Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Mandatory Programs”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,765 records · Page 98Linked to original sources
PubMed2005

[Rational treatment of uncontrollable, life-threatening hemorrhage with recombinant factor VIIa].

We present a standardised treatment algorithm used to treat life-threatening haemorrhage (LTH) due to trauma, surgery, or delivery at Rigshospitalet, Copenhagen University Hospital. Balanced transfusion therapy and infusion of fibrinogen must precede recombinant factor VIIa (rFVIIa) treatment. rFVIIa is indicated in patients with uncontrollable LTH ( > 1 blood component per 10 kg of whole body weight per hour) despite surgical treatment and adequately balanced transfusion. We recommend rFVIIa at a dose of 100 microg/kg. The dosage recommendation is not evidence-based. A thorough, prospective surveillance program to monitor the treatment's efficacy and safety is therefore mandatory. The Blood Bank services, guides and coordinates the treatment.

Blood Component Transfusion↗
PubMed2006

[Status of the clinical laboratory in the mandatory postgraduate medical training system: from the medical technologists' view (2)].

When the new system of mandatory postgraduate medical training was introduced, we developed a new training program in our clinical laboratory. We will describe this training program in the microbiology laboratory and our experience. We have had 45 min practice of basic microbiology tests, including Gram staining and microscopic examination, for first-grade postgraduate doctors since 2004, and during this practice we emphasize the importance of quality in the clinical specimens collected for cultures and at the same time, explain how to read microbiological test results. Although we had prepared a kit for the Gram-staining procedure to be used any time they want, it was very disappointing that no doctors used this kit to diagnose an infectious disease. In 2005, four 2nd grade doctors selected the training course in our clinical laboratory for 2 months and 3 of them have finished. In the microbiological laboratory we were in charge of the program for 1 or 2 weeks, which includes the isolation and identification of bacterial pathogens from clinical samples and their susceptibility tests, and the isolation, identification and nucleic acid amplification test for Mycobacterium tuberculosis. All of these trainees acquired the basic knowledge and skills required for microbiological diagnosis. This activity gave us a great opportunity to understand what they do not know and what they want to know. We now have some useful suggestions to develop a good education system for medical microbiology for postgraduate doctors.

Education, Medical, Graduate↗
PubMedDate not supplied

Promoting heart health promotion.

Prevention of ischaemic heart disease is a priority for public health. Revised Mandatory Guidelines have resulted in substantial investment in individual healthy lifestyles programs and local health units have been encouraged to develop comprehensive heart health promotion programs. Initiatives to support this direction include the Heart Health Action Program, the Canadian Heart Health Initiative, the Ontario Heart Health Network, the Report of the Chief Medical Officer of Health and the Teaching Health Unit program. In spite of this, local health units have been slow to adopt comprehensive heart health approaches. The Canadian Heart Health Initiative-Ontario Project (CHHIOP) is studying the dissemination of community heart health programming, particularly factors influencing adoption by local public health departments. CHHIOP's observational component uses province-wide health unit and community "scans" and in-depth studies using qualitative methodology. CHHIOP's interventional component is developing a provincial linkage system.

Canada↗
PubMed1997

The high grade match kidney sharing algorithm of the South-Eastern Organ Procurement Foundation (SEOPF): altering recipient demographics through improved matching.

BACKGROUND: Studies of kidneys shared through the South-Eastern Organ Procurement Foundation (SEOPF) have shown that regional organ procurement (ROP) trays can predict negative crossmatch in highly sensitized patients when the HLA match is of a high grade. In an attempt to offer more well-matched kidneys to highly sensitized patients, SEOPF organized the High Grade Match (HGM) Program. METHODS: This United Network for Organ Sharing (UNOS)-approved allocation variance requires mandatory sharing of all kidneys by participating centers after UNOS mandatory sharing requirements have been met. The HGM levels of sharing are: (1) 0 A,B mismatch (MM); panel-reactive antibody (PRA) > or = 40%; negative ROP crossmatch; (2) 0 B,DR MM with > or = 40% PRA; negative ROP crossmatch; (3) 0 B,DR MM with PRA < 40%. Non-HGM cadaveric transplants at the same participating centers--locally or distally procured--serve as the control group. RESULTS: During the first 18 months of this program, the 23 participating centers shared 124 kidneys of the 1592 that were available. Well-matched kidneys (two mismatches or less) accounted for 91.1% in the HGM group, but only 19% of the controls (P<0.0001). Highly sensitized patients (PRA > or = 40%) represented 13.8% of the HGM group, but only 3.3% of the non-HGM group (P<.0001). With HGM kidneys, there was a shift in recipient demographics. Patients with blood group O, female patients, older patients, and retransplanted patients all accounted for significantly larger percentages of the HGM group compared with the non-HGM control group. The racial composition of the recipients of high-grade matches was, however, no different than that of the control recipients at the same centers. CONCLUSION: The HGM Program resulted in longer ischemia times, but graft survival was not affected. The 1-year actuarial graft survival rate (Kaplan-Meier) for HGM kidneys was not different from the control cadaveric graft survival rate. By sharing kidneys based on improved HLA matches with consideration for high PRA, the HGM Program offered more transplant opportunities to women, blood group O recipients, retransplants, and older patients.

ABO Blood-Group System↗
PubMedDate not supplied

Is your OSHA compliance program up to date?

OSHA safety inspections in dental offices have decreased dramatically over the past several years. But this development does not mean that compliance with safety regulations is no longer mandatory. Recent changes and some additions to the OSHA regulations should serve as a catalyst to review and update your office safety program. This article highlights the new standards and proposes a plan for such a review.

Dental Offices↗
PubMed2003

Regimented research: a recipe for success?

Cardiology trainees at the University of Toronto participate annually in a mandatory research competition. Its purpose is to promote creative thinking, help develop a greater understanding of the scientific method and encourage them to pursue research as a career. Since its inception, this research competition's outcomes have not been assessed. This study set out to determine which components of a cardiology training program are important in the development of a career in cardiovascular research and addressed whether participation in this mandatory research competition was considered important to the development of a career in cardiovascular research. This study found that both faculty and trainees considered the following factors to be important in the development of a research career: (1) a mentor to provide support and guidance; (2) regular attendance at national and international meetings; (3) a fixed block of time within the training program dedicated solely to research activity; and (4) an academic environment that provides exposure to clinicians with varied research interests and ability. Neither trainees nor faculty believed that mandatory participation in a research competition was of significant benefit in the development of a research career, although faculty's perception of such a benefit was greater than the trainees'.

Biomedical Research↗
PubMedDate not supplied

[The toxicology and prevention of the risks of occupational exposure to aromatic polycyclic hydrocarbons. III. The effects: epidemiological evidence, early effects. Individual hypersusceptibility. Health surveillance].

Adverse effects following occupational exposure to polycyclic aromatic hydrocarbons (PAH) are mainly carcinogenic. The available epidemiological data suggest that some substances and industrial processes, in which PAH exposure is frequent, are classified as carcinogenic to humans: primary aluminium industry, cola gasification, coke production, iron and steel foundry, coal tar, pitch, creosote, untreated mineral oils, asphalt, soot. The target organs are mainly lung, bladder, skin. Other relevant effects are skin lesions such as folliculitis. The studies on early biological effects (chromosomal aberrations, sister chromatid exchanges, micronuclei) have shown contradictory results, mainly because of differences in exposure intensity. The metabolic polymorphism may account for a higher susceptibility to lung and bladder cancer following exposure to risk factors; the role of PAH occupational exposure is however to be examined, and the use of indicators of genetic susceptibility is currently limited to research programs. Health surveillance for PAH exposed workers is funded on the Italian laws (DPR 303/56 and D.Lgs. 626/94) and it is mainly dedicated to prevention of carcinogenic effects. Preventive examinations should consider PAH target organs (skin, lung, bladder, larynx) and look for early signs and symptoms. Particular attention will be paid to life habits such as tobacco smoking or diseases which could represent condition of susceptibility. Periodical examinations (every six months) will similarly evaluate PAH target organs. Health surveillance is also programmed for formerly exposed workers and the institution of exposure and cancer registries is mandatory. On the basis of the current scientific data, it is not advisable the use of tumor markers or cytogenetic tests at the individual level as well as the screening of asymptomatic PAH exposed workers for early diagnosis of lung or bladder cancer. Information and formation activities will be part of medical examinations and will be included in specific programs in cooperation with other company functions.

Carcinogens↗
PubMed1997

Pregnancy and addiction: translating research into practice.

In some areas of the United States pregnant women are incarcerated if they are addicted to illegal substances, particularly crack cocaine. However, incarceration does not happen to all pregnant addicts, but instead reflects racial/ethnic and socioeconomic categories of prejudice. In the following article, the authors suggest that analysis of this pattern of incarceration is clarified by the use of critical medical anthropology perspective with its explicit historical, political and economic foci. In addition, the authors introduce a program for addicted women that incorporates into practice the findings of the initial research and demonstrates how research can be translated into practice.

Adult↗
PubMed1993

Developing a comprehensive maltreatment intervention program.

The dental health care professional must understand that every individual cannot be saved from maltreatment, but the task is not futile. Suspicion must be investigated. The responsibility for investigating reports of suspected maltreatment lies at the state level. Every state has established a protective service reporting agency. Begin by determining the names and addresses of the protective agencies in your area and the procedure for reporting suspected cases of maltreatment. Determine the most effective and thorough means of gathering current and relevant information on the detection and proper evaluation of maltreatment. Consider the knowledge and training that dental personnel need to make an intervention program successful. Decide now dental staff should proceed and what timetable should be set for the implementation of an intervention. Dental health care providers must be a part of coordinated effort involving all groups concerned with the welfare of the aged and the young. Be proactive not reactive. Additional information may be obtained from the ADA's Council on Dental Practice at 1-800-621-8099, ext. 2895; the National Center on Child Abuse and Neglect, Department of Health & Human Services, P.O. Box 1182, Washington, D.C. 20013 (703) 821-2986; or the National Committee for the Prevention of Child Abuse 111 E. Wacker Drive, Suite 510, Chicago, IL 60601. Reporting agencies include: local department of public welfare; local police department; state departments of public welfare; state department of health & human services; national child abuse hotline, toll free (1-800-422-4453).

Adult↗
PubMed1991

The impact of Blue Cross and Blue Shield Plan utilization management programs, 1980-1988.

This study evaluates the aggregate and temporal impact seven Blue Cross and Blue Shield Plan utilization management (UM) programs have on hospital utilization and payments over a nine-year period, 1980 through 1988. The impact of these programs is determined using a statistical model that controls for variations in organizational characteristics of 56 Blue Cross and Blue Shield Plans, the health care market of the individual Plan, and several state and federal health care regulations. The statistical results indicate that over the entire period 1980 to 1988, preadmission certification, concurrent review, and denial of payment (as a part of the retrospective review program) programs were associated with lower hospital admissions, and fewer inpatient days and payments per 1,000 members. Mandatory second surgical opinion did not have a statistical impact on hospital utilization and payments. The aggregate reduction in hospital payments for all Blue Cross and Blue Shield Plans with both a preadmission certification and concurrent review program was estimated at $2.55 billion in 1988 dollars. For those Plans conducting preadmission certification, concurrent review, denial of payment, and case management programs in 1988, the total per enrollee reduction of inpatient payments was $52.94.

Blue Cross Blue Shield Insurance Plans↗
PubMed1986

The impact of aeromedical helicopter programs on emergency medicine resident training: resident attitudes, perceived risks, and benefits.

Using emergency medicine residents as helicopter flight physicians is a recent evolution in residency training. In an effort to study the impact such a system has on residents in emergency medicine, residents participating in helicopter transport were surveyed at 10 programs in the United States. The potential survey field was 118 residents with (81%) responding. Generally helicopter transport was perceived to be educational (80%), enjoyable (88%), and safe (74%). A total of 75% felt that benefits of transport outweighed the risks, despite an increase in aeromedical helicopter fatalities in 1985. In six of ten programs residents wore shoulder restraints, in two they wore helmets, and in no program were fire-retardant clothing worn on a regular basis. Of the 72 residents involved in mandatory participation, 69% would continue flying in a voluntary system. Although it is clear that selected patients benefit from aeromedical transports, refined triage protocols as well as further studies to identify the costs and benefits of such transport programs to participating emergency medicine residents are needed. Flight safety equipment including helmets, shoulder-harness restraints, and fire-retardant suits are underutilized at all programs surveyed.

Aircraft↗
PubMed1999

A reconditioning program to lower the recurrence rate of brachial plexus neurapraxia in collegiate football players.

OBJECTIVE: To present clinical techniques for managing class I brachial plexus neurapraxia (BPN) in collegiate football players. BACKGROUND: During a football career, up to 50% of college football players develop BPN. It is difficult to return the player to practice and competition without many recurrences during the same season. Postseason reconditioning programs may improve the outcome by allowing the injured nerves a chance to heal adequately. Flexibility and strength of the neck and shoulder girdle are the focus of this proposed postseason BPN reconditioning program. This clinical technique is designed to reduce or eliminate inflammation, weakness, and hypomobility that contribute to reinjury of the brachial plexus and the resulting class I BPN. DESCRIPTION: After the football season, the team physician performs a mandatory follow-up examination. Any pathology that may be exacerbated is ruled out before beginning this program. Conservative management is prescribed during the first 4 weeks postseason. Then an 8-week period of aggressive reconditioning is initiated. Players begin manual resistance and Nautilus neck machine exercises 3 times per week. A cervical spine mobilization and modified shoulder resistance program is performed 2 days per week. Subsequently, players proceed with modification of the general neck and shoulder program used by the rest of the squad. Shoulder pad and neck orthoses selection should be reviewed to ensure that the best protection against reinjury is used when the athlete returns to play. To minimize any chance of recurrence, a progressive pattern of gradually increasing collision work is employed after the athlete is cleared by the physician. CLINICAL ADVANTAGES: Postseason observation of players after 1 year should reveal decreased recurrence of brachial plexus injury. The reconditioning program format, together with protective equipment considerations, may have a significant effect in reducing or eliminating the recurrence of BPN in football players.

Journal Article↗
PubMed1997

1995 survey of physics teaching efforts in radiation oncology residency programs.

A physics teaching survey was constructed and sent to the 83 radiation oncologist training programs. The survey requested program information regarding size, staffing, curriculum, lab/rotation programs, organization, requirements, instructor makeup, teaching materials, and board certification examination results. The surveys were sent to the physicist responsible for the physics program. Forty-nine (59%) institutions returned completed surveys, of which 43 (88%) were university-associated programs, and 27 (55%) were 4-year programs. On average, there were two residents/year. Most programs (39) taught physics exclusively during the first year (PG2). Some programs taught different subjects (or levels) to different year residents. Radiation dosimetry, treatment planning, and brachytherapy constituted nearly half of the teaching hours. On average the total classroom time expended by physicists was 61.4 h/year with a range of 24-118 h. The mean for laboratory/demonstration time was 27 h/year with 18 programs providing none. Physics orientation/rotations ranged from 1 to 480 h with a mean of 170 h for a physics rotation taking place in year 2 (PG3). Mandatory attendance was 80% for first-year residents and decreased in later years. Homework was assigned in 76% of the programs, and 65% of the programs were graded. The primary instructors averaged 18.2 years of experience, and the majority were ABR/ABMP certified. Khan's textbook was the most prevalent resource for most subjects. No correlation could be made between teaching hours and ABR physics percentile scoring. The survey results reveal enormous differences in national teaching efforts.

Curriculum↗
PubMed2004

Breastfeeding peer support programs.

A review of nursing research literature recommends peer support for breastfeeding mothers, as it contributes to better breastfeeding duration and exclusivity rates. Promoting and supporting the development of breastfeeding peer support is a requirement of the Ontario provincial mandatory guidelines The Breastfeeding Peer Support Network project was an initiative of the city of Ottawa's Healthy Babies, Healthy Children program, and was designed to identify best practices for peer support programs The recommendations for a breastfeeding peer support network were developed as part of a clinical placement by an MScN student from the University of Ottawa. This article describes the literature search and a survey of Ontario health units and the resulting recommendations for a peer support program. Twelve Ontario health units were contacted. Interviewing nurses for this scan yielded a wealth of ideas for developing a peer support program. The final recommendations include suggestions for program design, ongoing program coordination and evaluation and development of the peer educators/volunteers network, including recruitment, orientation, ongoing in-services, documentation and recognition.

Breast Feeding↗
PubMed2005

Satisfaction of impaired health care professionals with mandatory treatment and monitoring.

OBJECTIVE: To measure the satisfaction of impaired health professionals with treatment and monitoring programs in Michigan and Indiana. METHOD: Mailed surveys assessed overall program satisfaction, usefulness of various aspects of monitoring, and several miscellaneous items. Persons active in the Michigan (n = 620) and Indiana (n = 267) programs in July 2002 were included. Anonymous responses were received from 263 (43%) of Michigan and 120 (45%) of Indiana participants. RESULTS: Means on the 1 to 5 satisfaction subscale were 3.6 (SD = .94) for Michigan and 4.1 (SD = .86) for Indiana. Means on the 1 to 4 monitoring subscale were 2.7 (SD = .62) for Michigan and 2.7 (SD = .57) for Indiana. 40% of Michigan respondents and 53% of Indiana respondents lacked insurance coverage for program costs. 39% of Michigan and 35% of Indiana respondents reported substance abuse or mental health difficulties prior to their professional career.

Adult↗
PubMed1975

Delivery of health care in hemophilia.

Data on 56 severe and 16 moderate hemophiliacs who were intensively trained in self-therapy and have completed one to five years on this program reveal several principles not emphasized by prior reports. (1) The immediate application of therapy for suspected hemarthrosis, before the appearance of physical signs, leads not only to a striking decrease in morbidity but to a slight decrease in the quantity of plasma products required. (2) Dollar costs of this method of health care delivery are considerably lower than other effective methods and now average $3500 per patient per year, in our hands. (3) Intensive education and training of patients and family members makes lay persons extremely valuable members of the health care team and produces occasional dramatic health benefits. (4) Progression of long-term problems such as hemarthrosis, formerly found in 90% of our group, still exists for 19%. (5) The failure rate is highest in the older hemophiliacs. (6) Periods of several months of prophylactic therapy have a limited but valuable role in selected cases. (7) Mechanisms for mandatory periodic comprehensive health evaluation mjst be a part of every home infusion program, in order that the inevitable failures can be detected and appropriate corrective measures instituted.

Delivery of Health Care↗
PubMed1991

Autologous hemodonation in the corrective surgery of craniostenosis.

Homologous transfusions are mandatory in most surgical procedures for correcting craniofacial malformations in infancy. A program of preoperative and intraoperative auto-hemodonation was developed and carried out in eleven infants. Although homologous transfusion could have been avoided in only 7 patients, we think that further experiences and minor corrections of our program may improve these results.

Blood Transfusion, Autologous↗
PubMed1982

Trial of labor following cesarean section: a two-year experience.

Elective repeat cesarean section is one of the major factors responsible for the increase in the total cesarean section rate observed since 1970. Beginning in January, 1980, a voluntary program encouraging a trial of labor for patients with a documented previous low-transverse cesarean section and no apparent recurring indication was instituted. Two hundred seven patients were managed with an adequate trial of labor, and 84.5% were delivered vaginally over a 2-year period. There were no deaths associated with a trial of labor, and maternal and fetal morbidity was negligible. This voluntary program resulted in a 27.9% decrease in the repeat cesarean section rate over the 2 years reported. Patient and physician acceptance of such a program was evaluated by follow-up questionnaires. Current recommendations include a mandatory trial of labor in patients with only one previous low-transverse cesarean section and no current indication for cesarean delivery. A more liberal management policy regarding patients with two or more previous low-transverse cesarean sections also seems warranted.

Cesarean Section↗