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At least 451 records · Page 25Linked to original sources
PubMed1991

[The treatment of acute lymphatic leukemia in adults: pilot project with intensive early therapy without a maintenance phase].

Acute lymphoblastic leukemia (ALL) is conventionally treated in three phases: remission induction, consolidation and maintenance. In adults initial remission rates of nearly 80% can be achieved. The 3 to 5 year leukemia free survival is 20 to 40%. Most relapses occur during maintenance, despite continuous therapy for 2 to 3 years. The value of maintenance therapy following intensive induction in adults is not documented. In this pilot study we treated 34 patients with ALL in five Swiss centers between 1986 and 1989 with intensive induction/consolidation therapy alone. Three induction/consolidation courses were applied: course I, 43 days, consisting of daunomycin, vincristine, prednisone, methotrexate, L-asparaginase and intrathecal CNS prophylaxis; course II, 6 days, consisting of high dose cytosine arabinoside and VP-16; course III, three non randomized arms, either allogeneic or autologous bone marrow transplantation (BMT) or high dose cyclophosphamide and repeated intrathecal therapy alone. 32 patients (94%) reached complete remission (CR): 24 after course I (71%), 7 after course II (cumulative 91%) and one after course III only (cumulative 94%). 3 patients had early, relapses before course III, 3 died of infection, and 2 of graft-versus-host disease. One patient had refractory leukemia in all three courses. 26 patients (76%) were in CR after completion of therapy. 16 relapsed within 1 to 17 months (median 5). 10 patients are free of disease after 10 to 44 months (median 24): 5 had had allogeneic BMT, 3 autologous BMT and 2 cyclophosphamide in course III.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2002

A pilot project to study the use of ultrasonography for teaching physical examination to medical students.

The purpose of this study was to study the use of ultrasound as an aid to teaching physical examination. Five medical students were given a 1-week course in ultrasound, and were then assigned to clinical rotations to perform ultrasound and physical examinations on patients. Basic ultrasound skills were assessed by having each student scan the same normal model at the conclusion of the first week and at the conclusion of the project. Clinical cases were presented to a preceptor, and the ultrasound images were graded on a five-point scale. At the end of the first week, the mean grade of ultrasound examinations performed on the control model was 3.2, improving to 4.4 at the end of the project. Grading of ultrasound exams performed during the first clinical week averaged 4.1, improving to 4.5 at the end of the project. An exit survey indicated a favorable response to using ultrasound as an educational tool.

Adult↗
PubMed2005

Evaluation of new external quality assessment guidelines involving random blinded rechecking of acid-fast bacilli smears in a pilot project setting in Mexico.

SETTING: Laboratories in Mexico that support the national tuberculosis (TB) control program have been involved in an acid-fast bacilli (AFB) microscopy external quality assurance program which includes rechecking 100% of smears identified as AFB-positive by the local laboratories and 10% of smears identified as AFB-negative. Very few errors have been detected in Mexico using non-random selection and unblinded rechecking of the slides. OBJECTIVE: To evaluate the results from a 1-year pilot program involving blinded rechecking of randomly selected AFB slides from local TB laboratories in two Mexican states and determine its feasibility for future implementation. DESIGN: To reduce potential bias, laboratory staff from the National TB Laboratory, Institute for Epidemiological Diagnosis and Reference (InDRE), performed quarterly statistical sampling of AFB smears and on-site evaluations in local laboratories in each state. AFB smears were rechecked at the respective state laboratories with discordant results resolved at InDRE. RESULTS: A significantly greater percentage of errors was detected on the randomly selected, blinded AFB smears than on the non-randomly selected, unblinded smears. CONCLUSION: Random blinded rechecking provides more accurate estimates of AFB microscopy results, resulting in improved diagnosis and monitoring of treatment response.

Bacteriological Techniques↗
PubMed1993

Philippines: pilot project on HIV and AIDS education and prevention.

The project set up by Christian Children's Fund-Philippines and STOP Trafficking of Filipinos aims to identify cultural practices of young people which may have bearings on their sexual practices and information on how they think and feel about HIV and AIDS. The baseline study found that a number of young adults shared common misconceptions about boy-girl relationships and sex; therefore, there is a need to clarify these concepts and develop self-awareness in order to promote sound and healthy attitudes toward interpersonal relationships and sexual behaviors. The study also found the need for young people to undergo training as a strategy for information dissemination and acquisition of right information and/or expand knowledge to deal effectively with current realities including HIV/AIDS and human sexuality. This baseline information is used to design intervention and communication packages composed of training modules, posters, and other materials that can be used for an educational program for youth. This project was supported by the National AIDS Prevention and Control Program of the Department of Health in the Philippines.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Summative assessment: a pilot project in the west of Scotland.

In the autumn of 1991 the Committee in General Practice of the west of Scotland region appointed a working party to investigate the possibility of developing a credible, valid and reliable programme of summative assessment for general practitioner trainees. The working group formulated a four-part package consisting of a multiple true-false paper, a trainee audit project, the trainers' judgement, and analysis of videotaped consultations. The reasons for the use of this selection of methods are discussed. It is suggested that a summative assessment process for trainees should make use of the trainers' considerable knowledge of the trainee, have an external component, be criterion referenced, have an element of continuous assessment, and involve direct assessment of clinical competence. A pilot study of assessment of clinical competence using videotapes of routine trainee consultations by 25 volunteer general practitioner assessors is described. A rating instrument for use in differentiating the competent from the not yet competent trainee is discussed. The working group and the group of videotape assessors came to the provisional conclusion that the use of videotaped consultations may be a valid and feasible method of assessing the competence of general practitioner trainees as part of a balanced summative assessment programme.

Clinical Competence↗
PubMed1991

[Quality assurance in health care. With special reference to the the pilot project quality assurance in Schleswig-Holstein hospitals].

Quality assurance is growing in significance in health care world wide. The European Office of the World Health Organization has included quality assurance in its 38 health-policy targets for health care. Most experience in this field has hitherto been gained in the USA and in the Netherlands. In West Germany, the most extensive step which has been taken to provide quality assurance has been the perinatal study which is a record of approximately 80 per cent of births. Apart from this, there are pilot studies in existence in particular in the areas of surgery, of operative gynecology and of paediatry. Quality assurance in in-patient and out-patient care has been laid down by law in West Germany since 1st January 1989. Using this as a basis, the Institute for Health-Systems Research is acting as advisor for a pilot study ("Pilot Study for Quality Assurance in Hospitals of Schleswig-Holstein") which is at present being carried out in Schleswig-Holstein and in which 12 hospitals are participating. The pilot study is so structured that it has developed methods for measuring quality assurance in the fields of surgery, internal medicine, gynecology and obstetrics, nosocomial infections, haemotherapy and nursing. Quality assurance is a sensitive area. Indications will be given to what should be heeded when introducing measures for quality assurance in hospitals. Institutes with clearly defined functions are required in order to carry out quality assurance.

Germany↗
PubMed2004

Can oncology nurses treat depression? A pilot project.

BACKGROUND: Depression is a common problem in all medically ill populations. Reported prevalence rates of major depression in patients with cancer are up to 50%. Cancer patients attending primary care and medical outpatient clinics with comorbid major depressive disorder frequently do not receive effective treatment. More effective ways of identifying and treating patients with both cancer and depression are therefore urgently required. AIM: The paper reports a study addressing the question of whether oncology nurses can be trained to take on a greater role in the management of major depression in their patients. METHOD: We developed and piloted an intervention that can be delivered by a specially trained oncology nurse. The intervention is multifaceted and based on a problem-solving model. It requires a widening of the role and expertise of specialist nurses. DISCUSSION: The challenges this role presents to the nurses are discussed. We suggest that they must have a varied work programme that is not exclusively about managing depression, that they require adequate peer support and are likely to be most effective when working as part of a multidisciplinary psycho-oncology team. CONCLUSION: We conclude that it is possible to train selected specialist oncology nurses to manage major depression in patients with cancer in the context of an appropriately constituted multidisciplinary team.

Ambulatory Care Facilities↗
PubMed1998

[Inpatient treatment of depressed patents. Conceptual considerations and results of a pilot project for quality assurance in Baden-Württemberg].

Quality-assurance activities will become more important in psychiatry during the next few years. In relation to other medical disciplines, some special aspects concerning structure, process and outcome quality as well as practical realization and methodologic aspects must be considered. These specific issues were the focus of a study dealing with the treatment of depressed inpatients. The experiences and results as well as considerations concerning future quality-assurance projects are discussed.

Adult↗
PubMed2002

Introducing ecological sanitation: some lessons from a small town pilot project in Mozambique.

The paper explores the development of ecological sanitation (EcoSan) within the small-town context of Lichinga, Niassa Province, Mozambique. The paper looks at how ESTAMOS (a Mozambican NGO) and WaterAid introduced EcoSan in Lichinga, how families and communities have responded to EcoSan, and key lessons learned during the process to date that could be relevant to others within and beyond Mozambique.

Ecology↗
PubMed1977

Newborn infant hearing screening - a five year pilot project.

The criteria for screening infants' hearing in the newborn nursery are reviewed. The problems encountered are discussed and a screening program outlined. Over 12,000 newborn infants were screened for hearing over a five year period and a total of eight were confirmed deaf - an incidence of one in 1,500 live births.

British Columbia↗