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PubMed1976

Projections of the globus pallidus and adjacent structures: an autoradiographic study in the monkey.

Because the globus pallidus gives rise to the principal efferent system of the corpus striatum and is traversed by several fibers systems, attempts were made to study the projections of its cells by autoradiographic technics. Tritiated amino acids (L-leucine, L-proline and L-lysine) were injected into: (1) the medial pallidal segment (MPS), (2) the MPS and the substantia innominata (SI), (3) portions of the MPS and the lateral pallidal segment (LPS) and (4) parts of the putamen. Cells labeled by injections of the MPS transported isotope to thalamic nuclei (ventral anterior, VApc, ventral lateral, VLo and VLm, and the centromedian, CM), the pedunculopontine nucleus (PPN), and the lateral habenular nucleus (Hbl). Labeled cells of the MPS and SI transported isotope to: (1) thalamic nuclei (VLo, VLm and CM), (2) PPN, (3) Hbl, (4) lateral and posterior regions of the hypothalamus, and (5) extensive dorsal regions of the substantia migra (SN). Comparisons of label transported from uptake of isotope by cells of the MPS, and cells of both pallidal segments, suggest that the LPS projects fibers only to the subthalamic nucleus (STN). Not all regions of the STN appear to receive fibers from the LPS. Selectively labeled neurons of the putamen transport isotope to broad regions of both pallidal segments and to the pars reticulata of the SN. This study suggests that cells of the MPS project profusely and topographically to: (1) the rostral ventral tier thalamic nuclei (VApc, VLo and VLm), (2) lateral portions of CM, and (3) the PPN. Fibers of the lenticular fasciculus appear to terminate preferentially in VLo. Cells in sublenticular portions of SI, and those extending into the medullary laminae of the pallidum, appear to project to: (1) HB1 via the stria medullaris, (2) the pars compacta of SN, (3) lateral and posterior regions of the hypothalamus, and (4) the so-called nucleus of the ansa lenticularis. Some fibers from cells of SI appear to join the dorsal stria terminalis, but none enter the inferior thalamic peduncle and none project to any part of the dorsomedial nucleus of the thalamus.

Amygdala↗
PubMedDate not supplied

[Update of the Italian Society of Nephrology Project No. 1 of the 2004-2006 SIN programme].

In the last few years the Italian Society of Nephrology has addressed many technical-scientific and management aspects to better patient satisfaction. Project No. 1 of the 2004-2006 programme on 'Quality and Accreditation of National Renal Units' focuses on four essential points. The first is the questionnaire mailed to all the Presidents and Regional Delegates on the relationship between Nephrology units, Local Government Health-System and the Regional Healthcare Agency. The results evidence that the 'political' decision-making power of nephrologists decreases in the absence of a national strategy. The second point, in collaboration with the National Census Group, includes the quality analysis and the standardization of resources (human and structural) and management of the Renal Units. The third point is based on 'Educational Courses for Quality and Accreditation' held in Rome (3-5 October 2005: L'Accreditamento all'Eccellenza dell'Unita' Operativa di Nefrologia, Dialisi e Trapianto; 17-19 October 2005: Il Manuale di Accreditamento della Specialità di Nefrologia). The courses aim at training members responsible for each region to hold courses in their specific region to create a network including each single Renal Unit to create an acceptable homogenous language on the models of analysis and on the correct use of 'The Guide for Excellence Accreditation'. The fourth point concerns both the on-line Guide for Excellence Accreditation and 'Peer Review Accreditation' and the NEQUASY (Nephrology Quality System) project. The manual must be 'user friendly' allowing each Centre to self-evaluate using national and regional standards.

Accreditation↗
PubMedDate not supplied

Africa: support for family planning grows.

African countries, generally regarded as among the world's most cautious on family planning matters, may be the most dramatic growth area for family planning projects over the next few years, according to the Kenya-based Regional Director for Family Planning International Assistance (FPIA), PPFA's own worldwide aid program. In a recent status report to FPIA's New York headquarters, L. Robinson, a U.S. citizen and former Peace Corps volunteer who recently left FPIA to join the staff of the new House Committee on Population, forecasts a near-tripling of FPIA-funded projects in 1978 - from 7 to 19. Most of the potential new projects - in Nigeria, Togo, Liberia, Tanzania, and Sierra Leone - will involve the addition of family planning services to existing maternal and child health delivery systems, with emphasis upon the training of physicians and other medical, counseling, and educational personnel. Other prospective projects include family life education for adolescents in Cameroun and Ghana, and a full-scale rural, mobile services delivery program in Tunisia. Behind these promising prospects is what Mr. Robinson sees as a quiet but deliberate move by several governments - including Sierra Leone, Togo, and Cameroun - towards accepting family planning as an integral component of maternal and child health services. The moves in Cameroun and Togo are especially significant since both are French-speaking, and traditionally "pro-natalist and somewhat hostile to family planning." The pattern of change in these and other countries tends to be somewhat slow and low-keyed, he notes; most governments "prefer not to have explicit official policies and programs, but rather to allow the gradual evolution of private services becoming an integral part of government-administered health and medical facilities." And even in some countries where government policies remain highly restrictive - Ivory Coast, e.g., where laws prohibit family planning except when necessary on medical and health grounds - many druggists stock a variety of contraceptives, all available to individuals and couples upon request. FPIA's current program in Africa, as in other regions, has 2 principal components: distribution of family planning commodities and supplies (more than $500,000 worth of commodities have been distributed in African countries over the past 3 years), and financial and technical support of service and educational projects. Of the current projects, 2 are in Egypt and Kenya, 2 in Ethiopia, and 1 in the Sudan. In one of the most advanced of these - a project in Kenya designed to introduce family life education into the nation's primary and secondary schools - project leaders recently completed and presented to the Ministry of Education a comprehensive package of syllabi, curriculum texts, and teaching guides.

Africa↗
PubMed1991

The MAClinical Workstation Project at Georgetown University.

The intent of the MAClinical Workstation Project is to develop computer workstations for medical students of the sort they will use in future medical practice. The idea is to instill information query habits in the daily clinical activities of these young physicians-in-training. The Georgetown University Medical Center Library spearheads the project in conjunction with the School of Medicine. The library handles technical support, including software development, user training, equipment maintenance, and network installations. The project began in 1988 with nine Macintosh computers; today thirty machines are distributed throughout the Georgetown University Hospital conference rooms, faculty and resident offices, and at four affliated hospitals. The Macintosh computers are connected to the medical center's local area network (LAN) with access to the Integrated Academic Information Management System (IAIMS) and Library Information System (LIS) databases. The MAClinical workstations serve multiple educational purposes in the clinical setting. Primarily, students gain experience in medical informatics by using a variety of software systems installed at the stations: the H&P Writer, a history and physical system written in the C programming language, can be used by students to prepare the admission record on patients they examine; also, students can keep patient records, check findings against a diagnostic system, look up drugs and treatment protocols, develop medical sketches, and find additional information when needed in the medical literature.

Computer Systems↗
PubMed2005

Community environmental health assessment strengthens environmental public health services in the Peruvian Amazon.

In December 1999, the Centers for Disease Control and Prevention (CDC) and the Cooperative for Assistance and Relief Everywhere, Peru Country Office (CARE Peru), initiated the Urban Environmental Health Project (SAU, in Spanish) to strengthen environmental public health services in urban and periurban settlements in Peru. The project received funding from the Woodruff Foundation as part of the CARE-CDC Health Initiative (CCHI). The "Protocol for Assessing Community Excellence in Environmental Health" (PACE EH) guided the development of a community environmental public health assessment (CEHA) process in Cardozo, a settlement in Iquitos, Peru. The project developed a three-phase process that merged scientific understanding and community perception about local environmental health problems. In phase 1, local environmental health technicians assisted the community in understanding environmental health conditions in Cardozo and selecting priorities. During phase 2, local technicians assessed the community-selected priorities: water and sanitation. Results from recent water quality assessments revealed that 82% (9 of 11) of samples from shallow dug wells, 18% (2 of 11) from deeper drilled wells, and 61% (11/18) from household drinking containers were positive for thermotolerant coliforms. Phase 3 activities produced an action plan and an intervention to mitigate health problems associated with inadequate water and sanitation services in the Cardozo community. As a result of the CEHA process, CARE Peru obtained funding from the United States Agency for International Development (USAID) to develop and implement an environmental health risk monitoring system and the proposed water and sewage intervention in the settlement. CDC continues to provide technical assistance to the local environmental health services groups in Iquitos through an agreement with CARE Peru as part of the USAID-funded Urban Environmental Health Models Project (MUSA). Technical assistance activities and the development of the environmental health risk monitoring system have helped to strengthen the local environmental public health services delivery system.

Community-Institutional Relations↗
PubMed1982

Subcortical structures projecting to visual cortical areas in squirrel monkey.

In 17 adult squirrel monkeys (Saimiri), horseradish peroxidase was used as a retrograde tracer substance to reveal the subcortical structures (other than the lateral geniculate nucleus and pulvinar) which project to the occipital lobe, and, in particular, to the central visual field representation in areas, 17, 18, 19, and MT. Evidence is provided that each of areas 17, 18, and MT receives a projection from locus coeruleus, nucleus dorsalis raphae, nucleus annularis, nucleus centralis superior, formation reticularis pontis oralis, nucleus basalis of Meynert, lateral hypothalamus, claustrum, and nuclei paracentralis and centralis medialis thalami. Area 19 receives a projection from all these structures except from the nucleus annularis. Only area MT was determined to be a target of a projection from the nucleus linearis. For technical reasons, only area MT was determined to receive afferent fibers from the nucleus basalis lateralis amygdalae. The results indicate that there is no topographical organization of subcortical inputs to the central visual field representation in individual cortical areas.

Animals↗
PubMed2005

Preventive measures to reduce bioaerosol exposure during refuse collection: results of field studies in the real-life situation.

The aim of the present research project was to investigate and evaluate technical and organisational measures targeted at bioaerosol reduction during the refuse collection and to determine the exposure of refuse collectors to dust, fungi and endotoxins in an on-the-job situation with different vehicle technologies and states of hygiene. The following technical factors were found to influence the bioaerosol concentration at the refuse collector's workplace: compaction method, lifting device control, rave rail height, hopper depth, design of intake area and dust interception. For instance, notably higher total fungal counts were recorded with rotating drum compaction than with packer plate compaction. A hinged lid closure at the lifting device in conjunction with a suction unit induced a positive effect. In addition, the automatic lifting system had a positive influence on rear-end loaders, as did loading operation control from the closed driver's cab on side loaders. Regular internal and external high-pressure cleaning of the lifting device at intervals of not more than 14 days is recommended as a basic rule for vehicle hygiene.

Aerosols↗
PubMed2005

Pathology as the enabler of human research.

Academic Pathology is a key player in human molecular science and in the powerful initiatives of the National Institutes of Health. Pathologists generate data crucial to virtually every molecular study of human tissue, and have the necessary skills and authority to oversee processing of human tissues for research analysis. We advocate that Academic Pathology is optimally positioned to drive the molecular revolution in study of human disease, through human tissue collection, analysis, and databasing. This can be achieved through playing a major role in human tissue procurement and management; establishing high-quality 'Pathology Resource Laboratories'; providing the scientific expertise for pathology data sharing; and recruiting and training physician scientists. Pathology should position itself to be the local institutional driver of technology implementation and development, by operating the resource laboratories, providing the expertise for technical and conceptual design of research projects, maintaining the databases that link molecular and morphological information on human tissues with the requisite clinical databases, providing education and mentorship of technology users, and nurturing new research through the development of preliminary data. We also consider that outstanding pathology journals are available for the publication of research emanating from such studies, to the benefit of the pathology profession as an academic enterprise. It is our earnest hope that Academic Pathology can play a leading role in the remarkable advances to be made as the 21st century unfolds.

Biomedical Research↗
PubMed2000

A quality assurance audit: phase III trial of maximal androgen deprivation in prostate cancer (TROG 96.01).

In 1997 the Trans-Tasman Radiation Oncology Group (TROG) performed a quality assurance (QA) audit of its phase III randomized clinical trial investigating the effectiveness of different durations of maximal androgen deprivation prior to and during definitive radiation therapy for locally advanced carcinoma of the prostate (TROG 96.01). The audit reviewed a total of 60 cases from 15 centres across Australia and New Zealand. In addition to verification of technical adherence to the protocol, the audit also incorporated a survey of centre planning techniques and a QA time/cost analysis. The present report builds on TROG's first technical audit conducted in 1996 for the phase III accelerated head and neck trial (TROG 91.01) and highlights the significant progress TROG has made in the interim period. The audit provides a strong validation of the results of the 96.01 trial, as well as valuable budgeting and treatment planning information for future trials. Overall improvements were detected in data quality and quantity, and in protocol compliance, with a reduction in the rate of unacceptable protocol violations from 10 to 4%. Audit design, staff education and increased data management resources were identified as the main contributing factors to these improvements. In addition, a budget estimate of $100 per patient has been proposed for conducting similar technical audits. The next major QA project to be undertaken by TROG during the period 1998-1999 is an intercentre dosimetry study. Trial funding and staff education have been targeted as the key major issues essential to the continued success and expansion of TROG's QA programme.

Androgen Antagonists↗
PubMed1978

[The differential projection index as a sign of metastases in lymph nodes (author's transl)].

Five hundred and fourty-four lymph nodes seen in 107 lymphograms were examined at operation and histologically. According to our findings the differential projection index (Px) of Wiljasalo has a high degree of accuracy. The index is calculated from the maximal (a) and minimal (b) diameter of the node in various projections, expressed as a percentage formula: see text. Even considering technical sources of error, such as varying degrees of magnification of lymph nodes on oblique projections, the accuracy of the index is very high at 80%. It can be considered as the most accurate sign of metastases during lymphography.

Humans↗
PubMed1985

Handicap research in Denmark.

In connection with recent social developments in Denmark increasing interest has been shown in research in the area of handicaps. Three Danish Research Councils (for Medicine, the Humanities and the Social Sciences) appointed a Committee to investigate this area of research. A survey conducted in the relevant fields gave evidence of much activity in this area. Very few research projects, however, integrated educational, psychological, medical, technical and social aspects. The need for more cooperation, information and training was therefore stressed as a prerequisite for better interdisciplinary handicap research in Denmark. Research seminars and workshops held in 1982-83 supported the results of the survey, especially as regards the need for training in the methods of interdisciplinary research and understanding among professionals (nurses, teachers, social workers, therapists, etc.). A formal coordination agency is recommended in order to establish the necessary cooperation among researchers, planners and users in Danish handicap research.

Denmark↗
PubMed2004

Key elements for successful integrated health information systems: lessons from the States.

The Genetic Services Branch, Maternal and Child Health Bureau of the Health Services and Resources Administration has provided funding to state health departments to integrate their newborn dried blood-spot screening programs with other early child health information systems since 1999. In 2001, All Kids Count conducted site visits to these grantees to identify and describe best practices in planning, developing, and implementing their integration projects. The site visits were organized around 9 key elements considered critical to the success of an information systems integration project: leadership, project governance, project management, stakeholder involvement, organizational and technical strategy, technical support and coordination, financial support and management, policy support and evaluation. Best practices for each of the key elements and 5 lessons learned were documented in Integration of Newborn Screening and Genetic Service Systems with Other Maternal & Child Health Systems: A Sourcebook for Planning and Development. The lessons learned are overarching conclusions that agencies should consider when planning and implementing integrated information systems. This article briefly describes the key elements, their best practices as implemented by states, and the lessons learned.

Child↗
PubMed1989

Quantitative dual-energy radiographic absorptiometry of the lumbar spine: in vivo comparison with dual-photon absorptiometry.

Quantitative dual-energy radiographic absorptiometry (DRA) and dual-photon absorptiometry (DPA) were compared to determine the best means of assessing bone density. Both methods were used to evaluate the lumbar spine in 107 women (aged 35-84 years [mean, 64 years]) referred for evaluation of osteoporosis risk. High correlation was documented between measurements derived by the two techniques, with a .95 linear regression coefficient for the total spine density measurement. Age-related regression equations were similar in slope but manifested different intercepts. Bone mineral density values derived with DRA were consistently lower than those obtained with DPA (conversion equation: DPA density = [1.067 X DRA density] + 0.163). Besides the inherent imperfections of each system, it was found that inaccurate identification of intervertebral spaces on the low-resolution DPA images introduced errors in patient data. DRA may replace DPA as the dedicated projectional densitometric procedure of choice for technical reasons, but at present a conversion equation must be used to compare DRA data to DPA data.

Adult↗
PubMed1980

Reproducibility of pulmonary structures on conventional chest films.

All available chest films of 26 patients with pulmonary noduli (3 to 15 mm in diameter) were compared. Great variations in the appearance of one and the same nodule was noted. On 7 films the nodule could not be detected at all, in spite of the fact that other films taken in the same geometric projection did show it and no technical faults were apparent. Blurring caused by pulsating pulmonary blood flow and minute variations in the background surrounding the noduli are considered to be the main causes of a certain 'from exposure to exposure' variability of the conventional chest film.

Hamartoma↗
PubMed2006

Standards for data collection and monitoring in a telemedicine research network.

While a networked, nationwide health information system is financially and logistically impractical, the development of independent, regional systems is realistic and feasible. A Telemedicine Research Network (TRN) could connect a number of geographically disparate health systems. This would require the reconciliation of policies and practices in five principal areas: partner agreement on project scope; privacy, security and confidentiality; technical standards; telecommunications and computer infrastructure; change management and training. Initial establishment of a first-stage TRN would require very little technical development and would, instead, rely on trust among the partners. The development of standards-based TRNs will greatly increase the quality and quantity of telemedicine research.

Confidentiality↗