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PubMedDate not supplied

Source of service and visit rate for family planning services: United States, 1982.

The factors that affect how women choose their source of family planning care and how often they go for such care were investigated in the National Survey of Family Growth. The survey is based on a national sample of women 15-44 years of age interviewed in 1982, 4,318 of whom had family planning visits in the last 3 years. In contrast, previous research has been based on small, nonrepresentative samples, usually in one or a few locations or limited to visits to either private doctors or clinics, but not both; been limited to teenagers; or had no multivariate analysis. This study overcomes those limitations. When other variables were controlled, race, income, and insurance coverage had important effects on provider choice; marital status was important for white women, but not for black women. Contraceptive method, insurance coverage, and race were important determinants of the frequency of family planning visits, independent of other variables. It is suggested that relative costs or ability to pay, confidentiality, knowledge of alternative sources, and convenience of location affect choice of provider and visit rates.

Adolescent↗
PubMed2005

Comparisons of NMR spectral quality and success in crystallization demonstrate that NMR and X-ray crystallography are complementary methods for small protein structure determination.

X-ray crystallography and NMR spectroscopy provide the only sources of experimental data from which protein structures can be analyzed at high or even atomic resolution. The degree to which these methods complement each other as sources of structural knowledge is a matter of debate; it is often proposed that small proteins yielding high quality, readily analyzed NMR spectra are a subset of those that readily yield strongly diffracting crystals. We have examined the correlation between NMR spectral quality and success in structure determination by X-ray crystallography for 159 prokaryotic and eukaryotic proteins, prescreened to avoid proteins providing polydisperse and/or aggregated samples. This study demonstrates that, across this protein sample set, the quality of a protein's [15N-1H]-heteronuclear correlation (HSQC) spectrum recorded under conditions generally suitable for 3D structure determination by NMR, a key predictor of the ability to determine a structure by NMR, is not correlated with successful crystallization and structure determination by X-ray crystallography. These results, together with similar results of an independent study presented in the accompanying paper (Yee, et al., J. Am. Chem. Soc., accompanying paper), demonstrate that X-ray crystallography and NMR often provide complementary sources of structural data and that both methods are required in order to optimize success for as many targets as possible in large-scale structural proteomics efforts.

Animals↗
PubMed2003

Worm control practices and anthelmintic usage in traditional and dairy cattle farms in the southern highlands of Tanzania.

Worm control practices and anthelmintic usage in 177 cattle farms in Iringa district in the southern highlands of Tanzania was determined through a questionnaire survey. A total of 76 traditional, 92 small-scale dairy and 9 large-scale dairy cattle farms were included in the survey. Results indicated that 87.7% traditional, 97.8% small-scale dairy and 100% large-scale farmers relied solely on the use of anthelmintics, 2.7% traditional farmers used traditional medicines while 9.6% traditional farmers had not any form of worm control practice. Worm infection was ranked the second most important constraint of productivity in cattle in the three production systems. Most farms (57.6% traditional, 35.8% small-scale dairy, 66.7% large-scale dairy) used anthelmintics with a combination of levamisole and oxyclozanide. Benzimidazoles were used only in traditional (25.4%) and small-scale dairy (32.1%) farms while nitroxynil (Trodax) was mostly used in large-scale dairy farms (33.3%). Generally, 40% of farmers treated three or four times a year and the frequency in some farms was surprisingly high for resource poor small-scale farmers. The frequency of anthelmintic treatment was mostly the same regardless of the management system. Treatments in most farms depended on availability of money and drugs and not the epidemiology of parasites. A significant proportion (46.3%, P=0.007) of farmers especially in rural areas failed to follow their pre-planned treatment schedules due to lack of money (86%) and unavailability of drugs (6.6%). Many farmers (58.9%) had used the same type of anthelmintic for four or more consecutive years and 85.3% of them would continue with the same anthelmintic. Farmers in all management systems mostly purchased anthelmintics from private veterinary drug shops and about 43% traditional and 33.3% small-scale dairy farmers mostly in rural areas obtained anthelmintics from village extension officers. Despite the fact that all farmers were aware of worm infection and the associated signs in cattle, 42.5% had poor knowledge on the source of worm infection. Small-scale dairy farmers allowed only a 1-day withdraw period for milk regardless of the type of anthelmintic used and there was no milk and slaughter clearance in traditional farms. It was concluded from this study that worm control in Iringa faces serious constrains and that education of farmers and farm hands is not adequate. Moreover, poor quality control and high price of potent anthelmintics, few extension workers, low income and low education among farmers contributed significantly to erratic worm control practices and anthelmintic usage in peri-urban and rural areas.

Animals↗
PubMed1990

Uncertainties in dosimetric data and beam calibration.

Recent studies indicate that the calibration of therapeutic beams is one of the main sources of uncertainty in the mean absorbed dose to the target volume in radiotherapy. Interaction coefficients and data used through the different steps in the calibration are pointed out as the main contribution to this uncertainty. Procedures used to select dosimetric data, that is, input parameters used in the specification of the quality of the beam, cause another contribution. In this paper the actual status of the data used for the dosimetry of photon and electron beams is introduced first. Uncertainties along the dosimetric chain are analyzed according to the procedure and data used in recent publications. Uncertainties in stopping-power ratios, considered the main contribution, are discussed in detail starting from the basic electron stopping-power data. Overall uncertainties in the presently available set of stopping-power ratios are analyzed. Recent developments in the dosimetry of electron beams, related to the effect of energy and angular spread and electron and photon contamination, are discussed in connection with the procedure to select stopping-power ratios for clinical dosimetry. Uncertainties along the dosimetric chain are evaluated in terms of the present knowledge of error sources.

Calibration↗
PubMed1996

Aspects of follicle and oocyte stage that affect in vitro maturation and development of bovine oocytes.

Success of in vitro maturation (IVM) and production of bovine embryos as related to aspects of follicle source and oocyte size were evaluated. First, it was determined that bovine oocytes continue growing in all follicular sizes studied, including >1- to 15-mm follicles. Populations of oocytes were collected from surface visible (peripheral) and cortical follicles from the same ovaries. When the number of oocytes from both peripheral and cortical follicles was combined, the yield of oocytes was approximately double that collected from 1 ovarian site alone. Oocytes from cortical follicles were smaller than those from the surface population, and the smaller cortical oocytes had a lower potential for both meiotic maturation and embryo development Only cortical oocytes with the largest diameters underwent IVM and subsequently developed to blastocysts at rates comparable to oocytes from peripheral follicles. As the diameter of the oocytes recovered from peripheral follicles increased, so did their developmental potential. When the stage of the estrous cycle was observed, it was found to have no effect on developmental potential. Finally, oocytes which extruded polar bodies at an earlier time during maturation were, on average, larger than those which extruded polar bodies later. The results serve a practical purpose in assisting selection of oocytes capable of developing into blastocysts and they give useful correlates of oocyte competencies based on knowledge of follicle source and oocyte stage.

Journal Article↗
PubMed1998

Demographic and socioeconomic determinants of variation in food and nutrient intake in an Andean community.

Understanding the sources of variation in a community's diet is vital for development work, as well as being a source of anthropological and cultural insights. Previous surveys in the South American Andes suggest that nutrient deficiencies may be widespread; however, such interpretations have remained tentative since variance in Andean populations' diet has not been thoroughly examined. In this paper we consider the variation in diet due to variation in age, sex, and socioeconomic status and variation attributed to inter- and intraindividual variation in the diet. One to six days of dietary data (mean = 3.1) were collected via 24 h recalls from 221 residents of a small, rural community in highland Ecuador. The contribution of various food groups to the diet varied with land holdings and age but not sex. For example, animal-derived foods contribute more and tubers contribute less to the diet of the households with > or = 5 Ha, and sweets contribute more to the diet of children. The interindividual variation in energy and nutrient intake was low and the intraindividual variation high relative to developed countries. The consequence are twofold. First, because interindividual variability is low, group mean intake can be estimated relatively easily, facilitating group comparisons. Second, because intraindividual variation is high, individual nutrient intake cannot be easily estimated, which will decrease the ability to detect associations between nutrient intake and health measures. This knowledge of the sources of dietary variation can lead to better study and survey designs in the rural Andes and elsewhere in the developing world.

Adolescent↗
PubMed2002

Preparing medical students to teach.

OBJECTIVE: Residents do a significant amount of teaching. Therefore, as medical students prepare for the clinical aspects of their residency, it is also important for them to prepare for their role of physician as teacher. With the goal of offering fourth-year students an opportunity to enhance their teaching skills, an elective was designed that presented them with an opportunity to expand their knowledge base in education, and then apply and practice this new set of knowledge. A week-long elective, Physician as Teacher, was designed to encompass core educational information such as needs assessment of learners, establishing goals and objectives, teaching methods, and evaluation and feedback. This core information was then applied and enriched during an end-of-course teaching presentation. Aside from this course, there is no forum during their undergraduate medical training for the students to acquire knowledge and skills about how to be teachers. DESCRIPTION: The course was developed with the appreciation that application of knowledge is a rich source of learning. The course began with interactive classroom teaching sessions designed to facilitate acquisition of core educational knowledge. Sessions topics included assessment of learner needs, methods of teaching, learning styles, microprecepting, and feedback. Also incorporated were sessions on facilitating small groups, and teaching and learning how to use technology. Those classroom sessions were then enhanced by a complement of sessions that asked the students to apply their new knowledge to clinical situations. Those more application-based sessions included observation and follow-up discussion of clinical teaching and small-group teaching sessions with the goal of developing the students' skills with respect to the teaching and learning process. An end-of-course teaching presentation by each student provided them with a capstone experience of applying the knowledge and skills learned throughout the week. The topic of the teaching presentation was of their choosing, and could incorporate technology. Each student's teaching presentation was videotaped, immediately viewed by the student, and discussed using a structured format of facilitated feedback. DISCUSSION: Students reported that the end-of-course teaching presentation was a rich source of their learning, and an important vehicle for helping them apply and synthesize the new knowledge. Fifteen percent of fourth-year students enrolled in and completed the elective. Seventy-one percent of those students "strongly agreed" and 29% "agreed" that the course provided useful knowledge and skills. Seventy-nine percent "strongly agreed" and 21% "agreed" that their teaching would be better because of the course. Based on comments, the students appeared to feel that the experience of presenting a teaching session at the end of the course was a rich source of their learning, and helped them to apply and synthesize the new knowledge. Students noted, "the teaching project was an excellent idea to see how much we have learned; I never realized what a responsibility we have as residents to teach our peers; I have been enlightened this past week and will now consciously make an effort to share what little information I currently have; I will be a better teacher because I have been given the appropriate tools."

Education, Medical, Undergraduate↗
PubMed1979

Psychoanalytic training. Problems and perspectives.

The increasing prolongation of the didactic analysis and supervisory hours that has occurred in most psychoanalytic institutes over the past several decades has not only failed to guarantee a better trained and more scientific group of psychoanalysts, but, because of the unhealthy and authoritarian hegemony of training analysts over their candidates, may be having a contrary effect of fostering rigidity and dogmatism. If psychoanalysis is to remain vital, it must be open to growth and change like any other branch of science and its practitioners must be flexible and open to new vistas of knowledge from whatever source. A suggestion is offered that would enable psychoanalytic candidates, in most instances, to complete their training within a four-year period.

Education, Medical, Graduate↗
PubMed1996

Interlaboratory variability in fluorescence in situ hybridization analysis. The NCI Bladder Tumor Marker Network.

Reliable interpretation of fluorescence in situ hybridization (FISH) data, especially data that have been generated in more than one laboratory, requires knowledge of the sources of variability inherent in FISH analysis. Possible sources of variation may derive from differences in sample preparation, probes used, intrasample heterogeneity, hybridization protocols, counting criteria within and between scorers, fluorescence microscopes, and filters. This study characterized the relative weight of some of these factors in order to determine the degree to which FISH results are comparable between laboratories. We used a hierarchical partitioned chi 2 analysis to measure sources of variation. We found that replicate counts varied no more than expected based on counting statistics (i.e., multinomial variation). However, with replicate hybridizations done in two separate laboratories, the variability increased significantly. Thus, care must be taken when interpreting FISH data that are derived from more than one institution. Previously agreed upon counting criteria as well as standardized FISH hybridization protocols may decrease this variability.

Chi-Square Distribution↗
PubMed2005

PROTICdb: a web-based application to store, track, query, and compare plant proteome data.

PROTICdb is a web-based application, mainly designed to store and analyze plant proteome data obtained by two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) and mass spectrometry (MS). The purposes of PROTICdb are (i) to store, track, and query information related to proteomic experiments, i.e., from tissue sampling to protein identification and quantitative measurements, and (ii) to integrate information from the user's own expertise and other sources into a knowledge base, used to support data interpretation (e.g., for the determination of allelic variants or products of post-translational modifications). Data insertion into the relational database of PROTICdb is achieved either by uploading outputs of image analysis and MS identification software, or by filling web forms. 2-D PAGE annotated maps can be displayed, queried, and compared through a graphical interface. Links to external databases are also available. Quantitative data can be easily exported in a tabulated format for statistical analyses. PROTICdb is based on the Oracle or the PostgreSQL Database Management System and is freely available upon request at the following URL: http://moulon.inra.fr/ bioinfo/PROTICdb.

Computer Graphics↗
PubMed1977

[Coronary embolism in the medico-legal autopsy material (author's transl)].

The author discusses the problem of diagnosis and evaluation of coronary embolism (CL). He presents four cases of his own observation, including histological examinations and a review of the pertinent literature. The following facts are necessary to make the diagnosis of CE: 1. An embolus consisting of foreign elements like tumor-cells, suture material or similar things. 2. Dilatation of the arterial lumen where the embolus is found. 3. No adherence between the embolus and the arterial wall. 4. Normal consistence of the arterial wall. 5. Knowledge of the source of the embolus. 6. Histomorphological conformity of the source of the embolus and the embolus itself. The mechanisms of flow and the interrelation between trauma and CE which are often difficult to judge in forensic medicine are discussed.

Adult↗
PubMed1980

Community mental health centers and the elderly: a time for expansion of planning, research, and demonstration projects.

The purpose of this paper is to acquaint persons working in Community Mental Health Centers with federal funding resources which support planning, research, and demonstration projects related to mental health and aging. The significance of exploration by CMHCs into the aging area is suggested by the legislative histories of CMHCs and aging programs, our expanding aging population which requires increasing health and mental health services, and the growing number of resources available for the development of services related to aging. Principal funding sources related to mental health and aging are: Alcohol, Drug Abuse and Mental Health Administration, National Institutes of Health; Administration on Aging; and Health Care Financing Administration. Each funding source is presented through a review of five key items: 1) name of program; 2) objectives; 3) funds awarded; 4) legislative mandate; and 5) contact person and address. Program areas for each funding source are discussed. Knowledge of these funding resources should enable CMHCs to plan services and to expand capabilities to serve the growing over-60 population.

Aged↗
PubMed1995

Kinetic images of neuronal activity of the human brain based on the spatio-temporal MNLS inverse: a theoretical study.

Prior work proved that it is possible to find a unique solution to the problem of defining the configuration of electric current underlying observed extracranial magnetic fields, if sufficient priori knowledge of the source configuration is available. This minimum-norm least-squares (MNLS) inverse solution for a magnetic source image (MSI) is extended here to include temporal as well as spatial parameters of the underlying current pattern. This capitalizes on the temporal resolution of magnetoencephalography (MEG), which is on the order of milliseconds. Other forms of functional brain imaging are far less sensitive to the rate of change of states of the brain. Influences on the quality of the resulting MSI by measurement noise and errors in determining the image surface are characterized. A new technique for reducing noise in the inverse problem is developed by taking into consideration the spatial and time-dependence of the noise detected by the sensors. This new approach to regularization reduces the contribution from noisy measurements to the inverse calculation, and therefore improves the stability of the inverse.

Brain Mapping↗
PubMed1996

Adaptive Management: Promises and Pitfalls

Proponents of the scientific adaptive management approach argue that it increases knowledge acquisition rates, enhances information flow among policy actors, and provides opportunities for creating shared understandings. However, evidence from efforts to implement the approach in New Brunswick, British Columbia, Canada, and the Columbia River Basin indicates that these promises have not been met. The data show that scientific adaptive management relies excessively on the use of linear systems models, discounts nonscientific forms of knowledge, and pays inadequate attention to policy processes that promote the development of shared understandings among diverse stakeholders. To be effective, new adaptive management efforts will need to incorporate knowledge from multiple sources, make use of multiple systems models, and support new forms of cooperation among stakeholders.

Journal Article↗
PubMed2004

[Use of information on nosocomial outbreaks for infection control].

Outbreaks of nosocomial infections can be associated with significant morbidity in the patients involved and require time, effort, and resources. In addition, they may lead to panic reactions among health care workers and patients as well as the community. However, their systematic analysis can contribute to knowledge about the sources and transmission of nosocomial infections and the best methods for prevention. Furthermore, the results of outbreak investigations may serve as a valuable tool for education. That is why a systematic register of nosocomial outbreaks would be a very useful instrument for people working in the field of nosocomial infection control. This article describes the need for a systematic collection of outbreaks published in the literature and an available possibility for filling this gap.

Adult↗
PubMed1997

[Skin disease and sexuality. An empirical study of sex behavior or patients with psoriasis vulgaris and neurodermatitis in comparison with skin-healthy probands].

Fifty-three patients with psoriasis, 24 patients with atopic eczema and 52 controls with healthy skin were compared with regard to their sexual behavior. For the test, questionnaires developed by Arentewicz as well as our own questionnaire on sexuality and partnership were used. Patients with skin diseases had a significantly impaired sex life, compared to those with healthy skin. There was a highly significant reduction in the exchange of tenderness in patients of both sexes, and in the capacity for orgasm in female patients. On the other hand, no significant difference was found concerning the frequency of intercourse. Patients with psoriasis felt more impaired than those with atopic eczema. Ninety-three percent of psoriatics and 96% of patients with atopic eczema had not been asked about their sexual life by their attending doctor. We discuss to what extent skin diseases are possibly involved in the regulation of nearness and distance among partners. The dermatologist should a be knowledgeable and understanding source for patients which skin diseases who have questions about their disease and its effect on their sex life.

Adult↗
PubMed2004

[The incorrect laboratory result. Part 1: Pre- and postanalytical phase].

Laboratory results play a key role in the diagnostic procedure, the decision of treatment and the follow up of diseases. A high validity of the laboratory result is an important precondition for the efficacy in clinical medicine. Analytical standards have been developed under strong quality control criteria, however, there are no sufficiently defined standards for the pre- and postanalytical phase in laboratory diagnostics. Thus, most of laboratory errors are caused by pre- and postanalytical mistakes. The competent knowledge of possible sources for laboratory errors is a critical precondition for their avoidance. Diagnostic sensitivity and specificity play an important role for the choice of a laboratory test, whereas the predictive value should be considered for the medical relevance of the test result. In addition, many interference factors, which may influence the results of the laboratory tests have to be considered as age, sex, race, lifestyle, drugs, pregnancy, specimen collection, quality and handling as well as special factors, which may influence the complex of immunological and molecular diagnostics.

Blood Chemical Analysis↗
PubMed2005

Mathematical models for the early detection and treatment of colorectal cancer.

Colorectal cancer is a major cause of death for men and women in the Western world. When the cancer is detected through an awareness of the symptoms by a patient, typically it is at an advanced stage. It is possible to detect cancer at an early stage through screening and the marked differences in survival for early and late stages provide the incentive for the primary prevention or early detection of colorectal cancer. This paper considers mathematical models for colorectal cancer screening together with models for the treatment of patients. Illustrative results demonstrate that detailed attention to the processes involved in diseases, interventions and treatment enable us to combine data and expert knowledge from various sources. Thus a detailed operational model is a very useful tool in helping to make decisions about screening at national and local levels.

Colorectal Neoplasms↗