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Results for “Program Design”

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At least 181 records · Page 10Linked to original sources

PubMed1997

[Contraception in adolescents included in a family planning program].

OBJECTIVE: To describe the motives of consultation, kinds of contraceptive methods and side-effects of oral contraceptives (OCs) in adolescent users of a family planning program. DESIGN: Family planning program at the District Primary Care Unit, Cádiz, Spain. PATIENTS: 283 adolescent females who requested attendance in a family planning program from January 1993 until January 1994. MEASUREMENTS AND MAIN RESULTS: A medical history of every adolescent was carried out and every patient was examined. Those who were recommended the use of OCs passed through 3 controls: at the beginning, after the 6th month and after 1 year. These controls consisted in recording sexual risk behaviours as well as several analytic tests. RESULTS: Most adolescents requested the prescription of contraceptive methods (81.7% of the most prescribed and demanded methods were OCs). We found no serious side-effects after 1 year, so we can conclude that OCs are an usefull contraceptive choice for sexually active adolescents because of its security, acceptance and easy use.

Adolescent↗

PubMed1983

Comprehensive primary care at the neighborhood level: an Israeli experiment that failed.

This paper is an analysis of the first stage of a demonstration program designed to integrate within neighborhood clinics various health and welfare services that were previously provided separately. The program included the active participation of quasi-public, governmental, private, philanthropic, and university institutions. The purpose here is to understand the failure to achieve the original goals and purposes. The analysis takes an organizational perspective, and should contribute to a better understanding of why programs designed to change existing service-delivery systems are inclined to fail. Although this is a case-study of a demonstration program in Israel, the findings should have relevance and interest for academicians and professionals in other countries.

Community Health Centers↗

PubMed1994

DESIGN: a guide to protein crystallization experiments.

Existing guidelines for crystallizing proteins generally require substantial amounts of protein and scarce laboratory resources. To address this problem we have developed the program DESIGN, which, suited to daily laboratory usage, utilizes statistics when screening variables of crystallization. The program DESIGN is described in considerable detail and examples of its outcome and capabilities are shown. In addition, a new scoring scale for crystallization trials is described. It is expected that the use of such an approach may provide additional constraints toward crystallizing the protein, even if the conditions applied are not successful.

Calmodulin↗

PubMed1996

A randomized study of the efficacy of the PROPATH Program for patients with Parkinson disease.

OBJECTIVES: To assess (1) the effects of the PROPATH Program, a health management program designed for patients with Parkinson disease, on perceived general health and psychological well-being and satisfaction with medical care, (2) utilization of health care resources by patients with Parkinson disease, and (3) physician impressions of the PROPATH Program. DESIGN: Patients were randomized to receive either the PROPATH Program in addition to usual care or usual medical care only. All patients and their physicians completed periodic questionnaires designed to assess the study variables. SETTING: Staff model health maintenance organization from June 1992 through June 1993. PATIENTS: Forty-six English-speaking patients diagnosed with Parkinson disease of Hoehn-Yahr stages I through IV. RESULTS: Enrollment in the PROPATH Program resulted in a statistically significant improvement in patient perception of general health and psychological well-being after 1 year. There was no significant difference in patient satisfaction with medical care or utilization of health care resources. The large majority of physicians did not find the PROPATH Program to be helpful for development of a treatment plan, management of the illness, identification of problems sooner than by usual treatment, or identification of drug side effects. CONCLUSIONS: The PROPATH Program may play a useful role in assisting patients to deal with the psychological aspect of Parkinson disease by improving perception of general health and psychological well-being. The program had no significant effect on patient satisfaction with medical care or medical resource utilization.

Aged↗

PubMedDate not supplied

Managed dental care in the HMO setting.

DHMOs are gaining in popularity, and are the fastest-growing dental managed-care product, primarily because of their ability to reduce premium and patient costs. Dentistry, because of the strong correlation between prevention and disease control, is more suited to a managed-care system than medicine. However, there remains a wide gulf between theory and practice, as the DHMO industry continues to evolve. Poorly designed programs will save money but create problems with patient satisfaction and unmet treatment needs. Well-designed programs use the principles of population management to bring large numbers of patients to maintenance oral health levels. In any event, the continuing growth and development of DHMOs will benefit patients, group purchasers, and the dentists who can understand and embrace the concepts of dentistry in the HMO environment.

Capitation Fee↗

PubMed1983

Program development and maternal-child health consultation: a conceptual model for role enactment in developing countries.

Increasingly, nurses are serving as consultants in designing programs to improve the health of individuals in developing countries. In order to be effective, such programs must reflect the socio-cultural context in which identified health problems occur. This can become problematic when nurses work as consultants in cultures with which they are unfamiliar. This paper proposes the use of the World Health Organization's risk strategy approach as a conceptual framework for developing culture specific programs in maternal-infant health. Suggested consultant role behaviors are articulated with this approach and the various phases of program development using an ongoing project in Juarez, Mexico to which the author has provided nursing consultation as a concrete example.

Child Health Services↗

PubMed1986

DIGICALC: a restriction fragment analysis program.

DIGICALC is a program designed to aid in the acquisition, storage, and analysis of nucleic acid restriction fragment data. The chief considerations during program design were (i) ease of use for people with varying degrees of computer experience, (ii) minimal hardware requirements (e.g. an IBM PC), (iii) portability and ease of modification, and (iv) improved functionality in sizing and comparing restriction fragments over manual methods. The program accepts manual or digitizer input of nucleic acid fragment mobility, calculates the fragments' sizes, and provides the means to search the fragment database and to produce charts of fragment sizes.

Base Sequence↗

PubMedDate not supplied

Low back pain: risk evaluation and preplacement screening.

As screening tests in a currently asymptomatic population, all of the available methods for predicting low back pain and disability have serious technical, ethical and legal limitations. From a technical point of view, none of the predictive tests appear to have sufficient sensitivity or specificity to justify routine usage. The most sensitive indicator (a past history of low back pain) lacks reliability and specificity. Muscle strength-testing may be predictive of future musculoskeletal injury as part of a well-designed program that considers specific job demands in relation to specific worker capabilities. Unfortunately, the conditions necessary for a well designed program--a large number of predictable high-risk jobs that have measurable specific demands that can be reproduced reliably in a testing situation--are rarely met. In the future, the use of computer-assisted multivariate models analogous to those used in the prediction of cardiovascular risk may be capable of integrating information about an individual's medical history, physical exam, physical capacity and other tests with specific job requirements to give us a more accurate prediction of the future risk of back pain and disability. If such predictive models are ever developed and verified, it would then be appropriate to examine various interventions and their effectiveness in modifying risks for the population and the individual worker. From a legal point of view, all of the techniques described hold potential for significant discrimination against legally protected groups. Making employment decisions with regard to a past history of low back pain or on the basis of an x-ray will lead to systematic age discrimination and discrimination against the handicapped. The use of muscle strength-testing will systematically discriminate against women and certain ethnic groups. The ethical implications of predictive screening for low back pain clearly depends on what is done with the information that is garnered from such tests. If the information is used only to make a safe job placement for an individual, and this placement does not affect the individual's salary or future job possibilities, then the testing program may have a net social value to the extent that it leads to true prevention of low back pain and disability. If the tests are used merely to reduce employer liability by refusing employment to those who are thought to be at "high risk," the technical, legal and ethical limitations will far outweigh any perceived benefits.

Back Pain↗

PubMed1990

Clinical pastoral education for laity.

Medical science, with its high technology, has had a major impact on today's hospitalized patient. Not only has the length of stay been shortened dramatically but the level of illness is much more intense. Both of these factors have influenced the role pastoral care plays as a member of the health care team if patients and families are to receive holistic care. Carefully selected and trained laity can help meet the expanding pastoral care needs of hospitalized patients. This article describes a program designed exclusively for laity, which equips these volunteers through a clinical process similar to that of Clinical Pastoral Education (CPE). The authors contend that any program designed to prepare laity for pastoral care must include the clinical component. Their experience with 38 laity who have completed the program described in this article has led them to the conclusion that such a process inspires a dynamic growth in faith as laity claim their rightful authority in pastoral care.

Chaplaincy Service, Hospital↗

PubMed1990

Comparing nutrition programs conducted by public health and Cooperative Extension personnel.

We surveyed 218 county extension agents, 75 state extension specialists, 163 public health nutritionists, and 87 public health administrators in 16 states to compare the nutrition program characteristics of extension personnel with public health personnel. Public health personnel were most strongly influenced by funding regulations--more than 80% of public health nutritionists cited infant/preschool nutrition and nutrition for pregnant/lactating women as program topics. About half of the extension agents listed food preservation and preparation as the dominant topics provided. Public health personnel most frequently designed programs for pregnant and lactating women and low-income clientele; 91% of the nutritionists ranked one-to-one counseling as one of their three most important delivery methods. Extension personnel designed programs more often for homemakers/adults and youth and ranked a combination of group and media delivery methods as most important. Public health personnel use anthropometric measures and food intake records to evaluate their programs; extension personnel use written questionnaires and program records. More than 50% of the nutritionists ranked improving the health of their clients as one of the three most important impacts of their programs; more than 50% of the extension agents ranked increasing knowledge and improving skills as their most important impacts.

Dietary Services↗

PubMed1993

Medicare program; revised designation of states in which Medicare SELECT insurance policies may be issued--HCFA. Notice.

Section 4358(c) of the Omnibus Budget Reconciliation Act of 1990, provides for the designation of 15 States in which Medicare supplemental insurance policies (commonly referred to as "Medigap" policies) may be approved for issuance as Medicare SELECT policies during the period January 1, 1992 through December 31, 1994. This notice announces two revisions in the list of States designated under this authority.

Centers for Medicare and Medicaid Services, U.S.↗

PubMedDate not supplied

Culture and the management of family planning programs.

Integrating family planning programs with local cultures can increase or undermine their effectiveness. Program design and organization will be influenced by kinship and reproductive decision-making, which varies across regions, racial and communal divisions, and religions. Program implementation depends on four aspects of culture: (1) the understanding, acceptance, and continued practice of family planning by clients; (2) the climate in the organizations responsible for fieldwork, which affects the disposition to work and the tasks to be done; (3) the ability and willingness of field implementers to do their work; and (4) the communities in which clients live, including collective attitudes toward family planning and local pressures put on clients to participate. The Indonesian family planning program is a case in which these elements of culture are often positive. Other programs, such as that in Kenya, have a more negative environment for action.

Cross-Cultural Comparison↗

PubMed1985

Educational and exercise programs for asthmatic children.

We designed programs to teach appropriate exercises to asthmatic children and to educate their parents about their special needs. Each of 11 programs over a six-year period included a weekly two-hour session for four weeks. Lectures for parents dealt with the etiology and precipitating events of asthma, environmental control and drug therapy, family interaction with a psychiatrist, and hyposensitization therapy and food allergy. The 59 children, aged 4 to 13, played group games, learned breathing exercises, and were assisted by their parents in postural drainage. School absences decreased in 59%, emergency room visits decreased in 70%, medication usage decreased in 54%, and the number of attacks decreased in 70%. Greater understanding of asthma by both parents and children improved the quality of life and lessened the severity of the disease.

Asthma↗

PubMed1997

Self-directed patient education in soft-tissue rehabilitation: rationale and analysis of a pilot project.

OBJECTIVES: To determine the compliance level and topic choice selection frequency of rehabilitation patients in a self-directed education program offered in conjunction with a rehabilitation exercise program. DESIGN: Descriptive study. SETTING: Soft-tissue injury rehabilitation clinic located within a chiropractic college. SUBJECTS: Twenty-four rehabilitation patients with injured spines who were enrolled in a daily in-clinic program. OUTCOME MEASURES: Data was collected from patient log-book pages, which recorded frequency of use, topic, medium and personal satisfaction for each selected resource. Clinic attendance data was collected by the clinical staff. RESULTS: Eighty-one percent (81%) of the patient group voluntarily used the learning center. Average frequency of use was approximately one visit per patient per week. Of the 13 subject areas included in the resource center collection, back injury care (30), nutrition (22) and fitness/exercise (14) received the most use. Patient satisfaction with the resources' value/interest averaged 78.4%. CONCLUSIONS: Most (81%) patients in this group were willing to spend some of their own time learning information that they thought was important. The results may allow for patient education program designs that put more responsibility for learning with the patient and allow for more efficient clinician time allocation.

Adult↗

PubMed1989

Project SMART parent program: preliminary results of a chronic disease risk reduction trail.

Project SMART Parent Program is a school-based healthy lifestyle promotion program designed to reduce chronic disease risk in adults and to provide a health-conscious home environment for children through the adoption of healthy lifestyle by their parents. Parents in the high involvement condition received comprehensive health status appraisals, and a program designed to reduce dietary fat intake, and increase aerobic activity levels. Parents in the low involvement condition received only the comprehensive health status appraisals. ANCOVA, using treatment condition as the independent variable and change scores as the dependent variables, were used to assess program outcomes. At the first posttest measure, the intervention group compared to the control group had a significantly greater decrease in blood cholesterol, a greater gain in aerobic fitness, a greater weight loss, and a greater decrease in body fat. At the second posttest measure, the intervention group had significantly greater gain in aerobic fitness, a greater decrease in body fat, a greater decrease in systolic blood pressure, and a marginally significant decrease in weight. Preliminary results provide strong support for the effectiveness of the Parent Program in reducing chronic disease risks.

Adolescent↗

PubMed1997

[The Breast Program--25-year role of the health service].

In screening for breast cancer, the discovery of screening positive cases can be carried out either with screening mammographic examination, with breast physical examination, or with breast self-examination. The screening positive cases should be examined with diagnostic mammographic examination. In BSE-screening, one-way communication about BSE does not influence health behaviour like e.g. monthly BSE-performance, followed by self-referral to a physician if breasts change from normal. Aimed at behavioural change, two-way communication strategies are needed in comprehensive program designs. The finnish Mama Program Screening is based on delivery of the message with two-way communication and the use of specially designed Mama-calenders for follow-up of the health behaviour of the participants during the continuous program. In a cohort, exposed to the Mama Program, compliance with BSE increased from 2% to 55% monthly performance. Two percent self-referred to the diagnostic mammographic examinations arranged within public health care facilities. In a 14 years follow-up of the complying women, 20% more breast cancers were detected than expected and mortality from breast cancer was 29% less than expected in all age groups. The Mama Program Screening has been implemented in public health care in Finland on a voluntary basis as an easy and inexpensive basic screening for women in all ages. It can be implemented in different PHC and private health care systems.

Adult↗

PubMed1983

Integrating cognitive strategies into the physical therapy setting.

Effectively integrating cognitive management concepts into the physical therapy setting is dependent upon an adequate understanding of the cognitive and behavioral consequences of head injury and the appropriate use of diagnostic and prognostic cognitive data as a basis for program design. The intent of this article is to provide a framework for simultaneously addressing the physical and cognitive consequences of head injury. Behavioral manifestations of cognitive dysfunction and a means of clinically observing and assessing patient performance are provided as a basis for program design. Specific examples of treatment strategies applicable to various phases of cognitive recovery are described.

Behavior↗

PubMed1996

Implementation of neck/shoulder rehabilitation in primary health care clinics.

OBJECTIVE: To provide primary health care practitioners with the practical information necessary to implement rehabilitation of patients with neck/shoulder pain in clinical facilities. Equipment and program design are discussed in detail. DATA SOURCE: A Medline literature search was performed. English and Scandinavian language references were included in the review. Key words included neck/shoulder pain, neck pain, rehabilitation, equipment, exercise. STUDY SELECTION: The studies selected included clinical trials in which rehabilitation was the main intervention in the treatment of patients with neck/shoulder pain. DATA SYNTHESIS: Reestablishing functional capacities of the musculature of the cervical spine can be accomplished with modest equipment and can be easily incorporated into the clinical setting. The extensors of the cervical spine are the most important muscle group that require rehabilitation and exhibit the highest values in all strength parameters. High-intensity rehabilitative protocols accompanied by the encouragement of fellow patients and support from personnel are essential for treatment success. CONCLUSIONS: Complete primary health care treatment of patients with chronic, recurrent and post-traumatic neck/shoulder pain will necessitate longer rehabilitation programs. Future studies will provide additional information regarding specific program design.

Arthralgia↗