Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Program Appropriateness”

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 1,387 records · Page 77Linked to original sources
PubMed2003

Ethnic differences in weight loss behavior among secondary school students in Beirut: the role of weight perception.

OBJECTIVES: Assessing the prevalence of weight loss attempts in Beirut, Lebanon, a country characterized by a diversity of ethnic and religious groups and examining the interplay between ethnicity, body mass index (BMI) and weight perception and their relationship to weight loss behavior. METHODS: A school-based survey of risk behaviors conducted among secondary students (grade 10-12) in 1997. Subjects consisted of 827 boys and girls, aged 15 to 23 years, the majority of whom were Moslems (65.4%). Multiple logistic regression was used to estimate the association between ethnicity and weight perception with the likelihood of trying to lose weight controlling for BMI and a number of potential covariates. RESULTS: The prevalence of weight loss attempts was 19.1% and 42.6% in boys and girls respectively. Christians were more likely to perceive themselves as overweight and to attempt weight loss than Moslems across all BMI levels, however this trend was significant in the underweight category. While controlling for BMI did not change appreciably the results observed, after controlling for weight perception, ethnic differences in weight-loss behavior disappeared. CONCLUSION: Findings of the study suggest that whereas actual weight may constitute only partially the driving force for differentials by ethnicity, the perception of body weight acts as a mediating factor in the relationship between ethnicity and weight loss behavior. Understanding the disparities in weight management behavior across various adolescent groups is key to develop culturally appropriate educational and intervention programs for the youths.

Adolescent↗
PubMed2007

The evolution of bird migration--a synthesis.

We approach the problem of the evolution of bird migration by asking whether migration evolves towards new breeding areas or towards survival areas in the non-breeding season. Thus, we avoid the ambiguity of the usually discussed "southern-home-theory" or "northern-home-theory". We argue that migration evolved in birds that spread to seasonal habitats through gradual dispersal to enhance survival during the non-breeding season; this in contrast to the alternative idea suggesting that migration evolved towards new breeding areas to increase reproductive success. Our synthesis is based on the threshold model explaining how migratory traits can change rapidly through microevolutionary processes. Our model brings former theories together and explains how bird migration, with the appropriate direction and time program, evolves through selection after genetically non-directed events such as dispersal and colonization. The model does not need the former untested assumptions such as competition as a reason for migration and for the disappearance of sedentary populations or higher reproductive success in temperate breeding areas. Our theory offers answers to questions such as how birds with a southern origin may gradually reach northern latitudes, why migration routes may follow historical expansion routes and why birds leave an area for the non-breeding season and move back instead of breeding on their wintering grounds. The theory proposes gradual change through selection and not sudden changes such as long distance dispersal or mutations and can be applied to migration at all latitudes and in all directions. The scenario provides a reasonable concept to understand most of the existing migratory phenomena on the basis of the ecology and genetics of migratory behaviour.

Animal Migration↗
PubMed1998

The Pollution Prevention Act of 1990: A Policy Whose Time Has Come or Symbolic Legislation?

/ In 1990, the United States officially entered the era of pollution prevention with passage of the Pollution Prevention Act. This paper analyzes EPA's implementation of the Pollution Prevention Act from its passage in 1990 to the present. It examines the barriers EPA must overcome if it is to effectively integrate pollution prevention into its existing regulatory structure, including impediments created by statutory and organizational structure, the existing relationship between EPA and the groups it regulates, the fragmented implementation scheme of national environmental regulation, the balancing of conflicting demands advanced by powerful interests, industry's economic and technical concerns, and institutional inertia. It also examines issues such as industry commitment, the limits of prevention, and measurement concerns. The findings suggest that EPA's efforts at shifting to a pollution prevention regulatory ethic that holds primacy over pollution control are mixed. Its organizational structure, statutory authority, and incentives system still reflect a single-medium pollution control focus, appropriations for pollution prevention programs and activities are paltry compared to traditional pollution control programs, and participation in the program is voluntary. Yet, the findings also point to some promising programs that are working to institutionalize a pollution prevention regulatory ethic, and many states appear very committed to the concept.KEY WORDS: Pollution prevention; Source reduction; Pollution control; Alternative regulatory design; Barriers to implementation

Journal Article↗
PubMed2003

["Memory-clinics" in German-speaking countries].

This article gives an evaluation of the organization, diagnostics and offers of therapy from 41 memory-clinics conducted in German-speaking countries and shows that there is no uniform standard for the care of those suffering from dementia. As a result there are problems with quality assurance and financing. The survey shows that Switzerland has the most extensive as well as intensive care program which is also appropriately funded. It is therefore necessary to provide guidelines for defining a uniform quality standard while taking into account the reasons of the various institutes for implementing such departments. It is also essential that these guidelines do justice to the patients and their relatives.

Aged↗
PubMed1996

Knowledge and beliefs about hypertension among Jamaican female clients.

Hypertension is a major health problem in the Caribbean Region. If health promotion programs are to be appropriate and effective, the clients' knowledge and beliefs regarding this chronic health problem need to be identified. The purpose of this study was to determine the knowledge level and beliefs about hypertension among female clients attending primary health care clinics in Jamaica, West Indies. Data were collected from 240 female clients with the use of a pretested interview schedule. Findings indicated that the respondents were of low socio-economic status, lacked knowledge regarding the predisposing factors and characteristics of the disease and had a number of misconceptions surrounding the illness. Implications for nurses and health care providers are discussed with suggestions for future research.

Adult↗
PubMed1985

Hypertension control in Europe.

Hypertension control is a complex process with many facets; it is dependent upon many factors, e.g., local culture, economic factors, and organization of health care. Examples from the practice of hypertension control in Europe are quoted to illustrate various levels of such activities, their scope, and the methods used. Different operational approaches are illustrated with a number of locally appropriate solutions. Measures of program effect, such as changes in population blood pressure levels, awareness and treatment status of hypertension, drug consumption, and morbidity and mortality statistics, are also examined. Finally, some special issues are summed up: the community problem of "mild" hypertension, sex differences in achieving hypertension control, and partial "overtreatment" (unwarranted drug therapy) in the community. More data are needed on the quality of hypertension control in the populations of Europe.

Blood Pressure↗
PubMed1987

Simple quality assurance measures.

A performance indicator is presented which has been useful to management for quantifying compliance with agency quality assurance policy regarding appropriateness of referrals to programs from intake.

Community Mental Health Centers↗
PubMed1989

PEPTY: a knowledge-based program for assisting medical reasoning in peptic diseases.

PEPTY is a program developed with the aim of providing a diagnostic and therapeutic assistance in managing peptic diseases. Its theoretical basis is an accurate analysis of current concepts in peptic disease diagnosis and treatment. This was done by reviewing recent literature and consulting skilled gastroenterologists. The decision tree includes three sections dealing with diagnostic, therapeutic and monitoring problems. The diagnostic section starts by evaluating clinical data from patient history and physical examination; the diagnostic hypotheses given at this level are refined and eventually confirmed by further information in the following section. Here the decision tree becomes modular in that a proper therapeutic and monitoring pathway is defined for four disease classes: gastroduodenal peptic ulcer and duodenitis, gastro-oesophageal reflux, erosive gastritis, and chronic antral gastritis. In the therapeutic section a cost-benefit analysis of possible therapeutic choices is always performed, but the final decision is made by the user. Complications, side effects and treatment efficacy are also considered and the program finally suggests the appropriate maintenance treatment. Patient data display, storage and retrieval, and explanation facilities are supplied. The system can provide a 'second opinion' in the medical practice and may be a useful learning tool for medical students.

Artificial Intelligence↗
PubMed1994

Control, culture and chronic pain.

In the past decade, the literature on chronic pain shows an increasing interest in the relationship between patients' locus of control (LOC) beliefs and their responses to the chronic pain experience [1-5]. However, few of these studies assess the relationships between ethnic or cultural background and LOC style in the chronic pain experience--despite research suggesting that culture affects chronic pain responses [6-8]. This report of two quantitative and qualitative research projects among chronic pain sufferers in New England and in Puerto Rico, shows significant relationships between patients' LOC style and variations in reported chronic pain intensity and responses. Our studies also demonstrate a relationship between LOC style and ethnic or cultural background and an interaction between LOC style and cultural identity in variations in reported pain intensity. In addition, we found intra-ethnic/cultural-group variations in the pain experience related to LOC style. In these chronic pain populations, the qualitative data further suggests that LOC style may not be a permanent, unchanging characteristic or cognitive interpretation. Instead, an individual's LOC style may be altered by the chronic pain experience and such a style may change at various stages in the chronic pain 'career'. These studies also show that in many ethnic/cultural groups, an increased sense of control may contribute to an increased ability to cope successfully with the chronic pain experience. In light of these findings, we suggest that it may be possible to alter a patient's sense of control through the development of deliberate culturally appropriate and personally relevant programs designed to help the patients establish a sense of control over their lives and their pain.

Adaptation, Psychological↗
PubMed1994

A survey of physician beliefs and self-reported practices concerning screening for early detection of cancer.

Cancer is the second leading cause of death in the United States. Early detection of cancer greatly improves 5-year survival for many sites, and in 1980 the American Cancer Society (ACS) published recommendations for performing cancer screening with the goal of promoting early cancer detection in asymptomatic persons. This cross-sectional survey examined beliefs and practices related to six cancer screening tests and procedures in a group of 68 primary care physicians in a multi-specialty group practice in Houston, Texas. Constructs from the Health Belief Model and Social Cognitive Theory were used to identify factors that might influence performance of cancer screening. Physicians in this study reported greater compliance with ACS recommendations for performance than has been found in other studies, and there is an indication that some screening tests may be performed even when not indicated based on age-specific criteria. Respondents reported performing digital rectal examination, stool occult blood testing, and sigmoidoscopy more frequently in men than in women. No belief factor emerged as being associated with performance of all screening procedures, and associations that were noted for some procedures were not consistent across patient age and gender groups. Some possible directions for further research and development of programs to promote the appropriate and cost effective use of cancer screening are physician education to include information about age and gender appropriate guidelines for screening and opportunities for skills training and practice workshops for some procedures.

Adult↗
PubMed1982

Over-reports of recent alcohol consumption in a clinical population: a validity study.

Decisions concerning appropriate treatment in alcoholism programs are often based on the self-reports of the clients. However, few programs have incorporated validation procedures (such as breath tests) since it is generally assumed that alcoholics will deny the extent of their drinking and their subsequent alcohol problems. The self-reports of recent alcohol consumption of sixty-five new entrants to an alcoholism treatment program were validated with breath tests. Five estimates of blood alcohol concentrations were derived by varying elimination rates. For all five estimates, over-reporters comprised a substantial proportion of the total sample (23%-57%) and exceeded the percentage of consistent reporters for those people who had a positive breath test. Correlations between self-reports and breath tests were not significant which indicates that the amount of alcohol consumed does not necessarily relate to reporting behavior. It is concluded that despite the widely held notion that alcoholics deny the extent of their drinking, errors in the direction of over-reporting should be taken seriously and examined more closely. On an individual level, over-presentation of a client's condition may be related to subsequent behavior in a treatment program; on an aggregate level, over-reports may bias the findings of evaluation studies by inflating success rates.

Adult↗
PubMedDate not supplied

Medicare and the financing of nursing education: implications of Board of Trustees v Sullivan.

In 1991 a federal court decided a case of first impression about the appropriateness of reimbursement to programs of nursing education under Medicare. The court confirmed that the University of Mississippi could continue receiving Medicare reimbursement for a proportionate share of the costs of clinical education for nurses in its affiliated hospital. However, it ruled that the $2 million in costs for classroom nursing education incurred by the School of Nursing would not be reimbursed despite the fact that both the hospital and nursing school were controlled by the same entity, the university system. This article reviews the court's decision in Board of Trustees of State Institutions of Higher Learning v Sullivan within the context of the available nursing literature on this topic. It describes the provisions of the Medicare statute, which allow for reimbursement of programs of nursing education, and the implications of the court's decision for nursing education. Finally, it suggests directions for additional research and discussion about the availability of an additional source of federal funding.

Education, Nursing↗
PubMed2005

Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter-blind preliminary study.

OBJECTIVE: To investigate the effects of virtual reality (VR) on cortical reorganization and motor recovery. DESIGN: Nonparametric pre- and posttest design with experimenter blinded. SETTING: University medical center. PARTICIPANTS: Five patients with hemiparesis (age, 59.8+/-3.4y) were recruited. INTERVENTION: Five patients received VR for 60 minutes a day, 5 times a week for 4 weeks. VR was designed to provide a virtual rehabilitation scene where the intensity of practice and sensory feedback could be systematically manipulated to provide the most appropriate, individualized motor retraining program. MAIN OUTCOME MEASURES: Cortical activation and associated motor recovery were measured before and after VR using functional magnetic resonance imaging and standardized motor tests, respectively. Nonparametric tests were used at P less than .05. RESULTS: Prior to VR, the bilateral primary sensorimotor cortices (SM1s), contralesional premotor cortex, and contralesional or ipsilesional supplementary motor area were activated. After VR, the altered activations disappeared and predominantly the ipsilesional SM1 was activated (P<.05). Motor function was improved (P<.05). CONCLUSIONS: This is a novel demonstration of VR-induced neuroplastic changes and associated motor recovery in chronic stroke.

Adult↗
PubMed2004

Single base oligodeoxyguanosine upregulates Fas ligand release by nonspecific cytotoxic cells.

Nonspecific cytotoxic cells (NCC) are a type of teleost NK-like cell. In the present study a novel stimulus secretion model is described for catfish NCC utilizing single base oligodeoxyguanosine. Binding of guanosine 20-mers (dG20) to NCC up-regulated expression of cytosolic FasL detected by an anti-human FasL monoclonal antibody (mab). In vitro treatment of purified NCC with dG20 produced a 7-fold increase in expression of soluble Fas ligand (sFasL) after 3 h. Antibody binding to NCC was saturable and approximately 30-35% of total NCC were positive for sFasL expression. The teleost FasL equivalent produced programmed cell death of appropriate FasR positive targets. Supernatants from dG20 activated NCC produced hypoploidy and annexin-V binding by FasR bearing HL-60 cells. Treatment of activated supernatants with immobilized anti-FasL mab neutralized these activities. These studies demonstrated that an NK like cell (NCC) produces and secretes sFasL following binding by single base oligodeoxyguanosine.

Animals↗
PubMed2006

National cancer institute perspectives.

The National Cancer Institute (NCI) Perspectives this year presented information on the systemic targeted radionuclide therapy (STaRT) research projects: (1) being investigated at the NCI's Intramural Center for Cancer Research; (2) funded by NCI's Radiation Research Program and other extramural programs; and (3) the appropriate National Institutes of Health/NCI funding mechanisms applicable to researchers for obtaining funds for STaRT projects.

Antibodies, Monoclonal↗
PubMed2006

Accreditation of sleep disorders programs.

The accreditation of a sleep program ensures a high quality of care for the patient who has a sleep disorder. With more sleep laboratories becoming available, accreditation may be the best single way for a consumer to determine the adequacy of the facility. The process for accreditation requires the sleep program to develop policies and procedures that meet rigorous national and local standards. By adhering to protocols that have been proven to outline the optimal care for any given disorder associated with sleep, the provider of that care can assure the public that the program will deliver the appropriate treatment for these problems.

Accreditation↗
PubMed2004

Maternally derived humoral immunity to bovine viral diarrhea virus (BVDV) 1a, BVDV1b, BVDV2, bovine herpesvirus-1, parainfluenza-3 virus bovine respiratory syncytial virus, Mannheimia haemolytica and Pasteurella multocida in beef calves, antibody decline by half-life studies and effect on response to vaccination.

The passive immunity transferred to calves from their dams was investigated in a beef herd to determine half-life of antibody, estimated time to seronegative status and effect on immunization. One hundred two beef calves in a commercial ranch under standard management conditions were utilized. Samples were collected at branding (day 0). This was the first possible date to collect samples postcalving. This was approximately 2 months postcalving, and days 95 and 116. The calves were divided into two groups: vaccinates (51) and nonvaccinates (51). The calves were vaccinated with a commercial inactivated viral vaccine containing bovine viral diarrhea virus (BVDV)1a, BVDV2, bovine herpesvirus-1 (BHV-1), parainfluenza-3 virus (PI-3V), and bovine respiratory syncytial virus (BRSV) on days 0 and 95. Half of the vaccinated and unvaccinated calves also received one dose of an experimental Mannheimia haemolytica and Pasteurella multocida vaccine at day 95. Serums were tested for neutralizing antibody titers to BVDV1a, BVDV1b, BVDV2, BHV-1, PI-3V, and BRSV. Antibodies were detected by ELISA to M. haemolytica whole cell, M. haemolytica leukotoxin, and P. multocida outer membrane protein (OMP). The mean half-life of viral antibodies in nonvaccinated calves to each virus was: BVDV1a, 23.1 days (d); BVDV1b, 22.8 d; BVDV2, 22.9 d; BHV-1, 21.2 d; PI-3V, 30.3 d; and BRSV, 35.9 d. The mean half-life of viral antibodies was greater for vaccinates than for nonvaccinates for all viruses except BRSV. The calculated mean time to seronegative status for nonvaccinates based on titers at day 0 was: BVDV1a, 192.2 d; BVDV1b, 179.1 d; BVDV2, 157.8 d; BHV-1, 122.9 d; PI-3V, 190.6 d; and BRSV, 186.7 d. There was an active immune response after vaccination with two doses to all the viruses, except BRSV. Mean antibody titers of vaccinates at day 116 were statistically higher than nonvaccinates for all viruses except BRSV. However on an individual calf basis there were few seroconversions (four-fold rise or greater to BVDV1a, BVDV1b, BVDV2, PI-3V, or BRSV; or two-fold rise for BHV-1) in the presence of viral antibodies. The predicted time of seronegative status for a group of calves for vaccination programs may not be appropriate as there may be a range of titers for all calves at day 0. In this study the range for BVDV1a was 16-16,384; BVDV1b, 8-8192; BVDV2, 0-8192; BHV-1, 0-935; PI-3V, 8-2048; and BRSV, 8-4096. Using the half-life of 23 d for BVDV1a, the time thereafter for seronegative status would be 46 and 299 d compared to the calculated date of 192.2 d using the mean of estimated time to seronegative status for all the calves. There was an active humoral response in the vaccinated calves to M. haemolytica and P. multocida. Cowherd humoral immunity based on serum antibodies should be monitored as it may relate to transfer of maternal antibodies to calves. Exceptionally high levels of viral antibodies transferred to calves could interfere with the antibody response to vaccination.

Animals↗