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Effects of biofeedback-assisted attention training in a college population.

A program of stress management employing open-focus attention-training workshops was developed at Baruch College to bring the benefits of stress reduction to students. The purpose of the research reported here was to evaluate the results of the open-focus attention-training technique. Open-focus technique without biofeedback training was used for two semesters. Biofeedback training was incorporated in the third semester. In the first study, changes in grade point average (GPA), stress-related symptoms, and physiological measures were examined. The experimental subjects' stress data for this study was reported previously (Valdés, 1985). In the second study, changes in the same variables for experimental and control subjects were evaluated. Students in the control group showed decreased GPA, while those who participated in open-focus training showed a trend toward improved GPA. Stress-related symptoms associated with anxiety and management of emotional problems showed significant posttraining improvement, as did physiological measures in all of the biofeedback modalities in which the experimental subjects were specifically trained. The results support the hypothesis that the workshops were successful in reducing stress levels, and suggest that further controlled research be conducted to verify these findings, and to identify the most effective components of the training procedure.

Achievement

A comprehensive approach to dental health in a school population.

A program to provide school children with dental health education and preventive services was initiated by the Boston University School of Graduate Dentistry. This program utilized several generally untapped resources. The emphasis was on classroom education using teachers who were motivated by special workshops as well as students of dental auxiliary training programs. These dental auxiliary students under the supervision of a dental health educator were used to educate the classroom teachers as well as to teach children in the classroom. Direct dental services were also provided in the program in the form of preventive services utilizing an unused dental chair available at a school.

Boston

[An increase in the knowledgeability of the population on the problem of arterial hypertension as a result of conducting a secondary prevention program in a nonorganized rural population].

The paper is concerned with evaluating the efficacy of sanitary and health measures carried out within the framework of the program of secondary prophylaxis of arterial hypertension (AH) in an open rural population in terms of changes in the information of the community about hypertension. The program included regular radio transmissions, talks and lectures pertaining to the problems of essential hypertension prevention and treatment. During 4 years, the information of the respondents about hypertensive action of table salt increased 4-fold (from 8 to 32.3%), especially among persons suffering from AH. The number of persons who referred to overweight as one of AH causes rose 6-fold (from 2.6 to 18.1%). The information did not depend on the sex, age, or the presence of hypertensive factors in the examinees. Alterations were recorded in the attitude of the examinees to AH and its treatment: the portion of those who took hypotensive drugs increased more than 2-fold (from 10.9 to 23.4%) whereas the percentage of subjects treated successfully from 6.8 to 10.1%. The data obtained attest to a high enough efficacy of sanitary and health measures in relation to AH in the rural population.

Adult

Probabilistic incremental program evolution

Probabilistic incremental program evolution (PIPE) is a novel technique for automatic program synthesis. We combine probability vector coding of program instructions, population-based incremental learning, and tree-coded programs like those used in some variants of genetic programming (GP). PIPE iteratively generates successive populations of functional programs according to an adaptive probability distribution over all possible programs. Each iteration, it uses the best program to refine the distribution. Thus, it stochastically generates better and better programs. Since distribution refinements depend only on the best program of the current population, PIPE can evaluate program populations efficiently when the goal is to discover a program with minimal runtime. We compare PIPE to GP on a function regression problem and the 6-bit parity problem. We also use PIPE to solve tasks in partially observable mazes, where the best programs have minimal runtime.

Journal Article

The contribution of social science research to population policy and family planning program effectiveness.

Social science research has made important contributions to population policy and to the effectiveness of family planning programs. Social science concepts, theories, and methods potentially are relevant to all aspects of reproductive behavior, including actual fertility, proximate variables, and desired family size. Social science research also contributes to the understanding of the social, economic, and political institutions that potentially affect, either directly or indirectly, the whole biosocial reproductive system and family planning programs. At least as important as its specific theories and findings is the role of social science in testing how to adapt such knowledge to distinctive national and local cultural circumstances of family planning programs. A central point is that carefully monitored pilot projects are desirable before launching full-scale national programs, as well as being continuing resources for program development. The research on early programs in Asia has been important, because those programs encountered and overcame some of the presumed obstacles to new programs.

Asia

Antacid use in an ambulatory elderly population. A report from Dunedin Program.

Antacid use was studied in a population of 3192 elderly ambulatory subjects. Antacids were used by 18.6% of women and 12.9% of men. Three common antacid products accounted for 63.8% of all antacids used by these subjects. Serum phosphorus concentrations of participants using aluminum antacids were significantly lower than in a nonantacid user control group (P less than 0.02). Total protein and serum calcium concentrations of subjects using aluminum and magnesium combination antacid products were significantly lower than the control group (P less than 0.001 and P less than 0.04). Men using calcium carbonate antacids reported diarrhea significantly more frequently than control subjects.

Age Factors

Influence of diagnostic and treatment factors in the population pharmacokinetics of gentamicin.

Using the NONMEM program, the population kinetics of gentamicin were retrospectively studied in a series of 51 patients with different pathologies undergoing treatment (single or three daily doses) with gentamicin whose serum gentamicin levels were being monitored. Renal function, the type of treatment and cancer proved to be the covariates which affected drug clearance, while patient weight was found to govern the distribution volume. The distribution coefficient of gentamicin in the patients was 0.37 litres/kg, justifying gentamicin doses higher than those used conventionally. The optimized population model allowed us to simulate drug serum levels at 8 and 12h, as well as the area under the curve of gentamicin and its variability in patients with high distribution volumes when dosage regimens based on a single daily dose administration are implemented.

Abscess

Community demonstration project initiative: technical support for program development at the community level.

Select population groups are at greater than average risk for cancer incidence and mortality. Lack of experience reaching high-risk populations, particularly those characterized by high proportions of the socioeconomically disadvantaged, presented a challenge to the American Cancer Society (ACS). A partial solution was to integrate outreach to high-risk populations into ACS national priorities and to fund community demonstration projects consistent with these priorities. Technical assistance (TA), which includes expert advice and problem solving, was provided during the first phase to facilitate the development of these projects into "model" projects to learn what initiatives can best be disseminated, or diffused, into target populations. TA also was used to assess how it can enhance the potential for replication. Evaluation of this initiative resulted in a plan to disseminate model projects to selected ACS divisions with varied resources and capabilities (e.g., outreach to high-risk populations, planning, program development, and evaluation) for replication. During the next phase, projects will be evaluated to document the role of TA in facilitating local empowerment and nationwide diffusion of effective cancer prevention and control programs.

Community Health Services

Human contact with bait containing vaccine for control of rabies in wildlife.

OBJECTIVE: To document the number of human contacts with bait containing liquid vaccinia-rabies glycoprotein (V-RG) vaccine, to evaluate factors that might affect human contact with bait-vaccine units, and to summarize adverse reactions in people after contact with vaccine. DESIGN: Retrospective 4-year survey of directors of 6 oral rabies vaccination programs. SAMPLE POPULATION: Human residents in areas of vaccination programs. PROCEDURE: Data were collected from report forms and telephone conversations with directors of oral rabies vaccination programs in Florida, Massachusetts, New Jersey, Texas, and New York. Data collected included information regarding human contact with bait and vaccine, sex and age of person involved in contact, human population density, bait density, type of labeling used on bait, and other factors. RESULTS: Human contact with bait was more likely in areas where bait had white labels (vs lettering in black ink) and in areas with high human population densities. Directors of all programs reported that human contact with bait-vaccine units was minimal. Adverse reactions in exposed people were not reported. On the basis of these findings, concerns about V-RG vaccine posing a substantial public health risk remain unfounded. CLINICAL IMPLICATIONS: Directors of oral rabies vaccination programs should systematically collect information about exposures and potential factors affecting exposure of people to bait-vaccine units. People with substantial exposure to V-RG vaccine should be evaluated for immune status and any resulting symptoms should be documented and monitored.

Animals

Helping hospitalized smokers quit: new directions for treatment and research.

To date, relatively little work has been done to develop or evaluate effective inpatient quit-smoking treatment programs. However, there is growing interest in programs that motivate and assist the hospitalized smoker to quit smoking and remain abstinent. This article presents the rationale for hospital-based smoking treatment programs and introduces a practical minimal-contact treatment model based on extensive studies of primary-care-based and self-help interventions, on a limited number of inpatient studies, and on several prominent theories of health behavior change. Recent controlled and exploratory studies of inpatient interventions are reviewed, including programs for the general medical population and programs for special patient groups such as patients hospitalized for cardiovascular disease, pulmonary disease, cancer, and drug or alcohol dependency. Major findings are summarized, and recommendations are given for future treatment and research.

Follow-Up Studies

Performance of a level II nursery in a neonatal regional program: part I. Patient population and role of the general pediatrician.

We examined the performance of a level II nursery in a regional neonatal program during a 30-month period. Of 3,851 live-born infants, 527 (13.7%) were admitted to the special care nursery and 70 (1.8%) were transferred to a level III nursery. There were 23 neonatal deaths, ten of them in the level II facility; the other 13 infants had been transferred to a level III center and died there. Three hundred eleven (59%) of the admissions to the special care nursery were infants whose birth weights exceeded 2,500 gm, and 241 (46%) were of more than 37 weeks' gestation. There were 262 infants admitted with respiratory distress. In an additional 55 infants, respiratory distress was part of their clinical presentation. Procedures done by the professional staff reflected these needs. A total of 3,476 days of care were provided in the special care nursery, with a mean duration of 6.6 +/- 5.91 days (+/- 1 SD). Physician time required in the special care unit was 2,317.3 hours, an average of 4.4 hours per admission. These data support the contention that general pediatricians operating level II nurseries within a regionalized program can provide care of the majority of newborns, including care of the majority of ill neonates.

Georgia

Health, population, and economic development. International health programs have an important role in promoting economic development and population control.

Health as a basic human value is particularly important to people in the developing world. Rates of economic development lower than had been hoped for and ever more steeply rising population growth have precipitated a reaction against public health programs. Among economists, agriculturalists, and even health professionals the philosophy arose that one should "hold back" on using modern weapons against disease because they are "too effective." To satisfy the recognized popular demand, simple and relatively ineffective measures of curative medicine could be substituted. It was said that the emphasis should be, instead, on agriculture, community development, education, and industrialization and that family planning should be pushed as a separate program. Documentation presented here sharply challenges such a point of view. No segment of the total development process can be effective without the other sectors.

Demography

LINKERS: a simulation programming system for generating populations with genetic structure.

Significant features are described of a Monte Carlo simulation system, LINKERS, that generates nuclear family data conforming to one locus and two loci genetic models. Software engineering techniques help to produce a user friendly environment for studies of genetic ascertainment. LINKERS' 39 code modules are maintained and optimized using VAXset. Within a VAX/VMS workstation environment LINKERS generates a useful population of 10,000 families in 1 min. An example is presented to illustrate the use of LINKERS. Generated data were analysed using the segregation program POINTER. Likelihood ratio tests showed the effects of multiple alleles, gene frequency and incorrect specification of disease prevalence.

Computer Simulation

[Value of the analysis of new cases of arterial hypertension in an organized population for the purpose of planning primary prevention programs].

Within the framework of the 5-year program for the control of arterial hypertension, "detriment" to the population program caused by the lack of preventive work among the so-called healthy portion of the population was estimated at a Moscow machine-building plant. The proportion of patients in whom arterial hypertension was successfully reduced or controlled was matched against the proportion of those whose arterial BP went up above the normal or marginal level during the same period. The study demonstrated the possibility of identifying high-risk individuals in need of primary preventive care within a population, and timely and purposive planning of preventive programs.

Adult

Developing innovative programs for unique student populations.

BACKGROUND: Optometric education has been faced with ever-increasing expectations. These include the ability to educate students and practitioners to care for new patient populations, deal with more diverse and complex clinical problems, to be significant participants in the research community and to fulfill leadership positions within the profession. To fulfill this expectation, schools and colleges need to diversify their program offerings to attract and educate unique student populations who come from diverse backgrounds and bring a range of pre-existing knowledge and skills. RESULTS: This paper provides an overview of The New England College of Optometry's efforts in this area and two programs, the "Advanced Standing International Program" and the "Accelerated Doctor of Optometry Degree Program," are examined in detail. An emphasis is placed on outcomes assessment to ensure the programs are fulfilling their purpose and the results of a retrospective analysis of the two programs is provided.

Curriculum

Family planning, managed care, and rural America.

Within the United States, rural residents encounter a greater number of barriers in accessing health care services than their urban counterparts. In general, rural Americans have less access to both family planning services and managed care delivery systems. Given the rapid changes in health care, we reviewed the implications for the provision and integration of family planning and managed care services in rural areas, where there is limited experience in establishing working relationships between those services. In many instances, family planning services are well established in rural areas where managed care has not yet penetrated. Our case study in Minnesota suggests that, although managed care and family planning services are developing in rural areas, there is little evidence of collaboration. Several innovative and successful family planning projects do exist in rural areas, however, and serve as models of successful population-based programs that could work well with health plans. Although this study concentrated on the provision and utilization of subsidized family planning services, there is a compelling need for further work to determine accurately where rural residents are accessing such services and how the expansion of managed care will affect the delivery of reproductive health care.

Family Planning Services