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PubMed1980

Regeneration of an abnormal ipsilateral visuotectal projection in Xenopus is delayed by the presence of optic fibres from the other eye.

Optic fibre regeneration was studied by [3H]proline autoradiography and by mapping electrophysiologically the direct visuotectal projections to the contralateral and ipsilateral tecta 12-16 weeks after sectioning the right optic nerve in Xenopus two to four weeks after metamorphosis. The experiments were carried out in three groups: (A) optic nerve section in newly metamorphosed animals with embryonic left-eye enucleation; (B) optic nerve section with simultaneous left-eye enucleation; and (C) optic nerve section with delayed left-eye enucleation 5-31 days prior to sacrifice. In all but three animals regenerated optic fibres were demonstrated morphologically both in the contralateral and ipsilateral tecta. The contralateral visuotectal projection was fully restored within the 12-16 weeks in all animals. In animals with embryonic enucleation or in those where the enucleation was carried out simultaneously with optic nerve section, a direct ipsilateral visuotectal projection was established at the same time as the restoration of the contralateral projection. In contrast, no direct ipsilateral visuotectal projection was detectable in the presence of optic fibres from the other eye in the doubly innervated tecta. However, 14-31 days after the removal of the incumbent optic fibres by left-eye enucleation a direct visuotectal projection from the right eye to the ipsilateral tectum was established, and its polarity corresponded to the normal contralateral retinotectal projection. The apparent disparity between morphological and electrophysiological findings in the doubly innervated tectum suggests that superimposed optic fibres are unable to form normal synaptic relations with tectal neurons during early regeneration, delaying the establishment of the induced direct ipsilateral visuotectal projection.

Action Potentials↗
PubMedDate not supplied

Mediolateral differential projection to the nodulus from the inferior olive in the albino rat: a retrograde WGA-HRP study.

The mediolateral topographic organization of olivocerebellar projections to the nodulus in rats was investigated by a retrograde WGA-HRP method. The nodulus received olivary afferents from the contralateral dorsal cap, nucleus beta, ventrolateral outgrowth, and dorsomedial cell column. The mediolateral extent of terminal areas of the olivocerebellar fibers arising from these subnuclei differed. The dorsal cap projected to the entire mediolateral area of the contralateral nodulus; the rostral and caudal parts of the dorsal cap projected to the lateral and medial parts of the nodulus, respectively. The nucleus beta projected to the medial and intermediate parts of the nodulus. Differential projections from the nucleus beta were observed in a rostrocaudal direction as those from the dorsal cap; the rostral and medial parts of the nucleus projected to the intermediate and medial parts of the nodulus, respectively. The ventrolateral outgrowth projected only to the intermediate part of the nodulus. The dorsomedial cell column projected to the lateral half of the nodulus, including its lateral tip. These and previous findings are compared with respect to this mediolateral topography.

Animals↗
PubMed1993

The modular organization of projections from areas V1 and V2 to areas V4 and TEO in macaques.

In addition to the major anatomical pathways from V1 into the temporal lobe, there are other smaller, "bypass" routes that are poorly understood. To investigate the direct projection from V1 to V4 (bypassing V2) and from V2 to TEO (bypassing V4), we injected the foveal and parafoveal representations of V4 and TEO with different retrograde tracers in five hemispheres of four macaques and analyzed the distributions of labeled neurons in V1 and V2 using flattened preparations of the cortex. In V1, labeled neurons were seen after injections in V4 but not TEO. The V4-projecting neurons were located in the foveal representation of V1, in both cytochrome oxidase (CO)-rich blobs and CO-poor interblob regions. In V2, TEO-projecting neurons were intermingled with V4-projecting neurons, although the former were far sparser than the latter. Across the cases, 6-19% of the TEO-projecting neurons were double labeled, that is, also projected to area V4. Both V4- and TEO-projecting neurons formed bands that ran orthogonal to the V1/V2 border, and both were located in CO-rich thin stripes and CO-poor interstripe regions. In some cases, a continuous band of V4-projecting neurons was also found along the V1/V2 border in the foveal representation of V2. The results indicate that the pathways from V1 to V4 and from V2 to TEO involve anatomical subcompartments thought to be concerned with both color and form. These "bypass" routes may allow coarse information about color and form to arrive rapidly in the temporal lobe. The bypass route from V2 to TEO might explain the partial sparing of color and form vision that is seen after lesions of V4. By analogy, given the bypass route from the foveal representation of V1 to V4, lesions of V2 affecting the foveal visual field would also be insufficient to block color and form vision.

Amidines↗
PubMed1993

Perception of a schistosomiasis control project in rural Kenya by the beneficiaries.

A schistosomiasis control project was implemented in Mwea Rice Irrigation Scheme in Central Kenya between late 1983 and December 1988 by Kenya Medical Research Institute scientists in collaboration with the National Irrigation Board. The aim of the project was to control schistosomiasis through provision of alternative water sources, bath and laundry units, latrines, chemotherapy and health education. The community participated fully. Five years later in December 1988, 203 household heads were interviewed on their perception of the control project in terms of purpose, project ownership and management, benefits, continuity and their knowledge of schistosomiasis transmission cycle. 61% of the respondents were females and 39% males. 92% of them said that the purpose for the project was to treat, control and prevent bilharzia from spreading, and to promote good health. Slightly over 50% said that the project belonged to them but that they would have liked to be more involved in its management. 74% said that they are able to save time because the facilities are now nearer to them; whilst 79% felt that they were saving money because they did not have to buy drugs since they felt healthier. 99% said that they thought that bilharzia has been controlled, and 82% said that their children looked healthier. 95% said that they could see the project surviving for a long time period suggesting that it was self sustaining and they were willing to start a maintenance of facilities fund. Overall, the community appreciated the social, economic and health benefits derived from the control project.

Communicable Disease Control↗
PubMed1995

[Preferential projections for mapping and ablation of tachycardia of the right ventricle outflow. Anatomoradiological study].

PURPOSE: To select ideal radiologic projections for mapping and ablation of tachycardias of right ventricular outflow tract (RVOT). METHODS: Ten hearts from human corpses were studied utilizing radiopaque material to identify the pulmonary valve and three distinct sites on this valve: septal anterior (A), septal posterior (P) and free-wall (L). Next, the hearts were filmed in the frontal plane and in oblique projections with 15 degrees increments to the right and to the left. The projections in which the sites were lateralized on the valve, eased radiologic interpretation and were considered ideal for mapping and ablation. Depending on the proximity of the sites to the lateral extremes of the pulmonary valve, the projections were considered ideal ( ), intermediary (++) and inadequate (+). RESULTS: Projections [table: see text] CONCLUSION: The A site of RVOT was best indicated in the 60 and 45 degrees left anterior oblique projections; the 0 degree postero anterior projection was best for mapping the P site; the L region was best explored in the 60 degrees right anterior oblique projection.

Adult↗
PubMed1996

Health sciences library building projects: 1995 survey.

The Medical Library Association's fifth annual survey of recent health sciences library building projects identified twenty-five libraries planning, expanding, or constructing new library facilities. None of the fifteen new library projects are free standing structures; however, several occupy a major portion of the project space. Ten projects involve renovation of or addition to existing space. Information regarding size, cost of project, type of construction, completion date, and other factual data was provided for twelve projects. The remaining identified projects are in pre-design or early-design stages, or are awaiting funding approval. Library building projects for three hospital libraries, three academic medical libraries, and an association library are described. Each illustrates how considerations of economics and technology are changing the traditional library model from a centrally stored information depository housing a wide range of information under one roof where users come to the information, into an electronic model gradually shifting from investment in the physical presence of resources to investment in creating work space for creditible information specialists who help in-house and distanced users to obtain information electronically from any place and at any time. This new model includes a highly skilled library team to manage, filter, and package the information to users trained by these resident experts.

Canada↗
PubMed1996

[The projections of the ventral field of the tegmentum mesencephali, substantia nigra and amygdaloid nuclei to different segments of the putamen in the dog].

Organization of protections of the complex "substantia nigraventral tegmental field" (SN-VTA) to dorsal and ventral segments of rostral and caudal regions of putamen was studied in dog by method based on retrograde axonic transport of horseradish peroxidase. A difference is found in organization of projections of subcortical formations studied both in rostro-caudal and dorso-ventral directions. Only compact SN part projects to putamen rostral region dorsal segment and both compact and dorsal SN parts--to this region ventral segment. Apart from these two parts of lateral SN area also project to putamen caudal regions dorsal and ventral segments. Limbic system structures projections to putamen dorsal and ventral segments make a significant difference as well. VTA and amygdala were found to project only to putamen anterior and posterior regions ventral segments and not to dorsal. Putamen rostral region ventral segment receive projection from all fibres from neurons of macro- and mediocellular parts of amygdala basal nucleus to the same extent and same segment located more caudally--mostly from its macrocellular part. In putamen ventral segments SN projection fibres end too and thus on this area overlapping of functionally different subcortical formations projections occurs.

Amygdala↗
PubMed1997

Postnatal development of corticospinal projections from motor cortex to the cervical enlargement in the macaque monkey.

The postnatal development of corticospinal projections was investigated in 11 macaques by means of the anterograde transport of wheat germ agglutin-horseradish peroxidase injected into the primary motor cortex hand area. Although the fibers of the corticospinal tract reached all levels of the spinal cord white matter at birth, their penetration into the gray matter was far from complete. At birth, as in the adult, corticospinal projections were distributed to the same regions of the intermediate zone, although they showed marked increases in density during the first 5 months. The unique feature of the primate corticospinal tract, namely direct cortico-motoneuronal projections to the spinal motor nuclei innervating hand muscles, was not present to a significant extent at birth. The density of these cortico-motoneuronal projections increased rapidly during the first 5 months, followed by a protracted period extending into the second year of life. The densest corticospinal terminations occupied only 40% of the hand motor nuclei in the first thoracic segment at 1 month, 73% at 5 months, and 75.5% at 3 years. A caudo-rostral gradient of termination density within the hand motor nuclei was present throughout development and persisted into the adult. As a consequence, the more caudal the segment within the cervical enlargement, the earlier the adult pattern of projection density was reached. No transitory corticospinal projections were found. The continuous postnatal expansion of cortico-motoneuronal projections to hand motor nuclei in primates is in marked contrast to the retraction of exuberant projections that characterizes the development of other sensory and motor pathways in subprimates.

Animals↗
PubMed1997

Insular cortical projections to functional regions of the striatum correlate with cortical cytoarchitectonic organization in the primate.

We examined the striatal projections from different cytoarchitectonic regions of the insular cortex using anterograde and retrograde techniques. The shell and medial ventral striatum receive inputs primarily from the agranular and ventral dysgranular insula. The central ventral striatum receives inputs primarily from the dorsal agranular and dysgranular insula. Projections to the central ventral striatum originate from more posterior and dorsal insular regions than projections to the medial ventral striatum. The dorsolateral striatum receives projections primarily from the dorsal dysgranular and granular insula. These results show that cytoarchitectonically less differentiated (agranular) insular regions project to the ventromedial "limbic" part of the ventral striatum, whereas more differentiated (granular) insular regions project to the dorsolateral "sensorimotor" part of the striatum. The finding that the ventral "limbic" striatum receives inputs from less differentiated regions of the insula is consistent with the general principle that less differentiated cortical regions project primarily to the "limbic" striatum. Functionally, the ventral striatum receives insular projections primarily related to integrating feeding behavior with rewards and memory, whereas the dorsolateral striatum receives insular inputs related to the somatosensation. Information regarding food acquisition in the insula may be sent to the intermediate area of the striatum.

Animals↗
PubMed1998

Methodology of quality improvement projects for the Texas Medicare population.

The Texas Medical Foundation, the quality improvement organization for the state of Texas, develops local quality improvement projects for the Medicare population. These projects are developed as part of the Health Care Quality Improvement Program undertaken by the Health Care Financing Administration. The goal of a local quality improvement project is to collaborate with providers to identify and reduce the incidence of unintentional variations in the delivery of care that negatively impact outcomes. Two factors are critical to the success of a quality improvement project. First, as opposed to peer review that is based on implicit criteria, quality improvement must be based on explicit criteria. These criteria represent key steps in the delivery of care that have been shown to improve outcomes for a specific disease. Second, quality improvement must be performed in partnership with the health care community. As such, the health care community must play an integral role in the design and evaluation of a quality improvement project and in the design and implementation of the resulting quality improvement plan. Specifically, this article provides a historical perspective for the transition from peer review to quality improvement. It discusses key steps used in developing and implementing local quality improvement projects including topic selection, quality indicator development, collaborator recruitment, and measurement of performance/improvement. Two Texas Medical Foundation projects are described to highlight the current methodology and to illustrate the impact of quality improvement projects.

Angina Pectoris↗
PubMed1985

A comparison of two methods to project regional and state populations for the U.S.

"This paper is a comparison of two contrasting methods for projecting population at the regional and state levels. A projection of the U.S. Bureau of the Census employs standard demographic methods, while the population projection by Data Resources, Inc., is based on economic opportunity. The methodological differences between these two projections are discussed, and the projections for the year 2000 are compared....The U.S. Bureau of the Census projects population decline in the Northeast and rapid growth in the West while Data Resources, Inc., projects some population growth in the Northeast and less rapid growth in the West."

Americas↗
PubMed1990

The uses and users of population projections in Australia.

"It is widely recognized that population projections are increasingly used in formulating policy in many public and private sectors. However, little information exists on the nature of the projections or their users. This paper reports the results of a survey conducted to rectify this situation. The results confirm that the applications of projections are very broad and that the prime area of increase has been in small-area projections. At this level many users make their own projections rather than use official projections and the paper reviews the methodology used to make these projections. A number of suggestions are made for improving communication between national and subnational producers and local users." The geographical focus is on Australia.

Australia↗
PubMed2000

Measuring the quality of clinical audit projects.

The aim of the study was to develop and pilot a scale measuring the quality of audit projects through audit project reports. Statements about clinical audit projects were selected from existing instruments assessing the quality of clinical audit projects to form a Likert scale. Audit facilitators based in Scottish health boards and trusts piloted the scale. The participants were known to have over 2 years of experience of supporting clinical audit. The response at first test was 11 of 14 and at the second test 27 of 46. Audit facilitators tested the draft scale by expressing their strength of agreement or disagreement with each statement for three reports. Validity and reliability were assessed by test - re-test, item - total, and total - global indicator correlation. Of the 20 statements, 15 had satisfactory correlation with scale totals. Scale totals had good correlation with global indicators. Test re-test correlation was modest. The wide range of responses means further research is needed to measure the consistency of audit facilitators' interpretations, perhaps comparing a trained group with an untrained group. There may be a need for a separate scale for reaudits. Educational impact is distinct from project impact generally. It may be more meaningful to treat the selection of projects and aims, methodology and impact separately as subscales and take a project profiling approach rather than attempting to produce a global quality index.

Evidence-Based Medicine↗
PubMed2002

Distance learning project--information skills training: supporting flexible trainees in psychiatry.

This one-year project was designed to investigate the skills training needs of a group of 12 specialist registrars in psychiatry working as flexible trainees (part time) in the NHS. They had expressed concerns about their lack of information technology skills at training assessment seminars. A part-time project officer, was appointed to support the group giving information skills training to each flexible trainee on an individual basis, through a series of home visits. The project officer worked under the supervision of the London Library & Information Development Unit (LLIDU) from a home base, to identify with the insular feelings expressed by the project group. Project funding purchased a laptop computer with modem and a printer for each participant to use during the project. The training covered: basic search skills and developing search strategy techniques using quality filters particularly in relation to the MEDLINE database; how to search the Cochrane Library and PubMed and exploiting Internet information resources. The group asked for help with word processing and presentation software use. These needs were met in a series of half-day workshops. Experience and insight gained during the project will feed into future planning of information skills training for larger numbers of flexible trainees.

Education, Distance↗
PubMed1987

Tests of forecast accuracy and bias for county population projections.

"This article deals with the forecast accuracy and bias of population projections for 2,971 counties in the United States. It uses three different projection techniques and data from 1950, 1960, 1970, and 1980 to make two sets of 10-year projections and one set of 20-year projections. These projections are compared with census counts to determine forecast errors. The size, direction, and distribution of forecast errors are analyzed by size of place, rate of growth, and length of projection horizon. A number of consistent patterns are noted, and an extension of the empirical results to the production of confidence intervals for population projections is considered." A comment by Paul M. Beaumont and Andrew M. Isserman is included (pp. 1,004-9) together with a rejoinder by the author (pp. 1,009-12). This is a revised version of a paper presented at the 1986 Annual Meeting of the Population Association of America (see Population Index, Vol. 52, No. 3, Fall 1986, p. 456).

Americas↗
PubMed2003

Community governance of the Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Mohawk Nation, Canada.

Health promotion emphasizes the importance of community ownership in the governance of community-based programmes, yet little research has been conducted in this area. This study examined perceptions of community ownership among project partners taking responsibility for decision-making related to the Kahnawake Schools Diabetes Prevention Project (KSDPP). Project partners were surveyed cross-sectionally at 18 months (T1) and 60 months (T2) into the project. The perceived influence of each project partner was assessed at T1 and T2 for three domains: (i) KSDPP activities; (ii) KSDPP operations; and (iii) Community Advisory Board (CAB) activities. Project staff were perceived to have the greatest influence on KSDPP activities, KSDPP operations and CAB activities at both T1 and T2. High mean scores of perceived influence for CAB members and community researchers, however, suggests that project decision-making was a shared responsibility among multiple community partners. Although academic researcher influence was consistently low, they were satisfied with their level of influence. This was unlike community affiliates, who were less satisfied with their lower level of influence. In keeping with Kanien'kehaka (Mohawk) culture, the findings suggest a participatory democracy or shared decision-making as the primary mode of governance of KSDPP.

Adult↗
PubMed1999

Scaling the quality of clinical audit projects: a pilot study.

OBJECTIVE: To pilot the development of a scale measuring the quality of audit projects through audit project reports. DESIGN: Statements about clinical audit projects were selected from existing instruments, assessing the quality of clinical audit projects, to form a Likert scale. SETTING: The audit facilitators were based in Scottish health boards and trusts. STUDY PARTICIPANTS: The participants were audit facilitators known to have over 2 years experience of supporting clinical audit. The response at first test was 11 out of 14 and at the second test it was 27 out of 46. INTERVENTIONS: The draft scale was tested by 27 audit facilitators who expressed their strength of agreement or disagreement with each statement for three reports. MAIN OUTCOME MEASURES: Validity was assessed by test-re-test, item-total, and total-global indicator correlations. RESULTS: Of the 20 statements, 15 had satisfactory correlations with scale totals. Scale totals had good correlations with global indicators. Test-re-test correlation was modest. CONCLUSIONS: The wide range of responses means further research is needed to measure the consistency of audit facilitators' interpretations, perhaps comparing a trained group with an untrained group. There may be a need for a separate scale for reaudits. Educational impact is distinct from project impact generally. It may be more meaningful to treat the selection of projects and aims, methodology and impact separately as subscales and take a project profiling approach rather than attempting to produce a global quality index.

Female↗
PubMed2005

Advancing the clinical perspective: a practice development project to develop the nurse practitioner role in an acute hospital trust.

AIMS: The aims of this project were to investigate awareness and foster understanding of the concept of the nurse practitioner and to facilitate and support the development of nurse practitioner roles within an acute hospital trust. BACKGROUND: A limited understanding of and minimal support for the development of the nurse practitioner (NP) role were identified within an acute hospital trust in the south of England. This was the impetus for pursuing the project outlined in this paper. THEORETICAL PERSPECTIVE: The project used practice development theory synonymously with action research methodology comprising of four action research cycles. METHOD: Data were collected in a variety of ways within the four overlapping cycles using formal and informal methods, which were analysed concurrently during the project. Techniques included questionnaires, semi-structured interviews, meetings, discussions and the project leader's field notes' diary. OUTCOMES: A better understanding of the concept and support for NP posts were enhanced across the trust. A Nurse Practitioner Development Group (NPDG) was established, which helped to facilitate the development of NP posts. An example of such a post was established within a NP-led gynaecology pre-operative assessment clinic, which was a pilot project and constituted Action Research cycle 3. CONCLUSION: It is concluded that the development of NP roles, with the support of a NPDG, within an agreed strategy offers a robust process for NP development within an acute hospital setting. RELEVANCE TO CLINICAL PRACTICE: This project demonstrated how practice development and action research might be used together as a systematic process for developing and supporting professional roles that aim to improve the quality of patient care and the effectiveness of health care services.

Acute Disease↗