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At least 1,063 records · Page 59Linked to original sources
PubMed2000

Educational skills and knowledge needed and problems encountered by continuing medical education providers.

BACKGROUND: The objective of this study was to identify the training needs and difficulties encountered by continuing medical education (CME) providers in Quebec. METHODS: A questionnaire comprised of open-ended and closed questions was sent to 224 general practitioners across Quebec who organize CME meetings. To complement and validate the data, interviews were conducted with 18 physicians selected from this group, based on their years of experience with CME, and with the managers of two organizations involved in CME. RESULTS: The questionnaire response rate was 54%. Quantitative analysis was used to identify the main training needs expressed by CME providers affiliated with the Quebec Federation of General Practitioners, namely, methods for identifying needs (74%), group leadership techniques (69%), basic principles in adult education (69%), and organization of CME activities (66%). The main problems encountered by respondents in their duties are stimulating and maintaining the interest and participation of physicians in formal CME activities (52%), identifying and meeting physicians' educational needs (32%), and motivating physicians to get involved in any kind of CME initiative (18%). The interviews highlighted the wide disparity in the approaches used by CME providers when planning activities and the failure of providers to pass on relevant information to their successors. IMPLICATIONS: Based on the difficulties and the training needs identified, we were able to develop tools (structured training program, biannual newsletter, reference books, and resources) suited to the needs of general practitioners who organize CME activities.

Education, Medical, Continuing↗
PubMed2003

A needs assessment of medical school faculty: caring for the caretakers.

INTRODUCTION: We conducted an assessment of need for faculty development and mentoring in a medical school to guide program planning and use of scarce resources. METHODS: A multifaceted approach included semi-structured interviews, nominal group process, and a 36-item questionnaire to reach all faculty in the school, including senior administrators. RESULTS: With a 72% response rate, we validated the questionnaire and, using principal components analysis, identified and prioritized the eight interpretable subdimensions: personal growth, achieving balance, teaching, professional networking, research, administrative skills, career progression, and diversity/ethics. All groups of faculty prioritized learning for sustaining their vitality, balancing their personal and professional lives, finding meaning in their work, relationships, and personal growth. Senior administrators prioritized the following for faculty: time management, an institutional outlook, teamwork, and improved performance in teaching, research, and clinical practice. Junior faculty expressed the need for mentoring, scholarship, research, and career planning. DISCUSSION: Attention to faculty humanistic needs and the disparity between the perceived needs by faculty and senior administrators may help explain the attrition of faculty in academic medicine.

Faculty, Medical↗
PubMed1994

Role of mouse germ-cell mutagenesis in understanding genetic risk and in generating mutations that are prime tools for studies in modern biology.

Highlights are presented on (1) the role mouse germ-cell mutagenesis has played in assessing the genetic harm from radiations and chemicals, and (2) the contributions to the field of modern biology that are being made by the products of this research--the propagated mutations. Among the numerous findings in radiation mutagenesis were the humped dose-effect curve for spermatogonial stem cells, the major differences between the sexes and between germ-cell stages of each sex in both yield and nature of mutations, the dose-rate effect, which provided the first evidence for repair of mutational (or premutational) damage, the augmenting effect of certain regimes of dose fractionation, and many others. Chemical mutagenesis studies that followed revealed at least three patterns of mutation yield and demonstrated that germ-cell stage--much more than the nature of the chemical--governs the nature of the DNA lesions induced. Two "supermutagens," one for intragenic mutations and one for deletions and other rearrangements, have become very useful in the manufacture of mutations for specific purposes. The mutations propagated from radiation- and chemical-mutagenesis experiments are providing prime resources for basic studies in genome organization, gene structure, and function. DNA lesions that involve specific loci have made possible increasingly detailed characterization of extensive deletion complexes that facilitate high-intensity physical and functional mapping within them. Numerous loci associated with interesting developmental anomalies have been identified and have become accessible to positional cloning. Several of the genes accessed with the aid of induced mutations (deletions, other rearrangements, and point mutations) are furnishing prime reagents for elucidating human disease conditions.

Animals↗
PubMed1978

A survey of financial planning models for health care organizations.

This paper describes "what if?" financial planning models developed for health care administrators and financial managers to study and evaluate the economic impact of changes in a health care organization's charge structure, operating policies, reimbursement plans, and services and resources. Models for inpatient and outpatient care systems are presented. The models are described in terms of input, output, and application. An assessment of the state of the art of financial planning and prospects for the future of what if?models are given.

Economics, Hospital↗
PubMed2006

Response times seen as decompression times in Boolean concept use.

This paper reports a study of a multi-agent model of working memory (WM) in the context of Boolean concept learning. The model aims to assess the compressibility of information processed in WM. Concept complexity is described as a function of communication resources (i.e., the number of agents and the structure of communication between agents) required in WM to learn a target concept. This model has been successfully applied in measuring learning times for three-dimensional (3D) concepts (Mathy and Bradmetz in Curr Psychol Cognit 22(1):41-82, 2004). In this previous study, learning time was found to be a function of compression time. To assess the effect of decompression time, this paper presents an extended intra-conceptual study of response times for two- and 3D concepts. Response times are measured in recognition phases. The model explains why the time required to compress a sample of examples into a rule is directly linked to the time to decompress this rule when categorizing examples. Three experiments were conducted with 65, 49, and 84 undergraduate students who were given Boolean concept learning tasks in two and three dimensions (also called rule-based classification tasks). The results corroborate the metric of decompression given by the multi-agent model, especially when the model is parameterized following static serial processing of information. Also, this static serial model better fits the patterns of response times than an exemplar-based model.

Adolescent↗
PubMed1984

The population biology of bacterial viruses: why be temperate.

A model of the interactions between populations of temperate and virulent bacteriophage with sensitive, lysogenic, and resistant bacteria is presented. In the analysis of the properties of this model, particular consideration is given to the conditions under which temperate bacteriophage can become established and will be maintained in bacterial populations. The effects of the presence of resistant bacteria and virulent phage on these "existence" conditions for temperate viruses are considered. It is demonstrated that under broad conditions temperate phage will be maintained in bacterial populations and will coexist with virulent phage. Extrapolating from this formal consideration of the population biology of temperate bacteriophage, a number of hypotheses for the conditions under which temperate, rather than virulent, modes of phage reproduction are to be anticipated and the nature of the selective pressures leading to the evolution and persistence of this "benign" type of bacterial virus are reviewed and critically evaluated. Two hypotheses for the "advantages of temperance" are championed: (1) As a consequence of the allelopathic effects of diffusing phage, in physically structured habitats, lysogenic colonies are able to sequester resources and, in that way, have an advantage when competing with sensitive nonlysogens. (2) Lysogeny is an adaptation for phage to maintain their populations in "hard times," when the host bacterial density oscillates below that necessary for phage to be maintained by lytic infection alone.

Bacteriophages↗
PubMed1990

New York University Medical Center's Cooperative Care Unit: patient education and family participation during hospitalization--the first ten years.

The New York University Medical Center Cooperative Care (CC) program is a model of a delivery system of acute inpatient hospital care characterized by a live-in family member or friend acting as a "care partner". It has an emphasis on education in order to encourage full patient and family involvement in care during the acute hospitalization, thereby preparing both parties for management at home after discharge. The education-intensive experience of CC provides an alternative to traditional inpatient hospital care with the expected outcome of CC being to increase patient and family knowledge and satisfaction, adherence to the medical regimen, and appropriate self-management. The functioning ability of the patient-care partner team should be improved on discharge, which may result in decreased subsequent utilization of high cost healthcare resources such as rehospitalization. This paper describes the structure of the CC form of inpatient care, the types of patients appropriate for such care, and the experience of its first ten years of operation, with its implications as a replicable model for other institutions.

Academic Medical Centers↗
PubMedDate not supplied

Methadone maintenance counseling. Definition, principles, components.

Counseling has been a major service component of methadone maintenance since its inception. Yet, there is no consensus about what methadone counseling is or how it should be practiced. This paper proposes a definition of professional methadone counseling as a specialized modality of addiction therapy and rehabilitation. Five principals of methadone counseling are reviewed: (1) coordination of care, (2) use of the counseling relationship, (3) attention to the stage of recovery, (4) structure and flexibility, and (5) facilitation of patient resourcefulness and social recovery. Fifteen components of methadone counseling are also reviewed. These include interventions focused on (1) the initial phase of treatment, (2) the treatment itself, and (3) the work of rehabilitation. General counseling issues are considered, such as counselor education, the role of the counselor in the program, the methadone controversy, as well as the impact of HIV disease and "crack/cocaine." In closing, the advantages of the proposed model are stressed.

Combined Modality Therapy↗
PubMed2005

Maternal and child health and neighborhood context: the selection and construction of area-level variables.

BACKGROUND: Increasingly, maternal and child health researchers are employing the statistical approach of multilevel modeling analysis to simultaneously examine the relationship between contextual and individual determinants and maternal and child health outcomes. This review addresses the following questions: (1) What categories of neighborhood characteristics have been addressed? (2) How were those neighborhood characteristics operationalized? METHODS: A literature review identified 31 relevant articles published between January 1999 and March 2004. The articles were read with special attention toward the measurement of neighborhood characteristics. RESULTS: Twelve categories of neighborhood characteristics represented in the articles include income/wealth, employment, family structure, population composition, housing, mobility, education, occupation, social resources, violence and crime, deviant behavior and physical conditions. A wide diversity of approaches was used to measure these characteristics. The most widely utilized source of data was that of administrative records from the census or local government authorities. Although most authors provided theoretical explanations of their choice to examine broad neighborhood constructs, few were explicit about why certain indicators were selected to measure these constructs. CONCLUSIONS: There are theoretical, methodological and practical barriers in the measurement of the neighborhood context which must be addressed for the field to move forward. These barriers are discussed and recommendations are made for addressing them in future research.

Adolescent↗
PubMed2004

A framework for modeling health behavior protocols and their linkage to behavioral theory.

With the rise in chronic, behavior-related disease, computerized behavioral protocols (CBPs) that help individuals improve behaviors have the potential to play an increasing role in the future health of society. To be effective and widely used CBPs should be based on accepted behavioral theory. However, designing CBPs while at the same time specifying their linkages to behavioral theory and developing reusable CBP components (interventions) are challenges to developers of CBPs. Having an ontology with which to describe CBPs could help with these issues. As a first step towards creating such an ontology, we modeled PACE-Adolescent, a theory-based behavioral protocol that uses the Stages of Change Model and Social Cognitive Theory, using PROTEGE-2000, an ontology editor and knowledge acquisition system. We created a three-part knowledge model. Two sub-ontologies described behavioral interventions and psychological theories. The third component, implemented using Guideline Interchange Format (GLIF3), provided a way to describe the structure of a protocol and to link intervention resources and groups of actions to elements of psychological theory. Using this framework, we formally described the PACE-Adolescent protocol. Creating knowledge models such as this may lead to improvements in the design and evaluation of computerized health behavior protocols.

Adolescent↗
PubMed2004

Social organization in the cat: a modern understanding.

An increasing body of research work has made it clear that, while Felis catus can survive in the solitary state, social groups with an internal structure, are formed whenever there are sufficient food resources to support them. Most people who have cats have two or more cats. Failure to understand what will promote either friendly or aggressive behavior can lead to various behavior problems, including aggression and conflict over resources, such as food, resting sites and litterboxes. An understanding of the natural social organization, relationships and communication between cats is therefore essential, and is the subject of this paper.

Animals↗
PubMed2005

REFOLD: an analytical database of protein refolding methods.

The expression and harvesting of proteins from insoluble inclusion bodies by solubilization and refolding is a technique commonly used in the production of recombinant proteins. To bring clarity to the large and widespread quantity of published protein refolding data, we have recently established the REFOLD database (http://refold.med.monash.edu.au), which is a freely available, open repository for protocols describing the refolding and purification of recombinant proteins. Refolding methods are currently published in many different formats and resources--REFOLD provides a standardized system for the structured reporting and presentation of these data. Furthermore, data in REFOLD are readily accessible using a simple search function, and the database also enables analyses which identify and highlight particular trends between suitable refolding and purification conditions and specific protein properties. This information may in turn serve to facilitate the rational design and development of new refolding protocols for novel proteins. There are approximately 200 proteins currently listed in REFOLD, and it is anticipated that with the continued contribution of data by researchers this number will grow significantly, thus strengthening the emerging trends and patterns and making this database a valuable tool for the scientific community.

Databases, Protein↗
PubMed1988

Development of immunoreagents to ciliary zonules that react with protein components of elastic fiber microfibrils and with elastin-producing cells.

We describe the generation of a monoclonal antibody library to ocular zonule components and the characterization of three monoclonal antibodies: 1) one specific for microfibrillar associated glycoprotein (MAGP), a component of both ocular zonules and microfibrils of elastin fibers, 2) an antibody to an as yet unidentified 70,000 dalton antigen that is present in abundance in the extracellular matrix (ECM) of elastin-producing cells, and 3) an antibody reacting with the 67000 dalton subunit of the elastin receptor. The presence of antigenic determinants common to the ocular zonule and elastic fiber microfibrils suggests that zonules, which can be obtained in relatively pure form, can provide a valuable resource for characterizing proteins common to both microfibrillar structures.

Animals↗
PubMedDate not supplied

[Simulation of a hospital emergency department and its potential use in management].

We developed a computer simulation model of Emergency Department Operations of the Hospital Ntra. Sra. del Pino as a queue system. We designed and analyzed alternative functional structures of the Department and their implications on resources organization and reallocation. We programmed the operations, relations and flows between the components of the system with the simulation language SIMSCRIPT II.5. We have designed alternative configurations to assess how technical efficiency could be improved through the reallocation of human resources; how the system react would to interarrival time of patients changes; and what decisions must be taken about resources allocation in order to improve efficiency. Triage, Emergency Laboratory and radiology have the maximum average waiting times (11, 31 and 12 minutes, respectively). Some alternative organization patterns may improve this problem. Their social cost is also quantified in this work.

Computer Simulation↗
PubMed1998

Computed tomographic simulation of craniospinal fields in pediatric patients: improved treatment accuracy and patient comfort.

PURPOSE: To reduce the time required for planning and simulating craniospinal fields through the use of a computed tomography (CT) simulator and virtual simulation, and to improve the accuracy of field and shielding placement. METHODS AND MATERIALS: A CT simulation planning technique was developed. Localization of critical anatomic features such as the eyes, cribriform plate region, and caudal extent of the thecal sac are enhanced by this technique. Over a 2-month period, nine consecutive pediatric patients were simulated and planned for craniospinal irradiation. Four patients underwent both conventional simulation and CT simulation. Five were planned using CT simulation only. The accuracy of CT simulation was assessed by comparing digitally reconstructed radiographs (DRRs) to portal films for all patients and to conventional simulation films as well in the first four patients. RESULTS: Time spent by patients in the CT simulation suite was 20 min on average and 40 min maximally for those who were noncompliant. Image acquisition time was <10 min in all cases. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with portal and/or simulation films to within 5 mm in five of the eight cases. Discrepancies of > or =5 mm in the positioning of the inferior border of the cranial fields in the first three patients were due to a systematic error in CT scan acquisition and marker contouring which was corrected by modifying the technique after the fourth patient. In one patient, the facial shield had to be moved 0.75 cm inferiorly owing to an error in shield construction. CONCLUSIONS: Our analysis showed that CT simulation of craniospinal fields was accurate. It resulted in a significant reduction in the time the patient must be immobilized during the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization.

Adolescent↗
PubMed2001

Using the national registry of HIV-infected veterans in research: lessons for the development of disease registries.

Disease-specific registries have many important applications in epidemiologic, clinical and health services research. Since 1989 the Department of Veterans Affairs has maintained a national HIV registry. VA's HIV registry is national in scope, it contains longitudinal data and detailed resource utilization and clinical information. To describe the structure, function, and limitations of VA's national HIV registry, and to test its accuracy and completeness. The VA's national HIV registry contains data that are electronically extracted from VA's computerized comprehensive clinical and administrative databases, called Veterans Integrated Health Systems Technology and Architecture (VISTA). We examined the number of AIDS patients and the number of new patients identified to the registry, by year, through December 1996. We verified data elements against information obtained from the medical records at five VA sites. By December 1996, 40,000 HIV-infected patients had been identified to the registry. We encountered missing data and problems with data classification. Missing data occurred for some elements related to the computer programming that creates the registry (e.g., pharmacy files), and for other elements because manual entry is required (e.g., ethnicity). Lack of a standardized data classification system was a problem, especially for the pharmacy and laboratory files. In using VA's national HIV registry we have learned important lessons, which, if taken into account in the future, could lead to the creation of model disease-specific registries.

HIV Infections↗
PubMed2006

Economic impact of dementia in developing countries: an evaluation of costs of Alzheimer-type dementia in Argentina.

BACKGROUND: There is no previous information about economic costs of Alzheimer's disease (AD) in South America. The objective of this study was to evaluate the costs of AD in Argentina. METHODS: Eighty community-dwelling patients, 20 institutionalized AD patients and their respective primary caregivers, and 25 healthy elderly subjects participated in this study. The cognitive and neuropsychiatric impairments and severity of dementia were assessed with the Mini-mental State Examination, Neuropsychiatric Inventory and Clinical Dementia Rating, respectively. A structured interview about health and health-care resources used during the past 3 months was administered to family caregivers. The time devoted by carers to looking after the patients and the caregiver burden (Zarit's Burden Interview) were recorded. RESULTS: The annual direct costs of the disease increased with cognitive deterioration from US$3420.40 in mild to US$9657.60 in severe AD, and with institutionalization (US$3189.20 outpatient vs. US$14,447.68 institutionalized). Most direct costs were paid for by the family. CONCLUSIONS: With the projected increase in the number of persons at risk for developing AD in emerging countries, the family cost of the disease will be significant. Dementia costs should be a matter of analysis when health policies are being designed in developing countries.

Aged↗
PubMed2002

Distant collaboration in drug discovery: the LINK3D project.

The work describes the development of novel software supporting synchronous distant collaboration between scientists involved in drug discovery and development projects. The program allows to visualize and share data as well as to interact in real time using standard intranets and Internet resources. Direct visualization of 2D and 3D molecular structures is supported and original tools for facilitating remote discussion have been integrated. The software is multiplatform (MS-Windows, SGI-IRIX, Linux), allowing for a seamless integration of heterogeneous working environments. The project aims to support collaboration both within and between academic and industrial institutions. Since confidentiality is very important in some scenarios, special attention has been paid to security aspects. The article presents the research carried out to gather the requirements of collaborative software in the field of drug discovery and development and describes the features of the first fully functional prototype obtained. Real-world testing activities carried out on this prototype in order to guarantee its adequacy in diverse environments are also described and discussed.

Computer Graphics↗