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PubMed1990

Assistant programming software: a new tool for an improved programming of pacemakers.

Programming the new DDD pacemakers is becoming increasingly difficult. One must take into account the pacemaker's complexity, the fact that some parameters are linked to others, and the clinical profile of the patient. This difficult problem will lead to the design of software to assist programming, which will help the implanting physicians in choosing adequate programmed settings adapted to the functioning of the device and to the physiology and pathology of the patient. These programming aides should meet certain basic requirements to make them safe, efficient, and easy to use. One such system designed by ELA Médical, "Programming Assistant" is herein described. The preliminary results of an initial study on the acceptance of this programming aide among physicians involved in cardiac pacing are given and discussed.

Adult↗

PubMed1986

[A population survey on a mass screening program for gastric cancer. 1. Population characteristics related to examination rates for the screening program].

The types of examination received for gastric cancer during the past 3 years have been surveyed by a self-administered questionnaire among residents of a small town near Kitakyushu City. Among 3660 surveyed, 2205 subjects who completed the questionnaire are analyzed in this study. Examination rates of mass screening for males were higher than those for females. Males in their forties and fifties and females in their forties through sixties have higher examination rates than other age groups. Higher examination rates were seen in public officials and employees who have opportunities to receive the screening program at work site. On the other hand, among people without a job and housewives who have opportunities to receive a screening program offered only by the town hall, examination rates of the mass screening program were low. More people with a family history of cancer death were examined than those without a similar family history. There was no difference in the examination rates by the mass screening program between the people who took care of their health and those who did not. In order to raise examination rates for the mass screening program, it is essential to improve the systems of this program which can be easily accepted, and to educate residents in order to stimulate motivation for screening.

Adult↗

PubMed1979

The four basic types of evaluation: clinical reviews, clinical trials, program reviews, and program trials.

Four basic types of evaluation, each appropriate in a distinctive situation, are the clinical review and the clinical trial, which are concerned with the care of the individual patient, and the program review and program trial, which deal with programs or services directed at groups or populations. Evaluative reviews are primarily motivated by concern with the welfare of the specific population served, and they appraise specific activities in specific settings as a basis for decisions concerning these activities. Clinical and program trials aim to generate knowledge of more general applicability, especially concerning causal relationships between care and outcomes. The types of evaluation differ in the questions they pose and in the methods used to answer them. Failure to draw a distinction between program reviews and program trials is a frequent cause of wasteful or unhelpful evaluative studies.

Consumer Behavior↗

PubMed1991

Development of an exercise program for older adults: pre-exercise testing, exercise prescription and program maintenance.

Health care practitioners have the technical skills, frequency of contact and credibility with older adults to use exercise as a health-promoting and disease-preventing intervention. This article acquaints the clinician with how to develop an exercise program specifically for older adults. The health-promotion and disease-prevention outcomes of exercise in older adults, including an explanation of the three stages of exercise programming for older adults, are also reviewed. Stage one is labeled pre-exercise testing and discusses assessment protocols for aerobic capacity, body composition, flexibility and strength. Guidelines for who should and should not exercise are also explored. The second stage of exercise programming is exercise prescription. An explanation of how to develop a beginning level of training and guidelines for how to set goals based on the initial pre-exercise testing are presented. Program maintenance is the third stage; this includes suggestions for designing an exercise program that increases program compliance, reduces attrition and prevents relapses to non-exercise behaviors.

Aged↗

PubMed1991

[A study of exercise programs and instructors for a fitness program in a corporate setting].

The objective of the study was to evaluate the importance of diversity in exercise programs and athletic instructors in a corporate physical fitness program. Subjects were 717 Japanese chemical factory employees (male 524, female 193) in Japan who were surveyed using a questionnaire, with a resultant response rate of 84%. Many employees who participated in regular physical activities on a voluntary basis were motivated to exercise for reasons other than health, with a variety of motivating factors suggested. The total number of sports programs in which male and female employees participated voluntarily were 31 and 15, respectively. For employees not yet participating in physical activities but expressing interest in joining a company sponsored sports class, the total number of programs in which interest was shown was 40 for males and 22 for females. Professional athletic instructors from outside fitness clubs appeared to have far more appeal to employees than athletic instructors who were recruited from company employees and given a short athletic instructor course to become health care leaders at the same factory in addition to their regular job. In order to enhance participation in and adherence to a corporate fitness program, it was suggested that the number of exercise programs be increased and that outside professional athletic instructors be employed.

Adult↗

PubMedDate not supplied

An educational program for total hip and knee replacement patients as part of a total arthritis center program.

An outpatient and inpatient educational program was developed to meet the medical and surgical needs of arthritis patients undergoing a total hip or knee replacement. This program is one component of a total Arthritis Center Program that includes outpatient treatment, inpatient rehabilitation, and acute medical and joint surgery. The education program consists of five standard classes: Presurgical Total Joint Replacement; What is Arthritis?; Arthritis Medications; Pain, Stress and Coping; and Discharge Total Joint Replacement. The program attempts to prevent complications, decrease anxiety, decrease hospital length of stay, decrease pain, and address the underlying arthritis by preparing patients for the surgery, postsurgery, and discharge.

Arthritis↗

PubMed1992

A program model to enhance adherence in work-site-based fitness programs.

We describe a program model designed to achieve high adherence, a major problem for work-site exercise/fitness programs. Our model is a 6-month program consisting of 15 1-hour program meetings, with participants exercising on their own time four times per week. Procedures employed to enhance adherence are contracting, group competition, monitoring, and social support. This program model has been applied nine times. One hundred fifty-nine university employees took part in the initial test with a dropout rate of 9% (15 persons). The average adherence rate for nondropouts was 98%, which is higher than rates usually reported in the literature. Adherence was defined as exercising four times a week.

Adult↗

PubMedDate not supplied

Assessing the effects of employee assistance programs: a review of employee assistance program evaluations.

Employee assistance programs have grown at a dramatic rate, yet the effectiveness of these programs has been called into question. The purpose of this paper was to assess the effectiveness of employee assistance programs (EAPs) by reviewing recently published EAP evaluations. All studies evaluating EAPs published since 1975 from peer-reviewed journals in the English language were included in this analysis. Each of the articles was assessed in the following areas: (a) program description (subjects, setting, type of intervention, format), (b) evaluation design (research design, variables measured, operational methods), and (c) program outcomes. Results indicate numerous methodological and conceptual weaknesses and issues. These weaknesses included lack of controlled research designs and short time lags between pre- and post-test measures. Other problems identified are missing information regarding subjects, type of intervention, how variables are measured (operational methods), and reliability and validity of evaluation instruments. Due to the aforementioned weaknesses, positive outcomes could not be supported. Recommendations are made for future EAP evaluations.

Alcoholism↗

PubMed1988

Compliance with an outpatient stress reduction program: rates and predictors of program completion.

The rate at which medical patients physician-referred to an 8-week stress reduction program completed the prescribed intervention was measured and predictors of compliance sought. Seven hundred eighty-four consecutive patients who enrolled in the program over a 2-year period were studied. Of these, 598 (76%) completed the program and 186 (24%) did not. Multiple regression analysis showed that (1) among chronic pain patients, only sex discriminated between completers and noncompleters, with females more than twice as likely to complete the program as males (odds ratio = 2.4; 95% CI = 1.2, 4.4); (2) among patients with stress-related disorders, only the OC scores of the SCL-90-R discriminated between completers and noncompleters (odds ratio = 2.0; 95% CI = 1.2, 3.4). Completion rates for specific diagnoses are reported and discussed. The high rate of completion observed for this intensive program in health behavior change is discussed in terms of the design features and therapeutic modalities of the intervention.

Adult↗

PubMed1979

A community program for the control of cardiovascular risk factors: a preliminary evaluation of the effectiveness of the CHAD program in Jerusalem.

A community program for the control of cardiovascular risk factors, the CHAD program, was instituted in a family practice in western Jerusalem in 1971. The effectiveness of the program was evaluated by comparing the findings of community surveys conducted in 1970 and 1975 and by comparing the changes with those observed in an adjacent control neighborhood. This paper reports the findings among men aged 35 years and above. In the community exposed to the program there was a decrease in mean systolic and disatolic pressures, in the prevalence of hypercholesterolemia, and in the prevalence of cigarette smoking. The changes in blood pressures and smoking habits were significantly greater than those observed in the control population. In the control population (only) there was a small increase in mean body weight and a decrease in reported physical activity. The findings suggest that it is possible for a program that operates and through primary health care to have an appreciable influence upon cardiovascular risk factors in the community.

Adult↗

PubMed1976

Relation between programming time and duration of the response being programmed.

When the nature of motor response is varied, holding the number of alternative responses constant, differences in choice reaction time can be attributed to differences in response programming time. The present experiments suggest that although changes in response duration are not necessary to produce small differences in programming time, such response duration changes may be a sufficient condition for the programming time to change and necessary condition for very large changes in programming time. Implications of this conclusion for theories of response programming are discussed.

Feedback↗

PubMedDate not supplied

The effect of an educational program on transfusion practices in a regional blood program.

With the increased complexity of blood component therapy, it is important to be able to modify physician behavior with reliable educational programs. A standardized educational program on the use of red blood cells and whole blood was tested in 22 hospitals in a regional blood program using medical audit and computer monitoring to evaluate effectiveness. Most hospitals were eager to take advantage of the education program but were unwilling to use the audit-education cycle. At the same time, computer monitoring of indivisual hospital ordering and transfusion practices demonstrated an increased utilization of red blood cells in 64 per cent of hospitals with an overall improvement of 8 per cent. The improved use of red blood cells was appreciated within the month of the program and then sustained for six to twelve months at the new level.

Blood Transfusion↗

PubMedDate not supplied

Developing a computer program to assist the nursing process: phase I-from systems analysis to an expandable program.

In a three-stage project, a computer program was devised to assist in the nursing process. As Stage I, a definition of nursing was developed upon which a systems model of the nursing process was constructed. In Stage II, the computer program was written to collect patient data and formulate nursing diagnoses related to functions of the skin, mucous membranes, nails, and hair. The program was designed to serve as a model for the development of a more comprehensive program that would include other functional areas, suggest patient objectives and nurse interventions, and help to evaluate nursing care. In Stage III, initial trials were conducted to obtain feedback from nurses. Nurses found the program took too long but agreed that with modification it could help them give better care.

Computers↗

PubMed1991

Physical training programs and their effects on aerobic capacity and coronary risk profile in sedentary individuals. Design of a long-term exercise training program.

Currently the prevalent perception is that regular exercise training, besides increasing maximal oxygen uptake (VO2max), may have a beneficial effect on blood pressure and plasma lipid fractions. This is the basis for recommending exercise training for health maintenance and as a part of any prevention program for middle aged and older individuals. The purpose of this work was first, to review whether a basis exists for these recommendations and if so, to secondly design an exercise training program adjusted to these groups. Its parameters should be efficient enough to cause improvements in VO2max and risk profile, yet prevent cardial and orthopedic problems. The structure and the results of exercise programs in 27 experimental studies (n = 1153) were reviewed. The findings indicate that significant changes in VO2max, apart from individuals having least favourable values initially, do not necessarily effect simultaneous improvements in either blood pressure or plasma lipid fractions. Results strongly indicate the permanent benefits of participating in a long-term exercise program. This program should therefore provide a very useful and natural addition to the accepted dietary and pharmacological therapies.

Adult↗

PubMed1990

Industry's voluntary program: Community Awareness and Emergency Response Program and the Emergency Planning and Community Right-to-Know Act.

This paper describes the chemical industry's Community Awareness and Emergency Response (CAER) Program, and voluntary and mandatory actions by the chemical industry to comply with the major environmental legislation. The chemical industry started the voluntary CAER Program soon after the Bhopal Disaster in 1984; it is coordinated through the Chemical Manufacturer's Association. This program, which began in March 1985, is a long-term industry commitment to develop a community outreach program and to improve local emergency response planning. The Congress of the United States began, in 1985, to consider proposals for mandatory programs. This led to enactment of the Superfund Amendments and Reauthorization Act of 1986, known as SARA. A portion of this Act, entitled Title III is also known as the Emergency Planning and Community Right-to-Know Act. Although this legislation has many mandatory requirements, it should be emphasized that a significant degree of voluntary industrial participation is needed if the purposes of the statute are to be achieved. Title III has created an intricate and still evolving system that ties together the EPA, industrial plant managers, state emergency response commissions, local emergency planning committees and fire departments with jurisdiction over the facility. Each of these groups has a different role and responsibilities but must work cooperatively with other participants. Because of the intricate network of participants, the magnitude of the information flow, and the continuing evolution of the system, unique public relations problems exist in order to comply with Title III.(ABSTRACT TRUNCATED AT 250 WORDS)

Awareness↗

PubMed1988

Comparison of a Bayesian program with three microcomputer programs for predicting gentamicin concentrations.

A recently developed Bayesian regression program was compared with three other aminoglycoside pharmacokinetic dosing programs available for clinical use. From 30 adult patients, 152 measured serum gentamicin concentrations (SGC) were evaluated retrospectively (78 peak and 74 trough). Predictive performance was compared for each method by using the first peak and trough SGC pair to predict subsequent serum concentrations, making a total of 92 predictions (48 peak and 44 trough). The two Bayesian programs (Brater and Koup) were further evaluated using only one initial peak or trough SGC to make the same predictions. Mean predicted error (ME), mean absolute error (MAE), and root mean squared error (RMSE) were calculated for each method. Prediction bias and precision were compared statistically, between each method, by calculating the 95% confidence intervals for the delta ME and delta MAE, respectively. No statistically significant differences were found in the MAEs among any of the methods for predicting peak SGCs, with the exception of the Brater program, using a single trough SGC, which was statistically less precise (less than 0.05). There were few statistically significant differences in the MAEs for trough SGCs; however, Koup's Bayesian program using a single trough concentration yielded statistically more precise predictions than the other methods. The ME was found to differ significantly (p less than 0.05) among estimates for peak and trough SGCs provided by some of the predictive methods.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1988

A note on sampling variance estimates for Social Security program participants from the Survey of Income and Program Participation.

The Census Bureau's Survey of Income and Program Participation (SIPP) provides data that can be used to study the characteristics of Old-Age, Survivors, and Disability Insurance (OASDI) and Supplemental Security Income (SSI) program participants. It is important that estimates of sampling errors accompany such studies because the estimates may have large sampling errors due to the small number of sample cases available for specific analyses. The generalized sampling variances provided by the Census Bureau did not identify separately either program's participants and, therefore, do not pertain directly to analyses of these groups. This article describes an approach to the direct computation of sampling variances for OASDI and SSI program participants. The approach uses the pseudo stratum and half-sample codes available in SIPP public use data files. A table of generalized standard errors is constructed for participants of both programs aged 18 or older. Generalized standard errors could not be computed for child beneficiaries under age 18 because of a wide variation of design effects across subpopulation estimates.

Adolescent↗

PubMed1985

Neural mechanisms of motor program switching in the mollusc Pleurobranchaea. I. Central motor programs underlying ingestion, egestion, and the "neutral" rhythm(s).

The buccal musculature of the carnivorous gastropod Pleurobranchaea is used in three cyclic patterns of coordination underlying, respectively, ingestion, egestion, and a third, unknown behavior(s) (Croll, R. P., and W. J. Davis (1981) J. Comp. Physiol. 145: 277-287; Croll, R. P., and W. J. Davis (1982) J. Comp. Physiol. 147: 143-154). The corresponding three motor programs can be identified and distinguished in the intact animal (Croll, R. P., and W. J. Davis (1981) J. Comp. Physiol. 145: 277-287), the reduced preparation (Croll, R. P., and W. J. Davis (1982) J. Comp. Physiol. 147: 143-154, and the present paper), and the isolated CNS (present paper), on the basis of several qualitative and quantitative criteria. Distinguishing parameters developed here include: the activity of the salivary duct, which bursts in phase with protraction during ingestion, is silent during egestion, and usually bursts biphasically and in antiphase with protraction during the third ("neutral") rhythm(s); and the protractor duty cycle, which is generally 33 to 50% during ingestion, greater than 50% during egestion, and less than 33% during the neutral rhythm(s). Retractor duty cycles did not differ significantly between the three motor programs. The neutral rhythm(s) may be a low-intensity version of the ingestion motor program, with which it shares most features. The three buccal motor programs can be elicited in the reduced preparation (sensory feedback intact) and in the isolated, deafferented CNS. Therefore, multiple motor programs in this metastable motor system are each endogenous to the CNS; i.e., they can each be generated by a central pattern generator(s) in the absence of sensory feedback.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗