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At least 163 records · Page 9Linked to original sources
PubMed1994

[Acceptance of electronic data processing supported documentation of ultrasound findings in routine clinical practice. A survey].

We carried out a survey to determine the acceptance of the ultrasound documentation software, CUBUS, in clinical practice. Since August 1, 1988, CUBUS, versions V1.01 to V2.02 has been employed in clinical routine. By October 1991 10,850 reports had been stored in version 2.02. The software is installed on a personal computer (Siemens PCD-2, 40MB, 640 KB RAM) to which a laserprinter is connected. The work of operating the system is shared between the nursing and medical staff. In order to investigate the acceptance of the printed reports produced with this system, we carried out a poll among the physicians working at the hospital. Among the 86 physicians who receive 95% of the US reports, 58% (n = 50) responded. On the basis of the categories good, satisfactory, adequate and poor, we requested an assessment of layout, presentation, comprehension, completeness and overall impression. The overall impression was assessed as good or satisfactory in 34% and 42%, respectively. In the case of the individual criteria (see above), the categories good and satisfactory scored 62% and 34%, 58% and 32%, 68% and 18% and 72% and 24%, respectively. The terminology used was accepted by 84%. Addition of, for example, image documentation, and endosonography, will expand the advantages of the input of findings and further improve the good overall impression made by the report printout in our survey, so that the relatively long input time requirement accounting for some 30% of the total examination time, is accordingly justified.

Attitude of Health Personnel↗
PubMed2001

An evaluation of telehealth in the provision of rheumatologic consults to a remote area.

OBJECTIVE: To evaluate the feasibility and acceptability of providing telehealth consultations in rheumatology. METHODS: A prospective review of new consults from a rural area assessed by a rheumatologist in an urban area using telehealth. Patient demographics were recorded along with a self-administered questionnaire reporting assessment of the acceptability of the process. Referring physician and consultant provided open ended feedback as to relative strengths and weaknesses of telehealth versus traditional consult. A simple cost and time benefit analysis was undertaken. RESULTS: The spectrum of patients with rheumatic disease assessed was similar to a traditional consultation clinic. Patients found the overall process to be acceptable and effective. Apart from accessibility to specialist consultation, the greatest benefit was improved communication among patient, referring physician, and consultant. The process was determined to be efficient in both time and cost savings. CONCLUSION: Telehealth rheumatology consultations are feasible, acceptable, and cost/time effective and are therefore advocated for those geographic areas where traditional consultations are not readily available.

Adolescent↗
PubMed2001

EBM in practice: internal medicine.

Specialists in internal medicine have a strong research and evidence culture, and there is a large evidence base, particularly for diagnostic tests and therapeutics. Deficiencies in evidence exist in the area of clinical diagnosis, including the sensitivity, specificity and positive and negative predictive values of clinical signs. The practice of evidence-based medicine (EBM) by internal medicine specialists is hindered by lack of clinical information support systems for ongoing practice evaluation, benchmarking and improvement. Many internal medicine practitioners are moving towards the use of clinical practice guidelines to aid the EBM process. A greater acceptance of EBM processes, including evaluation and guidelines, and resolving issues of distrust of bureaucracies, practitioner protection and consumer privacy, would increase the use of EBM in internal medicine.

Evidence-Based Medicine↗
PubMedDate not supplied

[Physiopathologic changes in brain death. Their importance for management and organ donation decisions].

Technological advances in the medical area have allowed for development of useful techniques to treat patients with diverse diseases. For example, at intensive care units this technology allows maintenance blood flow and tissue oxygenation even when brain death (BD) is already established and the individual cannot function. The function of heart, lungs, and other organs can be maintained with different devices, but maintenance of cerebral functions is not not yet possible. Therefore, when a subject fulfills legal and medical requirements for BD, we must be clear that any patient procedure will not keep him alive, although the subject looks alive due to support devices; when BD is present, death must be accepted. Obviously, death is a difficult process to accept, including for health personnel. We consider that it is very important for medical and nursing personnel directly responsible for patient care to receive knowledge on BD and recognize the alternatives with regard this situation, to be able to provide specific orientation when it is required. This paper is a review of the BD concept, main physiopathologic changes, and some possible treatment alternatives to maintain the patient as a potential organ donor.

Brain Death↗
PubMed2003

Using risk communication to disclose the outcome of a participatory decision-making process: effects on the perceived acceptability of risk-policy decisions.

It has been suggested that public participation during decision making about risks can lead to more widely accepted risk policies. This article discusses an experiment to determine if this is true when people are made aware of the fact that a participatory decision-making process has taken place only through information disclosed during a subsequent risk communication effort. The results from this experiment showed that, after receiving information during risk communication that cast risk policies about space exploration as the product of a participatory decision process, participants in the study felt more supportive of the resulting decisions than did participants in a control group. This result coincided with the participants in the study group perceiving the risks associated with the decision to be lower and the benefits higher. Responses from these participants also showed that they were more satisfied with the decision-making process than they were with the outcome of the decision itself Therefore, it may be premature to view the objective of participatory decision-making approaches-and the risk communication efforts that discuss them-as a means of making risk policies more widely acceptable to the public at large. Rather, it may be better to view the benefits of these approaches in terms of their ability to help lead to higher quality decisions that are the product of more widely accepted decision processes.

Journal Article↗
PubMed2006

Establishment of critical hygiene indices for meat cooling processes evaluated by a temperature function integration method.

A temperature function integration technique that involves the calculation of the potential growth of Escherichia coli to obtain a process hygiene index (PHI) is the New Zealand industry standard method for assessing the potential for growth of enteric bacteria during meat cooling processes. The existing criteria to determine the acceptability of a cooling process with PHI values take no account of the differences between meat products and thus limit processing flexibility. A methodology was developed to set criteria for processing acceptability, based on the frequency distribution of the indicator organism E. coli number on meat carcasses immediately after slaughter (in log2 CFU per square centimeter) and a requirement that the E. coli numbers at the end of the cooling process be less than or equal to some maximum acceptable level. This methodology was used, along with accepted guidelines for maximum acceptable levels of E. coli in the meat and measured initial E. coli numbers for the whole New Zealand meat industry, to develop a set of PHI criteria that would be satisfied by a good-practice meat processing operation. A Monte Carlo modeling approach was used to illustrate the implications of these criteria if they had been applied to cooling processes for beef and lamb previously evaluated by the authors. If the proposed criteria were adopted, the maximum allowable PHI for beef cooling could be higher than that for lamb cooling because of the lower initial E. coli numbers found on beef than on lamb carcasses.

Animals↗
PubMed1976

Signal processing: from mathematical theory to clinical acceptance or vice-versa?

Signal processing in physiology and medicine hasn't developed as well as one could have hoped in spite of important efforts in research. The bases for present techniques in signal processing are evaluated for the two types of signals encountered in physiology, namely, continuous signals and point processes. It seems that morphological analysis ought to be adapted to the study of continuous physiological signals and that point processes constitute an important form of signals. The principal areas where industrial development can be expected are explored.

Action Potentials↗
PubMed1981

Posttranslational processing of methyl-accepting chemotaxis proteins in Escherichia coli.

Methyl-accepting chemotaxis proteins (MCPs) of Escherichia coli undergo changes in methylation state in response to chemical stimuli. The addition of methyl groups to MCP is dependent on cheR function; their removal is dependent on cheB function. This MCP methylation system is instrumental in establishing the unstimulated swimming pattern of E. coli and in enabling the cell to carry out sensory adaptation after a chemotactic response. We employed electrophoresis in sodium dodecyl sulfate-containing polyacrylamide gels to analyze MCP molecules synthesized in cheR deletion mutants lacking MCP-specific methyltransferase activity. MCP made under these conditions proved to be completely devoid of methyl groups. In the absence of cheB function as well, this unmethylated MCP is made in a form, designated 2(*), that exhibits several properties characteristic of methylated MCP. In the presence of cheB function, MCP 2(*) is processed to a form, designated 1(*), that no longer resembles methylated MCP. The rate of this conversion process is modulated by chemotactic stimuli. Both MCP 1(*) and MCP 2(*) are capable of initiating changes in flagellar rotation in response to stimuli, and, in the presence of cheR function, both forms can accept methyl groups. We suggest that MCP 2(*) is a normal intermediate in MCP synthesis in which one or more of the methyl-accepting glutamic acid residues carry a methyl-ester-like modification, which, like glutamic acid methyl esters, can be removed by cheB function. This cheB-dependent processing event does not appear to be reversible, but nevertheless it may play an important role in modulating the signaling behavior of newly synthesized MCP molecules.

Bacterial Proteins↗
PubMed2003

[Evaluation of preexposed step wedges in acceptance tests of film processing in mammography].

It was tested with 5 different types of mammography films in which manner the values of "Lightspeed" (LS) and "Lightcontrast" (LC), according DIN V 6868-55 will be changed, when preexposed film strips are used, stored at different climates and spaces of time in comparison to strips, which are exposed immediately before processing. It was proved, that the value LS of preexposed film strips in general will be lowered with increasing storage time compared to freshly exposed film strips, when both strips are processed simultaneously. This drift will be enhanced with increasing rel.humidity levels during storage. The value of LC increases in general with longer storage time and higher rel.humidity levels. The tested film types have all individual drifts in LS and LC. The precision of a single measurement using preexposed film strips was established over all different types of films at in about: Delta LS=0.06 and Delta LC (%)=16% [in the borders of 2 sigma (sigma)]. This uncertainty includes solely the precision of sensitometer, densitometer, the method to establish sensitometric values and unavoidable statistical fluctuations. Even when the systematic drift of the used film type is well established, the required precision, restricted to the listed items and prescribed in DIN V 6868-55, table D.1 to determine the values of LS with Delta LS=0.039 and the values of LC with Delta LC=7.2% is overstepped in so far, that it is impossible to draw a precise conclusion from the measured values to the performance of the subsystem film and processing. If any exceeding of the dose in image receptor plane is monitored, there is no tracking possible to a misadjustment of the subsystem film and processing.

Climate↗
PubMed2006

[Evaluation of duration for direct admission dispatch process in an urban area].

OBJECTIVE: In France, when physicians in ambulances take care of patients, they report medical status to the dispatch centre. Then the dispatching physician search for the available and appropriate hospital service to agree in directly receiving the patient. We attempted to evaluate this direct admission dispatch, in a urban area, with many health care facilities. STUDY DESIGN: Prospective evaluation. PATIENTS AND METHODS: All the files for out of hospital interventions with a dispatch process were included. Data collected and analysed were: main pathologies, started time and end time of direct admission dispatch process and number of services called before finding the right place. RESULTS: 959 patients files were included, 849 could be analysed. The average duration of direct admission dispatch process is 10 (+/-13) minutes. Traumatology speciality shows a longer dispatch process than medicine disease (p < 0.001), and this time increased during summer (p < 0.05). The other parameters did not influence this duration. CONCLUSION: The average duration of direct admission dispatch process is acceptable. The increased duration of direct admission dispatch process in some pathology during summer may induce a risk for the patients. This problem will be improved only when the management of the available bed for emergency traumatology, will be implemented a regional coordination.

Adult↗
PubMed1989

Accepting criticism. A positive process.

Criticism often has negative connotations, even when it is a planned supervisory technique and is part of a comprehensive approach aimed at improving employee behavior without damaging employee morale. The nurse may be the target of criticism from a variety of other people that he or she encounters in the health care setting. The nurse's response to criticism is important to optimal conflict resolution and to maintaining relationships with integrity. The nurse's actions and attitudes in response to criticism should be planned deliberately and directed at resolving the conflict.

Anger↗
PubMed1990

Uniform guidance for medical care. A description of the process for preparing guidelines accepted by different levels of care.

Advice by telephone is an important part of primary health care service. Telephone advice is given at different levels of care. In order to give people confidence in the health care system it is important that personnel at different levels give similar advice for the same symptom or complaint. In order to establish generally accepted guidelines, discussions were held between personnel at different levels of care. This procedure was laborious but successful. Generally accepted guidelines could be agreed upon for all the symptoms and complaints discussed, altogether more than 60. This paper describes the procedure used during the collaborative work to provide these guidelines. It must be emphasised, though, that the guidelines should be adapted to local circumstances before being used as a practical aid in the health care service at health centres and at other outpatient units.

Clinical Protocols↗
PubMed1990

Evaluation of radiographs developed by a new ultrarapid film processing system.

The image quality of radiographs developed by a new ultrarapid processor was evaluated to determine if faster processing causes degradation in the image. The processor used was the Konica Super-Rapid SRX-501 model. Two films designed for this processor (Konica MGH-SR and MGL-SR) were processed in 45 sec and were compared with standard rapid processing in 90 sec of corresponding conventional films (Kodak TMG and OC). Rare-earth screens (Kodak Lanex Regular and Lanex Medium) used with the new and conventional films interleaved during angiographic studies or for phantom images were assessed for image quality. The basic imaging properties of the screen-film systems were examined by measuring (1) Hurter and Driffield curves, (2) modulation transfer functions by using the slit method, and (3) noise Wiener spectra. Subjective clinical assessment showed that the images obtained with ultrarapid processing were acceptable, with increased contrast and graininess. Hurter and Driffield curve measurements confirmed higher gradients. Modulation transfer function measurements were the same as for the conventional films. Noise Wiener spectrum measurements showed a 10% increase in noise for MGH-SR vs TMG film and a 30% increase for MGL-SR vs OC film. We conclude that acceptable image quality can be obtained using ultrarapid processing, with processing time approximately 60% that of conventional rapid processing. Potential applications include all areas in which rapid availability of the radiograph for interpretation is important. Although the processor studied was the first of its kind available, our evaluation indicates that the technology is available for a new class of ultrarapid processors.

Evaluation Studies as Topic↗
PubMed2006

Pulsed electric fields versus thermal treatment: equivalent processes to obtain equally acceptable citrus juices.

Pulsed electric field treatment has been claimed to produce more acceptable chilled citrus juices than those obtained by conventional thermal treatment. The pectin methylesterase activity and the acceptability of nine juices obtained from Clementine mandarins, Valencia oranges, and Ortanique fruits (hybrid of mandarin and orange), untreated, pasteurized (85 degrees C for 10 s), and treated by pulsed electric fields (25 kV/cm for 330 micros), were evaluated. The treatments, selected to reach a similar level of pectin methylesterase inactivation, produced juices that did not differ in acceptability from each other for the three varieties and in all cases were less acceptable than the untreated juice.

Bacteria↗
PubMed2002

[From taboo to self-actualization--acceptance problems and learning processes in working with mentally handicapped patients].

The article introduces the topic of "sexuality and people with developmental disabilities". It presents the historical stages of development and the institutional framework of the work with people with disabilities in Germany. Six criterions and standards respectively, are pointed out, that help to determine whether institutions support or hinder sexual self-determination. These standards are formulated as rights in the sense of the basic human rights.

Adolescent↗