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At least 577 records · Page 32Linked to original sources
PubMed1987

Mass screening for cervical cancer in Ostfold county of Norway 1959-77.

In 1959, the Norwegian Cancer Society started a research project in Ostfold county to assess the effect of a mass screening program for cervical cancer. The program comprised 5 screening rounds during the period 1959-77. At each screening a clinical gynecological examination was performed in addition to the cytological test. A total of 45,960 women aged 25-59 years at the first screening were invited to participate. The follow-up, which was based on the data base of the Cancer Registry of Norway, lasted until December 31, 1982. For the follow-up period as a whole, the observed incidence and mortality were reduced to 78% and 83% of the expected values, respectively. Through the initial phase of the program there was a cumulation of patients with early-stage disease, while the incidence of advanced disease and mortality were reduced. In the later part of the follow-up period, a decrease in incidence of early and advanced disease as well as in mortality was observed. Women not participating in the screening program had a significantly higher risk of cervical carcinoma than the reference population, and a less favorable stage distribution as well. Among participants in the screening program, the reduction of risk was dependent upon the number of previous negative smears. Women with 5 previous negative smears had a risk of disease which was only 18% of that expected. Problems concerning choice of reference population, migration, attendance rates, sensitivity and specificity of the cytological tests and intervals between screenings are discussed. Also, the probable conversion rates of pre-cancerous lesions to cancer and the health hazards involved in possible over-treatment of pre-cancerous cases which otherwise would have regressed, are considered. A dynamic model is suggested. In order to achieve a reduction of mortality in the short term, the efforts of the program should initially be concentrated on older women. To achieve a reduction of incidence in the long run, younger women should gradually be included. Finally, special efforts should be made to increase attendance rates among high-risk women.

Adult↗
PubMed1994

From dialysis to basic paediatric nephrology: an unorthodox project applied in Yerevan, Armenia.

Following the earthquake in December 1988, a long-term project was developed: starting from haemodialysis, it was extended to basic nephrology and urology, with a programme for schooling and psychosocial care. Medical training had first priority. The programme relied on robust and often second-hand equipment and voluntary work. The approach chosen (an inverse help programme, from sophisticated to basic medicine) strongly stimulated motivation and proved to be practicable.

Adolescent↗
PubMed1994

Decision trees based on automatic learning and their use in cardiology.

Computerized information systems, especially decision support systems, have become an increasingly important role in medical applications, particularly in those where important decision must be made effectively and reliably. But the possibility of using computers in medical decision making is limited by many difficulties, including the complexity of conventional computer languages, methodologies and tools. Thus a conceptual simple decision making model with the possibility of automating learning should be used. In this paper we introduce a cardiological knowledge-based system based on the decision tree approach supporting the mitral valve prolapse determination. Prolapse is defined as the displacement of a bodily part from its normal position. The term mitral valve prolaps (PMV), therefore, implies that the mitral leaflets are displaced relative to some structure, generally taken to the mitral annulus. The implications of the PMV are the following: disturbed normal laminar blood flow, turbulence of the blood flow, injury of the chordae tendinae, the possibility of thrombus's composition, bacterial endocarditis, and finally hemodynamic changes defined as mitral insufficiency and mitral regurgitation. Uncertainty persists about how it should be diagnosed and about its clinical importance. It is our deep belief that the echocardiography enables properly trained experts armed with proper criteria to evaluate PMV almost 100%. But unfortunately, there are some problems concerned with the use of echocardiography. In that manner we have decided to start a research project aimed at finding new criteria and enabling the general practitioner to evaluate PMV using conventional methods and to select potential patients from the general population.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1999

[Arguments and basic principles for continuous monitoring of social differences in the health of Swiss children].

On the basis of the thesis that social inequality has increased during the nineties in all western societies, and that this development is a reason for considerable concern with respect to public health, the authors propose the establishment of a long term monitoring system within the Swiss school health services. A re-analysis of the data obtained in a Swiss epidemiological study of seven-year-olds in the eighties demonstrates that social class was an important determinant of health and development of these children also during a period of economic boom. For various health and developmental problems odds-ratios (lower class vs. upper class) between 1.7 and 6.4 were found. Social class of the parents is considered as a reliable indicator of the socio-economic situation of children also for future long term observations. The number of significant somatic health problems as well as disorders of motor and speech development of six- or seven-year-olds are proposed as indicators of health status which can be assessed repeatedly at reasonable cost and with standardised methodology. This project could be started rather easily within the newly established Swiss "Health Observatory".

Child↗
PubMed1985

Research in the Division of Pharmaceutical Technology.

Within the Center for Bio-Pharmaceutical Sciences the release characteristics of drugs form the major research object of the Division of Pharmaceutical Technology. Transdermal systems are being developed that can supply a drug during several days. Irritation of the skin may be avoided by using hydrogels. To enable long-term transdermal application also the colloidal structure of creams and ointments is investigated. As most drugs are to be taken orally, however, a research project was also started to make cheap and easy to produce controlled release tablets. The results with a microporous polypropylene polymer are promising.

Academies and Institutes↗
PubMed2006

The facial skin lesions "see and treat" clinic: A prospective study.

Facial lesions are commonly referred to ear, nose and throat surgeons. Almost all are amenable to excision under local anaesthetic as a day case. However, in the UK, there is still a significant delay between referral by the general practitioner (GP) and final surgery. To address this delay, a one stop see and treat consultant led clinic was set up in the community. The aim of this study was to assess the impact of the one stop clinic on waiting times and to ascertain the satisfaction of patients with the treatment they received in this clinic. Patients with facial skin lesions were referred by the GPs to the ENT department in the usual manner. The referral letters were screened by two consultants, the appointments were booked by telephone and the patients were seen and treated in a single visit. The clinics were held in a minor surgery unit of a centrally located GP practice. Patients were seen, assessed and if the facial lesion was considered amenable to excision under local anaesthetic, the patient was consented and the procedures carried out immediately. The clinic was audited over a 1 year period. Waiting times were compared before and after the start of the project. Patients were asked to fill in a questionnaire immediately after surgery. The attendance rate was 96%. The waiting time was reduced from 121 to 47 days. Patients rated the clinic experience as excellent (88%) or good (12%) indicating a very high satisfaction rate. During the study period, 160 lesions were excised of which 22% were malignant. Patients with malignant lesions did not show any sign of recurrence at a follow up of 9 months, except in one case with basal cell carcinoma. This was operated on and removed completely. Our project shows that the aims of reducing waiting times and improving patient care were achieved with this community model of a one stop facial lesions clinic. This clinic is now an integral part of the service provided by the ear, nose and throat department at Ipswich hospital, UK.

Ambulatory Care Facilities↗
PubMed1992

Extra enforcement and the use of seat belts by drivers in Illinois.

The use of seat belts by drivers was measured in three target and three control cities in Illinois before, during, and after the application of heightened police enforcement of the seat belt law in the target cities. The extra enforcement produced increases in the use of seat belts by drivers during the four months of the heightened enforcement. Observations of seat belt use continued for four months after the end of the enforcement, and a substantial residual effect remained in two of the three target cities. In one target city the use of seat belts had dropped close to the level at the start of the project by the end of the second month after the end of enforcement. Taking account of the percentage of drivers who became aware of the increased enforcement suggested that a sustained program of enforcement may result in 60%-70% of drivers using seat belts.

Cooperative Behavior↗
PubMed1995

Ergonomic development work: co-education as a support for user participation at a car assembly plant. A case study.

This study deals with the design, trials and evaluation of a co-education programme at the Volvo Uddevalla plant in Sweden. Involving operators, manufacturing engineers and managers, the programme served as a support for the creation of a participatory ergonomics process, intended for continuous use at the plant. It consisted of a basic ergonomics knowledge package, and a dialogue model defining the roles and relations of actors involved. As a practical part of the programme, trial development projects were also carried out by the participants. The main and long term objective of the project was to start the participants cooperating in a continuous change and development process on the shop-floor. The outcome of the co-education programme was evaluated immediately after the first two regular courses, and, as a longterm follow-up, after seven subsequent courses shortly after the closing of the Uddevalla plant. The co-education programme was shown to be successful. Later on, the expertize of both operators and manufacturing engineers became obvious to everyone at the plant, and the cooperation between operators and manufacturing engineers increased steadily. The main conclusion drawn was that the co-education programme is a good starting point for a process of participation and industrial change work. However, in order to get a permanent impact, the whole organization must nurse and nourish the further development, and implementation of the process.

Journal Article↗
PubMed1993

Cephalometric evaluation of the changes in patients wearing complete dentures: a 20-year study.

The purpose of this continuing longitudinal investigation was to study the changes on the craniofacial complex in complete denture wearers; herein are reported the 20-year findings. At the onset of the study complete dentures were made for 64 persons. Two dentures techniques were employed: a complex method of construction and a simplified method. At the start of the project the patients' ages ranged from 30 to 60 years (average age 53 years) and all had been edentulous for at least 1 year (range 1 to 30 years). Lateral cephalometric radiographs were made immediately after initial placement of the dentures and during subsequent years (1, 2, 3, 4, 5, 7, 10, 15, and 20). The same cephalostat was used throughout and all films were exposed with the teeth in centric occlusion. Thirty-four subjects presented for the 20-year follow-up. Of this number, the radiographs of 24 subjects (14 women and 10 men; average age 65.5 years [range 50-83 years]) (12 complex denture wearers; 12 simplified technique denture wearers) were used in this report (10 had denture alterations over the 20-year period that excluded them). The 20-year observations corroborate earlier findings. There is a loss of the vertical dimension of occlusion as viewed from the right profile, and the mandible rotates in a counterclockwise fashion resulting in an increase in relative prognathism. The maxillary alveolus was stable, the mandibular alveolus resorbed, and the dentures rotated counterclockwise and shifted slightly forward. The observed changes were not significantly affected by the sex of the patient or by the denture technique employed.

Aged↗
PubMed1993

A prototype integrated medical workstation environment.

In this paper the requirements, design, and implementation of a prototype integrated medical workstation environment are outlined. The aim of the workstation is to provide user-friendly, task-oriented support for clinicians, based on existing software and data. The prototype project has been started to investigate the technical possibilities of graphical user-interfaces, network technology, client-server approaches, and software encapsulation. Experience with the prototype encouraged discussion on both the limitations and the essential features for an integrated medical workstation.

Computer Graphics↗
PubMed2006

Implementation of computerized alcohol screening and advice in an emergency department--a nursing staff perspective.

Changes in attitudes towards alcohol prevention among nursing staff are evaluated after implementing an opportunistic computerized alcohol screening and intervention (e-SBI) at an emergency department. After having assessed the patients in the triage room the nurses asked patients to perform the e-SBI on a touch screen computer. Before the start of the project more than 60% of the nurses expected the patients to react negatively when asked about their alcohol habits. After one year of screening only 10% reported experience of negative reactions from the patients. More than 50% of the nurses found it easy or very easy to ask the patients to perform the e-SBI and more than 75% of the nurses agreed that the e-SBI did not affect their workload. The proportion of nurses who considered alcohol prevention to be part of their duties at the emergency department did not change (40%) after implementing the e-SBI. During the two-year study period, 1982 patients completed the e-SBI which constituted 10-20% of all patients between 16 and 70 years of age attending the department for a sub critical condition. The e-SBI seems to have better potential than ordinary alcohol screening and intervention for implementation into routine emergency departments due to its simplicity and low time consumption.

Adolescent↗
PubMed2005

An exploratory study of depression among older African American users of an academic outpatient rehabilitation program.

Variation in the presentation of depressive illness among older African Americans may complicate assessment of depression, especially among those with multiple medical comorbidities and functional disabilities. The purpose of this study was to explore the prevalence of depression among older poor African Americans attending an academic outpatient rehabilitation program, using a depression measure with low somatic item content. Correlates of depression in this population also were explored. Health-care records of 150 older African Americans seen over a 2-year period were examined. Depression was assessed on admission using the 30-item Geriatric Depression Scale (GDS). Using a GDS cutoff score for depression of 11 or higher, 30% of the sample (age 75.5 +/- 7.16 years, range 65-95, 75% women) scored positive for depression. Nine percent also reported having suicidal thoughts within the previous week. Consistent with existing literature, depressed patients, as compared to nondepressed patients, were significantly younger, more suicidal, more likely to rate their general health as poor, had higher mean ratings of pain, and more often limited their social activities. Six GDS items were found to have little ability to discriminate between depressed and nondepressed patients: satisfaction with life, getting bored easily, prefer staying at home, find life exciting, getting started on new projects, and full of energy. The authors recommend further testing of the GDS with similar populations of older, poor, medically ill, and functionally disabled older adults.

Academic Medical Centers↗
PubMed2007

Biomonitoring of PCDD/Fs in populations living near portuguese solid waste incinerators: levels in human milk.

In the context of two Environmental Health Surveillance Programs, launched in response to public and scientific concern in relation to waste incinerators located near Lisbon and in Madeira Island, two human biomonitoring projects have been started in Portugal, focussed in dioxins and dioxin-like compounds in human milk. Results from the undertaken studies have already provided data on the extent and pattern of dioxin body burden of both studied groups as well as a preliminary temporal trend of dioxin levels for the population residing near Lisbon incinerator. The present paper investigates difference between exposed and non-exposed subjects under study and, from a preventive perspective, possible covariates of the dioxin levels in human milk. Emissions from both incinerators appear to be well controlled as there is no increase of human body burden of dioxins as measured in human milk of individuals living near these facilities. Concerning other determinants of dioxin levels, results suggest confirmation of previously found significant age-dependent trend towards higher levels of dioxins in aged subjects. On the contrary, association between mother's levels of dioxins and parity lost significance. Apart from the issue of incineration, the general conclusion for the general population is that living in Lisbon as compared to Madeira results in higher milk dioxin levels and possible health risks. The profile of the single congeners for PCDD/Fs in human milk from Madeira and Lisbon shows similar contributions for 12378-PCDD, 23478-PCDF, 123678-HCDD and 2378-TCDD, that account altogether for about 84% of the total identified dioxin body burden in the studied groups.

Adult↗
PubMed2005

Helping social workers address the educational needs of foster children.

OBJECTIVE: The main aim was to evaluate the effectiveness of the Education Initiative, an intervention program in one of the largest urban counties in the US seeking to increase the responsiveness of social workers to the educational needs of foster children. METHOD: A pre-post test control group design was used. Data from case files and social workers were examined at the start of the project and 18 months later to determine changes in social workers' (a) knowledge and practices regarding school programs and services and (b) maintenance of educational records for children on their caseloads. RESULTS: Data were analyzed from approximately 300 case files and over 200 questionnaires completed by social workers. Findings indicated that social workers who received training and had access to an education liaison (1) increased their knowledge about the school system and (2) were more likely to gather current educational data and comment on schooling needs in the case files. On questionnaires measuring knowledge and practices, supervisory social workers showed no gains while case workers increased their levels of knowledge and involvement. CONCLUSIONS: Evaluative data from both sources support the effectiveness of this collaborative model between the school and child welfare agency for addressing the educational needs of foster youth. Social workers in the pilot offices knew more and focused more on the school experience of youth on their caseloads than workers in the control offices. They reported more educational information in the case files and solicited current progress reports from the schools. Discrepancies between worker and school reported performance data raise questions as to whether social workers by themselves are the most effective advocates for foster children.

Adolescent↗
PubMed2004

Oligonucleotide microarrays in microbial diagnostics.

Oligonucleotide microarrays offer a fast, high-throughput alternative for the parallel detection of microbes from virtually any sample. The application potential spreads across most sectors of life sciences, including environmental microbiology and microbial ecology; human, veterinary, food and plant diagnostics; water quality control; industrial microbiology, and so on. The past two years have witnessed a rapid increase of research in this field. Many alternative techniques were developed and validated as seen in 'proof-of-concept' articles. Publications reporting on the application of oligonucleotide microarray technology for microbial diagnostics in microbiology driven projects have just started to appear. Current and future technical and bioinformatics developments will inevitably improve the potential of this technology further.

Ecosystem↗
PubMed2001

Na(+)/H(+) antiporters.

Na(+)/H(+) antiporters are membrane proteins that play a major role in pH and Na(+) homeostasis of cells throughout the biological kingdom, from bacteria to humans and higher plants. The emerging genomic sequence projects already have started to reveal that the Na(+)/H(+) antiporters cluster in several families. Structure and function studies of a purified antiporter protein have as yet been conducted mainly with NhaA, the key Na(+)/H(+) antiporter of Escherichia coli. This antiporter has been overexpressed, purified and reconstituted in a functional form in proteoliposomes. It has recently been crystallized in both 3D as well as 2D crystals. The NhaA 2D crystals were analyzed by cryoelectron microscopy and a density map at 4 A resolution was obtained and a 3D map was reconstructed. NhaA is shown to exist in the 2D crystals as a dimer of monomers each composed of 12 transmembrane segments with an asymmetric helix packing. This is the first insight into the structure of a polytopic membrane protein. Many Na(+)/H(+) antiporters are characterized by very dramatic sensitivity to pH, a property that corroborates their role in pH homeostasis. The molecular mechanism underlying this pH sensitivity has been studied in NhaA. Amino acid residues involved in the pH response have been identified. Conformational changes transducing the pH change into a change in activity were found in loop VIII-IX and at the N-terminus by probing trypsin digestion or binding of a specific monoclonal antibody respectively. Regulation by pH of the eukaryotic Na(+)/H(+) antiporters involves an intricate signal transduction pathway (recently reviewed by Yun et al., Am. J. Physiol. 269 (1995) G1-G11). The transcription of NhaA has been shown to be regulated by a novel Na(+)-specific regulatory network. It is envisaged that interdisciplinary approaches combining structure, molecular and cell biology as well as genomics should be applied in the future to the study of this important group of transporters.

Amino Acid Sequence↗
PubMed2002

Effects of parental style of interaction on language development in very young severe and profound deaf children.

AIMS: (1) To study the influence of different styles of parent-child interaction in the language development of very young deaf children. (2) To find out if there are differences in parent-child interaction between two groups of very young deaf children following an Aural/Oral or a Bilingual approach to education. METHODS: Subjects were selected from all deaf children in the County of Avon who were under 3 years of age at the time of first assessment, had severe or profound, bilateral, sensorineural hearing loss and no associated medical problems. There were 16 children and families at the start of the project but only 13 completed all the assessments. The Bristol Language Developmental Scales (BLADES) was used to assess both sign and spoken language development. Interaction was studied through analysis of contingency and book-reading applied to selected periods of 3 min from four videorecorded sessions, taken at 3 months intervals for a period of 1 year. RESULTS: From the 13 children studied, only seven presented with some degree of expressive language measurable by the BLADES. Analysis of contingency showed that parents present with higher percentage of both Direct Related Acts and ON then their children Acts (On Acts: where both individuals are involved in the same task). Regarding bookreading, it was observed that parents often attend to child initiatives and acknowledge most of them but they make little effort to expand or use the child's message as topic for further conversation. In the reduced sample of seven children with expressive language, those with better language development had parents with: (a) higher percentage of DR acts; (b) higher percentage of ON acts; (c) higher percentage of appropriate responses to child communicative initiatives. CONCLUSIONS: In this small group language development seems to be facilitated by encouraging child participation and using a more contingent and child centred interaction. No significant differences were found between oral and bilingual families in terms of quality of interaction.

Child, Preschool↗
PubMed1999

Ras-mediated signaling pathway regulates the expression of a low-molecular-weight heat-shock protein in fission yeast.

In fission yeast, Schizosaccharomyces pombe, deficiency of ras1 gene causes an abnormal cell shape and abolishes mating ability. However, target genes of this signaling pathway are largely unknown because of the lack of an appropriate analysis system. To overcome this problem, we have started a novel project to categorize entire genes based on their expression levels under different growth conditions. Using this strategy, we screened genes whose expression levels were affected in the presence or absence of the ras1 gene product. For this purpose, we utilized high-density arrays of clones covering the entire genome of the fission yeast, and probed with labelled cDNA derived from various strains and growth conditions. Here, we demonstrate the detection of a low-molecular-weight heat-shock protein gene, hsp16, whose expression is very likely to be regulated by a ras-mediated signaling pathway, but not by the heat-shock response.

Amino Acid Sequence↗