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PubMed2004

[Health education for the mentally ill: a first-hand account].

The account in this text refers to an effective health education project in a Mental Health post in Sao Paulo for which nursing department students are responsible. The belief in the mentally ill person conquering rights as citizens as well as understanding that the education may become the individual's most valuable emancipation tools were the starting point of the project. There was a short phase as well as a long one, both of which occurred in the weekly open group format to users and their family members, and whose characteristics were free participation, since the space was open for discussion and the exchange of both opinions and experiences. The themes were chronic illnesses, and those highlighted ones were mental illnesses, communicable diseases and chronic degenerative-illnesses.

Humans↗

PubMed1970

An overview of RMP library activities: present and future.

The creation of the Regional Medical Programs has resulted in the origin of many library-related projects. Different regions have had a variety of projects. Surveys of resources in hospital libraries, continuing medical education surveys, and workshops for training hospital library personnel have been frequent. Instructional materials for library education have been developed or improved. Reference services have been stressed in many regions, and union lists of serials have been started. Grants for library projects total $1.4 million.

Education, Continuing↗

PubMed1996

Stereoscopic visualization system for clinical angiography.

Four dimensional visualization (FDV) project for clinical angiography has started at National Cancer-Center since 1995 in cooperation with medical virtual reality projects in our center. All stereo pair of x-ray angiographic images, both digital images and film based conventional x-ray images, are available in this system. FDV system software was developed on a Silicon Graphics platform. Every stereo pair angiographic images can be viewed stereoscopically using a stereoscopic visualization interface. Series of image data sets provide three dimensional blood flow dynamics that is very useful to diagnose vascular encasement by the tumor and to determine vessel of purpose which locates in front or in back from superimposed angiographic images. FDV system is expected to improve the accuracy and efficiency of diagnostic radiology and interventional radiology (IVR) procedures. In future, angiography system will equipped with a stereoscopic visualization interface that will provide a more flexible and more effective guidance tool for diagnostic radiology, especially for IVR that requires image-guided procedure.

Angiography↗

PubMed2005

Modeling the dynamics and control of Schistosoma japonicum transmission on Bohol island, the Philippines.

We have investigated a mathematical model for the transmission of Schistosoma japonicum in the infested region of northeastern Bohol island in the Philippines. The development of transmission models is important for planning control strategies. Since S. japonicum has a complicated mode of transmission, the rates of transmission among its hosts cannot be measured directly by field observation. Instead, they have been estimated through model analysis. The model takes into account the seasonal variations and includes a function of control measures. In 1981, a project to eliminate schistosomiasis started on Bohol island. The prevalence decreased dramatically and has kept low level less than 1%. The simulations based on the model predicted that there is little probability of resurgence of an epidemic in the northeastern endemic villages of Bohol island due to the fact that the project has attained a high coverage of selective mass treatment based on stool examination accompanied by a successful snail control operation.

Animals↗

PubMed1997

MIRIAM: the PACS project in Paris: overview and implementation.

In this article the authors describe the Management Informatique de la Radiologie et de l'Imagerie Médicale (MIRIAM) major picture archiving and communication system (PACS) project in Paris, France. The Assistance Publique of Paris, France is a healthcare provider and took the initiative to start the largest PACS program in Europe to date. The MIRIAM project will start in 1997 and will be used in different, consecutive phases. A consortium of several companies is in charge of the implementation. Thirty-three hospitals with 54 imaging departments will be integrated in one system.

Computer Communication Networks↗

PubMed1980

Low threshold afferent projections from the oral cavity and the face to the cerebral cortex of the cat.

The projections of low threshold afferents from the oral cavity and the face to the cerebral cortex of cats anaesthetized with chloralose were investigated. The projection fields of the ipsi- and contralateral lingual, inferior alveolar, mental, superior alveolar, infraorbital, (separate branches from whiskers and nose), ophthalmic, great auricular and the contralateral superficial radial nerves were localized. Surface potentials of short latency and maximal amplitude were recorded and their location traced on photographs of the rostral part of the right cerebral hemisphere. Reference points were indicated with india ink punctures. The extent of the cytoarchitectonic areas was determined on histological serial sections and the borders transferred to the photographs of the hemisphere. The features of the projections were related to the cytoarchitecture and to the pattern of the gyri and sulci. It was observed that the low threshold afferents from the oral cavity and the face projected via fast conducting, presumably three synaptic paths, to separate locations in areas 3a, 3b, 5a and 6a beta. The projections to area 3b were somatotopically organized starting with the auricular and the ophthalmic nerve projections lateral to the 3b projection of the forelimb in the posterior sigmoid gyrus and continuing with the maxillary nose, maxillary whiskers, mental nerve, superior alveolar, inferior alveolar and lingual nerve fields along the coronal gyrus towards the presylvian sulcus. The somatotopy was, however, not isomorphic with the body surface but displayed consecutive, overlapping bands across area 3b. The projections to area 3a were similarly organized. The somatotopy was less obvious in area 5a and 6a beta. Convergent projections with responses of slightly longer latency were observed in area 43 (gyrus orbitalis).

Afferent Pathways↗

PubMed1997

The quality of the discharge planning process: the effect of a liaison nurse.

A project employing a liaison nurse has been started in the Dutch Zaandam region. The liaison project will focus on the experience of problems in preparing for hospital discharge and on continuity between hospital and home care. This article discusses the effect of the liaison nurse on the quality of the discharge planning process. The investigation included a pre-test and a main test for which data were collected using questionnaires. These were sent to patients who had received after-care on being discharged from hospital. To measure the quality of the discharge process and after-care continuity, use was made of explicit quality criteria, targeting discharge planning. The results show that discharge planning in hospitals has improved. No significant improvement was detected with respect to continuity of care. It may be concluded that the discharge process requires more attention. The quality criteria used here could function as points of departure.

Aftercare↗

PubMed2006

Working with a Head Start population with asthma: lessons learned.

The Early Childhood Asthma Project involved asthma case identification in 35 Head Start centers in Detroit, MI, and attempted implementation of an intervention designed to help families manage a child's asthma more effectively. Surveys were distributed to the parents of all Head Start children (3408), and 2198 complete surveys were returned. Case detection found probable asthma in 30% of the children whose parent returned a sufficiently complete survey. Implementation of the intervention was unsuccessful in this setting. Obstacles to effective implementation included the sample's low participation and high attrition, limited involvement of Head Start personnel, factors related to the program approach, and the target population's beliefs about asthma.

Asthma↗

PubMed1976

[Nature of the curves of the cranial vault and their relationship with various brain structures].

A radiometric investigation for various angles of two dry craniums and of the encephalographic or cerebral arteriographic pictures of 250 subjects has revealed the following facts: The architectural lines of the dome of the skull found by orthogonal projection of the profile, from the front, and in vertical projection, are hyperbolic spirals starting from the base of the skull and converging on the sphenoid. These lines join up in the parietal region forming a hyperbole. The frontal spiral is a simple hyperbolic spiral. The temporal spiral is of the lituus type. The axes of these lines converge in a frontal plane on the epiphysis. The axis of the parietal hyperbole on a projection of the profile passes through the epiphysis and is followed by the parietal artery. Central cranio-encephalic formations follow the same spiral path. The contour of the upper edge of the cerebellum is a lituus spiral. The outline of the lower part of the cerebellum is a simple hyperbolic spiral. The right side of the polar origins of a spiral plotted in the plane of the insula coincides with the right side of the opercula. It can always be plotted, in theory, and forms an angle of 22 degrees 30' with the right side of the median frontal spiral. It cuts the axis of the parietal hyperbole at the apex of the insular triange. The bissector of the angle formed by the two right sides of the polar origins bissects the axis of the parietal hyperbole at a point corresponding to the epiphysis. The temporal hyperbolic lituus spiral has its focal point under the anterior, clinoid, at the junction of the segments CII and CIII of the carotid siphon the curve of which follows the convolutions of the temporal spiral. The right side of the polar origins of this curve indicates the mean direction of the posterior cerebral. The contours of the corpus callosum are homothetic with those of the dome of the skull as far as the axis of the parietal hyperbole. The frontal and parietal curves converge according to four types in the main Pacchionian granulations. The sections of the frontal spiral are often marked by bone abnormalities on the internal table. This analytic test is invariably valid whatever the constants of the spirals or the eccentricities of the hyperboles. Combinations between spirals with different constants and hyperboles of various eccentricities amount to very many types which call for separate study.

Brain↗

PubMed1995

Effect on breast cancer mortality of biennial mammographic screening of women under age 50.

The effects on breast cancer mortality seen after 16 years of biennial screening of younger women are assessed in this prospective cohort study. Since 1975 some 13,500 women, aged 35-49 in 1975, were invited to participate in the Nijmegen screening programme comprising a mammographic examination every 2 years. By the end of 1990, 75 women had died of breast cancer out of the 332 cases diagnosed after the start of the screening project. Women from the same birth cohort, living in Arnhem, a neighbouring city with a comparable population and without a screening project, were used as controls. In this city, 74 breast cancer deaths out of 284 cases occurred during the same period. In Nijmegen, after 16 years of follow-up, breast cancer mortality showed a non-significant reduction of 6% (95% confidence interval: 32% reduction, 29% excess). In the relevant period, after a time lag of 10 years from the start of the programme, this reduction rose to 20% (95% confidence interval: 48% reduction, 23% excess). No reduction in breast cancer mortality was observed in the first decade of screening. For a later period, a shift towards a reduction emerges, but the data are as yet inconclusive.

Adult↗

PubMed2000

Reconstruction of the projected crystal potential in transmission electron microscopy by means of a maximum-likelihood refinement algorithm

The projected crystal potential is reconstructed from a nonperiodic high-resolution transmission electron microscopy exit wave function using a maximum-likelihood refinement algorithm. The convergence and the accuracy of the algorithm are investigated using simulated exit wave functions of SiGe, a Shockley partial dislocation in Ge and an area containing randomly distributed Ge columns at different specimen thicknesses. The performance of two different start models for the projected crystal potential is investigated: the weak-phase-object model and a model based on the electron-channelling approximation. The reconstruction is successful even under the strongly nonlinear dynamical diffraction conditions at larger specimen thicknesses, relevant for high-resolution work, and on specimen areas large enough to cover defects in crystalline materials.

Journal Article↗

PubMed2006

School-based prevention of schistosomiasis: initiating a participatory action research project in northern Tanzania.

The main aim of this project was to undertake participatory action research in two primary schools in northern Tanzania in order to create enabling environments for the schoolchildren and other community members to adapt practices relevant for reducing the transmission of schistosomiasis. This paper describes the process of initiating the project. The school activities started in 2002 by screening all schoolchildren (n=1146) in the two schools for schistosomiasis and intestinal helminths and treating those infected. This was interspersed with school essay writing, video recorded dramas and household sanitation observations. The first activities made the researchers realise that they had to focus more on the teachers and change their perspective from one of "helping the research team with their project" to become full partners in the research process. Preliminary results are the actions taken by the teachers to develop a curriculum for enhanced schistosomiasis education in primary schools, making household sanitation surveys part of school activities, better links between the school and the community, and actions taken by community members to create safe swimming places. The experiences and lessons learned so far are discussed.

Adult↗

PubMed2001

[Iliopsoas impingement in 12 patients with a total hip arthroplasty].

PURPOSE OF THE STUDY: We report 12 cases of iliopsoas impingement, an under-recognized cause of hip pain in total hip arthroplasty patients. MATERIAL AND METHODS: Between January 1998 and October 2000, we diagnosed 12 cases of iliopsoas impingement among 280 total hip arthroplasty patients with hip pain (4.3%). Our population was composed of 9 women and 3 men aged 62 to 80 years (mean 72 years). Nine patients had a first intention arthroplasty and 3 had a revision prosthesis. Delay from implantation to diagnosis of impingement ranged from 6 months to 5 years. Common cases of pain after hip arthroplasty, infection, loosening, were ruled out in all cases. A standard x-ray series including an AP view of the pelvis, an AP view of the hip and a surgical false-lateral view of the hip as well as a CT scan were obtained when iliopsoas impingement was suspected. The CT series extended from the lower part of the acetabulum through the fixation screws. RESULTS: Pain had been observed immediately after implantation in 10 cases (83%) and in 2 cases (17%) 3 to 5 years later. These patients did not have to use crutches when pain started to develop. Pain projected anteriorly and was always exaggerated when moving from the sitting position to the upright position and when going up stairs. In one patient, palpation revealed a mass in the groin that corresponded to a massive iliopsoas bursitis. Two non-pathognomonic physical signs were found in all cases: groin pain induced by active flexion against force in the lateral reclining position and at hip extension, and pain in the dorsal reclining position at deflexion of the hip, starting at 45 degrees. The standard AP views showed evidence of defective anteversion of 4 press fit cups, 1 off-centered screwed cup and 3 oversized cups. The CT scan demonstrated that the impingement involved the anterior border of the cup applied against the iliopsoas tendon in 8 cases either due to anterior uncovering in a dysplasic hip or anterior cup overhang. In 4 cases the cup fixation screws protruded anteriorly in front of the ilion and came in contact with the posterior aspect of the iliopsoas muscle. A bursitis had developed in 50% of the cases. DISCUSSION: When infection and loosening have been ruled out, hip pain after total hip arthroplasty would suggest a possible impingement of the acetebular component on the iliopsoas muscle due to defective anteversion or centering, the use of oversized cups, and/or the use of fixation screws. We emphasize the importance of a correct position for the cup to avoid an overhanging anterior border and discuss the use of screwed cups for primary total hip arthroplasty and of oversized cups for revision procedures.

Aged↗

PubMed2002

[Comparative study on objective-setting public health policy--historical background and path dependence].

The historical background and the path dependence of objective-setting public health policy are described in this review. The New Public Health movement appeared in the 1980s and was inspired by the Ottawa Charter on Health Promotion. This movement is based on the idea that public health is mostly promoted by creating a supportive environment for health as well as by individual efforts toward a healthy life style. The first objective-setting public health policy called Healthy People was proposed in USA, 1979, under the influence of The Lalonde Report published in Canada, 1974. Goals and targets were set in order to reduce the mortality of American people. This project led to Healthy People 2000 and Healthy People 2010. In the 1990s, objective-setting public health policies prevailed in Western countries, such as United Kingdom, Australia, New Zealand, and also in Japan. The objective-setting public health policy is the application of the management by objectives in the health policy domain. This policy is especially accepted in Anglo-Saxon countries where public sector reform was conducted on the basis of the New Public Management theory in the 1980s, which is when the WHO Regional Office for Europe started the Healthy Cities project that emphasized a network of project cities. The Health 21 in 1999 is another model of object-setting public health policy. A comparative study of four different objective-setting public health policies (USA, United Kingdom, WHO Regional Office for Europe, and Japan) was conducted regarding the goals and domains of the targets, methods of targeting, and evaluation of the project. The goals were almost identical in the four public health policies, while the domains of the targets were different. These differences were explained by the past experience of public health policy development in each country.

Europe↗

PubMed1992

Further evidence of benefits of a (non-randomised) breast cancer screening programme: the DOM project.

STUDY OBJECTIVE: The aim was to demonstrate the benefits of breast cancer screening on mortality. DESIGN: The study was an evaluation of a breast cancer screening programme by means of different approaches: (1) a case-control study, breast cancer deaths being the cases; (2) comparing the numbers of breast cancer deaths in screened and unscreened women; (3) comparing breast cancer mortality before and after start of the programme; (4) comparing breast cancer mortality in different large cities; (5) comparing screening activity with mortality reduction. SETTING: The setting was a breast cancer screening programme in the city of Utrecht, the DOM project, for women aged 50-64 years old at intake, birth cohort 1911-1925. The programme started in 1974, and there were five screening rounds up to 1984. Participation rate in the first round was 72% (14,697 women). MAIN RESULTS: (1) Screening was protective against dying from breast cancer, odds ratio 0.52, with a stronger effect in older women and no evidence of confounding; (2) risk ratio of dying from breast cancer for women in the response group was the same as the odds ratio, 0.52; (3) breast cancer death rate after the start of the project was nearly 20% lower than before the project started; after correcting for women who could not have benefited from screening the reduction was 33%; (4) a rise in breast cancer mortality in birth cohort 1911-1925 seen in other large cities without a screening programme due to aging of the cohort was not seen in the city of Utrecht; (5) mortality reduction followed the screening activity with a time lag of approximately 5 years. CONCLUSIONS: Early diagnosis of breast cancer by mammography reduces breast cancer mortality in women 50-64 years old at intake; different approaches to the evaluation of the project give different estimates of the screening effect, making clear that the effect depends on the intensity of the programme.

Breast Neoplasms↗

PubMed2002

[New avenues to quality assurance--a model project for recording bedsore incidence].

Bedsores can usually be avoided by adequate care and preventive measures. In the context of the local agenda process a local district office (Landratsamt) and inspection units initiated a variety of activities to promote sensitisation in health institutions and contribute to an increase in life quality of the persons concerned. Nearly all nursing care homes, domiciliary services and hospitals participated in a pilot study which was accompanied by the Fraunhofer IAO in Stuttgart. Objectives of the pilot study were to implement internal quality assurance to sensitise for persons the topic and to collect comparable data to achieve benchmarking. Software-tool institutions recorded data on care days, days spent with bedsores according to care level from July till September 01. Major result was that - although institutions had already a decreasing incidence in bedsores since the start of discussing the project - bedsore quotas could be further decreased from 2.15 to 1.84 %.

Aged↗

PubMed2005

Best practice in communicating the results of European research to the public.

Dissemination of results is a contractual obligation of participation in research initiatives supported under the European Union's Framework Six Programme. The European Commission's Directorate-General for Research is heavily involved in communicating the results of EU-funded research to the media and the general public. In any research project it is important to start thinking about dissemination and exploitation right at the beginning. How can this be possible when the project has not yet yielded any results? Examples from two ongoing EU supported projects are shared and discussed.

Communication↗

PubMed1999

Newborn screening for PKU and congenital hypothyroidism in Latvia.

The newborn screening program in Latvia was started in 1980 as pilot study project. Mass screening for phenylketonuria (PKU) in the whole republic was started in 1987, but for congenital hypothyroidism (CH) it begun in 1996. Last two years the Latvian State Medical Genetics Center (SMGC) screened nearly 25,000 newborn dried blood specimens per year. Approximately 25% are repeat and control specimens. Efficiency of the screening program is nearly 97%. Fluorometric method is used for PKU screening, followed by amino acid analysis (HPLC) and analysis of DNA samples for mutations of the PAH gene. Most of the 51 Latvian PKU patients detected from 1980 to 1998 were selected by neonatal screening (38), while the others (13) were diagnosed during genetic counseling. The incidence of PKU in Latvia is 1:8,700 births. CH screening is based on measurement of thyroid stimulating hormone (TSH), using fluoroimmunoassay method, with cut-off value 10 mlU/l, as the primary screening test, and T3 and T4, as confirmatory tests for diagnosis. From 38,684 newborns 37,380 were screened for CH in 1996 and 1997. From these 1,438 (3.8%) newborns were recalled because of initial elevation of TSH level. From these 85 (0.2%) newborns had elevated TSH level during first two weeks of life and were referred to SMGC for repeat testing and follow-up. The diagnosis of CH has been confirmed in 6 babies. The incidence of CH in Latvia is about 1:6,450.

Congenital Hypothyroidism↗