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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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PubMed1989

Integrating social work and public health education: a clinical model.

In Florida, the need for clinically oriented social workers with expertise in planning and evaluating maternal and child health programs has led to the establishment of a joint master of social work and master of public health degree program. This program has a clinical social work concentration combined with a public health concentration in maternal and child health content, administration, and research design. The philosophy and development of the program, the course content and degree requirements, the field placement content, issues regarding student acceptance and advisement, faculty appointments, and program directions and goals are discussed. Descriptions of both the social work and public health programs that operate the joint-degree curriculum and the differing perspectives are outlined as well as skills that students obtained through their participation in the program.

Curriculum↗
PubMed1990

Elderly clients' perceptions of public health nursing care.

Although the health benefits of illness prevention and health promotion are accepted, little is known about the reasons for which elderly clients attend public health programs or the benefits they perceived from public health nursing care. This study reports the major reasons for which men and women age 60 and over sought care in a public health nursing program and the major benefits they perceived. The sample included 137 new and 360 returning clients. Responses to open-ended questions were content analyzed into categories of like statements, which in turn were placed into overall groups. The results suggest that most clients realized significant benefits from receiving public health care and were able to articulate these benefits. Eliciting client's perceptions can assist public health nurses to implement and market programs in a way that is acceptable and accessible to the recipients.

Aged↗
PubMedDate not supplied

Osteoporosis screening by community pharmacists: use of National Osteoporosis Foundation resources.

OBJECTIVES: To assess the feasibility of establishing an osteoporosis screening program in rural community pharmacies based on information and resources provided by the National Osteoporosis Foundation (NOF), to survey primary care providers regarding the usefulness of this screening program, and to recommend strategies for pharmacists interested in working with patients at risk for osteoporosis. DESIGN AND PARTICIPANTS: Pharmacists and/or nurses enrolled women 65 years of age and older into the study, measured calcaneal bone density, administered a questionnaire to ascertain subjects' osteoporosis risk factors, and provided NOF literature to subjects. With their agreement, women's bone mass data and risk factor assessments were provided to primary care providers along with NOF's Physician's Guide to Prevention and Treatment of Osteoporosis. These providers were surveyed as to whether they found this information useful. SETTING: Five independent community pharmacies in rural Wisconsin. RESULTS: We enrolled and tested 133 women. Of these, 122 (92%) agreed to have information mailed to their primary health care providers. These 57 providers were surveyed and 24 (42%) responded; of these 24, 20 (83%) found the information they received useful. CONCLUSION: A community pharmacy-based osteoporosis screening program using NOF materials was well accepted by physicians. NOF resources and recommendations can provide a strong foundation for such programs.

Absorptiometry, Photon↗
PubMed1985

Mandatory continuing pharmacy education in Alberta, Canada: the response to live programs and correspondence courses.

This report briefly describes mandatory continuing pharmacy education in Alberta and provides survey data to determine the response of pharmacists to the program. The survey results indicate that most pharmacists exceeded the required number of education units and that more than 70 percent of the total acquired were obtained by completing correspondence courses. Females, those under 40 years of age and retail staff preferred correspondence programs. Managers, hospital staff and those over 40 years of age took somewhat fewer education units by correspondence, but attended more live programs than the former group. The popularity of correspondence is presumably due to the fact that most were provided free and because they are a more convenient method of obtaining education units. The freedom allowed to design their own educational program plus the modest costs involved are probably the two main reasons for the acceptability of Albert's continuing education program to pharmacists.

Alberta↗
PubMedDate not supplied

The effectiveness of family planning clinics in serving adolescents.

Data from surveys conducted by The Alan Guttmacher Institute (AGI) in 1981 have been used to create three indicators of the effectiveness of family planning clinics in serving teenagers: the mean delay between first intercourse and first clinic visit (which for teenage clinic patients is 13.2 months); teenage patient retention (67 percent; and the average excess of patient satisfaction over dissatisfaction with clinic policies and services (33 percent). Clinics run by Planned Parenthood are more effective than other types of facility, according to the mean delay indicator, whereas other clinics, such as those associated with community action programs and neighborhood health centers, rank highest in levels of patient satisfaction and patient retention. All three measures indicate that clinics serving 1,000-2,499 family planning patients per year are more effective in serving teenagers than either smaller or larger clinics, and that nonmetropolitan clinics are more effective in providing services than those in cities. Regression analysis shows that clinic administrators might take a number of actions to shorten the mean delay among teenagers between first intercourse and first clinic visit. These include offering community education programs for teenagers, enlisting the support of local churches, developing relationships with local youth groups, opening the clinic during evenings and weekends, accepting more teenagers as walk-in patients and locating a clinic in or near neighborhoods where many teenagers live. Two of the same factors--developing an active relationship with youth groups and opening the clinic to teenagers on evenings and weekends--were also found to be particularly effective in keeping teenagers as clinic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Development of a screening program for tardive dyskinesia: feasibility issues.

This report is part of a feasibility study focused upon developing a valid and reliable method of screening for tardive dyskinesia. The research questions concerned establishing the validity and reliability of the procedure, the acceptability of the procedure to the subjects, and the characteristics of the subjects with scores that exceeded more than a minimal level. Sixty patients were screened in four randomly selected psychiatric aftercare homes. A 12-hour training program was developed to prepare the raters. The interrater reliability achieved for total score using the Abnormal Involuntary Movement Scale (AIMS) was .90, p less than .01, and the validity of the examination was achieved and maintained at an 80-percent agreement level between the nurse raters and a study expert. Thirty percent of the population had scores exceeding minimal symptoms for tardive dyskinesia. The screening program was acceptable to the subjects. A program of training for professional-level raters is described, which is applicable to many settings.

Adult↗
PubMed1994

The United States Neurological Surgery Residency Matching Program.

After 3 years of deliberations, The Society of Neurological Surgeons approved a national Neurological Surgery Matching Program in 1983 for residency positions beginning July 1, 1985. All directors of United States neurological surgery residency training programs agreed to participate and abide by the rules of the match. A review of 10 years' experience with 11 matches from 1983 to 1994 indicates full acceptance by both applicants and program directors and a highly successful process and outcome, satisfactory for everyone except for qualified applicants who failed to obtain a residency position. Since 1985, 1455 neurosurgical (Postgraduate Year 2) residency positions have been offered for match, and 2708 applicants have submitted a ranking list, filling 1434 positions with the initial computer run each year and leaving 1274 unmatched applicants. Thus, the ratio of applicants to available positions is almost 2:1. Various interesting details about multiple-year applications, International Medical Graduates, and nonstart, transfer, and dropout rates are presented, including the eventual practice activities of residents not completing neurosurgical training. A comparison of all United States medical schools, considering data on applications and matches for neurosurgical residency versus number of senior medical students, reveals wide differences. These differences are probably related to the availability of neurosurgical clerkships, faculty participation in the undergraduate curriculum, and the presence of a neurosurgical residency program.

Career Choice↗
PubMed2002

Influence of patients perception on their acceptance and understanding of dental care within an education system.

This study examined the effects of conditions (that is, the fee structure and the easy of obtaining a dental appointment) on patient understanding and cooperation in clinical practice for dental hygiene and dental students. A questionnaire was given sequentially to 1483 patients attending the Tokyo Medical and Dental University dental hospital on "clinical education and patient satisfaction". Direct participants consisted of 650 patients, of which 213 (32.8%) were male and 422 (64.9%) female. The remaining 15 (2.3%) did not specify their gender. Patients who were satisfied with care received by dentists tended to be older compared to patients who were dissatisfied with dentists. The difference was significant (p < 0.001). Acceptable conditions for patients such as fees and appointments at the clinical session had an effected on patient acceptance of clinical training. The findings of this study suggest that patient satisfaction should be considered as part of the reasons for patients accepting dental care by students in their clinical education programs. Fees and appointment schedules strongly affect patient acceptance of clinical education.

Adult↗
PubMed2004

Promoting evidence-based practice: an internship for staff nurses.

Implementing evidence-based practice is a complex but valued process that requires support for nurses to make it a reality in care delivery. To address this, an Evidence-Based Practice Staff Nurse Internship was developed at the University of Iowa Hospitals and Clinics in the United States. PROGRAM OVERVIEW: The objective of this internship is to promote use of evidence by staff nurses to improve patient outcomes. Through a competitive application process, six nurses are accepted in each cohort. The program provides didactic content and dedicated work time on topics interns select (e.g., family pet visitation, sedation management, bowel sounds assessment, guided imagery, family transition to pediatric floor). Interns receive paid clinical release time for participating. ROLES AND RESPONSIBILITIES: Teams include the staff nurse, the nurse manager, and an advanced practice nurse. Responsibilities for each step are assigned to the person with the appropriate expertise. EVALUATION: Interns report understanding the process, appreciate the opportunity for professional growth, and report their objectives are being met. Participants evaluated the program very positively and also provided recommendations for revision (e.g., revising class content). The program resulted in improved quality of care such as increased patient and family satisfaction, decreased length of stay, and cost savings. IMPLICATIONS: Programs that support practitioners through the evidence-based practice process are needed for use in a variety of settings internationally. This unique program supports staff nurses in making evidence-based practice a reality for their work and patients and might be transferable across settings.

Attitude of Health Personnel↗
PubMed1977

Attitudes of departments of medicine in the United States toward provision of internal medicine training for prospective neurologists.

A questionnaire was sent to directors of training programs in internal medicine to assess attitudes towards providing a year of internal medicine training for prospecitve neurologists. Such applicants are handled in a variety of ways. Among the 92 responding institutions with neurology training programs, three were not willing to accept prospective neurologists for 1 year of internal medicine. Seventy-three percent would either reserve places for prospective neurologists, arrange with neurology for a position through the intern matching program, or arrange medical rotations for candidates accepted by neurology. Twenty-four percent would accept neurologists for a single year without specifying any special arrangement.

Attitude of Health Personnel↗
PubMed1986

Efficacy and effectiveness trials (and other phases of research) in the development of health promotion programs.

The concepts of efficacy and effectiveness are examined from the viewpoints of the traditions and philosophies of health-care research and social program evaluation. Consideration of the status of the program being assessed, its availability to, and its acceptance by the target audience leads to the derivation of four levels of health promotion program testing: efficacy trials, under optimum conditions of program implementation and recipient participation; treatment effectiveness trials, with expected variation in target audience acceptance; implementation effectiveness trials, under varying conditions of implementation; and program evaluation of previously untested programs. These four levels of testing, together with experience in one area of health promotion research (smoking prevention), suggest eight phases of research for the development of health promotion programs: basic research, hypothesis development, pilot applied research, prototype evaluation studies, efficacy trials, treatment effectiveness trials, implementation effectiveness trials, and demonstration evaluations. Issues of design, the use of random assignment, the use of blinding procedures, and of the role of process evaluation in these different research levels, particularly efficacy and effectiveness trials, are considered in light of the terminologies and methods of health-care and social program evaluation research. Suggestions are made for improved health promotion research.

Clinical Trials as Topic↗
PubMedDate not supplied

Getting it right: appropriate therapeutic recreation programs for community based consumers of mental health services.

Over the last two decades in Australia, the deinstitutionalization process, which began with the intent of moving consumers of mental health services from in-patient facilities and then seeking to integrate these same individuals into the community, has served to highlight a wide range of consumer needs that have remained largely unfulfilled throughout the process. One such need has been the provision of appropriate therapeutic recreation programs for the community based consumers of the various state co-ordinated mental health services. This paper argues a case for a change in the approach which professional staff provide and lead therapeutic recreation based programs to enable participants to be empowered, rather than disempowered, through their involvement. Further, this paper contends that there is a need for health care staff, more generally, to accept the concept of such programs for the community based consumers of various mental health services as a valued one.

Australia↗
PubMedDate not supplied

Nothing is going to stop me now: obstacles perceived by low-income women as they become self-sufficient.

As low-income women struggle to become self-sufficient, they encounter many obstacles. The literature identifies physical and mental health problems, inadequate childcare, inadequate occupational skills, lack of transportation, criminal histories, and limited educational abilities as major barriers to be overcome in this transition. Qualitative data collected from low-income women attending Innovative Alternatives for Women, an occupational skills and health information training center which was developed and implemented by a nurse, refutes several of the previously identified obstacles. Inadequate childcare and transportation were not seen as barriers to success by the program participants, but were viewed as socially acceptable reasons for not working. Eight obstacles were identified by the program participants as being the real reasons for their lack of success. The identified obstacles included the following: lack of self-esteem, especially relating to school; "bad" relationships with men; lack of support from family and friends; limited life options; lack of training for nonwelfare recipients; lack of quality programs; criminal histories; and fear of success.

Anecdotes as Topic↗
PubMed1993

A quality assurance program for the measurement of capillary blood cholesterol levels in private pediatric practices. The Children's Health Project.

OBJECTIVE: To develop an easy to use quality assurance program for the measurement of capillary blood cholesterol levels in private pediatric practices. The program needed to comply with the guidelines laid down by the National Cholesterol Education Program. DESIGN: Intervention study. SETTING: Nine private pediatric practices in and around northern Philadelphia, Pa. PARTICIPANTS: The analysts included clinic staff members with laboratory expertise ranging from none to some previous experience. None of the participants had previous experience with a quality assurance program. INTERVENTIONS: Progress was reported monthly to the Lipid Research Laboratory, Philadelphia, and action was taken to correct inaccuracies in bias or variance. MAIN OUTCOME MEASURE: Compliance with the analytical guidelines laid down by the National Cholesterol Education Program in that the coefficient of variation was no greater than 5% and the bias was no greater than +/- 5% in the first year of the study. RESULTS: Within the first year of the study, there were 152 monthly quality assurance returns for each of two lyophilized control materials. On four occasions the coefficient of variation was greater than 5% while the overall bias was within the desired +/- 5% on 143 (94%) of 152 occasions. After the first 3 months of the study, as user confidence increased, intervention by the Lipid Research Laboratory became minimal. The internal quality assurance was further evaluated by a successful performance in a quarterly external quality assurance program. CONCLUSIONS: It is possible to devise an easy to use quality assurance program for extra laboratory measurement of cholesterol levels in children, and, with minimal assistance, maintain acceptable standards of cholesterol analysis. The quality assurance improved following the first 3 months of training and education. Subsequent continuous quality improvement was maintained with minimal involvement of the specialist center. Should the controversial issue of private office measurement of blood cholesterol levels become universally acceptable, the implication from our study is that standards acceptable to the National Cholesterol Education Program and the Clinical Laboratory Improvement Amendments of 1988 are possible using a suitable quality assurance program.

Bias↗
PubMed2004

Implications of the age range in a population-based BRCA1 testing program with eligibility based on family history of breast and ovarian cancer.

The current options available to BRCA1 mutation carriers can be classified as either cancer risk reduction or increased disease surveillance. Risk reduction might be preferable to young women. Increased surveillance might be more attractive to women when their cancer risk is highest. The aim of this report is to estimate the sensitivity, specificity and ability to detect carriers for a population-based BRCA1 testing program with eligibility based on family history of cancer, and examine the effect of age on the program's performance. A computer model was used to simulate the incidence of breast and ovarian cancer in a woman's family, based on her BRCA1 mutation carrier status. Age-specific estimates of the sensitivity and specificity for family history as an indicator of mutation status were applied to local population figures. Sensitivity of the program increased with the age of the proband and the size of her family. Sensitivity ranged from 0.33 for 20-year-olds with small families, to 0.98 for 60-year-olds with large families. Specificity was greater than 0.95, regardless of a woman's age or family size. If 0.12% of people carry a BRCA1 mutation, a province-wide testing program for people aged 20-69 with referrals based only on family history would have a sensitivity of 0.55. Only 2% of the genetic test results would be positive. The acceptability of a genetic testing program depends on its sensitivity and specificity, and on the options available to women who are found to carry a mutation. Compared with variation due to family size, the program sensitivity and specificity does not differ substantially amongst the various age groups.

Adult↗
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↗
PubMed1997

A Multiple Sclerosis (MS) Center Injection Training Program.

Injectable treatments for Multiple Sclerosis inspire hope and challenges. Abilities, anxiety levels and acceptance of treatment modalities vary so a creative program and comprehensive care plan combined to meet individual needs. A flexible, two session program developed at the University of Pennsylvania MS Center includes planning, practice, and even "homework" before the initiation of drug therapy. Hints are given to manage anticipated side effects and written instructions supplement product literature. Training focuses on subcutaneous or intramuscular injection technique. Since IM injections require special skills, those prescribed Avonex (beta Interferon la) are given "anatomy lessons"; they ease tension and are fun. Learning is informal, stories are shared and expectations discussed. The patient is encouraged to maintain an informed, active role in his care, adopt a wellness lifestyle and participate fully in goals of treatment. Physical, psychological and cognitive capabilities are assessed. Safety, compliance, and relationship issues are evaluated. Rapport developed during training goes far to promote adherence to therapy, minimize lifestyle disruption and preserve an acceptable quality of life. The nurse as liaison to other professionals, particularly the prescribing physician, facilitates innovative management of treatment issues. Moving patients and carepartners toward self responsibility, informed choices and competent administration of treatments benefits all. New models of care develop and by empowering others, we empower ourselves.

Humans↗