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At least 433 records · Page 24Linked to original sources
PubMed2000

Addressing glenohumeral stiffness while treating the painful and stiff shoulder arthroscopically.

The shoulder can be primarily or secondarily stiff. Cadaveric cutting studies have shown increases in passive range of glenohumeral motion when certain portions of the capsule are released. This study has recorded the intraoperative gains made in passive range of motion for external rotation, flexion, abduction, and internal rotation with sequential release of the rotator interval, inferior capsule, and posterosuperior capsule, regardless of initial etiology, and followed-up over time. Thirty one of 60 shoulders, found clinically to have a loss of passive range of motion and having failed a nonoperative approach, underwent a capsular release. Eighteen patients underwent a partial capsular release (group 1) and 13 patients (group 2) underwent a complete capsular release. Thirty of 31 shoulders had statistically significant gains in passive range of motion with sequential release. In general, resection of the rotator interval contributed to gains in external rotation; resection of the inferior capsule (anteroinferior and posteroinferior) contributed gains to external rotation, forward flexion, and internal rotation; and resection of the posterosuperior capsule contributed to gains only in internal rotation. At a minimum of 18 months follow-up, 30 of 31 shoulders retained their intraoperative gains. There was no difference in the results between primarily and secondarily stiff shoulders for motion gains (P >.05). Arthroscopically addressing capsular tightness is beneficial in returning shoulders with a loss of passive glenohumeral motion to normal regardless of the etiology.

Adult↗
PubMed2003

Spondylitis association of America: the member-directed, nonprofit health organization addressing the needs of ankylosing spondylitis patients.

Ankylosing spondylitis (AS) involves a spinal arthritis that affects young adults, with an onset usually between 17 and 35 years of age. Although historically underdiagnosed, AS strikes at least 1 million Americans. Enhancing the quality of lives of AS patients in the United States is one of the goals of the Spondylitis Association of America (SAA). To this end, the SAA strives to expand the knowledge and resources available for AS patients and for health professionals. This article explores how the SAA addresses the needs of patients living with spondylitis. This article explains that through its effective collaborations, the SAA dedicates itself to the eradication of AS and related diseases through education, advocacy, awareness, and research.

Humans↗
PubMed2003

Investigation on light-addressable potentiometric sensor as a possible cell-semiconductor hybrid.

This article reports an investigation on light-addressable potentiometric sensor (LAPS) to be used as a possible biological cell-semiconductor hybrid that will enable us to make an interface between the physical and biological system. To increase the surface potential sensitivity, we used a LAPS structure with single insulator (SiO2) coated with poly-L-ornithine and laminin (PLOL) on Si. Efficient culturing of PC-12 and nerve cells of Lymnaea stagnalis on PLOL-coated Si3N4 and SiO2 was achieved. The thickness of the PLOL layer was found to be about 4 nm by the atomic force microscope (AFM) measurement. Using the advantage of this thin layer of PLOL, we compared the performance of a novel structure to the previously reported "PLOL-coated Si3N4/SiO2/Si" structure. Due to high insulating capacitance, the photocurrent response of the novel LAPS was found to be very steep. As a result, higher sensitivity was achieved. This steepness did not degrade during 10 days when the sensor surface was kept in contact with the cell culture medium and environment. The thickness of PLOL layer, its ability to improve the biological cell adhesion, enhanced sensitivity, and experiment with simulated neural action potential (AP) applied to the novel LAPS show a good promise for LAPS to be a biological cell-semiconductor hybrid.

Action Potentials↗
PubMed2003

A comparative study of electrochemically and fluorometrically addressed molecular reporter groups: effects of protein microenvironment.

To probe the effects of protein microenvironment on electrochemically and fluorometrically addressed molecular reporter groups, genetically engineered apo-cytochrome c peroxidase derivatives W51C, A174C, K243C, and S246C, each containing a single cysteine residue, were labeled at identical sites with two kinds of microenvironment sensitive reporters, either an electrochemically active sulfhydryl-reactive reagent, [Ru(II)(NH(3))(4)(1,10-phenanthroline-5-maleimide)](PF(6))(2) [RuPA4] or a fluorescent 6-acryloyl-2-dimethylaminonaphthalene [acrylodan] probe. Two types of sites were labeled with each probe based on their predicted solvent accessibilities from the known structure for holo-cytochrome c peroxidase. One set of sites (K243C and S246C) was selected to be completely solvent exposed, while the other two sites (W51C and A174C) were less accessible, residing in or near the heme binding site. Spectroscopic properties of the fluorescent probe were consistent with predictions for relative solvent accessibilities; however, even the less solvent accessible probes reported a quite polar environment, suggesting that this region of the apo-protein is either substantially solvent exposed or undergoes significant dynamic motion. A linear correlation was observed between the lambda(max) of the metal to ligand charge-transfer (MLCT) absorption band of the RuPA4 complex and the acrylodan emission maximum for the four labeled apo-protein variants. The same trend occurred for the formal potential of RuPA4 versus the acrylodan emission maximum, with the exception of electrochemical probe behavior at position 174, possibly due to specific probe-protein interactions.

2-Naphthylamine↗
PubMed2002

Addressing the challenge of intergroup studies in oncology: the EORTC experience. European Organisation for Research and Treatment of Cancer.

Intergroup studies are conducted by more than one clinical research group. There are several difficulties that hamper in practice the possibility of conducting such trials, as all interested parties will have to address unusual and complex issues. These are mainly related to differences in size, interests, motivations and means among different research organisations. The EORTC recognises the importance to promote intergroup collaboration providing to all interested groups the necessary expertise and organisational support to conduct intergroup studies. The role of the EORTC evolved from the spontaneous organisations of intergroup trials to the definition of a basic set of principles and criteria that groups have to fulfil to participate in intergroup trials. Recently, a specific EORTC Intergroup Office started its activity devoted to solve the issues related to the intergroup co-operation. This office will have an increasing role to promote and help in conducting intergroup studies.

Clinical Trials as Topic↗
PubMed2001

The role of backbone conformation in deltorphin II binding: a QSAR study of new analogues modified in the 5-, 6-positions of the address domain.

The delta selectivity of the opioid heptapeptides deltorphin I and II has been attributed to the C-terminal 'address' domain, the hydrophobic Val(5)-Val(6) residues apparently playing a topographical role. We now report the synthesis, opioid binding affinities, and a QSAR study of a series of peptides in which one of the valine side chains was altered. QSAR analyses included previously published models for a binding pocket interaction and an optimum size (Schullery, S.; Mohammedshah, T.; Makhlouf, H.; Marks, E.; Wilenkin, B.; Escobar, S.; Mousigian, C.; Heyl, D. Bioorg. Med. Chem. 1997, 5, 2221), and a new approach for backbone conformational effects using Langevin dynamics simulation (PM3 semi-empirical force field) of an isolated peptide fragment containing the side chain and flanking peptide bonds. No evidence is found of binding pocket interactions or optimum size for either the position-5 or -6 side chain. Rather, delta binding is generally disfavored while mu binding is either unaffected (position-5) or favored (position-6) by larger side chains. The dynamics results provide evidence of similar 'local' conformation roles for the positions 5 and 6 side chains. Specifically, delta binding is favored by side chains that maximize the extension of the backbone, measured as the through-space distance between peptide fragment ends, the angle between lines connecting the alpha-carbon with fragment ends, or the difference between the psi and phi peptide angles.

Algorithms↗
PubMed2006

Addressing Japan's fertility decline: influences of unintended pregnancy on child rearing.

Japan has been experiencing a continuing decline in fertility and an increase in premarital conceptions and abortions among young people. Child rearing is often viewed as a burden. In response, Japan is now seeking ways to improve the child-rearing environment for parents. In this context, we conducted a prospective study among 206 pregnant women in Sukagawa City, Fukushima, to explore the influences of pregnancy intention on child rearing. We found that unintended pregnancy was associated with a higher risk of negative child-rearing outcomes, including lower mother-to-child attachment, increased negative feelings of mothers and a lower level of participation of fathers in child rearing. Unintended pregnancy exacerbates the real and perceived burdens of child rearing. Japan is currently facing a conflict between wanting to reduce unintended pregnancies and increase the national fertility rate. We believe the government needs to address the social challenges affecting people's family lives, which underpin low fertility, rather than focus on fertility decline per se. We suggest Japan seeks to reduce unintended pregnancies and provide support to parents at high risk of child-rearing difficulties. We also suggest adopting a comprehensive approach to improving the lives of young couples, with a focus on adolescents, including life-skills education to prepare for adulthood, marriage and parenthood.

Abortion, Induced↗
PubMed2002

Addressing the insulin resistance syndrome: a role for the thiazolidinediones.

The global epidemic of type 2 diabetes and cardiovascular disease (CVD) is mirrored by increasing prevalence of the Insulin Resistance Syndrome (IRS) or Metabolic Syndrome. Accumulating data indicate that insulin resistance is the common denominator underlying this cluster of related CVD risk factors. Therapeutic interventions that address insulin resistance and other components of the IRS may be of benefit in reducing the significant health and socioeconomic burden presented by diabetes and CVD. Evidence is discussed that the thiazolidinediones, which improve glycemic control by directly targeting insulin resistance, have the additional benefit of improving many of the CVD risk factors in the IRS, and thus have the potential to reduce CVD in patients with type 2 diabetes.

Cardiovascular Diseases↗
PubMed1995

What resources? Addressing the needs of the epilepsy community.

Epilepsy is a condition which spans several disciplines within medicine, as well as having an impact on many non-medical areas such as employment and education. Services for epilepsy in the UK have not been developed according to any coherent strategy and remain fragmented and unevenly distributed. Successive attempts to address these shortcomings by publishing recommendations, even with government assistance, have not led to major improvements. Recent changes in the organization of health care services might at least present an opportunity to effect change by educational initiatives directed towards purchasers and providers. However, the absence of epilepsy from The Health of the Nation objectives represents a failure to get the message through to those with the ability to direct policy. The plethora of new, effective and expensive pharmaceutical treatments should lead to a raising of epilepsy awareness among the medical profession as a consequence of marketing activity, but this is already causing conflict with Family Health Service Associations (FHSAs) and others with equivalent lack of vision. I would suggest that only by politicizing the consumer can the change we seek be brought about.

Community Health Services↗
PubMed2000

Using root cause analysis to address patient satisfaction and other improvement opportunities.

BACKGROUND: Despite the considerable attention that health care organizations are devoting to the measurement of patient satisfaction, there is often confusion about how to systematically use these data to improve an organization's performance. A model to use in applying traditional quality improvement methods and tools to patient satisfaction problems includes five primary steps: (1) identifying opportunities, (2) prioritizing opportunities, (3) conducting root cause analysis, (4) designing and testing potential solutions, and (5) implementing the proposed solution. PATIENT SATISFACTION SURVEYS: A satisfaction survey serves best as a high-level screening device, not as a tool to provide highly detailed information about the root causes of patient dissatisfaction. The primary purpose of the survey in the model is to identify improvement opportunities and areas of significant improvement or deterioration. Secondary tools such as brief patient interviews or focus groups may better serve to probe intensively into the problem areas identified by the survey. These tools allow for a direct dialog with the patient to uncover root causes of dissatisfaction and establish potential solutions. DISCUSSION: Although the primary focus of this model has been patient satisfaction issues, the basic steps could easily be applied to virtually any improvement opportunity. Improvement teams should commit to a schedule of 90-minute weekly meetings for 7 weeks. The model, a simple translation of traditional improvement methods and tools to address the unique issues facing patient satisfaction improvement teams, can save improvement teams considerable time, resources, and frustration as they design and launch initiatives to improve patient satisfaction.

Causality↗
PubMed1999

Moving out of the red zone: addressing staff allocation to improve patient satisfaction.

BACKGROUND: Each summer, Hermann Hospital (Houston), like virtually all health care organizations, faces staffing challenges because of employee vacations, increased patient load, and staff turnover. A "zone" system was developed to address staff allocation, which was identified as a factor in deterioration of the hospital's patient satisfaction performance. ZONE SYSTEM: Every day, each unit or department designated the zone most appropriate based on factors identified in root cause analysis--high patient census, high patient acuity, emergent activity, and the number of float, agency, or unfamiliar staff members. A green zone defines conditions where the staff is very comfortable; yellow reflects increased activity; and red indicates that staff members are stressed and overwhelmed with patient needs. ACTION STEPS: Management's action steps included decreasing the nursing vacancy rate to minimize reliance on agency and float staff members and securing longer-term commitments from temporary staff members. Individual units also generated contingency plans, such as identifying a "partner unit" to provide shared staff members, supplies, and other assistance. RESULTS: The percentage of patients rating their overall experience at Hermann Hospital as "good" or "excellent" increased from 83% in August 1997 to 89% in August 1998, despite increases in admissions, patient days, operating room cases, and emergency department visits. DISCUSSION: The zone system provides a rapid way to quantify contributing factors to patient dissatisfaction and respond to them. Hermann Hospital is currently developing a broader zone system to include staff vacancy rates by departments, areas of increased patient census for prolonged periods, and balancing episodic zones with prolonged zones.

Hospitals, General↗
PubMed2003

A pilot study addressing the effect of aromatherapy massage on mood, anxiety and relaxation in adult mental health.

This study was carried out with eight subjects specifically referred for aromatherapy; each received a standardised aromatherapy massage weekly for 6 weeks. The subjects' levels of anxiety and depression were measured using the Hospital Anxiety and Depression (HAD) Scale prior to the first massage and after the final massage. The subjects' levels of mood, anxiety and relaxation were recorded using a visual analogue before and after each massage and then again 6 weeks after the last massage. Comparison was made between the HAD Scale results for each client and also the visual analogue scale results for before and after massage and also first massage and 6 weeks postmassage for the sample group. Improvements were shown in six out of eight subjects' HAD Scale results. Improvements were also shown in all areas when comparing the visual analogue scale results. The study was carried out over an 8-month period. To date there have been few studies addressing the effect of aromatherapy massage on mood, anxiety and relaxation (Therapist 9 (1996) 38). It is acknowledged that there may be a number of reasons for this such as factors related to obtaining a sample group, informed consent, the interaction of current medication regimes and so forth. It is acknowledged that whilst this is a small pilot study a number of methodological issues are raised concerning research into the use of aromatherapy in this clinical field. By reporting on this work, it is hoped that this paper will generate reflection, discussion and debate so forwarding the knowledge base in this discipline.

Adult↗
PubMed2003

Targeting RNA: new opportunities to address drugless targets.

Historically, pharmaceutical industries have focussed on the discovery of compounds that target the protein products of genes. The intermediary product between gene and protein, consisting of RNA, has remained largely unexplored. Several drugs targeting the rRNA of bacteria have been, however, in clinical use for over half a century. One of these drug classes, the aminoglycoside antibiotics, also targets human rRNA, and have been developed as therapeutics for genetic disorders. Targeting at the RNA level is an economical approach to address non-drugable proteins and targets that have failed to give leads by hits in HTS, as it can build on biological knowledge gathered over years. RNA also offers entirely new opportunities for drug development, such as targeting of non-coding RNA sequences.

Aminoglycosides↗
PubMed2001

Molecular addresses in blood vessels as targets for therapy.

We have isolated several organ- and tumor-homing peptides by using in vivo phage display. This technology involves the screening of peptide libraries in a living animal. The peptides that result from such a selection home to specific organs or tissues because they recognize molecular 'addresses', receptors that are differentially expressed in vascular beds. Targeted delivery of chemotherapeutics, pro-apoptotic peptides and cytokines to tumors using these peptides improved therapeutic efficacy in animal models. Translation of this technology into clinical applications will form the basis for targeting therapeutic and imaging agents in the context of cancer and other diseases.

Animals↗
PubMed2004

Looking for the evidence: a systematic review of prevention strategies addressing sport and recreational injury among children and youth.

OBJECTIVES: To examine evidence on the effectiveness of current injury prevention strategies in selected sport and recreational activities, determine the applicability of the evidence to children and youth and discuss the implications related to policy, programming and future research. METHODS: Research questions and relevance criteria were developed a priori. Potentially relevant studies were located through electronic and hand searches. Two independent assessors assessed articles for first relevance and then quality. Relevant articles were abstracted and synthesised for activities that had three or more relevant articles. RESULTS: A total of 21,499 articles identified through database and manual searching yielding 117 that met inclusion criteria. The majority of the studies (93 or 89%) involved eight activities: baseball, basketball, cycling, football, ice hockey, rugby, alpine skiing and soccer. Children and youth were identified as the specific target group in 45% of the studies and another 12% included children in their sample. Studies addressed a range of intervention strategies and varied on quality of evidence. CONCLUSIONS: Surprisingly few well-designed and controlled studies investigating strategies to prevent injuries were found and an even smaller number evaluated strategies to reduce injury in children and youth. As governments in developed countries continue to focus on increasing physical activity among children and youth, thought must be given to the issue of risk of injury and the relative lack of evidence of effective preventive measures.

Adolescent↗
PubMed2005

Facile, comprehensive, high-throughput genotyping of human genital papillomaviruses using spectrally addressable liquid bead microarrays.

Human papillomavirus (HPV) is the worldwide cause of carcinoma of the uterine cervix, a cancer that is the second most common neoplasm in women, resulting in nearly 250,000 deaths a year. The magnitude of the risk of cancer after HPV infection, however, is virus type-specific. Over 40 HPV types can infect the genital tract. Comprehensive, high-throughput typing assays for HPV, however, are not currently available. Blending multiplex PCR and multiplex hybridization using spectrally addressable liquid bead microarrays we have developed a high-throughput, fast, single-tube-typing assay capable of simultaneously typing 45 HPV. The overall incidence of HPV in 429 women tested using this new assay was 72.2% for those with squamous intraepithelial lesions, 51.5% for those with atypical squamous cells of undetermined significance and 15.4% for women with normal cytology, respectively. This compared well with the incidence of HPV detected by a parallel non-typing generic high-risk assay. The new assay detected a wide spectrum of HPV types and a high incidence of mixed infections. We believe our assay may find widespread applications in areas requiring virus type-specific information, such as in epidemiological studies, cancer screening programs, monitoring therapeutic interventions, and evaluating the efficacy of HPV vaccine trials.

DNA, Viral↗
PubMed1992

Health technologies for the developing world. Addressing the unmet needs.

This paper provides a critical overview of several strategies and mechanisms that have been employed by the Program for Appropriate Technology in Health over the past decade to address the unmet needs for health technologies in the developing world. Partnerships between public and private-sector organizations are emphasized in order to share risks, encourage efficiency, and ensure the availability of priority products for health care in resource-poor settings. Incentives for the involvement of the commercial sector, the means to protect the interest of the public sector, and the role of bridging organizations are discussed in the light of the shifting goals of the public sector.

Developing Countries↗
PubMedDate not supplied

An Internet-based exercise as a component of an overall training program addressing medical aspects of radiation emergency management.

The use of ionizing radiation and radioactive materials continues to increase worldwide in industry, medicine, agriculture, research, electrical power generation, and nuclear weaponry. The risk of terrorism using weapons of mass destruction or simple radiological devices also has increased, leading to heightened concerns. Radiation accidents occur as a consequence of errors in transportation of radionuclides, use of radiation in medical diagnosis and therapy, industrial monitoring and sterilization procedures, and rarely, nuclear power generation. Compared to other industries, a small number of serious radiation accidents have occurred over the last six decades with recent cases in the Republic of Georgia, Peru, Japan, and Thailand. The medical, psychological, and political consequences of such accidents can be considerable. A number of programs designed to train medical responders in the techniques of radiation accident management have been developed and delivered in many countries. The low frequency of serious radiation accidents requires constant re-training, as skills are lost and medical staff turnover occurs. Not all of the training involves drills or exercises in which responders demonstrate learning or communication over the broad spectrum of medical response capabilities. Medical preparedness within the context of a total emergency response program is lacking in many parts of the world, particularly in Central and Eastern Europe and the Newly Independent States. This paper describes an effort to enhance medical preparedness in the context of a total program of international cooperation and conventions facilitated by the International Atomic Energy Agency. The paper concludes that novel application of telecommunications technology as part of a training activity in radiation accident preparedness can help address gaps in training in this field in which preparedness is essential but experience and practical field exercises are lacking.

Attitude of Health Personnel↗