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PubMed2005

Use of focus groups for the environmental health researcher.

Qualitative research techniques, such as focus groups, are often underutilized by the environmental health researcher. Researchers can use the data from focus groups for study planning and implementation, as well as the interpretation of study results. Focus group data can also be used to understand community risk perceptions and potential barriers to co munity acceptance of programs and policies. This paper describes the value of focus groups for the environmental health researcher. Examples from the literature are inccorporated to demonstrate the effective use of focus groups in a variety of environmental health research settings. A brief review of data analysis approaches, including commercially available software, is provided. The authors encourage increased application of this and other qualitative research methods in environmental health research.

Environmental Health↗
PubMed2005

Anthropology and psychiatry.

In this paper anthropology and psychiatry are defined as well as their scientific area, their methods and research objectives; the high level of their mutual thematic and methodological complementarity has been emphasized. The sociocultural factors which are inherent in the area of cultural anthropology can affect mental health in a number of ways: by forming a certain personality type that is predisposed for a certain type of disorder, by an education model which increases the frequency of some disorders, by criticism and sanctions of a certain behaviour that is actually desirable from the point of view of mental health preservation, by supporting and rewarding a behaviour model that is harmful for mental health; by its complexity and, in some of the segments, by mutual contradictions they can cause mental disorders; by forming symptoms of mental disorders i.e. by a pathoplastic action through which they become an area of scientific interest of cultural psychiatry. Anthropology directs psychiatry towards creating preventive and therapeutic programs that accept the mutual influence and interconnectedness of socio-cultural conditions and the mental health status.

Anthropology↗
PubMedDate not supplied

Remote surgicenter experience with hernia repair.

A remote outpatient surgicenter was planned and constructed with three partner groups-76 physicians and two competing hospitals. The CFS was opened in July 1994 and has since performed a large volume of procedures: >124,800 total and, in 2003, 14,900 cases. This multispecialty center during that same period of time (1994 to date) has performed 2659 hernia operations. Patients were discharged home in 1-2 hours after surgery to be followed as outpatients in the physician's office. Only six patients were admitted to the hospital. This efficient and economic model is well suited for hernia repair in the selected adult and pediatric patient population without a significant number of adverse events. The community has readily accepted this program for adult and pediatric hernia repair. Patients, family members, referring physicians, and participating physicians have endorsed and recommended the program.

Adolescent↗
PubMed2006

[Updating security instruments].

In the middle of the 1980s, Centers for Disease Control and Prevention (CDCs) began insisting on the necessity for universal prevention measures and protocols as the best means to prevent the transmission of blood-borne viruses. These CDCs have been carrying out an essential task, one which at first had little success, but in the past five years have been better accepted; their programs focus on ensuring that all personnel at risk to these blood-borne infections receive effective protection.

Equipment and Supplies↗
PubMed1991

Effect of a selective restriction policy on antibiotic expenditure and use: an institutional model.

Strictly enforced antibiotic formulary restriction in combination with formulation of agreed guidelines for antibiotic use in common infection problems such as septicemia, febrile neutropenia, urinary tract infection, biliary sepsis, liver abscess, peritonitis, nosocomial pneumonia, soft tissue infection and purulent meningitis, generated a combined savings of 307,748.5 bahts or 13.5 per cent cost reduction over a 6 month period, and improved quality of use, appropriate 54.8 vs 67.5 per cent, statistically significance (P less than 0.002). Although this saving was offset in part by increased spending of unrestricted antibiotics, such as Penicillin and Gentamicin, an overall cost saving remained. In the months during the restrictions, no significant changes occurred regarding patients response and mortality. However, after the onset of the controls, it was revealed that antibiotics were more appropriately used afterwards. This study has shown, most importantly, that savings were achieved with no negative effect on good patient care. Moreover, the antibiotic use control was operationally successful, most house-staff and attending physicians, not only antibiotic evaluating team, have accepted the program in a very positive way. Overall, this program successfully achieved its initial goal, cost saving without compromising good medical practice. We are now continuing our program and also trying to modify so that it will be useful to all departments in the hospital.

Anti-Bacterial Agents↗
PubMed1991

Diagnosis and imaging of gastrointestinal tract cancers.

Recent trends in the diagnosis and imaging of cancers of the gastrointestinal tract include developments in screening for colorectal cancer and innovations in ultrasonography and magnetic resonance imaging of primary and metastatic hepatic tumors. Mathematical models suggest that screening for colorectal cancer will be as cost-effective as several other widely accepted screening programs, including the Papanicolaou smear for cervical cancer and screening mammography. There is considerable discussion regarding the relative roles of procedures such as fecal occult blood testing, sigmoidoscopy, colonoscopy, and radiology in screening strategies. The issue remains unsettled. In ultrasonography, the use of intraoperative ultrasound allows for the detection of more metastatic lesions in the liver than do preoperative computed tomography and ultrasound. Esophageal endoscopic ultrasonography has been used for the preoperative assessment of depth of invasion by esophageal cancer. The technique is limited in cases of stenotic cancer in which the endoscope cannot be passed through the lesion. Similarly, endorectal ultrasound can be used for staging of rectal cancer. Color Doppler ultrasound has been used for the evaluation of blood flow in relationship to hepatic neoplasms. Magnetic resonance imaging has been used not only for detecting liver tumors but also for differentiating between neoplasm and hemangioma.

Diagnostic Imaging↗
PubMed1991

Evaluation of a system designed to enhance the resident selection process.

The purpose of this research was to evaluate the use and effectiveness of the Universal Medical Student Performance Profile System in enhancing the resident selection process. The Universal Medical Student Performance Profile System involved the use of a standardized student evaluation form completed by surgery clerkship directors to summarize student performance. These student profile forms were then forwarded to general surgery program directors to whom each student applied. Twenty-five surgery clerkship directors volunteered to complete student profile forms on students pursuing surgical careers for the classes of 1986 and 1987. Program directors who had accepted students in their programs on whom these standardized evaluation forms had been completed were asked to complete a similar form based on the graduate's first year of residency performance. Findings showed statistically significant relationships in several assessment categories between clerkship and program directors' ratings. A survey of program directors showed they agreed with the concept of a standardized medical student evaluation form and found the student profile forms helpful in making decisions on resident selection. We concluded form this baseline study that the use of a standardized student evaluation form will have limited predictive validity, unless clerkships improve efforts to standardize clerkship objectives, expectations, and performance measures.

Education, Medical↗
PubMedDate not supplied

The health consequences of teenage fertility.

A review of the literature on the health consequences of teenage pregnancy and childbirth shows remarkable similarity in findings from studies conducted in the United States, Canada, Britain, France and Sweden. In particular, results of studies conducted since 1970 have tended to indicate that the increased risk of maternal complications from pregnancy and delivery among teenagers--especially those older than 15--is associated more with socioeconomic factors than with the biological effects of age. Smaller differences in maternal mortality between teenagers and older women exist in England and Wales than in the United States and France; this finding suggests that England and Wales may have minimized the age or socioeconomic factors contributing to a difference in rates. Inadequate prenatal care may be a major cause of pregnancy-related complications for mothers, since teenagers in all countries are more likely than older mothers to seek care late in the pregnancy or not all. There is a very marked association between young age of mother and low birth weight in all countries. Sweden has the lowest rate of low birth weight at all maternal ages, and the United States generally has the highest. Some of the apparent effect of young maternal age on birth weight may be because the birth is likely to be the mother's first, and first births have a higher incidence of prematurity. As in the case of maternal health, inadequate prenatal care has been singled out as an important determinant of both prematurity and low birth weight. Late fetal death rates in the United States, England and Wales, and France are slightly higher among teenagers than among women in their 20s. In Canada and Sweden, however, no substantially increased risk for young women is found. Perinatal death rates, which one might expect to be influenced more by environmental factors than are late fetal deaths, show a more marked increase among infants of teenagers than do rates of late fetal deaths. Again, Sweden does not fit the pattern. Studies that separate data for young teens and older teenage mothers also indicate that increased perinatal and late fetal mortality rates may occur only among very young teenage mothers. There is no evidence of an overall increase in congenital malformations among babies born to teenagers. When individual birth defects are examined, some studies have shown increased rates of cardiovascular and central nervous system malformations among the children of teenage mothers.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1988

[The influence of exhausting training on the development of the motor pattern of swimming and on the sleep-wake behavior of growing rats].

At present it is generally accepted that programs of physical training which require coordinate performances of the central and the vegetative nervous system may be conducive to the complex development of central nervous functions. The aim of the study was to investigate the effect of an exhausting swim training with albino rats aged 6-30 days on the development of motor pattern of swimming and on the sleep-wake behaviour. Daily training rats performed the adult motor pattern of swimming earlier than controls which were not trained. Trained animals are more active and longer awake than control rats which were treated daily only by a short stress (stay in cold water for 10 s). During the growth period before puberty exhausting training produces complex effects: the development of motor patterns is accelerated and the central vigilance level is raised. It is unknown which consequences might possibly arise as to the central nervous integration in adult mammals which were strongly trained in early infancy.

Animals↗
PubMed1987

The effect of a summer MCAT performance improvement program on minority medical student acceptance.

The effect of a commercial Medical College Admission Test (MCAT) review course on MCAT retake scores and acceptance into medical school for a group of minority students is reported. The review course enhanced MCAT performance in all of the subgroups. The increase in total MCAT score was more pronounced in students with an initial MCAT score below 36 or a high undergraduate total or science grade point average. Results suggest a relationship between MCAT performance and medical school admission.

College Admission Test↗
PubMed1978

[Fully automatic computer-analysis of electrocardiograms in clinical routine (author's transl)].

A fully automated Ecg recording and interpretation system (Hewlett Packard HP 5) consisting of a central computer and two peripheral units was evaluated during a four-month period. Ecgs were transmitted via public telephone lines, as was the report from central station to peripheral recording and print-out unit. Within a few seconds after recording and print-out unit. Within a few seconds after recording and transmission a preliminary report is available in printed format. The transmitted Ecgs are stored at the central computer and are being retrieved and evaluated manually there. Three cardiologists read the tracings and furnished final reports. 468 Ecgs were thus compared in our test time of 10 days for statistical evaluation with the following results: 1. 73.1% of all statements were read correctly by the computer. 2. There is a large range of diagnostic accuracy between 0% and 100%. 3. The evaluation of Ecg changed by cardiologists reflects the individual experience of the controllers regarding the Ecg statements as well as computer-dependent possibilities like modification etc. of Ecg. 4. As an example the diagnosis "myocardial infarction" is compared with other Ecg computer programs by means of a quality index calculated from sensitivity and specificity: HP 5 with 158.5 points reaches a similar level as the Pipberger program with 162.6 and the Bonner with 159.5 points. 5. Referring to false negative results this program is acceptable in all diagnostic groups with ca. 8%, except conduction defects with 17.7%. 6. Referring to false positive results the diagnostic groups myocardial infarction/ischemia and conduction defects are not satisfactory with 36.5% and 23.4%. 7. In all the tested system seems to be very useful in routine Ecg interpretation of bigger hospitals.

Cardiology↗
PubMedDate not supplied

The shift from natural to controlled fertility: a cross-sectional analysis of ten Indian states.

This study investigates the causes of the transition from natural to controlled fertility in India by comparing couples who have ever used contraception with those who remained under natural fertility conditions. Using sample study data this paper considers the relative effects of the factors involved in the shift to controlled fertility among ten early-transitional Indian States in 1970. The results indicate that it is primarily improvements in child mortality and its effects through intervening factors that account for the transition. The implication is that the success of a family planning program is largely a function of improvements in child health.

Child, Preschool↗
PubMed1994

Transfer RNA binding to 80S ribosomes from yeast: evidence for three sites.

The number of tRNA binding sites in 80S ribosomes from Saccharomyces cerevisiae was assessed by means of tRNA saturation and translocation experiments. In the absence of cognate mRNA yeast ribosomes could bind 0.6 [32P]tRNA(Phe) per 80S while poly(U) programmed ribosomes accepted up to 1.7 tRNA(Phe) molecules per 80S or 0.5 molecules of Ac[14C]Phe-tRNA(Phe) per 80S. Compared with the known features of E. coli ribosomes these binding values indicated both the presence of three tRNA binding sites and the validity of the exclusion principle for peptidyl-tRNA binding to yeast ribosomes. Upon EF-2 dependent translocation of a complex containing deacyl-tRNA in the P-site and AcPHe-tRNA in the A-site, the deacylated tRNA does not leave the ribosome quantitatively. This observation suggests the presence of an E site in 80S ribosomes which is functionally equivalent to the one previously characterized in prokaryotic systems.

Binding Sites↗
PubMed1976

Resident evaluation - is our method effective?

In an earlier paper, "Resident Evaluation--Is Your Method Effective?", it was emphasized that the objectives for the residency program in Radiology should be clearly delineated and used to judge the performance of the resident in all stages of the training program. After having had approximately three years' experience in the use of the procedures outlined in the original paper, we are recommending some changes and modifications. The purpose of the evaluation is to provide clear and detailed evidence of the performance of the resident over the period of his training program. As outlined in the previous paper, the basic principles -- learning is a very individual matter, learning depends on the motivation of the individual, and learning depends on the satisfaction in the learning task--remain unaltered. Changes have been made in the design, execution and details of evaluation. The final sucess of any training program will necessarily be measured by the degree to which the residents attain the outlined objectives of the program and the degree to which the graduates of the program are accepted into the specialty by the accrediting bodies.

Canada↗