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PubMed1998

Developing guidelines on the care and use of animals.

Oversight of laboratory animal care and use in the research environment is multilayered. Federal and state regulations apply to many laboratory animal species; funding agencies frequently require adherence to additional guidelines; institutions may develop in-house policies; and an institution may choose to voluntarily participate in an accreditation program, indicating a commitment by the institution to apply the most rigorous standards to the animal care and use program. In general, regulations follow a prescriptive "engineering" approach, while guidelines applied to the care and use of research animals follow a "performance" approach, which defines the desired outcome in detail, but acknowledges that multiple methods may achieve that outcome. The performance approach relies on sound professional judgment, thereby allowing flexibility based on an institution's unique circumstances. Further, this approach should facilitate the international harmonization of animal care and use standards. The performance, or outcome, approach to developing guidelines is described, using the Guide for the Care and Use of Laboratory Animals (NRC, 1996) as the model.

Animal Experimentation↗
PubMed2000

Dementia in developing countries. A consensus statement from the 10/66 Dementia Research Group.

Less than one-tenth of all population-based research into dementia is directed towards the two-thirds or more of cases living in developing parts of the world. The 10/66 Dementia Research Group has been formed to redress this imbalance, encouraging active research collaboration between centres in different developing countries and between developed and developing countries. The 10/66 group consisted initially of researchers attending a symposium on dementia research in developing countries, held at the 1998 Alzheimer's Disease International conference. They noted a growing interest in this area, with many active researchers and others wishing to start new studies. There was felt to be an urgent need for more research: quantifying prevalence and incidence, exploring regional variations in international collaborations using harmonized methodologies, describing care arrangements for people with dementia, quantifying the impact on caregivers and evaluating the effectiveness of any newly implemented services. Methodological problems need to be addressed, particularly development of culture- and education-fair dementia diagnostic procedures. Good-quality research can generate awareness, pioneer service development and influence policy.

Cost of Illness↗
PubMed2001

Decoherence in a classically chaotic quantum system: entropy production and quantum-classical correspondence.

We study the decoherence process for an open quantum system that is classically chaotic (a quartic double well with harmonic driving coupled to a sea of harmonic oscillators). We carefully analyze the time dependence of the rate of entropy production showing that it has two relevant regimes: For short times it is proportional to the diffusion coefficient (fixed by the system-environment coupling strength); for longer times (but before equilibration) it is fixed by dynamical properties of the system (and is related to the Lyapunov exponent). The nature of the transition time between both regimes is investigated and the issue of quantum to classical correspondence is addressed. Finally, the impact of the interaction with the environment on coherent tunneling is analyzed.

Journal Article↗
PubMed1999

Uniforming of outpatient health care statistics.

In the process of developing the health care information system, the Public Health Institute of the Republic of Slovenia harmonized the outpatient health care statistics at the national level. This paper presents the goals, contents, methodology and a brief analysis of the new data structure. The main functions of the ZUBSTAT computer program, user training methods, and planned further activities in this field are described.

Adolescent↗
PubMed1982

[Current concepts of hospitalization in pediatric psychiatry].

Although it remains valuable for evaluating the patient and planning pharmacotherapy, hospitalization in a psychiatric department is no longer restricted to these purposes. Hospitalization enables separation of the child or adolescent from his usual environment during periods of acute conflict. It is aimed at modifying and overcoming the conflicts between family members which are underlying in the child's or parent's request for support. Hospitalization can become an essential part of the child's treatment if it is carefully planned and harmonized with the other curative and preventive methods.

Adolescent↗
PubMed1994

Continuous improvement of oral health in Europe.

The oral health action programmes of the WHO Regional Office for Europe (WHO/EURO) comply with the overall European Health Policy and targets for the improvement of health in Europe by the year 2000 (HFA2000) and focus on promotive and preventive care approaches primarily at the community level. Various activities, including the development of guidelines for local action projects, have been established to support WHO/EURO's Member States in initiating preventive oral health care system and introducing the concept of continuous quality development in oral health care. The main focus for Countries of Central and Eastern Europe (CCEE) is to formulate national goals for oral health and to further develop oral health services in the region. Collection of national data using agreed European quality indicators for oral health will form the basis of appropriate monitoring and development of technologies to improve oral health care services and the oral health status at large. The WHO/EURO action programmes aim to implement oral disease prevention and health promotion activities. Guidelines have been established to support individual Member States who intend to establish community-based programmes in accordance with scientifically sound principles and methods. The ORATEL Project (Telematic System for Quality Assurance in Oral Health Care) is part of the Commission of European Communities (CEC) strategy for harmonization and standardization in health care (CEC) Programme for advanced informatics in medicine--AIM/CEC) and ORATEL is the only AIM/CEC project related to oral health. The ORATEL Project aims to improve the oral health status in the European Region through use of appropriate computerized information systems. The Project will support management and administration of dental clinics and will be an integral part of a quality assurance system to promote a standardized level of quality in the field. Its advanced educational and decision-support tools can be used by professionals at all levels of the system. ORATEL possesses tools for aggregating and transmitting data upwards for monitoring and evaluation purposes at local, national and supranational administrative levels.

Adolescent↗
PubMed1993

The pediatric cardiovascular surgery patient: a case study.

The pediatric cardiovascular surgery patient has many needs, based not only on the complexity of the surgical procedure, but also on anatomic, physiologic, and emotional differences. These differences have implications for nursing care in the postoperative period. This article focuses on the special needs of a child who required correction of a congenital heart defect. The specialized knowledge required by the pediatric critical care nurse to make accurate assessments of the child's status and to intervene appropriately are emphasized. Issues surrounding the care of the family of the child who experiences cardiac surgery are highlighted.

Critical Care↗
PubMed2002

Open Facilities for Training in European Neurology (OFTEN): a European Board of Neurology initiative.

The European Board of Neurology has established Open Facilities for Training in European Neurology (OFTEN) by creating a databank of excellent or good neurological departments from 14 European countries willing to receive trainees from abroad (http://www.uems.be/neuro.htm). Further expansion of this databank with an increased number of participating departments and countries is planned. The databank should make it easier both to find a relevant department for training abroad and to obtain funding from various sources. No financial support is available in the program itself. The ultimate aim of this cross-European training is to improve neurological skill, knowledge and attitude. It will also promote European co-operation and harmonization in quality of care.

Databases, Factual↗
PubMed1995

A survey of dual-energy X-ray absorptiometry (DEXA) normal reference ranges used within the UK and their effect on patient classification.

Differences between dual-energy X-ray absorptiometry (DEXA) normal ranges can lead to patients being characterized as osteoporotic using one range and normal using another. To investigate the diversity of normal ranges used within the UK, a survey of all DEXA sites was carried out with a 60.6% response rate. The effect of the different ranges was evaluated by translating each range to an equivalent range for a Norland XR-26 system and applying the ranges to stratify a representative sample of over 1000 patients into grades of bone density based on percentages of age-matched mean BMD, Z-scores and T-scores. The effect of femoral neck and P/A spine L2-L4 regions was considered both separately and jointly. Large differences between the normal ranges were apparent, which resulted in the classification of the number of patients with a Z-score of less than -2.0 varying by a factor of more than 20 for the femoral neck and more than 3 for the spine. The number of patients defined as osteoporotic by a T-score less than -2.5 varied from none to over one-third of patients for the hip and by a factor of almost 3 for the spine. The exclusion criteria used for construction of the normal ranges varied markedly with none constructed using population-based sampling. Smoothing of normal ranges was carried out by DEXA manufacturers, while local normal ranges made use of raw unprocessed data. There is reason to question the validity of such processing. We recommend the construction of a unified UK normal range applicable to all UK DEXA systems in order to harmonize patient management and care.

Absorptiometry, Photon↗