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PubMedDate not supplied

Background of the demonstrated IMAGIS activities and future expectations.

In The Netherlands a national PACS development programme has been started, supported by the Dutch Society of Radiology and funded by the Dutch Department of Health because of the national character of the project. Three main partners are cooperating in this development: the Utrecht University Hospital (AZU), BAZIS and Philips International (Product Division Medical Systems), with the Delft University of Technology as the main BAZIS subcontractor. The non-profit foundation BAZIS, developing and supporting the ZIS Hospital Information System (in use in some 30 Dutch hospitals, over 15,000 acute beds), initiated its current IMAGe Information System (IMAGIS) projects in 1984. The activities were later integrated into the Dutch PACS project started in 1986. The final goal of the project is to achieve a PACS which is fully integrated with already existing hospital information systems (HIS). The development and operation of a HIS-PACS include many aspects of technical and clinical. The current efforts of BAZIS are concentrated on three main issues: diagnostic image quality evaluation (e.g. effects of data compression); modelling, software simulation and technology assessment of a prototype PACS (both general and detailed aspects); and coupling and integration of PACS and HIS (e.g. the BAZIS ZIS). Philips, Hamburg, is supplying equipment, particularly prototype components. A systematic clinical evaluation will take place at the Utrecht University Hospital.2+ We outline the background of the intermediate results as demonstrated during the 6th EuroPACS Conference:the psychophysical software package for Feature Evaluation And System Inspection By Logged Experiments (FEASIBLE); the modelling and simulation software package for Medical Image Representation, Archiving and Communication, Learned by Extensive Simulation (MIRACLES); and first results of the coupling experiments.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗
PubMed1984

Prenatal and postnatal development of retinogeniculate and retinocollicular projections in the mouse.

The development of retinal projections to the dorsal lateral geniculate nucleus (dLGN) and superior colliculus (SC) has been studied in fetal and neonatal mice of the pigmented C57BL/6 strain, using the anterograde transport of tritiated proline and horseradish peroxidase (HRP). Retinal efferents are present contralaterally just beyond the chiasm at E14. By E16 they have grown into both dLGN and SC. Ipsilateral fibers are limited to the proximal optic tract at E16; their growth into dLGN and SC is delayed until E18-birth. During the first 2 postnatal days, an early population of ipsilateral fibers invades the dLGN. Most of these fibers grow in or around the medio-dorsal sector of the dLGN, i.e., the future binocular segment. Fibers are also present, but at lower densities, in the ventral half of the nucleus and thereafter become dispersed or are lost, without at any stage becoming dense. Some denser labeling is also present ipsilaterally in the outer rim of dLGN, just below the optic tract, and later disappears. On the third postnatal day, the ipsilateral fibers establish a deep and denser projection along the medial and dorsal borders of dLGN; this projection overlaps part of the crossed projection, which at this age extends to the whole nucleus. The segregation of each projection starts on the fourth postnatal day, when crossed fibers begin to disappear from the small region of uncrossed projection. This process goes on for another 4 days. During this period, the ipsilateral fibers withdraw from the deepest layer of dLGN, and their terminal density increases gradually; by the eighth postnatal day, both projections are already well separated. Dense crossed projections first appear near the surface of the SC at birth. Prior to this, retinal fibers course throughout neurons of the collicular plate and underneath the pia. The uncrossed fibers invade the SC between birth and P3. They are located preferentially in the anterior and medial aspect of the SC. Subsequently, there occurs a diminution in the laminar and tangential extent of these projections, simultaneously with an intensification of the ipsilateral input to several small, longitudinally oriented clusters located deep to the crossed projections.

Animals↗
PubMedDate not supplied

Epidemiology as basis for preventive intervention.

The paper describes the progress of a project starting out with an extensive psychiatric survey of the population of Oslo, and ending up with an intervention project aiming at the prevention of mental disorder in a particular high risk group. Hence the study is an example of experimental epidemiology. Lack of social support is identified as a psychiatric risk factor in the epidemiological part of the study, and stimulation of social network formation is a central part of the intervention project. Some preliminary results are given.

Adult↗
PubMedDate not supplied

Three-dimensional reconstruction of the sevenfolded form of Bacillus subtilis Gro EL Chaperonin.

Bacillus subtilis grown at 42 degrees C produces a major form of Gro EL-like chaperonin that has been analyzed by electron microscopy. Most of the views show a clear sevenfold symmetry when studied by rotational analysis. The particles were classified into defined families by multivariate analysis and supervised fuzzy-set classification methods, and those belonging to a sevenfold family were averaged to produce a two-dimensional representative projection. These selected particles were then used, when titled by 55 degrees in the microscope goniometer stage, as the starting projections for a three-dimensional reconstruction protocol based on the random conical tilt series method. The resulting reconstruction shows the Gro EL-like chaperonin from B. subtilis as a cylindrical body with seven well defined lobules arranged almost parallel to the longitudinal axis of the particle. There is a channel that is placed along this axis and appears fully open in both sides. The geometry of the channel is polar and presents differences in both faces of the particle.

Bacillus subtilis↗
PubMed1999

The National Survey of America's Families: an overview of the health policy component.

This report describes one aspect of "Assessing the New Federalism," a multi-year research project, started by the Urban Institute in 1996, to analyze the devolution of responsibility for social programs from the federal government to the states. The project combines case studies in 13 diverse states with analyses of data drawn from a wide range of sources, including a new household survey--the National Survey of America's Families (NSAF). The NSAF, which contains nationally representative data from almost 45,000 families, was fielded in 1997 and 1999, and is planned for 2001 and again at subsequent two-year intervals. In this paper, we provide an overview of the NSAF's purpose; the sampling approach and methods; the questionnaire content, with particular emphasis on questions of interest to health policy researchers; health policy research planned by Urban Institute staff; and the timetable for public release of the NSAF data.

Family Health↗
PubMed2001

[Hospital infection control in 21st century, the importance of networking with each division and clinical laboratory in the hospital. 1. From the aspect of clinical laboratory division].

Clinical laboratory division plays an important roll for the management of nosocomial infection. Staff from clinical laboratory division including technologist and/or medical doctor can work as a part of infection control team. Since the bacterial surveillance data from clinically isolated strains accumulates in the clinical laboratory division, these staff have a chance to notice outbreak in hospital at first time. While handling information from each strain, we need to feedback these data with additional information for physicians. From June, 2000, a national project started. That was a surveillance program for drag-resistant bacteria. We can compare information from local isolates and nation-wide isolates by this project. Genotypic methods especially pulsed-field gel electrophoresis(PFGE) is suitable for the identification of infection route in the hospital environment. And PFGE analysis for pathogenic strains works effective in our hospital.

Cross Infection↗
PubMed2001

Effective planning and implementation of ecological rehabilitation projects: a case study of the regional municipality of Waterloo (Ontario, Canada).

The literature guides environmental planning and, specifically, how to use ecological rehabilitation projects to achieve long-term planning goals and landscape-scale environmental sustainability. There is, however, a perceived gap between principles in the literature and the use of them by practitioners involved in smaller-scale ecological rehabilitation projects. Using interviews with practitioners involved in 11 projects within the Regional Municipality of Waterloo, Ontario, Canada, we tested whether practitioners used five principles for effective planning and implementation of ecological rehabilitation that we derived from the literature. These five principles were: establishing political and ecological context, using ecologically appropriate objectives and practices, using comparative multidisciplinary and cross-scale approaches, using adaptive planning and implementation, and establishing good communication within and external to projects. Few projects followed all five principles, and practitioners indicated that they used three more project-specific principles: obtaining political/social support, promoting projects and changing attitudes about projects, and securing sufficient and persistent funding to maintain a project's life. While the literature emphasizes that ecological rehabilitation is only effective if projects are coordinated on a watershed basis, most practitioners focused solely on the goals of their specific project. The gap between literature and practice may arise because most practitioners are new to the field of ecological rehabilitation and still are focused on the methods involved. Time pressures force practitioners to obviate the literature and get projects started quickly, lest support evaporate. Complicating these difficulties is decreased support from federal and provincial governments for large-scale environmental planning. It is unclear whether ecological rehabilitation projects in Waterloo Region (at least) will ever become effective at promoting landscape-scale ecological goals or remain smaller-scale stop-gaps.

Animals↗
PubMed1985

Ten years of the North Karelia project.

Medical and epidemiological research into the aetiology of CHD has drawn attention to the likely causal role of certain risk factors, especially elevated serum (LDL) cholesterol and blood pressure levels, and smoking. Conventional trials to establish the causality have come up against problems of feasibility and study design. Community-based studies have considerable potential in introducing changes to the general lifestyle and risk factors in large numbers of people (since the risk factors are closely related to the way of life and other features of the community). Thus a well evaluated community-based study can augment our knowledge on the role of the risk factors. Furthermore, a community study examines how the existing service structure and community resources can be used and assesses the overall feasibility and consequences of such an intervention. The North Karelia project, started in eastern Finland in 1972, has been a major community-based study on the prevention of CHD. The results of the 10-year evaluation of the project illustrate the feasibility and consequences of the approach. During the 10-year period 1972-82 the following net changes (i.e. adjusted for changes in the reference area) occurred in the risk factor means of the population aged 30-59 in North-Karelia: -28% for smoking (p less than .001), -3% for serum cholesterol (p less than .001) and -3% for systolic BP (p less than .001). During the period 1974-79 the age-standardized CHD mortality of men aged 30-64 was reduced by 22% in North Karelia, 12% in the reference area and 11% in the rest of Finland (p less than .05 compared with NK).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

The Italian support to prevention of blindness programmes in developing countries.

The authors point out that Italy, as a tradition, has always dedicated special attention to developing countries, due to its geographical position and its cultural background and that in 1971 the Italian Government has created by a law, as part of the Ministry of Foreign Affairs, the Department for Cooperation and Development, the objective of which is to contribute to the enhancement of the living conditions in developing countries. The authors report data on a Trachoma Control Project started in 1973 lasting to 1981, financially supported by the Ministry of Foreign Affairs and technically guided by some of the authors and point out that the major success of this Project is that, since they left the Country in 1981, trachoma control activities are still now carried out by using the same methodologies. Finally, the authors report data on a National Prevention of Blindness Programme, the extension of which will be guided in the near future by the Referral Center for Public Health Ophthalmology of Rome that has just prepared the plan of operation that foresees the reorganization and strengthening of the existing structures and manpower at the head quarter, tertiary, secondary and primary levels.

Blindness↗
PubMed1988

From pilot project to national implementation: experiences from the North Karelia Project.

The North Karelia Project started in 1972 as a response to the request of the local people. It was aimed at reducing the exceptionally high mortality and morbidity from cardiovascular diseases in the area. The Project's activities have been directed towards inducing behavioural changes amongst the entire population. Equally, the care of those already sick (such as hypertensives) has also simultaneously been reorganized. The Project has involved the whole of that society, in addition to the health care system, and has collaborated with the food industry, schools and various voluntary organizations. The most recent new activity is a programme to promote marketing of local vegetables and berries to have a substitution for dairy farming, as consumption of dairy products reduce with new dietary habits. The results are encouraging. The individually reported health behavioural changes are reflected by a clear net reduction in biological risk factors (serum cholesterol, blood pressure) compared to the reference community. Also statistics show that mortality from ischaemic heart disease has been reduced more significantly in North Karelia (-22%) than in the rest of Finland (-11%) during the period 1974-1979. The activities tested in North Karelia, and found to be feasible, have been recommended for implementation nationwide in Finland. For instance, anti-smoking activities were first tested in North Karelia before the introduction of national legislation, and experiences obtained in health education have been conveyed to other sectors of the Finnish population through national television in several programmes. The county of North Karelia continues to be a demonstration area in Finland, at present for the Integrated Programme for the Prevention of Noncommunicable Diseases.

Cardiovascular Diseases↗
PubMed2002

ReproMED on the Internet today and tomorrow.

ReproMED comprises a range of projects applying and researching the role of information technology to support clinical care, education and research in reproductive medicine. This article traces the development of ReproMED on the Internet and concludes by speculating on the future. The project started with a critical evaluation of the infertility information needs of general practitioners and the role of hypertext in meeting those needs, leading to the production of a ReproMED CD-Rom. However, as the project was under development in 1995, Microsoft launched its first web browser amid major expansions of the Internet, thus the project switched to a series of websites and played host to national bodies including the British Fertility Society and the British Andrology Society. After a critical evaluation of the role of the Internet in supporting postgraduate medical education in the southwest region, reproductive medicine training over the Internet was piloted. This pilot was followed by a series of similar training programmes for junior doctors, specialists and general practitioners, leading to the establishment of a formal MSc delivered principally over the Internet. In addition to professional education and research, the ReproMED websites provide patients with extensive interactive information. The future holds many exciting possibilities with rapid technological developments and ever-increasing information needs.

Computer-Assisted Instruction↗
PubMed1999

[Standards, options and recommendations (SOR) for diagnosis, treatment and follow-up of osteosarcoma. Groupe de travail SOR].

CONTEXT: The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres and specialists from French Public Universities, General Hospitals and Private Clinics. For pediatric issues, this project is a collaboration between the FNCLCC and the French Society of Pediatric Oncology (SFOP). The main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. OBJECTIVES: To develop clinical practice guidelines according to the definitions of Standards, Options and Recommendations for the clinical care of osteosarcoma in children and adult. METHODS: Data have been identified by literature search using Medline (1985-december 1998) and the expert groups personal reference lists. The main criteria considered were incidence, risk factors, prognostic factors and efficacy of treatment. Once the guidelines were defined, the document was submitted for review to 27 national and international independent reviewers, and to the medical committees of the 20 French Cancer Centres and, in particular, the 4 which have particular expertise in pediatric cancer management. RESULTS: The main recommendations for osteosarcoma management are that: 1) the clinical diagnosis is based on appropriate clinical and radiological findings; 2) the final diagnosis is pathological and the biopsy should be performed by the surgeon who will subsequently perform the definitive surgery; 3) surgical biopsy must be of adequate size and performed by an experienced surgeon; 4) the therapeutic strategy for osteosarcoma is based on surgery with neoadjuvant and adjuvant chemotherapy given in experienced centres. Inclusion of high dose methotrexate is recommended for children, and the dose of methotrexate must be adapted for adults. Inclusion of children in SFOP protocols and adults in EORTC and FNCLCC clinical trials is recommended; 5) treatment of metastatic osteosarcoma is based on chemotherapy and surgery to lung metastases which may be curative. Amputation is rarely appropriate. Inclusion of children in SFOP and of adult in EORTC and FNCLCC clinical trials for metastatic osteosarcoma is recommended; 6) at the present time, there are no clear data on which to base guidelines for timing and duration of follow-up studies in this condition.

Antineoplastic Agents↗
PubMed1998

[Standards, options and recommendations (SOR) for clinical care of rhabdomyosarcoma (RMS) and other soft tissue sarcoma in children. Federation of the French Cancer Centers. French Society of Pediatric Oncology].

CONTEXT: The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres and specialists from French Public Universities, General Hospitals and Private Clinics. For pediatric issues, this project is a collaboration between the FNCLCC and the French Society of Pediatric Oncology (SFOP). The main objective is the development of clinical practice guidelines to improve the quality of health care and outcomes for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. OBJECTIVES: To develop a clinical practice guideline according to the definitions of Standards, Options and Recommendations for the clinical care of rhabdomyosarcoma and other soft tissue sarcoma in children and adolescents. METHODS: Data have been identified by literature search using Medline (1985-may 1997) and experts group personal references lists. The main criteria considered were incidence, risk factors, prognostic factors and efficacy of cancer treatment. Once the guideline was defined, the document was submitted for review to 14 national and international independent reviewers, and to the medical committees of the 20 French Cancer Centres and, in particular the 4 which have expertise in pediatric cancer management, for agreement. RESULTS: The main recommendations for rhabdomyosarcoma management are: 1/ diagnosis is based on appropriate clinical and radiological findings; 2/ pathological and immunohistochemical studies are essential to confirm the diagnosis; 3/ surgery must be performed by an experienced surgeon. Surgery and radiotherapy must be as conservative as possible; 4/ therapeutic strategies for rhabdomyosarcoma depend on location and extends and are based on chemotherapy, surgery and radiotherapy. Inclusion of patients in SFOP, SIOP and IRS clinical trials is recommended; 5/ treatment of metastatic rhabdomyosarcoma is based on intensive chemotherapy, and surgery with or without radiotherapy; 6/ the management of non-rhabdomyosarcoma is based on the likelihood of sensitivity to chemotherapy; 7/ at the present time, there are no clear data on which to base guidelines for timing and duration of follow-up studies in these conditions.

Child↗
PubMed1988

Social Security area population projections: 1987.

The following article, first published as Actuarial Study No. 99, describes the population projections that underlie the long-range cost estimates for the Old-Age, Survivors, and Disability Insurance (OASDI) program, which are included in the 1987 Report of the OASDI Board of Trustees. The projections start from a recent estimate of the population in the Social Security Area by age, sex, and martial status and from an estimate of existing marriages by age of husband and age of wife. Three separate projections, denoted Alternatives I, II, and III, are developed by analyzing historical data and making three different sets of assumptions about future net immigration, birth rates, and death rates.

Actuarial Analysis↗
PubMed1999

[IDDM-Sardinia Project: a study model on the etiopathogenesis of insulin-dependent diabetes mellitus and other autoimmune pathologies. Gruppi di studio IDDM-Sardegna].

The "IDDM-Sardinia project" started in the beginning '90s and this main objective was, and still is, to clarify the epidemiological aspects of insulin-dependent diabetes mellitus in Sardinia, an island with a high incidence of the disease. Initially, the project included three main aims: 1) to continue monitoring the incidence of the disease and to design maps of geographical distribution of it in the island; 2) to study the pre-diabetes period, by assaying islet-related autoantibodies (ICA, GADA and IA-2icA), and to design models of prediction in a general population from a large cohort of 10,000 schoolchildren, and 3) to investigate the natural history of the disease by monitoring the appearance of islet-related autoantibodies in a cohort of 19,000 newborn. Most recently, new research lines branched from these main topics, and now the project is also investigating other autoimmune diseases, in particular coeliac disease and autoimmune thyroiditis. In this paper we still summarise and discuss the state-of-the-art of the whole project.

Adolescent↗
PubMed1997

Cardiovascular disease risk factors and dental caries in adolescents: effect of a preventive program in Northern Sweden (the Norsjö project).

Since 1985 a 10 year prevention programme aiming to reduce cardiovascular diseases (CVD) has been running in the county of Västerbotten in Northern Sweden. The project started in Norsjö. The present investigation is a study on dietary intake, medical CVD risk factors and dental caries in five cross-sectional groups of 15-year-olds during 5 years (1987-1991) of the "Norsjö project". Most of the measured medical and dietary variables followed a similar trend, i.e. a positive trend during the first 3 years (1987-1989) and in the last 2 years (1990-1991) the averages returned towards baseline values. Dental caries prevalence followed a similar trend. Parental educational level did not have a major influence on diet or medical CVD risk factors, but higher caries scores were noted in adolescents with parents with "low" education compared with adolescents where the parents had higher educational levels. The results from the study also point to the fact that dental caries prevalence together with body mass index may indicate adolescents with CVD risk factors at unfavourable levels. Dietary counselling by dental personnel to adolescents with high caries and moderate obesity can be of advantage in reducing caries risk, as well as risk for development of CVD at higher ages.

Adolescent↗
PubMed2000

"The history of health in Dayton": a community-academic partnership.

Academic institutions have always found it a challenge to persuade community members to participate in academic research projects. Starting an open dialogue is usually the critical first step. To begin this dialogue with community members in Dayton, Ohio, in 1999, staff from Wright State University decided to organize a community forum, "The History of Health in Dayton." The forum was intended as the first project of a new research organization, the Alliance for Research in Community Health (ARCH), established with federal funding from the Health Resources and Services Administration in 1998. ARCH was created as a bridge between the Department of Family Medicine of Wright State University School of Medicine and the Center for Healthy Communities, a health advocacy and service organization committed to health professions education. ARCH's mission is to improve the health of citizens of Dayton through research involving community participation. Through ARCH, community members help researchers define priorities, resolve ethical issues, refine procedures, and interpret results. Guidelines for participatory research, proposed by the National Primary Care Research Group in 1998 and adopted by the alliance, emphasize the importance of open dialogue among researchers, subjects, academics, and community members. The initial response to the forum was enthusiastic, with a majority of community residents expressing interest in attending future presentations.

Community Health Planning↗
PubMedDate not supplied

A clinical teaching project: examination of a clinical teaching model.

This project, started in 1985 by Dr Infante, is based on theory of the use of the clinical laboratory in nursing education. It fully recognizes the complementary roles of nursing education and nursing service by having practitioners participate as preceptors, role models, and mentors. Six clinical agencies participated in this innovative clinical teaching project with the goal of improving the effectiveness and efficiency of nursing education and nursing practice. It is hypothesized that the synchronization of clinical laboratory experiences with instruction in nursing theory and science and a closer collaboration among faculty, students, and nurse practitioners will give students an appropriate balance of academic and clinical practice perspectives and skills to prepare them effectively to meet the complex health care needs of patients. The subjects were 173 undergraduate baccalaureate nursing students enrolled in an upper-division generic program. For the purpose of testing Infante's clinical model, the students were randomly assigned to a control or experimental group for two successive incoming classes of nursing students. Each student's academic and clinical progression was monitored. Data were gathered using grade point average, a standardized test for nursing knowledge (Mosby Assesstest; Mosby, St Louis), college laboratory practicum, and simulated testing for clinical application skills.2+ Data were analyzed using independent t tests. The findings indicate that the students in the experimental group, who used the experimental clinical model, achieved higher grade point averages, higher scores on the Mosby Assesstest, and higher college laboratory practicum scores than the students in the control group. The findings support the need for further investigation of innovative clinical teaching models.

Clinical Competence↗