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PubMedDate not supplied

Enhancing the safety of children in foster care and family support programs: automated critical incident reporting.

The Adoption and Safe Families Act of 1997 has made child safety an explicit focus in child welfare. The authors describe an automated critical incident reporting program designed for use in foster care and family-support programs. The program, which is based in Lotus Notes and uses e-mail to route incident reports from direct service staff to supervisors and administrators, facilitates timely clinical oversight and risk management and ensures the security of clients' protected health information. The authors present data collected using the program to illustrate how it can be used to monitor abuse and neglect allegations in a foster care program. A survey of users found that the program saved time, was easy to use, and helped manage critical incident reports.

Adolescent↗
PubMed1991

[Knee joint hemarthrosis. An absolute indication for operation?].

The degree of severity of an injury of the knee joint is estimated mainly on the basis of the history given by the patient, stability testing and hemarthrosis. Once these are known the surgeon usually decides whether an arthroscopy should be done or not. In a group of 365 patients who had undergone arthroscopy after acute knee injury, we made a retrospective check of the indications. The purpose of the study was to evaluate the sensitivity of hemarthrosis as an indicator of severe injury of the knee joint necessitating operative treatment. For stability testing we used the varus and valgus stress test, the Lachman test, the Anterior drawer test, the pivot shift test and the anterior drawer test with medial and lateral rotation. The Lachman test was repeated under general anesthesia in the majority of patients just before the arthroscopy. The results were evaluated retrospectively with the aid of electronic data processing. In nearly 70% of cases the arthroscopy was indicated because of positive signs of instability together with a typical history provided by the patient or hemarthrosis. In another 27%, the hemarthrosis was the sole reason for the surgeon's decision to perform an arthroscopic investigation of the injured knee joint. In 80.5% of all cases the clinical diagnosis of lesion of the anterior cruciate ligament (ACL) or combined injury to ligaments and menisci was confirmed by the arthroscopy. In addition to this group, in another 10.8% we found other severe lesions necessitating by operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Epidemiologic and genetic analysis of veterinary data of German Brown cattle].

In totally 3740 cows of the breed German Brown Swiss distributed over 115 herds risk factors for the occurrence of diseases were analysed using a threshold model. Disease data were recorded by ten practitioners in southern Bavaria. The most frequent diseases were fertility disorders, followed by metabolic, udder and calving disorders. The influence of the herds could demonstrated clearly for all diseases analysed. The effect of the lactation number contributed significantly to the frequency of milk fever, mastitis, retained placenta, endometritis/metritis and ovary cysts. Heritability estimates vary between h2 = 0.5% and h2 = 4.2% with exception of anestrus/acyclia (h2 = 8.8%). With higher milk yield of cows the disease frequencies increase, especially fertility diseases. However, increasing herd milk yield is associated with decreasing disease frequencies. A depression of A.I.-parameters and an increase of culling rate caused by diseases could be observed. In the case of the occurrence of uterus- and ovary disorders days open are elongated by 58 days in comparison to cows without diseases. Recording of disease data for use in electronic data processing seems necessary, in order to diminish production diseases by breeding and herd control programmes. An important prerequisite in organization of disease data recording is an efficient cooperation between the veterinary practitioner, farmer, inseminator and the official milk recording organisation.

Animals↗
PubMed1991

[Measurement accuracy of oscillatory and whole body plethysmography determination of airway resistance. Study of a mechanical model].

The degree of accuracy of the plethysmographic and oscillatory method in determining respiratory resistance has been examined on a mechanical lung model. At this model different levels of the resistance could be reproducibly adjusted and exactly determined with sensitive measuring instruments. The plethysmographic method allows a precise estimation of the resistance. It was found that the absolute variation of the plethysmographically measured values is not greater than 5%. The Ros pointer scale of the Siregnost FD 5 yields systematically incorrect curve diagrams. In the lower range of the resistance the measured values are to high while the measured results of the resistance become progressively to low with an increasing resistance. The reason is the Ros pointer scale which does not show the real component of the impedance at a phase angle of 0 degree. The values of the real component of the respiratory impedance (Rreal) which yields the Siemens standard set show a great coincidence with the lung model resistance (R(aw)). The coincidence could be even improved by use of electronic data processing. With a computer program developed by us it is possible for the first time to indicate and registrate consecutively individual and average values of the real component (Rrealcomp) and the reactance of the respiratory impedance as well as the phase angle between the alternating pressure delta p and the oscillating flow (V). Thereby the accuracy of measurement is improved and the long winded analysis with the "phase diagram" is not necessary anymore. Further experimental and clinical investigation have to show whether the oscillatory method in the way described above will offer new possibilities for the assessment of the pulmonary function. The phase angle and its course during the respiration cycle is in this connection of special importance as a possible new parameter.

Airway Resistance↗
PubMedDate not supplied

A surgical program. Director's view.

In summary, the two major facts that have emerged from a year and a half of experience with 405 regulations are shown in Table VI. The increased staffing with the monies made available has greatly enhanced patient care and decreased the resident workload. I want to again compliment Dr. Axelrod for the foresight to make these funds available despite adverse criticism. He clearly understood that the changes needed were quite expensive because the problems are primarily economic in origin. What type of paramedical personnel are needed is yet uncertain. I mentioned briefly earlier that the "data manager" combines an excellent administrative secretary and a nurse. The simple institution of electronic data processing can, surprisingly enough, worsen the problem rather than help. For example, institution of a beeper system, making it possible for anyone to "beep" a house officer at any time, resulted in an astonishing increase in "beeper frequency," a house officer receiving seven or eight such messages per hour, 24 hours a day, rather than communicating by other methods. Such "instant" communication can become a serious hazard rather than a help. Second, as repeatedly mentioned, the on-call time concept is crucial, permitting flexibility that avoids fatigue and yet maintains continuity of care. Otherwise there is a real danger with a rigid time-on/time-off schedule.

Continuity of Patient Care↗
PubMed1990

[Spectroscopically controlled preparation of hard tooth structures using a UV laser].

During preparation of hard tooth structures with a 193nm-(ArF)*-excimer laser, the laser beam produces a specific fluorescent light whose spectrum is governed by the structure of the specimen. These fluorescence spectra allow an analysis of the removed tissues. The data thus obtained may be used to control the laser system so that only specific structures, such as carious tissue, are removed: reproducible fluorescence spectra were established by means of standardized samples (pure synthetic hydroxyl apatite ceramics, enamel, dentine and carious dentine) and the characteristic absorption bands (peaks) for the different substances were measured. With the aid of electronic data processing these reference spectra could be compared with the fluorescence spectra obtained during preparation. When a spectrum differed from the predefined limits of relative intensities, preparation was stopped. Since ablation per pulse is only to a small depth (0.04-4 microns) with the 193nm-(ArF)*-eximer laser, this feedback system of ablation and fluorescence spectroscopy allows decisions as to continuing or stopping the preparation process to be taken within the range of a few microns.

Dental Cavity Preparation↗
PubMed1988

[Morphologic changes in the epithelium of the uterine cervix in long-term administration of the 19-norsteroid-containing oral hormonal contraceptives Non-Ovlon and gravistat].

The objective of this study was to give a contribution to the question whether there are changes in the uterine cervix after longterm application of 19-norsteroid-containing contraceptives Non-Ovlon and Gravistat relating to carcinogenesis. Histologic examinations have been performed on 19,760 cervical sections obtained from 280 women aged 25-45 years. 141 women had taken Non-Ovlon or Gravistat for at least 5 years, 139 women had never taken hormonal contraceptives. The cervices were equally obtained from surgical- and conization material from 1976 to 1982. The evaluation was made according to 108 single characteristics of quality, semiquantity and topography. These characteristics were evaluated by electronic data processing. Our investigations revealed no morphological evidence for a relation between longterm application of Non-Ovlon or Gravistat and the occurrence of squamous epithelial or adenomatous cervical neoplasias.

Adult↗
PubMed1989

[Computer-assisted tumor documentation, after-care and medical correspondence in radiotherapy].

Without electronic data processing the recording and statistical evaluation of a great number of tumor patients is only hardly possible. A tumor register and follow-up program is described which has been established for radiotherapy during the development of a national tumor register organized at present. This tumor register also serves as a basis for letter-writing to physicians. The software can easily be adapted to the needs of every hospital because a commercial data bank system has been used. The data input and output is carried out over several terminals. The hardware and software system as well as the incorporation of the data bank into the national tumor register are described.

Aftercare↗
PubMed1989

[Technology and progress in orthodontics].

As in other areas of dentistry, too, technological progress has resulted in new developments for diagnostic and therapeutic applications in orthodontics. The use of new technologies is focussed on two main areas: the use of new materials and methods in the treatment with fixed appliances, and the use of electronic data processing in diagnosis, particularly in cephalometry.

Cephalometry↗
PubMed1979

[Changes in dentistry].

Although collective and individual prophylactic measures have been shown to drastically reduce or totally prevent dental caries and periodontal disease, a recent survey of over a thousand twenty-year olds from all areas in Switzerland revealed an average DMFT value of 14.5, including 8.6 teeth already filled. Alarmingly, more than two thirds of all the proximal fillings examined radiographically were inadequate and therefore sources of marginal irritation. Dentistry in the future must accordingly concentrate on increased primary prevention and, where restorations are necessary, on placing restorations that will not lead to secondary caries and destructive marginal periodontitis. These goals can be most economically achieved through a team approach where the dentist delegates to his (or her) dental hygienist and specially trained chairside assistant the tasks of radiological and clinical diagnosis of caries and of marginal irritants in order to interfere with the progress of periodontal disease. The dentist, in addition, freed from administrative tasks by electronic data processing, will direct the team, and his practice will, in the future, fall into one of two large areas: preventive dentistry and/or pedodontics of curative gnathology.

Adult↗
PubMed1986

[Flow cytometry: a multiparameter cytological analysis technic].

Cytometry is a cell analysis technique which owns its effectiveness to advances in immunology, chemistry, data processing, electronics and optics. Taken together, all these sciences have led to the development of the cytometer, an instrument which analyzes and sorts the cells with the help of structural and/or functional parameters determined on each individual cell. Because of the diversity of cell parameters which can be quantified by cytometry, this technique is now widely used in oncology, immunology and pharmacology.

Flow Cytometry↗
PubMed1978

[Sport and prolongation of life (author's transl)].

In a retrospective study a group of 80-year-old men (114) were compared with regard to their living habits with a group of men from the same firm (131) who had died before the age of 65. The aim of the study was to present factors which could possibly affect the limitation of life expectancy. By means of electronic data processing the findings of the investigation and historical data (family history, personal history, risk factors, physical activity, occupational and social status) were evaluated and possible correlations looked for. The cause of death was particularly included in the interpretation. The risk factors of greatest importance were: cigarette smoking, adiposity, little physical activity.

Humans↗
PubMed1979

[Atypical courses of rheumatoid arthritis].

For the investigation of the question of atypical forms of course selected findings of a multicentric electronic data processing investigation carried out on 1,000 patients with manifest rheumatoid arthritis were attracted. In these cases differences of the clinical symptomatology in the sexes were the result, at a different moment of the beginning and concerning serological findings. The latter was concerned clearly by the titres of rheumatoid factors, only suggestively cases with antinuclear factors. These differences, however, were not regarded as special forms in the sense of separated disease units. They rather represent only statistically provable deviations, the borderlines of which are by far transgressed by individual characteristics.

Adult↗
PubMed1988

The frequency of IgA-deficiency in the Austrian population. A protocol for large-scale screening by ELISA and a study on 3056 blood donors.

A protocol for large scale screening of blood donors for IgA-deficiency with the help of an ELISA is described. The ELISA method proved to be fast and reliable, the obtained data can be managed by electronic data processing. Donors were regarded as IgA-deficient when their serum level was below 10 mg/dl (normal values 90 to 450 mg/dl). At this concentration ELISA shows acceptable reproducibility (within +/- 15% limits). We found 8 deficient donors, i.e. one in 382 or 0.26%. Seven of these donors were totally deficient by ELISA, 2 of them having a strong anti-IgA in their serum. We conclude that ELISA is a simple, reliable, and inexpensive method for screening blood donors for IgA-deficiency.

Blood Donors↗
PubMed1986

The history of computing.

This article follows the development of computerized devices from the primitive manual systems of the ancient world to the sophisticated electronic devices of today.

Computers↗
PubMed1987

[Problem-specific grading in disease course assessment and calculation of the likelihood of transition of chronic cardiovascular diseases].

For the course rating of cardiovascular caused drop in efficiency a problem-specific grading is introduced, the characterization of which is composed of simple, non-invasive parameters. The grading is specified for 4 clinical diagnostic classes (hypertension, coronary heart diseases, pulmonary heart, "other heart and vessel diseases") and takes into consideration the frequent coincidence or connection of several diagnoses of heart and vessel diseases with each other. The choice of parameter and connection have to fulfil the demand, which is essential for the course rating of heart and vessel diseases, like practicability proportionate with the frequency of heart and vessel diseases, adequate registration of changes in severe degrees, statement about the patient and not about several parameters. Furthermore it has to make it possible to calculate provisional probabilities under variable conditions as well as to make possible a valuation of prognosis. For that purpose the construction of suitable matrixes is shown and an integral projection is represented, which is used for the interpretation of courses dependent on severe degrees. The conception of grading has the function to modify necessary parameters for inclusion in the hierarchy according to medical starting position (for instance primary mode of registration). The model which is applicable to level of population makes possible an electronic data - processing - based evaluation including algorithmic classification.

Cardiovascular Diseases↗
PubMed1987

[A plan for the medical prevention of pneumoconiosis in coal mining].

Some assumptions of a system of pneumoconiosis prevention for coal miners have been presented. An essential element of the system consists in replacing fluororadiograms with full-size X-ray pictures, as a method of primary selection. Provisions have been also made for promotion of the detection and treatment of chronic bronchitis and some other respiratory system diseases, along with obligatory spirometric tests. It is planned that the examinations will also involve pensioners. The current analysis of the collected information will be made using the electronic data processing.

Anthracosilicosis↗