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PubMed1995

Teambuilding: a positive force in times of change.

The health care system continues to undergo revolutionary changes in the 90's. Never before in this area have we seen so many changes occur so quickly in such a short period of time. Funding changes and decreases to hospitals are only one of the critical factors ultimately effecting patient care and the direction of health in the future. Staffing changes because of bumping due to seniority and redesign efforts have had an even greater impact on the day to day operation of a hospital unit. This article attempts to address some of these concerns with one practical process that is universally accepted and can be readily implemented. This process which is springing up in the literature and is fast becoming the popular term of this decade is that of "TEAMBUILDING". In the next few pages an interdisciplinary team will describe their successful efforts at teambuilding in one clinical program.

Communication↗
PubMed1983

Fermented foods, feeds and beverages.

There has been a proliferation of books and papers dealing with the indigenous fermented foods/beverages of the world. It is anticipated that these foods/beverages will play an ever-increasingly important role in feeding both the developing and the developed world as population increases from approximately 4.5 billion to 6 billion by the year 2000 and to 8 to 12 billion people in the 21st century. The indigenous fermented foods consist of microbial protein grown on edible substrates. Microbial or single cell protein (SCP) per se continues to receive research and development attention. It is likely to play an important role in feeding animals in the future when it becomes competitive with soy protein. It may play a direct role in feeding humans in the future after its safety for feeding animals has been adequately demonstrated and it has been shown that it can be processed into foods acceptable to humans. At the present time, mushrooms, a form of microbial protein highly acceptable to humans, which can be grown readily on ligno-cellulosic and other agricultural and food processing wastes, offer considerable opportunity for expanding man's food supply.

Journal Article↗
PubMed1989

The use of local entropy measures in edge detection for cytological image analysis.

Accurate edge detection is a fundamental problem in the areas of image processing and pattern recognition/classification. The lack of effective edge detection methods has slowed the application of image processing to many areas, in particular diagnostic cytology, and is a major factor in the lack of acceptance of image processing in service orientated pathology. In this paper, we present a two-step procedure which detects edges. Since most images are corrupted by noise and often contain artefacts, the first step is to clean up the image. Our approach is to use a median filter to reduce noise and background artefacts. The second operation is to locate image pixels which are 'information rich' by using local statistics. This step locates the regions of the image most likely to contain edges. The application of a threshold can then pin-point those pixels forming the edge of structures of interest. The procedure has been tested on routine cytologic specimens.

Algorithms↗
PubMedDate not supplied

Centralized drug review processes in Australia, Canada, New Zealand, and the United kingdom.

Many countries have centralized the clinical and economic assessments necessary for evidence-based drug coverage policy. We analyze such processes in Australia, Canada, New Zealand, and the United Kingdom. These countries apply comparable approaches to the assessment and appraisal of evidence but apply the processes to different types of drugs and use the reviews within different decision-making contexts. Review processes applied to all medicines and clearly tied to coverage decisions appear to influence national drug use. Rigor of process and transparency of data and rationale are believed to be important for maximizing the impact and political acceptability of the processes.

Australia↗
PubMed2004

Should given information come before new? Yes and no.

It has been noted for some time that given information tends to be placed before new information (e.g., Clark & Clark, 1977). To determine whether this holds generally, double-object and NP-PP sentences like the following were tested in two speeded acceptability judgment experiments. (1A) The senator mailed the woman a report. (1B) The senator mailed a woman the report. (1C) The senator mailed the report to a woman. (1D) The senator mailed a report to the woman. Given-before-new (or definite before indefinite) ordering facilitated processing for double-object structures, with (1A) processed faster and accepted more often than (1B), but did not facilitate processing of (1C) relative to (1D) in NP-PP structures. A third self-paced reading experiment showed that the advantage of the definite-before-indefinite new ordering holds for constructions with a shifted NP (The senator mailed to the woman a report) but also showed that facilitation from having a definite NP immediately after the verb was limited to cases where the two arguments of a verb contrast in definiteness. The results suggest that the presumed given-before-new preference is not general, but is instead limited to certain constructions and is based on the language comprehension system being sensitive to the requirements of language production.

Cognition↗
PubMed1993

Investigating children's knowledge and understanding of AIDS.

Though AIDS education in schools reaches many adolescents, the incidence of adolescent HIV infection has risen dramatically. Reasons for failure to properly educate adolescents include not educating children prior to adolescence and neglecting to assess and address children's varying levels of cognitive development when designing AIDS education programs. Citing examples from a study of more than 600 elementary-age schoolchildren, this paper focuses on the importance of assessing children's understanding of disease processes rather than accepting their use of key phrases in appropriate contexts as reflecting knowledge, and using the level at which they understand disease processes rather than age as the primary determinant of students' readiness for comprehending AIDS-related concepts. Guidelines for assessing how well children understand disease processes, including use of nonleading probes, are presented.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Workshop: Credentialing of Anticoagulation Providers: A Proposed Model.

The winter 1997 survey of Anticoagulation Forum members identified a strong desire for an anticoagulation provider certification program. The Anticoagulation Provider Certification Working Group (APCWG) is a multidisciplinary committee formed (1) to develop the objectives and process required to achieve the competencies for anticoagulation therapy providers, (2) to propose a framework for a national certification process that validates achievement of anticoagulation therapy provider competencies, and (3) to create a reproducible educational framework for all clinicians involved with anticoagulation therapy. The APCWG assessed the need for credentialing the levels of mastery expected of anticoagulation providers, identified key elements of a certification program, assessed published anticoagulation provider competencies, studied elements of a successful regional credentialing program, proposed core anticoagulation domains of knowledge and associated competencies, and solicited and incorporated broad-based multidisciplinary feedback on such domains and competencies. As a result, the APCWG has developed a draft of five knowledge domains: physiology/pathophysiology of thromboembolic disorders, patient assessment and management, patient education, pharmacology of antithrombotic agents, and operational processes surrounding the coordinated care of an anticoagulated patient. These draft domains of knowledge and the accompanying list of detailed competencies were distributed to all attendees of the May 1997 Anticoagulation Forum Meeting for review and feedback. The plan is to incorporate comments and revise the documents, develop and pilot a certification process, and present the results of the pilot(s) to a national organization to serve as a foundation of a valid and accepted national certification process.

Journal Article↗
PubMed2002

The body remembers: grieving and a circle of time.

Using a phenomenological perspective, the author explored the experience of body memory following a significant loss. Ten women who had experienced the loss of a special loved one participated. Uncovered in this research were the hidden processes involved in grief work, which were cyclical and nonrational. Body memory experienced by each participant was unique in its expression, the common pattern being that it was relived as it was originally lived. This study brings to light processes of grieving that have been hidden and have remained silent in response to a social world that has been unwilling to accept a grieving process that extends out of the boundaries of the expected norm.

Adaptation, Psychological↗
PubMed2003

Negotiating medications: patient perceptions of long-term medication use.

OBJECTIVE: To investigate how adults with one of several chronic illnesses (bipolar disorder, multiple sclerosis, rheumatoid arthritis, schizophrenia/schizoaffective disorder, or systemic lupus erythematosus) perceive their need to take medications during the course of their illness. METHOD: Eighty-three adults, aged 18-64 years, all members of a health maintenance organization, were interviewed. Each participant completed an ethnographic interview that was transcribed verbatim and analysed using grounded theory techniques. RESULTS: Participants described two forms of ongoing efforts to negotiate their need for medications, internal and external. The former category includes struggles over self-identify (e.g. worries about becoming dependent on drugs, feeling like a 'guinea pig'). The latter includes negotiations with health care providers over the type, route, and frequency of medication use. Dimensions of both negotiation types include acceptance and resistance. Specifically, patients with chronic illness must manage not only drug regimens, but also renegotiate their self-identities as formerly well persons. During this dynamic process, patients may accept and/or resist taking prescribed medications. CONCLUSION: Practitioners should recognize that patients experience not only physical, but emotional side effects of medications, and that resistance might be part of a negotiation process rather than a final stance.

Adult↗
PubMed1995

Acceptability and viscosity of low cost home processed supplementary foods developed for preschool children.

Four supplement mixtures using whole wheat, pearl millet, bengal gram, green gram, groundnuts and amaranth leaves were developed employing roasting and malting techniques. Malting used in the formation of the supplements reduced significantly hot paste viscosity of all the four supplements and increased their nutrient density per unit volume. The organoleptic trials conducted on rural mothers revealed that taste, texture, colour, aroma, appearance and overall acceptability of all the four supplements were found to be excellent with mean overall acceptability. Children did not develop any GIT disorders after consuming the products. Trained panelists found all the four supplements acceptable as indicated by a nine point hedonic scale.

Amaranthus↗
PubMed2006

Emergency department screening for risk for post-traumatic stress disorder among injured children.

OBJECTIVE: To discuss the successes and challenges associated with the implementation of a post-traumatic stress disorder (PTSD) screening tool in two pediatric emergency departments (ED). METHODS: The STEPP screening tool has been developed previously on an inpatient population of motor vehicle trauma patients. It was applied here to the general ED population at two different pediatric trauma centers. Nurse screeners were trained and a convenience sample of patients with unintentional injuries who met study criteria were screened in the ED. Feedback from nurse screeners was obtained. RESULTS: The process of implementing a screening tool to identify patients and their families significantly at risk for PTSD symptomatology presented some barriers, but overall acceptability of the process was high for both the emergency department staff and the patient. Recommendations for others considering implementation of screening programs in the ED are offered. CONCLUSIONS: Future research using screening protocols in the ED should, in their design, attempt to capitalize on the successes identified in the current protocol and circumvent barriers also encountered.

Accidents, Traffic↗
PubMed1994

Acceptability and viscosity of low cost home processed supplementary foods developed for pre-school children.

Four supplement mixtures using whole wheat, pearl millet, bengal gram, green gram, groundnuts and amaranth leaves were developed employing roasting and malting techniques. Malting used in the formation of the supplements reduced significantly hot paste viscosity of all the four supplements and increased their nutrient density per unit volume. The results of organoleptic trials conducted on rural mothers revealed that taste, texture, colour, aroma, appearance and overall acceptability of all the four supplements were excellent with mean scores of overall acceptability (9.77, 9.33, 9.11 and 8.75) for supplements I, II, III and IV, respectively. Children did not develop any GIT disorders after consuming the products. Trained panelists found all the four supplements acceptable as indicated by Nine point hedonic scale.

Amaranthus↗
PubMed1999

The distinction between beliefs legitimizing aggression and deviant processing of social cues: testing measurement validity and the hypothesis that biased processing mediates the effects of beliefs on aggression. Conduct Problems Prevention Research Group.

In 2 studies the authors examined knowledge and social information-processing mechanisms as 2 distinct sources of influence on child aggression. Data were collected from 387 boys and girls of diverse ethnicity in 3 successive years. In Study 1, confirmatory factor analyses demonstrated the discriminant validity of the knowledge construct of aggression beliefs and the processing constructs of hostile intent attributions, accessing of aggressive responses, and positive evaluation of aggressive outcomes. In Study 2, structural equation modeling analyses were used to test the mediation hypothesis that aggression beliefs would influence child aggression through the effects of deviant processing. A stronger belief that aggressive retaliation is acceptable predicted more deviant processing 1 year later and more aggression 2 years later. However, this latter effect was substantially accounted for by the intervening effects of deviant processing on aggression.

Aggression↗
PubMed2006

Preference by Vespula germanica (Hymenoptera: Vespidae) for processed meats: implications for toxic baiting.

The German yellowjacket, Vespula germanica (F.) (Hymenoptera: Vespidae), was introduced into Australia in 1959 and has established throughout southern Australia. In urban environments, V. germanica is frequently a nuisance pest at public gatherings and to homeowners. In native environments, it has the potential to pose a threat to native invertebrates. The current practice for controlling the wasps is nest destruction with pesticide. However, locating the nest(s) is not always practical or possible. Meat baits impregnated with an insecticide that foraging wasps cut and carry back to the nest offer a means of suppressing wasps where the nest sites are unknown. The success of meat baits depends on the attractiveness and acceptance of the meat to the wasp and the mode of action of the insecticide. Our objective was to determine wasp preference and acceptance of five processed meats: canned chicken or fish and freeze-dried chicken, fish, or kangaroo. We found that more wasps visited and took freeze-dried kangaroo and canned chicken than the other baits. Canned and freeze-dried fish were similarly preferred, and freeze-dried chicken was the least attractive and accepted by foraging wasps. Our findings demonstrate that wasps prefer some processed meats and hence take more loads back to the nest. By combining a suitable insecticide with a meat bait preferred by wasps, the likelihood of effective suppression of nuisance wasp populations should be increased.

Animals↗
PubMed1984

Processed bovine cartilage: an improved biosynthetic implant for contour defects.

Irradiated human cartilage has been found to be a superior implant material for correction of contour defects; however, availability problems have prevented this material from gaining wide acceptance. Implantation of processed irradiated bovine cartilage in primates and rabbits, as described here, provides strong evidence that this material performs like irradiated allograft cartilage antigenically and has certain cosmetic advantages over allograft cartilage. Our studies in primates have shown that there is no systemically measurable antibody-antigen reaction, either cellular or noncellular, to irradiated processed bovine cartilage. Neither primary nor second-set provocative implantations produced any measurable rejection. In rabbits, composite grafts of two pieces of irradiated bovine cartilage adjacent to each other were also well tolerated, with no measurable absorption and with capsule formation typical of a foreign body reaction to an inert object.

Animals↗
PubMed2005

Centralized blood processing for the selenium and vitamin E cancer prevention trial: effects of delayed processing on carotenoids, tocopherols, insulin-like growth factor-I, insulin-like growth factor binding protein 3, steroid hormones, and lymphocyte viability.

This experiment examined the effects of delays in separation and freezing of whole blood components on analytes of interest in studies of prostate cancer prevention, in order to evaluate the feasibility of centralized processing of blood for the multisite Selenium and Vitamin E Cancer Prevention Trial. Blood from 40 healthy men was subjected to four treatment protocols, allowing the contrast of immediate processing to delays of 32, 72, and 144 hours. At 32 hours, simulating refrigerated storage and overnight shipping, there was a 2.9% decrease (95% confidence interval, 0.7-5.1) in insulin-like growth factor-I (IGF-I) but no significant change in carotenoids, tocopherols, testosterone, 3alpha-androstanediol glucuronide (AAG), sex hormone-binding globulin (SHBG) or insulin-like growth factor binding protein 3 (IGFBP3). A 144-hour processing delay, simulating weekend blood collection or shipping delay, resulted in significant changes in gamma-tocopherol (-1.5%), IGF-I (-5.7%), IGFBP3 (-2.9%), SHBG (-4.0%), testosterone (+4.7%), and AAG (+5.5%). The rank-order and intraclass correlations between analytes from blood processed immediately and those subjected to delayed processing were 0.96 or higher for carotenoids, tocopherols, AAG, and SHBG, and between 0.87 and 0.95 for IGF-I, IGFBP3, and testosterone. A 32-hour delay decreased lymphocyte viability from 82.5% to 75.0% (P = 0.45), but a 72-hour delay decreased viability to 36.8% (P < 0.001). Overnight shipping and centralized processing is an acceptable approach to blood collection in large multisite trials examining the cancer-related measures proposed in the Selenium and Vitamin E Cancer Prevention Trial. Longer processing delays, however, have small but statistically significant effects on many analytes and substantially decrease lymphocyte viability.

Adult↗
PubMed2005

Maynard Smith: amplifying the reasons for signal reliability.

One of the many questions to which John Maynard Smith contributed was that of why most animal signals are reliable. He initially rejected the "handicap" argument but gradually accepted it, a process I briefly describe. This episode illustrated his preference for mathematical models over verbal ones, and the generosity with which he could change his mind. Even after accepting that some signals are reliable because of their strategic costs, he argued for a pluralistic approach to signal reliability. Signal complexity was a developing interest when he died. Signals usually involve several components, some of which appear to amplify other signal components. The terms "amplifier" and "index" require more thought to reduce the scope for semantic confusion. I conclude by describing Maynard Smith's fascination with peacocks Pavo cristatus.

Animal Communication↗
PubMed1999

Is the societal perspective in cost-effectiveness analysis useful for decision makers?

BACKGROUND: The U.S. Public Health Service's Panel on Cost-Effectiveness in Health and Medicine recommends that cost-effectiveness analyses (CEAs) intended to help allocate health resources in the public interest include a reference case analysis, conducted from the perspective of society as a whole. This perspective requires that an analysis measure all health effects and changes in resource use caused by an intervention. VALUE OF SOCIETAL CEAs: Tensions unavoidably arise among the parties to medical decisions--patients, their families and friends, clinicians, and third-party payers. One common approach to handling these tensions is to ignore some of them, to "solve" them by pretending they do not or should not exist. Patients do this when they demand the best care for themselves without regard to the cost to others, payers when they make coverage decisions that shift costs ot others. But by estimating all gains and losses, calculations that reflect the safety, effectiveness, and side effects of an intervention as well as its costs, societal CEAs can help resolve those tensions and provide the basis for decisions that are fair to all parties, an agenda for negotiating such decisions, and information essential for designing compensation and incentives to support them. MAKING BETTER USE OF SOCIETAL CEAs: Use of the societal perspective asks that all parties be aware of and consider the interests of others. Some process or procedure needs to be developed for presenting CEA information to the parties most likely to be affected by decisions, soliciting their views, and negotiating an acceptable decision. This process could be used by government decision makers or by managed care organizations, professional societies, or payers.

Attitude to Health↗