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PubMed1995

[Development and validation of QPD 32, a specific questionnaire for measuring the quality of life of patients with peptic ulcer].

Drugs need to be evaluated both in terms of efficacy, safety and regarding the patient's perception of his own health status. For these reasons, sensible, reliable and patient-oriented instruments are needed, besides the methodologies for evaluation of drug efficacy and safety. Such instruments substantially evaluate Health related Quality of Life (HrQoL). Concerning gastric acid hypersecretion few papers are available, based on HrQoL questionnaires, both general and specific. A research project led us to develop through patients and physicians involvement, a specific instrument to evaluate HrQoL as to the various aspects of the peptic disease. The project started in 1993 through a series of 4 focus groups with gastroenterologists and patients, followed by the preparation of a questionnaire named QPD48. Such instrument was psychometrically validated through a study named Herqules 1, involving 176 gastroenterologists and 1774 patients. The psychometric analysis on QPD48 led to the re-issue of a questionnaire named QPD32 with Chronbach's alfa equal to 0.91, based on 3 factor-referenced subscales evaluating pain, induced anxiety, constrained daily living and awareness of symptoms and agents. Concerning the concurrent validity a one-way analysis of variance showed highly significant differences associated with attack frequency with substantial effect sizes ranging from 0.46 to 1.27 of a standard deviation in the full scale. QPD 32 is patent protected and will be used in clinical trials.

Adult↗
PubMed1999

The AAMFT-Head Start Training Partnership Project: enhancing MFT capacities beyond the family system.

This paper summarizes the experience of a two-year project to promote partnerships between 12 graduate Marriage and Family Therapy (MFT) training programs and their 12 local Head Start partners. The American Association for Marriage and Family Therapy (AAMFT) awarded 9 grants to MFT-Head Start partnerships that had established relationships with each other prior to the project. Three MFT-Head Start pairs that had no preexisting relationship but wanted to develop one received planning grants. The partnership project provided an exciting opportunity for MFT faculty and interns to integrate family systems theory into larger organizational settings and to enhance the capacity of MFTs to serve disadvantaged, low-income, culturally diverse families and the community agencies that work with them. Preparing MFT students to intervene and respond systemically both in organizations and with the families they serve represents a viable alternative to more traditional approaches to MFT that limit the focus to the family system. Survey results and interview data reflect the rich experiences of MFT faculty and supervisors, MFT interns, and Head Start staff. Implementation issues are discussed and recommendations are made to improve the collaboration between MFTs and community-based agencies such as Head Start.

Child, Preschool↗
PubMed2001

Japanese experience of telemedicine in oncology.

We started telemedicine projects from 1990 with a telepathology system within Tsukiji Campus of National Cancer Center. In 1994, we connected Tsukiji Campus and Kashiwa Campus by 6 Mbps optical fiber leased line using IP protocol for data transmission, for teleconference, telepathology, and teleradiology projects. We also started connection of regional cancer centers and are now forming a cancer center network of 14 cancer centers. We are at present organizing 130 teleconferences per year with an attendance of more than 16000 people as summary. We have also used a high-resolution image transferring system, such as SHD (2000 pixelsx2000 pixels resolution) system on one side, and an economical telemedicine system using JAVA and a WWW browser (NCC_image) on the other side. We think that providing information is another field of telemedicine. We began the experimental gopher and WWW service in 1993. We are now providing official up-to-date cancer information for patients and healthcare professionals. We are getting more than 400000 hits per month. We are also providing a teleconference video session which is held every week on the Internet using a Real Video system with synchronized slide presentation on the WWW browser. We are also organizing a Cancer Image Reference Database System including DICOM images with viewer software. This paper is a summary of the telemedicine projects performed at the National Cancer Center.

Community Networks↗
PubMed2005

The Starting Well Health Demonstration Project.

This paper describes the initial development and implementation of the Starting Well Health Demonstration Project, Scotland's national child health demonstration project. The Project, initially launched in 2000, aims to demonstrate that child health can be improved by a program of activities that both supports families and provides them with access to enhanced community-based resources. Early process outcomes will be presented and policy implications arising out of the Project to date will be explored.

Child↗
PubMed1995

Measurement of the costs in two mammographic screening programmes in the province of Florence, Italy.

OBJECTIVES: To estimate and to compare the cost per woman examined and per breast cancer detected in two mammographic screening programmes in the province of Florence. SETTING: Two ongoing, population based, mammographic screening programmes in the province of Florence. The first (district project) was started in the seventies in a rural area, whereas the second (city project) was started in the city at the end of 1990. METHODS: All relevant resources consumed by the programmes (costs) were listed and measured. The costs are related to 1993. The unit cost for each phase (recruitment, screening, assessment) of the screening process was estimated by dividing the total cost of the phase by the number of women examined. The cost per cancer detected was obtained by dividing the total cost of the programme by the number of cancers detected at screening. RESULTS: The costs per woman examined were $38.1 and $41.1 in the district and city programmes respectively. The cost per breast cancer detected was $7424 in the district programme and $5180 in the city programme. Staff accounted for more than 50% of the total cost. The unit cost in the screening phase was higher in the district programme, whereas it was lower in the assessment phase. CONCLUSIONS: Our results are consistent with, although slightly lower than, published estimates of the cost per woman screened. Important parameters for determining the efficiency of a mammographic screening programme are the compliance rate and the recall rate.

Breast Neoplasms↗
PubMedDate not supplied

Top-down design of a picture archiving and communications system (PACS) by means of simulation.

The development of picture archiving and communications systems (PACS) for medical applications can be regarded as a challenging field in medical informatics. Since 1982, several projects have been started into this direction worldwide. The Dutch IMAGIS (Image Information System) project, started in 1984, is one of them. Within this project, a top-down design strategy is chosen, with the following first steps: (1) A thorough information analysis for a Radiology Department, in which both qualitative and quantitative aspects are included. Such an analysis can be used to estimate the workload on a future PACS system. (2) The construction of a flexible performance prediction tool, based on discrete even simulation. Such a tool can be used to predict the performance of a certain computer system configuration under a certain workload. Based on the information analysis, and using the performance prediction tool, a PACS system is drafted for the thorax section of the Diagnostic Radiology Department of the Leiden University Hospital. In this first design attempt, the assumption was made that current working procedures concerning images will be maintained as much as possible.

Archives↗
PubMedDate not supplied

[Obstetric nursing in prenatal consultation].

This study consists of a report about a research project which started in August, 1997. The project involved teachers from the maternal-paediatrics department with Faculdade de Enfermagem--UERJ (Nursing Faculty with State University of Rio de Janeiro) and professionals from the municipal health center in Rio de Janeiro--SMS/RJ. The introduction of prenatal nursing consultation as a new subject in the nursing graduation course, as well as its formation, and implementation in the referred municipal health center is reported in this paper. This study also proposes a review of the current biomedical consultation model, in order to motivate reflection, break paradigms, and increase the prenatal consultation process in Rio de Janeiro.

Female↗
PubMed1958

Studies on Schistosoma japonicum infection in the Philippines. 1. General considerations and epidemiology.

The geographical location and physical features of the island of Leyte in the Philippines, where bilharziasis is endemic and where the studies reported here were conducted, are described in the first part of this paper. An account is also given of the climate, soils, vegetation, population and rural structure, and public health of the island.The second part opens with a brief historical review of bilharziasis japonica in the Philippines up to 1953, when a control project was started. The objectives of this project, the areas selected, the census data and sampling used, and the techniques adopted are described. There follows a discussion of the prevalence of bilharziasis and its relationship to age, sex, occupation and environment; the prevalence of other common helminthic infections is also considered. In a section on the natural history and public health significance of bilharziasis, an approach to quantitative assessment of disease and disability and a method for evaluating the economic burden of bilharziasis are suggested. The incidence of disease in children of 5-9 years is reviewed in the same section. An analysis is made of possible strain differences of S. japonicum in Leyte, and the relative role of human and other animal hosts is assessed. The last section deals with the egg-laying habits of S. japonicum.

Animals↗
PubMedDate not supplied

[Distance learning using internet in the field of bioengineering].

The Leonardo da Vinci training programme supports innovative transnational initiatives for promoting the knowledge, aptitudes and skills necessary for successful integration into working life. Biomedical engineering is an emerging interdisciplinary field that contributes to understand, define and solve problems in biomedical technology within industrial and health service contexts. Paper presents a Leonardo da Vinci pilot-project called Web-based learning and training in the field of biomedical and design engineering (WEBD). This project has started on 2001. The WEBD project proposes to use advanced learning technologies to provide education in the www. Project uses interactive 3D graphics and virtual reality tools. The WEBD distance training permits users to experience and interact with a life-like model or environment, in safety and at convenient times, while providing a degree of control over the simulation that is usually not possible in the real-life situation.

Biomedical Engineering↗
PubMed1954

Experience with excreta-disposal programmes in rural areas of Brazil.

As part of a wide public-health programme for rural areas of Brazil, the Serviço Especial de Saúde Pública (SESP) has, since 1944, placed considerable emphasis on the problem of excreta disposal. Except in a few cities where conditions justified the construction of sewer systems, projects were started for the erection of pit privies, some 18,000 having been built up to 1952. The projects are conducted by specially trained personnel ("guardas"), who first carry out a sanitary survey of the area concerned, at the same time explaining the benefits of sanitation to the people. A general plan having been drawn up, construction is begun under the supervision of the guardas, who strive to enlist the co-operation of the house-owners as far as possible.Various types of privy have been tried, local building materials being used wherever possible. In almost all cases, however, concrete slabs have been used, covering a hole which may vary in width, but which is generally 2 m deep. Where possible, the SESP has sought the financial collaboration of the local authorities, but the earlier projects were entirely financed by the SESP.Surveys carried out before the projects were started and 3-4 years later show that in certain areas the fall in the percentage of the examined population found positive for Ancylostoma was from 37.6 to 25.4 and all severe infestations (over 500 eggs per g of faeces) had disappeared. This result, though appreciable, would probably have been greater had all the inhabitants used the privies and had they been better maintained.

Brazil↗
PubMed1989

[Employees without pension arrangements].

Old age pensions in modern western industrial countries rest on three pillars: public, collective and individual-private arrangements. The flat-rate public system and the collective systems, domain of industrial relations, prevail in Holland. Since the early seventies the public old age pension (AOW) has been raised to the net minimum wage level. In the meantime the importance of the collective systems has been increasing. The pension levels of these systems are, however, not prescribed by law. In order to measure the present state of the collective systems the Dutch Chamber of Pensions has started a research project to investigate how many workers lack such an arrangement and why they lack it. The results of the project have recently been reported: in 1985 18% (650,000) of the workers (25-65 years) lacked an arrangement. The vast majority of them (87%) was found in the sector of services, especially the commercial services. A second research project has been started to find out the quality of the existing pension arrangements. The results of the two projects together are meant to answer the question whether or not some sort of collective pensions must be enforced by law. The improvement of collective pension schemes, however, should not lead automatically to decreasing public schemes. For most people the public pension system is the most important source of income.

Adult↗
PubMed2000

Why German medical students abandon dissertations.

In Germany, conducting a research project followed by writing a thesis is necessary to receive the title "Doctor" but is not necessary to work as a physician. To determine the reasons that students abandon their dissertations, we conducted and analyzed a survey among 160 fifth and sixth-year medical students at the University of Wuerzburg. Fifteen of 160 respondents (9%) reported to have stopped working on their original project before starting their current replacement thesis research project. Among these 15, the major reasons for abandoning the original research project were: seven (47%) reported lack of supervision, three (20%) reported no recognizable progress, and another three (20%) reported an unacceptable burden of work. Unfamiliarity with experimental methods led two students (13%) to stop working on their original research project. Close supervision and a thorough training remain necessary to prevent students from abandoning medical dissertations and thus should be an essential part of every research project in which medical students are involved.

Journal Article↗