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At least 541 records · Page 30Linked to original sources

PubMed2000

The PRO-SELF Program: a self-care intervention program for patients receiving cancer treatment.

OBJECTIVES: To describe the development, testing, and refinement of the PRO-SELF Program as used in randomized clinical trials. DATA SOURCES: Research studies and articles. CONCLUSIONS: The PRO-SELF Program has made an important contribution in enhancing patients' self-care and reducing morbidity. It has the potential to contribute to self-care abilities of children and adolescents who have cancer. IMPLICATIONS FOR NURSING PRACTICE: It is imperative that patients and their families have the essential information, skills, and support to carry out effective self-care symptom management.

Adolescent↗

PubMed1996

Sources of selection bias in evaluating social programs: an interpretation of conventional measures and evidence on the effectiveness of matching as a program evaluation method.

This paper decomposes the conventional measure of selection bias in observational studies into three components. The first two components are due to differences in the distributions of characteristics between participant and nonparticipant (comparison) group members: the first arises from differences in the supports, and the second from differences in densities over the region of common support. The third component arises from selection bias precisely defined. Using data from a recent social experiment, we find that the component due to selection bias, precisely defined, is smaller than the first two components. However, selection bias still represents a substantial fraction of the experimental impact estimate. The empirical performance of matching methods of program evaluation is also examined. We find that matching based on the propensity score eliminates some but not all of the measured selection bias, with the remaining bias still a substantial fraction of the estimated impact. We find that the support of the distribution of propensity scores for the comparison group is typically only a small portion of the support for the participant group. For values outside the common support, it is impossible to reliably estimate the effect of program participation using matching methods. If the impact of participation depends on the propensity score, as we find in our data, the failure of the common support condition severely limits matching compared with random assignment as an evaluation estimator.

Bias↗

PubMed1995

Dietary effects of the National School Lunch Program and the School Breakfast Program.

In this paper we use 24-h dietary recall data to assess the dietary effects of participation in the National School Lunch Program (NSLP) and the School Breakfast Program (SBP). After adjustment for differences in characteristics between NSLP participants and nonparticipants, NSLP participation is associated with higher lunch intakes of vitamin A, calcium, and magnesium, and a lower intake of vitamin C. Although mean intakes of other key dietary components such as food energy, iron, cholesterol, and sodium are higher for NSLP participants than for nonparticipants, these differences appear to be due to underlying differences in unobserved characteristics (eg, food preferences, appetites, or food energy needs) rather than to the NSLP. Both at lunch and over 24 h, NSLP participation is associated with consumption of a higher percentage of food energy from fat and saturated fat. SBP participation is associated with higher breakfast intakes of food energy, calcium, riboflavin, phosphorus, and magnesium, and with a higher percentage of breakfast food energy from fat and saturated fat, and a lower percentage of food energy from carbohydrate.

Adolescent↗

PubMed2006

ARFA: a program for annotating bacterial release factor genes, including prediction of programmed ribosomal frameshifting.

UNLABELLED: Correct annotation of genes encoding release factors in bacterial genomes is often complicated by utilization of +1 programmed ribosomal frameshifting during synthesis of release factor 2, RF2. In the absence of robust computational approaches for predicting ribosomal frameshifting, the success of proper annotation depends on annotators' familiarity with this phenomenon. Here we describe a novel computer tool that allows automatic discrimination of genes encoding class-I bacterial release factors, RF1, RF2 and RFH. Most usefully, this program identifies and automatically annotates +1 frameshifting in RF2 encoding genes. Comparison of ARFA performance with existing annotations of bacterial genomes revealed that only 20% of RF2 genes utilizing ribosomal frameshifting during their expression are annotated correctly. AVAILABILITY: The PHP based web interface of ARFA and the source code are located at http://recode.genetics.utah.edu/arfa

Base Sequence↗

PubMed2003

Programs and procedures for a large x-ray safety program.

As radiation safety surveys of x-ray equipment are the responsibility of many health physicists, actual procedures vary among facilities. In an effort to share survey methodology of a large research institution, aspects of the x-ray safety program at Los Alamos National Laboratory are described. A definition of an intentional x-ray generating device is proposed in light of the absence or inadequacy of such a definition in applicable federal law and national consensus guidance documents. Regulations and procedures are discussed, and a sample database used in managing the Los Alamos program is presented.

Data Collection↗

PubMed1996

Quality of patient care in the Medicare End-Stage Renal Disease Program: the basis and implementation of the 1994-1997 End-Stage Renal Disease Health Care Quality Improvement Program.

Substantial changes have occurred in the quality assurance and improvement programs conducted by the Health Care Financing Administration in the Medicare End-Stage Renal Disease Program. This review is a brief description of these changes and an introduction to the health policy, epidemiology, health services research, clinical nephrology, and statistical process control literature that is the basis for this initiative.

Humans↗

PubMedDate not supplied

Implementing a predictive modeling program, part II: Use of motivational interviewing in a predictive modeling program.

This is the second article of a two-part series about issues encountered in implementing a predictive modeling program. Part I looked at how to effectively implement a program and discussed helpful hints and lessons learned for case managers who are required to change their approach to patients. In Part II, we discuss the readiness to change model, examine the spirit of motivational interviewing and related techniques, and explore how motivational interviewing is different from more traditional interviewing and assessment methods.

Anger↗

PubMed2005

A bioassay program for biomedical research programs.

An effective radiation safety program for biomedical research minimizes both external and internal exposures. Limited time and resources can make it difficult to find the right balance between the external dosimetry and internal bioassay components: research typically involves chronic use of small activities rather than acute use of large quantities; concern for external exposures, especially extremities, distracts from the potential for intake; regulatory guidance for only tritium and iodine leave the impression there is little need to monitor for other radionuclides; conversely some licensees over rely on frequent bioassays. Too often researchers discount the potential for intake, especially those who repeatedly use small quantities. This program emphasizes minimizing external and internal exposures while providing the radiation protection staff with criteria for determining the need to assay for any radionuclide under a wide variety of working conditions.

Biological Assay↗

PubMed1998

Breast cancer screening: first round in the population-based program in Valencia, Spain. Collaborative Group of Readers of the Breast Cancer Screening Program of the Valencia Community.

PURPOSE: To analyze the results of round 1 of the population-based Valencia Breast Cancer Screening Program. MATERIALS AND METHODS: In this program, 78,224 (72.98%) of the 107,178 women invited (aged 45-65 years) underwent screening. Complementary views were obtained in 5,771 women (7.38%). Among the total population studied, 3,502 (4.48%) underwent short-term mammographic follow-up studies; 3,898 (4.98%) underwent additional studies and treatment at hospitals. Five hundred eighty-seven women (0.75%) underwent biopsy. RESULTS: Cancer was detected in 334 patients (4.27 cancers per 1,000 women [3.24 per 1,000 women aged 45-49 years, 6.30 per 1,000 women aged 60-65 years]; six patients with lobular carcinoma in situ excluded). The estimated sensitivity was 89%; specificity, 99%. The positive predictive value of mammography was 8.56%; of mammography with additional examinations, 26.82%; and of biopsy, 56.89%. Forty-one patients (12.28%) had ductal carcinoma in situ; 284 (85.03%) had infiltrating carcinoma. In 73 (25.70%) of the 284 patients, infiltrating carcinomas were smaller than 1 cm. Two hundred twenty-five patients (76.27%) had no lymph node involvement. One hundred seventy-nine (61.09%) had stage 0 or 1 cancer. CONCLUSION: Results are consistent with other published results; differences are due to methods and patient population characteristics.

Aged↗

PubMed1999

Successful conversion from a linear accelerator-based program to a Gamma Knife radiosurgery program: the Cleveland Clinic experience.

From August 1989 to January 1997, 307 treatments in 293 patients were performed with a linear accelerator-based (LINAC) stereotactic radiosurgery system. Because of the program s success, the need for a dedicated radiosurgery unit in Ohio and the desire to treat functional disorders, the Cleveland Clinic Health System (CCHS) obtained the first Gamma Knife in the state of Ohio. Based on the previous volume of patients for radiosurgery, it was estimated that 75-100 patients would be treated during the first year of operation. However, during the first calendar year, 214 treatments were performed on 205 patients, which far exceeded expectations. The success of the CCHS Gamma Knife Center can be attributed to an increase in a number of factors. These included marketing efforts, patient awareness, increased use for functional disorders, physician understanding of radiosurgery, use by qualified nonaffiliated radiation oncologists and neurosurgeons, and outpatient delivery (95% with the Gamma Knife vs <5% with the LINAC). With proper planning, education, and awareness, the opening of a Gamma Knife Center can greatly increase the volume of radiosurgery performed when compared with a LINAC-based program.

Brain Neoplasms↗

PubMed2005

An examination of characteristics of lung and colon cancer patients participating in a web-based decision support program. Internet-based decision support programs.

OBJECTIVES: Little is known about the characteristics of cancer patients who employ the Internet as a technique to gather information to assist them in their management. METHODS: To address this issue, aggregate data from individuals with colon (n=7,543), non-small cell lung (n=24,778) and small cell lung (n=13,817) cancers who provided personal clinical information through participation in a proprietary Web-based decision support program (NexProfiler Treatment Option Tools for Cancer; NexCura, Inc., Seattle, Wash., USA) were evaluated for potential differences between specific patient subgroups. RESULTS: Examination of a number of objective (e.g., prior therapy) and subjective (e.g., overall health, activity level) parameters failed to reveal any major differences based on sex, geographical location (US vs. non-US) or newly diagnosed versus recurrent disease (non-small cell lung cancer patients). Several notable findings included: (1) overall >65% of colon cancer patients and >70% of lung cancer patients stated that they 'were interested in learning about clinical trials'; (2) 65-70% of patients with recurrent non-small cell lung cancer stated that their 'general health was good', while >60% noted they had symptoms and >50% declared their activity level to be essentially 'normal'; (3) while almost 80% of small cell lung cancer patients noted symptoms, >60% stated their activity level was 'normal'. CONCLUSION: These data suggest that the population of patients who seek information from Web-based decision support programs share a number of relevant clinical features, yet they appear to represent a unique subset among all individuals with malignant disease. It will be important for oncologists to more fully understand the objectives of this population in order to assist such patients (and their families) in their use of this remarkably powerful, but essentially unregulated, technology.

Activities of Daily Living↗

PubMed1979

Community support programs: program evaluation and public policy.

The plight of chronic psychiatric patients in the community has led to a major federal effort to resolve fragmented and disorganized care. The Community Support Programs (CSPs) recently funded by NIMH offer the promise of reducing these difficulties by creating comprehensive human service systems at the local and state levels. However, the author points out that these demonstration projects should be evaluated lest they continue to operate on the basis of rhetoric rather than fact. He presents an evaluation framework whereby indexes pertinent to each program goal of the CSPs can be measured and the resulting data used for public policy purposes.

Community Mental Health Services↗

PubMed1994

Prognosis of patients with severe congestive heart failure referred to the cardiac transplant program. Osaka University Cardiac Transplant Program.

In any program for cardiac transplantation, appropriate recipient selection is critically important. The purpose of this study is to evaluate the prognosis of 42 patients with severe cardiac dysfunction who were referred to the Patient Referral Committee of the Osaka University Cardiac Transplant Program from August 1990 to July 1993. All of the patient profiles and clinical data were presented and discussed in the Committee Conference. The Committee classified the patients into three groups according to the following criteria: Class A; 14 patients judged to have a medical indication for heart transplantation, Class B; 7 patients with possible indications which required reevaluation for a definite indication after further intensive medical treatments, and Class C; 21 patients who did not have indications for heart transplantation or who required further clinical examinations and/or medical treatments before a final judgment. Twelve of the 14 Class A patients had a history of NYHA functional class IV and ejection fractions were 25% or less in all of the patients but one (18.5 +/- 1.7%). Six patients in Class A had a history of ventricular tachycardia. The one-year survival rate of Class A patients was 60%, and only 28% survived for 28 months. One patient underwent successful heart transplantation in the United States. If we assume that this patient would have died within a year without heart transplantation, the estimated one-year survival rate would fall to 48%, which is comparable to the survival rate of patients who have been accepted for transplant, but are being treated medically, in Western countries.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗

PubMed2004

Exploiting micronutrient interaction to optimize biofortification programs: the case for inclusion of selenium and iodine in the HarvestPlus program.

Biofortification of staple food crops with micronutrients by either breeding for higher uptake efficiency or fertilization can be an effective strategy to address widespread dietary deficiency in human populations. Selenium and iodine deficiencies affect a large proportion of the population in countries targeted for biofortification of staple crops with Zn, Fe, and vitamin A, and inclusion of Se and I would be likely to enhance the success of these programs. Interactions between Se and I in the thyroid gland are well established. Moreover, Se appears to have a normalizing effect on certain nutrients in the body. For example, it increases the concentration of Zn and Fe at key sites such as erythrocytes when these elements are deficient, and reduces potentially harmful high Fe concentration in the liver during infection. An important mechanism in Se/Zn interaction is selenoenzyme regulation of Zn delivery from metallothionein to Zn enzymes. More research is needed to determine whether sufficient genetic variability exists within staple crops to enable selection for Se and I uptake efficiency. In addition, bioavailability trials with animals and humans are needed, using varying dietary concentrations of Se, I, Zn, Fe, and vitamin A to elucidate important interactions in order to optimize delivery in biofortification programs.

Avitaminosis↗

PubMed1996

A comparison between an outpatient hospital-based pulmonary rehabilitation program and a home-care pulmonary rehabilitation program in patients with COPD. A follow-up of 18 months.

AIM: In this study, the effects of a 12-week hospital-based outpatient pulmonary rehabilitation program (HRP) are compared with those of a 12-week home-care rehabilitation program (HCRP) in COPD patients. A control group received no rehabilitation therapy. METHODS: After randomization and stratification, effects on lung function, exercise performance (4-min walking test and cycle ergometer test), dyspnea, and leg effort during exercise, and well-being were assessed in 45 COPD patients with moderate to severe airflow limitation (mean [SD] FEV1 percent predicted, 42.8 [8.4]). RESULTS: After HRP and HCRP, at 3 to 6 months after the start of the study, equal improvements were detected in exercise capacity and in Borg dyspnea and leg effort scores at similar work levels during the cycle test. However, whereas after HRP at longer term values tended to return to baseline outcome, after HCRP a further ongoing significant improvement in exercise capacity was observed, while Borg dyspnea scores remained significantly improved over 18 months. Improvements in cycle workload and dyspnea score were significantly better maintained after HCRP as compared with HRP. Lung function, arterial oxygen saturation, and heart frequency during exercise did not change. A significant improvement in well-being was maintained over 18 months in both rehabilitation groups. CONCLUSION: Beneficial effects are achieved both after a HRP and a HCRP in COPD patients with moderate to severe airflow limitation. Yet we recommend to initiate HCRPs as improvements are maintained longer and are even further strengthened in this setting.

Aged↗

PubMed1980

Coordination of benefits in dental prepayment programs: Council on Dental Care Programs.

The 1979 House of Delegates adopted Resolution 49H which directed the Council on Dental Care Programs to initiate discussion with the Health Insurance Association of America, Delta Dental Plans Association, Blue Cross and Blue Shield Associations, and the Health Care Financing Administration, Department of Health and Human Services, to develop suitable inexpensive, uniform procedures for the Coordination of Benefits of Prepaid Dental Programs. Additionally, the Council was directed to disseminate these procedures to the membership through Association publications. The following is a report detailing the results of the Council's activities.

Humans↗

PubMed1997

Voluntary programs: ADA Seal program and international implications.

For about 130 years the American Dental Association (ADA) has aided the profession and the public in selecting safe and effective dental products. Since 1930, dental products have been evaluated through the ADA Seal program. In accordance with the ADA's Bylaws, the Council on Scientific Affairs assesses information evaluating the safety, efficacy, appropriate use, and promotional claims of dental products. In doing so, the Council may award the ADA's Seal of Acceptance. In collaboration with interested parties, expert consultants, and Council members, the ADA produces guidelines suggesting appropriate methodologies and submission data to assist manufacturers in voluntarily earning the Seal of Acceptance. To date, numerous professional and consumer products have been evaluated, and about 1,300 of these products bear the Association's Seal of Acceptance. When a product is awarded the Seal it means that adequate data have been submitted and reviewed and, based on available information, the product meets ADA guidelines of safety and effectiveness. Dental health care professionals and consumers who use products that have the Seal can be confident that a product's properties and performance are consistent with current professional standards and manufacturers' claims. The ADA Seal program serves to help dentists and manufacturers meet their ethical obligations to the public by promoting safe and effective health care products.

American Dental Association↗

PubMed1983

The rural dental health program: the effect of a school-based, dental health education program on children's utilization of dental services.

Eighteen-hundred rural children ages five through thirteen were randomly assigned for dental treatment to a school-based practice, and to private practitioners in the community. Simultaneously, five of the nine public schools attended by the children offered an enriched program of dental education while the remaining schools taught the regular health education courses. All children participated in a school based fluoride program and their dental treatment was provided without charge. Data indicating how the children utilized dental services were collected over the three-year treatment phase of the study. Evidence from the third treatment year indicates that children assigned to the school based practice who also attended a school offering enriched dental health education used dental services on a more regular basis than children in the other three groups. Evidence obtained from log-linear modeling supports the hypothesis that dental health education had a positive effect on children's utilization of dental service.

Adolescent↗