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PubMedDate not supplied

[Implantation of porous polytetrafluoroethylene orbital inserts: techniques and outcomes. Communication 1].

This paper presents the outcomes of 230 primary, advanced, and secondary implants of polytetrafluoroethylene orbital inserts manufactured by the closed joint stock company "Nauchno-Proizvodstvennyi Kompleks (Scientific-and-Production Complex) "Ekoflon" (Saint Petersburg). The duration of a follow-up was 6-36 months (mean 15.9 +/- 037 months). The accumulated experience suggests that polytetrafluoroethylene orbital inserts are noted for their biocompatibility, easiness of manual treatment, and simplicity of implantation. Thus, porous polytetrafluoroethylene orbital inserts are promising medical articles designed for the prevention and treatment of the anophthalmic syndrome.

Adolescent↗
PubMed2004

Effects of a 105 hours psychological training program on attitudes, communication skills and occupational stress in oncology: a randomised study.

There is today a wide consensus regarding the need to improve communication skills (CS) of health-care professionals (HCPs) dealing with cancer patients. Psychological training programs (PTPs) may be useful to acquire the needed CS. Testing the efficacy of PTP will allow to define their optimal content. The present study was designed to assess the impact of a PTP on HCP stress, attitudes and CS, and on HCP and patients' satisfaction with HCP communication skills in a randomised study. A total of 115 oncology nurses were randomly assigned to a 105-h PTP or to a waiting list. Stress was assessed with the Nursing Stress Scale, attitudes with a Semantic Differential Questionnaire, CS used during one simulated and one actual patient interview with the Cancer Research Campaign Workshop Evaluation Manual, and satisfaction with the nurses' CS with a questionnaire completed by the patients and the nurses. Trained (TG) and control (CG) groups were compared at baseline, after 3 months (just following training for TG) and after 6 months (3 months after the end of training for TG). Compared to controls, trained nurses reported positive changes on their stress levels (P</=0.05) and on their attitudes (P</=0.05). Positive training effects were found on CS used during the simulated interview: a significant increase in facilitative behaviours (open questions: P</=0.001; evaluative functions: P</=0.05) and a significant decrease in inhibitory behaviours (inappropriate information: P</=0.01; false reassurance: P</=0.05). Less positive training effects were found regarding interviews with a cancer patient: a significant increase in educated guesses (P</=0.001) was noticed. No training effect was observed on nurses' satisfaction levels, but a positive training effect was found on patients' satisfaction levels (P</=0.01). Although results outline PTP efficacy, they indicate the need to design PTP, amplifying the transfer of learned CS to clinical practice.

Adult↗
PubMed1995

Patient data management systems in anaesthesia: an emerging technology.

The purpose of this review is to define the expectations of an on-line automatic patient data management system (PDMS) into anaesthesia work-stations in and around the operating room suite. These expectations are based on review of available information in the medical literature, and trials of several systems that are available commercially, three of them in a more detailed fashion (i.e. Informatics, Datex and North American Drager). The ideal PDMS should: -- communicate with and capture the information from different monitors, anaesthesia machines and electronic gadgets (e.g., infusion pumps) used in the operating room (OR), while presenting selected relevant values and trends on a screen. -- inform the anaesthetist of deviations from preselected limits of physiological and technical values. In the future, the system will hopefully be upgraded to include an algorithm-based decision support system. -- communicate with the hospital mainframe computer, and automatically transfer demographic data, laboratory and imaging results, and records obtained during preoperative consultations. -- at the end of each anaesthetic procedure, create an anaesthetic record with relevant data automatically collected by the system, as well as that which was entered manually by the physician during the procedure. A copy of this anaesthesia file must be kept on a computerized archive system. None of the systems so far evaluated fulfilled all our expectations. We have therefore adopted approach for the gradual introduction of such a system into our OR environment over the next two to five years, during which expected improvements may be incorporated to upgrade the system.

Anesthesiology↗
PubMed2001

Puncture-proof picture archiving and communication system.

As we become increasingly dependent on our picture archiving and communications system (PACS) for the clinical practice of medicine, the demand for improved reliability becomes urgent. Borrowing principles from the discipline of Reliability Engineering, we have identified components of our system that constitute single points of failure and have endeavored to eliminate these through redundant components and manual work-around procedures. To assess the adequacy of our preparations, we have identified a set of plausible events that could interfere with the function of one or more of our PACS components. These events could be as simple as the loss of the network connection to a single component or as broad as the loss of our central data center. We have identified the need to continue to operate during adverse conditions, as well as the requirement to recover rapidly from major disruptions in service. This assessment led us to modify the physical locations of central PACS components within our physical plant. We are also taking advantage of actual disruptive events coincident with a major expansion of our facility to test our recovery procedures. Based on our recognition of the vital nature of our electronic images for patient care, we are now recording electronic images in two copies on disparate media. The image database is critical to both continued operations and recovery. Restoration of the database from periodic tape backups with a 24-hour cycle time may not support our clinical scenario: acquisition modalities have a limited local storage capacity, some of which will not contain the daily workload. Restoration of the database from the archived media is an exceedingly slow process, that will likely not meet our requirement to restore clinical operations without significant delay. Our PACS vendor is working on concurrent image databases that would be capable of nearly immediate switchover and recovery.

Computer Systems↗
PubMed2003

Why did language develop?

Language developed for communication, to facilitate learning the use of tools and weapons, to plan hunting and defence, to develop a "theory of mind" and the tools of thought, and to attract and keep a mate. The adaptations required took place over many millions of years. The first important one was left-sided specialisation of the neural apparatus controlling involuntary emotional vocalisations that began more than 200 million years ago. The next was the development in primates of "mirror neurones" in the pre-motor cortex some 45 million years ago. These enabled the imitation and voluntary control of previously involuntary manual gestures and vocalisations. The third important adaptation was the descent of the larynx, 100,000 years ago, which greatly increased the phonological range of vocalisations that could be made. Thus, language did not develop all at once as suggested by Chomsky, but evolved gradually building upon adaptations originally meeting quite different needs.

Brain↗
PubMed2007

Seeking informed consent to cancer clinical trials; evaluating the efficacy of doctor communication skills training.

INTRODUCTION: Clinical trials have come to be regarded as the gold standard for treatment evaluation. However, many doctors and their patients experience difficulties when discussing trial participation, leading to poor accrual to trials and questionable quality of informed consent. We have previously developed a communication skills training program based on a typology for ethical communication about Phase II and III clinical trials within four categories. The training program consisted of a 1 day experiential workshop that included didactic teaching, exemplary video and role play. The aim of this study was to evaluate the effectiveness of the communication skills training workshop. METHOD: Oncologists were recruited from three major teaching hospitals conducting oncology outpatient clinics in three Australian capital cities. Ten oncologists and 90 of their adult cancer patients who were eligible for a Phase II or III clinical trial participated. Ninety informed consent consultations were audiotaped before (n = 59) and after (n = 31) training, and fully transcribed. The presence or absence of each domain component was coded and these were summed within categories. A coding manual was produced which enabled standardization of the coding procedure. Patients completed questionnaires before and after the consultation, and doctors completed a short measure of satisfaction after the consultation. RESULTS: Doctors increased their use of some aspects of shared decision-making behavior (t(87) = -1.945, p = 0.05) and described some aspects of essential ethical/clinical information more commonly. In addition they used less coercive behaviors (z = -1.976, p = 0.048). However, they did not provide more clinical information or structure their consultations in the recommended fashion. Patients in the post-training cohort reported more positive attitudes to clinical trials, but other outcomes were not affected by the intervention. CONCLUSIONS: This short training programme demonstrated limited success in improving the oncologist's communication skills when gaining informed consent. A larger randomized controlled trial of extended training is now underway.

Adult↗
PubMedDate not supplied

Evaluating cost center productivity.

The monthly and yearly productivity summaries were developed and applied to a computer spreadsheet to aid the nurse manager in better understanding and communicating budget issues for diverse ambulatory care departments. A computerized spreadsheet using a commercially available personal computer program, such as Lotus, Quattro Pro, or Excel, can be used to more quickly and accurately track and summarize monthly budget reports. The data can be entered into the spreadsheet either manually or imported by query from the financial mainframe system. Contact your agency's finance or information department for information on how to accomplish this. Periodically acuity and resources should be measured and compared with quality monitors to maintain standards. For the past 10 years, our facility has successfully used this tool to make more informed decisions by identifying trouble spots early, and taking corrective action to avoid crisis management.

Ambulatory Care↗
PubMed2002

Intelligent agent software for medicine.

An important trend for the future of health technology will be the increasing use of intelligent agent software for medical applications. As the complexity of situations faced by both patients and health care providers grows, conventional interfaces that rely on users to manually transfer data and manually perform each problem-solving step, won't be able to keep up. This article describes how software agents that incorporate learning, personalization, proactivity, context-sensitivity and collaboration will lead to a new generation of medical applications that will streamline user interfaces and enable more sophisticated communication and problem-solving.

Artificial Intelligence↗
PubMed1995

Meeting the needs of young adults.

As they mature and become sexually active, more young people face serious health risks. Most face these risks with too little factual information, too little guidance about sexual responsibility, and too little access to health care. Meeting young adults' diverse needs challenges parents, communities, health care providers, and educators. Despite urgent needs, program efforts have been slight and slowed by controversy.

Adolescent↗
PubMedDate not supplied

Writing research reports.

The findings of nursing research are of little value unless they are communicated to other nurses and other health professionals. Therefore, writing the research report is an essential component of the research process. This article gives a general guide for the organization and presentation of a research report. For specific rules on style and format, the reader is referred to style manuals and to guides for authors for specific journals.

Nursing↗
PubMed1994

Can we differentially diagnose an attention deficit disorder without hyperactivity from a central auditory processing problem?

This article examines the dilemma involved in properly diagnosing children with Central Auditory Processing Deficits (CAPD) and children with Attention Deficit Disorders (without hyperactivity) (ADD) as they may not be mutually exclusive. With the help of a case illustration, the diagnostic difficulties are highlighted. There is a strong need for professionals in the speech/language and psychiatric communities to communicate to differentially diagnose a child who exhibits characteristics of both CAPD and ADD.

Auditory Perceptual Disorders↗
PubMed1992

Claims submission leads electronic advances.

To increase and accelerate reimbursement, providers are increasingly establishing electronic linkages with payers at all points in the patient accounting process where labor costs can be reduced and accuracy of information can be improved. The greatest advances are being seen in claim submission, as manual data entry of claims information is being replaced by electronic data interchange. Cleaner claims, faster payment, and reduced staff are just some of the results.

Computer Communication Networks↗
PubMed1997

BASCD surveys and computer communication. British Association for the Study of Community Dentistry.

The British Association for the Study of Community Dentistry (BASCD) has coordinated National Health Service surveys of the dental health of school children since 1985, when Wales and parts of England were included. Scotland joined in 1987 and Northern Ireland in 1994. This series spans an interesting time in the growth of accessible technology in both statistics and medical research. The purpose of this paper is to chart the development of this data base from pen and paper via microcomputers to the Internet. The annual work now involves calibration of examiners, data collection with portable computers or by manual transcription and subsequent 'punching', paper reports passed to regional coordinators who fill in spread sheets that are passed by e-mail or through posted discs to the data coordinating centre at the Dental Health Services Research Unit at the University of Dundee. The data is checked; statistical analyses are undertaken; a paper is prepared for print and the data is deposited on the BASCD Web Site. Four operating systems and at least eight software packages are used to produce and distribute the survey results.

Adolescent↗
PubMed2003

Complementary health and healing in nursing education.

This study is a description of the current status of complementary health and healing in undergraduate nursing education in the United States. A sample of 105 respondents from 202 baccalaureate nursing programs accredited by the Collegiate Commission on Nursing Education in fall 2001 completed an 11-item survey. Findings revealed the majority of nursing programs (77%) responding include content and/or experiential learning in complementary health and healing in the curriculum. A wide range of content related to mind-body healing, alternative medicine, herbal supplements, manual and energy healing, and environmental modalities is included. Experiential learning is incorporated less frequently than is didactic content. Use of a holistic nursing curriculum model facilitates the inclusion of nursing interventions that promote complementary health and healing. Integration of content and experiential learning can promote students' critical thinking and communication skills, appreciation and honoring of diversity, self-care and healing practices, and leadership skills in addressing the public's health needs.

Complementary Therapies↗
PubMed2003

Subjective visual vertical and Romberg's test correlations in hydrocephalus.

OBJECTIVE: Exploration of the subjective visual vertical in pitch and Romberg's test in patients with hydrocephalus. Patients Eleven patients with communicating normal pressure hydrocephalus and six with non-communicating hydrocephalus due to aqueductal stenosis were examined before and after surgical treatment. METHODS: The subjective visual vertical was examined with a simple, custom-made articulated rod. The rod was faintly illuminated from within so as to appear floating in space when presented in darkness. The test task was to manually adjust the rod's position in pitch so that it appeared perfectly vertical. Romberg's test was performed under standardized conditions. RESULTS: Patients with a backward movement on Romberg's test showed a deviation of the subjective visual vertical, tilting the upper end of the rod closer to their eyes. Patients moving in other directions tilted the rod in the opposite direction (p < 0.01). The time in which the patients managed Romberg's test with open eyes correlated with the intratest variability of rod placement (r = 0.86, p < 0.001). After surgery, improvements on Romberg's test correlated with a decreased intratest variability of the subjective visual vertical. There were no differences between the two patient groups. CONCLUSIONS: Quantitative measurements of the subjective visual vertical in pitch correlate strongly with results of Romberg's test in patients with hydrocephalus.

Adult↗
PubMedDate not supplied

The assessment of pain and discomfort in individuals with mental retardation.

This research was conducted to replicate and expanded the work of Bodfish et al. [Bodfish, J. W., Harper, V. N., Deacon, J. R., & Symons, F. J. (2001, May). Identifying and measuring pain in persons with developmental disabilities: A manual for the Pain and Discomfort Scale (PADS). Western Carolina Center Research Reports] by assessing the functional sensitivity of the Pain and Discomfort Scale (PADS) in patients with MR. We used the PADS to detect pain and discomfort during a dental scaling and polishing procedure. Subjects (N=28) with cognitive and communication deficits were assessed at multiple baselines, during and after the procedure. The results indicated that scores on the PADS were significantly higher during the scaling procedure than during all other observations quantified by the PADS. We conclude that the PADS is a functionally sensitive measure that may lack specificity, but that may also represent the state of the psychometric art of assessing pain in patients who have MR.

Adult↗
PubMed1995

Medication-management component of a point-of-care information system.

Implementation of and experience with the medication-management component of a point-of-care information system are described. A point-of-care information system (CliniCare) implemented at a 326-bed primary and tertiary care center provides online medication profiles, medication administration scheduling, and other patient data. All medications are bar coded and are scanned at or near the patient's bedside by using hand-held scanners; this prompts a safety check, records medication administration, and generates the drug charge. Use of the system has resulted in a lower medication error rate, improved medication records, improved scheduling of medications, better communication between nursing and pharmacy staff, more efficient drug monitoring, and more accurate and timely billing. Problems include the need for a bar-coding operation for unit dose oral solids and injectable dosage forms, the steep learning curve for some nurses and physicians, and resistance to the change from a manual system. A point-of-care information system has improved medication management but has been difficult to implement.

Clinical Pharmacy Information Systems↗