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PubMed1999

A partnership for community-based nursing experience: Head Start/Harper College.

In an effort to provide a meaningful community-based nursing experience for the students of William Rainey Harper College, a project was developed with the Community Economic Development Association of Cook County, Illinois to link second-year nursing students and clients in a Head Start program. The goals were designed to meet the needs of both the students and the Head Start clients. The students provided a portion of the health service plan for the Head Start families, and at the same time they received a comprehensive community/family learning experience. Throughout the second year of the nursing program the students followed their assigned family utilizing a unique integration of pediatric and psychiatric nursing concepts. The article will outline the project from development to completion of the first year of student involvement. It will address successes, failures, and changes made in the second year of the program.

Child, Preschool↗
PubMed2006

A web-based smoking cessation and prevention curriculum for medical students: why, how, what, and what next.

This paper summarises some major developments in medical education relating to the health risks of tobacco and to training in tobacco cessation and prevention strategies, and discusses some of the barriers to training. We also describe a project whose purpose was to design, implement and evaluate a web-based self-study tobacco curriculum for medical students to teach medical students to assist smokers to quit and to counsel non-smoking adolescents not to start smoking. This curriculum addresses some of the barriers, namely lack of curriculum time, lack of access to materials and experts, and relevance of the materials. The project was designed and evaluated at two medical schools in Georgia: Morehouse School of Medicine and Mercer University School of Medicine. A curriculum on tobacco control strategies and techniques designed for use in clinical settings was made available to first-year medical students as interactive computer-based tutorials. The curriculum, based on the US Public Health Service Clinical Guideline for Treating Tobacco Use and Dependence, was divided into two parts: the tutorial and practicum sections. Pre- and post-exposure measures were collected for the evaluation. The mean differences for correctly answered knowledge items in the two schools were similar: mean for Morehouse was +2.07 and for Mercer +1.67, indicating improvements in knowledge for both schools. There were statistically significant improvements in all categories of self-rated ability to perform six counselling skills, except for Mercer students for the 'Ask' skill category (p=0.069). The amount of exposure (measured only at Morehouse) was not related to overall change in scores but was associated with self-reported improvement in skill in assisting patients to quit smoking, confidence in counselling patients not interested in quitting, and confidence in counselling teens. The web-based curriculum successfully improved the students' self-rated counselling skills. Given the need and desire on the part of practitioners for training, the curriculum may be found useful by practising physicians and other health-care professionals who wish to improve their skills in smoking prevention and cessation.

Adult↗
PubMed2025

Estimated Long-Term Benefits of Finerenone in Heart Failure: A Prespecified Secondary Analysis of the FINEARTS-HF Randomized Clinical Trial.

IMPORTANCE: People living with heart failure (HF) with mildly reduced or preserved ejection fraction have substantially curtailed life expectancy free from clinical events compared with their peers of comparable age. The nonsteroidal mineralocorticoid receptor antagonist, finerenone, was recently shown to reduce risks of cardiovascular events in this population over a median follow-up of 2.6 years; as patients with HF typically continue treatment beyond this time frame, estimating the potential long-term benefits of finerenone could inform shared clinical decision-making. OBJECTIVE: To estimate the projected long-term treatment effects of finerenone in patients with HF with mildly reduced or preserved ejection fraction if treated over a patient's lifetime. DESIGN, SETTING, AND PARTICIPANTS: Prespecified analyses were conducted of the FINEARTS-HF trial, a phase 3 randomized clinical trial conducted across 653 sites in 37 countries. Adults 40 years and older with symptomatic HF and left ventricular ejection fraction of 40% or greater were randomized from September 2020 to January 2023. Median (IQR) follow-up was 2.6 (1.9-3.0) years. INTERVENTIONS: Finerenone (titrated to either 20 mg or 40 mg) or placebo. MAIN OUTCOMES AND MEASURES: The primary composite outcome was time to cardiovascular death or worsening HF event. The long-term gains in survival free from a primary end point with finerenone were iteratively estimated with age-based Kaplan-Meier curves using age at randomization rather than time from randomization. Differences in areas under the survival curves between the finerenone and placebo arms represented event-free survival gains. RESULTS: Among 6001 participants (median [IQR] age, 73 [66-79] years; 3269 male [54.5%]), mean survival free from the primary end point for a 55-year-old participant was 13.6 years (95% CI, 11.9-15.2 years) with finerenone and 10.5 years (95% CI, 6.8-11.3 years) with placebo, representing a gain in event-free survival of 3.1 years (95% CI, 0.8-5.4 years; P = .007). Mean event-free survival for a 65-year-old participant was 11.0 years (95% CI, 10.1-11.9 years) with finerenone and 8.9 years (95% CI, 8.1-9.8 years) with placebo, representing a gain of 2.0 years (95% CI, 0.8-3.3 years; P = .001). Projected mean event-free survival was numerically greater with finerenone than with placebo for every starting age between 50 to 80 years. Lifetime gains in event-free survival were observed even among individuals already treated with a sodium-glucose cotransporter 2 inhibitor (65-year-old participant: 3.1 years; 95% CI, 0.1-6.0 years; P = .04). CONCLUSIONS AND RELEVANCE: In this prespecified secondary analysis of the FINEARTS-HF randomized clinical trial, long-term treatment with finerenone was estimated to extend event-free survival by up to 3 years among people with HF with mildly reduced or preserved ejection fraction. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04435626.

Humans↗
PubMed1990

Progress towards boron neutron capture therapy at the High Flux Reactor Petten.

During 1988 the first positive steps were taken to proceed with the design and construction of a neutron capture therapy facility on the High Flux Reactor (HFR) at Petten. The immediate aim is to realise within a short time (summer 1989), an epithermal neutron beam for radiobiological and filter optimisation studies on one of the 10 small aperture horizontal beam tubes. The following summer, a much larger neutron beam, i.e., in cross section and neutron fluence rate, will be constructed on one of the two large beam tubes that replaced the old thermal column in 1984. This latter beam tube faces one whole side of the reactor vessel, extending from a 50 x 40 cm input aperture to a 35 x 35 cm exit hole. The radiotherapeutic facility will be housed here, with the intention to start clinical trials at the beginning of 1991. This paper describes the present status of the project and includes: a general description of the pertinent characteristics with respect to NCT of the HFR; results of the recently completed preliminary neutron metrology and computer modeling at the input end of the candidate beam tube; the structure and planning of the proposed Work Programme; and the respective direct and indirect participation and collaboration with the Netherlands Cancer Institute and the European Collaboration Group on BNCT.

Animals↗
PubMed1993

A note on the low-dimensional display of multivariate data using neural networks.

A novel neural network technique has been proposed (Livingstone et al. J. Mol. Graphics 1991, 9, 115-118) which is useful for a low-dimensional display of multivariate data sets. The method makes use of the activity values of the hidden neurons in a trained three-layer feed-forward network to produce the low-dimensional display. It was claimed that in contrast to conventional techniques, such as principal components analysis or nonlinear mapping, this technique could be used also to reconstruct, from a given point in the low-dimensional display, the corresponding multivariate input vector via the completely known weight matrices of a suitably trained network. We show here that this claim is unjustified in this general form. When previously unknown, grossly different input vectors are presented to the trained network, they can occupy, for example, exactly the same point in the low-dimensional display which is occupied also by a given training vector, if certain linear relationships between the vector components are fulfilled. Thus, an infinite set of different linearly dependent input vectors is projected onto one single point in the low-dimensional display. Reconstruction of a multivariate vector, starting from this point in the low-dimensional display, is able to lead back to only one multivariate vector (in the example given, to the original training vector).

Guanine↗
PubMed2003

Blood pressure self-surveillance for health also reflects 1.3-year Richardson solar wind variation: spin-off from chronomics.

Self-experimentation concerns not only scientists, but also each individual for the sake of his/her chronobiologic health and science literacy, eventually to be acquired in primary and secondary education. Public education ensures that everybody who knows how to read or write can dispense with the service of a costly scribe. At all ages, public education can teach equally well how to find out whether one's blood pressure (BP) and heart rate (HR) responds to an increase in sodium intake with a rise, with no change or with a decrease in BP. This task and many others could become a matter of informed self-surveillance. Whenever there are inter-individual, sometimes opposite differences in response, government-sponsored trials on groups that do not consider such differences cannot solve what only the individual can do, at first by help from schools. Eventually special institutions may be designed for chronomics, the monitoring, interpretation and archivization of chronomes (time structures; from chronos = time and nomos = rule) of biological variables, also charged with a demographic analyzing and reporting system. Each individual's properly coded record, to guard confidentiality, becomes part of a promptly accessible database for one's own needs and for society's requirements. What individuals and small groups started as chronobiology, what is immediately available on back burners, as a service by an international project on the biosphere and the cosmos (BIOCOS) (corne001@umn.edu) could become a public system of planned surveillance archivization of one's rhythms from womb to tomb. Alterations of a rhythm's amplitude or acrophase or of a deterministic or other chaotic endpoint, such as a correlation dimension and approximate entropy, or of a standard deviation, among a multitude of other endpoints, can signal (in the otherwise neglected normal range) reversible risk elevations. If these elevated risks are detected and prompt the institution of countermeasures, such prehabilitation can save the cost of rehabilitation or of long-term care after morbid events; suffering also can be prevented such as that by those who are unlucky enough to helplessly survive a massive brain, heart or societal "stroke". As an equally important dividend, science gains in basic and applied terms, as illustrated herein by the demonstration of a trans-year, an approximately 1.3 to 1.6-year, heretofore unknown component of the human BP and HR spectrum, beating with the circannual component and characterizing the same data. Chronomically interpreted self-monitoring is a civic duty for both one's health and everybody's science.

Blood Pressure Monitoring, Ambulatory↗
PubMed2005

Micronutrient status and fertilizer use scenario in India.

India was dependent on external food supplies in the early 1960s. To meet the growing demand for food, fiber and fuel, high yielding cultivars were introduced. These high yielding crop cultivars were highly responsive to fertilizers. Thus, slowly the soils were exhausted of their nutrients. Application of major nutrients (nitrogen, phosphorus, potassium) became common, therefore the crops started responding to micronutrient fertilizers. Concerted efforts have been made through the All India Coordinated Research Project on Micronutrients to delineate the soils of India regarding the deficiency of micronutrients. At present about 48.1% of Indian soils are deficient in diethylene-triaminepentaacetate (DTPA) extractable zinc, 11.2% in iron, 7% in copper and 5.1% in manganese. Apart from the deficiency of these micronutrients, deficiencies of boron and molybdenum have also been reported in some areas. Areas with multi-micronutrient deficiencies are limited, thus simple fertilizers are sufficient to exploit the potential of crops and cropping systems. Based on the extent of deficiency, cultivated area, and crop removal, the micronutrient fertilizer demand in 2025 is projected using sufficiency and maintenance approaches.

Fertilizers↗
PubMed2002

Synexpression analysis of ESTs in the rat brain reveals distinct patterns and potential drug targets.

The gene expression profiles of 146 novel ESTs were characterized in newborn and adult rat brains via radioactive in situ hybridization. Using Euclidean metrics and hierarchical clustering tools the brain expression profiles obtained clustered into seven synexpression groups. The groups were: I, non-detectable expression (68 ESTs); II, low expression in hippocampus (40 ESTs); III, low expression in adult, high expression in newborn (two ESTs); IV, medium expression throughout brain (31 ESTs); V, high expression throughout brain (three ESTs); VI, selective high expression in hippocampus, caudate and putamen (one EST); VII, selective high expression in hippocampus (one EST). Five ESTs were expressed in the striatum and three responded transcriptionally to neuroleptic and neuroprotective drug treatments, suggesting that this approach could be used to detect novel drug targets. These results provide a useful starting point to explore the functional genomics of genes without known functions forthcoming from various genome projects.

Animals↗
PubMed2002

Un lugar seguro para sus ninos: development and evaluation of a pesticide education video.

The need exists for culturally appropriate and effective educational interventions to reduce pesticide exposure in migrant and seasonal farm-worker (MSFW) communities. The development of one such intervention was part of a community-based research project which partnered the Oregon Health Sciences University and the Oregon Child Development Coalition (Migrant Head Start). The process involved identifying an optimal educational method and content, evaluating existing educational materials on pesticides, developing the selected educational tool (a video), and assessing the effectiveness of the video as an intervention. Focus groups were conducted with MSFWs to elicit their perceived need for education and desired content, method, and delivery. Four currently used educational tools were evaluated for satisfaction, preference, recall ability and knowledge change. Based on these findings, a pesticide exposure video directed at the protection of children was produced. To determine the effectiveness of the video, knowledge, satisfaction and self-reported behaviors were assessed with MSFWs. A sizeable increase in overall pesticide knowledge was measured after seeing the video (p < 0.0001). MSFWs overall were satisfied with the video and reported increased protective behaviors after seeing the video.

Journal Article↗
PubMed2001

Collecting and harvesting biological data: the GPCRDB and NucleaRDB information systems.

The amount of genomic and proteomic data that is entered each day into databases and the experimental literature is outstripping the ability of experimental scientists to keep pace. While generic databases derived from automated curation efforts are useful, most biological scientists tend to focus on a class or family of molecules and their biological impact. Consequently, there is a need for molecular class-specific or other specialized databases. Such databases collect and organize data around a single topic or class of molecules. If curated well, such systems are extremely useful as they allow experimental scientists to obtain a large portion of the available data most relevant to their needs from a single source. We are involved in the development of two such databases with substantial pharmacological relevance. These are the GPCRDB and NucleaRDB information systems, which collect and disseminate data related to G protein-coupled receptors and intra-nuclear hormone receptors, respectively. The GPCRDB was a pilot project aimed at building a generic molecular class-specific database capable of dealing with highly heterogeneous data. A first version of the GPCRDB project has been completed and it is routinely used by thousands of scientists. The NucleaRDB was started recently as an application of the concept for the generalization of this technology. The GPCRDB is available via the WWW at http://www.gpcr.org/7tm/ and the NucleaRDB at http://www.receptors.org/NR/.

Binding, Competitive↗
PubMed2002

MIPS Arabidopsis thaliana Database (MAtDB): an integrated biological knowledge resource based on the first complete plant genome.

Arabidopsis thaliana is the first plant for which the complete genome has been sequenced and published. Annotation of complex eukaryotic genomes requires more than the assignment of genetic elements to the sequence. Besides completing the list of genes, we need to discover their cellular roles, their regulation and their interactions in order to understand the workings of the whole plant. The MIPS Arabidopsis thaliana Database (MAtDB; http://mips.gsf.de/proj/thal/db) started out as a repository for genome sequence data in the European Scientists Sequencing Arabidopsis (ESSA) project and the Arabidopsis Genome Initiative. Our aim is to transform MAtDB into an integrated biological knowledge resource by integrating diverse data, tools, query and visualization capabilities and by creating a comprehensive resource for Arabidopsis as a reference model for other species, including crop plants.

Arabidopsis↗
PubMed1997

Attitudes toward the unconscious.

As a keynote to a conference bringing together psychoanalysts and analytical psychologists, this paper addresses different mythic attitudes toward the unconscious, starting with the caricatures of Oedipus and Narcissus that the author feels Jung and Freud originally projected onto each other in the course of their quarrel. He moves on to the fairytale-like stories of Perseus and Beauty and the Beast to discover more complex images of the stance taken in relation to the unconscious by present-day analysts working within both the Jungian and the Freudian traditions.

Attitude↗
PubMed1991

Documenting a time-bound, circular view of hierarchies: a microanalysis of parent-infant dyadic interaction.

This article presents a new theory that separates the levels of communication and relates them circularly, namely, by separating time from space/meaning variables. Documenting this proposition requires sequential microdescriptions--a far-out project in the field of family therapy. In an extensive study of clinical and nonclinical families, starting with available microanalytic data on nonverbal parent-infant dialogue, distinct time organizations have been found to modify the degree of circularity between the levels of interaction according to the observed types of engagement, that is, consensual, conflictual, and paradoxical. The double description of the dyad as a totality versus the dyad as a framing/developing organization imparts crucial information on how development proceeds in dyadic, co-evolutive systems, and presumably in larger ones too. In this perspective, a model is elaborated and then applied to a case description in our therapeutic consultation.

Communication↗
PubMed1995

Novel heuristics of functional neural networks: implications for future strategies in functional neurosurgery.

A hypothesis is proposed that (a) the skeletomotor basal ganglia-thalamocortical loop functions as a model of the behavior of the body and the environment, and that (b) dopaminergic neurons of the substantia nigra pars compacta comprise the substrates of an error distribution system projecting to the striatum. This error signal initiates the learning process in the basal ganglia - learning starts with increasing intensity of the error signal and is complete when the signal is minimized. Parkinson's disease (PD) may be considered as a disruption of learning processes in the basal ganglia that results from progressive degeneration of the substrate that is the error distribution system for this functional motor loop. Numerous clinical and experimental observations obtained from functional procedures for PD that show identical clinical effects in alleviating parkinsonian symptoms, e.g. thermocoagulative lesions and chronic stimulation, can be explained through the use of this conceptual theory of basal ganglia function. Because any controlling neural network must possess a model of the behavior of its controlled object, the heuristics outlined in this theory are broadly applicable for explaining the function of the nervous system, as well as being useful for planning surgical procedures and future strategies in functional neurosurgery.

Basal Ganglia↗
PubMedDate not supplied

Lymphatic mapping and sentinel node identification in squamous cell carcinoma and melanoma of the head and neck.

AIM: The aim of our study was to evaluate the role of scintigraphy in lymphatic mapping and in the identification of the sentinel lymph node (SLN) in patients with head and neck cancer. METHODS: Between September 1999 and February 2001 we enrolled 22 consecutive patients with cancer in the head and neck region: five squamous cell carcinomas, one Merkel cell tumor of the cheek, and 16 malignant melanomas. Lymphoscintigraphy was performed three hours before surgery after injection of 30-50 MBq of 99mTc -Nanocoll in 0.3 mL; the dose was fractionated by injecting the radiotracer at two points around the lesion. Static acquisition (anterior and/or lateral views, 512 x 512 matrix, 5 mins pre-set time) was started immediately after the injections so as to visualize the pathways of lymphatic drainage. The skin projection of the SLN was marked with ink. Intraoperative SLN detection was performed with perilesional injection of patent blue. RESULTS: SLNs were found with lymphoscintigraphy in all patients. Thirty-three SLNs were identified: one occipital node, three nodes at the base of the tongue, 10 superficial lateral nodes (external jugular), five submandibular nodes, five submental nodes, three mastoid nodes and six supraclavicular nodes. Biopsy was performed in 21/22 patients. In 20/22 patients the first lymph nodes were visualized in the proximal cranial regions (retroauricular, jugular and submandibular) at five minutes post injection. The SLN positivity rate was 13.6% (three patients). All patients with tumor-positive SLNs were submitted to radical dissection. Poor concordance in the detection of sentinel nodes was observed with patent blue. CONCLUSIONS: The flow of nanocolloid in the lymph vessels of the head is rapid. In our experience immediate scintigraphic imaging was essential to visualize the pathways of lymphatic drainage and the first SLN. Radioguided SLN biopsy is therefore recommended within three hours. Injection of patent blue is inadvisable because of the poor concordance with lymphoscintigraphy and the risk of permanent tattooing of the face.

Carcinoma, Squamous Cell↗
PubMed2005

Multi-ontology sense making: a new simplicity in decision making.

Imagine organising a birthday party for a group of young children. Would you agree a set of learning objectives with their parents in advance of the party? Would those objectives be aligned with the mission statement for education in the society to which you belong? Would you create a project plan for the party with clear milestones associated with empirical measures of achievement? Would you start the party with a motivational video so that the children did not waste time in play not aligned with the learning objectives? Would you use PowerPoint to demonstrate to the children that their pocket money is linked to achievement of the empirical measures at each milestone? Would you conduct an after-action review at the end of the party, update your best practice database and revise standard operating procedures for party management? No! Instead, like most parents, you would create barriers to prevent certain types of behaviour, you would use attractors (party games, a football, a videotape) to encourage the formation of beneficial largely self-organising identities; you would disrupt negative patterns early, to prevent the party becoming chaotic, or necessitating the draconian imposition of authority. At the end of the party you would know whether it had been a success, but you could not have defined (in other than the most general terms) what that success would look like in advance.

Decision Making, Organizational↗
PubMed1983

Foreign aid and its role in maintaining the exploitation of the agricultural sector: evidence from a case study in Africa.

Today most foreign aid donors are genuinely committed to the idea that development in Third World countries should start with rural development. Therefore, a sizable proportion of their development funds are invested in rural projects. However, donors channel these funds through local governments (most often representing local bourgeois interests) that are not as committed to the principle of rural development. These governments are often also embarked in policies that are actually--directly or indirectly--expropriating the surpluses generated by agriculture and investing them in the other sectors of the economy. The peasants are therefore footing most of the bill of overall national development. This paper contends that, because of this state of affairs, foreign aid directed toward rural development is actually filling the investment gap left by an internal system of unequal returns to production in agriculture. In so doing, foreign aid is indirectly financing the development of the other sectors of the economy, even if this result is unintended. This perpetrates maldevelopment without redressing the basic exploitation process of peasants which lies at the core of underdevelopment. Evidence to support this hypothesis is presented using data from a primarily agricultural exporting country: the United Republic of Cameroon.

Agriculture↗
PubMed1984

Relationship between use of increased primary health care service and other care in a Swedish urban area. III. Utilization of emergency house calls.

The Matteus Primary Health Care Centre (MPHCC) is a pilot project with fullscale established future primary health care. Before the project began, the average district of a general practitioner consisted of 9 000 inhabitants. After the start of MPHCC the district level was 3 000 inhabitants per general practitioner in the study district. The populations utilization of the Stockholm emergency car service (SCS) has been analysed both before and after the establishing of the MPHCC in the northern inner city of Stockholm. The results confirm the hypotheses that the establishment of MPHCC reduces the workload on the SCS by 24%. The reduction is significant in all ages and for both men and women. The main period of the reduction is on weekdays 7 a.m. to 5 p.m. when the MPHCC is open.

Adolescent↗