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PubMed2005

Public dental health care program for persons with disability.

The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means of self-administered questionnaires completed by the person responsible locally for the program in each municipality. The response rate was 84%. The following topics were included: (1) Number of persons attending the program, (2) procedure for identification of persons eligible for the program, (3) payment of service, (4) providers of oral health care, (5) special training of staff, 6) dental services delivered, (7) ethical issues, and (8) patient rights. Less than one-third of persons estimated by the health authorities were enrolled in the program. On average, 0.4% of the municipal population attended the program, ranging from 0.03% to 1.53%. In large municipalities, and where internal providers delivered oral health care, relatively more persons were enrolled in the program (p < 0.001). Overall, more than 20 categories of personnel were involved in the selection procedure; attitude and lack of knowledge of oral health and oral health care for persons with disability were barriers to equal access to the program. Preventive dental services were the most frequent services delivered, although relatively few oral hygienists were involved in the program. Special training was most frequent in large municipalities. To secure equal access for persons with disability, it is recommended that joint collaboration between smaller municipalities should be made regarding procedures of such programs. Special training of dental personnel and of the staff responsible for selecting persons for the program should be systematically organized at a higher administrative level. The pattern of dental services delivered justifies further involvement of oral hygienists in the program.

Aged↗
PubMed1998

Precollege enrichment programs intended to increase the representation of minorities in medicine.

The authors reviewed the literature published from 1966 to 1996 to identify enrichment programs for underrepresented minority precollege students sponsored by medical schools and affiliated programs, finding 19 articles describing 27 programs. The authors categorized the reported programs according to the components they contained. Most programs contained more than one component type. Twenty-four programs had an academic enhancement component. Two thirds had a motivational component to encourage students to consider medical and other health careers. Two programs set up mentoring relationship between students and health professionals. There were four research apprenticeships and three academic partnerships between medical schools and local school districts. Twelve of the 27 programs were evaluated in the literature. Eight evaluations focused on identifying the numbers of students who continued their education into college and professional schools. Five programs reported participant satisfaction or identified other short-term outcomes such as gains on standardized tests. While the percentage of participants completing college and entering health care careers is impressive, the authors do not believe that the educational success of participants can be attributed to involvement in these programs. The authors recommend ways to improve the quality and interpretability of enrichment program evaluations. Evaluators should adopt common terminology for activities and outcomes. Participants' economic and educational disadvantages should be described. Programs' theoretical underpinnings should be identified and related to evaluation. Measures should include immediate effects as well as long-term outcomes. Where possible, data from comparison groups should be reported to support conclusions. Adequate funding needs to be available to design and complete reasonable evaluations.

Education, Medical↗
PubMed2004

Internal medicine-pediatrics residency training: current program trends and outcomes.

PURPOSE: Combined internal medicine-pediatrics (med-peds) residency programs have existed since 1967. Due to the rapid growth in the number and size of programs during the 1990s, most current med-peds physicians completed their residency in the last ten years, making older studies of med-peds programs obsolete. The authors sought to determine completion rates of med-peds residency programs and describe the initial career plans for five cohorts of graduating residents from combined med-peds training programs. METHOD: Program directors of all U.S. med-peds residency programs were asked to complete a Web-based survey and base their responses on the records of cohorts of residents completing their programs from 1998 through 2002. To allow sufficient time to complete both the American Board of Pediatrics (ABP) and American Board of Internal Medicine (ABIM) certification examinations, certification status was requested only for the cohort completing training in 1998. RESULTS: Responses were obtained from 92% (83/90) of the programs, reflecting 1,595 residents entering med-peds programs. Of these residents, 91% graduated from a med-peds program. Among the graduates, 82% were seeing both adults and children, 22% went on to subspecialty residencies, 21% began practice in rural or underserved areas, and 25% entered an academic position. ABIM and ABP pass rates for the 1998 cohort were 97% and 96%, respectively. Overall, 79% of the 1998 graduates are board certified in both specialties. CONCLUSIONS: Compared with previous studies, a greater proportion of residents who recently entered med-peds programs completed their dual training, and a larger percentage of graduates are seeing both adults and children. The proportion of residents entering subspecialty residencies has increased significantly, but the proportion of graduates in academic careers has remained stable.

Adult↗
PubMed2003

Promoting participation: evaluation of a health promotion program for low income seniors.

This article describes a qualitative evaluation of the Seniors Active Living in Vulnerable Elders (ALIVE) program, a 10-month health promotion program for low income seniors. Program interventions delivered in seniors' apartment buildings included exercise classes, health information sessions (i.e., health corners), and newsletters. The evaluation examined program participation, program impacts, and how the program worked. The most frequent reason for joining the program was recognizing the benefits of exercise, and the most frequent reason for not attending the program was having other priorities. The main participant impact was "feeling better." Specific impacts were also noted in physical, mental, and social domains. Fun, program delivery adaptations, autonomy, social interactions, and staff-participant relationships were discovered to be important program processes. These processes all contributed to participant's "comfort" in the program. How and why the program worked is examined in relation to Pender's (1996) revised health promotion model and implications for nursing are indicated.

Aged↗
PubMedDate not supplied

A review of health-related outcomes of multi-component worksite health promotion programs.

PURPOSE: The purpose of this article is to critically review evaluation studies of the health-related effects (i.e., health risk modification and reduction in worker absenteeism) of multicomponent worksite health promotion programs. SEARCH METHOD: A comprehensive literature search conducted under the auspices of the Centers for Disease Control and Prevention identified 36 articles that examined health-related outcomes of multi-component programs. The authors identified 11 additional articles through manual searches of recent journal issues and through personal contacts with worksite health promotion researchers. Forty-seven studies describing the results of 35 worksite health promotion programs were reviewed. IMPORTANT FINDINGS: The worksite health promotion programs reviewed for this article varied tremendously in the comprehensiveness, intensity, and duration of the intervention activities. All of the programs provided health education to employees. In a majority of the programs, opportunities to learn and practice new skills were also offered. A smaller number of programs incorporated modifications in organizational policy or the physical work environment. Results from well-conducted randomized trials suggest that providing opportunities for individual risk reduction counseling for high risk employees within the context of comprehensive programming may be the critical component of an effective worksite health promotion program. Just offering low intensity, short duration programs aimed at increasing awareness of health issues for the entire employee population may not be sufficient to achieve desired outcomes. MAJOR CONCLUSIONS: The results of the studies reviewed provide both cautious optimism about the effectiveness of these worksite programs and some general guidance as to the critical components and characteristics of successful programs. Overall, the evidence suggests that a rating of indicative/acceptable may best characterize this literature.

Absenteeism↗
PubMedDate not supplied

Factors influencing the adoption and maintenance of Canadian, facility-based worksite health promotion programs.

PURPOSE: The purpose of this study was to determine senior management's rationale for adopting and maintaining worksite health promotion programs and the congruence of this rationale with the program objectives of health professionals who manage the programs. DESIGN: A multiple case study design was used. SETTING: Nine major Canadian organizations which had adopted facility-based health promotion programs were the settings for this study. DATA COLLECTION: Semi-structured interviews (22 conducted) and two questionnaires (36 completed) were the methods used to collect data. RESPONDENTS: Senior managers involved in program adoption, senior managers responsible for program budgets, and senior health professionals responded to the interviews and questionnaires. RESULTS: Impetus for health promotion program adoption in the organizations we studied had more to do with tangential issues such as an organization moving to a new facility or having access to unused space than with employee health or organizational performance considerations. The most common program adoption rationale was related to employee recruitment/retention. Program continuance was based on process issues such as participation rates and the quality of activity offerings rather than on health or organizational outcomes. While health professionals and senior management both considered human relations and morale more important than cost savings outcomes, health professionals considered cost savings outcomes more important than did senior management. CONCLUSIONS: It is important for health promotion professionals to develop program objectives which are shared by organizational management. Future program adoptions and maintenance will be influenced by closer analyses of the effect of these programs on organizational performance.

Canada↗
PubMedDate not supplied

An analysis of comprehensive health promotion programs' consistency with the systems model of health.

Purpose. The purpose of this article is to report a review and analysis of the concordance between current comprehensive corporate health promotion programs as described in the published literature and the systems model of health and to explore emerging trends in the field of health promotion. Search Methods. MEDLINE, BIOSIS, and PsycINFO searches were conducted from 1985 to 1991, and the bibliographies of articles thus obtained were back searched for additional descriptions of corporate health promotion programs. Inclusive criteria included "comprehensive" corporate programs, published in peer-reviewed journals or books, and descriptions adequate enough to permit coding in the majority of analysis matrix categories. Out of 63 identified programs, 16 met the inclusion criteria; 47 were excluded. A common reason for rejection was the limitation imposed by inadequate program descriptions in the published literature. Major Findings. On average, the comprehensive corporate programs reviewed were initiated between 1984 and 1987 and set in the context of a manufacturing firm with over 10,000 employees. A minority of programs (12.5%) consistently satisfied systems model criteria. The most common category of programs were those which were inconsistent (44%), meeting some of the criteria of a systems model of health promotion, but not all. The mechanistic medical and public health models predominated strongly (63%) with the preeminent goal being individual risk factor modification. Conclusions. The limitations of the published literature do not permit strong conclusions about the number or degree to which current corporate comprehensive programs are concordant with the systems model of health. Although mechanistic models of health predominated, there is evidence that a number of comprehensive programs were inconsistent with the mechanistic model, meeting some of the criteria, but also meeting some systems model criteria. To continue the advancement of health promotion with clarity and focus, further research is needed to clarify outcomes across different "world view" models of health promotion. Health promotion specialists need to carefully scrutinize programs emanating from different "world view" models as they design, develop, implement, and evaluate corporate programs.

Attitude to Health↗
PubMedDate not supplied

Identifying program preferences through conjoint analysis: illustrative results from a parent sample.

PURPOSE: The purpose of this article is to illustrate the application of conjoint analysis, a consumer research technique, using data from a survey of parents' preferences for prevention programs. DESIGN: This study utilized a one-time, cross-sectional telephone survey. SETTING: Data were collected from subjects living in economically disadvantaged rural midwestern counties. SUBJECTS: Subjects were 202 randomly selected parents with preadolescents who indicated interest in family-focused prevention programs. MEASURES: Conjoint analysis software was employed in computer-assisted telephone interviews to evaluate relative preferences for 39 individual features of family-focused prevention programs falling under 11 categories (e.g., program meeting time, facilitator background). The software also guided computer simulations of parent choices among four types of programs. RESULTS: Findings indicated that meeting time was the most important category of program features. Strongly preferred individual features included meetings scheduled on weekday evenings, instruction by child development specialists, and programs based on extensive research. Two multiple-session programs evaluated via computer simulations incorporated several preferred features and received higher ratings than did single-session programs. Estimated variance z-tests indicated limited differences in perceived importance of program feature categories across sociodemographic subgroups. CONCLUSIONS: Findings highlight a) differences in the relative value parents place on various features of prevention programs in the surveyed population and b) the importance of practical aspects of program delivery.

Adolescent↗
PubMed2000

A study on the socio-psychiatric aspects of short-term ARP (Alcohol Rehabilitation Program).

The duration of the majority of Alcohol Rehabilitation Programs (ARP) at major hospitals specializing in this treatment is three months. Recently, however, because of diverse backgrounds and patients needs, long periods of hospitalization have become difficult. In response to this, Okamotodai Hospital initiated a one-month ARP program three years ago. One feature of this program is that it can be freely structured to meet the requirements of individual patients. This study compares the prognosis of patients treated under this one-month program with that of those who have undergone the three-month program. A group of 56 patients who had completed a one-month ARP program during a period of two to three years was compared with a group of 46 patients who had completed a three-month program over a similar period. The backgrounds of the subjects were researched by questionnaire. A comparison of the prognosis of patients in the respective programs showed there was no statistical difference, with a recovery rate of 45% for both programs. Results of this study statistical difference, with a recovery rate of 45% for both programs. Results of this study cannot be generalized, due to the lack of subjects and recovery of questionnaires. Since enforcement of the one-month ARP, increasing number of patients have been using the program. This fact doesn't necessarily show that the use of ARP improve, although the possibility remains that utilization of the one-month ARP is promoted. In recent years, utilization of brief intervention has been demonstrated and recovery from alcoholism in the outpatient clinics reported. Considering such things, results of the study show that the one-month ARP is a valid and effective program.

Adult↗
PubMed2001

Development of a residency/MPH program.

BACKGROUND AND OBJECTIVES: Public health complements the care physicians provide to patients. Few residencies, with the exception of preventive medicine residencies, offer trainees the opportunity to obtain a public health degree. The University of California, San Francisco-Fresno (UCSF-Fresno) Family Practice Program and California State University-Fresno (CSU-Fresno) spearheaded the creation of a combined residency/MPH program at the UCSF-Fresno Medical Education Program. METHODS: We developed a combined residency/MPH program that allows family practice residents to obtain an MPH degree during their residency training years. We describe the development process, which included initiation of the program, setting goals and objectives, identifying MPH course content and funding, and selecting applicants for entry into the program. RESULTS: The program was successfully funded, and the course content was developed. Participant selection, registration, and enrollment procedures have now been developed. Performance standards have been established, and scheduling conflicts have been addressed. The program has thus far enrolled 29 residents and faculty. Nearly one third have dropped out of the MPH component of the program, mostly because of the workload involved in simultaneous residency and MPH training. CONCLUSIONS: Other training programs can replicate a combined residency/MPH program if a strong relationship with a nearby university offering a MPH degree can be forged. The experience at UCSF-Fresno can help guide others contemplating a combined residency/MPH program.

California↗
PubMed2001

Uli'eo Koa Program: incorporating a traditional Hawaiian dietary component.

Traditional Hawaiian Diet (THD) programs were developed over the past 15 years as a culturally appropriate community intervention for improving the health status of Native Hawaiians. THD programs are generally three weeks in length and incorporate a diet regimen of foods traditional to the Hawaiian culture, coupled with an education component that emphasizes cultural beliefs and practices that support health and wellness. In accordance with traditional practice, THD meals consist mainly of vegetable foods, with controlled amounts of protein. THD programs have demonstrated high success in weight reduction of severely overweight individuals, as well as reductions of serum cholesterol, triglycerides, glucose, and blood pressure. THD programs, to date, have focused on the reduction of these risk factors. The Uli'eo Koa Program, Warrior Preparedness Program, is a pilot study that incorporated a traditional Hawaiian diet component to ascertain its effects on a group of moderately active, non-obese Native Hawaiian adults--specifically the diet's contribution to wellness and physical fitness. Other components of the Uli'eo Koa Program were a physical exercise regimen and a traditional healing component. The purpose of the dietary component of the Uli'eo Koa Program was to provide the nutritional support needed to sustain nutritional requirements for increased physical activity within this group. The year-long Uli'eo Koa Program consisted of three phases. In Phase I, exercise was conducted twice a day and three meals, including snacks, were provided for participants over a three-week period. During Phase II, structured exercise time and meals were decreased to three times a week and two times a week, respectively, for eight weeks. Participants were responsible for maintaining these regimens on their own outside of the structured activities. In Phase III (in progress at the time of this manuscript preparation), the remainder of the program year, participants were solely responsible for structuring their own physical and dietary behaviors. The nutrient composition of the meals followed a traditional Hawaiian diet, which was typically high in complex carbohydrates, low (< 10%) in total dietary fat and limited in protein (as compared to a standard American diet). Dietary assessments were conducted at the onset (baseline) of the program, using a 24-hour dietary recall methodology. When the post-dietary assessments, conducted at the end of Phase II, were compared to the baseline assessments, positive results were indicated by the reported increases in intakes of all major nutrients, including key vitamins and minerals required for exercise. A final dietary assessment will be conducted at the end of the program year (Phase III) to determine maintenance of positive dietary habits. Implications and future research are discussed.

Adult↗
PubMedDate not supplied

Preventing pregnancy and improving health care access among teenagers: an evaluation of the children's aid society-carrera program.

CONTEXT: Despite the recent declines in rates of teenage pregnancy, relatively little is known about the few programs that have been successful in reducing adolescent pregnancy. METHODS: Six agencies in New York City each randomly assigned 100 disadvantaged 13-15-year-olds to their usual youth program or to the intervention being tested--the Children's Aid Society-Carrera program, a year-round afterschool program with a comprehensive youth development orientation. Both program and control youth were followed for three years. Multivariate regression analyses assessed the effects of program participation on the odds of current sexual activity, use of a condom along with a hormonal contraceptive, pregnancy and access to good health care. RESULTS: Seventy-nine percent of participants remained in the program for three full years. Female program participants had significantly lower odds than controls of being sexually active (odds ratio, 0.5) and of having experienced a pregnancy (0.3). They had significantly elevated odds of having used a condom and a hormonal method at last coitus (2.4). However, participation in the program created no significant impact on males' sexual and reproductive behavior outcomes. Nonetheless, program participants of both genders had elevated odds of having received good primary health care (2.0-2.1). CONCLUSIONS: This program is one of only four whose evaluation has successfully documented declines in teenage pregnancy using a random-assignment design. Better outcomes among males may be achieved if programs reach them even earlier than their teenage years.

Adolescent↗
PubMed2005

International comparison and review of a health technology assessment skills program.

OBJECTIVES: A review of the Alberta Heritage Foundation for Medical Research's (AHFMR) 6-month Health Technology Skills Development Program was undertaken within an international context with the purpose of describing and assessing the current program, further formalizing the program based on identified opportunities for improvement, and enhancing collaborative linkages with other agencies. The objectives of the review were to (i) compare the AHFMR program with similar programs in other health technology assessment (HTA) agencies internationally; (ii) assess the value of the program; (iii) identify program strengths and opportunities for improvement; and (iv) review, critique, and recommend enhancements to the program model and role description. METHODS: The review involved a qualitative study design that included a survey of the Skills Development Program participants' experience and perceptions; semistructured interviews with program stakeholders, and a written survey of HTA agencies/programs in other Canadian and international jurisdictions. CONCLUSIONS: The review concluded that the program was successful and valued by participants, the Foundation, and stakeholders in the policy and research communities. Findings suggest participant products have a potential for broad influence, including impact on funding decisions related to technology diffusion, influence through publications and presentations, and knowledge transfer in the participants' disciplines and employment settings. The main opportunity for enhancement was to differentiate the program into two streams according to different needs of participants, specifically between those who desire to be HTA producers and/or make HTA their careers, and those who desire to apply HTA in their employment capacity as policy or clinical decision-makers.

Alberta↗
PubMed1991

Cardiac rehabilitation programs.

Cardiac rehabilitation programs are safe and effective in improving the functional activities of patients with cardiac disease, but they may be hazardous to those patients whose life might be in jeopardy if subjected to exercise. It is clear that not all cardiac patients require supervised rehabilitation programs to return to normal pre-cardiac-event activities. Many patients who have suffered cardiac events recover from the events without much functional debilitation, usually because they were normally active prior to the cardiac event. Patients who have had heart transplants, percutaneous transluminal coronary angioplasty, or heart valve surgery have no unique characteristics that differentiate them from cardiac patients who have had a myocardial infarction or coronary artery bypass graft or who have stable angina in terms of the necessity for participating in supervised rehabilitation programs. Therefore, patients who have had these surgical procedures might be selected for enrollment in cardiac rehabilitation programs on the basis of their physical and psychological conditions. Those patients who benefit from rehabilitation programs usually accomplish their goals within the 12-week sessions of the usual programs. Patients with stable cardiac conditions who are at high risk and have minimal functional capacities (3-5 METs) appear to benefit most, while patients who are of low risk and have functional capacities of 7-9 METs have minimal need for the program. High-risk patients have been described as including those who develop ventricular arrhythmias or marked ischemia with exercise. Low-risk patients have been described as including those who have functional capacities at 3 weeks postoperation of 8 METs or more, which allows them to resume most of their vocational and recreational activities. Patients with intermediate risk and functional capacities benefit from the programs, but they may not require the full 12 weeks of participation. The latter group may safely exit the programs when they attain the goals of the cardiac rehabilitation programs, e.g., the resumption of pre-cardiac-event activities and return to a relatively normal life. Accordingly, heart transplant patients and patients who have undergone percutaneous transluminal coronary angioplasty or heart valve surgery could benefit from prescribed cardiac rehabilitation programs if they have the need as described. The available information implies that many heart transplant, PTCA, or heart valve surgery patients are in excellent functional status after the surgical intervention and require minimal or no supervised exercise programs. However, a significant number of patients may lack confidence in their capabilities and may benefit from earlier exercise testing that would demonstrate to them their functional capabilities.(ABSTRACT TRUNCATED AT 400 WORDS)

Aftercare↗
PubMed1996

[Evaluating the efficacy of selected programs for prophylaxis of caries and periodontal diseases in school children with special reference to guidelines for oral cavity hygiene].

Endeavouring to improve the oral cavity soundness in 7-8 year-old children, an attempt was made to elaborate three prophylactic-educational programs with the possibility to apply them in school conditions. The aim of the work was to evaluate the efficacy of the said programs in the field of oral cavity hygiene, the status of periodontium and dental caries, as well as to observe the moulding of consciousness and correct hygiene habits. The clinical and questionnaire studies covered 255 pupils of two elementary schools in Szczecin. For the first 2-3 years of their lives the majority of children used tap water having been fluoridated to optimal level. The pupils of both schools were receiving planned stomatological treatment and contact fluoridation. The clinical evaluation was accomplished on the basis of 18-month-long observation of the increase in the number of teeth and dental surface with caries (DMFt and DMFs), status of periodontium (ind. GI) and state of hygiene (ind. OHI-S and QH). The tooth brushing method applied by children was additionally observed. The questionnaire studies were employed for estimating the changes in the health consciousness and hygienic habits. The three selected programs were implemented in three groups of studied children (Tab. 1). Program I was based on II individual, motivating instructions of tooth brushing. The main motivating factor was each time colouring of the bacterial plaque. Programs II and III were expanded by educational activity among children and parents. Program III was additionally enriched by professional cleaning of teeth, sealing and intensive conservative treatment. The above programs were carried out in cooperation of school stomatologist, teachers and V year stomatology students and girl pupils training for hygienists. The high frequency and intensity, hardly fair hygiene of the oral cavity and improper habits, having been disclosed in 7-year-old children during preliminary examinations, indicated that there was an urgent need to intensify the educational-prophylactic-therapeutic procedures. After 18-month-long studies it appeared that program I was effective with regard to improving hygiene (reduction of ind. QH by about 13%) (Fig. 1) and the status of gums (reduction of ind. GI by about 54%) (Fig. 2), however, it failed to exert any effective influence on the reduction of caries. Programs II and III were found to be effective with respect to the improvement of hygiene (reduction of ind. QH about 18 and 20%) (Fig. 1), status of gums (reduction of ind. GI about 67 and 67%) (Fig. 2) as well as reduction of caries (about 68 and 56%). Thus, for the exploitation under school conditions each of the three evaluated programs may be engaged, but the most recommendable would be program II or III. The actual studies have also shown the possibility of obtaining a distinct improvement in hygiene in a short time, however, a longer period of time was necessary to stabilize it. Moreover, the process of introducing a correct method of brushing the teeth appeared to be relatively difficult, but it was much easier to achieve that in the children who up to now have made use of partly correct method than in those who used an incorrect one. The implementation of the selected programs had stronger influence on the correction of health consciousness and weaker on the moulding of the habits of brushing the teeth with appropriate frequency. Reverse proportional dependence was also revealed to exist between caries intensity in children studied and the education of their parents.

Child↗
PubMedDate not supplied

[The national program for the early detection and treatment of premalignant and malignant diseases of the lower genital system in women].

Lower genital tract malignancies are often seen in our female population; their detection is often delayed and treatment fails frequently. Latest scientific data on their etiology and newer methods of their detection and treatment in the early stages opens roads in the field of primary and secondary prevention and for the effective therapy, as well. In order to improve current status of the women's health in this field, on October 10, 1995 year, the Section for cervical pathology and colposcopy in addition to Yugoslav Association of Gynecologists and Obstetricians (UGOJ), has been established. One of the most important aims of the Section is introduction of premalignant and malignant diseases of female lower genital tract. So far, the Section has: 1. Submitted the Program proposal to the Ministry of Health of Serbia; on the basis of that proposal, on April 10, 1996 year, the Ministry issued: "Expert instruction for the conduction of assignments aimed at early detection of the cancer of the uterine cervix". In that act obligatory for all health institutions, that have gynecology depts, all activities and goals for National Program introduction are prescribed. 2. The Yugoslav School for pathology of the cervix, vagina, vulva and colposcopy, opened in 1996, year, under the patronage of the Ministry of Health of the Republic Serbia provides the theoretical and practical training for the Program carriers and medical doctors receiving their training in gynecology and obstetrics. The first generation, the School attendees consisted of 149 doctors from the entire country. 3. Creation and submission of a draft common Health Form intended for the computerized and professional use, to provide for more efficient introduction of the National Program. The Form, should be introduced by the Health Ministry as an Official Health Document, to be used by all OBG institutions. 4. Submitted proposal of the activities and tasks in the field of Program realisation according to Health institutions' profiles. 5. Creation of the draft Protocol for actual activities and procedures in order to provide for an early detection and treatment of premalignant and malignant diseases of the female lower genital tract. Having the future mandatory character of this Protocol, the Section will divulge it to the professional audience. 6. Created a project of the National program and submitted it at the beginning of 1996 year, to the Republic Bureau of Health protection, with a request for its financial support in that program. In addition to the activities mentioned, the section management undertook and is taking measures for faster achievement of the aim-of the National Program introduction. Official Health institutions are assigned responsibilities of the Program introduction, the funding and a resolve all the legal, organisational and financial issues. Results that we are expected from this Program include introduction of the primary and secondary measures aimed at disease prevention; early detection of the diseases and its treatment; reduction of the numbers of cases in the advanced stages; significant improvement of gynecological status, and reduction of costs of the treatment of advanced stages of disease. The results should stimulate all, and become must for all subjects involved in the National Program realisation. The Program introduction into the daily OBG practice is a prerequisite of already well established practice in a number of countries, saving life and limb of most women affected by the lower genital tract malignancies.

Female↗
PubMedDate not supplied

Programs that mitigate the effects of poverty on children.

This article reviews six federally funded in-kind public assistance programs that are intended to mitigate the effects of poverty on low-income children by providing access to basic human necessities such as food, housing, education, and health care. The evidence suggests that, while each program can be improved, these programs do achieve their basic objectives. In general, food stamps, the Special Supplemental Food Program for Women, Infants, and Children (WIC), and school nutrition programs are successful at providing food assistance to low-income children, starting with the prenatal period and continuing through the school years. The Food Stamp Program provides food assistance nationwide to all households solely on the basis of financial need and is central to the food assistance safety net for low-income children. The WIC program has helped reduce the prevalence of iron-deficiency anemia in infants and children and has increased intakes of certain targeted nutrients for program participants. The school nutrition programs provide free or low-cost meals that satisfy the dietary goals of lunches and breakfasts to most school-age children. The Medicaid program has extended health insurance coverage to millions of low-income children. However, many children remain uninsured, and children enrolled in Medicaid do not have the same access to medical care as privately insured children. Relatively little is known about the effects of Medicaid on children's health status. For Head Start, empirical evidence suggests that participating children show enhanced cognitive, social, and physical development in the short term. Studies of the longer-term impacts of Head Start are inconclusive. Although housing assistance improves housing quality and reduces housing costs for recipients, there is a large unmet need for acceptable, affordable housing among poor families. Important gaps remain in our knowledge of the effects of these programs on the well-being of children. Questions regarding a program's effects over time on health and developmental outcomes particularly need more study.

Adolescent↗
PubMed2003

Assessing evidence-based dermatology and evidence-based internal medicine curricula in US residency training programs: a national survey.

OBJECTIVES: To examine attitudes toward evidence-based medicine and evidence-based dermatology and to assess evidence-based training in US internal medicine and dermatology residency programs. METHODS: A 1-page self-administered questionnaire was mailed to residency training directors and chief residents at 104 dermatology and 103 internal medicine residency programs from the same or affiliated medical centers. RESULTS: Questionnaires were returned by respondents from 70 (68%) of 103 internal medicine programs and 86 (83%) of 104 dermatology programs. Most respondents (91% internal medicine and 70% dermatology) strongly agreed or agreed that evidence-based internal medicine/dermatology is valuable and should be included in residency training (93% internal medicine and 70% dermatology). Respondents from internal medicine programs agreed more strongly with both statements than respondents from dermatology programs (P =.001). Dedicated evidence-based curricula were in place at significantly more internal medicine programs (50 [71%] of 70) than dermatology programs (20 [23%] of 86) (P<.001). Curricula at internal medicine programs offered significantly more evidence-based medicine training sessions (24 vs 6; P<.001) and biostatistics sessions (10 vs 2.3; P =.03), and internal medicine programs more frequently evaluated the curricula using clinical question applications (56% vs 30%; P =.04). CONCLUSION: Despite favorable attitudes toward evidence-based dermatology, compared with internal medicine programs, dedicated evidence-based training is underdeveloped in dermatology programs.

Attitude of Health Personnel↗