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PubMedDate not supplied

Background of the demonstrated IMAGIS activities and future expectations.

In The Netherlands a national PACS development programme has been started, supported by the Dutch Society of Radiology and funded by the Dutch Department of Health because of the national character of the project. Three main partners are cooperating in this development: the Utrecht University Hospital (AZU), BAZIS and Philips International (Product Division Medical Systems), with the Delft University of Technology as the main BAZIS subcontractor. The non-profit foundation BAZIS, developing and supporting the ZIS Hospital Information System (in use in some 30 Dutch hospitals, over 15,000 acute beds), initiated its current IMAGe Information System (IMAGIS) projects in 1984. The activities were later integrated into the Dutch PACS project started in 1986. The final goal of the project is to achieve a PACS which is fully integrated with already existing hospital information systems (HIS). The development and operation of a HIS-PACS include many aspects of technical and clinical. The current efforts of BAZIS are concentrated on three main issues: diagnostic image quality evaluation (e.g. effects of data compression); modelling, software simulation and technology assessment of a prototype PACS (both general and detailed aspects); and coupling and integration of PACS and HIS (e.g. the BAZIS ZIS). Philips, Hamburg, is supplying equipment, particularly prototype components. A systematic clinical evaluation will take place at the Utrecht University Hospital.2+ We outline the background of the intermediate results as demonstrated during the 6th EuroPACS Conference:the psychophysical software package for Feature Evaluation And System Inspection By Logged Experiments (FEASIBLE); the modelling and simulation software package for Medical Image Representation, Archiving and Communication, Learned by Extensive Simulation (MIRACLES); and first results of the coupling experiments.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗
PubMed2004

[The EDIT project. Problem-based learning on the web challenges students' thinking].

EDIT is short for Educational Development using Information Technology. The EDIT project was initiated by the Faculty of Health Sciences at Linköping University. The aim was to develop web-based scenarios for problem-based learning (PBL). Patient case studies and other medical problems or situations are illustrated by using realistic texts and multimedia, e.g. pictures and short films. Since the project started in 2001, EDIT-scenarios have been developed for six undergraduate programmes. The project covers two years of the medical programme. The use of multimedia has introduced new possibilities to challenge students' thinking by stimulating more senses. The different parts of a scenario are designed to raise questions without providing answers. Both students and tutors have perceived EDIT-scenarios as more motivating and interesting than the case studies on paper previously used. EDIT has contributed to improving and updating PBL-scenarios. This process has helped vitalise the discussions about pedagogical issues. For students as well as teachers, the project has lead to increased general familiarity with IT. In this paper, the project concept, practical aspects of the implementation, and pedagogical outcomes are discussed.

Education, Medical↗
PubMed2005

Lessons learned in building a global information network on chemicals (GINC).

The Global Information Network on Chemicals (GINC) was a project to construct a worldwide information network linking international, national, and other organizations working for the safe management of chemicals. Proposed in 1993, the project started the next year and lasted almost 10 years. It was begun as a joint project of World Health Organization (WHO), International Labor Organization (ILO), and United Nations Environment Program (UNEP), and later endorsed by the Intergovernmental Forum on Chemical Safety (IFCS). Asia, particularly East Asia and the Pacific islands, was chosen as the feasibility study region. The author's group then at the National Institute of Health Sciences (NIHS) of Japan led this initiative and hosted numerous meetings. At these meetings, tutorial sessions for communicating chemical safety expertise and emerging new information technologies relevant to the safe management of chemicals were offered. Our experience with this project, particularly the Web-based system and the tutorial sessions, may be of use to others involved with Web-based instruction and the training of chemical safety specialists from both developed and developing countries.

Chemical Phenomena↗
PubMed1984

Prenatal and postnatal development of retinogeniculate and retinocollicular projections in the mouse.

The development of retinal projections to the dorsal lateral geniculate nucleus (dLGN) and superior colliculus (SC) has been studied in fetal and neonatal mice of the pigmented C57BL/6 strain, using the anterograde transport of tritiated proline and horseradish peroxidase (HRP). Retinal efferents are present contralaterally just beyond the chiasm at E14. By E16 they have grown into both dLGN and SC. Ipsilateral fibers are limited to the proximal optic tract at E16; their growth into dLGN and SC is delayed until E18-birth. During the first 2 postnatal days, an early population of ipsilateral fibers invades the dLGN. Most of these fibers grow in or around the medio-dorsal sector of the dLGN, i.e., the future binocular segment. Fibers are also present, but at lower densities, in the ventral half of the nucleus and thereafter become dispersed or are lost, without at any stage becoming dense. Some denser labeling is also present ipsilaterally in the outer rim of dLGN, just below the optic tract, and later disappears. On the third postnatal day, the ipsilateral fibers establish a deep and denser projection along the medial and dorsal borders of dLGN; this projection overlaps part of the crossed projection, which at this age extends to the whole nucleus. The segregation of each projection starts on the fourth postnatal day, when crossed fibers begin to disappear from the small region of uncrossed projection. This process goes on for another 4 days. During this period, the ipsilateral fibers withdraw from the deepest layer of dLGN, and their terminal density increases gradually; by the eighth postnatal day, both projections are already well separated. Dense crossed projections first appear near the surface of the SC at birth. Prior to this, retinal fibers course throughout neurons of the collicular plate and underneath the pia. The uncrossed fibers invade the SC between birth and P3. They are located preferentially in the anterior and medial aspect of the SC. Subsequently, there occurs a diminution in the laminar and tangential extent of these projections, simultaneously with an intensification of the ipsilateral input to several small, longitudinally oriented clusters located deep to the crossed projections.

Animals↗
PubMedDate not supplied

Epidemiology as basis for preventive intervention.

The paper describes the progress of a project starting out with an extensive psychiatric survey of the population of Oslo, and ending up with an intervention project aiming at the prevention of mental disorder in a particular high risk group. Hence the study is an example of experimental epidemiology. Lack of social support is identified as a psychiatric risk factor in the epidemiological part of the study, and stimulation of social network formation is a central part of the intervention project. Some preliminary results are given.

Adult↗
PubMed2003

Development and testing of a framework for assessing the effectiveness of health promotion.

OBJECTIVES: The purpose was to develop and test a framework for assessing the overall effectiveness of health promotion in one Canadian province. METHODS: The project relied on expert opinion and consensus. A multidisciplinary team developed a Project Description Framework and a Health Promotion Evaluation Framework. Two sets of inclusion criteria were developed for selecting projects to be assessed using the Framework. The sampling frame was all health promotion projects starting in Alberta in January 1993 or later for which a written program evaluation could be obtained. Of 180 project reports, 91 met the first set and 35 met the remaining inclusion criteria. Two research associates independently used the Project Description Framework. Three associates independently applied the inclusion criteria. Consensus was reached in all cases. Research team members used the Health Promotion Evaluation Framework to assess the 35 projects and to comment on its utility and any gaps identified. RESULTS: A framework for assessing the effectiveness of health promotion was developed and tested. CONCLUSION: This framework is a useful tool as evidenced by the review that was obtained and subsequent applications.

Alberta↗
PubMedDate not supplied

Three-dimensional reconstruction of the sevenfolded form of Bacillus subtilis Gro EL Chaperonin.

Bacillus subtilis grown at 42 degrees C produces a major form of Gro EL-like chaperonin that has been analyzed by electron microscopy. Most of the views show a clear sevenfold symmetry when studied by rotational analysis. The particles were classified into defined families by multivariate analysis and supervised fuzzy-set classification methods, and those belonging to a sevenfold family were averaged to produce a two-dimensional representative projection. These selected particles were then used, when titled by 55 degrees in the microscope goniometer stage, as the starting projections for a three-dimensional reconstruction protocol based on the random conical tilt series method. The resulting reconstruction shows the Gro EL-like chaperonin from B. subtilis as a cylindrical body with seven well defined lobules arranged almost parallel to the longitudinal axis of the particle. There is a channel that is placed along this axis and appears fully open in both sides. The geometry of the channel is polar and presents differences in both faces of the particle.

Bacillus subtilis↗
PubMed2005

Case management in vocational rehabilitation: a case study with promising results.

PURPOSE: The aim of the current study was to investigate whether Case Management and the strengths model could be a successful method in vocational rehabilitation of unemployed people on long term sick leave in Sweden. An additional aim was to further highlight the actual rehabilitation process. MATERIAL AND METHOD: Ten clients, five men and five women aged between 35 and 40, were included in the project. All ten were at the project start both long-term unemployed (2-13 years) and on long term sick leave (2-6 years). The project was evaluated from four perspectives: Quality of life (SF 36), sickness absence, and contact with working life were investigated before and after the project. The rehabilitation process was investigated during and after the project. RESULTS AND CONCLUSION: The result from the study was positive. Of the 10 clients who participated in the project, six have improved their quality of life, seven have a diminished sickness absence and seven have a closer contact to working life after the project than before. With regards to the rehabilitation process, the results here also impart a positive picture. It should be noted, however, that the study is small and not based on a random sample. The results should not be generalized, but recognized instead as a positive indication.

Absenteeism↗
PubMed2005

Aspergillosis in the CLEAR outcomes trial: working toward a real-world clinical perspective.

Aspergillosis is a potentially lethal infection of immunocompromised patients. Until 10 years ago, antifungal therapy was largely limited to amphotericin B deoxycholate. Perceived poor response rates and inherent toxicities with amphotericin B deoxycholate were a major stimulus for the development of newer antifungals, including lipid-formulated amphotericin B, broad spectrum azoles, and echinocandins. Response rates to antifungals are highly dependent on the underlying diagnosis and degree of immune suppression of the patient. Patients at highest risk of death from aspergillosis also have very high mortality rates from other causes as well. Outcomes reported in historical literature reviews fail to distinguish between overall mortality and death attributable to aspergillosis. While this distinction can often be difficult to assess clinically, the net effect is to underestimate the therapeutic success rates of antifungals. The CLEAR (Collaborative Exchange of Antifungal Research) project started as a post approval survey to monitor clinical use of amphotericin B lipid complex (ABLC). The scope of the CLEAR project included collection of clinical data to assess outcomes in patients with invasive fungal infections treated with ABLC. Clinical data from more than 3500 patients were entered into the CLEAR database. Outcomes were assessed for 509 patients with documented aspergillosis and complete data records. Overall response rate was 63% (cured/improved/stable) with site-specific response rates of 61%, 59%, and 32% for lung, sinus, and central nervous system infections, respectively. Solid organ transplant recipients had higher response rates than patients with hematological malignancies. Bone marrow transplant recipients had the lowest response rates. Clinical response rates with ABLC reported in the CLEAR trial are higher than response rates reported for amphotericin B deoxycholate in other trials. Since it is unlikely we will see any new comparative Phase III trials for aspergillosis, CLEAR-type outcome studies will prove useful for the foreseeable future to guide clinical management of aspergillosis.

Amphotericin B↗
PubMed1999

The National Survey of America's Families: an overview of the health policy component.

This report describes one aspect of "Assessing the New Federalism," a multi-year research project, started by the Urban Institute in 1996, to analyze the devolution of responsibility for social programs from the federal government to the states. The project combines case studies in 13 diverse states with analyses of data drawn from a wide range of sources, including a new household survey--the National Survey of America's Families (NSAF). The NSAF, which contains nationally representative data from almost 45,000 families, was fielded in 1997 and 1999, and is planned for 2001 and again at subsequent two-year intervals. In this paper, we provide an overview of the NSAF's purpose; the sampling approach and methods; the questionnaire content, with particular emphasis on questions of interest to health policy researchers; health policy research planned by Urban Institute staff; and the timetable for public release of the NSAF data.

Family Health↗
PubMed2001

[Hospital infection control in 21st century, the importance of networking with each division and clinical laboratory in the hospital. 1. From the aspect of clinical laboratory division].

Clinical laboratory division plays an important roll for the management of nosocomial infection. Staff from clinical laboratory division including technologist and/or medical doctor can work as a part of infection control team. Since the bacterial surveillance data from clinically isolated strains accumulates in the clinical laboratory division, these staff have a chance to notice outbreak in hospital at first time. While handling information from each strain, we need to feedback these data with additional information for physicians. From June, 2000, a national project started. That was a surveillance program for drag-resistant bacteria. We can compare information from local isolates and nation-wide isolates by this project. Genotypic methods especially pulsed-field gel electrophoresis(PFGE) is suitable for the identification of infection route in the hospital environment. And PFGE analysis for pathogenic strains works effective in our hospital.

Cross Infection↗
PubMed2001

Effective planning and implementation of ecological rehabilitation projects: a case study of the regional municipality of Waterloo (Ontario, Canada).

The literature guides environmental planning and, specifically, how to use ecological rehabilitation projects to achieve long-term planning goals and landscape-scale environmental sustainability. There is, however, a perceived gap between principles in the literature and the use of them by practitioners involved in smaller-scale ecological rehabilitation projects. Using interviews with practitioners involved in 11 projects within the Regional Municipality of Waterloo, Ontario, Canada, we tested whether practitioners used five principles for effective planning and implementation of ecological rehabilitation that we derived from the literature. These five principles were: establishing political and ecological context, using ecologically appropriate objectives and practices, using comparative multidisciplinary and cross-scale approaches, using adaptive planning and implementation, and establishing good communication within and external to projects. Few projects followed all five principles, and practitioners indicated that they used three more project-specific principles: obtaining political/social support, promoting projects and changing attitudes about projects, and securing sufficient and persistent funding to maintain a project's life. While the literature emphasizes that ecological rehabilitation is only effective if projects are coordinated on a watershed basis, most practitioners focused solely on the goals of their specific project. The gap between literature and practice may arise because most practitioners are new to the field of ecological rehabilitation and still are focused on the methods involved. Time pressures force practitioners to obviate the literature and get projects started quickly, lest support evaporate. Complicating these difficulties is decreased support from federal and provincial governments for large-scale environmental planning. It is unclear whether ecological rehabilitation projects in Waterloo Region (at least) will ever become effective at promoting landscape-scale ecological goals or remain smaller-scale stop-gaps.

Animals↗
PubMed1985

Ten years of the North Karelia project.

Medical and epidemiological research into the aetiology of CHD has drawn attention to the likely causal role of certain risk factors, especially elevated serum (LDL) cholesterol and blood pressure levels, and smoking. Conventional trials to establish the causality have come up against problems of feasibility and study design. Community-based studies have considerable potential in introducing changes to the general lifestyle and risk factors in large numbers of people (since the risk factors are closely related to the way of life and other features of the community). Thus a well evaluated community-based study can augment our knowledge on the role of the risk factors. Furthermore, a community study examines how the existing service structure and community resources can be used and assesses the overall feasibility and consequences of such an intervention. The North Karelia project, started in eastern Finland in 1972, has been a major community-based study on the prevention of CHD. The results of the 10-year evaluation of the project illustrate the feasibility and consequences of the approach. During the 10-year period 1972-82 the following net changes (i.e. adjusted for changes in the reference area) occurred in the risk factor means of the population aged 30-59 in North-Karelia: -28% for smoking (p less than .001), -3% for serum cholesterol (p less than .001) and -3% for systolic BP (p less than .001). During the period 1974-79 the age-standardized CHD mortality of men aged 30-64 was reduced by 22% in North Karelia, 12% in the reference area and 11% in the rest of Finland (p less than .05 compared with NK).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2006

A web-based repository of surgical simulator projects.

The use of computer-based surgical simulators for training of prospective surgeons has been a topic of research for more than a decade. As a result, a large number of academic projects have been carried out, and a growing number of commercial products are available on the market. Keeping track of all these endeavors for established groups as well as for newly started projects can be quite arduous. Gathering information on existing methods, already traveled research paths, and problems encountered is a time consuming task. To alleviate this situation, we have established a modifiable online repository of existing projects. It contains detailed information about a large number of simulator projects gathered from web pages, papers and personal communication. The database is modifiable (with password protected sections) and also allows for a simple statistical analysis of the collected data. For further information, the surgical repository web page can be found at www.virtualsurgery.vision.ee.ethz.ch.

Computer Simulation↗
PubMed1990

The Italian support to prevention of blindness programmes in developing countries.

The authors point out that Italy, as a tradition, has always dedicated special attention to developing countries, due to its geographical position and its cultural background and that in 1971 the Italian Government has created by a law, as part of the Ministry of Foreign Affairs, the Department for Cooperation and Development, the objective of which is to contribute to the enhancement of the living conditions in developing countries. The authors report data on a Trachoma Control Project started in 1973 lasting to 1981, financially supported by the Ministry of Foreign Affairs and technically guided by some of the authors and point out that the major success of this Project is that, since they left the Country in 1981, trachoma control activities are still now carried out by using the same methodologies. Finally, the authors report data on a National Prevention of Blindness Programme, the extension of which will be guided in the near future by the Referral Center for Public Health Ophthalmology of Rome that has just prepared the plan of operation that foresees the reorganization and strengthening of the existing structures and manpower at the head quarter, tertiary, secondary and primary levels.

Blindness↗
PubMed1988

From pilot project to national implementation: experiences from the North Karelia Project.

The North Karelia Project started in 1972 as a response to the request of the local people. It was aimed at reducing the exceptionally high mortality and morbidity from cardiovascular diseases in the area. The Project's activities have been directed towards inducing behavioural changes amongst the entire population. Equally, the care of those already sick (such as hypertensives) has also simultaneously been reorganized. The Project has involved the whole of that society, in addition to the health care system, and has collaborated with the food industry, schools and various voluntary organizations. The most recent new activity is a programme to promote marketing of local vegetables and berries to have a substitution for dairy farming, as consumption of dairy products reduce with new dietary habits. The results are encouraging. The individually reported health behavioural changes are reflected by a clear net reduction in biological risk factors (serum cholesterol, blood pressure) compared to the reference community. Also statistics show that mortality from ischaemic heart disease has been reduced more significantly in North Karelia (-22%) than in the rest of Finland (-11%) during the period 1974-1979. The activities tested in North Karelia, and found to be feasible, have been recommended for implementation nationwide in Finland. For instance, anti-smoking activities were first tested in North Karelia before the introduction of national legislation, and experiences obtained in health education have been conveyed to other sectors of the Finnish population through national television in several programmes. The county of North Karelia continues to be a demonstration area in Finland, at present for the Integrated Programme for the Prevention of Noncommunicable Diseases.

Cardiovascular Diseases↗
PubMed2004

Lectin-based structural glycomics: glycoproteomics and glycan profiling.

Structural glycomics (SG) plays a fundamental part of concurrent glycobiology aiming at comprehensive elucidation of glycan functions ( i.e. , functional glycomics) in the context of post-genome sciences. The SG project started in April 2003 and will continue for 3 years in the framework of NEDO (New Energy and Industrial Technology Organization) under the METI (the Ministry of Economy, Trade, and Industry), Japan. The main purpose of the project is the development of high-throughput and robust machines, which should greatly contribute to the structural analysis of complex glycans. In this chapter, 2 major research items, i.e. , (1) glycoproteomics, which enables comprehensive analysis of glycoproteins, and (2) "glycan profiling" by means of lectins, are described. For the latter, frontal affinity chromatography has been adopted as a starting tool for comprehensive analysis of the interaction of 100 lectins and 100 oligosaccharides under the concept of "hect-by-hect," which refers to 100 x 100.

Animals↗
PubMed2002

ReproMED on the Internet today and tomorrow.

ReproMED comprises a range of projects applying and researching the role of information technology to support clinical care, education and research in reproductive medicine. This article traces the development of ReproMED on the Internet and concludes by speculating on the future. The project started with a critical evaluation of the infertility information needs of general practitioners and the role of hypertext in meeting those needs, leading to the production of a ReproMED CD-Rom. However, as the project was under development in 1995, Microsoft launched its first web browser amid major expansions of the Internet, thus the project switched to a series of websites and played host to national bodies including the British Fertility Society and the British Andrology Society. After a critical evaluation of the role of the Internet in supporting postgraduate medical education in the southwest region, reproductive medicine training over the Internet was piloted. This pilot was followed by a series of similar training programmes for junior doctors, specialists and general practitioners, leading to the establishment of a formal MSc delivered principally over the Internet. In addition to professional education and research, the ReproMED websites provide patients with extensive interactive information. The future holds many exciting possibilities with rapid technological developments and ever-increasing information needs.

Computer-Assisted Instruction↗