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PubMed2006

[Standard precautions: are these known? Are they applied?].

A study carried out among postgraduate nurses detected a high degree of confusion regarding standard precautions. This led to the formation of a multidisciplinary group from various sections of the health system to investigate this topic in greater detail. Our study observed a high degree of conceptual confusion and a lack of knowledge about standard precautions and the new recommendations regarding decontamination and hand washing in diverse health collectives. It is worrisome to detect at risk habits in relation to self-protective measures among one-third of those surveyed. Knowledge of standard precautions should be integrated with greater efficiency in the medical study programs as well as in continuing professional development programs for health professionals.

Guideline Adherence↗
PubMed2006

Clinical Care Classification (CCC) System Charting Model.

This is a demonstration of the Clinical Care Classification (CCC) System Charting Model. The Model software is designed for any personal computer (PC) with Windows using Microsoft Office and Access. The program has been tested as efficient and effective for charting patient care plans using the CCC System's Standardized language following the nursing process. It is available for integration in any electronic health record (E.H.R) system.

Humans↗
PubMed1991

[Neuronal nets].

Neural networks are used as models of cognitive systems. On the basis of results from brain research, the processing of knowledge and information can be conceived as occurring through parallel interaction of multiple but simple and uniform processor elements in a network structure. In these 'neural networks' knowledge is stored in a distributed way throughout the network and subjected to parallel processing. According to Hebb's concept of synaptic plasticity, the process of learning is based on the strengthening of the links between the processing elements. The implementation of network models in electronic data processing systems allows for simulation of cognitive phenomena such as learning and forgetting or abilities such as recognition of acoustical or optical patterns, in a more efficient way than conventional computer programming. Neural network modelling can help to understand the abilities and disorders of the brain.

Cognition↗
PubMedDate not supplied

HIV seroprevalence surveys of childbearing women--objectives, methods, and uses of the data.

A seroprevalence survey of human immunodeficiency virus (HIV) among childbearing women is being conducted in 43 States and Territories as one of the family of HIV seroprevalence surveys. This blinded survey, in which serologic test results are not linked to identifiable persons, uses neonatal dried blood specimens on filter paper to test for maternal antibodies to HIV. This survey provides relatively unbiased estimates of prevalence of HIV infection in the population of women delivering live children during given survey periods, by month or quarter of delivery, geographic area, and demographic subgroup. This objective will be met while protecting the integrity and efficient conduct of neonatal screening programs and ensuring patient anonymity. Information from this survey will be used to (a) assess the levels and trends of HIV infection in women and infants, (b) help develop and evaluate prevention programs, and (c) project the number of women and children who will develop HIV infection and the acquired immunodeficiency syndrome (AIDS) and will require health care and social services in the future.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Switching from standard dialysis to rapid high efficiency dialysis with reuse.

The chronic outpatient renal unit of Lutheran Hospital Inc. has chosen to become a high-tech hemodialysis unit. We reconstructed our method of administering hemodialysis by instituting high efficiency, kinetic modeling, and reuse programs. Implementing these programs concurrently was a task that we would like to share with ANNA Journal readers.

Clinical Protocols↗
PubMed1989

[Prevalence of premorbid forms and chronic nonspecific lung diseases: study based on special examination of the population of 3 administrative districts of Leningrad].

For the first time ever, a familial study of 15,319 residents of three administrative districts in Leningrad has provided data on the prevalence of premorbid pulmonary conditions (157%) and chronic nonspecific pulmonary disease (118%). For Leningraders, average risk of premorbid conditions transforming into clinical ones was about 40%, which is the most objective criterion of the efficiency of bronchopulmonary disease prevention programs in large cities. In addition, data on the pattern of transformation of premorbid conditions into chronic nonspecific pulmonary disease are presented with respect to sex and age.

Adolescent↗
PubMed1985

Preoperative crossmatch ordering and blood use in elective hysterectomy.

Preoperative crossmatch guidelines have been shown to improve crossmatch ordering practices. To refine crossmatch ordering, specific characteristics of 258 patients who underwent abdominal hysterectomy and 277 patients who underwent vaginal hysterectomy were correlated with blood transfusion by univariate and multivariate analyses. Abdominal hysterectomy patients with pelvic inflammatory disease with adhesions and/or abscess were significantly more likely to require blood transfusion. Specimen weight correlated significantly with blood transfusion only for patients with ovarian pathology. Blood use was independently correlated with reduced preoperative hemoglobin and with estimated blood loss. Vaginal hysterectomy patients who had a colporrhaphy were more likely to require blood transfusion. Preoperative crossmatch recommendations made on the basis of these results reduce costs and increase the efficiency of predeposit autologous transfusion programs and preoperative crossmatch ordering practices.

Abscess↗
PubMed1981

Emergency-room services for a community health center.

The development and maintenance of an organized system of emergency care in isolated ambulatory health-care centers are described. A system of three community health centers, staffed chiefly by midlevel practitioners (i.e., physician's associates and nurse practitioners), had a need to provide occasional emergency care to patients. Emergency care needed to be provided (for up to one hour) until an ambulance arrived to transport the patient to a hospital. A system of emergency care, consisting of treatment protocols, a drug manual, equipment and medications, and a program for periodic inservice education was developed by physicians, midlevel practitioners, and pharmacists. Weekly checks of the supplies and medications are conducted. Lists of supplies and medications stocked, and a sample drug monograph, are included in the paper. The program has resulted in more efficient emergency care, including less confusion in executing and documenting treatment.

Community Health Centers↗
PubMed1980

The influence of ascites on the pharmacokinetics of amikacin.

The pharmacokinetics of Amikacin are studied after the administration of 7.5 mg/kg body weight to 10 ascitic patients diagnosed with various hepatic disorders. The antibiotic was determined microbiologically in plasma and in the ascitic fluid. The antibiotic follows a two-compartment kinetic model, and it may be seen that once the rapid disposition phase has ended, an inflexion in the plasma-time levels curve takes place, with a passing increase in the plasma concentrations. From the pharmacokinetic study of Amikacin in these patients, it may be deduced that the ascitic liquid forms part of the central compartment for the effects of distribution, though not for the effects of elimination. The plasma half-life of the slow disposition phase is analogous to that obtained from non-ascitic patients with normal renal function. In one of the patients, the antibiotic was administered intraperitoneally; following this, the plasma concentrations of Amikacin were detected. In the last of the 10 patients included in the survey, the evolution of the plasma concentrations of the antibiotic were studied while the patient was undergoing a multiple dosage regimen with the aim of determining the accumulation of Amikacin in the ascitic fluid. A dosage regimen of multiple doses is programmed which should guarantee the efficiency and safety of the antibiotic.

Amikacin↗
PubMed1980

Effects of early intervention and stimulation on the preterm infant.

To test the hypothesis that early intervention can enhance the development of high-risk preterm infants, a prescribed multimodal sensory enrichment program, within a regional neonatal intensive care unit, was designed and implemented. Twenty-eight appropriate-for-gestational age infants with birth weights between 1,200 and 1,800 gm were selected for study. To prevent control group contamination by the enrichment procedure the first 14 infants were designated as the control group, and the next 14 as the treatment group. Treated infants had significantly higher developmental status than control infants, as measured by the Bayley Scales of Infant Development, at six months past the maternal expected date of confinement (F = 14.98, P < .001, and F = 16.46, P < .001 for the mental and motor scales, respectively). Mean infant weight gain per day and mean total weight gain during the hospitalization were not significantly different for the two groups although the treatment group received significantly less calories per kilogram per day than the control group (F = 9.02 P < .006). Our data suggest that a prescribed intervention program for high-risk preterm infants appears to enhance the quality of development as measured at six months past the expected date of confinement. Further studies are necessary to determine the long-term value of early intervention and the apparent ability of infants receiving an enrichment program to utilize calories more efficiently than control infants.

Body Weight↗
PubMedDate not supplied

Environmental sampling: a brief review.

Proper application of statistical principles at the onset of an environmental study can make the difference between an effective, efficient study and wasted resources. This review distills some of the thoughts current among environmental scientists from a variety of backgrounds and organizes them according to statistical principles. Collection and review of preliminary information is important for guiding sampling design. Problems must be carefully defined before rational sample selection is possible. Many potential sources of variability exist, and as many of these sources as possible should be identified, assessed, and, ideally, minimized. Sample selection itself will depend on the precise questions that are to be addressed by the study and on what assumptions can be reasonably made about structures and patterns of contaminants in the field. Careful specification of protocols for sample procurement are needed. Choices of statistical analyses will depend on how data are collected, and intended analyses should be predetermined as part of the sampling plan. Proper attention to these principles will substantially increase the quality and efficiency of an environmental sampling program.

Data Collection↗
PubMed1993

Phospholipase activation triggers apoptosis in photosensitized mouse lymphoma cells.

Photodynamic therapy (PDT), an experimental cancer treatment employing a photosensitizer and visible light, is a highly efficient inducer of apoptosis (or programmed cell death) in mouse L5178Y lymphoma cells, resulting in extensive DNA fragmentation within 1-2 h. The major targets for PDT are in cellular membranes, and we now find that PDT sensitized by aluminum phthalocyanine causes the rapid (< 1 min) activation of phospholipase C and the breakdown of membrane phosphoinositides, as well as a similarly rapid release of Ca2+ from intracellular pools. A phospholipase C inhibitor, U73122, blocks the rapid transient increases in both inositol-1,4,5-trisphosphate and intracellular Ca2+ levels as well as the subsequent fragmentation of nuclear DNA, whereas the analogue U73343 is much less effective against all of the aforementioned responses. In addition, p-bromphenacyl bromide, an inhibitor of phospholipase A2, blocks DNA fragmentation, and PDT stimulates the release of arachidonic acid, probably by phospholipase A2-dependent breakdown of membrane phospholipids. Thus, photodynamic damage to cell membranes can mimic natural stimuli of phospholipases and initiate apoptosis in L5178Y cells.

Animals↗
PubMed1997

Screening infants and young children for hearing loss: examination of the CAST procedure.

A computer-mediated visual reinforcement audiometry (VRA) screening procedure, the Classification of Audiograms by Sequential Testing (CAST), was used with 59 infants and young children who received both CAST screening and conventional audiologic assessment. Approximately one-third of the children had normal hearing, one-third had conductive hearing loss, and the remaining one-third had previously diagnosed sensorineural hearing loss. The sensitivity and specificity of CAST were calculated and the relationship between the predicted CAST pattern and the child's actual audiogram was examined. CAST outcome was also considered along with the results of tympanometry and pneumatic otoscopy to formulate proposed follow-up strategies. CAST appears to be a useful tool for the behavioral screening of infants and young children: one component of a screening program designed to maximize the efficient identification and follow-up of infants and children with hearing loss.

Acoustic Impedance Tests↗
PubMed1998

Developing competency systems: a never-ending story.

A competency system in its whole and its parts is described. Such a system can help dental educators rationally and efficiently organize and articulate educational programs, curricula, and courses. Repeated iterations of standard setting, design of experiences, and appraisal can reduce the need for less desirable rework or remediation and rejection of the objects of the experience such as dismissing students. Such an iterative process is one in which there is constant cyclical improvement which can move a dental education organization to develop a shared vision and become a true learning organization.

Accreditation↗
PubMedDate not supplied

[Outcome after an intensive, holistic and multidisciplinary rehabilitation program after traumatic brain injury. Medico legal values].

INTRODUCTION: This paper was designed to evaluate the integral rehabilitation treatments for patients with traumatic brain injury; data about efficiency of the C.RE.CER. intensive, holistic and multidisciplinary rehabilitation program is given. PATIENTS AND METHODS: The study was done keeping in mind not only the clinical aspects of rehabilitation, but also setting it within the judicial realm in which a great number of brain injury cases are found, mainly when caused by traffic accidents. A sample of 10 severe traumatic brain injury patients was studied, aged between 19 and 39. All the patients were assessed at the beginning and the end of the treatment, using a neuropsychological test battery, meanwhile were treated with the C.RE.CER. intensive, holistic and multidisciplinary rehabilitation program. RESULTS AND CONCLUSIONS: The results show a high efficiency of treatments in the majority of the patients, with reductions of more than 70% in emotional deficits and more than 60% in the global recovery of the patients that carried out the programs. This paper also shows some limitations of the criteria for compensation in Spanish legislation.

Adult↗
PubMed2001

Technology as an aid to coping with caring: a usability evaluation of a telematics intervention.

This paper presents evaluation data for an interactive software program designed to provide family carers with information, advice and psychological support by way of feedback of their coping capacity. The multimedia program consists of an information-based package that provides carers with advice on health promotion and relaxation and offers them a range of coping strategies (for example, positive self-talk, assertiveness training and relaxation tapes and videos). The program also includes a carer's self-assessment instrument, designed to provide both family and professional carers with information to assess how family carers are coping with their care-giving role. As part of the usability evaluation, casual users (family carers, professional carers and older people) were invited to test the program and were administered a program evaluation questionnaire measuring quality and efficiency in utility and usability. Quantitative data were analysed by using the Statistical Package for the Social Sciences (SPSS) and qualitative data were analysed by content analysis. Findings indicated that the program is visually pleasant, easily understood, responds quickly and corresponds with user expectations. A number of recommendations are made for improvement of the navigation of the program.

Adaptation, Psychological↗
PubMed1998

Effect of frameshift-inducing mutants of elongation factor 1alpha on programmed +1 frameshifting in yeast.

The translational apparatus very efficiently eliminates errors that would cause a spontaneous shift in frames. The probability of frameshifting can be increased dramatically by either cis or trans-acting factors. Programmed translational frameshift sites are cis-acting sequences that greatly increase the frequency of such errors, at least in part by causing a transient translational pause. Pausing during programmed +1 frameshifts occurs because of slow recognition of the codon following the last read in the normal frame. Frameshifting can also be elevated in strains carrying mutations in the homologous elongation factors EF-Tu in bacteria, and EF-1alpha in the yeast Saccharomyces cerevisiae. This phenotype implies that the factors contribute to frame maintenance. Because EF-Tu/EF-1alpha modulate the kinetics of decoding, it is possible that the frameshift suppressor forms of the factors transiently slow normal decoding, allowing spontaneous frameshifting to occur more efficiently, resulting in phenotypic suppression. We have used a set of frameshift reporter plasmids to test the effect of suppressor forms of EF-1alpha on constructs that differ widely in the efficiency with which they stimulate +1 shifting. When these results were compared to the effect of increased translational pausing, it was apparent that the mutations affecting EF-1alpha do not simply prolong the translational pause. Rather, they appear to generally increase the likelihood of frame errors, apparently by affecting the error correction mechanism of the ribosome.

Codon↗
PubMed1992

Multi-institutional approach to regionalization of pediatric critical care. Seven year experience.

A multi-institutional, pediatric intensive care program initiated in Jacksonville, Florida, is a systematic approach to critical care which avoids costly duplication and provides efficient clinical services and an academic fellowship program. A total of 6,876 consecutive admissions to the two units over a seven-year period are discussed and compared to national data. A coordinated system may provide a model for other communities; however, the ability to expand services in a market where public and private third party funding is being reduced may become a problem.

Adolescent↗