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PubMed1992

ADA dental product evaluation: case history.

The ADA Acceptance Programs entail a rigorous evaluation of products and offer clear benefits to manufacturers, dental professionals, and consumers alike. This paper outlines the implications of the ADA product-evaluation programs for each of these three constituencies and concludes that while there may be an occasional downside from the manufacturer's standpoint, their net effect is to provide assurances that products are safe, efficacious, and promoted properly.

American Dental Association↗
PubMedDate not supplied

A national survey of medical risk assessment instruction in general practice residency programs (Part II).

This is the second part of a three-part series reporting a national survey of general practice residency directors and their evaluation of the medical risk assessment (MRA) instruction curriculum in their programs. The purpose of Part II is to evaluate the degree of success of the implementation of the ADA Commission on Accreditation's standard for MRA programs. Acceptable levels of achievement were attained in most areas of basic and intermediate-level skills. However, approximately one-third to one-half of general practice residency directors report that they are not achieving the standard for some intermediate or advanced assessment skills. When various instructor categories were compared, physicians scored significantly higher than oral and maxillofacial surgeons or other dentists in their ability to achieve acceptable outcomes in MRA instruction. The results of this survey, coupled with available literature concerning medical risk assessment instruction, support that changes in the undergraduate curriculum, a mandatory additional year of training, or modification of defined goals and outcomes should be considered.

American Dental Association↗
PubMed1986

Towards better nutrition: lip service or a realistic fight?

Progress towards the objective of the World Food Conference of 1974 that "no child should go to bed hungry" is reviewed. The low market price of primary products keeps developing countries poor. Yet in these countries industry rather than agriculture has been supported by governments. All regions are increasing total food production but population growth threatens to offset this increase. In some areas there is decrease in food production per head of population. In many countries the social situation of women affects the nutrition of families. Other causes of malnutrition are discussed and future policies are recommended.

Africa↗
PubMedDate not supplied

Introducing the quality Institute of the Cleveland Clinic Health System.

Several quality measurement needs surfaced when the Cleveland Clinic Health System (CCHS) was formed, including a need for standardized measurement of clinical processes and outcomes, patient satisfaction, critical care, and patient safety. The Quality Institute (QI) facilitates system teams to address these issues, manages selection of measurement tools, collects and analyzes performance data, coordinates presentations, and presents team findings. The QI manages the CCHS performance improvement plan and coordinates activities designed to accomplish priority goals, in collaboration with multiple CCHS teams and the regional and hospital staffs. The most important outcome of the QI's operations is improved care, as demonstrated through objective measurement. Other outcomes include external recognition and funding; implementation of standardized measurement systems, data management activities, and production of quarterly reports; increased internal recognition; completion of several education programs; acceptance of data by payers and plans; and participation in attainment of Joint Commission on Accreditation of Healthcare Organizations network accreditation.

Critical Care↗
PubMed2002

Toward better compliance with iron-folic acid supplements: understanding the behavior of poor urban pregnant women through ethnographic decision models in Vadodara, India.

This study made an attempt to develop ethnographic decision models to understand and improve iron-folic acid supplement procurement and compliance-related behaviors of poor urban pregnant women in Vadodara, India, based on data obtained through the use of qualitative research tools. Open-ended, in-depth interviews were conducted with 36 pregnant women (17-32 weeks of gestation) purposively selected from four urban slums. Fortnightly home visits were made to the houses of 20 pregnant women-family member pairs to elicit behaviors related to iron-folic acid supplement procurement and compliance at the household level, from which the ethnographic decision models were developed. The hemoglobin levels of these women were also assessed. Regular counseling until delivery, based on the ethnographic data, helped to improve compliance, which resulted in 95% of the women consuming over 90% of the required dose. The mean hemoglobin level also improved from 9.6 to 11.08 g/dl until the end of the last trimester. This study highlighted the need for qualitative ethnographic data to develop such models that would help in the understanding of specific behaviors that influence program acceptance. Such data would have policy-level implications, for example, developing appropriate information-education-communication material and counseling strategies.

Adult↗
PubMed2004

A review of the 'Statistical Analysis for Genetic Epidemiology' (S.A.G.E.) software package.

The 'Statistical Analysis for Genetic Epidemiology' (S.A.G.E.) software package is an integrated, comprehensive package of computer programs designed to perform many of the different analyses required in the study of genetic epidemiology. It offers a graphical user interface for most platforms and, unlike many programs available in the public domain, is flexible in both receiving many types of input files and in allowing the user to choose among output files. All of the programs accept the same data files and together provide the means to perform familial correlation, segregation, linkage and association analyses, as well as many of the ancillary analyses that help achieve these goals. Many, but not all, of the same or similar analyses can be performed (with more difficulty) using publicly available freeware. The primary limitations of S.A.G.E. at present are the lack of software for estimating haplotypes or for identifying probable double recombinants in linkage analysis. S.A.G.E. is continually being extended and upgraded, however, with automatic downloading of the latest version always available to users.

Databases, Genetic↗
PubMed1986

Utilization of health services by Mexican immigrant women in San Diego.

The limited empirical data available on maternal health problems among Mexican immigrant women in the United States suggest that they underutilize health services, especially general preventive care. Research conducted among legal and undocumented women in the Mexican immigrant population in San Diego, California, support these findings. Among undocumented mothers, 11.5% of their births in the U.S. occurred with no prenatal care or care sought in the third trimester, which is much higher than Mexican women legally in the country (3.6%) and the general San Diego maternal population (3.8%). When we examine births which occurred within the last five years by immigration status, we find that women legally in the country have a much higher rate of cesarean delivery of both undocumented women and women in the general San Diego maternal population. Undocumented women in our sample were much less likely than their legal counterparts to return for postpartum examinations for themselves, to seek neonatal care for their infants, and to have had Pap examinations or carry out breast self-examinations.

California↗
PubMed1989

Childbearing and women's choice of nurse-midwives in Washington, D.C. hospitals.

This research focuses on the extent to which choosing a certified nurse-midwife (CNM) for the management of birth in the hospital is an option. Licensing laws affect this option by determining access to hospitals for CNMs in the form of hospital practice privileges. Data for this descriptive case study of Washington, D.C. hospitals were collected from interviews with CNMs and hospital personnel, including physicians, and from secondary sources, including legislative acts and hospital bylaws. Our findings suggest that although the option for a CNM managed birth has increased in the District with the granting of hospital privileges to CNMs in 3 of 9 hospitals providing obstetrical services, restrictions on CNM practice still exist. These are the capacity to admit patients in the CNMs' name and the issue of supervision of CNMs by a physician in the hospital.

Delivery, Obstetric↗
PubMed2004

A three-year clinical evaluation of two dentin bonding agents.

BACKGROUND: A new restorative called a "giomer composite" has been introduced. The authors conducted a study to determine retention, anatomical form, caries, staining, marginal discoloration, marginal adaptation, surface roughness and sensitivity of giomer compared with those of a microfilled composite. METHODS: The authors placed 40 sets of restorations randomly in canines and premolars in vivo. They used a giomer composite and a microfilled composite in erosion/abrasion/abfraction Class V lesions that were not altered with rotary instruments. They placed the restorations according to manufacturer's recommendations, and two calibrated examiners evaluated the restorations independently using modified U.S. Public Health Service criteria at baseline and at six, 18 and 36 months. The lesions receiving the restorations did not differ from each other in the amount of circumferential enamel present, the percentage of the surface area of dentin or lesion type. RESULTS: There were no differences in the restorations at baseline, an evaluation made two weeks after placement. At 36 months, the giomer and microfilled composite restorations were not significantly different from one another in any of the eight criteria evaluated. The percentage agreement between examiners was at least 83 percent for each criterion in each evaluation period. CONCLUSIONS: Both the giomer and the microfilled composite used in this study meet the clinical portion of the Acceptance Program Guidelines for Dentin and Enamel Adhesives Materials established by the American Dental Association. CLINICAL IMPLICATIONS: Both the giomer and the microfilled composite used in this study can be used with confidence in Class V lesions.

Adult↗
PubMed1994

The accessibility of drug treatment for pregnant women: a survey of programs in five cities.

Through simulated calls to 294 drug treatment programs in five cities, this study investigated access for pregnant women and compared New York City's provision of services in 1989 to that in 1993. In all sites, the majority of programs accepted pregnant women. There was also a marked improvement in the availability of services in New York City. Yet options were more limited for Medicaid recipients and women needing child care, and an appointment or referral for prenatal care was usually not offered. Although the door for treatment may be opening for pregnant women, institutional barriers still remain.

Child Care↗
PubMed1988

The well baby lottery: motivational procedures for increasing attendance at maternal and child health clinics.

A lottery system was used to improve attendance at four well baby clinics in four colonias in Tijuana, Mexico. Mothers earned one lottery ticket for each visit to each clinic during the intervention period. At the end of each month, ticket receipts were entered into drawings for one of three bags of groceries. The lottery system was evaluated within a "multiple baseline design" whereby the intervention was staggered across the four clinics on a month-by-month basis. Although attendance was not enhanced uniformly, an overall improvement of 25 percent was realized. The lottery system was at times hampered by administrative problems, such as the breakdown of a public address system used to announce the open hours of a clinic in one of the colonias.

Child Development↗
PubMed1994

Neuropsychiatric adverse drug reactions: passive reports to Health and Welfare Canada's adverse drug reaction database (1965-present).

OBJECTIVE: Since 1965, Health and Welfare Canada has operated an adverse drug reaction (ADR) program. The program accepts spontaneous reports of adverse drug reactions, and maintains an ADR database. The purpose of this article is to summarize the Psychiatric ADRs reported to this database since 1965. The nature of the information prohibits its use in the evaluation of epidemiological hypotheses about the etiology of drug-induced mental disorders. However, in an exploratory sense, the contents of the database may contribute to the development of epidemiological hypotheses about the etiology of drug-induced mental disorders. Of particular interest are areas of apparent contradiction between the contents of the database and the clinical literature. METHODS: The database was searched for reports of ADRs to a group of drugs which have been frequently implicated in causing psychiatric toxicity. All reports characterized as "psychiatric disorders" were down-loaded from the database for the analysis (n = 1822). The reports were further classified into nine categories according to the type of psychiatric symptoms described. RESULTS: There were several reports of hallucinations caused by methyldopa, and also several reports of benzodiazepine-induced hallucinations and encephalopathy. These reactions have not been described in the literature. Also, there were few reports of digoxin-induced organic depression, and an absence of reports of organic mania induced by H-2 blockers, despite descriptions of these sorts of reactions in the clinical literature. CONCLUSIONS: Further research is needed to define the neuropsychiatric toxicity associated with medical drugs. Clinicians must continue to consider the potential role of medications in the etiology of psychiatric symptoms.

Adverse Drug Reaction Reporting Systems↗
PubMed1988

The selection and training of primary health care workers in Ecuador: issues and alternatives for public policy.

This article employs quantitative analysis to evaluate the effectiveness of the community health worker (CHW) training program used by the Ministry of Public Health in Ecuador. The study first assesses CHW knowledge in the areas of prevention, maternal-child health, first aid, and treatment of common illnesses. The analysis reveals that CHWs retained less than 50 percent of what they learned one year after graduation. Demographic factors accounted for some variance in performance. Higher levels of community organization were associated with improved CHW knowledge. The presence of a health committee was also an important factor. The second phase of the study was designed to assess the community impact of the program. Surprisingly, neither the demographic characteristics of the health worker nor his or her level of competence affected the impact of the program on the community, as measured by patient satisfaction, utilization indices, and adoption of preventive health behaviors. It was the characteristics of the beneficiaries themselves that accounted for the variance in community impact. These results yield some important implications for public health policy in Ecuador.

Community Health Workers↗
PubMed2005

Addendum to concerns about professional schools.

The present research adds to the October 2004 comments in the American Psychologist of Templer and Arikawa who reported that traditional clinical psychology graduate students had greatly higher mean GRE scores than professional school students. The traditional and professional students had mean undergraduate GPAs of 3.62 (SD= .13) and 3.36 (SD= .14), respectively. The mean respective percentages of applicants to 148 traditional and 50 professional programs accepted were 10.4 (SD= 9.5) and 44.4 (SD= 19.5), respectively.

Adult↗
PubMedDate not supplied

3D rendering of SAR distributions from Thermotron RF-8 using a ray casting technique.

A comprehensive 3D visualization package developed for CT-based 3D radiation treatment planning has been modified to volume-render SAR data. The program accepts data from sequential thermographic thermometry measurements as well as calculated data from thermal models. In this presentation sample data obtained from a capacitive heating system 'Thermotron-RF8' is presented. This capability allows the generation of accurate standardized volumetric images of SAR and provides a valuable tool to better preplan hyperthermia treatments.

Evaluation Studies as Topic↗