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At least 1,783 records · Page 99Linked to original sources
PubMed1998

[Study with thoracic and abdominal spiral CT in intensive care unit patients].

INTRODUCTION: The severe clinical conditions of intensive care unit patients need frequent imaging studies to detect the pathologic changes in the patients' situation and to plan the correct therapeutic management. The yield of bedside plain radiography is often not diagnostic but moving the patients to the radiology department could affect their clinical conditions. Conventional CT is difficult to perform in these patients because they need continuous assistance and cannot cooperate during the diagnostic examination. MATERIAL AND METHODS: The authors examined with Spiral CT 46 unconscious patients in poor clinical conditions who presented a variety of pulmonary and abdominal diseases. Thirty coma patients were submitted to bedside chest radiography and then to Spiral CT because there was disagreement between the radiographic and the clinical findings. Sixteen patients with abdominal conditions underwent Spiral Ct, 11 of them after bedside US. The chest and abdomen were examined with Spiral CT in 2/16 patients and the abdomen only in 5 cases; twenty-two of 46 patients were under assisted ventilation. During all the Spiral CT studies, the patients had their arms along the body. Spiral CT results were compared with those of bedside chest radiography in 30 cases and with those of bedside abdominal US in 11 patients. DISCUSSION AND CONCLUSIONS: Spiral CT is a fast examination technique with no major artifacts which can be used safely also in unconscious patients. It confirmed a variety of pathologic conditions which may be misdiagnosed by conventional chest radiography, which improves the care of these patients. Bedside plain radiography is limited by several factors depending on the patient (no cooperation, variable respiration, still decubitus), the examination technique (X-ray projection, exposure, poor diagnostic yield), and the anatomical region of interest (mediastinal vessels). Even though our technical standard for conventional radiography was high, Spiral CT was better in detecting parenchymal consolidation and pleural effusion, a missed pneumothorax or thromboembolic disease. We always performed Spiral CT when the clinical findings did not match the results of bedside plain radiography. Moving the patients was very easy because the intensive care unit in our hospital is in the same building as the radiology department and there were dedicated devices supporting the coma patients.

Aged↗
PubMedDate not supplied

How SmithKline Beecham makes better resource-allocation decisions.

Major resource-allocation decisions are never easy. For a pharmaceuticals company like SmithKline Beecham, the problem is this: How do you make good decisions in a high-risk, technically complex business when the information you need to make those decisions comes largely from the project champions who are competing against one another for resources? In 1993, the company experimented with ways of depoliticizing the process and improving the quality of decision making. In most resource-allocation processes, project advocates develop a single plan of action and present it as the only viable approach. In SB's new process, the company found an effective way to get around the all-or-nothing thinking that only reinforces the project-champion culture. Project teams were required--and helped--to create meaningful alternatives to current development plans. What would they do with more money? With less? With none at all? In another important departure from common practice, SB separated the discussion of project alternatives from their financial evaluations. In doing so, SB was able to avoid the premature evaluations that kill both creativity and the opportunity to improve decision making. The new process at SB has allowed the organization to spend less time arguing about how to value its R&D projects and more time figuring out how to make them more valuable. In the end, the company learned that by tackling the soft issues around resource allocation--such as information quality, credibility, and trust--it had also addressed the hard ones: how much to invest and where to invest it.

Decision Making, Organizational↗
PubMed1999

A patient determined general practice satisfaction questionnaire.

OBJECTIVES: To develop and explore the use of a patient satisfaction questionnaire based on patient perceptions of items which influence satisfaction and to explore patient and practitioner characteristics which influence the results. METHOD: Twenty focus groups identified 39 items which were then assembled into a questionnaire which was evaluated by attendees at 133 Australian general practices. MAIN OUTCOME MEASURES: Overall satisfaction with general practitioner services and the appropriateness of the 39 items identified by focus group participants; socio-demographic characteristics of patients and practitioners and the impact of these characteristics on the results; factor analysis of the relationship of the items to each other and to overall satisfaction. RESULTS: Questionnaires were completed by 12,605 patients of 133 general practices. Seventy-three percent of these patients reported they were overall very satisfied with the care they received and 26% were satisfied. There were five individual items for which an average of more than 10% of patients reported they were not satisfied: waiting time at the surgery (18%); ease of obtaining home visits (17%); ease of seeing the doctor out of normal hours (15%); cost of drugs (12%) and facilities for children in the waiting room (10%). Factors which were more likely to result in a report of patients being very satisfied included: patients being older; if patients had visited recently; if they had attended the practice for a long time; if they visited only one general practice and had more consultations in the past 12 months. Patients of solo practitioners were more likely to report they were satisfied with individual items and patients of practices of three or more practitioners were least likely. No significant differences between practices of different sizes in the level of overall satisfaction were detected. Factor analysis identified three major factors which we have described as containing interaction, technical and accessibility items. These three factors explained 44.4% of the variance in results. CONCLUSION: This project found the items patients identified were similar to those identified by practitioners, and reiterated previous findings that there is substantial variability in the levels of satisfaction reported by patients of Australian general practices.

Adolescent↗
PubMed1975

[Legal foundations for the processing of iodine 125 in radioimmunological laboratory tests, exemplified by the phadebas RAST and phadebas RIST tests (author's transl)].

The processing of iodine 125 poses legal and technical problems that can be solved if the respective guidelines are taken into consideration. The test projects have to be notified to, and approved by the authorities. In addition, the reagents have to be isolated and locked away in a suitable place and the requisite laboratory bench space locked up when not in use. If no more than 2 test kits are processed at the same time, the demands on the personnel and working place are minimal and the removal of wastes is unproblematic.

Air Pollution, Radioactive↗
PubMed2001

A More Efficient Catalyst for the Carbonylation of Chloroarenes Palladium-Catalyzed Reactions for Fine Chemical Synthesis, Part 19. This project was suported by the Solvias AG, Basel (Switzerland), and from the Bildungsministerium des Landes Mecklenburg-Vorpommern. We thank Dres. H.-U. Blaser, M. Studer, A. Schnyder, and F. Spindler (Solvias AG) for helpful contributions, M. Heyken (IfOK) for technical support, and Dr. C. Fischer, K. Kortus, and S. Buchholz (IfOK) for analytical work. Part 18: ref.

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Journal Article↗
PubMed1983

[Forecasting cohort fertility rates by using an exponential function].

"Population forecasts based on cross sectional data do not allow for the variations in cohort fertility. In this paper methods are developed to fit cohort fertility rates by an exponential function. Out of a number of selected functions the Weibull-function shows the best fit. For predicting cohort fertility pattern the parameter values can be derived from the forecasts of a small number of demographic statistics." (summary in ENG)

Birth Rate↗
PubMed1985

[Predictability of demographic changes in the short run].

The author discusses the value of univariate time series models to assess the accuracy of official short-term population forecasts in the Netherlands. "Three time series methods (exponential smoothing, ARIMA-model and structural time series model) are applied to Dutch data on live births, deaths, marriages, immigrants and emigrants." The data concern the period 1979-1984. The methods are also applied to data for the period 1970-1975 for comparative purposes. (summary in ENG)

Demography↗