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Nursing in project Head Start: improving health.

The purpose of this study was to evaluate the effectiveness of a nurse-directed health promotion program in decreasing upper respiratory illness symptoms and injury rates in preschool children attending a Head Start (HS) program. The health promotion program presented to the Head Start staff consisted of signs and symptoms of childhood illnesses, infection control, injury prevention and first aid. The 47 children had their health evaluated by a registered nurse once per week for 4 weeks before the program and once per week for 4 weeks after the program. The children's health was evaluated using the Child Health Assessment Inventory. Symptoms of upper respiratory illness were significantly decreased after the intervention of the program. Injury rates increased, but further data analysis determined that 88% of the injuries had occurred at home.

Child Day Care Centers↗

The Croatian telemedicine.

Telemedicine developed in Croatia in two phases. The first phase during the 1970s was limited because of insufficient technology and scarce resources. But that phase was important as a learning process and the preparatory stage for the promising future. The communications infrastructure was heavily destroyed during the 1991-92 war but it was reconstructed and rebuilt as a modern technology based on optical fibres. The new technical and technological infrastructure was the base for the development of CARNet (Croatian Academic and Research Network). CARNet was linked to the Internet and enabled the international exchange of information for the scientific community. Telemedicine projects started firstly as pilot projects around the same time as in other countries. They were financially covered mostly by the Ministry of Science either directly or through the CARNet. The telemedicine projects, like telepathology, teleradiology, teleneurosurgery, teleeducation, developed in a very sophisticated way and are now in the phase of implementation into the routine health practice. Some projects are still in the pilot phase, but thanks to highly trained professionals, they are promising and it can be expected that with the growing economic stuation they will be implemented soon.

Computer Communication Networks↗

[Experiences with the "Mannheim Starting Help Project"--a 5-year trial of occupational and rehabilitation positions for psychiatrically handicapped patients].

Experiences, goals and results obtained with the "Mannheimer Starthilfe-Project" over five years (1983-1988) regarding on-the-job vocational rehabilitation for mentally impaired persons are presented. In an aftercare programme 350 patients (mainly suffering from psychotic disorders) have so far been referred to 68 on-the-job vocational placements in 42 local establishments (industrial and municipal).

Follow-Up Studies↗

Fine-needle aspiration biopsy of the thyroid nodule. Results of a start-up project in a general teaching hospital setting.

The results of the initial 102 fine-needle aspiration biopsies of the thyroid performed at a 795-bed general teaching hospital are reported. Eighty-four of the nodules (82%) were cytologically benign, 18 nodules (18%) were suspicious, and none of the nodules was diagnosed as malignant. Five nodules In the suspicious group (28%) were found to be malignant following microscopic examination of the surgical specimens. There was one false-negative result. Based on the data from 21 patients with both cytologic and histologic diagnoses, the positive predictive value of this procedure was 38% and the negative predictive value was 87% (sensitivity, 83%; specificity, 47%). Our results were comparable with those of major referral centers. Guidelines for establishing a fine-needle aspiration biopsy program at a general hospital are suggested.

Biopsy, Needle↗