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At least 451 records · Page 25Linked to original sources
PubMed2004

A reproducible model of cardiac hypertrophy in rats. Problems and obstacles we faced.

AIM: To develop a reproducible model of significant left ventricular hypertrophy in order to study the role played by the tumor suppressor protein 53 (P53) in the mechanisms of cardiac hypertrophy, the cross-talk with the other factors and the connection between expression and activity of P53, cardiac myocyte apoptosis and heart hypertrophy; to discuss the problems and obstacles we faced. METHODS: Male Wistar rats were used in the experiments. Left ventricular hypertrophy was induced by banding the abdominal aorta. Three series of the experiment were performed differing in the place of banding and the size of constriction in order to find the most suitable model for our further research. RESULTS: Forty five days after banding the abdominal aorta just below the diaphragm the cardiac index increased by 30% in comparison with that in the controls. CONCLUSION: We have developed a reproducible model of significant left ventricular hypertrophy in rats. The main advantages of the model are: a) it is technically simple; b) it may be realised in any laboratory all over the world; c) it allows the most common lab animals (male Wistar rats) to be used for studies without having to be subjected to thoracotomy and hence requiring a long recovery period.

Animals↗
PubMed2005

Obtaining access to coastal areas for large-scale mussel farming: obstacles and possibilities.

Eutrophication in the coastal waters of the northern part of the Swedish west coast is causing structural and functional changes to the coastal ecosystems. Large-scale mussel farming is proposed in the Program of Measures, required by the EU Water Framework Directive to reduce the nutrients in the coastal water and improve water quality over a transition period of 10-20 years. Ownership, land parcelling, conflicts of interest, and the protection of coastal water are obstructing accessibility to suitable water areas for the establishment of mussel farming plants. This paper studies the obstacles and possibilities in the relevant laws and legal regulations governing the accessibility to coastal waters for large-scale mussel farming. Alternative ways to solve the problem are shown and discussed, within the framework of the Planning and Building Act, the Environmental Code and the laws concerning land-parceling and property. It is shown that the Planning and Building Act, when used in a proper manner, can provide useful instruments for society to gain access to coastal water for mussel farming plants with the purpose of improving the ecological status of the water.

Animals↗
PubMed2005

Obstacles to Implementing an Execution Engine for Clinical Guidelines Formalized in GLIF.

This article is on obstacles we faced when developing an executable representation of guidelines formalized the Guideline Interchange Format (GLIF). The GLIF does not fully specify the representation of guidelines at the implementation level as it is focused mainly on the description of guideline's logical structure. Our effort was to develop an executable representation of guidelines formalized in GLIF and to implement a pilot engine, which will be able to process such guidelines. The engine has been designed as a component of the MUltimedia Distributed Record system version 2 (MUDR(2)). When developing executable representation of guidelines we paid special attention to utilisation of existing technologies to achieve the highest reusability.Main implementation areas, which are not fully covered by GLIF, are a data model and an execution language. Concerning the data model we have decided to use MUDR(2)'s native data model for this moment and to keep watching the standardisation of a virtual medical record to implement it in execution engine in the near future. When developing the execution language, first of all we have specified necessities, which the execution language ought to meet. Then we have considered some of the most suitable candidates: Guideline Execution Language (GEL), GELLO, Java and Python. Finally we have chosen GELLO although it does not completely cover all required areas. The main GELLO's advantage is that it is a proposed HL7 standard. In this paper we show some of the most important disadvantages of GELLO as an executable language and how we have solved them.

Decision Making, Computer-Assisted↗
PubMedDate not supplied

[Methodological obstacles encountered in the evaluation of psychotherapies of schizophrenic patients. A general review].

Through a critical review of literature, authors suggest a methodological reflexion about problems in evaluation of effects of psychotherapies of schizophrenics, taking into account not only individual techniques but also institutional ones with psychotherapeutic orientations. Among the main difficulties are: evaluation with too much unspecific and over simplified criteria, for example criterium of rehospitalisation; lack of real comparability between groups, or techniques, and lack of validity of randomisation, still considered as a pawn of methodological rigour; diversity of levels of experience, and education of therapists, too unmatched model of functional organisation of the different centers, and in the same time too unequal recruitment of patients and at length of proposed therapeutic programs. Moreover, and even before these methodological bias, a more basic obstacle must be considered. It is the non-opening of models to the falsification, denounced by Bignami as the impossible verification of the heuristic value of the proposed models, ie the impossible verification of the utility of the proposed programs for individual therapies of schizophrenics.

Bias↗
PubMed1991

Tobacco control--action and obstacles.

World experience has shown the crucial need for government commitment, funding, and action in reducing the tobacco epidemic. It is recommended that each country establish a national council on tobacco or health to coordinate a comprehensive tobacco control program. This program should incorporate data collection including evaluation of specific anti-tobacco measures; legislative measures including strong, rotating health warnings, limits on harmful substances, establishment of smoke-free areas, bans on any new forms of tobacco use, and a total ban on all promotion of tobacco products; health education campaigns; and taxation and price policies. The support and involvement of the medical profession are vital. Obstacles to success include cultural factors, the intertia of governments and the medical profession, but most importantly the tobacco industry, the largest, wealthiest, most determined, and strongest opposition to tobacco control worldwide.

Adult↗
PubMed1989

Introducing a National Health Service: obstacles.

Historical background to proposals for a Natural Health Service is briefly given. The need for a National Health Service is described and substantiated and obstacles to the transformation of the South African Health Service are described. Suggestions are made for laying the foundation for substantial changes in the future.

Africa, Southern↗
PubMed1989

[Obstacles to maintaining the elderly in their own homes].

Elderly people desire deeply to remain in their own homes even if age or illness should limit their independence. This observation leads the authors to examine the obstacles for maintaining them in their own homes, i.e.: health problems leading to what is termed "social hospitalization", architectural barriers, housing crisis, and financial difficulties. They propose a number of solutions designed to reduce the number of patients placed in hospitals and institutions. In addition to psychological benefits, such measures could yield substantial financial savings.

Activities of Daily Living↗
PubMed1989

Nurses' networks: obstacles and challenge.

Occupational cohesiveness and network formation among nurses are widely advocated as logical solutions to practical problems and as sources of emotional support. However, actual nurses' networks have not been studied. As part of a larger study, this report analyzes the social support networks of 35 psychiatric nurses. The nurses, who were employed in a large public hospital, were studied as individuals who had private as well as occupational roles. Properties, significance, and articulation of private and public portions of networks were examined for patterns that correlated with characteristics of the nurses. Evidence of significant barriers to practice-level relationships among nurses is presented. Realistic expectations for development of effective networks require management of those obstacles.

Adaptation, Psychological↗
PubMedDate not supplied

Community mental health care for the elderly--a look at the obstacles.

Despite the recent attention given to mental disorders in the aged and their higher risk for organic mental disorders, older people rarely receive specialized mental health treatment. This paper reviews recent research on some of the major obstacles to the use of treatment by the elderly. These include claims of "ageism" by health care professionals, the negative attitudes and behaviors of older persons toward mental disorders and their treatment, and the failure of general practice physicians to recognize or treat symptoms of mental disorders in their elderly patients or to refer these patients to geriatric mental health specialists. It is suggested that increased public education in geriatric mental health is urgently needed for potential patients, their families, and their general physicians.

Adult↗
PubMed1988

[Obstacles to university studies: the point of view of Quebec nurses].

This research project aimed at identifying obstacles that prevent nurses from taking university courses. Through a random stratified sampling method, we selected 2,063 persons among the 22,494 French speaking nurses of Quebec who worked as nurses and did not take any courses beyond their professional training at the CEGEP level or at the hospital. A 50 statement questionnaire was mailed out and 1,197 questionnaires were returned and reviewed. The ten most important statements were considered under three main themes: lack of time, lack of interest and strenuous working conditions. Statements relating to lack of time and working conditions were dependent upon (X2, p less than .05) the nurses' situation, i.e. employment status, marital status, number of children and age. Theoretical and practical advice are given to interested nurses.

Attitude↗
PubMed1987

[The Whitaker test. Apropos of an obstacle not to be ignored].

Since 1980, 35 pyelomanometric procedures have been performed in the Department of Clinical Urology for dilatations of the upper urinary tract of uncertain etiology. During two recent procedures, pressure measurements were modified by an extra-urinary obstacle caused by the patient's position. Our experience confirms the value of the Whittaker test as well as the need for a faultless technique.

Adult↗
PubMed1987

Ischemic heart disease. A major obstacle to becoming old.

Four classes of etiologic agents that cause human illness have been discovered. Sometimes members of two or more classes of agents cooperate to cause illness. Knowledge of etiology is necessary if a disease is to be eradicated. The leading causes of death in the United States have changed dramatically in the last century. Infection has been replaced by chronic illnesses of obscure etiology. Ischemic heart disease is the leading cause of death in middle age and is the major obstacle to becoming old. There are numerous similarities between animals deficient in copper and people with ischemic heart disease. The most important of these similarities are glucose intolerance, hypercholesterolemia, abnormal electrocardiogram, hyperuricemia, and hypertension, as these characteristics are predictive of risk of ischemic heart disease. No other nutritional insult has produced these characteristics in experiments with animals; men fed diets low in copper have been found to have increased cholesterol, decreased glucose tolerance, and abnormal electrocardiograms. The process that results in ischemic heart disease is remarkably similar to that of copper deficiency. Links have been found between copper metabolism and several hypotheses on the origin of ischemic heart disease. Several aspects of the lipid hypothesis can be interpreted in terms of copper metabolism. More features of the etiology, pathogenesis, and pathophysiology of ischemic heart disease can be explained in terms of copper deficiency than can be explained by any other environmental insult.

Adolescent↗
PubMed1985

Treatable dementias: differential diagnosis and obstacles to recognition.

Dementia is a clinical syndrome with reversible and irreversible causes. The differential diagnosis of treatable dementias includes reversible intracranial conditions, systemic disorders, intoxications, and depression. The major obstacles to recognition of treatable dementias are the overdiagnosis of Alzheimer's disease and the incorrect assumption that dementia is an expected development of aging.

Brain Diseases↗
PubMed1984

Some obstacles to the evaluation and effective performance of health appraisals.

Certain obstacles exist in evaluating screening tests and health examinations. When a voluntarily screened group is compared with an unscreened group and when the survival of cases detected in these two groups is compared, self-selection bias, lead-time bias, length bias and overdiagnosis confuse the evaluation and usually make an examination seem better than it really is. A randomized controlled trial overcomes these biases; one group is offered screening, the other is not and the outcomes in both entire groups are observed. Unavoidable crossovers between the groups tend to obscure any benefit of the examination, however. Evaluations of screening tests have tended to emphasize the value of positive results and have neglected the value of negative results. In obtaining maximum benefit from health appraisals, attention needs to be directed at self-selection, nonmedical threats to life and health, risk factors in addition to early disease and tailoring an examination to the needs of individual patients.

Adult↗
PubMedDate not supplied

Opportunities and obstacles in the implementation of barrier technology.

This paper was developed from the keynote address given at the Isolation Technology Users Group (ITUG) meeting held in Raleigh, North Carolina in December of 1993. Present at the meeting were over 100 individuals representing a cross section of users and suppliers. Unfortunately not all suppliers of isolation technology equipment were represented at this meeting. Subsequent to the meeting, ITUG has decided to operate as a special interest group within the Parenteral Drug Association and attendance will be open to all PDA members. I anticipate that the affiliation of ITUG within PDA will facilitate the free exchange of ideas and information among those interested in barrier technology without interference from commercial considerations. My hope is that we can nurture within the industry a common effort among all users and suppliers to overcome the obstacles and realize the opportunities inherent in isolation technology. While it could be construed that certain of my comments represent an endorsement or a chastisement of certain suppliers of isolator systems that was certainly not my intent. It was prepared in a spirit of egalitarianism to assist the industry at large with what I believe to be a technology of great promise.

Drug Contamination↗
PubMed1995

Implementation of quality assurance and medical audit: general practitioners' perceived obstacles and requirements.

BACKGROUND: The introduction of quality assurance and medical audit has been an important development in general practice. However, the introduction of such programmes does not necessarily mean they are implemented by general practitioners. AIM: A study was undertaken to describe the problems and requirements perceived by general practitioners in relation to the implementation of quality assurance and medical audit in general practice. METHOD: Interviews were carried out with a stratified sample of 120 Dutch general practitioners. Knowledge, acceptance and application of quality assurance and medical audit activities were investigated, and perceived problems and requirements in implementing quality assurance and audit activities were explored. RESULTS: General practitioners in the Netherlands were generally positive towards quality assurance activities, but had little experience of carrying out such activities. The most frequently mentioned obstacles to implementing quality assurance activities concerned lack of time, colleagues' negative attitudes and fear of assessment and criticism by colleagues. Requirements for implementing quality assurance included having regular meetings with colleagues about quality assurance, having information on the aims and methods of quality assurance, having data from other practices with which to compare performance, having support in data collection, in audit in the practice and in setting up local peer review, and having financial support. The most important factor predicting the actual application of quality assurance activities was found to be knowledge of specific quality assurance activities. CONCLUSION: Well-designed programmes for the implementation of quality assurance and medical audit, using a variety of different interventions, have to be developed. Such programmes should include the training of professionals in the concepts and methods of quality assurance as well as the provision of financial support for quality assurance activities.

Family Practice↗
PubMedDate not supplied

School-based clinics: overcoming the obstacles.

Obstacles to the establishment of school-based clinics are investigated to determine possible strategies for the future. The current social environment necessitates a health care model that provides increased access and improved outcomes for children in particular. The advanced registered nurse practitioner is an integral part of the school-based clinic. Although opposition to school-based clinics has been well organized in the past, proponents are learning new ways to deal with this challenge.

Adolescent↗