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PubMed2001

Emergency medicine in Southern Brazil.

Emergency medicine is developing rapidly in southern Brazil, where elements of both the Franco-German and the Anglo-American models of emergency care are in place, creating a uniquely Brazilian approach to emergency care. Although emergency medical services (EMS) in Brazil have been directly influenced by the French mobile EMS (SAMU) system, with physicians dispatched by ambulances to the scenes of medical emergencies, the first American-style emergency medicine residency training program in Brazil was recently established at the Hospital de Pronto Socorro (HPS) in Porto Alegre. Emergency trauma care appears to be particularly developed in southern Brazil, where advanced trauma life support is widely taught and SAMU delivers sophisticated trauma care en route to trauma centers designated by the state.

Brazil↗
PubMed2000

Direct oral microscopy and its value in diagnosing mucosal lesions: a pilot study.

OBJECTIVE: Clinical examination of the oral mucosa often leads to an uncertain diagnosis, and a supplementary biopsy with a histopathologic examination of the lesion is necessary to establish a definite diagnosis. However, the site for the biopsy is a subjective choice that sometimes raises doubts about its representativeness. So far, no simple and reliable method is available for selecting the most appropriate area for biopsy. STUDY DESIGN: In a prospective study, we performed direct oral microscopy (oral application of the colposcopy technique used in gynecology) in 35 patients with various clinical diagnoses, such as leukoplakia, oral lichenoid lesions, or suspected malignancy. First, the oral mucosa was examined with direct microscopy, and the most representative site, according to colposcopic criteria, was selected. Then, the mucosa was clinically inspected by an independent examiner. The best site for biopsy according to clinical criteria was noted, and any difference in biopsy sites was recorded. Biopsy specimens were taken from 2 of these sites. RESULTS: Twenty-nine patients (83%) showed changes in the vascular picture on microscopy, according to the colposcopy criteria. In 14 patients (40%), the biopsy sites identified by direct oral microscopy showed more advanced histologic signs than those selected by routine clinical examination (0.01 < P </=.05). Four patients (11%) had more advanced histologic signs in the biopsy samples, as identified during routine clinical examination. In 17 patients (49%), we found no differences between the biopsy specimens. CONCLUSION: Direct oral microscopy of mucosal lesions seems to offer advantages in selecting more representative sites for biopsy than routine clinical examination alone.

Adult↗
PubMed2000

The academic surgeon and industry.

Academic surgeons should be aware of the tremendous potential that exists to partner with private companies on projects relating either to basic or clinical research. This is particularly timely now because many of these companies are experiencing unprecedented growth and market valuation. The development of these relationships requires knowing who to deal with as well as how to negotiate. Most academic medical centers have individuals who have expertise in developing sponsored research agreements, and young investigators should take advantage of this expertise.

Academic Medical Centers↗
PubMed2000

Information technology adoption in health care: when organisations and technology collide.

The implementation of advanced information systems is enabling great social and organisational changes. However, health care has been one of the slowest sectors to adopt and implement information technology (IT). This paper investigates why this is so, reviewing innovation diffusion theory and its application to both health organisations and information technology. Innovation diffusion theory identifies variables that influence the 'innovativeness' of organisations and the rate at which a technology diffuses. When analysed, these variables show why IT implementation has progressed at a slower rate in health compared with other industry sectors. The complexity of health organisations and their fragmented internal structure constrain their ability to adopt organisation wide IT. This is further impacted upon by the relative immaturity of strategic health IT which is complicated and unable to show quantifiable benefits. Both organisational and technological factors lead to the slow adoption of strategic IT. On the other hand, localised IT solutions and those providing measurable cost reductions have diffused well.

Diffusion of Innovation↗
PubMed2003

Health: IT leader or laggard? A comparative assessment of IT maturity.

The health industry has acquired a reputation as lagging in the use of IT. This reputation is usually based upon the relatively narrow measure of comparative IT expenditure, often examined as a proportion of total revenue. This study has been undertaken to assess health's use of IT using a broader frame of reference. The health industry was compared to the banking industry, on the basis that the banking industry is widely perceived as a leading IT user. The research confirmed that in these two 'knowledge' industries, health is slower to adopt IT with an apparent lower maturity level. This was the case across a range of best practice management, procedural and cultural topics as well as in the level of resources applied to IT.

Attitude to Computers↗
PubMed2003

Knowledge systems for sustainable development.

The challenge of meeting human development needs while protecting the earth's life support systems confronts scientists, technologists, policy makers, and communities from local to global levels. Many believe that science and technology (S&T) must play a more central role in sustainable development, yet little systematic scholarship exists on how to create institutions that effectively harness S&T for sustainability. This study suggests that efforts to mobilize S&T for sustainability are more likely to be effective when they manage boundaries between knowledge and action in ways that simultaneously enhance the salience, credibility, and legitimacy of the information they produce. Effective systems apply a variety of institutional mechanisms that facilitate communication, translation and mediation across boundaries.

Agriculture↗
PubMed2001

Trends in social, political and technological impact factors of hygienic risks in German households.

This paper considers actual German trends of impact factors contributing to hygienic risks in domestic settings: Have there been or are there still alterations which may be relevant and which should have consequences for hygiene behavior? How is hygiene consciousness organized in the German society? Each of the alterations of hygiene determinants described below may appear to be marginal when looked at separately, thus disregarding any relationship to hygiene. However, as a whole to anticipate the conclusion they have clearly altered the hygiene risks in the household; some risks have decreased but others have grown worse. The author intends to initiate an objective discussion on home hygiene in Germany. The intention is not creating a sterile environment in the home but to realize the "hot spots" of hygiene in modern domestic settings in order to develop a targeted hygiene.

Diet↗
PubMed2001

EDF involvement in research and development of RF and microwave industrial processes in Europe. The "Club Rayonnements".

In France, RF and microwave techniques are now mature. They are commercialized by industries having now reliable references in different fields of manufacturing industry. The present situation is the result of many studies and collaborations where universities and public technical centers were strongly involved during the last three decades. During this period, the "Club Rayonnements" sponsored by EDF has been a real "melting pot" for people coming from university, industry and technical centers.

Equipment and Supplies↗
PubMed1995

Consumer participation in identifying research and development priorities for power wheelchair input devices and controllers.

A focus group comprised of persons who use power wheelchairs and professionals working in the field were asked to participate in a brainstorming session to determine priorities for the development and application of power mobility input devices and control concepts. The group consensus was that durability and reliability are the most important criteria. Essentially, the expectation is that a power wheelchair must work everyday in the way a person needs it and wants it. At the same time, there is a desire to enhance and advance the features of input devices and control systems. Many would say these changes constitute designing "smarter" power wheelchairs, such as systems that can independently detect obstacles and can provide users with more feedback. This paper presents the rationale behind forming this focus group and details of the results of a brainstorming session where ideas were generated and prioritized. The five most important issues as determined by the group are discussed in depth.

Community Participation↗
PubMed2004

The Russian biological weapons program: vanished or disappeared?

The legacy and arsenal of biological weapons Russia inherited from USSR in 1991 became a lingering unsolved issue, in terms of a prime strategic arm that ought to be eliminated, advisably, in accordance with the Biological Weapons Convention Russia is committed to, and considering further undertakings and declarations made by the Russian regime. Indeed, that inheritance was created by USSR as a powerful, highly sophisticated component of utmost importance within the Soviet military paradigm, based on a wide spectrum of virulent, stabilized pathogens and toxins plus delivery systems. Moreover, remarkably advanced biotechnologies were thus applied to procure stockpiles of military-grade pathogens and toxins. Yet, an intriguing debate aroused with regard to the extent of the weaponized biological inventory accumulated by USSR, as well as the in effect attitude of Russia towards perpetuating or wiping out that inheritance. It turned out to form a far reaching and challenging complexity, both strategically and scientifically. The present study concentrates on the strategic as well as scientific spheres shaping that overall issue at large, attempting to thoroughly analyze it through an innovative methodology. One main conclusion thereby reached at is that the Russian military still poses a potential menance, in terms of both stockpiled, probably deployable biological weapons, and prevailing production capacities.

Biological Warfare↗
PubMedDate not supplied

From research to clinical practice: considerations in moving research into people's hands. Personal reflections that may be useful to others.

It may take many years for published clinical research findings to be found, understood, adopted and applied in practice. In recognition of this delay, many jurisdictions and agencies are now promoting a stronger link between research and its dissemination in useable forms that will enable practitioners to access, understand and use new ideas. The purpose of this paper, first presented as a keynote address at the 15th Annual Meeting of the European Academy of Childhood Disability in Oslo in October 2003, is to share experiences of the author and his colleagues at a childhood disability system-linked research centre in Ontario, Canada. The lessons learned include the value of striving to describe one's findings in plain language; writing study reports for parents and children who are involved in research studies; using multiple methods to disseminate one's work; and making explicit the potential importance and applicability of the findings to readers of the work. Engaging end users at many stages of the development and field testing of one's work will enhance buy-in and lend added credibility to the work, as well as influencing content and process as the research unfolds. The result is likely to be greater recognition of 'familiar' aspects of the research and the adoption of relevant findings.

Diffusion of Innovation↗