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PubMed2002

Recently reported sightings of ball lightning: observations collected by correspondence and Russian and Ukrainian sightings.

The observations in the first section of this paper were sent to John Abrahamson in response to the publication of a recent paper on ball lightning, with the correspondents either reading the original paper, or reports of it in popular science articles. A selection of the cases has been made, including those which showed interesting detail possibly useful in debating ball lightning mechanisms. Any inserted text within parenthesis is the observer's response to follow-up queries from J.A. The age of the observer (where noted) is that at the time of the observation. Three observations (1 q-s) did not show motion independent of their surroundings, but have been included because of their other similarities to ball lightning. It is interesting to note the high proportion (greater than 0.5) of scientifically or technically trained observers in this collection. The data presented in the second section of this paper come from both letters and interviews. Our interview questionnaire consisted of 46 questions and was mostly carried out in quiet conditions. Observations in 2 a, e, h, l, m, q-t were corrected during several (two or three) interviews. Heading each observation case we note the most unusual property of the object. Ball lightning appears in Russia and the Ukraine usually in summer (June-August), and more rarely in spring (March-May), or autumn (September-November). It appears usually during the daytime, 13:00-17:00 h, when most summer thunderstorms take place. Observers in their descriptions usually use the term "morning" to describe the period from 06:00 to 11:00 h, "daytime" for 12:00-18:00 h, and "evening" for 19:00-21:00 h. The term "time' means the local time, and sometimes it is difficult to compare it with the local geographic time due to frequent official state summer-winter time changes. The decree time in Russia can in general differ from the geographic time by 1-2 h.

Female↗
PubMed2002

Marketing issues for the hospital industry.

The controls on payments by insurance companies and governmental agencies (Medicare, Medicaid, Title 19) to hospitals have led to restricted hospital services for patients. This situation has caused over-capacity in hospitals. Also, there is a surplus of both hospital capacity and doctors. However, there are frequent shortages of nurses and many other trained technical personnel. This situation has behavioral implications which are discussed in this paper.

Cooperative Behavior↗
PubMed1984

A community of scholars or scholars of the community? A note on the limits of relevance.

Universities are increasingly expected to be accountable for the large sums of public money they spend. Universities in Australia are currently under pressure to turn out graduates who are technically trained for immediate entry into the work force. Universities are expected to teach knowledge and skills which are relevant to what the community needs now. If the universities accept such obligations of accountability and relevance, what are the implications for the university enterprise? Over the past decade, medical schools have attempted to spell out their purposes, writing their overall goals and then specific objectives to guide teaching in all departments. These lists of goals and objectives usually incorporate a strong orientation to meeting current community needs. One expression of these community needs is the call for 'Health for all by the year 2000', supported by all governments through the World Health Organization. Turning out graduates to provide community health care would be a relevant goal which an accountable medical school could hardly deny. What evidence is available about university responses to such needs?

Community Health Services↗
PubMedDate not supplied

The optometrist's role in the multidisciplinary diabetes team: towards a more holistic approach.

Diabetes is a chronic and costly disease, which is increasingly affecting Australians of all ages. It imposes a personal and public health threat. Every health care provider will encounter numerous people with diabetes in the course of practice and will have the opportunity to influence the course of diabetes in individual patients. Optometrists have recognised technical training and expertise in detecting diabetic eye disease but can also be effective in helping to improve overall diabetes outcomes by adopting strategies which can assist in: 1. the earlier detection of undiagnosed diabetes, 2. earlier referral to appropriate services for people with established diabetes and who may be experiencing problems and 3. greater patient awareness of recommendations for optimal diabetes care. This article provides an overview of the way diabetes services are currently provided in Australia and the role of non-medical providers in the management of diabetes. Suggestions are made for greater involvement of optometrists as members of the multi-disciplinary diabetes team.

Journal Article↗
PubMed1989

Cryostat use and tissue processing in Mohs micrographic surgery.

Information of cryostat use and reliability was collected from 130 members of the American College of Mohs Micrographic Surgery and Cutaneous Oncology. The Damon IEC International cryostat was utilized by 38% of the survey participants, followed by the Reichert Histostat (18%) and the LabTek/TissueTek (13%). Data were also collected on methods of frozen-section embedding and technical training.

Cryosurgery↗
PubMed1998

Plato, Nightingale, and contemporary nursing.

PURPOSE: To explore the influence of Plato's ideal of leadership on Nightingale's vision for nursing. Nightingale left her imprint on nursing; greater understanding of Nightingale's legacy clarifies several contemporary problems in the field. ORGANIZING FRAMEWORK: Qualitative, historical research in which the great person framework is used to focus on Nightingale and Plato. Nightingale's familiarity with Plato, whose work she read in the original Greek, is established. SOURCES: Evidence for Platonic influence is uncovered in primary sources, then inductive reasoning and reflective analysis are used. FINDINGS: Nightingale's conception of nursing is akin to Plato's conception of public service. Platonic education aims to turn talented people into leading citizens who care for the good of the community. Modern nursing did not evolve from a craft guild tradition, as did medicine. This profound difference in the constitution of nursing is part of what distinguishes it. CONCLUSIONS: Reminiscent of Plato's "Republic," Nightingale's legacy leaves a guardian-like stamp on nursing. Although this legacy also leaves nursing with some ambiguities about technical training and hierarchical systems, it is an orientation to the general good that provides the basis for nursing's holism.

Education, Nursing↗
PubMed1997

A twofold reduction in the incidence of acute ankle sprains in volleyball after the introduction of an injury prevention program: a prospective cohort study.

The purpose of this study was to examine the effects of an injury prevention program, consisting mainly of an injury awareness session, technical training (with emphasis on proper take-off and landing technique for blocking and attacking) and a balance board training program, for players with recurrent sprains. Baseline data were collected during the 1992-93 season and the program was introduced during the 1993-94 season. The 1994-95 season was used to evaluate the effects of the prevention program. The coaches and players in the top two division of the Norwegian Volleyball Federation kept monthly records of exposure time and acute injuries (causing a player to miss at least one playing day). The total exposure time was 149968 h, 132757 h of training and 17211 h of match play during the three seasons. The incidence of ankle injuries was reduced from 0.9 +/- 0.1 per 1000 player hours during the 1992-93 season (48 injuries) to 0.7 +/- 0.1 during the 1993-94 season (38 injuries; NS vs. 1992-93) and to 0.5 +/- 0.1 during the 1994-95 season (24 injuries, P < 0.01 vs. 1992-93).

Adult↗
PubMed1998

What do the public and profession know about dental caries prevention in Korea?

The availability of known preventive dental measures has no value, unless they are used appropriately by the public and by dental health care providers. Nevertheless, there is a wide gap between what is known about preventive procedures and dental public health measures in the preventive and public health dental world and what is known and used by the public and dental health care providers in Korea. The gap should be minimised to enable dental caries to be conquered. Firstly, an emphasis on the appropriate use of preventive procedures is needed in colleges of dentistry, dental hygienist training technical colleges and continuing educational courses. Simultaneously, there should be reform of the state run qualifying examinations for dentists and for dental hygienists in order to upgrade preventive and public health dentistry. Meanwhile, to promote personal dental health, introduce community preventive dental measures and maintain their use through self-help personal efforts and organised combined efforts, all dental health care providers have to educate the public. In addition, dental health care providers and the public should be regularly questioned on their knowledge, opinions and practices about community water fluoridation programmes, school-based fluoride mouthrinsing programmes and preventive procedures at an interval of several years, as a test to measure the achievements of dental educational and dental health education aims.

Attitude of Health Personnel↗
PubMed2000

China's forest policy for the 21st century.

A half-century policy of forest exploitation and monoculture in China has led to disastrous consequences, including degradation of forests and landscapes, loss of biodiversity, unacceptable levels of soil erosion, and catastrophic flooding. A new forest policy had been adopted in China called the Natural Forest conservation Program (NFCP), which emphasizes expansion of natural forests and increasing the productivity of forest plantations. Through locally focused management strategies, biodiversity and forest resources will be sustained, and downstream regions will be better protected from flooding. This new policy is being implemented with a new combination of policy tools, including technical training and education, land management planning, mandatory conversion of marginal farmlands to forest, resettlement and retaining of forest dwellers, share in private ownership, and expanded research. These policy tools may have wider relevance for other countries, particularly developing countries.

Agriculture↗
PubMed1992

Rapid detection of group A streptococci: comparative performance by nurses and laboratory technologists in pediatric satellite laboratories using three test kits.

Rapid tests for detecting group A streptococci in throat swabs are often performed outside hospitals or commercial laboratories by individuals with little or no technical training. We compared the abilities of nurses and technologists to perform and interpret three commercial kits (Directigen 1-2-3, ICON Strep A, and Culturette Brand 10-Minute Strep A ID) in three hospital satellite locations (the emergency department, a walk-in emergency clinic, and a general pediatric clinic). When the three tests were compared with culture, the sensitivities of the tests as performed by nurses and technologists, respectively, were 39 versus 44% for Directigen, 55 versus 51% for Culturette, and 72 versus 39% for ICON. A significant difference in sensitivity was found only with ICON tests. This result was largely explained by the tendency of technologists to test moist swabs, while nurses generally processed dry swabs; ICON test sensitivity was significantly greater with dry swabs. The specificities of Directigen and ICON tests performed by nurses and technologists were high (97 to 100%). The difference in the specificities of the Culturette test as determined from results obtained by nurses and technologists (80 versus 98%) was due to the tendency of one nurse to overinterpret the latex agglutination reaction. Analysis of the accuracies of the tests during practice periods compared with the accuracies of the tests during the study periods revealed statistically significant improvement in test performance. We conclude that these tests are specific but not sensitive when performed by nurses and technologists in satellite laboratories. With one exception, nurses and technologists performed the tests with comparable accuracy after brief training periods.

Emergency Service, Hospital↗
PubMed2004

Influence of non-penetrating glaucoma surgery on aqueous outflow facility in isolated porcine eyes.

PURPOSE: To investigate, in vitro, the influence of non-penetrating glaucoma surgery (NPGS) and the influence of tightly suturing the superficial scleral flap on the aqueous outflow facility of isolated porcine eyes. MATERIALS AND METHODS: The anterior chambers of 12 enucleated porcine cadaver eyes were cannulated and perfused. NPGS was performed by the same surgeon. The overall ocular aqueous outflow facilities were assessed before and after the surgical interventions of NPGS, as well as after scleral flap closure. RESULTS: The mean (SD) aqueous outflow facility, which was 0.164 (0.014) microl/min/mm Hg before surgery, increased significantly after NPGS to 1.584 (0.217) microl/min/mm Hg, p<0.001. When the superficial flap was closed, the aqueous outflow facility significantly decreased (0.754 (0.107) microl/min/mm Hg, p<0.001) but remained significantly higher than preoperatively (p<0.01). After suturing the superficial flap, the overall resistance increased to 1.625 (0.210) microl/min/mm Hg. The difference in the resistance to outflow before and after flap closure was 0.848 (0.169) microl/min/mm Hg. CONCLUSION: After NPGS suturing the scleral flap can modulate aqueous outflow resistance. The experimental set up described might provide an efficient model for the technical training of glaucoma surgeries.

Animals↗
PubMed2001

Evidence-based practices for services to families of people with psychiatric disabilities.

Family psychoeducation is an evidence-based practice that has been shown to reduce relapse rates and facilitate recovery of persons who have mental illness. A core set of characteristics of effective family psychoeducation programs has been developed, including the provision of emotional support, education, resources during periods of crisis, and problem-solving skills. Unfortunately, the use of family psychoeducation in routine practice has been limited. Barriers at the level of the consumer and his or her family members, the clinician and the administrator, and the mental health authority reflect the existence of attitudinal, knowledge-based, practical, and systemic obstacles to implementation. Family psychoeducation dissemination efforts that have been successful to date have built consensus at all levels, including among consumers and their family members; have provided ample training, technical assistance, and supervision to clinical staff; and have maintained a long-term perspective.

Evidence-Based Medicine↗
PubMed1996

Evaluation of media advocacy efforts within a community trial to reduce alcohol-involved injury. Preliminary newspaper results.

This article examines coverage of alcohol-related topics in local newspapers as applied to a conceptual model of media advocacy being tested in a five-component community trial to reduce alcohol-involved injuries. Based on a literature review of determinants of exposure of newspaper articles, it uses a composite measure that takes into account the likelihood that given articles will be read. This measure is evaluated in terms of the timing of media advocacy training, technical consultation, and resulting media advocacy efforts. Three hypotheses find support. First, postintervention levels of coverage across experimental communities appear generally higher than similar preintervention coverage. Second, although postintervention local and county coverage appears higher across experimental communities, no equivalent effect is present across comparison communities. Third, increases in local and county coverage in experimental communities were not matched by increases in state and national coverage in these communities.

Accident Prevention↗
PubMedDate not supplied

A comparison of knee kinetics between male and female recreational athletes in stop-jump tasks.

We compared the knee kinetics of 10 male and 10 female recreational athletes (aged 19 to 25 years) performing forward, vertical, and backward stop-jump tasks. Three-dimensional videography and force plate data were used to record the subjects' performance of the three stop-jump tasks, and an inverse dynamic procedure was used to estimate the knee joint resultant forces and moments. Women exhibited greater proximal anterior shear force than did men during the landing phase. All subjects exhibited greater proximal tibia anterior shear force during the landing phase of the backward stop-jump task than during the other two stop-jump tasks. Women also exhibited greater knee extension and valgus moments than did men during the landing phase of each stop-jump task. Men exhibited greater proximal tibia anterior shear force than did women during the takeoff phase of vertical and backward stop-jump tasks. These results indicate that female recreational athletes may have altered motor control strategies that result in knee positions in which anterior cruciate ligament injuries may occur. The landing phase was more stressful for the anterior cruciate ligament of both women and men than the takeoff phase in all stop-jump tasks. Technical training for female athletes may need to be focused on reducing the peak proximal tibia anterior shear force in stop-jump tasks. Further studies are needed to determine the factors associated with the increased peak proximal tibia anterior shear force in female recreational athletes.

Adult↗
PubMed2006

Virtual respiratory system for education and research: simulation of expiratory flow limitation for spirometry.

BACKGROUND: Due to economic and ethical problems, virtual organs may appear more convenient than experiments on animals or limited investigations on patients. In particular, a virtual respiratory system (VRS) may be useful for tasks such as respirators and support methods testing, education, staff (medical and technical) training, (initial) testing of scientific hypotheses. METHODS: A comparative study of simulated and real spirometric results for different patient states (healthy lungs, restrictive lung disease, and obstructive lung disease of different localization and degree) was performed. The volume-flow curve and such standard parameters as FEV1, FEV1%VC, MEF75 etc. were analyzed. RESULTS: A mathematical description of collapsing bronchi was proposed. All fundamental phenomena present during spirometry also appeared in VRS, especially characteristic dependence between lung volume and air flow for forced expiration. In particular, both airway resistance and the flow limitation were described with one formula derived from commonly known dependence of the resistance on lung volume. Generally there were no significant differences between simulated results and those seen in clinical practice. Only simulation of obstruction in upper airways gave incorrect results, which suggested a different flow limitation mechanism (perhaps wave-speed limitation). CONCLUSIONS: Our VRS can already be used in medical education, e.g. courses of spirometry, and in some other applications. It seems that the significance of the wave-speed criterion has been overestimated.

Computer Simulation↗
PubMed2006

Hypoxaemia among children in rural hospitals in Papua New Guinea: epidemiology and resource availability--a study to support a national oxygen programme.

AIMS: To support a national approach to oxygen systems in Papua New Guinea, we conducted a study to document the incidence of hypoxaemia, its geographical distribution, epidemiological determinants and resource availability in several regions of the country. We also established baseline mortality rate data for all children admitted to five hospitals, for children with a diagnosis of pneumonia and for neonates to evaluate a future intervention. METHODS: Data were collected prospectively from over 1300 hospital admissions in five hospitals in 2004. To establish the baseline case fatality rates, data on outcome were collected retrospectively over 3 years (2001-2003) for over 20,000 children admitted to five hospitals. RESULTS: A total of 1313 admissions were studied prospectively in the five hospitals. Altogether, 384 (29.25%, 95% CI 26.8-31.8) had hypoxaemia, defined as SpO(2) <90%. The incidence of hypoxaemia was much greater in highland hospitals (40% of all admissions) than on the coast (10% of all admissions). This large difference in incidence persisted when the uniform definition of hypoxaemia was adjusted for altitude, and was largely because of differences in the incidence of acute respiratory tract infection. Oxygen was not available on the day of admission for 22% of children (range between hospitals, 3-38), including 13% of all children with hypoxaemia. Oxygen was less available in remote rural district hospitals than in provincial hospitals in regional towns. Clinical signs proposed by WHO as indicators for oxygen would have missed 29% of children with hypoxaemia and, if these clinical signs were used, 30% of children without hypoxaemia would have been considered in need of supplemental oxygen. CONCLUSIONS: Based on this study, an approach to improving the detection of hypoxaemia and the availability of oxygen has been trialled in these five hospitals where a programme of clinical and technical training in the use and maintenance of pulse oximetry and oxygen concentrators has been introduced.

Developing Countries↗
PubMed1997

Education and training of practice nurses.

Seventeen nurses in eight rural general practices participated in a distance education project. Low-cost videoconferencing equipment was assessed for its suitability in two training sessions, concerning asthma and travel immunization. The intended learning outcomes were reached and although initially apprehensive, the nurses quickly became accustomed to the medium. Videoconferencing has now become an accepted part of in-service training. Technical reliability remains the most important problem.

Asthma↗
PubMed1993

Indications for the AO plate with a myocutaneous flap instead of revascularized tissue transfer for mandibular reconstruction.

Our preferred technique for mandibular reconstruction uses a revascularized osseomyocutaneous flap. However, to reconstruct small lateral defects in dentulous patients, the AO mandibular reconstruction plate (MRP) is used. Its advantages include quick, reliable placement without a donor site or the need for advanced technical training. This review examines 16 patients who underwent primary mandibular reconstruction after ablative oncologic surgery using an AO MRP without a bone graft. The average follow-up was 32 months. Twelve patients (75%) had successful reconstructions, while 4 (25%) developed serious complications resulting in failure of the MRP. The most significant factor limiting rehabilitation was disease progression, affecting 12 (75%) of the 16 patients. In this subgroup of selected patients with small (< 6 cm) lateral mandibular defects, useful dentition, and advanced disease, or whose general medical condition precludes prolonged general anesthesia, primary mandibular reconstruction using an AO MRP and a myocutaneous flap without a bone graft is a viable reconstructive alternative.

Adult↗