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At least 1,063 records · Page 59Linked to original sources
PubMed2003

Genetics. Gene genies.

A new white paper on genetics shows how it is starting to affect mainstream services, at both acute and primary care trust level. It is vital that managers begin to consider service redesign now. Many managers lack knowledge and do not know where to gain it.

Administrative Personnel↗
PubMed2003

E-oncology and health portals: instructions and standards for the evaluation, production organisation and use.

In 2002 the Italian Ministry of Health promoted the institution of a network and a web portal, E-oncology (2), for the seven NHS research institutions specialising in oncology (Istituti di Ricovero e Cura a Carattere Scientifico-IRCCS). One of the aims was to gather and provide information on tumoral pathologies to operators and the public. For an optimum organisation of a health web site it is necessary to comply with the standards internationally used. The World Wide Web Consortium (W3C) has developed guidelines for accessibility and usability of the sites, implemented in Italy through governmental issues. Many international organisations adopt rules and codes of conduct to validate biomedical information and have organised quality portals such as NLM, OMNI, MEDCIRCLE, HON etc. Some terminological standards, such as the MESH thesaurus and UMLS, have been produced by the libraries for a correct management and an effective information retrieval, and are currently used by the most important biomedical web sites. The Dublin Core, metadata standard for the integration of information deriving from heterogeneous archives, has also been developed by the libraries. The easy access to information dims the complex architecture necessary for the construction of a web site. The contribution of different professionals is necessary to guarantee the production of quality medical/health web sites, among them librarians have always been involved with the management of knowledge and their skills are extremely valuable. Furthermore, the libraries' network is essential in order to guarantee universal access to health information, mostly still against payment, and to contribute to overcoming the 'digital divide' and 'second-level digital divide'.

Evaluation Studies as Topic↗
PubMed2003

Stapedectomy and variations of the facial nerve.

The aim of the study was to analyze the incidence of anatomical variations and abnormalities of the facial nerve found during stapedectomy. Specific management in the case of an anomalous course of the facial nerve was also described. A retrospective analysis of clinical records of 316 stapedectomies was carried out in search for facial nerve anomalies. In 25 (7.9%) patients the facial nerve had an abnormal course. Twenty patients exhibited partial and two total overhang of the nerve over the oval window. In two of them the facial nerve was dehiscent in the tympanic segment and in three patients an obliterative type of the disease was also noted. The facial nerve dehiscence without the protrusion was found in two more patients. Another individual demonstrated otosclerotic bone over the facial nerve. In one case a duplicated facial nerve was found. Two branches of the nerve were almost covering the oval window (Fig. 1B). The piston was placed in the footplate between the branches of the duplicated nerve. The patient developed slight facial weakness (grade III in H-B scale) after the surgery. The function of the facial nerve returned to normal within 5 months. Anomalies of the course of the facial nerve can be found in about 8% of stapedectomies and they require specific management. The knowledge of the possible abnormalities and relevant procedures is crucial for safe and successful stapedectomy.

Adolescent↗
PubMed2002

Enhancing a medical e-learning environment: the adaptive DI2@DEM approach.

Current medical e-learning tools suffer from a variability of student user. Students are different in terms of motivations, training backgrounds, technical skills and learning objectives. It is obvious that these students do not accede relevant information if their educational resources access is misadapted. Adaptive environments propose to take the user into account in order to provide him or her with the most relevant educational resources. We present the adaptive DI(2)ADEM approach, which enhances the MEDIDACTE e-learning environment of the Faculty of Medicine in Marseille. DI(2)ADEM objective is to select the most relevant information and offer it to the user in an adaptive manner. Adaptability is based on management of knowledge regarding both the user and resources distributed. A match is made between student's profile and knowledge of resources organization and semantics.

Computer Simulation↗
PubMed2004

The GLARE approach to clinical guidelines: main features.

In this paper, we present GLARE, a domain-independent prototypical system for acquiring, representing and executing clinical guidelines. GLARE has been built within a 7-year project with Azienda Ospedaliera San Giovanni Battista in Turin (one of the largest hospitals in Italy) and has been successfully tested on clinical guidelines in different domains, including bladder cancer, reflux esophagitis, and heart failure. GLARE is characterized by the adoption of advanced Artificial Intelligence (AI) techniques, to support medical decision making and to manage temporal knowledge.

Decision Making, Computer-Assisted↗
PubMed1992

Rabies.

Rabies is usually contracted through wounds and usually causes death in those infected. The major weapon against rabies infection is postexposure immunization, and by virtue of treating numerous animal bites and scratch wounds, emergency physicians play a key role in keeping rabies rare in the United States. Proper management requires knowledge of the changing epidemiology of animal rabies and its impact on postexposure prophylaxis.

Humans↗
PubMed2003

[Elderly women, invisible lesbians].

The social invisibility of aging lesbians is a major obstacle to the adaptation of residential services to their needs. After looking at the difficulties associated with aging among lesbians, this article examines social mechanisms that reproduce their invisibility. Findings are based on a qualitative analysis of two series of interviews, 10 with service providers in private residences for older people and 10 with aging lesbians. On one side, there is openness at the level of personal attitudes, but proactive commitment in residence management and knowledge about older lesbians' psychosocial needs are lacking. On the other side, aging lesbians perceive residences as an environment where they would not feel secure enough to be open about their sexual orientation.

Age Factors↗
PubMed2006

[Pacemaker implantation in children: is this a therapy or a pathogenetic mechanism for ventricular dysfunction?].

Ventricular pacing, typically initiated from a right ventricular apical electrode, inherently causes abnormal biventricular activation, decreases left ventricular function, and may cause histopathological changes. Data regarding cardiac resynchronization therapy in pediatric patients are limited. Some authors evaluated the potential of improving paced left ventricular function by a septal electrode implant site. For this reason the role of pacing is not clear in children. In isolated congenital atrioventricular block, cardiac pacing represents a satisfactory treatment. However, recent evidence has demonstrated that a subset of patients with isolated congenital complete atrioventricular block develops dilated cardiomyopathy. Patients with congenital heart diseases after surgery represent a unique and expanding population. Some will require pacemaker or implantable defibrillator therapy. They pose technical and management challenges not encountered in other groups receiving pacing, and the complication and reintervention rates specific to this population are not well defined. Moreover, the small patient size, structural cardiac abnormalities, and growth may complicate pediatric pacemaker management. Better knowledge of risk factors for lead failure in these patients may help improve future outcomes. In this review we analyzed many of these problems.

Child↗
PubMed1991

Occupational health nursing education. Curricular content in baccalaureate programs.

It is important that occupational health nursing content be offered in academic institutions to support the scope of practice in the specialty. Less than 50% of the schools responding (N = 215) included content specific to occupational health nursing concepts and practice, related fields of knowledge, and management of the occupational health unit. Occupational health nurses in practice settings and educational institutions should collaborate on the development of occupational health content in nursing school curricula.

Curriculum↗
PubMed1989

New training for new roles.

Assistant medical practitioners in Sri Lanka are justifiably dissatisfied with their training, which should be modified so that they are enabled to function more effectively in the country's predominantly rural communities. Furthermore, in order to motivate these health professionals to the greatest possible extent, they should be offered an attractive career structure.

Curriculum↗
PubMed1989

Work-related stresses of pediatric bone marrow transplant nurses.

The stress that nurses experience when working in specialty units, such as the intensive care unit (ICU) and the neonatal intensive care unit (NICU), has been described in many studies as being a significant variable in nurse retention, job satisfaction, and quality of patient care. Although some investigation of stress has extended to other areas of nursing, one specialty where stress has not been studied is bone marrow transplant (BMT) nursing. The purpose of this study was to identify work-related stresses of pediatric BMT nurses. The convenience sample consisted of 31 RNs and LPNs who had at least 6 months of experience in a laminar air flow (LAF) BMT unit in a pediatric facility in the southwest United States. Eighteen nurses responded to a questionnaire asking them to describe two incidents in their experience that were most stressful to them. Thirty-seven incidents were collected. Categories and subcategories described in the literature, as well as from the researcher's experience, were used in the content analysis of the incidents. Each incident was analyzed independently by three nurse-judges who identified categories and subcategories in each incident. Several new subcategories were identified from the data. Negotiations for categorization occurred until full agreement among the nurse-judges was reached. Categories of stress identified, in decreasing order of frequency, included: patient care, philosophical/emotional/ethical, environment, interpersonal relations/communication, knowledge base, management of the unit, bureaucratic/political/organizational.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Digestive and respiratory complications in enteral nutrition].

Enteral nutrition is a safe technique but complications may arise. Mechanical problems can occur as a result of tube malposition: regurgitation can induce respiratory distress. Esophagitis is rare and does not seem to be related to acid gastro-oesophageal reflux. Diarrhea, the main gastro-intestinal side effect, has a complex etiology; management requires knowledge of gastro-intestinal physiology during enteral nutrition. Many of the problems encountered with enteral feeding can be avoided by using a fine bore tube, administering the feed by continuous infusion, and careful monitoring of patients for metabolic abnormalities.

Diarrhea↗
PubMed1985

Prediction of the cause, effects, and prevention of drug-nutrient interactions using attributes and attribute values.

Drug-nutrient interactions and their adverse outcomes have previously been identified by observation, investigation, and literature reports. Knowing the attributes of the drugs, availability of knowledge base management systems for microcomputer use can facilitate prediction of the mechanism and the effects of drug-nutrient interactions. Examples used to illustrate this approach are prediction of lactose intolerance in drug-induced malabsorption, and prediction of the mechanism responsible for drug-induced flush reactions. In the future we see that there may be many opportunities to use this system further in the investigation of complex drug-nutrient interactions.

Drug Interactions↗