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At least 307 records · Page 17Linked to original sources
PubMed1998

Impact of genetics on disease resistance.

The genetics of a bird or flock has a profound impact on its ability to resist disease, because genetics define the maximum achievable performance level. Careful attention should be paid to genetics as an important component of a comprehensive disease management program including high-level biosecurity, sanitation, and appropriate vaccination programs. Some specific genes (e.g., the MHC) are known to play a role in disease resistance, but resistance is generally a polygenic phenomenon. Future research directions will expand knowledge of the impact of genetics on disease resistance by identifying non-MHC genetic control of resistance and by further elucidating mechanisms regulating expression of genes related to immune response.

Animals↗
PubMed1981

The cultural appropriateness of the WIC Program in Cherokee, North Carolina.

The data presented in this article illustrate the WIC program's ability to function within the Cherokee Indian culture. The respondents reported that WIC foods are accepted and widely distributed in the Cherokee WIC participant households. In addition, they stated that infant and child feeding practices are affected by the information they receive from advice givers. These factors in combination with the Cherokees' positive attitude toward the WIC program make for effective implementation of the national WIC nutrition goal: to maximize the WIC food package's effect on nutritional status considering all ethnic, cultural, and geographic preferences.

Attitude↗
PubMed1998

Identification and restoration of lapsed skills for primary care providers.

OBJECTIVE: Individualized educational programs based upon structured comprehensive evaluations have the highest opportunity for success in addressing the needs of physicians with lapsed skills. The purpose of this article is to describe the Physician Prescribed Educational Program (PPEP), an integrated series of programs that incorporate a formalized, structured evaluation strategy. METHODS: The PPEP is structured to determine: 1) The presence of deficits which are amenable to educational remediation, 2) The likelihood that an appropriate educational program can be developed, and 3) The structure of such a program. RESULTS: Of 300 referrals, 100 have received evaluations thus far. A wide range of deficits were addressable, although there were specific exclusions to participation. CONCLUSIONS: Administrators and others who wish to undertake these efforts should avail themselves of educational and other resources but should not expect rapid results. With careful planning and execution, these programs can provide appropriate and successful experiences for participants.

Clinical Competence↗
PubMed1979

EEG data acquisition and preprocessing by microcomputer satellite system.

Recent development in computer technology allows already medium scale EEG data processing to be performed within the clinical neurophysiology department, if a fast minicomputer with adequate mass storage and graphical output facilities is used. Data acquisition, however, should be delegated to a microcomputer which also should take over as much preprocessing as possible. A system is presented, where one or several microcomputer-based satellite units perform analog-digital conversion, Fourier transformation (FFT), calculation of power spectra and crossproducts, as well as event related averaging or other preprocessing procedures. The units are connected to a fast central minicomputer, where a supervisor program loads the microprocessors with their programs, supervises their activity, receives preprocessed data and activates appropriate postprocessing programs to produce the final results.

Analog-Digital Conversion↗
PubMed1991

Diagnosis and treatment of cranial neuralgias.

Both medical and surgical therapies may be used in the treatment of trigeminal neuralgia and glossopharyngeal neuralgia. Ordinarily, the treatment is medical; however, if a response to drugs is not forthcoming, or if the patient becomes toxic while taking medications or refuses to abide by an appropriate medical program, then surgical consultation should be obtained and the appropriate operation performed. The form and type of neurosurgical procedure will probably depend to a considerable extent on the expertise of the neurosurgeon and his training. Generally, in the elderly, the simplest procedure should be attempted first. It may be necessary to employ both medical and surgical procedures in the individual patient. The medical drug of first choice is carbamazepine. Atypical facial neuralgia is a general term used to cover a variety of head and face pains that are poorly defined and that may not deserve separate clinical status. The pathogenesis of the atypical facial neuralgias is uncertain, and multiple causation seems likely. Search for local inflammatory pathology, neoplasms, vasomotor phenomena, and depressive symptoms is indicated. Treatment should be guided by the findings.

Facial Pain↗
PubMed2005

Congenital rubella syndrome in Iran.

BACKGROUND: Congenital rubella syndrome (CRS) can be prevented with appropriate vaccination programs. The prevalence rates of rubella and CRS in Iran are unknown; therefore, the risk of exposure in pregnant women is not clear. The prevalence of CRS in the pre-vaccine period can be estimated by evaluating the proportion of children in the population with sensorineural hearing loss attributable to rubella. METHODS: This was a case-control study to estimate prevalence of CRS in Tehran (Iran) by evaluating the proportion of children with sensorineural hearing loss attributable to rubella. The study used rubella antibody titer as an indicator, and compared the prevalence of rubella antibody between children with and without sensorineural hearing loss. Using these findings, the proportion of cases of sensorineural hearing loss attributable to rubella was estimated. RESULTS: A total of 225 children aged 1 to 4 years were entered into the study (113 cases and 112 controls). There was a significant difference between cases and controls with regard to rubella antibody seropositivity (19.5% vs. 8.9%, respectively, odds ratio = 2.47, 95% CI = 1.04-5.97). The proportion of sensorineural hearing loss cases attributable to rubella was found to be 12%, corresponding to a CRS prevalence of 0.2/1000. CONCLUSION: The prevalence of CRS was approximately 0.2/1000 before rubella vaccination in Iran, Moreover; the results suggest that implementation of appropriate rubella vaccination programs could potentially prevent about 12% of cases of sensorineural hearing loss in Iranian children. This data could potentially be used as baseline data, which in conjunction with an appropriate method, to establish a surveillance system for rubella vaccination in Iran. An appropriate surveillance system is needed, because the introduction of a rubella vaccine without epidemiological data and an adequate monitoring program could result in the shifting of rubella cases to higher ages, and increasing the incidence of CRS.

Antibodies, Viral↗
PubMed2001

National Institutes of Health Consensus Development Conference Statement: phenylketonuria: screening and management, October 16-18, 2000.

OBJECTIVE: To provide health care providers, patients, and the general public with a responsible assessment of currently available data regarding screening for and management of phenylketonuria (PKU). PARTICIPANTS: A nonfederal, nonadvocate, 14-member panel representing the fields of pediatrics, genetics, human development, public policy, nursing, and molecular physiology and including patient representatives. In addition, 19 experts in pediatrics, medical genetics, psychology, pediatric neurology, biochemical and molecular genetics, and gene therapy presented data to the panel and to a conference audience of 312. EVIDENCE: The literature was searched using Medline for January 1980 through July 2000, and an extensive bibliography of 3394 references was provided to the panel. Experts prepared abstracts for their conference presentations with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. CONSENSUS PROCESS: The panel, answering predefined questions, developed its conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement, which was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately after its release at the conference and was updated with the panel's final revisions. The statement is available at http://consensus.nih.gov. CONCLUSIONS: Genetic testing for PKU has been in place for almost 40 years and has been very successful in preventing severe mental retardation in thousands of children and adults. Metabolic control is necessary across the lifespan of individuals with PKU. A comprehensive, multidisciplinary, integrated system is needed to delivery of care to individuals with PKU. Greatly needed are consistency and coordination between screening, treatment, data collection, and patient support programs. There should be equal access to culturally sensitive, age-appropriate treatment programs. Ethically sound, specific policies for storage, ownership, and use in future studies of archived samples remaining from PKU testing should be established. Research into the pathophysiology of PKU and relationship to genetic, neural, and behavioral variation is strongly encouraged. Uniform policies must be established to remove financial barriers to the acquisition of medical foods and modified low-protein foods and to provide access to support services needed to maintain metabolic control in individuals with PKU. Research on nondietary alternative treatments for PKU is strongly encouraged. To achieve optimal statistical power and cross-cultural applicability, it will be beneficial to use data acquired via national and international collaboration.phenylketonuria, hyperphenylalanimea, phenylketonuria screening, phenylalanine-restricted diet, maternal phenylketonuria, newborn screening, phenylalanine monitoring, phenylketonuria outcomes.

Adult↗
PubMed1985

Enhancing the effectiveness of alcohol and substance abuse prevention programs for children.

Questionnaire responses of eighth-grade students who had made a brief visit to a residential substance (alcohol and drug) abuse treatment center were analyzed to determine the impact of the experience over and above traditional classroom presentations about substance abuse. Questions were designed to test the hypotheses that the brief encounter would result in greater assimilation of and accommodation to more correct information about substance abuse, greater changes in substance abuse constructs, and concomitant changes in attitudes and behaviors. It was expected that visitors would maintain fewer naive, idealized beliefs of the type that facilitate "backing" into participation in substance abuse. Some expected significant differences were found in responses to questions reflecting knowledge and attitudes. The visitors manifested a more realistic, factually based view of substance abuse and substance abusers. It is concluded that intensive prevention/education programs are appropriate for this age group and that the school-based program was significantly enhanced by the brief naturalistic exposure to the people of a therapeutic community. Implications for cognitive learning theory and needed future research are discussed.

Adolescent↗
PubMedDate not supplied

Phenylketonuria (PKU): screening and management.

OBJECTIVE: To provide health care providers, patients, and the general public with a responsible assessment of currently available data regarding screening for, and management of. phenylketonuria (PKU). PARTICIPANTS: A non-Federal, non-advocate, 14-member panel representing the fields of pediatrics, genetics, human development, public policy, nursing, molecular physiology, and including patient representatives. In addition, 19 experts in pediatrics, medical genetics, psychology, pediatric neurology, biochemical and molecular genetics, and gene therapy presented data to the panel and to a conference audience of more than 300. EVIDENCE: The literature was searched using MEDLINE and an extensive bibliography of references was provided to the panel. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. CONSENSUS PROCESS: The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately following its release at the conference and was updated with the panel's final revisions. CONCLUSIONS: Genetic testing for PKU has been in place for almost 40 years and has been very successful in the prevention of severe mental retardation in thousands of children and adults. Metabolic control is necessary across the lifespan of individuals with PKU. A comprehensive, multidisciplinary, integrated system is required for the delivery of care to individuals with PKU. Greatly needed are consistency and coordination among screening, treatment, data collection, and patient support programs. There should be equal access to culturally sensitive, age-appropriate treatment programs. Ethically sound, specific policies for storage, ownership, and use in future studies of archived samples remaining from PKU testing should be established. Research into the pathophysiology of PKU and relationship to genetic, neural, and behavioral variation is strongly encouraged. Uniform policies need to be established to remove from the individual and the family financial barriers to the acquisition of medical foods and modified low-protein foods, as well as to provide access to support services required to maintain metabolic control in individuals with PKU. Research on nondietary alternatives to treatment of PKU is strongly encouraged. To achieve optimal statistical power, as well as cross-cultural applicability, it will be beneficial to use data acquired via national and international collaboration.

Cost-Benefit Analysis↗
PubMed2003

[Subacromial impingement syndrome in athletes: prevention and exercise programs].

The shoulder joint, the most mobile joint in the human body, is at greater risks for injuries. Several factors contribute to shoulder impingement syndrome including rotator cuff weakness, capsular tightness, poor scapulohumeral rhythm, and muscle imbalance of the scapular upward rotation force couple. Rehabilitation and training of the shoulder in throwing and overhead athletes has dramatically improved during the last decade. There are numerous reasons for rapid return to athletic training and competition. A preventive program designed for the glenohumeral joint is mainly based on an appropriate preparation, which should include overall body conditioning, flexibility, and strengthening of the musculature around the glenohumeral joint and the scapula. Activity levels represent a helpful guide in determining an appropriate rehabilitation program for shoulder patients ranging from disabled to those competing at the highest levels of athletics. This article discusses issues related to prophylactic measures, non-operative treatment, postoperative treatment, and rehabilitation programme of impingement syndrome in athletes.

Athletic Injuries↗
PubMed1977

Future of anesthesia.

The authors present an account of some of the problems facing the specialty of anesthesia, which suggests that the interdependence of these problems and of their solutions should be recognized. Recruitment, job satisfaction and clinical standards will be improved as a result of greater involvement by anesthetists in preanesthetic care as part of the health care team. Teaching programs require appropriate expansion and modification. The incorporation of a physician-assistant program is essential to the future of anesthesia.

Anesthesiology↗
PubMed2004

Culturally appropriate breast health educational intervention program for African-American women.

The purpose of this study was to provide a culturally specific intervention program for African-American women to alter selected behavioral risk factors, psychosocial responses, and breast self-care variables. Two primary directional hypotheses were tested with an alpha set at 0.05. These hypotheses were: (1) a Culturally Appropriate Breast Educational Intervention Program (CABHEIP) will lower selected behavioral risk factors (high fat intake, inadequate amount of physical activity, inadequate fiber intake) and selected psychosocial responses (perceived stress, negative coping, low self-efficacy, perceived barriers to Breast Self Examination [BSE] and Clinical Breast Examination [CBE]) in African-American women, 20 to 40 years of age, who participate in the program as compared to whose who do not participate; and (2) a CABHEIP will raise compliance with BSE, proficiency of BSE, and perceived benefits of BSE and CBE in African-American women, 20 to 40 years of age, who participate in the program as compared to those who do not participate. A sample of 120 (N = 120) African-American women was randomly assigned to the control and treatment groups (60 women per group; (n = 60 intervention group; n = 60 attention control group). The sample was obtained from a population of African-American women from four southern and three central Mississippi counties. The intervention group, in clusters of 3 to 9 women, received education on breast cancer, breast self-exams, healthy eating, exercise, and stress management; and heard stories from breast cancer survivors. The attention control group, in clusters of 3 to 8 women, received education on poison control in the home environment. Data was collected and analyzed using descriptive statistics, correlation coefficients, and repeated measures of analysis of covariance (ANCOVA) controlling for covariates. Significant differences between groups for BSE proficiency I (p < 0.0001), BSE proficiency II (p = 0.013), and benefit BSE (p = 0.053) were found. Compliance for BSE approached significance between groups (p = 0.053). Significance to nursing is that education can change outcomes in health promotion for breast cancer in African-American women. Further studies with similar interventions and larger sample sizes are needed to determine other avenues to decrease modifiable risk factors for breast cancer in African-American women.

Adult↗
PubMed1996

Hospice and palliative care: program needs and academic issues.

With the renaissance of interest in how best to care for patients with terminal illness comes the need to recognize palliative care and hospice programs as the completion of comprehensive cancer care, not as its antithesis. In practical terms, admission to a hospice program is appropriate when efforts to control the biologic disease have ceased to be helpful and the primary medical focus is on symptom control and quality of life. In this article, the authors explore the goals of palliative care, review the transition to a hospice program, and assess the Medicare Hospice Benefit. Furthermore, they reflect on the importance of and barriers to the appropriate adoption of palliative care programs as well as palliative care education in oncology.

Comprehensive Health Care↗
PubMed1994

Decision support in medicine: examples from the HELP system.

Computerized health information systems can contribute to the care received by patients in a number of ways. Not the least of these is through interactions with health care providers to modify diagnostic and therapeutic decisions. Since its beginning, developers have used the HELP hospital information system to explore computerized interventions into the medical decision making process. By their nature these interventions imply a computer-directed interaction with the physicians, nurses, and therapists involved in delivering care. In this paper we describe four different approaches to this intervention. These include: (1) processes that respond to the appearance of certain types of clinical data by issuing an alert informing caregivers of these data's presence and import, (2) programs that critique new orders and propose changes in those orders when appropriate, (3) programs that suggest new orders and procedures in response to patient data suggesting their need, and (4) applications that function by summarizing patient care data and that attempt to retrospectively assess the average or typical quality of medical decisions and therapeutic interventions made by health care providers. These approaches are illustrated with experience from the HELP system.

Adult↗