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PubMedDate not supplied

Internal e-mail: an avenue of educational opportunity.

Internal e-mail systems offer an ideal opportunity to provide cost-effective, user-friendly educational experiences for employees. This article describes the use of computer technology to reach employees working different hours and in a variety of professional and nonprofessional roles. Monthly newsletters that provided contemporary, compressed, educational activities were created by the education department staff at a Veterans Affairs medical center. The educational sessions provided individualized, self-paced learning, supportive of the adult learner. Employees selected the educational activities that suited their needs. Although participation was optional, employees consistently took part in the activities.

Adult↗
PubMed1993

Cancer among farmers in central Italy.

This case-referent study evaluated cancer risks among farmers in central Italy. Cancer cases (N = 1674, 17 sites) were selected from all deceased men aged 35-80 years; a random sample of 480 decedents formed the reference series. Farmers had a decreased risk of lung and bladder cancer and melanoma and nonsignificant excess risks for stomach, rectal, kidney, and nonmelanoma skin cancer. Stomach and kidney cancer were significantly increased among the farmers with > 10 years' experience, and stomach, rectal, and pancreatic cancer were increased among licensed pesticide users with > 10 years' experience. Possible relationships emerged between specific crops and cancer: fruit and colon and bladder cancer, wheat and prostate cancer, olives and kidney cancer, and potato and kidney cancer. The results regarding stomach, pancreatic, lung, bladder, and prostate cancer and melanoma congrue with earlier results. The kidney cancer excess, the association of colon and bladder cancer with orchard farming, and the excess of rectal cancer among licensed farmers are new and unexpected findings.

Adult↗
PubMed1991

Special report. Electronic article surveillance systems in health care--an update.

Patients who wander from hospitals and nursing homes are a challenge to personnel in charge of their protection. Patients with Alzheimer's disease, head injuries, Parkinson's disease or other forms of dementia are likely wanderers. In our special report on Electronic Technology and the Wandering Patient (February 1986 issue,) we reported that several hundred nursing homes and a few hospitals had turned to Electronic Article Surveillance (EAS) systems that detect wanderers. Since then, the same type of technology has been extended to protect newborns from being kidnapped from hospital maternity wards as well as protect hospital property from being removed. In this report we will describe many of the leading EAS systems in use in the health care environment. We'll also present firsthand reports by users on their experience with this technology.

Confusion↗
PubMed2000

Developing a tool to measure holistic practice: a missing dimension in outcomes measurement within complementary therapies.

Despite the wide and continuing debate over the relevance of particular research methods to evaluate complementary therapies, less attention has been given to what outcome criteria and measures to use and/or whether these have a sufficient breadth in perspective. While complementary and alternative medicine researchers have paid heed to the importance of measuring the subjective experience of therapy users, they have left unmeasured the notion of holism, in particular, the measurement of the effect of the interaction between therapist and therapy user, and its underlying philosophy of health and healing. This paper reports on an exploratory, qualitative study aimed at developing a measure of holism and holistic practice. It draws out some key features requiring measurement and provides insight into the emerging measure. Further development work is needed before the measure can be used within research or routine practice.

Complementary Therapies↗
PubMed2000

Implementation and deployment of healthcare management information system.

In the following article we present development of the Management Information System, an implementation of our own Data Warehouse, build on top of the existing Healthcare Information System. We discuss requirements and phases of development of the system, we present the structure of the system, the experiences with end users and obstacles that we met, as well as possible improvements end extensions of the system. The system is designed as a framework that works with workload measurement sub-systems, which are defined as multidimensional arrays, and are observed through different units of time. Each of the axis has several hierarchical structures build on top of it. Setting up the system is a difficult task, because it requires a good knowledge of organisational structure of a particular hospital. We used an incremental approach in defining the organisational structure. On top of the framework we build a user customisable graphical user interface, which enables different types of end users to efficiently use the system.

Data Collection↗
PubMed1995

ESA's participation in the International Microgravity Laboratory (IML-2) mission.

The second International Microgravity Laboratory (IML-2) mission was a truly international event, paving the way for cooperation in the scientific utilisation of the forthcoming International Space Station. ESA provided several major facilities for conducting research in microgravity, as did France and Germany. The facilities were used jointly with scientists from the US; in exchange, NASA provided the mission itself. Several experiments measured and characterised the microgravity environment and the astronauts' response to spaceflight conditions. Others were in the fields of biology, biotechnology, fluid dynamics, crystal growth and alloy solidification, and near-critical-point investigations. Another important objective of the mission was to demonstrate remote payload operations or telescience. Using that method, principal investigators monitored and controlled their flight experiments from various user centres and laboratories across Europe. This approach is proving to be a very efficient and cost-effective way to conduct and optimise scientific research, and it will become increasingly important as long-duration access to space becomes available.

Biological Science Disciplines↗
PubMed2005

An innovative approach to enhancing the surveillance capacity of state-based diabetes prevention and control programs: the Diabetes Indicators and Data Sources Internet Tool (DIDIT).

The Diabetes Indicators and Data Sources Internet Tool (DIDIT) is an interactive Web-based resource with information on 38 diabetes indicators (e.g., diabetes-associated complications, care, lifestyle) and 12 associated data sources frequently used by state diabetes prevention and control programs. This tool is designed to strengthen the ability of states to conduct diabetes surveillance and to promote consistency in defining and tracking indicators across states. In this way, the DIDIT supports one of the 10 essential public health services: the timely and accurate assessment of public health. In addition to serving as a central repository of information on diabetes surveillance, the DIDIT also allows users to share experiences of using these indicators and data sources in their diabetes surveillance activities, data analysis, and tracking of diabetes-related objectives stated by Healthy People 2010. The DIDIT is an innovative approach to enhancing public health surveillance at the state and national levels.

Delphi Technique↗
PubMed2003

[Botulinum toxin--interventional neuropediatrics in spastic movement disorders in childhood].

Botulinumtoxin A (BTX) is widely used for the treatment of spastic movement disorders in childhood. Safety and local efficacy of BTX are well documented by the experience of many users and verified by several clinical trials. Indications for the use of BTX in children include facilitation of care, better tolerance of ortheses as well as the quantitative and qualitative improvement of motor abilities. This article differentiates clinical indications for which the use of BTX has been proven from those in which effectiveness is only suspected or is yet unclear.

Botulinum Toxins, Type A↗
PubMed2006

Severe, diffuse coronary artery spasm after drug-eluting stent placement.

OBJECTIVES: Three cases of severe, diffuse coronary artery spasm after drug-eluting stent placement at our institution prompted this review. BACKGROUND: Drug-eluting stents have gained widespread use due to extraordinarily low rates of restenosis. Despite these generally superior clinical outcomes, the specter of rare idiosyncratic reactions remains a concern. METHODS: We performed searches of Medline and the U.S. FDA Manufacturer And User facility Device Experience database (MAUDE) to identify and describe spasm after coronary stent placement. Searches included drug-eluting and bare-metal stents. Institutional cases are reviewed. Location, time course and outcome of cases are described. RESULTS: Thirteen cases of spasm were identified after stent placement. Seven cases occurred after Cypher drug-eluting stent placement, 2 after Taxus drug-eluting stent placement, 1 after BiodivYsio and 3 after bare-metal stents. Five patients experienced diffuse, multivessel spasm--2 after Cypher, 2 after Taxus, and 1 after a Velocity stent. Of these 5 patients, 2 died. An additional 2 required intra-aortic balloon pump placement for cardiogenic shock. Another had persistent symptomatic, diffuse coronary spasm documented by angiography at 1 year. CONCLUSIONS: We describe coronary spasm after stent placement, particularly after drug-eluting stents. Outcomes associated with diffuse severe spasm after stenting are poor, and the pathophysiology remains poorly understood.

Angioplasty, Balloon, Coronary↗
PubMed1991

Cocaine-induced psychosis.

BACKGROUND: Chronic stimulant use can produce a paranoid psychosis that is similar to acute paranoid schizophrenia. While this phenomenon has been systematically explored in amphetamine abusers, it has been relatively unexplored in a systematic fashion in cocaine abusers. METHOD: The experience of cocaine-induced psychosis was evaluated in 55 individuals consecutively admitted for treatment of DSM-III-R cocaine dependence. Each subject was interviewed about their experiences of psychosis while intoxicated by means of a standardized, semistructured interview. RESULTS: Fifty-three percent (29/55) of those interviewed reported experiencing transient cocaine-induced psychosis. There was no significant difference in lifetime amount of cocaine use or amount of cocaine use in the month before admission between those who experienced psychosis and those who did not. The psychosis-positive group used significantly more cocaine in the year prior to admission (p less than or equal to .02) and had a longer duration of use (p less than or equal to .01). Males were significantly (p less than or equal to .05) more likely than females to develop psychosis. Ninety percent (26/29) developed paranoid delusions directly related to drug use. Ninety-six percent (28/29) of the subjects experienced hallucinations: 83% (24/29), auditory hallucinations; 38% (11/29), visual hallucinations; and 21% (6/29), tactile hallucinations. Twenty-seven percent (15/55) of subjects developed transient behavioral stereotypies. CONCLUSION: Cocaine-induced paranoia is a common experience among chronic users. Amount and duration of use are related to its development. Implications for a kindling model of cocaine-induced psychosis will be discussed.

Administration, Inhalation↗
PubMed1991

Stealing and dealing: cocaine and property crimes.

A common thread in all studies of this nature is the level of use of cocaine and/or the concomitant use of other drugs, suggesting that economic necessity plays a role in the decision to commit crimes to help defray the costs of use. While a truly causal link between use and crime activity in marginal income populations is apparent. Whether that association is driven primarily by economics or lifestyle considerations is not answered by simple examination of the numbers. Statistically, the use of cocaine is related to criminal activity as a function of the income level and prior criminal experience of the user. This relationship is better defined by looking at the threshold effect in marginal income groups, where use that goes beyond what the pocket can bear produces a significantly greater chance that illegal sources will be found. However, many occasional users or even regular users with resources are able to fund their use through routine sources and never resort to criminal activity or to unconventional financial resources. A large number of cocaine users probably fall into this middle ground: they are neither the "high rollers" that often make the media nor the traditional heroin/cocaine addicts. For them, criminal activity may surface when use exceeds funds or not at all. For still others, cocaine is part of a criminal lifestyle rather than a motivation for it. Statistically, all these cocaine users look the same, though the relationship between their use and their crime may be quite varied. The descriptions of three cases discussed in an earlier paper (Hunt et al. 1985) clarify this point. The first case was a 32-year-old white male former heroin addict and former drug dealer who reported cocaine use intravenously three to four times a month, smoked marijuana weekly, and used no other drugs. He was married, working, and had a small child. He also reported dealing in stolen merchandise and clothing that he got from someone else to sell. This pattern had been his custom for several years, observed at close hand by the author, and he had not been arrested for many years, though he had a prior history of arrests dating back more than 15 years. This individual did not link his selling stolen merchandise with his cocaine use. He linked it with the need for supplementary funds and was as likely to deal goods for Christmas money as for cocaine.(ABSTRACT TRUNCATED AT 400 WORDS)

Cocaine↗
PubMed1990

[Data processing the the RAST laboratory].

We describe a clinical laboratory information system for the RAST laboratory based on personal computers. In developing this system, we paid special attention to easy handling which does not require any computer experience on the user's side. Data storage and retrieval are managed by a relational database system with fast data access. Aside from the usual functions of a laboratory information system, the laboratory work is facilitated by a clear distribution of samples, the possible on-line connection to various analyzers, as well as the provision of cumulative results and a fast access to archive data.

Allergens↗
PubMed1989

Teaching human genetics in biochemistry by computer literature searching.

We describe a new user-intense-learning experience that incorporates the teaching of clinical and research applications of human genetics in biochemistry while training first-year medical students to develop skills in computer access to the literature. Human genetics was incorporated into the biochemistry curriculum by providing each student with experience in on-line literature searching in MEDLINE, using Grateful Med, in order to write an abstract about a specific inherited biochemical disorder. We stressed the need for the students to obtain current information in order to understand and interpret the rapidly changing field of human genetics. We taught the students that the most efficient method of obtaining such information was by searching the medical literature via computer.

Biochemistry↗
PubMed1974

MEDLEARN:an orientation to MEDLINE.

(***)MEDLEARN(***), an orientation to MEDLINE, was developed to educate members of the biomedical community to become competent on-line searchers. It appears in two complementary forms: an interactive terminal presentation available on the TYMSHARE Network and a supporting hard-copy manual which contains the didactic portions of the computer program as well as additional items which are not suitable for on-line presentation. (***)MEDLEARN(***), a flexible instructional tool, is divided into forty sections which may be selected in various sequences depending on the user's previous experience. Two MEDLINE simulations and feedback sections after practice on MEDLINE provide motivation for continued learning. The orientation program was evaluated at several medical centers with uniformly favorable results.

Computer-Assisted Instruction↗
PubMed1979

Fast and economic conversion of images to a tactile presentation for blind people.

A new procedure for the conversion of binary black and white images to a tactile presentation perceptible by the blind is described. Conventional procedures are very time-consuming and expensive and are not adapted to produce the required low editions of tactile displays, e.g., for schools for the blind or individual applications. The procedure recently developed allows the fast, economical conversion of even single drawings to a tactile display with high resolution. An account of the investigations and valuations of all possible physical procedures of optical-to-tactile conversion is given. The new procedure, based on a slightly modified Xerox copying process in a first step and gumming tactile material with the tone powder at the darkened regions in a second step, is described in detail. The device realised is presented. It allows the conversion of one page of a drawing to a tactile display with a resolution of 0.3 mm within 1 min. Various applications of the system and experiences with blind users are reported. The implement proved to meet most of the requirements of blind people. It is easy to handle and produces tactile drawings of excellent quality. As it is based on commercial subsystems it promises an economical production even at small series.

Blindness↗
PubMed1984

Gastroduodenal damage due to drugs, alcohol and smoking.

In man, convincing data have been obtained in short-term observations that some drugs can cause acute gastroduodenal damage including gastritis and erosions. Useful clinical and epidemiological studies on the relationship between these acute lesions and peptic ulceration, and between the chronic ingestion of these drugs and peptic ulceration or massive upper gastrointestinal haemorrhage are, however, rare. Even for the most widely used and studied greatest offender--acetylsalicylic acid (ASA)--an association with major bleeding or gastric ulceration could only be established for frequent and heavy ASA intake. The percentage of those ASA users who will experience such a serious event each year is about 0.01 to 0.05 per cent. By the use of special (e.g. enteric-coated) ASA formulations and other precautions, this low rate may be further reduced. Although for most of the other non-steroidal anti-inflammatory drugs (NSAIDs), anecdotal reports on putative drug-related major gastric bleeding or peptic ulceration exist, the ulcerogenicity of these drugs has not yet been conclusively proven in controlled studies. Some of the newer NSAIDs seem at normal dosage to be far less damaging than traditional ASA or indomethacin. Glucocorticoids might enhance ulcer risk to a minor extent when administered at high dosage for prolonged periods to susceptible individuals. Chronic moderate alcohol consumption by itself does not seem to increase the liability to peptic ulceration. With highly concentrated alcoholic beverages, gastric bleeding from acute lesions may, however, be occasionally precipitated under certain circumstances, such as when unbuffered ASA is taken concomitantly. Smoking of cigarettes is associated, and perhaps causally related, with an increased incidence of gastric and duodenal ulcerations, impaired ulcer healing, and more frequent ulcer recurrences. Duodenal ulcer patients in particular should be advised to stop smoking.

Acetaminophen↗
PubMedDate not supplied

[Various possibilities for using computer dialogs in biomedical research].

Problems involved in the development of interaction software for biomedical investigations and in the preparation of experimenters for using a computer in the interactive mode are discussed. An interaction program for data analysis is suggested. The program is used to build an interactive modification that makes it possible to carry out a computer-aided verification of the mechanisms of erythropoiesis regulation in space flight. It is shown that a simple interactive terminal facility can be employed in the software of biomedical investigations, taking into account changes in the requirements placed by users and their experience of computer interaction.

Computers↗