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PubMed1998

[The Program for Integrated Women's Health Care]

The Program for Integrated Women's Health Care (PAISM) was launched by the Brazilian Ministry of Health in 1983 as a new and different approach to women's health. Paradoxically, the PAISM also became the first case in which the Brazilian state explicitly proposed and implemented (albeit partially) a program regulating fertility. This raised suspicions as to disguised promotion of birth control. However, a brief analysis of the history of this program and its social significance suggests that the PAISM was a pioneering undertaking (even within the international scenario) in proposing integrated women's health care as opposed to isolated family planning measures. This helps explain why women's movements in Brazil immediately began to struggle to see it properly implemented. The program contained the definition of reproductive health adopted by the World Health Organization in 1988, which was expanded and consolidated in Cairo in 1994 and Beijing in 1995. Consequently, adoption of the PAISM meant a significant step towards recognition of women's reproductive rights, even before gaining the various international forums for struggle.

Journal Article↗

PubMed1998

Direct transfer of bovine embryos frozen-thawed in the presence of propylene glycol or ethylene glycol under on-farm conditions in an integrated embryo transfer program.

An integrated bovine embryo transfer program was conducted in collaboration with 11 Japanese prefectural livestock experiment stations. The program was conducted to evaluate the practicability of the direct transfer method for bovine embryos frozen-thawed in the presence of propylene glycol (PG) or ethylene glycol (EG) under on-farm conditions. Embryos at the compacted morula to expanded blastocyst stages were collected from superovulated donors on Day 7 or 8 after estrus and equilibrated in 1.6 M PG or 1.8 M EG in Dulbecco's phosphate-buffered saline (DPBS) supplemented with 20% heat-inactivated calf serum. Embryos were then loaded individually into a 0.25-ml straw and placed directly into a cooling chamber of a programmable freezer precooled to -7 degrees C. After 2 min, the straw was seeded, maintained at -7 degrees C for 8 min more, and then cooled to -30 degrees C either at 0.3 degree C/min or 0.5 degree C/min before being plunged into liquid nitrogen. Embryos at the same stages were also frozen in the presence of 1.4 M glycerol (GLY) by a conventional method, which served as a control. The frozen embryos were thawed by allowing the straws to stand in air for 5 to 10 sec and then immersing them in a 30 degrees C water bath. Embryos frozen-thawed in the presence of PG or EG were nonsurgically transferred into the uterine horn without diluting the cryoprotectant. Embryos frozen-thawed in the presence of GLY were nonsurgically transferred after removing GLY either by the stepwise method (GLY-I) or by in situ dilution with 0.3 M sucrose solution (GLY-II). A total of 1,273 (PG: 400, EG: 418, GLY-I: 177, GLY-II; 278) frozen-thawed embryos was transferred into recipients, yielding 545 pregnancies (overall: 42.8%, PG: 36.0%, EG; 44.7%, GLY-I; 48.6%, GLY-II; 46.0%). The pregnancy rate with PG was significantly lower than that with EG or GLY-II (P < 0.05). The pregnancy rate was affected by the type of cryoprotectant, the region where the embryo transfer program was carried out, the developmental stage of the embryos, the parity of the recipients, and corpus luteum (CL) quality of the recipients. There were no differences in rates of abortion and stillbirth among the 3 cryoprotectants. The present study demonstrates that EG can be effectively used as a cryoprotectant for freezing and direct transfer of bovine embryos, and that the direct transfer method is applicable under on-farm conditions.

Animals↗

PubMed1995

Innovative programs for integrated delivery systems.

These programs are most effective under a MCO setting, but will succeed only if there are individuals within the organization to champion these programs. Many pharmacists have taken the lead and are working closely with manufacturers to identify the best use of these programs. These individuals ensure that the programs are implemented and that the appropriate pathways are followed. The pharmacist can assist in identifying those who are not using products appropriately. Using the manufacturer's resources (sales force) to supply the provider with educational material can help the provider follow the pathways and focus on appropriate use. The pharmacist can monitor the data and offer suggestions on program modifications. Therefore, the pharmacist plays a key role in meeting the challenges presented by outcomes performance programs and in creating an opportunity for the patient care organization to achieve its financial goals. With the MCO and manufacturer as partners, these programs will be successful and can increase the quality of care to MCO members who receive care in an institutional or community managed care setting.

Capitation Fee↗

PubMedDate not supplied

[Community in medical education programs of integral general medicine].

This paper includes the chief considerations about the community work in the Integral General Medicine Program Called Plan A36. General considerations are made abour the four years of trainign program in which the medical student in exposed to be in close contac with the most common medical and health problems in his country, and during this period of time, he becomes capable to develop all the techniques to act as a primary contac physicain.

Community Medicine↗

PubMed1992

The Integrated Trauma Program: a model for cooperative trauma triage.

The Integrated Trauma Program (ITP) is the cooperative trauma triage service of the University of Toronto trauma and burn hospitals and the Ontario Ministry of Health. It provides physicians in referring hospitals direct access to a trauma team leader (TTL) in one of several trauma centers through a single phone number. Three adult trauma centers, one pediatric trauma center, and one burn center, all affiliated with the University of Toronto, participate in this program. This article describes the system during the first two years of operation. From July 1989 to June 1991, 1530 requests for patient transfers from a total of 97 hospitals were processed. Of these transfer requests, 77% were accepted by the TTL to a trauma service as multiple trauma cases, 16% were accepted directly to a surgical service without involving the trauma team, 4% were refused by the TTL as inappropriate referrals, and 3% of requests were cancelled by the referring physician. The transfer requests are distributed to a specific trauma center by request of the referring physician (10%), according to a rotation (70%), or as selected by the ITP (20%) when the scheduled hospital is not readily available. Closure of all adult trauma centers occurred on 43 occasions. During these closures, 48 patients bypassed the Toronto trauma centers and were transferred to other cities. The ITP office also keeps an ongoing data base of patients transferred. The mechanism of injury in the majority of cases is vehicular crashes. The mean Injury Severity Score is 24 for adults and 17 for children.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1981

The role of neuroleptics in an integrated treatment program for chronic schizophrenics.

An integrated treatment programme for patients with psychoses and hospitalization syndromes is presented. Most of the patients are schizophrenics with many years of hospital care. Neuroleptics are used in conventional doses and since 1971 flupenthixol decanoate is the drug of choice. The residual states are analyzed as well from a medical as from a social psychological point of view. Psychotherapy and social training inside and outside the hospital were means to reach treatment progress. Behaviour therapy was successful on the most deteriorated patients and in young patients a more psychodynamic approach was used including family therapy. Forty-two patients were activated to a life in flats. In 21 patients living near the hospital an economic analysis was made. The economic benefits of the treatment are large. The results show that patients suffering from chronic mental diseases must be treated with a composed programme including medical, social, and psychological parts.

Adult↗

PubMed1991

A practicum in clinical nutrition as the internship component of an integrated masters/internship program.

In September 1990, Chedoke McMaster Hospitals (CMH) admitted two students to the Practicum in Clinical Nutrition. This program was developed at CMH in affiliation with the graduate programs in nutrition offered at McMaster University and the University of Guelph. This is the first program in Canada to integrate a graduate nutrition degree at the Master's level with a clinical nutrition training program. The purpose of this paper is to describe the need, goals, educational philosophy, developmental process and anticipated benefits of this practicum.

Curriculum↗

PubMed1995

Visions realized and dreams dashed: Helen Penhale and the first basic integrated baccalaureate program in nursing in the west, at the University of Alberta 1952-1956.

The first basic degree program in nursing in Canada was established at the University of British Columbia in 1919. This program and those that followed elsewhere were of the non-integrated form, wherein a diploma program offered by a hospital was supplemented by university courses in the arts, humanities, and sciences. In 1942 an innovative basic baccalaureate program in nursing was established at the University of Toronto; courses in nursing, given by the university, were offered in conjunction with university courses in other subjects. Only two other attempts were made to set up integrated programs in Canada prior to release of the Report of the Royal Commission on Health Services of 1964; McMaster University established a program in 1946, and, in an attempt that was ultimately unsuccessful, a program was established at the University of Alberta in 1952. The purpose of this study was to examine the conditions surrounding the initiation and termination of a basic degree program in the 1950s at the University of Alberta, in order to understand the key issues in the movement to establish basic university degree programs for nurses, and the gender discrimination relative to nurses and nursing students that has prevailed in health and education. Although the conflict at the University of Alberta was a very difficult one for the nurses involved, and although the Director who had the temerity to establish the program relinquished her position when the program was summarily terminated, this episode in Canadian nursing history provides insight into the climate in which baccalaureate nursing education existed and into some of the issues relative to its development.

Alberta↗

PubMed1999

A method of teaching clinical research in a community hospital residency program.

BACKGROUND: To provide clinical research experience in community hospital programs, we integrated research training with the daily work of surgical residency. METHODS: Teaching conferences and daily care of patients served as a source of projects. Emphasizing team work, high-yield projects are assigned to principal resident investigators, who lead a project team. Regular meetings with the faculty provides guidance and supervision, working to meet an abstract deadline. RESULTS: Over a 3-year period, 10 of 16 trainees participated in at least one project. Thirteen projects were presented at national meetings and 13 articles (including 6 from presentations) were published. Three projects were abandoned for lack of progress, and 5 manuscripts have been rejected. CONCLUSION: The integrated program trains multiple residents/projects with low requirements in space and funding, but high demands of organization and faculty time.

Curriculum↗

PubMed1998

New approaches to smoking prevention in the north.

Morbidity and mortality rates of noncommunicable diseases (NCD) are very high in Siberia. The prevalence of NCD risk factors is also very high, smoking being one of the most widespread risk factors. Prevention and cessation of smoking may improve the health of the population. Within the framework of the WHO MONICA (Monitoring Cardiovascular Diseases) project, we have conducted three population surveys in Novosibirsk within a 10-year period (1984-1995) to show trends of cardiovascular diseases and their risk factors. We also conducted similar surveys in some Siberian regions. Economic crisis and social stress greatly affect the health of the population, and new methods and approaches to disease prevention are needed. As participants in the WHO CINDI program (Countrywide Integrated Program for Disease Prevention), we started our work to reduce and control the main NCD risk factors. Smoking being widespread in Siberia, we started an anti-smoking campaign in Novosibirsk as participants in the international "QUIT & WIN" campaign in 1994. In 1995 we arranged a similar contest at the local level in the city; and now in May 1996 we are again taking part in the QUIT & WIN campaign.

Adult↗

PubMed1999

Integrating Application Programs for Bioinformatics Using a Web Browser.

We have constructed a general framework for integrating application programs with control through a local Web browser. This method is based on a simple inter-process message function from an external process to application programs. Commands to a target program are prepared in a script file, which is parsed by a message dispatcher program. When it is used as a helper application to a Web browser, these messages will be sent from the browser by clicking a hyper-link in a Web document. Our framework also supports pluggable extension-modules for application programs by means of dynamic linking. A prototype system is implemented on our molecular structure-viewer program, MOSBY. It successfully featured a function to load an extension-module required for the docking study of molecular fragments from a Web page. Our simple framework facilitates the concise configuration of Web softwares without complicated knowledge on network computation and security issues. It is also applicable for a wide range of network computations processing private data using a Web browser.

Journal Article↗

PubMed1998

MoldaNet: a network distributed molecular graphics and modelling program that integrates secure signed applet and Java 3D technologies.

MoldaNet is a molecular graphics and modelling program that integrates several new Java technologies, including authentication as a Secure Signed Applet, and implementation of Java 3D classes to enable access to hardware graphics acceleration. It is the first example of a novel class of Internet-based distributed computational chemistry tool designed to eliminate the need for user pre-installation of software on their client computer other than a standard Internet browser. The creation of a properly authenticated tool using a signed digital X.509 certificate permits the user to employ MoldaNet to read and write the files to a local file store; actions that are normally disallowed in Java applets. The modularity of the Java language also allows straightforward inclusion of Java3D and Chemical Markup Language classes in MoldaNet to permit the user to filter their model into 3D model descriptors such as VRML97 or CML for saving on local disk. The implications for both distance-based training environments and chemical commerce are noted.

Computer Graphics↗

PubMed2026

Digital Structured Education With Behavioral Nudge Tools for Adults With Type 2 Diabetes: Multicenter Randomized Controlled Trial.

BACKGROUND: Digital interventions offer scalable alternatives to traditional face-to-face diabetes education, but often face challenges related to inconsistent clinical effectiveness, and declining user engagement. However, whether a digital structured education program integrated with behavioral nudge tools can improve metabolic, behavioral, and psychological outcomes in adults with type 2 diabetes remains unclear. OBJECTIVE: This study aimed to evaluate the effectiveness of a digital structured education program integrated with behavioral nudge tools in improving metabolic, behavioral, and psychological outcomes among adults with type 2 diabetes. METHODS: This multicenter randomized controlled trial was conducted in the endocrinology departments of 4 hospitals in China. Adults with type 2 diabetes were randomly assigned to an intervention group receiving a digital structured education program integrated with behavioral nudge tools (n=146) or a control group receiving standard digital diabetes education (n=147). Assessments were conducted at baseline and 12-week follow-up. The primary outcome was hemoglobin A1c (HbA1c) at 12 weeks, adjusted for baseline HbA1c, and study center. Secondary outcomes included fasting blood glucose (FBG), weight, BMI, waist circumference, blood pressure, lipid profiles, self-management behaviors, self-efficacy, and habit strength. RESULTS: Among 293 participants (mean age 49.19, SD 10.02 y), 287 (97.9%) completed follow-up. At 12 weeks, the intervention group demonstrated significantly greater improvements than the control group in HbA1c (adjusted mean difference -0.38%, 95% CI -0.68% to -0.09%; P=.01), FBG (adjusted mean difference -0.75, 95% CI -1.27 to -0.44 mmol/L; P<.001), weight (adjusted mean difference -0.84, 95% CI -1.61 to -0.07 kg; P=.03), BMI (adjusted mean difference -0.38, 95% CI -0.65 to -0.11 kg/m²; P=.01), systolic blood pressure (adjusted mean difference -2.71, 95% CI -4.62 to -0.79 mm Hg; P=.01), diastolic blood pressure (adjusted mean difference -2.92, 95% CI -4.47 to -1.37 mm Hg; P<.001), and total cholesterol (adjusted mean difference -0.27, 95% CI -0.48 to -0.05 mmol/L; P=.02). The intervention was also associated with significantly greater improvements in self-management behaviors, self-efficacy, and habit strength (all P<.05). CONCLUSIONS: Digital structured education integrated with behavioral nudge tools improved metabolic outcomes and strengthened psychological and behavioral determinants of self-management among adults with type 2 diabetes over a 12-week period. These findings suggest that a digital structured education program integrated with behavioral nudge tools may enhance diabetes self-management beyond standard digital diabetes education. Further studies with longer follow-up and real-world implementation are warranted to evaluate the sustainability, generalizability, and long-term clinical impact of this integrated intervention.

Humans↗

PubMed1980

Automated determination of salts in water-soluble certifiable color additives by ion chromatography.

A previously developed ion chromatographic method for the determination of salts in water-soluble certifiable color additives was automated, using a Model 12 Dionex ion chromatograph equipped with a program controller and programmable computing integrator. Programs were written for the program controller for continuous automated analysis of up to 59 samples in about 20 h, with periodic regeneration of the suppressor column and automatic shut-down. All data were processed through the integrator, programmed to give results in weight/weight percent. Recoveries were performed on 4 anions: chloride, phosphate, bromide, and sulfate. Twenty-five color additives could be analyzed by the method. Standard deviations in the determinations ranged from 0.01 to 0.16 at addition levels of 0.20-9.45% with 6 replications. Recoveries for addition levels of 0.2-5.0% with 2 replications fell within the range of 84.0-105.0%. Approximate lower limits of detection for each anion were as follows: chloride, 0.07%; phosphate, 0.10%; bromide, 0.06%; sulfate, 0.07%.

Anions↗

PubMed1978

How evaluation findings can be integrated into program decision making.

The paper describes difficulties in integrating the findings of research and evaluation studies back into the ongoing process of decision making. The paper suggests how to present information in such a way as to improve its intellectual understandability and to decrease affective resistances to the acceptance of new information. The paper also describes common blocks that are met in the attempt to implement recommendations and describes methods to overcome them.

Affect↗

PubMed1986

[Features of the hemodynamics of myocardial infarct patients undergoing the most widely used rehabilitation programs].

Integrated body rheography, radiocardiography and radionuclide ventriculography were used to investigate hemodynamic changes in 101 myocardial infarction patients during the hospital stage of the disease. Changes in major hemodynamic parameters were demonstrated by the end of the 1st week and when walking was resumed. At the resumed-walking stage, the mechanism of declining stroke and cardiac indices was shown to depend on physical activation rates. Hemodynamic response is mostly conditioned by myocardial insufficiency when walking is resumed rapidly during the 2nd week, and by smaller venous return due to hypovolemia where it is resumed slowly during the 4th week. Expanding motion regimens at slow rates results in persistent hemodynamic disturbances in myocardial infarction patients.

Adult↗

PubMed1989

Effectiveness of a sensory integrative therapy program for children with perceptual-motor deficits.

This study was an evaluation of the sensory integrative therapy (SIT) program (Ayres, 1972a) for children at the Christchurch Hospital. Fifty-five children were randomly assigned to the SIT program, a parallel physical education program, or to a no-treatment condition. The children were assessed before and after treatment on measures of perceptual-motor development, language and reading development, self-concept, and handwriting skills. Covariance analysis, with age and pretest scores as covariates, found no significant differences between groups on any of the measures except reading progress among those children who could already read at the beginning of the program. Children who made the least progress during therapy were those who (a) had epilepsy, (b) were from a low-income, single-parent family, or (c) had behavioral problems.

Child↗

PubMed1984

The birth of a curriculum: utilization of the Betty Neuman Health Care Systems Model in an integrated baccalaureate program.

The authors have described the birth of an integrated baccalaureate curriculum at the University of Pittsburgh School of Nursing. The curriculum design reflects our philosophy and our conceptual framework and includes components of the Betty Neuman Health Care Systems Model. The major theoretical formulations, the vertical and horizontal strands and the constructs for categorization of stressors are also described.

Curriculum↗