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PubMed1997

[Report on medico-legal data from the mass-investigation performed by the Medico-Legal Society of Japan (XIV). Autopsy cases of traffic accidents in Japan (1990-1994). Planning and Development Committee of The Medico-Legal Society of Japan].

Autopsy findings in 3, 185 cases of death due to traffic accidents obtained from all institutions belong to the Medico-Legal Society of Japan between 1990 and 1994 were analyzed statistically. The results are summarized as follows: 1) The annual number of autopsy cases related to traffic accidents was stable and accounted for 10% of all autopsy cases examined. The autopsy cases also accounted for only 6% of all deaths due to traffic accidents. Cases requiring judicial autopsy are few despite the fact that deaths due to traffic accidents are considered deaths resulting from professional negligence. 2) The purposes of autopsy were, in a decreasing order of frequency, (1) to examine whether the accident was a hit-and-run case, (2) to examine whether the case was multiple accidents, and (3) to clarify the relationship of death with the accident. 3) According to the age, those who were involved in accidents while they were on foot overwhelmingly aged 70 years or above, and those who were involved in accidents while they were riding motorcycles were predominantly in their teens to the 20's. Concerning the situation of the accident, run-over cases, were frequently those in their 40's, and collision cases were predominantly those in their 70's. Among those who died in cars, the drivers were most frequently those in their 50's, followed by those in their 20's. 4) The degree of external and internal injuries was compared. About half the victims sustained severe injuries both internally and externally, and the remaining half sustained mild external injuries and severe internal injuries. Run-over cases generally had severe injuries both internally and externally, but collision cases tended to have mild external injuries and severe internal injuries. 5) The most frequent cause of death was brain injury, followed by loss of blood and traumatic shock. 6) Tire marks were observed in 23% of the run-over cases, and they were observed in the head, face, neck, and thoracoabdominal region in most cases. 7) Of the collision cases, collision injuries were observed in 55.6%, and the sites of collision injuries were the crural and femoral regions. 8) Of those who died in the car, about 46% were the drivers. 9) Deaths while driving due to internal causes accounted for 3% of all autopsy cases who died in traffic accidents, and ischemic heart disease was the most frequent of the internal causes. 10) Concerning injuries caused by safety devices, 3.5% of the drivers and 4.4% of non-driver passengers were injured by the seat belts, and 3.9% of those who were riding motorcycles were injured by the helmets. 11) Alcohol was detected from 47.7% of the cadavers examined, and the alcohol level was 0.5 mg/ml or above in 19% of those driving and 50.2% of those on foot. 12) Stimulants were detected in 5 (3.8%) of 132 cases examined, and thinner was detected in 17 (13.0%) of 131 cases examined.

Accidents, Traffic↗
PubMed1997

[Report on medico-legal data from the mass-investigation performed by The Medico-Legal Society of Japan (XV). Autopsy cases of therapeutic complications and other medical misadventures in Japan (1981-1991). Planning and Development Committee of The Medico-Legal Society of Japan].

As the continuation of the previous report covering the period of 5 years (1976-1980) from the Medico-Legal Society of Japan, a statistical study was made of therapeutic fatal complications examined by forensic pathologists in Japan in the 11 year period between 1981 and 1991. The total number of the cases obtained was 315, composed of 179 male and 136 female cases. Eighty cases (male 33, female 47) were associated with anesthesia, 74 (53, 21) with injections except anesthetics, 31 (13, 18) with operations, labor and clinical examinations, and 14 (9, 5) with drug administration or inhalation of drugs, respectively. Three cases were associated with blood transfusion and other 3 cases with hemodialysis. Fifteen patients died owing to erroneous diagnosis at the first medical examination. There were 9 cases of drug misuse, of which 7 cases were administered drugs through a wrong route and 2 were carelessly given a drug different from prescription. Miscellaneous cases where autopsy revealed diseases, nursing mishaps, etc. to account for death were 86 (51, 35) in number. Except for the miscellaneous cases, the number of therapeutic fatal complications tends to decrease gradually in comparison with that of the preceding 5 years (1976-1980). Medical practitioners should especially be aware of a slightly large number of the deaths associated with wrong diagnosis as well as those with anesthesia, injections and operations, labor and clinical examinations.

Adolescent↗
PubMed2000

The exchange of radiotherapy data as part of an electronic patient-referral system.

PURPOSE: To describe the implementation and use of an electronic patient-referral system as an aid to the efficient referral of patients to a remote and specialized treatment center. METHODS AND MATERIALS: A system for the exchange of radiotherapy data between different commercial planning systems and a specially developed planning system for proton therapy has been developed through the use of the PAPYRUS diagnostic image standard as an intermediate format. To ensure the cooperation of the different TPS manufacturers, the number of data sets defined for transfer has been restricted to the three core data sets of CT, VOIs, and three-dimensional dose distributions. As a complement to the exchange of data, network-wide application-sharing (video-conferencing) technologies have been adopted to provide methods for the interactive discussion and assessment of treatments plans with one or more partner clinics. RESULTS: Through the use of evaluation plans based on the exchanged data, referring clinics can accurately assess the advantages offered by proton therapy on a patient-by-patient basis, while the practicality or otherwise of the proposed treatments can simultaneously be assessed by the proton therapy center. Such a system, along with the interactive capabilities provided by video-conferencing methods, has been found to be an efficient solution to the problem of patient assessment and selection at a specialized treatment center, and is a necessary first step toward the full electronic integration of such centers with their remotely situated referral centers.

Computer Communication Networks↗
PubMed1997

Sustainable water future with global implications: everyone's responsibility.

The current use and management of freshwater is not sustainable in many countries and regions of the world. If current trends are maintained, about two-thirds of the world's population will face moderate to severe water stress by 2025 compared to one-third at present. This water stress will hamper economic and social development unless action is taken to deal with the emerging problems. The Comprehensive Assessment of the Freshwater Resources of the World, prepared by the UN and the Stockholm Environment Institute, calls for immediate action to prevent further deterioration of freshwater resources. Although most problems related to water quantity and quality require national and regional solutions, only a global commitment can achieve the necessary agreement on principles, as well as financial means to attain sustainability. Due to the central and integrated role played by water in human activities, any measures taken need to incorporate a wide range of social, ecological and economic factors and needs. The Assessment thus addresses the many issues related to freshwater use, such as integrated land and water management at the watershed level, global food security, water supply and sanitation, ecosystem requirements, pollution, strengthening of major groups, and national water resource assessment capabilities and monitoring networks. Governments are urged to work towards a consensus regarding global principles and guidelines for integrated water management, and towards their implementation in local and regional water management situations. The alternative development options available to countries facing water stress, or the risk thereof, needs to be considered in all aspects of development planning.

Conservation of Natural Resources↗
PubMed2003

A conceptual framework for intelligence-based public health nutrition workforce development.

OBJECTIVE: This paper describes a conceptual framework and associated intelligence requirements for problem-based workforce development for public health nutrition. METHODS: A conceptual framework for public health nutrition workforce development was constructed based on a review of the literature and consideration of the intelligence needs to inform workforce development planning. RESULTS: A cyclical conceptual framework including five intelligence-linked components including public health nutrition problems and priorities, solutions and best buys, work needed, capacity to do the work and workforce development needs. This framework applied to the Australian situation illustrates its applications in workforce development research and planning. Although the existing availability of workforce development intelligence in each of these components varies, the framework does provide a systematic approach for workforce development research and planning directly related to public health nutrition problem resolution. CONCLUSIONS: This framework highlights deficiencies in the existing public health nutrition workforce development intelligence and the need for further research to inform workforce development strategy planning.

Australia↗
PubMed2006

Prevention and Control of Influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP).

This report updates the 2005 recommendations by the Advisory Committee on Immunization Practices (ACIP) regarding the use of influenza vaccine and antiviral agents (CDC. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2005;54[No. RR-8]:1--44). The 2006 recommendations include new and updated information. Principal changes include 1) recommending vaccination of children aged 24-59 months and their household contacts and out-of-home caregivers against influenza; 2) highlighting the importance of administering 2 doses of influenza vaccine for children aged 6 months--<9 years who were previously unvaccinated; 3) advising health-care providers, those planning organized campaigns, and state and local public health agencies to a) develop plans for expanding outreach and infrastructure to vaccinate more persons than the previous year and b) develop contingency plans for the timing and prioritization of administering influenza vaccine, if the supply of vaccine is delayed and/or reduced; 4) reminding providers that they should routinely offer influenza vaccine to patients throughout the influenza season; 5) recommending that neither amantadine nor rimantadine be used for the treatment or chemoprophylaxis of influenza A in the United States until evidence of susceptibility to these antiviral medications has been re-established among circulating influenza A viruses; and 6) using the 2006-07 trivalent influenza vaccine virus strains: A/New Caledonia/20/1999 (H1N1)-like, A/Wisconsin/67/2005 (H3N2)-like, and B/Malaysia/2506/2004-like antigens. For the A/Wisconsin/67/2005 (H3N2)-like antigen, manufacturers may use the antigenically equivalent A/Hiroshima/52/2005 virus; for the B/Malaysia/2506/2004-like antigen, manufacturers may use the antigenically equivalent B/Ohio/1/2005 virus. A link to this report and other information can be accessed at http://www.cdc.gov/flu.

Adolescent↗
PubMed2003

Universal coverage and public health: new state studies.

Recent evaluations of the California Health Service Plan (CHSP) confirmed that financing health care through a single government payer can provide universal coverage-while saving significantly on health care spending-to a degree unparalleled by alternative approaches. Public ownership of the delivery system can further provide authority and accountability for critical reforms that improve the population's health and quality of care, including coordination of the delivery system. The federal government's State Planning Grant Program provides states with funding to develop plans to cover their uninsured populations. California created a Health Care Options Project that requested proposals that could expand coverage and contracted with a financial modeler and a qualitative analyst to evaluate the resulting plans. The CHSP was one of 9 plans evaluated through this process.

California↗
PubMedDate not supplied

Population size, distribution and growth in Iran.

The author examines population size, distribution, and growth in Iran using data for 1966, 1976 census data, and some historical data for the nineteenth century. "This paper discusses changes in the size of population through time, population distribution, and regional patterns of population growth of the 23 provinces. It has been argued in this paper that because of a large family size norm as a religious duty to increase the numbers of the Islamic faith, early age at marriage, especially among females, common practice of polygamy, and the war with Iraq, population will grow even faster. It is concluded that population policy must be integrated into the national development plans."

Asia↗
PubMed2000

Bioterrorism: challenges and opportunities for local health departments.

The emerging threat of bioterrorism will significantly impact local health departments. If a bioterrorism attack occurs, local medical and public health personnel will have the primary role of recognition and response. Federal assistance and training to deal with bioterrorism have been directed to 120 of our largest cities. Despite progress, much needs to be done. The public health approach to bioterrorism must begin with the development of local and state plans developed by public health, emergency response, and law enforcement communities, which must work together closely if an epidemic is to be detected in a timely manner.

Biological Warfare↗
PubMed1994

How economic development and family planning programs combined to reduce Indonesian fertility.

This paper examines the contributions of family planning programs, economic development, and women's status to Indonesian fertility decline from 1982 to 1987. Methodologically we unify seemingly conflicting demographic and economic frameworks into a single "structural" proximate-cause model as well as controlling statistically for the targeted (nonrandom) placement of family planning program inputs. The results are consistent with both frameworks: 75% of the fertility decline resulted from increased contraceptive use, but was induced primarily through economic development and improved education and economic opportunities for females. Even so, the dramatic impact of the changes in demand-side factors (education and economic development) on contraceptive use was possible only because there already existed a highly responsive contraceptive supply delivery system.

Adolescent↗
PubMed1996

Analysis of Lower Green Bay and Fox River, Collingwood Harbour, Spanish Harbour, and the.Metro Toronto and Region Remedial Action Plan.(RAP) Processes

This article presents a model of remedial action planning, which includes four key variables that determine progress in plan development and implementation and explain the differing level of achievement in individual sites. The model is illustrated by the characteristics and developments of four remedial action plan (RAP) processes (Lower Green Bay and Fox River, Collingwood Harbour, Spanish Harbour, and the Metro Toronto and Region RAPs). Differences in the local context of the plans have, to a significant degree, predisposed individual planning and implementation experiences. Local context includes three variables, namely geographical-technical and sociopolitical aspects and the previous history of water pollution management in the area. RAP precursors are a necessary precondition for progress in planning and substantive achievements. While there is a tendency that most geographically focused RAPs in administratively simple areas accomplish most, the motivation and political clout of RAP participants are strongly intervening factors. Resource input from upper levels of government, in particular financial commitment for plan implementation, is the fourth necessary ingredient for progress due to the RAPs' weak regulatory and institutional framework. Unfortunately, upper levels of government have shown widespread reluctance to lead in remedial action planning. This was only in part offset by local commitment and support for RAP and its cause.

Journal Article↗
PubMed1995

Physical assessment in the community pharmacy.

As pharmacists continue to define their role in the health care system of the future and implement pharmaceutical care, they will need new or enhanced skills in managing patient care cost-effectively. Their ability to perform basic physical assessments will be a vital tool in managing their patients' health status. By using the SOAP method of evaluation and plan development and by using a systematic approach to obtaining physical data, pharmacists can properly perform initial assessment and monitor the patients they now serve. This enhanced level of care will be well accepted by patients and other health care team members when pharmacists provide them in a professional manner and serve as partners with these practitioners in developing and managing appropriate care plans.

Aged↗
PubMed2003

Leading interprofessional practice: a conceptual framework to support practitioners in the field of learning disability.

One of the key challenges for practitioners in present day health and social care has been responding effectively in the interprofessional teamwork setting, where collaboration is at the centre of professional activity. For whilst practitioners are expected to work interprofessionally there often remains limited attention to the actual process of interprofessional practice itself, within organizational strategy, local workforce development planning and individual continuing professional development. These concerns were a driver for this research with practitioners in the field of learning disability which resulted in the development of a conceptual framework for interprofessional practice. This paper sets out the process of conceptual framework development, underpinned by the concepts of knowledge of learning disabilities, contextual socialisation, empowerment, conflict management, transforming capability and interprofessional reflection on action. The researcher suggests that the framework may offer clinical leaders in learning disabilities and a range of other practice settings a tool to facilitate individual practitioner development, enabling as it does, the identification of a range of critical factors which impact on the outcomes of interprofessional practice intervention.

Attitude of Health Personnel↗
PubMed2001

Juvenile male sexual offenders: the quality of motivation system of assessment and treatment issues.

A group of juvenile male sexual offenders (n=100) completed the Quality of Motivation Questionnaire (QMQ) upon entry into a residential treatment facility. The concepts of Quality of Motivation (QM) Theory are presented to explain the QMQ scores. The scores include Disclosure Level, Sources of Motivation, Life Style Characteristics and Power. The results indicate abnormal motivation scores in the area of Disclosure Resistance, Depression, Primary and Learned Sources of Motivation, and all of the Maladaptive Skills Scores. Recommendations of treatment issues for therapists are prioritized according to QM Theory and presented in a treatment plan format called the Personal Development Plan (PDP). Implications for further research with the QMQ include outcome measurement of changes and comparison with non-offender groups.

Adaptation, Psychological↗