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PubMedDate not supplied

'Imi Hale -- the Native Hawaiian cancer awareness, research, and training network: second-year status report.

PURPOSE: The purpose of this paper is to describe 'Imi Hale, a program developed and managed by Native Hawaiians to increase cancer awareness and research capacity among Native Hawaiians. This US subgroup of indigenous people of the Hawaiian islands has disproportionately high rates of cancer mortality and low rates of participation in health and research careers. METHODS: As a community-based research project, 'Imi Hale spent its first year gathering data from Native Hawaiians about their cancer awareness and research priorities. These findings guide 'Imi Hale's community and scientific advisors, a community-based Institutional Review Board, Na Liko Noelo (budding researchers), and staff in developing and carrying out projects that address these priority areas. Emphasis is placed on transferring skills and resources to Native Hawaiians through training, technical assistance, and mentorship. A biennial survey assesses the extent to which community-based participatory research principles are being followed. PRINCIPAL FINDINGS: By the end of the school year, statewide and island-specific awareness plans were produced, and 9 funded awareness projects are supporting the development and dissemination of Hawaiian health education materials. Research accomplishments include the enrollment of 42 Native Hawaiian Na Liko Noelo (budding researchers), 22 of which are involved in 14 funded research projects. The biennial evaluation survey found that 92% of our advisors felt that 'Imi Hale was promoting scientifically rigorous research that was culturally appropriate and respectful of Native Hawaiian beliefs, and 96% felt that 'Imi Hale was following its own principles of community-based participatory research. CONCLUSION: 'Imi Hale's community-based approach to promoting cancer awareness will result in a sustainable infrastructure for reducing the cancer burden on Native Hawaiians.

Awareness↗
PubMed1985

Application in continuing education for the health professions: chapter five of "Andragogy in Action".

Although the threat of human obsolescence confronts all of humanity, given the accelerating pace of change in our society, it has a particularly strong impact on the professions--especially the health professions. The half-life of the knowledge, skills, attitudes, and values required by physicians, nurses, allied health professionals, and pharmacists is shrinking with increasing speed. Citizens worry about being treated by health practitioners who have not kept up to date and have reacted by passing laws mandating relicensing and continuing professional education. The health care professions and institutions have responded to the threat by mounting massive programs of continuing professional education; in fact, this is probably the fastest-growing aspect of all of education. And, since the clientele of continuing professional education consists exclusively of adults, these programs have tended increasingly to be based on principles of adult learning. This chapter opens with a description of a pilot project for physicians at the University of Southern California, in which the central theme is self-directed learning. The selection presents the need for and assumptions and goals of the project and the major program components, including needs assessment, individualized learning plans, information brokering, and the use of peer resource groups. Then follow three selections focused on the continuing education of nurses. Selection 2, by the American Nurses' Association, sets forth a policy statement and guidelines for self-directed continuing education in nursing. Its provisions could easily be adapted to other professions. The application of the andragogical model to highly technical training in cardiovascular nursing at Doctors Hospital in Little Rock is presented in selection 3, and selection 4 describes an innovative inservice education program in which primary responsibility is placed on the clinical nursing units at St. Mary's Hospital in Waterbury, Connecticut.

Education, Medical, Continuing↗
PubMed2002

Dental aid organisations: baseline data about their reality today.

AIM: To collect basic data about non-governmental dental aid organisations on a global scale and thus contribute to a better understanding of their diversity, activities and limitations. METHODS: Data was collected through a mailed questionnaire to all organisations listed by the FDI World Dental Federation. A second questionnaire was e-mailed to those organisations identified as non-governmental organisations (NGO) by the first questionnaire. FINDINGS: The response rate to the first questionnaire to detect NGOs was 36.2%, to the second e-mailed form 84.4%. About two thirds of NGOs originated in developed countries, one third responded from developing countries. The majority had been established after 1980. Developed countries dental NGOs tended to have larger membership and disposed of greater budgets. In general, income was generated predominantly from donations and own resources. The workforce was primarily based on volunteers. High priority activities: service provision, education and training, technical assistance, community development. Measures for quality assurance showed low complexity. Frequent areas of problems were associated with funding and staff. Collaborative links with other stakeholders in development were weak and focussed on information exchange. CONCLUSIONS: Recommendations for NGOs, donors, FDI and future research are developed.

Budgets↗
PubMed1989

Should there be a formal mechanical-optic-electronic biomedical-engineering program?

To progress in the development of laser medicine and laser surgery, multidisciplinary efforts are required. One important phase in its development is the laser biomedical engineering program being offered following the basic laboratory research. Some of this type of programming is present today, but more development is needed for a formal program offering crossfertilization between engineering and medical uses. Therefore, a formal program is being proposed, which will be reviewed by mixed groups over a period of time. A final recommendation will indicate whether to go ahead with this revision of the program, to wait for further development of the program, or to maintain the status quo. The relationship of technical training for technicians in laser biomedical engineering is also reviewed.

Biomedical Engineering↗
PubMed2000

User acceptability--a critical success factor for picture archiving and communication system implementation.

The Department of Diagnostic Imaging at the Hospital for Sick Children (HSC), Toronto, implemented a picture archiving and communication system (PACS) during the last year. This report describes our experience from the point of view of user acceptability. Based on objective data, the following key success factors were identified: user involvement in PACS planning, training, technical support, and rollout of pilot projects. Although technical factors are critical and must be addressed, the main conclusion of our study is that other nontechnical factors need to be recognized and resolved. Recognition of the importance of these factors to user acceptance and clear communication and consultation will help reduce negative user attitudes and increase the chance of a successful PACS implementation.

Academic Medical Centers↗
PubMed1998

[Clinical results of endovascular stent graft repair for fifty cases of thoracic aortic aneurysms].

Between February 1995 and December 1997, 50 cases (55 lesions) of thoracic aortic aneurysms including 20 cases of aortic dissections were treated with an endovascular technique using the stent grafts. All patients were treated in the operating room under general anesthesia and the stent grafts were implanted through 18 Fr. or 20 Fr. sheaths via femoral arteries under fluoroscopic guidance. The stent graft was composed of several units of self-expanding stainless-steel Z stents covered with an ultra-thin polyester fabric. Stent graft deployment was technically successful in 53 of 55 lesions (delivery success rate: 96.4%). Exclusion of the aneurysms and entry closing without endoleak were achieved within two weeks after the operation in 43 of 53 lesions (initial success rate: 81.1%). Endoleak was found in 10 lesions (minor endoleak: 8 and major endoleak: 2 lesions). Two patients died in the periopertive period of delivery failures as injury to external iliac artery and damage to the delivery sheath caused by tortuous and narrow access routes. Endovascular stent graft repair of thoracic aortic aneurysms is minimally invasive operation in comparison with conventional surgical graft replacement with extracorporeal circulation. These early results suggest that the stent graft repair is possibly safe and useful treatment for the patients of thoracic aortic aneurysms especially in high risk patients. However, careful long-term follow-up is necessary to prove the value and the effects of this endovascular treatment and improvement of the stent graft system and technical training of endovascular surgery for operators are required to reduce the delivery failure and to determine the stent graft repair is reliable treatment.

Adult↗
PubMed2006

Implementing community-based prevention programming: a review of the literature.

In this review of literature we identify consensually validated conclusions and recommendations for implementing community based prevention programming. The general recommendations identified from the literature are as follows: (1) a community must be ready for a prevention program, (2) effective community coalitions must be developed, (3) programming must fit the community, (4) program fidelity should be maintained, and (5) adequate resources, training, technical assistance, and attention to evaluation are necessary. The existing research and expert opinion in the field of prevention science indicate that when these crucial recommendations are incorporated into community prevention practice, the effectiveness of prevention efforts is optimized.

Community Health Planning↗
PubMed1995

Virtual reality in surgical education.

Virtual reality (VR) is an emerging technology that can teach surgeons new procedures and can determine their level of competence before they operate on patients. Also VR allows the trainee to return to the same procedure or task several times later as a refresher course. Laparoscopic surgery is a new operative technique which requires the surgeon to observe the operation on a video-monitor and requires the acquisition of new skills. VR simulation could duplicate the operative field and thereby enhance training and reduce the need for expensive animal training models. Our preliminary experience has shown that we have the technology to model tissues and laparoscopic instruments and to develop in real time a VR learning environment for surgeons. Another basic need is to measure competence. Surgical training is an apprenticeship requiring close supervision and 5-7 years of training. Technical competence is judged by the mentor and has always been subjective. If VR surgical simulators are to play an important role in the future, quantitative measurement of competence would have to be part of the system. Because surgical competence is "vague" and is characterized by such terms as "too long, too short" or "too close, too far," it is possible that the principles of fuzzy logic could be used to measure competence in a VR surgical simulator. Because a surgical procedure consists of a series of tasks and each task is a series of steps, we will plan to create two important tasks in a VR simulator and validate their use. These tasks consist of laparoscopic knot tying and laparoscopic suturing. Our hypothesis is that VR in combination with fuzzy logic can educate surgeons and determine when they are competent to perform these procedures on patients.

Clinical Competence↗
PubMed1987

Dot enzyme immunoassay. A simple, cheap and stable test for antibody to human immunodeficiency virus (HIV).

A dot enzyme immunoassay for antibody to HIV has been developed and tested with a panel of positive and negative sera. It has proved to be of equal or greater sensitivity compared with a commercial ELISA kit, is simple and quick to perform, requires neither sophisticated equipment nor highly trained technical staff. The reagents are stable enough for postal distribution in tropical countries and, other than for the antigen, the costs are low, making it an appropriate test for use in the developing world when funds for expensive commercial kits are not available.

Acquired Immunodeficiency Syndrome↗
PubMed1990

A comparison of alkaline phosphatase and radiolabelled gene probes with bioassays for enterotoxigenic Escherichia coli.

Alkaline phosphatase-conjugated oligonucleotide probes (APO), 32P-labelled oligonucleotide (RO) and cloned polynucleotide (RP) probes were evaluated for their ability to detect enterotoxigenic Escherichia coli (ETEC) as defined by bioassay. These three sets of probes were applied to 301 E. coli strains that had previously been defined by the Y1 adrenal cell assay for heat-labile enterotoxin (LT) and the infant mouse assay for heat-stable enterotoxin (ST). The correlation of the APO probe for LT with the bioassay was 98% with five discrepancies and a positive predictive value (PPV) of 100%. For the APO/ST probe the correlation with the bioassay was 98% with seven discrepancies and a PPV of 96%. The correlation of the RO probe for LT was 99% with four discrepancies and a PPV of 100%, while the overall correlation for the two RO/ST probes was 97% with eight discrepancies and a PPV of 97%. For the RP probes, the correlation for LT was 99% with four discrepancies and a PPV of 100% and for ST was 98% with seven discrepancies and a PPV of 98%. These findings suggest that the APO probes were as sensitive as the RO and RP probes in detecting ETEC by colony hybridization and could be a practical alternative to bioassays and radiolabelled probes for ETEC since they do not require expensive equipment or extensive technical training.

Alkaline Phosphatase↗
PubMed1991

[Interventional radiology in oncology].

Oncology represents a very wide field of applications in interventional radiology. Procedures are diagnostic as well as therapeutic; approaches may be endovascular (either arterial or venous), endocanalar, or transcutaneous; guidance may need X-ray, sonographic, CT scan or endoscopic control. Such a diversity in methods makes clinical and technical training especially long. Main indications of endoarterial approaches are: pain, bleeding, abnormal secretion (endocrine tumors and paraneoplastic syndrome), abnormal function (kidney, spleen), preoperative devascularization of tumors, redistribution of arterial flows before intra arterial chemotherapy, chemoembolizations. Venous pathology is known to be particularly frequent in oncology. Current indications are inferior vena cava filter placement, angioplasty and stenting in case of superior vena cava syndrome, local fibrinolysis, foreign bodies extraction. Drainages, stenosis dilations and stent placements are daily procedures in urinary and biliary tracts in order to treat obstructions, sepsis or fistulas. Transcutaneous approaches under radiological guidance allow biopsies, drainage of deep collections, antalgic nerve infiltrations, gastrostomy. Nowadays, interventional radiology can be considered as a requisite weapon for a correct cancerous patient management, since it is useful from the initial diagnostic biopsy to the palliative care of cancer complications.

Humans↗
PubMed2006

Nurses and emergency disasters: what is known.

Following the events of September 11, 2001, the threat of bioterrorism events has become a realistic concern for health care workers in the United States. Bioterrorism events caused by infectious agents will be challenging because nurses will need to recognize unfamiliar infections and work long hours with limited resources in stressful conditions. During a bioterrorism event caused by biologic agents, nurses will be expected to provide care to infected patients and may fear that they, or their families, could also become infected. A review of literature suggests that nurses' response to working during a bioterrorism event is not well described. The limited number of studies regarding nurses' concerns, fears, and anxieties is focused on nurses' experiences in natural disaster or war situations. Additional studies are needed to validate the appropriateness of applying findings from disaster response studies to bioterrorism events. During bioterrorism events, nurses will be expected to provide physical care and emotional and psychologic support for victims and victims' families. Realistic bioterrorism plans should incorporate strategies to support nurses and address their physical, psychologic, and emotional issues. Strategies to optimize safe working conditions and minimize psychologic trauma such as technical training regarding bioterrorism agents and debriefing opportunities should be included.

Attitude of Health Personnel↗
PubMed2005

Mirror system for photodocumentation in plastic and aesthetic surgery.

Photodocumentation of the face before aesthetic or plastic surgery is of fundamental importance for at least three reasons: it is an aid to surgical planning, it can be used for illustrative purposes in discussions with the patient, and it satisfies medico-legal requirements for documentation. To achieve efficient and economic documentation of preoperative and postoperative status in aesthetic and reconstructive plastic procedures, the mirror system described here permits the required planes to be documented in a single photograph. The simple and inexpensive technical design allows six planes to be documented in constant and, therefore, comparable quality. Because the patient's data are also documented with the photographic record, the potential for mistaken patient identity is eliminated. No technical training is needed to operate the device and it can, therefore, be readily used by ancillary medical personnel. In a typical nasal surgery department performing about 150 rhinoplasty procedures per annum, the mirror system offers cost and time savings generated as a result of reducing the documentation burden by 750 photographs.

Documentation↗
PubMed2004

An introduction to mountain search and rescue.

Alpine search and rescue teams must perform each incident response safely. To do so requires experience, organizational skills, technical training, and ability. In addition, teams should interface with emergency medical control advisors who are familiar with local terrain, mountain rescue operations, and the evacuation techniques employed. To facilitate safety and organization, each mission can be divided into four linked stages: location, reach, stabilize, and evacuate.

Aircraft↗
PubMed2004

The testing of chemicals in the Syrian hamster embryo (SHE) cell transformation assay for assessment of carcinogenic potential.

The Syrian hamster embryo (SHE) cell transformation assay was used to test 28 chemical substances for their ability to induce morphologically transformed colonies. The purpose was to determine how well the assay method could be transferred from an experienced laboratory by including 18 chemicals previously evaluated and 10 new chemicals. Technical training was obtained in the experienced lab prior to testing. The assay was conducted at pH 6.7, a treatment period of 7 days was used, and single experiments were performed for each chemical. With this limited testing, 78% concordance with rodent bioassay results was obtained, and this high concordance would have increased if small, but statistically negative responses from single trials were overturned by positive data from repeat trials. Similarly, the results were highly concordant (90%) with the experienced lab results; only 2 chemical evaluations were discordant, and the use of repeat experiments would likely have eliminated these apparent disagreements. Thus, with appropriate training, the pH 6.7 SHE assay was successfully and reliably transferred.

Animals↗
PubMed1982

Nuclear medicine and complementary modalities in renal trauma.

The diagnosis of renal trauma for many years was achieved through history, clinical findings, the performance of a survey film of the abdomen, urinalysis, excretory urography, aortography, and selective renal artery arteriography. The development of the scintillation camera and the availability of 99mTc, as well as 99mTc labeled pharmaceuticals, approximately fifteen years ago has widened this diagnostic horizon. Exquisite new imaging modalities have become available recently. As a result of constantly improving technology, these techniques--including computed tomography, sonography, with real time enhancement, and digital video subtraction angiography--are utilized more and more frequently. The full impact of these newest wonders is not yet realized. Cost-effectiveness, radiation exposure, accumulative drug side-effects, availability of facilities and personnel and professional and technical training have become major considerations.

Contusions↗
PubMed1999

The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections.

BACKGROUND: An ever increasing demand to evaluate the effect of dietary supplements on specific health conditions by use of a "significant scientific" standard has prompted the publication of this study. OBJECTIVE: To study the effect of megadose Vitamin C in preventing and relieving cold and flu symptoms in a test group compared with a control group. DESIGN: Prospective, controlled study of students in a technical training facility. SUBJECTS: A total of 463 students ranging in age from 18 to 32 years made up the control group. A total of 252 students ranging in age from 18 to 30 years made up the experimental or test group. METHOD: Investigators tracked the number of reports of cold and flu symptoms among the 1991 test population of the facility compared with the reports of like symptoms among the 1990 control population. Those in the control population reporting symptoms were treated with pain relievers and decongestants, whereas those in the test population reporting symptoms were treated with hourly doses of 1000 mg of Vitamin C for the first 6 hours and then 3 times daily thereafter. Those not reporting symptoms in the test group were also administered 1000-mg doses 3 times daily. RESULTS: Overall, reported flu and cold symptoms in the test group decreased 85% compared with the control group after the administration of megadose Vitamin C. CONCLUSION: Vitamin C in megadoses administered before or after the appearance of cold and flu symptoms relieved and prevented the symptoms in the test population compared with the control group.

Adolescent↗
PubMed2000

Computed tomography for the evaluation of children with chronic rhinosinusitis: proposal of a reduced examination and comparison with the standard examination.

Rhinosinusitis is a disease that has attracted increasing attention both in terms of triggering factors and of treatment evolution, with its possible complications and repercussions. Follow-up of chronic cases almost always requires imaging evaluation and computed tomography (CT) has been considered the 'gold standard' for these cases, for which the exam must often be repeated more than once. This fact implies submitting the patient to a greater radiation load and, in the case of some children, to repeated sedation, causing possible damage to the patient, concern to the parents and to the physician when he requests this procedure. In the present study, the authors propose a reduced CT technique compared to the standard exam, with a smaller number of slices, to be used for the initial evaluation of a case and for the follow-up of chronic cases, with the standard examination reserved for cases requiring the best possible anatomical detailing, such as surgical cases. The standard technique involves 2-mm thick sections spaced 5 mm apart. In the reduced technique, the spacing is 10 mm, with a consequent reduction in the number of sections. Twenty-one children aged 4-13 years were submitted for the examination. The advantages of the proposed method reside in the reduction of the radiation load to which the patient is exposed, in its better agility, with a reduced time of execution and a consequent increase in collaboration on the part of the child, and in the reduction on cost of the procedure. It is also a technique of easy execution that does not require specific technical training.

Adolescent↗