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At least 1,639 records · Page 91Linked to original sources
PubMed1991

The impact of curriculum-based suicide prevention programs for teenagers.

The impact of three school-based suicide prevention programs was assessed by comparing attitudes and knowledge of 758 9th and 10th graders with those of 680 control pupils, matched on age, ethnicity, and socioeconomic status at the school level, who did not receive the programs. Evaluations were conducted before exposure to the programs and again 1 month later. A large majority of students knew and subscribed to some of the more important program goals before exposure to the program. There was little evidence of program impact among the minority that did not. Most students were interested by the programs, and positive reactions were more common among female and minority students.

Adolescent↗
PubMed1997

Probabilistic incremental program evolution

Probabilistic incremental program evolution (PIPE) is a novel technique for automatic program synthesis. We combine probability vector coding of program instructions, population-based incremental learning, and tree-coded programs like those used in some variants of genetic programming (GP). PIPE iteratively generates successive populations of functional programs according to an adaptive probability distribution over all possible programs. Each iteration, it uses the best program to refine the distribution. Thus, it stochastically generates better and better programs. Since distribution refinements depend only on the best program of the current population, PIPE can evaluate program populations efficiently when the goal is to discover a program with minimal runtime. We compare PIPE to GP on a function regression problem and the 6-bit parity problem. We also use PIPE to solve tasks in partially observable mazes, where the best programs have minimal runtime.

Journal Article↗
PubMed1976

Comprehensive alcohol treatment planning, implementation, and evaluation.

A descriptive overview of a developing comprehensive alcohol treatment program is presented. The influence of staffing practices and client recruitment on implementation of treatment components is reviewed. Program evaluation and current issues regarding such evaluation are discussed.

Age Factors↗
PubMed2003

[Periconceptional intake of a folic acid supplement: evaluation of a promotional program].

This study evaluates the efficacy of a regional program promoting periconceptional folic acid intake. Data were collected through a self-administrated questionnaire among 721 (405 for phase I; 316 for phase II) primiparous women. For phase I, 26.1% (CI [Confidence Interval] 95%: 21.9%-30.4%) of respondents took an adequate periconceptional folic acid supplement, whereas this proportion was 31.6% (CI 95%: 26.5%-36.7%) for phase II (p>0.05). For phase I, 62.0% (CI 95%: 57.3%-66.7%) of women recognized the role of folic acid. For phase II, this proportion significantly rose to 70.9% (CI 95%: 65.9%-75.9%). Regional activities promoting periconceptional folic acid intake, if maintained, should be modified to significantly increase the proportion of women taking an adequate amount of folic acid.

Adult↗
PubMed2005

Capacity building for international tuberculosis control through operations research training.

SETTING: In resource-poor countries, few tuberculosis (TB) program staff at the national, provincial, and even district levels have the basic analytical and epidemiological skills necessary for collecting and analyzing quality data pertaining to national TB control program (NTP) improvements. This includes setting program priorities, operations planning, and implementing and evaluating program activities. OBJECTIVES: To present a model course for building capacity in basic epidemiology and operations research (OR). DESIGN: A combination of didactic lectures and applied field exercises were used to achieve the main objectives of the 6-day OR course. These were to increase the understanding of quantitative and qualitative research concepts, study design, and analytic methods, and to increase awareness of how these methods apply to the epidemiology and control of TB; and to demonstrate the potential uses of OR in answering practical questions on NTP effectiveness. As a final outcome, course participants develop OR proposals that are funded and later implemented. RESULTS: Since 1997, this OR course has been conducted nine times in five countries; 149 key NTP and laboratory staff have been trained in OR methods, and 44 OR protocols have been completed or are underway. CONCLUSION: This low-cost model course can be adapted to a wide range of public health issues.

Health Priorities↗
PubMed1989

Infant mortality in West Virginia. Identifying risk factors for public health intervention.

Because infant death rates vary within populations, it is important for program managers and planners to identify high-risk subgroups for whom effective interventions can be targeted. Matching infant death certificates with birth records permits us to describe infant mortality and calculate risks by a variety of maternal and infant characteristics recorded at birth. In this paper, we illustrate how several variables are associated with infant death, and show how analysis of a recent birth cohort in West Virginia can assist health officials in determining appropriate strategies for risk reduction. While efforts need to focus on reducing social and economic barriers to maternal and infant health, different strategies are required to address separately the neonatal and postneonatal components of infant mortality. Matched records can be used in a variety of ways to develop support for, and highlight the needs of, West Virginia's Maternal and Child Health programs, to monitor trends over time, to evaluate program achievements, and to modify program goals.

Cause of Death↗
PubMed1989

Point-of-service computer system and drug-use evaluation: implications for pharmacy practice in ambulatory care.

The point-of-service (POS) computer system and its possible effects on ambulatory-care pharmacy practice are described. The POS system, a key component of the Medicare Catastrophic Coverage Act, is an electronic claims-transmittal device to be installed in community pharmacies. The system transmits information about the patient and the prescribed drug to a claims processor, which verifies the eligibility of the patient for Medicare drug benefits, determines the amount of payment allowed, and sends information back to the POS terminal in less than 30 seconds. Because prescription information can be consolidated into a central data pool, drug-use patterns can be reviewed. The system will also permit automated screening of drug-drug interactions. Problems posed by the POS system relate to (1) the lack of a claims-transmittal device that can communicate with all claims processors, (2) the lack of a direct interface between the POS system and all pharmacy computer systems, (3) the expense of training personnel to operate the POS system, (4) the cost incurred by pharmacies in installing the POS system, and (5) the conflict between protecting the privacy of a patient's drug profile and permitting the monitoring of drug interactions. The catastrophic coverage act proposes that POS data be used to assess the appropriateness of drug use with a focus on outcome and quality-of-care issues; for the full intent of the act to be achieved, the components of an effective drug-use-evaluation program must be employed. Drug-use evaluation should eventually decrease health-care costs and improve quality of care.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Care Information Systems↗
PubMed2005

Traditional healers for HIV/AIDS prevention and family planning, Kiboga District, Uganda: evaluation of a program to improve practices.

In the face of ongoing epidemics of HIV/AIDS and STI, high demand for family planning, and limited resources, traditional healers may be under-utilized providers of reproductive health education in rural sub-Saharan Africa. We implemented a training program in HIV prevention and family planning methods for healers in the Kiboga district of Uganda and evaluated the program's impact on healers' clinical practice and the diffusion of information to their female clients. Of 46 healers recruited, 30 (65%) completed a pre- and post-training interview. Following training, traditional healers increased discussions of family planning with their clients. Of 84 female clients recruited, 44 (52%) completed the interview before and after the training for healers. Female clients corroborated that they increased discussions of family planning with their healers, as well as discussions about HIV/AIDS. Both healers and their female clients were more likely to make a connection between family planning, condom use, and HIV prevention after the training compared to before the training. Findings provide evidence that traditional healers in a rural area of Uganda can successfully adapt HIV prevention messages and family planning information into their clinical practices.

Adult↗
PubMed2004

Student evaluation practices in pediatric clerkships: a survey of the medical schools in the United States and Canada.

Despite the curriculum changes during the past decade, there is paucity of information regarding the structure and evaluation processes in pediatric clerkships. Information regarding the educational components of the pediatric clerkship and student evaluation practices was obtained from the pediatric clerkship directors via a paper/electronic survey. Completed surveys were received from 97 US and Canadian medical schools and were analyzed. The average length of a clerkship was 7 weeks. Most clerkships required a 4-week ward, a 1-week newborn rotation, and a 2-week ambulatory rotation. Students were evaluated on each component of the clerkship in 93.5% of the programs. All programs evaluated student's clinical performance and fund of knowledge; 85.6% evaluated student's written record. Student's clinical performance was evaluated by direct observation in 57% of the programs. Penalties for failing in clinical performance were harsher. In 56% of programs, a student failing in clinical performance failed the entire clerkship in contrast to 21.8% or 7% of the programs where a student failed the entire clerkship if they failed in the examination for the fund of knowledge or written record evaluation, respectively. The survey demonstrated a fair amount of consistency in clerkships across programs when compared with data obtained in 1981 and 1986. There was a noticeable increase in the well-baby nursery rotation; however, there was a decline in direct observation to assess physical examination or clinical performance.

Canada↗
PubMedDate not supplied

Changing surgical education strategies in an environment of changing health care delivery systems.

Emerging changes in health care delivery will have a significant impact on the structure of surgical education in academic departments of surgery. Based on some assumptions as to the probable nature of the final product of this reform, this article encourages a proactive stance by surgical educators to anticipate changes and move toward restructuring in areas of curricular content, the teaching process, performance evaluation strategies, and faculty infrastructure of the academic department. Curriculum changes must bridge the gap between public health and medicine and continue the aggressive trend toward teaching in the outpatient setting. Surgical educators must adapt to evolving computer and instructional technology that will make multimedia presentations, distance education, teleconferencing, hypermedia, and virtual reality commonplace in the teaching setting. Increased emphasis on accountability and accreditation will require stringent criteria in performance and program evaluation methodology. The academic infrastructure will need to adapt to the changing goal of training more general surgeons and fewer specialists and yet maintain the fundamental responsibility of an academic surgeon for mentoring the medical student and surgical resident.

Computer-Assisted Instruction↗
PubMed2006

Driving and dementia in older adults: Implementation and evaluation of a continuing education project.

PURPOSE: We aimed to develop and evaluate a multimedia workshop curriculum to educate physicians and other health professionals about (a) driving-related assessment in older adults with dementia, and (b) strategies to encourage driving retirement for impaired individuals. DESIGN AND METHODS: A curriculum developed by the Older Drivers Project of the American Medical Association was expanded for presentation by a multidisciplinary team. One pilot and seven test workshops were offered. A program evaluation method-testing knowledge, confidence, attitudes, and practice behaviors-was employed at four points in time: T1 (Time 1; pretest focusing on the previous 12 months), T2 (Time 2; same-day post-test), T3 (Time 3; post-test at 3 months), and T4 (Time 4; post-test at 12 months). RESULTS: At T1, participants (N = 147) expressed high agreement that an assessment of driving ability is an important issue in clinical dementia care, but they reported low knowledge of assessment strategies, resources, and state reporting requirements. Modest gains in knowledge and confidence were demonstrated at both T3 (n = 93) and T4 (n = 63). In addition, the frequency of driving-related practice behaviors (i.e., incorporation of driving-related questions into clinical evaluation, chart documentation, reporting of impaired drivers) had increased significantly by T3 and T4. IMPLICATIONS: The results indicate that a focused workshop curriculum, with practical and immediate applications to care, can motivate measurable changes in clinical practice. Once they are informed, health professionals can address issues of driving ability in older patients with dementia and, with the support of available resources, encourage impaired individuals to retire from driving for the safety of everyone on the road.

Aged↗
PubMed1999

Cancer prevention education in developing countries: toward a model for nurse educators.

The National Cancer Institute, United States of America, funded a series of continuing education courses in cancer prevention between 1986 and 1994 for nurses from developing countries. The purpose of this program was to stimulate interest and facilitate an increase in the participants' knowledge of primary and secondary cancer prevention. The long-term objectives were to increase the number of nurses, internationally, prepared to engage in the prevention and the early detection of cancer in their countries, to expand the international cancer nursing network, and to have these nurses ultimately play a role in reducing the incidence of cancer in developing countries. More than 50 nations were represented. Participants were chosen for their demonstrated ability to influence nursing education and practice in their country. They completed a demographic data sheet, an attitude inventory, a program evaluation and pre- and postconference activities surveys. Before and after attending the conference, participants were asked to identify anticipated problems and obstacles to their goal achievement. These problems included a lack of screening facilities and a lack of primary prevention services. Although numerous differences existed in their education, experience, and personal attributes, the participants voiced common problems with cancer prevention programs. Results from the postconference survey showed a substantial increase in cancer-related activities conducted by the participants. Activities included an increase in cancer content in nursing education programs, an increase in public and professional presentations on cancer prevention, and improvement in the delivery of cancer care.

Adult↗
PubMed2005

Continuous quality improvement in rural health clinics.

AIM: Continuous quality improvement has been shown to work in urban and suburban clinics. The objective of this project is to test whether continuous quality improvement would improve the quality of care for patients with diabetes mellitus and/or hypertension in a rural health clinic. SETTING: Rural health clinic with 3 providers and two and half full-time registered nurses. Patients were mostly older adults with Medicare health insurance. PROGRAM DESCRIPTION: Health care providers and nursing staff agreed on the quality improvement project. The intervention included providing quarterly feedback to health care providers, empowering the nurses to remind patients of diabetes care, and flagging the charts to remind providers. PROGRAM EVALUATION: The proportions of diabetic patients who had ophthalmologic exam, pneumococcal vaccine and lipid screening significantly improved over 12-month period. The proportions of patients with hypertension who had blood pressure less than 140/90 and patients who were taking aspirin also significantly improved over 12-month period. CONCLUSION: The quality of care for patients with diabetes and patients with hypertension could be improved in rural health clinics using repetitive cycles of measurements, implementation of interventions and evaluation of outcomes. This process could be used as the backbone for translation of evidence into practice and improving quality of care.

Adolescent↗
PubMedDate not supplied

Complementary and alternative medicine. Integrative medicine: business risks and opportunities.

Much of the buzz over integrative medicine is well deserved. The opportunities seem to outweigh the risks, but superior management skills are needed to guide these programs through adolescence into clinical and business maturity. By carefully considering the staffing, team building, compensation methods, marketing, and program evaluation and development issues explored in this article, health care and physician executives should be able to steer between the rocks on their way to integrative medicine decisions that are right for their organizations. Many claim that integrative medicine has the potential to reshape health care delivery in a more patient-centered direction. While this may be true, such programs must prove themselves from financial and clinical operational perspectives in order to achieve this potential. Luminary clinical skills are not enough to guarantee the survival of such programs--a strong clinical base of expertise in alternative therapies is a key success factor. As with any health care venture, there are no substitutes for clinical excellence or sound management.

Complementary Therapies↗
PubMedDate not supplied

Using marketing research methods to evaluate a stage-specific intervention.

OBJECTIVE: To show how marketing methods can be used to distribute and evaluate a health promotion intervention. METHODS: Mass media promotion was used to communicate a physical activity resource. Brief telephone interviews were used to screen callers and recruit participants into a controlled trial. Follow-up was conducted 3 months later. RESULTS: Information was gained about the attitudes and motivation of callers. The majority of participants (study and control) made significant changes in their activity levels. CONCLUSION: The study demonstrated that even when mass media channels are used, market segmentation can be achieved and program evaluation conducted.

Adult↗
PubMedDate not supplied

Cardiac rehabilitation survey: maintenance of lifestyle changes and perception of program value.

Graduates from a Phase II cardiac rehabilitation program were surveyed about their maintenance of healthy lifestyle changes from 1 to 4 years after completing the program. Patients were queried about their continued performance of routine aerobic exercise; use of safe exercise principles; adherence to a low-fat, low-cholesterol diet; and surveillance of lipid levels. Results showed that 74% of patient graduates reported exercising aerobically three to four times weekly, and 50% used their pulse rate to guide exercise intensity. The patients were also asked their opinions about the value of the cardiac rehabilitation program; 91% of patients reported an improvement in their quality of life, and 97% felt the program was a good use of insurance dollars. The findings of this study have implications for program evaluation and modification.

Adult↗
PubMed2004

Effectiveness of personal protective equipment: relevance of dermal and inhalation exposure to chlorpyrifos among pest control operators.

This study assessed the effectiveness of a custom fit personal protective equipment (PPE) program aimed at reducing occupational exposure to pesticides. The intervention study was carried out on 15 pest control operators (PCOs) during mixing/loading and application of chlorpyrifos. Each worker was measured twice; first while the worker used PPE as normal (baseline measurement), and second after making some adjustments to the PPE (postintervention measurement). The applied intervention consisted of a tight-fitting, full-face respirator, fit-testing, long gloves, chemical-proof boots, a Tyvek hood, and an instruction video that was shown prior to putting on the PPE. A comprehensive evaluation program was used for the within-subject comparisons, including assessment of potential dermal exposure, actual dermal exposure, inhalation exposure, and internal dose as measured by the urinary metabolite 3,5,6-trichloro-2-pyridinol (TCP). The PPE program resulted in a significant increase in fit factors from a mean of 670 to 132,000. Actual dermal exposure levels decreased on average by fourfold after implementation of the PPE program (baseline AM = 132.1 microg; postintervention AM = 32.6 microg). The TCP levels in urine collected 24-32 hours after spray activities were lower in the postintervention data set (AM = 21.2 microg TCP/g creatinine vs. AM = 13.9 microg TCP/g creatinine). However, it is impossible to attribute these differences totally to the PPE program since workers had significant and varying urinary TCP levels before onset of spraying activities. Linear regression models showed that dermal exposure was only a predictive parameter for TCP levels in urine in the baseline data set. Although the results should be interpreted cautiously this study suggests a protective effect of the evaluated PPE program.

Administration, Cutaneous↗
PubMedDate not supplied

Prevention of body dissatisfaction and disordered eating: What next?

Eating disorder prevention is a young field that has made significant strides in the past two decades. It is timely to take a look back at what we have learned during this period in order to begin to address the question, "What next?" This paper considers several key issues based upon a review of the literature and the authors' perspectives. Topics discussed include: (1) environmental approaches; (2) global mental health versus eating disorder specific interventions; (3) participatory approaches; (4) the integration of obesity and eating disorder prevention; (5) boys; (6) program evaluation; and (7) whether we know enough to move ahead.

Adolescent↗