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At least 343 records · Page 19Linked to original sources

Quality circles in the United States: a conceptual reevaluation.

Faced with industrial decline, American managers have begun searching for strategies for increasing productivity. Recent attention has focused on Japanese management practices, particularly on quality circles (QCs). Drawing upon social science research, this article evaluates the assumptions behind QCs implemented in the United States. The authors present a conceptual analysis that indicates possible reasons for the differing rates of success for QCs in Japan and the U.S. The article also makes suggestions for the effective implementation of American QCs.

Japan↗

GRATEFUL MED searching: a hospital library perspective.

The Health Sciences Information Center of Cedars-Sinai Medical Center implemented an end user search service utilizing NLM's GRATEFUL MED software. A librarian-taught seminar is required of all end users. The course's teaching strategies are described. A survey of users was conducted and results are shared.

Computer User Training↗

Multimedia bootcamp: encouraging faculty to integrate technology in teaching.

As students entering college, graduate, and professional schools have increased needs and preferences for multimedia in instruction, faculty need to learn appropriate techniques for integrating technology into their educational duties. Instructional designers at the Claude Moore Health Sciences Library at the University of Virginia developed and implemented aMultimedia Bootcamp to help faculty and their support staff develop the skills necessary to integrate technology into teaching.

Communications Media↗

Donaldson v. Van de Kamp: cryonics, assisted suicide, and the challenges of medical science.

In recent years, advances in medical science have left the legal community with a wide array of social, ethical, and legal problems previously unimaginable. Historically, legislative and judicial responses to these advances lagged behind the rapid pace of such developments. The gap between the scientist's question, "Can we do it?," and the lawyer's question, "Should/may we do it?'" is most evident in the field of cryonics, with its technique of cryonic, or cryogenic, suspension. In cryonic suspension, a legally dead but biologically viable person is preserved at an extremely low temperature until advances in medical science make it possible to revive the person and implement an effective cure. The terminally ill patient who wishes to benefit from such treatment is faced with the dilemma that present life must be ceased with hope of future recovery. As a result, the process challenges our traditional notions of death and the prospects of immortality while raising a host of concomitant legal dilemmas. Some facets of this dilemma are exemplified by Donaldson v. Van de Kamp. In Donaldson, Thomas A. Donaldson sought the declaration of a constitutional right to premortem cryonic suspension of his body and the assistance of others in achieving that state. Donaldson, a forty-six-year-old mathematician and computer software scientist, suffers from a malignant brain tumor that was diagnosed by his physicians in 1988. This tumor is inoperable and continues to grow and invade his brain tissue. Donaldson's condition will gradually deteriorate into a persistent vegetative state and will ultimately result in death. Physicians predict his probable death by August 1993. Donaldson petitioned the California courts, seeking a declaration that he had a constitutional right to achieve cryonic suspension before his natural death. His doctors believe that if Donaldson waits until his natural death to be suspended, future reanimation will be futile because the tumor will have destroyed his brain. In addition, Donaldson's doctors sought an injunction against criminal prosecution for their participation in the suspension, because Donaldson, once suspended, would be considered "dead" under California law. Donaldson and his doctors built their novel argument upon the recent right-to-die cases in which the courts recognized a patient's right to have life-sustaining medical treatment withdrawn. Donaldson argued that his right to privacy and self-determination is paramount to any state interest in maintaining life. Thus, according to Donaldson, balancing the state's reasons to end--or "interrupt," as cryonics enthusiasts would have it--his own life was not necessary. The trial court dismissed the complaint for failure to state a cause of action, and Donaldson appealed to the California Court of Appeals. Because the cryonic process would necessarily involve physician-assisted death, or the aiding, advising, or encouraging of another to commit suicide, the appellate court affirmed the ruling of the trial court, holding that Donaldson did not have a constitutional right to assisted death. Additionally, in light of Donaldson's First Amendment challenge to the statute, the court upheld the criminal statute prohibiting the aiding, advising, or encouraging of another to commit suicide. This Note briefly discusses the process of cryonic suspension and explores the holding of Donaldson in light of the underlying rationale of the California right-to-die cases. Considering the contradictory state and individual interests balanced in the right-to-die cases, this Note concludes that, under a similar balancing test, premortem cryonic suspension could be permitted under certain circumstances; however, the right to premortem cryonic suspension may be more effectively recognized through legislation.

California↗

Using online learning in a traditional face-to-face environment.

A model for designing online learning was developed and implemented in a Registered Nurse-to-Bachelor of Science in Nursing course using online and face-to-face methodologies. The combination of online and face-to-face learning modalities may help the student who is a novice Internet explorer or seasoned Web navigator by offering technological support as well as providing constant in-person feedback regarding course requirements. The face-to-face component facilitates a sense of community and peer support that sometimes is lacking in an entirely online course. During the 2 semesters this model was used, students expressed satisfaction with having the course facilitator/professor physically available for consultation and advisement. Evaluation of this online/on-site course is ongoing and uses computer-administered qualitative questionnaires, a facilitator-moderated focus group, and Likert-type course evaluations.

Computer-Assisted Instruction↗

Enacting narrative pedagogy. The lived experiences of students and teachers.

Reforming nursing education to meet contemporary challenges in educational and clinical environments is needed through the development and implementation of new pedagogies. Nancy Diekelmann is advancing the science of nursing education by describing a new phenomenological pedagogy, Narrative Pedagogy, identified through interpretive research in nursing education. Narrative Pedagogy is an approach to reforming nursing education that is always site specific and not generalizable from school to school. However, the processes of Narrative Pedagogy are transferable and can be enacted in many contexts. This study describes the common experiences and shared meanings of teachers and students engaging in or enacting Narrative Pedagogy. Diekelmann gathered seven teachers and students in five schools of nursing in four midwestern states to share their experiences. Interpretive phenomenology was used to analyze the group interview. One of the findings identified during this analysis, Enacting Narrative Pedagogy, is explicated, and two themes, Decentering Skill Acquisition and Content and Attending to the Practices of Thinking, are described.

Education, Nursing↗

[On "early pathologic anatomy" and "anatomy of medical structure": continuity or point of epistemological rupture?].

The aim of this paper is to analyse the technical, conceptual and institutional changes from which, through macroscopic pathology, a new medical science (microscopic pathology) emerged. The "early" pathology was mainly implemented by the Ecole de Paris, at the beginning of the 19th century. After 1850, histo-pathology emerged, in German university institutes (which were separate buildings from the wards and from the dissecting rooms of the hospitals). The birth of histo-pathology is also linked with technical improvements in mass manufactured microscopes, with better techniques for fixing and staining histological samples and lastly, in (1848) withVirchow's cellular theory. Among French doctors, only one, the very famous physician Jean-Martin Charcot (1825-1893) was aware of these dramatic changes. Charcot wrote many texts which are testimonies of an epistemological rupture between two very different types of medicine, the old French "médecine d'hôpital" and the new "lab medicine", developed in German speaking countries and based on the microscope.

France↗

Development of on-line real-time menu management system.

An on-line, real-time menu management system was developed as a module of the integrated computer-assisted food management system implemented at the University of Missouri-Columbia Health Sciences Center Department of Nutrition and Dietetics. This system supplants a former automated form generating system and permits flexibility in menu design. The major data base in the system is the Master Menu File, which is updated using real-time processing. This file contains data about each occurrence of menu items and is interfaced with existing recipe files to produce numerous printed documents and to display the menu on a video display terminal. The major benefits of the system are flexibility and elimination of typing of worksheets. Entering a new menu or changes to the menu require only a brief amount of time; new revised documents relative to the menu can be generated on the same day. Some of the types of documents available from this system are: master menu, nutrient syllabi, menu audit, and food production forms. The menu is available on-line at all times for reference by dietitians and supervisors. The Master Menu File will be utilized more fully as new modules are designed to interface with the Menu Management System. Production forecasting, patient menu printing, and individualized diet planning are three potential enhancements to the system which will utilize data in the Master Menu File. The file was designed to accommodate additional data as the system in further matured.

Food Service, Hospital↗

Teaching behavioral science to family medicine residents: integrating training into the family practice unit.

The teaching of behavioral science is an integral part of the education of family physicians. This paper presents a model of a program that integrates the teaching of behavioral science with residents' daily activities in their clinical placement. It outlines the format of the program, the curriculum, teaching methodologies, evaluation and funding. The authors stress the importance of collaboration between family physician and psychiatrist in planning and implementing the program.

Behavioral Sciences↗

The ethical aspects of biomedical research in developing countries.

The European Group on Ethics is made up of 12 independent experts appointed by the European Commission. It is a multidisciplinary body that advises the Commission on ethical aspects of science and new technologies in connection with the preparation or implementation of EU legislation or policies. Its latest, 17th, opinion is reproduced below: since the current EU framework programme of medical research encourages partnerships with developing countries, it concerns the ethics of such research.

Advisory Committees↗

Undergraduate pharmacological training programs applicable to agricultural science majors.

Undergraduate training programs leading to degrees in pharmacology or toxicology do not exist on most university campuses. Agricultural science students who may ultimately use large quantities of herbicides, pesticides, and other agricultural products may obtain degrees without any exposure to the disciplines of pharmacology or toxicology; some reasons for this are discussed. The design and implementation of some courses suited to the qualifications of most undergraduate agricultural science majors are outlined. In general, a blend of lectures, discussions, and student presentations facilitates adequate presentation of the course material. Specific suggestions for student term projects are mentioned. Some of the available textbooks suitable for undergraduate courses of this type are very briefly discussed. It is suggested that in order to educate nonacademic users of agricultural chemicals, pharmacologists and toxicologists may have to work closely with both industry and those closer to the agricultural community such as county agricultural extension agents and farm youth organizations.

Agriculture↗

In search of the CPR.

In 1991, the National Academy of Sciences' Institute of Medicine defined, endorsed, and called for the implementation of the computerized patient record (CPR) by 2001. Seven years later, in 1998, health care is still arguing about what a CPR is, how it's to be implemented, and when. This article discusses the origins of the CPR and its initial development efforts. It explores the roadblocks that stalled its development and how managed care may have jump-started the process. Finally, it explains current CPR development efforts and what's on the horizon.

Health Care Reform↗

Hemophilia A--from basic science to clinical practice.

This article summarizes achievements of basic research and their implementation in clinical treatment of one of the most common inherited bleeding disorders hemophilia A, which is caused by genetic deficiency of coagulation factor VIII (FVIII). We discuss the structure of FVIII, its major interactions in the intrinsic pathway of blood coagulation, and the catabolism of FVIII. We also discuss achievements in the contemporary clinical practice of treatment of hemophilia A. Replacement therapy has substantially improved by development of purification and virus inactivation procedures, allowing preparation of safe and effective therapeutic plasma-derived FVIII concentrates. We give special attention to the principles used in the development of contemporary recombinant FVIII products, which do not inherit a potential risk for viral or prion transmission. Development of FVIII inhibitory antibodies is the major complication of FVIII replacement therapy. We summarize the accumulated knowledge regarding epitopes of FVIII inhibitors and mechanisms by which they inactivate FVIII and discuss approaches to overcome the effects of inhibitors and to prevent their formation by induction of immunotolerance. We also analyze the main concepts and scientific priorities in the gene-therapeutic approach for treatment of hemophilia A.

Animals↗

Assessing the reliability and credibility of industry science and scientists.

The chemical industry extensively researches and tests its products to implement product stewardship commitments and to ensure compliance with governmental requirements. In this commentary we argue that a wide variety of mechanisms enable policymakers and the public to assure themselves that studies performed or funded by industry are identified as such, meet high scientific standards, and are not suppressed when their findings are adverse to industry's interests. The more a given study follows these practices and standards, the more confidence one can place in it. No federal laws, rules, or policies express a presumption that scientific work should be ignored or given lesser weight because of the source of its funding. To the contrary, Congress has consistently mandated that agencies allow interested or affected parties to provide information to them and fairly consider that information. All participants in scientific review panels should disclose sources of potential biases and conflicts of interest. The former should be considered in seeking a balanced panel rather than being used as a basis for disqualification. Conflicts of interest generally do require disqualification, except where outweighed by the need for a person's services. Within these constraints, chemical industry scientists can serve important and legitimate functions on scientific advisory panels and should not be unjustifiably prevented from contributing to their work.

Chemical Industry↗

Chicago area methyl parathion response.

The Illinois Department of Public Health participated in the Chicago, Illinois, area methyl parathion (MP) response with several other federal, state, and local government agencies beginning in April 1997. This response was initiated on evidence that hundreds of homes in the Chicago area were illegally treated for cockroaches with MP over a period of several years. Through applicator receipt books and information reported by property owners and tenants, 968 homes were identified as having been treated with MP. Upon implementation of a response plan developed by the Methyl Parathion Health Sciences Steering Committee, environmental sampling and urine monitoring were provided for eligible households. Environmental sampling was conducted in 903 homes, with MP detected above levels of concern in 596 residences. Residents of these homes were offered urine sampling to determine the extent of exposure to MP. Urine samples were collected and analyzed for p-nitrophenol in 1,913 individuals. Implementation of the protocol resulted in 550 residents being relocated during the remediation of 100 households.

Adolescent↗

The use of the evidence-based approach in a periodontal therapy contemporary science workshop.

BACKGROUND: When appropriately evaluated and carefully managed, the integration of emerging technology into practice can improve health and enhance the quality of life. Since the last American Academy of Periodontology Workshop in 1996, great technological advances in the areas of data access, retrieval, and management have been made. The World Wide Web has "exploded" with great possibilities for gathering data from many sources. Evaluation methods such as meta-analysis and modeling have likewise improved, permitting a more objective and useful assessment of the retrieved information. The purpose of this paper is to demonstrate how the evidence-based (EB) approach was used to plan and implement a consensus conference on periodontal therapy, the Workshop on Contemporary Science in Clinical Periodontics. RATIONALE: The methodologies and philosophies associated with the EB approach provided the ideal framework for assessing the applicability of the newest clinical research to patient therapy. METHODS: Evidence-based systematic reviews on 15 topics associated with contemporary clinical periodontal practice were conducted prior to the Workshop. High standards of scientific rigor and scholarly ideals were stressed throughout the process. At the highly structured conference the reviews served as the basis for development of consensus reports that include implications for practice and research. MATERIAL COVERED: 1. The rationale, design, and implementation of a conference on contemporary clinical periodontics using an evidence-based approach. 2. Data management, clinical versus statistical significance, and the challenges of technology transfer and dissemination. 3. The benefits and limitations of using the EB approach in a consensus conference. CONCLUSIONS: The consensus statements resulting from the conference should serve to augment clinical decision-making, research priorities, education, and reimbursement. The evidence-based approach removed much of the subjectivity traditionally associated with classical reviews of the literature and allowed participants to focus on substantive issues.

Consensus Statements as Topic↗

[Investigation of academic degrees sought by radiological technologists].

This study attempted to clarify whether medical radiological technologists of the Japanese Society of Radiological Technology in Gunma sought to obtain Bachelor degrees and Master of Science degrees. In September 2005, a postal questionnaire survey was conducted on a sample of 153 technologists, and 68.0% (104/153) of the questionnaires were returned. The percentage of respondents who wished to obtain a degree was 25.0% (26/104) . The first reason for wishing to obtain a degree was to improve the quality of their work 47.8% (11/23) . Moreover, 28.8% (30/104) of respondents indicated a desire to obtain a master's degree. A total of 103 respondents indicated the subject they wished to study: 45.6% (47/103) indicated their own specific area, and 34.0% (35/103) indicated clinical psychology. The results of the survey showed that a high ratio of radiological technologists in Gunma would like to obtain an advanced degree. Even the radiological technologists who did not wish to obtain an advanced degree indicated their desire to continue in more specialized areas of radiology. The above investigation suggested some ways to implement lifelong education at the Gunma Prefectural College of Health Sciences.

Adult↗

Pediatric behavioral science in family practice.

Behavioral science is a well-accepted component of family practice, but official guidelines and proposed curricula have a predominantly adult focus. This paper describes a pediatric behavioral science curriculum for family practice residents that has been successfully integrated into the three-year family practice residency curriculum at the University of Colorado. Details of development and implementation are presented: the requisite knowledge base, skills, and attitudes; the core pediatric behavioral science topics and diagnoses; the family physician's role in handling each core diagnosis; guidelines for making management decisions; suggested approaches to teaching the curriculum; and a reference list for behavioral science faculty.

Attitude of Health Personnel↗