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PubMed2005

Influence of experimentally induced anxiety on gastric sensorimotor function in humans.

BACKGROUND & AIMS: Unexplained dyspeptic symptoms are associated with changes in gastric sensorimotor function and several psychopathologic dimensions, including anxiety. It is unclear whether this reflects common predisposition or a causal relationship. The aim of this study was to investigate whether experimentally induced anxiety would alter gastric sensorimotor function in health. METHODS: Fourteen subjects underwent a gastric barostat study to assess gastric sensitivity and accommodation. Eighteen subjects underwent a 10-minute satiety drinking test (30 mL/min) with registration of epigastric symptoms on a visual analogue scale (VAS) at 2-minute intervals. Emotional context was modulated for 10 minutes at the start of each experiment by combined projection of validated facial expressions and an audiotape recalling a neutral or an anxious autobiographical experience. Anxiety levels were assessed using a VAS and the Spielberger State-Trait Anxiety Inventory (STAI). RESULTS: VAS and STAI scores confirmed efficacy of anxiety induction. During the anxiety condition, gastric compliance was significantly decreased (57 +/- 5 vs 40 +/- 5 mL/mm Hg; P < .01). Intraballoon pressures inducing discomfort during gastric distention were not altered, but the corresponding volume (630 +/- 47 vs 489 +/- 39 mL; P < .005) was significantly lower. Meal-induced relaxation was inhibited during the anxiety condition and this persisted for the 60-minute measurement (157 +/- 29 vs 100 +/- 24 mL; P < .05). During the satiety drinking test, the anxiety condition was associated with significantly higher scores for satiety, fullness, and bloating. CONCLUSIONS: Experimentally induced anxiety alters gastric sensorimotor function, suggesting that psychological factors may play a causal role in the pathogenesis of some dyspeptic symptoms and mechanisms.

Adult↗
PubMed2004

The HcrVf2 gene from a wild apple confers scab resistance to a transgenic cultivated variety.

The Vf gene from the wild species Malus floribunda 821 is the most studied apple scab resistance gene. Several molecular markers mapping around this gene were the starting point for a positional cloning project. The analysis of the bacterial artificial chromosome clones spanning the Vf region led to the identification of a cluster of genes homologous to the Cladosporium fulvum resistance gene family of tomato. One of these genes, HcrVf2 (homologue of the C. fulvum resistance genes of the Vf region), was used to transform the susceptible apple cultivar Gala. Four independent transformed lines resistant to apple scab were produced, proving that HcrVf2 is sufficient to confer scab resistance to a susceptible cultivar. The results show that direct gene transfer between cross-compatible species can be viable when, as in apple, the use of backcrosses to introduce resistance genes from wild species cannot exactly reconstitute the heterozygous genotype of clonally propagated cultivars.

Ascomycota↗
PubMed2006

The relationship between peak height velocity and physical performance in youth soccer players.

Longitudinal changes in height, weight and physical performance were studied in 33 Flemish male youth soccer players from the Ghent Youth Soccer Project. The players' ages at the start of the study ranged from 10.4 to 13.7 years, with a mean age of 12.2 +/- 0.7 years. Longitudinal changes were studied over a 5 year period. Peak height velocity and peak weight velocity were determined using non-smoothed polynomials. The estimations of peak height velocity, peak weight velocity and age at peak height velocity were 9.7 +/- 1.5 cm x year-1, 8.4 +/- 3.0 kg x year-1 and 13.8 +/- 0.8 years, respectively. Peak weight velocity occurred, on average, at the same age as peak height velocity. Balance, speed of limb movement, trunk strength, upper-body muscular endurance, explosive strength, running speed and agility, cardiorespiratory endurance and anaerobic capacity showed peak development at peak height velocity. A plateau in the velocity curves was observed after peak height velocity for upper-body muscular endurance, explosive strength and running speed. Flexibility exhibited peak development during the tear after peak height velocity. Trainers and coaches should be aware of the individual characteristics of the adolescent growth spurt and the training load should also be individualized at this time.

Acceleration↗
PubMed1997

Changing health professions education in West Virginia.

The education of students in medicine, nursing, pharmacy, and dentistry in the seven health professions schools of the University System of West Virginia has undergone remarkable changes since 1991 to become more responsive to community needs. The changes have also enabled the schools to remain in sync with other anticipated changes in health care delivery. A primary care, community-based academic system has been developed, and students, campus-based faculty, community-based field professors, and lay community members collaborate to identify and resolve problems important to the communities located in the 42 counties designated Under-served Health Professions Service areas, and five additional rural counties. The system is governed by a board consisting of a majority of community members not employed by the health care system, and the deans of the seven health professions school; all members function as equals in reaching decisions. In the new system, all health professions students in the University System of West Virginia are required to complete a rural rotation of 12 weeks. The five-years demonstration project that began the new system started in 1991 with four rural sites. By 1996, the system had expanded greatly and consisted of 13 consortia of communities with a total of over 100 rural primary care centers plus several small rural hospitals, public health departments, and other health and social services agencies. The 1996 West Virginia legislature approved funds for the higher education budget that will support and sustain this primary care, community-based academic system.

Community Health Services↗
PubMed2000

Overview of aircraft radiation exposure and recent ER-2 measurements.

The intensity of the different particles making up atmospheric cosmic radiation, their energy distribution, and their potential biological effect on aircraft occupants vary with altitude, geomagnetic latitude, and time in the sun's magnetic activity cycle. Dose rates from cosmic radiation at commercial aviation altitudes are such that crews working on present-day jet aircraft are an occupationally exposed group with a relatively high average effective dose. Crews of future high speed commercial aircraft flying at higher altitudes would be even more exposed. Present calculations of such exposures are uncertain because knowledge of important components of the radiation field comes primarily from theoretical predictions. To help reduce these uncertainties for high-altitude flight, the National Aeronautics and Space Administration (NASA) and the Department of Energy (DOE) started the Atmospheric Ionizing Radiation (AIR) project. The measurement part of the AIR project is an international collaboration of 12 laboratories placing 14 instruments on multiple flights of a NASA ER-2 aircraft. This paper describes the basic features of cosmic radiation in the atmosphere as they relate to exposure of aircraft occupants and then describes the AIR ER-2 measurements and presents some preliminary results from a series of flights in June 1997.

Aircraft↗
PubMed2002

State AIDS Drug Assistance Programs: equity and efficiency in an era of rapidly changing treatment standards.

BACKGROUND: The 54 state AIDS Drug Assistance Programs (ADAP) provide medications to HIV-infected persons with limited resources. Eligibility and coverage vary, raising concerns about health inequities. OBJECTIVE: To compare the relative clinical and economic performance of ADAP programs. RESEARCH DESIGN: A state-transition simulation model of HIV disease was used to explore the clinical consequences and lifetime costs associated with selected state policies. Clinical data came from the Multicenter AIDS Cohort Study, AIDS Clinical Trials Group Protocol 320, and other published randomized trials. Cost data came from the national AIDS Cost and Services Utilization Survey, and the 1999 Red Book. ADAP data came from National Association of State and Territorial AIDS Directors reports and interviews. MEASURES: Projected life expectancy, quality-adjusted life expectancy, total lifetime direct medical costs, cost-effectiveness in dollars per quality-adjusted life year (QALY) gained. RESULTS: ADAPs vary considerably in terms of formulary policies, health outcomes, expected costs, and cost-efficiency. Conservative projections, based on a cohort with starting mean CD4 count of 250 cells/microL, yield life expectancies ranging from 5.36 to 6.81 life years (4.69-6.01 quality-adjusted life years [QALYs]). Total per person lifetime direct medical costs range from $81,200 to $112,700; higher costs reflect increased spending on medications. Expected costs per QALY gained range from $7000 to $28,000. Under pessimistic assumptions regarding initial CD4 counts, drug efficacy, and discounting, the most comprehensive policy remains below $33,000/QALY. CONCLUSIONS: Even the most comprehensive ADAPs constitute a cost-effective use of HIV care resources. A uniform, national ADAP formulary warrants consideration.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Effect of mild mental stress on solid phase gastric emptying in healthy subjects.

Radionuclide gastric emptying studies are performed in clinical routine but the possible influence of the mental state of the patient is never taken into account. We wanted to evaluate the effect of a mild psychological stress on solid phase gastric emptying in healthy young male volunteers. The standard meal consisted of a pancake (500 kJ) without additional liquid. Simultaneous dynamic acquisitions of gastric activity in anterior and posterior projection were taken during 90 min starting from the onset of the meal. Gastric emptying was evaluated three times in basal conditions and once under mental stress. Stress was induced by means of a dichotomous listening test, lasting for 30 min, starting at the end of the meal. The results of rest and stress studies were compared. Mild mental stress has a significant influence on gastric emptying. The lag phase increased from 11 +/- 3 min to 36 +/- 10 min (mean +/- S.D.) (p less than 0.005) and the gastric emptying rate from 79 +/- 13%/hour to 100 +/- 31%/hour (mean +/- S.D.) (not significant). During a stress period gastric emptying as a whole is delayed but this is mainly due to the prolongation of the lag phase. Our data also suggest that during the stress period gastric emptying is interrupted and reactivated once the stress period has ended.

Adult↗
PubMed1994

Target Specifications and Performance of the ESRF Source.

Construction of the ESRF source started in 1988 as a joint project of 12 European countries. The facility consists of a 200 MeV electron linear accelerator, a 6 GeV fast-cycling booster synchrotron and a 6 GeV low-emittance storage ring optimized to produce high-brilliance X-rays from insertion devices. The project is now nearing the end of the construction phase (scheduled for July 1994), and is expecting its first external users from September 1994 onwards. All source design-goal specifications had been reached by mid-1992. This article reviews these specifications and associated basic source parameters, then discusses the actual peak performances recorded, many of them such as intensity and lifetime being well in excess of the original targets (175 mA compared with 100 mA, 42 h compared with 8 h). Current plans for upgrading, which should lead to a considerable gain in brilliance by 1995, include increasing the current to 200 mA, lowering the emittance and decreasing the coupling, improving the beam-position stability, introducing mini-gap undulators and using innovative undulator-spectrum shimming techniques.

Journal Article↗
PubMed2006

Validating self reported home safety practices in a culturally diverse non-inner city population.

OBJECTIVE: To determine the validity of face to face, self reported responses to questions about the presence of safety devices and use of safety practices in the home aimed at preventing unintended injuries to preschool aged children. METHODS: The authors invited families with children enrolling in a medium sized Midwestern US community Head Start program to participate in a randomized study of home safety practices. Participation involved consenting parents (n = 452) completing an initial questionnaire during Head Start enrollment or in their home. Project staff conducted home inspections to confirm parental responses to 16 questions. Only inspections conducted within 34 days of questionnaire completion (n = 259) were included in the validation study. Parents were told that the home visit would assess the need for safety devices, but were not informed of the validation aspect of the study. RESULTS: Sensitivities were generally high for all 16 safety practices, whereas negative predictive value and specificity varied considerably. Positive predictive value was also high for most practices, and did not vary by ethnicity. Answers provided by parents in their home were different and more reliable than those provided by parents interviewed at school (p = 0.001). CONCLUSIONS: Use of safety devices and practices by parents of preschool aged children reported in a face to face interview are generally reliable. Reliability increases if the interview is conducted in the home. Parents may also be more willing to report potential problems if they perceive they may receive corrective assistance.

Accident Prevention↗
PubMed1984

Indication in psychotherapy on the basis of a follow-up study.

The problem of indication is a central one of psychotherapy research. Unfortunately up to now only few scientific results contribute to a therapist's decision in selecting patients for a specific therapeutic setting. Thus, indication and outcome research should be combined. A critical view on traditional research strategies demonstrates that psychotherapy research should replace the ideal of normative and general rules by the rational investigation of one's own therapeutic practice. From this point of view some results of the Heidelberg Follow-Up Project of 110 psychotherapies which were started on an inpatient and continued on an outpatient basis are presented. Based on the therapeutic changes of these 110 patients the question is investigated whether the decisions of the indications correspond with the therapeutic goals of the treatment models. Moreover, the question is discussed what kind of success a specific treatment model offers for 'problem patients'.

Adaptation, Psychological↗
PubMedDate not supplied

A road map for the last journey: home telehealth for holistic end-of-life care.

The Advanced Illness/Palliative Care (AIPC) program started as a 2-year pilot project to determine if a telehealth model of care would benefit veteran patients with life-limiting illness. The goals of the project were to manage the physical, emotional, functional, and spiritual care needs during the last 2 years of patients' lives and to foster an earlier enrollment of patients into hospice by educating providers about palliative care. The AIPC program partners the skills and expertise of both spiritual and medical care practitioners, along with cutting-edge home telehealth devices to improve symptom management and quality of life for veterans and families coping with end of life.

Adaptation, Psychological↗
PubMed2000

Increasing access to prenatal care: an evaluation of minority health coalitions' early pregnancy project.

Early prenatal care utilization is a problem for racial and ethnic minority women in Indiana. Minority health coalitions in Indiana developed early pregnancy care coordination projects to address this need. To evaluate project outcomes, birth certificates of infants born to project mothers were matched with birth certificates of infants whose mothers did not receive care coordination. Results showed that project mothers were significantly more likely to start prenatal care earlier, had better prenatal care utilization as measured by the Kessner Index (Kessner, Singer, Kalk, & Schlesinger, 1973), and had better adequacy of care as measured by the APNCU Index (Kotelchuck, 1994) than the noncare-coordinated mothers. Although the project was successful in meeting its primary objective, specific recommendations are made for community health nurses to partner with the coalitions in improving the content of prenatal care, decreasing sociocultural barriers to care, and assisting in the evaluation of outcomes of future projects.

Adolescent↗
PubMed1998

The spatial relationships among cutaneous, muscle sensory and motoneuron axons during development of the chick hindlimb.

Previous studies have suggested that interactions with other axons are important in sensory axon pathfinding in the developing chick hindlimb. Yet the nature of these interactions remains unknown, in part because information about the spatial relationships among the different kinds of axons is lacking. To obtain this information, we combined retrograde axonal tracing with an immunofluorescent labelling approach that distinguishes between sensory and motoneuron axons. This allowed us to follow the trajectories of sensory axons having a known destination, while also identifying their neighbors. We found that as sensory and motoneuron axons meet in the spinal nerves and travel into the limb, sensory axons remain bundled together. The large bundles that are present proximally gradually split into smaller bundles as the axons course distally in the spinal nerves; more distally, some bundles join to again form large bundles. Younger, later-growing sensory axons appear to grow primarily along bundles of older sensory axons that grew out earlier. Starting from very proximal levels, axons projecting along an individual cutaneous nerve are found together in bundles that are situated in characteristic regions of each spinal nerve. Some of these bundles are initially interspersed with bundles of axons projecting along other nerves, thereby indicating that the initial position of a cutaneous axon in the spinal nerves does not strictly determine its subsequent trajectory. As they travel distally, bundles of axons projecting along one cutaneous nerve gradually join one another, becoming increasingly separated from axons having different destinations. In contrast, muscle sensory axons are situated adjacent to motoneuron axons innervating the same muscle for much of their course. This suggests that muscle sensory axons may be guided to the appropriate muscles by fasciculating along motoneuron axons. Taken together, the results show that sensory axons projecting along different nerves are different from one another and respond to cues in their environment to navigate through the spinal nerves and plexus. Thus, sensory neurons must be intrinsically specified with respect to their peripheral targets. Sensory axons appear to respond differentially to the axons they encounter, segregating from axons that project along different nerves and often growing with axons destined for the same nerve, suggesting that fasciculation may aid pathfinding.

Animals↗
PubMedDate not supplied

Pressure area management: a static-led approach.

An increase in expenditure and inappropriate use of pressure-relieving equipment, along with high-prevalence figures, initiated the evaluation of current practice of pressure damage prevention in an acute general hospital. This evaluation started with the organization of a project group, who (after a baseline audit) identified and procured the resources required to introduce and manage an effective pressure damage prevention programme. The investment in high-quality static mattresses for all patients including those who are at high risk of developing pressure damage was based on available clinical evidence. This investment meant a reduction in the amount of dynamic systems needed as many of those patients are at high risk of pressure damage, and are now successfully managed on a static system. The development of a local policy including documentation facilitated regular reassessment of risk level based on a risk assessment tool and clinical rationale. This static-led approach has reduced not only costs but also improved the appropriate allocation of pressure-relieving/reducing equipment. The approach has also simplified the choice of equipment for staff who were previously expected to match patients' needs with varying levels of dynamic mattress efficiency. This article highlights the action taken from the initial identification of a specific need through to the effective implementation, management and monitoring of this innovative practice.

Equipment and Supplies, Hospital↗
PubMed1996

International cooperative research.

The Special Cancer Research Program was newly established in 1984 within the existing International Scientific Research Program of the Monbusho (Ministry of Education, Science and Culture) as a part of "the Comprehensive 10-Year Strategy for Cancer Control" which was launched by the Japanese Government in 1984. The Comprehensive 10-Year Strategy for Cancer Control ended successfully 1993 and the Second 10-Year Program was started in 1994. When the Special Cancer Research Program started in 1984, the number of projects was 12 and the number of collaborating countries was 18. Since then the numbers of projects and collaborating countries have increased year by year to 27 projects and 30 collaborating countries in 1995. The cumulative (actual) number of projects from 1984 to 1995 was 216 (62) and the total number of collaborating countries was 57. Major topics covered by the Special Cancer Research Program are; exchanges of scientific information on cancer researches in advanced countries, viruses and parasites related to carcinogenesis, carcinogens/promoters and their inhibitors in the natural environment, migrant studies on cancer, studies on the etiology and prevention of cancers of special interest, and studies on diagnosis and treatment of cancer.

Female↗
PubMed1998

From the North Sea to the Mediterranean? Constraints to health reform in Greece.

The report of an international experts' committee, recently invited by the Ministry of Health to review Greece's health care system, recommended the creation of a network of family doctors, reimbursed on a capitation basis. The committee also proposed that family doctors should manage a budget for the purchase, on behalf of their patients, of specialist and hospital services and drugs. The author examines the exportability of the fundholding experience from Britain to a country in which health care organization is very different, social health insurance is fragmented, private health care is large and growing, ambulatory health care services are provided by specialists, and behavioral-cultural factors cast doubt on the consequences of the proposed change. An attempt to implement fundholding in Greece is likely to have effects opposite to those intended. The more humble task of tackling the inequities and inefficiencies of the present system should be the starting point of all future reform projects.

Ambulatory Care↗
PubMedDate not supplied

Drug use in very rural Alaska villages.

The Alaska Native Preschool Project was centered in the Head Start Programs of two typical Alaska native villages near the Bering Sea. Data were collected over 5 years, 1990 to 1995, from preschool parents (N = 342) with surveys, a panel of villagers (N = 25 to 30) using qualitative interviews; villagers using participant observation; and a limited review of public records. The villages typify the changing life of Alaskan villagers who live in the Bering Straits area. Qualitative data indicated that a number of problems were associated with drug and alcohol use in the villages. The level of smokeless tobacco use from surveys in the previous month among preschool parents (41%) was self-reported to be almost 10 times greater than the national level reported in the 1995 National Household Survey. The use of marijuana reported by preschool parents in the previous month was almost 3 times higher than the 1995 National Household Survey estimates (19 vs 6.7%). Tobacco use in the previous month was reported at over 56%, a level that was over 1 1/2 times the level of use at 34.7% estimated from the 1995 National Household Survey. For 26-34 year olds, previous month alcohol use was lower for the village parents than estimated from the 1995 National Household Survey (38 vs 63%). The self-reported levels of other drug use among preschool parents were very low compared with overall United States rates.

Adult↗
PubMedDate not supplied

PACS in practice: the status of the PACS project at the St. Radboud University Hospital. Part A: Introduction and the picture system.

A so-called bottom-up approach of a Picture Archiving and Communication System (PACS) is initiated by existing clinical questions. It is investigated how far existing Data-Acquisition (DA) modalities combined with the existing computer infrastructure of the hospital can provide soil to a, at first local, PACS system. Examples of current research projects in Digital Subtraction Angiography (DSA), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) demonstrate how image and raw data processing evolve from applications based on a general matrix manipulation software package to projects within the field of PACS. Starting from the existing facilities a stepwise increase of connections and expansions of required features is going to be brought about by separately considering the picture system, the communication system and the archive system. A three step phasing is proposed: (1) Software linking; (2) Hardware linking: small scale; and (3) Hardware linking: local area network. Examples are given from the first phase, i.e. the development and expansion of software on existing DA-modalities or processing hardware to receive the data on floppy disk, hard disk or tape. Data are converted and transported for further processing: (a) within the department; (b) between hospital departments; and (c) between research centres. With regard to the picture system special attention has to be given to the requirements for digitizing analogue film images and the reading of images from monitor screens instead of films on lightboxes.

Computer Communication Networks↗