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At least 91 records · Page 5Linked to original sources
PubMed1994

Normal and paralyzed muscle force and fatigability induced by electrical stimulation.

OBJECTIVE: The aim of this article is to review the basic research concerned with force and fatigue induced by electrical stimulation. Specific reports on human and animal models are covered. Articles dealing with specific afflictions of the neuromuscular system are also reviewed. DATA SOURCES: The main sources for article retrieval were the classic bibliographic data bases in the exercise, rehabilitation and physiological science fields such as Index Medicus and Medline. Indexing terms used included human and animal in conjunction with electrical stimulation, force and fatigue. Language and time constraints limited the search to French and English texts of this century. Proceedings of different electrical stimulation conferences were also covered. STUDY SELECTION: All authors had to approve the selection of the articles to be included in this review. The narrow scope of the review made it possible to include most of the articles investigated. Redundancy of information was the only rejection criterion. DATA EXTRACTION: Initially, the first author collated the articles and extracted the relevant data. This collation was then verified with respect to the original information and approved by all authors. DATA SYNTHESIS: Possible sites of the fatigue mechanisms may include the central nervous system, the peripheral nervous system, the neuromuscular junction, and the muscle excitation-contraction coupling. Even though not unanimous, data gathered from normal muscles seem to support that the major contributor to fatigue is the muscle fiber and not the nervous system or the neuromuscular junction. Other work involving paralyzed muscles suggest that electrically induced exercise alters the contractile properties of the muscle more specifically. CONCLUSIONS: It appears that muscle intracellular processes dominate the force decrease associated with muscular fatigue. Accordingly, when dealing with a problem involving loss of force and hyperfatigability, the metabolic aspects and muscle physiology should be prime considerations in choosing a therapeutic approach. The nervous and/or neuromuscular implications are, however, not to be discarded.

Animals↗
PubMed2026

Cochlear size variation in a large-scale international multicentre cohort.

AIM: This study aims to (1) review the literature on cochlear size, measured by the A-value, to assess reported variation across studies, and (2) consolidate cochlear parameters-specifically basal turn diameter (A-value) and width (B-value)-measured using the standardized DICOM viewer OTOPLAN®, and compare these with published data. METHODS: A scoping literature review was conducted using the search term "diameter of cochlear basal turn" to identify studies reporting A-value measurements. To complement this, cochlear measurements obtained with OTOPLAN® were collected from clinical collaborators across multiple international centres. The ratio of B- to A-values, which defines the cochlear basal turn shape, was calculated as previously described by Khurayzi et al. (2021). RESULTS: The literature review identified 38 studies comprising 5,206 A-value measurements (average: 9.08 mm; range: 8.01-10.03 mm). Additionally, 5,580 OTOPLAN® measurements were collected from 43 clinics across 25 countries (mean: 9.07 mm; range: 6.67-11.45 mm). Overall, 68.7% of cochleae exhibited an elliptical basal turn shape. CONCLUSION: Using a large, international multicentre dataset and a standardized measurement tool, this study demonstrates substantial variation in cochlear size and shape across clinical cohorts from different regions. The mean A-value (9.07 mm) is consistent with previously published literature, while the wider observed range highlights greater anatomical variability within a multicentre clinical population than previously reported. The majority of cochleae demonstrate an elliptical basal turn configuration.

Humans↗
PubMed1989

Understanding compliance with the medical regimen: the scope of the problem and a theoretical perspective.

This article reviews the scope of the compliance problem and introduces a social cognitive model as a framework for understanding the many factors influencing compliance behaviors. Among the broad categories of factors influencing compliance are the nature of the regimen, immediate controlling factors such as the locale in which the regimen is to be followed, the patients' expectations concerning the regimen, characteristics of the health-care setting, and social support. Each of these factors is considered in some detail. It is concluded that compliance is a complex behavior deserving of thorough investigation by the health-care team, requiring long-term monitoring in chronic health problems, and is susceptible to change by a variety of interventions.

Attitude to Health↗
PubMed2006

Work physical therapy and rehabilitation ergonomics: a review and discussion of the scope of the areas.

PURPOSE: There has been a recent development of the work physical therapy area in Brazil. The relationship between work physical therapy and rehabilitation ergonomics needs to be highlighted to avoid segregation and fragmentation of these complementary fields. For these reasons, the purpose of this article was to review and clarify the scope of the areas of work physical therapy and rehabilitation ergonomics. METHOD: The available literature discussing the roles of the areas of interest was critically reviewed. RESULTS: Both areas are concerned with workers' health and safety and they complement each other. CONCLUSIONS: Work physical therapy can be considered as rehabilitation ergonomics practiced by physical therapists with their specific interests. Hopefully, this paper will contribute to further interaction between the areas of work physical therapy and rehabilitation ergonomics not only in Brazil but worldwide. This may contribute to improved occupational disability prevention and rehabilitation.

Canada↗
PubMed2003

The scope of enrolled nurse practice: a review of the literature.

In this paper the scope of nursing practice of enrolled nurses (EN) is discussed within the context of the current demands of the health care environment and the impact of a changing grade mix for qualified nurses. Discussion is provided about EN practice, roles, functions, and competencies. The need for consistency in legislative and national guidelines, educational preparation, and the implementation of a decision-making framework is argued.

Australia↗
PubMedDate not supplied

Social, ethical and practical aspects of perinatal substance use.

Substance use in pregnancy has garnered increasing attention over the last decade as a particularly concerning facet of the larger national drug problem. This concern stems from the unique circumstance presented by pregnancy, in which the fetus may suffer harm as a result of maternal behavior. Furthermore, organizing a response to this problem is complicated by the ethically and legally challenging nature of the maternal-fetal relationship. The medical implications of perinatal substance use are profound. A discussion of these associated medical and obstetrical complications lies outside the focus of this paper, and the reader is referred to other reviews (Andres & Jones, 1994; Robins & Mills, 1993). This article is intended to assist obstetricians and others in their approach to the substance using pregnant patient. We first review the scope of this problem in social and financial terms and then review the important ethical and legal issues involved in current policymaking. Lastly, we suggest a clinical intervention focusing on education and improvement in identification and management of this subset of patients.

Adolescent↗
PubMed1992

The Fourth PRO Scope of Work: automating the medical review process through the Uniform Clinical Data Set.

With the advent of the Fourth Scope of Work, peer review organizations are beginning to implement the Uniform Clinical Data Set, an automated medical review system designed to collect standardized data from Medicare medical records and provide a data base to determine the most effective treatment for a given illness or disease. In this article, the author discusses the Health Care Financing Administration's development of the Uniform Clinical Data Set and its proposed application within the context of the Health Care Quality Improvement Initiative and the Fourth Scope of Work.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2002

Iodised salt for preventing iodine deficiency disorders.

BACKGROUND: Iodine deficiency is the main cause for potentially preventable mental retardation in childhood, as well as causing goitre and hypothyroidism in people of all ages. It is still prevalent in large parts of the world. OBJECTIVES: To assess the effects of iodised salt in comparison with other forms of iodine supplementation or placebo in the prevention of iodine deficiency disorders. SEARCH STRATEGY: We searched the Cochrane Library, Medline, the Register of Chinese trials developed by the Chinese Cochrane Centre, and the Chinese Med Database. We performed handsearching of a number of journals (Chinese Journal of Control of Endemic Diseases, Chinese Journal of Epidemiology, Chinese Journal of Preventive Medicine, and Studies of Trace Elements and Health up to February 2001), and searched reference lists, databases of ongoing trials and the Internet. Date of latest search: November 2001. SELECTION CRITERIA: We included prospective controlled studies of iodised salt versus other forms of iodine supplementation or placebo in people living in areas of iodine deficiency. Studies reported mainly goitre rates and urinary iodine excretion as outcome measures. DATA COLLECTION AND ANALYSIS: The initial data selection and quality assessment of trials was done independently by two reviewers. Subsequently, after the scope of the review was slightly widened from including only randomised controlled trials to including non-randomised prospective comparative studies, a third reviewer repeated the trials selection and quality assessment. As the studies identified were not sufficiently similar and not of sufficient quality, we did not do a meta-analysis but summarised the data in a narrative format. MAIN RESULTS: We found six prospective controlled trials relating to our question. Four of these were described as randomised controlled trials, one was a prospective controlled trial that did not specify allocation to comparison groups, and one was a repeated cross-sectional study comparing different interventions. Comparison interventions included non-iodised salt, iodised water, iodised oil, and salt iodisation with potassium iodide versus potassium iodate. Numbers of participants in the trials ranged from 35 to 334; over 20,000 people were included in the cross-sectional study. Three studies were in children only, two investigated both groups of children and adults and one investigated pregnant women. There was a tendency towards goitre reduction with iodised salt, although this was not significant in all studies. There was also an improved iodine status in most studies (except in small children in one of the studies), although urinary iodine excretion did not always reach the levels recommended by the WHO. None of the studies observed any adverse effects of iodised salt. REVIEWER'S CONCLUSIONS: The results suggest that iodised salt is an effective means of improving iodine status. No conclusions can be made about improvements in other, more patient-oriented outcomes, such as physical and mental development in children and mortality. None of the studies specifically investigated development of iodine-induced hyperthyroidism, which can be easily overlooked if just assessed on the basis of symptoms. High quality controlled studies investigating relevant long term outcome measures are needed to address questions of dosage and best means of iodine supplementation in different population groups and settings.

Cross-Sectional Studies↗
PubMed1995

The effect of financial incentives on physicians' behaviour in health maintenance organizations.

Examines the relationship between the presence of financial incentives and their effect on physician behavior in health maintenance organizations (HMOs). By reviewing the scope and dimensions of both HMOs and financial incentives, a foundation is laid for the review of the current empirical evidence. Further analysis and conceptual development is given to this topic by stating the limitations of existing research--in the confounding variables, in the complexity of incentives, and in the unanswered questions of quality of care--and by proposing innovative ways of studying the ¿other aspects of physician behavior' not previously considered. Questions and implications are raised for future research and practice.

Capitation Fee↗
PubMed2005

Parents' psychological adjustment in families of children with spina bifida: a meta-analysis.

BACKGROUND: Spina Bifida (SB) is the second most common birth defect worldwide. Since the chances of survival in children with severe SB-forms have increased, medical care has shifted its emphasis from life-saving interventions to fostering the quality of life for these children and their families. Little is known, however, about the impact of SB on family adjustment. Reviewers have struggled to synthesize the few contradictory studies available. In this systematic review a new attempt was made to summarize the findings by using meta-analysis and by delimiting the scope of review to one concept of family adjustment: Parents' psychological adjustment. The questions addressed were: (a) do parents of children with SB have more psychological distress than controls? (b) do mothers and fathers differ? and (c) which factors correlate with variations in psychological adjustment? METHODS: PsycInfo, Medline, and reference lists were scanned. Thirty-three relevant studies were identified of which 15 were eligible for meta-analysis. RESULTS: SB had a negative medium-large effect on parents' psychological adjustment. The effect was more heterogeneous for mothers than for fathers. In the reviewed studies child factors (age, conduct problems, emotional problems, and mental retardation), parent factors (SES, hope, appraised stress, coping, and parenting competence), family factors (family income, partner relationship, and family climate), and environmental factors (social support) were found to be associated with variations in parents' psychological adjustment. CONCLUSION: Meta-analysis proved to be helpful in organizing studies. Clinical implications indicate a need to be especially alert to psychological suffering in mothers of children with SB. Future research should increase sample sizes through multi-center collaborations.

Adaptation, Psychological↗
PubMed1992

Consultants' views of a district's services.

A postal questionnaire survey of consultants in the Bath Health District was conducted to establish a means for individual consultants to express their views about the provision of health services in the district, so that by working together a new relationship between the District Health Authority (DHA) as purchaser and the clinicians as providers of services could commence. A response rate of 84 per cent was achieved. The survey sought views on clinical and management issues to be used in the development of service agreements (contracts) and views on topics identified by general practitioners (GPs) as areas in need of improvement. Detail is given of results relating to out-patient services, issues of communication and the continuing role of community hospitals. Most consultants sanctioned the appropriateness of referrals by GPs to out-patient services but they identified some out-patient referrals as inappropriate. This justifies a further review of the out-patient services to be purchased by the DHA. Consultants were in agreement that there was scope for review of out-patient follow-ups. They agreed with GPs that discharge summaries could be provided within 24 hours of patient discharge to improve communication with GPs and that consultants should be available by pager to be contacted by GPs, but disagreed with GPs about the feasibility of giving patients on waiting lists a firm admission date at the time of going on the waiting lists. The majority of consultants were in favour of continuing support for community hospitals. They identified overall social value of community hospitals and greater clinical value of out-patient services than in-patient services in community hospitals.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Care↗
PubMed2001

Getting evidence into practice: the work of the Cochrane Effective Practice and Organization of care Group (EPOC).

Policy makers and continuing educators often face difficult decisions about which educational and quality assurance interventions to provide. Where possible, such decisions are best informed by rigorous evidence, such as that provided by systematic reviews. The Cochrane Collaboration is an international organization that aims to help people make well-informed decisions about health care by preparing, maintaining, and ensuring the accessibility of systematic reviews of the benefits and risks of health care interventions. International collaborative review groups prepare Cochrane reviews for publication in The Cochrane Library, a collection of databases available on CD-ROM and the World Wide Web and updated quarterly. The Cochrane Effective Practice and Organization of Care Group (EPOC) aims to prepare and maintain systematic reviews of professional, financial, organizational, and regulatory interventions that are designed to improve professional practice and the delivery of effective health services. EPOC has 17 reviews and 20 protocols published in Issue 3, 2000, of the Cochrane Library, with further protocols in development. We also have undertaken an overview of previously published systematic reviews of professional behavior change strategies. Our specialized register contains details of over 1,800 studies that fall within the group's scope. Systematic reviews provide a valuable source of information for policy makers and educators involved in planning continuing education and quality assurance initiatives and organizational change. EPOC will attempt to keep the Journal of Continuing Education in the Health Professions informed on an ongoing basis about new systematic reviews that it produces in the area of continuing medical education and quality assurance.

CD-ROM↗
PubMed2006

State-mandated benefit review laws.

OBJECTIVE: To determine which states have laws that require the review of mandated health insurance benefits and describe the various approaches states take in reviewing mandated benefits, as stated in the mandated benefit review (MBR) laws. DATA SOURCES: We queried online databases of the individual state statutes and reviewed the state statutes and state legislative agendas for all 50 states and Washington, DC to identify those states with active MBR laws as of September 2004. STUDY DESIGN: We reviewed the identified MBR laws to catalog their various components. The components chosen for this analysis include: general review strategy, designated reviewers, time frame for conducting reviews, criteria used in the review, requirements to use actuaries, sources of funding, and state data collection systems. Two of the authors independently created analysis categories and coded the MBR laws to document details on the major components of the laws. PRINCIPAL FINDINGS: We identified 26 state MBR laws active as of September 2004. A majority of the MBR laws specified a prospective review approach and only one law used an exclusively retrospective review approach. A substantial amount of variation was found with regards to the designated reviewers, time frames for conducting reviews, and criteria used in the review. Few states specified the use of actuaries, sources of funding, and state data collection systems. CONCLUSIONS: The number of states that have enacted MBR laws has increased substantially in recent years, however, different states have structured the review of mandated benefits differently, according to the values and perceived needs of the state legislatures. It is important that states increasingly consider a broader scope of review criteria so state decision makers can position themselves to mandate only those benefits that add real value to the state's health care system.

Insurance Benefits↗
PubMed2000

Guidelines in motor neurone disease (MND)/amyotrophic lateral sclerosis (ALS)--from diagnosis to patient care.

This paper reviews the scope of current guidelines in motor neurone disease (MND)/amyotrophic lateral sclerosis (ALS) and examines issues which have arisen in the preparation of these documents. The review concludes with an evaluation of the impact of the guidelines which have been produced to date and looks towards potential future developments in this area.

Amyotrophic Lateral Sclerosis↗
PubMed2005

The C-value enigma in plants and animals: a review of parallels and an appeal for partnership.

AIMS: Plants and animals represent the first two kingdoms recognized, and remain the two best-studied groups in terms of nuclear DNA content variation. Unfortunately, the traditional chasm between botanists and zoologists has done much to prevent an integrated approach to resolving the C-value enigma, the long-standing puzzle surrounding the evolution of genome size. This grand division is both unnecessary and counterproductive, and the present review aims to illustrate the numerous links between the patterns and processes found in plants and animals so that a stronger unity can be developed in the future. SCOPE: This review discusses the numerous parallels that exist in genome size evolution between plants and animals, including (i) the construction of large databases, (ii) the patterns of DNA content variation among taxa, (iii) the cytological, morphological, physiological and evolutionary impacts of genome size, (iv) the mechanisms by which genomes change in size, and (v) the development of new methodologies for estimating DNA contents. CONCLUSIONS: The fundamental questions of the C-value enigma clearly transcend taxonomic boundaries, and increased communication is therefore urged among those who study genome size evolution, whether in plants, animals or other organisms.

Animals↗
PubMed1994

The consequences of long-term antipsychotic drug administration on basal ganglia neuronal function in laboratory animals.

Antipsychotic drugs (APDs) have been widely utilized in the treatment of a variety of psychiatric disorders, most prevalently for schizophrenia. In addition to their desired therapeutic effects, repeated administration of APDs often produces various motor side effects. Experimental evidence has implicated alterations in the nuclei of the basal ganglia as the basis for the motor dysfunctions that may arise during APD treatment. Because APDs are invariably administered for extended periods of time, a great deal of research has focused on the effects of prolonged drug exposure. Animal models have been a particularly valuable tool for studying APD effects on basal ganglia function following several weeks (subchronic) to months or years (chronic) of administration. The present paper reviews the scope of studies that have assessed various aspects of basal ganglia function in laboratory animals treated with APDs for prolonged period of time. Possible mechanisms of action are reviewed regarding subchronic and chronic APD effects on basal ganglia function as well as directions for future research.

Animals↗