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At least 1,243 records · Page 69Linked to original sources
PubMed1998

Rheumatic findings in Gulf War veterans.

BACKGROUND: Rheumatic symptoms were commonly described among soldiers who served in previous wars. OBJECTIVE: To describe the frequency of rheumatology consultations, along with the diagnoses, and abnormal results on serologic testing in Gulf War veterans evaluated for Gulf War syndrome. METHODS: The medical records of the first 250 consecutive Gulf War veterans referred to the comprehensive clinical evaluation program at Wilford Hall Air Force Medical Center and Brooke Army Medical Center, San Antonio, Tex, were reviewed for demographic characteristics and frequency of subspecialty consultations. A retrospective review of rheumatic diagnoses and the frequency of abnormal serologic test results was recorded. RESULTS: Of the 250 Gulf War veterans evaluated in the comprehensive clinical evaluation program, 139 (56%) were referred for rheumatology consultation, which was the most common elective subspecialty referral. Of the patients evaluated, 82 (59%) had soft tissue syndromes, 19 (14%) had rheumatic disease, and 38 (27%) had no rheumatic disease. The most common soft tissue syndromes were patellofemoral syndrome (33 patients [25%]), mechanical low back pain (23 patients [18%]), and fibromyalgia (22 patients [17%]). Of the 19 patients with rheumatic disease, 10 had osteoarthritis, 2 had rheumatoid arthritis, 2 had gout, and 1 each had systemic lupus erythematosus, Behcet disease, parvovirus arthritis, psoriatic arthritis, and hypothyroid arthropathy. Abnormal serologic test results were common among the Gulf War patients regardless of the presence or absence of rheumatic disease. CONCLUSIONS: The rheumatic manifestations in Gulf War veterans are similar to symptoms and diagnoses described in previous wars and are not unique to active duty soldiers. Overall, the results of serologic screening were poor predictors of the presence of rheumatic disease.

Adult↗
PubMed1978

The psychologist in the community mental health center: an analysis of activities and training needs.

Professional activities and expressed needs for additional training were examined in the case of 211 psychologists employed in 51 community mental health centers in western United States. Two-thirds of the work week is taken up directly or indirectly with traditional clinical services, 19% with community mental health activities; and the balance in program development, administration, research, and program evaluation. In contrast to the common assertion linking psychologists and research activity, the current results indicate that psychologists in community mental health centers devote very little time to research or program evaluation. Expressed training needs parallel reported activity patterns - highest for clinical functions and moderately high for community mental health functions. The significant impact of the community mental health movement is seen in both the distribution of professional activities and in expressed needs for additional competence.

Adult↗
PubMed2006

Malaria prevention during pregnancy: assessing the disease burden one year after implementing a program of intermittent preventive treatment in Koupela District, Burkina Faso.

The World Health Organization recommends that pregnant women in malaria-endemic areas receive >or= 2 doses of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp/SP) in the second and third trimesters of pregnancy to prevent maternal anemia, placental parasitemia, and low birth weight (LBW). In 2001, a program evaluation in Koupéla District, Burkina Faso demonstrated that despite widespread use of chloroquine chemoprophylaxis, the burden of malaria during pregnancy remained high. In 2003, the Burkina Faso Ministry of Health piloted a program of IPTp/SP (three doses) and accelerated distribution of insecticide-treated nets (ITN) to pregnant women in Koupéla District. In 2004, a follow-up program evaluation was conducted. Coverage with >or= 1 doses of IPTp/SP was high among women attending antenatal clinics (ANCs) (96.2%) and delivery units (DUs) (93.5%); ITN ownership was moderately high (ANC = 53.9%, DU = 61.6%). In multivariate analysis, >or= 1 dose of IPTp/SP was associated with a significant reduction in the prevalence of peripheral parasitemia at ANCs (risk ratio [RR] = 0.49, P = 0.008), >or= 2 doses of IPTp/SP were associated with a reduction in the prevalence of placental parasitemia (RR = 0.56, P = 0.02), and three doses of IPTp/SP were associated with a reduced risk of LBW (RR = 0.51, P = 0.04). The proportions of women at ANCs with peripheral parasitemia and anemia were significantly lower in 2004 than in 2001 (RR = 0.53, P = 0.001 and RR = 0.78, P = 0.003, respectively). The proportions of women at DUs with peripheral and placental parasitemia were also significantly lower in 2004 than in 2001 (RR = 0.66, P < 0.0001 and RR = 0.71, P = 0.0002, respectively). These data suggest that a package of IPTp/SP and ITNs is effective in reducing the burden of malaria during pregnancy in Burkina Faso.

Adolescent↗
PubMedDate not supplied

Integration of international and transcultural content in nursing curricula: a process for change.

A brief review of education and nursing literature indicates that it is essential to help students develop a global perspective as they prepare to practice nursing in a world of increasingly interdependent nations and people. The process currently being implemented to integrate international and transcultural content in the undergraduate nursing curriculum at a Midwestern state university is described in this article. Assessment of the school indicated that the student population and faculty are characterized by a high degree of radical-ethnic homogeneity. Assessment also included the mapping of content in all required courses in the undergraduate curriculum in the following areas: cultural differences, health care delivery systems in other countries, nursing in other countries, and international health organizations and issues. Recommendations were then made regarding content in required courses, continuation of elective courses, and informal educational strategies. Examples of these are described, as well as the resultant changes. Some of the changes described include content added and educational strategies used to integrate transcultural and international health content in required courses. Elective courses, taught both on-campus and abroad, are briefly described. Evaluation is an ongoing part of overall program evaluation. Highest priority for future planning is currently being placed on development of a semester study-abroad program and increasing cultural diversity in all students' educational experiences.

Consultants↗
PubMed2004

[CAPES evaluation model: desirable and necessary, but incomplete].

Seeking to contribute to the improvement of evaluation criteria in the public health graduate studies program, this article presents the main characteristics identified by foreign observers during the 2001 program evaluation of the Brazilian government research support agency CAPES (Coordinating Body for Training University-Level Personnel) and presents some critical observations on the criteria used to evaluate the quality of teaching in graduate studies programs. These comments were based on recent trends in other countries.

Brazil↗
PubMed1997

Evaluation issues and strategies for community-based organizations developing women's HIV prevention programs.

This article discusses issues and strategies for program evaluation particularly useful for community-based organizations (CBOs) involved in the development and implementation of HIV preventing programs for women. The approach the authors present is an extension of a traditional public health paradigm suggested for use in the development and evaluation of violence prevention programs. This study incorporates Becker's Health Belief Model, which provides a framework for viewing the influence of various psychosocial variables on health-related behavior, into this development and evaluation paradigm. Factors influencing the successful development and evaluation of HIV prevention programs for women are reviewed and discussed. The purpose of this article is to provide some guidance to CBOs to strengthen their evaluation strategies and to encourage their use of evaluation during all phases of program development and implementation.

Community Networks↗
PubMed1978

Understanding rheumatoid arthritis. Evaluation of a patient education program.

We evaluated a patient education program on understanding rheumatoid arthritis; 94% of those responding to our questionnaire considered the program helpful in increasing their understanding of their condition, and 93% said it enhanced their communication with their family. A total of 85% reported one or more behavioral changes, such as not abusing joints (63%), getting more rest (56%), and using medications more meticulously (48%) after participating in the program. We recommend patient education as an effective means of helping patients understand and hence comply with physicians' instructions as well as helping patients to assume greater responsibility for their own health care.

Arthritis, Rheumatoid↗
PubMed1999

A comparison of urban versus rural experiences of nurses volunteering to promote health in churches.

Recent years have seen a resurgence of the health and healing role of the church. Nurses have been involved in this movement through the development of health ministry and parish nursing with a growing number of nurses volunteering their services to congregations. This program evaluation research study compares two programs (one in an urban environment and the other in a rural environment) that use nurses who volunteer in congregations to promote health and well-being. The study found that the two programs differed significantly with regards to the location where nurses provided care. The urban nurses provided most service at the church, while the rural nurses provided service through home visits and phone calls as well as at the church. The groups were also significantly different in the ethnicity, education, work status, and age of the nurses. Further differences were also found in the type of services the nurses provided; for example, the rural nurses were more involved in case management and practical assistance than their urban peers. The two groups were similar in the program support they valued and in their appreciation of the opportunity to integrate their faith and their nursing practice.

Adult↗
PubMed1998

The Drug Evaluation Classification Program: using ocular and other signs to detect drug intoxication.

BACKGROUND: A systematic approach to determining drug intoxication has been developed for use by police officers. By considering specific physiological signs, trained officers can detect the effects of seven major drug types. METHODS: Officers follow a 12-step testing sequence and evaluate signs such as pupil sizes and responses, eye movements, heart rate, body temperature, mental timing, and balance. A matrix is then used to compare that subject's signs to those that would be produced by the seven types of drugs. If a pattern match is found, the officer concludes that the subject is under the influence of a drug and specifies the drug type. RESULTS: Several field and laboratory validation studies have been conducted using these procedures. In general, officers were 70% to 90% accurate in determining intoxication status and drug classification, but poly-drug use and drug rebound effects can sometimes cause problems in interpretation. CONCLUSION: Ocular and other physiological signs can be used to detect drug intoxication and classify the type of drug taken. Knowledge of the procedures used in the Drug Recognition Program can enable optometrists to serve as consultants to the police and as expert witnesses in cases involving the use of ocular signs that indicate illicit drug use.

Body Temperature↗
PubMedDate not supplied

A family physician smoking cessation program: an evaluation of the role of follow-up visits.

Our purpose in this randomized clinical trial was to compare a two-visit smoking cessation intervention by family physicians with the same intervention supplemented by additional follow-ups. Forty-one southern Ontario family physicians volunteered for the study and subsequently participated in a four-hour training program on smoking cessation techniques. Physicians advised patients who smoked and indicated an interest in attempting to quit with the help of their physician to stop smoking at the end of a regularly scheduled visit. Physicians instructed patients to make a specific appointment for an evaluation of their smoking habits. Six hundred forty-seven patients returned for that assessment and were than randomized into either the two-visit intervention group (with risk assessment, support, the setting of a cessation date, self-help literature, and a prescription for nicotine gum, where appropriate) or into the other intervention group (with the same maneuvers as well as the offer of four more supportive follow-up visits). We found no statistically significant difference in one-year, biochemically validated, sustained cessation rates between the group offered the long-term follow-up visits (12.5%) and the group given the brief intervention (10.2%). The 95% confidence interval on the difference between the groups was 2.8% in favor of the brief intervention group to 7.3% in favor of the group offered follow-up. The results do not support the value of long-term follow-up visits for smokers.

Adult↗
PubMed2026

A Clinically Integrated Pediatric Patient-Derived Xenograft Program Enables Evaluation of Cohort and Patient-Specific Biology and Therapeutic Strategies.

UNLABELLED: Preclinical translational research has increasingly utilized patient-derived xenograft (PDX) models for mechanistic and experimental therapeutic studies, yet most existing models have been developed from adult cancer types. We describe the establishment of a PDX program to expand the availability of pediatric-specific PDXs for preclinical research and enable studies of pediatric cancer histologies, including ultrarare diseases. Processes for PDX generation were integrated into established clinical workflows to facilitate universal model generation. Methodologies for tissue procurement, processing, and cryopreservation were optimized to enable intra- and interinstitutional PDX model generation. Over a 6-year span, 388 PDX tumor models representing more than 40 diagnoses were generated, including ultrarare tumors and longitudinal models established from pretherapy, posttherapy, and relapse tumors from the same patient. Genomic characterization of these PDXs demonstrates excellent concordance and recapitulation of molecular alterations of the source tumor. Successful PDX generation was enhanced from relapsed samples, was higher in sarcomas compared with other solid tumor types, and was a negative prognosticator for clinical outcome. With a broad portfolio of molecularly annotated models, we demonstrate utility for validating cross-histology biomarker-driven therapeutic strategies by demonstrating antitumor activity of an MAT2A inhibitor in MTAP-deficient PDXs. Universal model creation also allows for experimental validation of therapeutic hypotheses on a patient-specific basis, as we describe the characterization of a novel RAF1 fusion (EPB41L2::RAF1) in an osteosarcoma PDX. Development of a diverse collection of pediatric PDX models enables hypothesis-driven and cross-histology studies that expand our understanding of cancer biology and aid ongoing drug prioritization efforts in rare tumors. SIGNIFICANCE: A clinically integrated, genomically annotated pediatric PDX portfolio supported by systematic benchmarking of model generation facilitates exploratory biomarker-driven and patient-specific translational studies.

Humans↗
PubMed1998

The Ability Program: improving statewide access to assistive technology for adults with disabilities.

In 1995, the Kate B. Reynolds Charitable Trust awarded $2.4 million to support the Ability Program, a statewide initiative to improve awareness of and access to assistive technology for adult North Carolinians with disabilities. This coordinated effort resulted in 11 funded projects, each using a different approach to deliver assistive technology to persons in rural communities. An overall management, technical assistance, and evaluation program ensured coordinated use of the Trust's funds. This paper describes the development and implementation of the Ability Program in North Carolina, accomplishments of program grantees, and results of a comprehensive program evaluation system used to document process and outcome measures. After 2 years of operation, the type and extent of assistive technology services for adults with disabilities in North Carolina increased as a result of the Ability Program.

Activities of Daily Living↗
PubMedDate not supplied

Group evaluation of programs unites educators.

The Northwestern Washington Chapter of the American Society for Health Manpower Education and Training focused on alternative methods of educational programming to create a forum for planned constructive sharing of ideas and problem solving. This project served not only to enhance the existing program, which consists of a quarterly business meeting and educational events, but also to strengthen the cohesiveness of the membership

Evaluation Studies as Topic↗
PubMed2004

An evaluation of an educational program for clinical supervision.

Clinical supervision for mental health nurses has become an area of priority since the implementation of the Enterprise Bargaining Agreement of August 2000 in Victoria. Clinical supervision has been identified as a strategy to improve both the job satisfaction of nurses and the quality of care provided to consumers. A review of the literature suggests that adequate education for supervisors is crucial if this strategy is to prove successful. In response to this identified need, the Centre for Psychiatric Nursing Research and Practice developed the "Clinical Supervision for Health Professionals" program. The evaluation of participants from the first 2 years of the program (n = 63) are mentioned here. The findings suggest a high level of satisfaction with the education provided and that it has been successful in improving participants' attitudes towards, and level of confidence in providing, clinical supervision.

Attitude of Health Personnel↗
PubMed1996

Evaluation of gene structure prediction programs.

We evaluate a number of computer programs designed to predict the structure of protein coding genes in genomic DNA sequences. Computational gene identification is set to play an increasingly important role in the development of the genome projects, as emphasis turns from mapping to large-scale sequencing. The evaluation presented here serves both to assess the current status of the problem and to identify the most promising approaches to ensure further progress. The programs analyzed were uniformly tested on a large set of vertebrate sequences with simple gene structure, and several measures of predictive accuracy were computed at the nucleotide, exon, and protein product levels. The results indicated that the predictive accuracy of the programs analyzed was lower than originally found. The accuracy was even lower when considering only those sequences that had recently been entered and that did not show any similarity to previously entered sequences. This indicates that the programs are overly dependent on the particularities of the examples they learn from. For most of the programs, accuracy in this test set ranged from 0.60 to 0.70 as measured by the Correlation Coefficient (where 1.0 corresponds to a perfect prediction and 0.0 is the value expected for a random prediction), and the average percentage of exons exactly identified was less than 50%. Only those programs including protein sequence database searches showed substantially greater accuracy. The accuracy of the programs was severely affected by relatively high rates of sequence errors. Since the set on which the programs were tested included only relatively short sequences with simple gene structure, the accuracy of the programs is likely to be even lower when used for large uncharacterized genomic sequences with complex structure. While in such cases, programs currently available may still be of great use in pinpointing the regions likely to contain exons, they are far from being powerful enough to elucidate its genomic structure completely.

Alternative Splicing↗
PubMed2004

Evaluating disease management program effectiveness: an introduction to survival analysis.

Currently, the most widely used method in the disease management industry for evaluating program effectiveness is the "total population approach." This model is a pretest-posttest design, with the most basic limitation being that without a control group, there may be sources of bias and/or competing extraneous confounding factors that offer plausible rationale explaining the change from baseline. Survival analysis allows for the inclusion of data from censored cases, those subjects who either "survived" the program without experiencing the event (e.g., achievement of target clinical levels, hospitalization) or left the program prematurely, due to disenrollement from the health plan or program, or were lost to follow-up. Additionally, independent variables may be included in the model to help explain the variability in the outcome measure. In order to maximize the potential of this statistical method, validity of the model and research design must be assured. This paper reviews survival analysis as an alternative, and more appropriate, approach to evaluating DM program effectiveness than the current total population approach.

Disease Management↗