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PubMed2006

Evaluation of an improved technique for lumen path definition and lumen segmentation of atherosclerotic vessels in CT angiography.

Vessel image analysis is crucial when considering therapeutical options for (cardio-) vascular diseases. Our method, VAMPIRE (Vascular Analysis using Multiscale Paths Inferred from Ridges and Edges), involves two parts: a user defines a start- and endpoint upon which a lumen path is automatically defined, and which is used for initialization; the automatic segmentation of the vessel lumen on computed tomographic angiography (CTA) images. Both parts are based on the detection of vessel-like structures by analyzing intensity, edge, and ridge information. A multi-observer evaluation study was performed to compare VAMPIRE with a conventional method on the CTA data of 15 patients with carotid artery stenosis. In addition to the start- and endpoint, the two radiologists required on average 2.5 (SD: 1.9) additional points to define a lumen path when using the conventional method, and 0.1 (SD: 0.3) when using VAMPIRE. The segmentation results were quantitatively evaluated using Similarity Indices, which were slightly lower between VAMPIRE and the two radiologists (respectively 0.90 and 0.88) compared with the Similarity Index between the radiologists (0.92). The evaluation shows that the improved definition of a lumen path requires minimal user interaction, and that using this path as initialization leads to good automatic lumen segmentation results.

Angiography↗

PubMed1989

Perception of nurses in expanded role.

This is a study aimed at identifying nurses' responsibilities and the perceptions of consumers of health care regarding the expanded roles of nurses in the delivery of primary health care through institutional clinics. Questionnaires were distributed to various categories of workers and students who were receiving care in the selected clinics attached to higher educational institutions, in order to determine the acceptability of nurses in expanded role. Responses of consumers revealed a high degree of acceptability of the nurse's expanded role, with Users scoring higher than Non-users. All the nurses involved had a positive perception of their role which they felt could be improved with the provision of necessary equipment and refresher courses at regular intervals. Other factors necessary for enhancing their role in the provision of primary health care are highlighted.

Adult↗

PubMed1981

Congregation sites for youthful multiple drug users: locations for epidemiological research and intervention.

Field research techniques were used to collect observational and interview data at outdoor sites in the south Chicago suburbs where youthful drug users congregated during good weather to buy, sell and use multiple drugs. Results indicated that the distribution system for non-opiate drugs is more stable than previously thought and that drug purchase occurs at such outdoor sites in the summer months and at the homes of drug users' friends during the winter. The largest and most active site in the area, a forest preserve, was intensively studied utilizing epidemiological survey and participant observation techniques. In contrast to smaller, neighborhood sites, this area attracted drug users and dealers extensively involved in heavy multiple drug use. Subjects came from an extremely wide area and were not organized into cohesive friendship groups formed during grade school and high school. A wide range of drug types was regularly available. The large proportion of unemployed youth and high school dropouts among the sample suggested that field techniques at such sites would be more likely to contact those youth most heavily involved in drug distribution and use than programs based in schools or industry.

Adolescent↗

PubMed2004

Endogenous gamma-hydroxybutyric acid levels in postmortem blood.

The goal of this study was to determine how the postmortem interval and duration of storage of blood at 4 degrees C affect endogenous gamma-hydroxybutyric acid (GHB) levels in blood. Forty-three autopsy cases of non-users of GHB were involved. The postmortem interval ranged from 8 to 132 h. Blood samples were collected and stored without any preservatives at 4 degrees C for 1 day up to 15 months until analysis. In some cases, samples were also stored at -20 degrees C for 10 days to 7 months to determine GHB levels at autopsy. Blood GHB concentrations were measured by headspace gas chromatography after GHB was converted to gamma-butyrolactone. Blood GHB concentrations ranged from 0 to 43.0 microg/ml and averaged 9.80 microg/ml. A positive correlation was observed between concentration and postmortem interval (r = 0.571) but no correlation was found between concentration and storage interval at 4 degrees C. In 14 blood samples stored at -20 and 4 degrees C for 10 days, GHB concentrations were 4.55+/-3.88 and 6.06+/-4.27 microg/ml, respectively. In another eight blood samples stored at -20 and 4 degrees C for 1-7 months, GHB concentrations were 3.77+/-2.76 and 5.49+/-2.97 microg/ml, respectively. A large portion of endogenous GHB detected in blood of corpses may be produced during the interval between death and autopsy, rather than during storage of blood at 4 degrees C until analysis. In an additional experiment, it was suggested that glycolysis by bacteria may enhance endogenous GHB production.

Adolescent↗

PubMed2000

Complementing police road-crash records with trauma registry data--an initial evaluation.

This paper examines the consistency of hospital and police reporting of outcomes of road traffic crashes using a database of linked police crash reports and trauma registry records. Criteria for inclusion into the trauma registry include trauma-related causes with subsequent stay of more than 24 h or death due to injuries. During the 1997 calendar year there were 497 cases of road-related injuries within the combined trauma registry of Sir Charles Gairdner and Fremantle Hospitals, of which only 82% had matching police records. Linkage rates were associated with gender, injury severity and the number of vehicles involved. Within the road user category, pedestrians were least likely to link. Of the linked records, police classification of injury severity was correct in 78% of cases. Male casualties were more likely to be correctly classified than females, after adjustment for related variables including injury severity. Correct classification of injury by police was also closely related to severity of injury. Identification and targeting of these groups of casualties is vital in refining the road-crash reporting system. Increased crash reporting and availability of data from these two sources will provide road authorities with more reliable measures of injury outcome.

Accidents, Traffic↗

PubMed1997

Automated detection of local artery wall thickness based on M-line signal processing.

The Young's modulus of an arterial segment, a measure of the elastic properties of the arterial wall, requires the simultaneous and local assessment of pulse pressure, wall thickness, diameter, and distensibility (relative increase in cross-sectional area per change in blood pressure). The diameter and relative increase in cross-sectional area can be obtained with a wall track system, processing the radiofrequency (r.f.) ultrasound signals received along a single line of observation (M-line processing). It will be demonstrated that it is feasible to combine, in a single measurement, the assessment of wall thickness and the (relative change in) diameter involving a minimum of user interaction. Phantom tests show a standard error of the estimate for intima-media thickness measurements of less than 20 microns; in vivo registrations exhibit a variation on the order of 45 microns. It is concluded that processing of the radiofrequency ultrasound signal, acquired along an M-line, provides an accurate and time-efficient alternative for videoprocessing of 2-dimensional B-mode ultrasound images to estimate artery wall thickness.

Adult↗

PubMed2002

3,4-Methylenedioxymethamphetamine ("Ecstasy") induces apoptosis of cultured rat liver cells.

"Ecstasy" (3,4-methylenedioxymethamphetamine, MDMA) has been shown to be hepatotoxic for human users, but molecular mechanisms involved in this effect remained poorly understood. MDMA-induced cell damage is related to programmed cell death in serotonergic and dopaminergic neurons. However, until now there has been no evidence of apoptosis induced by MDMA in liver cells. Here we demonstrate that exposure to MDMA caused apoptosis of freshly isolated rat hepatocytes and of a cell line of hepatic stellate cells (HSC), as shown by chromatin condensation of the nuclei and accumulation of oligonucleosomal fragments in the cytoplasm. In both cell types, apoptosis correlated with decreased levels of bcl-x(L), release of cytochrome c from the mitochondria and activation of caspase 3. In HSC, but not in hepatocytes, MDMA induced poly(ADP-ribose)polymerase (PARP) proteolysis. These results suggest that apoptosis of liver cells could be involved in the hepatotoxicity of MDMA.

Animals↗

PubMed1997

A microcomputer program for automated neuronal spike detection and analysis.

A system for on-line spike detection and analysis based on an IBM PC/AT compatible computer, written in TURBO PASCAL 6.0 and using commercially available analog-to-digital hardware is described here. Spikes are detected by an adaptive threshold which varies as a function of signal mean and its variability. Since the threshold value is determined automatically by the signal-to-noise ratio analysis, the user is not actively involved in controlling its level. This program has been reliably used for the detection and analysis of the spike discharge of vestibular system afferent neurons. It generates the interval-joint distribution graph, the interval histogram, the autocorrelation function, the autocorrelation histogram, and phase-space graphs, thus, providing a complete set of graphical and statistical data for the characterization of the dynamics of neuronal spike activity. Data can be exported to other software such as Excel, Sigmaplot and MatLab, for example.

Ambystoma↗

PubMed2003

Recognizing the institutional benefits of bar-code point-of-care technology.

BACKGROUND: The application of bar-code technology to medication administration is growing, and its benefits are increasingly recognized. This article describes a hospital's experience with bar-code point-of-care (BPOC) technology and discusses the benefits of BPOC, considers the essential role of the pharmacist when implementing BPOC in a hospital setting, and provides a financial model for cost avoidance using a BPOC system. IMPLEMENTING BPOC: In 1998 Northern Michigan Regional Health System (Petoskey, Mich) partnered with a software company to create a BPOC system. Major milestones associated with implementation were involving and preparing end users, examining the hospital's entire medication process, updating the formulary and mapping drugs accurately, and identifying a process to maximize bar-code label attachment to medications. RESULTS: Visibility of prevented errors increased as compared with occurrence reports. Among the prevented errors, approximately 25% of the not-due errors occurred between shifts or between caregivers; wrong-dose errors included nurse attempts to give one tablet when two were ordered and giving two tablets when one was ordered; and wrong-patient errors were predominantly associated with intravenous piggyback medications. Omitted doses or missed doses were virtually eliminated by BPOC. DISCUSSION: A BPOC system provides a much-needed safety net at the bedside to avert potentially injurious medication errors. Another benefit that a BPOC system provides is a record of actual medication administrations. Conducting a thorough assessment of a hospital's readiness for a BPOC system will guide system implementation and help avoid potential installation pitfalls.

Clinical Pharmacy Information Systems↗

PubMed2003

Case-control study of the association between kava use and pneumonia in eastern Arnhem and Aboriginal communities (Northern Territory, Australia).

Pneumonia causes significant morbidity and mortality in Aboriginal populations in Australia's Northern Territory (NT). Kava, consumed in Arnhem Land since 1982, may be a risk factor for infectious disease including pneumonia. A case-control study (n = 115 cases; n = 415 controls) was conducted in 7001 Aboriginal people (4217 over 15 years). Odds ratios (OR) were calculated by conditional logistic regression with substance use and social factors as confounders. Pneumonia was not associated with kava use. Crude OR = 1.26 (0.74-2.14, P = 0.386), increased after controlling for confounders (OR = 1.98, 0.63-6.23, P = 0.237) but was not significant. Adjusted OR for pneumonia cases involving kava and alcohol users was 1.19 (0.39-3.62, P = 0.756). In communities with longer kava-using histories, adjusted OR was 2.19 (0.67-7.14, P = 0.187). There was no kava dose-response relationship. Crude ORs for associations between pneumonia and cannabis use (OR = 2.27, 1 18-4.37, P = 0.014) and alcohol use (OR = 1.95, 1.07-3.53, P = 0.026) were statistically significant and approached significance for petrol sniffing (OR = 1.98, 0.99-3.95, P = 0.056).

Adult↗

PubMed2001

The functions of internet use and their social and psychological consequences.

Although the Internet has spawned significant changes in communication and interpersonal behavior, the data concerning the social and psychological effects of its use are equivocal. Drawing on the uses and gratifications model of communications media, it was hypothesized that the social and psychological effects of Internet use depend primarily on the user's reasons and goals for using the technology. That is, the Internet's social and psychological effects depend upon the functions it serves for users. A theoretical model involving the functions of Internet use, dimensions of social integration, and dimensions of psychological well-being was examined. In study 1, participants indicated the primary reasons for which they use the Internet. Principle components analyses indicated that these reasons fell under two empirically robust dimensions accounting for about half of the total variance in Internet use. These dimensions, or functions, were labeled Socio-Affective Regulation (SAR) and Goods-and-Information Acquisition (GIA); SAR may be conceptualized as a social or an affiliative orientation toward Internet use, whereas GIA may be conceptualized as a utilitarian or practical orientation toward Internet use. In study 2, structural equation modeling revealed that Internet use driven by SAR negatively influences psychological well-being by first reducing social integration. However, Internet use motivated principally by GIA appears to have a favorable effect on psychological well-being by first increasing social integration. Implications of these results and directions for future research are discussed.

Computer Communication Networks↗

PubMed2004

Analysis of the forms, functions and facilitation of social support in one English county: a way for professionals to improve the quality of health care.

Voluntary organisations are an integral part of community care, and the available research indicates the value of their social support role. However, surprisingly little is known about the forms and functions of this support, or the links to the formal support provided by the National Health Service (NHS), so hampering quality improvements. Therefore, a small sample of voluntary service organisations in one English county participated in a pilot study. This involved the staff and users of these organisations, and a geographically linked sample of NHS mental health professionals. Interview data indicated that the voluntary sector users and staff held similarly positive views of the appropriately varied forms and functions of the provided social support, and all participants held unusually similar and positive views of their links, although areas for improvement were suggested by both groups (e.g. links to GPs).

Adolescent↗

PubMed2000

Is MDMA ('Ecstasy') neurotoxic in humans? An overview of evidence and of methodological problems in research.

Evidence from research with a range of animal species, from rodents to non-human primates, has shown that MDMA (+/-3, 4-methylenedioxymethamphetamine) is neurotoxic. This article explores the evidence that MDMA may be neurotoxic in humans by briefly overviewing three types of research: (1) neurobiological, (2) psychological/somatic and (3) psychiatric. The first type of evidence derives from neuropharmacological and neuroendocrine studies, the second type focuses on psychological function and somatic symptoms in MDMA users, and the third involves studies of psychiatric cases in people who have taken MDMA. Evidence from these types of studies is indirect and differs in the degree to which any causative links are implied between observed effects, MDMA use and human neurotoxicity. These issues are critically discussed within the context of the wide-ranging methodological problems in human research with MDMA.

Hallucinogens↗

PubMed2003

PathMAPA: a tool for displaying gene expression and performing statistical tests on metabolic pathways at multiple levels for Arabidopsis.

BACKGROUND: To date, many genomic and pathway-related tools and databases have been developed to analyze microarray data. In published web-based applications to date, however, complex pathways have been displayed with static image files that may not be up-to-date or are time-consuming to rebuild. In addition, gene expression analyses focus on individual probes and genes with little or no consideration of pathways. These approaches reveal little information about pathways that are key to a full understanding of the building blocks of biological systems. Therefore, there is a need to provide useful tools that can generate pathways without manually building images and allow gene expression data to be integrated and analyzed at pathway levels for such experimental organisms as Arabidopsis. RESULTS: We have developed PathMAPA, a web-based application written in Java that can be easily accessed over the Internet. An Oracle database is used to store, query, and manipulate the large amounts of data that are involved. PathMAPA allows its users to (i) upload and populate microarray data into a database; (ii) integrate gene expression with enzymes of the pathways; (iii) generate pathway diagrams without building image files manually; (iv) visualize gene expressions for each pathway at enzyme, locus, and probe levels; and (v) perform statistical tests at pathway, enzyme and gene levels. PathMAPA can be used to examine Arabidopsis thaliana gene expression patterns associated with metabolic pathways. CONCLUSION: PathMAPA provides two unique features for the gene expression analysis of Arabidopsis thaliana: (i) automatic generation of pathways associated with gene expression and (ii) statistical tests at pathway level. The first feature allows for the periodical updating of genomic data for pathways, while the second feature can provide insight into how treatments affect relevant pathways for the selected experiment(s).

Arabidopsis↗

PubMed2003

Heterosexual activity of male prisoners in England and Wales.

A random sample of 1009 adult male prison inmates from 13 prisons covering short-, medium- and long-term establishments across England and Wales was interviewed about sexual behaviour, drug use and tattooing, inside and outside of prison. We report here on their heterosexual behaviour. Inmates had had a high number of sexual partners compared to population samples. The majority of sexual partners were casual and there were high levels of sexual involvement with injecting drug users and with prostitutes. Prisoners engaged in more risky sexual practices than did the general population and used condoms infrequently. A high number of prisoners had also injected drugs. Inmates reported a high frequency of past sexually transmitted diseases.

Adolescent↗

PubMed2005

Self-assessment of health and social care needs by older people: a review.

This article explores the meaning and significance of 'self-assessment', a term that is increasingly being used in relation to developments affecting community practice. Self-assessment for health and social care needs has been used over a considerable period of time and for purposes as diverse as case finding for depression to assessment of housing options. Self-assessment has usually involved the use of short scales and questionnaires, but it can involve the use of physiological tests (such as testing urine for glucose) or complex, computerized decision-support systems. Although often explored as a simple means for extending the 'reach' of professional assessments (e.g. mass screening) and ensuring 'appropriate' use of health services (e.g. self-care algorithms), self-assessment is increasingly being advocated as a means of actively involving and empowering service users. However, a recent review of the topic (Griffiths et al, 2005) revealed the complexity of the topic and the pitfalls of a simplistic approach to self-assessment, which those engaged in developing the process should bear in mind.

Aged↗

PubMedDate not supplied

Consumerism 2: preregistration nursing and midwifery curricula.

This article, the second of two parts, presents findings from a four-stage study exploring the extent to which consumerism and its related aspects have been incorporated into the preregistration nursing and midwifery curriculum. The study was undertaken in recognition that NHS policy (as considered in the first article: Vol 12(5): 321-6) increasingly gave emphasis to the development of a health service that was more consumer and user focused. The study involved use of a Delphi panel, postal questionnaire, review of curriculum documentation, and timetables, together with a small focused group discussion. Findings indicate some aspects relevant to consumerism in health care, e.g. communication and ethical principles were included in the curriculum. Other aspects, such as advocacy, quality assurance, and lay health beliefs, were viewed logically from the perspective of the professional role. In essence, no curriculum transparently addressed consumerism in a central and focused way, although midwifery--and to some extent mental health, learning disabilities, and child branches--gave more overt attention to consumerism than adult branches.

Consumer Behavior↗

PubMed1998

Sex partners of Alaskan drug users: HIV transmission between white men and Alaska Native women.

This study describes patterns of sexual behavior and condom use in a sample of 1125 Black, White, and Alaska Native drug users. Data are self-reports of recent sexual behavior, including descriptions of (up to) the five most recent sex partners. This provided information on 1116 sex partner pairs, of which at least one partner was a drug user. Sex partner pairs involving a White man and an Alaska Native woman were frequently reported. Level of condom use within these pairs was significantly lower than within all other pairs. The implications of a potential vector of HIV transmission from White, drug using men to Alaska Native women are discussed.

Adult↗