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At least 721 records · Page 40Linked to original sources
PubMed1993

Use of transputers for real time dose calculation and presentation for three-dimensional radiation treatment planning.

PURPOSE: Real-time 3-dimensional dose calculation will allow display of isodose contours and other metrics for a planner to assess plan effectiveness during plan development, facilitating optimization. METHODS AND MATERIALS: Parallel processing provides an effective means to calculate 3-dimensional dose distribution in real-time while plan parameters are being chosen and adjusted. An array of 20 transputers and a high performance graphics workstation have demonstrated the feasibility of real-time 3-dimensional beam parameter specification, dose calculation, and dose-distribution presentation for evaluation. A mesh connected set of processors using surface processors to generate and terminate rays, and ray processors to calculate ray attenuation and dose distribution has been developed to efficiently utilize large numbers of processors and provide good load sharing, even for small beams that intersect only a small part of the volume. RESULTS: Our feasibility study has calculated dose distribution by the Effective Path Length method in about one second per beam for a treatment volume of 56,400 voxels. We expect to reduce the total time for computation, communication, and display, with even larger volumes, to less than one second. The number of processors can easily be increased for larger treatment volumes or more accurate and computation-intensive dose-calculation algorithms. Transputers provide an elegant and economical method for harnessing up to hundreds of powerful general-purpose processors for computational tasks including dose calculation and isodose contour generation. The same distributed-memory parallel-processing configuration is also suitable for calculation of isodose contours and dose-volume histograms for plan evaluation, automatic calculation of apertures and filters as beam parameters are manipulated, and more accurate dose calculation algorithms that incorporate the effects of scatter. CONCLUSION: Parallel processors can efficiently provide real-time calculation of the information necessary to evaluate treatment plans as they are developed allowing the planner to optimize the plan based on dose distribution and its effects on tumor control and complications.

Humans↗
PubMedDate not supplied

The evaluation of three computer-assisted learning packages for general dental practitioners.

Two studies were undertaken to determine the acceptability of computer-assisted learning (CAL) to general dental practitioners. The first was a single programme in two parts designed to give experience in orthodontic cases assessment and treatment planning, developed at the Bristol Dental School. The second contained two modules, one on the planning and management of dental biopsy and the other on surgical endodontics, developed within the Leeds Dental Institute. An identical self-administered questionnaire was completed by participants in the evaluation study. Knowledge and skill gains were indicated following study of the modules. The modules were also found to be easy to use and useful. The CAL approach was rated positively compared to audio tapes, books and journals, but a less consistent pictures when CAL was compared with videotapes. The study provides evidence for the acceptability and potential of the CAL approach to general dental practitioners.

Attitude to Computers↗
PubMed1992

Valuing the primary care patient base.

This analysis, albeit limited, can help clinics and integrated health systems with their medical staff planning, and it demonstrates the importance of the primary care patient base as a foundation for health services planning and economic and market strategies. It is important to note, however, that when primary, specialty, subspecialty, surgical, and hospital care are well planned and marketed, it is virtually impossible to identify the relative contribution of each to the overall success of the system. Consequently, primary care physicians should not attribute the value discussed here solely to their efforts. Hospital executives should be mindful of two related issues: First, some administrators remain focused on inpatient services when outpatient services may offer greater economic potential over time. Ambulatory interventional diagnostics and therapeutic procedures (e.g., outpatient surgery) are often undervalued or overlooked in medical staff development plans. The net profits available from additional ambulatory surgical cases can be significant. Second, success in developing a medical staff plan requires more than calculating physician supply and demand ratios. A balance must be struck between meeting the hospital's needs for additional physicians and meeting the needs of the existing medical staff. A number of hospital executives have found that devoting all physician-related resources to recruiting new staff can create resentment among physicians who have remained loyal to their hospitals without financial and other practice incentives and inducements. We encourage multispecialty group practices to become students of primary care development as well and urge them to guard against focusing on the high overhead costs of primary care without recognizing the value of an organized primary care strategy.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost-Benefit Analysis↗
PubMedDate not supplied

Advances in treatment with intensity-modulated conformal radiotherapy.

The modern practice of radiotherapy centres on the development of conformal radiotherapy, techniques to ensure the high-dose volume is tightly wrapped around the diseased tissue and excluded as far as possible from adjacent normal structures. The development of conformal radiotherapy is a chain of processes involving treatment planning, development of new methods to deliver radiation, verification of the accuracy of radiation delivery and improvement of biological outcome. This is an enormous field of activity. This invited review paper summarises some of the main elements of progress towards implementing intensity-modulated conformal radiotherapy. This is the newest and most exciting development and, when achieved clinically, will lead to a quantum leap in tumour control probability with a fixed level of normal tissue damage.

Humans↗
PubMed2003

[The development of educational CD-program for obesity prevention and management for primary school students].

PURPOSE: The study is designed to develop an educational CD-Program for prevention and control of obesity among primary school students. METHOD: The study is conducted from June 15, 2000 to April 15, 2002. Based on the course of program development suggested by Dick and Cray (1990), the study followed the planning, development, education and evaluation of a program. RESULT: The developed CD-Program consists 2 parts each for lower and higher grades of primary school students. The introduction part of the first trial for lower grade students uses quiz to encourage their motivations, the body proceeds with motion pictures and animations to trigger their interests. The introduction part of the second trial for the lower grades consists of remembering the exhibition lecture. The first trial for higher grades of primary school students builds on the contents of the low grades. Its body part, how to determine obesity and calculate ones own obesity, puts ones own weight and height in by the mouse. For the second trial of the higher grades, the body consists of life-style, diet, and regiments. CONCLUSION: The merits of this CD-Program are that to be possible an interaction between teachers and students.

English Abstract↗
PubMed2002

How legislation has historically helped nursing when in crisis point.

Health is a political issue. Healthcare is political because it is integral to development. Health-related services must be a part of socioeconomic plans developed at the national level. Nurses are directly influenced by these matters. Recruitment, retention, education and practice of nurses are affected by the demand for services, reimbursement systems, prevalent healthcare problems, and research findings.

History, 20th Century↗
PubMedDate not supplied

Professional development framework. Pathway to the future.

Staff development educators in a large midwestern university hospital developed a framework for professional development. The framework, applicable to all nurses, has four levels of professional development, from professional awareness to professional mastery. Within each developmental level five dimensions of nursing practice are identified: nursing process and practice skills, communication/collaboration, leadership, professional integration, and research/evaluation. This framework for professional development is reported and its potential use in the areas of planning, development and evaluation of staff development programs; restructure of a clinical ladder for nurses; and individual career development is discussed.

Communication↗
PubMed1994

Investigation of a spontaneous abortion cluster: development of a risk communication plan.

A risk communication plan was developed for a group of payroll office workers who were investigated for a possible cluster of spontaneous abortions (SABs). Survey and focus group methods were used to assess the workers' attitudes, beliefs, and information preferences. We found that four features of the workforce needed to be considered in developing an effective plan: 1) subgroups of workers varied on their levels of concern, awareness, involvement, and definitions of the problem; 2) workers did not have the necessary knowledge concerning SABs or the scientific method to participate in a two-way communication; 3) workers were highly stressed; and 4) workers were distrustful that they would be told the truth about the SABs. A multicomponent risk communication strategy was developed to overcome these barriers. Specifically, we recommended that background information on SABs and the scientific method be presented before the report of the study results and that follow-up sessions should be conducted on job stress and the emotional aspects of miscarriages.

Abortion, Spontaneous↗
PubMed2005

Domains of research, development and strategic planning in rehabilitation medicine.

Rehabilitation systems are almost universally struggling to maintain or improve their standings. In this sense it is very useful to draw strategic plans for research and development taking into consideration the characteristics of the profession and, at the same time, the environment where they perform. Five domains of activities can be identified in this sense: measurement of clinical outcomes (including cost/effectiveness and quality assurance), services delivery: the continuum of care, technologies/procedures, pharmacological treatments and opportunities (''niches''). Each domain is described and the different possibilities analyzed. Each system--regional, national--or even a facility should make a selection of what fits their strategic plan best and which modality can be easily incorporated and where human and material resources exist or can be acquired. The need for the justification of the rehabilitation services looks by now as a must, universally.

Biomedical Research↗
PubMedDate not supplied

Quantifying uncertainty: calculating interval estimates using quality control results.

EPA's Great Lakes National Program Office (GLNPO) is leading one of the most extensive studies of a lake ecosystem ever undertaken. The Lake Michigan Mass Balance Study (LMMB Study) is a coordinated effort among state, federal, and academic scientists to monitor tributary and atmospheric pollutant loads, develop source inventories of toxic substances, and evaluate the fate and effects of these pollutants in Lake Michigan. A key objective of the LMMB Study is to construct a mass balance model for several important contaminants in the environment: PCBs, atrazine, mercury, and trans-nonachlor. The mathematical mass balance models will provide a state-of-the-art tool for evaluating management scenarios and options for control of toxics in Lake Michigan. At the outset of the LMMB Study, managers recognized that the data gathered and the model developed from the study would be used extensively by data users responsible for making environmental, economic, and policy decisions. Environmental measurements are never true values and always contain some level of uncertainty. Decision makers, therefore, must recognize and be sufficiently comfortable with the uncertainty associated with data on which their decisions are based. The quality of data gathered in the LMMB was defined, controlled, and assessed through a variety of quality assurance (QA) activities, including QA program planning, development of QA project plans, implementation of a QA workgroup, training, data verification, and implementation of a standardized data reporting format. As part of this QA program, GLNPO has been developing quantitative assessments that define data quality at the data set level. GLNPO also is developing approaches to derive estimated concentration ranges (interval estimates) for specific field sample results (single study results) based on uncertainty. The interval estimates must be used with consideration to their derivation and the types of variability that are and are not included in the interval.

Confidence Intervals↗
PubMed1992

Attitudes toward discussing life-sustaining treatments in extended care facility patients.

OBJECTIVE: To determine nursing home residents' attitudes toward discussing life-sustaining treatment plans with their physicians and the factors associated with these attitudes. DESIGN: Random-sample, interviewer-administered survey. SETTING: Forty-one nursing homes in which some residents were cared for by house-staff physicians of the Hennepin County (Minnesota) Medical Center Extended Care Department. PATIENTS: Random sample of 150 nursing home residents receiving primary care from Extended Care Department physicians, 131 (87%) of whom completed the interview. RESULTS: Older individuals were less likely to have spoken with physicians and family members about treatment plans (p < 0.05), and to have felt that they had more say than necessary in their treatment (P < 0.05). Only 19 (14.5%) residents had formal treatment plan discussions about limiting life-sustaining treatment. Although perceived current health status did not differ between residents with and without treatment plans, those residents who had discussions about advance directives were more likely to report health improvement over the past 6 months (P < 0.05). Residents with formal advance directives were, on average, 8.4 years younger than those without them (P < 0.05). CONCLUSIONS: Younger patients are more likely to have had discussions about life-sustaining treatment and are also more frequently involved in plan development. Preferences for level of involvement should be considered during advance directive planning, and it should be recognized that these preferences may vary with age. Future research should evaluate whether this age relationship is a true age or a cohort effect.

Adult↗
PubMedDate not supplied

[Public health in Cuba and its international experience (1959-2005)].

The past 42 years of Cuba's healthcare system have been characterized, among other things, by broad-based international experience and projects, which began in 1962 with the deployment of the first Cuban medical mission to Algeria. Since then, it has collaborated with more than 101 countries in Asia, Africa and Latin America, providing aid missions to areas suffering from natural disasters and sending medical staff to regions where they did not exist before. It has also helped some countries draw up medical development plans according to their specific needs. Cooperation with human resource training and development has also been carried out, with the result that hundreds of thousands of youths have been able to start their medical studies in countries all over the Americas and in some nations from Asia and Africa.

Cuba↗
PubMed1997

Developing a European professional record of achievement in engineering: towards portable qualifications.

This paper describes a Leonardo da Vinci pilot project the aim of which is to establish a Professional Record of Achievement within the engineering industry for developing and recording career development plans and the resulting requirements for learning and for personal and professional development. recording learning achievements and professional development, and the accumulation of credit towards relevant qualifications. The project will draw upon recent experiences and developments in different countries. A survey of some previous work in the area of portfolios or records of achievement in Europe is presented.

Accreditation↗
PubMed2002

Services for sexually transmitted infections in the new millennium--some thoughts from the United Kingdom.

Individuals who have acquired sexually transmitted infections (STIs) have been cared for, over time, by a wide variety of practitioners. In western Europe, most care for STIs is delivered in the primary care sector with dermatovereologists providing the specialist care. With a rising incidence of STIs across Europe, it is appropriate to look at different arrangements for the future. The developing plans in the United Kingdom (UK) are described with its national sexual health strategy, targets to be met, plans for greater use of nurses and primary care and possible future developments using the internet.

Health Services↗
PubMed2003

Staff satisfaction. Down the line.

A survey of 34,400 staff in 59 London trusts found general dissatisfaction with pay but satisfaction with immediate managers, equal opportunities and communications. A good working relationship with an immediate manager emerged as key to feeling valued. The better the communications in a trust, the more staff felt valued. Forty-two per cent of respondents--14,000 people--did not have a personal development plan and had not had an appraisal, leaving them outside major career development systems. This left them dissatisfied.

Attitude of Health Personnel↗
PubMed1990

Planning for successful home mechanical ventilation.

Home mechanical ventilation has evolved to permit discharge of patients on portable negative or positive pressure mechanical ventilators. Assessment of the patient for home discharge is initiated by a multidisciplinary team. The nurse, physician, social worker, respiratory therapist, speech therapist, occupational therapist, home health nursing agency, durable medical equipment supplier, and caregivers constitute the team. The crucial links to a successful patient discharge are an involved family and a well-developed plan of care, although patient finances also are important. The nurse develops, coordinates, and implements the teaching plan over a period of 2 or more weeks. The home caregivers provide total care for the patient several days before discharge. The home health agency and the durable medical equipment supplier provide services which ease the transition of care from hospital to home. One alternative to home discharge is placement in an extended care facility.

Adult↗
PubMed2006

Characterization of fine particle sources in the Great Smoky Mountains area.

A source apportionment study to characterize sources of fine particles in the Great Smoky Mountains area was conducted analyzing ambient PM(2.5) (particulate matter< or =2.5 microm in aerodynamic diameter) speciation data collected at a Interagency Monitoring of Protected Visual Environments (IMPROVE) monitoring site. A total of 1442 samples collected between March 1988 and December 2003 analyzed for 30 elemental species were analyzed with the application of the positive matrix factorization (PMF). Eight major sources were extracted: summer-high secondary sulfate (55%), carbon-rich secondary sulfate (16%), summer-low secondary sulfate (2%), gasoline vehicle emissions (13%), diesel emissions (1%), airborne soil (6%), industry (5%), and secondary nitrate (2%). The contributions from the carbon-rich secondary sulfate particles are likely a combination of local and regional influences of the biogenic as well as anthropogenic secondary particles. The compositional profiles for gasoline vehicle and diesel emissions are similar to those identified in other US areas. Backward trajectories indicate that the high impacts of airborne soil were likely caused by Asian and Saharan dust storms. This study would assist in the implementation plan development for attaining the air quality standards for PM(2.5), regional haze rule planning, and source-specific community epidemiology.

Air Pollutants↗
PubMedDate not supplied

Cancer resource center: a setting for patient empowerment.

Access to information can play a crucial role in enabling patients and families to cope effectively with the complexities of cancer. A cancer resource center providing medical information in a supportive environment can empower patients to become familiar with medical terminology, increase their understanding of proposed treatments, and develop the confidence to become active participants in their healthcare. The oncology nurse and medical librarian responsible for the development and implementation of a cancer resource center describe the needs assessment, facility planning, development of the collection and services, evaluation, and continued improvement of the library.

Humans↗