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At least 1,531 records · Page 85Linked to original sources
PubMed1997

An evaluation of educational outreach to general practitioners as part of a statewide cervical screening program.

OBJECTIVES: The purpose of this study was to determine the acceptability, effectiveness, and cost of a face-to-face educational outreach intervention in the context of a program aimed at increasing cervical screening in Victoria, Australia. METHODS: All identified general practitioners in a specified intervention area were offered a visit by a general practitioner educator. Practitioners completed a questionnaire evaluating the acceptability of the visit. Odds ratios for a woman being screened in the 3 months following the visits were determined. RESULTS: Fifty-nine general practitioners (69.4%) accepted the offer of a visit. Most found both the process and the content of the intervention to be acceptable. The intervention and nonintervention regions did not differ either before or after the intervention. In both regions, there was a statistically significant increase in number of Pap tests performed. There was no difference in the change in screening between the two regions. Costs were estimated at Au$34 per general practitioner visited. CONCLUSIONS: This strategy cannot be recommended for widespread use in a cervical screening program.

Adult↗
PubMed2002

Evaluation of a population-based prevention program against influenza among Swiss elderly people.

INTRODUCTION: Influenza is a major cause of morbidity and mortality and occurs in epidemics in the winter. This study is an evaluation of a population-based prevention program against Influenza, implemented during autumn 2000 by the Health Department of the Canton of Vaud. METHODS: A pre-intervention/post-intervention design was used. In June 2000 and March 2001, 4007 questionnaires were sent to two different stratified random samples of people aged 65 and over living in the Canton of Vaud, Switzerland. Univariate, bivariate and multivariate analyses were performed. RESULTS: Vaccination coverage among people older than 65 was 58.0% in 1999 (95% CI: 56.2%-59.8%) and 58.4% (95% CI: 56.6%-60.2%) in 2000. A 6.5% significant increase in vaccination coverage was seen in the group of people aged 65 to 69 (p = 0.008). In the pre-intervention survey immunisation rates were 22.6% among people who had not consulted a physician, 59.2% among those who had consulted a physician once, and 73.2% among those who consulted twice or more (p = 0.001). These rates were respectively 30.8%, 58.0% and 75.1% (p = 0.001) in the post-intervention survey. CONCLUSIONS: No global increase in Influenza vaccination coverage in the elderly population could be observed following a community based intervention in a Swiss Canton. However, the enhanced vaccination rates noted in the 65-69 years old group and in people who did not receive medical care are compatible with an effect of the campaign. Further increase in vaccination coverage may be obtained by diversification and repetition of such promotion campaigns.

Age Factors↗
PubMed1990

Undergraduate health administration education in the 1990s.

The current destabilizing period of the health care industry and higher education has major implications for undergraduate education, especially given its adolescent stage of development. Although undergraduate programs have progressed a great deal in gaining acceptance within the industry and the academy, it must not be assumed that curricula, programs, or a consortium of programs can rest on past accomplishments. This paper has attempted to describe the threats and opportunities facing undergraduate programs and to discuss some strategies for future development that might be explored collectively or individually. It is hoped that the above observations will provoke a healthy dialogue as well as a plan of action by undergraduate programs. Undergraduate health administration programs must respond to the future and make themselves relevant and necessary to the new challenges facing the field of both practice and higher education.

Curriculum↗
PubMed1988

Reduction and replacement of laboratory animals in toxicological testing and research. Interim report 1984-1987.

The reasons reduction and replacement of laboratory animals are advancing rapidly in basic biomedical research, and why in industrial toxicology progress is much slower, are analyzed. Reference is made to a previous report from our laboratory, and the general concept of the program is outlined. Encouraging developments concerning acceptance of new concepts in acute toxicity testing by various regulatory agencies are reviewed (OECD, IKS, EEC, and Bureau of Pharmaceutical Affairs, Ministry of Health and Welfare, Japan). On the basis of new concepts proposed by the British Toxicology Society, a program which attempts to evaluate acute toxicity of chemicals as far as possible without causing mortality was started. Continuous in-cage monitoring of motility of animals, regular control of general health, body weight, food and water consumption, and body temperature are used as variables. The possibilities of reducing animal use in toxicology by application of toxicological screening procedures are explained. Screening tests under development include an operant conditioning technique to detect adverse drug interactions with ethanol and a procedure for the detection of nephrotoxic properties. The successful completion of a collaborative program designed to upgrade toxicity testing with contraceptive steroids and to abolish the 7-year beagle and 10-year monkey studies is reported. The application of in vitro cytotoxicity tests for assessment of irritant and corrosive properties of chemicals is discussed and some encouraging progress on regulatory acceptance of such tests (OECD) is reported. A new test developed at the institute is described. An in vitro model for the investigation of chemically induced changes of collagen synthesis in human fibroblasts is presented. Other cell culture methods under development include a culture system of chick brain, retina, and menings cells for the study of neurotoxic chemicals and neurobehavioral teratogens, primary hepatocyte cultures for the study of drug effects on DNA and protein synthesis and ploidy, using flow cytometry, and various in vitro models for the assessment of genotoxic and tumor-promoting activities and malignant cell transformation. The problem of analgesic treatment of animals with chronic pain was investigated. Several analgesics were evaluated, and treatment modalities providing demonstrable analgesia for prolonged periods of time in mice and rats were worked out.

Animal Welfare↗
PubMed1997

The impact of vaccination strategy and methods of information on influenza and pneumococcal vaccination coverage in the elderly population.

We compared the coverage achieved with either an age-based, free-of-charge vaccination program offering influenza vaccine alone or with pneumococcal vaccine with a restricted risk disease-based influenza vaccination program supplemented by self-funded immunization. We also compared two means of informing the public, either using mailed personal reminders or through the mass media only. Forty-one administrative districts with a total of 41,500 persons aged 65 years or older participated in the study during three consecutive seasons from 1992 to 1994. The average vaccination coverage achieved by the risk disease-based program was 20%, by the age-based program with mass media information, 52%, and by the age-based program with mailed personal reminders 82%. The availability of free-of-charge vaccines is thus not sufficient to ensure a high vaccination rate. The effect of the personal reminders was restricted to the year they were sent. The addition of pneumococcal vaccine to the age-based influenza vaccination program had little influence on the acceptance rate.

Age Factors↗
PubMed1987

A review of achievements of the national schistosomiasis control program in middle and upper Egypt areas.

In Egypt the "national schistosomiasis control program" was formulated to control transmission by reduction of prevalence and intensity of current infections, and thereby achieve an acceptable level of schistosomiasis disease control. The program was implemented foremost in Middle Egypt (1977) and Upper Egypt (1980), collectively extending 800 km alongside of the River Nile and accommodate about 10.5 million people. Schistosoma haematobium has been essentially the prevailing species infection in both areas. The strategy of control entailed both area-wide mollusciciding with niclosamide, and selective population chemotherapy with metrifonate. Evaluation in 1986 showed that prevalence dropped from pre-control 29.4% in Middle Egypt and 26.3% in Upper Egypt to 6% and 7.8% respectively, together with a remarkable drop of infections among children. Also mean intensity attained low levels consistent of low grade infections. It is evident therefore that in these areas where an enhancement of schistosomiasis infections had been anticipated the employment of the twofold strategy effected a state of low-prevalence/low-intensity signifying a lowered reservoir of infection and a substantial interference with the potentials of transmission.

Animals↗
PubMed1973

Nurse practitioners in primary care. I. The McMaster University educational program.

In 1971 McMaster University offered an educational program for nurse practitioners sponsored jointly by the Faculty of Medicine and the School of Nursing. Priority in the pilot program was given to nurses employed in family practice settings and to those participating in related McMaster studies. Because of the implications of a change in role for both nurse and physician, one requirement for acceptance of a nurse in the program was participation of the physician-associate in the educational program.The program prepares registered nurses to extend their responsibilities in primary health care activities for the assessment and management of patients in family practice. The current evaluations of the pilot-study results suggest that such programs can contribute effective resources towards meeting expectations of ready access to primary care by the people of Canada.

Comprehensive Health Care↗
PubMed2003

Network visualization system for computational chemistry.

Network Visualization System for Computational Chemistry (NVSCC) is a molecular graphics program designed for the visualization of molecular assemblies. NVSCC accepts the output files from the most popular ab initio quantum chemical programs, GAUSSIAN and GAMESS, and provides visualization of molecular structures based on atomic coordinates. The main differences between NVSCC and other programs are: Network support due to built-in FTP and telnet clients, which allows for the processing of output from and the sending of input to different computer systems and operating systems. The possibility of working with output files in real time mode. The possibility of animation from an output file during all steps of optimization. The quick processing of huge volumes of data. The development of custom interfaces.

Journal Article↗
PubMed2002

Programmed death phenomena: from organelle to organism.

Programmed death phenomena appear to be inherent not only in living cells (apoptosis), but also in subcellular organelles (e.g., self-elimination of mitochondria, called mitoptosis), organs (organoptosis), and even whole organisms (phenoptosis). In all these cases, the "Samurai law of biology"--it is better to die than to be wrong--seems to be operative. The operation of this law helps complicated living systems avoid the risk of ruin when a system of lower hierarchic position makes a significant mistake. Thus, mitoptosis purifies a cell from damaged and hence unwanted mitochondria; apoptosis purifies a tissue from unwanted cells; and phenoptosis purifies a community from unwanted individuals. Defense against reactive oxygen species (ROS) is probably one of the primary evolutionary functions of programmed death mechanisms. So far, it seems that ROS play a key role in the mito-, apo-, organo-, and phenoptoses, which is consistent with Harman's theory of aging. Here a concept is described that tries to unite Weismann's hypothesis of aging as an adaptive programmed death mechanism and the generally accepted alternative point of view that considers aging as an inevitable result of accumulation in an organism of occasional injuries. It is suggested that injury accumulation is monitored by a system(s) actuating a phenoptotic death program when the number of injuries reaches some critical level. The system(s) in question are organized in such a way that the lethal case appears to be a result of phenoptosis long before the occasional injuries make impossible the functioning of the organism. It is stressed that for humans these cruel regulations look like an atavism that, if overcome, might dramatically prolong the human life span.

Aging↗
PubMed1977

The volunteer program in the psychiatric division of a children's hospital.

Volunteers in the division of child psychiatry of Children's Memorial Hospital in Chicago are interviewed and given a general orientation by the volunteer department, which is headed by a paid employee, and are given specific, task-oriented, on-the-job training by staff members in the division. Volunteers ranging in age from the teens to the mid-sixties are active in outpatient services, in the day hospital program, which accomodates 48 children, and in the 18-bed inpatient unit. In a typical month an average of 90 volunteers give approximately 1900 hours of service. The authors list several reasons for the successs of the volunteer program, including the one they feel is most important--administrative and staff acceptance of volunteers as an integral part of the program, not as do-gooders to be tolerated.

Adolescent↗
PubMed1987

Acceptance testing of medical imaging equipment: CT and MRI.

Acquisition of medical imaging equipment should be followed by verification of its ability to satisfy clinical objectives. This verification normally is fulfilled by initial acceptance testing before clinical use and by an ongoing quality-assurance program thereafter. This article describes our experience with the acceptance testing of computed tomography scanners and magnetic resonance imaging systems.

Equipment and Supplies, Hospital↗
PubMed2003

Use of program logic models in the Southern Rural Access Program evaluation.

The Southern Rural Access Program (SRAP) evaluation team used program logic models to clarify grantees' activities, objectives, and timelines. This information was used to benchmark data from grantees' progress reports to assess the program's successes. This article presents a brief background on the use of program logic models--essentially charts or diagrams specifying a program's planned activities, objectives, and goals--for evaluating and managing a program. It discusses the structure of the logic models chosen for the SRAP and how the model concept was introduced to the grantees to promote acceptance and use of the models. The article describes how the models helped clarify the program's objectives and helped lead agencies plan and manage the many program initiatives and subcontractors in their states. Models also provided a framework for grantees to report their progress to the National Program Office and evaluators and promoted the evaluators' visibility and acceptance by the grantees. Program logics, however, increased grantees' reporting requirements and demanded substantial time of the evaluators. Program logic models, on balance, proved their merit in the SRAP through their contributions to its management and evaluation and by providing a better understanding of the program's initiatives, successes, and potential impact.

Benchmarking↗
PubMed1999

Sealant use in public and private insurance programs.

Dental sealants are a safe and efficacious method for preventing caries in pits and fissures. An increase in sealant use has been observed in the NHANES III survey. However this increase still accounts for less than one fifth of children aged 5-17 having sealants on their teeth. Reimbursement and coverage of sealants by public and private insurance programs have lagged behind the widespread acceptance of this methodology by the profession. Medicaid preventive services are poorly used by patients and the profession: and the inclusion of sealants in traditional, indemnity, fee-for-service commercial plans has been inconsistent. Managed care programs include dental sealants, but lack financial incentives to increase their use.

Adolescent↗
PubMed2006

Interventions to improve guideline compliance following coronary artery bypass grafting.

BACKGROUND: Lifestyle modification and appropriate medical therapy improve long-term outcomes following coronary artery bypass grafting (CABG). Our institutional experience suggested that evidence-based recommendations were not being followed postdischarge after CABG. We undertook this study to document our rate of compliance with evidence-based guidelines and to correct deficiencies in our discharge practices. METHODS: Seven evidence-based interventions were studied after CABG: (1) institution of beta-blocker therapy, (2) angiotensin-converting enzyme (ACE) inhibitor therapy, (3) aspirin, (4) lipid-lowering therapy, (5) smoking cessation intervention, (6) heart-healthy diet therapy, and (7) physical activity recommendations. The rate of compliance with guidelines in 50 control patients was measured at discharge. A multidisciplinary team including cardiac surgeons, nurses, dieticians, physical therapists, and clinical pharmacists evaluated the guideline compliance in the control group and developed interventions to assure guideline compliance at the time of discharge. A subsequent study group of 50 patients was then assessed prospectively to measure the guideline compliance after institution of intervention programs. The multidisciplinary team agreed on predefined acceptable compliance limits as follows: (1) >80% of patients receive ACE inhibitors at discharge, (2) 100% of patients receive beta-blockers, aspirin, and lipid-lowering agents at discharge, and (3) 100% of patients receive lifestyle modification counseling at discharge. Compliance with guidelines was defined as documentation in the medical record of provision of medications and lifestyle counseling at the time of discharge. RESULTS: In the control group, the rate of guideline compliance was surprisingly low. Rates of compliance with guidelines increased significantly after the multidisciplinary interventions were undertaken. CONCLUSIONS: We conclude that compliance with guidelines known to improve long-term outcome is suboptimal after CABG. A multidisciplinary intervention program can improve compliance with currently accepted guidelines and quality indicators in patients following CABG.

Adrenergic beta-Antagonists↗
PubMed2000

Comparison of service member and military spouse satisfaction with installation fitness facilities and exercise programs.

Satisfaction with fitness facilities has long been accepted as a positive contributing factor to physical activity, readiness, and overall quality of life for military families. Our findings are based on a random sample of military families surveyed at 38 installations worldwide and at remote locations. A total of 8,572 service member and 3,493 spouse (55% and 32% response rate, respectively) questionnaires were completed and returned. Overall, members were satisfied with fitness facilities and programs, but spouses were less satisfied and more unfamiliar with these facilities. Most valued programs were fitness centers and swimming pools. Members reported that elimination of fitness facilities would greatly decrease the quality of life on installations, particularly at sites outside the continental United States, whereas spouses reported that this would not have a dramatic effect. The results of this study could be used to direct funding allocations, improve the health and fitness of military families, and suggest areas for further research.

Adult↗
PubMed2002

Biofeedback and behavioral treatment of persistent pain in the older adult: a review and a study.

Persistent pain is a common health problem for older adults, age 60+, with a prevalence twice that in younger adults. Yet, older adults with chronic pain and headache are underrepresented in behaviorally oriented clinical programs that have proven effective for younger adults. A review of the literature indicates that older adults develop multiple pain-related problems that are similar to those of younger individuals. When offered the opportunity, older pain patients accept and benefit from multidisciplinary pain programs, cognitive-behavioral therapies and biofeedback training. A study comparing 58 older and 59 younger adults in a multidisciplinary pain program indicates that older pain patients readily acquire the physiological self-regulation skills taught in biofeedback-assisted relaxation training, and achieve comparable decreases in pain for the pain program as a whole.

Adult↗
PubMed1996

Awards recognizing quality in health care.

A variety of awards have been recognizing business, public, and educational sectors for their quality efforts. As of 1995, 10 states include the health care sector in their programs. The national Malcolm Baldrige Award now accepts volunteer applications from the health care sector as a prelude to their inclusion in 1996 in the regular award program. An evaluation model is common to the several award programs that describes how quality is enabled, the systems that make it work, and the desired goals in seven categories. Each category has criteria that allow the flexibility desired by individual programs. The important features are the self-examination required of the organization in preparing the application and the feedback reports to all applicants that note the strengths of applicant and the areas for improvement by the applicant. Health care organizations are encouraged to participate in these award programs as part of their individual improvements efforts.

Awards and Prizes↗