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PubMed1985

Securing a biomedical communications future: thinking strategically.

Ensuring continued growth and viability of the biomedical communication function has become a critical task of the biomedical communications director. Thinking strategically is a cognitive process which assists a director in visualizing programs and tactics which meet clients needs, creates competitive advantages for the biomedical communications unit and builds on existing unit strengths. Thinking strategically can be divided into five phases: strategic vision, strategy development, strategic plan implementation, strategic plan dissemination, and strategic plan evaluation. Each sequence leads the biomedical communications director through a process designed to increase the effectiveness of the biomedical unit and to meet the challenges posed by an environment characterized by diminished financial, material, and human resources as well as respond to threats and opportunities posed by increased competition in the biomedical communications product and marketplace.

Communication↗

PubMed1992

[Poverty on the psychiatric unit--a central problem in mental health treatment].

72 patients of the psychiatric department of the general hospital in Berlin Neukölln were interviewed unselectedly to the subjects of lodging and income with the help of a semistructured interview. Only 16 (22%) patients still had a job, 17 (24%) were without job and 31 (43%) were on pension. 10 patients (14%) were homeless, 12 patients (17%) lived in insufficient conditions of housing. Only 11 patients (15%) earned their own wage/salary. All together 25 patients (36%) were in some way dependent on support by social security. Half of the patients had a regular income of less than DM 1000.--a month. The everyday dealing with the problem of poverty on the ward is pointed out and discussed. Obviously this theme is not integrated enough in the therapeutic process. This subject can not only be delegated to the responsibility of the social worker.

Adult↗

PubMed1992

[Immigrants in Switzerland: possibilities and difficulties of integration].

Immigrants find it hard--although not all in the same way--to adapt to the language, the social structure and the way of life of their host country. Different factors overlap: the foreigners' social and cultural background, their education and their adaptability to a foreign environment, their plans for the future, the political and legal situation in the host country as well as the local population's acceptance of and tolerance and respect for a foreign culture. The fact that 75% of all foreigners in Switzerland possess a residence permit can be considered as rather positive; however, this does not necessarily mean that these people are familiar with the local language and way of life. Isolation and a continuously postponed return to the home country are conditions well known even among resident foreigners. Seasonal workers, on the other hand, feel great uncertainty and concern. In critical life situations, for instance caused by illness, accidents or unemployment, the process of rehabilitation can strongly be influenced by earlier living conditions. The Swiss legislation on foreigners as well as the legislation on social security can often bring about fundamental fateful questions. In order to find efficient solutions to the wide range of possible difficulties, a whole-hearted interdisciplinary cooperation is extremely important.

Acculturation↗

PubMedDate not supplied

Medical informatics and health care organizations.

A dialogue between upper management and operational elements over an organization's informatics policies and procedures could take place in an environment in which both parties could succeed. Excellent patient care practices can exist in organizational settings where upper management is not concerned with the specifics of the medical care process. But as the medical care process itself becomes costly, complex, and part of the purview of upper management, solutions to ambiguous informatics policies and practices need to be found. As the discussion of cost determination suggests, a comprehensive "top-down" solution may not be feasible. Allowing patient care expertise to drive the design and implementation of clinical computing modules without unduly restrictive specifications from above is probably the best way to proceed. But if the organization needs to know the specifics of a treatment episode, then the informatics definitions specific to treatment episodes need to be unambiguous and consistently applied. As the discussion of Social Security numbers suggests, communication of information across various parts of the organization not only requires unambiguous data structure definitions, but also suggests that the communication process not be dependent on the content of the messages. Both ideas--consistent data structure definitions for essential data and open system communication architectures--are current in the medical informatician's vocabulary. The same ideas are relevant to the management and operation of large and diffuse health care enterprises. The lessons we are learning about informatics policy and practice controls in clinical computing need to be applied to the enterprise as a whole.

Costs and Cost Analysis↗

PubMed1991

[Changes in clinical, hematologic and biochemical indicators in controlled respiration during anesthesia in dogs].

Some clinico-biochemical parameters were investigated in fifty clinically healthy dogs in the course of controlled breathing in halothane inhalation anaesthesia to evaluate in a complex manner the dynamics of metabolic processes in the dog organism. The test dogs were divided into three groups. In the first test group, ECG and values of acid-base balance parameters in venous blood were followed in ten dogs. In the second test group, the values of blood gases were followed in addition to the above-mentioned parameters in twenty anesthetized dogs. In the third test group comprising twenty animals, acid-base parameters in arterial blood and blood gas tension were evaluated. Greatest divergences were recorded in pH values, blood gas tension and acid-base balance values. Partly compensated respiration acidosis was observed already in 30 minutes from the start of anaesthesia, as shown by complex evaluation. The results indicate that also in optimum ventilation programme it is necessary to apply infusion solutions to the internal environment of organism which will secure metabolic rebalancing in the course of artificial pulmonary ventilation.

Anesthesia, Inhalation↗

PubMed1977

[Security at work in terms of risk factors (author's transl)].

Accident epidemiology aims at determining those factors which are associated with an increased risk. Here accidents at work are considered in which any given situation involves: one or many individuals (I); one or many tasks (T); one or many machines or production tools (M); an environment (E). Eight factors are proposed for each of which one of the above components is dominant. Each factor is defined and examples are given. In addition, where applicable, the following are given: subfactors; references to studies which demonstrate the association between risk and factor; one or several possible action mechanisms; proposals enabling a quantitative evaluation to be made for statistical purposes; suggestions for prevention. The factors are: Individual disposition (I) or liability. Worker's inexperience (I). Stress (T) imposed on the worker. Recovery (T) (an exceptional task must be performed in order to regain normal work conditions). Catachresis (M) (a tool is used for an unusual purpose or a machine is required to exceed normal work load). Material wear (M) or damage. Interference (E) between partially independent processes. Insufficient information (E) concerning the state of the system.

Accidents, Occupational↗

PubMed1988

Modern technology in the rehabilitation process.

Modern technology gives a variety of new opportunities for severely disabled persons. It is time to start a serious discussion about how these new opportunities can be incorporated in rehabilitation theory and practice. In this article we show how modern technology may support independent life for the severely disabled. And we also discuss how modern technology can be used to change the environment. Removal and prevention of environmental barriers for participation is one main practical rehabilitation method. Modern technology therefore must also be evaluated by its environmental consequences. One important question is: How can modern technology open up more areas of normal participation for the disabled? The research approach is fieldwork, interviews with disabled persons, co-operation with organizations inventing and producing new products, as well as participation in social analysis and environmental change. Two conclusions to date are: (1) There is a wide gap between new technical possibilities and the real life situation of most people with severe disabilities; (2) Modern technology used as aids for people with severe disabilities has a rehabilitative effect only if it is supported by a sufficient social system for transport, security and care.

Activities of Daily Living↗

PubMed1989

Ethical decision making in clinical practice.

Contemporary nursing ethics education focuses on the use of an analytical model of ethical decision making for both its process and its content. Perhaps this is the case because it bears some resemblance to the nursing process, which is taught in a similar fashion. Thus, a deductivist method of ethical decision making fits within the same general schema of the hypotheticodeductive method of decision making that is taught for nursing diagnosis. Ethics requires that nurses respect persons, inform patients and secure their consent, not inflict harm, preserve the patient's quality of life, prevent harm and remove harmful conditions, do good for patients, and minimize risk to themselves. These are among the norms of obligation that guide ethical analysis and judgment in nursing practice and are the substance of the analytical model of ethical decision making. Nursing's ethics has established high ideals and strong demands for nurses. These are demands which nurses have met and ideals which have often been realized. Whatever the strength of our science, nursing is an inherently moral endeavor and is only as strong as its commitment to its ethical obligations and values. Between the grinding edges of the forces that affect it, nursing must establish its priorities among the aspects of its environment that it attempts to control. Ethics must be chief among those priorities.

Beneficence↗

PubMed2026

Low-pass whole-genome sequencing reveals genomic diversity and ecotype-specific adaptation in indigenous Tigrayan chickens.

Indigenous chickens play a critical role in food security and climate resilience in smallholder systems, yet their genomic diversity and adaptive potential remain insufficiently characterised. This study employed low-pass whole-genome sequencing (LP-WGS; 0.2-1.99×) to investigate genomic diversity, population structure, inbreeding and candidate environment-associated genomic variation in 33 chickens from highland, midland, and lowland agroecologies in the Tigray region of northern Ethiopia. After imputation and stringent filtering, 23.4 million high-confidence SNPs were retained, including ~ 17% novel variants, indicating substantial uncharacterised genetic diversity in these populations. SNP density (13.8 ± 8.6 SNPs/kb) was comparable to values reported from high-coverage Ethiopian chicken datasets, demonstrating the suitability of LP-WGS for population genomics in resource-limited settings. Marked differences in genomic diversity were observed among ecotypes: midland chickens showed the highest nucleotide diversity (π = 0.00267), followed by lowland (π = 0.00233), whereas highland chickens showed the lowest diversity (π = 0.00203) and elevated genomic inbreeding (FROH and FHOM ≈ 0.18). Population structure analyses revealed clear genetic separation among ecotypes. PCA (13.91% variation explained) distinguished lowland chickens along PC1 and separated highland from midland along PC2, while ADMIXTURE and FST patterns supported three major ancestral genomic backgrounds. Functional annotation of private missense variants uncovered distinct adaptive signatures reflecting the contrasting agroecological conditions. Highland chickens showed enrichment of candidate genes potentially involved in physiological processes relevant to high-altitude environments, including cold response, angiogenesis, cardiovascular regulation and metabolic homeostasis (eg., PARP1, ACOX2, ITGB3, EDNRB, SOX8, and SOX10). Midland chickens exhibited candidate signals of selection in genes with known roles in innate antiviral immunity, bacterial defence and inflammatory regulation (eg., BAK1, CLSTN1, CYSLTR1, CYSLTR2, CXCR7, GIPR, DSCAM, GDAP1, TLR3, TLR4, TLR7, IFIH1, ADORA1, EPHB1, and TMPRSS2). Lowland chickens displayed candidate variants associated with heat-stress response, DNA damage repair, oxidative balance and cardiovascular support under extreme temperatures (e.g., MLH1, BDKRB1, GPR19, FLT1, CCL18, TGM2, and RAMP3). Overall, the results indicate substantial genomic differentiation among ecotypes and suggest candidate environment-associated genetic divergence across Tigray's diverse agroecological zones. These populations may represent important reservoirs of adaptive genetic variation for climate-resilient poultry breeding, warranting further functional validation and conservation-oriented management.

Animals↗

PubMed1989

Peripheral nerve regeneration through blind-ended semipermeable guidance channels: effect of the molecular weight cutoff.

Synthetic nerve guidance channels are used to better understand the cellular and molecular events controlling peripheral nerve regeneration. In the present study, the contribution of wound-healing molecules to peripheral nerve regeneration was assessed by varying the molecular weight cutoff of the tubular membrane. Nerve regeneration through polysulfone tubular membranes with molecular weight (Mw) cutoffs of 10(5) and 10(6) Da was analyzed in a transected hamster sciatic nerve model. Cohorts of 6 animals received tubes of either type for 4 or 8 weeks with the distal end of the polymer tube capped. Other cohorts of 6 animals received tubes of either type for 4 weeks with the distal nerve stump secured within the guidance channel so as to create a 4 or 8 mm gap between both nerve stumps. Both types of channels contained regenerated tissue cables extending to the distal end of the guidance channel at both 4 and 8 weeks in the absence of a distal nerve stump. The cables regenerated in the 10(5) Da channels were composed of nerve fascicles surrounded by a loose epineurial sheath, whereas those regenerated in the 10(6) Da channels were composed mainly of granulation tissue. The numbers of myelinated and unmyelinated axons were significantly greater in the 10(5) Da than in the 10(6) Da channels at both 4 and 8 weeks. Both types of channel contained regenerated tissue cables with numerous nerve fascicles when the distal nerve stump was present with either gap length. However, when the gap distance was 8 mm, the 10(6) Da channels contained significantly fewer myelinated axons than the 10(5) Da channels. The present study reveals that the Mw cutoff of a semipermeable guidance channel strongly influences the outcome of peripheral nerve regeneration, possibly by controlling the exchange of molecules between the channel's lumen and the external wound-healing environment. These results suggest that the wound-healing environment secretes humoral factors that can either promote or inhibit the nerve-regeneration process.

Animals↗

PubMed1985

The attitudes of religious, environmental, and science policy leaders toward biotechnology.

Biotechnology is an increasingly visible and important item on the national science policy agenda. With growing corporate and governmental funding, basic research in recombinant DNA and related technologies is expanding rapidly. In a parallel and related process, new agricultural, medical, and other applications are being developed and a growing list of genetically-engineered products is ready for field testing and market distribution. In the months and years ahead, the flow of genetically-engineered products into the marketplace and the media coverage related to those new products will increase the public's awareness of biotechnology. In addition, it is possible that some public policy debate will occur over the issue of field testing new genetically-engineered materials. Media coverage of this type of controversy will also heighten awareness and influence the aggregate level of public awareness of biotechnology. The prospect of a public debate or controversy over any biotechnology issue illustrates a fundamental problem in the formulation of science policy within a democratic political system. The processes and techniques involved in genetic engineering and complex and require some level of scientific background knowledge. A 1979 study found that only seven per cent of American adults met a minimal definition of scientific literacy. It is clear that the current levels of public awareness and knowledge about biotechnology will not allow a public policy debate similar to those associated with controversies involving Social Security or gasoline prices. How, then, does a democratic society establish public policies on advanced technical issues like biotechnology? This report will outline a model of policy formulation for specialized issues and describe the results of a national study of relevant policy leaders concerning biotechnology. To understand the formulation of public policy toward biotechnology, it is necessary to focus on the role of the policy leaders in a stratified model. In general, when there is agreement on a given policy between the decision-makers and the policy leaders, the policy is implemented and there is no wider involvement in the policy formulation process. A large number of science and technology policy issues have been handled in this manner in the decades since the Second World War and it is likely that most science policy matters will continue to be resolved directly between policy leaders and decision-makers. Looking at the general science policy formulation process, it is clear that policy leaders are an important component.(ABSTRACT TRUNCATED AT 400 WORDS)

Attitude↗

PubMed1987

A functional analysis of recidivistic arson.

Evidence from studies of pathological arson and normal fire setting as well as the authors' clinical experience with arsonists in a maximum security hospital is employed to generate a model of recidivistic arson within the conceptual framework of functional analysis. It is contended that certain psychosocial stimuli, in the context of major setting conditions, predispose the individual towards incendiarism which is initially positively and negatively reinforced. However, the longer-term consequences of arson are considered to maintain and exacerbate the antecedent problems encountered by arsonists. Specifically, arson is viewed as an attempt to exert a change in the arsonist's life conditions where alternative behaviours have proved, or are perceived to be, ineffective. The model incorporates adaptations of the displaced aggression and arousal hypotheses of arson, and examines possible developmental aspects of pathological arson from normal childhood fire play, and suggests that a transition from fire setting in the company of others to incendiarism alone constitutes a major factor in the pathological process. The social, clinical and theoretical implications of the model are discussed with reference to current management and treatment strategies as well as future research.

Arousal↗

PubMed1988

[Factors influencing implantation of mouse embryos fertilized in vitro].

To examine the process and the rate of implantation of mouse eggs fertilized in vitro, we transferred the eggs to the opposite uterine horn of the donor mouse and assessed the effect of culture conditions on the early-stage embryos. In vitro fertilization of mouse ova Crj: CD-1 (ICR) was performed according to the technique of Toyoda et al. Embryo transfer (2 cell, 4 cell, morula and blastocyst stage) was performed by a modified McLaren's technique. Sister chromatid exchanges (SCE) were examined as indicators of cytogenetical factors, and a comparison was made of three different environmental conditions: I. in vitro fertilization-in vitro culture, II. in vitro fertilization-in vivo development, III. in vivo fertilization-in vitro culture, IV. in vivo fertilization-in vivo development. The results were as follows. 1) The implantation rate of blastocysts transferred within donor mice was 20% and the growth rate to fetus was 14.5%, but embryos from the 2 cell to morula stage could not be implanted on the endometrium of the contralateral uterine horn. 2) Where donor and recipient were different mice, there was a decrease in the implantation rate, when the recipient and donor were at a synchronized stage of the cycle. An improvement in the rate was secured when the recipient's stage was delayed 24 hours. 3) The SCE score increased significantly in groups I and III (p less than 0.001, Student's t-test) as compared with that of group IV. The decrease in the IVF embryo implantation rate vs. natural conception is due to the non-physiological environment and growth retardation of the IVF embryo causes asynchronization with endometrial age.

Animals↗

PubMed1992

[Prevalence and persistence of back pain in foreign workers: class or culture-induced?].

Physically working people are more likely to suffer from backache. Not only is their work hard and menial but usually also degrading. Unpleasant circumstances such as an offensive environment, the monotony of work, poor qualifications or unsatisfactory work generally influence the persistence of pain. The course of an illness such as a lingering backache, is hardly ever determined by somatic factors. A prognosis is rather based upon the attitude and behaviour of the single patient and his social surroundings, as well as upon the pathological process. Medication might even worsen rather than improve the patient's condition. The typical foreign worker, who generally merely has an elementary education and whom we therefore assign unqualified work, does not only risk to suffer from backache. His personal strength and his circumstances can seriously hinder his rehabilitation, more than it would be the case with native patients. The accumulation of negative factors is closely connected to his role of a foreign worker, whereas cultural aspects do not seem to be determining. Therefore, the foreign patient's rehabilitation can be fostered and improved by adopting the same methods used with Swiss patients against the chronicisation of backache. Nevertheless, the mentioned unfavourable factors and additional language problems considerably foil all efforts to a successful rehabilitation.

Acculturation↗

PubMedDate not supplied

["Released" employees of the 6th decade--a new retirement generation. Report on central results of a meeting of experts on the topic].

More and more workers and employees leave their working places and renumerated employment for good from the age of 50 onwards - by way of acknowledged incapacity to continue work due to health reasons, unemployment, forced retirement after production plants have closed down and early retirement schemes. How retirement is experienced very much depends on the living conditions encountered and on the process of transition to retirement. Acceptancy of premature retirement is of central importance - as are the opportunities of influencing by one's own decisions the age of retirement, the predictability of this event and the chances of transition through a phase of gradual re-orientation. Differentiation between those with good and very good income levels and those with only minimal financial means is imperative. Negative outcomes of the latter situation may be a feeling of total hopelessness, frictions within the family, reduction of social contacts and of out-of-door activities--a tendency to hide away in shame. To be labelled as old in too early a phase in life is not acceptable. The social status attained tends to be unclearly defined with accompanying negative effects on the self-concept as well as on the image held by others.

Aged↗