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The Oral History Program: I. Personal views of health sciences librarianship and the Medical Library Association.

The Medical Library Association Oral History Program uses accepted oral history techniques to collect and preserve interviews with members. The original taped interviews and transcripts are kept in the Medical Library Association archives and made available for research purposes; edited copies of the interviews are distributed through the National Network of Libraries of Medicine, and members are encouraged to borrow and read the histories. Summaries of forty-three interviews provide personal views on health sciences librarianship and the Medical Library Association.

History, 20th Century↗

The Oral History Program: II. Personal views of health sciences librarianship and the Medical Library Association.

The Medical Library Association Oral History Program uses accepted oral history techniques to collect and preserve interviews with members. The original taped interviews and transcripts are kept in the Medical Library Association archives and made available for research purposes; edited copies of the interviews are distributed through the National Network of Libraries of Medicine, and members are encouraged to borrow and read the histories. Summaries of forty-three interviews provide personal views on health sciences librarianship and the Medical Library Association.

Archives↗

The Oral History Program: III. Personal views of health sciences librarianship and the Medical Library Association.

The Medical Library Association Oral History Program uses accepted oral history techniques to collect and preserve interviews with members. The original taped interviews and transcripts are kept in the Medical Library Association archives and made available for research purposes; edited copies of the interviews are distributed through the National Network of Libraries of Medicine, and members are encouraged to borrow and read the histories. Summaries of forty-three interviews provide personal views on health sciences librarianship and the Medical Library Association.

History, 20th Century↗

[Subjective well-being and self acceptance].

The purpose of the present study was to examine the relationship between subjective well-being and self acceptance, and to design a happiness self-writing program to increase self acceptance and subjective well-being of adolescents. In study 1, we examined the relationship between social interaction and self acceptance. In study 2, we created a happiness self-writing program in cognitive behavioral approach, and examined whether the program promoted self acceptance and subjective well-being. Results indicated that acceptance of self-openness, an aspect of self acceptance, was related to subjective well-being. The happiness self-writing program increased subjective well-being, but it was not found to have increased self acceptance. It was discussed why the program could promote subjective well-being, but not self acceptance.

Adolescent↗

Double-disease management or one care manager for two chronic conditions: pilot feasibility study of nurse telephonic disease management for depression and congestive heart failure.

This study assessed the feasibility of a telephonic nurse double-disease management program (DDMP) for patients with depression and congestive heart failure. Thirty-five patients with depression and congestive heart failure were entered into a novel DDMP modeled after Wagner's chronic illness care model and implemented as part of a 13-month Breakthrough Series Collaborative administered by the Institute of Healthcare Improvement. Twenty-four patients remained in the program long enough to complete at least one follow-up assessment (ie, 6 weeks or longer). Patients were entered into the program based on depression severity scores from either the interactive voice response (IVR) version of the Hospital Anxiety and Depression Scale (HADS) or the self-administered (or telephonic) Patient Health Questionnaire (PHQ). Because use of the IVR version of the HADS was eliminated after several weeks into the program (because of poor patient acceptance), 19 patients had both entry and follow-up scores on the same instrument (PHQ). Depression "response" was defined as a 50% improvement in PHQ score. Mixed models regression was used to test the statistical significance of change in PHQ scores over time. Patient and clinician reports were obtained to evaluate program acceptability and satisfaction. Eighty-two percent of patients (n = 11) with Major Depressive Disorder (MDD) responded, and 75% of patients (n = 8) with "other depression" (PHQ score < 10) responded. Mean change in PHQ scores for the sample as a whole improved significantly over the 24 weeks of the program (p < 0.0003), as well as for those with major depression and other depression considered separately (p < 0.01 for both). In some patients who refused medication, depression seemed to respond to self-management support interventions of the care manager. Based on patient acceptance and clinicians' reports, the program appeared feasible and possibly effective. DDMP appears feasible and possibly effective. Future clinical trials are warranted.

Aged↗

Influences on family planning acceptance: an analysis of background and program factors in Malaysia.

Which factors have the greater influence on family planning performance: fixed background variables such as racial composition, urbanization, and mortality, which are affected by level of development, or program inputs such as assignment of personnel and location of clinics, which are subject to manipulation by administrators? An analysis of differences in family planning acceptance among 70 districts of Malaysia shows that two main program-manipulable variables--level of personnel deployment and accessibility of clinics--have the largest direct effect upon acceptance levels. Variations in background factors explain a smaller proportion.

Contraception Behavior↗

Nurse educators' acceptance of the computer in baccalaureate nursing programs.

Although several studies have investigated nurse educators' perceived knowledge of and acceptance of computer technology, none have incorporated objective indicators of knowledge or acceptance. This descriptive research study used standardized and investigator-developed tests to examine acceptance of the computer by randomly selected administrators and faculty in private baccalaureate nursing programs. Levels of computer literacy and attitudes were sufficiently positive to promote the awareness, interest, and evaluation stages of Roger's diffusion and adoption model. Responses were not sufficiently positive to promote the trial and adoption of computer technology for instructional and administrative activities. Recommended approaches to meeting this challenge included instruction related to computer software and educational applications and the use of consortial arrangements to share knowledge, computer hardware and software, and application experiences.

Attitude to Computers↗

Intern candidates who withdraw from contracts: incidence and internal medicine program directors' attitudes.

OBJECTIVE: To study the prevalence of intern candidates accepted through the National Resident Matching Program (NRMP) or after the match who subsequently withdraw and the attitudes of program directors regarding this issue. DESIGN: Mailed survey. SETTING: Four hundred fifty-four internal medicine program directors. MEASUREMENTS: Questionnaires assessing program directors' attitudes toward interns who contract for positions after having verbal or written agreements elsewhere (and the program directors who accept them), the importance of this problem, and the incidence of this problem. MAIN RESULTS: Fifty-five programs (of the 221 responding) experienced intern withdrawals. Programs with larger numbers of open positions after the match had more intern withdrawals (p = 0.03). Eleven of the program directors knew of the prior commitment of the intern, and in all cases the other program director was called for permission to accept the intern. Program directors had negative feelings about both the interns who withdrew and the program directors who accepted them. Community, municipal, and Veterans Affairs hospital program directors were significantly less negative than those in university and university-affiliated hospitals toward interns who withdrew from written commitments (p = 0.001) and the program directors who accepted them (p < 0.05). CONCLUSION: Problems with intern candidate withdrawals from offered/matched programs affect a significant proportion of programs, especially those with larger numbers of unmatched positions. Program directors are generally disapproving.

Analysis of Variance↗

[Acceptability of dietary supplements of the national Mexican program "Oportunidades"].

OBJECTIVE: To identify cultural beliefs and practices to evaluate the acceptability of dietary supplements of Oportunidades Program. MATERIAL AND METHODS: Ethnographic study with in-depth interviews (n=43)--mothers of children less than five years of age and pregnant and breasfeeding women (PBW)--, key informants (n=9); focus groups (n=8) and direct observation, in four communities from North, Central, South and Southwest of Mexico. RESULTS: The supplement was prepared in several different ways. The liquid preparation was best accepted; generally the supplement was mixed with milk. Initially, the supplement caused nausea, vomiting and diarrhea, but these symptoms disappeared with continued consumption. Acceptance was highest among PBW. CONCLUSIONS: The supplement tends to replace milk as a food product in the daily diet. There is a necessity to develop culturally specific evaluations in regions with different food intake practices. The study results should be interpreted in the context of other program components, such as health care and education.

Adult↗

Comparative evaluation of three commercial software packages for analysis of DNA polymorphism patterns.

OBJECTIVE: In the present study we have compared three commercial software packages, GelCompar, Molecular Analyst Fingerprinting, and BioImage, to determine if the results generated by the programs were comparable and correlated adequately with visual interpretation of electrophoretic gels, in the analysis of several well characterized incidents of infections. METHODS: Infections caused by Pseudomonas aeruginosa, Candida dubliniensis, C. albicans, and serotypes of Salmonella were characterized by restriction endonuclease analysis, macrorestriction analysis of genomic DNA with pulsed-field gel electrophoresis, and random amplified polymorphic DNA. The genotypes were visually detected based on band presence or absence in the different gels. The similarity values of DNA profiles were computed using Dice coefficient and were presented in dendrograms by UPGMA. The concordance or agreement between the number of genotypes obtained and their clustering, using the computerized programs, was determined. RESULTS: In general, agreement in number of genotypes obtained visually and by using the commercial DNA analysis software was achieved, but discrepancies were also denoted between the systems. The concordance between the visual and the computerized analysis ranged from 72% to 100%. CONCLUSION: In our experience, although the programs evaluated in the present study performed acceptably well, such programs may be used as an aid in the analysis of complex banding patterns, and they do not provide an indisputably correct analysis in genotype definition.

Animals↗

Organizational approach to medication administration in day care.

Because young children have numerous infections and other conditions that require medication during the day, medication administration is an issue for every day care program. While all day care programs may not accept responsibility for administration of medication, every program must have a policy about it. Where medications are given in day care, care givers need training to handle their responsibility appropriately. Health professionals have a role in determining when the need for a medication is great enough to warrant the transfer of responsibility from parents to day care personnel and to attempt to adjust regimens to avoid the need for medication in day care, where possible. Health professionals should also help parents and care givers understand when to use medication, including over-the-counter medications, which are so strongly advertised. Safety precautions, intervals, doses, procedures, and techniques for administration of medication in day care are areas of knowledge and skill for which guidelines are available.

Child Day Care Centers↗

Practical strategies for a plaque-control program.

With many patients the control of dental plaque is accepted as an important factor in the prevention and treatment of periodontal diseases. However, for others, because this aspect of oral hygiene is not yet totally understood or accepted, plaque control programs often prove to be frustrating and too time-consuming for the general practitioner. This article provides some practical strategies to overcome common pitfalls in delivering a plaque-control program.

Dental Plaque↗

Comparison of MS-DOS and Macintosh pharmacokinetic analysis programs using a two-compartment, two-infusion dosing scheme.

Pharmacokinetic values derived by three nonlinear least-squares regression computer programs for sets of serum drug concentration data were compared. The three programs selected for comparison were the MS-DOS-based programs PCNONLIN and ADAPT and the Macintosh program BOOMER. Data on serum recainam hydrochloride concentration in 10 patients given an i.v. loading dose followed by a maintenance infusion were fitted by the appropriate models in each program. Samples had been subjected to reverse-phase isocratic high-performance liquid chromatography with ultraviolet light detection; intraday and interday coefficients of variation were less than 8% over the range of concentrations measured. A two-compartment model was used for all regressions. Each program was given identical initial estimates, and the simplex minimization algorithm of each program was used to fit the model to the data. An identical weighting scheme was used for all three programs. The mean pharmacokinetic values estimated by each program for the 10 data sets were essentially identical. Slightly larger rate constants and smaller volume terms were derived by BOOMER. BOOMER yielded the lowest weighted sum of squares and the highest correlation coefficient. A mean concentration-time plot showed that the programs all produced values that described the data very well. The three computer programs used in this analysis derived essentially the same pharmacokinetic values to describe sets of serum drug concentration data. The BOOMER program provides an acceptable alternative to MS-DOS-based programs for pharmacokinetic analysis.

Chromatography, High Pressure Liquid↗

The implementation of a cardiovascular school health promotion program: utilization and impact of a school health advisory committee: the Heart Smart program.

A multidisciplinary school health advisory committee was developed to enhance acceptance and support for a total elementary school cardiovascular health promotion program (Heart Smart). Composed of teachers, school lunch personnel, physical educators and parents, this coalition served as a liaison between the school and project investigators, providing feedback on program acceptability. As an environmental support mechanism to the Heart Smart intervention, the group was additionally charged with designing and implementing adjunct health promotion activities within the school. The interactive nature of this committee, coupled with self-directed goal setting, provides a school model for institutionalizing health promotion, providing school personnel and parents with program ownership, and reinforcing school commitment to heart health. The theoretical and organizational framework used in implementing a health advisory committee is described.

Cardiovascular Diseases↗

Osteoporosis preventive behavior in Thai older adults: feasibility and acceptability.

The authors used a one-group pre-test-post-test design to examine the feasibility and acceptability of an osteoporosis prevention program and the effects of the program on knowledge, health beliefs, self-efficacy; and osteoporosis preventive behaviors in older adults. Participants included 48 older adults who attended a health center in Thailand. Results revealed that the program was feasible and acceptable. A significant improvement in osteoporosis knowledge, health beliefs, self-efficacy, and osteoporosis preventive behaviors occurred. Findings suggest that the program helps older adults incorporate new knowledge and skills into their daily lives and helps them maintain bone health.

Aged↗

Delivering comprehensive services to homeless mentally ill offenders.

A consortium of social services agencies developed a comprehensive community mental health services program for homeless mentally ill offenders in Portland, Oregon. Residential services were provided in a single-room-occupancy hotel. Forty-seven clients were accepted for the program, 38 actually entered the program, and 14 graduated--that is, attained sobriety and were placed in community housing. Problems complicating program implementation included differing philosophical approaches of key agencies, staff turnover, and financial shortfalls. Many potential clients were not accepted into the program because of recent violence or potential violence; some clients were expelled or reincarcerated because of violent behavior.

Adult↗

A comparison of consumer sensory acceptance and value of domestic beef steaks and steaks from a branded, Argentine beef program.

To determine consumer sensory acceptance and value of branded, Argentine (grass-finished, aged 30+ d) and domestic (U.S. grain-finished beef, aged 9 d) strip loins were paired based on similar Warner-Bratzler shear force values (P = 0.34) and similar marbling levels (P = 0.82). Consumers in Chicago, IL, and San Francisco, CA (n = 124 per city), evaluated one pair of Argentine and domestic steaks, and had the opportunity to participate in a silent, sealed-bid auction to purchase steaks matching the taste panel samples. Consumers were categorized into three groups based on overall acceptability ratings: 1) those who found Argentine steaks more acceptable, 2) those who found domestic steaks more acceptable, and 3) those who were indifferent. Consumers rated domestic steaks higher (P < 0.05) in juiciness, tenderness, flavor, and overall acceptability. Consumers in both Chicago and San Francisco were willing to pay more (P < 0.05) for domestic steaks (0.86 dollars and 0.52 dollars per 0.45 kg, respectively). In both cities, consumers who found Argentine samples more acceptable were willing to pay more (P < 0.05) for Argentine steaks (0.74 dollars per 0.45 kg in Chicago and 1.82 dollars per 0.45 kg in San Francisco), and consumers who found domestic samples more acceptable were willing to pay more (P < 0.05) for domestic steaks (1.66 dollars per 0.45 kg in Chicago and 1.34 dollars per 0.45 kg in San Francisco). Consumers who were indifferent were willing to pay similar (P = 0.99) amounts for Argentine and domestic steaks. Although some consumers found Argentine beef more acceptable than domestic beef (19.7 and 16.5% in Chicago and San Francisco, respectively) and were willing to pay more for it, most consumers found domestic beef to be more acceptable (59.0% in Chicago and 61.5% in San Francisco) and were willing to pay more to obtain a more acceptable product.

Animals↗

Interactive multimedia information program for use by breast-care nurses--a patient acceptability study.

AIMS: To design an interactive multimedia program for use by breast-care nurses and evaluate the acceptability of this technology to patients in the clinical setting. METHODS: In order to ensure that the clarity of the information was maintained the multimedia program was developed by a multidisciplinary team, including non-medical personnel and patients. A prospective analysis of the subjective impressions of patients with symptomatic breast disorders and breast-care nurses to a multimedia patient information system was then performed using a standard questionnaire and semi-structured interviews. RESULTS: Fifty women were recruited for the study. Thirty-six (72%) considered the multimedia counselling to be superior to the traditional modalities. Forty-nine (98%) graded the system as good or better. No patient regarded the technology as anxiety-provoking or inferior to the traditional leaflet-based approach. Women over 55 years old found the system as acceptable and easy to use as the younger women. CONCLUSIONS: The multimedia breast counselling programme was acceptable to patients and was considered superior to the traditional leaflet-based approach by the majority. The inherent advantages of this technology will lead to its increasing utilization in the clinical setting.

Adult↗