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PubMed1991

Homeless youths and HIV infection.

Risk of human immunodeficiency virus (HIV) infection exacerbates the already difficult lives of 1.5 million homeless adolescents in the United States. Homeless youths engage in sexual and substance-abuse behaviors that place them at increased risk of contracting HIV, and they demonstrate other problem behaviors that reduce their coping responses. Model HIV prevention programs and interventions for HIV-positive youths, implemented for homeless adolescents, need to be disseminated on a national level. Social policies must recognize adolescents' rights to satisfaction of basic survival needs; comprehensively address the needs of dysfunctional, disenfranchised, and single-parent families; and provide continuity of care for adolescents to facilitate independent living. Special provisions must be made when designing programs for gay, sexually abused, and substance-abusing youths.

Adolescent↗

PubMed1996

Computer software for pharmacy oncology services.

A computer program designed to manage the informational, clinical, and data requirements for a pharmacy oncology service is described. Specialized pharmacy oncology software was developed at Rhode Island Hospital and implemented in a multihospital, integrated health system. The software performs various safety functions, supplies on-screen access to pertinent drug and patient information, manages data, and assists in the product formulation process. The programmed safeguards can be modified to meet changing requirements. The system has been in use for more than seven years and has helped detect prescribing errors and prevent preparation and administration errors. A pharmacy oncology computer program streamlines pharmacists' work and helps prevent errors in antineoplastic drug therapy.

Clinical Pharmacy Information Systems↗

PubMed1990

Chile: perspectives in school health.

The leading health problems of children and adolescents in Chile is reviewed. The Chilean educational system and how the system addresses its principal health problems are described. A school health program is described as well as other educational programs designed and developed by nongovernmental institutions which have a smaller coverage. Current research studies regarding growth and development, child morbidity, nutritional level, and mental health studies are reviewed. In addition, principal challenges that include developing more efficient ways of referring children, enriching the curriculum and teacher training, assigning school hours for health teachers, and enlarging coverage of the health care evaluation programs are outlined. Of special importance is developing prevention programs for parents and children using school and community leaders to prevent health problems in areas such as human sexuality education, decision-making, social abilities, and alcohol and drug abuse. Main efforts should be directed toward low-income families and children to improve life conditions.

Chile↗

PubMed2005

Using intervention mapping to develop a breast and cervical cancer screening program for Hispanic farmworkers: Cultivando La Salud.

This article describes the development of the Cultivando La Salud program, an intervention to increase breast and cervical cancer screening for Hispanic farmworker women. Processes and findings of intervention mapping (IM), a planning process for development of theory and evidence-informed program are discussed. The six IM steps are presented: needs assessment, preparation of planning matrices, election of theoretic methods and practical strategies, program design, implementation planning, and evaluation. The article also describes how qualitative and quantitative findings informed intervention development. IM helped ensure that theory and evidence guided (a) the identification of behavioral and environmental factors related to a target health problem and (b) the selection of the most appropriate methods and strategies to address the identified determinants. IM also guided the development of program materials and implementation by lay health workers. Also reported are findings of the pilot study and effectiveness trial.

Adolescent↗

PubMed2005

Hypoglycemia, hypoglycemia unawareness and counterregulation in children and adolescents with type 1 diabetes mellitus.

Three clinical phenomena have been defined in the last decade in patients with diabetes mellitus as a dangerous iatrogenic sequel of hypoglycemia. These are hypoglycemia unawareness, defective glucose counterregulation and a lowered hypoglycemic threshold for hypoglycemic symptoms. Former mild hypoglycemia episodes cause a decrease and a delay in the protective hormonal counterregulatory response and warning symptoms in subsequent episodes, and in the absence of these, risk of severe hypoglycemia increases considerably. It has been demonstrated that when protection is provided against hypoglycemia with strict monitoring programs designed to avoid even mild hypoglycemia episodes, blunted autonomic symptoms and counterregulatory hormonal responses are rectified. Therefore, the best course of action in the treatment of pediatric diabetes mellitus is frequent blood sugar measurements, flexible multiple dose insulin regimens facilitating insulin dose adjustments as required, and a diet. In order to implement this, it is essential to organize an intensive training program with the patient and family, and to provide psychological support and close coordination with the diabetes treatment team.

Adolescent↗

PubMed2004

Comparison of two programs to teach firearm injury prevention skills to 6- and 7-year-old children.

BACKGROUND: Each year, hundreds of children unintentionally kill or injure other children while playing with firearms in the United States. Although the numbers of these deaths and injuries are distressing, few prevention programs have been developed to prevent gun play among children. OBJECTIVE: This study compared the efficacy of 2 programs designed to prevent gun play among young children. DESIGN: A posttest-only, control group design with 2 treatment groups was used. Children were randomly assigned to 1 of 2 treatment groups or a control group. For all children who did not exhibit the skills after training, 1 in situ (ie, real-life situation) training session was conducted. SETTING: Participant recruitment, training sessions, and assessments were all conducted in the children's after-school program facility. PARTICIPANTS: Forty-five children, 6 or 7 years of age, were recruited for participation. INTERVENTIONS: The efficacy of the Eddie Eagle GunSafe Program, developed by the National Rifle Association, and a behavioral skills training program that emphasized the use of instruction, modeling, rehearsal, and feedback was evaluated. MAIN OUTCOME MEASURES: The criterion firearm safety behaviors included both motor and verbal responses, which were assessed in a naturalistic setting and then assigned a numerical value based on a scale of 0 to 3. RESULTS: Both programs were effective for teaching children to verbalize the safety skills message (don't touch the gun, get away, and tell an adult). However, children who received behavioral skills training were significantly more likely to demonstrate the desired safety skills in role-playing assessments and in situ assessments than were children who received Eddie Eagle program training. In addition, in situ training was found to be effective for teaching the desired safety skills for both groups of children. CONCLUSIONS: Injury prevention programs using education-based learning materials are less effective for teaching children the desired safety skills, compared with programs incorporating active learning approaches (eg, modeling, rehearsal, and feedback). The efficacy of both types of injury prevention programs for teaching the desired skills could be significantly enhanced with the use of in situ training. This program, when implemented with 6- and 7-year-old children, was effective in teaching the desired safety skills.

Child↗

PubMedDate not supplied

Academic incentives for students can increase participation in and effectiveness of a physical activity program.

The authors sought to determine whether a greater academic incentive would improve the effectiveness and student adherence to a 12-week voluntary exercise program designed to decrease students' percentage of body fat. They randomly assigned 210 students to 1 of 2 groups with different academic reward structures. The group with the greater reward structure showed better exercise adherence and lost more body fat than those without the additional incentive. These findings suggest that an academic incentive can increase overall student adherence to a voluntary exercise program and can boost the effectiveness of the program in a university environment. The findings also have potential implications for on-campus promotion of physical activity.

Exercise↗

PubMed2001

Canadian guidelines for cardiac rehabilitation and atherosclerotic heart disease prevention: a summary.

Atherosclerotic heart disease (AHD) is the leading cause of death in Canadian women and men. Cardiac rehabilitation has been repeatedly shown to reduce cardiac morbidity and mortality significantly among patients with documented AHD. The Canadian Association of Cardiac Rehabilitation (CACR) has defined cardiac rehabilitation as "the enhancement and maintenance of cardiovascular health through individualized programs designed to optimize physical, psychological, social, vocational and emotional status. This process includes the facilitation and delivery of secondary prevention through heart hazard (risk factor) identification and modification in an effort to prevent disease progression and the recurrence of cardiac events". This summary presents a limited amount of background information and the majority of clinical practice recommendations contained within the previously published CACR Guidelines. These evidence-based clinical recommendations are intended as guidelines to good clinical practice rather than as standards of care. The key focus of this summary is the need for complete and targeted intervention of all heart hazards in patients at high or very high risk for, or with documented, AHD. To achieve this goal, the CACR Guidelines and this summary present risk stratification strategies designed to determine unambiguously a patient's risk of exercise-related cardiac events (short term absolute risk or disease prognosis) and their risk of recurrent AHD events (long term absolute risk from disease progression). The establishment of the short term and long term absolute AHD risks can then be used to determine heart hazard targets and the type of exercise program prescribed for patients with AHD. Despite the use of evidence-based medical practices, none of the recommendations presented in this document can replace the expert judgment of properly trained and experienced cardiac rehabilitation professionals. Health care providers must always be free to choose where and when clinical practice guidelines are applied, modified or superceded, depending on individual patient circumstances.

Canada↗

PubMed2000

Enhancing breastfeeding initiation in adolescent mothers through the Breastfeeding Educated and Supported Teen (BEST) Club.

The purpose of this study was to determine if specific breastfeeding education, provided by a lactation consultant in group classes for pregnant adolescents, would increase breastfeeding initiation among students enrolled in a high school adolescent pregnancy program. Ninety-one pregnant adolescents participated in the study and were divided into two groups: those who did not receive specific breastfeeding education and those who did, through the Breastfeeding Educated and Supported Teen (BEST) Club. There were no significant differences in breastfeeding initiation with regard to age or ethnicity. Of the 48 adolescents who received no specific education, 7 (14.6%) initiated breastfeeding. Of the 43 adolescents in the education group, 28 (65.1%) initiated breastfeeding, which indicates a significant difference between groups with regard to infant feeding choice (P < .001). The results of this study indicate that targeted educational programs designed for the adolescent learner may be successful in improving breastfeeding initiation in this population.

Adolescent↗

PubMed1988

How do we teach pathology? The laser videodisc and computer-assisted learning.

A laser videodisc, holding 54,000 still frames per side, can be used to provide visual material of excellent quality for pathology teaching. In a collaborative project between ten pathology departments, the first pathology videodisc has recently been completed and the production of the disc is described. When used as illustrative material for computer-assisted learning programs, the videodisc offers accurate random access of still frames and allows the overlay of computer-generated graphics onto the video picture. This can be used to pre-identify every individual feature of a particular frame, and an example tutorial program is described to show how this may be used to improve the students' understanding of what they see. Details and costs are given for a workstation suitable for this application and potential future developments for this teaching method are discussed. Although objective assessment of the cost-effectiveness of interactive video in teaching pathology has yet to be undertaken, one suitably designed program can give individual tuition to many students, making this a most efficient use of teaching time.

Computer-Assisted Instruction↗

PubMed2005

Evaluation of the parents as primary sexuality educators program.

PURPOSE: To determine the effectiveness of a sexuality education program designed to help parents become more confident and competent in communicating with their children about sex and sexuality. METHODS: Parents attending a four- to five-part workshop series between February 2001 and April 2002 were recruited to participate. A total of 27 workshop series were conducted at various sites in neighborhoods with high teen pregnancy and STD rates. For each series, program staff administered written pre- and post-workshop surveys to parents and parent surrogates. A follow-up telephone survey was conducted with participants 10 weeks after the last workshop. Matched pre-workshop and follow-up surveys were obtained from 174 participants. RESULTS: Comparison of follow-up to pre-workshop responses revealed that more participants thought discussing sexuality with their children was very important (83% vs. 75%; p < .01). More participants also reported that they often initiate conversations with their children on a variety of topics including sex/intercourse, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), pregnancy, sexuality and gender issues, and their personal standards for sexual behavior. Participants also became more comfortable discussing sensitive topics with their children. At follow-up, more participants responded that they were very comfortable answering their children's questions on the above topics. (All p values < .01.) CONCLUSIONS: The Parents as Primary Sexuality Educators program may be an effective way to increase parent-child communication about health, sexuality, and values. Enhancing parents' ability to communicate expectations and values about sexuality may help support children in making healthy decisions about sexual behavior as adolescents.

Adolescent↗

PubMed2001

A genetic algorithm for structure-based de novo design.

Genetic algorithms have properties which make them attractive in de novo drug design. Like other de novo design programs, genetic algorithms require a method to reduce the enormous search space of possible compounds. Most often this is done using information from known ligands. We have developed the ADAPT program, a genetic algorithm which uses molecular interactions evaluated with docking calculations as a fitness function to reduce the search space. ADAPT does not require information about known ligands. The program takes an initial set of compounds and iteratively builds new compounds based on the fitness scores of the previous set of compounds. We describe the particulars of the ADAPT algorithm and its application to three well-studied target systems. We also show that the strategies of enhanced local sampling and re-introducing diversity to the compound population during the design cycle provide better results than conventional genetic algorithm protocols.

Algorithms↗

PubMed2004

Intervention to increase screening mammography among women 65 and older.

This paper reports the results of a practice-based intervention program to increase mammography screening among women 65 and older who receive their health care in the private sector. Forty-three primary-care practices and 2147 women in central and western North Carolina were enrolled in the study, and 1911 women completed all phases of the study. The intervention was a three-stage educational and counseling program designed to become progressively more intensive at each stage. The interventions included provider education in the form of current information on issues in mammography for older women, simply written educational materials on breast cancer and screening mailed to women, and a brief telephone counseling session for the women. While the analysis revealed no overall effect across all three stages of the intervention program, tests for interaction indicated a significant program effect for women who were 80 or older, had less than 9 years of education, were black, or had no private insurance to supplement Medicare. The results suggested that providing primary-care physicians with information on screening older women and providing the women with useful educational materials can increase participation in screening mammography among subgroups of women currently least likely to receive mammography screening.

Aged↗

PubMed2006

Long-term exercise adherence in the elderly with chronic low back pain.

OBJECTIVE: Chronic back pain is common in the elderly population and can be treated with exercise. Long-term adherence to exercise recommendations has been documented in adults of <65 yrs of age but not for elderly adults. This study explored exercise behaviors of elderly adults with a history of chronic back pain before and 2 yrs after treatment in an exercise-oriented rehabilitation program. DESIGN: This study utilized a case series design to survey 126 subjects >65 yrs old who underwent physical therapy during the year 2000 for complaints of chronic low back pain. Of these, 89 (70%) responded to the 2-yr questionnaire. Outcome measures included visual analog scale for pain, Oswestry disability questionnaires, back flexibility and strength, and a questionnaire exploring exercise behaviors. All subjects underwent a 6-wk physical therapy program that consisted of exercise coupled with advice to remain active. RESULTS: Improvements in flexibility and strength occurred during treatment. Mean Oswestry disability scores (0-100 scale) improved from 32 to 20, and pain scores (0-10 scale) from 5.0 to 3.0 during treatment (P < 0.001) and were maintained at the 2-yr follow-up, regardless of exercise adherence. The percentage of patients who performed at least some exercise increased from 49% before treatment to 72% at the 2-yr follow-up. The changes in disability or pain observed during treatment did not influence exercise compliance. The most frequently stated reasons for nonadherence was that exercise did not help or aggravated pain (33%). For those who exercised regularly, 80% did so because of the health benefits from exercise. CONCLUSIONS: The exercise behaviors of many elderly adults with chronic low back pain can increase after an exercise-oriented spine physical therapy program.

Aged↗

PubMedDate not supplied

The role of an early intervention on enhancing the quality of mother-infant interaction.

The study examines an intervention designed to influence mothers' sensitive responsiveness toward their infant by presenting information about the newborn's competence to interact and promoting affectionate handling and interaction with the infant. Thirty-six primiparous mothers and their newborn infants participated in the study. On day 2/3 after delivery, mother-infant dyads were assigned to either: (1) an experimental group that received an intervention program designed to enhance mother-infant interaction; or (2) a control group that was presented with an intervention that emphasized basic caregiving skills. One month later an observation was undertaken in the home to assess mother-infant synchronous and asynchronous co-occurrences during free-play and infant bathing. The enhancement group showed a reliably greater frequency of co-occurrences involving vocal exchanges, looking to the partner, and physical contact. There also were differences in mothers' responsiveness to infant crying and involuntary responses. The findings show that even a modest videotaped early intervention can enhance mothers' sensitive responsiveness to the infant.

Adult↗

PubMed1993

Music: making the connection with persons who are homeless.

1. Persons who are homeless experience isolation and loneliness; many lack social skills or the ability to interact comfortably with others. A music program designed to increase socialization and relaxation of homeless persons using a multiservice shelter is described. 2. The use of music provides the psychiatric nurse an entry into therapeutic relationships and an opportunity to establish relationships with persons who often do not initiate contact with others. 3. Music promotes relaxation and interaction with others. Listening to music decreases loneliness and isolation. The music program was effective in fostering a sense of well-being and allowing the participants to join together in a meaningful activity.

Crisis Intervention↗

PubMed2000

The burden of cancer in Kentucky. The 1998 Kentucky cancer incidence report.

The purpose of collecting this important disease burden information is just for reports like this. The real value lies in use of data for cancer control research, program planning, resource allocation, program design, and evaluation. Data in the annual KCR report and on the website should be a valuable resource for health agencies, clinicians, policymakers, voluntary organizations, etc in their assessment of health problems in their area and as critical decisions are made about how to utilize limited intervention resources. The Kentucky Cancer Registry will continue to work very closely with the Kentucky Cancer Program, Kentucky Medical Association, and programs and research efforts at the University of Kentucky Cancer Control Program (Mid South Cancer Information Service, Appalachia Cancer Network, Kentucky Prevention Research Center) and the Brown Cancer Center at the University of Louisville to make these data available to partners throughout the Commonwealth to help guide their assessment and planning processes. If you have questions about this data you are encouraged to contact Regional Coordinators for the Kentucky Cancer Program in your Area Development District. The contact information is shown in Appendix I.

Adolescent↗

PubMed2001

Assisting people with a low income to start and maintain their own community kitchens.

Q'wlut tu cicut ("My Parents Are Cooking") is a community kitchen program designed to help low-income people to facilitate their own cooking groups. Participants attended 20 weeks of instruction and received practical experience in topics such as meal planning, cooking, communication, and team building. At the end of 20 weeks, each participant was assisted in recruiting other people to start their own cooking group. To support the formation of these secondary groups, program staff and cooking group leaders met every second week for a further ten weeks. Another 30-week session has taken place since the initial session. The program had a high rate of completion. Each of the 24 participants who completed the program recruited an additional two to four people and started a cooking group with these people. Four months after completion of the first session, 80% of participants were facilitating their own cooking groups. After eight months, 50% of participants were still cooking in groups. All participants who completed the program stated that they had met their food- and nutrition-related goals, and they cited numerous program benefits to themselves and their families.

Budgets↗