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At least 1,531 records · Page 85Linked to original sources
PubMedDate not supplied

Pharmacist-managed tobacco cessation program in Veterans Health Administration community-based outpatient clinic.

OBJECTIVE: To describe an ongoing pharmacist-managed tobacco cessation clinic and assess the long-term effectiveness of the program. SETTING: Veterans Health Administration (VHA) community-based outpatient clinic in Missoula, Montana. PARTICIPANTS: Pharmacy professor/clinical pharmacy specialist, advanced pharmacy practice experience students, and tobacco cessation participants. PRACTICE DESCRIPTION: Ongoing, pharmacist-managed tobacco cessation program offered to veterans. PRACTICE INNOVATION: With use of the "Vets without Cigarettes" program developed by the Montana VHA and the most current strategies reported in the literature, the clinical pharmacy specialist and pharmacy students provide tobacco cessation services for Missoula Veterans Affairs Primary Care Center veterans. Activities include a three-session program using the Transtheoretical Model of Change, tobacco cessation pharmacotherapy, behavioral strategies, cognitive techniques, documentation, and follow-up survey. MAIN OUTCOME MEASURE: Percentage of veterans contacted reporting tobacco abstinence. RESULTS: Follow-up survey results were obtained for 130 (87.8%) of 148 veterans attending one or more sessions of the tobacco cessation class between November 1999 and December 2003. Of the 130 veterans contacted, 54 (41.5%) continued to be tobacco free. CONCLUSION: This program demonstrates that pharmacists are effective providers of tobacco cessation services. Furthermore, a comprehensive tobacco cessation program is provided that can serve as a model to guide pharmacists in assisting more patients to become tobacco free and live healthier lifestyles.

Ambulatory Care Facilities↗
PubMed2003

Suicide prevention in first episode psychosis: the development of a randomised controlled trial of cognitive therapy for acutely suicidal patients with early psychosis.

BACKGROUND: Young people with early psychosis are at particularly high risk of suicide. However, there is evidence that early intervention can reduce this risk. Despite these advances, first episode psychosis patients attending these new services still remain at risk. To address this concern, a program called LifeSPAN was established within the Early Psychosis Prevention and Intervention Centre (EPPIC). The program developed and evaluated a number of suicide prevention strategies within EPPIC and included a cognitively oriented therapy (LifeSPAN therapy) for acutely suicidal patients with psychosis. We describe the development of these interventions in this paper. METHOD: Clinical audit and surveys provided an indication of the prevalence of suicidality among first episode psychosis patients attending EPPIC. Second, staff focus groups and surveys identified gaps in service provision for suicidal young people attending the service. Third, a suicide risk monitoring system was introduced to identify those at highest risk. Finally, patients so identified were referred to and offered LifeSPAN therapy whose effectiveness was evaluated in a randomised controlled trial. RESULTS: Fifty-six suicidal patients with first episode psychosis were randomly assigned to standard clinical care or standard care plus LifeSPAN therapy. Forty-two patients completed the intervention. Clinical ratings and measures of suicidality and risk were assessed before, immediately after the intervention, and 6 months later. Benefits were noted in the treatment group on indirect measures of suicidality, e.g., hopelessness. The treatment group showed a greater average improvement (though not significant) on a measure of suicide ideation. CONCLUSIONS: Early intervention in psychosis for young people reduces the risk of suicide. Augmenting early intervention with a suicide preventative therapy may further reduce this risk.

Acute Disease↗
PubMed1993

Advanced human resources planning.

Programs developed to advance the careers of pharmacy staff members are important tools to attract and retain qualified staff members. Integration of career development with the advancement of the department's efforts to achieve pharmaceutical care are integral for the future success of the department. Design of programs for all major positions/classifications should be considered. These programs must be developed in concert with the employees affected. In the future, these programs can demonstrate enhanced outcomes for patient care by ensuring appropriately trained and credentialed employees. This will require a commitment to advanced human resources planning.

Career Mobility↗
PubMed2003

Questioning the "big assumptions". Part I: addressing personal contradictions that impede professional development.

BACKGROUND: The ultimate success of recent medical curriculum reforms is, in large part, dependent upon the faculty's ability to adopt and sustain new attitudes and behaviors. However, like many New Year's resolutions, sincere intent to change may be short lived and followed by a discouraging return to old behaviors. Failure to sustain the initial resolve to change can be misinterpreted as a lack of commitment to one's original goals and eventually lead to greater effort expended in rationalizing the status quo rather than changing it. OBJECTIVE: The present article outlines how a transformative process that has proven to be effective in managing personal change, Questioning the Big Assumptions, was successfully used in an international faculty development program for medical educators to enhance individual personal satisfaction and professional effectiveness. This process systematically encouraged participants to explore and proactively address currently operative mechanisms that could stall their attempts to change at the professional level. CONCLUSIONS: The applications of the Big Assumptions process in faculty development helped individuals to recognize and subsequently utilize unchallenged and deep rooted personal beliefs to overcome unconscious resistance to change. This approach systematically led participants away from circular griping about what was not right in their current situation to identifying the actions that they needed to take to realize their individual goals. By thoughtful testing of personal Big Assumptions, participants designed behavioral changes that could be broadly supported and, most importantly, sustained.

Attitude↗
PubMedDate not supplied

Development of new faculty in higher education.

Faculty development programs in nursing, as well as in other disciplines, are needed to respond to changing expectations about the quality of undergraduate education, student populations, decreasing resources, and widespread use of technology in education. Problems facing new and senior faculty center on these changing demands. Preparing faculty to use technology in teaching is especially important. The problem of diminishing resources for faculty development must be balanced with the overwhelming need for faculty education in this changing environment.

Education, Nursing↗
PubMedDate not supplied

A tribute to clinical preceptors. Developing a preceptor program for nursing students.

Implementing a preceptor program required the collaboration of nursing administrators, staff development personnel, and nursing faculty. However, registered nurse preceptors were the major contributors to the effectiveness of the program. The author developed a preceptor program for unlicensed associate degree nursing students and describes the experiences encountered during the first three semesters of the preceptor program.

Education, Nursing, Associate↗
PubMed1992

Workplace literacy education: writing skills.

Remedial programs must be flexible and planned to meet the needs of the participants. Using both work and creative writing exercises provides a balance and relieves boredom. Educators need to be alert to the varying education and skill level of employees. For example, many management development program planners assume a certain level of literacy and English fluency among the managerial group. As a result, some supervisors may avoid programs or not learn the material because of difficulty in comprehending the material. The basic thread of our program was the integration of humor and content. Few classes ended without laughter. This laughter was not at the expense of an individual's self-esteem. We laughed at humorous examples of unclear writing and mistakes unintentionally made by the instructors. We laughed at some of their own humorous writing. One of the participants wrote a particularly amusing and entertaining story of a disastrous camping trip. Other times members delighted in catching mistakes in hospital communications. It was obvious that they were reading with more alertness. An unexpected result of the program was the increased rapport between the involved supervisors, their managers, our department, and our local community resources. The program opened channels that have led to an on-site GED program and closer ties with the county literacy efforts. Managers in plant services have increased their involvement and support for employees seeking to improve their education. The TMC educational reimbursement system has been made more available for all.

Adult↗
PubMed1999

Children's needs in shelters: mother's perceptions.

The needs of children who witness violence directed at their mothers have only recently gained attention. While shelter services to address children's responses are increasingly evident, there is still much we do not understand about their plight, particularly from the perspective of their mothers. This study used focus-group methodology to identify mothers' perceptions of their children's needs while they were in shelters. Five focus group sessions were held with 27 mothers who had experienced violence in their homes and had used shelter services within the previous two-year period. Data were analyzed to identify six dominant categories of need and 12 supporting thematic categories. The dominant categories included: the counselling needs of the children; day-to-day living needs, such as maintaining family integrity and normality; recreational needs; the needs of children with respect to parenting; and finally, aspects of shelter support for mothers, and the impact of the shelter environment on children. The implications of the findings for program development are discussed.

Adult↗
PubMed1990

The time has come for vascular medicine.

Advances in the diagnosis and treatment of patients with vascular disorders have led to the emergence of a new kind of internist with special skills in vascular medicine. The growth of this field will accelerate as recent major advances in vascular biology attain clinical application. In recognition of these developments, programs for vascular medicine are in place or in development across the country. Proliferation of these programs will be facilitated by multidisciplinary collaboration among cardiologists, radiologists, vascular surgeons, and other physicians with special expertise in the wide range of vascular disorders. Internists trained in these programs fill major needs; they will advance the field of vascular medicine by forming a bridge with vascular biologists to bring research advances to clinical fruition; they will apply the latest therapeutic and diagnostic tools to give optimum care to patients suffering from vascular disease and associated medical disorders such as hyperlipidemia, hypertension, and hypercoagulopathy; and they will appropriately refer these patients for invasive interventions.

Cardiology↗
PubMed2003

Cure4Kids - building online learning and collaboration networks.

The International Outreach Program of St. Jude Childrens' Research Hospital has been developing programs to help countries with limited resources develop treatment centers to treat children with catastrophic diseases such as pediatric cancer and AIDS. Cure4Kids (www.cure4kids.org) is the Internet learning network that delivers medical education to doctors and nurses on pediatric cancer and AIDS. The objective of Cure4Kids is not only education, but also to provide tools for communications and collaborations among individuals.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Capacity building to improve women's health in rural China.

The Women's Reproductive Health and Development Program (WRDHP) is an ambitious attempt to operationalize two important tenets of health development thinking within a rural reproductive health context. First, it is important for communities to participate in decisions about the services and programs that affect them. Secondly, the complex nature of healthcare is best addressed by intervention processes which call for a multi-functional approach to planning and coordination. In both planning and intervention approach, the WRHDP recognizes the social, cultural and economic realities that affect women's efforts to secure the health and well-being of themselves and their families. The focus of the WRHDP is on capacity-building within a rural reproductive health environment, in this case Yunnan Province in rural China. Rather than using international donor funding to provide a specific intervention, the WRDHP used Ford Foundation funding as a lever to encourage community investment in environmental resources that affect health, to improve the technical skills of individuals within the existing health bureaucracies, and to promote structural changes within existing health and development bureaucracies to support interagency collaboration and community empowerment within the region's health and development agencies. This article describes how the WRHDP created new methods for provincial and local agencies to overcome obstacles and work with one another to improve women's health. It also describes the processes used in the rural areas of Chengjiang and Luliang counties to assess local conditions and needs, and the supported and expanded local efforts in improving woman's reproductive and family health that resulted from the processes.

China↗
PubMedDate not supplied

Using facilitators in mock codes: recasting the parts for success.

BACKGROUND: Members of the CHRISTUS Santa Rosa Children's Hospital staff development committee identified a need for a mock code program which would address a range of learning needs for nurses and other caregivers with varying levels of knowledge, skills, and experience. METHOD: We implemented a mock code program using experienced caregivers, usually emergency room and pediatric intensive care RNs and respiratory therapists to serve as facilitators to code participants during the mock code drills. Facilitators have dual roles of teaching and guiding the code participant as well as evaluating performance. RESULTS: Code participants and facilitators benefit from the design of this program. Debriefing session input and written program evaluations show that code participants value the opportunity to practice their skills in a nonthreatening situation in which they receive immediate feedback as needed. Facilitators learn to teach and coach and strengthen their own code knowledge and skills at the same time. CONCLUSION: This mock code program serves as a unique way to include novice and experienced nurses in mock codes together. The knowledge, skills, and confidence of the code participants and the facilitators have matured. The design of the program allows for immediate teaching/learning where needed, as well as appropriate evaluation. This program develops stronger, calmer, more efficient, and more confident nurses during codes. Practice and equipment changes can be based on findings from the mock codes. The program is invaluable to patients, staff, and hospital.

Cardiopulmonary Resuscitation↗
PubMedDate not supplied

Implementing a standardized testing program: preparing students for the NCLEX-RN.

The undergraduate nursing faculty of a large Midwestern university initiated a program of standardized computerized testing for two purposes: to provide students experience with standardized computerized testing prior to taking the National Council Licensure Exam for Registered Nurses (NCLEX-RN) and to increase the students' NCLEX-RN passing rate. This article chronicles the process of implementing a comprehensive testing program developed by the Assessment Technologies Institute (Overland Park, KS). Although the first class of students to have taken the entire testing package has just graduated, midprogram results have demonstrated potential as key indicators for identifying at-risk students. The trends in scores on standardized computerized tests, grades in prerequisite science courses, and grades in medical-surgical courses are used to identify students who are at risk for failure in the program and on the NCLEX-RN. Faculty advisors meet with these students to develop individual plans of study and to provide additional resources. The testing process is going on smoothly, and faculty members are learning to use the extensive information on students' test scores to further assist them in passing the NCLEX-RN.

Attitude of Health Personnel↗
PubMed2001

Planning of a community-based approach to injury control and safety promotion in a rural community.

This paper describes the planning of a community-based approach to injury control and safety promotion, the Kolan Injury Prevention Program. The process involved the establishment of a local steering committee, 11 months of injury surveillance, a critical review of the evidence base, community consultations and assessment of community resources. There were 412 recorded injury cases during the surveillance period, with higher rates among men, manual workers, those aged 15-34 years, sport/leisure activities and around the home and farm. Salient issues for residents included a lack of access to safety information and skills, particularly with regard to first aid and bush fire for isolated residents and rurally inexperienced new residents. While injury prevention was identified as an important issue for the community, the rapidly changing size and nature of the community and its infrastructure made this a particularly challenging issue. Challenges included limited availability of volunteers from key sectors, lack of formal data collection systems, difficulties in mobilising support for a broad issue like injury, limited communication networks and the negative impact of distance and role uncertainty on community ownership of the program. This case study illustrates the steps involved in an effective community-based needs assessment addressing injury prevention. Such an approach, if carried out systematically, will help ensure that the strategies and programs developed will be both appropriate and likely to obtain the support of the local community.

Adolescent↗
PubMed2000

Amifostine: mechanisms of action underlying cytoprotection and chemoprevention.

Amifostine is an important drug in the new field of cytoprotection. It was developed by the Antiradiation Drug Development Program of the US Army Medical Research and Development Command as a radioprotective compound and was the first drug from that Program to be approved for clinical use in the protection of dose limiting normal tissues in patients against the damaging effects of radiation and chemotherapy. Its unique polyamine-like structure and attached sulfhydryl group give it the potential to participate in a range of cellular processes that make it an exciting candidate for use in both cytoprotection and chemoprevention. Amifostine protects against the DNA damaging effects of ionizing radiation and chemotherapy drug associated reactive species. It possesses anti-mutagenic and anti-carcinogenic properties. At the molecular level, it has been demonstrated to affect redox sensitive transcription factors, gene expression, chromatin stability, and enzymatic activity. At the cellular level it has important effects on growth and cell cycle progression. This review focuses on relating its unique chemical design to mechanisms of action that underlie its broad usefulness as both a cytoprotective and chemopreventive agent for use in cancer therapy.

Adolescent↗
PubMed2003

Caspase-9 takes part in programmed cell death in developing mouse kidney.

Programmed cell death is a mechanism by which organisms dispose of unwanted cells, and it is thought to be an important process in organogenesis. We have already reported the role of caspase-3 in the developing metanephros. While caspase-3 is thought to be positioned downstream of the caspase-activating cascade, the upstream caspase for programmed cell death in the developing kidney is still unknown. In an attempt to identify it, we blocked caspase activity in metanephric explants with caspase inhibitors. Administration of a caspase-9 inhibitor (Ac-IETD-CHO) effectively prevented both ureteric bud branching and nephrogenesis, the same as a caspase-3 inhibitor (Ac-DEVD-CHO). On the other hand, administration of a caspase-8 inhibitor (Ac-LETD-CHO) did not inhibit ureteric bud branching or nephrogenesis. Apaf-1, which executes programmed cell death in the caspase-9-related pathway, was detected in the cells exhibiting caspase-9 activity, and our results suggest that Apaaf-1/caspase-9 activates caspase-3 in kidney organogenesis.

Animals↗
PubMed1998

Improving physician participation in billing compliance programs.

Billing compliance programs represent a challenge for all members of healthcare organizations. Despite the importance of such programs, many physicians often seem reluctant to embrace them. The solution to gaining physician buy-in to such programs lies in educating physicians, involving them in the programs' development and implementation, and making compliance as easy as possible.

Attitude of Health Personnel↗
PubMed2005

Towards the solution of the eluent elimination problem in high-performance liquid chromatography-infrared spectroscopy measurements by chemometric methods.

The high-performance liquid chromatography-infrared spectroscopy (HPLC-IR) technique utilizing on-line flow through cell (FTC) detection has an inherent practical problem: strong absorption bands of the eluent may mask valuable analytical regions of the IR spectrum. The experimentalists' answer to this challenge is physical elimination of the chromatographic eluent before spectroscopic detection, which however results in off-line measurement of spectra. In the present work, the capabilities of some chemometric algorithms using iteratively applied multi-way methods such as parallel factor analysis (PARAFAC) and PARAFAC2, developed with the aim of overcoming the problems of eluent elimination are examined and evaluated. Test calculations done on simulated liquid chromatographic infrared (LC-IR) data cubes have shown that although PARAFAC2 performs much better than the simple PARAFAC method, it does not give correct decompositions, just like multivariate curve resolution with alternative least squares (MCR-ALS) and related bilinear data based methods. In search for a better solution, a method named objective subtraction of solvent spectrum with iterative use of PARAFAC and PARAFAC2 (OSSS-IU-PARAFAC and OSSS-IU-PARAFAC2) has been developed. Calculations performed with the corresponding Matlab program developed by the authors and run with the appropriate functions in PLS_Toolbox yielded very promising results in evaluations of both simulated and real HPLC-IR data sets, after necessary data pretreatments.

Algorithms↗