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At least 1,243 records · Page 69Linked to original sources
PubMedDate not supplied

[Modular project of the Picture Archiving and Communication System (PACS). Preliminary operational experience. I].

Since september 1988 a PAC System (Comm View by AT & T and Philips) has been operating in the Radiology Department of the University Hospital, Trieste. A research project is presently in progress aiming at providing factual evidence for the evaluation of this kind of systems as far as operational, technical, clinical and economic aspects are concerned. The general approach to this research consists in implementing and monitoring a PACS in a stepwise way, starting with a small system connected to some digital modalities only, in order to test the feasibility and effectiveness of the system within a Radiology Department, and to test the possibility of matching the PACS to the Radiological System. The present paper describes in detail the present configuration of this entry-level system and its technical features. The planned development (october 1989) is also depicted. Further developments devise at managing in an integrated way all the radiological images of the four hospitals of Trieste. At present, the PACS is currently used to manage and store on optical disks all the images acquired from the connected modalities plus the related reports, and to perform the reporting sessions for CT examinations (brain and abdomen). The present research effort is devoted to two main areas: clinical evaluation and operational analysis. The object of the operational analysis was the assessment of the impact of PACS on the operations of a Radiology Department. The general approach followed for this research consists in analysing the procedures as they are performed in the conventional way (manual operations), and comparing them to the way they are, or could be, performed using a PACS System (automatic operations). This stage of the project is divided into three phases, concerning respectively the analysis of the organization and operations before PACS, the analysis of the impact of PACS in its initial configuration and the forecast of the influence of PACS in its future setting. A first evaluation concerned the activities carried out from the moment the images are generated to the moment they are ready to be achieved. They include image acquisition, reporting, delivering and returning of images from the departments. The time required to carry out each of the activities involved was recorded, both in the manual and in the automatic version; furthermore, a more detailed analysis was performed on the reporting procedure. The conclusions reached through this analysis are that this kind of operation is mostly affected by the way the Radiology Department is managed, rather than by the tools employed.(ABSTRACT TRUNCATED AT 400 WORDS)

Computer Systems↗
PubMedDate not supplied

Recovering from cancer: a nursing intervention program recognizing survivorship.

The Oncology Nursing Task Force of the Cleveland Clinic Cancer Center and the local county unit of the American Cancer Society jointly sponsored "EXPO '88: Recovering from Cancer" on the first National Cancer Survivors' Day held on June 5, 1988. The event--a day of survivor recognition and celebration, education, and support-provided a setting for oncology nurses to participate in a program recognizing cancer survivorship and enhancing awareness of survivors' issues. Program goals, development, planning, evaluation, and implications for nursing are discussed.

Adult↗
PubMed1990

Future directions in cancer control for the Louisiana Cancer Consortium.

The incidence and mortality rates of all cancers in Louisiana are among the highest in the nation. Cancer control measures must be instituted in order to have an impact on the reduction in cancer deaths which amounted to 8,120 in 1987. Cancer prevention and early detection by means of changes in lifestyles are among the highest priorities of the Louisiana Cancer Consortium. The Consortium is a nonprofit corporation, established by the LSU Medical Centers in New Orleans and Shreveport, Tulane Medical Center and School of Public Health and Tropical Medicine, Ochsner Medical Foundation, and the Louisiana Department of Health and Hospitals. The goal of the Consortium is to plan, develop, and implement cancer control programs focusing on tobacco education, health promotion at the worksite, cancer education, early detection, and reduction of exposure to carcinogenic substances.

Health Education↗
PubMedDate not supplied

Environmental risk analysis: a case study.

Traditional risk analysis which has evolved to fit the requirements of regulatory agencies, is often too time-consuming and cumbersome for specific environmental decision making activities in public health. For instance, the discovery of an old chemical landfill operation may require highly focussed risk information to help make a decision to abandon, decontaminate, or develop the site. This paper presents an alternate approach to risk analysis which is more efficient than traditional methods in assessing the human health risks associated with specific development plans. The method is illustrated with an example of a building site in British Columbia.

Child↗
PubMed1987

Clinical development of a new recombinant DNA hepatitis B vaccine.

The clinical development plan for the new recombinant DNA yeast-derived hepatitis B vaccine manufactured by SmithKline Biologicals is summarized. Initially, the emphasis was on assessing the risk of hypersensitivity to yeast-derived contaminants. This was followed by an evaluation of local and general reactions after vaccination. Next, the optimal dose of vaccine to be administered was ascertained followed by an evaluation of the efficacy of different vaccination schedules. The reactogenicity and immunogenicity of the yeast-derived vaccine was compared with that of two commercially available plasma-derived vaccines. The recombinant vaccine's protective efficacy was assessed in chimpanzees and by comparing attack rates in historical homosexual control groups with those in vaccinated homosexuals. Ongoing studies are investigating the protection of neonates born to HBeAg-positive carrier mothers.

Antigens↗
PubMed1987

[An expert system of aiding decision making in breast pathology connected to a clinical data base].

The René Huguenin Cancer Center holds a medical file for each patient which is intended to store and process medical data. Since 1970, we introduced computerization: a development plan was elaborated and simultaneously a statistical software (Clotilde--GSI/CFRO) was selected. Thus, we now have access to a large database, structured according to medical rationale, and utilizable with methods of artificial intelligence towards three objectives: improved data acquisition, decision making and exploitation. The first application was to breast pathology, which represents one of the Center's primary activities. The structure of the data concerning patients is by all criteria part of the medical knowledge. This information needs to be presented as well as processed with a suitable language. To this end, we chose a language-oriented object, Mering II, usable with Apple and IBM 4 micro-computers. This project has already allowed to work out an operational model.

Breast Neoplasms↗
PubMed1985

Antibody-toxin hybrids: a clinical review of their use.

Immunotoxins are protein molecules composed of monoclonal antibodies linked covalently to either peptide toxins or polypeptides related to toxins. These molecules can be used in the therapy of a number of malignant diseases including lymphoma, leukemia, and solid tumors. They can be used to prevent graft-versus-host disease or rejection in transplanted organs, such as bone marrow and pancreas. The design and development of these molecules, as well as a clinical development plan, will be discussed.

Antibodies, Monoclonal↗
PubMed1966

Psychiatric seminars for the general practitioner.

A program of case-centred seminars in psychiatry designed for general practitioners was begun in Ontario during 1965. It came into being as the result of the cooperative endeavour of the Ontario Chapter, College of General Practice, the Ontario Psychiatric Association and the Division of Postgraduate Medicine, University of Toronto. The program was conducted on a regional rather than on a centralized basis. No general practitioner had to travel more than 30 miles to his seminar, thus ensuring regular weekly attendance for an average of 12 weeks. The Ontario Chapter recruited the general practitioners, the Psychiatric Association selected appropriate regional psychiatrists, and the University gave a brief preliminary course for these psychiatrists. Nineteen separate groups were formed in 13 different Ontario cities, with an average total weekly attendance of 120. A review conference of participating psychiatrists and general practitioners, held in November 1965, developed plans for renewal and extension of the program for 1966. This approach seems especially appropriate for large geographic regions with scattered populations.

Education, Medical, Continuing↗
PubMed1984

The Ancillary Services Review Program in Massachusetts. Experience of the 1982 pilot project.

In 1982, a pilot program to review the use of ancillary services in 25 hospitals was implemented in Massachusetts. The program analyzed hospital claims data to generate statistical models of ancillary use. Hospitals where the model demonstrated substantially higher use were subjected to clinical review. For laboratory services, three of the four hospitals reviewed were found to have more than 30% inappropriate use of selected tests, compared with approximately 20% in other hospitals. For cardiac services, three hospitals were each found to have more than 30% inappropriate use of selected tests, compared with 16% in other hospitals. When informed of these results, five of the six hospitals used them to develop plans of corrective action. Based on the pilot program, a review of ancillary services began in all Massachusetts hospitals in 1983.

Ancillary Services, Hospital↗
PubMedDate not supplied

[Urbanization in tropical countries].

Rural populations are still the most numerous in tropical countries. But we can witness an unprecedent process of urbanization. However the dynamics of the phenomenon differs greatly in different countries and in different towns. As a matter of fact, the greatest overcrowded metropolis attract the greatest part of the migrants from rural areas; the attractive factors are multifarious and universal. This not easily controllable trend seems to be irreversible. The migrant farmers will generally find a job within the informed economic sector. The zones of spontaneous and precarious settlement are often their first environmental living conditions. Some of these unhealthy dwelling areas are subject to development plans; some of them being extremely well designed.

Africa↗
PubMed1984

[Nursing in primary care in Mexico].

In keeping with the global goal of health for all, the National Development Plan of Mexico describes health as a social right. To give effect to this right it is felt that the health sector must be restructured so as, among other purposes, to improve the coverage of services and strengthen the coordination of education institutions and social security agencies with health establishments, and to make the training of health personnel responsive to the country's real needs. No profession is better suited than nursing to the diversity of tasks in primary care. The authors describe the key role of this personnel in extending the coverage of health services to the entire population. They enumerate the range of basic--technical, administrative and educational--functions performed by nurses, and some factors that reinforce and others that restrict the contribution of nursing to primary health care in Mexico.

Health Education↗
PubMed1978

[Hospital care norms for treating patients with malignant neoplasms of the head and neck].

The authors have studied the rate of malignant head and neck tumors morbidity among the population of Vinnitsa Province for 1960--1974 as well as the condition of stationary medical service, frequency of hospitalization, and average terms of patients' stay at the hospital. The index for specialized hospital beds for patients with malignant head and neck tumors was found to be 2.6 per 100 000 population. Within a 15-year period an average annual utilization of hospital beds for every 100 patients with lip cancer rated 7.2 beds, with cancer of the tongue--22.4, salivary glands--11.7, oral mucosa--19.7, pharynx--15.6, nose and sinuses--15.3, larynx--20.7, jaw--20.9, skin--5.3. These data may be rather helpful for the planned development of specialized hospitals at any site of the country.

Bed Occupancy↗
PubMed1980

Demographics can help guide health policy.

The changing demographics of our over-65 population help us to see what changes in our national health care policy will best improve the desperate situation of the elderly.

Aged↗
PubMed1980

Psychiatric service options within a health maintenance organization.

The authors describe a prepaid mental health program affiliated with a Phoenix-based health maintenance organization. Challenged by the need to limit financial risk and by high outpatient utilization rates, this prepaid health plan, developed a policy of service delivery which could both satisfy patient and consultee demands and conserve costs. Staff philosophies, services, administrative characteristics and client population are described. Key concepts in the delivery of service are outlined. The authors conclude by reviewing some of the ethical and financial dilemmas confronting the prepaid mental health professional.

Adolescent↗