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PubMed1985

Profile analysis in facial plastic surgery.

We devised a simple and reliable method of profile analysis for facial plastic surgery. Profile photographs are taken with the natural head position technique. Key cephalometric landmarks are then identified and digitalized from either photographs or slides, using a digitalizer with a resolution of 0.001 in. The digitalizing pad is connected to a microcomputer. The menu-driven software allows selection of multiple functions from different cephalometric systems. Data can be stored on disk for future analysis. The method is useful in preoperative planning and postoperative evaluation of facial plastic surgery procedures.

Face↗
PubMed2002

Barcelona 2002: law, ethics, and human rights. Advancing research and access to HIV vaccines: a framework for action.

In light of the continuing spread of HIV infection and the devastating impact of the disease on lives, communities, and economies, particularly in the developing world, the investment in new treatments, vaccines, and microbicides has clearly been inadequate. Efforts must be intensified to develop effective HIV vaccines and to ensure that they are accessible to people in all parts of the world. This article is a summary of a paper by Sam Avrett presented at "Putting Third First: Vaccines, Access to Treatments and the Law," a satellite meeting held at Barcelona on 5 July 2002 and organized by the Canadian HIV/AIDS Legal Network, the AIDS Law Project, South Africa, and the Lawyers Collective HIV/AIDS Unit, India. In the article, Avrett calls for immediate action to increase commitment and funding for HIV vaccines, enhance public support and involvement, accelerate vaccine development, and plan for the eventual delivery of the vaccines. The article briefly outlines steps that governments need to take to implement each of these objectives. The article also provides a menu of potential actions for vaccine advocates to consider as they lobby governments.

AIDS Vaccines↗
PubMed1993

The relationship between space sickness and preflight diet.

The nine astronauts who flew three Skylab missions during 1973 and 1974 were on carefully planned diets. Each astronaut selected his preferences from a list of approximately 70 food items, from which dietitians developed a rotating sequence of six daily menus. In addition to strict control of the inflight diet, each crewman consumed his planned diet for 21 days preflight and for 18 days postflight. While the amount consumed at each particular meal was largely discretionary, all deviations from the planned meals (which were few) were fully documented. Diets were controlled to provide adequate calcium, phosphorus, and protein because of bone and muscle losses observed on previous flights. Each day's menu had a similar elemental composition; if any particular item was not consumed, supplements in the form of capsules or tablets were prescribed the next day to make up for the shortfall. However, the dieticians did not so carefully control the relative proportions of carbohydrate, fat, and protein (though meticulous records were kept), which were instead selected somewhat incidentally as menus were constructed around each astronaut's food preferences. There are several possible physiologic determinants for food preferences and the regulation of dietary macro-nutrients. Monozygotic twins chose more similar intakes of total energy, protein, fat, and carbohydrate than did dizygotic twins, suggesting a genetic component of dietary regulation. The biosynthesis of neurotransmitters is directly influenced by the availability of their precursor nutrients, such as tryptophan for serotonin and choline for acetylcholine. Diet affects behavior, and it has been suggested that dietary self-selection by rats is regulated by effects of the diet on brain neurotransmitters. Some preflight variables relating to fluid, electrolyte and cardiovascular status, and to environmental exposures, have previously been found to have significant relationships to space sickness. The purpose of this study was to determine if diet could be another factor contributing to space sickness, since diet determines so much of physiology and behavior.

Diet Records↗
PubMed2002

Display of positron emission tomography with Cadplan.

Recent clinical experience at Peter MacCallum Cancer Institute (PMCI) with the use of unregistered Positron Emission Tomography (PET) images for radiotherapy target marking in the lung suggests that co-registered PET images would be invaluable. PMCI has three radiotherapy treatment planning systems but none of them currently is able to display or co-register PET images with Computed Tomography (CT) images. This paper details the approach taken to display co-registered PET images with the CADPLAN treatment planning system. CT Image files are normally transferred to Cadplan by DICOM transfer, but the Cadplan DICOM server will not receive (has no presentation context for) PET images. The fundamental design of the CADPLAN system envisages display of only a single image dataset, which must be a CT scan for planning reasons. The problem of data transfer is crudely solved by File Transfer Protocol (FTP) over the network. Fortunately the multislice format of the PET image files makes individual transfer manageable. A menu based C program running at the same time as Cadplan is invoked to sample the DICOM PET Image and create multiple Cadplan CART image format files that are co-registered with each existing transverse CT slice. With the Cadplan in contour mode, the program allows the co-registered PET images to be swapped in and out of the image section of the CART files promptly, while keeping the contour information. This allows radiotherapy target volumes to be marked using transverse PET emission images, and effectively circumvents the design constraints prohibiting the display of more than one image set. Contours can be over-laid for review on reconstructed sagittal or coronal views of CT or PET images constructed using the standard Cadplan tools. Co-registration is facilitated by identical positioning with the aid of lasers and FDG loaded fiducial markers on the PET scanner and CT couch. A polyurethane cast fixed with EFFILOCK is used to ensure identical patient orientation on the CT and PET couches. Since both imaging modalities are without significant geometric distortion the co-registration is then simply a translation. PET transmission images can be used for co-registration verification. The practical implementation of display of PET images with CADPLAN has enabled us to begin a trial of 10 patients, the results of which will be reported separately.

Data Display↗
PubMedDate not supplied

Cardiac rehabilitation: goals, interventions and action plans.

Cardiac rehabilitation services are now well established in the UK. There is a growing evidence base for cardiac rehabilitation interventions but, despite this, there remains much variation in service models and delivery. The 'National Service Framework for Coronary Heart Disease' sets out goals for cardiac rehabilitation interventions based on lifestyle change; however, many people do not have access to cardiac rehabilitation towards menu-driven approaches, which may suit individual need more than a standardized approach. Nurses play a crucial role in the delivery of cardiac rehabilitation services and hold the necessary skills and expertise so to do. Future challenges to cardiac rehabilitation include developing increasingly patient-focused services across the boundaries of primary, secondary and social care, and increasing patient and public involvement in services.

Coronary Disease↗
PubMed1991

QARx: the quality assurance prescription.

The QARx program provides the necessary tools for organizing and effectively implementing a quality assurance program for a pharmacy department that truly offers the ever-elusive potential for creating an environment that promotes on-going quality improvement for the department. Eventually there will be a plethora of criteria sets available so that a pharmacist will be able to just choose the pertinent indicators from the shelf (if you choose not to create your own). There is an option to import criteria sets from the utilities menu, and the availability of pertinent sets should provide an attractive option for actually selecting certain readily available sets of indicators, monitors, and outcomes to be automatically imported into your existing quality assurance plan. This program is a must for any department manager trying to organize and orchestrate an effective quality assurance program in a health care institution. For more information about QARx, contact the American Society of Hospital Pharmacists, Special Projects Division, 4630 Montgomery Avenue, Bethesda, MD 20814, (301) 657-3000.

Clinical Pharmacy Information Systems↗
PubMed1975

Comparison of Type A and nutrient standard menus for school lunch. I. Development of the nutrient standard method (NSM).

Methodology was developed for planning school lunch menus which meet a specific nutrient standard. The method considered nine indicator nutrients plus calories and percentage of calories coming from fat. The nutrient composition of approximately 625 school lunch menu items were calculated using Agriculture Handbook No. 8 data. All nutrient data were converted to bead units which were summed on an abacus until the meal requirements were met. Preliminary testing of the method showed it to be usable by school lunch menu planners and provided menus meeting certain minimal nutrient constraints. After the test, suggested modifications were incorporated into the method to enhance its use. The method is described and a sample week's given.

Adolescent↗
PubMed1999

The menu-setting problem and subsidized prices: drug formulary illustration.

The menu-setting problem (MSP) determines the goods and services an institution offers and the prices charged. It appears widely in health care, from choosing the services an insurance arrangement offers, to selecting the health plans an employer proffers. The challenge arises because purchases are subsidized, and consumers (or their physician agents) may make cost-ineffective choices. The intuitively comprehensible MSP model--readily solved by computer using actual data--helps structure thinking and support decision making about such problems. The analysis uses drug formularies--lists of approved drugs in a plan or institution--to illustrate the framework.

Budgets↗
PubMed1997

[Computerization experience in a day hospital of integrated radiochemotherapy].

INTRODUCTION: We report on a cost-effective easy-access software developed for the functional integration of the clinical records and history of oncologic patients with the management of the Day Hospital of the Radiotherapy Department of the University Hospital A. Gemelli, in Rome. MATERIAL AND METHODS: The software was designed to archive the clinical records and history of oncologic patients and the relative chemotherapy, to manage the examination scheduling, to draw up nursing files with the planned therapy and to make statistical analyses of the department activity. Five forms are available: the patient form, recording patient data; the admission form, recording the type of therapy (e.g., chemotherapy, tests, medical examinations, etc.), the relative cost and chemotherapy protocol, detailing for instance the type of drug; the nursing file, detailing chemotherapy schedule and the dilution of each drug; the menu, to select and retrieve any record. The minimum configuration requires a 386 Intel CPU, 4 Mb RAM and 4 Mb free on the hard disk. The software is the File Maker Pro 2.1 for Windows which can interact with Apple Macintosh computers. RESULTS: Since October, 1995, we have saved the clinical records of 272 oncologic outpatients (2415 entries in all), with a mean of 201/month. This computer system permitted us to save and retrieve data for both clinical and didactic purposes and to plan our activity. CONCLUSIONS: One year after it was implemented and used in clinical practice, the system is a cost-effective and user-friendly tool for the management of the Radiochemotherapy Day Hospital of our Radiotherapy Department.

Combined Modality Therapy↗
PubMed2001

The independent older Australian: Implications for food and nutrition recommendations.

The World Health Organisation has restructured their program for health and the elderly, renaming it Aging and Health, focussing on aging as a part of life rather than a static age group separated from the rest of the population. As the older population becomes more heterogeneous, nutrition and food service providers in the community are faced with new challenges. This paper presents nutrition recommendations relevant to community nutrition programs in Australia including the recently released Dietary Guidelines for Older Australians. The subsequent discussion focuses on issues associated with implementation of community based food and nutrition intervention programs. The following strategies for successful implementation of community based food and nutrition programs were identified: Meals on Wheels services. 1. should maintain a register of food service systems for each site to assist in the planning process. 2. Develop a procedure for the nutritional assessment of menus focussing on a standardised methodology and recipes as well as ensuring trained staff are available to apply the procedure. 3. Validate recommended serving sizes and recommend serving utensils for specific menu items. Provide advice on the purchasing, use and calibration of scales as well as containers. 4. Develop alternative, informal methods of assessing client satisfaction to ensure the clients' experience with the service, rather than their reaction to the experience, be assessed. 5. Develop a management training program which focuses on a "train-the-trainer' strategy to ensure continuous, on-site training. Meeting the nutritional needs of the heterogeneous group of older people implies a modified approach to nutritional support. All those involved in community nutrition organisations need to recognise the significance of the "caring" role as well as that of food provider and the impact of this on the nutritional status of the client. The development of consistent guidelines and tools will assist organisations in meeting the needs of their target groups. As professionals we need to understand and accept the constraints that these organisations deal with to ensure the services we provide are appropriate. These constraints include all of those issues detailed in this paper - production capability, training resources and the availability of volunteers.

Aged↗
PubMed1993

PC program for estimating polynomial growth, velocity and acceleration curves when subjects may have missing data.

A stand-alone, menu-driven PC program, written in GAUSS386i, for estimating polynomial growth, velocity, and acceleration curves from longitudinal data is described, illustrated and made available to interested readers. Missing data are accommodated: we assume that the study is planned so that individuals will have common times of measurement, but allow some of the sequences to be incomplete. The degrees, Di, adequate to fit the growth profiles of the N individuals are determined and the corresponding polynomial regression coefficients are calculated and can be saved in ASCII files which may then be imported into a statistical computing package for further analysis. Examples of the use of the program are provided.

Achondroplasia↗
PubMed1988

Status of menu item forecasting in dietetic education.

The status of forecasting techniques included in educational programs and the need for instructional material on this topic were investigated. A survey instrument was developed to determine which forecasting techniques were included in instructional programs. The validated questionnaire was mailed to directors of coordinated undergraduate programs or to Plan IV representatives at all universities with programs approved or accredited by the ADA. The response rate was 59%, or 156 dietetic programs. Analysis of the survey data revealed that mathematical techniques (Box-Jenkins, regression, exponential smoothing, moving average) were not taught in the majority of educational programs. Educators responded that forecasting was an important concept and that continuing education concerning forecasting techniques that may be employed in foodservice management was needed. As a result of the analysis of the data, two self-instructional modules that could be utilized by both practitioners and educators to enhance the level of practice and education were developed. Graduate and undergraduate students at 11 universities and 35 randomly selected practitioners tested the self-instructional modules. For all groups--undergraduate, graduate, and practitioners--the t-statistic was significant at the p less than .0000 level; thus the modules were effective in teaching foodservice forecasting concepts.

Dietary Services↗
PubMed1994

A PC program for computing confidence bands for average and individual growth curves.

Dawson et al. (Am. J. Med. Genet. 7, 529-536, 1980) developed a procedure for constructing confidence bands for both average and individual growth curves which may be of considerable value in the study of growth and development. This paper describes their method for constructing, and provides a menu-driven GAUSS386i program for computing these confidence bands. It is demonstrated how these bands are useful for both the diagnosis and prognostication of growth patterns with known levels of confidence. It is assumed that the study is planned so that individuals will be measured at the same times, but missing data are allowed.

Confidence Intervals↗
PubMed2004

[Development of Web-based multimedia content for a physical examination and health assessment course].

PURPOSE: This study was to develop Web-based multimedia content for Physical Examination and Health Assessment. METHOD: The multimedia content was developed based on Jung's teaching and learning structure plan model, using the following 5 processes : 1) Analysis Stage, 2) Planning Stage, 3) Storyboard Framing and Production Stage, 4) Program Operation Stage, and 5) Final Evaluation Stage. RESULTS: The web based multimedia content consisted of an intro movie, main page and sub pages. On the main page, there were 6 menu bars that consisted of Announcement center, Information of professors, Lecture guide, Cyber lecture, Q&A, and Data centers, and a site map which introduced 15 week lectures. In the operation of web based multimedia content, HTML, JavaScript, Flash, and multimedia technology (Audio and Video) were utilized and the content consisted of text content, interactive content, animation, and audio & video. Consultation with the experts in context, computer engineering, and educational technology was utilized in the development of these processes. CONCLUSIONS: Web-based multimedia content is expected to offer individualized and tailored learning opportunities to maximize and facilitate the effectiveness of the teaching and learning process. Therefore, multimedia content should be utilized concurrently with the lecture in the Physical Examination and Health Assessment classes as a vital teaching aid to make up for the weakness of the face-to- face teaching-learning method.

Computer-Assisted Instruction↗
PubMed1993

Development of a multistage diet for dysphagia.

A multistage dysphagia diet was developed by the nutrition and the speech-language pathology sections of an inpatient rehabilitation unit to meet a growing need for a diet that would allow dysphagic patients to eat safely and to progress to a wider variety of foods as their swallowing function improved. The diet was constructed empirically by evaluating all foods on the hospital menu for ease of swallowing. It consisted of five solid-food stages and two liquid stages; thickened liquids were provided for patients unable to manage regular liquids. Menus that offered patients choices among food items were designed for most stages. During planning and implementation of the diet, special attention was given to food production concerns, education of staff and other caregivers, and development of instructional materials for patients leaving the hospital. The diet met its goals of providing dysphagic patients with a maximum number of foods that could be swallowed safely, maintaining or improving nutritional status, avoiding unnecessary tube feeding, and winning the support of patients and caregivers.

Cooking↗
PubMed2006

Coding and payment for immunizations.

To maximize reimbursement rates for services related to immunization delivery, pediatricians must develop a best-practice five step action plan for providing immunizations in practice. These include: Implementing optimal coding practices for immunization administration and vaccine products; Capturing the work of associated evaluation and management services with coding; Supporting CPT coding with appropriate ICD-9-CM diagnostic coding links; Incorporating an immunization coding menu, including CPT and ICD-9-CM codes discussed in this article, into the standard practice encounter form; and Aggressively contracting with payers for adequate, flexible payment for immunization services. With knowledge of immunization CPT and ICD-9-CM coding, as well as coding for association E/M visits, the pediatrican is well prepared to deliver immunizations in the medical home.

Child↗
PubMed1994

A PC program for classification into one of several groups on the basis of longitudinal data.

A stand-alone, menu-driven PC program, ZCLASS, written in GAUSS386i, for classifying subjects into one of several distinct, existing groups on the basis of longitudinal data is described, illustrated, and made available to interested readers. The program accepts data from studies where common times of measurement are planned, but missing data are accommodated in that one or more measurement sequences may be incomplete.

Anthropometry↗