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PubMed2002

Global view on functional foods: Asian perspectives.

There is an old Chinese thought meaning that medicine and food are isogenic. In Japan, a national research project started to endorse the thought scientifically, with the birth of functional foods that are now known to function to reduce the risk of life-style related diseases. The science gave rise to a national policy in which some functional foods were legally approved in terms of Foods for Specified Health Use. China has also constructed a unique system for approving some functional foods. This paper pinpoints a recent trend of functional foods characteristic to Asia, with special reference to relevant topics in Japan.

Aging↗

PubMed1995

Epidemiology and control of schistosomiasis mansoni in communities living on the Cuando River floodplain of East Caprivi, Namibia.

The Cuando River area of eastern Caprivi, Namibia, is highly endemic for Schistosoma mansoni whereas S. haematobium transmission, due to the scarcity of its intermediate host snail, Bulinus africanus, does not occur. Chemotherapy (6-monthly blanket treatments with praziquantel) combined with focal mollusciciding (monthly application of niclosamide) was used in a project in the area to control the disease. Although as many adults and pre-school children as possible were tested and treated, the project concentrated largely on school-age children. It took 3 years for prevalence to decline from > 80% to 20% because of a lack of proper sanitary facilities and piped water supplies and high rates of absenteeism and re-infection. However, intensity of infection decreased more rapidly, from an arithmetic mean of > 200 to < 5 eggs/g faeces. Hepatomegaly was common among school children when the project started but could be seen in only a small percentage of them after 3 years of control. Neither the bovine schistosome, S. mattheei, nor the lechwe schistosomes, S. margrebowiei and S. leiperi, were observed in the excreta of humans living in the area.

Adolescent↗

PubMed1998

Interdisciplinary rehabilitation of hospital employees with musculoskeletal disorders.

At Lund University Hospital a cooperation project started in 1989 between the Rehabilitation Clinic and the Occupational Health Service Unit for the rehabilitation of 34 hospital employees with musculoskeletal problems and a median sick-listing time of 6 months, treated as day-patients by an interdisciplinary team. Evaluation instruments used were the Nottingham Health Profile (NHP), Pain Drawing, Visual Analogue Scale for pain, and the Disability Rating Index (DRI). The most prominent immediate effect was a significant increase of perceived energy and significant improvement of the total score of health-related quality of life (NHP). After 12 months, 25 out of 34 (74%) subjects had returned to work. The reference group used consisted of 57 subjects referred earlier from the Occupational Health Service Unit to the Personnel Department, for vocational rehabilitation. The groups were followed by 2-4 years using questionnaires concerning working conditions and current health status. There was a significant difference (p = 0.038) in return to work: intervention group 77%, reference group 58%.

Adult↗

PubMed1999

Occupational health care in small and medium sized enterprises--How many doctors do we need and how do we ensure good care?

The translation of the framework directive 89/391/EEC (Council Directive 89/391/EEC) into national law aims at supplying occupational protection and health care to all employees of large, small, and medium-sized enterprises (SMEs) likewise, depending on assessed exposure. Prior incomplete protection of the German workforce with bias against the SMEs requires an assessment of quantitative and qualitative adequacy of present occupational health care practice and also of future needs. Therefore, the Federal Institute for Occupational Safety and Health of Germany initiated a study to evaluate the present state of occupational health care in 4 regions with different geographic and economic structure. Based on these data the future demand for adequately trained occupational physicians will be estimated by employing a statistical method that allows for including a large number of modifying variables (economic development, demographic change, etc.). Expected result of the applied technique are the estimated minimal and maximal number of occupational physicians that have to be trained to meet future demand. In the same study models of best practice will be identified and evaluated for general application. The project started in October 1997 and will be finished by January 2000.

Benchmarking↗

PubMed2002

Centres for Clinical Education (CCE): developing the health care education of tomorrow--a preliminary report.

A new interdisciplinary concept of medical and health care education has been introduced at Karolinska Institute in collaboration with the County Council in Stockholm under the motto Learning together to be able to work together. Centres of Clinical Education are built up in four major hospitals to promote meeting places during clinical education for students from different categories. During a three-year project more than 5000 students from four educational programmes have been involved--medicine, nursing, occupational therapy and physiotherapy. The project started in 1998 and will turn into regular activities in 2002. The Centres consist of three parts. First is the Clinical Training Ward, a ward without patients where manual skills as well as skills in communication are taught, practised and videotaped. Second is the Clinical Education Ward, a student-driven ward where students during two-week periods experience their own professional roles in day-to-day work and learn how to work together. Third is the Multidisciplinary Team, where teachers from the four programmes plan and provide opportunities for students to learn together. Opportunities to meet and learn together have promoted a wider understanding of each professional in health care teams among students and staff. The Centres of Clinical Education provide excellent opportunities to bridge professional borders and to coordinate undergraduate studies and clinical reality.

Journal Article↗

PubMed1996

The influence of the IAEA standard holder on dose evaluated from TLD samples.

The EROPAQ quality assurance project started in 1994 with TLD postal dose intercomparisons for photon beams used in 47 radiotherapy centres in the middle and eastern European countries. The photon dose intercomparisons include beam output checks and beam quality checks. Since an acceptance limit of +/- 3% was chosen for the EROPAQ intercomparisons, any systematic error in dose evaluation by the measuring centre should be minimized. The standard IAEA TLD holder is used in the intercomparisons. In this work the magnitude of the holder attenuation is evaluated and holder corrections derived both for output and photon beam quality checks for beam qualities ranging from Co-60 up to 18 MV. The correction of the dose at the depth of reference does not exceed 1% and decreases with increasing beam energy. A correction of the beam quality ratio of the order of 1% and that is independent of the photon energy has been determined by both calculation and measurements. These corrections are consistent with the preliminary data published by the IAEA and EC QA network.

Biophysical Phenomena↗

PubMed1989

Description of a real-time system to extract the fetal electrocardiogram.

An overview is given of the FEMME-project (Fetal Electrocardiogram Measuring Method and Equipment). The project started in 1981 and is, at the moment, close to producing a prototype personal computer-based system. This records simultaneously a number of cutaneous potential signals and derives from this set one or more maternal electrocardiogram-free fetal heart signals, by combining linearly the recorded signals. An on-line adaptive algorithm based on the Singular Value Decomposition (SVD) has been designed to compute the coefficients in these linear combinations. This algorithm will be implemented on a DSP board that can be plugged into the real-time recording system. The system will be very useful in studies of the fetal electrocardiogram during pregnancy, but also in all other studies such as fetal heart rate variability, fetal movements, etc., where a precise trigger of the electrical signal from the fetal heart is required.

Computer Systems↗

PubMed1986

Effect of establishing a primary health care centre on the utilization of primary health care and other out-patient care in a Swedish urban area.

The aim of the study was to describe the changes in the way the population in the catchment area of one parish in Stockholm utilized the available out-patient services after primary health care in the area had been expanded by establishing the Matteus health centre. Primary health care resources in the district expanded from two district physicians, one assistant physician and four district nurses before the project started to 7.5 district physicians, 15 district nurses plus other assistant personnel. A controlled longitudinal before and after design was used over a period of four years, 1978-81. The results showed that the population in the study district doubled the number of visits to district physicians and nurses after establishment of the health centre. Visits to hospital out-patient clinics were reduced by 26% (40% reduction for emergency visits and 16% for polyclinic appointments). Visits to nonpublic employed physicians (private, occupational and school health physicians) decreased by 31% after establishment of the Matteus health centre. Furthermore the population decreased their utilization of the Stockholm emergency car service by 28%. These results support the workload reduction hypothesis--that an expansion of primary health care leads to a reduction of the workload of hospitals, and not an overall increase in utilization of health care.

Adolescent↗

PubMed2004

SCOP database in 2004: refinements integrate structure and sequence family data.

The Structural Classification of Proteins (SCOP) database is a comprehensive ordering of all proteins of known structure, according to their evolutionary and structural relationships. Protein domains in SCOP are hierarchically classified into families, superfamilies, folds and classes. The continual accumulation of sequence and structural data allows more rigorous analysis and provides important information for understanding the protein world and its evolutionary repertoire. SCOP participates in a project that aims to rationalize and integrate the data on proteins held in several sequence and structure databases. As part of this project, starting with release 1.63, we have initiated a refinement of the SCOP classification, which introduces a number of changes mostly at the levels below superfamily. The pending SCOP reclassification will be carried out gradually through a number of future releases. In addition to the expanded set of static links to external resources, available at the level of domain entries, we have started modernization of the interface capabilities of SCOP allowing more dynamic links with other databases. SCOP can be accessed at http://scop.mrc-lmb.cam.ac.uk/scop.

Animals↗

PubMed1998

Effects of chronic electrical stimulation on spiral ganglion neuron survival and size in deafened kittens.

We have studied spiral ganglion cell (SGC) survival and soma size in neonatally pharmacologically deafened kittens. They were implanted with a four-electrode array in the left cochlea at 100 to 180 or more days of age. Eight animals were chronically stimulated approximately 1000 hours over approximately 60 days with charge-balanced, biphasic current pulses; three were unstimulated controls. Using three-dimensional computer-aided reconstruction of the cochlea, the SGC position and cross-sectional area were stored. SGC position was mapped to the organ of Corti by perpendicular projections, starting from the basal end. The basal region of the cochlea was divided into three 4-mm segments. SGC survival (number per 0.1 mm of the length of the organ of Corti) and soma size for stimulated cochleae were compared statistically with implanted but unstimulated cochleae. There was no evidence of an effect of electrical stimulation on SGC survival under this protocol and with this duration. On the other hand, the cell size on the stimulated side was significantly larger than the control side in the middle segment (4 to 8 mm from the basal end). SGCs undergo a reduction in size after prolonged auditory deprivation; however, these changes may be partially moderated after chronic intracochlear electrical stimulation.

Animals↗

PubMed2005

The Aristotle method: a new concept to evaluate quality of care based on complexity.

PURPOSE OF REVIEW: Evaluation of quality of care is a duty of the modern medical practice. A reliable method of quality evaluation able to compare fairly institutions and inform a patient and his family of the potential risk of a procedure is clearly needed. It is now well recognized that any method that purports to evaluate quality of care should include a case mix/risk stratification method. No valuable method was available until recently in pediatric cardiac surgery. RECENT FINDINGS: The Aristotle method is a new concept of evaluation of quality of care in congenital heart surgery based on the complexity of the surgical procedures. Involving a panel of expert surgeons, the project started in 1999 and included 50 pediatric surgeons from 23 countries. The basic score adjusts the complexity of a given procedure and is calculated as the sum of potential for mortality, potential for morbidity and anticipated technical difficulty. The Comprehensive Score further adjusts the complexity according to the specific patient characteristics (anatomy, associated procedures, co-morbidity, etc.). The Aristotle method is original as it introduces several new concepts: the calculated complexity is a constant for a given patient all over the world; complexity is an independent value and risk is a variable depending on the performance; and Performance = Complexity x Outcome. SUMMARY: The Aristotle score is a good vector of communication between patients, doctors and insurance companies and may stimulate the quality and the organization of heath care in our field and in others.

Benchmarking↗

PubMed2025

Genetic Newborn Screening for Retinoblastoma: A Belgian Initiative Baby Detect.

Baby Detect Project, started in September 2022, aimed to create a newborn screening test using targeted next-generation sequencing for all early-onset, treatable, and serious conditions. The elaborated gene panel covers 405 genes, associated with 165 genetic conditions, and includes RB1, linked to retinoblastoma, the only oncological disease tested for. Germline RB1 mutations concern around 50% of all retinoblastoma cases and 100% of the most severe, bilateral cases. Ninety percent of them occur de novo, which delays the diagnosis by about a year with subsequent loss of vision and sometimes the eye itself. Detecting children with germline RB1 mutation at birth would greatly improve functional and anatomic outcomes, limiting invasive treatments and general anesthesias through early childhood. We discuss herein the novel approach of population screening, the rationale for newborn testing for RB1 mutations, the incidence of expected cases, the reliability of the test and its costs. The next step is to move to a nation-scale population; this initiative marks a landmark in retinoblastoma patients' care.

Humans↗

PubMed1999

Calculation of attenuation factors from combined singles and coincidence emission projections.

We have developed a simple method for determining coincidence attenuation-correction factors C (the inverse of the total attenuation factors) from collimated singles (SPECT) and coincidence [positron emission tomography (PET)] projections without transmission data. Attenuation-correction factor estimates are determined for individual lines of response (LOR's) independently. The required data can be acquired using a gamma-camera system with coincidence capabilities. A first-order approximation (R) of C for an LOR is given by the product of the singles count rates, taken at each end of the LOR divided by the square of the coincidence count rate. The method was tested using simulated singles and coincidence projections starting with emission and attenuation maps from patient PET scans. Noise and resolution effects were modeled in separate studies. In the noise-free, high-resolution simulations, a scatter plot of the C values versus the corresponding R values for all LOR's produces a well-defined trajectory with little variance. Values of lnR were reconstructed into good quality attenuation maps that compare favorably with the originals. We conclude that the method works well on ideal data. The introduction of noise results in degraded images. In a simulated patient study, lung and outer body boundaries were visible in images produced with 3.2 x 10(4) coincidence counts.

Computer Simulation↗

PubMed1979

Cell contacts between chorda-mesoderm and the overlaying neuroectoderm (presumptive central nervous system) during the period of primary embryonic induction in amphibians.

Using transmission and scanning electron microscopy we were able to show that during primary embryonic induction in amphibians (Triturus alpestris) the interspace between the inducing chorda-mesoderm and the reacting ectoderm (presumptive medullary plate) of mid-gastrula stages is traversed by cell projections starting from cells of both tissue layers. In addition intimate membrane contacts between the main bodies of the ectodermal and chorda-mesodermal cells could be observed. It could be ruled out that cytoplasmic bridges (anastomosis) exist between cells of inducing chorda-mesoderm and reacting ectoderm, which would allow a free transfer of inducing substances without passing through membranes, as Eakin and Lehmann [1] have postulated. The possible role of cell to cell contact for neural induction is emphasized.

Animals↗

PubMed1994

The Italian Artificial Heart Program.

In Italy, artificial heart development was promoted by virtue of a special program on technological and industrial development in areas related to cardiology and cardiosurgery. A first prototype series of electromechanical total artificial hearts (TAHs) and ventricular assist devices (VADs), with ball-screw-based actuation technology, has been developed, and preliminary bench tests and short-term animal implant experiments were performed. The project started with analysis and development of existing TAH and VAD models, and it included a fill-sensor-free control scheme and anatomical fitting studies using a three-dimensional computer model of the chest cavity. Second-generation prototypes are currently being developed, and they are scheduled for medium-term bench and in vivo testing by early 1994.

Animals↗

PubMed1994

Psychological mechanisms of enhanced risk of addiction in children of alcoholics: a dual pathway?

The background and rationale of a recently started project of the Amsterdam Institute for Addiction Research are outlined. This project is aimed at the psychological mechanisms underlying an enhanced risk of (later) addiction in children of alcoholics and the relationship with childhood psychopathology. A dual pathway mechanism is proposed, in which the type of alcoholism of the parent plays a major role. The child of a multigenerational primary alcoholic parent may suffer from an inherited mild dysfunction of the prefrontal cortex, expressed in neuropsychological and personality characteristics similar to those of the alcoholic parent. These are impulsive, aggressive and reward-seeking behaviour, response perseveration and, in some children, related psychopathology such as conduct disorders. For a child of a secondary alcoholic parent, another mechanism is proposed. In these children, stress and social learning may lead to negative affectivity and repressive coping style, with emotional problems at a later age, and the risk of falling into the "circle of secondary alcoholism". In both pathways, alcohol-related expectancies are suggested to constitute a "final common pathway" between different risk factors and later alcohol abuse. Specific expectancies might be related to different pathways and to gender differences in later drinking patterns.

Adaptation, Psychological↗

PubMed1996

The changing panorama of cerebral palsy--bilateral spastic forms in particular.

Our Swedish population-based cerebral palsy (CP) project started 25 years ago and today covers the birth years 1954-1990, with over 1400 CP cases. This large series (1, 2, 3) has opened new perspectives on time trends and aetiological background factors, where two areas of successively increasing knowledge stand out as particularly helpful. One is the growing amount of biological and clinical data from the continuously increasing cohorts of surviving very preterm infants, the other is the rapidly expanding and refined information from neuroimaging. Bilateral spastic CP (BSCP), including spastic and ataxic diplegia, tetraplegia and spastic-dyskinetic CP, is the most prevalent clinical group of CP syndromes, present in around 75% of preterm and 45% of term CP, and has shown the most significant prevalence changes over time. In this presentation we, therefore, focus on BSCP, also analysed in a collaborative study between southwest Germany and western Sweden and recently presented in a series of four papers (4, 5, 6, 7).

Cerebral Palsy↗

PubMed2000

Profile: a native son comes home to help.

In December 1996, Omu Anzala returned to Kenya after completing his Ph.D. work in Canada on HIV's interactions with the immune system to work with a collaborative AIDS research project started by researchers from his university and the University of Manitoba. Now the International AIDS Vaccine Initiative has funded Anzala and his collaborators to fashion an AIDS vaccine based on a strain of HIV circulating in Kenya.

AIDS Vaccines↗