[Chronic neurasthenic syndrome].
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Chronic Disease↗
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Results for “Manual Communication”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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[A mission to Mars: the prognostic analysis of concurrent psychological problems].
Psychological implications of situations that may take place during a mission to Mars including desynchronosis, fatigue, psychic asthenization, acute mental disorders, interruption of the information flow, unpredicted transformation of the socio-psychological needs, a persistent conflict tension in the crew, errors in manual control of the vehicle, refusal or impossibility to fulfill an operation, difficulties in communication between the crew and ground controllers were analyzed for determination of their causes and consequences, probable starting time, ways and methods of preventing and surmounting each of these situations.
Astronauts↗
Visual communication with non-literates: a review of current knowledge including research in northern India.
In this article previous research on the perception of visual aids by non-literates in Kenya, Zambia, Ghana, Papua New Guinea, Mexico, as well as among immigrant groups in London and Paris, in Nepal and, by the authors in northern India, is reviewed. Recognition of pictures is affected by the particular culture of each group. In Africa, photos are better understood and liked: in the Indian subcontinent, line drawings are well recognized and appreciated. Recognition can be reduced by inaccurate detail, stylization and perspective. The authors found that overall size could be kept small if the pictures were simple. Complicated pictures, or a group of interrelated pictures, are not usually well recognized. Familiarity, realism and simplicity seem the most important components for a successful picture. Ways of attaching value ("good" or "bad", for example) have not in the past been very successful, but the authors found that a "vocabulary" of fourteen signs were, once explained, well understood. The values of colours in the culture must be understood and utilized. To be successful, visual materials for non-literates must start from the local culture and not come untested from behind a desk in the capital city.
Audiovisual Aids↗
Apolipoprotein E status as a predictor of the development of Alzheimer's disease in memory-impaired individuals.
OBJECTIVE: The outcome of patients with mild cognitive impairment is not known, yet these patients present a difficult dilemma for the clinician. This study was designed to characterize the outcome of a group of patients with mild cognitive impairment and to determine whether the presence of the epsilon 4 allele on the apolipoprotein E gene (APOE) is a predictor of that outcome. DESIGN: A prospective, longitudinal inception cohort. SETTING: General community clinic. PARTICIPANTS: A consecutive sample of 66 patients who met criteria for a diagnosis of a mild cognitive impairment and who had at least one clinical reevaluation was identified from the Mayo Clinic Alzheimer's Disease Center/Alzheimer's Disease Patient Registry. INTERVENTIONS: We evaluated patients initially and at 12- to 18-month intervals up to 54 months using standard neurological and neuropsychological measures such as the Mini-Mental State Examination, the Dementia Rating Scale, the Wechsler Adult Intelligence Scale--Revised, the Wechsler Memory Scale--Revised, and the Free and Cued Selective Reminding Test. The APOE status of study patients was determined. MAIN OUTCOME MEASURE: The development of dementia as determined by the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition and the National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association criteria. RESULTS: Sixty-six individuals had been reevaluated once (mean of 18 months), 36 individuals twice (mean of 36 months), and 22 individuals on three occasions (mean of 54 months), with conversion rates to dementia at these intervals of 24%, 44%, and 55%, respectively. A multivariate Cox regression model demonstrated that possession of an APOE epsilon 4 allele was the strongest predictor of clinical outcome. CONCLUSIONS: These data suggest the following: (1) patients with mild cognitive impairment can be clinically defined, (2) many members of this group progress to Alzheimer's disease, and (3) APOE epsilon 4 allele status appears to be a strong predictor of clinical progression.
Aged↗
[General practitioner's handbook and database will be international].
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CD-ROM↗
Analysis of search in an online clinical laboratory manual.
Online laboratory manuals have developed into an important gateway to the laboratory. Clinicians increasingly expect up-to-date laboratory test information to be readily available online. During the past decade, sophisticated Internet search technology has developed, permitting rapid and accurate retrieval of a wide variety of content. We studied the role of search in an online laboratory manual. We surveyed the utilization of search technology in publicly available online manuals and examined how users interact with the search feature of a laboratory handbook. We show how a laboratory can improve its online handbook through insights gained by collecting information about each user's activity. We also discuss future applications for search-related technologies and the potential role of the online laboratory manual as the primary laboratory information portal.
Clinical Laboratory Information Systems↗
Development of a resource manual for returning neonates to community hospitals.
To facilitate the transfer of an infant from a tertiary NICU to a community Level II hospital for convalescing follow-up care, the tertiary staff must know the referral center's capabilities. This will help to establish a trusting relationship between hospitals, will enable the tertiary staff to send infants back to the referral center in a timely manner, will enable them to reassure the patient's parents concerning the transfer, and will facilitate communication between the hospitals and the patient's family. This article describes the development of a referring hospital resource manual designed to facilitate the transfer process.
Academic Medical Centers↗
Channels and vehicles of communication: the asbestos awareness campaign.
In April 1978, the U.S. Department of Health, Education, and Welfare launched a multimedia campaign to inform doctors, workers, and others about the increased risks of asbestos exposure. Unlike most worker notification efforts, this one has no lists of workers or even of workplaces but faced the challenge of locating people who had worked in the shipbuilding industries more than 30 years earlier. Multiple mass media channels were used, but since most messages were distributed as public service announcements, gatekeepers were critical to the success of the campaign. Some campaign messages were aired, but mostly at hours other than prime time, and the coverage focused more on the controversial, fast-breaking events rather than on estimates of risk or on behaviors to reduce risk. The campaign was effective in increasing the number of people who believed they were at risk, but was less successful with older Americans than with manual laborers.
Advertising↗
Social determinants of diagnostic labels in depression.
The role of diagnostic labels in medicine is usually that of labelling an illness as a means of communication. Control over labelling processes in medicine is ordinarily imposed via medical schools, textbooks, education or by diagnostic manuals. Diagnostic labels often change following new discoveries in underlying pathology such as 'consumption' being relabelled as 'TB' or 'cancer'. Sub-types of broad diagnostic labels also often emerge from such discoveries e.g. 'lung cancer' or 'throat cancer'. In mental health, underlying pathology is the subject of ongoing debate spanning ideas including the brain as a faulty organ, faulty genetics and environmental problems. With controversy over pathology comes controversy over labels and the idea that labels may be used not just for communication, but as devices of social and professional control, arising out of a social process. This study explores the codification of the diagnostic label 'depression' which emerged in the twentieth-century and has proliferated with numerous sub-types over the last 40 years. The aim is to examine its social determinants and context. Medline is used as a data source for professional label usage. A range of depression sub-type labels in professional use was identified. This exercise revealed many official and 'unofficial' terms in professional use. Citation rate plots by year were then generated for these depression sub-type labels. The rise and fall of different labels are examined in relation to social determinants and context, including publication of diagnostic manuals DSM and ICD, power shifts in psychiatry, the discovery of psychiatric drugs and the shift from inpatient to community care. Exploring the changing use of official and unofficial labels over time in this way provides a novel historical perspective on the concept of depression in the late twentieth-century.
Bibliometrics↗
The telephone interview is an effective method of data collection in clinical nursing research: a discussion paper.
There are varying points of view regarding the advisability and utility of using the telephone to conduct research interviews. When undertaking the Women's Recovery from Sternotomy Study, we found the telephone was an effective mechanism for data collection. Our aim is to identify the advantages and challenges of using the telephone as a mechanism for data collection in clinical nursing research. The potential benefits associated with using telephone interviews as a mechanism of data collection include (a) using economic and human resources efficiently, (b) minimizing disadvantages associated with in-person interviewing, (c) developing positive relationships between researchers and participants, and (d) improving quality of data collection. The potential challenges to telephone interviewing include (a) maintaining participant involvement, (b) maintaining clear communication, (c) communicating with participants who offer extraneous information, (d) encountering participants with health concerns, and (e) communicating with a third party. Telephone interviewing can be an effective method of data collection when interviewers understand the potential benefits as well as challenges. We offer solutions to the identified challenges and make pragmatic recommendations to enhance researcher success based on the current literature and our research practice. Supportive training for interviewers, effective communication between interviewers and with research participants, and standardized telephone follow-up procedures are needed to ensure successful telephone data collection. We have found our 'Manual of Operations' to be an effective tool that assists research assistants to meet the requirements for successful telephone interviewing.
Canada↗
Infection control policies and guidelines--Scandinavian experience.
In the Scandinavian countries few regulations govern hospital infection control. In Sweden a common procedure manual is used nationwide, consisting of guidelines covering a wide range of nursing and medical procedures performed by the nursing staff. It is revised every fifth year. A recent enquiry to over 150 wards in some 100 hospitals demonstrated that the manual is widely accepted and used. In the other Scandinavian countries, guidelines and policies on a variety of infection control topics have been published.
Clinical Protocols↗
Are you getting the message? A look at the communication between the Department of Health, manufacturers and anaesthetists.
A questionnaire sent to 109 anaesthetists in the South West Region has revealed that there is a problem with dissemination of information relating to hazards with equipment. Thirty-four per cent of consultants, and 67% of junior anaesthetists were only slightly or not at all confident that they see the Hazard Notices and Safety Action Bulletins relating to the equipment they use. The study has also demonstrated the large amount of new equipment coming into circulation and has highlighted deficiencies in the reading of equipment manuals. Some suggestions are made as to how the current system may be improved.
Anesthesiology↗
The role of quality in today's research university.
Today's research universities strive to meet goals in education, research, and service within an academic environment. A quality assurance and quality control program is critical to achieving excellence in all areas. However, the role of quality in research at higher education institutions is difficult to determine or consistently implement due to the broad nature of the research and academic goals. In addition, it is compounded by the loose organizational structure common to most universities. Formal quality assurance programs are not historically found at academic institutions. Faculty and staff often have neither the experience nor training in good quality assurance practices. Implementation of a formal quality assurance program is made more difficult by university space and financial limitations and a reward system based on peer-reviewed publications. A successful formal quality assurance program must be sufficiently flexible to meet all needs, must focus on those needs, and must be willingly supported by all participants. The Institute of Wildlife and Environmental Toxicology (TIWET) at Clemson University in South Carolina has implemented a quality assurance program designed to comply with several quality assurance regulations, including the good laboratory practice (GLP) standards. The program relies on study protocols or plans, standard operating procedures (SOPs), data collection forms, a quality assurance manual, quality assurance checklist/plans, and a quality assurance unit. The program maximizes flexibility while complying with several quality regulations and consensus standards. Since implementation, improvements in communication, study design, data recording, and reporting have been noted.(ABSTRACT TRUNCATED AT 250 WORDS)
Facility Regulation and Control↗
Communication: what happens during the first encounter between patient and physiotherapist?
First encounters between patients and physiotherapists have been video-taped and analysed as part of a research-project. Emphasis was on both functional assessment and patterns of interaction. Three groups of physiotherapists participated; manual therapists, psychomotor therapists, and district physiotherapists. The three groups used different approaches when examining their patients. Thus they conveyed different messages of content, roles, and relationships. Commonly, communication is discussed and analysed separately from diagnostic and therapeutic activity. Rejecting such separation, it is argued that it is important to highlight the way in which physiotherapists relate to their patients through their professional actions. The focus in this article is the implicit communication in the physiotherapist's examination. For physiotherapists, as for doctors, the body is the basis of their work. It is emphasized that it is especially important to discuss the body in connection with implicit communication.
Communication↗
Relationships between extrapyramidal signs and cognitive function in a community-dwelling cohort of patients with Parkinson's disease and normal elderly individuals.
The relationship between extrapyramidal sign (EPS) severity and cognitive function was investigated in 184 patients with idiopathic Parkinson's disease (PD) and 301 normal elderly individuals from a community-dwelling cohort in northern Manhattan, New York City. Fifty-six of the patients with PD met criteria for dementia of the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised, and of the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association. EPS were rated according to the Unified Parkinson's Disease Rating Scale. Cognitive function was assessed by neuropsychological tests of memory, orientation, abstract reasoning, language, construction, and psychomotor speed. Significant associations were found between EPS and neuropsychological performance in PD patients without dementia. Yet EPS severity was unable to account for the pronounced cognitive impairment in PD dementia. Individuals in the normal group with subtle EPS, but without overt idiopathic PD, showed widespread cognitive changes, including impairment in most of the tests that differentiated PD patients from normal subjects. Prospective follow-up of these individuals will determine whether this represents a preclinical stage of PD or constitutes an early manifestation of dementia.
Aged↗
The psychological impact of mammographic screening. A systematic review.
Concerns have been raised regarding the possible negative psychological impact of the cancer screening programmes offered in the UK. This review aims to assess the extent of and factors associated with the adverse psychological consequences of mammographic screening. Fifty-four papers from 13 countries were identified, a majority of which were published after 1990, coinciding more or less with the onset of routine mammographic screening. The results report that mammographic screening does not appear to create anxiety in women who are given a clear result after a mammogram and are subsequently placed on routine recall. However, women who have further investigations following their routine mammogram experience significant anxiety in the short term, and possibly in the long term. The nature and extent of the further investigation that women are exposed to during mammographic screening determines the intensity of the psychological impact. Factors associated with the adverse psychological impact of mammographic screening included: social demographic factors of younger age, lower education, living in urban areas, manual occupation, and one or no children; cancer screening factors of dissatisfaction with information and communication during screening process, waiting time between recall letter and recall appointment, pain experienced during the mammographic screening procedures, and previous false positive result; and cancer worry factors including fear of cancer and greater perceived risk of breast cancer. Difficulties in measuring the psychological impact of screening are discussed, and methods of alleviating the negative psychological outcomes are suggested.
Age Factors↗
DICOM modality worklist: an essential component in a PACS environment.
The development and acceptance of the digital communication in medicine (DICOM) standard has become a basic requirement for the implementation of electronic imaging in radiology. DICOM is now evolving to provide a standard for electronic communication between radiology and other parts of the hospital enterprise. In a completely integrated filmless radiology department, there are 3 core computer systems, the picture archiving and communication system (PACS), the hospital or radiology information system (HIS, RIS), and the acquisition modality. Ideally, each would have bidirectional communication with the other 2 systems. At a minimum, a PACS must be able to receive and acknowledge receipt of image and demographic data from the modalities. Similarly, the modalities must be able to send images and demographic data to the PACS. Now that basic DICOM communication protocols for query or retrieval, storage, and print classes have become established through both conformance statements and intervendor testing, there has been an increase in interest in enhancing the functionality of communication between the 3 computers. Historically, demographic data passed to the PACS have been generated manually at the modality despite the existence of the same data on the HIS or RIS. In more current sophisticated implementations, acquisition modalities are able to receive patient and study-related data from the HIS or RIS. DICOM Modality Worklist is the missing electronic link that transfers this critical information between the acquisition modalities and the HIS or RIS. This report describes the concepts, issues, and impact of DICOM Modality Worklist implementation in a PACS environment.
Forms and Records Control↗
Incidence of dementia, Alzheimer's disease, and vascular dementia in Italy. The ILSA Study.
OBJECTIVES: To estimate the incidence of dementia, Alzheimer's disease (AD), and vascular dementia (VaD) in older Italians and evaluate the relationship of age, gender, and education to developing dementia. DESIGN: Cohort incidence study in the context of the Italian Longitudinal Study on Aging. SETTING: Population sample from eight Italian municipalities. PARTICIPANTS: A dementia-free cohort of 3,208 individuals (aged 65-84), individuated after a baseline evaluation performed in 1992 / 93, aimed at detecting prevalent cases. MEASUREMENTS: The dementia-free cohort was reexamined in 1995 to identify incident cases. The Mini-Mental State Examination (cutoff 23 / 24) was employed to screen for dementia. Trained neurologists evaluated the individuals who screened positive. Final diagnoses had to meet Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised criteria for dementia, National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria for AD, and International Classification of Diseases, Tenth Revision criteria for VaD. RESULTS: Before the follow-up examination, 382 individuals had died (232 had reliable information). Of the 2,826 survivors, 2,266 completed the study. Overall, 127 new dementia cases were identified. Average incidence rates per 1,000 person-years were 12.47 (95% confidence interval (CI)=10.23-14.72) for dementia, 6.55 (95% CI=4.92-8.17) for AD, and 3.30 (95% CI=2.14-4.45) for VaD. Both AD and VaD showed age-dependent patterns. Education was protective against dementia and AD. Women carried a significantly higher risk of developing AD (hazard ratio=1.67, 95% CI=1.02-2.75), and men of developing VaD (hazard ratio=2.23, 95% CI=1.06-4.71). CONCLUSIONS: Incidence of dementia in Italy paralleled that in most industrialized countries. About 150,000 new cases per year are expected. A significant gender effect was evidenced for major dementia subtypes. The burden of VaD, especially in men, offers opportunities for prevention.
Age Distribution↗