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PubMed2001

Human navigation in electronic environments.

The problem of human navigation in electronic environments is central to the debate on human experience with new technologies. The studies carried out, in particular in environmental psychology, offer a starting point for a better understanding of the origin of cognitive difficulties and the problems that can occur when moving in new habitats. A project aimed at improving the usability of these environments and their compatibility with human beings cannot fail to include a wide-ranging ergonomic examination that considers the multiple cognitive and cultural aspects implied. This study considers hypermedial and three-dimensional interactive graphic environments. We describe some weak points encountered during user navigation and we examine certain improvements made by research in the sector. Lastly, a hybrid system that combines these two different types of systems was created and discussed. This system, called Percepta, offers users the possibility of adopting cognitive systems for human navigation that are already effective in the real world and permits the planning of efficient strategies for navigation, taking account of the initial pre-established aims and the continuous reprocessing that occurs during navigation. Future research lines will analyze qualitative and quantitative aspects of this software to produce an accurate final assessment.

Behavior↗
PubMed1999

When did bovine spongiform encephalopathy (BSE) start? Implications on the prediction of a new variant of Creutzfeldt-Jakob disease (nvCJD) epidemic.

BACKGROUND: Knowing the starting date of the BSE epidemic and its size at the very beginning is crucial to interpret the timing of the nvCJD cases and to forecast the nvCJD epidemic. The first cases occurred in 1985. The models devised by Anderson (back-calculation) and Dealler (age-period-cohort) led to an estimate of less than 50 cases in 1983, and none earlier. Here, we applied age-cohort models to the BSE data in order to estimate the earliest possible date of the first unrecognized BSE cases. METHODS: The numbers of confirmed BSE cases in the UK, by age group and by calendar year from 1988 to 1996, were analysed by Poisson regression. The cases' age distribution was considered as constant between the different birth cohorts. The herd's age structure was taken into account. RESULTS: According to the models, BSE cases may have occurred as early as 1980. The expected number of cases before 1990 is almost twice the number of confirmed cases and exceeds by more than 20% the expected value of Anderson's model. The scenario of first human exposure in 1980 leads to fewer future nvCJD cases than predicted by Cousens with exposure patterns starting in 1983 or 1985. CONCLUSION: The first birth cohort available, consisting of two cases older than 10 in 1988, does not allow any projections before 1980. Moreover, confidence intervals are wide and the power of the study is limited by the great dispersion of the data; the precision of the estimations would be improved by considering geographical incidence. Nevertheless, our projections are consistent with Wilesmith's survey of rendering plants relating the emergence of BSE to the dramatic fall in the proportion of meat and bone meal following solvent extraction, initiated in the late 1970s (65% in 1977 to 10% in 1983).

Animals↗
PubMed1997

The NRSub database: update 1997.

In the context of the international project aiming at sequencing the whole genome of Bacillus subtilis we have developed NRSub, a non-redundant database of sequences from this organism. Starting from the B.subtilis sequences available in the repository collections we have removed all encountered duplications, then we have added extra annotations to the sequences (e.g. accession numbers for the genes, locations on the genetic map, codon usage index). We have also added cross-references with EMBL/GenBank/DDBJ, MEDLINE, SWISS-PROT and ENZYME databases. NRSub is distributed through anonymous FTP as a text file in EMBL format and as an ACNUC database. It is also possible to access the database through two dedicated World Wide Web servers located in France (http://acnuc.univ-lyon1.fr/nrsub/nrsub.++ +html ) and in Japan (http://ddbjs4h.genes.nig.ac.jp/ ).

Academies and Institutes↗
PubMed1993

The role of extracellular calcium in generating and in phase-shifting the Bulla ocular circadian rhythm.

Since extracellular calcium is known to be involved in the entrainment of the circadian pacemaker in the retina of Bulla gouldiana, we have assessed the requirement for extracellular calcium in the generation of the circadian rhythm. To enable us to assay the state of the pacemaker during low-calcium treatment, which often obscures rhythmicity, long-duration pulses of low-calcium artificial seawater (no added calcium, 10 mM EGTA, calculated calcium concentration = 4.5 x 10(-10) M) were applied, and the phase of the subsequent rhythm was measured. Pulse treatments started at zeitgeber time (ZT) 6, and durations ranged from 4 to 72 hr. Although no phase shifts followed pulses ending before the next projected dawn (ZT 24), phase delays of up to 4 hr followed pulses ending after projected dawn, and delays of up to 8 hr followed pulses spanning two dawns. Some activity records exhibited unequivocal circadian rhythmicity during the long low-calcium treatments, with phases and periods similar to untreated control eye records; this finding suggests that the phase delays observed following long low-calcium pulses are attributable to the pulsatile nature of the treatment. These data suggest that extracellular calcium is not an essential requirement for the pacemaker in generating the circadian rhythm.

Action Potentials↗
PubMed2001

Ductal adenocarcinoma of the prostate with endometrioid features in a 69-year-old man.

We describe a case of ductal adenocarcinoma of the prostate with endometrioid characteristics presenting as painless hematuria and intraurethral tumor. A 69-year-old man had intermittent painless hematuria for 2 months. The serum prostate-specific antigen concentration was elevated (22.0 ng/mL). An enlarged prostate with a necrotic tumor was noted in the right lobe of the prostate on computerized tomography and magnetic resonance imaging studies. A polypoid and worm-like tumor was found within the prostatic urethra near the verumontanum. The tumor had a distinctly papillary configuration with a focal glandular structure on microscopy. Radical prostatectomy was performed and histology of the tumor specimen revealed it to be composed of a closely packed glandular structure lined by single layers of high columnar cells with focal stratification. Frequent papillary projections of glandular epithelium and intraglandular bridging were noted, with a histopathologic appearance similar to endometrioid carcinoma of the uterus. Androgen deprivation therapy was started immediately following surgery. No evidence of recurrence or metastasis was found at follow-up 27 months postoperatively. Distinct features of ductal adenocarcinoma of the prostate include intraurethral papillary tumor close to the verumontanum, urethral obstruction, and easy bleeding of the tumor. Its more aggressive behavior than classical microacinar adenocarcinoma of the prostate makes early recognition of this type of prostatic malignancy important.

Aged↗
PubMedDate not supplied

Cities in distress: a rescue strategy.

Too serious to ignore any longer, the world's rampant urban health deterioration now requires serious and fast rescue efforts by not only the health authorities but all government and community sectors. One impetus to national plans of action was the technical discussions at this year's Forty-fourth World Health Assembly whose goal was to map out "strategies for Health for All in the face of rapid urbanization." It became evident that primary health care should be made as relevant to the inmates of the cities' shantytowns as it is to rural inhabitants. ICN's statement at the discussions (p. 108) shares WHO's preoccupation with the unacceptable urban environmental health standards and recommends a strategy based on a primary healthcare approach and intersectoral cooperation. During the talks ICN nurse consultants also voiced ICN's views on mobilizing the communities and the necessary involvement and education of women, who are considered the best representatives from among the urban poor to be involved in community health. Nurses are an indispensable part of these urban health teams and, if they are not already, should start now to become involved in urban policymaking and planning and consider how their national nurses' association can individually or collaboratively support healthy city projects and national healthy city networks. Some guidelines for future strategy can be derived from the following overview of the magnitude of the urban crisis and the WHA technical discussions.

Health Planning Guidelines↗
PubMed1984

[Medicine and tobacco: a psychosomatic step?].

One of the first concern in medicine today is focused on illnesses resulting from interacting risk factors. Such an analysis requires a multidisciplinary approach. Smoking behaviour is a well known risk factor and is related to real, symbolic and imaginative life. Starting to smoke is monitored by psychosociological factors as well as smoking habits seems to be combined with biological factors. A smoker's consultation project is presented: individual preliminary talks and group therapy are seen from a psychosomatic point of view including positive connotation and mental imagery training.

Belgium↗
PubMed1983

Evaluation of the impact of oral rehydration therapy on the outcome of diarrheal disease in a large community.

Diarrheal diseases are a serious public health problem in the Gaza Strip, being the most important cause of hospitalization in infants and responsible for about half of postneonatal deaths, Oral rehydration therapy using oral rehydration solution (ORS), a formula recommended by WHO, has been proven effective in the treatment of dehydration in acute childhood diarrhea. The availability of a well-organized health service in Gaza provided an excellent opportunity to institute a large-scale project to evaluate the effectiveness of early ORS therapy in reducing diarrhea-related hospital admissions, mortality and malnutrition. A 3-year program was started in 1979, encompassing all community health centers and including intensive community education in the use of ORS. Compared with the prestudy year 1977, diarrhea-related hospital admissions were reduced by 35.3% in 1980 and 42.0% in 1981; hospital deaths from diarrheal diseases were reduced 34.4 and 37.4% in 1980 and 1981, respectively. Total deaths in the 0- to 3-year age-group were reduced by 28.7% in 1980 and by 41.7% in 1981. Diarrheal mortality was reduced by 35.6% in 1980 and 53.2% in 1981. This study succeeded in establishing active community and family participation.

Child, Preschool↗
PubMed1981

Regional program for the study of glomerulonephritis. Central Committee of the Toronto Glomerulonephritis Registry.

The Toronto Glomerulonephritis Registry, a regional program for studying the natural history of the different types of glomerulonephritis and the effects of drug therapy on them, was established 6 years ago in Toronto. Data for all patients with histologic evidence of glomerulonephritis seen at the 16 participating hospitals are collected on standard forms and stored in a computer. Randomized controlled trials of different types of therapy for five types of glomerulonephritis have been started under the coordination of the central registry. In view of the registry's low cost and high potential benefit, greater support for such projects is needed. Other centres should consider establishing similar registries to promote more rapid collection of cases and thus allow better evaluation of the development and treatment of this major cause of renal failure.

Clinical Trials as Topic↗
PubMed1978

[Dysperception of body image and dysmorphophobias in mental anorexia. Apropos of 115 cases involving both sexes. III. Physiopathogenic deductions and introduction of a novel definition of the disease].

Ignoring of emaciation (IE), fear of any weight recovery (Dalpha), and dismorphophobias (DPP) represent the central problem of AN, with different incidence. Fundamental need of being lean expresses, at lesss in girls, distress of personality insufficiently prepared to autonomous adult life, with its responsabilities. Obesity-DPP may correspond to projection upon the body of the obsessing conviction of being inferior, with regard to social and publicitary patterns, and get an active play in starting and management of weight loss. So AN is either an attempt to accomodate this critic situation, trying to incarnate actual female archetype, either, in the more severe cases, a renouncing with an obstinate physical and psychological recession to the state of a protected child. It seems to correspond to an attempt of negation of morbid character of this situation, so that it may be perpetuated and so that feeling of culpability can be decreased in front of familial recrimination. Constancy of these symptoms, and their relation with deep meaning of this illness, justify their introduction into a new definition of AN, diagnosed by association of at less 2 out of 3 major criterious (loss of weight superior to 10% premorbid weight, feed restrictions and Dalpha) and one out of 2 minor criterions (amenorrhea and IE).

Adolescent↗
PubMed1978

The analysis of normal stepping movements as a possible basis for locomotor assessment of the lower limbs.

Sagittal plane rotations of the thigh and shank when leading or trailing during forward or backward and during upward or downward stepping manoeuvres (one step, starting and finishing with erect stance) were recorded by polarized light goniometry in the form of thigh-knee angle diagrams. Angles and limb projections corresponding to key features of the diagrams were measured for 21 normal subjects and at three step heights. Correlations of the measurements with the height of step relative to stature were examined and predicted norms presented for a step equal to 10% of stature. The eight possible movements on a given step consist of four conjugate pairs; the members of a pair have reversed time-sequences and gravity assists one while opposing the other. The similarities of the conjugate manoeuvres were analysed statistically. A test of locomotor function is suggested on the premise that disturbances of function would be revealed by within-subject comparisons of conjugate manoeuvres. The suitability of 10% step tests for clinical use and the problems of selecting data of manageable proportions are discussed.

Adolescent↗
PubMed2001

Improving design project experiences through improved assessment practices.

This paper is offered as an introduction to the ways in which improved foci on educational outcomes associated with engineering design project experiences may lead to: (a) improvements in the learning of engineering students and consequently, (b) improved knowledge, design and technology to benefit individuals in need. Strategies to improve learning outcomes of design experiences include clearly articulating what it is that we want students to know and achieve, having detailed means of assessing each of the learning outcomes we target, communicating about the assessment process with students from the start of their design experiences, and providing thorough evaluative feedback to students to foster learning while we still have access to them. This paper is based on ongoing work within the National Science Foundation (NSF) Senior Design Projects to Aid Persons with Disabilities program. Readers are invited to collaborate in further efforts in this area.

Biomedical Engineering↗
PubMedDate not supplied

An experiential interdisciplinary quality improvement education initiative.

Seven learners, including 2 preventive medicine fellows, 2 family medicine residents, 1 internal medicine resident, and 2 master's-level nursing students participated in an experiential 4-week quality improvement rotation at a major academic medical center. Together they worked on a quality improvement project that resulted in enhanced medication reconciliation in a preventive medicine clinic. Learner knowledge measured on the QI Knowledge Application Tool increased from an average of 2.33 before the start of the rotation to 3.43 (P = .043) by the end of the rotation. At the conclusion, all learners said they were confident or very confident that they could make a change to improve health care in a local setting. Although this pilot supports the feasibility and potential benefits of interdisciplinary quality improvement education, further research is necessary to explore strategies to implement the same on a larger scale, and to examine the impact on patient outcomes.

Health Knowledge, Attitudes, Practice↗
PubMed2000

Implementing short-course zidovudine to reduce mother-infant HIV transmission in a large pilot program in Thailand.

OBJECTIVES: To describe a pilot mother-infant HIV prevention program started by the Ministry of Public Health of Thailand in July 1998 and to report on the first year of its implementation. DESIGN: Analysis of monthly summaries of data from project logbooks, simple data forms in antenatal clinics and delivery rooms, site visits and workshops, mail survey. SETTING: All 89 public hospitals in seven north-eastern provinces of Thailand. PARTICIPANTS: Childbearing women, program officials. INTERVENTIONS: Counseling and HIV testing for pregnant women, short-course antenatal zidovudine for HIV-infected pregnant women, and infant formula for their children. MAIN OUTCOME MEASURES: Proportion of women with HIV test, proportion of HIV-infected women receiving zidovudine. RESULTS: Of 75,308 women who gave birth between July 1998 and June 1999, 74,511 (98.9%) had antenatal care, 51,492 (69.1%) in the same district and 23,019 (30.9%) outside the district where they gave birth. HIV test results were available at delivery for 46,648 (61.9%) women, 410 (0.9%) of whom tested positive. Of these HIV-infected women, 259 (63.2%) participated in the zidovudine program and 6 (1.5%) received zidovudine from other sources. The proportion of women whose HIV test results were known and proportion of HIV-infected women who received zidovudine increased significantly during the year. CONCLUSIONS: A mother-infant HIV prevention program using short-course antenatal zidovudine was quickly implemented in a large region of Thailand with moderate HIV prevalence. This successful experience is leading to national implementation of a perinatal HIV prevention program in Thailand and may prompt other developing countries to start similar programs.

Adolescent↗
PubMed1996

BEN as a presumptive target recognition molecule during the development of the olivocerebellar system.

It has been shown previously that in the chick embryo the cell adhesion molecule BEN/SC1/DM-GRASP is expressed by neurons in the inferior olive (IO) and by their terminal axonal arbors in the cerebellar cortex, the climbing fibers (Porquié et al., 1992b). Here, new information on the expression of BEN during the formation of the olivocerebellar projection adds the important notion that BEN is also expressed by the cerebellar targets of inferior olivary axons, Purkinje cells (PCs) and deep nuclear neurons. This expression is transient, starting at E7-E8 and vanishing shortly after hatching. More importantly, BEN expression is restricted to precise subsets of IO neurons and PCs. In the cerebellar cortex, BEN-immunoreactive (BEN-IR) structures are not found randomly but are distributed according to a reproducible pattern of parasagittal stripes. A maximum of four distinct sagittal stripes is found in each lobule, along the whole rostrocaudal extent of the cerebellum. Moreover, BEN-expressing stripes belong to two classes; one contains BEN-IR climbing fibers terminating on BEN-IR PCs and the other, more frequent class is solely composed of BEN-IR climbing fibers. Organotypic cultures of isolated cerebella have shown that the expression of BEN in the IO and in the cerebellum arise independently, probably because of an intrinsic developmental program. Thus, the cell adhesion molecule BEN meets all criteria for a recognition molecule involved in the formation of the olivocerebellar projection.

Animals↗
PubMed1993

Prevalence of frequent headache in young Finnish adults starting a family.

A questionnaire study on pre-pregnancy headache and its predictors was carried out in a representative sample of young adults expecting their first baby. The study was part of a major project on the competence of Finnish families. It included 1322 women and 1257 men, either married or cohabiting (in total, 1262 families), followed from their first contact with a maternity health care unit. A questionnaire was given separately to the women and men inquiring about their health and health behaviour, as well as about sociodemographic and psychosocial factors. The prevalence of frequent headache (at least one episode per month) was 34.3% in women, 19.3% in men and 47.1% in families. On multivariate analysis, after age-adjustment, the independent predictors of headache occurrence in women were depression, menstrual pain, responsibilities at work and psychosocial stress. The predictors in men were nervousness, psychosocial stress, lack of or irregular physical exercise and long-term disease, depression, responsibilities at work and insomnia.

Adolescent↗
PubMed1999

SC starts on-line physician comparison data system.

South Carolina will soon give physicians the ability to access physician-specific comparison data on hospitalizations, length of stay, complications, and outcomes through the Internet. The project director says this will allow physicians to manage care and dramatically improve outcomes. The state's two medical schools plan to use the data to drive their decisions on which continuing medical education programs to offer.

Benchmarking↗
PubMedDate not supplied

Long-term epidemiological survey of hepatitis B virus infection in a hyperendemic area (Afragola, southern Italy): results of a pilot vaccination project.

In 1983, a pilot project of universal hepatitis B vaccination was introduced in a hyperendemic area in southern Italy (Afragola) and is ongoing to date. In this area before the start of vaccination, we found significant evidence of HBV endemicity: the acute viral hepatitis B incidence in the general population averaged 63/100,000; the HBsAg and anti-HBc prevalence rates were 13.4% and 66.9%, respectively; there was involvement of hepatitis B virus (HBV) in 48.1% of chronic liver pathologies (46.3%) in chronic viral hepatitis, 49.5% in cirrhosis and 71.7% in hepatocellular carcinoma cases). We studied the acute viral hepatitis incidence during the vaccination period from 1983 to 1997 and compared the HBsAg and anti-HBc prevalences in 1978 to those in 1997, after 15 years of vaccination. The HBV-related chronic pathology prevalence was also studied. We found a remarkable drop in the acute viral hepatitis incidence, from an average annually of 63/100,000 in the five years before vaccination to 3/100,000 in the last five years of vaccination. In addition, the HBsAg carrier prevalence in the general population decreased from 13.4% in 1978 to 3.7% in 1997. The percentage dropped in children and adolescents from 6.8% to 0.7%, in young people from 10.2% to 1.1% and in adults from 15.8% to 4.0%. The anti-HBc carrier prevalence, found to be 66.9% in 1978, was 34.2% in 1997. Finally, we found a much less significant involvement of HBV in chronic liver pathologies; in fact, it was present in only 18.2% of cases in 1997 and in 48.2% in 1982. In the light of the data, we can assert that universal hepatitis B vaccination has had a substantial effect on HBV endemicity in the Afragola area. We believe that the reduction found in the incidence of acute viral hepatitis B and HBV-related chronic liver pathologies is connected to the decrease in HBV carriers in the area, which therefore reduces the risk of contagion for the unvaccinated.

Adolescent↗