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At least 1,747 records · Page 97Linked to original sources
PubMed1988

Quality assurance: how it can help a poison information center.

Quality assurance (QA) has become a benchmark program for health care in the 1980's. We have developed and implemented an innovative poison information center (PIC) QA program which includes: a peer review system of the PIC's medical records; a detailed routing system of medical records that allows for immediate access to cases involving business and industry accounts, on-going research, hospitalization, etc; and a standardized list of abbreviations for documentation of PIC medical records. The program additionally provides secondary gains of improving internal communications between the PIC staff and provides an excellent source of professional continuing education relative to poison management. QA is an essential program for all PIC's.

Medical Records↗
PubMed2005

Aural rehabilitation for deaf children: a northeastern Thailand experience.

Aural rehabilitation for deaf children (hearing loss > 90 dB) has been established since World War II. Many developed countries such as USA, Canada, United Kingdom, Netherlands and Australia have famous institutes providing aural rehabilitation for these children so that they are able to communicate with other people in the hearing society. Teaching programs include auditory training, speech stimulation, speech correction and developing language skills by using natural conversation and real models. In Thailand, the most common mode of communication for deaf children is total communication which focuses on sign language, thus, limiting the ability to communicate with other people. With the realization of this problem, the preschool program for deaf children was set up in 1993 by an audiologist and a speech pathologist at the speech and hearing clinic, Department of Otolaryngology, Faculty of Medicine, Khon Kaen University. A study of 31 deaf children with the average better ear hearing threshold of 103 dB (103.5 +/- 7.01), who visited the program regularly showed that it took an average of 277 days or approximately 9 months (9.25 +/- 4.1) after hearing aid fitting, in acquiring spontaneous meaningful single words or 638 days or approximately 21 months (21.3 +/- 4.3) in acquiring simple conversation or sentences of more than three words. The limitation and problems of the program will be discussed.

Child↗
PubMed1989

The Computerized Laboratory Notebook concept for genetic toxicology experimentation and testing.

We describe a microcomputer system utilizing the Computerized Laboratory Notebook (CLN) concept developed in our laboratory for the purpose of automating the Battery of Leukocyte Tests (BLT). The BLT was designed to evaluate blood specimens for toxic, immunotoxic, and genotoxic effects after in vivo exposure to putative mutagens. A system was developed with the advantages of low cost, limited spatial requirements, ease of use for personnel inexperienced with computers, and applicability to specific testing yet flexibility for experimentation. This system eliminates cumbersome record keeping and repetitive analysis inherent in genetic toxicology bioassays. Statistical analysis of the vast quantity of data produced by the BLT would not be feasible without a central database. Our central database is maintained by an integrated package which we have adapted to develop the CLN. The clonal assay of lymphocyte mutagenesis (CALM) section of the CLN is demonstrated. PC-Slaves expand the microcomputer to multiple workstations so that our computerized notebook can be used next to a hood while other work is done in an office and instrument room simultaneously. Communication with peripheral instruments is an indispensable part of many laboratory operations, and we present a representative program, written to acquire and analyze CALM data, for communicating with both a liquid scintillation counter and an ELISA plate reader. In conclusion we discuss how our computer system could easily be adapted to the needs of other laboratories.

Cell Line↗
PubMed2005

Patient-physician communication: why and how.

Patient-physician communication is an integral part of clinical practice. When done well, such communication produces a therapeutic effect for the patient, as has been validated in controlled studies. Formal training programs have been created to enhance and measure specific communication skills. Many of these efforts, however, focus on medical schools and early postgraduate years and, therefore, remain isolated in academic settings. Thus, the communication skills of the busy physician often remain poorly developed, and the need for established physicians to become better communicators continues. In this article, the authors briefly review the why and how of effective patient-physician communication. They begin by reviewing current data on the benefits of effective communication in the clinical context of physicians caring for patients. The authors then offer specific guidance on how to achieve effective communication in the patient-physician relationship.

Communication↗
PubMed1997

Applied infectious disease epidemiology in Germany.

Applied epidemiology emphasizes the study of the distribution and determinants of disease and health in populations and the application of this study to the control of health problems of immediate public health consequence. Outbreak investigation symbolizes the use and methodology of applied epidemiology for public health. The steps of an outbreak investigation are summarized. Development of a network for applied infectious disease epidemiology involving health departments and other institutions is being built in Germany through epidemiologic training, building communication systems, providing support for outbreak investigation, development of national reference laboratories, and building a comprehensive research program.

Communicable Disease Control↗
PubMed2004

An organized approach to trauma care: legacy of R Adams Cowley.

The organized approach to caring for trauma patients was introduced into the civilian setting by the innovative pioneer, R Adams Cowley. His system in Maryland has the following 11 components: (1) a State Police Aviation Division that transports patients throughout the State; (2) trained paramedics at the scene of the accident as well as on the helicopter, who will stabilize the patients en route to the Shock Trauma Center; (3) one central dispatch communication center in Baltimore that coordinates information between paramedics and the Trauma Center; (4) a Shock Trauma Center with a helicopter landing zone near the building; (5) trained trauma nurses and trauma technicians to transfer the patient from the helicopter by stretcher to the resuscitation area; if there is a special complication, such as an airway problem, the anesthesiologist and or trauma surgeon may meet the helicopter on the roof as well; (6) trauma surgeons, board-certified in surgery, with a certificate of added qualification in surgical critical care, to treat the critically ill trauma patients in the resuscitation area; (7) a CT scan and portable X-ray units in the admission area that aid in the diagnosis of the injury; (8) operating rooms adjacent to the admission area for repair of trauma injuries; (9) a surgical intensive unit to care for the trauma patient; (10) a team of specialty physicians trained in a wide variety of specialties who work as a multidisciplinary unit caring for the hospitalized patient; and (11) an ambulatory outpatient unit that allows the patient to be followed in the center after discharge. Dr. R Adams Cowley incorporated each of these 11 components for an organized trauma center into Maryland. In recognition of his landmark contributions to trauma, the eight-story Shock Trauma Center was named the R Adams Cowley Shock Trauma Center. There is growing evidence that this organized system in trauma care seen in Maryland must be replicated in every state in our nation. The results of the Health Resources and Services Administration Report in 2002 show serious limitations in our nation's organized approach to emergency and trauma care. This report indicates that many Americans do not have access to well-trained pre-hospital emergency personnel. Between 10 and 15% of the US population does not have access to basic emergency medical and communication services. Moreover, the presence of key trauma system components continues to vary throughout the country, most likely because of growing economic constraints. Emergency communication systems remain fragmented, and adequate training programs and protective equipment for health personnel remains notably absent. The threat of inadequate funding for the state manifests itself in the consistent uneasiness regarding the recruitment and continued retention of trauma care providers. Federal authorities must devise national emergency medical and organized trauma programs to save the lives of injured Americans.

Disaster Planning↗
PubMed2006

Use of aided language stimulation to improve syntactic performance during a weeklong intervention program.

This pilot study assessed the performance of nine children, aged 4;8-14;5, who used augmentative and alternative communication (AAC) systems before and after a weeklong aided language stimulation intervention program. Pre/post test data were analyzed to evaluate the participants' syntactic complexity when using (a) a manual communication board and (b) a dynamic display speech generating device (DD-SGD). Results indicate that most participants improved their syntactic performance and that these gains were more pronounced when the participants used a manual communication board as compared with a DD-SGD. There was considerable individual variation in performance.

Adolescent↗
PubMed1978

Pragmatics and early childhood language disorders: communicative interactions in a half-hour sample.

An early childhood language analysis and intervention program, based on two models of pragmatics, is described. The theoretical constructs of each pragmatics model are described first, followed by a discussion of how the clinicians in the program translate these constructs into procedures for the analysis of and intervention with language disorders in preschool-aged children. Mention is made in conclusion of the limitations within which the program operates.

Child↗
PubMedDate not supplied

Use of interactive health communication to affect smoking intentions in middle school students: a pilot test of the "Headbutt" risk assessment program.

PURPOSE: Developing and disseminating innovative and effective approaches for smoking prevention among middle school children remains a public health priority. This pilot study evaluates the use of a Web-based tobacco prevention program, Headbutt, to change intentions of middle school children to smoke tobacco. METHODS: Headbutt was implemented with the use of a single-group pretest-posttest study design in sixth grade classes of nine middle schools in Texas (student n = 2227). The program assesses cognitive determinants of smoking and provides intervention feedback tailored to the child's responses. RESULTS: Headbutt significantly affected smoking intentions, prosmoking attitudes, self-efficacy expectations, and knowledge of negative consequences (all p < or = .001) measured with scales adopted from the Texas Tobacco Initiative Survey. Change in prosmoking attitudes had the greatest predictive effect on smoking intentions (p < .001). These results were moderated by ethnicity and age of students. CONCLUSION: Findings need to be interpreted in the light of study design limitations. However, strong associations between the Headbutt program and intention change suggests that a more rigorous effectiveness trial is indicated.

Child↗
PubMedDate not supplied

An evaluation of sex education and information resources and their provision to adults with traumatic brain injury.

OBJECTIVES: To evaluate sex education and information resources developed to address the sexual health concerns of persons with traumatic brain injury (TBI) and the means by which agencies have introduced this clinically sensitive program initiative. DESIGN: A process evaluation methodology was used to assess program reach, participant satisfaction, program component usage, and quality of materials. SUBJECTS: Two samples comprising multidisciplinary rehabilitation and disability staff (n = 37) from 36 brain injury agencies that had been utilizing the resources and 12 people with brain injury, respectively. SETTINGS: A diverse range of rehabilitation and community brain injury agencies. OUTCOME MEASURES: Two purpose-designed evaluation protocols for staff and consumers, respectively, and a readability analysis to assess the comprehensibility of program materials (eg, information sheets) for people with TBI. RESULTS: Agencies strongly endorsed their role in addressing consumer sexual health concerns. Agencies generally used a selective rather than a universal approach to sex education, with an average of 10% of consumers within agency caseloads receiving some intervention within the previous 12 months. The 4 issues most frequently addressed in education programs were sexual dysfunction, how to meet people, what is sexuality, and sexual adjustment in the context of established preinjury relationships. Finally, the average reading age needed to comprehend the resources was higher than the recommended levels for communicating health information. CONCLUSION: The sex education program resources have been positively evaluated by both rehabilitation and community agencies as a means of providing education and information to address the sexual health concerns of people with TBI.

Brain Injuries↗
PubMed1988

Reducing the malpractice threat through patient communications.

The majority of malpractice claims do not result from fatalities or even severe disabilities, but occur because the patient is angered when his or her often exaggerated expectations are not met. Three out of four of these claims arise primarily from a breakdown in patient communications. Understanding four major types of communication breakdowns can help administrators formulate more effective loss prevention programs. Administrators need to remedy problems such as inadequate discharge instructions, lack of informed consent, lack of courtesy and respect, and inadequate handling of angry patients. Administrators would do well to assess their institution's patient communications. To gain the patient's perspective--to experience the hospital as if he or she were stretched out helpless on a gurney--an outside specialist should conduct a "gurney survey," looking at the communication skills in the departments and activities most crucial for communications. An institution-wide patient education program needs to be led by one coordinator, to involve all departments, to be adequately funded, and to have an identifiable quality assurance component.

Child↗
PubMed2001

A randomized trial of a brief intervention to increase fruit and vegetable intake: a replication study among callers to the CIS.

BACKGROUND: Results are reported from a large randomized trial designed to increase fruit and vegetable consumption among callers to the National Cancer Institute's Cancer Information Service (CIS) (n = 1,717). METHODS: CIS callers assigned to the intervention group (n = 861) received a brief proactive educational intervention over the telephone at the end of usual service, with two follow-up mailouts. Key educational messages and print material derived from the NCI 5 A Day for Better Health program were provided to intervention participants. Participants were interviewed by telephone at 4 weeks (n = 1,307), 4 months (n = 1,180), and 12 months for follow-up (n = 1,016). RESULTS: Results obtained from a single-item measure of fruit and vegetable consumption indicate a significant intervention effect of 0.88 servings per day at 4 weeks follow-up (P < 0.001), 0.63 servings per day at 4 months follow-up (P < 0.001), and 0.43 servings per day at 12 months follow-up (P < 0.001). Using a 7-item food frequency measure, an intervention effect of 0.63 servings per day was obtained at 4 weeks follow-up (P < 0.001), compared with 0.39 servings per day at 4 months follow-up (P = 0.002) and 0.44 servings per day at 12 months follow-up (P = 0.002). A 24-h recall assessment included in the 4-month interviews also yielded a significant intervention effect of 0.67 servings per day (P = 0.015). The vast majority of callers (90%) endorsed the strategy of providing 5 A Day information proactively within the CIS. CONCLUSIONS: This brief educational intervention was associated with higher levels of self-reported fruit and vegetable intake at both short- and long-term follow-up. Additional research is recommended to test this or a similar intervention in diverse populations.

Adult↗
PubMed2026

Integrative Multi-Omics Analysis Identifies Thrombosis-Associated Molecular Features Linked to Germline Susceptibility and Immune Cell Communication in Gastric Cancer.

Emerging evidence indicates that coagulation-related molecular programs are associated with thrombosis, tumor progression, and molecular dysregulation in gastric cancer (GC). However, thrombosis-associated molecular features in GC and their potential links to inherited susceptibility remain insufficiently understood. Integrated analyses of transcriptomic data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) datasets were performed to identify thrombosis-associated genes and establish a machine learning-based prognostic signature. Genome-wide association study (GWAS), expression quantitative trait loci (eQTL), transcriptome-wide association study (TWAS), and Mendelian randomization (MR) analyses were conducted to investigate susceptibility-associated transcriptional programs in GC. Functional assays were used to evaluate candidate genes associated with malignant phenotypes. Single-cell RNA sequencing (scRNA-seq) and cell-cell communication analyses were further performed to characterize cell-type-specific expression patterns and potential intercellular interactions. A total of 22 differentially expressed thrombosis-associated genes were identified, and a prognostic signature comprising 14 genes was established. The signature stratified patients into high- and low-risk groups and showed prognostic performance in both the training and validation cohorts. Integrative GWAS, eQTL, and TWAS analyses identified susceptibility-associated transcriptional programs that were positively correlated with the thrombosis-associated risk score. Silencing ACTN2 and CRYAB significantly reduced GC cell migration and invasion. scRNA-seq analysis revealed relatively high CRYAB expression in neutrophils, and CellChat analysis suggested potential neutrophil-B cell interactions involving COLLAGEN-related signaling. This integrative multi-omics study identified a thrombosis-associated molecular signature linked to prognosis and germline susceptibility-associated transcriptional programs in GC. ACTN2 and CRYAB may represent candidate genes associated with GC cell migration and invasion, while single-cell analysis suggested potential immune-related communication features.

Humans↗
PubMedDate not supplied

Integrated decision-making in response to weapons of mass destruction incidents: development and initial evaluation of a course for healthcare professionals.

INTRODUCTION: Standardized, validated training programs for teaching administrative decision-making to healthcare professionals responding to weapons of mass destruction (WMD) incidents have not been available. Therefore, a multidisciplinary team designed, developed, and offered a four-day, functional exercise, competency-based course at a national training center. OBJECTIVE: This report provides a description of the development and initial evaluation of the course in changing participants' perceptions of their capabilities to respond to WMD events. METHODS: Course participants were healthcare professionals, including physicians, nurses, emergency medical services administrators, hospital administrators, and public health officials. Each course included three modified tabletop and/or real-time functional exercises. A total of 441 participants attended one of the eight course offerings between March and August 2003. An intervention group only, pre-post design was used to evaluate change in perceived capabilities related to administrative decision-making for WMD incidents. Paired evaluation data were available on 339 participants (81.9%). Self-ratings for each of 21 capability statements were compared before and after the course. A 19-item total scale score for each participant was calculated from the pre-course and post-course evaluations. Paired t-tests on pre- and post-course total scores were conducted separately for each course. RESULTS: There was consistent improvement in self-rated capabilities after course completion for all 21 capability statements. Paired t-tests of pre- and post-course total scale scores indicated a significant increase in mean ratings for each course (all p < 0.001). CONCLUSION: The tabletop/real-time-exercise format was effective in increasing healthcare administrators' self-rated capabilities related to WMD disaster management and response. Integrating the competencies into training interventions designed for a specific target audience and deploying them into an interactive learning environment allowed the competency-based training objectives to be accomplished.

Bioterrorism↗
PubMed2003

Next generation simulation tools: the Systems Biology Workbench and BioSPICE integration.

Researchers in quantitative systems biology make use of a large number of different software packages for modelling, analysis, visualization, and general data manipulation. In this paper, we describe the Systems Biology Workbench (SBW), a software framework that allows heterogeneous application components--written in diverse programming languages and running on different platforms--to communicate and use each others' capabilities via a fast binary encoded-message system. Our goal was to create a simple, high performance, opensource software infrastructure which is easy to implement and understand. SBW enables applications (potentially running on separate, distributed computers) to communicate via a simple network protocol. The interfaces to the system are encapsulated in client-side libraries that we provide for different programming languages. We describe in this paper the SBW architecture, a selection of current modules, including Jarnac, JDesigner, and SBWMeta-tool, and the close integration of SBW into BioSPICE, which enables both frameworks to share tools and compliment and strengthen each others capabilities.

Biochemical Phenomena↗
PubMed2003

The medical information sciences program of Amsterdam.

The medical information sciences program of Amsterdam has been in existence for 15 years now. Starting in 1987, the program has been modified several times. Now a full-fledged 4 years master program exists. Students are taught skills to adequately and systematically apply information and communication technologies in order to optimize health care information processing. The program is offered within the Faculty of Medicine of the University of Amsterdam. The structure and contents of the current program will be described.

Curriculum↗
PubMed2005

Knowledge transfer between researchers and practitioners in SUCOZOMA.

A primary aim of the SUCOZOMA research program has been the transfer of knowledge from the scientific community to research users. This paper describes the intentions and ambitions regarding knowledge transfer within the program, reflecting the aim of its financier, the Swedish Foundation of Strategic Environmental Research, but also a general trend within research policy. The study investigates the areas in which SUCOZOMA has actively tried to transfer knowledge, reaching out to management and different practitioners. Many examples of communication and participation of research users in the program are described. The paper also identifies the bottlenecks and limits to communication.

Conservation of Natural Resources↗