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At least 487 records · Page 27Linked to original sources
PubMed1999

Papillomatous digital dermatitis and associated risk factors in US dairy herds.

The objective of this study was to describe the incidence of papillomatous digital dermatitis in the US (including regional and herd size patterns) and to evaluate specific herd-level management factors associated with high incidence of digital dermatitis in US dairy herds. The study design was a population-based cross-sectional survey. US dairy operations with at least 30 cows in 20 states, representing 79% of US dairy cows, were sampled. On participant operations, a questionnaire was administered by veterinary medical officer or animal-health technicians on-farm to dairy managers. Papillomatous digital dermatitis was reported in milk cows in the previous 12 months from 43.5% of US dairy herds. Seventy-eight percent of affected herds reported that their first cases occurred in 1993 or later. Regions of the USA with the highest percent of herds affected included the Southwest, Northwest, and Northeast. Factors associated with high (> 5%) incidence of papillomatous digital dermatitis included region, herd size, type of land lactating cows accessed on a daily basis, flooring type where lactating cows walked, percent of cows born off the operation, use of a primary hoof trimmer who trimmed cows' hooves on other operations, and lack of washing of hoof-trimming equipment between cows. Papillomatous digital dermatitis has been recently reported from dairy herds across the US. This study suggests that a high percentage of herds with digital dermatitis could be prevented. Management strategies to potentially prevent or reduce incidence of digital dermatitis on dairy operations include those related to biosecurity and 'cow hoof' environmental conditions.

Animals↗
PubMed2002

The perineorectal reflex The perineorectal reflex in health and obstructed defecation.

PURPOSE: Many females with obstructed defecation apply digital pressure on their perineum to facilitate defecation. This study investigated the impact of this maneuver on rectal tone. METHODS: Forty-five female patients with obstructed defecation were studied. Thirty-four patients (76 percent) regularly applied digital pressure on their perineum to facilitate defecation. Total colonic transit time was normal in 32 patients and prolonged in 13 patients. For comparison, 17 female controls were studied. With the subject in the left lateral position, a thin, "infinitely" compliant polyethylene bag was inserted into the rectum at 10 cm from the anal canal. Rectal tone was assessed by measuring variations in bag volume with a computer-controlled electromechanical air injection system. After an adaptation period of 15 minutes, digital pressure was applied to the anterior perineum by one of the authors (WRS). In a second recording session, the tonic response of the rectum to an evoked urge to defecate was examined. RESULTS: During the application of perineal pressure, all controls showed an increase in rectal tone (mean value, 52.8+/-19 percent). In the whole patient group, this response was significantly lower (mean value, 24.2+/-19 percent; P < 0.001). Eight of these patients (18 percent) showed no response at all. None of them applied perineal pressure. In the remaining 37 patients (72 percent), the perineorectal reflex was present but was significantly lower (mean value, 29.8+/-17 percent; P < 0.001). Thirty-four of these females (92 percent) stated that they applied perineal pressure on a regular basis to facilitate their defecation. All controls showed an increase in rectal tone during an evoked urge to defecate (mean value, 37.8+/-8 percent). In the patients, this response was significantly lower (16.7+/-6 percent). Eight of these patients showed no increase in rectal tone at all. These patients were the same patients in whom the perineorectal reflex was absent. Regarding the tonic response of the rectum to perineal pressure, no difference was found between patients with a normal colonic transit time and those with a prolonged colonic transit time. CONCLUSION: Digital pressure applied on the perineum results in an increase in rectal tone. This perineorectal reflex is present, although significantly lower, in the majority of females with obstructed defecation. This observation might explain why females with obstructed defecation frequently apply perineal pressure to facilitate defecation.

Adolescent↗
PubMed2001

Cyclical mastalgia: prevalence and associated health and behavioral factors.

Perimenstrual breast pain (cyclical mastalgia) is a common problem that can be sufficiently severe to interfere with usual activities, and has been associated with elevated mammography usage in young women. This study was undertaken to replicate clinic-based research on cyclical mastalgia, and to examine the association between this disorder and health-related behaviors and perceived stress. Using random digit dialing throughout Virginia, 874 women aged 18-44 were interviewed. Sixty-eight per cent of women experienced cyclical breast symptoms; 22% experienced moderate to extreme discomfort (classified as cyclical mastalgia). Hormonal contraceptive usage was associated with significantly less mastalgia and premenstrual syndrome (PMS). Smoking, caffeine consumption and perceived stress were associated with mastalgia (odds ratios = 1.52, 1.53 and 1.7, respectively). Young women (under 35 years) with mastalgia were more likely to have had a mammogram (20.2%) than those without mastalgia (9.9%). Most women with this disorder (77.5%) did not have PMS. The prevalence of cyclical mastalgia and its association with mammography replicate clinic-based findings. Associations with smoking and stress had not previously been reported. Prospective research is needed to determine the biopsychosocial factors contributing to this disorder.

Adolescent↗
PubMedDate not supplied

Redesigning courses for the World Wide Web.

The use of computer-based instructional technologies has become almost ubiquitous in education, including health professions education. In addition, clinical practice requires the use of digital information, networking, and continued learning. Faculty, students, and clinicians must be prepared to use computer-based technologies and telecommunications. Many faculty members in the health professions need assistance with the transfer of traditional (campus-based) courses or course material to the World Wide Web. This article presents the instructional design and pedagogical aspects of redesigning a traditional campus-based course for the World Wide Web. Specific steps and a template are identified. The development of a virtual community of learners is also discussed as a critical element of on-line teaching and learning.

Computer-Assisted Instruction↗
PubMedDate not supplied

Aerospace technology transfer to breast cancer imaging.

In the United States in 1996, an estimated 44,560 women died of breast cancer, and 184,300 new cases were diagnosed. Advances in space technology are now making significant improvements in the imaging technologies used in managing this important foe. The first of these spinoffs, a digital spot mammography system used to perform stereotactic fine-needle breast biopsy, uses a backside-thinned CCD developed originally for the Space Telescope Imaging Spectrometer. This paper describes several successful biomedical applications which have resulted from collaborative technology transfer programs between the National Aeronautics and Space Administration (NASA), the National Cancer Institute (NCI), and the U.S. Dept. of Health and Human Services Office on Women's Health (OWH). These programs have accelerated the introduction of direct digital mammography by two years. In follow-on work, RTI is now assisting the HHS Office on Women's Health to identify additional opportunities for transfer of aerospace, defense, and intelligence technologies to image-guided detection, diagnosis, and treatment of breast cancer. The technology identification and evaluation effort culminated in a May 1997 workshop, and the formative technology development partnerships are discussed.

Astronomical Phenomena↗
PubMed2003

Physician advice about smoking and drinking: are U.S. adults being informed?

BACKGROUND: Population-based estimates for the prevalence of smokers receiving advice from a health professional to quit smoking and the prevalence of binge drinkers being talked to about alcohol use are lacking for U.S. adults. This information is useful for clinicians and public health professionals. METHODS: Data are from the Behavioral Risk Factor Surveillance System, a continuous random-digit-dial telephone survey of U.S. adults. In 1997, 10 states collected data on these health interventions for tobacco and alcohol use. The prevalence of professional advice to quit smoking and about alcohol use was calculated and examined by demographic characteristics. The number of at-risk adults who had a routine checkup in the last year and had not received these interventions was also estimated. RESULTS: By self-report, 70% of smokers were advised to quit, and 23% of binge drinkers were talked to about their alcohol use. Using multivariate logistic regression analyses, we found among smokers that women and older persons were more likely to receive advice; among binge drinkers, health intervention was more likely to occur for men and non-Hispanic blacks. Across the 10 states, approximately 2 million smokers and 2 million binge drinkers with a routine checkup in the past 12 months were not advised to quit smoking or talked to about their alcohol use. CONCLUSIONS: Many opportunities to intervene with smokers and binge drinkers are lost. Efforts to increase physician education and to identify and reduce other barriers may help.

Adult↗
PubMed2004

R-E-S-P-E-C-T: patient reports of disrespect in the health care setting and its impact on care.

OBJECTIVE: The health care encounter is a setting in which racial/ethnic disparities can arise. Patients who experience disrespect in this encounter may be less likely to use health care services that improve outcomes. The objective of this study was to examine factors in the health care encounter and to model how negative perceptions of the encounter influence health care utilization. DESIGN, SUBJECTS, AND SETTING: Data were derived from the Commonwealth Fund 2001 Health Care Quality Survey, a nationwide random-digit-dial survey of 6722 adults, conducted between April 30 and November 5, 2001. Bivariate and multivariate analyses were performed on weighted data. MAIN OUTCOME MEASURES: Measures of negative perceptions of the patient-provider relationship included feelings of being treated with disrespect or being looked down upon, a belief that unfair treatment was received due to race or language spoken, and a belief that better treatment would have been received had the respondent had been of a different race. Measures of utilization included receipt of a physical exam within the prior year, receipt of optimal cancer screening and recommended elements of chronic disease care, delay of needed care, and not following the doctor's advice. MAIN RESULTS: Minorities were significantly more likely to report being treated with disrespect or being looked down upon in the patient-provider relationship. Specifically, 14.1% of blacks (P=.06), 19.4% of Hispanics (P<.001), and 20.2% if Asians (P<.001) perceived being treated with disrespect or being looked down upon, compared with only 9.4% of whites. Persons who thought that they would have received better treatment if they were of a different race were significantly less likely to receive optimal chronic disease screening and more likely to not follow the doctor's advice or put off care (P<.01). CONCLUSIONS: Perceptions of disrespect or of receiving unfair treatment within the patient-provider relationship are prevalent, particularly among racial/ethnic minorities. Such negative perceptions influence health care utilization and may contribute to existing health disparities.

Adult↗
PubMed2002

[Tanning benches to accusation benches].

Sunbeds used in sun parlours do not garantee a controlled innocuity. By contrast, health hazards are obvious in many instances. Forceful tanning is a transitory aspect behind which the spectrum of many skin changes includes accelerated photoageing, irreversible pigmentary and keratotic changes, and cutaneous malignancies including malignant melanoma. In the absence of protection, the eye is also affected. Even if tanning salon exposure increases the risk for skin cancer by a small amount, it represents a significant potential public health hazard given the number of people attending salons. Digital dermoscopy and ultraviolet light videoscopy are new methods allowing to predict the cutaneous ransom to be paid by the sunbed worshippers.

Humans↗
PubMed1999

Preferences for different sources of information about cancer.

A wide range of cancer information resources is available to patients and their relatives, who are increasingly acting as independent learners. In order to examine preferences for different types of information and to establish the appropriateness of providing a Web-based cancer information resource (CancerHelp UK) a questionnaire survey was undertaken. Of 258 questionnaires distributed to patients attending for oncology outpatient or general practice appointments, 205 (80%) were suitable for analysis. 74% (95% confidence interval 68% to 80%) of participants wanted as much information as possible. All participants cited people most frequently as a future source of cancer information. All participants frequently cited television as a source of both general and cancer-specific information. Despite a lack of computer experience patients were significantly more likely than other groups to say that they would like to use the Web-based resource. It is suggested that such resources are likely to be increasingly well used, particularly by cancer patients, given the growth in health information on the Web and developments in delivery of digital information into the home via television.

Adult↗
PubMed1989

Computer-assisted image analysis of sperm concentration in human semen before and after swim-up separation: comparison with assessment by haemocytometer.

Evaluation of male fertility is based predominantly on results from semen analysis and determination of the sperm concentration is one of the main parameters of the analysis. The availability of a fully automated videomicrographic digital image analyser would offer both an objective and rapid method for determination of the sperm concentration. In the present study the sperm concentration in 327 semen samples was determined by haemocytometer according to the World Health Organization guidelines, and also by a computer-assisted digital image analyser system. Results were classified according to the routine procedure (haemocytometer) before statistical analyses. The computerized measurements caused a shift to the right in the frequency distribution of sperm concentration. Sperm concentrations were more often overestimated significantly (P less than 0.001) by the computerized measurements in semen samples with concentrations up to 80.0 x 10(6)/ml. This overestimation seemed to be caused by the presence of particles in seminal plasma that were recognized incorrectly as sperm by the computer program. The computerized digital image analyser gave an average sperm concentration of 2.2 +/- 0.6 x 10(6)/ml (mean +/- SEM) in 17 azoospermic semen samples while the routine procedure did not detect the presence of sperm cells. After removing the seminal plasma by washing and centrifugation with culture medium, and using the swim-up procedure to harvest motile sperm, the computerized measurements showed comparable results with the routine procedure for those sperm preparations (n = 44) with sperm concentrations greater than 5.0 x 10(6)/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed2005

[Accuracy of the cytopathological telediagnosis of palpable limphoadenopathies. A study design simulating the diagnostic support from remote access to health workers in the developing countries].

It has been estimated the accuracy of the cytologic diagnosis, carried out by a cytopathologist, on digital images (DID) of fine needle aspiration lymphonode biopsies (FNAB), in order to validate the telematic support to health workers practising in specialist-lacking remote areas of the developing countries. A blind-cross check simulation design was drawn-up. A non-pathologist practictioner selected the microscopic fields of 39 cases of FNAB, took the pictures with a digital camera, stored them and submitted to a cytopathologist for DID. The DID were compared against the original diagnosis in direct view (DVC). The histologic diagnosis on the surgical biopsies were the golden standard to refer to. The results demonstrate that: 1) DVC and DID have similar and satisfactory sensitivity rates (88.2 e 85.3%) and positive predictive values (96.8 e 90.1%); 2) DID have lower specificity and efficiency rates against DVC (40.0 vs 80.0 and 79.5 vs 79.2%); 3) the negative predictive values are low both in DVC and DID (50.0 e 28.6%), but the data ought to be confirmed in a well-balanced ratio malignancy-benignancy; d) the accuracy of DID could be increased by improving the selection process of the microscopic fields; e) the remote access-assisted cytologic diagnosis of FNAB can be a procedure to carry out easily and cheaply in areas where the histopathology facilities are unavailable. The accuracy is the highest in metastasis, in high-grade non-Hodgkin lymphoma and in lymphocite depletion and mixed cell sub-groups of Hodgkin lymphoma.

Developing Countries↗
PubMed2000

e-business means survival for health care organizations in 2010.

Within the next five years, most health care organizations will communicate with suppliers, other providers, payers, regulators, and patients through the Internet. The Internet will recalibrate expectations of speed and service for patients and providers, but it also will increase accountability in which digitalized information is tracked and analyzed. The rate at which health care organizations are developing Web-based solutions is neck-snapping in the United States. As individual product lines, departments, and subsidiaries grow their own e-health businesses, organizations must decide which initiatives they must fund, which are essential to survival, and which could be financial black holes.

Commerce↗
PubMed2001

An epidemiological survey of constipation in canada: definitions, rates, demographics, and predictors of health care seeking.

OBJECTIVES: The prevalence of functional constipation is highly variable among epidemiological surveys and may relate to the definitions applied. We estimated the population prevalence of self-reported, Rome I-defined, and Rome II-defined constipation in Canada and determined the variables that best predicted health care seeking. METHODS: A research firm was employed to conduct a random digit dial national survey, inviting household members at least 18 yr of age to participate in a study assessing personal health issues. The sample was stratified to ensure that each region of Canada was represented. Data collection involved three stages: 1) recruitment of participants by phone, 2) mailing of the questionnaire, and 3) data retrieval through a follow-up phone call. The Rome II questionnaire was used to derive the prevalence of functional constipation using both Rome I and Rome II criteria. RESULTS: Of the 1149 participants, 27.2% self-reported constipation within the past 3 months, and 16.7% and 14.9% had functional constipation according to Rome I and II, criteria, respectively. For all three definitions, the rate for women was close to twice that for men. Approximately 34% of those with self-reported constipation had visited a physician for it, versus 26.3% of Rome II subjects. In a regression model, subjects self-reporting in the past 3 months were more likely to have seen a doctor for their constipation (odds ratio 2.47, p < 0.01) and significantly more women than men (35.6% vs 19.5%, p < 0.05). CONCLUSIONS: Functional constipation and related health care seeking are common in the Canadian population and are strongly determined by the definition used. The Rome II criteria for this disorder seem to be satisfactory, but modifications may be considered to allow for constipated subjects taking laxatives and to increase the number of qualifying symptoms.

Adolescent↗
PubMed2002

Consumer Health Information for Asians (CHIA): a collaborative project.

According to the 2000 United States Census, the Asian population in Houston, Texas, has increased more than 67% in the last ten years. To supplement an already active consumer health information program, the staff of the Houston Academy of Medicine-Texas Medical Center Library worked with community partners to bring health information to predominantly Asian neighborhoods. Brochures on health topics of concern to the Asian community were translated and placed in eight informational kiosks in Asian centers such as temples and an Asian grocery store. A press conference and a ribbon cutting ceremony were held to debut the kiosks and to introduce the Consumer Health Information for Asians (CHIA) program. Project goals for the future include digitizing the translated brochures, mounting them on the Houston HealthWays Website, and developing touch-screen kiosks. The CHIA group is investigating adding health resources in other Asian languages, as well as Spanish. Funding for this project has come from outside sources rather than from the regular library budget.

Academic Medical Centers↗
PubMed2004

The National Survey of Early Childhood Health .

OBJECTIVES: The National Survey of Early Childhood Health (NSECH) is a new survey that was designed to provide nationally representative data on the health and development of children and to fill an information gap in the pediatric literature on parents' views of the delivery of health care to their young children. DESIGN: The selection of topics was guided by previous studies conducted to examine parents' expectations and needs in child health supervision visits. The NSECH is a random-digit-dial telephone survey of a nationally representative sample of 2068 children aged 4 to 35 months. This sample includes an oversample of black and/or Hispanic children so that results for these minority groups could be estimated with greater precision. The sampling frame for NSECH is from the State and Local Area Integrated Telephone Survey (SLAITS), which is a program of surveys conducted by the National Center for Health Statistics that makes economical use of the large sampling frame of the National Immunization Survey (NIS). SLAITS takes advantage of the NIS screening effort by fielding interviews on other health topics with households screened for the NIS. The respondent was the parent or guardian identified as the person most responsible for the sampled child's medical care. Spanish-language interviews composed 19% of all completed interviews. The Council of American Survey Research Organizations response rate was 65.6%. CONCLUSION: The NSECH provides a unique data set that allows a well-rounded picture of the health, health care utilization, health care content, and interpersonal quality of health services received by young children in the United States. It also contains important information about family characteristics, patterns of health-promoting behaviors, and family routines that are associated with promoting the developmental health of young children. NSECH results can also help national policy makers understand the health needs of families with young children and how well the health system is meeting those needs.

Child Development↗
PubMed1999

Prevalence of attempting weight loss and strategies for controlling weight.

CONTEXT: Overweight and obesity are increasing in the United States. Changes in diet and physical activity are important for weight control. OBJECTIVES: To examine the prevalence of attempting to lose or to maintain weight and to describe weight control strategies among US adults. DESIGN: The Behavioral Risk Factor Surveillance System, a random-digit telephone survey conducted in 1996 by state health departments. Setting The 49 states (and the District of Columbia) that participated in the survey. PARTICIPANTS: Adults aged 18 years and older (N = 107 804). MAIN OUTCOME MEASURES: Reported current weights and goal weights, prevalence of weight loss or maintenance attempts, and strategies used to control weight (eating fewer calories, eating less fat, or using physical activity) by population subgroup. RESULTS: The prevalence of attempting to lose and maintain weight was 28.8% and 35.1 % among men and 43.6% and 34.4% among women, respectively. Among those attempting to lose weight, a common strategy was to consume less fat but not fewer calories (34.9% of men and 40.0% of women); only 21.5% of men and 19.4% of women reported using the recommended combination of eating fewer calories and engaging in at least 150 minutes of leisure-time physical activity per week. Among men trying to lose weight, the median weight was 90.4 kg with a goal weight of 81.4 kg. Among women, the median weight was 70.3 kg with a goal weight of 59.0 kg. CONCLUSIONS: Weight loss and weight maintenance are common concerns for US men and women. Most persons trying to lose weight are not using the recommended combination of reducing calorie intake and engaging in leisure-time physical activity 150 minutes or more per week.

Adult↗
PubMed2000

Upgrading legacy systems for the Integrating the Healthcare Enterprise (IHE) initiative.

As technology vendors have adopted standardized communication protocols, including Digital Imaging and Communications in Medicine (DICOM) and Health Level 7 (HL7), interconnectivity between various devices has been simplified. The recent Integrating the Healthcare Enterprise (IHE) initiative will further promote the use of standards for interconnectivity. Until these standards are universally accepted, we must live in a transitional world where some components will communicate without any modification, while others require upgrades to allow them to meet the new standards. In designing and implementing the network at University of California Los Angeles (UCLA) Medical Center, some integration problems were found that are common to the industry. Creating departmental workflow with only a limited number of acquisition devices supporting the DICOM worklist was the initial problem addressed. Although many manufacturers provide this function for their new scanners, upgrading existing equipment is often cost-prohibitive. To ensure the quality of the demographic information in the image data and the workflow of the system, third-party worklist components were required to upgrade the legacy acquisition devices. These worklist components provided a standards-compliant facade on top of the legacy equipment, allowing seamless integration with the remainder of the network. To support the distribution of worklist information and the feedback of procedure status, a bidirectional HL7/DICOM protocol bridge was required. Although many radiology information system (RIS) manufacturers will be providing native DICOM capabilities in future product releases, the majority of current RIS installations have no DICOM functionality. Similar to the legacy scanners, the HL7/DICOM bridge provided a DICOM-compliant facade to the non-DICOM RIS. The additional use of web-based technology for worklist display further extended flexibility of this facade. We have demonstrated standards-compliant facade technology allowing legacy components to operate seamlessly in an IHE environment at a fraction of the cost of upgrading to new equipment.

Computer Communication Networks↗
PubMed1997

Highlights of the Digital Imaging Network-Picture Archiving and Communications System Project.

The Department of Defense issued its requirements for a Digital imaging Network-Picture Archiving and Communications System (DIN-PACS) in a Request for Proposals to industry in January, 1997. The DIN-PACS shall be an open systems network of digital devices designed for the effective acquisition, transmission, display and management of diagnostic imaging studies. This network is primarily based on two international standards, Digital imaging and Communications in Medicine (DICOM) and Health Level 7 (HL7). The DIN-PACS is required to communicate in a bidirectional manner with the Department of Defense standard hospital information system called the Composite Health Care System (CHCS) through an HL7 compliant interface. The DIN-PACS model and its published specifications stress functionality and performance rather than system architecture to allow industry to propose optimal approaches for implementation. This paper discusses the functional requirements of the DIN-PACS in terms of its internal operations as well as its communication with external systems and components. This is a US government work. There are no restrictions on its use.

Diagnostic Imaging↗