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PubMed2026

Identifying and Prioritizing Core Components of Relationship Education Programs: a Case Study of an Artificial Intelligence (AI) Assisted Systematic Review.

The field of prevention science seeks to identify and implement effective strategies to address social, emotional, and health challenges. A critical aspect of this endeavor is determining the core components of prevention programs that drive positive outcomes. This article presents a case study utilizing artificial intelligence (AI)-assisted systematic review methods to identify key components of healthy marriage and relationship education programs. Given the growing body of research in this domain, AI tools offer a promising means to enhance the efficiency and accuracy of literature reviews. This study employed AI to screen, code, and validate research articles, demonstrating its effectiveness in expediting systematic reviews while maintaining high accuracy in inclusion screening. This case study involved a systematic review of 22,028 resources (identified from PsycINFO, Academic Search Ultimate, and Google) and a final data set of 268 relevant studies. AI screening was integral in effectively conducting multiple rounds of screening. However, findings also highlight challenges in AI-assisted qualitative data abstraction, underscoring the continued need for human expertise in complex coding tasks. The study contributes to the ongoing discourse on integrating AI into prevention science methodologies and offers insights for optimizing AI applications in systematic reviews.

Artificial Intelligence↗

PubMed2006

Beyond deworming: the promotion of school-health-based interventions by Japan.

Deworming bestows a variety of health and socioeconomic benefits and has been embraced by developing countries. To extend the beneficial impact of deworming, the Asian Centre of International Parasite Control (ACIPAC) project has carried out activities to link deworming with health-promoting school programs in the Greater Mekong Subregion (Cambodia, Laos, Myanmar, Thailand and Vietnam). ACIPAC has also conducted an integrated school-health-based program, including deworming and malaria education, under the umbrella of the health-promoting schools initiative. Implementing "beyond-deworming" efforts is now a practical challenge in the subregion.

Animals↗

PubMed2004

Parking, energy consumption and air pollution.

This paper examines the impacts of different ways of parking on environmental effects, mainly vehicle emissions and air pollution. Vehicle energy consumption and the urban air quality at street level, related to location and design of parking establishments, need to be assessed and quantified. In addition, the indoor parking environment needs attention. This paper gives a description of a methodological approach when comparing different parking establishments. The paper also briefly describes a Swedish attempt to create methods and models for assessing and quantifying such problem. The models are the macrolevel model BRAHE, for regional traffic exhaust emission, and the micromodel SimPark, a parking search model attempt combined with emission models. Until now, very limited knowledge exists regarding the various aspects of vehicle parking and environmental effects in the technical field as well as in the social and human behaviour aspects. This requires an interdisciplinary approach to this challenging area for research, development and more directly practically implemented surveys and field studies. In order to illustrate the new evaluation methodology, the paper also contains some results from a pilot study in Stockholm. Given certain assumptions, a study of vehicle emissions from parking in an underground garage compared with kerbside parking has given an emission reduction of about 40% in favour of the parking garage. This study has been done using the models mentioned above.

Air Pollutants↗

PubMed2006

Participation in curbside recycling schemes and its variation with material types.

Local authorities throughout the UK are refining or implementing curbside recycling schemes as they attempt to achieve challenging statutory recycling targets. Despite the importance of curbside schemes there are few published studies that have reported on actual measured levels and frequency of participation by residents, hindering transferability of lessons learned nationally and internationally. This paper reports measurements and analysis over at least four weeks for three different curbside recycling schemes operating in England, with at least 1400 samples in each. It is found that the participation rate is higher in schemes that collect more types of materials. Participation rates of 38%, 49% and 65% were measured for schemes that collected 1, 2 and 3 material types, respectively. The increase appears to be related not only to extra participants setting out the additional materials, but also increased participation for the common materials. It is found that for one scheme, more households tend to set out plastics and cans compared to newspapers.

Adolescent↗

PubMed1991

Medicare: a strategy for quality assurance, I: A recapitulation of the study and a definition of quality of care.

The first of a series of articles on the Institute of Medicine study on a quality review and assurance program for Medicare, this article reviews the findings, conclusions, and recommendations of the IOM study committee and discusses the quality-of-care definition, which became a focal point for the report. A QA system should achieve a balance among important dimensions of "quality of care;" several such dimensions were identified. Turning the definition into practical measurement and intervention approaches and implementing a QA strategy based on it remain significant challenges.

Medicare↗

PubMed1998

Emergency medicine in Germany.

During the last 25 years the German EMS system has developed into a professional organization that covers the whole country with essentially the same standards. Standardized ambulances and rescue helicopters, equipment, dispatch centers, and training requirements characterize the system. The challenge for the future will be the development and implementation of a creative quality management system to improve system performance in spite of pending budget reductions.

Emergency Medical Services↗

PubMed2003

An intravenous formulation decision tree for discovery compound formulation development.

Discovery and pre-clinical animal efficacy assessment formulation development efforts are challenged by limited compound availability and stringent timelines. The implementation and use of a systematic discovery formulation scheme can facilitate this important process. We observed that nearly 85% of Pfizer, Ann Arbor discovery compounds (n>300) submitted for discovery and pre-clinical injectable formulation development in the year 2000 could be formulated by pH adjustment, cosolvent addition, or a combination of the two approaches. Based on the vehicle data generated by this laboratory, a discovery formulation decision tree, that utilizes the solubilization approaches described above, is proposed. The proposed decision tree can be adapted and modified by pharmaceutical scientists to conform to best practices put forth by their institutions for discovery animal studies requiring injectable dosage forms.

Buffers↗

PubMedDate not supplied

Issues to consider in operationalizing reproductive health.

The International Conference on Population and Development (ICPD) served as the international launchpoint for a broadened reproductive health agenda, bringing global attention to a variety of underlying issues that impact on women's health and well-being, and highlighting the need to redress imbalances in gender equity that have had negative health and social consequences in particular for women and girls. To meet the challenges of the ICPD, programs must assess, prioritize and implement an expanded set of reproductive health interventions within an environment of diminishing resources. This paper argues that hidden social and health costs that particularly affect women must be included in the assessment and prioritization of reproductive health interventions. In addition, it argues that issues of gender and sexuality cannot be separated from the delivery of appropriate family planning and reproductive health care if we are to have a significant impact on improving the reproductive health of current and future generations.

Family Planning Services↗

PubMed1999

The patient exit interview as an assessment of physician-delivered smoking intervention: a validation study.

In evaluating the efficacy of physician-delivered counseling interventions for health behavior changes such as smoking cessation, a major challenge is determining the degree to which interventions are implemented by physicians. The Patient Exit Interview (PEI; J. Ockene et al., 1991) is a brief measure of a patient's perception of the content and quantity of smoking cessation intervention received from his or her physician. One hundred eight current smokers seen in a primary care clinic completed a PEI following their physician visit. Participants were 45% male, 95% Caucasian, with a mean age of 42 years and an average of 22 years of smoking. The PEI correlated well with a criterion measure of an audiotape assessment of the physician-patient interaction (r = .67, p < .001). When discrepancy occurred, in general it was due to patients' over-reporting of intervention as compared with the criterion measure. Implications and limitations of these findings are discussed.

Adult↗

PubMed2006

Gene signature evaluation as a prognostic tool: challenges in the design of the MINDACT trial.

This Review describes the work conducted by the TRANSBIG consortium in the development of the MINDACT (Microarray In Node negative Disease may Avoid ChemoTherapy) trial. The goal of the trial is to provide definitive evidence regarding the clinical relevance of the 70-gene prognosis signature, and to assess the performance of this signature compared with that of traditional prognostic indicators for assigning adjuvant chemotherapy to patients with node-negative breast cancer. We outline the background work and the key questions in node-negative early-stage breast cancer, and then focus on the MINDACT trial design and statistical considerations. The challenges inherent in this trial in terms of logistics, implementation and interpretation of the results are also discussed. We hope that this article will trigger further discussion about the difficulties of setting up and analyzing trials aimed at establishing the worth of new methods for better selection of patients for cancer treatment.

Breast Neoplasms↗

PubMed2006

Getting started in evidence-based practice for childhood speech-language disorders.

PURPOSE: Evidence-based practice (EBP) entails a critical mindset and rigorous methods that foster the judicious integration of scientific evidence into clinical decision making. The purpose of this tutorial is to present strategies, resources, and examples to help speech-language pathologists get started in EBP for childhood speech and language disorders. METHOD: The tutorial begins with an overview of key principles of EBP, including potential benefits and challenges, and other initial considerations. Five recommended steps for implementing EBP are then presented: posing a question, locating the evidence, appraising the evidence, making and implementing clinical decisions, and evaluating those decisions. Included is a compilation of synthesized evidence resources, such as systematic reviews/meta-analyses and EBP guidelines. Finally, illustrative examples are provided to assist practitioners with integrating research evidence into clinical decision making in childhood speech-language disorders. CONCLUSIONS: Speech-language pathologists who work with children are encouraged to adopt EBP for clinical decision making.

Child↗

PubMed2005

Active-space coupled-cluster study of electronic states of Be3.

The active-space coupled-cluster (CC) and equation-of-motion (EOM) CC methods with all single and double excitations with triple excitations defined via active orbitals (CCSDt, EOMCCSDt), as implemented with TENSOR CONTRACTION ENGINE, are applied to the challenging Be3 system, which is characterized by a large number of low-lying excited states dominated by two-electron transitions and significant high-order correlation effects in the ground electronic state. It is demonstrated that the CCSDt and EOMCCSDt methods provide an excellent description of complicated electronic quasidegeneracies present in the Be3 cluster. Different strategies for defining triple excitations within the CCSDtEOMCCSDt approach are discussed.

Journal Article↗

PubMed1999

Malaria in pregnancy: its relevance to safe-motherhood programmes.

Severe anaemia in pregnancy is an important contributor to maternal and perinatal morbidity and mortality. In sub-Saharan Africa severe anaemia in pregnancy is very common, the main causes being iron and folate deficiency, malaria, hookworm infestation and advanced HIV infection. Though most of these causes are preventable, the overall prevalence of anaemia has not changed over many years. This is probably due to a mixture of reasons, including operational problems and inadequate interventions. In addition, a true effect on severe anaemia may have been missed if the only measure taken is of the overall prevalence of anaemia. One cause of anaemia that has been neglected by safe-motherhood programmes has been malaria in pregnancy. In endemic areas, malaria in pregnancy is usually asymptomatic and often associated with a negative peripheral-blood film. Hence the condition needs to be treated and prevented as a matter of routine in all women at risk of infection. A trial conducted in Kenya demonstrated that intermittent treatment with the antimalarial sulfadoxine-pyrimethamine (SP), given a couple of times during pregnancy when women attend for antenatal care, can reduce severe anaemia in primigravidae by 39%. The results of this study demonstrate the important contribution of malaria to severe anaemia in pregnancy in areas of endemic transmission. Intermittent treatment with SP in pregnancy has also been shown to be effective in improving birthweight. Though questions remain about the optimal way to deliver this intervention to different groups of women, we cannot afford to wait for all of the answers. The degree to which malaria contributes to severe anaemia in pregnancy is now clear. In Kenya intermittent SP is now policy for pregnant women from malarious areas. The challenge now is for this regimen to be successfully implemented as part of an integrated programme of anaemia control in pregnancy.

Anemia↗

PubMed2005

Tomographic bioluminescence imaging by use of a combined optical-PET (OPET) system: a computer simulation feasibility study.

The feasibility and limits in performing tomographic bioluminescence imaging with a combined optical-PET (OPET) system were explored by simulating its image formation process. A micro-MRI based virtual mouse phantom was assigned appropriate tissue optical properties to each of its segmented internal organs at wavelengths spanning the emission spectrum of the firefly luciferase at 37 degrees C. The TOAST finite-element code was employed to simulate the diffuse transport of photons emitted from bioluminescence sources in the mouse. OPET measurements were simulated for single-point, two-point and distributed bioluminescence sources located in different organs such as the liver, the kidneys and the gut. An expectation maximization code was employed to recover the intensity and location of these simulated sources. It was found that spectrally resolved measurements were necessary in order to perform tomographic bioluminescence imaging. The true location of emission sources could be recovered if the mouse background optical properties were known a priori. The assumption of a homogeneous optical property background proved inadequate for describing photon transport in optically heterogeneous tissues and led to inaccurate source localization in the reconstructed images. The simulation results pointed out specific methodological challenges that need to be addressed before a practical implementation of OPET-based bioluminescence tomography is achieved.

Computer Simulation↗

PubMed2000

Improving follow-up after an abnormal pap smear: results from a quasi-experimental intervention study.

The success of cervical cancer control programs depends on regular screening with the Pap smear test and prompt and appropriate treatment of early neoplastic lesions. Recognizing the potentially grave consequences of lack of follow-up for abnormal Pap smears, numerous intervention studies have tested the impact of a variety of strategies to increase return for follow-up. The majority of these studies were evaluated under controlled experimental conditions. Despite the encouraging findings of these trials, the next step in the research continuum requires that the effectiveness of these interventions be demonstrated in real world settings before full implementation is initiated. We report the results of an evaluation study assessing the combined effectiveness of three intervention modalities found effective in prior randomized studies: a tracking follow-up protocol, transportation incentives, and financial incentives. This study used a before-after, nonequivalent control group design to assess the impact of a multifaceted intervention that included a computerized tracking protocol with transportation and financial incentives. The study was implemented at two major hospitals, two comprehensive health centers (CHC), and nine public health centers (PHC) under the jurisdiction of the Los Angeles County Department of Health Services. One hospital, one CHC, and the four PHC located in the catchment area of the CHC were selected as experimental sites. The control sites - one hospital, one CHC, and five PHC - provided usual care. All women with an abnormal Pap smear at the intervention and control sites were included in the study. The study consisted of a 1-year period of baseline data collection (September 1989-August 1990), followed by a 2(1/2)-year intervention period (September 1990-February 1993). During the intervention period, the intervention protocol was implemented at the experimental sites, and the control sites provided usual care. Overall, we found that the rates of receipt of follow-up care were consistent with those found in similar studies. In contrast to results obtained in these prior randomized trials, we did not find strong and consistent evidence for intervention effects. Significant findings emerged only at the CHC and hospital levels and only for selected years. Results underscore the importance of testing interventions in real world conditions before large-scale implementation is initiated. In addition, this study highlights the challenge of detecting intervention effects in large-scale studies because of the greater measurement difficulties in field studies as compared with controlled experiments.

Adult↗

PubMed2006

Epidemiology of a primary pneumonic plague in Kantoshu, Manchuria, from 1910 to 1911: statistical analysis of individual records collected by the Japanese Empire.

BACKGROUND: Among the potential uses of Yersinia pestis, intentional release of its aerosolized form, causing person-to-person transmission, is thought to be the most threatening. With the current rarity of pneumonic plague epidemics, our epidemiological knowledge remains insufficient for detailed characterization of effective control measures. METHODS: Temporal patterns and key biological parameters of a pneumonic plague epidemic in Manchuria from 1910 to 1911 were analysed based on historical records collected by Kanto Totokufu, the administration of the Japanese Empire in Manchuria at that time. The serial intervals were fitted to gamma distribution using the maximum likelihood method, and time-delay distributions from onset-to-admission, admission-to-death, and onset-to-death were investigated. RESULTS: Whereas a total of 228 cases were diagnosed with pneumonic plague in areas under direct control of the Japanese Empire, 4,781 cases were also recorded in surrounding areas. Although the epidemic grew exponentially in the early phase, the average doubling time steadily increased reflecting successful control efforts. The estimated mean serial interval (and standard deviation) was 5.7 (3.6) days. All cases with known dates of onset were admitted to hospital within 4 days after onset, and the mean time from onset to admission was 1.1 (0.4) days. CONCLUSIONS: The increase in doubling time demonstrates the efficient and rapid countermeasures employed. Since the short interval from onset to death implies the importance of rapid responses, the challenge in confronting a future bioterrorist attack is to implement rapid and appropriate integration of control measures both at the individual and community level to prevent further transmissions as well as lower case fatality.

Containment of Biohazards↗

PubMed2002

Methodological, practical, and ethical challenges to inner-city health research.

Inner-city health research can be challenging because it deals with vulnerable populations and sometimes puts investigators in difficult situations. Some challenges are methodological, including selecting the optimal research design, implementing effective methods of recruitment and retention, and determining the best approach to data analysis. Other issues are practical, including addressing potential biases in social research; dealing with conflicting research agendas among investigators, community agencies, and funding agencies; and disseminating research findings effectively. Another set of issues relates to the ethical conduct of research, including ensuring privacy, maintaining confidentiality, and obtaining consent that is informed, not coerced, and not influenced by undue inducements. Throughout the research endeavor, the inner-city health researcher must carefully balance the roles of investigator, advocate, activist, and caregiver.

Confidentiality↗

PubMed1996

Routine voluntary antepartum HIV antibody counseling and testing: a sound public health prevention strategy.

Routine voluntary antepartum HIV antibody counseling and testing are important HIV prevention strategies based on sound public health principles. The ultimate goal of this testing strategy is two-fold: identification of high-risk seronegative women for risk reduction counseling; and identification of HIV-infected parturients for counseling, prenatal care, and long-term medical management. To achieve these objectives, there must be nationwide implementation of the CDC HIV prenatal testing guidelines. Our challenge as healthcare providers is to ensure that all of our prenatal patients are afforded the opportunity to have HIV counseling and testing performed.

Anonymous Testing↗