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PubMed1992

WHO programme for the prevention of rheumatic fever/rheumatic heart disease in 16 developing countries: report from Phase I (1986-90). WHO Cardiovascular Diseases Unit and principal investigators.

The programme was initiated in 1984 by WHO in close collaboration with the International Society and Federation of Cardiology (ISFC). Sixteen countries in five WHO Regions participated: Mali, Zambia and Zimbabwe (in Africa); Bolivia, El Salvador and Jamaica (in the Americas); Egypt, Iraq, Pakistan and Sudan (in the Eastern Mediterranean); India, Sri Lanka and Thailand (in South-East Asia); and China, the Philippines and Tonga (in the Western Pacific). The programme was planned for implementation in three phases: pilot study and control programme in a selected area, control programmes in all the selected communities, and their extension to the whole country. In Phase I, a total of 1,433,710 schoolchildren were screened and 3135 cases of rheumatic fever/rheumatic heart disease (RF/RHD) were found, giving a prevalence of 2.2 per 1000 (higher in the African and Eastern Mediterranean regions); 33,651 recently identified or already known cases were registered; completion of secondary prophylaxis was irregular but averaged 63.2% coverage; percentages of adverse reactions (0.3%) and recurrence of acute RF (0.4%) were very small; 24,398 health personnel and teachers were trained. Health education activities were organized for patients, their relatives, and the general public in hundreds of health education sessions. Thousands of pamphlets, brochures and posters were distributed, and health education programmes were broadcast on radio and television. The quality of care for RF/RHD patients improved under the programme, which has been expanded to other areas.

Adolescent↗
PubMed2005

Screening for prostate cancer: who and how often?

Engage patients in shared decision making by discussing the benefits and risks of prostate cancer screening. Patients who review educational pamphlets before an office visit engage more fully in the decision-making process. If performing prostate cancer screening, limit to men with greater than 10 years life expectancy. Because the lead time of a diagnosis based on PSA screening is estimated to be 5 to 7 years, PSA screening every other year is unlikely to cause a loss of sensitivity. Men with tumors with a Gleason score less than 5 are the best candidates for "watchful waiting," having a favorable 20-year survival.

Biopsy↗
PubMed2004

[Dangerous liasions - Swedish-German contacts in Nazi medicine 1933-1945].

Sweden and Germany have developed extensive scientific, economical and cultural contacts since many centuries. During the nazi period in Germany 1933-1945 several Swedish physicians, although still a minority, were influences by the ideology of nazi medicine, often following an outspoken admiration for German science and culture in the first place. THe most prominent representative of Swedish nazi-oriented physicians was Ake Berglund (1898-1976), Alsten, Stockholm. He was working as a general practitioner and became the writer of several papers and pamphlets on questions related to the development in Germany and issues of public health. His interest in social medicine was combined with the ideology of racial biology and selection on health grounds. DUring the war years, Berglund was active in different nazi organisations and therefore under surveillance by the Swedish security police, which resulted in several classified reports on his political activities. In 1954, Berglund tried to defend an academic thesis on his ideological visions of a social medicine serving the race and the people. This thesis was however rejected by the Board of Karolinska Institute in Stockholm, due to shortcomings and ideological biases. In retrospect it seems as if Ake Berglund was a complicated man and physician travelling a hard road on his way to nazi political ideology, marked by problems and heated debates with political antagonists. At the end of his life, Berglund turned into a Christian believer, and defended things that might not have been the case during his earlier years. Further studies will explore other Swedish-German contacts in medicine during this period.

Family Practice↗
PubMed2004

[Ivar Broman - professor of Anatomy at the University of Lund with controversial views].

The Swedish physician and Professor of Anatomy Ivar Broman (1868-1946) came from a poor countryside family in the province of Skåne, southern Sweden. As he was intelligent and talented he received help from local people to get him an education at the nearby University of Lund. He stayed both there and at the University in Uppsala, but also in Kiel, Germany, during his early years. Soon Ivar Broman showed his dedication for embryology and comparative anatomy, publishing several books and papers. Later on he also wrote several contributions for daily newspapers, telling about new scientific discoveries and public health related issues. At one occassion Ivar Broman went to Africa for collecting embryos of different mammals. In the political world he showed strong emotional ties to Germany where he had several friends and contacts in medicine. This led Ivar Broman to sign, among 400 other people, a pamphlet calling for establishing a Swedish-German friendship organisation in 1938. He was not a party member of any Nazi party, but was, similar to other of his contemporary friends and scientists, an admirer of German science and culture. In some of his writings Broman was very modern in try to popularize science and new discoveries, but also devoted to aspects of purifying the population and using racial biological arguments. The lesson from Ivar Broman is that a devoted and skilled scientist, with many modern views, could also hold some authoritarian and politically darker views. This could be an example of a "Faustian" dilemma in science during a period of political tensions and distant thunders of war.

Anatomy↗
PubMed2005

Britain's Siberia: Mary Coutts's account of the asylum system.

This paper examines a pamphlet entitled Britain's Siberia. The High Statistics of Insanity Explained by a Certified Lunatic. Research has revealed that the writer was Mary Coutts and that she had been a detained patient in the Aberdeen Royal Asylum. The paper analyses what Coutts had to say about her experiences and compares this to the official asylum records and what they reveal about her inmate stay. The paper also relates Coutts' account to that of other patients who have written about their experiences. As one of the few women to have left a record of life in the asylum, Coutts' story is of particular interest.

Commitment of Persons with Psychiatric Disorders↗
PubMed2005

[Feasibility of the programme of focusing on early childhood development in impoverished rural areas in China].

OBJECTIVE: To study the feasibility of the programme "Focusing on early childhood development" in impoverished rural areas in China. METHODS: A questionnaire survey was conducted among 100 mothers, about half with junior middle school education, 18% with grade-school education, and 29% being illiterate, of children aged under two years in 7 villages in Changfeng County, Anhui Province, a native impoverished county, to understand their knowledge and attitudes about child healthcare. Then these mothers were randomly divided into 2 equal groups: experimental group, receiving face-to-face guidance in the practice of early healthcare for children at home with a pamphlet developed by WHO as teaching material; and control group without receiving guidance. Two months later the mothers received the second session of guidance. Six months after the same questionnaire survey was conducted among the 100 mothers to investigate the changes in knowledge and practice and Gesell development test was made to observe the changes in mental development. Two-days' training on the technique of early child healthcare in the form of reading, videotape presenting, and exercise, was given to 29 village doctors. Questionnaire survey was conducted among them before and 1 month after the training to understand the changes of their knowledge and attitudes towards early child healthcare. RESULTS: After the guidance the knowledge and fostering skills in terms of early child healthcare were improved significantly among the mothers of the experimental group in comparison with the mothers of the control group (P < 0.01). After the training most of the village doctors managed put the knowledge they had learned into practice, however, the percentage of those who lacked confidence in the smooth implementation of the programme remained unchanged (38% vs. 41%). Before the experiment the abilities in different fields were not significantly different between the children in these 2 groups. Six months after the implementation of the programme the abilities in fine motion, speech, and interpersonal communication were improved significantly among the children of the experimental group (all P < 0.05). CONCLUSION: Economic, simple, and effective, the programme "Focusing on early childhood development" is suitable for the impoverished rural areas in China.

Child Development↗
PubMed2005

[Developing quality indicators in hospitals: the COMPAQH project].

BACKGROUND: To select a set of quality indicators (QI) in order to test them in a panel of 36 French hospitals METHODS: The COMPAQH (COordination for Measuring Performance and Assuring Quality in Hospitals) project is coordinated by the French National Institute for Medical Research and supported by the French Ministry of Health and the French National Evaluation and Accreditation Agency. This project has four objectives: (1) to select a set of QI -2003- (2) to implement them in 2004-2005 in a volunteer panel of hospitals (3) to compare the hospitals anonymously (4) to explore quality management implications. QI were selected with a four-step process: (1) Establishment of a list of national priorities for Quality Improvement in relation with the Ministry of Health. (2) setting up a potential list of QI regarding these priorities. The COMPAQH staff determined a preliminary set of 81 QI, based on data in the literature and evidence about the scientific soundness of quality measures and the effectiveness of methods for improving quality. (3) Evaluation of the preliminary list. Each QI was presented in a pamphlet describing its operational definition, rationale, methodology, workload and responsibility of data collection The hospital panel (representatives) ranked the 81 QI with a validated evaluation tool which contained four dimensions: Importance, Scientific acceptability, Feasibility, and Usability. (4) Development of a consensus on a final selection. Based on a structured voting process (Delphi method, two rounds), the hospital panel selected a comprehensive set of 42 QI among the 81. RESULTS: (1) Eight national priorities were defined: pain management, continuity of care, management of nutritional disorders, Iatrogenic risks (including nosocomial infections), patient satisfaction, follow-up of practice guidelines, management of human resources, accessibility. (2) A set of 42 QI were selected: a set of 6 core QI and 7 to 18 specific QI according to the hospital type. CONCLUSION: Such a set of QI provides a foundation for developing a quality measurement system in French hospitals. It requires a pragmatic view for implementing them and a coherence between the different objectives of use (internal and external use).

Accreditation↗
PubMed2002

Processing complaints and disciplining nurses. An overview of the investigative process by the Kansas State Board of Nursing.

This is a brief review of the process the Kansas State Board of Nursing would utilize when investigating a complaint and determining discipline against a licensee, and does not include all points of law that could apply. Although the Kansas Administrative Procedures Act was discussed, there are many sections of the statute that were not addressed. The Board of Nursing has published two pamphlets "Your Rights Before the Kansas State Board of Nursing" and "The Investigative Process" which are valuable to the nurse in understanding the process. These are available on the KSBN's website www.ksbn.org or by mail.

Data Collection↗
PubMed2006

[A Kumamoto model of clinical training in tracheal intubation for paramedics].

BACKGROUND: Since July 2004, the Japanese Ministry of Health, Labor and Welfare approved certified paramedics to perform emergency prehospital tracheal intubation. A specialized training system in tracheal intubation has been established in Kumamoto Prefecture. METHODS: The Kumamoto Prefectural Medical Control Organization, a tracheal intubation task force was established: consisting of the departments of Anesthesiology at Kumamoto University and 11 other major hospitals, along with Kumamoto Prefecture and the 14 prefectural fire-departments. This group published the Kumamoto training guidelines and a training system for paramedics. RESULTS: Kumamoto Prefecture appealed for support of paramedic activity on television and in newspapers as public education. The prefectural governor officially asked hospitals to train paramedics. Because 9 of the 14 fire-departments had no regional teaching hospital, trainees were matched with other hospitals by the task force. The task force published a pamphlet to inform surgical patients about tracheal intubation training and to recruit patients as practice volunteers. Anesthesiologists undertook significant roles in making arrangements to facilitate the project at their hospitals, in addition to teaching paramedics prior to surgical procedures. CONCLUSIONS: The Medical Control Organization, Kumamoto Prefecture, anesthesiologists and emergency response personnel worked together successfully to promote the training program for clinical tracheal intubation by paramedics.

Allied Health Personnel↗
PubMedDate not supplied

[Intervention methodology for training and information for workers of the building sector].

Regarding the seriousness of work-accident in Gorizia district, various organizations as ASL 2 "Isontina" (local health agency), INAIL of Friuli Venezia Giulia (National Institute for occupational accident insurance), trade unions and trade associations created a organization called "Observatory for Working-accidents and Professional Illness Prevention". The aim of this association is the promotion of safety in working environment. Diffusing importance of safety in building trade was the first projects of Observatory. So, Observatory carried an initiative to make more aware the workers. Than, it organized training courses for building workers. Moreover, the construction of an informative pamphlet on risks in building trade was made. For some experimental investigation, Observatory works with Department of Psychology, University of Trieste.

Humans↗
PubMed2006

[The intubation practice of paramedics custom method of Takarazuka Municipal Hospital].

It is important "to obtain cooperation of a patient" and "to practice efficiently" in paramedic intubation practice. In our hospital, we distribute a pamphlet at the time of informed consent acquisition and we present a letter of thanks after the practice. Moreover, paramedics come to the hospital everyday throughout the practice period. By the time 5 paramedics have completed the practice period, the average time is 36.4 days, the rate of patient consent is 94% and the successful rate of intubation is 99%. The paramedic intubation practice is implemented relatively smoothly.

Allied Health Personnel↗
PubMed2006

No scalpel vasectomy advocacy and community mobilisation--a personal experience.

The so called myths and taboos among the people of India are obstactes controlling population explosion and thereby the nation is being handicapped with economic development. To propagate awareness and information, the NSV Resource Center took up organising mega camps for the acceptance of NSV as the method of family planning and male participation. The awareness material has been developed to bring forth total sociocultural transformation through development of intense desire, strong determination, effective management and inclusion of a zeal of perpetual efforts both among the promoters and acceptors. The information modules have been developed to suit the requirements of various vehicles through which the message has to be spread. Awareness messages are generated through the inputs from sociocultural, economic, ethical, hygienic and administrative acumen. The materials prepared are disseminated through display hoardings, wall writings, distribution of pamphlets, audiovisual clips, face to face counselling, etc. Communication technology serves mobilising and educating people, especially rural populace. Some steps are suggested to reach remotest villages which are elaborated. Counselling is an essential part of motivation to the client. During the last 5 years a significant surge has been noticed in terms of access to new communication technologies. This may be employed to successfully implement the family planning programme.

Awareness↗
PubMed2006

[Electronic medical handbooks--are they suitable for implementation of guidelines in health care?].

BACKGROUND: The Directorate for Health and Social Affairs commissioned a project to evaluate the distribution and use of a Norwegian electronic medical handbook (NEL). MATERIAL AND METHODS: NEL uses multimedia techniques and is distributed on a CD twice a year. A questionnaire about the use of NEL was given to 91 medical students. Health professionals at two hospitals and 12 health centres were interviewed. RESULTS: The use of the electronic handbook differed more within than between groups of professionals. NEL is applied for three main purposes: decision support, quality assurance and as a source for information pamphlets designed for patients. The professionals believed that NEL has contributed to patients' receiving more information and more uniform treatment. Criticism was made about the price and for the lack of integration with the electronic patient record. INTERPRETATION: The study has revealed some barriers to implementation and use of electronic information sources. Under certain circumstances an electronic handbook might be suitable way for authorities and others to distribute professional guidelines.

CD-ROM↗
PubMed1975

A biomedical information source: the National Clearinghouse for Alcohol Information.

The National Clearinghouse for Alcohol Information (NCALI) is an information resource developed by the National Institute on Alcohol Abuse and Alcoholism of the U.S. Department of Health, Education, and Welfare. It provides numerous alcohol-related information services to professionals in a wide spectrum of biomedical and other disciplines, services that are designed to aid information users in the discrimination and selection of useful literature from the volumes of available information. One such service will provide the biomedical professional, working in an alcohol-related field, with announcements of recent information in categories that he selects from 110 possible fields of interest. Another information service is the quality evaluation of technical documents. The quality evaluation system, which is under continuing development and refinement, serves the literature user by providing a literature quality prescreening process designed to aid users in their literature review and monitoring activities. Additional information services provided by the clearinghouse include Grouped Interest Guides, Subject Area Bibliographies, a quarterly magazine and a periodic general interest information service, and a wide range of special publications. Reference services provide a suitable depth of response to information requests through services that range from assemblages of standard information materials, such as pamphlets and similar publications, to automated data base searches for more technically oriented information requests.

Alcoholism↗
PubMed2006

Nursing intranet for communication and knowledge management.

Leveraging on staff's familiarity with the global Internet and the Hospital Information Technology infrastructure, nurses at Singapore General Hospital (SGH) first took the challenge to design and develop an in-house intranet, which serves as a communication network in 1997. This nursing intranet was further enhanced using multi-media technology to develop e-learning modules on nursing specialty, skill-based, and audio slides presentation training. In addition, it also serves as a repository for policies, operational, nursing procedure documents and catalogue of forms, patient instruction pamphlets. Nurses can easily print all these forms and teaching brochures on-line. The nursing intranet offers cost-effective solution for distributing information through virtual network and accessible from over 700 points in SGH, 6 other affiliated medical institutions, and from nurses' homes too.

Communication↗
PubMed2007

Radiation dose distribution in human kidneys by octreotides in peptide receptor radionuclide therapy.

UNLABELLED: Ex vivo autoradiographs of healthy kidney tissue from patients who received (111)In-DTPA-octreotide (DTPA is diethylenetriaminepentaacetic acid) before nephrectomy showed very heterogeneous radioactivity patterns in the kidneys. The consequences of the reported inhomogeneities have been evaluated for radionuclide therapy with (90)Y- DOTA-Tyr(3)-octreotide (DOTA is 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid), (177)Lu-DOTA-Tyr(3)-octreotate, and (111)In-DTPA-octreotide by calculating dose distributions and dose-volume histograms (DVHs) for the kidneys. METHODS: Monte Carlo radiation transport calculations were performed by using the MCNP code version 5. The autoradiography data were used in a 2-dimensional model of the kidney tissue sections. A voxel structure inside the MIRD Pamphlet 19 multiregion kidney model was developed to generate a 3-dimensional representation of the autoradiographs. Dose distributions were calculated for the beta-emitter (90)Y, the low-energy electron and gamma-emitter (111)In, and the beta- and gamma-emitter (177)Lu. Isodose curves were generated for the 2-dimensional kidney sections and DVHs for the 3-dimensional kidney model. RESULTS: The isodose curves for the high-energy beta-emitter (90)Y did not show a sign of the inhomogeneous activity distribution, apart from the cortex-medulla boundaries. Both (111)In and (177)Lu isodose curves follow the autoradiographic activity distribution exactly. The 2 gamma-rays from (111)In give higher doses to the low-radioactivity regions in the kidney sections. The DVHs show that the inhomogeneous activity distribution creates considerable volumes within the kidney and within the cortex with lower doses than the average kidney dose, together with volumes receiving much higher doses. This effect is most profound for (177)Lu, but also (111)In shows this heterogeneity in the dose distribution. CONCLUSION: Kidney dosimetry for radionuclide therapy can be based on average MIRD-based dose models for high-energy beta-emitters (such as (90)Y). In contrast, low-energy beta-emitters (such as (177)Lu) and Auger-electron-emitting radionuclides (such as (111)In) produce dose distributions in the kidneys that are very dependent on the activity distribution pattern in the kidney or renal cortex. Complication probability models for renal tissue damage after radionuclide therapy with these latter nuclides need to be developed, as the existing models based on average dose to the kidney or cortex from external beam therapy experience are most probably not valid.

Dose-Response Relationship, Radiation↗
PubMed1991

KAP study on mothers of children with Down syndrome.

We evaluated 50 mothers of children with Down syndrome attending Genetic Clinic of the Institute of Child Health and Hospital for Children, Madras, with special reference to their knowledge, belief and attitudes in the care of these children. After evaluation, they were educated individually and in groups with demonstration, picture cards and pamphlets, on the causation, expected health problems, developmental potential of Down syndrome and the ways and means to help the child to attain the maximum developmental potential. They were taught on preventive aspects of Down syndrome as well. Re-evaluation was done after three months, and considerable improvement was noted in the mother's knowledge, and attitude towards bringing up such a child. The mothers also showed an improvement in the skills in providing developmental enrichment to these children. Thus this study has formulated a programme in the management of such children, which can be practised on any population, anywhere, especially, in rural areas, and by less affluent folk, with poor educational background.

Adult↗
PubMedDate not supplied

Patients' perceptions related to the use of infection control procedures.

An assessment was made of the public's attitudes toward infection control techniques utilized in dentistry. Five hundred and nine adults in the State of Maryland responded to a detailed telephone survey in late 1989. Respondents reported that most of their dentists (87.0%) wore gloves and 69.8% of the respondents preferred gloves. Respondents who were most concerned about AIDS also preferred the dentist to wear gloves (92.6%). Respondents received information about AIDS from various sources, chief of which were newspapers or magazines (29.0%) and television (27.3%) but 80.9% would read pamphlets on AIDS if they were available in the dentist's office. Finally, few (13.1%) had ever discussed AIDS with their dentist but most (78.6%) would be comfortable doing so. This study demonstrated that the public accepts and welcomes the use of barrier protection by dentists. The public also is willing to discuss AIDS and infectious diseases with dentists and would read AIDS information supplied by dentists. Given the continued spread of the AIDS epidemic, it is increasingly important for dentists to educate the public about AIDS as well as about the continued safety of the dental office. The public is receptive to this education.

Acquired Immunodeficiency Syndrome↗