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At least 253 records · Page 14Linked to original sources
PubMed1997

Effect of environmental enrichment devices on behaviors of single- and group-housed squirrel monkeys (Saimiri sciureus).

Squirrel monkeys display an interest in novel places, habituate to new situations, and spend most of their daily activity in the wild in large groups engaging in feeding behaviors over a broad area. Captivity limits these behaviors and consequently may disrupt normal social organizations. In captivity, squirrel monkeys may exhibit stereotypical behaviors that are believed to indicate decreased psychologic well-being. When a monkey's behavior can be made to approach that seen in the wild, and stereotypical behaviors are minimal, it is assumed that psychologic well-being is adequate. Environmental enrichment devices have been used to address the Animal Welfare Act requirement that psychologic well-being of captive nonhuman primates be considered. The purpose of the study reported here was to examine whether various environmental enrichment devices improve the psychologic well-being of captive squirrel monkeys. In the study, we used behavioral observation to quantify the effectiveness of several environmental enrichment devices for reducing stereotypical behaviors in squirrel monkeys housed alone or in groups. Analysis of our results revealed that the environmental enrichment devices did not affect the expression of normal or stereotypical behaviors, but that the type of housing did.

Animal Welfare↗
PubMed2001

Zora: a pilot virtual community in the pediatric dialysis unit.

We describe a five-month pilot project conducted in the dialysis unit at Boston's Children's Hospital. Pediatric patients with renal disease used the Zora therapeutic community program while undergoing hemodialysis. Zora is a 3D multi-user computer environment designed at the MIT Media Laboratory to help young people explore issues of identity, while engaging in a virtual community. Users build "virtual rooms" and populate them with objects and characters, program them with storytelling behaviors, and converse with other young people in real-time through a virtual character representing themselves. It was specifically designed to help young people explore issues of identity, while engaging in a participatory virtual community. This paper presents the experience and evaluates the feasibility and safety of using Zora in a hospital setting. It describes how Zora facilitated explorations of identity and mutual patient support and interaction. Finally it also presents design recommendations for future interventions of this kind. More generally, this paper explores the potential of technology specifically designed with therapeutic purposes to help patients cope with their illness.

Attitude of Health Personnel↗
PubMed2002

AANA journal course. Update for nurse anesthetists. A common sense approach to hypothermia.

Hypothermia frequently is considered inadvertent in the perioperative setting. The preservation of vital body heat has been an issue since the 1800s. This article provides a select review of the causes of hypothermia and the methods for prevention of hypothermia during the perioperative period. Providing patients with an environment designed to foster normothermia can preclude the costs of longer hospital stays, prevent morbid conditions associated with hypothermia, and provide patients with a more comfortable perioperative experience. Our goal as perioperative healthcare providers is a normothermic perioperative experience for all patients.

Body Temperature Regulation↗
PubMed2002

Genistein inhibits tamoxifen effects on cell proliferation and cell cycle arrest in T47D breast cancer cells.

Tamoxifen is an antiestrogen used in the treatment of estrogen receptor-positive breast cancer in postmenopausal women. It functions by competitively inhibiting the estrogen receptor and inducing apoptosis and G1 cell cycle arrest. Genistein is a soy phytoestrogen that inhibits breast cancer cell growth in vitro at doses of 10 microM or above. At lower doses genistein may stimulate cell growth and entry into the cell cycle. We hypothesized that treatment with low-dose genistein would reverse the inhibitory effects of tamoxifen in estrogen-receptor-positive breast cancer cells. Cell cycle kinetics and cell proliferation in T47-D human breast cancer cells were examined after exposure to genistein and tamoxifen in a low-estrogen environment designed to mimic a post-menopausal state. Cell proliferation was assessed by a colorimetric assay. Cell cycle kinetics were determined by flow cytometry. Tamoxifen caused G1 arrest and a decrease in proliferation. Genistein reversed the inhibitory effects of tamoxifen on both proliferation and G1 arrest. Thus low-dose genistein was able to inhibit the therapeutic effects of tamoxifen in this postmenopausal model of breast cancer.

Antineoplastic Agents↗
PubMed2003

Evaluation and development of potentially better practices for improving family-centered care in neonatal intensive care units.

OBJECTIVE: Technological and scientific advances have progressively decreased neonatal morbidity and mortality. Less attention has been given to meeting the psychosocial needs of the infant and family than on meeting the infant's physical needs. Parents' participation in making decisions and caring for their child has often been limited. Environments designed for efficient technological care may not be optimal for nurturing the growth and development of sick neonates or their families. Eleven centers collaborating on quality improvement tried to make the care of families better by focusing on understanding and improving family-centered care. METHODS: Through internal process analysis, review of the evidence, collaborative learning, and benchmarking site visits to centers of excellence in family-centered care, a list of potentially better practices was developed. Choice of which practices to implement and methods of implementation were center specific. Improvement goals were in 3 areas: parent-reported outcomes, staff beliefs and practices, and clinical outcomes in length of stay and feeding practices. Measurement tools for the first 2 areas were developed and pilots were conducted. RESULTS: Length of stay and feeding outcomes were not different before the collaboration (1998) and at the formal end of the collaboration (2000). CONCLUSIONS: Prospective parent-reported outcomes are being collected, and the staff beliefs and practices questionnaire will be repeated in all centers to determine the impact of the project in those areas.

Benchmarking↗
PubMed1992

Prototyping an institutional IAIMS/UMLS information environment for an academic medical center.

The paper describes a prototype information environment designed to link network-based information resources in an integrated fashion and thus enhance the information capabilities of an academic medical center. The prototype was implemented on a single Macintosh computer to permit exploration of the overall "information architecture" and to demonstrate the various desired capabilities prior to full-scale network-based implementation. At the heart of the prototype are two components: a diverse set of information resources available over an institutional computer network and an information sources map designed to assist users in finding and accessing information resources relevant to their needs. The paper describes these and other components of the prototype and presents a scenario illustrating its use. The prototype illustrates the link between the goals of two National Library of Medicine initiatives, the Integrated Academic Information Management System (IAIMS) and the Unified Medical Language System (UMLS).

Academic Medical Centers↗
PubMed2004

PMTCT from research to reality--results from a routine service.

OBJECTIVES: Assessment of the efficacy of a prevention of mother-to-child transmission (PMTCT) programme in a routine service setting in comparison to a research environment. DESIGN: Descriptive study over a 13-month period utilising retrospective data obtained from hospital records complemented by prospective data on a sample of patients enrolled in a study to determine an affordable HIV diagnostic protocol for infants. SETTING: Routine PMTCT service at Coronation Women and Children's Hospital (CWCH) situated in Johannesburg and affiliated to the University of the Witwatersrand. SUBJECTS: Pregnant women known to be HIV infected who delivered at CWCH from 1 October 2001 to 31 October 2002. OUTCOME MEASURES: The HIV transmission rate to infants, which reflects nevirapine (NVP) delivery and infant feeding practices, and follow-up rates of perinatally exposed children. RESULTS: Of the 8,221 deliveries, 1,234 (15%) occurred in women known to be HIV infected. HIV transmission rates of 8.7% at 6 weeks and 8.9% at 3 months of age in the study population verifies the high rate of NVP administration and the ability of women to formula-feed their babies and abstain from breast-feeding. More than one-third of infants never return for follow-up and more than 70% are lost to follow-up by 4 months of age. CONCLUSIONS: The low HIV transmission rate confirms the efficacy of this routine service PMTCT programme. HIV-infected children are not being identified for medical management as part of PMTCT follow-up. It is imperative that record keeping is improved to facilitate ongoing monitoring.

Anti-HIV Agents↗
PubMed2004

Occurrence of contralateral inguinal hernia in children following unilateral inguinal herniotomy.

OBJECTIVE: To review the occurrence of contralateral inguinal hernia in infants and children who presented with unilateral inguinal hernia and underwent herniotomy in order to establish whether simultaneous contralateral exploration is a necessity in our environment. DESIGN: A retrospective study. SETTING: Muhimbili National Hospital Paediatric surgical ward. SUBJECTS: Seven hundred and thirty two children. RESULTS: Twenty five infants and children developed an inguinal hernia on the contralateral side 2-76 months after herniotomy. Follow-up period was one to thirteen years. Six hundred and seventy one were boys and sixty one girls (M:F = 11:1). Right side presentation was seen in two-thirds of the children. Subsequent contralateral hernia occurrence was more common in girls (4.9%) and slightly higher in children above 12 months of age (3.5%) but these comparisons were not significant (p values were 0.45 and 0.89 and R.R. values were 0.97 and 0.67 respectively). Subsequent development of contra lateral hernia in children with left-sided hernia was high (6.7%) and this was statistically significant (p = 0.002, R.R. = 3.38). CONCLUSION: The risk of occurrence of contra-lateral inguinal hernia following unilateral inguinal herniotomy is not significantly excessive when compared by age or sex implying that routine exploration on the contralateral side in infants and children clinically presenting with unilateral inguinal hernia is not justified and we recommend herniotomy only when there is adequate clinical evidence of an inguinal hernia. Despite the significant risk of developing a contralateral hernia in children with left-sided hernia, the authors do not recommend routine right-sided exploration as the frequency is not high.

Child↗
PubMed2005

Use of low-dose chlorpromazine in conjunction with environmental enrichment to eliminate self-injurious behavior in a rhesus macaque (Macaca mulatta).

A 7-year-old, captive-bred, female rhesus macaque was placed in a quarantine facility upon arrival at our institution. At release from quarantine, she was observed pawing at and chewing on her left cheek. Physical examination revealed ulcerative lesions on the buccal surface of the left cheek. Initial differential diagnoses included Cercopithecine herpesvirus 1 (B virus)-induced lesions and bacterial infection. Dental abnormalities and cheek pouch foreign body were ruled out during the physical exam. Treatment with 30 mg/kg cefazolin intramuscularly every 12 h was initiated. Twelve days later, the animal presented with a 2 x 2-cm, full-thickness erosion involving the opposite (right) cheek. Treatment with buprenorphine (0.1 mg/kg intramuscularly every 24 h) was initiated. Cultures for B virus were negative, and only nonpathogenic bacteria were isolated from swabs of the lesions. Hematology and serum chemistry profiles were normal. A wedge biopsy of the lesion revealed no definitive etiology. Further observation revealed that the lesions likely resulted from self-injurious behavior (SIB). Treatment with low-dose chlorpromazine (1 mg/kg intramuscularly once daily for 25 days, and then 0.5 mg/kg intramuscularly once daily for 25 days) was initiated. Bodyweight and condition were maintained during therapy, and serial hematology and serum chemistry profiles were normal. The animal was moved into a different room, and a toy "necklace" was created. The SIB was eliminated, and lesions healed within 35 days. Presently, 20 months after presentation, this animal remains in good health.

Animals↗
PubMed2005

[Cardiac surgery in octogenarians: a six-year follow-up with a multidimensional intervention].

BACKGROUND: Elderly subjects frequently experience a decline in function following hospitalization and surgery. Specific changes in the provision of acute hospital care can improve the ability of acutely ill older patients to perform activities of daily living at the time of discharge and the quality of life. The aim of this study was to investigate outcomes of older (age > or =80 years) cardiac surgery patients managed with multicomponent intervention. METHODS: Between 1998 and 2004, we studied records of 193 octogenarian patients who underwent cardiac surgery and were treated with a multicomponent intervention that included: specially designed environment, patient-centered care, planning for patient discharge at home, and an interdisciplinary approach that incorporates in- and out-of-hospital health professionals. RESULTS: Mean follow-up was 26.4 months and 100% complete. Mean age of patients was 82.3 +/- 2 years. Eighty-nine patients had myocardial revascularization (CABG), 40 aortic valve replacement (AVR), 34 AVR + CABG, 8 mitral valve replacement (MVR), 11 MVR + CABG and 11 other interventions. Rates of hospital death, major complications and prolonged stay (> 14 days) were as follows: CABG 4 (4.4%), 3 (3.3%), 6 (6.4%); AVR 1 (2.5%), 3 (7.5%), 2 (5%); AVR + CABG 1 (2.9%), 2 (5.8%), 4 (11.7%); MVR 0 (0%), 0 (0%), 1 (12.5%); MVR + CABG 2 (18.1%), 2 (18.1%), 3 (27.2%). Multivariate predictors of hospital deaths were NYHA class, cardiopulmonary bypass and cross-clamping time, urgent procedure and ischemic mitral valve procedures. The actuarial 6-year survival was as follows: CABG 91%,AVR 92.5%, AVR + CABG 88.2%, MVR + CABG 81.8%. Total survival rate, free from rehospitalization and redo surgery, was 89.7, 69.8 and 99% respectively. Multivariate predictors of late death were urgent procedure and ischemic mitral valve procedures. At follow-up NYHA classification had improved a median of two classes. Global patients' satisfaction was excellent in 76.7% of survivors; 95.7% were autonomous, 40.5% live at home, 64% had a light-moderate physical activity, and 70% of patients had good social relationships and quality of life. Medical therapy was reduced in 29.3% and level of anxiety improved in 76%. CONCLUSIONS: An interdisciplinary approach and multicomponent intervention with an appropriate postoperative care, provides beneficial effects on outcome in geriatric cardiac surgery patients.

Age Factors↗
PubMed2005

Shape characteristics of the foot arch: dynamics in the pregnancy period.

OBJECTIVES: The aim is data detection and finding some load consequences generated by various mechanical or physiological changes in the interaction of the end segment of the body--the foot--and the environment. DESIGN: Shape instability of the foot caused by e.g. loading of the foot by long-term frequency loads--walking, by extreme loads--sport, by hormonal changes--pregnancy, by aging, by pathologies, etc. The footprint surface was numerically described in 3D by means of stereo-photo-gram-metrical method--DMR digital relief model. Density of discrete points--250-400 per one print. SETTING: Detailed DMR was constructed by means of triangular web including contour picture with the use of Atlas program. The specified generated web is characterized by triangles with a cca 1 mm side in the number of up to 4,500 elements per one footprint model. RESULTS: The results enable us to deduce shape characteristics of DMR--the shape of the interactive boundary of the foot--the rest surface, to solve foot arch straining, to solve issues of discomfort and distribution of the pressure at the boundary of the foot--the rest surface, the shoe, etc. The gained findings can be interpreted in the field of prevention, therapy, orthopedics, podology, and enable us to come up with recommendations for the orthopedic practice and industrial use in the footwear production, etc. THE MAIN FINDINGS: The difference between volume reductions of the space under the foot arch characterizes the level of "fall" of the arch. This criterion is independent of the foot size, and is in 3D. CONCLUSIONS: Shape characteristics of footprints in pregnant women and in the period after childbirth were calculated on the basis of the defined criterion. The results of the group of four women tested in three periods suggest that there is no clear tendency towards the foot arch falling/increasing of the foot arch "fall" during the pregnancy period.

Biomechanical Phenomena↗
PubMed2006

Prevalence of workplace violence against nurses in Hong Kong.

OBJECTIVES: To determine the prevalence and nature of workplace violence against nurses, and how nurses deal with such aggression; and to identify the risk factors related to violence in the hospital environment. DESIGN: Cross-sectional questionnaire study. SETTING: University teaching hospital, Hong Kong. PARTICIPANTS: All nursing staff in the hospital, except nurses who were unable to read Chinese or who did not have patient contact (eg those worked in administrative positions), were invited to complete a questionnaire. MAIN OUTCOME MEASURES: Demographic data of the respondents, incidence of and risk factors contributing to workplace violence. RESULTS: A total of 420 nurses returned the completed questionnaire (response rate, 25%). Three hundred and twenty (76%; 95% confidence interval, 72-80%) nurses reported abuse of any kind--verbal abuse, 73%; bullying, 45%; physical abuse, 18%; and sexual harassment, 12%. Most (82%) nurses who experienced verbal abuse tended to confide in friends, family members, or colleagues. Some (42%) ignored the incident. Risk factors for workplace violence included: working in male wards and in certain specialties such as the Accident and Emergency Department, Community Nursing Service, and the Orthopaedics and Traumatology Department. CONCLUSION: Workplace violence against nurses is a significant problem in Hong Kong. Further large-scale studies should be conducted to more closely examine the problem.

Adaptation, Psychological↗
PubMed2006

Does a multifaceted environmental intervention alter the impact of asthma on inner-city children?

OBJECTIVE: To evaluate the impact of a multifaceted environmental and educational intervention on the indoor environment and health in 5-12-year-old children with asthma living in urban environments. DESIGN: Changes in indoor allergen levels and asthma severity measurements were compared between children who were randomized to intervention and delayed intervention groups in a 14-month prospective field trial. Intervention group households received dust mite covers, a professional house cleaning, and had roach bait and trays placed in their houses. RESULTS: Of 981 eligible children, 410 (42%) were enrolled; 161 (40%) completed baseline activities and were randomized: 84 to intervention and 77 to delayed intervention groups. At the study's end, dust mite levels were 163% higher than at baseline for the delayed intervention group. Overall asthma severity scores did not change. However, the median functional severity score (FSS) component of the severity score improved more in the intervention group (33% vs. 20%) than in the delayed intervention group. At the study's end, the median FSSs for the intervention group improved 25% compared with the delayed intervention group, (p<0.01). Differences between groups for medication use, emergency department (ED) visits or hospitalization were not significant. CONCLUSIONS: Despite low retention, the intervention resulted in decreased dust mite allergen levels and increased FSSs among the intervention group. The interventions probably contributed to the improvements, especially among the more severely affected children. This study highlights the complexities of designing and assessing the outcomes from a multifaceted asthma intervention.

Allergens↗
PubMed1987

[Epidemiologic survey on the living conditions of asthmatic patients].

Study of the living conditions of asthmatic subjects in comparison to a reference group showed that orientation of rooms to the East or North is much more frequent in asthmatics than in the reference group. This may explain the resistance to desensitization to mites found in some asthmatics.

Adolescent↗