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At least 1,225 records · Page 68Linked to original sources
PubMed2000

Nutrition and cancer education: ten years of progress.

The Nutrition Education and Research Program at the University of Nevada School of Medicine was awarded two separate NIH/NCI R25 cancer education grants over a ten-year period. With this support, a four-year longitudinal nutrition curriculum was implemented, including the required 20-hour freshman Medical Nutrition Course, junior and senior nutrition electives, and a senior assignment in nutrition and cancer during the rural rotation with faculty preceptors. Funding has also supported nutrition integration into the basic science courses, patient care courses, and specialty clerkships. A unique nutrition fellowship for medical students who specialize in nutrition during their four years of training and graduate with special Qualifications in Nutrition (SQIN) has also been instituted. The curriculum reflects a longitudinal, interdisciplinary, but flexible, integration of nutrition into an already crowded medical school education.

Curriculum↗
PubMedDate not supplied

Assessment of mechanobiological models for the numerical simulation of tissue differentiation around immediately loaded implants.

Nowadays, there is a growing consensus on the impact of mechanical loading on bone biology. A bone chamber provides a mechanically isolated in vivo environment in which the influence of different parameters on the tissue response around loaded implants can be investigated. This also provides data to assess the feasibility of different mechanobiological models that mathematically describe the mechanoregulation of tissue differentiation. Before comparing numerical results to animal experimental results, it is necessary to investigate the influence of the different model parameters on the outcome of the simulations. A 2D finite element model of the tissue inside the bone chamber was created. The differentiation models developed by Prendergast, et al. ["Biophysical stimuli on cells during tissue differentiation at implant interfaces", Journal of Biomechanics, 30(6), (1997), 539-548], Huiskes et al. ["A biomechanical regulatory model for periprosthetic fibrous-tissue differentiation", Journal of Material Science: Materials in Medicine, 8 (1997) 785-788] and by Claes and Heigele ["Magnitudes of local stress and strain along bony surfaces predict the course and type of fracture healing", Journal of Biomechanics, 32(3), (1999) 255-266] were implemented and integrated in the finite element code. The fluid component in the first model has an important effect on the predicted differentiation patterns. It has a direct effect on the predicted degree of maturation of bone and a substantial indirect effect on the simulated deformations and hence the predicted phenotypes of the tissue in the chamber. Finally, the presence of fluid also causes time-dependent behavior. Both models lead to qualitative and quantitative differences in predicted differentiation patterns. Because of the different nature of the tissue phenotypes used to describe the differentiation processes, it is however hard to compare both models in terms of their validity.

Animals↗
PubMed2004

Handheld-assisted field data collection for occupational risk assessment.

A computerized handheld procedure is presented in this paper. It is intended as a database complementary tool, to enhance prospective risk analysis in the field of occupational health. The Pendragon forms software (version 3.2) has been used to implement acquisition procedures on Personal Digital Assistants (PDAs) and to transfer data to a computer in an MS-Access format. The data acquisition strategy proposed relies on the risk assessment method practiced at the Institute of Occupational Health Sciences (IST). It involves the use of a systematic hazard list and semi-quantitative risk assessment scales. A set of 7 modular forms has been developed to cover the basic need of field audits. Despite the minor drawbacks observed, the results obtained so far show that handhelds are adequate to support field risk assessment and follow-up activities. Further improvements must still be made in order to increase the tool effectiveness and field adequacy.

Computers, Handheld↗
PubMed2000

A computer-based epidemiological skills module for medical undergraduates in Nepal.

OBJECTIVE: To ascertain whether undergraduate medical students could acquire the basic competence needed to design, analyze and use a computer-compatible database in an epidemiologically meaningful way. SETTING: Since 1998 the Manipal College of Medical Sciences (MCOMS) of Kathmandu University (KU), Nepal has included in its undergraduate medical curriculum a training module that incorporates knowledge and skills in doing computer-assisted data analyses of epidemiological questions. The present study was designed around the implementation of this module. SUBJECTS: All 96 students of the seventh semester (first six months of the fourth year) of the MBBS course at the MCOMS. METHODS: The teaching-learning activities for the module were carried out mainly in six 2-hour sessions, for groups of 16 students at a time. The software used was EPI-INFO. MAIN OUTCOME MEASURES: Knowledge and skills of computer-assisted data analyses were assessed. In addition, feedback was obtained from the students and scored on seven dimensions. FINDINGS: The pre-test/post-test questionnaire score difference, which evaluated the knowledge component, was highly significant (t = 51.3, p < 0.001). In the skills assessment session, 83% were successful. The students gave high average scores on the satisfaction, small group learning environment, curricular relevance and evaluation dimensions; but the scores were relatively low on the time, other resources and confidence dimensions. CONCLUSION: The module was successful in achieving its objectives and can be implemented even under tight resource constraints. Our plans for improving upon this first run of the module are outlined in the paper.

Journal Article↗
PubMed1993

Using yeast genetics to generate a research environment.

Many of the same features of the yeast Saccharomyces cerevisiae that have made it so useful as a genetics and molecular biology research organism make it equally useful as a teaching organism. Furthermore, the fact that it is a modern research organism makes it all the more exciting to students and teachers. The unique characteristic of yeast as a unicellular, eukaryotic organism with a complete sexual life cycle is ideal for teaching. A simple monohybrid cross to explore dominance and recessiveness, a dihybrid cross to demonstrate independent assortment, pigmented adenine auxotrophs for investigating the fundamentals of gene action, and easily measured responses to ultraviolet radiation provide an array of appropriate laboratory tools that put real science in the hands of students and teachers. Direct collaborations between scientists and science teachers bring together complementing knowledge and experience, providing an effective and efficient way to adapt and simplify techniques and procedures to accommodate time and money constraints. Collaborations quickly identify technical and theoretical problems that must be solved for implementation in classrooms. They also provide a continuing stimulus to teachers and students to participate in the research process.

Evaluation Studies as Topic↗
PubMed2000

Setting the educational agenda and curriculum for error prevention in emergency medicine.

Graduate and postgraduate medical education currently teaches safety in patient care by instilling a deep sense of personal responsibility in student practitioners. To increase safety, medical education will have to begin to introduce new concepts from the "safety sciences," without losing the advantages that the values of commitment and responsibility have gained. There are two related educational goals. First, we in emergency medicine (EM) must develop a group of safety-educated practitioners who can understand and implement safe practice innovations in their clinical settings, and will be instrumental in changing our professional culture. Second, EM must develop a group of teachers and researchers who can begin to deeply understand how safety is maintained in emergency care, develop solutions that will work in emergency department settings, and pass on those insights and innovations. The specifics of what should be taught are outlined briefly. Work is currently ongoing to identify more specifically the core content that should be included in educational programs on patient safety in emergency care. Finally, careful attention will have to be paid to the way in which these principles are taught. It seems unlikely that a series of readings and didactic lectures alone will be effective. The analysis of meaningful cases, perhaps supplemented by high-fidelity simulation, seems to hold promise for more successful education in patient safety.

Curriculum↗
PubMed2005

Evaluation of the COBAS TaqMan HCV test with automated sample processing using the MagNA pure LC instrument.

The COBAS TaqMan HCV Test (TaqMan HCV; Roche Molecular Systems Inc., Branchburg, N.J.) for hepatitis C virus (HCV) performed on the COBAS TaqMan 48 Analyzer (Roche Molecular Systems) currently relies on a manual sample processing method. Implementation of an automated sample processing method would facilitate the clinical use of this test. In this study, we evaluated the performance characteristics of TaqMan HCV following automated sample processing by the MagNA Pure LC instrument (MP; Roche Applied Science, Indianapolis, Ind.). The analytical sensitivity of TaqMan HCV following sample processing by MP was 8.1 IU/ml (95% confidence interval, 6.1 to 15.2). The assay showed good linearity (R(2) = 0.99) across a wide range of HCV RNA levels (25 to 5 x 10(6) IU/ml), with coefficients of variation ranging from 10% to 46%. Among 83 clinical specimens, the sensitivity and specificity of TaqMan HCV were 100% and 95%, respectively, when compared to the COBAS AMPLICOR hepatitis C virus test, version 2.0 (COBAS AMPLICOR; Roche Molecular Systems), with TaqMan HCV detecting two more HCV RNA-positive specimens than COBAS AMPLICOR. Both specimens were confirmed to be HCV RNA positive by the VERSANT HCV RNA qualitative test (Bayer HealthCare LLC, Tarrytown, N.Y.). There was also strong correlation (R(2) = 0.95) and good agreement between the results from TaqMan HCV and the VERSANT HCV RNA 3.0 assay (bDNA) (Bayer HealthCare LLC) among a group of 93 clinical specimens. The MP is a versatile, labor-saving sample processing platform suitable for reliable performance of TaqMan HCV.

Automation↗
PubMed2006

Air quality management using modern remote sensing and spatial technologies and associated societal costs.

This paper presents a study of societal costs related to public health due to the degradation of air quality and the lack of physical activity, both affected by our built environment. The paper further shows road safety as another public health concern. Traffic fatalities are the number one cause of death in the world. Traffic accidents result in huge financial loss to the people involved and the related public health cost is a significant part of the total societal cost. Motor vehicle exhausts and industrial emissions, gasoline vapors, and chemical solvents as well as natural sources emit nitrogen oxides and volatile organic compounds, which are precursors to the formation of ground-level Ozone. High concentration values of ground-level Ozone in hot summer days produce smog and lead to respiratory problems and loss in worker's productivity. These factors and associated economic costs to society are important in establishing public policy and decision-making for sustainable transportation and development of communities in both industrialized and developing countries. This paper presents new science models for predicting ground-level Ozone and related air quality degradation. The models include predictor variables of daily climatological data, traffic volume and mix, speed, aviation data, and emission inventory of point sources. These models have been implemented in the user friendly AQMAN computer program and used for a case study in Northern Mississippi. Lifecycle benefits from reduced societal costs can be used to implement sustainable transportation policies, enhance investment decision-making, and protect public health and the environment.

Air Pollutants↗
PubMed2002

Are bad outcomes from questionable clinical decisions preventable medical errors? A case of cascade iatrogenesis.

When a patient with multiple, complicated conditions is admitted to a hospital and risky procedures are performed that result in adverse outcomes, the difficulties inherent in determining whether and when a preventable medical error has occurred must be addressed. This article analyzes the case of a 40-year-old woman with a history of chronic aortic dissection and pericardial effusion who was admitted to a teaching hospital with unilateral swelling of her left breast and arm accompanied by dyspnea. During her hospitalization, the patient developed multiple complications from the diagnostic and therapeutic procedures that were performed. The authors argue that this case illustrates some limitations of routinely undertaking time-consuming and costly reviews, or "root-cause analyses," as a patient safety strategy when they are unlikely to reveal remediable "errors" or to suggest better systems of care that will prevent errors. The ability to establish causality through post hoc reviews is the linchpin in the recommendation for widespread adoption of error reporting and reviews. When causality is not established, it is impossible to know whether any changes adopted as a result of the reviews will be effective. This case, in which the causal pathways to the adverse events are very uncertain, may be much more typical than the egregious errors featured in a classic root-cause analysis. The authors recommend that the relative merits of this approach to patient safety be compared with other proven, cost-effective interventions to improve quality, such as appropriate treatment of myocardial infarction or depression, before scarce resources and enormous human capital are allocated for widespread implementation.

Adult↗
PubMed1999

Factors influencing attitudes within AIDS service organizations toward the use of research-based HIV prevention interventions.

Although the efficacy of small-group, risk reduction interventions based on cognitive behavioral principles has been widely documented in HIV behavioral research literature, little is known about how AIDS service organizations (ASOs) view these research-based models. From a nationwide sample of 77 ASOs, this study assessed factors influencing attitudes of prevention program directors and frontline staff toward research-based interventions. Characteristics of individual respondents as well as organizational characteristics of the ASO itself were used to predict perceived benefits of adopting this type of intervention, perceived efficacy (confidence) in the ASO's ability to implement it, and perceived barriers to adoption. Findings revealed uniformly positive perceptions of benefits among respondents from ASOs of different sizes and organizational experiences, although directors held more favorable evaluations than frontline staff. Respondents from ASOs that were larger, had previously delivered group or workshop interventions, or had received outside technical assistance in the past expressed more confidence in the ability of their ASO to implement the intervention. On the other hand, older and more highly education individuals had less confidence in their organization's ability to implement the model. Resource constraints (money, staff, and time) were the most common barriers cited by the respondents. Overall, higher organizational role and longer tenure at an ASO were associated with the perception of more barriers to adopting science-based interventions. Respondents from ASOs with a history of receiving technical assistance reported fewer perceived barriers. The successful dissemination of HIV prevention models from the research arena to the service arena will require mechanisms to provide appropriate funding and technical assistance, particularly to smaller organizations. Mindful of the resource constraints faced by ASOs, researchers can facilitate this process by attempting to develop interventions that are less resource- and time-consuming than current models.

Age Factors↗
PubMedDate not supplied

Technology Transfer--Bridging Space and Society. The Students of the Technology Transfer Design Project Team (ISU Summer Session 1997).

Strategies, policies and methods by which technologies can he cross-fertilized between the space and non-space sectors were examined by students of the design project "Technology Transfer--Bridging Space and Society". This project was undertaken by students attending the 1997 10th Anniversary Summer Session Program of the International Space University. General issues relating to transfer of technology were discussed including definitions and mechanisms (push, pull, interactive and pro-active). As well as looking at case studies and the impact of national policies on space agencies, the design project also sought to look at technology transfer on a country-by-country basis, selecting various countries for scrutiny and reporting on their technology transfer status. The project report shows how transfer of technology varies between nations and when analyzed with the case studies identifies the general strategies, policies and methods in use and how they can he improved. Finally, the report seeks to recommend certain issues to governments, space agencies and industrial organizations to facilitate the transfer of technology. These include the development of a generic metrics system and the implementation of better appropriate procedures and mechanisms for a positive diffusion process between space and non-space sectors.

Europe↗
PubMed2002

A chair on alternatives?

An overview is given on the legal framework in Europe for the use of experimental animals set by EU (European Union) Directive 86/609/EEC and on the activities of EU member states to implement this directive in the field of regulatory testing in animals. The significant decrease in the number of experimental animals in Germany during the past decade is described with particular reference to the recent increase that is due to transgenic animal models. From the regulatory and the animal welfare perspective the international harmonisation of test guidelines and the mutual acceptance of data are the way forward for chemical safety testing. The recent White Paper of the EU Commission for the future chemicals policy calls for an immediate increase in the number of validated in vitro toxicity tests to be accepted for regulatory purposes in the EU. In addition, deficits of properly educating young scientists in Germany in conducting animal experiments and implementing the 3-Rs concept of Russel and Burch are described. It is therefore, quite urgent to establish new chairs on animals and alternatives at universities in Europe. They should focus on both education young students of the biomedical sciences in the humane use of laboratory animals according to the 3-Rs concept and on developing new toxicity tests to be validated for regulatory purposes under the new EU chemicals policy by the established validation centres in Europe.

Animal Rights↗
PubMed1994

[Reasons for consultation in occupational medicine].

The inability to characterize more precisely the extent of occupational diseases limits the implementation of an effective preventive policy. Furthermore, not all work-related conditions are reported by the Swiss workers' compensation system. A seven-year (1986 to 1992) retrospective study of medical visits in an Institute of Occupational Health Sciences is presented. The objective of this study is to expand data on occupational diseases for clinical and public health intervention. 298 patients have been examined for a possible work-related condition. In 140 cases (47%), an occupational disease according to the Swiss Law was found. Respiratory tract was the main target of industrial pollutants. Respiratory irritations, solvent intoxications, contact dermatitis and asthma were the most frequent conditions seen. 97 workplace visits (32% of all medical visits) were necessary for diagnostic purposes. Painters (construction, cars) and other solvent exposed workers were at particular risk. Rare alpha-1-antitrypsin phenotypes were found several times in workers with respiratory diseases confirming the value of this test in occupational medicine. Despite many referral biases, direct clinical and public health applications of the data are possible. This study confirms the hypothesis that occupational respiratory diseases and intoxications are probably underreported in the workers' compensation statistics. Activities with an increased risk of work-related diseases have been identified so workplace intervention could be highly targeted. This study shows also that a more intense collaboration between primary care physicians, hospital services and occupational medical specialists is necessary to improve clinical and epidemiological surveillance of work-related health conditions.

Adolescent↗
PubMed1993

Adolescent substance abuse: psychosocial factors.

The prevention and management of adolescent substance abuse requires an understanding of the psychosocial context in which such a problem develops. This article reviews literature from the health and behavioral sciences and provides information about the prevalence of substance abuse, family and other psychosocial factors associated with substance abuse, and signs and symptoms of various kinds of substance abuse. Implications for school nursing practice are discussed and suggestions for implementation made.

Adolescent↗
PubMed1996

Successful tracheal weaning.

In 1994, neuroscience nurses and neurosurgeons at St. Boniface General Hospital and the Health Sciences Centre in Winnipeg completed a study on tracheostomy weaning. This collaborative effort was initiated in response to a perceived clinical need--weaning difficulties in our neurological and neurosurgical patients--and was the first step along the road to implementing a standardized weaning procedure.

Humans↗
PubMed1997

A survey of state health department compliance with the recommendations of the Institute of Medicine report, The Future of Public Health.

We repeated a survey of state health agencies (SHAs) designed to ascertain the extent that the recommendations of the Institute of Medicine's report, The Future of Public Health, have been implemented. This survey was originally done in 1989 and we repeated the same survey in 1996. While there has been progress in some of the recommendations, such as a separate department of health, agreed-upon public health duties, outreach, infrastructure, and scope of responsibilities, there continue to be problems with the implementation of some of the recommendations. For example, the proportion of agencies reporting that the core public health function of policy development is extant has actually declined since 1989. There continue to be problems, with developing linkages of public health with environmental health and mental health, with strengthening the public health infrastructure, and with expansion of the scope of public health responsibilities. We encourage the continued monitoring of the implementation of the IOM recommendations.

Guidelines as Topic↗
PubMed1992

The utilization of qualitative and quantitative data for health education program planning, implementation, and evaluation: a spiral approach.

The process of development of a Dutch smoking prevention project is described. An essential feature of the project is the combination and interaction of qualitative and quantitative research methods. It is advocated that each method has its own contribution and can be considered as a separate methodology contributing to social science in general and health education research in particular. Combining the two approaches in a spiral approach will result in a synergistic effect, because of the interaction of both approaches. The results of both methods suggest that qualitative methods enhanced the generation of ideas and theories. Qualitative methods were used to formulate ideas for improving quantitative data gathering, analyzing and comparing ideas with respect to program development, and for testing the internal validity of a quantitative design. The quantitative method enabled testing of results in different groups and detecting detailed differences. It also provided information that one of the assumptions of the program, the development of a teacher independent program, was not completely realized. The major advantage of using both methods is that this provides feedback between assumptions and data, thus enhancing comparison of results and critical reflection during the whole project.

Health Education↗