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[Frequency of repeated examinations in the ultrasonographic section of a radiological university department].

PURPOSE: What is the percentage of repeat examinations in the ultrasonographic section of a radiological university department? METHODS: All 4116 patients, who were first examined in the sonographic section of the Radiologic Department of the University of Cologne from 5/97 to 5/98, were asked by the medical staff, whether, how often and by whom ultrasonographic, CT or MR examinations of the same organ system had been carried out during the last 4 weeks without evidence of clinical changes. The data were documented using a structured questionnaire. RESULTS: Sonographic repeated examinations documented in 443 (10.8%) of the 4116 consultations. The proportion of in- to outpatients with repeat examinations was 26.0% to 74.0%. Contrarily, the repeated ultrasonographies were done by practitioners in 62.3% and by the university staff in 33.2% (radiology 48.2%). With regard to the 4116 consultations, the abdomen (81.1%) was the organ system most often examined repeatedly. Computed tomographies were already done or planned in 305 of 4116 patients (7.4%) and MR-tomographies were already done or planned in 57 patients (1.4%). CONCLUSION: The rate of repeated ultrasonographic examinations in a radiological university hospital was 19.6%.

Abdomen↗

[Investigations on the cornea donation at the Martin-Luther-University Halle-Wittenberg].

AIM: We analysed the number of the potential cornea donors of the Martin-Luther-University, Halle-Wittenberg over a four-years period, 1995 to 1998 in relationships to the number of the actual donors. PATIENTS AND METHODS: We retrospectively reviewed the data of 2545 patients who died at the hospitals of the Martin-Luther-University, Halle-Wittenberg over a four-years period, from January 1995 to December 1998. The medical records of the patients were inspected and contraindications for cornea donation examined. The patients who were younger than 12 months were omitted in our analysis. The patients with at least one contraindication were excluded as potential cornea donors. Additionally we registered the actual cornea donors of the hospitals of the Martin-Luther-University, Halle-Wittenberg between 1995 to 1998. RESULTS: The mean age of the died patients was 60 years. Because of contraindications 597 patients (23.5 %) were excluded from the cornea donation. An acute sepsis with 25.1 % as well as leukemias and lymphomas with 24.8 % matched about half of the exclusion criteria. In the period of investigation we counted 1948 potential cornea donors. In the hospitals of the Martin-Luther-University, Halle-Wittenberg only 57 (2.9 % of potential donors) actual cornea donors have been registered. CONCLUSIONS: The possible leading causes for the large discrepancy between the number of the potential and actual donors are: (1) the imperfect identification of potential donors, (2) the donor family have not been asked and (3) the denial of consent by the potential donors family.

Adolescent↗

[Prof. Carl Wilhelm von Zehender (1819-1916)--first professor of ophthalmology and co-founder of the ophthalmological clinic at the University of Rostock--commemorative lecture at the 100th DOG meeting in Berlin from 26.9 to 29.9.2002].

The Grand-ducal University Eye Department in Rostock was solemnly inaugurated 16 May 1892. According to many years of studies in Europe and on efforts to build this clinic, construction was outlined by Professor Carl Wilhelm v. Zehender, but the drafts were executed by the "Grossherzoglich-Mecklenburgisch-Schwerinschen Medicinalcommission" and Landbaumeister Schlosser in winter 1888/89. Professor v. Zehender, who originated from a very ancient Swiss family, was born in Bremen, 21 May 1819. He studied medicine in Goettingen, Jena, Prague, Paris and Vienna. During this time he developed a lifelong friendship with Albrecht v. Graefe. 1856 he took over the medical care for the hereditary duke Georg von Mecklenburg-Strelitz and published the "Correspondenzblatt für Aerzte im Grossherzoglichen Mecklenburg-Strelitz". 1857, during a conference in Heidelberg, his initiative led in the long run to the establishment of the "Heidelberger Ophthalmologische Gesellschaft", the forerunner of the "Deutsche Ophthalmologische Gesellschaft", which was founded in 1920. In 1863 the first edition of "Klinische Monatsblaetter für Augenheilkunde" was published as a periodical; the cover page bore its name as the founder of the magazine. In 1866, after the death of the hereditary duke and a professorship in his hometown Berne, he became honorary professor of the Rostock University, and from 1869 onwards he chaired the clinic as a regular professor. After all his efforts to build his own hospital had failed, he demonstratively and finally resigned from his professorship in 1889. He went to Munich and became editor of the " Klinische Monatsblaetter für Augenheilkunde". In 1907 he moved with his wife via Eutin to Warnemuende. There the nestor of world ophthalmologists died at the age of 98. His burial place without gravestone is situated in today's landscape park "Stephan Jantzen". So far all efforts of the author and of the Rostock University Eye Department taken after 1980 to create a worthy note to this exceptional ophthalmologist in the Baltic Sea resort Warnemuende were unsuccessful, also for financial reasons. But on 2.9.2002 with the help of the Lighthouse Club of Warnemuende a memorial plaque to Prof. C. W. v. Zehender was mounted on the guest house "Margarete". This plaque commemorates Professor Zehender's merits in establishing the DOG, planning and building the eye clinic of the university of Rostock.

Germany↗

Commercializing university research. Lessons from the experience of the Wisconsin Alumni Research Foundation.

Universities that are now seeking ways to capture the financial rewards of advances made in biotechnology and other fields on their campuses have been encouraged by the apparent success of previous efforts to benefit from the commercial application of research findings by obtaining patents and granting licenses. Notable among these efforts is the Wisconsin Alumni Research Foundation (WARF). A close examination of the experience of this foundation reveals that, with good fortune and good management, a patenting and licensing organization can enjoy financial success. It also indicates, however, that the success experienced by WARF would be difficult to achieve today and that such efforts may yield lower financial returns than university administrators expect. Universities should be aware that such ventures entail financial risks and pose potential threats to traditional university values.

Academic Medical Centers↗

Medical students' experiences of diseases in internal medicine in university and community hospitals.

Because medical students in The Netherlands should achieve common national objectives, it is important to know whether clinical experiences in different hospitals are comparable. The research questions were: (1) Do students achieve learning experiences of the required diseases during the internship in Internal Medicine and to what extent do they achieve these experiences? (2) Are there differences between the diseases experienced at a university hospital and at community hospitals? Completed logbooks of students were analysed; the percentage of students that achieved the required diseases and the mean number of experiences of diseases were calculated. A t-test was done to test for differences. Medical students in the university and in community hospitals get broad experience (76-131%) of the required diseases. In both hospitals there are many students who are not achieving the requirements, but the mean number of experiences of students at the community hospitals is higher than those at the university hospital. To eliminate the differences between students from the university hospital and the community hospitals, the educational programmes within both hospitals should be adjusted.

Clinical Competence↗

Prevalence and factors associated with physical and sexual assault of female university students in Ontario.

The authors examined the prevalence of physical and sexual assault of female university students and associated factors. In a survey of a random sample of 3,642 female students from 6 universities across Ontario, 24% of female students reported being physically assaulted and 15% reported being sexually assaulted during the previous year. When the assault measures were combined, 32% of university women reported being either physically or sexually assaulted during the previous year. Of those experiencing assault, 40% had been the victim of 2 or more types of assaults. Logistic regression analysis revealed that assault was associated with year of study, marital status, alcohol consumption, illicit drug use, prescription drug use, unhealthy eating and stress behaviors, less time spent on academics, and more time involved in social activities. University programs and activities directed toward the reduction of assault should incorporate the factors identified in this study to increase awareness of the situational factors surrounding likelihood of assault.

Crime↗

Condom sales at public universities in California: implications for campus AIDS prevention.

Public health officials have called for increased use of condoms to protect Americans from sexually acquiring human immunodeficiency virus (HIV) infection. To investigate the availability of condoms for sale on college campuses, we asked student union directors and bookstore managers from all 28 public universities in California, with a combined enrollment of half a million students, to complete a detailed questionnaire in August and September 1987. Two thirds of the campuses reported having condoms for sale in either their bookstores or convenience stores; one third said condoms were available in the men's and women's restrooms in their student unions. On most campuses, sales were instituted in the past year in response to the AIDS (acquired immune deficiency syndrome) epidemic. However, very few campuses provided AIDS education at the point of sale, and condoms were not easily available outside of store hours. Respondents felt that the most important obstacles to increasing the distribution of condoms on campus included concern about presenting a negative image of the university and the low priority assigned to this issue by the university administration and others on campus. This study suggests that although condom availability has improved in the past year, the opportunity exists at most California public universities to increase the distribution of condoms and improve associated AIDS-related health education efforts.

Acquired Immunodeficiency Syndrome↗

Seat belt use on a university campus.

Observed seat belt use on a private university campus was compared with use by the general population of the state in which the university is located. It was expected, given the higher educational level and socioeconomic status of the university population, that seat belt use would be higher than it is for the general population. The results of the study indicated that seat belt use by members of the university community was actually significantly lower than that reported statewide. The statistically significant difference was even greater for front-seat passengers than for drivers on campus.

Data Collection↗

Evaluating research misconduct policies at major research universities: a pilot study.

This pilot study evaluates the accessibility and usefulness of the research misconduct (RM) policies at the top-25 universities as ranked by NIH and NSF grant awards. Measuring accessibility demonstrates how readily-available policies are to the people they affect. Evaluating the range of policy content indicates whether policies and procedures on research misconduct are "useful" as opposed to merely "minimal" (Rhoades, 2003). On average, it took five clicks to get from a university's home page to its RM policies. Only nine policies were accessed within three or fewer clicks. Policy information was coded into categories comprising a total of 20 topic areas, which were then grouped into five content domains. The policies reveal a broad range of usefulness. Some provide relevant details on almost every topic area, while others leave most questions unanswered. Three of the 20 topic areas are almost universally covered in the policies analyzed. In contrast, five other topic areas average less than half of the information which could have been included. These policies, from elite U.S. research universities, may serve as role models; as such they should perhaps be held to the highest standards. If the message sent by a policy lacks clarity and precision, it should be revised to include an appropriate level of detail.

Biomedical Research↗

Interrelationships between anxiety, lifestyle self-reports and fitness in a sample of Hong Kong University students.

Although anxiety in university students has been well documented, the influence of lifestyle and fitness status in relation to anxiety has not been investigated from a cultural perspective previously. To make recommendations regarding the avoidance or management of anxiety in this anxiety-prone cohort that are rationally based, this preliminary investigation examined the interrelationship between anxiety, lifestyle self-reports and aerobic fitness in Hong Kong Chinese University students. The State Trait Anxiety Inventory (Form Y-2) and a lifestyle questionnaire were completed by 213 students. Female students were more anxious than male students. Subjects with high anxiety reported more deleterious lifestyle behaviours including higher salt consumption and lower levels of exercise; in addition to more frequent symptoms of anxiety such as headaches and daytime somnolence. The extremes of this sample were stratified into a low anxiety group (n = 17) and a high anxiety group (n = 14) to compare their fitness status. Although both groups had below normal aerobic capacity, the higher systolic blood pressure observed for the high anxiety group is consistent with signs of anxiety, or greater deconditioning in this group or both. The results of this study have highlighted anxiety as a concern in Hong Kong University students and identified some lifestyle and fitness correlates. Understanding lifestyle and pathophysiological correlates of anxiety in Hong Kong University students that may have a cultural basis, is a crucial step toward averting or managing anxiety when these students are studying either in Hong Kong or abroad.

Adult↗

Smoking addiction among university students in Istanbul.

In this study, we investigated smoking addiction and some risk factors among university students in Istanbul. A questionnaire survey of 236 university students studying in Istanbul Medical Faculty (n: 148) and other faculties (n: 88) was performed with cross-sectional and responding-under-observation methods in March-May 1999. Thirty-six per cent of the university students with mean age 24.0 (2.9 were addicted to smoking (n: 85): 41.3% males and 26.7% females; 67.5% were using imported and 32.5% were using local product cigarettes. Of the subjects, 18.1% were smoking 1-10 cigarettes a day, 61.4% 11-20 cigarettes a day and 20.5% more than 20 cigarettes a day. When alcohol and smoking addiction were compared with logistic regression analysis, with respect to gender, age, school, parents' educational levels, living style and the sources of income, the risk factor for alcohol addicts was found to be more 2.54 times than smoking addicts (OR = 2.54, 95% CI = 1.38-4.67; p = 0.003). The study has emphasized the association of alcohol and smoking addiction in university students and the prevalence of smoking addiction among adolescent females.

Adult↗

"A lab of one's own". The Balfour Biological Laboratory for Women at Cambridge University, 1884-1914.

The Balfour Biological Laboratory for Women was established at Cambridge University in 1884 to prepare the students of Newnham and Girton Colleges to sit the Natural Sciences Tripos, first opened to women in 1881. For thirty years, until its closure in 1914, the Balfour Laboratory served as the central conduit for biological instruction for the women of Cambridge, introducing them to the new program of experimental biology developed by the physiologist Michael Foster and the embryologist Francis Maitland Balfour. Directed by distinguished women graduates, the Balfour Laboratory became recognized as the leading center for women's biological instruction in Britain. Its significance, however, extends beyond its nominal status as a teaching laboratory. It provided university positions for able scientists who otherwise would not have been placed, offered advanced students the opportunity to engage in independent research, and, most important, formed the locus for the scientific subculture created by women at Cambridge to compensate for their exclusion from the social community of science. Drawing upon college and university archival records, this essay offers institutional, social, and biographical research that broadens our understanding of the experience of the first generation of women to pursue a higher education in the life sciences at one of the world's premier universities.

Biological Science Disciplines↗

Noncompliance with universal precautions and the associated risk of mucocutaneous blood exposure among Danish physicians.

OBJECTIVE: To study the compliance, and reasons for noncompliance, with Universal Precautions and the associated circumstances of mucocutaneous blood exposure (MCE) among Danish physicians. DESIGN: A nationwide questionnaire survey. SETTING: All Danish hospitals. PARTICIPANTS: All hospital-employed physicians. RESULTS: Of 9,384 questionnaires, 6,256 (67%) were returned, and 6,005 were eligible for analysis. Only 35% of respondents were compliant with the basic principle of Universal Precautions. Compliance with specific barriers in the preceding week among "surgeons and pathologists" and "other physicians" was as follows: gloves, 63.0% and 23.4%; masks, 55.2% and 17.6%; and protective eyewear, 11.5% and 4.0%, respectively. Common arguments for non-compliance were "interferes with working skills," "forget," "wear spectacles," "not available," "too much trouble to get," or "gloves do not fit." Detailed descriptions of 741 MCEs were obtained. Blood splashes in the eyes (n = 320) was the most common MCE in surgical specialties and pathology, whereas blood on the hands (n = 290) was most common in other specialties. In 20% of MCEs of the eyes, the exposure occurred despite the use of spectacles. An estimated 84% to 98% of MCEs potentially would have been preventable had appropriate barriers been worn. More than one half of MCEs were preventable by two interventions only: compulsory use of protective eyewear during operations and use of gloves during insertion of peripheral intravenous catheters. CONCLUSION: Compliance with Universal Precautions is unacceptably low, as reflected by the circumstances of MCE. Increased efforts to ensure education in Universal Precautions, easy accessibility of protective barriers, and improved design of the barriers are necessary to improve compliance and reduce the risk of MCE.

Blood-Borne Pathogens↗

Alcohol use among entrants to a Hong Kong University.

AIM: This study of first year entrants to one of the major universities in Hong Kong describes the pattern of their alcohol consumption, their binge drinking, alcohol abuse, and dependence. METHODS: A retrospective cross-sectional study was conducted. A representative sample of year 1 students 2630/2968 (89%) newly admitted to the Chinese University of Hong Kong in 2003 were recruited to participate in a structured self-administered questionnaire. RESULTS: First year university students in Hong Kong have low rates of ever drinking alcohol (62%), and the rates of binge drinking and alcohol-related problems were 7 and 0.8%, respectively. The pattern of binge drinking is more common than weekly drinking (2.3%). Binge drinkers are more likely to have experienced alcohol-related interpersonal problems or (95% CI) = 6.5 (1.7-24.5). Males were more likely to drink, to binge drink, and to drink frequently. CONCLUSIONS: In contrast with students in the west, the majority of first year university students in Hong Kong are not binge or regular drinkers. However, there is a subgroup who smoke, drink more, and use alcohol as a means of coping with stress. This group may be particularly in need of a brief intervention, such as providing counseling and referral services.

Adolescent↗

Temporal association between implementation of universal precautions and a sustained, progressive decrease in percutaneous exposures to blood.

To evaluate whether implementation of universal precautions was temporally associated with a decrease in reported parenteral exposures to blood, we analyzed data on self-reported parenteral injuries that were prospectively collected at the Clinical Center, National Institutes of Health (Bethesda, MD), from 1985 through 1991. We also assessed whether implementation of universal precautions, in concert with initiation of a program of postexposure chemoprophylaxis with zidovudine, was associated with decreased time to reporting of occupational exposures. Our data, possibly confounded by the occurrence of an occupational infection due to human immunodeficiency virus infection in 1988, nonetheless demonstrate a temporal association between a progressive, significant decrease in percutaneous injuries and the implementation of universal precautions that has been sustained through subsequent years. The analysis remains significant, regardless of the surrogate denominator chosen for analysis. No trend toward more rapid reporting of exposures was identified. Implementation of universal precautions appears to have contributed to decreased parenteral injuries in our hospital but did not affect reporting efficiency.

Blood-Borne Pathogens↗

Employee's perceived exposure to environmental tobacco smoke, passive smoking risk beliefs and attitudes towards smoking: a case study in a university setting.

Despite the growing literature on workplace smoking policies, few studies have focused on the implementation of such policies in university settings. Smoking in the workplace is still very common in many countries, including Spain. While the law is about to change and more non-smoking policies are to be implemented, it is not clear what kind of restrictions Spanish workers would find acceptable. This study investigated perceived exposure to environmental tobacco smoke (ETS), passive smoking risks beliefs and attitudes towards smoking at the University of Navarra (Spain). A questionnaire was sent by E-mail to 641 randomly selected employees and a response rate of 70.4% was obtained. The survey results suggest that 27.3% of the university employees were smokers and 26.6% were exposed to ETS on a daily basis. The majority of respondents (81.7%) supported a restrictive non-smoking policy. Acceptance among active smokers was significantly lower (59.2 versus 89.3%). Smoking prohibition with the provision of smoking areas was the most favored option (46.9%). Results suggest that employees are ready to restrict smoking in the university, but there was not enough support for a total ban. Employers considering adopting a ban on smoking should be encouraged to conduct a similar survey to identify potential barriers to policy implementation.

Cross-Sectional Studies↗

Universal health care coverage in the United States: barriers, prospects, and implications.

Universal health care coverage has long been a concern for social workers. This article examines barriers to and prospects for universal coverage in the United States. The article identifies major obstacles to universal coverage, addresses current problems with the U.S. health care system, discusses the debate over Medicare and Medicaid, and considers possible routes to universal coverage. The article also discusses implications for NASW and other supporters of a single-payer system.

Health Care Reform↗

Perception, reality, and the political context of conflict of interest in university-industry relationships.

The crucial issues in a policy debate are often matters of perception and interpretation rather than fact, and the values and norms that influence perceptions are central to an understanding of conflict in the policy arena. For example, science's norms of objectivity and disinterestedness are being modified today to accommodate closer academic-industry ties. The author traces in detail how these ties and the accompanying public distrust have developed, beginning with the post-World-War-II increase in public support for basic research and continuing with subsequent pieces of legislation that lowered the barriers between academic and industrial research in order to reap economic benefits. He then analyzes the impact of financial incentives in university-industry relationships on science and on public perceptions of science, and the price both science and the public would pay if the public loses trust in science and refuses to support it. He also reviews the history of the ill-fated National Institutes of Health guidelines for university-industry collaborations proposed in 1979 and the subsequent history of the policy on this topic recently adopted by the Public Health Service. He maintains that the PHS policy poses both a risk (the temptation to enforce the policy loosely) and an opportunity (for research institutions to grasp the initiative and develop meaningful conflict-of-interest guidelines of their own). But the policy falls short of responding to the much broader range of concerns associated with university-industry research collaboration, for example, the possible effects of such collaboration on the traditional openness and sharing among scientists. The available data on these effects are mixed. He concludes by maintaining that scientists and their industry partners should address the issues surrounding their collaboration now rather than waiting for negative events to trigger public arousal and force a mutually unsatisfying political solution. This article is one of three in this issue of Academic Medicine that deal with issues of conflict of interest in university-industry research relationships. These articles are discussed in an overview that precedes them.

Biomedical Research↗