Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Acceptance Process”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 523 records · Page 29Linked to original sources
PubMed2004

Multidisciplinary assessment at triage: a new way forward.

OBJECTIVE: To evaluate a dual doctor and nurse triage system at a tertiary referral hospital. METHODS: Data were compared between periods of multidisciplinary triage and periods of standard triage. Data comparison was also made between rostered multidisciplinary triage shifts and non-multidisciplinary triage shifts. Staff satisfaction with the process was assessed. RESULTS: The percentage of patients seen within Australasian Triage Scale performance indicator thresholds increased from 75% to 81% in Category 2 patients (P = 0.12) and 56% to 78% in Category 3 patients (P < 0.0001). There was a reduction of 50% in the number of patients who left prior to being seen by a doctor (P = 0.024). Surveys showed high staff satisfaction with the process. CONCLUSIONS: We feel that multidisciplinary triage performs a useful function in our department enabling us to reduce waiting times. The process is widely accepted amongst the staff and it ensures a senior doctor assesses most patients. It reduces the number of patients leaving prior to being seen by a doctor and it provides one way of getting around access block and a physically small department.

Attitude of Health Personnel↗
PubMed2001

A monitor unit "odometer" for measuring linac workload.

The annual linac workload is often required by regulatory agencies to assess compliance with license conditions. Summation of the monitor units produced by the machine is generally used for this purpose. Various methods of estimating this value have inherent inaccuracies. We have built an integrating Monitor Unit "odometer" that is able to automatically accumulate all MUs delivered by the linac and segregate the total by mode (photon or electron) and energy. The device has been used to record clinical linac MU workloads for 10 months, and was installed in a new dual-energy linac during the acceptance and commissioning process.

Electrons↗
PubMed2000

Transplantation and its biology: from fantasy to routine.

The replacement of diseased organs and tissues by the healthy ones of others has been a unique milestone in modern medicine. For centuries, transplantation remained a theme of fantasy in literature and the arts. Within the past five decades, however, it has developed from a few isolated attempts to salvage occasional individuals with end-stage organ failure to a routine treatment for many patients. In parallel with the progressive improvements in clinical results has come an explosion in immunology, transplantation biology, immunogenetics, cell and molecular biology, pharmacology, and other relevant biosciences, with knowledge burgeoning at a rate not dreamed of by the original pioneers. Indeed, there have been few other instances in modern medicine in which so many scientific disciplines have contributed in concert toward understanding and treating such a complex clinical problem as the failure of vital organs. The field has been a dramatic example of evolution from an imagined process to an accepted form of therapy.

Allergy and Immunology↗
PubMedDate not supplied

Diagnosis and management of chronic hepatitis C.

This mini-review is devoted to the main questions of diagnosis, treatment and prevention of chronic hepatitis C (CHC). Diagnosis of CHC is based on virological, biochemical and histological findings. The etiology of CHC should be proven by the presence of antibody to hepatitis C virus (anti-HCV) and detection of viral nucleic acid (HCV RNA), using qualitative and quantitative polymerase chain reaction or branched chain DNA techniques. Serum aminotransferase levels can reflect the biochemical activity of liver disease, while biopsy is very important in the grading and staging of the pathological process. The generally accepted treatment of CHC is interferon (IFN); however, recently, the combination of IFN with the oral nucleoside analogue ribavirin has become the therapy of choice, not only for relapsers but also for naive patients. Prevention of hepatitis C by vaccination is not yet available. Screening blood donors and members of high risk groups, as well as ensuring good public health measures, are imperative to inhibit the spread of HCV.

Alanine Transaminase↗
PubMed2000

Functional characteristics of S-59 photochemically treated platelet concentrates derived from buffy coats.

BACKGROUND: A photochemical treatment (PCT) process for inactivation of infectious pathogens and leukocytes has been developed and evaluated using single-donor platelet concentrates. This study assessed the application of PCT to platelets prepared from pooled buffy coats. In this study, in vitro functional characteristics of PCT platelets were compared to control platelets prepared from pooled buffy coats using the approved platelet-additive solution T-Sol((R)). Platelets in platelet PAS III additive solution without PCT were evaluated as well. PCT also included the use of a psoralen (S-59) reduction device (SRD). MATERIALS AND METHODS: Four types of platelet concentrates were compared: (1) platelet concentrate in plasma/T-Sol; (2) platelet concentrate in plasma/PAS III; (3) platelet concentrate in plasma/PAS III, PCT, 9 h SRD and (4) platelet concentrate in plasma/PAS III, PCT, 16 h SRD. PCT occurred on the day after whole-blood collection. In vitro assay parameters included: pH, pO(2), pCO(2), HCO(-)(3), platelet count, mean platelet volume, plasma glucose, plasma lactate, total ATP, expression of p-selectin, hypotonic shock response and electron microscopy. RESULTS: The results indicate that PCT is compatible with platelet concentrates prepared from pooled buffy coats for up to 7 days of storage. CONCLUSION: The PCT process resulted in acceptable in vitro platelet functional characteristics and is currently in clinical trials to evaluate the haemostatic efficacy of PCT platelets in thrombocytopenic patients requiring multiple platelet transfusions.

Blood Platelets↗
PubMedDate not supplied

Biomechanical analysis of patellar tendon allografts as a function of donor age.

We evaluated the biomechanical properties of patellar tendon allografts from donors aged 18 to 55 years. Bone-patellar tendon-bone complexes were harvested from acceptable donors and processed. Fat and soft tissue were removed, and the tendons were sectioned lengthwise leaving the central third. Area measurements were taken, and mechanical testing was performed. Specimens were pulled to failure at a rate of 10% of the initial length per second. The force at failure, tensile stress, modulus of elasticity, and percent elongation were determined for each specimen. There was no significant correlation (P > 0.05) between age and any of the mechanical properties. Load at failure ranged from 2110 to 4650 N, with a mean of 3424 N. Regression analysis showed slightly decreasing tensile stress with increasing age, but the correlation was not significant. It appears that patellar tendon allografts from donors up to age 55 have similar mechanical properties.

Adolescent↗
PubMed1993

Benefits of Good Laboratory Practice as a tool to improve testing.

The Organization for Economic Cooperation and Development (OECD) has promoted Good Laboratory Practice (GLP) since the mid 1970s. This paper describes the development of the concept through international harmonisation, Quality Assurance (QA), and compliance monitoring. Ultimately this process permits Mutual Acceptance of Data (MAD). An important aspect of the OECD's programme is the promotion of related training and information exchange.

Europe↗
PubMed2006

AgBase: a functional genomics resource for agriculture.

BACKGROUND: Many agricultural species and their pathogens have sequenced genomes and more are in progress. Agricultural species provide food, fiber, xenotransplant tissues, biopharmaceuticals and biomedical models. Moreover, many agricultural microorganisms are human zoonoses. However, systems biology from functional genomics data is hindered in agricultural species because agricultural genome sequences have relatively poor structural and functional annotation and agricultural research communities are smaller with limited funding compared to many model organism communities. DESCRIPTION: To facilitate systems biology in these traditionally agricultural species we have established "AgBase", a curated, web-accessible, public resource http://www.agbase.msstate.edu for structural and functional annotation of agricultural genomes. The AgBase database includes a suite of computational tools to use GO annotations. We use standardized nomenclature following the Human Genome Organization Gene Nomenclature guidelines and are currently functionally annotating chicken, cow and sheep gene products using the Gene Ontology (GO). The computational tools we have developed accept and batch process data derived from different public databases (with different accession codes), return all existing GO annotations, provide a list of products without GO annotation, identify potential orthologs, model functional genomics data using GO and assist proteomics analysis of ESTs and EST assemblies. Our journal database helps prevent redundant manual GO curation. We encourage and publicly acknowledge GO annotations from researchers and provide a service for researchers interested in GO and analysis of functional genomics data. CONCLUSION: The AgBase database is the first database dedicated to functional genomics and systems biology analysis for agriculturally important species and their pathogens. We use experimental data to improve structural annotation of genomes and to functionally characterize gene products. AgBase is also directly relevant for researchers in fields as diverse as agricultural production, cancer biology, biopharmaceuticals, human health and evolutionary biology. Moreover, the experimental methods and bioinformatics tools we provide are widely applicable to many other species including model organisms.

Agriculture↗
PubMed2005

Seeking new methodology for palliative care research: challenging assumptions about studying people who are approaching the end of life.

Palliative care researchers face many ethical and practical challenges. In particular, recruitment has proven difficult. New methodologies and methods need to be developed if barriers are to be overcome. This paper presents an example of a participatory approach to research with people receiving palliative care services. The approach was used for recruitment into an in-depth multi-methods study of weight loss and eating difficulties experienced by people with advanced cancer. Methods included a survey of patients on the case-loads of two community palliative care teams working in the South of England in 2003. The questionnaire was returned by 199 patients, 58% of the total patient population under the care of the two teams. Benefits of the approach taken are detailed, but also issues that emerged across the course of recruitment, thus highlighting points of interest for palliative care researchers. It is proposed that the success of the recruitment process can be attributed to the adoption of a context specific participatory approach. Successful recruitment into the study challenges the widely held belief that, for practical and ethical reasons, it is inappropriate to study people who are approaching the end of life. It demonstrates that a participatory approach enables clinical practice and research to share decision making and values, leading to a feasible and successful recruitment process that is acceptable to clinicians, researchers and patients.

Ethics, Research↗
PubMedDate not supplied

Design and implementation of an application and associated services to support interdisciplinary medication reconciliation efforts at an integrated healthcare delivery network.

Confusion about patients' medication regimens during the hospital admission and discharge process accounts for many preventable and serious medication errors. Many organizations have begun to redesign their clinical processes to address this patient safety concern. Partners HealthCare, an integrated delivery network in Boston, Massachusetts, has answered this interdisciplinary challenge by leveraging its multiple outpatient electronic medical records (EMR) and inpatient computerized provider order entry (CPOE) systems to facilitate the process of medication reconciliation. This manuscript describes the design of a novel application and the associated services that aggregate medication data from EMR and CPOE systems so that clinicians can efficiently generate an accurate pre-admission medication list. Information collected with the use of this application subsequently supports the writing of admission and discharge orders by physicians, performance of admission assessment by nurses, and reconciliation of inpatient orders by pharmacists. Results from early pilot testing suggest that this new medication reconciliation process is well accepted by clinicians and has significant potential to prevent medication errors during transitions of care.

Clinical Pharmacy Information Systems↗
PubMedDate not supplied

Strangers in a British world? Integration of international nurses.

This article, based on research carried out in 2002-2003, examines the experiences of recently internationally qualified migrant nurses to Britain and explores their stories with the aim of understanding aspects of their work-related identities. The migrant nurses' encounters at work may highlight their difference to the majority, namely the British qualified nurses. Despite attempts on behalf of some healthcare employers of embracing diversity, the process of achieving acceptance and respect as a migrant worker can be a taxing one. Findings indicate that the nurses' identity as a 'migrant', rather than as a 'man' or 'woman', drew most comment in their day-to-day work. While the nurses encountered some prejudice because of their foreign origin, they also experienced fair and respectful interactions. The study highlights the complexity of work-related identities among international migrants, a group of employees which, despite nursing shortages in the NHS, has attracted little research interest and poses a challenge to management.

Acculturation↗
PubMed2004

Signal transduction therapeutics: relevance for Alzheimer's disease.

It is now widely accepted that abnormal processing of the Alzheimer's amyloid precursor protein (APP) can contribute significantly to Alzheimer's disease (AD). APP can be processed proteolytically to give rise to several fragments, including toxic beta-amyloid (Abeta) fragments that are subsequently deposited as amyloid plaques in brains of AD patients. Data from several groups have revealed that APP processing can be regulated by phosphorylation and phosphorylation-dependent events. Consequently, the key players controlling such signal transduction cascades, the protein kinases and phosphatases, as well as their corresponding regulatory proteins, take on added importance. By characterizing how altered cell signaling might contribute to APP processing, one can identify potential targets for signal transduction therapeutics. Here, we review APP phosphorylation and phosphorylation-dependent events in APP processing, with particular focus on phosphatases that impact on APP processing, and their binding and regulatory proteins. Particular attention is given to protein phosphatase 1 (PP1), as it seems to have a central role not only in the regulation of APP cleavage events but also in the molecular control of neurotransmission and in age-related memory deterioration. The development of specific drugs targeting protein phosphatase binding proteins would constitute potential therapeutic agents with a high degree of specificity. The identification of such targets provides novel therapeutic avenues for normal aging and for neurodegenerative conditions such as AD.

Alzheimer Disease↗
PubMed2001

Do rodent and human brains have different N-glycosylation patterns?

A large number of studies on the structure of N-glycosidically linked oligosaccharides from glycoproteins of different organs and/or different species have been carried out in the past using various combinations of techniques such as monosaccharide analysis, permethylation, peracteylation, exoglycosidase sequencing, normal and reversed phase HPLC, mass spectrometry and nuclear magnetic resonance spectroscopy. Although it is widely accepted that the processing of N-glycans in the ER and Golgi of mammalian cells follows the same principal metabolic rules, analyses have revealed that the glycosylation pattern of a particular protein may differ depending on the cell type in which it is expressed. N-glycans from brain glycoproteins have been shown to include a variety of hybrid- and complex-type structures with structural features that are not so commonly found on glycoproteins from other organs and which have, therefore, been classified as 'brain-specific'. Comparison of the N-glycans of glycoproteins from homogenates of rat, mouse and human brains confirm that, in general, glycoproteins from human brain show a similar profile of brain-specific N-glycans as glycoproteins from mouse and rat brain.

Animals↗
PubMed1998

When are NSAIDs appropriate in osteoarthritis?

Osteoarthritis is a multifactorial disease that is more common in the elderly than in younger individuals. Opinion is divided on whether it is a degenerative or inflammatory process. Most rheumatologists accept that the disease has an inflammatory component, particularly when it is complicated by crystal deposition. Nonsteroidal anti-inflammatory drugs (NSAIDs) are particularly toxic in the elderly. The geriatrician should use a more conservative approach to initial therapy, which should include patient education, physiotherapy and even the consideration of intra-articular steroid injections. If systemic drug therapy is still required, simple analgesics should usually be tried first. If NSAIDs are then required, they can be selected according to their chemical structure (which bears some relation to adverse effects) or half-life (which is more relevant to optimum prescribing). Propionic acid derivatives are well established and remain the NSAIDs of choice: agents with a short half-life, perhaps given in low dosages, are preferred. The use of topical formulations, which are more expensive, may avoid some adverse effects; however, drug effects are unlikely to remain truly localised. It may be prudent to provide gastroprotective therapy for some elderly patients. A full evaluation of the new generation of cyclooxygenase-2 inhibitors in osteoarthritis is still awaited.

Adrenal Cortex Hormones↗
PubMed2006

Whole embryo culture: an important tool in developmental toxicology today.

The number of candidate chemicals or drugs for registration and authorization is increasing at a fast rate and only few of the existing substances have been tested for teratogenicity to date. Therefore, there is high pressure on authorities to accept models like the whole embryo culture as a screening system for safety evaluation procedures. In view of this background the gradual development of the whole embryo culture into a standardized, scientifically validated tool for developmental toxicology during the last 70 years is summarized. The methodological development of the culture technique is described with the completion, improvement and refinement of the basic culture method as main intention. Special attention was paid to different culture techniques, culture media, gassing schedules, and evaluation strategies. Furthermore the importance of taking "in vitro pharmacokinetics" into consideration when a comparison of in vitro/in vivo results from embryotoxicity testing is intended, is stressed. Additionally, the demonstration of the broad spectrum of useful scientific applications when using this culture system in combination with sophisticated analytical techniques is demonstrated. Finally, an overview on different strategies for the validation of this culture system as an in vitro embryo toxicity test is provided and the officially accepted formal validation process for this application is summarized. The successful validation makes the whole embryo culture a complex in vitro embryotoxicity test with high accuracy and predictability. This robust in vitro system modelling the main phase of rodent organogenesis with a high reproducibility is valuable enough to attract special attention in related scientific fields.

Animals↗
PubMed1982

Sonographic findings in perforation of the gallbladder.

The sonographic findings in 13 patients with proven gallbladder perforation are described. Two patients were scanned immediately before and after gallbladder perforation. The sonographic findings before gallbladder perforation were gallbladder distension (one case) and gallbladder wall edema (one case). Pericholecystic collections develop after gallbladder perforation. These collections have a varied sonographic appearance ranging from anechoic to complex collections, and their internal characteristics seem to depend on the duration of the pericholecystic process. The residual gallbladder lumen or calculi can be identified within or peripheral to the pericholecystic process. The most acceptable mechanism for perforation of the gallbladder is: (1) impaction of a calculus in the cystic duct; (2) gallbladder distension due to secretion into its lumen by mucous glands located in the walls of the gallbladder; (3) vascular impairment of the gallbladder due to distension of the viscus; and (4) ischemia, necrosis, and perforation of the gallbladder wall. Gallbladder perforation is a significant complication of acute cholecystitis associated with morbidity and mortality. Detection of this complication of acute cholecystitis by clinical means is difficult since the patient's symptoms are similar to those of uncomplicated acute cholecystitis. The inherent resolution of sonography offers an excellent display of the gallbladder and surrounding tissues allowing detection of pericholecystic collection secondary to gallbladder perforation.

Abscess↗
PubMed1997

Patients' opinion of mammography screening services: immediate results versus delayed results due to interpretation by two observers.

OBJECTIVE: The purpose of this study was to evaluate by random questionnaire mailings the preferences of women who have undergone mammography in our region regarding communication of mammography screening results. MATERIALS AND METHODS: Questionnaires were mailed to 400 randomly selected women who were more than 35 years old and who had been treated at our institution for medical or surgical reasons. Questions regarding use of mammography screening at our institution versus services at other locations were included. The questionnaire described two possible mammography services; either a double reading service that would provide delayed reports (DRDR) with the benefit of extra cancers detected, and a service that provides immediate reports given directly to the patient by an on-site radiologist. The presentation of the services was reversed in half the questionnaires to avoid bias. Patients' choices were collected, as were demographic data. The choice of one system over the other was evaluated using the one-sample lest for binomial probability. The chi-square test was used to determine if the order of questions on the survey or the site of patients' screening mammography affected responses. RESULTS: The response rate was 42% (n = 168). Of these, one response informed us of the death of a patient. Of the remaining 167 respondents, 75% (n = 126) preferred the DRDR system, 13% (n = 22) preferred the system providing immediate results (p < .0001), and the other 19 respondents did not select a preference. Of the 167 respondents, 156 answered the question regarding previous screening mammography experience. Of the 105 patients who had undergone screening mammography at our institution, 78% (n = 82) preferred the DRDR system. Of the 51 patients who had undergone mammography elsewhere or who had never undergone mammography, 75% (n = 38) preferred the DRDR system. We found that ordering of presentation of the systems in the questionnaire had no effect on responses. Likewise, whether a respondent had undergone mammography at our institution had no effect on responses (p = 1.0). CONCLUSION: A statistically significant number of women who responded to our questionnaire preferred the DRDR system of reporting screening mammographic results. Educational material about double reading that we included with each patient's questionnaire could account for these results. If the use of a second interpreter is feasible and is done for batch interpretation of screening mammograms, then education of patients about this process may increase acceptance of a delayed mammographic report.

Adult↗
PubMed1992

Composition and flavor of milk and butter from cows fed unsaturated dietary fat and receiving bovine somatotropin.

Composition and flavor of milk and butter were evaluated from cows divided into four treatments including a control, control with bST, added dietary fat from sunflower seeds with bST, or added dietary fat from safflower seeds with bST. Feeding added unsaturated dietary fat resulted in lower concentrations of short-and medium-chain and higher concentrations of long-chain fatty acids in milk fat and butter. Milk fat unsaturated fatty acid concentrations were 25.0, 28.4, 39.6, and 37.9%, and butter unsaturated fatty acid concentrations were 23.0, 26.9, 37.8, and 36.2% for control, control with bST, sunflower seeds with bST, and safflower seeds with bST, respectively. Sensory evaluations indicated that butters from the bST with sunflower seed and bST with safflower seed treatments were equal or superior in flavor to the control butter. Milk from cows receiving bST or fed added unsaturated dietary fat and receiving bST was no more susceptible to oxidized off-flavors than control milk. Butters from sunflower seed and safflower seed treatments with bST contained higher concentrations of unsaturated fatty acids, were softer at 4 and 20 degrees C, and possessed acceptable flavor and processing characteristics compared with butters from control and control with bST.

Animals↗