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PubMed2003

The practice of medical technology.

In this article, we review 25 years of sociological scholarship published in Sociology of Health and Illness on medical technologies. We divide the literature into three theoretical perspectives: technological determinism views medical technology as a political force to shape social relationships, social essentialism emphasizes how medical technologies are neutral tools to be interpreted in social interactions, and technology-in-practice highlights the dialectic relationship between technology and its users in health care. While the technology-in-practice orientation allows social scientists to critique the high hopes and dire warnings embedded in medical technologies, we argue that the logical next step of this paradigm is to move beyond criticism and influence the creation and implementation of medical technologies.

Bibliometrics↗
PubMed2000

A review of the scientist--practitioner model: reflections on its potential contribution to counselling psychology within the context of current health care trends.

Recent legislative changes in the National Health Service have resulted in the need to develop practices that are 'evidence-based'. The move away from opinion and experience in therapeutic decision-making towards use of research in service planning poses challenges to the identity, activities and roles of counselling psychologists. This highlights the need for a clearly articulated framework of professional activity to protect and enhance the future of the profession. The scientist-practitioner model is one such framework and despite its contentious history, it is argued that the difficulties traditionally associated with its implementation are largely owing to an outdated view of scientific activity which relies on a positivist philosophy of science. These themes are developed by exploring the historical context in which the scientist-practitioner model evolved and by drawing upon psychological models of identity, change and loss. A more contemporary meta-theoretical construction of science and scientific activity is also explored which offers a reformulation of the scientist-practitioner model that could complement the quest for evidence-based practice and is consistent with the philosophical underpinnings of counselling psychology. Critical questions for future research in this area are identified.

Counseling↗
PubMed2002

BioDataServer: a SQL-based service for the online integration of life science data.

Regarding molecular biology, we see an exponential growth of data and knowledge. Among others, this fact is reflected in more than 300 molecular databases which are readily available on the Internet. The usage of these data requires integration tools capable of complex information fusion processes. This paper will present a novel concept for user specific integration of life science data. Our approach is based on a mediator architecture in conjunction with freely adjustable data schemes. The implemented prototype is called BioDataServer and can be accessed on the Internet: http://integration.genophen.de. To realize a comfortable usage of the resulted data sets of the integration process, a SQL-based query language and a XML data format were developed and implemented.

Computational Biology↗
PubMed2006

['Multifactorial disorders in the genomics era'; notes on a recent report from The Royal Netherlands Academy of Arts and Sciences].

The Royal Netherlands Academy of Arts and Sciences (KNAW) has issued a report entitled 'Multifactorial diseases in the genomics era'. It makes two major recommendations. The ministers of Science, Health and Economic Affairs are advised to (a) to take steps to ensure the development, evaluation and implementation of advanced high-throughput technologies in order to improve the international position of the Netherlands, and (b) to actively promote the setting up of one or more general biobanks in the Netherlands that should contain biological samples and data from parts of the population and that are not restricted to a single disorder. The report fails to address some important aspects of biobanks, such as the registration of the ethnicity of patients and controls. In addition monogenetic subvariants in multifactorial disease are not mentioned.

Biomedical Research↗
PubMedDate not supplied

[International reporting of adverse drug reactions. Final report of CIOMS ADR Working Group].

Under the auspices of the Council for International Organizations of Medical Sciences, a working group composed of representatives of seven multinational pharmaceutical manufacturers and six regulatory authorities developed and implemented a standardized method for reporting post-approval adverse drug reactions (ADR). The method is based on a set of uniform definitions and procedures and a single reporting form, and has been demonstrated to be feasible and effective. Regulators and manufacturers, in establishing requirements and systems for reporting of adverse drug reactions, should consider adopting this method.

Drug-Related Side Effects and Adverse Reactions↗
PubMedDate not supplied

Designing a nursing science curriculum for administrators in Austria.

Nursing education at the university level has been a goal of Austrian nurses for many years. To answer this need a nursing science curriculum for graduate nurses preparing for administrative and teaching roles in nursing was designed and developed for implementation at an Austrian university. Below, a report on its development.

Austria↗
PubMed1996

HLA DQA1 and Polymarker validations for forensic casework: standard specimens, reproducibility, and mixed specimens.

This study describes the testing performed by the Minnesota Forensic Science Laboratory (MFSL) to validate the Amplitype DQA1 and Amplitype Polymarker (PM) PCR Amplification and Typing Kits before implementation for casework. All studies were based on the analysis of mock forensic case samples, which were assembled from various biological samples from individuals at the MFSL. To address the validation of standard specimens, DNA was isolated from semen, vaginal secretions, saliva, urine, and blood samples. Typing results from all tissues from a particular individual yielded the same typing results using both the DQA1 and PM systems. Reproducibility between laboratories was evaluated by having duplicate samples analyzed by a second laboratory. The Roche Biomedical Laboratories (RBL) were sent a duplicate set of mock cases and all analyses including extraction, quantitation, amplification, and typing were performed at the RBL using their established testing procedures. All typing results for both laboratories, from the approximate 30 single source samples analyzed, were in agreement. Mixed specimens were evaluated by examining the results obtained from semen/vaginal, semen/saliva, semen/blood, semen/ urine, and semen/vaginal/blood mixtures. All typing results of these mixtures for both laboratories were in agreement. It was determined that by incorporating a wash step of the sperm cell pellet, a complete separation of the nonsperm cell fraction was more likely to be attained. After completing the above studies, as well as population studies, environmental insult studies, and proficiency testing, the MFSL determined that both kits were suitable for use on forensic casework.

DNA↗
PubMed1998

Integrated clinical experience: University of Nebraska Medical Center.

The Integrated Clinical Experience (ICE) at the University of Nebraska College of Medicine is a required, two-year course of study for first- and second-year students. It provides early clinical experiences in primary care settings in metropolitan and rural areas, and related instruction in the social, behavioral, and ethical foundations of medicine. The authors describe the course goals, teaching format, topics, and evaluation of students and faculty. ICE is based on the assumptions that medicine is an applied behavioral science as well as an applied biological science, that critical reflection is important in professional education, and that early exposure to primary care will promote interest in primary care careers. The authors also describe some of the challenges associated with the implementation of this new course of study. These include student dissatisfaction with behavioral and ethical topics, resistance to critical reflection about their personal attitudes and values, and discomfort with "subjective" grading. ICE has also been controversial with some basic science faculty who feel they have had to sacrifice curriculum time to make room for this new program. Also, recruiting the large number of faculty, particularly physicians, needed to run the program has been difficult. Finally, the organization of the curriculum, with basic sciences in the morning and the ICE in the afternoon, may inadvertently reinforce the conceptual split between the biomedical and psychosocial dimensions of medicine. Efforts are under way to address this problem by exploring ways to intergrate the curriculum better.

Attitude of Health Personnel↗
PubMed1996

Orgasm without organisms: science or propaganda?

The worldwide epidemic of sexually transmitted diseases (STDs) presents a major public health challenge to medical practitioners and educators as they seek to implement preventive educational strategies in the adolescent population. The serious consequences of many STDs and the insufficient impact of condom promotion in this high-risk group have led to increasing recognition that sexual intercourse is medically unwise for young adolescents. As a result of this recognition, some educators have proposed that adolescent sexuality education focus on the explicit teaching of noncoital sexual activities, sometimes called outercourse. This paper explores the emergence of this educational strategy, the assertion that noncoital sexual activities will positively impact the rising incidence of STDs and unplanned pregnancy in teenagers, and the hypothetical benefits of adolescent noncoital sex.

Adolescent↗
PubMed2006

Colorectal cancer screening awareness in European primary care.

BACKGROUND: Adjustment for stage at diagnosis markedly reduces USA versus European colorectal cancer survival differences and a screening bias was therefore suspected. Moreover, little is known about colorectal cancer screening habits in European primary care and the history of guidelines implementation. The purpose of the study was to index the overall colorectal cancer screening attitudes of European physicians involved in primary care activities. METHODS: A systematic literature-search was performed in three major medical libraries: PubMed/MEDLINE, ISI web of science, and COCHRANE. RESULTS: We found only five eligible studies, but valuable data were presented only in four. Colorectal cancer screening was recommended by 65-95% of physicians, but the major part of them implemented it only among high-risk individuals; stool occult blood testing was advised by 42-83% and prescription of screening endoscopic modalities was inconsistent. Most European reports found were not eligible and were mainly focused on diagnostic delay in symptomatic subjects rather than on screening procedures among asymptomatic individuals. CONCLUSION: In comparison with European practice, colorectal cancer screening habits of American physicians are to a greater extent rational, evidence-based and well monitored and have a longer tradition in medical care thus allowing better prevention services for asymptomatic individuals.

Colorectal Neoplasms↗
PubMedDate not supplied

Science and practice: a case for medical informatics as a local science of design.

Because scientific research is guided by concerns for uncovering "fundamental truths," its time frame differs from that of design, development, and practice, which are driven by immediate needs for practical solutions. In medicine, however, as in other disciplines, basic scientists, developers, and practitioners are being called on increasingly to forge new alliances and work toward common goals. The authors propose that medical informatics be construed as a local science of design. A local science seeks to explain aspects of a domain rather than derive a set of unifying principles. Design is concerned with the creation, implementation, and adaptation of artifacts in a range of settings. The authors explore the implications of this point of view and endeavor to characterize the nature of informatics research, the relationship between theory and practice, and issues of scientific validity and generalizability. They argue for a more pluralistic approach to medical informatics in building a cumulative body of knowledge.

Computer Systems↗
PubMed2001

Intent-based process control configuration models.

Process control application engineering would be substantially less expensive if supported with readable self-documentation. An important advance would be models and languages designed to more clearly represent application Intent (as formalized herein), without the usual implementation obscurity. This paper analyzes how Intent, in the sense later defined, can be usefully defined and expressed. Process control has traditionally been defined in terms of a number of automation levels. This supports the intended Intent concept in one way, defining the implementation of higher application goals in terms of lower level ones. But a different, even more useful model is the leveling of physical sciences where each level of problem is best addressed by an appropriate kind of theory, itself dependent on lower level theories. Each theory must be proved by more fundamental theories even though those theories are much too complex to address the higher level problem directly. But more than leveling is needed. At each application level, the associated language should support concepts that make its normal usages clear. It should ensure that appropriate application practices can be expressed transparently in terms of their Intent. It should allow the engineer to clearly relate the result to the expected implementation, allowing him full control over the application. The paper will expand on prior papers to show more generally how these concepts can be developed.

Journal Article↗
PubMed2006

Utilizing multilevel partnerships to build the capacity of community-based organizations to implement effective HIV prevention interventions in Michigan.

The Michigan Department of Community Health (MDCH), utilizing the expertise of public and private, federal, state, and local partners, increased the proportion of state health department-funded community-based organizations implementing effective behavioral interventions (EBIs) from .05 (1:18) in 2002 to .78 (14:18) in 2004. As the stewards of nearly two thirds of the HIV prevention funds awarded annually by the Centers for Disease Control and Prevention, state health departments occupy an important position in diffusing the science of EBIs to their grantees. This article describes the strategies and partners employed by Michigan's state health department to build the capacity of community-based providers to implement effective behavioral interventions. Additionally, lessons learned by the MDCH are highlighted and challenges to the long-term sustainability of these interventions are also discussed.

Community Networks↗
PubMed1996

Regional training in AIDS prevention for health and behavioural science leaders in north-eastern Brazil.

This article reports results of a World AIDS Foundation-funded training programme in North-Eastern Brazil. Training objectives were: (1) to increase the effectiveness of existing medical and behavioural HIV-related services; (2) to prepare professionals to implement and evaluate social skills-based AIDS prevention programmes incorporating metacontingency systems; (3) to prepare professionals to disseminate training content in North-Eastern Brazil; and (4) to promote local involvement in regional AIDS programme planning. Fifty-eight health and behavioural sciences leaders from 5 North-Eastern Brazilian states represented a variety of institutions actually or potentially involved in AIDS prevention. Training activities focused on programme planning and evaluation and social skills training. Written pre- and post-test data indicate that all participants had a basic understanding of AIDS transmission at baseline. Significant knowledge increases (p < 0.01) resulted in all domains trained except for programme evaluation. For the two social skills evaluated (Condom Use Negotiation and Social Skills Trainer), significant improvements (p < 0.01) resulted in verbal and non-verbal content, assertiveness and anxiety, with the exception of near-significant levels (p < 0.10) achieved for assertiveness and anxiety on the 'Trainer' skill. Participants cofacilitated follow-up trainings in their respective states. These trainings demonstrated a successful model for technology transfer. More focused training is needed in programme design and evaluation methods.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Learning basic science alongside veterinary students: creating an interactive classroom.

Dr. Scott Brown's dedication and contribution to the instructional programs of the University of Georgia College of Veterinary Medicine have been exceptionally meritorious. In the last eight years, he has served with the leadership among faculty in the design and approval of a new curriculum, and as chair of the curriculum committee he led the College in its implementation. Throughout this period his research productivity, mentorship of professional and graduate students, and professional development continued. Dr. Brown instills energy, broadens learning experiences from personal and professional development to basic science, and, in all probability, provides positive, life-changing experiences for his students. I am very pleased that he was recognized in 2003 with the Carl J. Norden National Distinguished Teacher Award.

Awards and Prizes↗
PubMed2002

[Partnership and renewal of a educational paradigm in nursing sciences].

The Program of Interdisciplinary Family Surgical Procedures (PIFSP), is oriented towards the development of partnerships between families and nurses in order to respond to the specific needs of families with children suffering from health problems. It was implemented by the accumulation of information and expertise respective of the other and in regards to their relevance. A retrospective qualitative study on apprenticeships conducted with parents and nurses during a proposal by PIFSP shows at what point parents' and nurses' educational conduits are linked to faith, thought patterns, perception and behaviour, which corresponds to a specific conception of educational medical procedures in nursing science. This is part of the paradigm structure in educational and nursing science.

Adaptation, Psychological↗