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PubMed2002

Intrahippocampal connections in the pigeon (Columba livia) as revealed by stimulation evoked field potentials.

The hippocampal formation (HF) of mammals and birds is crucial for spatial learning and memory. However, although the underlying synaptic organization and connectivity of the mammalian HF are well characterized, comparatively little is known about the avian HF. Localized regions of the homing pigeon HF were stimulated at 400-600 microA while evoked field potentials (EFPs) were recorded from adjacent and more distant HF areas relative to the stimulation site. The shortest discernible EFP latency was 12.2 msec. The emerging connectivity profile (using the location of peak EFP amplitude after stimulation and making no determination of the number of intervening synapses) was characterized by projections from the dorsolateral (DL) HF to the dorsomedial (DM) HF (15-msec latency) at the same anterior/posterior (A/P) level, DM to ventrolateral (VL) and ventromedial (VM; 15 msec) HF across A/P levels, VM to VL (12 msec) and contralateral VM (15 msec) at the same A/P level, and VL to ventral DL (DLv; 15 msec) across A/P levels posterior to the stimulation site. Using these data as a first approximation, connectivity through the avian HF appears to be characterized by a discernible feed-forward network starting with a projection from DL to DM, DM to VL, VM, and contralateral VM, VM to VL, and VL to posterior ventral DLv. Although still speculative, the results suggest that the internal connectivity of the avian HF is similar to that of the mammalian HF, despite the large evolutionary divergence between the two taxa.

Animals↗
PubMed2006

Improving availability of EmOC services in Rwanda--CARE's experiences and lessons learned at Kabgayi Referral Hospital.

OBJECTIVE: CARE's work in Rwanda was designed to improve the functional capacity of health facilities for the delivery of EmOC services. METHODS: The project supported a comprehensive package of focused interventions that included hospital renovations, provision of essential equipment, training of staff and improvement of management systems at the Kabgayi regional referral hospital. RESULTS: There was an increased level of preparedness for emergencies and ability to manage common obstetric complications according to evidence-based practices. These changes ultimately led to increased availability, quality and use of services as demonstrated by an increase in the demand for care of obstetric complications at the facility. The met need increased from 16% at the start of the project (2001) to 25% in 2004, while the cesarean rate remained essentially the same (1.9% and 3.2%) over the same time period. There were progressive declines in the case fatality rates from 2.2% in 2001 to 1.2% in 2004. CONCLUSION: CARE's experience indicates that progress towards reducing maternal mortality requires specific efforts that support and strengthen existing health systems to provide skilled care that can save women's lives.

Delivery, Obstetric↗
PubMed1991

Establishment of research in primary health care in Greece. Experiences of Greek-Swedish collaboration.

The last few decades have seen great changes in health care and medical care in Greece, as well as in the Greek university system. A new law on health care and medical care has come into force, a new university hospital and new health centres have been built, and a faculty of medicine has been established at Heraklion in Crete. People are speaking of a change of paradigm. Simultaneous with the introduction of the new national health care system, the Department of Family and Social Medicine (DFSM) in Crete started a major project on public health, known as the Primary Health Care and Nutrition Programs (abbreviated as PPD). The purpose was to chart the state of health and living conditions of the Cretan population in the period 1986-1990. Cooperation in research and training began between DFSM and the Dalby Health Sciences Centre, Lund University in 1987. This was natural since there was a shared interest in research into family medicine and social medicine. In addition, a new Health Care Act had come into force in Sweden in 1982. The establishment phase of primary health care started in Sweden at the end of the 1960s. In the 1970s health centres were established, along with research and training in family medicine, in a way that is comparable in many respects to the situation in which Crete found itself a decade later. This paper concerns the organization and implementation of PPD and the research cooperation between Greek and Swedish institutions. This can be seen as an expression of the internationalization of research for which the two universities have striven.

Adolescent↗
PubMed1998

Standardization and security for the EMR.

The Ministry of Health and Welfare of Japan announced 'Healthcare Information Strategy 21' in 1994. This report shows that the Healthcare Information System is the key to improving the quality and efficiency of healthcare. One of the elements for realizing the new Healthcare Information System is the Electronic Medical Record (EMR). Following the publication of this report, work began with the aim of discovering a way to recognize the EMR as formal documentation and four national projects of research and development have been started. The themes of these projects are: 'Interoperability of EMR', 'Standardization of EMR', 'Modeling of the Clinical Process' and 'Security for EMR'. The Japanese Association of the Healthcare Information Systems Industry (JAHIS) is in charge of 'Security for EMR'. There are many discussions in relation to the security for EMR. However, many of these discussions relate to information technology, while there are few discussions regarding definitions of security. Therefore, there are many different theories about security itself, which will be an obstacle to standardization. To design the security system for EMR, JAHIS has defined 'Security for EMR' as the first step. The present study was conducted with medical informatics and security specialists. It has designed 'Requirement Definitions', 'Goals of Security', 'Estimation of threats to security', 'Necessity conditions' and a 'Security Model'. This paper covers these definitions and our security design concept.

Computer Security↗
PubMed2005

[JICA Leprosy Control and Basic Health Services Project in Myanmar].

Japan International Cooperation Agency (JICA) implemented a 5-year long bilateral technical cooperation project, "Leprosy Control and Basic Health Services Project" in Myanmar. The project was implemented by National Leprosy Control Program, Department of Health with close technical collaboration of JICA experts mainly from International Medical Center of Japan (IMCJ) and National Sanatoriums of leprosy in Japan. It accelerated to achieve the elimination of leprosy at national level, which was declared in January 2003, and at sub-national level onward. It also developed the appropriate technologies for prevention of disability and prevention of worsening of disability (POD/POWD), which were introduced in 9 townships as a pilot service program. The Government stratified the POD/POWD services as a national program since 2005 by taking up the former pilot area to start with. The project also strengthened the function of referral system of leprosy control (Diagnosis and treatment), POD/POWD and physical rehabilitation. Beside leprosy, the project conducted a series of refresher trainings for primary health care givers, Basic Health Service Staff (BHS), of project areas (48 townships) to improve the services on tuberculosis, Malaria, Leprosy, Trachoma and HIV/AIDS for 3 years (2001-2003), which was evaluated in 2004. It contributed to improve the services at township level hospitals in procurement of audio-visual equipments and in conducting microscope training on leprosy, Malaria and tuberculosis at project areas.

Health Services↗
PubMed2003

The European Smoking Prevention Framework Approach (EFSA): an example of integral prevention.

A smoking prevention project in six European countries (European Smoking prevention Framework Approach) was developed, featuring activities for adolescents, schools and parents, including out-of-school activities. Consensus meetings resulted in agreement between the countries on goals, objectives and theoretical methods. Countries' specific objectives were also included. National diversities required country-specific methods to realize the goals and objectives. The community intervention trial was used as the research design. Since interventions took place at the community level, communities or regions were allocated at random to the experimental or control conditions. Complete randomization was achieved in four countries. At baseline, smoking prevalence among 23 125 adolescents at the start of the project was 5.6% for regular smoking and 4.0% for daily smoking. Smoking prevalence rates were higher among girls than boys in all countries as far as weekly smoking was concerned. Process evaluations revealed that the project's ambitions were high, but were limited by various constraints including time and delays in receiving funds. Future smoking prevention projects should aim to identify the effective components within the social influence approach as well as within broader approaches and on reaching sustained effects.

Adolescent↗
PubMed2005

Replacement of the in vivo neutralisation test for efficacy demonstration of tetanus vaccines ad us. vet.

The bacterium Clostridium (C.) tetani is an ubiquitous pathogen. This anaerobic, gram-positive bacterium can form spores and can be found in the whole environment. It enters the body via injuries of the skin and wounds where it releases the neurotoxin "tetanospasmin" (= tetanus toxin). The animals most susceptible to tetanus infection are horses and sheep. Only active immunisation by tetanus vaccine provides effective protection against tetanus intoxication. The marketing authorisation requirements stipulate that efficacy of tetanus vaccines ad us. vet. must be demonstrated in all target animal species via determination of neutralising tetanus serum antitoxin concentrations. The standard method used for this purpose is still the toxin neutralisation test (TNT), as it quantifies the tetanus toxin-neutralising effect of tetanus serum antibodies in vivo. In this test, tetanus toxin is added to dilutions of serum from vaccinated horse and sheep. The serum dilutions are then administered to mice or guinea pigs, which are observed for toxic symptoms. Against the background of animal protection, the goal of one project of the Paul-Ehrlich-Institut (Bundesministerium fuer Bildung und Forschung (Federal Ministry for Education and Research), 0312636) was to establish an alternative to the toxin neutralisation test, enabling the testing of efficacy of tetanus vaccines with serological in vitro methods. For this purpose, a so-called double antigen ELISA (DAE) was established which enables the testing of sera of different species in one assay. In addition, the sera were tested in an indirect ELISA for horses and sheep separately. Altogether, ten groups of horses and eight groups of sheep were immunised with ten animals per group each. The tetanus vaccines comprised almost all products authorised for the German market at the start of the project. 564 horse sera and 257 sheep sera were tested using the two ELISA methods. Some sera were also tested in vivo. The kinetics of antibody responses were recorded. The in vitro DAE method seems to be suitable to replace the mouse neutralisation test used for the detection of tetanus antitoxin in sera of target animal species. The comparison of some sera in the ELISA and the TNT showed good equivalence of results. Nevertheless, before an ELISA titre in horse and sheep sera indicating unambiguous protection against tetanus can be fixed, further comparative assays of low titre sera in the TNT and the DAE will have to be performed.

Animal Testing Alternatives↗
PubMed2002

[Tuberculosis in Asia].

1. Philippines: The development, expansion and maintenance of pilot area activities: Cristina B. Giango (Technical Division, Cebu Provincial Health Office, the Philippines) In 1994, the Department of Health developed the new NTP policies based on WHO recommendations and started a pilot project in Cebu Province in collaboration with the Japan International Cooperation Agency. To test its feasibility and effectiveness, the new NTP policies were pre-tested in one city and one Rural Health Unit. The test showed a high rate of three sputum collection (90%), high positive rate (10%), and high cure rate (80%). Before the new guidelines were introduced, the new policy was briefed, a baseline survey of the facility was conducted, equipment was provided, and intensive training was given. Recording/Reporting forms and procedures were also developed to ensure accurate reporting. Supervision, an important activity to ensure effective performance, was institutionalized. Laboratory services were strengthened, and a quality-control system was introduced in 1995 to ensure the quality of the laboratory services. With the implementation of DOTS strategy, barangay health workers were trained as treatment partners. In partnership with the private sector, the TB Diagnostic Committee was organized to deliberate and assess sputum negative but X-ray positive cases. The implementation of the new NTP guidelines in Cebe Province has reached a satisfactory level, the cure rate and positive rate have increased, and laboratory services have improved. Because of its successful implementation, the new NTP guidelines are now being used nationwide. 2. Nepal: The DOTS Strategy in the area with hard geographic situation: Dirgh Singh Bam (National Tuberculosis Center, Nepal) Three groups of factors characterize the population of Nepal: 1) Socio-cultural factors, e.g. migration, poverty, language; 2) Environmental factors, e.g. geography and climate; and 3) Political factors, prisoners and refugee populations. These factors pose particular problems for implementing DOTS in various ways. Socio-cultural and environmental factors are particularly important in Nepal, and several measures have been developed to overcome these difficulties. One is active community participation through the DOTS committee. The committee consists of a group of motivated people, including social workers, political leaders, health services providers, journalists, teachers, students, representatives of local organizations, medical schools and colleges, industries, private practitioners, and TB patients. One DOTS committee is formed in every treatment center. A key role of the DOTS committee is to identify local problems and their solutions. It increases public awareness about TB and DOTS; supports people with TB in the community by providing treatment observers and tracing late patients; and encourages cooperation among health institutions, health workers, NGOs, and political leaders. The case finding rate is now 69%, and nearly 95% of diagnosed TB cases are being treated under DOTS. The treatment success rate of new smear-positive cases is nearly 90%. Thus, DOTS increases the case finding and treatment success. 3. Cambodia: HIV/TB and the health sector reform: Tan Eang Mao (National Center for Tuberculosis and Leprosy Control, Cambodia) Cambodia is one of the 23 high burden countries of tuberculosis in the world. Moreover, HIV/AIDS has been spreading rapidly since 1990s, which is worsening the tuberculosis epidemics. To cope with the burden, Cambodia has started implementation of DOTS in 1994 and has expanded it to most of public hospitals across the country by 1998. NTP of Cambodia is now enjoying high cure rate of more than 90%. However, due to the constraints such as weak infrastructure and the poverty, it is proved that many of TB sufferers do not have access to the TB services, resulting in still low case detection rate. It is for this reason that the NTP has decided to expand DOTS to health center and community level based on the new health system. Its pilot program that has been carried out in collaboration with JICA and WHO since 1999 has achieved promising results with high detection and cure rates. All of the over 900 health centers across the country will be involved in DOTS strategy by 2005. In the fight against TB/HIV, National Center for TB Control is providing free TB screening for PLWH (people living with HIV/AIDS), and it is developing a comprehensive plan of TB/HIV care including home delivery DOT services. 4. China: The World Bank Project and the Prevalence Survey in China: Hong Jin DuanMu (National Tuberculosis Control Center, China) Since 1992, China has utilized a World Bank loan to implement TB control projects among 560 million people in 13 provinces. Free diagnosis and treatment services have been provided to all patients, and a fully supervised standard short-course chemotherapy was applied to all diagnosed tuberculosis patients. In 1999, more than 190,000 smear-positive cases, ten times the number in 1992, were detected, and the registration rate of new cases reached 30 per 100,000 population. From 1992 to 1999, a total of 1.40 million smear-positive TB patients were discovered. The cure rate of smear-positive TB patients has been improved to an overall cure rate of 93.6%. The cure rates for the new cases and re-treatment patients were 95.1% and 89.6%, respectively. The fourth nationwide random survey for the epidemiology of tuberculosis was conducted in 2000. The prevalence of active tuberculosis was 367/100,000, the prevalence of infectious tuberculosis was 160/100,000, and the prevalence of smear-positive tuberculosis was 122/100,000. The tuberculosis mortality was 9.8/100,000. 5. Vietnam: The road to reaching the Global Target: Le Ba Tung (Pham Ngoc Thach Tuberculosis and Lung Disease Center, Vietnam) TB control activities started in 1957 and were reorganized in 1986 with the technical assistance of IUATLD, KNCV and material assistance of Medical Committee Netherlands Vietnam (MCNV). The New National TB Control Program follows the main directives of WHO and IUATLD's procedures of case-finding, chemotherapy and management. Passive case-findings are based on sputum smear. Chemotherapy with priority for smear positive cases is 3SHZ/6S2H2 for new cases and 3HRE/6H2R2E2 for retreated cases, which is undertaken with directly observed therapy (DOT strategy) mainly at commune health posts. Since 1989, DOTS strategy with 2SHRZ/6HE for new cases and 2SHRZE/1HRZE/5H3R3E3 for retreated cases has gradually been introduced in districts and communes of every province. In 1995, the government established the National and Provincial TB Control Steering Committees and has provided incentives for detected smear positive cases and cured smear positive cases. The government has also started strengthening the program of managerial and supervisory capacity for TB staff and has promoted the cooperation of all associated organizations of TB control. The WHO global surveillance and monitoring project reports that in 2000 Vietnam reached the global target, i.e., 99.8% population covered by DOTS with 80% of expected new smear positive cases being detected and a high cure rate ranging from 85.3% in 1989 to 90.3% in 1999. A distinguishing aspect of TB control in Vietnam is the effective international partnerships combined with high political commitment of the government nationally and provincially as well as active participation of all organizations in the community.

Asia↗
PubMed1996

A collaborative approach to cervical cancer screening.

OBJECTIVE: The main objective of this project was to evaluate a collaborative nurse and general practitioner approach to improve screening for cervical cancer. DESIGN: Multiple group time series design. SETTING: Six postal areas in the Hunter Valley of New South Wales, Australia, chosen as intervention sites because of very low Pap test rates compared with the rest of NSW (fewer than 50% of women screened). Six regions of similar size and with similar baseline screening levels were selected as comparison sites. SUBJECTS: All women selected in the resident postal areas. INTERVENTIONS: Women's health nurses worked in collaboration with general practitioners within the communities selected from within the Hunter area to promote and provide screening for cervical cancer. MAIN OUTCOME MEASURES: Qualitative information on initial expectations and impressions of the collaborative processes were collected at the start of the project period. Process data on client characteristics and Pap test results were obtained from minimum data collections; client satisfaction was assessed from client surveys. Outcome data on the increase in the number of women in each community who were screened for cervical cancer were obtained from Health Insurance Commission claims for screening Pap tests (and from nurses' records where Pap tests were examined under block funding arrangements). RESULTS: This project showed that nurses and general practitioners can collaborate to provide appropriate and highly acceptable cervical cancer screening services for women. Many of the women screened by the nurses were in the high risk age range for cervical cancer (40 years and older) and had only basic education levels, thus representing women who are most likely to have poor screening rates. Further, 33.1% of the women screened had not had a Pap test in the past four years or had never been screened. The number of women having a Pap test during the first six months of the project, compared with the number expected from preintervention patterns, was significantly greater in four intervention areas (P < 0.01). No corresponding increase was seen in comparison areas with similar screening rates at baseline. CONCLUSIONS: There is great potential for nurses to work in collaboration with general practitioners to improve the availability and coverage of community cervical cancer screening programmes.

Australia↗
PubMed1993

Coordination of environmental specimen banking in the Nordic countries, its mission and strategy.

Under the authority of the Nordic Council of Ministers and their Working Group for Environmental Monitoring, a project for coordination of environmental specimen banking in the Nordic countries started in 1991. The project covers the established and planned central environmental specimen banks in Sweden, Norway, Denmark and Finland. The aim of the project is to coordinate and harmonize procedures and methods used in specimen banking such as, collection of material, transport, preparation and storage. In order to increase the possibilities for future international cooperation in monitoring and ecotoxicological scientific work, the Project Group will form the strategy for the continuing work in the Nordic countries. The Project Group will propose adaptation to commonly utilized methods for morphometric measurements of specimens and collection of some common species for future monitoring. The national responsibility for specimen banking in an international perspective will be emphasized.

Denmark↗
PubMed1999

Cutaneous malignant melanoma in Norway: experiences from the Norwegian Melanoma Project.

The Norwegian Melanoma Project was conducted during 1989-1993 as a co-operative study by the dermatological, surgical, oncological and pathological departments of the five university hospitals in Norway. We present the results from the patients diagnosed and treated in our dermatological department at Ullevaal Hospital. During the study period 4582 patients received a clinical evaluation of pigmented lesions and 1347 patients were included in follow-up analyses, which consisted of a complete anamnestical evaluation and a clinical and pathological investigation of excised pigmented lesions. In all, 66 cutaneous malignant melanomas, 50 superficial spreading melanomas, seven lentigo maligna melanomas, eight nodular melanomas and one acral lentiginous melanoma were diagnosed. Correlation of the clinical and anamnestical information demonstrated an increased risk of developing malignant melanoma in persons with red hair and skin type I/II. When the histological thickness of superficial spreading melanomas diagnosed before the start of the project was compared with that of those treated during the project, there was a significant decrease in thickness in the project period.

Female↗
PubMed2005

Coalition models: lessons learned from the CDC's Community Coalition Partnership Programs for the Prevention of Teen Pregnancy.

PURPOSE: To describe the models created by the 13 communities in the Centers for Disease Control and Prevention's Community Coalition Partnership Program (CCPP), and the relationship between key organizational features of the coalitions and the perception by coalition members of interim and community-wide outcomes. METHODS: This study relied on three sources of data: interviews conducted on site with a sample of coalition staff, evaluators, and members (n = 364); a written survey administered after the site visit to those interviewed (n = 216) asking about perceived outcomes and changes between the beginning and end of the project; and a coalition member survey mailed to all coalition members at all sites (n = 341) focusing on perceptions of coalition functioning, outcomes, and satisfaction. RESULTS: A variety of coalition models were developed. Respondents were positive in their assessments of how their coalitions operated even though few were sustained. The coalitions for which members perceived more positive outcomes were better established at the outset of the grant, led by paid staff, and had an area-wide focus, a steering committee, and a hub that was not a community-based organization. Coalitions composed primarily of neighborhood members were difficult to maintain. CONCLUSIONS: Despite members' high ratings, by the end of the funding period most coalitions were no longer functioning. It may be that coalitions are useful but not as permanent structures in communities. Grassroots and individual members not affiliated with an agency may require meaningful incentives to sustain participation. Because maturity of the coalition at the start of the project was a good predictor of sustainability, time should be spent verifying the stage of coalition development before funding.

Adolescent↗
PubMedDate not supplied

Nursing, HIV & AIDS: AVERT funded project.

October 1991 saw the start of a two-year national investigation into the nursing care and treatment of people with HIV/AIDS. The project is based in the Daphne Heald Research Unit at the Royal College of Nursing and is funded by the AIDS Education and Research Trust (AVERT). The aim is to gather information on current approaches to nursing care and treatment at a number of centres around the country, and to identify some of the main issues that are important to nurses undertaking this work. This article is based on preliminary reading and discussions with nurses, and makes some general points about the nursing profession's response to HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed2006

[Comparison of three outpatient therapy forms for treatment of chronic low back pain-- findings of a multicentre, cluster randomized study].

The AOK Baden-Württemberg health insurance fund initiated a study on the outpatient rehabilitation of patients with chronic low back pain, aimed at improving the treatment concept for its insurees with chronic low back pain (START). This model project was scientifically guided by the Hochrhein-Institute in Bad Säckingen. The paper compares the effectiveness of Enhanced Outpatient Physiotherapy (Erweiterte Ambulante Physiotherapie, EAP), Outpatient Rehabilitation (Ambulante Rehabilitation, AR) and Medical Training Therapy (Medizinische Trainingstherapie, MTT) in patients with low back pain. In seven regions in Baden-Württemberg, one of these three intervention forms was provided to the patients. A total of 1,274 patients were included in the study. The AOK Baden-Württemberg patients receiving treatment in one of the three intervention forms were seriously restricted in both the physical dimension of their health status and in their physical mobility in everyday life and at the workplace. Besides, they frequently reported considerable psychosocial strain. The three interventions led to significant and relevant decreases in pain intensity and to an improved health-related quality of life. There were no significant differences between the various treatments in terms of effectiveness. The patients shared an equally high satisfaction with the treatment received. In MTT, the total therapy length of 15 weeks was by far longer than in AR and EAP (about 5 and 8 weeks). Unlike AR and, in parts, EAP, patients may continue to work while participating in MTT. Therefore an immediate therapy start within a week was more likely possible in MTT (59 %) than in AR (10 %) or EAP (23 %). In evaluating the results a number of restrictions have to be considered. Nevertheless, based on our research findings, the following can be concluded: MTT is a suitable therapy concept in patients with low back pain characterized by a rapid start and-- compared to the other two concepts-- by lower therapy costs. MTT might represent a meaningful therapy element also in new forms of provision such as integrated services. Patients showing severe psychosocial strain should be assigned to an interdisciplinary therapy as it is provided by inpatient and outpatient rehabilitation facilities. For effective differential assignment to the various programmes, realization of a standardized rehab assessment is an important precondition.

Activities of Daily Living↗
PubMed1998

Projection of HIV infection in Calcutta.

Starting with the base year of 1991, the HIV infection projection for 1992-99 for the total, as well as various high-risk sub-populations of Calcutta, the first of its kind is provided. These projections are based on statistical methodology developed in this paper. Our methodology for spread of HIV infection takes into account various social interactions and practices and also uses available data. Rates of these interactions and practices and estimates of demographic parameters used in making projections were obtained primarily from surveys and census data. Since one of these estimated rates, that of HIV transmission rate through heterosexual encounters between an infected and an uninfected had a large range, we have provided two sets of projections based on the largest of these rates (worst-case scenario) and another that is consistent with the available data. The total projection of the number of HIV infected cases in Calcutta for 1999 is between 49,000 and 1,26,000. Separate projections are also provided for high-risk sub-groups. Among these, the sex workers expectedly will continue to manifest the highest numbers of newly infected cases. The temporal rate of increase in prevalence is projected to be alarmingly higher in the general population than even among sex workers, although the actual prevalence will continue to be the lowest in the general population compared to all other sub-groups of the population.

Female↗
PubMed1981

Development in education in occupational medicine in the United Kingdom.

Postgraduate medical education in the United Kingdom has changed. Now, five years of undergraduate training merely prepare a doctor for postgraduate training, whatever his specialty will be. After undergraduate training (and a year in hospital) all doctors do three years General Professional Training followed by some four years Higher Specialist Training. Occupational physicians do the same General Professional Training as physicians or primary care general practitioners. Their Higher Specialist Training lasts four years and is based on supervised practical experience in the factory or other place of work. After the first two years of this they take an examination covering the broad field of occupational medicine (AFOM). After the next two years of supervised practical experience the doctor has to present evidence of special study and can then become specialist (MFOM). In the U.K. about 70% of occupational physicians work part time. Their supervised practical experience is therefore spread over a long period. Many stop at the AFOM. If, later in their career, they change to full time in occupational medicine, they can proceed to the specialist qualification (MFOM). Most part-timers do other work and therefore cannot go away to one of the few universities that provide courses for the AFOM. Those who live near one of the few universities can go on day release. A "distance teaching" project has been started to take teaching material on occupational medicine such as audio tapes, tape slides, and video tapes to these doctor. It will be supplemented by local seminars and short courses at universities.

Education, Medical, Graduate↗
PubMed2006

Studies on cellulosic ethanol production for sustainable supply of liquid fuel in China.

As the biggest developing country, China faces a serious challenge in satisfying its need for huge amounts of energy resources, especially for liquid fuel. The Chinese government has recently started a bioethanol project, and has produced about 1 million tons of ethanol fuel from corn and wheat in 2005. As it has the largest population in the world and limited lands for food production, cellulosic ethanol would be a more suitable choice for China. Many research projects in China on biodegradation and biotransformation of lignocellulosics have been carried out. Furthermore, understanding the biodegradation mechanism of lignocellulosics and developing practical processes for ethanol production have been ongoing. After more than 30 years of research, several pilot scale facilities have been set up, and lots of experience has been acquired. However, the calculated production cost of cellulosic ethanol is still higher than that of corn ethanol. To overcome this problem, the biorefinery conception has been introduced into research on lignocellulosics transformation. A corncob biorefinery process has been developed in Shandong University. By combining the cellulase and ethanol production with a xylose-related products production, the total production cost can be reduced. A scale of 50,000-ton/year cellulosic ethanol biorefinery is being planned to be built at Yucheng.

Biomass↗
PubMed2003

Rapid expression cloning of receptors using epitope-tagged ligands and high-speed cell sorting.

BACKGROUND: In this study we describe a new approach for expression cloning of receptors. METHODS: Our approach was based on highly efficient transfer of retroviral cDNA libraries into target cells and detection of receptor-ligand interaction with the use of an antibody directed against an epitope tag on recombinant ligands. Detection of the complex and isolation of receptor-transduced cells were achieved by flow cytometry and rare event high-speed cell sorting. Recovery of the cDNA coding for the receptor(s) was achieved by polymerase chain reaction. RESULTS: As a proof-of-concept study we set out to clone the receptor for B-lymphocyte stimulator protein (BlyS), not known at the start of the project but reported while this work was in progress. First, we detected binding of epitope-tagged BlyS to IM9 cells. Second, human T-lymphoblasts (CEM cells), which do not bind BlyS, were transduced with a retroviral cDNA library generated from IM9 cells. Transduced CEM cells binding epitope-tagged BlyS protein were identified by flow cytometry. After three sequential rounds of cell sorting, transduced CEM cell populations with high binding capacity for BlyS were identified. To determine the cDNAs conferring binding to the transduced CEM cells, the integrated proviral DNAs were amplified by polymerase chain reaction and analyzed by DNA sequencing. Rescued cDNAs contained Transmembrane Activator and calcium-modulator and cyclophilin ligand (CAML) Interactor (TACI) and B-Cell Maturation factor (BCMA) sequences, representing two published receptors of BlyS. CONCLUSIONS: Our data demonstrated that flow cytometry and high-speed cell sorting combined with transduction of retroviral cDNA libraries and binding of epitope-tagged orphan ligands as a selectable phenotype can be used efficiently for expression cloning of receptors. Of particular interest was our finding that apparently it is not necessary to purify the ligand but that conditioned medium containing the ligand can be used instead. Thus we concluded that our approach shortens the time to identify receptors for many orphan ligands and helps to exploit these receptors as drug targets.

Antibodies↗