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PubMed1988

Practical and technical considerations in establishing an intraoperative radiation therapy program in the community practice.

The Radiation Oncology Center in Sacramento, California, has developed a procedure for establishing an intraoperative radiation therapy facility in a community practice. The logistics pertaining to personnel, equipment, physical measurements, and quality assurance are presented. Particular emphasis is given to the most effective means of acquiring the large quantity of data needed to ensure a program of acceptable quality.

Facility Design and Construction↗
PubMed1979

A method of intrarenal blood flow measurement using xenon-133 in the intact rat.

A method is described for measuring distribution of intrarenal blood flow in anesthetized rats by a xenon-133 washout technique that avoids the trauma of opening the abdominal cavity and manipulating the kidney. Precise delivery of the tracer to the kidney and fine collimation of the radiation reduces the amount of tracer required. Washout curve analysis is achieved by a multifit computer program that accepts only count rates and time as input data.

Animals↗
PubMed1989

Improved biometry of the anterior eye segment.

In this paper, a method is presented to evaluate the true values of several optical parameters of the anterior eye segment. These are: the thicknesses of the cornea and lens, the depth of the anterior chamber and the anterior and posterior curvatures of the cornea and lens. First, a photo is taken of each patient's eye with a Topcon SL-45 Scheimpflug camera. There are two effects distorting the photo. As the film plane and the object plane are perpendicular to each other, the imaging scale is not constant over the photo, a phenomenon which is called the camera distortion. As the light passes through different refractive media on its way from the inner structures of the eye to the camera, the rays of light are refracted, which is called the refractive distortion of the eye. Following these distortions, the proportions on the photo do not correspond to those in the human eye. The intention of this paper is to calculate the true optical parameters of the anterior eye segment. The seeming optical parameters are taken from the photo and the path of light from a point in the film plane through the camera and the refracting surfaces into the eye is constructed by ray tracing. A set of representative points calculated according to ray tracing provides a basis to evaluate the true optical parameters. This work is done using a Basic program, that accepts the seeming parameters from the photo as input values and provides the true values as output. The adjectives seeming and true added to the optical parameters indicate a value correlating with a distorted photo and a value that was corrected by the theory. The two terms were chosen by mnemonic reasons, although another pair of adjectives such as distorted and corrected might have been of higher precision. For an average adult human eye the optical parameters from the photo were compared with the calculated ones. A phantom eye with well-known optical parameters was constructed and photos were taken from this eye to verify the calculations.

Anterior Eye Segment↗
PubMed1977

A community mental health center's consultation service in a general hospital.

A community mental health center operates a psychiatric consultation program as an integral part of the medical emergency service of a 550-bed general hospital. A major advantage of the system is that it allows the hospital to provide immediate comprehensive services--psychiatric as well as medical--to emergency patients. The consultation program also accepts referrals of hospitalized medical patients with apparent emotional problems and referrals of patients from such sources outside the hospital as pediatricians, clergymen, and other community agencies.

Clergy↗
PubMed2005

Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: preliminary report.

BACKGROUND: Vestibular rehabilitation (VR) is a well-accepted exercise program intended to remedy balance impairment caused by damage to the peripheral vestibular system. Alternative therapies, such as Tai Chi (TC), have recently gained popularity as a treatment for balance impairment. Although VR and TC can benefit people with vestibulopathy, the degree to which gait improvements may be related to neuromuscular adaptations of the lower extremities for the two different therapies are unknown. METHODS: We examined the relationship between lower extremity neuromuscular function and trunk control in 36 older adults with vestibulopathy, randomized to 10 weeks of either VR or TC exercise. Time-distance measures (gait speed, step length, stance duration and step width), lower extremity sagittal plane mechanical energy expenditures (MEE), and trunk sagittal and frontal plane kinematics (peak and range of linear and angular velocity), were measured. RESULTS: Although gait time-distance measures were improved in both groups following treatment, no significant between-groups differences were observed for the MEE and trunk kinematic measures. Significant within groups changes, however, were observed. The TC group significantly increased ankle MEE contribution and decreased hip MEE contribution to total leg MEE, while no significant changes were found within the VR group. The TC group exhibited a positive relationship between change in leg MEE and change in trunk velocity peak and range, while the VR group exhibited a negative relationship. CONCLUSION: Gait function improved in both groups consistent with expectations of the interventions. Differences in each group's response to therapy appear to suggest that improved gait function may be due to different neuromuscular adaptations resulting from the different interventions. The TC group's improvements were associated with reorganized lower extremity neuromuscular patterns, which appear to promote a faster gait and reduced excessive hip compensation. The VR group's improvements, however, were not the result of lower extremity neuromuscular pattern changes. Lower-extremity MEE increases corresponded to attenuated forward trunk linear and angular movement in the VR group, suggesting better control of upper body motion to minimize loss of balance. These data support a growing body of evidence that Tai Chi may be a valuable complementary treatment for vestibular disorders.

Biomechanical Phenomena↗
PubMed1983

Clinical problems in the management of patients with acute myocardial infarction from its onset to the patients' return to work.

Out of 330 patients with acute myocardial infarction (AMI) admitted to our institution, 256 patients entered our 3-week rehabilitation program and discharged from the hospital. Through the execution of the program, its feasibility and safety were examined, and guidelines for the progress of the program were re-evaluated. The state of outpatient community life and its determining factors were also investigated by a questionnaire. The following results were obtained: 1) Over 90% of patients with uncomplicated MI could complete the rehabilitation nearly on schedule, indicating the feasibility of the program. 2) Mortality after ambulation and serious complications related to rehabilitative activities were very few, indicating the safety of our rehabilitation program. 3) Among guidelines for the progression of the program generally accepted, the case for an elevation of blood pressure as well as an ST depression was found to be especially important in order to prevent serious complications. 4) Age, discharge exercise capacity, left ventricular function and the severity of coronary disease were important factors influencing the patients' returning to work.

Activities of Daily Living↗
PubMed1975

Adaptation to chronic dialysis: a two-way street.

While dialysis is a medical advance that enables people to live who would otherwise die, it is often experienced as an ordeal by those who must live with it. Patients and staff experience difficulties in their adaption to chronic dialysis. A program that accepts all patients, regardless of motivation and stability, carries with it the responsibility of offering care in a way the patient can tolerate and of providing a regimen within the context of his personality structure and social adaptation.

Adaptation, Psychological↗
PubMed1989

Paid family caregiving and the market view of home care: agency perspectives.

Home care agency administrators were surveyed to explore their views on hiring kin to care for their own relatives. The results suggest that formal systems may tend to view paid family caregiving in ways similar to policy makers who express concern about substitution for unpaid care and runaway costs. Many administrators expected that families may abuse the program and accept pay for work not performed. A major implication of the study is that implementation of family compensation through agencies could result in attempts to focus on controlling informal care.

Administrative Personnel↗
PubMed1999

Library residencies and internships as indicators of success: evidence from three programs.

This paper discusses post-master's degree internships in three very different organizations; the University of Illinois at Chicago, the National Library of Medicine, and the Library of Congress. It discusses the internships using several questions. Do the programs serve as a recruitment strategy? Do the programs develop key competencies needed by the participant or organization? Do the programs develop leaders and managers? Is acceptance into a program an indicator of future career success? A survey was mailed to 520 persons who had completed internships in one of the three programs. There was a 49.8% response rate. Responses to fifty-four questions were tabulated and analyzed for each program and for the total group. The results confirm the value of internships to the career of participants.

Adult↗
PubMedDate not supplied

Installing management by objectives in a public agency: a comparison of Black and White managers, supervisors, and professionals.

This paper explores the prediction of King and Bass (1974) that black managers and supervisors may be more reluctant than whites to accept management programs such as management by objectives. Data were collected from 77 black and 61 white managers and professionals of the City of Detroit transportation system (D-DOT), after they had been involved with MBO for almost one year. Analyses of t-test results indicate that blacks assessed MBO as more helpful in their individual jobs and more positive for the organization than their white counterparts. Explanations derived from the racial demographics of the organization, the MBO installation, and characteristics of MBO as a management process in public agencies are given.

Administrative Personnel↗
PubMed2003

Sustainable urban development in Brisbane City--the Holy Grail?

Impacts from urban stormwater runoff on receiving environments have been well documented, particularly through specific regional scientific studies. Using various local government planning and management elements, urban developments in Brisbane City are now able to address stormwater management in an increasingly holistic context. One key initiative includes facilitating Water Sensitive Urban Design (WSUD) components within an Integrated Water Management Strategy that looks at policy formation, planning strategies, design option, community marketing and acceptance, maintenance programs and finally evaluation of various WSUD approaches. These can include the use of Natural Channel Designs, grassed swales, bio-filtration systems, porous pavements and roofwater tanks in several economic combinations. By linking with the Cooperative Research Centre for Catchment Hydrology, Brisbane City Council has influenced the design of WSUD planning tools and benefited the city with academic inputs into extensive evaluation programs. As well, it has also contributed to the Cooperative Research Centre's research outcomes. These evaluation programs are increasingly providing better understanding of various stormwater quality best management practices throughout Australia. As part of the overall implementation process, active involvement by a range of stakeholders has been crucial. These stakeholders have included internal planning, development assessment and design staff, external consultants, developers, and other local and state government agencies. The latter two groups are assisting in the important task of "regionalisation" of Brisbane City Council's policies and guidelines. Implementation of WSUD initiatives and stormwater re-use strategies under Council's new "Integrated Water Management" agenda are showing some excellent results, suggesting that sustainable urban development is no longer like the search for the Holy Grail.

Conservation of Natural Resources↗
PubMed1992

Severe cutaneous hypersensitivity reactions during treatment of tuberculosis in patients with HIV infection in Tanzania.

Concurrent infection with HIV-1 and Mycobacterium tuberculosis is increasingly common in East Africa. In the past, a drug regimen consisting of 2 months of intramuscular streptomycin plus 12 months of isoniazid and thiacetazone has been used in tuberculosis control programs with acceptable efficacy and low incidence of adverse reactions. Anecdotal reports of increasing cases of Stevens-Johnson syndrome prompted a 2 month prospective search for cases of severe cutaneous hypersensitivity reactions at Muhimbili Medical Centre in Dar es Salaam, Tanzania. Five such patients were admitted to a single ward during this time, 4 of whom were HIV-seropositive and all of whom were being treated with isoniazid and thiacetazone. These findings have implications for the management of tuberculosis in East Africa and perhaps other countries with high prevalence of both HIV-1 and tuberculosis.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Morbid obesity does not preclude successful renal transplantation.

Many renal transplantation centers arbitrarily deny transplantation to patients with morbid obesity usually defined as body mass index > 35. We present a series of 173 primary renal transplant patients in a new transplant program that accepted all recipients with 3 yrs or greater life expectancy and no active malignancy or infection. When the patient outcomes are divided into groups by body mass index, it can be seen as expected that patients with body mass index > 30 have an increased prevalence of wound infections (p < 0.05). However, aside from this complication there are no statistically significant outcome differences between the three groups realizing the possibility of type II statistical error because of small numbers. Graft survival, patient survival and other surgical complications are the same in all groups regardless of body mass index. At the end of the 3-yr interval with a minimum transplant follow-up of 3 months, 169 of 173 patients were alive and 163 of 173 transplants were functioning. Based on our experience, morbid obesity should not be used to exclude patients arbitrarily from transplantation anymore than advanced age or diabetes should.

Body Mass Index↗