Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Program Accessibility”

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.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,351 records · Page 75Linked to original sources
PubMed1998

User-friendly and versatile software for analysis of protein hydrophobicity.

We have developed a simple and flexible program to analyze regional hydrophobicity of a protein from its amino acid (aa) sequence. This program runs as a Microsoft Excel document into which aa sequence can be copied from any Windows-compatible or Macintosh word processor. The program returns the hydrophobicity index of each aa residue and other analyses that can be used to predict transmembrane domains, amphiphilic alpha helices and putative antigenic epitopes in a protein using established algorithms. The program can also be easily modified to test user-defined algorithms and to accommodate non-conventional aa residues or ambiguities in the aa sequence. Simple modification of the program allows direct use of nucleic acid sequence information for various analyses. Graphic visualization of the results is readily achieved using the graphics function of Microsoft Excel. Alternatively, the data can be imported into other graphics software for preparation of publication-quality figures. By running as a document in Microsoft Excel, which can be found in virtually all personal computers, this program provides easy access even to the computer novice.

Amino Acid Sequence↗
PubMed1999

Establishing standards for health care archives: a case study of the Calgary Regional Health Authority.

Due to recent restructuring of Alberta's health care system, many historically valuable records are at risk. However, Freedom and Information and Protection of Privacy legislation has created awareness of the need to care for both administrative and medical records of health care institutions, and standards for the maintenance of these records are evolving. The Calgary Regional Health Authority has established archives, records management, and access and privacy programs, and now has the opportunity to establish a serious medical research repository. The CRHA's experience proves the feasibility of preserving historical health care records for both medical and historical use.

Archives↗
PubMed2004

Evaluation of a mobile diabetes care telemedicine clinic serving Aboriginal communities in Northern British Columbia, Canada.

INTRODUCTION: In British Columbia, Aboriginal diabetes prevalence, hospitalization and mortality rates are all more than twice as high as in the rest of the population. We describe and evaluate a program to improve access to diabetes care for Aboriginal people in northern communities. STUDY DESIGN: Cost-effectiveness evaluation. METHODS: A diabetes nurse educator and an ophthalmic technician travel to Aboriginal reserves, offering people with diabetes services recommended in current clinical practice guidelines: retinopathy screening by digital retinal fundus photography, glaucoma screening by tonometry, point-of-care urine and blood testing to detect microalbuminuria and dyslipidemia and to measure glycated hemoglobin, foot examinations and foot care advice, blood pressure and height and weight measurement and diabetes care advice. Via electronic communication, an ophthalmologist and an endocrinologist in Vancouver review the findings and supervise the mobile clinic staff. RESULTS: During the first year, 25 clinics were held at 22 sites, examining 339 clients with diabetes. Exit surveys showed high levels of client satisfaction. Mean cost per client (Cdn dollars 1,231) was less than for the alternative, transporting clients to care in the nearest cities (Cdn dollars 1,437). CONCLUSIONS: The mobile clinic is cost-effective and improves access to the recommended standard of diabetes care.

Adult↗
PubMedDate not supplied

Lourdes wins 1995 McGaw Prize. Camden, N.J., hospital receives coveted award for excellence in community service.

Once a year, the prestigious Foster G. McGaw Prize for Excellence in Community Service is presented to a hospital. This year's award, presented Aug. 21 at the American Hospital Association's 1995 convention in San Francisco, was awarded to Our Lady of Lourdes Medical Center in Camden, N.J. Camden, N.J., is a city awash in negative statistics. It is considered the most economically depressed city of its size in the United States. A Rand Corp. study considers it one of the three worst areas in the country (placed in the "disaster" class). Not surprisingly, the problems extend to healthcare indicators as well. In the middle of Camden and in the middle of the statistics in Our Lady of Lourdes Medical Center. Their efforts and their commitment to the community is driven by its mission and vision, which states that working collaboratively, Lourdes "...will be both a catalyst and major participant in the revitalization of the city...in community benefit programs and community activities that give meaning, dignity and hope to all." Our cover story this issue examines the many and varied programs that enabled Our Lady of Lourdes to win the coveted prize, awarded "to a healthcare organization that demonstrates commitment to community service through a range of innovative programs that expand access to healthcare." And if your healthcare organization plans to enter the competition next year, we've included a bonus: Some helpful hints from this year's winner on putting the application together.

Awards and Prizes↗
PubMedDate not supplied

Preventing repeat adolescent pregnancies with early adoption of the contraceptive implant.

CONTEXT: Even in intensive, adolescent-oriented programs, in which access to highly effective contraceptives is guaranteed, repeat adolescent pregnancies commonly occur. METHODS: To assess whether adoption of the contraceptive implant would lower the rate of repeat pregnancy, contraceptive use and pregnancy outcomes were tracked among 309 adolescent mothers--171 "early" implant users who began use within six months of delivery and 138 who either adopted another method or had used no method. Participants were interviewed at delivery and at six-month intervals through the second year postpartum. Multivariate logistic regression analyses were conducted to ascertain the likelihood of a repeat pregnancy within the first and second year postpartum. RESULTS: During the first year postpartum, although 7% of the early implant users had their implants removed, pregnancy rates were significantly (p < .0001) lower among early implant users (less than 1%) than among the other adolescent mothers in the sample (20%). By the end of the second year postpartum, 37% of early implant users had discontinued use. Nevertheless, their two-year pregnancy rate (12%) remained significantly lower (p < .0001) than that of the other adolescent mothers (46%). The multivariate analysis showed that early implant use was the only independent predictor of a repeat pregnancy within the first year postpartum, while early use, parity and number of risk factors for repeat pregnancy were independently associated with the likelihood of another pregnancy in the second year postpartum. CONCLUSIONS: Although early implant insertion significantly decreased the rate of rapid, repeat adolescent pregnancies, the rates of removal and of pregnancy by the end of the second year postpartum were high. Thus, health care providers need to address the motivational components of adolescent pregnancy even among those who accept ostensibly long-term methods.

Adolescent↗
PubMed1998

Disseminating multimedia protocols over Internet for emergency and catastrophe management.

Over the last years we have developed various computing methods to assist specialized personnel on various aspects of catastrophe and emergency management. New models can address tasks such as patient triage; stabilization, resource coordination and hospital alertness and techniques based on information technologies. In this paper we present various tools (written on Java and C+2) that we created to store, represent, and disseminate practice guidelines and protocols over the World Wide Web. Guidelines and protocols are stored using a standard database program (e.g., Microsoft Access), and represented in a flowchart format linked to multimedia information such as text, pictures, sound, video or external sources of data. Using our JAVA tool, protocols can be disseminated over the Web and viewed with any browser with JAVA compliance. We have implemented 15 emergency protocols that we developed in collaboration with specialized military personnel from the Ministry of Defense, Spain. Users can access remotely those electronic protocols comparing their procedures and methods. Our goal is to enhance agreement and consensus among remote medical centers regarding emergency and catastrophe management, establishing discussions over the network. Our tools have also a potential for training medical and paramedical personnel for emergency situations.

Clinical Protocols↗
PubMed1999

Hypertension, cardiovascular disease, and health care dilemmas in the Philadelphia Vietnamese community.

BACKGROUND AND OBJECTIVES: Prior studies have shown low awareness of hypertension and cardiovascular disease and low health care utilization in the US Vietnamese community. This study assessed awareness and understanding of these chronic conditions, health care barriers, and cultural beliefs in the Philadelphia Vietnamese community. METHODS: This qualitative study analyzed data collected from focus groups, family interviews, and individual interviews of community members and health care providers during 1996 and 1997. RESULTS: Awareness of hypertension was higher than expected but low for heart disease. Understanding of the cause and primary prevention of these illnesses was low, as was health care utilization. Major barriers to receiving health care included problems with language, medical insurance, and transportation. Desired resources were interpreter services, increased medical insurance, translated educational materials, health education classes, and community health fairs. The community widely held the belief that Western medicine is "stronger, faster, and curative" while folk medicine is "weaker, slower, but preventive." CONCLUSIONS: The Vietnamese community appreciates the importance of hypertension and cardiovascular disease and believes that traditional, Western medicine is necessary for care but perceives significant barriers. Providing needed services and specific intervention programs could improve access and understanding, as well as enable health promotion, disease prevention, and appropriate care.

Cardiovascular Diseases↗
PubMed1996

Clinical Evaluation of Current Stent Deployment Strategies.

BACKGROUND: Coronary stenting has been demonstrated to reduce the incidence of abrupt closure and restenosis. However, intensive anticoagulation regimens have increased the number of vascular complications and hospital length of stay. Consequently, the potential long-term cost effectiveness of stenting has been jeopardized by a significant increase in procedural and hospital costs. These drawbacks have resulted in evaluation of reduced anticoagulation programs and alternative access sites. METHODS: Access-site and anticoagulation strategies were analyzed in 377 patients who had undergone coronary stenting. Four groups were compared: 114 patients stented from the femoral artery and treated with warfarin, 87 patients stented from the radial artery and treated with warfarin, 88 patients stented from the femoral artery and treated with ticlopidine and aspirin anticoagulation, and 88 patients stented from the radial artery and treated with ticlopidine and aspirin. RESULTS: Primary success was similar in all groups. Subacute closure occurred only in the groups managed with warfarin. Access-site complications occurred only in the groups with femoral access. Total hospital and post-procedure length of stay and total hospital charge were significantly less in the ticlopidine groups. The radial/ticlopidine group was the most cost-effective. CONCLUSIONS: Ticlopidine/aspirin therapy following coronary stenting from either the femoral or radial approach reduced hospital length of stay and hospital charge without subacute closure. Access-site complications were not reduced by femoral/ticlopidine strategy but were eliminated by the radial approach with either anticoagulation regimen. The radial/ticlopidine strategy eliminated access-site complications and significantly reduced hospital length of stay and hospital charge as compared to femoral/ticlopidine and was the most cost-effective strategy.

Journal Article↗
PubMed2001

Integration through a city-wide brain injury network and best practices project.

Integration of systems of service for individuals who have sustained a brain injury (BI) is critical to their successful recovery and reintegration into the community [6,7,33]. The Toronto Acquired Brain Injury (ABI) Network, an umbrella organization of 17 partners in the city of Toronto, Canada, is attempting to create a cost-effective, seamless, efficient, and effective integrated system of service. The ABI Network includes organizations and agencies along the full continuum, from acute care inpatient to long term care reintegration and is ultimately focused on helping clients achieve their goals. Through a variety of projects and activities, progress is being made. A significant initiative, currently underway, is the development of Network-wide best practices, related to assessment and outcomes, rooted in empirical evidence and current research. The project also integrates the perspectives of clients and families. The hope is that this initiative will result in enhanced consistency across programs, ensuring universal access to treatment and interventions following brain injury from the time of an individual's injury through integration into the community.

Brain Injuries↗
PubMed1981

America's elderly: policy implications.

Senior citizens, particularly those aged 75 or older, are the fastest growing group in the US today. 25 million strong, the elderly make up 11% of the total population, the proportion ranging from 18.1% in Florida to 2.6% in Alaska. 1/4 of the federal budget, $155 billion in 1980, now goes to their support yet many face difficulty in gaining access to the programs designed to benefit them. The elderly, especially those who rely solely on Social Security, comprise a disproportionate share of all poor households. The retirement system itself is facing financing challenges that promise to grow as the baby boom generation swells the number of senior citizens to 55 million in 2030. Plans to coordinate government programs and improve the method of financing the retirement system are receiving increasing attention. Financing Social Security from revenue funds, or with actuarial reserves, are 2 alternatives to the present pay-as-you-go system. Another area of concern to policymakers is America's health care system, which is now crisis oriented and heavily biased toward institutionalization. Health care must be made more responsive to the long-term needs of the oldest segment of the population, many of whom suffer from chronic illnesses. Impaired elderly receive most of their care from family or friends, and private organizations, but this natural support network largely has been ignored by government. New program initiatives might emphasize homemaker services, geriatric day care, compensation for families that provide for the needs of an elderly relative, and the strengthening of the informal partnership between the elderly themselves, their families and friends, community groups, private organizations, and government at the state and local as well as the federal level.

Adult↗
PubMed2001

Ten-year changes in breast cancer knowledge, attitudes, and practices in Native Hawaiian women.

Compared to women in other ethnic groups, Native Hawaiian women have the highest breast cancer mortality rates in the state of Hawai'i. Nationally, the five-year relative survival rate for Native Hawaiian women is 9% shorter than for Caucasians and all races. This poor outcome has been attributed, in part, to late-stage detection of cancer in Native Hawaiians, and data suggest that breast cancer screening rates for Native Hawaiian women are relatively low. This study examined breast cancer knowledge, attitudes, and practices (KAP) among Native Hawaiian women, reached through their friendship, community, and organizational networks. Response to an initial KAP survey in 1989-1990 was rewarded by a voucher for a free mammogram. Participation in both the survey (n = 903) and mammogram offer (n = 496) was high. The initial, Time 1 participants were resurveyed in 1999-2000, yielding a sample of 117 women who completed KAP surveys at both time points. After 10 years, changes in women's knowledge and attitudes were minimal. However, remarkable improvements in breast health practices were seen, with 62% of women reporting compliance with American Cancer Society guidelines for mammogram screening in 1999-2000, compared to only 14% in 1989-1990. Findings suggest that breast health practices can be improved through appropriate outreach; encouragement by health professionals; and policies and programs that increase access and affordability.

Breast Neoplasms↗
PubMedDate not supplied

Medicine in Mississippi.

Adequate health care represents an issue that has always troubled rural America. From the earliest days of this country, affordable and quality health care has often been harder to find for those who those to live on the farm or in a small town or any place off the beaten path than it has for residents in urban areas. The State of Mississippi has undertaken an intensive program to widen access to health care--and, especially, to preventive health measures--by utilizing fully all available financial resources, including private foundations, by encouraging increased cooperation from our physicians and hospitals in caring for patients insured by Medicaid, and by involving the community in emphasizing the use of health care practitioners in delivering inexpensive but effective support to our rural population.

Delivery of Health Care↗
PubMed2003

Organized dentistry as an agent for helping others: the leadership of Donna J. Rumberger.

Dr Donna Rumberger graduated from New York University College of Dentistry in 1980 and has practiced dentistry in Manhattan ever since. Even before her graduation, she was active in organized dentistry, always viewing it as a conduit for helping other people. Working with the American Association of Women Dentists, she was cofounder of the Smiles for Success Foundation, a program started in New York City that helps women advance from welfare into the workforce with restored, healthy smiles. That program now has expanded to 14 other cities. Working with organized dentistry in New York City, she has been instrumental in initiating and running the Skate Safe program, which provides mouthguards and oral home care education for inner city children in Harlem. In addition, she has worked with the dentistry merit badge program for the Boy Scouts of America Jamborees, helped coalesce women's dental organizations in New York City, and led her dental society to collaborate with Columbia University in a program to improve access to dental care. As further evidence of her ability to get things done, she also has served as president of the American Association of Women Dentists, the Midtown Dental Society, and the New York County Dental Society--one of the largest dental societies in the country.

Dentists, Women↗
PubMed2003

Visceral leishmaniasis: consequences of a neglected disease in a Bangladeshi community.

Visceral leishmaniasis, or kala azar (KA), affects the rural poor, causing significant morbidity and mortality. We examined the epidemiologic, social, and economic impact of KA in a village in Bangladesh. A population-based survey among 2,348 people demonstrated a KA incidence of 2% per year from 2000 to 2002, with a case-fatality rate of 19% among adult women, compared with 6-8% among other demographic groups. Kala azar cases were geographically clustered in certain sections of the village. Anti-leishmanial drug shortages and the high cost of diagnosis and treatment caused substantial emotional and economic hardship for affected families. Communities wanted to learn more about KA, and were willing to take collective action to confront the problems it causes. To decrease the KA burden in endemic areas, community efforts should be supplemented with effective treatment programs to ensure access to appropriate and affordable diagnosis and case management.

Adolescent↗
PubMedDate not supplied

A national survey of alcohol screening and referral in college health centers.

To determine the extent and nature of alcohol screening and referral services provided by college health centers, the authors conducted a state-stratified, random sampling of 25% of 327 4-year accredited US colleges and universities with health centers. Of the 249 survey respondents, 32% routinely screened students for alcohol use. Urban, public, and large institutions were most likely to screen routinely. Only 11.7% of the sample reported they used standardized instruments, predominantly the CAGE. The health centers used an average of 3.4 referral options, but only 27.5% offered students access to campus programs specifically designed for students who are substance abusers. Findings suggest that the majority of college health centers are not providing routine alcohol screening for students or using standardized screening instruments. In addition, students are often referred to services that may be inappropriate or ineffective in addressing the needs of college drinkers.

Adolescent↗
PubMed2005

Lipodystrophy and dyslipidemia among patients taking first-line, World Health Organization-recommended highly active antiretroviral therapy regimens in Western India.

OBJECTIVE: To determine the prevalence of lipodystrophy, dyslipidemia, and hyperglycemia among HIV-infected patients taking long-term, first-line, World Health Organization (WHO)-recommended generic highly active antiretroviral therapy (HAART) regimens in India. DESIGN: : Cross-sectional study. METHODS: Asymptomatic, antiretroviral-naive patients and those treated for > 1 year with zidovudine (ZDV)/lamivudine (3TC)/nevirapine (NVP) and stavudine (d4T)/3TC/NVP were subjectively assessed for lipodystrophy (lipoatrophy, lipohypertrophy, and mixed patterns), and lipid profiles were determined after an overnight fast. The US National Cholesterol Education Program III guidelines were used to define dyslipidemia (total cholesterol > or = 200 mg/dL, low-density lipoprotein cholesterol > or = 130 mg/dL, triglycerides > or = 150 mg/dL, high-density lipoprotein cholesterol < 40 mg/dL, and total cholesterol/high-density lipoprotein cholesterol ratio > or = 6.5). Prevalence and risk factors associated with these complications were determined. RESULTS: Of the 306 patients (126 controls, 30 on ZDV/3TC/NVP, and 150 on d4T/3TC/NVP), the prevalence of lipodystrophy was 46.1%, and lipoatrophy was significantly associated with d4T use. The prevalence of dyslipidemia and fasting hyperglycemia was significantly higher in the treatment groups. Proportion of patients with high-density lipoprotein > or = 60 mg/dL was significantly higher in the treatment groups; however, this had little impact on the total cholesterol/high-density lipoprotein ratio. CONCLUSION: There is a high prevalence of lipodystrophy, dyslipidemia, and hyperglycemia in patients taking long-term WHO-recommended generic HAART in western India. Interventions to address these complications need to be incorporated into antiretroviral scale-up programs, including improving access to alternative less-offending drugs like tenofovir and abacavir.

Adult↗
PubMed1992

Integration of clinical genetics into assisted reproductive technologies: implications for nursing practice.

Assisted reproductive technologies (ART) have moved from the experimental periphery of clinical treatment to the center of routine practice in the field of reproductive endocrinology. With advances in technology, reduced operative risks, increasing third party reimbursement and increased accessibility to ART programs, a more heterogeneous group of couples is seeking these services. The traditional ART couple has been joined by a growing number of couples who are at risk for or affected by a genetic disorder. These individuals seek alternative methods of conception to minimize the risk of conceiving a child with a significant birth defect. Programs offering donor gamete, donor embryo, gestational carrier, and in the future, preimplantation genetic testing must be prepared for the unique needs of the "traditional" infertile and "nontraditional" fertile couple.

Chromosome Aberrations↗