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PubMedDate not supplied

The Centers for Disease Control program to prevent primary and secondary disabilities in the United States.

The Disabilities Prevention Program builds on traditional Centers for Disease Control (CDC) strengths in public health surveillance, epidemiology, and technology transfer to State and local governments in translating the findings of research into prevention programs. The objectives of the CDC program are to provide a national focus for the prevention of primary and secondary disabilities, build capacity at the State and community levels to maintain programs to prevent disabilities, and increase the knowledge base necessary for developing and evaluating effective preventive interventions. During 1989, CDC, in consultation with the National Council on Disabilities and members of the disability community, has elected to focus its effort in three areas: developmental disabilities, injuries to the head and spinal cord, and secondary complications among persons with physical disabilities.

Centers for Disease Control and Prevention, U.S.↗

PubMedDate not supplied

A consortium approach to nursing staff development.

Within a consortium framework, four teaching hospitals have developed a curriculum for nursing staff development. Since 1980, the institutions have realized significant savings. The courses provide networking and integration of new research and facilitate technological transfer. Other institutions may also find a collaborative approach beneficial.

Hospitals, Public↗

PubMed1989

The health sciences communicator as faculty developer.

To determine the content for a model faculty development program for primary care faculty, a combination of the Delphi and Nominal Group Technique was used resulting in a curriculum with five units of instruction: development of curriculum and instruction, teaching methods, evaluation, administration, and academic survival skills. A philosophy for conducting faculty development is presented which includes concepts of andragogy, technology transfer, the diffusion of innovation, and networking. Program types include short-term, long-term, and extended programs such as fellowships.

Communication↗

PubMed1988

Approaches to gene therapy in disorders of purine metabolism.

Model studies with gene transfer technology using retroviral vectors expressing the cloned human genes for adenosine deaminase (ADA), purine nucleoside phosphorylase (PNP), and hypoxanthine guanine phosphoribosyltransferase (HPRT) indicate that these disorders may eventually be treated by the introduction of the normal gene into defective cells. The autologous transplantation of bone marrow infected in vitro with retroviral vectors is the most developed approach at this time. The potential usefulness of this and other approaches for each of these three disorders of purine metabolism are discussed.

Adenosine Deaminase↗

PubMed1988

Hypertension research perspective in the United States.

Hypertension affects 30% of the U.S. adult population or 58 million Americans. A comprehensive national research effort has been developed for attacking this problem on multiple fronts including basic research, applied research and development, clinical research, clinical trials, demonstration and education research, and technology transfer through the National High Blood Pressure Education Program. As a result, important new insights into the etiology and pathogenesis of hypertension and advances in its control have been realized, but this momentum needs to be sustained to meet the many challenges presented by this disease.

Clinical Trials as Topic↗

PubMed1986

Tufts academic health information network: concept and scenario.

Tufts University School of Medicine's new health sciences education building, the Arthur M. Sackler Center for Health Communications, will house a modern medical library and computer center, classrooms, auditoria, and media facilities. The building will also serve as the center for an information and communication network linking the medical school and adjacent New England Medical Center, Tufts' primary teaching hospital, with Tufts Associated Teaching Hospitals throughout New England. Ultimately, the Tufts network will join other gateway networks, information resource facilities, health care institutions, and medical schools throughout the world. The center and the network are intended to facilitate and improve the education of health professionals, the delivery of health care to patients, the conduct of research, and the implementation of administrative management approaches that should provide more efficient utilization of resources and save dollars. A model and scenario show how health care delivery and health care education are integrated through better use of information transfer technologies by health information specialists, practitioners, and educators.

Academic Medical Centers↗

PubMed1980

New perspectives in coagulation testing.

The field of coagulation testing has undergone some major technological and conceptual developments, which are briefly reviewed here. The assessment of coagulation parameters is no longer restricted to the study of clot formation and its dissolution. The understanding of the biochemical nature of coagulation processes, coupled with the development of new therapeutic agents in the treatment of hemostatic disorders, has brought about the development of fast, reliable, and clearly defined laboratory test procedures to evaluate the components of this system. The introduction of methods involving synthetic substrates has been very significant because many of the coagulation parameters can now be measured with a spectrophotometer or fluorometer, by methods that lend themselves to the automation found in most large clinical chemistry laboratories. In our laboratory, we use automated synthetic-substrate methods for antithrombin-III, plasminogen, and prothrombin, and are developing the synthetic-substrate assay equivalent of clot-based prothrombin time and partial thromboplastin. Immunological methods such as laser/rate nephelometry, enzyme-linked immunoassays, electroimmunodiffusion, and radioimmunoassays have been utilized to evaluate coagulation proteins. The relation of functional and immunological properties of these proteins to their physiological function is being studied. In coming years the testing of coagulation function will undergo some major changes and will require input from clinical chemists and other laboratory scientists to facilitate the technology transfer and proper standardization of new methods.

Antithrombin III↗

PubMedDate not supplied

Statement on use of apolipoprotein E testing for Alzheimer disease. American College of Medical Genetics/American Society of Human Genetics Working Group on ApoE and Alzheimer disease.

OBJECTIVE: To evaluate the published data on the association between apolipoprotein E genotype (APOE) and Alzheimer disease (AD) and determine whether the data support the use of genetic testing for diagnosis or prediction of disease. This statement is intended for neurologists, psychiatrists, geneticists, primary care providers, diagnostic laboratories, and the public. PARTICIPANTS: The joint American College of Medical Genetics (ACMG) and American Society of Human Genetics (ASHG) Test and Technology Transfer Committee developed a 10-member ACMG/ASHG Working Group to assess available data on the association of AD with APOE alleles. To ensure inclusion of clinical specialists primarily involved with AD patients and families, the American Academy of Neurology (AAN) and the American Psychiatric Association (APA) appointed liaisons to the Working Group. EVIDENCE: Peer-reviewed journal publications obtained from an Index Medicus search or known to members of the Working Group were the source of data on which the statement is based. CONSENSUS PROCESS: Following discussions with all members of the Working Group, a draft statement was prepared by the chair and circulated among all members until a consensus was reached. The consensus draft was sequentially reviewed and endorsed by the appropriate scientific and executive committees of the ACMG, ASHG, AAN, APA, and the National Institutes of Health-Department of Education Working Group on Ethical, Legal, and Social Implications of Human Genome Research. In some instances, suggestions from these committees were incorporated into the final statement. CONCLUSIONS: There is general consensus that APOE epsilon 4 is strongly associated with AD and that when present may represent an important risk factor for the disease. However, at the present time it is not recommended for use in routine clinical diagnosis nor should it be used for predictive testing. Studies to date indicate that the APOE genotype alone does not provide sufficient sensitivity or specificity to allow genotyping to be used as a diagnostic test. Because AD develops in the absence of APOE epsilon 4 and because many with APOE epsilon 4 seem to escape disease, genotyping is also not recommended for use as a predictive genetic test. The results of a collaborative study under way will clarify some of these issues. Whether APOE genotypes have other uses in the management of AD will become apparent over the next few years.

Alleles↗

PubMed1994

Biotechnology in Chile (overview).

This article provides a brief overview of biotechnological activities in Chile. The role played by the scientific community is emphasized and aspects of technology transfer are commented.

Biotechnology↗

PubMed1995

Clinical evaluation of the Franklin Applied Physics Cosmetic Cover for lower limb prostheses: a preliminary report.

The Franklin Applied Physics (FAP) Cosmetic Cover is the result of research and development directed by Dr. Robert Erb at the Franklin Research Center, Norristown, PA. The FAP Cover is a silicone rubber cosmesis designed to improve the appearance of lower limb prostheses and provide wider social integration for the wearer. The Technology Transfer Section, Rehabilitation Research and Development Service, Department of Veterans Affairs, coordinated a pilot study of four pre-commercial covers at selected sites. Participating prosthetists and subjects evaluated fit, relevant physical criteria, and overall potential value of the cover. The following statements summarize responses of the participants: 1) well accepted with regard to overall fit, appearance, and ease of donning/doffing; 2) lightweight, highly elastic, and easy to maintain; and 3) split toe and closed toe versions are needed for above-knee and below-knee models. Data gleaned from the pilot study were used to define dimensions for standardized off-the-shelf sizing and to make recommended modifications, resulting in pre-market models that are ready for a national field evaluation.

Artificial Limbs↗

PubMed1994

Report on the evaluation of the DAV/Seattle Knee.

The Department of Veterans Affairs (VA) Rehabilitation Research and Development Service, Technology Transfer Section (TTS) managed a clinical evaluation of the DAV/Seattle Knee with collaboration from the Prosthetic and Sensory Aids Service (PSAS), VA Central Office (VACO) at 16 VA Medical Facilities, recruiting 46 subjects. The DAV/Seattle Knee was designed to provide a functional, lightweight artificial knee that would give veterans, with above-knee amputations, greater mobility than they experienced with other comparative man-made knees. This national evaluation was conducted to determine the acceptance of the DAV/Seattle Knee by veterans prescriptive criteria and to determine what modifications, if any, were needed to improve the product for optimal use by the targeted population and to enhance its marketability. TTS, with collaboration from PSAS/VACO, managed a clinical evaluation on 28 units with fluid swing control. The evaluation trials were conducted between May 1992 and May 1993. During the initial phase of the clinical trials, a common problem of the piston shaft end breaking was identified. This was a fail-safe situation; the knee support structure maintained its integrity and did not cause the subject to fall. All units were immediately returned to the manufacturer for installation of new damper mounts. Forty-six subjects were accepted; 28 fitted; 23 completed evaluation for 30 days, 8 subjects are currently wearing the DAV/Seattle Knee. The subjects' responses from the clinical trials successfully demonstrated that the DAV/Seattle Knee is safe and reliable when properly matched to the user's weight, stump length, and activity requirements.

Adult↗

PubMed1993

Research device to preproduction prototype: a chronology.

This paper describes the evolution of the Wheelchair Aerobic Fitness Trainer (WAFT), a wheelchair ergometer developed for determination of aerobic capacity and the diagnosis of coronary artery disease in lower limb disabled persons whose mobility depends primarily on the manual wheelchair. The device was originally developed for use in research studies to determine peak exercise capacity in persons with spinal cord injuries and other lower limb disabilities and to formulate associated graded exercise stress test protocols. In subsequent research, the device was incorporated into a specially designed testing station for the detection of coronary artery disease in persons who cannot adequately undergo treadmill or cycle ergometry testing because of lower limb disabilities. Based on the usefulness of the device for both rehabilitation and diagnostic purposes, the WAFT has been brought into the technology transfer process of the Department of Veterans Affairs Rehabilitation Research and Development Service. Under a contract with Packer Engineering, Inc., Naperville, IL, development of a preproduction version of the device and six units for field evaluation has commenced. The preproduction prototype of the WAFT has incorporated numerous improvements over the original device and promises to expand the potential for future research, rehabilitation, and diagnostic applications.

Adult↗

PubMed1994

[An original experience through the creation of a new functional rehabilitation center for Vietnamese lepers].

Since 1990, the creation of a Rehabilitation Center for Vietnamese leprosy patients under the aegis of "Oeuvres Hospitalières Françaises de l'Ordre de Malte" is the result of emphasized collaboration between governmental and non-governmental organizations, and between medical and paramedical specialists. This humanitarian action is not "a present home delivery". The end of this action is to set progressively a realist enterprise that depends on preliminary epidemiologic investigations on the spot to analyse means and necessities. Frequency of disabilities (49.6%) and predominance of grades 1 and 2 (83.5%) require aids. The realisation of technology transfer at all medical care levels is necessary. But at the same time, it is essential to build surroundings adapted infrastructure, to equip with effective material giving comfort and security for patients, and even to supply with pharmaceutic drugs in order to continue rehabilitation's activities. In short range, patient's selection and regular control give first objective results.

France↗

PubMed1993

Growth factors in the management of adult acute leukemia.

This review has explored the various ways that growth factors may be used in the management of adult acute leukemia. Growth factors have the potential to reduce the morbidity and mortality of both induction and postremission therapy by enhancing hematopoietic recovery or, when used as an adjunct to standard antimicrobial therapy, reducing the infectious complications of chemotherapy. In addition, they may have favorable effects on the biology of leukemia either by recruitment of leukemic progenitors into cycle, rendering them more sensitive to the cytotoxic effects of chemotherapy, or by inducing the terminal differentiation of the leukemic clone. Finally, disruption of aberrant growth factor networks, thought to play a role in the pathogenesis of leukemia, may be a therapeutic strategy now that soluble receptors and receptor antagonists to such growth factors as IL-1 are available. Whether growth factors used in such ways will have beneficial, or in fact adverse, effects on the treatment outcome for acute leukemia is not yet known. As such, the use of growth factors in the management of adults with acute leukemia is still experimental and needs to be studied in the context of clinical trials. Perhaps the ultimate benefit to be derived from the study of these growth factors will be a deeper understanding of the genetic perturbations that define the leukemic state. The development of molecular therapeutic techniques, such as gene transfer technology and the use of antisense oligonucleotides, has paralleled our increasing knowledge of cytokines. The hope is that as we come to understand leukemia at the molecular level, we will be able to develop the new therapeutic tools necessary to increase the numbers of patients cured.

Acute Disease↗

PubMed1993

Somatic gene therapy into hematopoietic cells. Current status and future implications.

Retroviral-mediated gene transfer is a powerful tool for introducing and expressing single genes into hematopoietic cells. There has clearly been a tremendous amount of progress in the development of retroviral gene transfer technology over the past 7 years. This is evidenced by improvements in transduction efficiency and expression in animals and its selected use currently in human trials. Critical experiments that must yet be performed relate to the in vitro identification, transduction, and expansion of pluripotent hematopoietic stem cells in vitro as well as the development of retroviral vectors that maximize in vivo expression in the desired target cells.

Animals↗

PubMed1993

The future of post-residency fellowship education.

Post-residency fellowship education has traditionally been a transitionary phase toward a possible career involving medical research and teaching. The increasing sophistication required for performing medical research, the emphasis on molecular medicine, significant overcrowding in specialty disciplines, high student indebtedness, declining availability of government research grant funding, and the rise or academic-corporate joint ventures facilitating technology transfer to the private sector are causing changes in the traditional approach to and content of fellowship programs. In light of the overall recent economic downturn with the consequent contraction in research budgeting, fewer fellows will probably be trained in the near future. Alternatives in fellowship programming and support are explored.

Curriculum↗

PubMed1995

Ultrasonic head controller for powered wheelchairs.

This report describes an evaluation by the Department of Veterans Affairs, Rehabilitation Research and Development Service, Technology Transfer Section (TTS). The Ultrasonic Head Controller Unit (UHCU) is the result of research and development conducted by the Palo Alto VA Rehabilitation Research and Development Center, under sponsorship of the Paralyzed Veterans of America and the VA Rehabilitation Research and Development Service. The UHCU provides an alternative to currently available human/machine interfaces for severely disabled individuals. Unlike switches or proportional joysticks, the UHCU operates without physical contact between the unit and the user. The UHCU produces analog signals in direct response to changes in the head position of the user. These signals can be used to control a variety of communication, robotic, mobility, and recreational devices. This clinical evaluation explored the use of the UHCU for powered wheelchair control by quadriplegic individuals.

Evaluation Studies as Topic↗

PubMed1996

Hearing aid systems in undeveloped, developed and industrialized countries.

The problems related with the hearing loss prevalence and deafness rehabilitation in Developing (D) countries are so complex that only basic needs and some suggestions are discussed in this paper. In fact for D countries the main demographic and social indi reveal the enormous gravity of the health situation and so the availability of a hearing aid delivery system is often considered less urgent and secondary to the basic unmet needs of the population. Nevertheless we think this concept may be applied to the adult, but for the child with a preverbal deafness it must deserve immediate attention in order to prevent a very serious handicap limiting all his life. Schematically the three types of handicaps developed by a child with a preverbal hearing loss are presented and discussed. The essential assumption, however, for any hearing aid program in D countries is the creation in loco of competent personnel for the prescription, for fitting and checking the aids. If D countries are to achieve this objective, industrialized countries must begin to transfer technology and training to develop pilote centers.

Africa↗