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PubMed2006

Acceptability of programs for the prevention of eating disorders.

Researchers can overcome difficulties with recruitment and implementation encountered by previous eating disorder prevention efforts by understanding targeted groups' opinions about such programs. Treatment acceptability methodology provides a framework to examine the social validity of interventions. Using this methodology, the acceptability of programs was examined with an often-targeted group. The study also assessed opinions of this group about the importance of prevention and methods of implementation. Male and female undergraduates (N = 347) rated the acceptability of sample programs. Results indicated that programs focused on information about eating disorders and their consequences were rated most acceptable. Participants felt programs should be offered to adolescents, within the school system, but ratings of the importance of eating disorder prevention were somewhat disappointing.

Adolescent↗
PubMed2005

Development and evaluation of a multifaceted ergonomics program to prevent injuries associated with patient handling tasks.

PROBLEM STATEMENT: Nurses have one of the highest rates of work-related musculoskeletal injury of any profession. Over the past 30 years, efforts to reduce work-related musculoskeletal disorders in nurses have been largely unsuccessful. SPECIFIC AIMS: The primary goal of this program was to create safer working environments for nursing staff who provide direct patient care. Our first objective was to design and implement a multifaceted program that successfully integrated evidence-based practice, technology, and safety improvement. The second objective was to evaluate the impact of the program on injury rate, lost and modified work days, job satisfaction, self-reported unsafe patient handling acts, level of support for program, staff and patient acceptance, program effectiveness, costs, and return on investment. INTERVENTION: The intervention included six program elements: (1) Ergonomic Assessment Protocol, (2) Patient Handling Assessment Criteria and Decision Algorithms, (3) Peer Leader role, "Back Injury Resource Nurses", (4) State-of-the-art Equipment, (5) After Action Reviews, and (6) No Lift Policy. METHODS: A pre-/post design without a control group was used to evaluate the effectiveness of a patient care ergonomics program on 23 high risk units (19 nursing home care units and 4 spinal cord injury units) in 7 facilities. Injury rates, lost work days, modified work days, job satisfaction, staff , and patient acceptance, program effectiveness, and program costs/savings were compared over two nine month periods: pre-intervention (May 2001-January 2002) and post-intervention (March 2002-November 2002). Data were collected prospectively through surveys, weekly process logs, injury logs, and cost logs. RESULTS: The program elements resulted in a statistically significant decrease in the rate of musculoskeletal injuries as well as the number of modified duty days taken per injury. While the total number of lost workdays decreased by 18% post-intervention, this difference was not statistically significant. There were statistically significant increases in two subscales of job satisfaction: professional status and tasks requirements. Self-reports by nursing staff revealed a statistically significant decrease in the number of 'unsafe' patient handling practices performed daily. Nurses ranked program elements they deemed to be "extremely effective": equipment was rated as most effective (96%), followed by No Lift Policy (68%), peer leader education program (66%), ergonomic assessment protocol (59%), patient handling assessment criteria and decision algorithms (55%), and lastly after action reviews (41%). Perceived support and interest for the program started at a high level for managers and nursing staff and remained very high throughout the program implementation. Patient acceptance was moderate when the program started but increased to very high by the end of the program. Although the ease and success of program implementation initially varied between and within the facilities, after six months there was strong evidence of support at all levels. The initial capital investment for patient handling equipment was recovered in approximately 3.75 years based on annual post-intervention savings of over $200,000/year in workers' compensation expenses and cost savings associated with reduced lost and modified work days and worker compensation. CONCLUSIONS: This multi-faceted program resulted in an overall lower injury rate, fewer modified duty days taken per injury, and significant cost savings. The program was well accepted by patients, nursing staff, and administrators. Given the significant increases in two job satisfaction subscales (professional status and task requirements), it is possible that nurse recruitment and retention could be positively impacted.

Absenteeism↗
PubMed2004

The acceptable mismatch program as a fast tool for highly sensitized patients awaiting a cadaveric kidney transplantation: short waiting time and excellent graft outcome.

There are many highly sensitized patients on the kidney waiting lists of organ exchange organizations because it is difficult to find a crossmatch negative cadaver kidney for these patients. Recently, several protocols have been developed to remove the donor-specific human leukocyte antigen (HLA) antibodies from the serum of these patients before transplantation. These approaches, including the use of intravenous immunoglobulins, plasmapheresis and immunoglobulins (plasmapheresis-cytomegalovirus-immunoglobulin), and immunoabsorption, seem to lead to a certain success rate, although the additional immunosuppression necessary to remove and control the production of donor-specific alloantibodies may have its impact on the short-term (infections) and long-term (incidence of cancer) immune surveillance. Furthermore, some of these therapies represent a considerable financial burden for patients and society. In the present report, we advocate selection of crossmatch negative donors on the basis of the Acceptable Mismatch Program, as the first and best option for highly sensitized patients to undergo transplantations. No additional immunosuppression is necessary, and graft survival in this group of "difficult" patients is identical to that of nonsensitized recipients. Because the nature of the HLA polymorphism does not allow all patients to profit from this approach, removal of circulating HLA antibodies can be considered as a rescue therapy for those patients for whom the Acceptable Mismatch Program does not give a solution.

Cadaver↗
PubMed1992

The how and why of the ADA's evaluation program for dental therapeutic products.

Since 1930, the Council on Dental Therapeutics of the American Dental Association has been evaluating dental drug products for safety and efficacy through its Acceptance Program. To date, numerous products have been evaluated, and many hundreds have received the council's seal of acceptance. Acceptance criteria are rigorous, and the council relies on expert consultants to evaluate the supporting data. There are no manufacturer fees involved with the Acceptance Program. When a product has been awarded the seal, it means that adequate data have been submitted, and that the product is safe and does what it says it will do. This paper describes, in detail, how the Acceptance Program works.

American Dental Association↗
PubMed1998

Low-fat school lunch programs: achieving acceptance.

A study was carried out to determine whether hands-on classroom experience with low-fat foods would increase children's acceptance of those foods in the school's lunch program. The 9-month project took place at an elementary school in upstate New York. Half of the classrooms served as the intervention group and received classroom experience with new foods; the other half served as the control group and received no classroom experience. Consumption measurements of 16 new foods, introduced at approximately 2-week intervals, were taken for all students who ate school lunches. Compared with children in the control group, those in the intervention group ate significantly more of the new foods when they were offered in the lunch program. The study demonstrated that experiential learning about food in the classroom is an effective way to gain acceptance of diverse, low-fat foods in the school lunch program.

Child↗
PubMed2000

ADA guidelines for the acceptance of tooth-whitening products.

Since the introduction of at-home tooth whitening using peroxide-containing agents in 1989, the procedure has been well-received by the public and is becoming one of the most popular cosmetic dental procedures today. To ensure the safety and efficacy of this treatment, the Guidelines for the Acceptance of this category of products by the American Dental Association were developed. This article provides background on the American Dental Association (ADA) Seal of Acceptance Program. It also offers an overview of the ADA Acceptance Program Guidelines for Home-Use Tooth Whitening Products as well as the process through which the document was developed.

American Dental Association↗
PubMed2003

Blueprint for establishing an effective Postbaccalaureate medical school pre-entry program for educationally disadvantaged students.

The purpose of this article is to provide public and private medical schools with a pragmatic blueprint for the development and implementation of an effective medical school pre-entry program that increases the pool of students interested in returning to health care shortage areas. An ancillary benefit of this program is an increase in the number of underrepresented minority students to medical schools. The structure, experiences, and results of the University of California, Davis, School of Medicine's Postbaccalaureate Reapplicant Program are used as a case study to construct the blueprint for returning 85-90% of program participants to shortage areas while increasing minority student admissions. The UC Davis program has been in place since 1991 and post-program acceptance rates have varied from 57% to 100% with an overall acceptance rate of 90.4% through 1999-00. Of 115 participating students who had previously been rejected by medical schools, 104 were accepted to health professional programs: 95 students were accepted to major U.S. medical schools and nine were accepted to masters in public health programs, physician's assistant programs, and one international medical school. This success rate has been achieved through a combination of intense assistance in study skills and test-taking skills, academic course work, and academic and pre-professional counseling.

California↗
PubMed1991

Innovative bridging program for overseas trained doctors.

Most overseas trained doctors wishing to practise in Australia are required to sit for examinations set by the Australian Medical Council (AMC) before they can seek registration through State medical boards. In 1989, the South Western Sydney Area Health Service, which is responsible for the delivery of health services to 650,000 people, initiated a bridging program with the joint aim of providing overseas trained doctors with the opportunity to undertake a comprehensive program of study and facilitating the recruitment of doctors into the area. The program comprises two integrated components, each extending over five months. Stage 1 relates to the AMC's multiple choice questionnaire (MCQ) examination; stage 2 prepares candidates for the clinical examination. In addition, provision is made for developing awareness of professional responsibility, standards and ethical bases for the practice of medicine in Australia. Participants are also required to study English and communication skills throughout the program. Acceptance into the program is based on a number of criteria including successful completion of a screening test and an interview. Progression to the Clinical Course requires that candidates pass the MCQ Course and undertake to work in the area. The program has been funded jointly by State and Commonwealth Government bodies. Results obtained by program participants in the MCQ and clinical examinations conducted by the AMC have been well ahead of the national average.

Australia↗
PubMedDate not supplied

Cathode ray tube quality control and acceptance testing program: initial results for clinical PACS displays.

The use of picture archiving and communication systems (PACS) and primary soft-copy interpretation in radiology is growing rapidly. The authors present a cathode ray tube (CRT) acceptance test and quality control (QC) program developed over a 5-year period on the basis of experience with multiple PACS and CRT vendors. The CRT QC procedures address monitor cleanliness and setup, qualitative image quality, and quantitative luminance and color measurements. Required materials include a photometer with luminance and color probes and 100%-video, flat-field window and test images from the Society of Motion Picture Test Engineers (SMPTE). Luminance was found to change over time for all gray-scale CRTs examined, which necessitated quarterly recalibration. The phosphor color of these monitors was also found to change, but changes were consistent and slow enough to warrant only annual measurements. Color measurements were found to be especially useful at initial setup and for CRT replacement. Use of this program allowed standardization of absolute luminance of individual CRTs, matching of phosphor color for multimonitor workstations, and systematic tracking of image artifacts. Implementation of a QC program is strongly recommended owing to the dynamic nature of CRT displays.

Color↗
PubMed1995

Should the audiometric database analysis method (draft ANSI S12.13-1991) for evaluating the effectiveness of hearing conservation programs be accepted as a US national standard?.

The value of audiometric database analysis (ADBA) procedures for evaluating the effectiveness of hearing conservation programs (HCPs) was studied in a population of 82,195 workers. We rated the HCP using four ADBA procedures. Results showed that the HCP ratings ran the gamut from "unacceptable" to "acceptable" from year to year and from procedure to procedure. A mere 7 percent of the total population was eligible for ADBA analysis. This drastically reduced sample size precludes subgroup analyses of even a large cohort and likely could not be applied to the HCPs of most small- and medium-sized businesses. The low levels of agreement observed (weighted kappa = 15%-25%) between the ADBA procedures reflect poor validity. Generalizability of these results would be inappropriate when so few nonrandomly selected individuals contribute to the evaluation. In view of these problems, acceptance of the ADBA method as a national standard may not be warranted.

Audiology↗
PubMed1986

Posterior composite resins. Council on Dental Materials, Instruments, and Equipment.

Information on the long-term clinical performance of composite resins in posterior restorations is still very limited. The council has classified some composite resins as "provisionally acceptable" for permanent teeth on the basis of information submitted under the guidelines for the acceptance program for composite resins for occlusal Class I and Class II restorations. This classification, however, does not imply their unlimited use as routine restorative material in stress-bearing areas in all situations. No justification exists to extrapolate the performance data to situations in which there are limited documented results. Also no justification exists to extrapolate the performance of one composite resin to other composite resins. The guidelines of the acceptance program were established on the basis of information available in 1981. Information is emerging that suggests that these limits do not necessarily provide a critical evaluation of the long-term performance of composite resins in posterior restorations. The guidelines are being reviewed and revised. The profession is advised to be cautious in the manipulation and application of composite resins as they are sensitive to technique. A composite resin should not be handled like an amalgam. Slight deviations from the proper technique may result in postoperative sensitivity, secondary caries, and clinical performances different from those reported in clinical studies. The cavity preparation should be conservative, and the restoration should be subjected to minimal occlusal stresses. The use of a rubber dam is essential. The profession should be aware that composite resins do have occlusal wear. Proximal contacts are difficult to establish.(ABSTRACT TRUNCATED AT 250 WORDS)

Composite Resins↗
PubMed1985

Noble metal alloys for metal-ceramic restorations.

A review of the comparative characteristics and properties of noble metal alloys used for metal-ceramic restorations has been presented. Selection of an alloy for one's practice should be based on long-term clinical data, physical properties, esthetic potential, and laboratory data on metal-ceramic bond strength and thermal compatibility with commercial dental porcelains. Although gold-based alloys, such as the Au-Pt-Pd, Au-Pd-Ag, and Au-Pd classes, may appear to be costly compared with the palladium-based alloys, they have clearly established their clinical integrity and acceptability over an extended period of time. Other than the relatively low sag resistance of the high gold-low silver content alloys and the potential thermal incompatibility with some commercial porcelain products, few clinical failures have been observed. The palladium-based alloys are less costly than the gold-based alloys. Palladium-silver alloys require extra precautions to minimize porcelain discoloration. Palladium-copper and palladium-cobalt alloys may also cause porcelain discoloration, as copper and cobalt are used as colorants in glasses. The palladium-cobalt alloys are least susceptible to high-temperature creep compared with all classes of noble metals. Nevertheless, insufficient clinical data exist to advocate the general use of the palladium-copper and palladium-cobalt alloys at the present time. One should base the selection and use of these alloys in part on their ability to meet the requirements of the ADA Acceptance Program. A list of acceptable or provisionally acceptable alloys is available from the American Dental Association and is published annually in the Journal of the American Dental Association. Dentists have the legal and ethical responsibility for selection of alloys used for cast restorations. This responsibility should not be delegated to the dental laboratory technician. It is advisable to discuss the criteria for selection of an alloy with the technician and the thermal manufacturer or supplier. Once an alloy is selected, the specific alloy name should be written on all laboratory prescriptions as well as in patients' charts. Maintenance of accurate dental records is necessary from a legal point of view, and it also allows the clinician to determine the longevity of specific metal-porcelain systems.

Cobalt↗