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PubMedDate not supplied

Telemedicine for the International Space Station.

The medical care for the integrated crew of the International Space Station (ISS) will require close co-operation between the partner agencies in the areas of selection, medical surveillance, countermeasures, and handling of acute medical problems. Based on a commonly accepted policy of shared care and responsibilities medical guidelines, procedures, and standards for medical data and communication need to be harmonised under the responsibility of the Multilateral Medical Operations Panel (MMOP). A supporting telemedical network connecting the partners on an organisational and technical level will facilitate the harmonisation process and provide new tools for effective co-operation between medical professionals. Earth bound projects with similar application areas can profit from and contribute to this development and need to be considered for efficient implementation and exploitation.

Aerospace Medicine↗
PubMed1995

The librarian as a partner in nursing education.

Welch Medical Library has explored new roles for librarians in knowledge management instruction programs throughout the Johns Hopkins University School of Nursing curricula. These programs have created roles for library staff as both instructors and knowledge management experts. By fostering strong communication and attention to quality instruction, librarians achieved their vision of a program in knowledge management integrated into the curriculum, where they are partners working with nursing faculty to define the students' knowledge management needs and decide how these needs can be met.

Baltimore↗
PubMed2006

MDGA1, an IgSF molecule containing a MAM domain, heterophilically associates with axon- and muscle-associated binding partners through distinct structural domains.

Molecules belonging to the immunoglobulin superfamily (IgSF) are reported to be involved in intercellular communication in the developing nervous system. We have identified a novel GPI-anchored IgSF molecule containing a MAM (meprin, A5 protein, PTPmu) domain, named MDGA1, by screening for genes that are expressed by subpopulations of cells in the embryonic chick spinal cord. MDGA1 is selectively expressed by brachial LMCm motor neurons, some populations of DRG neurons, and interneurons. We found that MDGA1 interacts heterophilically with axon-rich regions, mainly through its MAM domain. Interestingly, MDGA1 also interacts with differentiating muscle through its N-terminal region, which contains Ig domains. These results suggest that MDGA1 functions in MDGA1-expressing nerves en route to and at their target site.

Animals↗
PubMed2002

Patients as partners, patients as problem-solvers.

This article reports our ongoing work in developing a model of health care communication called collaborative interpretation, which we define as a rhetorical practice that generates building blocks for a more complete and coherent diagnostic story and for a collaborative treatment plan. It does this by situating patients as problem-solvers. Our study begins with an analysis of provider-patient interactions in a specific setting-the emergency department (ED) of an urban trauma-level hospital- where we observed patients and providers miscommunicating in at least 3 distinct areas: over the meaning of key terms, in the framing of the immediate problem, and over the perceived role of the ED in serving the individual and the community. From our observations, we argue that all of these miscommunications and missed opportunities are rooted in mismatched expectations on the part of both provider and patient and the lack of explicit comparison and negotiation of expectations-in other words, a failure to see the patient-provider interaction as a rhetorical, knowledge-building event. In the process of observing interactions, conversing with patients and providers, and working with a team of providers and patients, we have developed an operational model of communication that could narrow the gap between the lay public and the medical profession-a gap that is especially critical in intercultural settings like the one we have studied. This model of collaborative interpretation (CI) provides strategies to help patients to represent their medical problems in the context of their life experiences and to share the logic behind their health care decisions. In addition, CI helps both patient and provider identify their goals and expectations in treatment, the obstacles that each party perceives, and the available options. It is adaptableto various settings, including short, structured conversations in the emergency room, extended dialogue between a health educator and a patient in a clinical setting, and group discussions in support groups, community groups, or health education classrooms.

Communication↗
PubMed2001

Beyond connectivity: what the success of one health plan's e-solution means for the future of the healthcare industry.

This article highlights the statewide success and rapid acceptance by providers in North Carolina of PARTNERS National Health Plan's implementation of a multipayer Internet connectivity solution for providers, employers, and members. PARTNERS is a premier health plan in North Carolina that covers more than 400,000 lives. The company introduced on-line communication to their network of ten thousand providers and has seen the number of on-line users and interactions grow by approximately 25 percent a week to represent more than two thousand providers in the first six months of roll-out. Providers can now look up eligibility and benefits and review and submit claims and referrals on-line; soon they will be able to order and review lab results and perform prescription management. PARTNERS found their Internet solution in HealthTrio's Intelligent Connectivity, which allowed them to create Internet communications without replacing back-end office solutions.

Consumer Behavior↗
PubMed1993

Partnership in education: working toward the baccalaureate degree as entry to nursing practice in Canada.

In the early 1980s Canadian professional nursing associations officially adopted the goal of baccalaureate entry to practice by the year 2000. In the ensuing years, nursing educators have explored a variety of means to work toward achieving this goal. This paper describes a collaborative model of baccalaureate programme delivery developed between a university school and a hospital-based diploma school in Vancouver, British Columbia. The paper documents the history of the collaboration and the organization of human and physical resources for implementation. The issues and challenges encountered in the transition, the strategies used to facilitate the process, and the benefits gained by each partner are discussed.

Communication↗
PubMed1996

McGill makes Canada's first attempt to put medical curriculum in computerized format.

A member of McGill University's Faculty of Medicine wants Canadian medical schools to collaborate to create a central repository for the best teaching materials. Dr. David Fleiszer fears that many individual efforts are being undertaken without an overall plan being in place. For its part, McGill is putting its medical-school curriculum on line over the next 2 years, and is collaborating with industrial partners to develop clinical simulations.

Canada↗
PubMed1990

Using the partner in the psychosocial treatment of schizophrenia: a multiple single case design.

This report describes the treatment of six couples where one partner had a long psychiatric history and a long-standing diagnosis of schizophrenia. Using a multiple single case design, the effects of providing the couples with information about schizophrenia and systematic family management (comprising problem solving and communication training) were assessed. The results showed that providing information alone had no effect on presenting symptoms but did improve the partners' perception of their ability to cope and solve problems. While a causal effect of treatment on improvement was not conclusively proven, the cycle of readmission and relapse was altered.

Adaptation, Psychological↗
PubMed1987

Teaching interactive signing in a dialogue situation to mentally retarded individuals.

Verbal prompts, modeling, physical guidance, positive reinforcement, fading, and chaining procedures were used to teach two nonverbal individuals, one severely and one moderately mentally retarded, an interactive signing dialogue in a naturalistic snack time setting. Both were required to initiate signed communication and to respond to signed communication with either action or manual signing. Using a multiple probe design across three dialogue situations, each client was successively taught his role in each dialogue with a staff member serving as his partner. After both trainees had mastered a dialogue role, signing competency was formally probed as they interacted with their staff partner in a maintenance situation and with the other trainee in a generalization situation. Results showed that clients could learn to use signed communication in each dialogue situation but that extensive training was required. Data also indicated that only partial generalization to the client-client situation occurred.

Adolescent↗
PubMed1998

Interactive DICOM image transmission and telediagnosis over the European ATM network.

The European High-Performance Information Infrastructure in Medicine, n(o)B3014 (HIM3) project of the Trans-European Network--Integrated Broadband Communications (TEN-IBC) program, started on March 1996 and finished on February 1997, aimed to test the medical usability of the European asynchronous transfer mode (ATM) network in medical image transmission. The Department of Radiology, University of Pisa, Pisa, Italy, and St-Luc University Hospital, Brussels, Belgium, involved in the project as healthcare partners in the radiological domain, established several connection sessions finalized to test the usability of Digital Imaging and Communication (DICOM) image transmission and interactive telediagnosis tools in the daily radiological practice. The Pisa site was connected to the Italian ATM pilot (Sirius Network) through the Tuscany metropolitan area network (MAN), while St-Luc University Hospital was connected to Belgium ATM network through the Brussels MAN. By means of international connections provided by the European JAMES project, a link between the two sites was established, connecting both national ATM networks. Due to the large variety of hardware present in the medical centers, multiplatform software tools were used and tested: central test node (CTN) release 2.8 [3], VAT [6], NV-3.3 [7], and IDI (UCL homemade multiplatform teleradiology tool for interactive visualization and processing of DICOM images). During the telediagnosis session, lead by radiologists in both hospitals, each site submitted neuroradiological clinical cases to the other for remote consultation. The connection, available for a period of two weeks, at 2-Mbit/s bandwidth, allowed the transmission of MR images (256 x 256 x 12 bit) and simultaneous multimedia interactive discussion of the cases. Both off-line transmission and review of the images, using the CTN DICOM transfer routines, and on-line interactive image discussion, using the IDI telediagnosis software, were tested successfully from the technical and medical point of view.

Computer Communication Networks↗
PubMed2001

Functional level of young adults with cerebral palsy.

OBJECTIVE: To acquire insight into the level of functioning of young adults with cerebral palsy (CP). DESIGN: Descriptive cross-sectional study. SETTING: Rehabilitation Centre Den Haag, The Netherlands. METHOD: A structured questionnaire, including the Barthel Index was mailed to 134 young adults (aged 21-31 years) with cerebral palsy. RESULTS: Eighty subjects responded (60%). Of these, 60 (75%) were largely or fully independent in activities of daily living, 72 (90%) moved independently indoors, 56 (70%) outdoors. In 67 (77.5%) of the group the level of communication was adequate for telephone conversation. Twenty-four (30%) lived with their parents, 10 (12.5%) with a partner and 26 (32.5%) lived alone. Almost half lived in an unadapted house. Forty-two (53%) completed some form of secondary education and 29 (36.3%) had paid employment. CONCLUSION: Despite their considerable impairments, the large majority of this group of young adults with cerebral palsy are independent in activities of daily living, mobility and communication. Regarding the level of education, participation in paid employment and sports activities, however, young adults with CP are poorly integrated.

Activities of Daily Living↗
PubMed1999

Health informatics and community health: support for patients as collaborators in care.

Health informatics has much to offer community health care. Computer networks and telecommunications provide particular support that can enhance the collaboration among clinicians, care providers and patients. Special-purpose computer tools referred to as Consumer Health Informatics (CHI) represent the application of computer and information technologies specifically to support the health information and communication needs of patients and lay persons. Research projects like ComputerLink and CHESS demonstrate that CHI is acceptable to patients and promotes self-care and disease management. Three grand challenges must be faced to insure realization of the promise of health informatics to community health care: development of knowledge management and information discovery tools for patients, insurance of health information literacy for all persons, and re-engineering clinical practice to capitalize on patients as full partners in health care.

Community Health Services↗
PubMed1994

Assessing functional communication in aphasia: clinical utility and time demands of three methods.

A variety of methods has recently been used to assess everyday communication abilities in aphasic adults. This study compares three such methods for their clinical utility and the amount of a therapist's time they use. The three methods employed a standard rating schedule completed by relatives, analysis of speech elicited through role-play and a partial analysis of everyday conversation samples. The utility of these assessments as a clinical tool was measured in terms of the therapist's time needed, and the assessment's ability to show stability or change of communicative effectiveness on test-re-test measures and to illuminate areas for therapeutic intervention. Eight aphasic adults (five acute and three chronic) were tested on all three assessments, then re-tested after a period of 3 months. The results suggested that, although more time-consuming, the partial conversational analysis was a more sensitive measure of stability or change of communicative effectiveness over time than the other two measures, and had the potential advantage for indirect intervention of revealing conversational strategies used by the partner as well as those used by the aphasic individual.

Acute Disease↗
PubMed2001

Couples therapy for women survivors of child sexual abuse who are in addictions recovery: a comparative case study of treatment process and outcome.

Treatment for women who are survivors of child sexual abuse and who have a history of substance abuse has largely involved gender-specific interventions. This study examines the use of conjoint couple therapy with a cohort of women who were survivors of child sexual abuse and who are in addiction recovery and with their partners. A comparative case study analysis incorporated standardized clinical measures with client and therapist interviews. Brief conjoint therapy was found to assist couples in the specific relationship skill areas of communication and mutual problem solving. Further, substantive gains were found in the realm of affective relations. The women reported an increase in support from their male partners, and the men reported a decrease in negative emotional atmosphere in the relationship.

Adult↗
PubMed2003

Transmission of STIs/HIV at the partnership level: beyond individual-level analyses.

Mathematical modeling of transmission dynamics of sexually transmitted infections (STIs) and HIV has considerably advanced HIV research by highlighting the importance of certain types of partnerships in epidemic spread. Notably, concurrent partnerships, defined as a sexual partnership in which one or more of the partnership members have other sexual partners while continuing sexual activity with the original partner, have been shown to play a fundamental role in potentiating the spread of STIs and HIV. Risk behaviors such as concurrency and sex without condoms as well as STI/HIV prevalence vary with physical, social, and emotional factors within partnerships. The efficiency of STI/HIV transmission appears to vary across types of concurrent partnerships according to the differing dynamics within them. Previous research on partnership dynamics has improved our understanding of the multidimensional aspects of sexual partnering, but little is understood of how these aspects of sexual partnering interact and increase risks for HIV, nor how types of partnerships, partnership dynamics, and concurrency work together to affect both the behavior of condom use and the biological transmission of disease. In this article, we discuss the need to extend our understanding of concurrency to include partnerships among men who have sex with men (MSM) and to differentiate between types of partnerships and to develop interventions to modify risk within partnerships. We also introduce a conceptual framework that reflects how individual and partner characteristics influence partnership dynamics that in turn influence risk behaviors, such as concurrency and not using condoms, and associated risks for STIs and HIV.

Communication↗
PubMed1996

The future of intervention research at NIOSH.

The National Institute for Occupational Safety and Health (NIOSH) has recently made a commitment to increase both extramural and intramural support of control technology and intervention research. It is important for NIOSH to use intervention research more aggressively because it provides a mechanism to go beyond investigation, identification, and recommendations to actually determine if prevention has occurred. Intervention research can assess the effectiveness of the hierarchy of controls, workplace standards, and health and medical care, as well as provide important information on occupational disease and injury surveillance and health communication efforts. In pursuing intervention research, NIOSH will focus on enhancing its existing control technology and surveillance programs, seeking input from partners in industry and labor, pursuing interdisciplinary approaches, considering the cost and feasibility of controls, considering and integrating behavioral procedures, and widely disseminating the results.

Behavior↗
PubMed2005

The mammalian heterochromatin protein 1 binds diverse nuclear proteins through a common motif that targets the chromoshadow domain.

The HP1 proteins regulate epigenetic gene silencing by promoting and maintaining chromatin condensation. The HP1 chromodomain binds to methylated histone H3. More enigmatic is the chromoshadow domain (CSD), which mediates dimerization, transcription repression, and interaction with multiple nuclear proteins. Here we show that KAP-1, CAF-1 p150, and NIPBL carry a canonical amino acid motif, PxVxL, which binds directly to the CSD with high affinity. We also define a new class of variant PxVxL CSD-binding motifs in Sp100A, LBR, and ATRX. Both canonical and variant motifs recognize a similar surface of the CSD dimer as demonstrated by a panel of CSD mutants. These in vitro binding results were confirmed by the analysis of polypeptides found associated with nuclear HP1 complexes and we provide the first evidence of the NIPBL/delangin protein in human cells, a protein recently implicated in the developmental disorder, Cornelia de Lange syndrome. NIPBL is related to Nipped-B, a factor participating in gene activation by remote enhancers in Drosophila melanogaster. Thus, this spectrum of direct binding partners suggests an expanded role for HP1 as factor participating in promoter-enhancer communication, chromatin remodeling/assembly, and sub-nuclear compartmentalization.

Amino Acid Motifs↗