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At least 1,063 records · Page 59Linked to original sources
PubMed1993

Urban growth in India and its contemporary relevance.

"The paper deals with...urban growth in India in general with relevance to urban agglomerations of major significance on the basis of [the] Census of 1991. In addition the urban growth during 1981-91 is viewed in accordance with the projected population and the actual count as undertaken in the 1991 Census operations. Some of the questions arising out of the contemporary trends in these areas...may be of concern for academic and planning processes. More elaborate synthesis is obviously required when the detailed tables on socio-economic parameters are given by the Census in due course to cross-classify and examine more aspects of population at various levels."

Asia↗
PubMed2001

The epic project: developing national evidence-based guidelines for preventing healthcare associated infections. Phase I: Guidelines for preventing hospital-acquired infections. Department of Health (England).

In 1998, the Department of Health (England) commissioned the first phase of national evidence-based guidelines for preventing healthcare associated infections. These focused on developing a set of standard principles for preventing infections in hospitals together with guidelines for preventing hospital-acquired infections (HAI) associated with the use of short-term indwelling ureteral catheters in acute care and with central venous catheters in acute care. These guidelines are systematically developed broad statements (principles) of good practice that all practitioners can use and which can be incorporated into local protocols. A nurse-led, multi-professional team composed of infection prevention practitioners, clinical microbiologists/retrovirologist, epidemiologists, and researchers developed the guidelines. A rigorous guideline development process was used to inform the systematic reviews, the clinical and critical appraisal of relevant evidence, and linking that evidence to evolving guidelines. Both general and specialist clinical practitioners were involved in all stages of developing these guidelines, as were representatives from relevant Royal Colleges, learned societies, other professional organisations and key stakeholders. The introduction to these guidelines describes a robust and validated guideline development model that can be used by others to develop future guidelines. This model is described in more detail in the associated technical reports that can be found on the project web site http://www.epic.tvu.ac.uk. Locating and appropriately using good quality evidence to inform guideline development in this field is challenging. Evidence from rigorously conducted experimental studies was frequently limited and consequently a range of other types of evidence were systematically retrieved and carefully appraised. The concluding discussion on implementation highlights potential issues for clinical governance and areas for future research and suggests issues that need to be addressed to allow practitioners to successfully incorporate these guidelines into routine clinical practice.

Acute Disease↗
PubMed2003

Overview of the ISCE ECG "genome project".

The International Society for Computerized Electrocardiography (ISCE) "genome" project was begun at the end of 2000 to explore mechanisms for development of a cross-platform electrocardiogram (ECG) database. Ultimate feasibility of this project is based on established interactive cooperation of clinical investigators, engineers, and industry within the ISCE framework. The US Food and Drug Administration (FDA) mandate for centralized access to digitized ECG waveforms used in clinical trials provides a complementary stimulus to technologies that facilitate ECG database development. The constituency of ISCE is interested in acquisition and analysis of data from both standard 12-lead (resting) ECG and ambulatory (monitoring) ECG. Support for project goals from industry, at the Trustee as well as at the engineering level, has led to initial focus on the resting ECG. A one-year pilot project has been proposed to establish and implement software methodology for transmission, storage, and integrated reanalysis of digitized ECG waveforms provided by several major manufacturers. Beyond data acquisition, storage, and analysis, a number of critical issues are associated with database development. These include definition of clinically relevant "gold" standards, acquisition and validation of non-ECG data, protection of patient privacy, control and ownership of data, and accessibility and use of the database. However, implementation of the pilot project is a necessary first step, since all issues become moot without technical cooperation for shared formatting and analysis.

Databases as Topic↗
PubMed1995

Technical considerations in planning a distributed teleradiology system.

A large-scale teleradiology project is under way to link a Florida imaging center to the UCLA Department of Radiology. The initial goal is to provide Florida patients in a routine clinical practice environment with subspecialty consultation by academic radiologists. The plan then calls for the addition of other domestic and international sites. Technical issues in planning to establish the necessary teleradiology infrastructure include wide area network design, image compression, distributed archiving, and special viewing station features. Special emphasis is placed on archive design that makes intelligent use of information, such as triggering events from the radiological information system (RIS) for image prefetching and visual cues from photo-icons for full-size image retrieval. Concepts such as teleconsultation and remote procedure monitoring are aimed at providing the same level of services at distant sites that would be available in-house. This article highlights the system design parameters that must be considered to engineer a scalable distributed teleradiology system.

California↗
PubMed1976

The changing African family project: a report with special reference to the Nigerian segment.

The Changing African Family Project was begun in 1973 as a cooperative venture of the Sociology Department of the University of Ibadan and the Demography Department of the Australian National University, with research institutes and individual researchers in 11 representative countries of Africa, to investigate the preconditions for fertility decline. This paper reports initial initial findings from the large Nigerian segment of the project, which was used as a laboratory, and presents technical information about the surveys, as well as findings on economic supports for high fertility, factors affecting fertility, the role of sexual abstinence in determining fertility levels, the increase in contraception and its relation to family size limitation, and the incidence and nature of achieved small families. Information is also provided on the projects in Cameroon, the Congo (Brazzaville), Ghana, and the Sudan.

Adolescent↗
PubMed2005

Analysis and evaluation of methodologies to assess technical urban water systems.

The paper reports on the methodology and findings of a recent project on behalf of the Austrian Federal Ministry of Agriculture, Forestry, Environment and Water Management. The Ministry is seeking procedures for combining ecological and economic criteria to assess which technical urban water alternatives shall receive funding. To this end the current decision making process (DMP) for implementing urban water alternatives in Austria has been analyzed and compared with the situation elsewhere, e.g. in Sweden. The DMP entails specific requirements on assessment, whence the most common decision aid methodologies, ranging from LCA-based to multi-criteria methods, have been described and evaluated from an environmental, economic, legal and practical point of view, turning out recommendations to the Ministry. Their main points are: First the DMP should be kept as simple as possible in order to make it transparent. Second the aggregation of different criteria groups should and can be avoided. Therefore the stakeholders should not be allowed to make trade-offs. Finally clear objectives need to be stated.

Austria↗
PubMedDate not supplied

Organizing the present, looking to the future: an online knowledge repository to facilitate collaboration.

BACKGROUND: Comprehensive data available in the Canadian province of Manitoba since 1970 have aided study of the interaction between population health, health care utilization, and structural features of the health care system. Given a complex linked database and many ongoing projects, better organization of available epidemiological, institutional, and technical information was needed. OBJECTIVE: The Manitoba Centre for Health Policy and Evaluation wished to develop a knowledge repository to handle data, document research Methods, and facilitate both internal communication and collaboration with other sites. METHODS: This evolving knowledge repository consists of both public and internal (restricted access) pages on the World Wide Web (WWW). Information can be accessed using an indexed logical format or queried to allow entry at user-defined points. The main topics are: Concept Dictionary, Research Definitions, Meta-Index, and Glossary. The Concept Dictionary operationalizes concepts used in health research using administrative data, outlining the creation of complex variables. Research Definitions specify the codes for common surgical procedures, tests, and diagnoses. The Meta-Index organizes concepts and definitions according to the Medical Sub-Heading (MeSH) system developed by the National Library of Medicine. The Glossary facilitates navigation through the research terms and abbreviations in the knowledge repository. An Education Resources heading presents a web-based graduate course using substantial amounts of material in the Concept Dictionary, a lecture in the Epidemiology Supercourse, and material for Manitoba's Regional Health Authorities. Confidential information (including Data Dictionaries) is available on the Centre's internal website. RESULTS: Use of the public pages has increased dramatically since January 1998, with almost 6,000 page hits from 250 different hosts in May 1999. More recently, the number of page hits has averaged around 4,000 per month, while the number of unique hosts has climbed to around 400. CONCLUSIONS: This knowledge repository promotes standardization and increases efficiency by placing concepts and associated programming in the Centre's collective memory. Collaboration and project management are facilitated.

Databases as Topic↗
PubMed2003

'Taking public health out of the ghetto': the policy and practice of multi-disciplinary public health in the United Kingdom.

Until recently, a medical qualification was required for senior public health posts in the UK National Health Service. Since 1997, the new Labour government has expressed its intention to take public health 'out of the ghetto' and to develop multi-disciplinary public health. In particular, it has announced the creation of a new senior professional role of specialist in public health equivalent to the consultant in public health medicine, and open to a range of disciplines. This paper asks 'what is really going on with the policy and practice of multi-disciplinary public health in the UK?' The answer draws on recent debates in the sociology of the professions, in particular the theoretical perspectives of Freidson (Profession of Medicine: a Study of the Sociology of Applied Knowledge, Dodd, Mead & Co, New York, 1970; Professional Powers: a Study of the Institutionalization of Formal Knowledge, University of Chicago Press, Chicago, 1986) and Larson (The Rise of Professionalism: a Sociological Analysis, University of California Press, Berkeley, 1977) concerning the 'professional project', Foucault's (Ideol. Consciousness 6 (1979) 5) notion of 'governmentality' and Harrison and Wood's (Public Admin. 77 (1999) 751) concept of 'manipulated emergence'. Key characteristics of the professional project are 'autonomy', the profession's ability to control its technical knowledge and application, and 'dominance', control over the work of others in the health care division of labour. Although useful as an explanatory framework for the period 1972-1997, the concept of the professional project does not easily explain the process of change since 1997. Here Foucault's concept of governmentality is helpful. Governmentality entails all those procedures, techniques, mechanisms, institutions and knowledges that empower political programmes. Professions are part of the process of governmentality, and their autonomy is always contingent upon the wider political context. Thus public health doctors have not abandoned the professional project; they have simply accepted the political reality that the boundaries need to shift rapidly from a politically unsustainable medical/non-medical distinction to one between those with and without expert knowledge. The concept of manipulated emergence helps explain why, having expressed a commitment towards multi-disciplinary public health, the government has not supported its policy more fully.

Credentialing↗
PubMed1993

The human genome project.

The Human Genome Project in the United States is now well underway. Its programmatic direction was largely set by a National Research Council report issued in 1988. The broad framework supplied by this report has survived almost unchanged despite an upheaval in the technology of genome analysis. This upheaval has primarily affected physical and genetic mapping, the two dominant activities in the present phase of the project. Advances in mapping techniques have allowed good progress toward the specific goals of the project and are also providing strong corollary benefits throughout biomedical research. Actual DNA sequencing of the genomes of the human and model organisms is still at an early stage. There has been little progress in the intrinsic efficiency of DNA-sequence determination. However, refinements in experimental protocols, instrumentation, and project management have made it practical to acquire sequence data on an enlarged scale. It is also increasingly apparent that DNA-sequence data provide a potent means of relating knowledge gained from the study of model organisms to human biology. There is as yet little indication that the infusion of technology from outside biology into the Human Genome Project has been effectively stimulated. Opportunities in this area remain large, posing substantial technical and policy challenges.

Chromosome Mapping↗
PubMed1977

[Automatic processing of laboratory data using a process computer at the Dresden Medical Academy].

The prerequisites for the use of electronic data processing apparatuses in the laboratory diagnostics are explained and principal demands are formulated which are to be made to a laboratory organisation system supported by electronic data processing on the side of the clinic. The description of the project "LOL 2" practised at the Medical Academy Dresden deals above all with the demands of the laboratory, the establishment of findings referred to series and patients and their transmission to the requirer using the teleprinting technics. The first step of the practical use of this project is also used in the district hospitals Cottbus and Görlitz. The aim of this development is a comprehensive information system for the communication process between ward and laboratory.

Academies and Institutes↗
PubMed2004

[Perspectives in cardiological research].

German cardiological research is confronted with increasing difficulties. Clinical research is restricted by regulations, such as the working hours protecting law, the revised version of the legal articles against corruption and acceptance of advantage as well as by many parts of law for the general frame of the university structures. In addition more and more administrative duties are tranferred to doctors engaged in research. Furthermore cardiology is at a disadvantage as only part of the net profits for cardiological services are tranferred to the responsible clinic. Likewise the facilities for cooperation are increasingly restricted, as basic science institutions originally allocated to cardiological research, are now devoted to other subjects and as many pharmaceutical firms have left the country. Cardiology in our country is practically not supported by private research organizations. Research projects are, therefore, predominantly financed by grants from the Bundeministerium für Bildung und Forschung and by the Deutsche Forschungsgemeinschaft. The financial resources for research in our country are declining and much smaller compared, e. g., to the USA. As a consequence of the shortage of resources not only are the weak projects turned down; it is feared that also the very innovative projects are likewise excluded for entering unknown territory. In periods of financial restrictions the central office and the experts evaluating the projects have a special responsibility, which cannot be met by technical objections, such as e. g., an "unsufficient impact factor". In order to improve the conditions for cardiological research the net profits for cardiological services should be transferred unrestricted to the responsible clinic. The acceptance rate of cardiologcal projects may be increased by more intensive cooperation. At the end, the principle of help by self-help also applies to cardiological research; the British Heart Foundation has developed into an impressive research-supporting organization in similarly difficult times.

Cardiology↗
PubMed2006

Postnatal growth and morphological development of the brain: a species comparison.

The objective of this report is to summarize the available literature regarding the postnatal growth and morphological development of the brain and compare the timelines for these events between humans and experimental species. While not the primary focus of this report, in acknowledgement of the evident role of maturation of neurotransmitter systems in development, a brief description of the comparative development of the NMDA receptor is included. To illustrate the challenges faced in estimating developmental toxicity potential in humans, the importance of postnatal experience in CNS development is also briefly reviewed. This review is part of the initial phase of a project undertaken by the Developmental and Reproductive Toxicology Technical Committee of the ILSI Health and Environmental Sciences Institute (HESI) to bring together information on a selected number of organ systems and compare their postnatal development across several species (Hurtt and Sandler: Birth Defects Res Part B 68:307-308, 2003).

Animals↗
PubMed2006

Cervical pedicle screw placement: feasibility and accuracy of two new insertion techniques based on morphometric data.

This morphometric and experimental study was designed to assess the dimensions and axes of the subaxial cervical pedicles and to compare the accuracy of two different techniques for subaxial cervical pedicle screw (CPS) placement using newly designed aiming devices. Transpedicular fixation is increasingly used for stabilizing the subaxial cervical spine. Development of the demanding technique is based on morphometric studies of the pedicle anatomy. Several surgical techniques have been developed and evaluated with respect to their feasibility and accuracy. The study was carried out on six conserved human cadavers (average age 85 years). Axes and dimensions of the pedicles C3-C7 (60 pedicles) were measured using multislice computed tomography (CT) images prior to surgery. Two groups consisting of 3 specimens and 30 pedicles each were established according to the screw placement technique. For surgical technique 1 (ST1) a para-articular mini-laminotomy was performed. Guidance of the drill through the pedicle with a handheld aiming device attached onto the medial aspect of the pedicle inside the spinal canal. Screw hole preparation monitored by lateral fluoroscopy. In surgical technique 2 (ST2) a more complex aiming device was used for screw holes drilling. It consists of a frame with a fully adjustable radiolucent arm for carrying the instruments necessary for placing the screws. The arm was angled according to the cervical pedicle axis as determined by the preoperative CT scans. Drilling was monitored by lateral fluoroscopy. In either technique 3.5 mm screws made of carbon fiber polyetheretherketone (CF-PEEK) were inserted. The use of the CF-PEEK screws allowed for precise postoperative CT-assessment since this material does not cause artifacts. Screw placement was qualified from ideal to unacceptable into four grades: I = screw centered in pedicle; IIa = perforation of pedicle wall less than one-fourth of the screw diameter; IIb = perforation more than one-fourth of the screw diameter without contact to neurovascular structures; III = screw more than one-fourth outside the pedicle with contact to neurovascular structures. Fifty-six pedicle screws could be evaluated according to the same CT protocol that was used preoperatively. Accuracy of pedicle screw placement did not reveal significant differences between techniques 1 and 2. A tendency towards less severe misplacements (grade III) was seen in ST2 (15% in ST2 vs. 23% in ST1) as well as a higher rate of screw positions graded IIa (62% in ST2 vs. 43% in ST1). C4 and C5 were identified to be the most critical vertebral levels with three malpositioned screws each. Because of the variability of cervical pedicles preoperative CT evaluation with multiplanar reconstructions of the pedicle anatomy is essential for transpedicular screw placement in the cervical spine. Cadaver studies remain mandatory to develop safer and technically less demanding procedures. A similar study is projected to further develop the technique of CPS fixation with regard to safety and clinical practicability.

Aged, 80 and over↗