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PubMedDate not supplied

Computer program for diagnostic X-ray exposure conversion.

Presented is a computer program designed to convert any given set of exposure factors sequentially into another, yielding either an equivalent photographic density or one increased or decreased by a specifiable proportion. In addition to containing the wherewithal with which to manipulate a set of exposure factors, the facility to print hard (paper) copy is included enabling the results to be pasted into a notebook and used at any time. This program was originally written as an investigative exercise into examining the potential use of computers for practical radiographic purposes as conventionally encountered. At the same time, its possible use as an educational tool was borne in mind. To these ends, the current version of this program may be used as a means whereby exposure factors used in a diagnostic department may be altered to suit a particular requirement or may be used in the school as a mathematical model to describe the behaviour of exposure factors under manipulation without patient exposure.

Computers↗
PubMed2003

Weight loss with self-help compared with a structured commercial program: a randomized trial.

CONTEXT: Although commercial weight loss programs provide treatment to millions of clients, their efficacy has not been evaluated in rigorous long-term trials. OBJECTIVE: To compare weight loss and health benefits achieved and maintained through self-help weight loss vs with a structured commercial program. DESIGN AND SETTING: A 2-year, multicenter randomized clinical trial with clinic visits at 12, 26, 52, 78, and 104 weeks conducted at 6 academic research centers in the United States between January 1998 and January 2001. PARTICIPANTS: Overweight and obese men (n = 65) and women (n = 358) (body mass index, 27-40) aged 18 to 65 years. INTERVENTION: Random assignment to either a self-help program (n = 212) consisting of two 20-minute counseling sessions with a nutritionist and provision of self-help resources or to a commercial weight loss program (n = 211) consisting of a food plan, an activity plan, and a cognitive restructuring behavior modification plan, delivered at weekly meetings. MAIN OUTCOME MEASURES: Weight change was the primary outcome measure. Secondary outcomes included waist circumference, body mass index, blood pressure, serum lipids, glucose, and insulin levels. RESULTS: At 2 years, 150 participants (71%) in the commercial group and 159 (75%) in the self-help group completed the study. In the intent-to-treat analysis, mean (SD) weight loss of participants in the commercial group was greater than in the self-help group at 1 year (-4.3 [6.1] kg vs -1.3 [6.1] kg, respectively; P<.001) and at 2 years (-2.9 [6.5] kg vs -0.2 [6.5] kg, respectively; P<.001). Waist circumference (P =.003) and body mass index (P<.001) decreased more in the commercial group. Changes in blood pressure, lipids, glucose, and insulin levels were related to changes in weight in both groups, but between-group differences in biological parameters were mainly nonsignificant by year 2. CONCLUSION: The structured commercial weight loss program provided modest weight loss but more than self-help over a 2-year period.

Adult↗
PubMed1996

Evaluation of gene structure prediction programs.

We evaluate a number of computer programs designed to predict the structure of protein coding genes in genomic DNA sequences. Computational gene identification is set to play an increasingly important role in the development of the genome projects, as emphasis turns from mapping to large-scale sequencing. The evaluation presented here serves both to assess the current status of the problem and to identify the most promising approaches to ensure further progress. The programs analyzed were uniformly tested on a large set of vertebrate sequences with simple gene structure, and several measures of predictive accuracy were computed at the nucleotide, exon, and protein product levels. The results indicated that the predictive accuracy of the programs analyzed was lower than originally found. The accuracy was even lower when considering only those sequences that had recently been entered and that did not show any similarity to previously entered sequences. This indicates that the programs are overly dependent on the particularities of the examples they learn from. For most of the programs, accuracy in this test set ranged from 0.60 to 0.70 as measured by the Correlation Coefficient (where 1.0 corresponds to a perfect prediction and 0.0 is the value expected for a random prediction), and the average percentage of exons exactly identified was less than 50%. Only those programs including protein sequence database searches showed substantially greater accuracy. The accuracy of the programs was severely affected by relatively high rates of sequence errors. Since the set on which the programs were tested included only relatively short sequences with simple gene structure, the accuracy of the programs is likely to be even lower when used for large uncharacterized genomic sequences with complex structure. While in such cases, programs currently available may still be of great use in pinpointing the regions likely to contain exons, they are far from being powerful enough to elucidate its genomic structure completely.

Alternative Splicing↗
PubMed2004

Combining health promotion classroom lessons with health fair activities.

This article focuses on the important role of the school nurse in promoting healthy lifestyle choices through networking, resource identification, and working with community partners. "Everyone Is Healthy at Northeast" was a health promotion program designed and presented in two ways: classroom lessons and a health fair. There were interactive health promotion classroom lessons on topics such as proper hand washing, the effects of tobacco, and keeping one's heart healthy. These lessons were enhanced by community partners in delivering the healthy lifestyle message through a variety of teaching methods: music, interactive games, and hands-on visuals. The health promotion education program culminated in a schoolwide health fair that showcased the healthy lifestyle choice information at various stations. "Everyone Is Healthy at Northeast" was a success and promoted healthy lifestyle choices through creativity, collaboration, and support from the entire school community.

Health Fairs↗
PubMed2002

[Training midwives in developing countries in obstetric ultrasonography: goals and application].

Obstetric ultrasonography is one of the most important advances in antenatal and obstetric emergency care. As part of the program designed to reduce maternal and perinatal mortality, it can provide real patient benefit and should become a standard procedure in developing countries. The midwife is the ideal health worker to practice first level obstetric ultrasonography. Appropriate material can be procured and of specific training can be organized at a moderate cost. Several difficulties are encountered, but there is a solution for each. The concept of the training program is particularly important.

Developing Countries↗
PubMed2004

Differences in smoking and quitting experiences by levels of smoking among African Americans.

BACKGROUND: Despite smoking fewer cigarettes per day than their White counterparts, African Americans have higher tobacco-related morbidity and mortality. Since most tobacco control efforts have focused on heavy smokers, little is known about smoking and quitting experiences of African-American occasional and light smokers. METHODS: We conducted a survey of 484 African-American smokers, which included: 104 occasional (smoked in < or = 25 of last 30 days), 176 light [smoked 1-10 cigarettes per day (cpd)], 69 moderate (11-19 cpd), and 135 heavy (> or = 20 cpd) attending an inner-city clinic. The survey assessed their sociodemographic characteristics, smoking characteristics, and cessation experiences. RESULTS: Compared with moderate and heavy smokers, occasional and light smokers were, on average, younger, more likely to be female, and more likely to initiate regular smoking at an older age. Forty percent of occasional smokers used other tobacco products compared to 23.3%, 24.6%, and 27.4% for light, moderate, and heavy smokers, respectively. Motivation and confidence to quit were higher among occasional and light smokers. Interest in participating in a formal cessation program was equally high in all 4 groups (mean ranged from 7.6-8.0 on a scale of 1-10). The use of pharmacotherapy for smoking cessation was similar, and generally low, among all 4 groups. CONCLUSIONS: High levels of motivation for smoking cessation exist among African-American occasional and light smokers. The interest of these lighter smokers in smoking cessation represents a window of opportunity to design programs for a group that has been excluded from most cessation interventions.

Adult↗
PubMedDate not supplied

Demographic, psychosocial, and medical correlates of Pap testing: a literature review.

The approaches used to ensure regular Pap testing must be tailored to sociodemographic, psychosocial, medical, and motivational factors that may change over a woman's life. Careful descriptions of the determinants of Pap testing at different stages are needed; the success of Pap-emphasizing programs designed without this information may be severely limited. We review the literature on demographic and psychosocial correlates of Pap testing and on the relationship of Pap smear frequency to contact with the medical care system and to preventive health behaviors. We include a discussion of factors related to preventive health behavior in general, so that the Pap test can be viewed against a range of behaviors. Pap program efforts must focus more precisely; our review of the available literature provides recommendations for improving Pap screening programs.

Adult↗
PubMed1977

The hypertension detection and follow-up program: a progress report.

The NHLBI-supported Hypertension Detection and Follow-Up Program (HDFP) is a community-based program designed to assess the value of early detection and vigorous treatment of persons with high blood pressure of varied severity. HDFP staff members have measured the blood pressures of 158,906 persons in their homes or work places in 14 communities across the United States. Of those persons, 10,940 were found to be hypertensive in a two-state screening process and were enrolled in the Program. Half were referred on a random basis to sources of care in the community, and half were invited to the special Stepped-Care clinics sponsored by the HDFP. These clinics, in a vigorous attempt to normalize blood pressure for all these hypertensive participants, stress intensive follow-up and special attention to achieve compliance with treatment. More than 80% under Stepped Care are continuing on therapy after 2 years, and three-fourths of these have achieved desired normal levels of pressure. The majority of hypertensives found in this Program have less severe elevations of blood pressure, and even among them reductions in blood pressure were substantial because of the vigorous follow-up and special attention to compliance. The HDFP is continuing its efforts to find to what extent sustained treatment of those with elevated blood pressure can reduce mortality or complications due to hypertension.

Adult↗
PubMed1995

The public health leadership institute: leadership training for state and local health officers.

This paper describes the Public Health Leadership Institute (PHLI), a program designed to expand and enhance the leadership skills of senior public health officials. The background of PHLI is discussed, and organizations responsible for its organization, governance and funding are revealed. Methods of selecting a cohort of scholars to participate each year, along with the characteristics of scholars selected, are briefly outlined. A calendar of events and description of PHLI curriculum is included. Specific features of the PHLI program, including peer-learning through electronic conferencing, the one-week learning retreat, and the required action-learning projects are described. Also included are results from an evaluation by 99 participants from the first two years of PHLI's existence. The evaluation is based on a survey of the participants' satisfaction with the program and its personal and institutional effects. The Public Health Leadership Institute provides a model of leadership development for senior public health agency officials. The program has been popular with participants, and the vast majority report improved leadership skills. The personal and organizational effects of PHLI address the deficits in leadership identified in the Institute of Medicine's report, The Future of Public Health.

California↗
PubMed1992

Long-term effects of microgravity and possible countermeasures.

It is well known that long-term exposure to microgravity causes a number of physiological and biochemical changes in humans; among the most significant are: 1) negative calcium balance resulting in the loss of bone; 2) atrophy of antigravity muscles; 3) fluid shifts and decreased plasma volume; and 4) cardiovascular deconditioning that leads to orthostatic intolerance. It is estimated that a mission to Mars may require up to 300 days in a microgravity environment; in the case of an aborted mission, the astronauts may have to remain in reduced gravity for up to three years. Although the Soviet Union has shown that exercise countermeasures appear to be adequate for exposures of up to one year in space, it is questionable whether astronauts could or should have to maintain such regimes for extremely prolonged missions. Therefore, the NASA Life Sciences Division has initiated a program designed to evaluate a number of methods for providing an artificial gravity environment.

Adaptation, Physiological↗
PubMed2001

In-home continuing care services for substance-affected families: the bridges program.

Addressing substance abuse in families is an important concern for the social work field. This article presents a preliminary view of a continuing care substance abuse recovery services program designed to assist the substance-affected family. The intervention approach is a blended model of substance abuse recovery work and family preservation. Services are directed at helping substance-abusing parents with "recovering" their role with their families, developing support for their recovery work, and helping them gain the education and skills they need for effective parenting, supportive family involvement, and avoidance of drugs and alcohol. The program focuses on helping substance abusers and their families achieve relapse prevention by addressing functioning in four domains: individual actions and cognitions, individual recovery actions, family actions and cognitions, and family recovery actions. The article presents two case examples to highlight the efficacy of the intervention model and the general positive effect continuing care services are having on substance-affected families.

Adolescent↗
PubMed2003

A community development approach to rural recruitment.

Programs designed to empower rural communities for health care provider recruitment have usually focused on the health care sector without aggressively addressing broader community development issues. The Recruitable Community Project (RCP) in West Virginia includes community education on recruiting and also assessments of and recommendations to rural communities on broad-based community development, aiming to enhance communities' recruiting potential. The project provides multidisciplinary university-based planning assistance programs for small communities, involving collaborative community visits. The project also uses a project manager as a "community encourager" who participates in community education and in the formulation of sustained community recruiting efforts. From August 1999 through August 2001, 7 underserved rural communities completed the RCP organizational processes and hosted planning assistance teams. Members of community recruitment boards gave high marks to the RCP process, its planning assistance teams, and its usefulness in establishing community ties to state and academic agencies. Since working with the RCP, the 7 communities have recruited 27 providers, success possibly stimulated by their RCP involvement (data current as of September 2002). This model of community training and development to empower rural communities to better recruit health professionals shows early promise. This model could be broadened to include more collaboration of community development and health science disciplines programs for recruitment and retention efforts.

Community Health Planning↗
PubMed1992

Instructing occupational therapy students in information retrieval.

The effectiveness of a brief program designed to teach occupational therapy students enrolled in a graduate research methods class to conduct searches of four electronic databases was investigated. Students in the experimental class read an instructional booklet and received approximately 1 hour of supervised practice time using compact disk--read-only memory (CD-ROM) equipment. Questionnaire data revealed that compared with the students in the control class, the students completing the training program reported being significantly more familiar with six of seven key concepts and indicated significantly higher levels of usage of the four databases studied in the program.

CD-ROM↗
PubMed2003

The Canadian Urology Fair: a model for minimizing the financial and academic costs of the residency selection process.

INTRODUCTION: In 1994, the Canadian urology residency training programs designed the "Canadian Urology Fair"--a single-site (Toronto, Ont.), 1-day fair to conduct the personal interview portion of the residency selection process. The objective of the current study was to evaluate the success of the Urology Fair in achieving its original goals of decreasing the financial burden and minimizing time away from medical training for applicants and faculty. METHODS: Both candidates and Canadian urology training programs were surveyed regarding the financial and academic costs (days absent) of attending the 2001 Urology Fair. Data from the 2001 Canadian Resident Matching Service (CaRMS) was used to compare the financial and academic costs of attending personal interviews incurred by candidates declaring urology as their first-choice discipline to candidates interviewing with other surgical specialties throughout Canada. RESULTS: Financial costs incurred by candidates to attend the Urology Fair (mean Can dollar 367) were significantly lower than candidates' estimated costs of attending on-site interviews at the individual programs (mean Can dollar 2065). The financial costs of attending personal interviews by CaRMS applicants declaring urology as their first-choice discipline (mean Can dollar 2002) were significantly lower than the costs incurred by applicants interviewing with other surgical disciplines (mean Can dollar 2744). Financial costs to urology programs attending the fair (mean Can dollar 1931) were not significantly greater than the programs' estimated costs of conducting on-site interviews at their respective program locations (mean Can dollar 1825). Days absent from medical school to attend interviews were significantly lower among CaRMS applicants declaring urology as their first-choice discipline (3 d) compared with applicants who interviewed with other surgical specialties (9.1 d). CONCLUSION: The Canadian Urology Fair represents an innovative and efficient method for residency programs to conduct the personal interview portion of the residency selection process and should serve as a model for making the interview process less expensive and time-consuming for both candidates and faculty.

Absenteeism↗
PubMed2005

Evaluation of the traveling vision examiner program in the submacular surgery trials pilot study.

PURPOSE: To describe methods and results and to assess the value of a Traveling Vision Examiner (TVE) Program designed to provide masked vision measurements by expert vision examiners who were independent of, and traveled to, local clinical centers. METHODS: The Submacular Surgery Trials (SST) Pilot Study was conducted to refine the design and methods for a set of multicenter, randomized clinical trials to evaluate submacular surgery in patients with subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD) or ocular histoplasmosis (OHS), or idiopathic CNV in which the primary study outcome would be change in 2-year best-corrected vision from baseline. As part of the SST Pilot Study, the feasibility and value of a TVE Program was assessed. The goal of the program was to obtain unbiased vision measurements, according to a standard protocol, of best-corrected visual acuity, reading speed, and contrast threshold, of each patient at 2 and 4 years after enrollment. RESULTS: Eighty-three visits by TVEs were made to 16 centers participating in the SST Pilot Study; 239 patients had at least one masked vision examination. Comparison of pairs of vision measurements of the traveling vision examiners and local vision examiners for 71 patients made on the same day showed good agreement overall (intraclass correlation coefficient > or = 0.81). CONCLUSIONS: The proposed TVE Program was judged to be a feasible and useful method of providing standardized, unbiased, masked vision measurements. This approach was incorporated into the larger clinical trials conducted by the SST Research Group.

Choroidal Neovascularization↗
PubMed1983

Neuromuscular electrical stimulation for the head-injured patient.

Recent research has shown that electrical stimulation is effective in treatment programs designed to maintain or gain range of motion, to facilitate voluntary motor control, and to strengthen muscles weakened by disuse. All of these treatment goals are relevant to the head-injured patient who frequently demonstrates profound disuse atrophy, joint contractures with excessive muscle tone, and decreased voluntary motor capabilities. As the cognitive status of the head-injured patient improves, electrical stimulation can be incorporated into traditional treatment programs to enhance their effectiveness. This article discusses using neuromuscular electrical stimulation with programs aimed at managing contractures, reducing spasticity, and facilitating voluntary motion. The limitations of electrical stimulation in the head-injured patient population are addressed.

Adult↗
PubMed2004

Evaluation of an anaphylaxis training program for unlicensed assistive personnel.

This study evaluated a training program designed to prepare unlicensed assistive personnel (UAP) in high school settings to recognize and respond effectively to an anaphylactic emergency. Subjects included 53 adults employed by a high school district in the San Francisco Bay Area of California. A training model was developed based on Bandura's theory of sources of self-efficacy. Knowledge and perceived self-efficacy of participants were measured before and after the training program to determine if a theory-based anaphylaxis recognition and epinephrine auto-injector training program would increase participants' knowledge and self-efficacy in responding to an anaphylactic emergency. Paired t tests revealed significant improvement in scores for both knowledge and perceived self-efficacy following the intervention (p < .001). This theory-based training program offers a valuable model for other school nurses in providing knowledge and skill training for unlicensed assistive personnel in other health emergencies.

Adult↗
PubMedDate not supplied

The effects of attrition on implementing and evaluating a mental health continuing education program for nursing personnel in long-term care facilities.

BACKGROUND: The effects of attrition on a continuing education program for nursing personnel within long-term care facilities are described. METHODS: Allowing flexible participation can enhance the impact of a continuing education program designed for paraprofessional staff. Increasing the number of nursing staff who experience only a portion of the training has implications for the instructional design and the evaluation. Recommendations to improve accommodation of staff and enhance dissemination of training are offered as well as appropriate evaluation techniques. CONCLUSION: Self-contained short units of instruction allow those with minimal time to benefit from the training. Effective evaluation requires special sampling and measurement strategies. Cross-sectional methods make good use of training resources but usually yield measurable changes only in lower-level program objectives.

Education, Nursing, Continuing↗