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PubMed2005

The evaluation of comprehensive cancer control efforts: useful techniques and unique requirements.

This article discusses evaluation of comprehensive cancer control efforts as developed in the United States by involved partners at all levels -- community, regional, state, tribal, territorial, and national. Evaluation of comprehensive cancer control can concern the evaluation of a program, a plan or activities from a plan. In its development, it is grounded in both theory and practice, and the results are used in program development and implementation to document activities, inform decision making, and demonstrate accountability. Various types of evaluation have been shown to be important. Challenges to evaluating comprehensive cancer control include incorporating and working with a broad group of stakeholders; developing an agreed upon plan and evaluation, ensuring the necessary infrastructure for overseeing, facilitating, and disseminating results of evaluations; conceptualizing and communicating desired changes; and potentially implementing (and evaluating) programs at the community, regional, tribal, territorial, state, or national level. Using the CDC Framework for Evaluation, selected examples of state program evaluations are presented. These examples show the use of both process and outcome evaluations to illustrate programmatic improvement and the accomplishment of proposed objectives. As evaluation of comprehensive cancer control continues to be developed and results communicated, our ability to evaluate comprehensive cancer control programs increases and the growth of comprehensive cancer control efforts are encouraged.

Forecasting↗
PubMed2000

Reaching young Indonesian women through marriage registries: an innovative approach for anemia control.

In an effort to build iron stores before pregnancy and reduce the high prevalence of anemia in Indonesia, the Ministry of Health/Indonesia and the MotherCare project implemented an anemia control program for newly wed women. As part of an existing program to counsel couples about marriage and require them to obtain tetanus toxoid immunization before obtaining a marriage certificate, women also were counseled to buy and take 30-60 iron-folate (IFA) tablets. Women (n = 344) were enrolled from one of three participating districts in South Kalimantan, Indonesia. At first monitoring, at least 30 d after baseline, 261 women were tested for hemoglobin and asked about their IFA tablet consumption and knowledge of information, education, and communications (IEC) materials promoted through the program. Results showed that there was a decrease in the prevalence of anemia from 23.8 to 14.0% over the course of the program, 98% of women had taken at least some IFA tablets and 56% had taken >30 tablets.

Adult↗
PubMed2006

The effect of a therapy dog on the communication skills of an adult with aphasia.

UNLABELLED: Little evidence-based research has been published within the field of communication disorders on the role of dogs as catalysts for human communication. This single participant study, a point of entry into this realm of research, explores the effects of a therapy dog on the communication skills of a patient with aphasia receiving intensive speech and language therapy within a rehabilitation setting. The researchers conclude that the presence of the dog does have the potential to stimulate both overt social-verbal and social-nonverbal communication. LEARNING OUTCOMES: As a result of this activity the reader will be able to (1) describe the beneficial role of dogs to serve as catalysts for human communication (2) describe ways in which a person with aphasia may be assisted by a therapy dog and (3) become familiar with an animal-assisted therapy (AAT) program set-up for patients with communication disorders within a rehabilitation setting.

Affect↗
PubMed2005

Scaling properties of childhood infectious diseases epidemics before and after mass vaccination in Canada.

The goal of this paper is to analyse the scaling properties of childhood infectious disease time-series data. We present a scaling analysis of the distribution of epidemic sizes of measles, rubella, pertussis, and mumps outbreaks in Canada. This application provides a new approach in assessing infectious disease dynamics in a large vaccinated population. An inverse power-law (IPL) distribution function has been fit to the time series of epidemic sizes, and the results assessed against an exponential benchmark model. We have found that the rubella epidemic size distribution and that of measles in highly vaccinated periods follow an IPL. The IPL suggests the presence of a scale-invariant network for these diseases as a result of the heterogeneity of the individual contact rates. By contrast, it was found that pertussis and mumps were characterized by a uniform network of transmission of the exponential type, which suggests homogeneity in the contact rate or, more likely, boiled down heterogeneity by large intermixing in the population. We conclude that the topology of the network of infectious contacts depends on the disease type and its infection rate. It also appears that the socio-demographic structure of the population may play a part (e.g. pattern of contacts according to age) in the structuring of the topology of the network. The findings suggest that there is relevant information hidden in the variation of the common contagious disease time-series data, and that this information can have a bearing on the strategy of vaccination programs.

Canada↗
PubMed1989

Surveillance for quality assessment: I. Surveillance in infection control success reviewed.

This review of the use of surveillance by infection control practitioners (ICPs) in nosocomial infection control programs has identified key components that have led to and supported its continued application and success. These include: Surveillance targeting of events (diseases); Early development of standardized definitions; Wide acceptance of these criteria; Advocacy, leadership and education of methodology and; A high level of effectiveness in program practice.

Communicable Disease Control↗
PubMed1989

The Lesion Game: a special communication.

The Lesion Game is a personal computer program that allows the user to view and study muscle innervations and nerve lesions of the brachial plexus. The core of the program is a table that consists of 44 brachial plexus lesions, 50 muscles, and 2 sensations (for brachium and forearm) of the upper extremity, which are innervated by the brachial plexus. After the program randomly selects a lesion, the user attempts to find the lesion in as few guesses (manual muscle tests) as possible. As muscles are selected (muscle tested), the computer searches the table to find the appropriate "strength" of weak or normal, based on the location of the randomly selected lesion. After displaying the strength of the muscle selected, a graphic representation of the strength is shown on a diagram of the brachial plexus. The graphic aspect of the program helps the user to visualize areas of the brachial plexus that may still contain the lesion. While playing the Lesion Game, the user can view a detailed picture of the brachial plexus, view all the possible lesions of the Lesion Game, or view charts of upper extremity innervations. An additional program mode allows beginning users to view and study muscle innervations without having to solve lesions. The program is extremely simple to use because it is entirely mouse-driven.

Brachial Plexus↗
PubMed1991

The effect of planned walking on communication in Alzheimer's disease.

One of the effects of Alzheimer's disease is a diminution in the ability to communicate. A randomized, non-blinded two-group experimental study was undertaken to determine if planned walking has the capacity to improve the communication performance of patients with moderate to severe Alzheimer's disease. Thirty subjects meeting NINCDS-ADRDA diagnostic criteria for probable Alzheimer's disease, selected from two nursing homes, participated in the study. Intervention and comparison groups were each made up of subjects from both nursing homes. Subjects in one group were walked individually for 30 minutes three times a week for 10 weeks. Subjects in the comparison group were engaged in conversation for the same amount of time for 10 weeks. A multivariate analysis of variance (MANOVA) was performed on the communication data. Analysis of the data at post-testing indicated that communication performance improved significantly in the planned walking group over the conversation-only group (f = 4.29; df = 2.28; P = 0.024). The results suggest that a planned walking program has the capacity to improve the communication performance of patients with Alzheimer's disease.

Aged↗
PubMedDate not supplied

Interactive video instruction increases efficiency in cognitive learning in a baccalaureate nursing education program.

An interactive videodisc instruction module on therapeutic communication in nursing was evaluated to assess its impact on learning and retention. A pre-test, post-test, re-test, control group design was used on two comparison groups. Results showed that the intervention group met therapeutic communication course objectives more efficiently than the control group. Although all 65 student study participants met therapeutic communication course objectives equally well and at a high level by the end of the semester, the intervention group had achieved these objectives at a higher level than the control group within the first month of the semester. The results support the use of computer assisted instruction, and more specifically, interactive videodisc instruction for teaching therapeutic communication skills and permitting an increase in the student-faculty ratio, with no loss in quality.

Chi-Square Distribution↗
PubMed1990

Passing the torch. Medical staff retirement planning maintains continuity of care.

A medical staff retirement program can ensure long-term accessibility to care for the community and financial viability for the hospital. Thus hospitals should become actively involved in the physician retirement planning process. By so doing, they can preserve a patient base that may have taken years to develop and, once lost, may be difficult to recover. To establish a successful medical staff retirement plan, hospitals should: 1. Analyze medical staff demographics. 2. Set procedures for determining the practice's value. 3. Develop an approach for financing the sale. 4. Define the hospital's role as a financial intermediary in the sale. 5. Determine whether the hospital will share costs with the seller. 6. Establish a communication plan to introduce the retirement program to the medical staff. In the sale of a physician's practice, some of the hospital's options include purchasing the practice, helping the seller find an associate to purchase the practice, initiating a group at the hospital and merging the practices into the group, or simply providing the physician with moral support.

Communication↗
PubMed1998

Mental health consultant to law enforcement: Secret Service development of a Mental Health Liaison Program.

The Mental Health Liaison Program developed and used by the Secret Service is presented as a model for comprehensive, multidimensional interactions between law enforcement and mental health systems, with particular focus on assessing and preventing violent behavior. The structure of the program pairs consultants--psychologists and psychiatrists--with Secret Service field offices to provide (a) consultation regarding risk assessment and case management of individuals who threaten or display inappropriate interest in the President or other protectees; (b) training for agents on risk assessment, mental illness, and mental health care issues; and (c) liaison activities between the Secret Service and the mental health community. Practical benefits to the Secret Service are discussed to encourage more systematic use of broad based psychological and psychiatric consultation to law enforcement, with a goal of enhanced intersystem communication and collaboration. The need for program evaluation and outcome research is discussed in the context of applying the model to improve other mental health and law enforcement systems interactions.

Case Management↗
PubMedDate not supplied

Teaching the social sciences to undergraduate medical students.

An increasing number of medical schools have introduced undergraduate programs in the social sciences in an attempt to improve the ability of their graduates to communicate with patients and to meet their needs. However, teaching programs in the social sciences have often encountered varying degrees of student resistance, possibly because of their uncertain relevance for clinical practice, incongruity with the biomedical model, teachers' attitudes, and poorly defined educational goals. The objective of this essay is to analyze the causes of students' resistance to the social sciences and to identify the features of a teaching program responsive to their needs.

Attitude of Health Personnel↗
PubMed1996

Effectiveness of a continuous quality improvement program aiming to reduce unplanned extubation: a prospective study.

OBJECTIVE: To evaluate the effectiveness of a continuous quality improvement (CQI) program in reducing the incidence of unplanned endotracheal extubation. DESIGN: Prospective study over a 9-month period. SETTING: Adult intensive care units (ICUs including coronary care unit, medical ICU, surgical ICU, and cardiovascular surgical ICU) in a university-affiliated medical center. PATIENTS: 831 consecutive mechanically ventilated patients. INTERVENTIONS: CQI program focusing on standardization of procedures, improvement of communication, and identification and management of high-risk patients. MEASUREMENTS AND RESULTS: With the implementation of this CQI program, the overall incidence density of unplanned extubation (defined as number of new unplanned extubations per mechanical ventilation patient-days) significantly decreased from 2.6% in the first trimester to 1.5% in the second trimester and 1.2% in the third trimester (p = 0.01). This reduction was essentially the result of a decrease in unplanned extubation in orally intubated patients (incidence density 4.6, 1.7 and 1.0% for three trimesters, respectively; p < 0.0001). Unplanned extubation in nasally intubated patients remained largely unaffected (1.2, 1.4, and 1.4% for three trimesters, respectively; p = 0.92). CONCLUSIONS: The implementation of a concerted CQI program is effective in reducing the overall incidence of unplanned endotracheal extubation.

Critical Care↗
PubMed1979

The effects of systematic human relations training on freshman dental students.

Freshman dental students received training in communication skills via a systematic human relations model. The 35 students participating in the program substantially improved their ability to discern feelings of patients and to communicate with patients in a more understanding and accepting manner. The students thought that the training was beneficial and highly relevant to their future roles as dentists. This kind of training could be offered successfully to other dental health professionals through programs in continuing education.

Communication↗
PubMedDate not supplied

Local health departments implement a theory-based model to increase breast and cervical cancer screening.

Su Vida, Su Salud/Your Life, Your Health is a community program to increase participation in breast and cervical cancer screening. This program illustrates the diffusion of an innovative outreach strategy from a research environment to two local health departments. The program uses A Su Salud, the communication model in which positive role models are featured in the media, and community volunteers who give positive social reinforcement. Local health departments in Galveston and Corpus Christi, TX, were selected to implement the model because of excessive mortality rates in the region and the departments' adequate level of resources and commitment. Over an 18-month period, 54 stories of role models appeared in the media in Corpus Christi, and 60 appeared in Galveston. There were 490 volunteers active in Corpus Christi and 279 in Galveston. Of 365 inquiries to the Corpus Christi program, 35 percent were from the Mexican American target group of women ages 40-70. Of 1,457 women who contacted the Galveston program, 9 percent were from the African American target group ages 40-70. Local health departments are well-suited to participation in cancer control research applications because they have direct access to high-risk populations and have the authority to institutionalize effective interventions.

Adult↗