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At least 73 records · Page 4Linked to original sources
PubMed1986

Self-injurious behavior: a state-wide prevalence survey of the extent and circumstances.

A state-wide prevalence survey was conducted to determine the extent and circumstances of self-injurious behavior (SIB) among institutionalized mentally retarded individuals with 13.6% of the population (1,352 individuals) identified as being self-injurious from the approximately 10,000 clients in Texas' 13 residential facilities serving the mentally retarded. It was found that: (a) 89.8% of the clients were severely and profoundly mentally retarded; (b) differential therapeutic treatment modalities may have occurred according to the sex of the client; (c) 58.4% of the clients engaged in more than one SIB response topography; (d) 57% of the clients emitted SIB at least once per day; (e) 55% of all clients were aggressive toward others, with a higher incidence of aggression, property destruction, and sleep disturbances among clients who received psychoactive medication; and (f) 33.1% of the clients were on formalized positive treatment programs and 6.8% of the clients were on formalized aversive programs. Discussion highlights the extent and circumstances to which SIB exists and the need to implement effective and appropriate programming.

Aggression↗
PubMed1999

Beliefs about smoking cessation among out-of-school youth.

Although the majority of adolescents in the 13-18 age range are at school, there is a need to target specific groups of young smokers such as unemployed youth. For those young people who are not at school, few directed programs are available in either prevention or cessation and information is needed about the design and delivery of appropriate programs for this population. This report presents the results from a survey of unemployed youth and students at vocational colleges about various aspects of smoking cessation. The majority of out-of-school youth smokers had not tried to quit, but 52% were contemplating action to quit. Only a quarter of the smokers had quit for more than a week. Few young smokers would use a recognised program though more females would change to a lower nicotine brand, quit with the help of a friend or participate in a group quit program. The method of quitting most would recommend to peers is 'use of will power'. Incentives to quit were attractive to only a third of the smokers, and many enhancing and inhibiting factors for participation in programs were identified. In particular, efforts to quit increased their confidence in quitting, supporting the need to assist those who are contemplating action to quit. Programs need to incorporate input from youth and be tailored for them but not necessarily for different groups such as non-secondary school students and unemployed youth.

Adolescent↗
PubMed1989

Exercise in the elderly.

Regular physical activity in the elderly delays decline in physical abilities, improves quality of life, and enhances functional capacity. As medical costs rise, preventive measures such as exercise are attaining great importance. Physicians should encourage their patients to participate in routine exercise and assist them in selecting an appropriate program. Preexercise evaluation is mandatory and should include a history and physical examination, an exercise stress test, and appropriate laboratory tests.

Aged↗
PubMedDate not supplied

Factors influencing participation in worksite wellness programs among minority and underserved populations.

In the United States, employers and employees are increasingly paying a larger portion of the nation's healthcare bill. Preventive measures are being employed by businesses in an effort to contain the escalating costs of employee healthcare. The work site is an ideal setting for health promotion because 130 million Americans are employed and spend one third of their time at work. However, unhealthy workers tend to be the least likely to participate in health promotion activities. Worksite Wellness Programs must be designed to engage segments of the work force with the greatest health needs. Culturally sensitive and appropriate programs must be developed to engage economically challenged minority and other underserved populations.

Health Promotion↗
PubMedDate not supplied

A computerized method for the measurement of conspicuity. Comparison of film and digital nephrograms.

We have designed a computer program appropriate for comparing the conspicuity of an object of interest portrayed on film-based and photoelectronic images. To test this program, we evaluated nephrograms generated by exposing matched film tomograms and digital images of rabbit kidneys following contrast administration. We then evaluated their conspicuity--a measure of how well an object can be distinguished from its surround--by a computer program which automatically traced a concentric and equal area of surrounding background around operator-defined nephrograms. Computerized evaluation of these areas provides the formula elements (mean object and background density and variance values and the number of pixels) from which conspicuity is automatically calculated. Nephrogram conspicuity was greatest for digital subtraction images. This approach is useful for comparing film and digital techniques.

Analog-Digital Conversion↗
PubMed2001

The enculturation of our nursing graduates.

The transition from undergraduate nursing student to employment as a registered nurse is fraught with difficulties for a neophyte. This qualitative study used interviews and focus groups with graduate nurses from the Flinders University of South Australia in their first year of practice to ascertain their experiences as new graduates. The results reveal an enculturation of graduates not conducive to ongoing learning, consolidation of skills and application to practice. A rushed environment that was unpredictable, together with a lack of support, were recurrent themes from the graduates' perspective. Graduate nurse programs are run by institutions focused on outcomes and expenditure. There is little or no collaboration with the tertiary sector in providing appropriate programs according to graduates' needs. The graduates, as beginning practitioners, focused on not having the time to nurse holistically, an unrealistic workload, and the need for backup and continuous support on an individual basis. The wards, although possibly efficient and effective in providing health care, provided a culture where the graduates felt inadequate, rushed, overworked and unsupported, which is contrary to the aims and objectives of the graduate nurse programs. The nursing profession as a whole needs to develop a culture that is nurturing, enabling, supportive and protective of our young.

Education, Nursing, Baccalaureate↗
PubMed1977

Affecting the supply of rural physicians.

A model describing physician supply and distribution is described. Two surveys obtained information to examine elements of the model. The first survey identified a group of primary care physicians that had considered rural locations but ultimately selected an urban location. This sub-group, 29 per cent of the primary care supply pool, received a follow-up survey to provide more information about how they made their choice. About one-half of them finally chose on the basis of factors other than metropolitan/non-metropolitan considerations. For this half, some of the factors that entered into the decision were the availability of physician specialists, nearby hospital facilities, and access to medical school programs. Such factors could be affected by future policy decisions, but the cost is unknown. Even if such policy decisions were made, and appropriate programs instituted, the results would probably not solve the problem of disproportionate physician distribution. The most likely-to-succeed approach to increasing the number of rural physicians remains that of increasing the number of entrants to medical school with a rural background.

Career Choice↗
PubMedDate not supplied

The role of dental hygienists in state public health programs.

The role and personnel status of dental hygienists in state public health programs have not been documented. In October 1987, a 13-page questionnaire was mailed to the 55 state and territorial dental directors around the country, requesting information on dental hygienists who are employed by the state in public health positions. The questionnaire was divided into three categories: educational services; clinical services; and hygienists who divide their time between clinical and oral health educational services. Questions in each category requested information on job title, educational requirements, salary, benefits, and programmatic areas of responsibility. The purpose of this survey was to document the role and extent of participation by dental hygienists in state public health programs. Forty-eight states responded to the questionnaire, with 37 states employing dental hygienists in state public health programs. Twelve percent of the educational services and seven percent of the clinical services employing hygienists are in supervisory or management-level positions, with advanced degree requirements not necessarily a factor. Only 61% have dental hygienists involved with water fluoridation educational programs which, considering the known benefits of community water fluoridation, is surprisingly low. The survey results may be used to assist administrators in developing appropriate programs utilizing dental hygienists.

Adult↗
PubMedDate not supplied

A new curriculum for fitness education.

Regular exercise is important in a preventive approach to health care because it exerts a beneficial effect on many risk factors in the development of coronary heart disease. However, many Americans lack the skills required to devise and carry out a safe and effective exercise program appropriate for a life-time of fitness. This inability is partly due to the lack of fitness education during their school years. School programs in physical education tend to neglect training in the health-related aspects of fitness. Therefore, a new curriculum for fitness education is proposed that would provide seventh, eighth, and ninth grade students with (a) a basic knowledge of their physiological response to exercise, (b) the means to develop their own safe and effective physical fitness program, and (c) the motivation to incorporate regular exercise into their lifestyle. This special 4-week segment of primarily academic study is designed to be inserted into the physical education curriculum. Daily lessons cover health-related fitness, cardiovascular fitness, body fitness, and care of the back. A final written examination covering major areas of information is given to emphasize this academic approach to exercise. Competition in athletic ability is deemphasized, and motivational awards are given based on health-related achievements. The public's present lack of knowledge about physical fitness, coupled with the numerous anatomical and physiological benefits derived from regular, vigorous exercise, mandate an intensified curriculum of fitness education for school children.

Curriculum↗
PubMed2004

Barriers to enrollment in drug abuse treatment and suggestions for reducing them: opinions of drug injecting street outreach clients and other system stakeholders.

Alcohol and other drug abuse (AOD) treatment is a major means of HIV/AIDS prevention, yet clients of street outreach programs (SOP) who are injection drug users (IDU), and outreach workers and staff as well, report various obstacles to enrolling clients in AOD programs. This study assessed the barriers to AOD enrollment facing high risk street outreach clients and obtained suggestions for reducing them. Data were obtained from semistructured field interviews with: 1) IDU outreach clients (N = 144) of the six SOPs in New York City (NYC) and northern suburbs supported by the Office of Alcoholism and Substance Abuse Services (OASAS), the single state agency in New York State for AOD prevention and treatment, 2) outreach workers and staff of the six SOPs (N = 55), 3) staff of detox and AOD treatment programs in major modalities treating IDUs (N = 71), and 4) officials and administrators (N = 11) in OASAS, the AIDS Institute of the Department of Health (addresses all aspects of the HIV/AIDS epidemic in New York State), and the agency for public assistance in New York City, the Human Resources Administration (HRA). Principal barriers for street outreach clients included personal-family issues, lack of insurance/Medicaid, ignorance, suspicion, and/or aversion to AOD treatment (methadone maintenance especially), "hassles" with Medicaid, lack of personal ID, lack of "slots," limited access to intake, homelessness, childcare-child custody issues. Further, about 18% had no desire for AOD services, reported no barriers, or were too enmeshed in addiction to enroll. Outreach staff cited prospective client's lack of ID and lack of Medicaid, lack of "slots," and stakeholder agency bureaucracy. Treatment staff cited lack of client readiness, "hassles" posed by welfare reform, AOD programs' own "red tape," waiting lists, and near exclusionary preference for the Medicaid-eligible. Finally, agency managers cited client factors, inadequate funding and lack of appropriate programs, treatment program requirements, and societal stigmatization of addicts. Proposed remedies included dropping ID and insurance requirements for admission, major increases in resources, funding the transporting of outreach client treatment candidates to AOD services sites, education and training initiatives, increased inter-agency cooperation, and the need for stakeholder agencies, OASAS especially, to more effectively integrate abstinence-oriented AOD services with harm reduction and the public health aspects of AOD problems.

Adult↗
PubMed2006

Evaluating the relevance, generalization, and applicability of research: issues in external validation and translation methodology.

Starting with the proposition that "if we want more evidence-based practice, we need more practice-based evidence," this article (a) offers questions and guides that practitioners, program planners, and policy makers can use to determine the applicability of evidence to situations and populations other than those in which the evidence was produced (generalizability), (b) suggests criteria that reviewers can use to evaluate external validity and potential for generalization, and (c) recommends procedures that practitioners and program planners can use to adapt evidence-based interventions and integrate them with evidence on the population and setting characteristics, theory, and experience into locally appropriate programs. The development and application in tandem of such questions, guides, criteria, and procedures can be a step toward increasing the relevance of research for decision making and should support the creation and reporting of more practice-based research having high external validity.

Diffusion of Innovation↗
PubMedDate not supplied

Medical surveillance in the biotechnology industry.

A medical program appropriate for employees in biomedical laboratories should be based upon specific understanding of the risks and hazards associated with the work activities. Components of a medical program might include: preplacement examinations, periodic monitoring evaluations, tracking of prolonged or unusual illness, specific illness or exposure-related evaluations, epidemiological studies, immunization programs, and exit (or termination) evaluations.

Accident Prevention↗
PubMed1999

Health care incentives in immunisation.

BACKGROUND: Australia has introduced a nationwide immunisation incentive scheme. This yet to be evaluated two-year program offers financial rewards to providers and parents to encourage childhood immunisations. OBJECTIVES: To review the use of incentives in immunisation uptake, identify issues in developing an incentive program for childhood immunisation and examine the findings within the context of the Australian scheme. METHOD: Medline was searched under 'immunization and financial incentive' and 'immunization and incentive' in English 1966 to 1998. RESULTS: The search identified six and 93 articles respectively, of which six examined the role of material incentives influencing coverage of immunisation. References and reviews identified a further three studies. Among these nine studies (two British, six American, one Nicaraguan), two reported the same intervention. Of the eight incentives examined, four referred to non-financial incentives such as food vouchers and four to monetary incentives for parents (1) or providers (3). Groups receiving the incentives were up to three times more likely to be immunised and had overall immunisation rates up to 17% higher than comparison groups. CONCLUSIONS: Effective incentives require collaboration of key players, using a program appropriate to the characteristics of the population. Although varying in cost-effectiveness, both monetary and non-monetary incentives can improve childhood immunisation uptake. Evaluation of current programs including the Australian ones will assist future allocation of resources.

Child↗
PubMed1991

Community responsibility for the self-neglectful client.

Self-neglectful clients, including the elderly, are in jeopardy, partly through their refusal to accept community services that could help them; they require protection from the community. These people are alienated and isolated, and need to be integrated into the community. Their individual rights to control their own lives, however, must be protected. It is the responsibility of the community to structure services in a way that will engage these people. A comprehensive community service program appropriate to their needs would integrate formal and informal care systems by interweaving professional services, informal assistance, and mutual aid within structures that facilitate coordination of formal care programs.

Aged↗
PubMed1971

An investigation of the educational needs of health sciences library manpower. 3. Manpower supply and demand in health sciences libraries.

An investigation of the manpower requirements of health sciences libraries and of educational programs appropriate to these manpower needs was begun in March 1968. To date, 4,727 libraries have been identified as being used by 14,000 health sciences institutions and programs. Of this total, 2,628 are hospital libraries; 1,328 are health sciences libraries and collections located outside of hospitals; and 771 are academic or public libraries. Within these libraries some 14,938 persons are directly involved, either full- or part-time, in the delivery of health sciences library services. Of the total work force, 5,861 persons are employed in hospital libraries and 9,077 are employed in health sciences libraries and collections. The ratio between professional and nonprofessional employees is 1:2; professional and nonprofessional status was assigned by the chief librarian. Survey data indicate a 7 percent manpower shortage in positions classified as professional, and a 3 percent shortage in positions classified as nonprofessional.

Journal Article↗
PubMed2001

Automatic external defibrillator intervention in the workplace. A comprehensive approach to program development.

1. The planning and implementation of an automatic external defibrillator (AED) intervention in the workplace necessitates a comprehensive approach to program development. 2. Initiation of an AED intervention program at the worksite, based on an informed decision, requires each company to conduct a detailed assessment of need. 3. Prior to initiating an AED intervention program, appropriate resources should be consulted to examine national, state, and local law provisions and legal factors governing AED use in each specific community. 4. Essential components of an AED intervention program include: the combined cardiopulmonary resuscitation and AED use training program; written policies, procedures, and medical directives; a plan for the purchase, maintenance, and location of the AED equipment and supplies; an integrated emergency response plan; and an ongoing quality improvement process.

Electric Countershock↗
PubMed1983

Continuing education and the geographically isolated therapist.

The relationship between therapists' geographic location and three program planning variables in continuing education was studied using the descriptive survey method. The findings suggested that learning needs were high in evaluation related competencies and that family responsibility and lack of appropriate programs were major barriers to participation. The overwhelming preference in delivery systems was the one or two day workshop. The study concluded that there were few significant differences between urban and rural therapists in relation to the variables studied indicating restraint rather than innovation in programming for the geographically isolated therapist.

Analysis of Variance↗