Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Modernization”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,567 records · Page 87Linked to original sources
PubMed2000

Health implications of modern childhood.

Childhood has undergone many reconstructions since its 'recognition' in the 18th century. The medicalized child is rooted in eugenics, political economy and professional interests and has implication for practice. The modern child is now viewed as a stakeholder in a political sense. Childhood requires recognition in a 'health' sense if it is to survive as a category. Different medical expectations and models of childhood are likely to evolve.

Attitude to Health↗
PubMed2000

Complementary therapy: complement or threat to modern medicine?

Some believe that medicine has lost its holistic perspective as a result of which many people now seek help from 'alternative' practitioners who seem able to devote time to their patients and listen to their concerns. Such practitioners also treat the 'whole person' rather than only their symptoms, a feature which seems to be valued by patients. The use of complementary therapies is, therefore, increasing world-wide. This paper explores this increase, questioning whether this truly reflects dissatisfaction with 'traditional' (allopathic) medicine or rather represents an increased satisfaction with 'alternative' therapies. It also investigates the use of such therapies in mainstream medicine revealing considerable variation in attitudes towards and use of such therapies in current medical practice questioning whether this should be seen as a threat to modern medicine or their use may enhance patient well-being and quality of life.

Complementary Therapies↗
PubMed2002

Integration of herbal medicine into modern medical practices: issues and prospects.

The integration of herbal medicine into modern medical practices including cancer treatments must take into account the interrelated issues of quality, safety, and efficacy. Quality is the paramount issue because it can affect the efficacy and/or safety of the herbal products being used. Current product quality ranges from very high to very low due to intrinsic, extrinsic, and regulatory factors. Intrinsically, species differences, organ specificity, diurnal and seasonal variations can affect the qualitative and quantitative accumulation of active chemical constituents in the source medicinal plants. Extrinsically, environmental factors; field collection methods such as cultivation, harvest, post-harvest transport and storage; manufacturing practices; inadvertent contamination and substitution; and intentional adulteration are contributing factors to the quality of herbal medicinal products. Source plant materials that are contaminated with microbes, microbial toxins, environmental pollutants, or heavy metals; or finished products that are adulterated with foreign toxic plants or synthetic pharmaceutical agents can lead to adverse events. Substandard source materials or finished products will yield therapeutically less effective agents. Herbal medicine quality can also be attributed to regulatory practices. In a number of countries, herbal medicines are unregulated, which has led to product quality differences. Product quality improvement may be achieved by implementing control measures from the point of medicinal plant procurement under good agricultural practices (GAPs) and the manufacture of the finished botanical products under good manufacturing practices (GMPs), plus post-marketing quality assurance surveillance. The lack of pharmacological and clinical data on the majority of herbal medicinal products is a major impediment to the integration of herbal medicines into conventional medical practices. For valid integration, pharmacological and especially, clinical studies, must be conducted on those plants lacking such data. Adverse events, including drug-herb interaction must also be monitored to promote a safe integration of efficacious herbal medicine into conventional medical practices.

Delivery of Health Care, Integrated↗
PubMed2002

Modern treatment of pulmonary embolism.

Modern treatment of acute pulmonary embolism requires rapid and accurate diagnosis followed by risk stratification to devise an optimal management strategy. Patients at low risk have good outcomes simply with intensive anticoagulation treatment. Higher-risk patients may require more aggressive intervention with thrombolysis or embolectomy. Clinical risk factors for an adverse outcome include increasing age, cancer, congestive heart failure, systemic arterial hypotension, chronic obstructive pulmonary disease and right ventricular dysfunction. A promising approach is the Geneva Prognostic Score, which is based upon a rapid clinical assessment. On physical examination, signs of right ventricular failure, including distended jugular veins and a right-sided S3 gallop, should be looked for. The electrocardiogram may show evidence of right ventricular strain with a new right bundle branch block or T wave inversion in leads V1-V4. The troponin level may be elevated as a marker of cardiac injury and right ventricular microinfarction, even in the absence of coronary artery disease. The most useful imaging marker of high risk is the presence of moderate or severe right ventricular dilatation and hypokinesis on the echocardiogram, especially with progressively worsening right ventricular function despite intensive anticoagulation treatment. Patients at high risk should be considered for thrombolytic therapy or embolectomy rather than management with anticoagulation therapy alone. Special care must be taken to avoid thrombolytic therapy among patients who might be susceptible to intracranial haemorrhage. Intracranial haemorrhage reached a surprisingly high rate of 3.0% in the International Cooperative Pulmonary Embolism Registry of 2,454 prospectively evaluated acute pulmonary embolism patients at 52 hospitals in seven countries. An alternative approach to patients at high risk is a catheter-based or open surgical embolectomy. It is crucial to refer these patients as quickly as possible, rather than delaying intervention until cardiogenic shock has ensued. Fortunately the current tools for risk stratification provide an "early window" for prognostication and can help the coordination of a definitive treatment plan with optimal results.

Acute Disease↗
PubMed2005

The epidemiology and modern management of traumatic hemorrhage: US and international perspectives.

Trauma is a worldwide problem, with severe and wide ranging consequences for individuals and society as a whole. Hemorrhage is a major contributor to the dilemma of traumatic injury and its care. In this article we describe the international epidemiology of traumatic injury, its causes and its consequences, and closely examine the role played by hemorrhage in producing traumatic morbidity and mortality. Emphasis is placed on defining situations in which traditional methods of hemorrhage control often fail. We then outline and discuss modern principles in the management of traumatic hemorrhage and explore developing changes in these areas. We conclude with a discussion of outcome measures for the injured patient within the context of the epidemiology of traumatic injury.

Adolescent↗
PubMed2004

Helping motives in late modern society: values and attitudes among nursing students.

This article reports a follow-up study of Norwegian nursing students entitled 'The helping motive an important goal for choosing nursing education'. It presents and discusses a significant ambiguity within the altruistic helping motive of 301 nursing students in the light of classical and modern virtue ethics. A quantitative longitudinal survey design was used to study socialization and building professional identity. The follow-up study began after respondents had completed more than two-and-a-half years of the three-year educational programme. Data were collected using a questionnaire with closed questions, supplemented by 18 semi-structured, in-depth, audiotaped interviews. A motive such as 'desire for human contact/to help others' appeared to be highly significant. The research questions employed were: What motivates nursing students at the end of their studies to help other people? What does helping others mean for nursing students? Factor analysis revealed two factors. Factor 1 can be expressed as an altruism factor and factor 2 can be interpreted as an 'acknowledgement-from-the-patient factor' that in fact indicates an ambiguity within the helping motive itself. Findings from the interviews also reveal ambiguous helping motives. On one hand the students want to be altruistic and on the other they wish to receive positive feedback from patients when giving help. The findings indicate that this positive feedback is essential to the students in order for them to provide altruistic care.

Altruism↗
PubMed1988

Molecular genetics and human disease. Implications for modern psychiatric research and practice.

Techniques of molecular genetics, including recombinant-DNA technology, are likely to have a key role in modern psychiatric research and practice. This article reviews some methods of DNA analysis and their applications to clinical science: specifically, how these methods can be used to localise, identify, isolate, and clone clinically important genes, and how this should enable us to elucidate the molecular pathology of most inherited (psychiatric) disorders. The implications of these developments for prevention and treatment of genetic disease are discussed.

Brain Chemistry↗
PubMed1991

The history of 'nervous disorders' from 1600 to 1840, and a comparison with modern views.

In the 18th century the main varieties of nervous illness - hypochondria, hysteria, the spleen, the vapours and dyspepsia - became included under the general term 'nervous disorders'. When no physical disorder of the nerves could be detected in such conditions, the hypothesis of nervous disorder was replaced by the more vague concept of 'nervous temperament'. The fact that there is still no evidence of pathological change in such cases continues to expose physicians to the alternative hypothesis of a purely psychological cause. The modern era in our understanding of the nervous system may be said to date from 1843 when Du Bois Reymond showed the electrical nature of nervous conduction. The publication of Jorden's Briefe Discourse in 1603 may be taken to represent the start of a discrete period (1600 to 1840) in the history of neurotic illness.

Dyspepsia↗
PubMed1998

Primary mediastinal nonseminomatous germ cell tumors: results of modern therapy including cisplatin-based chemotherapy.

PURPOSE: Primary mediastinal nonseminomatous germ cell tumors (NSGCT) are uncommon neoplasms and clinically and biologically distinct from other germ cell tumors (GCT). We describe the clinical and biologic features of these patients and evaluate the results of treatment during the cisplatin era. PATIENTS AND METHODS: Between 1976 and 1993, 38 patients with mediastinal NSGCT received cisplatin-based chemotherapy as part of their primary treatment. Twenty-nine of them were initially treated at the Institut Gustave-Roussy (IGR), VillejuiF, France, and nine were referred for salvage treatment. RESULTS: Of the 29 patients initially treated at IGR, 11 (39%) had metastasis. A complete response (CR) to therapy was obtained in 19 of 29 patients (66%) after chemotherapy and surgery. Ten patients (34.5%) have remained free of disease with a median follow-up of 89 months. All patients who did not achieve a CR died of disease. The 2-year overall survival rate for the IGR patients is 45% and the 2-year disease-free survival is 37%. Only the presence of extrapulmonary metastasis was of prognostic significance in the univariate analysis (P = .0095). None of the 20 patients who required salvage therapy is currently disease-free. Five patients developed and subsequently died of a hematologic malignancy at an interval range of 1 to 47 months from treatment of mediastinal NSGCT. Cytogenetic analysis of leukemic cells found an isochromosome of the short arm of chromosome 12 (12p) in two cases. The incidence of leukemia was 21% in patients who attained a CR. CONCLUSION: Primary mediastinal NSGCT is a clinical and biologic entity that should be distinguished from other GCT. About 40% of these patients can envisage long-term survival with modern therapy that includes cisplatin-based chemotherapy followed by surgical resection of residual masses. New strategies are required for patients who do not attain a CR. Predictive factors and improvement in therapy are required for mediastinal NSGCT-associated leukemia.

Adolescent↗
PubMed2004

Are subjective health complaints a result of modern civilization?

Subjective health complaints without or with minimal somatic findings (pain, fatigue) are common and frequent reasons for encounter with the general practitioner and for long-term sickness leave and disability. The complaints are often attributed to the stressors of modern life. Is this true? We interviewed 120 Aborigine Mangyans (native population, M age = 33.5 years, 72.5% women) living under primitive conditions in the jungle of Mindoro, an island in the Philippines, and 101 persons living in a small coastal town on the same island (coastal population, M age = 33.8 years, 60.4% women). Both groups had more musculoskeletal complaints, fatigue, mood changes, and gastrointestinal complaints than a representative sample from the Norwegian population (N = 1,243). Our common subjective health complaints, therefore, are not specific for industrialized societies.

Adolescent↗
PubMed2003

A discussion of modern versus traditional psychometrics as applied to personality assessment scales.

Item response theory (IRT) methods are used by large testing firms, state agencies, and school districts to construct, analyze, and score most major aptitude, achievement, proficiency, entrance, and professional licensure exams. Personality assessment, in contrast, has not generally adopted these more powerful, modern psychometric techniques. We evaluate the possible role of IRT in the personality domain by highlighting key areas in which IRT and traditional methods differ. Although we conclude that IRT has a significant role to play in future personality measurement, there are many systemic and technical barriers to its routine application.

Forecasting↗
PubMed2001

Surgical management of GH-secreting pituitary adenomas: an outcome study using modern remission criteria.

The results of transsphenoidal surgery as initial therapy for GH-secreting pituitary adenomas in 57 acromegalic patients were analyzed retrospectively. Patients with prior surgery or radiation therapy were excluded from the study. Three different criteria were used to define remission: glucose-suppressed (nadir) GH less than 1.0 microg/liter, a normal sex- and age-adjusted IGF-I level, and postoperative random GH levels of 2.5 microg/liter or less. Additionally, we analyzed the neuropathological data, including immunohistochemistry and ultrastructural categorization, and the surgical complications. The short-term remission rate (6-wk postoperative follow-up visit), as determined by a random GH measurement of 2.5 microg/liter or less, was 48.8%; the remission rate, as determined by nadir GH, was 51.4%. For 57 patients followed for 12 months or more after surgery (mean, 37.7 months), surgical remission was achieved in 70.2%, 66.7%, and 61.1%, respectively, for patients assessed by normal IGF-I, random GH, and nadir GH. One patient (1.1%) developed recurrence of active acromegaly 81 months after initially successful surgical therapy. Extrasellar growth of the tumor (P = 0.04) and dural invasion by the adenoma (P = 0.008) were significant univariate predictors of a poor outcome. Tumor size was significantly greater in patients with persistent or recurrent acromegaly (P = 0.02). Patients with tumors of the ultrastructural categories of mixed GH/PRL cell and mammosomatotroph adenomas had the lowest remission rates (50% and 42.9%, respectively). There were no perioperative deaths, and there was no serious morbidity. The permanent complication rate was 3.3% (1 permanent DI and 2 nasal septal perforations). Surgical management of acromegaly currently provides prompt, effective, and satisfactory initial treatment for the majority of patients. Using stringent criteria for remission, primary transsphenoidal surgery for GH-secreting pituitary adenomas is effective and often definitive therapy for acromegaly. These results provide a benchmark for the contemporary results of surgical management as assessed by modern outcome criteria.

Acromegaly↗
PubMed2006

Advances and potential applications of chitosan derivatives as mucoadhesive biomaterials in modern drug delivery.

Pharmaceutical technologists have been working extensively on various mucoadhesive polymeric systems to create an intimate and prolonged contact at the site of administration. Chitosan is one of the most promising polymers because of its non-toxic, polycationic biocompatible, biodegradable nature, and particularly due to its mucoadhesive and permeation enhancing properties. Due to its potential importance in controlled drug delivery applications, pharmaceutical scientists have exploited this mucoadhesive polymer. However, chitosan suffers from limited solubility at physiological pH and causes presystemic metabolism of drugs in intestinal and gastric fluids in the presence of proteolytic enzymes. These inherent drawbacks of chitosan have been overcome by forming derivatives such as carboxylated, various conjugates, thiolated, and acylated chitosan, thus providing a platform for sustained release formulations at a controlled rate, prolonged residence time, improved patient compliance by reducing dosing frequency, enhanced bioavailability and a significant improvement in therapeutic efficacy. We have explored the potential benefits of these improved chitosan derivatives in modern drug delivery.

Adhesives↗
PubMed1985

Theodor Meynert: foreshadowing modern concepts of neuropsychiatric pathophysiology.

Theodor Meynert's neuroanatomic studies contributed to the development of the nineteenth-century "brain psychiatry" movement. His speculations--that certain cognitive impairments resulted from an imbalance in blood flow between cortical and subcortical structures--parallel modern controversies concerning the role of these brain regions in the pathophysiology of dementia. Meynert described a subcortical nucleus in the basal forebrain, the nucleus basalis of Meynert, which has recently been shown to provide cholinergic innervation to the cortex. Loss of cells in this structure in Alzheimer's disease, a so-called "cortical" dementia, and in the dementia of Parkinson's disease, a so-called "subcortical" dementia, probably accounts for the loss of cortical cholinergic markers in these diseases. An understanding of Meynert's contributions may avoid unproductive speculation in attempts to study the interactions between cortical and subcortical structures in neuropsychiatric diseases.

Austria↗
PubMed1992

Localization of sensorimotor cortex: the influence of Sherrington and Cushing on the modern concept.

According to Penfield, the work of Charles Sherrington's laboratory forced a change from the long-held concept of a broad, overlapping sensorimotor cortex to the concept of a narrow, discrete pre-Rolandic motor cortex separate from the post-Rolandic sensory strip. Harvey Cushing, one of the founders of modern neurosurgery, coined the term narrow motor strip. Cushing also appears to have been the first to color the precentral gyrus in a mosaic pattern and to use red coloring for the motor cortex and blue for the sensory cortex. Cushing's red and blue color coding is still used in textbooks, nearly 100 years later. In this article, we review the historical evolution of and the evidence for the concept of narrow and discrete motor and sensory strips anterior and posterior to the Rolandic cortex. A review of the historical development of the concept and recent physiological studies reaffirms the proposition that the motor and sensory areas are much broader and more complex than they were thought to be in the classic teaching that originated with Sherrington and Cushing.

Animals↗
PubMed1995

Modern management of spinal tuberculosis.

The resurgence of pulmonary tuberculosis in the United States has been paralleled by a concomitant rise in tuberculosis of the spine (Pott's disease). The appearance of drug-resistant strains of tuberculosis, infection in large numbers of immunocompromised hosts, newer imaging modalities, and the development of more effective spinal reconstruction techniques have raised important issues regarding the management of Pott's disease. In spite of this, there has been little published recently on the modern management of Pott's disease in developed countries. We report our experience with the management of 20 patients with Pott's disease in the past 5 years, 16 of whom were admitted during the last 18 months of this retrospective study. The mean patient age was 49 years. Sixteen (80%) were men. Nineteen (95%) had a positive tuberculin skin test, and 13 (65%) had pulmonary tuberculosis. Symptoms consisted of spinal pain, weakness, sensory complaints, and flank mass in order of decreasing frequency. Ten patients were neurologically intact; the remainder had motor deficits of variable severity. The thoracic spine was involved in 13 patients, the lumbar spine was involved in 4, the cervical spine was involved in 2, and the thoracolumbar spine was involved in 1. Spinal deformity was present in 11 patients, spinal epidural compression was present in 13, and a paraspinal mass was present in 18. Operative indications included motor deficits, spinal deformity, nondiagnostic computer tomographic-guided needle biopsy, and noncompliance with, or lack of, response to medical therapy. Eleven patients underwent operations. Six patients had vertebrectomy and bone grafting with posterior instrumentation when indicated; three had laminectomy, debridement, and abscess drainage; one had laminectomy and posterior instrumentation; and one had paraspinal abscess drainage. Two patients have died; the remainder have been monitored for at least 1 year and are neurologically improved or normal without residual infection. The average angulation decreased from 31 to 24 degrees by the follow-up examination. In selected patients, early operative treatment with instrumentation, when indicated, minimizes neurological deterioration and spinal deformity, allows early ambulation, and results in excellent neurological outcome.

Adult↗
PubMed2004

Information management and informatics: need for a modern pathology service.

Requirements for information technology in pathology now extend well beyond the provision of purely analytical data. With the aim of achieving seamless integration of laboratory data into the total clinical pathway, "informatics"--the art and science of turning data into useful information--is becoming increasingly important in laboratory medicine. Informatics is a powerful tool in pathology--whether in implementing processes for pathology modernization, introducing new diagnostic modalities (e.g. proteomics, genomics), providing timely and evidence-based disease management, or enabling best use of limited and often costly resources. Providing appropriate information to empowered and interested patients--which requires critical assessment of the ever-increasing volume of information available--can also benefit greatly from appropriate use of informatics. General trends in medical informatics are reflected in current priorities for laboratory medicine, including the need for unified electronic records, computerized order entry, data security and recovery, and audit. The increasing demands placed on pathology information systems in the context of wider developmental change in healthcare delivery are explored in this paper.

Data Collection↗
PubMed2005

An online survey of nurses' perceptions, knowledge and expectations of the National Health Service modernization programme.

We conducted an online survey to investigate nurses' perceptions, knowledge and expectations of the National Health Service (NHS) modernization programme in the UK. The questionnaire was available for 28 days via the Website of the Royal College of Nursing. The questionnaire was completed by 2020 nurses, midwives and health visitors working in all sectors of the health service in a wide range of specialties and environments of care. Less than one-quarter of respondents felt that they had adequate information about NHS information technology (IT) developments. In all, 528 (26%) said this was the first they had heard of the initiatives. Only 383 respondents (19%) felt adequately informed about the development of electronic health records; 470 (23%) felt inadequately informed and 456 (23%) had only heard something about it. The findings of this survey suggest that nursing staff are not widely aware of current IT plans and programmes in the NHS. They suggest that nurses also lack confidence in using advanced IT, which is compounded by lack of training.

Attitude of Health Personnel↗