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PubMed1987

Epidemiologic programs for computers and calculators. Inferences on odds ratios, relative risks, and risk differences based on standard regression programs.

Statistical analyses of the joint effects of several factors (covariates) on the risk of disease, death, or other dichotomous outcomes, are frequently based on a model that relates the effect of the covariates to some function of the probability of the outcome. The odds ratio, relative risk, and the difference in risks are among the simplest candidates for the outcome function. Each can be specified as a special case of the generalized linear model, but their use has been limited to researchers with access to specialized computer programs that are not yet generally available in standard computer packages. The purpose of this communication is to describe how to implement the maximum likelihood estimation procedures and hypothesis testing associated with the generalized linear model using any computer program that can perform weighted least squares analyses. The procedure is applied specifically to models for relative risks, risk differences, and odds ratios. The techniques are illustrated with SAS and SPSSx programs for data sets previously presented.

Computers↗

PubMedDate not supplied

A school reentry program for burned children. Part I: Development and implementation of a school reentry program.

Sustaining a burn injury is a devastating and painful experience. After acute concerns have been dealt with, continued support of the child and family is important in achieving a smooth return to normal activities. Reports from burned patients for whom physical therapy was a concern identified a need for physical therapy involvement in school reentry to facilitate a resumption of normal school routine. Physical therapy involvement in school reentry has been successful and rewarding with a reasonable commitment of manpower. Utilization of personnel in the administrative structure of state and local school systems promoted the acceptance of the program by local school personnel. Although this program is designed to meet the needs of burned children, the goals of the school reentry program may meet similar needs of children with other chronic illnesses.

Adolescent↗

PubMed1986

Dissemination of community health promotion programs: the Fargo-Moorhead Heart Health Program.

Dissemination often is the neglected phase of the development and distribution cycle. While attention has focused on developing and testing new health education and health promotion programs, relatively little effort has been placed on studying how the programs can be disseminated. This paper reviews the dissemination process, identifies factors critical to successful dissemination, uses examples from a community-based heart disease prevention study to illustrate how health promotion programs can be disseminated across a community, and suggests ways these methods might be applied to a community-based approach to adolescent drug use prevention.

Adolescent↗

PubMed1991

Who is served by programs for the homeless? Admission to a domiciliary care program for homeless veterans.

Demographic and clinical data are presented on 4,138 veterans assessed in the 20-site Department of Veterans Affairs (VA) Domiciliary Care for Homeless Veterans program during its first year of operation. More than two-thirds of the veterans who were screened had been hospitalized in VA medical centers during the year before assessment, and 34 percent were hospitalized at the time of assessment. Compared with veterans who were not admitted for residential treatment, veterans who were admitted were more likely to be previously involved in mental health treatment, literally homeless rather than at risk for homelessness, and without public financial support. Specialized service programs for the homeless such as the VA domiciliary care program may also be called on to play a broader role in the discharge and rehabilitative efforts of public mental health service systems.

Adult↗

PubMed1990

Attendance at health promotion programs: baseline predictors and program outcomes.

As part of a family cardiovascular health promotion project, 111 Mexican-American and 95 Anglo-American families with fifth- or sixth-grade children were assigned to either a primary prevention program involving 18 sessions or to a control condition. This article evaluates predictors of attendance at the year long sequence of sessions in the intervention group. In addition it considers the relationship between attendance and program outcomes. Low baseline scores on physical activity and cardiovascular fitness measures were associated with higher attendance for both children and adults. High initial health knowledge and self-motivation were also associated with attendance. Multiple regression analysis showed that adult attendance was significantly predicted by a model including completion of a three-day food record, low exercise, higher socioeconomic status, family adaptability, and self-motivation. Attendance was correlated with greater knowledge gains and larger reductions in blood pressure. The results indicate that motivated families who are in greater need of conditioning attended more sessions in a health promotion program.

Adult↗

PubMed1979

Program evaluation research: an experimental cost-effectiveness analysis of an armed robbery intervention program.

An armed robbery alarm system was implemented in 48 different stores in two separate geographical areas for 6 months and 12 months, respectively. The alarms were placed in the two separate areas at different times and all alarms were eventually removed. Thus, multiple baseline and reversal strategies were used to evaluate program impact. A device planted in a cash drawer was triggered whenever "bait" money was removed from the drawer sending an alarm signal directly to police cars and headquarters. On-scene apprehensions of armed robbers within target stores were greatly increased even though the armed robbery systems did not deter robbery incidents nor influence the court disposition of the cases. There was also no crime deterrence, crime displacement, or increased apprehensions in either the immediate neighborhoods of target stores or on a city-wide basis. The cost effectiveness of the program was calculated to be poor even though the program is being maintained because of the absence of an alternative robbery apprehension technology.

Cost-Benefit Analysis↗

PubMed1988

Differences in psychological need hierarchy between program completers and dropouts from a drug abuse treatment program.

Psychological need patterns among 116 drug addicts in treatment were measured with the Adjective Checklist. Compared to program completers, program dropouts had higher needs for autonomy and aggression and lower needs for deference, nurturance, and affiliation. This personality style may form the basis of dropping out, among certain types of addicts in certain types of programs, when faced with situational, environmental, or interactional stress. Results also suggest that we may be able to identify a personality pattern at risk for premature termination before the person experiences the impulse to leave.

Adult↗

PubMed1988

A comparison of motor performance of preschoolers enrolled in mental health programs and non-mental health programs.

Recognizing that the etiologies of some major mental illnesses may be in the physical domain, this study described and compared the motor performance of 27 preschool children enrolled in mental health programs with 27 children enrolled in Project Head Start, a non-mental health program. The two groups were matched for age, race, and sex. The Gross and Fine Motor scales of the Peabody Developmental Motor Scales were administered to all subjects. On both measures the children enrolled in mental health programs scored significantly lower than the children enrolled in Project Head Start. In addition their scores were more variable. The results of this study support other findings suggesting that developmental delays may be characteristic of children with emotional disturbances.

Child, Preschool↗

PubMed1992

[A program for continuous infusion of cardiovascular agents (CIRCULATION)--how to derive the algorithm and how to use the mathematical formula in this program].

Recently, many cardiovascular agents came to be administered to serious or perioperative cases continuously, and difficult calculation became necessary. For continuous infusion of cardiovascular agents, we devised a personal computer program (CIRCULATION) to avoid difficult calculation for PC-9801 series (NEC) by a C language (Turbo-C, Version 2.0). It is easy to use the program, and it calculates the algorithm for many cardiovascular agents in a second. The program is very useful for anesthesiologists and for other doctors when they administer various cardiovascular agents.

Algorithms↗

PubMed1991

Cardiovascular risk factor prevalence in African-American adult screenees for a church-based cholesterol education program: the Northeast Oklahoma City Cholesterol Education Program.

The status of selected cardiovascular risk factors was ascertained in a consecutive sample of 661 (222 men and 439 women) African-American adults who were screened for the Northeast Oklahoma City Cholesterol Education Program, a church-based cholesterol intervention program. Hypertension was present in 48.4% and 44.7% of men and women, respectively. Average systolic blood pressure levels were similar in men and women (132.0 vs 131.5 mm Hg, P = 0.40) although average diastolic blood pressure levels were higher in men (84.0 vs 81.1 mm Hg; P < .0001). A substantial proportion of the screenees were unaware of their hypertension, and blood pressure normalization (SBP < 140 and DBP < 90 mm Hg) was uncommon in drug-treated hypertensives. Average cholesterol levels were slightly higher in women compared to men (206.0 vs 199.6 mg/dL, P = 0.11). The majority of persons with elevated cholesterol levels (> or = 240 mg/dL) were unaware of their condition and were infrequently treated with cholesterol-lowering drugs. Overweight was highly prevalent, was more common with advancing age, and was related to the presence of hypertension in both men and women. In addition, a strong linear relation between overweight and blood pressure was present in both sexes. Overweight was more common in young men (< 35 years old) compared to age-matched women; however, women were increasingly more overweight than men after 35-44 years of age. In fact, by age 65, 90% of the women were overweight. These data indicate an excessive prevalence and high mean levels of modifiable cardiovascular risk factors in these church-attending African-American adults. Because churches are a central institution in most African-American communities, and their congregations appear to have an excessive cardiovascular disease risk factor burden, churches may be appropriate sites for the implementation of community-based risk factor control programs.

Adult↗

PubMed1991

Current and future perspectives regarding the framework for nurse anesthesia education: a freestanding academic program within a regionalized program framework.

In 1987, Pittsburgh's LaRoche College advanced its baccalaureate level nurse anesthesia program to the master's degree level. The coordinator of the didactic program collaborated with directors of two affiliated hospitals of nurse anesthesia to develop a program in which scientific concepts, theory and clinical applications have been well-integrated.

Curriculum↗

PubMedDate not supplied

Educational program evaluation: the University of Vermont family nurse practitioner program.

Graduates of the Family Nurse Practitioner (FNP) Program at the University of Vermont, Burlington, were surveyed to determine if the FNPs had enlarged their nursing roles following completion of the program. A sample of Vermont nurses served as a control group. Results of a questionnaire, used to obtain information about the nurses' training, functions, and attitudes, indicated that FNPs performed activities associated with an expanded nursing role more frequently than did their nonpractiioner counterparts. There was evidence that the two groups differed in their attitudes toward various aspects of their nursing roles. The evaluation is an ongoing study; as the number of program graduates increases, further characterization of their roles will be possible.

Attitude of Health Personnel↗

PubMed1989

Instructional computing in Alberta nursing programs as perceived by program leaders.

This paper summarized data from a survey which was conducted to establish the status of computing in Alberta's professional nursing programs. It describes the hardware and software applications in use and identifies barriers to the growth of instructional computing. The study reveals a range of activity in Alberta's nursing programs and definite progressive trends. Future directions as perceived by program leaders are reported.

Alberta↗

PubMedDate not supplied

The role of physicians in a community-wide program for prevention of cardiovascular disease: the Minnesota Heart Health Program.

The Minnesota Heart Health Program (MHHP) aims to reduce cardiovascular disease (CVD) morbidity and mortality by reducing risk factors among the mass of residents in three midwestern communities. A major aspect of the program is the involvement of community physicians because they have high credibility as citizen leaders, especially on health issues. In the MHHP, physicians contributed in a number of ways. The initial contacts with physicians resulted in their providing support and introductions to other community leaders, whose active support was also gained. Physicians sit as members of the central Community Advisory Borads of MHHP and serve on the executive committees of these boards. All MHHP issues related to medical practice are brought before Physicians' Advisory Groups in each community for resolution. Primary care physicians attend MHHP continuing education programs. In a survey of 109 physicians in one of the MHHP communities, 95 percent of respondents believed cigarette smoking to be an important risk factor for CVD, but only 15 percent judged themselves to be effective in dealing with patients who smoked. Forty-one percent of respondents said that elevated blood cholesterol is an important risk factor, but only 20 percent felt effective in treating the condition. Only 18 percent of the physicians in the sample believed that a poor eating pattern plays a substantial role in CVD, and 9 percent felt effective in counseling patients about eating habits. This pattern of results indicates the need not only for continuing education about risk factors for CVD, but also for training to improve patient counseling skills.

Attitude of Health Personnel↗

PubMed1966

Extramural programs of theNational Library of Medicine: program objectives and present status.

The National Library of Medicine Extramural Program, utilizing the authorities of the Medical Library Assistance Act of 1965 and the Public Health Service Act, includes support for library construction, improving and expanding basic library resources, research and development, man-power development, publications, and support for the operation of regional health sciences libraries. The program objectives relating to these various activities have been outlined. A $4,000,000 supplement has been appropriated by the Congress for fiscal year 1966 to implement the authorities of the Act. With the construction provision available in fiscal year 1967, over $13,000,000 has been requested for the second year of the program. The Medical Library Assistance Act is intended to catalyze and stimulate expanded support of medical libraries by their host institutions. Bold and imaginative plans by the medical library community are essential to the full success of the endeavor.

Legislation, Medical↗

PubMed1982

Teaching effectiveness in coordinated undergraduate program in dietetics. Assessments of students, graduates, and program directors.

The effect of practitioner experience on teaching effectiveness of faculty in coordinated undergraduate programs in dietetics (CUPs) was studied on the basis of ratings from program directors, students, and program graduates. Instruments to measure teaching effectiveness were developed that contained 36 items common to all teaching situations and 6 each related to teaching in clinical/community dietetics and to food service management. Four dimensions of effective teaching were identified using factor analysis: interpersonal skill, dietetic expertise, organizational focus, and clinical or practical orientation. Extensive practitioner experience did not contribute to teaching effectiveness.

Clinical Competence↗

PubMed1995

Petro-Canada Heart Health Program: successful program.

1. The economic impact of cardiovascular disease is significant, requiring 8.3 million annual inpatient days for treatment. Disability accounts for 25% of disability pensions paid by Canada Pension Plan to individuals less than 65 years of age. 2. Management of risk factors provides an opportunity to reduce the likelihood of coronary heart disease (CHD) and to mitigate the effects of non-modifiable risks. 3. There is an increased risk for CHD with elevated cholesterol. The best return on the value of a cholesterol program comes from testing work groups comprised mainly of males and older employees. 4. The goal of promoting and maintaining high levels of physical, mental, and social well being for workers can be achieved through programs such as the cholesterol screening and education programs.

Adolescent↗

PubMed1994

Therapeutic walking program: an alternative to a formal vascular rehabilitation program.

A formalized 3-day-a-week structured exercise program proved unsuccessful in a regional, inner-city referral center. However, a large number of patients who needed exercise training were seen. In response to this demand, a "Therapeutic Walking Program" was designed. This article describes the nurse's role, the exercise program, patient screening, and indications for future research.

Exercise Therapy↗