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PubMed1999

Cancer survivors as standardized patients: an innovative program integrating cancer survivors into structured clinical teaching.

BACKGROUND: Increasingly, standardized patients are involved in medical education; however, reports of cancer survivors functioning as standardized patients have not been available. This study describes the participation of cancer survivors as standardized patients in structured clinical teaching. METHODS: Forty-two cancer survivors, 354 trainees, and 54 faculty members took part in the structured clinical instruction modules (SCIMs) at five academic institutions. After completing the SCIMs, the cancer survivors answered evaluation questionnaire items concerning their perceptions of the course, and all participants (cancer survivors, faculty members, medical students, and residents) rated the benefit of the participation of cancer survivors. The evaluation items were rated on a five-point scale ranging from 1 = "strongly disagree" to 5 = "strongly agree. RESULTS: The evaluation responses were very positive, and the cancer survivors expressed a strong willingness to participate in future courses. Faculty members, residents, and medical students all rated the benefit of using cancer survivors highly. CONCLUSIONS: The participation of cancer survivors in structured clinical teaching was considered beneficial not only by the cancer survivors themselves, but also by the faculty members, residents, and medical students who were involved in the educational program. The role of cancer survivors in the education of physicians needs to be expanded.

Adult↗
PubMed1997

Children's smoking habits in an agricultural community in Japan and the importance of a no smoking program integrating family, school and community health.

The object of this study is to establish a model of integration of the health promotion projects which have been planned separately by schools and communities so far in an agricultural area in Japan, to solve the problem of children's smoking. The subjects of the study were 10-15 y old schoolchildren and their parents. The questionnaires were completed by the children themselves at school and also by their parents at home, in July 1995. One fourth of the junior high school boys had ever tried smoking, while most of their parents did not notice that their children were smoking. More than half of the children who had ever tried smoking mainly acquired tobacco from their homes. One tenth of them were prompted to smoke by their fathers or other relatives. To develop a health promotion project for children which includes prevention of smoking, the provision of a health education program and an environment which encourages health are important for children. The project should also be community-based because participation of local inhabitants in the project gives it additional impetus. In order to promote the comprehensive health of children, we emphasize the importance of setting up a healthy district plan based on the health policy of the general community.

Adolescent↗
PubMed1985

[Cooperative study on the multifactor prevention of ischemic heart disease and its development into an integral program for the prevention of noninfectious diseases].

The authors presented a preliminary analysis of the 5-year implementation of a cooperative trial of multifactor prophylaxis of CHD in Moscow and Kaunas. A stable decrease in the prevalence of arterial hypertension (AH) by 20-25% and smoking by 22%, a decrease in SAP and DAP mean levels and the number of smoked cigarettes as compared to initial levels were noted in the group of active prophylaxis (the 1st group). It caused the reduction of CHD death risk by 13.6%. In the group of comparison with common treatment (the 2nd group) the prevalence of smoking decreased by 11% and arterial hypertension tended towards a rise. The comparison of mortality rates in the 1st and 2nd groups showed that in the 1st group total mortality rates were lower by 21% and CVD mortality rates were lower by 41% as compared to the 2nd group. The most noticeable decrease in 5-year mortality rates was observed among the persons initially attributed to the CHD group. Analysis of mortality with relation to the presence and intensity of smoking habits in Moscow and Kaunas indicated to the association of smoking not only with CHD mortality but also with cancer and total mortality making appropriate the development of an integral approach to the prophylaxis of the main chronic noncommunicable diseases.

Adult↗
PubMedDate not supplied

DiaKin: an integrated program package for hemodialysis kinetics.

A flexible program for the IBM PC performing a number of calculations of relevance for the prescription of hemodialysis treatment has been developed. The program has a 'spreadsheet'-like user-friendly interface, and results may be presented graphically. The present implementation covers 89 algorithms/equations, all based on the assumption of single-pool kinetics. Some of these are detailed for the first time, including considerations on their implementation using a generalizing, structured approach.

Algorithms↗
PubMed1994

An integrated program for amplitude-modulated RF pulse generation and re-mapping with shaped gradients.

Efficient generation of amplitude modulated, frequency selective RF pulses has been demonstrated by the Shinnar-Le Roux (SLR) algorithm. In the present article, we provide an overview of a relatively comprehensive computer program that includes a version of the SLR algorithm and also incorporates an algorithm for re-mapping a selective RF pulse onto a new dwell time with modulated gradients. The re-mapping may be used to reduce SAR, or to shorten the RF pulse time by increasing the gradient and RF strength in regions where the original RF pulse amplitude was low. The program includes additional useful features including a Bloch equations algorithm, and pulse scaling, to enable examination of pulse profiles under a variety of conditions such as RF inhomogeneity and even nuclear relaxation. The program, MATPULSE, was developed with the MATLAB for Windows programming language and makes extensive use of the MATLAB graphical user interface (GUI) features to generate a user-friendly interface. A number of examples are provided to illustrate the capabilities of the MATPULSE program.

Image Processing, Computer-Assisted↗
PubMed2006

Influenza work on the regional level in Sweden: an integrated program for vaccination of risk groups, surveillance and pandemic planning which focuses on the role of the health care worker.

The aim of the study was to increase the vaccination rates of influenza among the risk groups in Region Västra Götaland, Sweden. The main interventions performed were education of doctors and nurses, information on the Internet and advice on administrative routines and organisation for the task. There was no campaign towards the risk group and no reimbursement. The vaccination rate increased from 33.6 to 54.6% in the Göteborg area between 1999 and 2004 and from 44.1 to 51.9% in the whole region. Vaccination rates increased with age and chronic disease in the elderly population, among person's 20-64 years of age with chronic disease only 23.8-34.0% were vaccinated. In order to increase the vaccination coverage in persons with chronic disease the program intensified the education of hospital staff. It was then evident that the awareness and knowledge about influenza and vaccination was limited among hospital doctors. The study demonstrates the key role of health care workers in a vaccination program and points at the importance of preparing the personnel for a pandemic situation. Co-ordination of the vaccination program with the surveillance and pandemic planning are effective means of strengthening the preventive work against influenza.

Disease Outbreaks↗
PubMed2000

Apoptosis and cancer: strategies for integrating programmed cell death.

Virtually all human cells are endowed with the capacity to commit suicide using an evolutionarily conserved mechanism that involves activation of caspase-family cell death proteases. Caspase activation culminates in a cell death process known as "apoptosis." The activation of these intracellular proteases is carefully controlled through a delicate balance of anti- and pro-death proteins, serving to precisely regulate cell life span. Defects in the natural death pathway promote tumorigenesis by prolonging cell life span and hence cell accumulation. Low-grade B-cell malignancies, particularly follicular lymphoma and chronic lymphocytic leukemia (CLL) represent quintessential examples of human neoplasms characterized primarily by a problem with cell death rather than cell cycle. Because the cell suicide pathway is also required for tumor eradication by the immune system, anticancer drugs, and irradiation, cancer-associated defects in the cellular apoptosis machinery also play an important role in treatment failures. Monoclonal antibody-based therapies may provide opportunities to either bypass defects in apoptosis pathways or to activate latent apoptotic programs in cancer cells, particularly in lymphoid malignancies where tissue-specific antigens can be exploited for cell-selective activation of apoptosis. Recent knowledge about apoptosis pathways is reviewed, and some examples of opportunities for therapeutic intervention are discussed.

Animals↗
PubMed2005

Hepatitis C virus infection in former commercial plasma/blood donors in rural Shanxi Province, China: the China Integrated Programs for Research on AIDS.

BACKGROUND: Unsafe practices during illegal plasma donation in the late 1980s and early 1990s spread bloodborne infections in central China. METHODS: A cross-sectional survey of a random sample of 538 adult residents of 12 villages in rural Shanxi Province, where there had been an illegal commercial plasma-collection center, was conducted in 2003. Structured questionnaires were administered, and blood samples were tested for hepatitis C virus (HCV) antibodies. RESULTS: HCV seroprevalence rates were 8.2% in all subjects, 27.7% in former commercial plasma/blood donors, and 2.6% in nondonors. Selling blood or plasma was the strongest independent predictor of HCV seropositivity (odds ratio [OR], 14.4 [95% confidence interval {CI}, 7.1-31.6]). A history of blood transfusion was also independently associated with HCV seropositivity (OR, 8.3 [95% CI, 2.1-32.0]). Plasma donors had a higher risk of being HCV seropositive than did whole-blood donors (OR, 7.6 [95% CI, 2.9-20.9]), and female donors had a lower risk than did male donors (OR, 0.32 [95% CI, 0.12-0.80]). The strength of the association between selling blood and HCV seropositivity was weaker when plasma donors were excluded (OR, 8.0 vs. 14.4). CONCLUSIONS: Unsafe practices during illegal plasma donation led to a high risk of HCV seropositivity for donors during the 1980s and 1990s. Failure to screen for HCV increased the risk of seropositivity for transfusion recipients during this same period. China has taken steps to halt illegal plasma collection and to improve blood-banking methods. However, there will be an ongoing challenge to care for patients with HCV infection, even as its incidence decreases.

Adult↗
PubMed1996

RNAdraw: an integrated program for RNA secondary structure calculation and analysis under 32-bit Microsoft Windows.

The use of algorithms for calculation and analysis of RNA secondary structures has largely been limited to mainframe computers, mainly due to the 16-bit memory restrictions imposed by MS-DOS. The program presented here, RNAdraw, moves calculations to the 32-bit Microsoft Windows environments with an intuitive user interface with extensive viewing, editing and printing possibilities. The algorithms for secondary structure/basepair probability matrix/heat curve calculation have been ported directly from a 32-bit Unix environment. RNAdraw also offers novel features such as the options to edit energy parameters, extract structures of different probability levels, create de novo secondary structures interactively, and combine viewing of structures and basepair probabilities.

Algorithms↗
PubMed1999

An integrated program for dementia evaluation and care management.

The growth of the geriatric population and the emergence of managed care dictate new approaches to dementia care. Management of Alzheimer's disease (AD) is a critical issue for health care policy as well as quality of life for patients and caregivers. The Alzheimer's Disease Education Program (ADEP) seeks to improve the quality of care for individuals with AD and to reduce the burden of caregiving experienced by families. Objectives of ADEP include early detection of AD through dementia screening followed by caregiver education and support. This article outlines an effective method of dementia evaluation and management.

Alzheimer Disease↗
PubMed1991

Providing an integrated program of low intensity tobacco cessation services in a health maintenance organization.

This paper reports on the development, promotion and use of a coordinated program of low intensity intervention services designed to appeal to smokers (and smokeless tobacco users) at various stages of change. An initial package of four components: a telephone advice line, self-help materials, single session group meetings and bi-monthly newsletter was offered to subjects in a variety of different settings (outpatient clinics, dental offices, worksites, hospitals) within a health maintenance (HMO) program project. Based upon consumer response and formative evaluations, these components were modified during the course of the year-long intervention. Results revealed differences in use of the various components of the program, with greatest use of self-help materials (manuals, 'tobacco substitutes' and a computerized smoking cessation aid) and least response to group meetings and the advice line. Most encouraging was the finding that it was possible to reach heavy smokers and to engage them in tobacco cessation activities through a centralized program of low intensity services. Data are presented on member characteristics associated with use/non-use of the various low intensity resources and suggestions are made for wider use of such interventions in other health care systems.

Adult↗