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At least 433 records · Page 24Linked to original sources

PubMed2001

Patients attachment patterns and response to a program for alleviating cardiovascular risk factors: a 1-year follow-up of patients in a patient education program.

This study was a 1-year follow-up of 295 consecutive patients at a patient education centre and assessed how attachment style influenced the outcome of the patient education program devised for individuals with multiple risk factors for cardiovascular disease. The program consisted of a 4-week residential program course, followed by a 4-day follow-up course a year later. In our cohort study, the 295 consecutive patients (mean age = 52years, S.D.=9.2) with multiple risk factors for cardiovascular disease, showed an initial overall reduction of 4.4 kg in weight (P=0.0001) and a reduction of 17/11 mm in systolic and diastolic blood pressure (P=0.0001 and 0.0001). The weight remained essentially the same at the follow-up 1 year later, whereas blood pressure tended to return to previous level. The attachment style was determined by means of a questionnaire: 87% were classified as 'secure', 9% 'avoidant' and 5% as 'ambivalent'. After 4 weeks, the ambivalent category had reduced weight (body mass index (BMI)) more than the secure group (P=0.04). At the 1-year follow-up, the avoidant category showed a more pronounced reduction in diastolic blood pressure than the other groups (P=0.001). Thus, it seems as if attachment style does have some influence on outcome. Patient education should take advantage of knowing patients' attachment style.

Cardiovascular Diseases↗

PubMed2001

[Research training in the programs of neurosurgery residency. Analysis of the situation in other developed countries and proposals to implementing the current program in Spain].

Research performed by neurosurgeons has been always linked to the progress of our specialty, and research training is included in the Neurosurgery Residency Programs in developed countries. Since the methodology of research related to the basic knowledge of the nervous system function is becoming increasingly complex, it could be proposed that neurosurgeons can not longer contribute to productive research in neurosciences, and this idea might be easily accepted in certain countries such as Spain, where research training is not contemplated in the Residency Program of Neurosurgery. However, all neurosurgeons academic or not, should exhibit a critical and inquiring mentality which enables them to evaluate scientific information and communicate their own clinical experience to the neurosurgical community. Such a critical capacity can not be acquired by a resident trained only in the art of clinical diagnosis and the surgical technique. The new medical practice is based on both basic and clinical-epidemiological research, and the new residents must be immersed into a motivating and inquisitive environment in which the scientific method is continuously applied to the clinical practice. In this paper I consider research training in Neurosurgery in developed countries with the aim of identifying a strategy for introducing a period devoted to research in the Spanish Residency Program. Thus, the methodologies, objectives, contents, duration and the moment for receiving research training in other countries are analysed and some alternatives for solving the problem in our country are pointed out.

Developed Countries↗

PubMed2002

Outcome measures across program sites for postsecondary supported education programs.

This article briefly describes three supported education programs and examines outcomes for each. The program settings were a mental health center, a clubhouse, and a community college. Students (n = 124) were followed for five semesters to assess program outcomes. Although this study did not statistically control for variations in services among sites, each site adhered to the principles and practice of supported education as a specialized intervention. Differences among sites in student demographics, education and employment outcomes, satisfaction with school, job/education fit, satisfaction with life, and self-esteem are reported. Although there were variations in outcomes among sites, few signifcant differences were found.

Adult↗

PubMed1984

The National Evaluation of School Nutrition Programs: program impact on family food expenditures.

Since the major goals of the school nutrition programs are to safeguard the health of children by providing nutritious meals and to promote consumption of domestic agricultural products, it is important to know the extent to which participation in the school nutrition programs increases the value of food obtained by participating families. The analysis of the factors that influence family food expenditures is described. No evidence is found that families reduce their other food expenditures in response to their children's participation in the school nutrition programs. The most important factors that influence family food expenditures are family size and income. The age of children in the family, location of the family, and educational attainment and employment status of heads of household also affect food expenditures.

Adolescent↗

PubMed1993

Nutrition knowledge and practices of physicians in a family-practice residency program: the effect of an education program provided by a physician nutrition specialist.

The purpose of this study was to determine the effects of a nutrition-education program provided by a physician nutrition specialist in a family-practice residency program on residents' and faculty members' nutrition knowledge and nutrition-related patient care, their patients' perceptions of the importance of nutrition, and the physicians' dietary patterns. The nutrition specialist provided recommendations for nutrition patient-care practices to the physicians for 6 mo. Pre- and post-intervention assessments included 1) nutrition exams for physicians and patients, 2) patient questionnaires concerning attitudes towards nutrition, 3) chart reviews, and 4) diet records for physicians. The educational intervention caused a small but statistically significant (P < 0.01) increase in physicians' nutrition-knowledge scores and a significantly higher (P < 0.05) frequency of physicians discussing nutrition and recommending diets for their patients. Effects were greater among residents than among faculty members. The results suggest that a physician nutrition specialist can provide effective nutrition education within a residency program.

Diet Records↗

PubMed1987

Epidemiologic programs for computers and calculators. Inferences on odds ratios, relative risks, and risk differences based on standard regression programs.

Statistical analyses of the joint effects of several factors (covariates) on the risk of disease, death, or other dichotomous outcomes, are frequently based on a model that relates the effect of the covariates to some function of the probability of the outcome. The odds ratio, relative risk, and the difference in risks are among the simplest candidates for the outcome function. Each can be specified as a special case of the generalized linear model, but their use has been limited to researchers with access to specialized computer programs that are not yet generally available in standard computer packages. The purpose of this communication is to describe how to implement the maximum likelihood estimation procedures and hypothesis testing associated with the generalized linear model using any computer program that can perform weighted least squares analyses. The procedure is applied specifically to models for relative risks, risk differences, and odds ratios. The techniques are illustrated with SAS and SPSSx programs for data sets previously presented.

Computers↗

PubMedDate not supplied

A school reentry program for burned children. Part I: Development and implementation of a school reentry program.

Sustaining a burn injury is a devastating and painful experience. After acute concerns have been dealt with, continued support of the child and family is important in achieving a smooth return to normal activities. Reports from burned patients for whom physical therapy was a concern identified a need for physical therapy involvement in school reentry to facilitate a resumption of normal school routine. Physical therapy involvement in school reentry has been successful and rewarding with a reasonable commitment of manpower. Utilization of personnel in the administrative structure of state and local school systems promoted the acceptance of the program by local school personnel. Although this program is designed to meet the needs of burned children, the goals of the school reentry program may meet similar needs of children with other chronic illnesses.

Adolescent↗

PubMed2002

Improving compliance in on-line, structured self-help programs: evaluation of an eating disorder prevention program.

Compliance rates from four iterations of Student Bodies, an 8-10 week computer assisted health education (CAHE) program for the prevention of eating disorders in college-aged women, were measured. Each iteration was modified with the hope of increasing participant compliance. Participants were 116 undergraduate women from two large West Coast universities who were randomly assigned to either the CAHE program or a wait-list group. Model 1 was delivered via CD-ROM, was anonymous, used an unstructured "grazing" approach, and participants received 10 dollars. Model 2 was web-based, had recommended assignments with telephone reminders, and participants received 25 dollars. Model 3 used a more structured approach to assignments. Model 4 eliminated anonymity, added an academic component, used email reminders, and offered course units as an incentive. Compliance was defined as percentage of screens read per number of screens assigned (n = 27-33). In Model 1, compliance was self-reported at 53%. In Models 2, 3, and 4, compliance, measured directly via computer logs, was 66%, 85%, and 84%, respectively. A Mann-Whitney test showed that the increase in compliance between Models 2 and 3 and Models 2 and 4 was statistically significant (p < 0.01). Compliance was significantly correlated with improvement on outcome. Suggestions for increasing compliance in other CAHE programs are offered.

Journal Article↗

PubMedDate not supplied

The AHF SCENE II Preceptorship Program: rationale and design of an educational program to optimize management of advanced heart failure.

Advanced heart failure requires specialized treatment to improve symptoms, increase survival, and reverse or slow disease progression. The Advanced Heart Failure Shared Clinical Experiences Network, or AHF SCENE, was founded in 1995 to provide small groups of health care professionals with better advanced heart failure management strategies by sharing clinical experiences from centers treating large numbers of patients. The original AHF SCENE program has since been modified to provide health care professionals with more information on current strategies for advanced heart failure management and to better serve the educational needs of professionals who care for these patients. AHF SCENE II promotes new methods, programs, procedures, and pharmacologic interventions and also describes strategies for tracking and improving clinical and economic outcomes in the management of advanced heart failure. AHF SCENE II supports the understanding that rapid, aggressive medical management is essential and is more effective in the context of a well designed program that spans the continuum of care. (c)2000 by CHF, Inc.

Journal Article↗

PubMed2006

Program report: GENECOUNTING support programs.

We describe a suite of programs which enhance the usability of GENECOUNTING, a program for estimating haplotype frequencies in unrelated subjects. The programs, called RUNGC, SCANASSOC, COMPGR, SCANGROUP and LDPAIRS, carry out likelihood ratio tests and permutation tests to detect differences in haplotype frequencies between cases and controls,or between predefined groups, and output likely haplotype assignments and tables of linkage disequilibrium statistics between all pairs of markers in a dataset.

Databases, Genetic↗

PubMed1986

Dissemination of community health promotion programs: the Fargo-Moorhead Heart Health Program.

Dissemination often is the neglected phase of the development and distribution cycle. While attention has focused on developing and testing new health education and health promotion programs, relatively little effort has been placed on studying how the programs can be disseminated. This paper reviews the dissemination process, identifies factors critical to successful dissemination, uses examples from a community-based heart disease prevention study to illustrate how health promotion programs can be disseminated across a community, and suggests ways these methods might be applied to a community-based approach to adolescent drug use prevention.

Adolescent↗

PubMed2004

Quality assurance program for clinical measurement of antiretrovirals: AIDS clinical trials group proficiency testing program for pediatric and adult pharmacology laboratories.

Clinical trials designed to compare antiretroviral regimens, investigate therapeutic drug monitoring, or measure pharmacometrics often include protease inhibitors (PIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs), and nucleoside reverse transcriptase inhibitors, requiring the measurement of these antiretrovirals in plasma. Within the adult and pediatric AIDS Clinical Trials Group (ACTG), a network of Pharmacology Support Laboratories (PSLs) is a component of the group laboratory infrastructure and conducts these types of pharmacologic assays. The adult ACTG has developed a comprehensive quality assurance program for the conduct of clinical pharmacology protocols, one component of which is the antiretroviral proficiency testing (PT) program that has been implemented between the adult and pediatric pharmacology laboratories of the ACTG. PT testing samples were prepared and distributed in July 2001, February 2002, and July 2002. High, medium, and low concentrations of PIs (indinavir, saquinavir, amprenavir, lopinavir, ritonavir, and nelfinavir) and NNRTIs (nevirapine and efavirenz) were added to drug-free EDTA plasma and distributed, on dry ice, to eight ACTG PSLs. One testing laboratory used liquid chromatography-tandem mass spectrometry, and seven used high-performance liquid chromatography-UV analysis. A result was considered acceptable if it was within 20% deviation of the assigned concentration. For all concentrations of PIs evaluated, 96% of samples tested (430 of 448 measurements) met the acceptance criteria. For both NNRTIs, 100% of samples tested (140 of 140 measurements) met the acceptance criteria. In conclusion, the PT program results presented demonstrate excellent interlaboratory agreement for all antiretrovirals tested and provide support for the merger of plasma concentration data among laboratories for large clinical trials.

Acquired Immunodeficiency Syndrome↗

PubMed1991

Who is served by programs for the homeless? Admission to a domiciliary care program for homeless veterans.

Demographic and clinical data are presented on 4,138 veterans assessed in the 20-site Department of Veterans Affairs (VA) Domiciliary Care for Homeless Veterans program during its first year of operation. More than two-thirds of the veterans who were screened had been hospitalized in VA medical centers during the year before assessment, and 34 percent were hospitalized at the time of assessment. Compared with veterans who were not admitted for residential treatment, veterans who were admitted were more likely to be previously involved in mental health treatment, literally homeless rather than at risk for homelessness, and without public financial support. Specialized service programs for the homeless such as the VA domiciliary care program may also be called on to play a broader role in the discharge and rehabilitative efforts of public mental health service systems.

Adult↗

PubMedDate not supplied

Building an academic tobacco control program while forging links with practice: the University of Washington Tobacco Studies Program.

Despite the tremendous impact that tobacco use and tobacco smoke exposure have on morbidity, mortality, and health disparities, few schools of public health in the U.S. offer courses of study on tobacco control or make it a priority in their curricula. An academic concentration in tobacco studies and a master's-level scholarship program were developed at the University of Washington School of Public Health and Community Medicine to support and encourage students to pursue tobacco-related coursework, seminars, internships, and thesis work. This article discusses the goals, strategies, and accomplishments of the programs, emphasizing a collaborative approach between the university and state and local health departments, nongovernmental agencies, and research organizations as instrumental to the program's success and ultimate continuation.

Curriculum↗

PubMed1980

Effectiveness of a cephalosporin education program--a pharmacy education program.

In October, 1977, a cephalosporin drug-use review and an educational program were initiated to maximize savings in the pharmacy budget at UCSF and to revise the formulatory to include only one parenteral cephalosporin. The results of the drug-use review were presented to the Pharmacy and Therapeutics Committee where our proposal for an education campaign to encourage appropriate dosing of cefazolin was approved. An explanatory document comparing cephalosporin costs and equivalency was developed for hospital-wide distribution. Pharmacy staffs were informed of program objectives to coordinate education efforts. Physician education was undertaken via document and personal contact with pharmacy personnel. A drug-use review one month after institution of the cephalosporin education program showed marked changes in physician prescribing habits, with greater impact on services where pharmacists were members of the medical rounding team. A change to appropriate dosage prescribing of cefazolin resulted in significant cost savings to the pharmacy budget. These findings resulted in formulary revision to cefazolin as the single cephalosporin available at UCSF. Because cefazolin is available from more than one manufacturer, we were able to obtain a lower bid price the following year, thus realizing an additional cost savings.

California↗

PubMed2002

Integrating quantitative and qualitative methods to assess the impact of child survival programs in developing countries: the case of a program evaluation in Ceara, Northeast Brazil.

In evaluating public health programs, the tradition has been to design quantitative approaches, relying on epidemiological and statistical techniques to determine if and to what extent a program has an effect on a predetermined targeted population. More recently, however, qualitative methods such as rapid ethnographic assessments and focus groups have been implemented more frequently. This article describes an outcome evaluation of a community health workers program that integrated quantitative and qualitative methods to assess the impact of child survival interventions in reducing infant mortality and inadequate weight gain in children among municipalities in the state of Ceara, Northeast Brazil. By using multiple methods that combine quantitative and qualitative components, researchers can broaden their understanding of complex public health issues and direct use of data for decision making.

Adult↗

PubMed1990

Attendance at health promotion programs: baseline predictors and program outcomes.

As part of a family cardiovascular health promotion project, 111 Mexican-American and 95 Anglo-American families with fifth- or sixth-grade children were assigned to either a primary prevention program involving 18 sessions or to a control condition. This article evaluates predictors of attendance at the year long sequence of sessions in the intervention group. In addition it considers the relationship between attendance and program outcomes. Low baseline scores on physical activity and cardiovascular fitness measures were associated with higher attendance for both children and adults. High initial health knowledge and self-motivation were also associated with attendance. Multiple regression analysis showed that adult attendance was significantly predicted by a model including completion of a three-day food record, low exercise, higher socioeconomic status, family adaptability, and self-motivation. Attendance was correlated with greater knowledge gains and larger reductions in blood pressure. The results indicate that motivated families who are in greater need of conditioning attended more sessions in a health promotion program.

Adult↗

PubMedDate not supplied

Successful public/private donation programs: a review of the Diflucan Partnership Program in South Africa.

A review of the partnership between Pfizer Inc. and the South African Ministry of Health to distribute free Diflucan (fluconazole) in the Diflucan Partnership Program (DPP) demonstrates that product donations may be a useful response to AIDS if they are coupled with efforts to build means of drug distribution and enhance professional healthcare capacity to treat patients. Equally important is the creation of a new set of productive working relationships between stakeholders who came to the project with different backgrounds and perspectives, as well as a frankly disparate set of objectives. A decision tree illustrates how these relationships were built into the DPP. This review concludes with a few lessons learned in providing medicines not only to South Africa, but also to the 77 other African countries now participating in the DPP. As the search for new treatments and vaccines continues, increasing access to existing medicines through targeted donations--including training and infrastructure support--is the most practical way for the health community to address the problem of ill health among the poor. In addition to a detailed analysis of the DPP, there is also a discussion of the benefits of a donation program that addresses the AIDS crises on a global scale. This review may serve as a blueprint for establishing programs that are successful in fighting AIDS and improving the lives of millions of people.

AIDS-Related Opportunistic Infections↗