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PubMed1994

Direct measurements and systematic observations of physical workload among medical secretaries, furniture removers and male and female reference populations.

The aim of this investigation was to collect quantitative information about the occurrence of manual materials handling and working postures in working life. Direct technical recordings and systematic observations by trained ergonomists were used throughout a whole working day on 12 male furniture removers, 13 female medical secretaries, 27 males and 45 females randomly sampled from the working population in the Stockholm area. A quantitative job exposure profile was obtained by weighting together exposure data obtained by observation of tasks occurring during a normal working week. The results showed no major differences in physical exposures between the male and female reference populations. The medical secretaries spent less time than the female population kneeling/squatting and longer time than any other group with repetitive hand movements. Exposure data for task and job should be clearly distinguished.

Journal Article↗
PubMed1995

Mikro-knemometry: an accurate technique of growth measurement in rats.

A novel, noninvasive technique for accurate measurements is presented which determines the distance between knee and heel of the rear lower leg in the conscious rat (mikro-knemometry). Each measurement consists of initially six, later four subsequent and independent estimations of this distance. During a 14-day training study, the mean standard deviation (technical error) of five (six minus the first estimation) decreased from 196 microns to 101 microns. Measurements at exact 24-h intervals revealed nonlinear increments of rat lower leg growth, with marked infradian variation once every four to six days, similar to "mini growth spurts", described in rabbit and human growth. There was also a significant circadian periodicity of leg length increment (p < 0.01), with a minimum leg increment (after midnight dip) between 2400 h and 0300 h (mean: 4.8% (SEM 2.3%) of the total 24-h increment, p < 0.01), and a maximum increment (early morning spurt) between 0600 h and 0900 h (mean: 34.9% (SEM 2.5%) of the total 24-h increment, p < 0.001). Thus, the technique of mikro-knemometry seems to be a useful tool for the investigation of longitudinal growth in laboratory rats, and may replace conventional techniques of growth measurements such as measuring body weight, nose-tail, or tail length.

Animals↗
PubMed1988

Swedish physicians' perspectives on work and the medical care system--III: Private practitioners on the public system.

This paper reports the results of focused interviews in 1978-1979 with Swedish physicians in private practice about the public system of medical care in Sweden. They were asked about the system as a work environment for physicians and as a system of care for patients. Respondents, who were outside the public system (although financed mainly by public mechanisms) said the public system as a place to work had advantages in its high technical quality, facilities for research and training, and the capacity to treat complicated disease; its disadvantages were said to be inefficiency, lack of communication, poor patient care, and blocked mobility for physicians without doctorates. As a system of care, its one advantage was said to be that it provided care at less out-of-pocket cost to patients; its reported disadvantages were poor quality care and a tendency to be overly comprehensive. These perspectives are discussed with respect to their structural and historical contexts.

Ambulatory Care↗
PubMed1979

Construction of a new psychiatric rating instrument, the Comprehensive Psychopathological Rating Scale (CPRS).

1. The CPRS (the Comprehensive Psychopathological Rating Scale) is a recently constructed rating instrument consisting of 65 scaled items, covering a wide range of psychiatric symptoms. Explicit definitions in a non-technical language are provided for items as well as scale steps. 2. The CPRS is mainly intended for evaluation of treatment effects, but due to the explicit descriptions, it has also been found useful for teaching purposes. It can be used in full, or as an item pool for which subscales for different psychiatric syndromes can be designed. Subscales exist, inter al., for depression, schizophrenia, obsessive-compulsive disorder, neurasthenic syndromes and mental distress in connection with severe physical illness. 3. The CPRS is available in parallel Swedish and English versions. It has been translated into all Scandinavian languages, and into German, Italian and Spanish. French and Russian versions are in preparation. 4. The rating is based on an interview which will require less than an hour in most cases if the scale is used in full. Due to the non-technical language used, raters without formal training in psychiatry (i.e. nurses, psychologists, general practitioners) can use the scale without reduction in reliability.

Humans↗
PubMed2005

Poison control centers in developing countries and Asia's need for toxicology education.

Poison control centers (PCCs) in developing countries have been set up in response to the challenge of decreasing mortality and morbidity from poisoning. The services range from poison information to actual clinical treatment mostly of acute cases. Lately, PCCs have expanded from their traditional role to one that actively engages in community health studies, toxicovigilance along with treatment of chronic poisoning. Recognizing that types of poisoning and specific needs may vary from country to country, toxicology education that addresses these unique regional issues has become more necessary. Toxicology education, both formal and informal, exists in various stages of development in Asia. Clearly, there are gaps that need to be addressed especially in areas where there are no poison centers or where strengthening is necessary. Collaboration between PCCs in developing countries can help augment available resources including human, analytical and technical expertise. The critical mass of trained toxicologists will fill in the demand for clinical and regulatory specialists and educators as well. This paper highlights the experiences and resources available to the Philippine and Malaysian poison centers and the strengths generated by networking and collaboration. The role of Asia Pacific Association of Medical Toxicology (APAMT) as the Science NGO representative to the Intergovernmental Forum on Chemical Safety (IFCS) forum standing committee in promoting chemical safety at the regional level will be discussed. The "Clearinghouse on the Sound Management of Chemicals", a platform for engaging multi-stakeholder and interdisciplinary partnerships, will be described as a possible model for capacity building to advance chemical safety through education and training not only in developing countries in Asia but globally as well.

Asia↗
PubMed2004

The two-incision minimally invasive total hip arthroplasty: technique and results.

Minimally invasive surgery has the potential for minimizing surgical trauma, pain, and recovery time in patients having THA. This minimally invasive two-incision total hip technique was found to be safe and facilitated a rapid patient recovery. Further-more, unique instruments and fluoroscopic assistance ensure accurate component position and alignment. This technique is technically challenging, however; as such, proper training, including cadaveric training, is essential to minimize complications and ensure success.

Arthroplasty, Replacement, Hip↗
PubMed1999

Vital elements for the successful control of foot-and-mouth disease by vaccination.

The efficient control of foot-and-mouth disease (FMD) by immunisation depends not only on the appropriate choice of vaccine in terms of innocuity, potency and strain composition, but also on a series of inter-related zoo-sanitary factors which are equally important. These include: national, centralised planning (including contingency planning) and control; vaccination and revaccination policy; the availability of epizootiological intelligence based on adequate diagnostic capability and ongoing immunological surveillance; the logistics of supply with its components of storage, transport and distribution; proper vaccine application; cleaning and disinfection of premises, vehicles and personnel; identification of individual animals; control of animal movement; recording; ongoing economic outcome and benefit analyses: training and retraining of professional and technical staff; public relations and especially the commitment of the agricultural community. These elements are reviewed in this paper.

Animals↗
PubMed1999

[Nursing in the profession of the "sub-surgeons" between 1750 and 1850].

Between 1750 and 1850 surgical training was professionalized as a consequence of newly established technical colleges for surgeons in Germany and Austria led by doctors rather than craftsmen. At first, anatomy, debridement and obstetrics was taught, then a technical knowledge of medical treatment in general was instructed at specific medical/surgical schools. Depending on their years of training, graduates then worked as country doctors or as surgical assistants ("Subchirurgen", second class wound doctors). Nursing care was also on the curriculum; therefore some students worked temporarily as nurses. After graduating, many supervised nursing care in hospitals. This profession died out due to developments in the medical profession of the mid-19th century. However, they never belonged to the proletarian class of orderlies.

Curriculum↗
PubMed1984

Studies in general practice: interpractice differences.

Based on results of a recent epidemiological study in general practice, interpractice differences are described and found to be rather marked. They include differences in patients population, case definitions and ability to diagnose nosologic groups. Based on relevant literature and own experiences, measures are described which help to reduce interpractice differences and to improve the quality of study data. Examples of training procedures, exchange of information and technical support are given. As a consequence of the interpractice differences these measures are found to be not only desirable but imperative.

Diagnosis, Differential↗
PubMedDate not supplied

[Current status of autologous chondrocyte transplantation].

PURPOSE: Autogenous chondrocyte transplantation (ACT) is a promising but disputable new method for the treatment of full thickness hyaline cartilage defects. Neither long-term follow-up studies nor prospective randomised comparative clinical trials exist to measure the outcome. METHODS: Several bioengeneering companies have emerged (Genzyme, Verigen, Co.don, etc.) and commercialised this new method of ACT which has generated enormous interest. Each company uses its own (secret) protocol for culturing human cartilage cells. These protocols vary considerably from each other with regard to culture media, enzymes and other additives (e.g. antibiotics) used. However, no quality control requirements for the culturing process of cartilage cells have been proposed which the companies have to fulfill. At the time of surgery the treating surgeon has to assume (and hope) that the cultured cells are viable, sterile, active and potent but a control mechanism does not exist. RESULTS: Considering the enormous price for ACT which the patients and the insurance companies are asked to pay quality control standards should be developed with the following informations given: cell viability, grade of differentiation, cell morphology, secretion levels of essential matrix components (collagen type II, IX, X and XI, Aggrecan) and the total cell number. None of the above information is currently provided by any of the companies involved. CONCLUSION: The widespread clinical use of this technique cannot be recommended at this stage as the scientific proof for reproducibility of ACT has not been given so far. The operative technique of ACT is demanding and should only be used by surgeons having attended special practical training courses and workshops to minimise technical failure rates. Clinical results should be documented in a uniform standardised way using established outcome scores and modern diagnostic measures (e.g. intraoperative biomechanical testing of repair tissue). Further controlled clinical trials, experimental research and the establishment of quality control standards are required.

Aggrecans↗
PubMed2003

Promoting safety--a component in health promotion in primary and secondary schools.

Accidents, especially accidents involving children or young people, are a key health problem that needs to find higher prominence in preventative measures. The school as the central socialisation institution plays a key role in the process of continual improvement. However, to date the prevailing approaches of technical accident prevention and behaviourled safety training have not led to sustained improvements in the safety of children and young people. This article presents the key elements and characteristics of a new approach that not only aims to make significant improvements in safety but is also aimed at schools having an improved perception of their key role--to instruct and educate. The authors assume that greater security can only be achieved in and through schools if safety promotion is at the same time school development. In this understanding, safety promotion focuses on the key players in the school and school life itself, and in particular endeavours to strengthen relationships and behaviour that promote safety and to minimise those that can have a negative effect. It emphasises practical changes to daily school life with regard to construction and fittings, education, training, organisation and politics, and involves the needs of everybody who lives and works at the school.

Accident Prevention↗
PubMed1991

Applications of survival analysis to aging research.

Many research questions in aging research treat time as the outcome variable. Researchers ask how much time must pass before a specific type of change or event occurs, and whether these times differ by characteristics of the subjects' background, training and treatment. Because of serious technical problems that arise when analyzing duration data, specially derived statistical methods--the methods of survival analysis--are required to answer the questions. In this paper, we introduce the conceptual framework of these new methodologies for analyzing duration data. We begin by identifying the types of research question that might appropriately treat time as an outcome. We then describe the new statistical methods for addressing such questions, provide a broad overview of their application, and identify relevant published sources containing additional background and technical information.

Aging↗
PubMed2006

Mental health and psychosocial response after the worst natural disaster in the history of the Maldives.

The Maldives as a geographically diverse nation had to face tsunami with a number of key issues in hand. These included large geographical spread of islands, varied levels of communication across islands and internal displacement of people. One third of the total population was directly or indirectly affected. All except nine inhabited islands were partially or totally flooded. Although the total loss of life was limited the effect on the population was tremendous. The cost to the economy was 62% of the annual GDP. The government not only assigned high priority to mental health and psychosocial support activities after the tsunami but took charge of training and support measures. The community outreach programme provided psychosocial support to every affected person. This was provided by local Maldivians, who were appropriately trained, thus making it culturally and technically appropriate. Long-term plans for mental health and psychosocial aspects of disaster preparedness have been initiated. The experiences of the tsunami disaster has provided an opportunity to review the existing state of mental health services in the Maldives and to develop a plan to meet the mental health and psychosocial needs of the community. A rapid and appropriate response to a disaster depends on an existing policy structure and system, and an ability to mobilize these plans.

Disaster Planning↗
PubMed1986

The pathologists' assistant. Distribution, use, and employer perceptions.

Pathologists' assistants have been formally trained since 1969 to assist in technical anatomic pathology procedures. The authors surveyed 165 assistants who are members of their national organization to determine the actual demographic distribution and patterns of use. One hundred respondents were slightly more concentrated in the eastern United States, usually in pathology groups larger than the national average. Assistants generally performed a large percentage of the autopsy and surgical specimen dissections and various ancillary functions: teaching, supervision, administration, or research. Sixty-six of 82 employer pathologists responded to a companion survey. They were satisfied with the assistant's work. Most hired assistants to free themselves from technical functions or to replace residents, believed that assistants' numbers will remain small, and favored a national certification program. Thus, pathologists' assistants are effectively filling a need for ancillary anatomic pathology personnel in selective situations, primarily in larger pathology practices.

Allied Health Personnel↗
PubMed2005

Health behaviour and lifestyle of Pacific youth surveys: a resource for capacity building.

The changing global socio-economic environment over the last two decades has had significant ramifications for the health and development of youth in lower- and middle-income countries. In the Pacific region, young people are exposed to similar causes of ill-health as their peers in developed countries. This paper describes the development, implementation and major findings of the Health Behaviour and Lifestyle of Pacific Youth (HBLPY) surveys, a regional initiative to obtain representative data about health-related behaviour and needs of adolescents in Vanuatu, Tonga and the Federated States of Micronesia. The Pacific HBLPY is modelled on the WHO Europe Health Behaviour in School-aged Children (HBSC) surveys. The surveys, undertaken in 2000-2001, were built upon strong local partnerships and were undertaken with youth participation to ensure survey ownership. A regional technical group was formed to provide training and support to strengthen health survey capacity of youth and their agencies. The findings showed that tobacco was most commonly used substance, with 29.7% of 15-year-old boys and 15.7% of girls smoking weekly. Over half of the students did not engage in physical activity for at least 2 h per week; these rates are substantially lower than those usually found in Europe. Dietary habits among this group are also of concern, reflecting international trends away from highly nutritious traditional diets. The HBLPY surveys have shown that it is possible to collect population-based data in lower- and middle-income countries so that appropriate youth health programmes and policies can be developed. Implementation of an ongoing surveillance system similar to the HBLPY model in these countries warrants further investigation. Such initiatives should be supported at the regional and global level.

Adolescent↗
PubMed1994

Medical graduates evaluate the effectiveness of their education.

In response to the General Medical Council's 1991 Consultative Document proposing changes to medical curricula, the King's College School of Medicine and Dentistry, London, established a steering group to plan a new curriculum. As part of this process a postal survey was undertaken of five cohorts of King's graduates to ascertain how well the medical course they had undertaken had equipped them for practice. The questionnaire explored the level of factual content, the adequacy of their skills training, and the development of personal attributes during the course. A total of 371 graduates replied, a response rate of 78%. Over 70% indicated that their education had satisfactorily equipped them for their medical practice. Significant differences were found, however, between those now practising in primary care and those in hospital medicine regarding the importance attached to different subjects within the curriculum, and also with respect to the personal attributes the graduates felt they had acquired. Both groups identified deficiencies in virtually all aspects of their skills training: clinical, analytical, communication, management and technical. This feedback from some of the 'consumers' of medical education is now being used to assist the planning of the new King's curriculum.

Attitude of Health Personnel↗
PubMed1981

Short-term dynamic psychotherapy: its history, its impact and its future.

Short-term dynamic psychotherapy is successful for the healthier patient, but also for the individual with severe and chronic problems. The author surveys the history of brief intervention since Freud. Despite favorable outcomes, there has been a lack of interest for short-term dynamic therapy. Analysts, emphasizing on long-term analysis, failed to distinguish between developing theory and treatment. Since the mid-fifties interest for short-term techniques has increased. Research is resulting in criteria for selection and outcome. Utilized are active techniques, as transference interpretation, in dealing with specified foci. Successful outcome is obtained in oedipal problems, grief reactions, obessive compulsive illnesses, multiple phobias and some boderline disorders. In future, research is necessary on differentiation between patients, on comparison between treatment methods, and on technical factors, next to education and training.

History, 19th Century↗
PubMed2001

Methods to identify and characterize developmental neurotoxicity for human health risk assessment. II: neuropathology.

Neuropathologic assessment of chemically induced developmental alterations in the nervous system for regulatory purposes is a multifactorial, complex process. This calls for careful qualitative and quantitative morphologic study of numerous brains at several developmental stages in rats. Quantitative evaluation may include such basic methods as determination of brain weight and dimensions as well as the progressively more complex approaches of linear, areal, or stereologic measurement of brain sections. Histologic evaluation employs routine stains (such as hematoxylin and eosin), which can be complemented by a variety of special and immunohistochemical procedures. These brain studies are augmented by morphologic assessment of selected peripheral nervous system structures. Studies of this nature require a high level of technical skill as well as special training on the part of the pathologist. The pathologist should have knowledge of normal microscopic neuroanatomy/neuronal circuitry and an understanding of basic principles of developmental neurobiology, such as familiarity with the patterns of physiologic or programmed cell de

Animals↗