Crisis intervention: program evaluation

Crisis intervention is based upon crisis theory and is defined as a short-term active mode of therapy that focuses on solving the client's immediate problem and reestablishing psychological equilibrium. The crisis intervention program was the first phase in the development of a broader mental health program with advancement decisions being based upon evaluation results of this initial phase. An evaluation methodology using the Stufflebeam Goal-Stakeholder Model (1980) was designed and implemented. A satisfaction survey was conducted to develop a database relative to the program's process. The Mental Health Category Measure, and the Crisis Call Outcome Rating Scale were used to capture outcome data. Analysis of the qualitative and quantitative data indicate that stakeholders are satisfied with the program. outcome data demonstrates that the program produces the intended outcomes. Triangulation, a method of comparing the qualitative and quantitative findings revealed consistency, and thus provides confidence in the accuracy of the findings.     

Lives on hold: evaluation of a caregiver''s support program

BACKGROUND: With the increasing number of surgeons using phacoemulsification techniques combined with sutureless scleral tunnel and clear corneal incisions for cataract surgery, the majority of patients will undergo an uncomplicated course of visual rehabilitation requiring no more than standard topical antibiotic and steroid regimen. Occasionally--even with an uneventful surgical course--postoperative complications arise. Many of these postoperative complications can be managed medically, without surgical intervention. Topical and oral glaucoma and nonsteroidal anti-inflammatory agents play an important role in the management of postoperative cataract complications. METHODS: A review of the common postoperative complications and their medical management using topical and oral pharmaceutical agents are presented. Emphasis is placed on current trends in treatment following contemporary cataract surgery. CONCLUSION: Although the complication rate is reduced with modern cataract surgery techniques, the primary care clinician should be prepared to identify and manage the most common clinical conditions. Armed with the proper knowledge of ophthalmic medications and their possible ocular and systemic interactions, optometrists can successfully manage and co-manage many postoperative cataract complications. Common postoperative complications are reviewed, along with current treatment regiments and dosage forms.     

Establishing a cancer risk evaluation program

Most of the clinical, histological and immunohistological features of fogo selvagem resemble those of idiopathic pemphigus foliaceus (PF). Both diseases are clinically characterized by small flaccid bullae evolving into to scaly and crusted lesions, sometimes with pustules, mainly in seborrheic areas of the skin. Mucosal surfaces are mostly spared. The main histologic feature of endemic pemphigus foliaceus is a subcorneal acantholytic blister. Standard immunofluorescence studies demonstrate intercellular IgG deposits throughout the entire epidermis. These IgG antibodies are mainly of the IgG4-subclass. Almost all patients have circulating IgG-autoantibodies in their serum directed against stratified epithelial desmosomes. The fogo selvagem autoantibodies and the PF antibodies are directed against the 160 kD desmosomal glycoprotein desmoglein 1 which together with plakoglobin (85 kD) forms a complex of adhesion proteins with desmosomes of stratified epithelia. Fogo selvagem occurs in endemic foci in some areas of Brazil and possibly in neighbouring South American countries, very often in children, adolescents and young adults. The etiology of fogo selvagem is still unknown. The frequent association with insect bites has lead to the concept of fogo selvagem being a transmissible disease with acquired immunity in adulthood. However, the infectious agent and possible vectors have not yet been identified.     

An evaluation of a family visit education program

OBJECTIVES: This study was designed to examine the impact of the Family Visit Education Program (FVEP) on family members, nursing staff, and nursing home residents with dementia. DESIGN: The study employed a 2 x 3 single-blind, randomized control group design with two study conditions, FVEP or usual care (UC), and three times of measurement, baseline, 3-months, and 6-months. SETTING: The study was conducted in five skilled-care nursing homes that ranged in size from 120 to 300 beds. PARTICIPANTS: Sixty-six residents with dementia and their primary visitor were randomly assigned to FVEP (n = 32) or UC (n = 34). MEASUREMENTS: Residents were assessed for (1) psychosocial functioning, (2) depression, (3) agitated behavior, and (4) degree of positive social interaction. Nursing staff were assessed for changes in the time and methods used to manage problem behaviors. Visitors were assessed for (1) dementia management skills, (2) extent of perceived caregiving hassles, and (3) visit satisfaction. RESULTS: FVEP was effective for reducing residents' problem behaviors and for decreasing their symptoms of depression and irritability. It was also effective for improving the way family members and other visitors communicated with residents, but, with the exception of reducing the use of mechanical restraints, it was not effective in changing nurses' management of residents' behavior problems. CONCLUSIONS: It is possible to educate family members to communicate and interact more effectively with nursing home residents with dementia. This has beneficial effects on residents but not on nursing staff's management of problem behaviors.     

Mid-term evaluation of a help program for smokers

BACKGROUND: Medical counsel to smokers is an intervention that has proved useful to motivate smokers to stop smoking. This study pretends evaluate the long-term impact (2 years and 9 months) of systematic and structured health counsel on the smoke habit from the primary health care. MATERIAL AND METHODS: In April 1990, in four primary care centers from Barcelona and Zaragoza, Spain, a program of systematic counselling to stop smoking with an offer of subsequent follow-up was initiated in all adult smokers (15-65 years of age). According to the answer, every patient was classified on one of seven established categories that allowed a individualized follow-up. Data from the total population included in the program from the beginning till January 1993, are analyzed. RESULTS: From 683 known smokers (59.2% males and 40.8% women), 20 were excluded for different reasons and 343 were included in the program (56.4% cover). Average age of included smokers was 35.1 years (SE = 0.6) and average number of visits of 5.3 (SE = 0.2) which was significantly higher than those not included in the program (33.4; SE = 0.6, and 2.7; SE = 0.1). An average follow-up of 14.3 months (SE = 0.5) and of 2.6 (SE = 0.1) interventions on each individual were done. The average daily number of cigarettes was 18.4 (SE = 0.6) in the initial period and 13.3 (SE = 0.6) on the last program evaluation. The final answers showed a 18.1% of quitters and a decrease of more than 50% on the initial consume on 32.6%. In 12% the answer was negative. CONCLUSIONS: Programs of systematic help for smokers show a higher level of favourable responses than does normal counselling.     

Methodological considerations in the evaluation of a teacher-training program.

Investigated the effects of 3 types of teacher training on graduate teaching assistants' (TAs) teaching behavior, perception of teaching ability, and ratings of effectiveness by their students. In addition, the effects of response-shift bias, an instrumentation-related problem, were examined to ascertain if this source of contamination was operating in the evaluation of this educational program. 38 TAs participated in the training. The training produced significant changes in the trained TAs' teaching behavior, self-ratings of teaching ability, and student ratings of instruction relative to the no-treatment control group. Response-shift bias was noted in the self-reports and controlled through the collection of retrospective pretests. Implications and methodological considerations for future teacher-training programs are discussed. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An ergonomic evaluation of a patient handling device: the elevate and transfer vehicle

This study evaluated a Patient Handling Device (PHD) called the Elevate and Transfer Vehicle (ETV). The ETV works on the principle of leverage to transfer a patient from one seated position to another. Three types of product evaluation were used: expert appraisal; user trials; and performance tests. Expert appraisal was conducted by a panel of 11 people including an ergonomist, an industrial designer, two engineers, including one employed as an academic in a School of Mechanical, Manufacturing and Medical Engineering, and seven health professionals. The experts evaluated the ETV using a checklist and group discussions. They generally agreed that the advantages of the ETV tested were it's simplicity, the convenient position to adjust clothing for toileting and the need for only one carer. They noted comfort, security of straps, centre of gravity and manoeuvrability as the main areas for improvement. User trials consisted of nine male and nine female volunteer users assigned to carer/patient pairs. Following a training period, each user subjectively evaluated the ETV by structured interview. User trial results indicated ease of use, prevention of back injuries in carers and minimal body contact were advantages of the ETV. The main problems with using the ETV appeared to be the inadequate 'prop' and straps, the 'jolt' and lack of dignity for the patient. Several critical performance tests were conducted to determine compliance to Australian Standards for design. Areas of non-compliance included strength of frame and static stability. The findings suggest that most of the identified problems of the ETV could be overcome with minor design improvements. The general consensus of participants was to keep the design simple, maintain fast transfers and maintain the position of the patient to enable ease of clothing adjustment for toileting.     

Participant reactions to a cognitive-behavioral guided self-help program for binge eating: developing criteria for program evaluation

This article evaluates the effectiveness of a telephone-based guided self-help program for women who binge eat. We report how key program components (e.g., phone sessions, the self-help book) contribute to the four self-help goals identified in the clinical literature: (1) decrease isolation/increase support; (2) increase knowledge of the problem; (3) broaden coping skills; and (4) improve self-esteem. Using the example of our feasibility study, we illustrate that even minimal interventions create a relational context which can promote entry into and engagement with treatment. We conclude that program evaluation should include not only traditional measures of outcome (e.g., reduction in symptomatology), but utilize outcome measures related to the specific goals of minimal interventions (e.g., changes in help-seeking behavior).     

Initiation and evaluation of a research-based fall prevention program

Phenomena of melanization of radioactively polluted soils, due to prevalence of melanin-containing species and positive radiotropism of some micromycetes have been found during monitoring of mycobiota of the 30-km alienation zone of the Chernobyl NPP for 10 years. To elucidate the contribution of the melanin system to the cell protection against irradiation, the influence of gamma-irradiation on the activity of protein synthesis in four Cladosporium cladosporioides (Fres.) de Vries strains has been investigated. Two strains isolated from radioactively polluted substrates were characterised by the presence of positive radiotropism. Laboratory strain 396 and its alb-mutant (with blocked melanin synthesis), did not possess this feature. The protein synthesizing activity was assayed by incorporation of 14C-leucine in the protein fraction of mycelium, grown during 7 days under continuous gamma-irradiation of low intensity and without it. The protein synthesis was activated in the radioactively treated mycelium of dark-pigmented C. cladosporioides strains and it was suppressed in similarly treated mycelium of alb-mutant of C. cladosporioides. The rate of 14C-leucine incorporation into biomass of investigated strains correlated with positive radiotropism. The dependence between protein synthesis intensity and the availability of melanin protection system in micromycetes is assumed.     

Three evaluation methods of a community health advocate program

BACKGROUND: The job demands-control model developed by Karasek has greatly influenced research on psychosocial factors at work and health. Validity of the English version of the psychological demands and decision latitude scales is documented. Psychometric qualities of the French version are investigated here in a representative sample of the general population, including blue-collars and white-collars. METHODS: The French translation of the psychological demand and decision latitude scales was administered by interview in a representative sample of the Quebec working population (N = 1,110). Internal consistency and factorial validity of the instrument were studied among white-collars and blue-collars separately. Discriminant validity was assessed for the whole population. RESULTS: Cronbach alpha coefficients, varying between 0.68 and 0.85, support the internal consistency of the scales. Demographic distribution of the scales and intercorrelations were consistent with the English version. Results of the factor analysis were consistent with the two dimensions expected from the theory. Mean scale scores and variations in the prevalence of high psychological demands combined with low decision latitude by age, sex, education, and job category support the discriminant validity of the instrument. CONCLUSIONS: Results support internal consistency, factorial validity, and discriminant validity of the French version of the psychological demands and decision latitude scales of the Karasek "Job Content Questionnaire" for white-collars and for blue-collars of the general population.     

Coping skills training: An evaluation of a psychoeducational program in a community mental health setting.

40 21–60 yr old clients of a community mental health center were randomly assigned to either a coping-skills training program based explicitly on a psychoeducational model or a group-counseling control condition. Ss in the psychoeducational program were provided with 30 hrs of instruction and training in progressive relaxation, anxiety management, social skills, and self-reinforcement procedures. Group-counseling control Ss received an equal amount of attention devoted to analyzing personal problems with anxiety and interpersonal relations but with no direct skills training. Significant differences between the 2 groups on measures of general anxiety, fear, and assertiveness emerged immediately after treatment and at a 3-mo follow-up. Further analyses revealed that Ss were similar in terms of major demographic characteristics to clients who did not volunteer for training, that a greater percentage of program Ss than control Ss scored in the range of a sample of "normal" Ss on 2 of the 4 dependent measures, and that fewer program Ss were hospitalized within 1 yr after participation than were control Ss. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mandibular erosion from silastic implants: evaluation with a dental CT software program

Silastic implants used to augment the chin during cosmetic surgery may cause erosive bone changes and complications. We describe the radiologic appearance of these changes and the dental CT reformatting programs by which they may be assessed. Multiplanar CT scans of four patients with Silastic chin implants were evaluated retrospectively for implant density, presence and size of bone defects, relationship of defects to root apices, relationship of defects to mental foramen, and associated findings. The dental CT software program was instrumental in delineating the relationship between the bone defects and the root apices.     

Development and evaluation of a learning strategy training program.

Developed an interactive learning strategy system consisting of primary and support strategies. A set of training procedures was also created to facilitate the communication of this system to college-age students. This system was assessed in the context of a 15-wk (2 hrs/wk) learning skills course with 108 Ss. Results indicate that Ss receiving this training exhibited (p?     

The annual evaluation of a program to aid the smoker

The cases are described of three adolescents in whom hip pain was found to be due to chondrolysis. Arthroscopy revealed chronic synovitis in all three cases. It is stated that the synovitis is probably the cause of the articular damage and that the disorder should be regarded as juvenile chronic arthritis of the oligoarticular type. Treatment with intra-articular triamcinolone acetonide and in two patients with an anti-inflammatory agent as well resulted in almost complete recovery of hip function.     

The evaluation of a sexual assault risk reduction program: A multisite investigation.

This article summarizes the results of the Ohio University Sexual Assault Risk Reduction Project, which is a program designed to reduce college women's risk for sexual assault. The program was evaluated at 2 separate universities with 762 women. Participants were randomly assigned either to the program or to the no-treatment comparison group, and they completed measures that assessed sexual victimization, dating behaviors, sexual communication, and rape empathy at the pretest and at the 2-month and 6-month follow-ups. At the 2-month follow-up, there were no differences between the groups on any of the outcome measures. However, those women who were moderately victimized during the 2-month follow-up were significantly less likely to be revictimized during the 6-month follow-up period if they participated in the program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)