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PubMed1979

Programs developed from concerns for women in medicine.

Since the Medical College of Pennsylvania, formerly the Woman's Medical College of Pennsylvania, became coeducational in 1969, there has been a continued effort to maintain the commitment of the institution to its heritage of women in medicine. An office has the role of coordinating and stimulating the establishment and maintenance of programs relevant to women in medicine throughout the institution. These programs are now available to men as well but particularly serve women's needs. They include the Summer Premedical Program, the Summer Health Policy Program, a restraining program for inactive physicians, a demonstration child care project, archives and special collections related to women in medicine, a women in medicine oral history project, and a bibliography of the literature on women physicians. The Medical College of Pennsylvania will continue its interests in the present and future needs of women physicians.

Archives↗
PubMed1988

Usefulness of a local oral health survey in program development.

In 1986, the Columbus (Ohio) Health Department conducted an oral health survey of children in grades 1, 2, 6, and 7. The World Health Organization's Pathfinder methodology served as the basis for survey design. The survey was made possible through collaboration and sharing resources among the local and state health departments and two universities. The findings of the children's portion of the survey proved useful in program planning, marketing (including resource procurement), constituency building, and educating the dental profession and the public. The data were used to support successful grant requests that led to the implementation of a school-based dental sealant program. The local government expanded the health department's dental budget to continue the sealant program beyond the grant period. The state health department considered the survey to be a pilot for a statewide effort.

Adolescent↗
PubMed1985

Heart and heart-lung transplantation: program, development, organization, and initiation.

Since the initiation of cardiac transplantation in 1967, more than 1,000 procedures have been done worldwide. A high percentage of these transplant procedures have been completed in the past few years. In 1983, II centers in the United States performed 173 transplant procedures; by 1984, there were more than 30 heart transplant centers. This sudden increase is due primarily to increasing survival of transplant recipients since the introduction of cyclosporine. However, most transplant surgeons believe that the use of this drug alone will not result in survival results and rehabilitation similar to those obtained in experienced transplant centers. Institutional commitment, adequate resources, attention to detail and most importantly, a dedicated transplant team, are important elements to ensure success. This manuscript will define guidelines for the establishment of a new transplant program and eludicate the organizational details necessary to implement such a program, based on our experience at the Johns Hopkins Hospital over the past two years.

Consumer Behavior↗
PubMed1989

The role of parents and older peers in school-based cardiovascular prevention programs: implications for program development.

This article describes a set of studies which compare the effectiveness of innovative interventions led by older peers and which included a parent component with teacher-led interventions for nutrition, blood pressure, and smoking prevention. Information about the agreement between parents' and children's (grades six through eight) perception of the children's health behavior and family interaction was also found, by surveying parents and children in 1051 households. Both teacher-led and older peer-led interventions were successful in increasing behavioral capabilities for nutrition and blood pressure, measured one year after the interventions. Results of the parent-child survey showed reasonable agreement between parents and children for reports of the child's exercise, dieting, and fast food consumption, but poorer agreement for smoking and perceptions of family interaction. Results are discussed in relation to the planning of future programs designed to address the importance of peer and parental role models.

Adolescent↗
PubMed1990

Changing practice patterns in the management of primary breast cancer: Consensus Development Program.

In the last decade, new knowledge has emerged concerning the efficacy of treatment for breast cancer. For that reason, the National Institutes of Health devoted a consensus conference to this topic. To determine whether the consensus conference had influenced practice patterns, and to evaluate the level of quality of care given to women with breast cancer, the medical records of 573 patients treated in ten hospitals throughout the state of Washington were abstracted and analyzed. Results showed no changes with respect to the consensus conference's recommendations for use of a total mastectomy with axillary dissection or the use of a two-step procedure in which the biopsy is performed first and therapeutic options are discussed before a definitive surgery is undertaken. Analyses of quality of care issues not addressed by the consensus conference revealed that 4 percent of the sample were explicitly staged preoperatively and 29 percent postoperatively and that little changed over time in the use of sentinel laboratory tests. These results also show that consensus recommendations will not necessarily change physicians' behavior even where change is possible, and that quality of care in diagnosis and treatment of breast cancer still needs to be addressed.

Adult↗
PubMed1989

Emotionally handicapped youth in transition: issues and principles for program development.

Seriously emotionally handicapped adolescents face significant transition issues as they move through our system of care and attempt to assume adult role responsibilities in the community. Service delivery efforts must be sensitive to these issues and begin to realistically address the transition needs of this population. Nine integrative principles are discussed which appear essential when developing transition services.

Adolescent↗
PubMed1989

The calcium-phosphorus metabolism expert system module: a program developed in the ALEX Smalltalk/V shell.

The object-oriented computing model of Smalltalk/V proved to be very well suited for the creation of a medical expert system on the diagnosis of calcium-phosphorus metabolism abnormalities. A major reason for this was that a disease could be viewed as a self-contained, active, entity. The expert system is implemented in ALEX, an expert system shell that is written in Smalltalk/V. The shell consists of classes and methods that can be modified, as needed, by the developer. The expert system is, at present, 140,000 bytes in size, and includes 43 diseases, arranged in 7 contexts. Sixty case reports were used to test the expert system. In 30 cases, there was complete agreement between clinician and expert system; in 12 cases, the expert system responded appropriately when presented with diseases that were not known to the system; and in 18 cases, the system gave plausible results.

Calcium↗
PubMed1985

An assessment of a toxicological incident in a drug development program and its implications.

In an exceptionally thorough program of preclinical toxicity testing in laboratory animals of the anti-allergy drug FPL 52757 (6,8-diethyl-5-hydroxy-4-oxo-4H-1-benzopyran-2-carboxylic acid), no significant hepatotoxic potential was detected. Despite this evidence of safety in a wide range of laboratory animals, the drug produced mild reversible hepatotoxicity in some patients in some clinical trials. Extensive toxicity and investigational studies are described, and the importance of the correct choice of species for toxicology evaluations based on sound pharmacokinetic principles is highlighted. This paper reviews this incident and the lessons to be learned from it in light of current regulatory requirements.

Animals↗