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PubMed1977

Essential features of a faculty evaluation program.

A faculty evaluation system should be developed by cooperation between evaluation specialists and dental faculty. The system should depend on a broad spectrum of data collected from a variety of sources in order to reduce personal bias and subjective judgments concerning the performance of all faculty members. Its primary purpose should be to help faculty improve and to this end should be linked to both a faculty development program and a reward system. The criteria for each faculty member's evaluation should be clearly specified in advance and be directly linked to his duties. Department and college goals must be considered as well as the individual faculty member's own interests. Standards or criteria for both rewards and sanctions should be clearly defined, and guidelines for the operation of the system should be given to each participant. The system itself should not cost more than the benefits derived from it justify, and adequate resources should be allocated to make the system effective.

Costs and Cost Analysis↗

PubMed1996

The Prevention for Elderly Persons (PEP) Program: a model of municipal and academic partnership to meet the needs of older persons for preventive services.

OBJECTIVE: To create a program to identify preventive needs for community-dwelling older persons and incorporate intervention strategies to improve implementation of these services. DESIGN: Program development and case-series. SETTING: Community-based meal sites, academically administered program. PARTICIPANTS: Persons 60 years of age or older attending meal sites and their primary care physicians. MEASUREMENTS: Demographic characteristics, self reported preventive health behaviors and services, blood pressure measurement. RESULTS: During the first 2 years of the program, 927 persons 60 years of age or older were screened. The most common physician-initiated preventive recommendations were: tetanus booster (72%), aspirin prophylaxis (68%), pneumonia vaccination (61%), and colorectal cancer screening (51%). The most common self-care recommendations have been: calcium supplementation (54% of women) and breast self examinations (51% of women). As part of the adherence intervention, we were able to complete health educator calls for 600 (65%) subjects. In addition, the physicians of 599 (65%) subjects were contacted either by telephone (n = 496) or by letter only (n = 97). CONCLUSION: A community based preventive services program can identify large numbers of unmet preventive services needs, and a dual intervention strategy aimed at meeting these needs can be delivered successfully to the majority of participants. Implementation rates of specific recommendations and impacts on health outcomes remain to be determined.

Academic Medical Centers↗

PubMedDate not supplied

Establishing standards for intranet on-line education.

Following a clear set of on-line programming standards assists educators with consistency the training expectations from participants. Placing staff educational materials and health information online is an effective way to disseminate information and an efficient method of providing ongoing staff education. The presentation of on-line programming should be organized, comprehensive, and up-to-date. In addition, on-line programming should also be appealing, dynamic, and, above all practical. Today's clinical staff are pushed to the limits of time and resources. On-line training is one way to help staff meet their learning needs in today's reality. The inception of the UWMF on-line educational programs began in January 2002. Since that date employee participation has increased steadily. The time for Intranet on-line program development is part of the staff education department. For example, one area of programming is the mandatory educational credits needed for the organizations 100 certified medical assistants (CMAs). Figure 1 shows the nearly 3.5 years (January 2002 through May 2005) of participation. The 912 sessions made available 1,870 CEs for the CMAs. If the organization's CMAs were to pay for the continuing education credits (CEs) outside of the clinic setting, it could cost on average of dollar 10.00 per CE, or dollar 18,700 during the same 3-year period. Another aspect of economics is the cost in time away from work. On-line education allows employees to participate when time is available, versus having to leave work when traditional educational inservices are being held. This flexibility in participation can lead to better staff coverage.

Computer Communication Networks↗

PubMedDate not supplied

The use of focus group interviews in pediatric health care research.

OBJECTIVE: To review and synethize the research material on focus groups with children and adolescents and to provide guidelines for future development. METHODS: Psychlit, Medline, and Cinahl electronic databases, as well as the reference lists of those articles consulted, were reviewed for information regarding focus groups with participants under the age of 18 years. Both empirical and methodological articles were part of this review. RESULTS: We review the utility of focus groups for exploratory research, program evaluation, program development, and questionnaire construction or adaptation. Based on previous research, we provide guidelines for focus groups with children and adolescents and outline suggestions for future development. CONCLUSIONS: There is evidence to suggest that focus groups are a valuable means of eliciting children's views on health-related matters, given an appropriate research question. However, empirical research is required in order to investigate systematically the effect of different processes and variables on the final outcome of focus group interviews.

Adolescent↗

PubMedDate not supplied

Natural hazards: causes and effects. Lesson 5--Tropical cyclones (hurricanes, typhoons, baguios, cordonazos, tainos).

The many conclusions drawn and lessons learned from past cyclones can be used to mitigate and better respond to future occurrences. Some of the most helpful are listed below: 1) Outbreaks of cholera do not follow cyclones. Cholera must be endemic previously to a community; 2) Waterborne diseases do not increase as a result of cyclones; 3) Massive food aid rarely is required after a cyclone; 4) Used clothing almost never is needed. It usually is culturally inappropriate. Though accepted by disaster victims, it almost never is worn; 5) Blankets can be useful, but if they are needed, they usually can be found locally and do not need to be imported; 6) Assistance by outsiders is most effective in the reconstruction period, not the emergency phase; 7) Most needs are met by the victims themselves or their local governments; 8) In general, victims do not respond to disasters with abnormal behavior. Cyclones do not incite panic, hysteria, or rioting; 9) Cyclone relief and reconstruction programs should be integrated with long-term development programs; 10) When properly executed, reconstruction assistance can provide a strong stimulus to recovery and a base for future development work; 11) Reconstruction programs should seek to reduce vulnerability to future disaster; 12) Re-establishment of the local economy, income security, and agriculture usually are more important to cyclone victims than is material assistance; and 13) Churches, schools, and other large buildings that often are designated as cyclone shelters usually are not safe. The number of deaths attributed to destroyed or flooded shelters is alarming. Most experts agree that the best alternative is adequate warning and evacuation of the threatened areas.

Disaster Planning↗

PubMed1995

Tracing as part of tuberculosis control in a rural Cambodian district during 1992.

SETTING: The rural Cambodian district of Banteay Meas, population 74,464. OBJECTIVE: To evaluate the effectiveness of a district based tracing program developed to improve tuberculosis control program treatment results. Specifically, to assess factors affecting patient non-adherence to therapy and return of patients to treatment. DESIGN: All patients started on treatment during 1992 were included. Standardized cohort analysis methods were applied to assess treatment outcome for all tuberculosis cases registered during Trimesters I-III. Absconders for the year were traced and followed as a separate cohort. Those returning to therapy were followed until the end of the study period in October 1993. RESULTS: Activity in 1992 included 171 admissions and 46 absconders. Of the 46, 57% were met at home. Among those met, 81% returned to treatment. Males absconded more than females even though females accounted for a majority of admissions. Socioeconomic factors (68%) were cited most often as the reason for non-adherence. Distance was not a factor. Cohort analysis showed improvement in the treatment completion rate (54.8% vs 69.2% vs 64%) coupled with a drop in the absconding rate (35.5% vs 25% vs 20%). Of the 21 patients returning, 76% have either completed or nearly completed treatment. CONCLUSION: These results support tracing as an effective means to improve patient adherence in rural Cambodia, thereby strengthening tuberculosis control programs at district level.

Adolescent↗

PubMed1997

Growth in weight, recumbent length, and head circumference for preterm low-birthweight infants during the first three years of life using gestation-adjusted ages.

Data from 867 preterm low-birthweight participants in the Infant Health and Development Program (IHDP) were used to develop reference data for growth status at an age and for increments from term to 36 month gestation-adjusted age (GAA). Weight, length and head circumference were recorded at 4 month intervals in the first year and at 6 month intervals in the second and third years. Selected percentiles for values at an age (status values) and increments for age intervals are presented in graphs separately for VLBW infants (< or = 1500 g at birth) and for LBW infants (1501-2500 g at birth). Percentiles of weight increments are presented beginning shortly before term for 1 month intervals to 6 month GAA, for 2 month intervals to 12 month GAA, and for 3-month intervals to 36 month GAA. Percentiles for length and head circumference increments are presented from term to 6 months for 2-month intervals, and to 36 month GAA for 3 month intervals. Among LBW infants, boys, had larger status and increment values than girls (P < 0.05), but there were no significant sex-associated differences in VLBW infants for status or increments. The mean status values and increments in weight and head circumference of the LBW infants were larger than those of VLBW infants, but the differences in length were not significant.

Aging↗

PubMedDate not supplied

Behavioral monitoring of trained insects for chemical detection.

A portable, handheld volatile odor detector ("Wasp Hound") that utilizes a computer vision system and Microplitis croceipes (Cresson) (Hymenoptera: Braconidae), a parasitoid wasp, as the chemical sensor was created. Five wasps were placed in a test cartridge and placed inside the device. Wasps were either untrained or trained by associative learning to detect 3-octanone, a common fungal volatile chemical. The Wasp Hound sampled air from the headspace of corn samples prepared within the lab and, coupled with Visual Cortex, a software program developed using the LabView graphical programming language, monitored and analyzed wasp behavior. The Wasp Hound, with conditioned wasps, was able to detect 0.5 mg of 3-octanone within a 240 mL glass container filled with feed corn ( approximately 2.6 x 10(-5) mol/L). The Wasp Hound response to the control (corn alone) and a different chemical placed in the corn (0.5 mg of myrcene) was significantly different than the response to the 3-octanone. Wasp Hound results from untrained wasps were significantly different from trained wasps when comparing the responses to 3-octanone. The Wasp Hound may provide a unique method for monitoring grains, peanuts, and tree nuts for fungal growth associated with toxin production, as well as detecting chemicals associated with forensic investigations and plant/animal disease.

Animals↗

PubMed1994

Designated-driver programs: college students' experiences and opinions.

We investigated the experiences and opinions of college students regarding the use of designated drivers. Although using designated drivers appeared to be common, results indicated that in many instances the designated driver did not abstain from drinking alcoholic beverages. The opinions of the participants indicated that the nondrivers in a drinking group may in fact drink more when there is a designated driver. Our findings lead us to question the overall value of currently practiced designated-driver programs for college student drinkers. Developing programs on how to be a designated driver are among our recommendations.

Adult↗

PubMedDate not supplied

Promoting the advancement of minority women faculty in academic medicine: the National Centers of Excellence in Women's Health.

Minority physicians provide care in a manner that promotes patient satisfaction and meets the needs of an increasingly diverse U.S. population. In addition, minority medical school faculty bring diverse perspectives to research and teach cross-cultural care. However, men and women of color remain underrepresented among medical school faculty, particularly in the higher ranks. National data show that although the numbers of women in medicine have increased, minority representation remains essentially static. Studying minority women faculty as a group may help to improve our understanding of barriers to diversification. Six National Centers of Excellence in Women's Health used a variety of approaches in addressing the needs of this group. Recommendations for other academic institutions include development of key diversity indicators with national benchmarks, creation of guidelines for mentoring and faculty development programs, and support for career development opportunities.

Career Mobility↗

PubMed2000

Evaluation of net atomic charges and atomic and molecular electrostatic moments through topological analysis of the experimental charge density

The atoms in molecules (AIM) theory may be used to derive atomic charges, atomic volumes and molecular dipole moments from the charge density. The theory is applied to theoretical periodic Hartree-Fock (PHF), density-functional (DFT) and experimental X-ray densities of p-nitroaniline using the program TOPOND and a newly developed program, TOPXD, for topological analysis of densities described by the Coppens-Hansen multipole formalism. Results show that, like dipole moments derived directly from the multipole refinement, AIM-derived atomic and molecular moments are dependent on the multipole model used. As expected, large differences are found between charges derived from the monopole parameters and those from AIM analysis of the experimental model density. Differences between the k'-restricted multipole model (KRMM) and the unrestricted multipole model (UMM) results are preserved in the AIM analysis. The enhancement of the molecular dipole moment of p-nitroaniline in the solid state is confirmed by both experiment and theory but the experimental dipole moment is in much better agreement with theoretical periodic Hartree-Fock and, especially, periodic DFT (PDFT) data when KRMM is used in the refinement. The AIM analysis allows a rigorous definition of the charges of the atoms in molecules and provides a realistic basis for comparison between molecules and between experiment and theory.

Journal Article↗

PubMedDate not supplied

Infant stimulation reassessed. A new approach to providing care for the preterm infant.

Developmental intervention is a new method of improving the care of preterm infants. Use of the Assessment of Preterm Infant Behavior (APIB) to determine the current behavioral functioning of an infant and how that information can be used to develop and implement an individualized program of nursing care are described. Three examples of individualized programs developed as a result of assessment are presented. General environmental guidelines for special care nursery procedures, parent involvement, and nurse training are given.

Boston↗

PubMed2006

From surveillance to action: early gains from the National Violent Death Reporting System.

OBJECTIVES: Drawing from the experiences of individual state programs that currently participate in the National Violent Death Reporting System (NVDRS), this article reviews some of the practical benefits that may accrue from the introduction of violent death surveillance systems. DESIGN: As a state-based surveillance system that uses multiple data sources and relies upon multiple stakeholders, the NVDRS program has fostered an array of initiatives within and among individual state programs. State-based initiatives highlighted in this article were selected on the basis of a purposive sampling strategy intended to illustrate key aspects of program development. SETTING: The NVDRS state programs are in Alaska, California, Colorado, Georgia, Kentucky, Maryland, Massachusetts, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin. RESULTS: The NVDRS has helped to build alliances and collaborative efforts between key stakeholders, facilitated the recognition of violent death as a public health problem through outreach and media attention, acted as a catalyst for new projects, enhanced surveillance of special populations and utility for evaluation, and identified key circumstances that will target interventions in state prevention planning. CONCLUSIONS: The NVDRS has implemented data collection efforts and is beginning to produce and analyze findings. In the process of implementing the data collection system and publicizing findings, state NVDRS programs are realizing other gains that strengthen their surveillance efforts. The use of data for prevention purposes will be the ultimate indicator of program success.

Centers for Disease Control and Prevention, U.S.↗

PubMed2006

Acknowledging adult bias: a focus-group approach to utilizing beauty salons as health-education portals for inner-city adolescent girls.

To assess the feasibility of using beauticians as health literacy agents and beauty salons as health-education portals for adolescent, inner-city, African American girls, the authors conducted focus groups with 25 women: salon clients, salon owners, and medical students. Facilitators to program development included (a) beautician-client relationships, (b) teens' access to health information, and (c) beauticians as information resources. Barriers included (a) adult opinions of teen behaviors, (b) teen mistrust of adults, and (c) low health literacy of beauticians. In developing a health-education program for this population, beauticians and salons may be excellent health information agents and portals if barriers including beautician poor health literacy, adolescent mistrust in adults, and adults' anti-adolescent bias are improved. Program implementation must not solely focus on teens but should also include adult salon users, with the goal of reaching the teens first through these adults and, with time and trust, reaching the teens directly.

Adolescent↗

PubMed1989

Assessment of gerontology certificate program quality: a follow-up study of graduates.

A follow-up survey of gerontology certificate program graduates was undertaken to elicit views about quality and impact of their interdisciplinary studies, professional roles, and usefulness of course offerings. Graduates provided recommendations about essential course content and suggestions to assist the university in certificate program development. The data strongly support program objectives and direction.

Curriculum↗

PubMed1998

[The current status of research on a cholera vaccine].

Cholera remains today a major health problem in most developing countries. The long-term control of cholera depends on the improvement of hygiene but this is a distant goal for many countries. The availability of an effective cholera vaccine is thus important for the prevention of cholera in such countries. More than a century after the first attempt to vaccinate against cholera by Ferran in Spain, there is still no truly effective cholera vaccine. A bacterial fraction vaccine, referred to as CH1 +2 was prepared by Professor A. Dodin. A field trial of this vaccine was carried out in Zaire in 1983. Significant protection was observed but this vaccine was not evaluated in additional trials. Two other oral cholera vaccines, developed in Sweden and in the USA, were widely experimented on human beings: a combination of cholera toxin B-subunit and inactivated bacterial cells, and a live attenuated vaccine containing the genetically manipulated Vibrio cholerae O1 strain CVD 103-HgR. Despite their efficiency as evaluated in field trials (inactivated vaccine) or on volunteers (live vaccine), these vaccines have drawbacks that may limit their usefulness as practical vaccines. Protection induced by the inactivated vaccine was transient in young children, lasting only approximately for six months. One of the safety concerns associated with live vaccines is a possible reversion to virulence. Efforts should be continued to find a better cholera vaccine. A new vaccine development program based upon the hypothesis that immunoglobulin G directed to the O-specific polysaccharide of Vibrio cholerae O1 could confer protective immunity to cholera. This program may lead to the development of a cholera conjugate vaccine to elicit protection in infants.

Adjuvants, Immunologic↗

PubMed1988

Patient representative program.

In this "Management in Action" article, Mr. Rush presents a patient representative program developed to provide personalized services to patients. He reviews the development and operation of the program, and discusses its results.

Hospital Bed Capacity, 500 and over↗

PubMed2001

Physicians Taking Action Against Smoking: an intervention program to optimize smoking cessation counselling by Montreal general practitioners.

In 1997 the Direction de la santé publique de Montréal-Centre initiated "Physicians Taking Action Against Smoking," a 5-year intervention program to improve the smoking cessation counselling practices of general practitioners (GPs) in Montreal. Program development was guided by the precede-proceed model. This model advocates identifying factors influencing the outcome, in this case counselling practices. These factors are then used to determine the program objectives, to develop and tailor program activities and to design the evaluation. Program activities during the first 3 years included cessation counselling workshops and conferences for GPs, publication of articles in professional interest journals, publication of clinical guidelines for smoking cessation counselling and dissemination of educational material for both GPs and smokers. The program also supported activities encouraging smokers to ask their GPs to help them stop smoking. Results from 2 cross-sectional surveys, conducted in 1998 and 2000, of random samples of approximately 300 GPs suggest some improvements over time in several counselling practices, including offering counselling to more patients and discussing setting a quit date. More improvements were observed among female than male GPs in both psychosocial factors related to counselling and specific counselling practices. For example, improvements were noted among female GPs in self-perceived ability to provide effective counselling and in the belief that it is important to schedule specific appointments to help patients quit; in addition, the perceived importance of several barriers to counselling decreased among female GPs. A greater proportion of the female respondents to the 2000 survey offered written educational material than was the case in 1998, and a greater proportion of the male GPs devoted more time to counselling in 2000 than in 1998; however, among male GPs the proportion who discussed the pros and cons of smoking with patients in the pre-contemplation stage declined between 1998 and 2000, as did the proportion who referred patients in the preparation stage to community resources. Our experience suggests that an integrated, theory-based program to improve physicians' counselling practices could be a key component of a comprehensive strategy to reduce tobacco use.

Counseling↗