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PubMed1992

Eurosentinel: development of an international sentinel network of general practitioners.

The Eurosentinel project was a European concerted action. It started in June 1988 and ended in June 1991. Its purpose was to coordinate activities in the field of sentinel practices with GPs and the ultimate goal was to establish a real European network of sentinel practices. This paper deals with the purposes of the project, the studies carried out in the frame of the project, and an evaluation of three years Eurosentinel.

Computer Communication Networks↗
PubMed2001

Development of Electron Probe Instrumentation during Those Early Days When Professor Castaing Visited Japan.

The development of the electron probe microanalyzer (EPMA) in Japan in the early 1960s, when Prof. R. Castaing visited Japan, is briefly outlined. In 1955, a review article was published by Prof. G. Shinoda in Oyobutsuri, the most popular journal in Japan, in which the EPMA was introduced. In 1957, a research group at the University of Tokyo started to develop an EPMA with a Grant-in-Aid for Developmental Research. Their research results led to the funding of a 2-year Grant-in-Aid for Cooperative Research Project (April 1960 to March 1962), which was chaired by Prof. Y. Sakaki. Prof. G. Shinoda who became the chairman of that project in April of 1962 led that group for another year until March of 1963. It was just after the start of the project that Prof. R. Castaing visited Japan in September of 1960 as a representative of the French Mission Culturelle. This visit gave a great push forward for the commercial development of EPMA instruments in Japan. The first three commercial EPMA instruments from Hitachi, JEOL, and Akashi Ltds. were installed in Tohoku, Osaka, and Waseda Universities in 1962, 1963, and 1964, respectively. Photographs of those first commercial EPMA systems, together with a brief description of the activities of the cooperative research projects, are presented.

Journal Article↗
PubMed2005

Anatomy of the soul as reflected in the cerebral hemispheres: neural circuits underlying voluntary control of basic motivated behaviors.

Understanding the principles of cerebral hemisphere neural network organization is essential for understanding the biological foundations of cognition and affect-thinking and feeling. A tripartite model of cerebral structure-function organization is reviewed, with attention focused on a behavior control system differentiation that mediates voluntary influences on three fundamental classes of goal-oriented behavior common to all animals. The model postulates just three cerebral divisions, one cortical and two nuclear (lateral or striatal, and medial or pallidal), that together generate a triple descending projection to the brainstem/cord motor system. This minimal circuit element is topographically organized and regionally differentiated, with the map of cortical areas serving as a basic starting point. Virtually all of the cerebral hemisphere projects on the upper brainstem behavior control column, atop the motor system hierarchy. The latter's rostral segment helps control ingestive (eating and drinking), defensive (fight or flight), and reproductive (sexual and parental) motivated behaviors, whereas its caudal segment helps control foraging or exploratory behavior to obtain or avoid specific goal objects associated with all classes of motivated behavior.

Animals↗
PubMed1975

Barbiturate spindle activity in functionally corresponding thalamic and cortical somato-sensory areas in the cat.

(1) Spontaneous barbiturate spindles were recorded from a locus in the thalamic nucleus ventralis postero-lateralis (VPL) and the corresponding projection area in the somato-sensory cortex (SI) in the cat. (2) Type I spindles32 recorded from such sites in the thalamus and cortex, regarded as being functionally on line, were cross-correlated. The analysis gave high negative cross-correlation coefficients, indicating that a considerable degree of wave synchrony existed between the spindles. Maximal wave synchrony was present in the first and middle part of the spindle. (3) The thalamo-cortical spindle wave synchrony was reduced by a small displacement of the cortical electrode within the somato-sensory cortex. Starting with a very lightly anaesthetized animal, small amounts of barbiturate did not influence the size of the cortical area which had spindles in synchrony with the thalamic spindles. (4) Spindles recorded from a VPL locus and from its cortical projection site started simultaneously. When the thalamic and cortical electrodes were positioned functionally off line this spindle coincidence decreased. The intervals between the spindle onsets increased with increasing off line positions of the electrodes. Those few thalamic and cortical spindles which occurred simultaneously showed no, or only weak, spindle wave synchrony. (5) These data suggest a point-to-point topographical relation between thalamic and cortical loci engaged in barbiturate spindle activity. (6) Type I and type II spindles32 differed with respect to spindle characteristics (amplitude, duration, incidence) and also with respect to corresponding thalamic rhythmic activity. These spindle types are, therefore, probably produced by different mechanisms. We suggest that type II spindles represent a purely cortical process initiated by type I spindles.

Animals↗
PubMed2002

Virtual reality in Latin American clinical psychology and the VREPAR project. Virtual Reality Environments for Psycho-Neuro-physiological Assessment and Rehabilitation.

Starting with the excellent collective work done by the European Community (EC)-funded Virtual Reality Environments for Psycho-Neuro-physiological Assessment and Rehabilitation (VREPAR) projects, I try to indicate some possible pathways that would allow a better integration of this advanced technology into the reality of Latin American psychology. I myself use analyses that I did in my master's degree in the PUCSP-Catholic University in São Paulo, Brazil. I also include a brief description of the CD-ROM Clinical Psychology Uses of Virtual Reality (CPUVR) that accompanies my thesis. I point out the importance of collaboration between psychology and other disciplines, including computer science. I explain the method that I used to work with digital information, important for the formation of a critical mass of people thinking in Portuguese and Spanish to accelerate a technological jump.

Computers↗
PubMed2001

Slovene smart card and IP based health-care information system infrastructure.

Slovenia initiated a nation-wide project to introduce smart cards in the health sector in 1995 and its full-scale deployment started in September 2000. Although the basic aim of the project was to support insurance related procedures, the system was designed in a flexible and open manner to present an infrastructure for the whole health sector. The functionality of the current system is described in this paper along with lessons learned so far. The upgrade of the system is outlined, with emphasis on technical details, the objective being to provide a real-time EDI based environment for a general set of applications in the medical sector, supported by the flexibility and security of modern smart card technologies. Integration with similar systems in other EU countries is discussed.

Computer Communication Networks↗
PubMedDate not supplied

Starting over at St. Jude.

Its $127 million expansion project will be complete in 1995 and will be six times larger than when it opened in 1962; almost none of the original building will remain.

Cancer Care Facilities↗
PubMed2004

A nation-wide project for the revision of the Belgian nursing minimum dataset: from concept to implementation.

This paper describes the process of revising the Belgian Nursing Minimum Data Set (NMDS). The study started in 2000. Implementation is planned from 2006. The project is divided in 4 major phases. The first phase (June-October 2002) implied the development of the conceptual framework based on literature review and secondary data-analysis. The Nursing Interventions Classification (NIC) was selected as framework for the revision of the NMDS. The second phase focused on the language development (November 2002 - September 2003) with panels of clinical experts (N=75) for six care programs. They indicated hospital financing, nurse staffing allocation and assessment of the appropriateness of hospitalization as priorities of a revised B-NMDS. A draft instrument with 84 variables, using NIC, was developed during this period. This leads to an alpha version of a revised NMDS. The third phase (October 2003 - December 2004) focused on the data collection and validation of the new tool. The new NMDS was tested on 158 nursing wards in 66 Belgian hospitals from December 2003 until March 2004. This test generated data for some 95.000 inpatient days. The interrater-reliability of the revised NMDS is tested. The criterion-related validity of the revised NMDS is compared with the actual NMDS. The discriminative power of the revised NMDS is tested to select the most relevant items for data collection. This will result in a beta version of revised NMDS in December 2004. The records of the revised NMDS are linked with the hospital discharge dataset and other mandatory datasets to integrate the revised NMDS in the broader health care management. The fourth phase (January-December 2005) will focus on information management.

Belgium↗
PubMed1998

Good practice in multimedia courseware development.

The main goal of the European TALENT/ESPRIT project is to create a generic environment for developing multimedia courseware. The first phase of the project concerns itself with developing conversion tools for converting text based course material into multimedia format. The second phase of the project adds network support to the courseware in the form of the network tutoring and networked supply chain support. One year into the project specifications for developing multimedia have been made and can be found in the project's deliverables. Also a summary of good practice in multimedia courseware development has been drawn up. First phase demonstrators (converted text based courses) are currently being prepared. This article starts with a global overview of the TALENT project itself. In more detail an overview of best practice guidelines in multimedia courseware development will be given. The information shown was obtained from an extensive survey among experts in the field of computer based training. The survey was conducted early this year as part of one of the project's deliverables. Finally some comments will be made on a multimedia demonstrator which is currently under development at HISCOM.

Computer-Assisted Instruction↗
PubMed1992

[Cardiologic emergencies: mortality and treatment. An analysis of 500 consecutive coronary events within the framework of the WHO-MONICA Project--Brianza Area. The Research Group of the WHO-MONICA Project--Brianza Area].

Recently, a decreasing trend in cardiovascular mortality, starting from 1976-78, has been observed in Italy, particularly in northern regions. In order to explore one possible cause of the phenomenon, a survey of acute coronary care has been performed in a sample area, with about one tenth of the population of Lombardy, the largest and most developed northern Italian region. The survey has been carried out within the framework of the WHO-MONICA project: the treatment of 500 consecutive suspected coronary events in the age group 25-64 years, has been examined according to the international protocol. The following items have been investigated: time between onset of symptoms and medical intervention; characteristics of initial care; cardiac arrest and cardiopulmonary resuscitation in or outside the hospital; intensive care unit admission and length of stay; type of treatment before, during and after the event. Marked improvements have been accomplished in managing cardiac emergency. They have reduced in-hospital coronary mortality by more than 50%. However, several problems were still present at the time of the study, 1986-87: a) only 52% of patients obtained assistance within 4 hours (Tab III); b) cardiac arrest was practically always fatal outside the hospital and in 75% of the cases inside (Tab V); c) essential drugs, e.g. beta-blockers, were not so widespread and substantially absent were angioplasty and coronary bypass surgery (Tab IX). It has been estimated that improving adherence to optimal therapeutic standards might save more than 700 lives a year in Lombardy in the age group 25-65 years.

Adult↗
PubMedDate not supplied

European Practice Database in the Czech Republic.

The EDTNA/ERCA European Practice Database (EPD) Project has been launched with the aim to collect data on professional practice and outcome of dialysis treatment throughout Europe. The Czech Republic had the privilege of taking part in the pilot phase together with Northern England and part of Italy. We first became involved in the EPD project during the annual EDTNA/ERCA conference in Nice, France. At this time the Research Board started to prepare an EPD questionnaire for the pilot phase. The project was officially launched in the Czech Republic during the Multidisciplinary Conference in Brno organised jointly by the Czech Association of Nurses and the EDTNA/ERCA in 2003. A presentation by Jean Yves De Vos, the EPD Co-ordinator, who introduced the final EPD questionnaire in detail, was the best promotion of the project.

Adolescent↗
PubMedDate not supplied

Liver cancer and its prevention.

Liver cancer is one of the leading causes of cancer deaths in Asia and Africa. The epidemiology of liver cancer is distinctive in Japan, where chronic infection with hepatitis C virus (HCV) rather than hepatitis B virus (HBV) plays the major role in the etiology. In this paper, together with a brief review of the descriptive epidemiology of liver cancer and its prevention, Japanese experiences of liver cancer occurrence and some epidemiological studies are described, and Japanese national projects directed against hepatitis and liver cancer are presented. Distinctive time-trends have been observed for liver cancer incidence in Japan. The rates for over 55-59 year olds (both sexes) showed a peak in the birth cohort of 1931-1935, while the rates for less than 50-54 year old females indicate a decreasing trend. The extremely high incidences among birth cohorts around 1931-1935 seems to be related to endemic HCV infection in this generation in Japan. Follow-up studies not only of patients with chronic hepatitis C but also of apparently healthy carriers of HCV showed an increased risk of hepatocellular carcinoma (HCC). Cumulative risk of HCC (40-74 years of age) was estimated as reaching 21.6% (males) and 8.7% (females) among anti-HCV positive voluntary blood donors. Retrospective cohort studies indicated interferon (IFN), with or without ribavirin, to be effective for reducing the risk of HCC among patients with chronic hepatitis C. Periodic examination with ultrasonography and measurement of alpha-fetoprotein has become common practice for early detection of HCCs among patients with chronic hepatitis or liver cirrhosis in Japan. A non-randomized controlled study was conducted to evaluate the effect of periodic examination on mortality, but we failed to show any beneficial effects of screening for liver cancer. In the fiscal year 2002, Japanese National Projects directed against hepatitis and HCC were started, in which blood tests for HCV and HBsAg are offered just once at the age of 40, 45, 50, 55, 60, 65 or 70 for five years. Participants are categorized as either HCV carriers or non-carriers. HCV carriers are further examined by liver disease specialists, seeking indications for IFN therapy. Type C chronic hepatitis patients are recommended to receive IFN therapy with or without ribavirin. This project is expected to become a model of liver cancer control in HCV-endemic countries. Recently however, the US Preventive Service Task Force has recommended against routine screening for HCV infection in asymptomatic adults in the general population who are not at increased risk of infection. This divergence of views is also discussed.

Adult↗
PubMed1989

Project IDEA: International Deaf Education Association.

This paper addresses some of the difficulties of educating the deaf in third world countries. Project IDEA (International Deaf Education Association) is an exemplary program started by the Peace Corps in Bohol, Philippines. The author made an on-sight visit to this project in 1986. Additionally, two Montana State University students completed internships there in early 1988 and their detailed accounts help form the basis for this descriptive report on the newly formed Bohol deaf community and their special educational/vocational program.

Adolescent↗
PubMed2005

The Tropical Biominer Project: mining old sources for new drugs.

The Tropical Biominer Project is a recent initiative from the Federal University of Minas Gerais (UFMG) and the Oswaldo Cruz foundation, with the participation of the Biominas Foundation (Belo Horizonte, Minas Gerais, Brazil) and the start-up Homologix. The main objective of the project is to build a new resource for the chemogenomics research, on chemical compounds, with a strong emphasis on natural molecules. Adopted technologies include the search of information from structured, semi-structured, and non-structured documents (the last two from the web) and datamining tools in order to gather information from different sources. The database is the support for developing applications to find new potential treatments for parasitic infections by using virtual screening tools. We present here the midpoint of the project: the conception and implementation of the Tropical Biominer Database. This is a Federated Database designed to store data from different resources. Connected to the database, a web crawler is able to gather information from distinct, patented web sites and store them after automatic classification using datamining tools. Finally, we demonstrate the interest of the approach, by formulating new hypotheses on specific targets of a natural compound, violacein, using inferences from a Virtual Screening procedure.

Animals↗
PubMed1997

Patient-oriented pharmacy on a special ward: results of a pilot project in Germany.

In Germany a pilot project in patient-oriented pharmacy has been started in the Berufsgenossenschaftliche Unfallklinik Ludwigshafen to demonstrate the efficiency of this modem way of practising pharmacy in hospital. A special ward of the orthopaedic department (spinal injuries, 25 beds) was chosen for this project. Since February 1st, 1994, the pharmacists have taken over the stock management on the ward and dispense oral drugs in unit-dose systems for each patient. The pharmacists participate also in ward rounds and check the patients' medication charts in order to support and inform the physicians. So the project is a combination of improved patient care and an advisory service in pharmaceutical questions for the medical staff. In the first year of this project, which is still ongoing (February 1994-January 1995), 123 patients were treated on the ward; the average duration of stay was about 77 days. During this first year the pharmacists registered 111 questions and events leading to pharmaceutical interventions. The most important results of the project are the improvement in drug safety and more effective drug use. Other positive results are: during the course of the project the cooperation between the medical and pharmaceutical staff has been improved and the drug management by the pharmacy has resulted in a 17 per cent reduction of medication costs in comparison to the year before. All these results clearly demonstrate the success of these first steps in patient-oriented pharmacy.

Germany↗
PubMed1988

Merging facility and financial planning: a new approach.

This article seeks to help hospital administrators and boards (especially planning and finance committees) balance facility and financial aspects of a construction project by planning for each concurrently. It recommends that the process start with formal strategic plans, and that facility and capital plans be advanced interactively, thus maintaining flexibility to ensure that the hospital's objectives can be met within manageable financial limits. The authors suggest that the project thus delivered will be the most effective and efficient project possible within defined constraints. And, once planned, the project will be ready for implementation--false starts will be eliminated.

Capital Financing↗
PubMed2005

Supporting adherence and healthy lifestyles in leg ulcer patients: systematic development of the Lively Legs program for dermatology outpatient clinics.

OBJECTIVES: The objective of our project was to develop a lifestyle program for leg ulcer patients at outpatient clinics for dermatology. METHODS: We used the intervention-mapping (IM) framework for systematically developing theory and evidence based health promotion programs. We started with a needs-assessment. A multidisciplinary project group of health care workers and patients was involved in all five IM steps; formulating proximal program objectives, selecting methods and strategies, producing program components, planning for adoption and implementation and planning for evaluation. Several systematic literature reviews and original studies were performed to support this process. RESULTS: Social Cognitive Theory was selected as the main theory behind the program 'Lively Legs' and was combined with elements of Goal-Setting Theory, the precaution adoption model and motivational interviewing. The program is conducted through health counseling by dermatology nurses and was successfully pre-tested. Also, an implementation and evaluation plan were made. CONCLUSION: Intervention mapping helped us to succeed in developing a lifestyle program with clear goals and methods, operational strategies and materials and clear procedures. PRACTICE IMPLICATIONS: Coaching leg ulcer patients towards adherence with compression therapy and healthy lifestyles should be taken on without delay. Systematic development of lifestyle programs for other patient groups should be encouraged.

Adolescent↗