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[Projection of primary school enrollments for the Taiwan-Fukien area, 1983-1987].

A projection of the population of school age in Taiwan is presented for the period 1983 to 1987. Special emphasis is given to the effects of recent fertility trends on educational needs. The projections include information on "(1) births corresponding to each academic year, (2) the survival ratio from birth to age at entrance, (3) projections of the grade 1 enrollments, (4) estimates of median grade-to-grade progression ratios, (5) primary school enrollments at each grade, (6) annual increase of students, (7) annual increase in number of classes, and (8) annual increase of teachers." The implications for future government spending are considered. Changes in educational plans to conform to available resources are discussed. (summary in ENG)

Asia↗

The demographic components of population aging in China.

"In this paper we examine measures of population aging in China from 1953 to 1982, and then project population aging to the year 2050 using a cohort-components methodology.... Results indicate that China's population will age at an unprecedented rate over the next 70 years, both in terms of the absolute size of the elderly population and their proportion of the total population. At least 50 percent of the projected increase in population aging in China between 1980 and 2050 will be a product of the momentum for aging that is already built into the present age structure and vital rates. However, prospective trends in the measures of population aging become increasingly more sensitive to varying assumptions about fertility and mortality with time, and as older age groups are considered."

Adult↗

Two projection computed tomography: the axial and Towne projections.

It is occasionally necessary in evaluating lesions around the third ventricle and posterior fossa to supplement the axial view with another projection. The authors have routinely used the coronal projection as a second projection. However, the Towne view for computed tomography can be used as a second projection instead of the coronal; it is technically easier and faster to perform than the coronal projection, and provided good evaluation of the posterior fossa and para third ventricular areas in children.

Cerebral Ventricle Neoplasms↗

Digital angiography in the diagnosis of congenital heart disease.

Based on experimental and clinical studies, the technical aspects (choice of projection, injection technique), experimental and clinical results, and the indications for computerized digital angiography in congenital heart disease are reviewed. To obtain high-quality diagnostic images consistently, ECG-gating, suspended or gated respiration, and short pulsewidth acquisition are required. Clinically useful diagnostic information has been acquired in children with suspected functional murmurs, cardiac surgery that is believed to be inadequate, and in cyanotic newborns after intravenous injection of contrast material. Increased diagnostic information has also been obtained after intracardiac injection of small amounts of contrast and computerized digital processing of images in children undergoing cardiac catheterization.

Angiography↗

[Fluoroscopy-based 3D navigation of complex correction osteotomies at the proximal femur].

BACKGROUND: Despite great advances in hip alloarthroplasty there are still numerous indications for joint-saving procedures such as correction osteotomies. Often these procedures include complex 3D rearrangements of the proximal femur, which are for the surgeon technically very demanding. The project aim was to develop a precise intraoperative virtual 3D planning tool including a detailed biomechanical analysis and enable the surgeon to realize exactly this plan by using computer-assisted techniques. METHODS: Using only two different angled fluoro frames a simplified femoral model was inversely constructed. For navigation a passive optical system was used with a C-arm calibration kit and PC-based software. For in vitro evaluation complex osteotomies were performed on ten femora under simulated OR conditions. RESULTS: The mean difference between the planning and real surgical outcome for the wedge size was less then 2 degrees and for the femur head center position less then 4 mm. No implant penetrated the femur neck isthmus. CONCLUSION: Without changing the standard operative procedure the method can be of high clinical importance to improve planning accuracy and consecutive operative realization for precise fragment positioning and plate location without penetrating the isthmus of the femoral neck. And -- besides precision -- it can potentially help to reduce intraoperative complications such as implant penetration and minimize X-ray use.

Computer Simulation↗

Improving street food vending in South Africa: achievements and lessons learned.

Until the late 1990s there were limited scientific data on the microbiological quality and safety of street-vended foods in South Africa, while information was already available in other developing countries, including those within the African region. At that time street-vended foods were perceived as unsafe and street food vending in South Africa was regarded as a practice, which should be outlawed. The first comprehensively documented scientific research into the safety of street-vended foods in South Africa was carried out through university-based research. This research found that street food vendors in South Africa were capable of producing relatively safe foods, with low bacterial counts, although there was still a need for proper hygiene conditions and access to basic sanitary facilities. The Department of Health of South Africa, when coordinating an FAO Technical Cooperation Programme (TCP) project on Improving Street Foods in South Africa, drew similar conclusions. This article provides information of the efforts by universities and health authorities in South Africa towards improving the safety and promoting the sale of street-vended foods. It is shown that a successful transition from street food vending being perceived as a nuisance by health authorities can be made to these authorities promoting and improving street food vending instead.

Commerce↗

Set-up of a decision support system to support sustainable development of the Laguna de Bay, Philippines.

Over recent decades, population expansion, deforestation, land conversion, urbanisation, intense fisheries and industrialisation have produced massive changes in the Laguna de Bay catchment, Philippines. The resulting problems include rapid siltation of the lake, eutrophication, inputs of toxics, flooding problems and loss of biodiversity. Rational and systematic resolution of conflicting water use and water allocation interests is now urgently needed in order to ensure sustainable use of the water resources. With respect to the competing and conflicting pressures on the water resources, the Laguna Lake Development Authority (LLDA) needs to achieve comprehensive management and development of the area. In view of these problems and needs, the Government of the Netherlands was funding a two-year project entitled 'Sustainable Development of the Laguna de Bay Environment'.A comprehensive tool has been developed to support decision-making at catchment level. This consists of an ArcView GIS-database linked to a state-of-the-art modelling suite, including hydrological and waste load models for the catchment area and a three-dimensional hydrodynamic and water quality model (Delft3D) linked to a habitat evaluation module for the lake. In addition, MS Office based tools to support a stakeholder analysis and financial and economic assessments have been developed. The project also focused on technical studies relating to dredging, drinking water supply and infrastructure works. These aimed to produce technically and economically feasible solutions to water quantity and quality problems. The paper also presents the findings of a study on the development of polder islands in the Laguna de Bay, addressing the water quantity and quality problems and focusing on the application of the decision support system.

Conservation of Natural Resources↗

Double interdomal suture in nasal tip sculpturing.

The authors stress that conservative correction should be the main goal in rhinoplasty in general and in the surgical treatment of the nasal tip in particular. After outlining contemporary concepts and criteria relating to the modeling of an aesthetically pleasing nasal tip and the consequent surgical planning for its achievement as well as the specific indications for tip plasty, they go on discuss the technical aspects of tip projection and rotation. A personal technique is proposed for reshaping and sculpturing the tip, completed by a double interdomal suture with different application points during closed rhinoplasty. The technique also involves ancillary procedures consisting in the execution of a series of incisions with a radial pattern at the domal level and, when necessary, in the undersurface of the lateral crus. The procedure is explained in detail and the results are illustrated and discussed.

Esthetics↗

Transforming an EPA QA/R-2 quality management plan into an ISO 9002 quality management system.

The Environmental Protection Agency's (EPA) Office of Emergency and Remedial Response (OERR) requires environmental data of known quality to support Superfund hazardous waste site projects. The Quality Assurance Technical Support (QATS) Program is operated by Shaw Environmental and Infrastructure, Inc. to provide EPA's Analytical Operations Center (AOC) with performance evaluation samples, reference materials, on-site laboratory auditing capabilities, data audits (including electronic media data audits), methods development, and other support services. The new QATS contract awarded in November 2000 required that the QATS Program become ISO 9000 certified. In a first for an EPA contractor, the QATS staff and management successfully transformed EPA's QA/R-2 type Quality Management Plan into a Quality Management System (QMS) that complies with the requirements of the internationally recognized ISO 9002 standard and achieved certification in the United States, Canada, and throughout Europe. The presentation describes how quality system elements of ISO 9002 were implemented on an already existing quality system. The psychological and organizational challenges of the culture change in QATS' day-to-day operations will be discussed for the benefit of other ISO 9000 aspirants.

Environmental Monitoring↗

Focus on: Watsonville Community Hospital Biomedical Engineering Department.

The Journal of Clinical Engineering is pleased to present this FOCUS on the Biomedical Engineering Department of Watsonville Community Hospital (Watsonville, CA). Since the Department's inception in 1983, the growth of the hospital and the surrounding area has resulted in the expansion of the Department and its duties. This paper describes the responsibilities of the two-man Biomedical Engineering Department, which serves this 130-bed hospital and oversees the preventive maintenance and repair of approximately 800 pieces of equipment. In addition, the Department is involved with staff education, equipment inventory control, new equipment purchases, technical consultations, and special projects.

Biomedical Engineering↗

Assessing organizational readiness and capacity for developing an integrated child health information system.

The Tool for Assessment and Planning (the Tool) assists public health teams in designing child health information integration projects from planning through early implementation. The tool is a companion to Integration of Newborn Screening and Genetic Services Systems with Other Maternal and Child Health Systems: A Sourcebook for Planning and Development (the Sourcebook). The Tool and the Sourcebook focus on 9 key elements considered critical to supporting information systems integration. The 9 key elements are: leadership, project governance, project management, stakeholder involvement, organizational and technical strategies, technical support and coordination, financial support and management, policy support, and evaluation. Project teams can use the Tool to assess their organizational readiness and capacity by examining the critical components and strategies required to support success based on the 9 key elements. The questions are intended to promote discussion among project team members and to identify specific action steps. The Tool includes a planning matrix to track those action steps and to identify accountable personnel. Strategically examining the critical elements and documenting next steps increases the likelihood of a successful integration project.

Child↗

New imaging techniques in the treatment guidelines for lung cancer.

Computed tomography (CT) remains the main imaging technique for the preoperative staging and post-therapeutic evaluation of bronchogenic carcinoma. Spiral CT has already overcome some of the problems encountered with central or more extensive tumours. Multislice CT offers further improvement and allows for scanning of the whole chest within a single breath-hold using a thin-section high-resolution technique. Problem-adapted sections in arbitrary directions become available and provide an excellent spatial resolution. One can expect improved accuracy for the evaluation of transfissural tumour growth, chest wall involvement, mediastinal infiltration and lymph node staging. Despite recent advances in magnetic resonance (MR) techniques for imaging the chest, the role of MR for staging of bronchogenic carcinoma remains limited. It offers advantages such as the assessment of chest-wall involvement or mediastinal involvement in patients in whom CT remains equivocal. Lymph-node-specific MR contrast agents offer new diagnostic potential for the assessment of metastatic disease. New techniques for the display of three-dimensional data sets include volume rendering and virtual bronchoscopy. These techniques represent new tools for the evaluation and demonstration of pathology within the central tracheobronchial tree. Their most important application is the guidance of bronchoscopic biopsies. The assessment of an indeterminate pulmonary nodule is frequently based on positron emission tomography imaging. As an alternative, nodule vascularization (contrast enhancement patterns on CT or magnetic resonance imaging (MRI)), calcifications (absorption characteristics at various X-ray energies on CT or dual energy radiography), and morphological features (high resolution imaging at CT) can be used as the basis for nodule differentiation. The dynamics of contrast enhancement in CT or MRI can also be used for the assessment of tumour viability after chemotherapy. Lung cancer screening programmes are still controversial. Low-dose computed tomography scanning and computed assisted detection algorithms based on chest radiographs or computed tomography scans form the technical basis for such projects.

Bronchography↗

Force feedback for virtual reality based minimally invasive surgery simulator.

This paper presents ongoing research towards an endoscopic surgery simulation system. Our specific application of interest is laparoscopic surgery. The goal is to conceive an endoscopic surgical training tool which allows to realistically simulate the interactions between one or several surgical instruments and the gastrointestinal organs in a virtual reality based environment. An artificial patient is being developed into which endoscopic surgical instruments can be inserted to operate upon virtual organs displayed on a video monitor. In order to achieve a faithful and precise simulation, not only a realistic graphical representation of the organic tissue and its behavior is needed, but also the forces and moments on the surgical instruments encountered during an operation are required to be simulated. The laparoscopic surgery simulator must therefore provide force feedback through the endoscopic instruments manipulated by the surgeon. This paper details the mechanical design of the force feedback mechanisms and addresses some of the technical challenges of this project.

Computer Simulation↗

From WING to MMSA: experiences with the implementation of a distributed HIS.

The following paper analyses the transition from a host centered to a client-server based Hospital Information System (HIS) which takes place at the University Hospital of Giessen, Germany, since 1995. It focuses on the overall concept and practical realisation of the cornerstone within this transition, the Macintosh Mosaic Software Architecture (MMSA) which delivers now more than 90% of the clinical data which is entered on the wards and within the operating rooms. Besides the technical problems of the project, the paper also describes some aspects of the organisational challenges which took place within a typical German University Hospital during the last 4 Years and which mainly affect the daily management of a large HIS.

Germany↗

Problems of ergonomics in Bali, Indonesia.

Development in Indonesia, particularly in Bali, has been planned and done through several stages of the Five-Year Development Programs, which started in 1969, and emphasized intensification of agriculture and extensification of industries related to potential resources available in the region. In the process, industrialization, being regarded as a prerequisite to higher living standards, brought with it problems concerning safety, health, and work conditions, especially with respect to transfer of technology. As examples, experiences and data, related particularly to ergonomics in the sectors of agriculture, hotel business, textile mills, transportation, and others in Bali, Indonesia, are reported. In dealing with such possible consequences of development, efforts to find fundamental solutions should be given the highest priority. It is necessary to make use of all the existing institutions having potential functions and roles in the policy of development planning, and to take into consideration the factors of safety, health, and work conditions in specifying technical and financial development projects for industrialization.

Agriculture↗