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Results for “Community Programs for Clinical Research on AIDS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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PubMed1999

Post-exposure prophylaxis for HIV.

The advent of preventive treatment for HIV highlights the urgent need for basic, clinical, and epidemiologic research targeting the pathogenesis and prevention of cutaneous and mucosal infection. In addition, the impact of HIV prophylaxis on the frequency of risk behaviors and antiretroviral drug resistance, especially in cities with high HIV prevalence, must be evaluated. In our view, the available data (albeit not definitive) are strong enough to support the provision of post-exposure prophylaxis in select cases of sexual and injection drug use exposure in addition to occupational exposures. However, post-exposure treatment should be used judiciously and only in the context of a comprehensive prevention program. Ultimately, primary exposure prevention, whether in health care facilities or in the community, is the most important strategy to prevent AIDS.

Anti-HIV Agents↗
PubMed2003

A public aid clinic prototype: utilizing a dental hygiene educational facility to increase access to care.

Few dentists in a rural Midwestern community participate in providing oral health care to public aid recipients. In response, faculty at a baccalaureate degree dental hygiene program located at Southern illinois University, Carbondale (SIUC) proposed, developed, and implemented the Heartland Dental Clinic to serve Medicaid participants. The unique program utilizes existing facilities, staff, and students to provide comprehensive oral health care to underserved populations. The state awarded a small grant to cover start-up costs. Two dental units were upgraded with fiber optics to allow restorative procedures. Dental hygiene students provide intake examinations and preventive care, while a staff dentist provides restorative care, dentures, and examinations. Dental technology students and faculty fabricate prostheses. A part-time clinic manager facilitates communication, patient scheduling, and billing. Two local Rotary Club members volunteer as receptionists for the clinic on the one evening per week that the clinic operates. The Rotary Club purchased educational pamphlets, a television/VCR, videotapes, and two signs for the clinic. By locating the clinic in the existing SIUC facility and utilizing dental hygiene students, a staff dentist, volunteer receptionists and dentists, student workers, and health care management interns, the clinic overhead costs have been kept to a minimum. The clinic provides a unique opportunity for dental hygiene students to experience firsthand scheduling, billing, and treating public aid patients while providing patients with an additional source for oral health care. The Heartland Dental Clinic model represents a cost effective method for increasing oral health access to underserved populations while also benefiting students in an educational program.

Clinical Clerkship↗
PubMed1996

Welfare reforms and services for children and families: setting a new practice, research, and policy agenda.

This article addresses barriers to family and community self-sufficiency. Many of these barriers have resulted from policymakers' biased definitions of self-sufficiency and related social program reforms. Social workers need to understand the worldviews and values that underlie political definitions of self-sufficiency to have a greater influence on social policy. This article describes a more appropriate definition of self-sufficiency and illustrates its usefulness with an example of community research conducted to identify social support needs. The author recommends changes in social work practice and education that can enable the profession to have a stronger influence on social policy. Finally, to achieve this social justice goal and integrate policy development into clinical and community practice, the author proposes new research and policy agendas for the profession.

Aid to Families with Dependent Children↗
PubMed1998

A randomized trial of a brief HIV risk reduction counseling intervention for women.

There is an urgent need for the development and implementation of effective and feasible behavioral HIV and STD interventions. The purpose of the present randomized controlled trial was to evaluate the effectiveness of a single-session, skill-based sexual risk reduction intervention for women. Participants were assessed at baseline and at 1 month and 3 months following the intervention on measures of AIDS knowledge, behavioral intentions, self-efficacy, and sexual risk behavior. Compared with women in an AIDS-education-only condition, women receiving the skill-based intervention reported significantly higher rates of condom use at 3-month follow-up. Results suggest that brief sexual risk reduction programs are feasible and effective within a community setting.

Adult↗
PubMed2003

Working more productively: tools for administrative data.

OBJECTIVE: This paper describes a web-based resource (http://www.umanitoba.ca/centres/mchp/concept/) that contains a series of tools for working with administrative data. This work in knowledge management represents an effort to document, find, and transfer concepts and techniques, both within the local research group and to a more broadly defined user community. Concepts and associated computer programs are made as "modular" as possible to facilitate easy transfer from one project to another. STUDY SETTING/DATA SOURCES: Tools to work with a registry, longitudinal administrative data, and special files (survey and clinical) from the Province of Manitoba, Canada in the 1990-2003 period. DATA COLLECTION: Literature review and analyses of web site utilization were used to generate the findings. PRINCIPAL FINDINGS: The Internet-based Concept Dictionary and SAS macros developed in Manitoba are being used in a growing number of research centers. Nearly 32,000 hits from more than 10,200 hosts in a recent month demonstrate broad interest in the Concept Dictionary. CONCLUSIONS: The tools, taken together, make up a knowledge repository and research production system that aid local work and have great potential internationally. Modular software provides considerable efficiency. The merging of documentation and researcher-to-researcher dissemination keeps costs manageable.

Databases as Topic↗
PubMedDate not supplied

A comparison of problems-of-life for blacks and whites entering substance abuse treatment programs.

Blacks in the general population experience alcohol-related health problems to a greater extent than Whites, even though surveys of drinking behavior find that Blacks generally drink no more than Whites and, in fact, at younger ages Blacks actually drink less than Whites. In this study, Blacks and Whites entering randomly selected state-supported substance abuse treatment programs within a given period of time were interviewed and administered a battery of assessment instruments; results are derived from the Addiction Severity Index. A major research question was whether the higher rates of alcohol-related problems for Blacks in the general population were matched by greater severity of life-problems for Blacks in a clinical treatment population. Blacks had more severe problems than Whites in two problem areas: employment support and other drug use. Results point to socioeconomic factors as well as combined alcohol and other drug use as potential contributors to the greater alcohol-related health problems for Blacks in the general population. Comprehensive study of alcohol and other drug use norms and customs within the Black community is recommended to aid in the development of prevention and treatment strategies for alcohol-related problems among Blacks.

Adolescent↗
PubMed1995

Statistical issues in the design of HIV vaccine trials.

HIV vaccine trials present significant challenges related to trial endpoints, vaccine efficacy measurement, and the role of nonvaccine interventions. Infection is a valid endpoint for detecting sterilizing immunity. But if the vaccine prevents AIDS without preventing infection, infection may be a misleading surrogate. Appropriate endpoints must be defined for other mechanisms of vaccine action. Direct, indirect, behavioral, and biological effects all determine vaccine efficacy. False security among HIV-vaccine recipients may make negative behavioral effects an important component of vaccine performance. Both biological potency and a more comprehensive program effectiveness should be measured. These goals may require unblinded designs or community randomization. Nonvaccine interventions are currently the only HIV-prevention strategy. Support for larger scale implementation requires more rigorous evaluation that is less dependent on self-reported behavioral changes. The vaccine trial cohorts provide a unique opportunity to cost-effectively evaluate behavioral interventions.

AIDS Vaccines↗
PubMedDate not supplied

Building community partnerships to improve HIV prevention efforts: implications for nurses.

Acquired immune deficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV), is a major and complex public health crisis. The Centers for Disease Control and Prevention (CDC) issued effective community-based HIV prevention planning in its 1993 "Supplemental Guidance on HIV Prevention Community Planning" through the formation of community planning groups (CPGs). These guidelines are reviewed along with behavioral and social science theories that are the crux of HIV prevention theory-based research and program development. Nurses' roles in community-based HIV prevention as community advocates, HIV prevention program planners, practitioners, and researchers are discussed. The article concludes with nursing implications for HIV prevention.

Attitude to Health↗
PubMedDate not supplied

Community partnerships for an LPN to BSN career mobility project.

Based on a 6-year, learn and earn curriculum, the authors report on a year-old project that assists licensed practical nurses (LPNs) to obtain a baccalaureate degree in nursing (BSN). Partnerships with 4 area healthcare agencies employing LPNs were developed to support students with full or partial tuition reimbursement and work schedules to accommodate classes. Key university staff in the offices of admissions, financial aid, adult programs and services, and nursing advisement are assigned to this student group to provide individualized assistance. The authors discuss unique components of the project including regularly scheduled role transition seminars, faculty mentors, BSN and nurse practitioner clinical mentors, and clinical experiences in nurse-managed clinics.

Adult↗
PubMed2005

[Evidence-based emergency pathways for patients with acute coronary syndrome].

We present an evidence-based diagnostic and therapeutic pathway for the treatment of subjects with suspected acute elevated ST-segment myocardial infarction (STEMI). The pathway was developed to aid the reorganization of the emergency service (ES) of the Lazio Region of Italy. Pathway development followed several phases: a) setting up of a multidisciplinary panel comprising all professional figures involved in the management of STEMI subjects; b) drafting of a list of important research questions with a particular focus on areas of clinical and organization uncertainty; c) systematic searches for relevant international scientific evidence to answer research questions; d) assessment, synthesis and classification of identified evidence according to the quality of evidence; e) formulation of management recommendations by their strength according to the methods used by the national guidelines program; f) presentation of draft findings and recommendations; g) external peer review of the draft document; h) editing the final version of the document. Our document identifies possible action scenarios (community, emergency room, major accident and emergency departments) and the following critical points: 1) quick diagnosis and individual risk definition; 2) rapid transmission of the electrocardiogram and vital parameters to the ES control center or to the competent coronary care unit (CCU) depending on where the event took place; 3) a direct link between the ES control center and the competent CCU; 4) the structuring of the regional CCU into a Hub & Spoke model; 5) electronic communication of data between ambulance, ES control center and the competent CCU. Our document also defines Hub regional reference centers and local Spoke centers. The pathway details roles and responsibilities of all players in the emergency chain for STEMI sufferers and critical points for the delivery of the pathway: regional programs on early warning, functions of relevant ES personnel and of emergency room physicians, efficiency of the electronic network and identification and organization of the regional Hub & Spoke network.

Algorithms↗
PubMed2006

Liposomal amphotericin B for the treatment of visceral leishmaniasis.

During the past decade, liposomal amphotericin B has been used with increasing frequency to treat visceral leishmaniasis (VL). The World Health Organization convened a workshop to review current knowledge and to develop guidelines for liposomal amphotericin B use for VL. In Europe, liposomal amphotericin B is widely used to treat VL. In Africa and Asia, the VL disease burden is high and drug access is poor; liposomal amphotericin B is available only through preferential pricing for nonprofit groups in East Africa. Clinical trials and experience demonstrate high efficacy and low toxicity for liposomal amphotericin B (total dose, 20 mg/kg) in immunocompetent patients with VL. Combination trials in areas with antileishmanial drug resistance, and treatment and secondary prophylaxis trials in VL-human immunodeficiency virus-coinfected patients, are important to safeguard the current armamentarium and to optimize regimens. The public health community should work to broaden access to preferential liposomal amphotericin B pricing by public sector VL treatment programs.

AIDS-Related Opportunistic Infections↗
PubMed2000

Minorities, women, and clinical cancer research: the charge, promise, and challenge.

Significant progress has been made since the war against cancer was launched. Discoveries in molecular medicine, genetics, and epidemiology have led to the recognition that certain cancers are potentially preventable and that elements of lifestyle, along with genetic, hormonal, and metabolic factors can be altered to reduce cancer risk. Advances in medical technology have led to the development of new imaging methods and computer technologies that can aid in efforts to detect, diagnosis, and treat cancer. Since the offensive against cancer was initiated, cancer treatments have become more powerful, more precise, less drastic, and safer. As a result, cancer incidence and mortality have begun to decline. Yet, while the nation boasts of the progress being achieved relative to cancer incidence and mortality, and federal research agencies retort that research applies to all populations, it is apparent that the declines do not translate to all populations in the United States. Clinical research is essential to cancer prevention and control. Within the oncology community, clinical cancer research trials are viewed as an efficient and economical way for patients to secure state-of-the-science medical care. Recognizing the need to improve access to state-of-the-science cancer treatment and control programs, minority and female participation in clinical cancer research trials has been encouraged. This recommendation is based on the belief that increased participation in well-designed clinical cancer research trials adhering to strict protocols and quality controls will, not only help validate the application of research findings to minority and female populations, but also result in better patient outcomes. Born out of a commitment to social equity, justice, beneficence, and the desire to ensure that data relevant to cancer prevention and control are both valid and generalizable to populations across the United States, several programs of research aimed toward increasing the representation of women and minorities in clinical cancer research have been pursued by the National Cancer Institute. This issue of the Annals of Epidemiology Minorities, Women, and Clinical Cancer Research presents issues and challenges that face the research community and descriptions of effective models, strategies, and practices that may be used to increase the participation of minorities and women in clinical cancer research trials and facilitate the conduct of research directed toward reducing the cancer burden within the United States.

Cost of Illness↗
PubMed1996

A randomized, controlled effectiveness trial of an AIDS prevention program for low-income African-American youths.

BACKGROUND: Some interventions to reduce the risk of the acquired immunodeficiency syndrome (AIDS) that target youths have resulted in short-term increases in self-reported condom use. However, long-term intervention effects have not been assessed. STUDY QUESTION: Can a theoretically and culturally based, AIDS-risk reduction intervention delivered to naturally formed peer groups increase self-reported condom use among African-American early adolescents at 6 and 12 months of follow-up? METHOD: A randomized, controlled trial of a community-based intervention delivered in eight weekly sessions involved 76 naturally formed peer groups consisting of 383 (206 intervention and 177 control) African-American youths 9 to 15 years of age. A theory-based, culturally and developmentally tailored instrument that assessed perceptions, intentions, and self-reported sexual behaviors was administered to all subjects at baseline (preintervention) and 6 and 12 months later. RESULTS: At baseline, 36% of youths were sexually experienced, and by 12 months of follow-up, 49% were sexually experienced. Self-reported condom use rates were significantly higher among intervention than control youths (85% vs 61%; P<.05) at the 6-month follow-up. However, by 12 months, rates were no longer significantly higher among intervention youths. The intervention impact at 6 months was especially strong among boys (85% vs 57%; P<.05) and among early teens (13 to 15 years old) (95% vs 60%; P<.01). Self-reported condom use intention was also increased among intervention youths at 6 months but not at 12 months. Some perceptions were positively affected at 6 months, but the change did not persist at 12 months. CONCLUSIONS: High rates of sexual intercourse underscore the urgent need for effective AIDS-risk reduction interventions that target low-income urban, African-American preteens and early teens. A developmentally and culturally tailored intervention based on social-cognitive theory and delivered to naturally formed peer groups recruited from community settings can increase self-reported condom use. The strong short-term improvements in behaviors and intentions followed by some relapse over longer periods argue for a strengthened program and research focus on sustainability.

Acquired Immunodeficiency Syndrome↗
PubMed1992

A community-based Inventory of Current Concerns of impoverished homeless and drug-addicted minority women.

The purpose of this series of studies was to refine and evaluate the psychometric properties of a measure of the concerns of impoverished minority women who were homeless and/or drug addicted. A comprehensive review of the literature and qualitative focus groups conducted with homeless and drug-addicted minority women were used to refine the inventory of Current Concerns (ICC) (Weisman, Worden, & Sobel, 1980). A 31-item revised Community-Based Inventory of Current Concerns (CICC) was critiqued by measurements and content experts, and content validity was established. The CICC was administered to 978 black and Hispanic women who were residents of drug recovery programs or were homeless and residing in shelters, single room occupancy hotels, or with family or friends. Principal components factor analysis with varimax rotation resulted in a five-factor solution explaining 53% of the variance. These factors were labeled Competency, Personal Instability/Despondency, Survival, Drug-Related, and Parenting Concerns. Alpha reliability coefficient was .90 for the total scale and .79 to .93 for the subscales. Construct validity was demonstrated by moderate correlations (r = .54) between the total CICC and the CES-D. The revised CICC can be used for clinical and research purposes to aid in assessing the concerns of minority impoverished women.

Adolescent↗
PubMedDate not supplied

The effectiveness of empowering in-service training programs for foreign nurse aides in community-based long-term care facilities.

The objective of the study was to examine the effectiveness of empowering in-service training programs for foreign nurse aides working in community-based long-term care (LTC) facilities. The design was a pretest and post-test design with experiment and control groups. The sample consisted of purposeful sampling from 10 LTC facilities in the Shihlin and Peitou areas of Taipei. A total of 35 foreign nurse aides participated in this study; 16 in the experimental group and 19 in the control group. The experimental group attended the training program for a 3-month period, whereas the control group did not receive any training. The research findings reveal that the training program was effective in increasing the work stress of workload/scheduling (Z = 2.01, p </= 0.05), meaning that the training program has raised the awareness of work stress for foreign nurse aides. The results could be used as a reference when considering the development of in-service training programs in LTC facilities.

Adult↗
PubMed1992

Sampling and accessing people with AIDS. Implications for program evaluation.

This article describes issues that arose in attempting to conduct a survey of people with acquired immune deficiency syndrome (AIDS) as part of an evaluation of a program to deliver health and social services to this population. Demands to maintain the confidentiality of people with human immunodeficiency virus (HIV) infection posed a large impediment to randomly sampling and accessing program recipients. Efforts to contact people with AIDS through the mediation of health service providers encountered problems of nonimplementation and slow accrual. Comparisons of the obtained sample with a more comprehensive data base of program clients suggest that clients who were more accessible and compliant were overrepresented in the sample. People with AIDS themselves, however, were willing to be interviewed, as demonstrated by refusal rates less than 11%. Future studies of people with AIDS must overcome direct service providers' lack of time to contact and recruit respondents; it may be wise to allocate funds to support recruitment activities conducted by an administrative staff person in the service delivery agency.

Acquired Immunodeficiency Syndrome↗
PubMed2006

[Sixteen years of nursing education with diploma at the Semmelweis University].

Nowadays it is already known that medical sciences on their own cannot achieve spectacular improvement in the state of health of the population even with high-tech appliances. Health care professionals, who can aid individuals, families, and communities in optimizing their physical, mental and social functions, are also needed in the fields of basic provision and clinical-hospital provision and, to achieve this, they possess wider medical, nursing and social scientific expertise. The training of registered nurses was first launched in Hungary at the Postgraduate Medical Institute's Faculty of Health Care (nowadays Semmelweis University Faculty of Health Care) in 1989 as a correspondence, then in 1990 as a full-time program. This was the first step towards the realization of a better, high-standard, individualized nursing system. The aim is training health care professionals who are able to individually assess the needs of people under their care, define the problems, plan, execute and evaluate the nursing-caring process, and take part in nursing research. Besides the positive results of the follow-up examinations of graduate students, the fact cannot be neglected that since the introduction of the training, in the last 15 years it has not become clear to everyone, why the training of registered nurses is necessary, and what these "new-type" professionals can be used for. It is clear to everyone that for real teamwork the mutual appreciation of each other's work, maximum accord, the acceptance and honor of each other are indispensable. Still, all these cannot be expected from school qualification only, these can only be achieved with the continuous proof of aptitude and expertise. For the realistic judgement of registered nurses it is also needed that their nearest colleague, the physician should know in depths and accept the syllabus of the training. That is why the author of the article feels that the history of the first sixteen years of the accredited training is important to be shown, and her message is grouped around four most important elements: curriculum, teachers participating in the training, practice bases and students.

Curriculum↗