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Ekwall's method in social medicine.

The application of Ekwall's method is of considerable importance not only in medicine but also in social sciences and in all sciences concerned with man where qualitative information is used. The authors developed their own variant of Ekwall's method and used it for the evaluation of results of a survey concerned with children at risk. After an explanation of the essence of the method and principles of its application, the authors explain the variant for possible use in social medicine. An important contribution of this procedure is above all the possibility to evaluate the individual comprehensively according to defined signs and to assess accurately the distribution and also the order of comprehensively evaluated individuals of the investigated group.

Child↗

[Status of pathological anatomy in the socialist and people's democracy countries].

The state of pathological anatomy in the SRV, GDR, PPR, PRB, HRP, CSSR, SFRYu is described on the basis of the literature, and some information on the development of this science in the USSR is presented. The materials of the International Symposium of representatives of the Societies of pathologists of the socialist countries (Berlin, March, 1979) have been used.

Communism↗

Health status measures in allied health curricula: results of a national survey.

Multidimensional health status measures can be used as vehicles to improve communications between patients and clinicians and to monitor, measure, and manage clinical progress. However, earlier work indicated that few multidimensional health status instruments were used as outcome measures in allied health research. To determine if these instruments were included in physical therapy (PT), occupational therapy (OT), respiratory therapy (RT), communication sciences and disorders (CSD) and health information management (HIM) career entry curricula, we surveyed the directors of all PT, OT, RT-BS, CSD and HIM programs in the United States. Based on responses from 130 (100%) of PT programs, 79 of 80 (99%) of OT programs, 31 of 32 (97%) of RT-BS programs, 144 of 199 (72%) CSD programs and 44 of 53 (83%) of HIM programs, we conclude that few allied health students are introduced to multidimensional health status instruments in their professional programs. We suggest that (1) the inclusion of multidimensional quality of life measures could be used as a mechanism to introduce allied health students to a broader definition of health; (2) the use of these instruments in clinical practice will assist therapists to communicate better with patients and address issues of their concern; and (3) their use will provide common clinical assessment instruments and vocabularies to facilitate the interdisciplinary management of patients.

Allied Health Occupations↗

Informatics and general pediatrics.

Medical informatics is both a science, which seeks to understand the information requirements of medical practice, research, and education, and an engineering discipline, which applies new technologies to help manage the explosion of data and new knowledge that confront contemporary physicians. Computerization of the patient record is expected to resolve long-standing problems with the current paper-based system. Medical decision support applications provide patient-specific advice and remind clinicians about problems that might otherwise be overlooked. New methods are required to evaluate the performance of expert systems in the medical domain where a single "gold standard" solution may not exist. Modern technologies can facilitate communication among multiple providers and between clinicians and patients. The need for improvements in user-interface design and for standards for recording and interchanging information pose ongoing challenges for informatics research.

Communication↗

The availability of research journals in South African academic medical libraries.

Biomedical researchers depend on the journals of science as a primary source of information. The spiralling cost of journals threatens the ability of libraries to provide their users' information needs. In this study the availability of a representative sample of journals used by South African biomedical researchers was determined at each of the seven medical faculty libraries. The application of a standardised document delivery test is described and the results are interpreted in terms of: (i) the capability index, which includes material obtainable through inter-library loans; and (ii) an availability index, or measure of the probability that a user will find an item without delay in his/her own library. The current status of availability of biomedical journals was found to be high at all the libraries; indeed, the scores compare favourably with results obtained at academic libraries overseas. There is, however, real concern that the financial crisis in tertiary education will cause the situation to deteriorate. Repetition of this test is recommended to monitor the (probably declining) level of journal availability. The information would support efforts to rationalise and subsequently strengthen academic medical libraries' collective holdings as a strategic national resource.

Costs and Cost Analysis↗

[Computer databases and scientific and research information systems].

Medical informatics, especially computer data bases for collecting, processing and searching of scientific and research informations and publications is important for medical science and for the medical practice. Medical scientific informatics has developed as a special part of medical informatics. It is very important for medical education, medical research and publishing in biomedical disciplines. This paper presents the main characteristics of scientific and research information, their resources, searching of medical literature from biomedical journals. A historical survey of the foundation of the System for Biomedical Scientific Information in ex Yugoslavia (SBMNI) has been presented, with its conceptual basis, the current organization, the achieved results and experiences obtained.

Information Systems↗

Biomechanics of malalignment.

This article summarizes the range and variation of femorotibial alignment, the horizontal orientation of the hip, knee, and ankle joint line, and other pertinent anatomic factors of the lower extremity in normal population groups evenly divided according to gender and age. Although the present data deals only with a two-dimensional frontal plane analysis, it should provide valuable information for subsequent clinical and basic science investigations.

Adult↗

The management of cardiac arrhythmias.

The first and most important aspect of the management of a cardiac arrhythmia is its precise identification, and intracardiac recordings should be made in cases of doubt. When confronted with a patient with an arrhythmia the first decision is whether it needs treating at all. If it does the next problem is to decide whether to begin with electrical or pharmacological treatment, and here the important feature is the clinical state of the patient: the more ill the patient and the larger the haemodynamic disturbance, the greater the relative indication for electrical (cardioversion or pacing) therapy. Although there has been some progress in the understanding of the pathological physiology of arrhythmias and attempts have been made to rationalize the classification of cardioactive drugs, these sciences have not so far provided information of clinical value. The drug therapy of arrhythmias is largely arbitrary, but few drugs are involved. The most important thing of all is for an individual clinician to become familiar with the most significant of these drugs and not to indulge in polypharmacy, because all antiarrhythmic drugs can lead to either depression or overexcitation of the myocardium.

Anti-Arrhythmia Agents↗

Nutri-action analysis as a research strategy to improve nutrition information, education and communication interventions in Asia.

What is lacking in nutrition information, education and communication (IEC) work today is accurate knowledge about the processes which bring about beneficial nutritional behavior changes. In this paper, Nutri-action Analysis is proposed as a mechanism for nutrition planners to gain this knowledge and seek ways to improve the effectiveness of nutrition IEC interventions. It suggests that a more holistic and dynamic approach is necessary to conceptualize nutrition IEC and increase its effectiveness in bringing about changes in behaviors which lead to nutritional status improvement. Nutri-Action Analysis, as a research strategy, is illustrated by a three-stage procedure: (i) pre-action, (ii) action, and (iii) post-action. This process leads investigators to begin conducting a macro-analysis of nutrition IEC in general and within their specific contexts in order to understand the system and identify the best approach to be adopted for a nutrition IEC intervention in their particular context. What is discovered should then be tested in a community-based operational research study using both quantitative and qualitative data so that it is possible to subsequently conduct a synthesis focusing on process determinants.

Asia↗

[Introduction of new GCP (good clinical practice)].

In 1997, a new GCP has taken effect by the Ministry of Health and Welfare, Japan, and will be enforced as of April, 1998. The GCP regulates the method of clinical trials in the light of ethics and science. The New GCP requires written informed consent, enforcement of the responsibility of the client and so on.

Antineoplastic Agents↗

Fundamental concepts of problem-based learning for the new facilitator.

Problem-based learning (PBL) is a powerful small group learning tool that should be part of the armamentarium of every serious educator. Classic PBL uses ill-structured problems to simulate the conditions that occur in the real environment. Students play an active role and use an iterative process of seeking new information based on identified learning issues, restructuring the information in light of the new knowledge, gathering additional information, and so forth. Faculty play a facilitatory role, not a traditional instructional role, by posing metacognitive questions to students. These questions serve to assist in organizing, generalizing, and evaluating knowledge; to probe for supporting evidence; to explore faulty reasoning; to stimulate discussion of attitudes; and to develop self-directed learning and self-assessment skills. Professional librarians play significant roles in the PBL environment extending from traditional service provider to resource person to educator. Students and faculty usually find the learning experience productive and enjoyable.

Curriculum↗