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PubMed2006

Follicular penetration: development of a method to block the follicles selectively against the penetration of topically applied substances.

Investigations into the penetration pathways of topically applied substances through the skin play an important role in dermatological science. Recently, the hair follicles have increasingly been recognized as an important pathway for percutaneous penetration, although the role of the follicles has still not been clarified in detail. Therefore, the aim of the present study was to develop an in vivo method for the analysis of the follicular rate of penetration processes. In order to reach this goal, the follicles were excluded from the penetration process of topically applied substances. Different study designs were evaluated, and we were able to show that the application of nail varnish to each follicular orifice represents an effective method of blocking the follicles selectively against the penetration of topically applied substances. In dermatological science, there is new information on the physiology of skin penetration processes, thus allowing examination of the follicular rate of penetration and improvement of the pharmacokinetics of topically applied substances.

Administration, Topical↗

PubMed1988

The information age in concept and practice at the National Library of Medicine.

The evolution of today's information age is mirrored in the growth of the National Library of Medicine's bibliographic services: from the pioneering work of the Library in the last century to develop Index Medicus, to developing the innovative computerized MEDLARS system in the early 1960s, to the easily searchable on-line data bases now available to health professionals. The evolution has not come about without controversy, however, as tension developed between the public sector, where the information was viewed as a social benefit, and the private sector, where it was viewed as a source of profit. The Library has fostered research and development in biomedical communications in the laboratories of its Lister Hill Center and through grants to assist in establishing the field of medical informatics. The future of biomedical communications will be profoundly affected by work now being carried out by the Library: in fields such as biotechnology, through integrative methodologies such as the Unified Medical Language System now under development, and by a grant program to improve the infrastructure for information within academic health science centers.

Diffusion of Innovation↗

PubMedDate not supplied

Motion loss after ligament injuries to the knee. Part I: causes.

Motion loss continues to be a difficult complication after ligament injury and surgery to the knee. A better understanding of the pathoanatomic causes of motion loss can lead to improved prevention and treatment strategies. When motion loss does occur, early recognition and appropriate treatment can be expected to restore motion and improve function in most patients. Treatment options, although varied, should improve outcome when implemented appropriately. This article is composed of two parts. The first part reviews the current concepts on definitions, incidence, and causes of motion loss. In the second part, to be published later, current strategies on prevention and treatment of motion loss after ligament injury to the knee are reviewed. Emphasis is placed on risk factors and prevention as well as on diagnosis and treatment. The article summarizes the latest information from the basic sciences as well as clinical studies on the problem of motion loss of the knee and attempts to provide a rational approach to these difficult clinical problems.

Humans↗

PubMed2005

Compassion stress and the qualitative researcher.

Human subjects are carefully protected in the research process. However, the same consideration is not currently being given to the qualitative researcher, even those investigating topics that are likely to elicit powerful emotions. The role of researcher's emotional responses and the self-care strategies that, in some circumstances, are appropriate for the researcher and other research support personnel have not received the attention they deserve in qualitative research literature. Based on experience in conducting research on the topic of self-directed learning and breast cancer, and on the limited literature available, the author makes the case for the use of strategies such as counseling, peer debriefing, and journal writing as means of dealing with the potential for "compassion stress" as experienced by the researcher and other research support personnel. She also suggests that the preparation of social science researchers should include information on appropriate self-care strategies.

Adaptation, Psychological↗

PubMed2005

Health care restructuring and family physician care for those who died of cancer.

BACKGROUND: During the 1990s, health care restructuring in Nova Scotia resulted in downsized hospitals, reduced inpatient length of stay, capped physician incomes and restricted practice locations. Concurrently, the provincial homecare program was redeveloped and out-of-hospital cancer deaths increased from 20% (1992) to 30% (1998). These factors all pointed to a transfer of end-of-life inpatient hospital care to more community-based care. The purpose of this study was to describe the trends in the provision of Family Physician (FP) visits to advanced cancer patients in Nova Scotia (NS) during the years of health care restructuring. METHODS: Design Secondary multivariate analysis of linked population-based datafiles including the Queen Elizabeth II Health Sciences Centre Oncology Patient Information System (NS Cancer Registry, Vital Statistics), the NS Hospital Admissions/Separations file and the Medical Services Insurance Physician Services database. Setting Nova Scotia, an eastern Canadian province (population: 950,000). SUBJECTS: All patients who died of lung, colorectal, breast or prostate cancer between April 1992 and March 1998 (N = 7,212). Outcome Measures Inpatient and ambulatory FP visits, ambulatory visits by location (office, home, long-term care facility, emergency department), time of day (regular hours, after hours), total length of inpatient hospital stay and number of hospital admissions during the last six months of life. RESULTS: In total, 139,641 visits were provided by family physicians: 15% of visits in the office, 10% in the home, 5% in the emergency department (ED), 5% in a long-term-care centre and 64% to hospital inpatients. There was no change in the rate of FP visits received for office, home and long-term care despite the fact that there were 13% fewer hospital admissions, and length of hospital stay declined by 21%. Age-sex adjusted estimates using negative binomial regression indicate a decline in hospital inpatient FP visits over time compared to 1992-93 levels (for 1997-98, adjusted RR = 0.88, 95%CI = 0.81-0.95) and an increase in FP ED visits (for 1997-98, adjusted RR = 1.18, 95%CI = 1.05-1.34). CONCLUSION: Despite hospital downsizing and fewer deaths occurring in hospitals, FP ambulatory visits (except for ED visits) did not rise correspondingly. Although such restructuring resulted in more people dying out of hospital, it does not appear FPs responded by providing more medical care to them in the community.

Adolescent↗

PubMed2003

Judgement call.

Explore the source record for details and available documents.

Access to Information↗

PubMed2004

Designing the future: NBIC technologies and human performance enhancement.

Never before has any civilization had the unique opportunity to enhance human performance on the scale that we will face in the near future. The convergence of nanotechnology, biotechnology, information technology, and cognitive science (NBIC) is creating a set of powerful tools that have the potential to significantly enhance human performance as well as transform society, science, economics, and human evolution. As the NBIC convergence becomes more understood, the possibility that we may be able to enhance human performance in the three domains of therapy, augmentation, and designed evolution will become anticipated and even expected. In addition, NBIC convergence represents entirely new challenges for scientists, policymakers, and business leaders who will have, for the first time, vast new and powerful tools to shape markets, societies, and lifestyles. The emergence of NBIC convergence will challenge us in new ways to balance risk and return, threat and opportunity, and social responsibility and competitive advantage as we step into the 21st century.

Biological Evolution↗

PubMed1987

Rationalization and computerization of the drug supply to an animal unit.

Drug stocks in an animal unit were rationalized by discarding out-of-date or unwanted items and drawing up an approved stock list. A computerized system of stock control which enables a regular and accurate inventory of pharmaceuticals to be made was then established. In addition, the paperwork required for reordering drugs is produced automatically. Pharmaceuticals to a total value of 1650 pounds were discarded during the rationalization phase. The value of drugs stocked in the animal unit then stabilized at about one-third of previous levels. In the first 6 months of operation of the new system drug expenditure fell by about 40% in comparison with the same period 1 year previously. The drug stock control system has proved economical to operate and accurate, and can be run by persons without computer expertise. Valuable savings in both cost and labour have resulted. Effective management of drug expenditure by the animal unit is now possible.

Animals↗

PubMed1981

Current status of studies concerned with evaluation of toxic effects of chemicals on the testes.

A brief review of the history of the subject is provided. An attempt is made to define the current status of the knowledge and the reasons why our knowledge in this area of science is poor. The information gained from studies employing lower species is contrasted with information on the human male. The most commonly utilized techniques for evaluating the effects of toxic agents on the male reproductive system is briefly summarized. The growth of knowledge in physiology, biochemistry, and hormonal control of testicular function during the past ten to fifteen years is discussed; and, the specific most pertinant advances are noted. The difficulties in utilizing the human subject for toxicologic studies are pointed out and the reasons why the knowledge of the effect of toxic agents on the human testes are meager are discussed. The methodology utilized for the study of the functional integrity of the human testes and the specific parameters widely utilized for this purpose are discussed and criticized. The fact that it is extremely difficult to evaluate changes in the testicular function of men are emphasized and the extremely wide variability is pointed out. Furthermore, it is demonstrated that at this moment, we are lacking some of the most fundamental information concerning the normal function of the human testes; and, that there is a poor understanding of parameters of "normalcy". The three parameters used most commonly to define normalcy of human testes, namely, testicular histology, sperm output, and hormonal levels are discussed and the difficulties and pitfalls of these measurements are pointed out.

Animals↗

PubMed1984

The role of the family history in preventive medicine: an introduction for medical librarians.

Health professionals are collecting and charting data about the family history of their patients in order to determine if a predisposition to heart, stroke, cancer and other debilitating conditions can be detected or alleviated through patient education and preventive medicine. Family history-taking for the purposes of preventive medicine is introduced, along with a brief history of the field. The pedigree chart and the genogram are described and their use by health personnel is discussed. A brief search strategy on MEDLINE and a selected bibliography are presented to aid the health sciences librarian to find information on the family history, genograms or pedigree charts.

Family↗

PubMed2003

Extending the hand of knowledge: promoting mobile technologies.

The widespread use of handheld computers and other mobile devices in the healthcare environment and their potential for providing access to information has prompted health sciences librarians everywhere to learn more about this technology. Early in 2001, the Health Sciences Library (HSL) at the University of North Carolina at Chapel Hill began exploring ways to support mobile computing. This paper describes the four basic approaches taken by the librarians that helped establish the HSL as a leader in the area of mobile technologies.

Academic Medical Centers↗

PubMed2002

Restriction fragment length polymorphism and polymerase chain reaction: HLA-DQA1 and polymarker analysis of blood samples from transfusion recipients.

The effect of blood transfusion on DNA profiles of an individual is a significant issue in the forensic context. In the present study, the effects of blood transfusion in 5 recipients were studied by performing restriction fragment length polymorphism and polymerase chain reaction HLA-DQA1 and Polymarker (LDLR, GYPA, HBGG, D7S8, and GC) assays (Roche Molecular Systems, Branchburg, NJ) on serial posttransfusion blood samples. Pretransfusion and posttransfusion DNA profiles of all 5 recipients were consistent with no evidence of the donor genetic material. Currently used DNA profiling techniques in forensic science are reliable and informative for paternity and identity purposes in situations involving transfusion of 1 or 2 U of blood up to 24 hours posttransfusion.

Blood Transfusion↗

PubMed2002

Gene repair and transposon-mediated gene therapy.

The main strategy of gene therapy has traditionally been focused on gene augmentation. This approach typically involves the introduction of an expression system designed to express a specific protein in the transfected cell. Both the basic and clinical sciences have generated enough information to suggest that gene therapy would eventually alter the fundamental practice of modern medicine. However, despite progress in the field, widespread clinical applications and success have not been achieved. The myriad deficiencies associated with gene augmentation have resulted in the development of alternative approaches to treat inherited and acquired genetic disorders. One, derived primarily from the pioneering work of homologous recombination, is gene repair. Simply stated, the process involves targeting the mutation in situ for gene correction and a return to normal gene function. Site-specific genetic repair has many advantages over augmentation although it too is associated with significant limitations. This review outlines the advantages and disadvantages of gene correction. In particular, we discuss technologies based on chimeric RNA/DNA oligonucleotides, single-stranded and triplex-forming oligonucleotides, and small fragment homologous replacement. While each of these approaches is different, they all share a number of common characteristics, including the need for efficient delivery of nucleic acids to the nucleus. In addition, we review the potential application of a novel and exciting nonviral gene augmentation strategy--the Sleeping Beauty transposon system.

Animals↗

PubMed1990

Quality of time use by adults with spinal cord injuries.

The self-perceived quality of time use of 15 community-based adults with spinal cord injuries was compared with that of 12 age- and sex-matched nondisabled adults through the use of the Activity Configuration Log (modified from an unpublished clinical assessment developed by Claudia Allen). Differences in how subjects classified their daily occupations were found between and within groups, especially for the categories of Work, Self-Maintenance, and Other. The results suggest that the subjects' classifications of occupations and interpretations of their meanings are important sources of information for both the science of occupation and occupational therapy practice. The subjects with spinal cord injuries had a high rate of unemployment (67%) and much more daily free time than did their nondisabled counterparts. The affective quality of particular occupations was found to be related to the affective quality of the entire day. Occupational therapists agreed more with each other than with the subjects with disabilities when classifying occupations. Implications for practice and research are provided.

Activities of Daily Living↗

PubMedDate not supplied

New technologies emerge.

Technology vendors continue to invent new devices, systems and processes to sell to the health care industry. Drugs, instruments and procedures continue to improve and address disease and injury treatment needs. In addition to these direct medical treatment innovations and enhancements, a number of new supporting systems and products have emerged. These support technologies hold significant promise for managers to make day-to-day execution of health care delivery more cost effective and customer friendly.

Diagnostic Imaging↗

PubMed1999

A hypergraphic model of medical informatics: curriculum development guide.

Medical informatics, as a descriptive, scientific study, must be mathematically or theoretically described. Is it important to define a model for medical informatics? The answer is worth pursuing. The medical informatics profession stands to benefit three-fold: first, by clarifying the vagueness of the definition of medical informatics, secondly, by identifying the scope and content for educational programs, and, thirdly, by defining career opportunities for its graduates. Existing medical informatics curricula are not comparable. Consequently, the knowledge and skills of graduates from these programs are difficult to assess. The challenge is to promote academics that develops graduates for prospective employers to fulfill the criteria of the health care industry and, simultaneously, compete with computer science programs that produce information technology graduates. In order to meet this challenge, medical informatics programs must have unique curricula that distinguishes its graduates. The solution is to educate students in a comparable manner across the domain of medical informatics. This paper discusses a theoretical model for medical informatics.

Computers↗

PubMed2001

The application of knowledge management principles to compliant coding activities.

This article applies the concepts of knowledge management to diagnostic and procedural coding performed by health care providers. The process of diagnostic and procedural coding is both an art and a science. In particular, the information stored away in the minds of individuals performing the coding function is ripe for the basis of an effective knowledge Health Information Management (HIM) coding management system. In this article, we explore the issues and processes that HIM professionals can take advantage of in standardizing the coding function.

Database Management Systems↗

PubMed2001

The challenge with tracking health outcomes.

Rising health care costs, questions about the effectiveness of medical interventions and demands for greater accountability and efficiency with respect to health care delivery have led to a growing interest in using patient outcomes as a primary measure of the quality of care. However, measuring outcomes is complex and expensive given the widespread lack of an integrated and comprehensive electronic health information system. Furthermore, the science of outcome measurement is relatively undeveloped and caution needs to be taken when attempting to relate health care provision to differences in outcomes. While the foregoing problems do not invalidate outcome measurement programs, they do stress the point that such initiatives need to be pursued cautiously and that their limitations must be clearly appreciated. The challenge with tracking health outcomes is discussed from the perspective of the Improving Cardiovascular Outcomes in Nova Scotia study. This outcome measurement and management project, one of the most ambitious ever undertaken in Canada, has been seeking to improve the medical care of patients with cardiovascular disease in Nova Scotia since October 1997.

Canada↗