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Results for “Pilot Projects”

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PubMedDate not supplied

Responses to the region 5 NHEXAS time/activity diary. National Human Exposure Assessment Survey.

The time/activity diary developed for use in the National Human Exposure Assessment Survey (NHEXAS) was completed by 249 participants in the Research Triangle Institute/Environmental and Occupational Health Sciences Institute (RTI/EOHSI) NHEXAS population-based pilot project conducted in the upper Midwest (EPA Region 5). The majority of participants successfully completed the diary during the 6-day study period. Participant responses showed internal consistency between related questions within the diary and between instruments used within the study. Comparison of response rates with the National Human Activity Pattern Survey, a nationwide population-based study, found consistent results when the same questions were used in both studies. Several questions identified age-specific activities. The value of the 6-day diary over 1-day surveys was apparent in discriminating between episodic and regularly conducted activities and in identifying subpopulations whose behavior may contribute to exposure to environmental pollutants.

Adolescent↗

PubMed1993

Process evaluation of a system (Partners for Prevention) for prevention-oriented primary care.

Process evaluation can identify program components that are related to success, that are generalizable to other settings, and that improve future applications of the program. The Partners for Prevention pilot project tested an office-based system aimed at increasing cancer prevention and screening in primary care offices and involving 17 physicians in private practice. Process evaluation techniques included monitoring systems, satisfaction surveys, and focus groups with the program participants. Each evaluation technique provided different information concerning strategies. The program was difficult to implement on busy days, the materials were useful but needed more flexibility, communication between patient and physician was facilitated, and the office coordinator was a crucial person. Program philosophy was acceptable, but materials needed refinement. The flow sheet and patient health check have been dramatically simplified and customized. New strategies are being tested in a randomized control trial.

Academies and Institutes↗

PubMed1992

[Thrombocyte aggregation and serum thromboxane B2 in patients with unstable angina pectoris treated with diltiazem or verapamil].

Patients with unstable angina pectoris have increased thrombocyte aggregation and disturbances in serum prostaglandin balance. As a pilot project, we conducted a single-blind investigation of 24 patients with unstable angina pectoris treated with dilthiazem (n = 12, 240-360 mg) or verapamil (n = 12, 240-360 mg) for ten days. At the commencement of the investigation, both patient groups had hyperaggregating thrombocytes and increased serum-thromboxan-B2 (TXB2) as compared to healthy individuals (p < 0.01). In the patient group treated with dilthiazem, the aggregation threshold rose (p < 0.01), and the serum TXB2 values fell to approximately normal (p < 0.05). In the patient group treated with verapamil, no significant changes were observed in the measurements registered. The difference between the two groups remained significant during the entire therapeutic period (p < 0.01). Thus, dilthiazem appears to counteract thrombocyte aggregation in patients with unstable angina pectoris.

Angina, Unstable↗

PubMed1993

The effects of nicotine on the blood flow of the ophthalmic artery and the finger circulation.

Cigarette smoking is associated with glaucoma. Nicotine from cigarette smoking is known to produce hemodynamic changes. We studied the effect of nicotine on the ophthalmic artery flow velocity using transcranial Doppler ultrasound to measure noninvasively the Peak (systolic) flow velocity (VP), mean-envelope flow velocity (VM) and end-diastolic flow velocity, as well as using a laser Doppler flowmeter on the finger blood flow of the finger prior to and after administration of 2-4 mg nicotine in a gum base. In a pilot project a group of 18 glaucoma patients and 8 normal subjects were tested with nicotine, and another group of 11 glaucoma patients were tested with placebo. VP, VM, and systolic blood pressure were significantly increased while finger blood flow was significantly decreased when comparing the nicotine-tested glaucoma group with the placebo-tested group (P = 0.02074, 0.01479, 0.02185, and 0.04209, respectively). The nicotine-tested group of normals also showed significant changes in VM, systolic blood pressure, and finger blood flow compared to a placebo group. The responses to the small doses of nicotine used in this study (approximately one-third that of cigarette smoking) were not significantly different between the glaucoma and the normal groups.

Aged↗

PubMed1988

A pilot outreach program for small quantity generators of hazardous waste.

The Massachusetts Department of Environmental Management initiated a pilot project to improve compliance with hazardous waste regulations and management of hazardous wastes with auto body shops around the state. The program consisted of mass mailings, a series of workshops throughout the state, a coordinated inspection program by the state regulatory agency, and technology transfer. At the start of the program in January 1986, approximately 650 of the estimated 2,350 auto body shops in the state had notified EPA of their waste generating activities; by January 1987, approximately 1,200 shops had done so. Suggestions for improving program efforts include tailoring the outreach effort to the industry, government-sponsored research and development directed at the needs of small firms, mandatory participation in hazardous waste transportation programs, and better coordination by EPA of its information collection and distribution program.

Automobiles↗

PubMedDate not supplied

Prone immersion physical exercise therapy in three children with cystic fibrosis: a pilot study.

Prone immersion physical exercise therapy has been used successfully in the physical rehabilitation of middle-aged adults with moderate to severe chronic obstructive pulmonary disease. The purpose of this pilot project was to evaluate the effects of PIPE therapy in children with cystic fibrosis. Three children with CF, two boys aged 6 and 14 years and one girl aged 15 years, voluntarily participated in the experimental training program. The patients performed individualized group exercise three times a week on alternate days for 28 consecutive weeks at an intensity of approximately 75 percent aerobic capacity. Duration of exercise gradually increased from 15 (3 x 5 minutes) to 60 (3 x 20 minutes) minutes while the rest period after each exercise was constant at two minutes. PIPE training resulted in increased physical work capacity and maximal oxygen consumption in all three subjects. Curiously, these changes were not accompanied by training bradycardia.

Adolescent↗

PubMedDate not supplied

Job experiences of personal assistants employed in a consumer-directed personal assistance services programs.

The demand for personal assistants for persons with disabilities is outpacing the supply. The objective of this pilot project was to describe the training and supervision needs of personal assistants, the nature of the assistant-consumer relationship, and the job satisfaction associated with being employed as a personal assistant. Telephone interviews were conducted with 24 personal assistants. All of the participants reported being competent and well trained in their work and 79% of the participants reported being very satisfied with their work as a personal assistant. All also reported they had an opportunity to accomplish something worthwhile in their jobs. Participants reported high levels of satisfaction with their relationship with their employers and with their jobs in general, despite dissatisfaction with low wages. Further research is needed to identify strategies for increasing the supply of personal assistants, who are pivotal to helping consumers maintain their independence.

Adult↗

PubMed1998

Earlier discharge of infants from neonatal intensive care units: a pilot program of specialized case management and home care. Delaware Valley Child Health Alliance.

A multidisciplinary approach using a neonatology independent physicians association, affiliated hospitals, a pediatric home care company, and a health maintenance organization was designed to promote earlier safe discharge of infants from intensive care. This pilot project involved 43 infants who received case management and early discharge home with home oxygen, monitoring, intravenous antibiotics, gavage feedings, phototherapy, or nutritional management for poor weight gain. A staff neonatologist remained the primary physician until the patient would have been discharged according to standard criteria. Two patients had unscheduled readmissions and all infants survived. This approach resulted in an estimated savings of 456 hospital days and $329,982; 89% of parents rated the care as good to excellent, and 83% were satisfied with the program and outcome. This study suggests that a prospectively designed program can be designed to promote safe earlier discharge of infants in intensive care.

Case Management↗

PubMed1963

RESULTS OF AGE-GROUPING DISSECTIONS ON FOUR SPECIES OF ANOPHELES FROM SOUTHERN GHANA.

The entomological survey during the preparatory phase of the Malaria Eradication Pilot Project in Ghana included a programme of age-grouping dissections on the local malaria vectors. After an initial year spent on the older methods, some 1700 female mosquitos were dissected following Detinova's techniques. These latter results, though limited to a division of the nulliparous from the parous, are examined in detail to discover what they reveal of the age-structure of the anopheline populations concerned.Analysis of the proportion parous of A. gambiae populations showed, inter alia, that they fluctuated considerably in age make-up from week to week, even though appearing fairly stable over longer periods. The risk of calculating survival probabilities without an exact knowledge of the structure of the nulliparous population is also illustrated, and it is suggested that such estimations should be restricted to an expression of the proportion parous.

Animals↗

PubMed1992

Evaluating strategies for health surveillance. Health event ascertainment at a nuclear facility.

The US Department of Energy's Health Surveillance System is a pilot project to design, implement, and evaluate a system of routine morbidity surveillance based on routinely collected occupational medical data at participating Department of Energy facilities. At the Hanford Site, most health events have been ascertained using a 21-day threshold-of-absence criterion. This provisional threshold, established under the assumption that it would capture all important morbidity, has been criticized as potentially omitting morbidity of interest. A review of all health-event absences occurring over a 1-year period revealed that the efficacy of the 21-day threshold varies widely by diagnosis and that absence based eligibility criteria are not useful for all morbidity of interest. Future development will require supplementation of health-event ascertainment by other, diagnosis-based criteria to ensure completeness of ascertainment.

Absenteeism↗

PubMed1997

Approaches for studying radiation-induced leukemia.

According to the conclusion of the International Programme on the Health Effects of the Chernobyl Accident (IPHECA) Haematology Pilot Project (1991-1995), there was no increase in the incidence of malignant disease in hematopoietic and lymphoid tissues after the Chernobyl accident. Nevertheless, since studies of A-bomb survivors indicate that the peak in morbidity may occur more than 10 years after radiation exposure, long-term studies of hemoblastoses and myelodysplastic syndromes are needed today. Study of these leukemias and lymphomas that are potentially induced by ionizing radiation must include both fundamental and applied approaches, i.e., A) epidemiological design; B) utilization of modern methods of diagnosis (cytomorphology, immunocytochemistry, cytogenetics); C) studies of gene mutations, mechanisms of apoptosis, and G1 delay; D) monitoring of oncogene and multidrug resistance gene expression, and E) tracking changes in cell-cell signaling in the bone marrow microenvironment.

Apoptosis↗

PubMed2004

From directly observed therapy to accompagnateurs: enhancing AIDS treatment outcomes in Haiti and in Boston.

Like tuberculosis, human immunodeficiency virus (HIV) disease is associated with poverty and social inequalities, conditions that hamper the delivery of care. Like tuberculosis, treatment of HIV infection requires multidrug regimens, and the causative agent acquires drug resistance, which can be transmitted to others. A pilot project in rural Haiti introduced DOT-HAART (directly observed therapy with highly active antiretroviral therapy) for the care of patients with advanced acquired immune deficiency syndrome. A similar DOT-HAART effort was launched in Boston for patients with drug-resistant HIV disease who had experienced failure of unsupervised therapy. In both settings, community health promoters or accompagnateurs provide more than DOT: they offer psychosocial support and link patients to clinical staff and available resources. DOT-HAART in these 2 settings presents both challenges and opportunities. These models of care can be applied to other poverty-stricken populations in resource-poor settings.

Anti-HIV Agents↗

PubMed1990

Panic disorder among American Indians: a descriptive study.

Little is known about panic disorder among American Indians. In a pilot project involving two Northwest Coast Indian villages, community health representatives screened the population for panic disorder, substance abuse, and major depression using DSM-III criteria. Accompanying the screening were subsequent patient education and further evaluation by a psychiatrist, a social worker, and primary care physicians. Of fifty community residents who agreed to take the screening examination, seven were found who met diagnostic criteria for panic disorder. Four of the seven had symptoms of alcohol abuse which complicated the course and diagnosis of panic disorder, and individuals with panic disorder reported more than twice the lifetime prevalence of depression in comparison with other community members. Limitations of the study and refinements of study design are needed in future study discussions.

Adult↗

PubMed2006

Taking charge: a pilot curriculum of self-defense and personal safety training for female veterans with PTSD because of military sexual trauma.

The authors describe an overview of the pilot project Taking Charge, a 36-hour comprehensive behavioral intervention involving psychoeducation, personal safety, and self-defense training for 12 female veterans with posttraumatic stress disorder (PTSD) from military sexual trauma. Self-defense training can incorporate the benefits of repeated exposure while teaching proactive cognitive and behavioral responses to the feared stimuli, and thus facilitate emotional and physical rescripting of and mastery over the trauma. Results up to 6 months follow-up indicate significant reductions in behavioral avoidance, PTSD hyperarousal, and depression, with significant increases in interpersonal, activity, and self-defense self-efficacy. The authors propose that this therapeutic self-defense curriculum provides an enhanced exposure therapy paradigm that may be a potent therapeutic tool in the treatment of PTSD.

Adult↗

PubMed1998

Does your care plan tell my story? Documenting aspects of personhood in long-term care.

Learning about aspects of one's personhood allows the nurse to know the individual as a person and to individualize the care provided. A pilot project was conducted on a supportive residential care unit to explore why health records in long-term care rarely reveal who the person is. Five nurse participants generated a list of features of an individual's personhood that they felt should be known by members of the team. They subsequently gathered that information from a variety of sources, with documentation in a designated location provided on the plan of care. They were thus able to overcome some of the previously encountered barriers to collecting and documenting the personhood data reflecting their knowledge of the individual as a person. Although nurses were successful in learning who the persons were, changes in approach to care as a result of the new knowledge have not been measured.

Aged↗

PubMed2005

Family medicine obstetrics. Collaborative interdisciplinary program for a declining resource.

PROBLEM BEING ADDRESSED: A continuing decline in the number of family physicians in Canada providing obstetric, and particularly intrapartum, care. OBJECTIVE OF PROGRAM: The Maternity Centre of Hamilton in Ontario was a pilot project initiated to help family physicians provide full obstetric care through a collaborative interdisciplinary model and shared call. PROGRAM DESCRIPTION: Eleven family physicians provided care in collaboration with a nurse practitioner and other health professionals. Women came from the Maternity Centre's own practices, community physicians, or agencies, or through self-referral. More than a quarter of the women were considered psychosocially high-risk patients. Key features of the program included interdisciplinary collaboration and information technology that supported prenatal and birth documentation. CONCLUSION: The program has helped family physicians, and even recruited some, to practise full obstetric care and has provided high-quality, accessible services to pregnant women. Physicians experienced increased jab and personal satisfaction, and patients were highly satisfied with the service.

Cooperative Behavior↗

PubMed1986

CEPRIME (Continuing Education and Peer Review in Internal Medicine): linking quality assurance with continuing medical education.

This was a pilot project intended to evaluate the practicalities of a new method of linking Peer Review with Continuing Medical Education for consultant physicians (internists). Peer Review of the physicians' reports to the referring general practitioners on each consultation. Sixteen physicians were enrolled for varying periods of time. They submitted from 12 to 454 cases for review (mean 94 cases) overall. One half of the cases attracted comment from the reviewers. The main themes of critical comments have been identified. Appropriate study courses based on the results of the review were developed for some of the participants. The latter were in general agreement that the CEPRIME system has potential to achieve its purpose; but it is obvious that certain modifications would improve the flow of material and the value of the exercise to the physicians.

Adult↗

PubMed2006

Responses to a virtual reality grocery store in persons with and without vestibular dysfunction.

People with vestibular dysfunction often complain of having difficulty walking in visually complex environments. Virtual reality (VR) may serve as a useful therapeutic tool for providing physical therapy to these people. The purpose of this pilot project was to explore the ability of people with and without vestibular dysfunction to use and tolerate virtual environments that can be used in physical therapy. We have chosen grocery store environments, which often elicit complaints from patients. Two patients and three control subjects were asked to stand and navigate in VR grocery stores while finding products. Perceived discomfort, simulator sickness symptoms, distance traveled, and speed of head movement were recorded. Symptoms and discomfort increased in one subject with vestibular dysfunction. The older subjects traveled a shorter distance and had greater speed of head movements compared with young subjects. Environments with a greater number of products resulted in more head movements and a shorter distance traveled.

Activities of Daily Living↗