A preliminary investigation of the effectiveness of a sleep apnea education program

Objectives: This study aimed to evaluate a standardised sleep apnea patient education program and develop a study design that may be used to evaluate other such education programs. Method: Thirty-four adults diagnosed with obstructive sleep apnea hypopnea syndrome (OSAHS) underwent a standard sleep apnea education program and completed measures of knowledge of and beliefs about sleep apnea before, after, and 3 months following education. Two outcome measures were used: the Apnea Knowledge Test (AKT) and the Apnea Beliefs Scale (ABS). Results: AKT results showed significant knowledge gains posteducation, which were maintained at follow-up. Patients also reported more positive beliefs about their ability to change their behaviour and comply with continuous positive airway pressure (CPAP) treatment recommendations after education. Discussion: Findings from this preliminary investigation suggest that the education program used in this study may improve patients' knowledge of CPAP and promote functional beliefs about OSAHS treatment. This program clearly warrants further research, and ultimately such programs may prove important in improving CPAP compliance. (C) 2004 Elsevier Inc. All rights reserved.

The effectiveness of an inpatient group cognitive behavioral therapy program for alcohol dependence

The present study evaluated the effectiveness of attendance at a clinically based, short-term, in-patient group CBT program largely based on Monti, Abrams, Kadden, and Cooney(1) to treat problem drinking. Participants were 37 males and 34 females diagnosed with alcohol dependence. Patients attended 42 CBT sessions over three weeks, with each session being one hour in duration. Measures included the Khavari Alcohol Test (KAT), the Short Alcohol Dependence Data Questionnaire (SADD), the Beck Anxiety Index (BAI), the Symptom Checklist-90-Revised (SCL-90), a General Self-Efficacy scale (GSE), and the Drinking Expectancy Profile (DEP). Group attendance rates were monitored daily. Two structured phone calls were conducted at one month and three months post-discharge. Results showed that attendance rates at CBT group sessions were not associated with improvements found at the end of therapy or in drinking behaviors at three-month follow-up. Full support could not be found for the effectiveness of group CBT and cognitive models of problem drinking.

Cost-effectiveness analysis of a kidney and cardiovascular disease treatment program in an Australian aboriginal population

The objective of the study was to assess, from a health service perspective, whether a systematic program to modify kidney and cardiovascular disease reduced the costs of treating end-stage kidney failure. The participants in the study were 1,800 aboriginal adults with hypertension, diabetes with microalbuminuria or overt albuminuria, and overt albuminuria, living on two islands in the Northern Territory of Australia during 1995 to 2000. Perindopril was the primary treatment agent, and other medications were also used to control blood pressure. Control of glucose and lipid levels were attempted, and health education was offered. Evaluation of program resource use and costs for follow-up periods was done at 3 and 4.7 years. On an intention-to-treat basis, the number of dialysis starts and dialysis-years avoided were estimated by comparing the fate of the treatment group with that of historical control subjects, matched for disease severity, who were followed in the before the treatment program began. For the first three years, an estimated 11.6 person-years of dialysis were avoided, and over 4.7 years, 27.7 person-years of dialysis were avoided. The net cost of the program was $1,210 more per person per year than status quo care, and dialyses avoided gave net savings of $1.0 million at 3 years and $3.4 million at 4.6 years. The treatment program provided significant health benefit and impressive cost savings in dialysis avoided. (C) 2005 by the National Kidney Foundation, Inc.

Az európai uniós támogatások hatékonysága és hatásossága közötti különbség a ROP 1.2 intézkedésnél (The difference between the efficiency and effectiveness of using the EU-subsidies at Regional Operational Program)

A szerző cikkében megpróbál rávilágítani annak fontosságára, hogy az Európai Unióból érkező fejlesztési támogatások hasznosulása és a támogatási rendszer hatékonysága között jelentős különbség van. Ha nem tudjuk hatékonyan és hatásosan felhasználni az Unióból érkező pénzügyi eszközöket, akkor a cél: a kohézió, a konvergencia az Európai Unió régi tagállamainak fejlettségi szintjéhez, jólétéhez még nehezebben és lassabban érhető el. Az uniós támogatások hatékonysága alapvetően a rendelkezésre álló pénz lekötésének, lehívásának arányából, illetve a lekötött, lehívott és esetleg visszafizetett összeg arányából állapítható meg (kvantitatív megközelítés). A támogatások felhasználásának hatékonyságánál bonyolultabb, jóval összetettebb megközelítést igényel a hatásosság fogalma. A felhasználás hatásosságát a projektszinten a támogatás hatására megtermelt hozzáadott értékkel, programszinten a GDP hozzáadott növekedéssel lehet kifejezni. A cikk alapvetően a ROP 1.2 "Turisztikai fogadóképesség javítása" pályázati kiírás nyertes projektjeinél végzett kutatás eredményein keresztül kívánja szemléltetni a projektszintű vagy mikro hatásosság fontosságára (kvalitatív megközelítés). _________ The author tries to highlight the importance the difference between the efficiency and effectiveness of using the EU-subsidies. If Hungary cannot use the financial means of the EU efficiently and effectively, than the goal: cohesion and convergence to the level of the old, developed countries of the EU will be much harder and slowly. The efficiency of the EU-subsidies can be measured by the ratio of the amount of money obliged and the amount of money spent, and by the amount of money withdrawn by the Commission, which is actually lost (quantitative approach). The effectiveness of EU-subsidies needs a much more complicated and complex approach, than the efficiency. The effectiveness of usage on project level can be measured by the "added value" of the project, on program level by the added GDP growth or employment. The article is analysing basically the results of a survey made among the winner project of the application ROP 1.2 (Regional Operational Program 1.2) Improving the capacity for tourism (project level or micro effectiveness – qualitative approach).

Effectiveness of the Teaching Enrichment Activities to Minorities (TEAM) program at increasing underrepresented students in gifted programs

This study examined the effectiveness of the TEAM (Teaching Enrichment Activities to Minorities) program in preparing and identifying underrepresented students for entrance into the gifted program. Miami-Dade County Public Schools (M-DCPS) developed the TEAM program as an intervention program aimed at developing student's thinking skills and critical thinking skills in all subject areas and prepare students for possible placement into the gifted program. ^ A systematic sampling strategy was utilized to select three TEAM schools from each of the six regions in M-DCPS for the sample, for a total of 18 schools. A pool of the students that participated in the TEAM program in 2003-2004 in the 18 schools selected were identified as the TEAM Sample students. A matching sample was created from 18 public schools in Miami-Dade County that did not implement the TEAM program in 2003-2004. The Matching Sample created a match for 806 students in the TEAM sample, for a total of 1612 subjects for the study. ^ This study used a logistical regression design to analyze the relationships of multiple independent variables, including: ethnicity, limited English proficiency, gender, free/reduced lunch status, grade level, reading achievement, mathematics achievement, and participation TEAM on the dependent variables of referral for the gifted program and eligibility into the gifted program. The first analysis found the variables of grade level, participation in TEAM, reading achievement, and mathematics achievement were all significant variables in determining if a student was referred for the gifted program. The second analysis found the variables of grade level, gender, free/reduced lunch status, reading achievement, and mathematics achievement were all significant variables in determining if a student was eligible for the gifted program. ^ Recommendations based on the results of this study include the expansion of the TEAM program in M-DCPS to include additional grade levels and schools. Additionally, adopting a broadened definition of giftedness and reviewing the screening and placement policies for potentially gifted students is recommended. Adopting multicultural and broader definitions of giftedness and constructing better tools and programs, such as TEAM, for assessing and identifying potential gifted students, represent small steps towards creating equitable education for all students. ^

Evaluating the Effectiveness of a Public School Prekindergarten Program for Children with Disabilities

A stratified sample of teachers was surveyed to determine their opinion about a Pre-k Program for Children with Disabilities. The results revealed that the teachers were satisfied with their students' progress, the support received from their administrators and district, and their ability to implement the curriculum to meet students' needs.

An Investigation of the Features and Effectiveness of the Full-Day Early Learning Kindergarten Program in Ontario

This dissertation includes two studies. Study 1 is a qualitative case study that describes enactment of the main components of a high fidelity Full-Day Early Learning Kindergarten (FDELK) classroom, specifically play-based learning and teacher-ECE collaboration. Study 2 is a quantitative analysis that investigates how effectively the FDELK program promotes school readiness skills, namely self-regulation, literacy, and numeracy, in Kindergarteners. To describe the main components of an FDELK classroom in Study 1, a sub-sample of four high fidelity case study schools were selected from a larger case study sample. Interview data from these schools’ administrators, educators, parents, and community stakeholders were used to describe how the main components of the FDELK program enabled educators to meet the individual needs of students and promote students’ SR development. In Study 2, hierarchical regression analyses of 32,207 students’ self-regulation, literacy, and numeracy outcomes using 2012 Ontario Early Development Instrument (EDI) data revealed essentially no benefit for students participating in the FDELK program when compared to peers in Half-Day or Alternate-Day Kindergarten programs. Being older and female predicted more positive SR and literacy outcomes. Age and gender accounted for limited variance in numeracy outcomes. Results from both studies suggest that the Ontario Ministry of Education should take steps to improve the quality of the FDELK program by incorporating evidence-based guidelines and goals for play, reducing Kindergarten class sizes to more effectively scaffold learning, and revising curriculum expectations to include a greater focus on SR, literacy, and numeracy skills.

An Investigation of the Impact of an Aspiring Principals Preparation Program on Principal Leadership Effectiveness

School districts need to “build the bench” to ensure that their schools will have effective principals when vacancies arise (Johnson-Taylor & Martin, 2007). Assistant principals represent a potential pool of new school leaders who are prepared to move confidently into the principalship (Oliver, 2005). Although a critical leader in schools, the assistant principal position is underutilized and under-researched (Oleszewski, Shoho, & Barnett, 2012). This lack of focus on assistant principals is concerning because they are part of the school leadership team and often advance to the position of school principal. The purpose of this study was to examine the impact of Bay City Public Schools’ (a pseudonym) Aspiring Principals Preparation Program (AP3; also a pseudonym) on assistant principals’ learning-centered leadership behaviors, as assessed by the Vanderbilt Assessment of Leadership in Education (Val-Ed) survey. The study compared the Val-Ed scores of assistant principals who had participated in one of three cohorts of AP3 training to the scores of assistant principals who did not participate. The results indicated that participation in the AP3 had no significant impact on respondents’ learning-centered leadership behaviors, as assessed on the VAL-ED instrument. This study may be useful as the district seeks to validate the effectiveness of AP3 and identify potential refinements and program modifications.

The effectiveness of educational practice in diabetic foot: a view from Brazil

Background: The aim of the present study was to evaluate the prevention and self-inspection behavior of diabetic subjects with foot at ulcer risk, no previous episode, who participated in the routine visits and standardized education provided by the service and who received prescribed footwear. This evaluation was carried out using a questionnaire scoring from 0-10 (high scores reflect worse practice compliance). Results: 60 patients were studied (30 of each sex); mean age was 62 years, mean duration of the disease was 17 years. As for compliance, 90% showed a total score <= 5, only 8.7% regularly wore the footwear supplied; self foot inspection 65%, 28,3% with additional familiar inspection; creaming 77%; proper washing and drying 88%; proper cutting of toe nails 83%; no cuticle cutting 83%; routine shoe inspection 77%; no use of pumice stones or similar abrasive 70%; no barefoot walking 95%. Conclusion: the planned and multidisciplinary educational approach enabled high compliance of the ulcer prevention care needed in diabetic patients at risk for complications. In contrast, compliance observed for the use of footwear provided was extremely low, demonstrating that the issue of its acceptability should be further and carefully addressed. In countries of such vast dimensions as Brazil multidisciplinary educational approaches can and should be performed by the services providing care for patients with foot at risk for complications according to the reality of local scenarios. Furthermore, every educational program should assess the learning, results obtained and efficacy in the target population by use of an adequate evaluation system.

Effect of a 36-month pharmaceutical care program on pharmacotherapy adherence in elderly diabetic and hypertensive patients

Objective: The primary objective of this study was to evaluate the effect of a pharmaceutical care program on pharmacotherapy adherence in elderly diabetic and hypertensive patients. The clinical outcomes of this pharmacotherapy adherence approach were the secondary objective of the study. Setting: Public Primary Health Care Unit in a municipality in the Brazilian State of Sao Paulo. Method: A 36-month randomized, controlled, prospective clinical trial was carried out with 200 patients divided into two groups: control (n = 100) and intervention (n = 100). The control group received the usual care offered by the Primary Health Care Unit (medical and nurse consultancies). The patients randomized into the intervention group received pharmaceutical care intervention besides the usual care offered. Main outcome measure: Pharmacotherapy adherence (Morisky-Green test translated into Portuguese and computerized dispensed medication history) and clinical measurements (blood pressure, fasting glucose, A1C hemoglobin, triglycerides and total cholesterol) were evaluated at the baseline and up to 36 months. A P value < 0.05 was considered statistically significant. Results: A total of 97 patients from the intervention group and 97 patients from the control group completed the study (n = 194). Significant improvements in the pharmacotherapy adherence were verified for the intervention group according to the Morisky-Green test (50.5% of adherent patients at baseline vs. 83.5% of adherent patients after 36 months; P < 0.001) and the computerized dispensed medication history (52.6% of adherent patients at baseline vs. 83.5% of adherent patients after 36 months; P < 0.001); no significant changes were verified in the control group. Significant improvements in the number of patients reaching adequate values for their blood pressure (26.8% at baseline vs. 86.6% after 36-months; P < 0.001), fasting glucose (29.9% at baseline vs. 70.1% after 36 months; P < 0.001), A1C hemoglobin (3.3% at baseline vs. 63.3% after 36 months; P < 0.001), triglycerides (47.4% at baseline vs. 74.2% after 36 months; P < 0.001) and total cholesterol (59.8% at baseline vs. 80.4% after 36 months; P = 0.002) were verified in the intervention group, but remained unchanged in the control group. Conclusion: These results indicated the effectiveness of pharmaceutical care in improving pharmacotherapy adherence, with positive effects in the clinical outcomes of the patients studied.

An evaluation of the Keep on Talking program for maintaining communication skills into old

Communication skills change with age as a result of sensory deficits, memory loss, and increasing word finding difficulties The Keep on Talking program (L. Hickson, H. Barnett, L. Worrall, & E. Yiu, 1994) was developed to assist older people to develop their own strategies for maintaining communication skills into old age. Two hundred and fifty-two healthy older people were recruited from the community and were assessed on a battery of communication assessments on entry to the study and at 1 year after entry. The experimental group (n = 120) participated in the 5-week group Keep on Talking program run by volunteers A further 130 control subjects were assessed only. The short-term effectiveness of the program was evaluated using a short knowledge based and attitudinal questionnaire and qualitative written feedback. At the I-year follow up, subjects were also asked whether they had taken any action as a result of the project. Results concluded that there was a significant difference between the number of correct questionnaire responses on the knowledge based items and the ratings on the attitudinal items pre- and postprogram questionnaire for the experimental subjects. Qualitative written feedback was positive with many participants remarking on the amount of information that they had acquired. Forty-eight experimental and 69 control subjects (n = 117) were assessed I year later, and there was a significant difference between the groups in terms of the number of subjects who reported having taken action as a result of the program. The Keep on Talking program increased knowledge about communication, produced a positive change in attitude toward the importance of communication, and encouraged participants to take action to maintain their communication skills. Maintaining communication skills may prevent social isolation. This simple 5-hour group program has been effective in empowering participants to maintain. their communication skills as they age.

Effects of a program of intervention on parental distress following infant death

A longitudinal study of 144 patents (65 fathers, 79 mothers) was conducted to evaluate the effectiveness of a program of intervention in relieving the psychological distress of parents affected by infant death. Participants were assessed in terms of their psychiatric disturbance, depression, anxiety, physical symptoms, dyadic adjustment, and coping strategies. The experimental group (n = 84) was offered an intervention program comprising the use of specially designed resources and contact with a trained grief worker. A control group (n = 60) was given routine community care. Parental reactions were assessed at four to six weeks postloss (prior to the implementation of the intervention program), at six months postloss, and at 15 months postloss. A series of multivariate analyses of valiance revealed that the intervention was effective in reducing the distress of parents, particularly those assessed prior to the intervention as being at high-risk of developing mourning difficulties. Effects of the intervention were noted in terms of parents' overall psychiatric disturbance, marital quality, and paternal coping strategies.