are discussed.

Black or African American↗
PubMed1994

Evaluation of a managed care program for the non-Medicaid urban poor.

In 1988, Detroit and surrounding Wayne County, Michigan, began CountyCare, an innovative managed care program designed to deliver health care services to the very poor while reducing excessive emergency-room and inpatient care. We interviewed 279 former CountyCare participants to assess differences in off-program utilization, use of clinical services, hospitalization, and patient satisfaction among respondents assigned to one of four CountyCare provider groups. Patients responded favorably to CountyCare, although off-program utilization was substantial and emergency-room and inpatient care were not significantly reduced. We conclude that how such a program is managed and administered, and a provider's degree of motivation, govern the extent to which it succeeds in reducing health care costs and increasing patient satisfaction.

Adult↗
PubMed2006

Nonpolarizing beam splitter designed by frustrated total internal reflection inside a glass cube.

A method for the design of an all-dielectric nonpolarizing prism beam splitter utilizing the principle of frustrated total internal reflection is reported. The nonpolarizing condition for a prism beam splitter is discussed, and some single layer design examples are elaborated. The concept can be applied to a wide range of wavelengths and arbitrary transmittance values, and with the help of a computer design program examples of 400-700 nm, T(p)=T(s)=0.5+/-0.01, with incident angles of 45 degrees and 62 degrees are given. In addition, the sensitivity and application of the design are also discussed.

Journal Article↗
PubMed2005

Cost and utilization analysis of a pediatric emergency department diversion project.

OBJECTIVE: States are struggling to find effective means to decrease Medicaid costs. The objective of this pilot study was to compare emergency department (ED) cost and utilization by members who were enrolled in a pilot program (designed to reduce the use of hospital EDs) with the costs and utilization incurred by a control group. METHODS: A large, private, primary care pediatric practice launched a pilot ED diversion program that provided extended office hours, multiple access locations, and care coordination. Participants in the program were Medicaid recipients who were younger than 18 years. Enrollment in the program was through either patient self-selection or mandatory assignment by the state Medicaid agency. A total of 17,382 children who were enrolled in the enhanced access program (intervention group) and 26,066 Medicaid-eligible children who received services from other local community primary care providers (control group) were included in the study. Children who had chronic health conditions and were receiving Supplemental Security Income benefits were excluded from this analysis. Regression analyses and t tests were applied to analyze the medical claim data that were collected for this project. Three variables were used as dependent variables to measure different aspects of the ED cost and utilization: per member per month cost, per thousand member per month encounter frequency, and per encounter cost. These variables were used to compare the intervention group with the control group for ED claims, as well as for the overall cost of care during the study period. RESULTS: In the 12-month period subsequent to program initiation, the average per member per month cost for ED utilization of the intervention group was 1.36 dollars less than that of the control group. However, there was no significant difference in terms of per-visit cost related to ED utilization. Therefore, the savings seemed to come as a result of a reduction in ED visits, not from reduced cost per visit. On average, children in the intervention group visited the ED approximately 8 fewer times per thousand members per month than the control group, yet there was no significant difference in the overall (ED and non-ED) cost of care between the intervention and control groups. CONCLUSION: Analysis from the first year of this pilot program demonstrates that by providing enhanced, coordinated, primary care access to Medicaid children, the utilization of the ED was significantly lowered among healthy children, whereas the overall cost of care remained the same.

Child↗
PubMed2000

African-American teen smokers: issues to consider for cessation treatment.

Previous reports have indicated ethnic differences in both tobacco-related morbidity and treatment outcome for smoking cessation among adults. We assessed smoking-related characteristics in African-American and non-African American teenagers applying to a cessation trial. 115 teens (15.9 +/- 1.8 years, 68% females, 27% African-American) responded via telephone to media ads. Self-reported sociodemographic, medical and smoking-related data were obtained to determine pre-eligibility for a full intake screen prior to trial participation. Compared to non-African American, African American teen applicants were older (16.4 +/- 1.7 years versus 15.6 +/- 1.6; p = 0.015), had lower Fagerström Test for Nicotine Dependence (FTND) scores (5.3 +/- 2.3 versus 6.1 +/- 1.8; p = 0.018, ANOVA controlling for age) and smoked fewer cigarettes on the weekend (27 +/- 16 versus 38 +/- 17; p = 0.001). African American teens reported similar duration of smoking (3.3 +/- 1.4 versus 3.1 +/- 1.5 years) and time elapsed between first cigarette ever smoked and daily smoking (0.7 +/- 0.9 versus 0.6 +/- 0.7 years). African American and non-African American teens had similar motivation to quit scores and frequency of reported health problems (e.g., asthma, psychiatric conditions). These data suggest that cessation treatment programs designed for African American youth should include lower Fagerstrom-defined levels, and possibly other criteria for tobacco dependence. These observations also highlight the importance of ethnocultural issues in treatment research programs.

Adolescent↗
PubMed2001

Taking a systemwide approach to improving quality care.

For the past decade, health insurer Anthem has been working with more than 300 hospitals in Ohio, Kentucky, and Indiana in a quality program designed to help them better use clinical data, monitoring, outcomes, and best practices to improve care in their facilities and promote patient safety. The results have been stimulation of new quality programs at the hospital level and a sense of partnership.

Benchmarking↗
PubMed1984

Preparing nonretarded young persons to meet mentally retarded adults.

A representative sample of 420, 15- and 16-year-old students in Dublin city participated in a short educational program designed to introduce them to mentally retarded adults. The main feature was a carefully, structured contact session with retarded peers held in the students' school. Various control procedures ascertained that the program had been effective at increasing the students' confidence at meeting retarded people. Moreover, the majority of students voluntarily chose to visit a local mental retardation center, and a proportion of them maintained regular contacts. We argued that students need to be given explicit guidance on how to interact with retarded peers.

Adolescent↗
PubMed1993

Clinical continuing education for school nurses.

Because of the increased presence of medically complex students in schools, school nurses need to maintain a high level of clinical expertise and continuing education must now include the technical and clinical aspects of care. The authors describe a unique continuing education program designed to update the theoretical knowledge and clinical skills of school nurses caring for students with respiratory disabilities. This report focuses on the development, implementation, and evaluation of a continuing education program with a specific clinical component.

Clinical Competence↗
PubMedDate not supplied

Use of process evaluation to guide health education in Forsyth County's project to prevent cervical cancer.

The Forsyth County, NC, Cervical Cancer Prevention Project is a 5-year public health education program designed to increase the proportion of black women in the county who are appropriately screened for cervical cancer. In this paper, the authors report on process evaluation--the procedures used to monitor the intervention and to insure that the target population was reached with a high quality, community-based health education program. A system that encompasses documentation of program activities, interviews with women in waiting rooms of primary care providers, semiannual interviews with a panel of approximately 100 women from the target population, and telephone followup with participants in direct education workshops was designed and implemented. Through October 1990, more than 2,100 interviews had been conducted. Data from these activities have facilitated continued development and refinement of educational materials, provided guidance for developing new strategies for reaching the target population, and provided continuous feedback to program managers to allow monitoring the impact of all program activities.

Black or African American↗
PubMed2002

Serving the underserved: school-based asthma intervention programs.

Asthma is a common and costly disease, which disproportionately affects young, ethnic minority, and impoverished individuals. A heightened public awareness has catalyzed a variety of efforts to reduce the impact of childhood asthma in the United States. Despite these efforts, however, at-risk groups continue to suffer excess morbidity. Strategies are required that can specifically address the needs of underserved communities. We review the underlying rationale and progress of school-based programs designed to assist asthmatic children.

Asthma↗
PubMed2006

Value-based insurance design: aligning incentives to bridge the divide between quality improvement and cost containment.

Rising costs and suboptimal clinical quality have spawned efforts to redesign healthcare benefit packages. Momentum has gathered behind 2 trends; the first, represented by disease management initiatives and pay-for-performance programs, focuses on the quality of care, and uses tools to manage patient health. The second trend, represented by increased patient cost sharing and consumer-driven health plans, focuses on the cost of care and uses financial incentives to alter patient and provider behavior. These 2 trends create a conflict for the patient in that disease management programs--designed to improve patient self-management--aim to enhance compliance with specific clinical interventions, while rising copayments create financial barriers that discourage the use of these recommended services. When patients are required to pay more for their healthcare, they buy less, even if the intervention is potentially lifesaving. Thus, the challenge for purchasers is to devise benefit packages that incorporate a range of features that complement each other in the effective and efficient delivery of care while explicitly avoiding the unwanted negative clinical effects associated with increased cost sharing.

Cost Control↗
PubMedDate not supplied

Self report of competence. A tool for the staff development specialist.

This study was conducted to identify self perception of clinical competence reported by medical-surgical nurses. The study used the model of clinical competence advanced by Benner (1984). Participants were invited to compare themselves with key aspects of Benner's (1984) model through analyzing their responses on a researcher-generated scale. Analysis of the responses on the Nursing Expertise Self Report Scale suggested both that the nurses were at the competent-to-proficient level of clinical practice and that nurses may not accomplish all aspects of the transition from novice to expert at the same rate. In this article, the use of self report of clinical competence in educational program design is explored.

Clinical Competence↗
PubMed2000

Basic concepts of artificial neural network (ANN) modeling and its application in pharmaceutical research.

Artificial neural networks (ANNs) are biologically inspired computer programs designed to simulate the way in which the human brain processes information. ANNs gather their knowledge by detecting the patterns and relationships in data and learn (or are trained) through experience, not from programming. An ANN is formed from hundreds of single units, artificial neurons or processing elements (PE), connected with coefficients (weights), which constitute the neural structure and are organised in layers. The power of neural computations comes from connecting neurons in a network. Each PE has weighted inputs, transfer function and one output. The behavior of a neural network is determined by the transfer functions of its neurons, by the learning rule, and by the architecture itself. The weights are the adjustable parameters and, in that sense, a neural network is a parameterized system. The weighed sum of the inputs constitutes the activation of the neuron. The activation signal is passed through transfer function to produce a single output of the neuron. Transfer function introduces non-linearity to the network. During training, the inter-unit connections are optimized until the error in predictions is minimized and the network reaches the specified level of accuracy. Once the network is trained and tested it can be given new input information to predict the output. Many types of neural networks have been designed already and new ones are invented every week but all can be described by the transfer functions of their neurons, by the learning rule, and by the connection formula. ANN represents a promising modeling technique, especially for data sets having non-linear relationships which are frequently encountered in pharmaceutical processes. In terms of model specification, artificial neural networks require no knowledge of the data source but, since they often contain many weights that must be estimated, they require large training sets. In addition, ANNs can combine and incorporate both literature-based and experimental data to solve problems. The various applications of ANNs can be summarised into classification or pattern recognition, prediction and modeling. Supervised 'associating networks can be applied in pharmaceutical fields as an alternative to conventional response surface methodology. Unsupervised feature-extracting networks represent an alternative to principal component analysis. Non-adaptive unsupervised networks are able to reconstruct their patterns when presented with noisy samples and can be used for image recognition. The potential applications of ANN methodology in the pharmaceutical sciences range from interpretation of analytical data, drug and dosage form design through biopharmacy to clinical pharmacy.

Algorithms↗