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PubMed2000

[Early discharge project appropriate for the healthy newborn].

Recently the stay in the hospital of the pueperae and of their newborns has progressively been shortened in several Countries. A lot of reports evaluating the risks of early discharges have not shown any significant differences in the hospital readmission rates between newborn early discharged and case-controls. This phenomenon is occurring also in Italy and the early discharge after the delivery is one of the aims of the "Percorso-Nascita" in the National Health Program of 1998-2000. Since three years ago, in the Nursery of the Department of Neonatal Medicine of University of Parma we have been discharging the newborns at term in the second day of life, choosing the healthy newborns in agreement with the obstetricians. The increment of the early discharges has happened in our Department after realizing that those did not create an increment of the hospital admissions in the neonatal period. Since January 2000 in Parma the project of appropriate discharge named "around the cradle" derived from the cooperation between hospitals and territory is working. This project consists of a continuous essistential support for mothers and children throughout an organic integration between hospital and territory. The women that take part to this project have the opportunity to be discharged from the hospital between the 44 and the 56 hours after the physiological delivery, being followed at home by the local obstetrician and paediatrician. The project is divided into three parts. The first part, pre-partum, is based on the information that is delivered to all the pregnant women that are eligible; the second part, the hospital phase, implies the usual and routinary care to the pueperae and their newborns as well as the clinical neonatal and obstetrical evaluation that allows to select our cohort. In the latter phase, extra-hospital, the local paediatrician take care of the newborn and start examining him/her within 72 hours after the discharge, while the home assistance of the local obstetrician will be within 48 hours. After initial difficulties, the organization of this project is quite efficient with a constant increment of attending requests to our project by the patients. Of course this is an organizative model quite complex that needs to verify process, efficiency and results, but anyway it sees the cooperation among many professionists of different specialities: neonatologists, paediatricians, obstetricians, practitioners, all working together for a common programme.

Humans↗
PubMed2001

Patient education in Belgium: evolution, policy and perspectives.

Patient education started in Belgium in the late 70s. Tuberculosis and diabetes management and care were the first topics addressed. In the two main regions of the country (Flemish and French), the development of patient education has been very different. The Belgian French Ministry of Health and regional hospital associations appointed a non-profit resource center, the "Center d'Education du Patient", in order to help hospital departments and health care teams start and improve patient education work and programs. University training programmes were created in the 80s, and an inter-hospital network organized to facilitate collaborations. Later, patient education hospital committees and coordinators were appointed, and professional organizations (patient education nurses and coordinators organization) were set up. In 1999, 98% of French speaking hospitals state that they have patient education programmes (three per hospital, on average), a remarkable growth from 7% in 1983. Belgium has joined the WHO health promoting hospitals project in 1996. In private practice, due to the "payment on service" system that does not allow means for patient education work, patient education is still rare. In the Flemish region, patient education programmes exist in some hospitals, on private initiatives, without support from the Ministry of Health, nor from the health promotion agency. On the conceptual side, programmes have shifted from a "patient instruction" perspective focusing on the biomedical aspects of health and disease, and professional expertize and needs assessment, to "patient participation" dealing with biopsychosocial health and disease. Lay and subjective needs and "life projects" are more and more taken as a basis for patient counseling and therapeutic education. With the renewed involvement of the government in patients rights, and the possibility to start funding patient education as any other care work, new developments of patient education are expected in the next years.

Belgium↗
PubMed1998

Planning and conducting a multi-institutional project on fatigue.

PURPOSE/OBJECTIVES: To describe the process used in proposal development and study implementation for a complex multisite project on cancer treatment-related fatigue (CRF), identify strategies used to manage the project, and provide recommendations for teams planning multisite research. DATA SOURCES: Information derived from project team meeting records, correspondence, proposals, and personal recollection. DATA SYNTHESIS: The project was built on preexisting relationships among the three site investigators who then built a team including faculty, research coordinators, staff nurses, and students. Study sites had a range of organizational models, and the proposal was designed to capitalize on the organizational and resource strengths of each setting. Three team members drawn from outside oncology nursing provided expertise in measurement and experience with fatigue in other populations. Planning meetings were critical to the success of the project. Conference calls, fax technology, and electronic mail were used for communication. Flexibility was important in managing crises and shifting responsibility for specific components of the work. The team documented and evaluated the process used for multisite research, completed a major instrumentation study, and developed a cognitive-behavioral intervention for CRF. CONCLUSIONS: Accomplishments during the one-year planning grant exceeded initial expectations. The process of conducting multisite research is complex, especially when the starting point is a planning grant with specific research protocols to be developed and implemented over one year. Explicit planning for decision-making processes to be used throughout the project, acknowledging the differences among the study settings and planning the protocols to capitalize upon those differences, and recruiting a strong research team that included a member with planning grant and team-building expertise were essential elements for success. IMPLICATIONS FOR NURSING PRACTICE: Specific recommendations for others planning multisite research are related to team-building, team membership, communication, behavioral norms, role flexibility, resources, feedback, problem management, and shared recognition.

Communication↗
PubMed2001

Project, design, and use of a pilot plant for nanocapsule production.

The aim of this study was to find the scale-up parameters necessary for the preparation of nanocapsules (NCs) for pharmaceutical purposes. Starting from the laboratory scale (0.06 L), we designed and assembled a pilot plant (2 L) to produce NCs with the so-called emulsification-diffusion technique. We wanted to check if classical tools adequate for the pharmaceutical industry and for industrial scale-up purposes according to well-known chemical engineering technique could be used to perform the NC preparation. Experiments were carried out by varying some operative parameters, such as the impeller speed, the agitation duration for the emulsion preparation, and the reagent concentrations. As expected, good accordance between the NC produced at the laboratory scale and at the pilot plant scale was obtained. We conclude that the pilot plant can be used to perform a scale-up study of the industrial production of NC.

Capsules↗
PubMed2004

Seal of transparency heritage in the CISMeF quality-controlled health gateway.

BACKGROUND: It is an absolute necessity to continually assess the quality of health information on the Internet. Quality-controlled subject gateways are Internet services which apply a selected set of targeted measures to support systematic resource discovery. METHODS: The CISMeF health gateway became a contributor to the MedCIRCLE project to evaluate 270 health information providers. The transparency heritage consists of using the evaluation performed on providers that are referenced in the CISMeF catalogue for evaluating the documents they publish, thus passing on the transparency label from the publishers to their documents. RESULTS: Each site rated in CISMeF has a record in the CISMeF database that generates an RDF into HTML file. The search tool Doc'CISMeF displays information originating from every publisher evaluated with a specific MedCIRCLE button, which is linked to the MedCIRCLE central repository. Starting with 270 websites, this trust heritage has led to 6,480 evaluated resources in CISMeF (49.8% of the 13,012 resources included in CISMeF). CONCLUSION: With the MedCIRCLE project and transparency heritage, CISMeF became an explicit third party.

Abstracting and Indexing↗
PubMed2005

The impact of school daily schedule on adolescent sleep.

OBJECTIVES: This study was initiated to examine the impact of starting school on adolescent sleep, to compare weekday and weekend sleep times, and to attempt to normalize the timing of the circadian sleep/wake cycle by administering bright light in the morning. This was a collaborative project involving high school students and their parents, as well as high school and university faculty members, for the purpose of contributing information to the scientific community while educating students about research processes and their own sleep/wake cycles and patterns. METHODS: Sixty incoming high school seniors kept sleep/wake diaries beginning in August and continuing through 2 weeks after the start of school in September. Sleep diaries were also kept for 1 month in November and 1 month in February. Early-morning light treatments were given to 19 students in the last 2 weeks of November and the last 2 weeks of February. Neuropsychologic performance was measured with computer-administered tests. Paper-and-pencil tests were used for assessment of mood and vigor. A testing period consisted of 2 consecutive days at the beginning and end of November and at the beginning and end of February. Tests were given 3 times per day, ie, in the morning before school (6:30-8:00 AM), during midday lunch periods (11:30 AM to 1:00 PM), and in the afternoon (3:00-4:30 PM), on each of the test days. RESULTS: Adolescents lost as much as 120 minutes of sleep per night during the week after the start of school, and weekend sleep time was also significantly longer (approximately 30 minutes) than that seen before the start of school (August). No significant differences were found between weekday sleep in the summer and weekend sleep during the school year. Early-morning light treatments did not modify total minutes of sleep per night, mood, or computer-administered vigilance test results. All students performed better in the afternoon than in the morning. Students in early morning classes reported being wearier, being less alert, and having to expend greater effort. CONCLUSIONS: The results of this study demonstrated that current high school start times contribute to sleep deprivation among adolescents. Consistent with a delay in circadian sleep phase, students performed better later in the day than in the early morning. However, exposure to bright light in the morning did not change the sleep/wake cycle or improve daytime performance during weekdays. Both short-term and long-term strategies that address the epidemic of sleep deprivation among adolescents will be necessary to improve health and maximize school performance.

Adolescent↗
PubMedDate not supplied

The status of breast cancer screening: a quarter of a century of research.

This article begins with a summary of the methods and results of the first randomized, controlled trial conducted to test the efficacy of periodic screening in reducing breast cancer mortality. The study was started in December, 1963 and the final phases of follow-up to determine the screening's long-term effect ended in 1986. Over 60,000 women aged 40-64 years, who were members of the Health Insurance Plan of Greater New York (HIP), were assigned at random to either a study group or a control group. The study group was offered screening examinations consisting of mammography and a clinical examination of the breast. About 67% accepted the invitation for an initial screening; a large proportion returned for 3 reexaminations at annual intervals. The control group continued to receive their usual medical care. By 10 years from entry, breast cancer deaths were reduced 30% among the study group women; over the long run of 18 years from entry, the decrease was 23-24%. The benefit from screening was found to be more certain among women who were over 50 years of age at the start of screening than among those aged 40-49 years. This article also describes research on efficacy of breast cancer screening started more recently in Sweden, the Netherlands, United Kingdom, and Canada, and reviews available findings which reinforce the results of the HIP project. Information is given on policies and guidelines being adopted in many countries regarding modalities, frequency, and ages to be included in breast cancer screening programs.

Breast Neoplasms↗
PubMed1991

Microglia in tadpoles of Xenopus laevis: normal distribution and the response to optic nerve injury.

We have studied the distribution of microglia in normal Xenopus tadpoles and after an optic nerve lesion, using a monoclonal antibody (5F4) raised against Xenopus retinas of which the optic nerves had been cut 10 days previously. The antibody 5F4 selectively recognizes macrophages and microglia in Xenopus. In normal animals microglia are sparsely but widely distributed throughout the retina, optic nerve, diencephalon and mesencephalon (other regions were not examined). After crush or cut of an optic nerve, or eye removal, there occurs an extensive microglial response along the affected optic pathway. Within 18 h an increase in the number of microglial cells in the optic tract and tectum can be detected. This response increases to peak at around 5 days after the lesion. At this time the nerve distal to the lesion contains many microglial cells; the entire optic tract is outlined by microglia, extended along the degenerating fibres; and the affected tectum shows a heavy concentration of microglia. This microglial response thereafter decreases and has mostly gone by 34 days. We conclude that the microglial response to optic nerve injury in Xenopus tadpoles starts early, peaks just before the regenerating optic nerve axons enter the brain, and is much diminished by the time the retinotectal projection is re-established. The timing is such that the microglial response could play a major role in facilitating regeneration.

Animals↗
PubMed1991

5-Fluorouracil (FU) with folinic acid (FA) and mitomycin C (MMC) in the adjuvant treatment of colorectal carcinoma. Part I. Evaluation of toxicity.

Ninety-six patients with colorectal cancer (stage B2-C) were randomized to the control arm or to receive adjuvant chemotherapy with folinic acid, FU and MMC. Ninety-three patients are evaluable. The median follow up is 12 months. The average time between surgery and the start of therapy is 28 days. Toxicity is evaluable in 36 of 41 treated patients. Four patients (10%) failed to complete the projected treatment due to toxicity. Toxicity observed in 208 courses of therapy was mostly gastrointestinal and hematological. No cases of treatment related death or cancer-associated hemolytic uremic syndrome (C-HUS) were reported. The average relative dose intensity (rDI) of the projected treatment was 82.6%. Our study is ongoing and further patients are required to achieve statistically significant results.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

A wide concentration range olfactometer for delivery of short reproducible odor pulses.

A multistage dynamic flow dilution olfactometer allowing the delivery of precisely controlled stimuli over a wide concentration range is presented. Discrete concentration values, in the range 10(-6) to 5.6 X 10(-2) of the saturated vapor of an odorous compound, are obtained from two original concentration by combining 4 dilution stages. Short stimulus pulses, of a known and reproducible concentration and with short rising and falling times, are sampled from steady concentration levels. A programmable controller manages the olfactometer dilution stage selection, the odor stimulus switch and starts the peripheral devices required by the experiment. The programming of olfactometer function makes it an extremely flexible system for various experimental projects in olfaction.

Animals↗
PubMedDate not supplied

Model-based particle picking for cryo-electron microscopy.

We describe an algorithm for finding particle images in cryo-EM micrographs. The algorithm starts from a crude 3D map of the target particle, computed from a relatively small number of manually picked images, and then projects the map in many different directions to give synthetic 2D templates. The templates are clustered and averaged and then cross-correlated with the micrographs. A probabilistic model of the imaging process then scores cross-correlation peaks to produce the final picks. We give quantitative results on two quite different target particles: keyhole limpet hemocyanin and p97 AAA ATPase. On these particles our automatic particle picker shows human performance level, as measured by the Fourier shell correlations of 3D reconstructions.

Adenosine Triphosphatases↗
PubMed2004

[AA Amyloidosis: recent knowledges on pathophysiology].

PURPOSE: Amyloidosis is a rare disease associated with an underestimated frequency because of the need of a pathological diagnosis identifying extracellular deposits with affinity for Congo red. There are moreover 20 proteins that can form extracellular fibril deposits. Some amyloidosis forms are more common than others, especially AA amyloidosis and AL amyloidosis. Among genetic amyloidosis, the transthyretin related amyloidosis is the most prevalent. The amyloid frequency could also be increased if amyloidosis related to Alzheimer's disease or prion's disease is included. In the absence of specific treatment for amyloidosis, researches are focused on amyloidosis pathophysiology especially, on AA amyloid pathophysiology. CURRENT KNOWLEDGE AND KEY POINTS: Amyloid is not only composed of fibrils but also of proteoglycanes, P component and amyloid-enhancing factor. A new research aim is focused on the cells involved in amyloid formation and on the relationship between amyloid, proteoglycanes and P component. FUTURE PROSPECTS AND PROJECTS: It was demonstrated that, in the absence of macrophages, an extracellular amyloid formation was possible with amyloid-enhancing factor as starting point. Some inhibitors of intra or extracellular amyloid formation are still to be discovered. Anti-P component has been recently developed; it was successful in the treatment of murin AA amyloidosis and gave some hope concerning the treatment of human amyloidosis.

Amyloidosis↗
PubMed2006

Improving the hit-to-lead process: data-driven assessment of drug-like and lead-like screening hits.

Drug-like and lead-like hits derived from HTS campaigns provide good starting points for lead optimization. However, too strong emphasis on potency as hit-selection parameter might hamper the success of such projects. A detailed absorption, distribution, metabolism, excretion and toxicology (ADME-Tox) profiling is needed to help identify hits with a minimum number of (known) liabilities. This is particularly true for drug-like hits. Herein, we describe how to break down large numbers of screening hits and we provide a comprehensive overview of the strengths and weaknesses for each structural class. The overall profile (e.g. ligand efficiency, selectivity and ADME-Tox) is the distinctive feature that will define the priority for follow-up.

Administration, Oral↗
PubMed1993

[HIV infection in pregnancy and childhood].

In two ongoing nationwide collaborative studies 375 children of 337 HIV infected mothers (Neonatal HIV Study [started in October 1986], C. Kind, M. D., St. Gall) and 154 pregnancies/induced abortions in 148 HIV infected women (HIV and Pregnancy [started in May 1989], Ch. Rudin, M. D., Basel) have been registered and studied to date. Experiences gained from the two ongoing projects are presented. Viral load during pregnancy seems to influence the vertical transmission rate. There are many differences between HIV infections in children and adults. This is also true for ophthalmologic involvement. Psychosocial problems may be prominent in the care of children born to HIV infected mothers. Recruitment of foster parents is the most serious problem in this context.

AIDS-Related Opportunistic Infections↗
PubMed1979

Sequence of shortening of the normal human left ventricle.

Left ventricular sequence of shortening was studied through the analysis of cineventriculograms in 30 degree right anterior oblique projection of 11 normal patients. In all patients transverse shortening progressed in base to apex direction, in a concentric fashion. Base descent started simultaneously with the first transverse inward motion and continued throughout systole. There was a slight protrusion of the apex in the beginning of systole, lasting a mean of 115 ms.

Adolescent↗
PubMedDate not supplied

Willet M. Hays, great benefactor to plant breeding and the founder of our association.

Willet M. Hays was a great benefactor to plant breeding and the founder of the American Genetic Association (AGA). We commemorate the AGA's centennial. We mined university archives, U.S. Department of Agriculture (USDA) yearbooks, plant breeding textbooks, scientific periodicals, and descendants for information. Willet Hays first recognized the individual plant as the unit of selection and started systematic pure-line selection and progeny tests in 1888. He developed useful plant breeding methods. He selected superior flax (Linum usitatissimum L.), wheat (Triticum vulgare L.), corn (Zea mays L.), barley (Hordeum vulgare L.), and oat (Avena sativa L.) varieties, and discovered Grimm alfalfa (Medicago sativa L.); all became commercially important. He initiated branch stations for better performance testing. Willet Hays befriended colleagues in other universities, in federal stations, in a London conference, and in Europe. He gathered and spread the scientific plant breeding gospel. He also improved rural roads and initiated animal breeding records and agricultural economics records. He started the AGA in 1903, serving as secretary for 10 years. He became assistant secretary of agriculture in 1904. He introduced the project system for agricultural research. He authored or coauthored the Nelson Amendment, the Smith-Lever Act, the Smith-Hughes Act, and the protocol leading to the United Nations Food and Agriculture Organization-all involved teaching agricultural practices that improved the world.

Agriculture↗