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Many articles define and explore the concept of mentoring. Few describe how an institution implemented a mentoring program. The author explains the development and content of the mentoring program at Jackson Memorial Hospital. With more than 100 participating nurses, the program is efficient, cost-effective, and easily adaptable to various settings.
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Larvae of Aedes aegypti and Aedes albopictus obtained from 6 consecutive ovitrap surveillance (OS) in Taman Samudera and Kg. Banjar were evaluated for their susceptibility to temephos. Larval bioassays were carried out in accordance with WHO standard methods, with diagnostic dosage (0.012 mg/L) and operational dosage (1 mg/L) of temephos respectively. Aedes aegypti and Ae. albopictus obtained from six OS in Taman Samudera showed resistance to diagnostic dosage of temephos with percentage mortality between 5.3 to 72.0 and 9.3 to 56.0, respectively, while Ae. aegypti and Ae. albopictus obtained from Kg. Banjar showed resistance to temephos with percentage mortality between 16.0 to 72.0 and 0 to 50.6, respectively. Only two strains of Ae. aegypti from Kg. Banjar were susceptible to temephos with 93.3% (OS 2) and 100% (OS 3) mortality. The 50% mortality at lethal time (LT50) for all strains of Ae. aegypti and Ae. albopictus tested against operational dosage of temephos showed range between 36.07 to 75.69 minutes and 58.65 to 112.50 minutes, respectively, and complete mortality was achieved after 24 hours. Our results indicated that there is weekly variations of the resistance status for Ae. aegypti and Ae. albopictus. Aedes susceptibility to temephos is changing from time to time in these two study sites. It is essential to continue monitoring the resistance of this vector to insecticides in order to ensure the efficiency of program aimed at vector control and protection of human health.
Pulmonary Embolism (EP) remains a major challenge for the physician, despite increasingly sophisticated investigations and efficient therapeutic programs. Many reasons explain persistent difficulties: the disorder crosses all specialties. A wide variety of clinical presentations has to be considered according to the size of the thrombus, the coexisting conditions ("predisposing factors") and the prior cardio pulmonary status. Major investigations include perfusion and ventilation lung scans, pulmonary angiography, invasive and non invasive investigations of the deep venous system. But obvious practical limitations exist; selection of the most suitable test includes severity of the present patient condition and risk of an early recurrence of EP; risk of the contemplated therapeutic procedure if the diagnosis of EP is confirmed; skillfulness required for the selected investigation. Angiography is mandatory if a substantial hemorrhagic risk exists, if massive EP is suspected, and if at risk treatment procedures are contemplated. In the other cases, and in the absence of significant pulmonary pathology, a lung perfusion scan is the advisable procedure; the diagnosis is excluded if the scan is normal. Previous or current significant pulmonary pathology requires angiography. However, proof of coexisting deep venous thrombosis is an alternative way to enhance the diagnosis in case of poor clinical conditions or other practical considerations.
A better understanding of the physiopathological and pathogenic characteristics underlying iron deficiency, has allowed for a more precise diagnosis and the opportune treatment of this disease. On the other hand, it has also permitted the designing of more efficient preventive programs. This study includes what is known to date and the applicable experiences when confronted with this problem in children. Iron deficiency; clinical manifestations; treatment; prevention.
Follow-up programs for periodontally treated patients may largely prevent loss of teeth and attachment. Consequently they are an indispensable part of periodontal treatment. The success of treatment hinges on the recall interval which should be determined individually (to 6 month for most patients), as well as on diagnosis and treatment, which need to be modified in accordance with the specific requirements of the follow-up. It is under discussion whether individual parts of the follow-up program should be handled by adequately trained assistant staff.
A large and growing body of evidence based in large part on randomized clinical trials of therapy has established the efficacy of neonatal intensive care. The efficacy of neonatal intensive care is "leveraged" by highly efficient regional programs for ascertainment and referral of patients at risk. Thus the impact of neonatal ICUs is keenly felt in the community. The population incidence of ROP and its sequelae may be expected to rise as infants at highest risk--those at the border of viability--survive in increasing numbers.
21 soldiers completing their military service in the Austrian army were assessed before and at the finalizing of their basic military training, also to disarmament by spiroergometric and lactate tests according to their physical condition. Soldiers employed in fighting duties improved slightly in physical fitness at commencement of the basic training. By the time they reached disarmament there was significant improvement. The monitoring of administration personal significantly increased their physical fitness after the basic training, nevertheless the physical condition achieved before disarmament relapsed to the same standard as prior to military service. As a conclusion we suggest that the physical inactive group should be kept as small as possible and get an efficient training program in future.
Surveillance of infections at the Ottawa General Hospital between September 1, 1971 and August 31, 1972 showed that the overall infection rate was 13.5% of which 5.6% was community-acquired while 7.9% was of nosocomial origin. These figures are comparable to those for equivalent hospitals in the United States and lower than those reported from the Boston City Hospital, but they nevertheless indicate that over half the infected patients in the hospital were infected after admission. Urinary tract infections accounted for 44.8% of all nosocomial infections and clearly dominated the picture. The postoperative wound infection rate was 3.9% and accounted for only 18% of nosocomial infections. It is probable that these findings are representative of general hospitals throughout Canada and indicate conditions which will not long be tolerated. The knowledge and techniques exist for the prevention of all hospital cross-infection and much autogenous infection. Specific measures are suggested for working towards this goal. These are (1) the replacement of archaic hospitals and hospital facilities, (2) the establishment in every hospital of an efficient surveillance program, (3) the institution of good catheterization and catheter care techniques, and (4) the establishment by hospitals of a quality control program whereby a specific explanation is required for every infection occurring within the hospital.
We describe the measurement of human immunoglobulins IgG, IgA, and IgM in diluted sera, with diluted commercial monospecific antisera, with use of a 36-place centrifugal analyzer (RotoChem IIa; American Instrument Co., Silver Spring, MD 20920). The assay involves a two-point kinetic turbidimetric technique. The changes in absorbance at 340 nm between 10 and 255 s are taken for standard curve construction with use of a computer-generated cubic least-squares fit. Patients' samples are quickly calculated from the stored curve. Multiple time-interval readings are taken to observe the reaction kinetics. The lowest detectable concentrations are: IgG, 5 mg/L; IgA, 20 mg/L; and IgM, 20 mg/L. Correlation with radial immunodiffusion was excellent. Precision, accuracy, linearity, and sensitivity were very acceptable. Antigen or antibody excess can be easily detected. The accuracy of the proposed method when measuring idiotypic monoclonal proteins is greater than radial immunodiffusion. Up to 30 patients' samples can be analyzed at one time, and calculation of test results by use of the computer program is efficient and rapid.
A computer program is described, by which data on reproduction (data on calving, oestrus and insemination, pregnancy diagnosis) in dairy herds may be processed. This program is designed to supply dairy farmers with information facilitating herd management. Thus, each month the famer is sent an advisory list stating which cows should be inseminated, which should be dried off and which can be expected to calve. In addition, he will receive an annual report on the fertility of his herd. Among others, the following items are listed: the pregnancy rate after the first insemination, the interval between parturition and first insemination, the interval between parturition and conception and the number of cows disposed of because of failure to conceive. The intention is to test this computer program for efficiency on 500 dairy cattle farms.
It is generally accepted that improving epidemiological knowledge of accidents in childhood and adolescence leads to a better implementation of more efficient prevention programs. Nevertheless, it is not yet generally admitted that any new preventive measure addressing these accidents has to be evaluated by competent epidemiologists. Obviously, there are exceptions regarding these two rules. Four examples of successful implementation are presented in this paper: safety packaging of aspirin; fences around private swimming pools; changes in minimal drinking and driving age in adolescence; bicycle accidents. The discussion is focused on four intervention levels suggested for the epidemiologists.
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This study reports the various steps involved in the design of a simplified information system for leprosy (OMSLEP), developed in cooperation between the Unit of Epidemiology, University of Louvain, Belgium, and WHO. The objective of the system is to permit the evaluation of a) the efficiency of programs within the context of established strategies and norms; b) the effectiveness of leprosy control methods from an epidemiological point of view; c) the efficacy and productivity of certain program components. Prior to designing the system, the relevant epidemiological and operational indices have been reviewed. A survey was also made of the forms used by some 78 leprosy control schemes throughout the world in order to analyze the current information now being collected. The proposed system is described. It includes individual record form to be filled at registration and once yearly in subsequent years of follow-up, a detection form, and an annual statistics form for the tabulation of total patients. The system is presently being tested in some 15 countries.
The knowledge base of Hepaxpert-I, a medical expert system for interpretive analysis of hepatitis A and B serologic findings, contains 13 rules for hepatitis A and 106 rules for hepatitis B serology. Formally, the construction of the knowledge base was done by forming a partition of the sets of possible serologic finding patterns--64 for hepatitis A and 4096 for hepatitis B serology--induced by an equivalence relation, divides the elements of the sets into disjoint subsets, the equivalence classes. Each equivalence class is represented as one If-Then rule that assigns to every member of the equivalence class one interpretive text. The partition of the possible finding patterns into equivalence classes and the disposal of one and only one interpretive text for each equivalence class made the creation of a very practical and efficient computer program for the precise interpretation of any finding pattern of serologic tests for hepatitis A and B possible. The complete set of the provided If-Then rules is represented in this paper.
Primary osteoporosis is common, with significant sociomedical consequences. This paper studies the prevalence of risk factors and risk behavior for osteoporosis in women of four different occupational groups: housewives, blue collar workers, white collar workers/civil servants and farmers. We analyzed risk factors and risk behavior associated with osteoporosis in the scientific literature. The sample comprises 9,939 women. The data set is based on a health survey conducted in 79 selected rural communities of Styria (Austria) between 1989 and 1993. Sociodemographic data, lifestyle, health complaints, chronic conditions and utilization of preventive and treatment services were surveyed by means of standardized personal interviews. The results show that the women of the four occupational groups were subjected to very different stresses. White collar workers/civil servants had the lowest risk with regard to osteoporosis. Our results suggest that efficient intervention programs to prevent osteoporosis need to specifically focus on the different social life styles of women.
Molecular biological methods developed for basic research have been increasingly employed in animal production. For example, individual animals can be identified by their unique DNA sequences in DNA fingerprints and their genetic relationships can be established by more detailed sequence comparisons. It is also possible to diagnose gene defects and to determine the sex of preimplantation embryos. This information can then be used as the basis for an efficient breeding program. Methods for the analysis of RNA yield information about genetic or environmental factors which influence the expression of specific genes for example genes of economic value in milk production or genes which are important for preimplantation embryo development. This information will enable further improvements in embryo transfer and associated biotechniques which promise to improve the rate of genetic improvement (NIEMANN and MEINECKE, 1993). In the following section, we will briefly describe these molecular biological methods and their applications in animal breeding using examples from current research in our research group.
A binomial logit model is fitted to the college attendance behavior of 27,046 male high-school juniors in 1960, divided into 20 subgroups defined by student ability and family income. Tuition, high admissions standards, travel costs, and room and board costs all have significant negative effects on attendance. The highest elasticities of demand are found to occur in the low-income strata and lower-middle ability quartile, suggesting that an efficient subsidy program should focus on these groups. Coefficients of forgone earnings and measures of the local payoff to college attendance are small but generally have the expected sign.