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PubMed1996

Computer-based diagnosis support for the interpretation of Hess charts.

Computer-based storage of patient data is the basis for their comprehensive use in science and patient care. Developing a data base for storage and interpretation of strabologic data must be prepared by an analysis of data items, terminologies, and diagnostic methods. We analyzed patient data collections and constructed a minimal strabologic data structure focused on methods for the examination of eye-muscle function. Geometric methods for the analysis of Hess charts help to prepare diagnostic parameters for assignment of Hess-result figures (classified according to their shapes) to certain diagnoses of muscle paresis. In this way the system can help in preparing and verifying diagnoses and structuring data according to various scientific or patient-management needs. Moreover, the system can support diagnostic training as it can present Hess charts, related diagnoses, and geometric parameters in a concise manner and hence enable learners to understand the diagnostic procedure.

Diagnosis, Computer-Assisted↗
PubMed1998

[Forty years study of systemic scleroderma (data of Institute of Rheumatology, Russian Academy of Medical Sciences)].

The basic stages and the results of 40-year studies of systemic scleroderma (SSD) at the Institute of Rheumatology, Russia Academy of Medical Sciences, are given. The goal-oriented studies of the systemic, peripheral, and visceral manifestations of the disease, which were undertaken in the 1960s basically altered our insight into the disease. Subsequently the diagnostic signs of the disease were developed, which substantially improved the diagnosis of SSD. Long-term studies examined the evolution of SSD and identified three major types of its course: acute, subacute, and chronic, which differ in the rapidity of progression of a pathological process, the pattern of clinical and morphological manifestations and prognosis, as evidenced by survival rates. The identified types of the course (n = 3) and clinical forms (n = 5) formed the basis for the Russia classification of SSD. Studying the pathogenesis of the disease mainly in the context of the mechanisms of formation of fibrosis and impaired microcirculation, as well as its clinical heterogeneity served as the basis for developing pathogenetic therapy regimens by differentially using disease-modifying agents and other therapeutical complexes. At present, the Institute of Rheumatology has accumulated unique experience in studying and following over 1500 patients with SSD and related diseases. There is a rise in the sclerodermal group of diseases, cross-over and combined forms of SSD along with great progress in the diagnosis and treatment, which enhances the quality of life of patients with SSD and prognosis in them.

Academies and Institutes↗
PubMed1995

[Decay of villages--population censuses at the end of the seventeenth century].

"The study raises an interesting methodological problem of population history research: the authenticity of bygone population censuses (in this case at the end of the 17th century [in Hungary]), their scientific applicability, and the interpretation of data...in these documents. The final conclusion of the study is that checking the data of population censuses from several aspects and accurate critics of the sources are extremely important...." (SUMMARY IN ENG)

Censuses↗
PubMedDate not supplied

Understanding the scientific issues embedded in the generic drug approval process.

OBJECTIVE: To review the major scientific issues embedded in the generic drug approval process. DATA SOURCES: Articles indexed initially under terms such as generic medications, generic drugs, bioequivalence, and bioinequivalence. These terms were used to search indexing services such as MEDLINE, International Pharmaceutical Abstracts, CINAHL (a database of nursing and allied health literature), and Science Citation Index. Additional data sources included the Code of Federal Regulations and regulatory guidances from the Food and Drug Administration (FDA) Center for Drug Evaluation and Research. STUDY SELECTION: Performed by the authors. DATA EXTRACTION: Not applicable. DATA SYNTHESIS: Despite the fact that regulations regarding bioequivalence have been in place for more than 20 years, controversies over bioequivalence continue to arise. Consensus on many of these issues is driving the development of new FDA guidances regarding bioequivalence. Still, despite the issuance of new guidance and consensus building among scientists, many clinicians and consumers remain uninformed regarding the scientific basis for establishing bioequivalence and the generic drug approval process in general. Although some have suggested that the generic drug approval process is flawed, overall, it appears that the process works. CONCLUSION: Understanding the generic drug approval process and the issues surrounding bioequivalence is of paramount importance to both clinicians and scientists.

Drug Approval↗
PubMedDate not supplied

Attrition in nursing: perspectives from the national survey of college graduates.

Problems with attracting and retaining nurses during a tight labor market are compounded by some fundamental issues related to attrition from the field. It is important to recognize that, of the students who graduate from nursing schools each year and enter the field of nursing, significant attrition occurs during the first 5 years in the profession [www.aacn.nche.edu/media/backgrounders/shortagefacts.htmaacn.nche.edu (2002)]. This article uses data from the National Science Foundation's National Survey of College Graduates to examine various scenarios and possible reasons for why some nurses abandon their careers [www.nsf.gov/sbe/srs/snscg/start.htm (2003)]. In doing so, we consider entry into, and attrition from, the nursing profession at various stages. Using data from the National Survey of College Graduates, the initial evaluation suggests that, at points during the career, the individual confronts potential problems and issues which can lead to career attrition.

Data Collection↗
PubMed1994

From Index Catalogue to Gopher space: changes in our profession as reflected in the Handbook and CPHSL.

A fifty-year review of the history of health sciences librarianship, as reflected in four editions of the Handbook of Medical Library Practice and its successor, Current Practice in Health Sciences Librarianship, illustrates the significant changes our profession has undergone. Publication in 1943 of the first edition of the Handbook marked an important milestone in the development of the Medical Library Association, as a group of dedicated volunteers documented standard practice and recorded useful data. Administration of health sciences libraries has moved from art to science. Responsibility for the development of collections is now the sole purview of professional librarians. Automation and bibliographic standards have revolutionized the methods for controlling and providing access to information resources. And, the means by which assistance is provided to library users, through the use of computer and telecommunications technology, has changed dramatically.

Cataloging↗
PubMed1987

Chemical information science coverage in Chemical Abstracts.

For many years Chemical Abstracts has included in its coverage publications on chemical documentation or chemical information science. Although the bulk of those publications can be found in section 20 of Chemical Abstracts, many relevant articles were found scattered among 39 other sections of CA in 1984-1985. In addition to the scattering of references in CA, the comprehensiveness of Chemical Abstracts as a secondary source for chemical information science is called into question. Data are provided on the journals that contributed the most references on chemical information science and on the languages of publication of relevant articles.

Abstracting and Indexing↗
PubMed2000

Pathophysiology of septic encephalopathy: a review.

OBJECTIVES: Encephalopathy is a common complication of sepsis. This review describes the different pathologic mechanisms that may be involved in its etiology. DATA SOURCES: The studies described here were derived from the database PubMed (http:¿¿www.nlm.nih.gov) and from references identified in the bibliographies of pertinent articles and books. The citations are largely confined to English language articles between 1966 and 1998. Older publications were used if they were of historical significance. STUDY SELECTION: All investigations in which any aspect of septic encephalopathy was reported were included. This selection encompasses clinical, animal, and in vitro cell culture work. DATA EXTRACTION: The literature cited was published in peer-reviewed clinical or basic science journals or in books. DATA SYNTHESIS: Contradictions between the results of published studies are discussed. CONCLUSIONS: The most immediate and serious complication of septic encephalopathy is impaired consciousness, for which the patient may require ventilation. The etiology of septic encephalopathy involves reduced cerebral blood flow and oxygen extraction by the brain, cerebral edema, and disruption of the blood-brain barrier that may arise from the action of inflammatory mediators on the cerebrovascular endothelium, abnormal neurotransmitter composition of the reticular activating system, impaired astrocyte function, and neuronal degeneration. Currently, there is no treatment.

Brain Diseases↗
PubMed1996

A biomechanical model of the lumbar spine during upright isometric flexion, extension, and lateral bending.

STUDY DESIGN: Task-specific and subject-specific lumbar trunk muscle function, muscle geometry, and vertebral density data were collected from 16 men. A biomechanical model was used to determine muscle strength and the compressive forces acting on the lumbar spine. OBJECTIVES: To develop an anatomic biomechanical model of the low back that could be used to derive task-specific muscle function parameters and to predict compressive forces acting on the low back. Several model-specific constraints were examined, including the notion of bilateral trunk muscle anatomic symmetry, the influence of muscle lines of action, and the use of density-derived vertebral strength for model validation. SUMMARY OF BACKGROUND DATA: Clinical and basic science investigators are currently using a battery of diverse biomechanical techniques to evaluate trunk muscle strength. Noteworthy is the large variability in muscle function parameters reported for different subjects and for different tasks. This information is used to calculate forces and moments acting on the low back, but limited data exist concerning the assessment of subject-specific, multiaxis, isometric trunk muscle functions. METHODS: A trunk dynamometer was used to measure maximum upright, isometric trunk moments in the sagittal (extension, flexion) and coronal (lateral flexion) planes. Task- and subject-specific trunk muscle strength or "gain" was determined from the measured trunk moments and magnetic resonance image-based muscle cross-sectional geometry. Model-predicted compressive forces obtained using muscle force and body force equilibrium equations were compared with density-derived estimates of compressive strength. RESULTS: Individual task-specific muscle gain values differed significantly between subjects and between each of the tasks they performed (extension > flexion > lateral flexion). Significant differences were found between left side and right side muscle areas, and the lines of action of the muscles deviated significantly from the vertical plane. Model-predicted lumbar compressive forces were 38% (lateral flexion) to 73% (extension) lower that the L3 vertebral compressive strength estimated from vertebral density. CONCLUSION: The present study suggests that biomechanical models of the low back should be based on task-specific and subject-specific muscle function and precise geometry. Vertebral strength estimates based upon vertebral density appear to be useful for validation of model force predictions.

Adult↗
PubMed1996

Fundamental analysis in research on well-being: distress and the sense of control.

Fundamental analysis defines the basic terms of social and behavioral research. It usually follows the rule "one concept to a measure." However, some responses inherently reflect more than one underlying attribute, as when a test score reflects both knowledge of the subject and practice with taking tests. The standard methods of fundamental analysis break down in the presence of such cross-cutting factors. In this article, we discuss two instances of confusion and disagreement among social and behavioral scientists generated by the effects of cross-cutting factors on critical measures. In the first instance, a tendency to agree with the statements of others can make beliefs about personal control over events and outcomes seem unrelated to beliefs about control by chance, fate, or powerful others. The tendency to agree correlates positively with age. In the second instance, emotional expressiveness can make the frequency or intensity of sadness seem unrelated to the frequency or intensity of happiness. Women, who make up the large majority of older Americans, express themselves more freely than men. The apparent disjointedness of internal and external attributions of control, or of positive and negative emotions, results from methods assuming that the response to each question reflects one and only one underlying factor. Cross-cutting factor models eliminate the bias and confusion produced by response tendencies and help isolate and define the essential dimensions of response.

Aged↗
PubMed1987

Laboratory experiments in the study of the chemistry of the outer planets.

The investigation of chemical evolution of bodies in our solar system has, in the past, included observations, theoretical modeling, and laboratory simulations. Of these programs, the last one has been the most criticized due to the inherent difficulties in accurately recreating alien environments in the laboratory. Processes such as wall reactions and changes in chemistry due to difficulties in achieving realistic conditions of temperature, pressure, composition, and energy flux may yield results which are not truly representative of the systems being modeled. However, many laboratory studies have been done which have yielded data useful in planetary science. Gross simulations of atmospheric chemistry have placed constraints on the nature of complex molecules expected in planetary atmospheres. More precise studies of specific chemical processes have provided information about the sources and properties of product gases and aerosols. Determinations of basic properties such as spectral features and reaction rate constants yield data useful in the interpretation of observations and in computational modeling. Alone, and in conjunction with modeling, laboratory experiments will continue to be used to further our understanding of the outer solar system, and some experiments that need to be done are listed.

Aerosols↗
PubMed1996

Clinical trials of arrhythmia management: methods or madness.

Some randomized controlled clinical trials (RCTs) involving antiarrhythmic agents have recently reported unexpected findings. Cardiologists have tried to explain these unforeseen results by pointing to possible inadequacies of trial design. Details of the design and the conduct of RCTs are essential for the proper interpretation of the data that emerge from the trial. Unless an RCT is carefully designed and meticulously conducted, the results may be difficult to interpret. Some trials of antiarrhythmic drugs and management strategies have had design faults that have complicated the interpretation of the trial data. Clinical trial results are only one component of the body of knowledge that clinicians must use when they plan patient management and prescribe therapies. Data from the basic sciences, other branches of medicine, personal experience, and clinical trials must all be available in order to reach the best decision. It is inappropriate to rely exclusively on the results of clinical trials because individual patients and their problems rarely, if ever, fully match the characteristics of patients enrolled into clinical trials. However, data from good RCTs should form an important base for clinical decision making.

Anti-Arrhythmia Agents↗
PubMedDate not supplied

Improving resource efficiency through management science.

Optimal management of resources is a very complex and difficult task for healthcare systems. Nevertheless, healthcare providers can employ data-driven methodologies and management science tools, coupled with managerial insights, to significantly improve both their resource effectiveness and efficiency. Understanding the full technical complexities of management science models is a daunting task for healthcare managers, but they can be aided by the increased availability of management science software. Readily available software does not require extensive technical competencies and is easily adaptable to resource changes. This article reports how a large healthcare system improved the cost effectiveness and service efficiency of its laboratory courier service through the use of management science techniques and readily available software. The laboratory courier system existed to serve a large multihospital healthcare system located in a major Texas metropolis. The routing and scheduling solution reported in this article yielded a very substantial 16.4 percent reduction in annual laboratory courier costs and a significant improvement in service levels. This study indicates that management science techniques and software are readily adaptable to the healthcare environment and are amenable to use by healthcare administrators.

Cost-Benefit Analysis↗