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At least 1,297 records · Page 72Linked to original sources

PubMed2000

The 1997-1998 epidemic of classical swine fever in the Netherlands.

In 1997, the pig husbandry in the Netherlands was struck by a severe epidemic of classical swine fever (CSF). During this epidemic 429 CSF-infected herds were depopulated and approximately 1300 herds were slaughtered pre-emptively. In addition millions of pigs of herds not CSF-infected were killed for welfare reasons (over crowding or overweight). In this paper, we describe the course of the epidemic and the measures that were taken to control it. The first outbreak was detected on 4 February 1997 in the pig dense south-eastern part of the Netherlands. We estimate that CSF virus (CSFV) had already been present in the country by that time for 5-7 weeks and that the virus had been introduced into approximately 39 herds before the eradication campaign started. This campaign consisted of stamping-out infected herds, movement restrictions and efforts to diagnose infected herds as soon as possible. However, despite these measures the rate at which new outbreaks were detected continued to rise. The epidemic faded out only upon the implementation of additional measures such as rapid pre-emptive slaughter of herds in contact with or located near infected herds, increased hygienic measures, biweekly screening of all herds by veterinary practitioners, and reduction of the transportation movements for welfare reasons. The last infected herd was depopulated on 6 March 1998.

Animals↗

PubMed2003

Venous outflow obstruction: An underestimated contributor to chronic venous disease.

OBJECTIVE: To assess the importance of iliac venous outflow obstruction in limbs with and without concomitant deep or superficial reflux, we performed a retrospective analysis of data contemporaneously entered into a set time-stamped electronic medical records program. MATERIAL AND METHOD: Four hundred forty-seven limbs underwent iliac vein stenting of chronic, nonmalignant obstruction when greater than 50% morphologic stenosis was found at transfemoral venography or intravascular ultrasonography. Group 1 (female-male ratio, 3.4:1; left limb-right limb, 2.7:1; nonthrombotic-thrombotic, 1.8:1) included 187 stented limbs in 176 patients with absence of deep and superficial reflux as identified at erect duplex Doppler scanning. Group 2 (female-male, 1.7:1; left-right, 1.9:1, nonthrombotic-thrombotic limb, 1:2.1) included 260 limbs in 253 patients with combination obstruction and reflux. Reflux was left untreated during the observation period. Clinical outcome (ulcer healing and recurrence rate, degree of pain per visual analog scale, swelling grade) and hemodynamic effects (ambulatory venous pressure, venous refilling time, venous filling index at 90 seconds) of iliac venous stenting were assessed. RESULT: Patients with reflux and obstruction had more severe disease (clinical class 4-6, 53% in group 2 vs 24% in group 1; P <.001). Similarly, rate of active ulcer was low in limbs with obstruction only (3% vs 24%, groups 1 and 2, respectively). Mean clinical follow-up was 13 +/- 12 months (SD) in 86% of limbs. Because of the presence of reflux in group 2, venous pressure was higher, venous filling time was shorter, and venous filling index at 90 seconds increased, compared with group 1. Multisegment scores were 2.6 +/- 1.6 and 0, respectively. Of greater interest, there was no deterioration in venous hemodynamics in group 2 after stenting. There was substantial clinical improvement in both groups after stenting. Approximately half of patients were completely relieved of pain after stenting, and a third were completely relieved of swelling. In addition, 55% of ulcerated limbs healed. CONCLUSION: Iliac venous outflow obstruction appears to have an important role in clinical expression of chronic venous insufficiency, particularly in producing pain, and is easily overlooked, mainly because of diagnostic difficulty. The combination of reflux and obstruction is seen more frequently with severe clinical disease than is obstruction alone. Ulcer prevalence is clearly associated with reflux, with a low incidence in patients with obstruction alone. Removal of iliac vein outflow obstruction does not result in increased axial reflux, with clinical deterioration in limbs with combined reflux and obstruction.

Adolescent↗

PubMed2001

Physician response to surveys. A review of the literature.

OBJECTIVE: Physician-specific surveys are a frequently used tool in health services research, but attempts at ensuring adequate response rates are rarely reported. We reviewed literature of survey methodology specific to physician surveys and report those found to be most effective. DATA SOURCES: Studies were identified by searching MEDLINE and PSYCHInfo from 1967 through February 1999. We included all English-language studies that randomized physician survey respondents to an experimental or control group. The authors independently extracted data from 24 studies examining survey methodology of physician-specific surveys. We included Mantel-Haenszel chi-squares comparing treatment groups, if present. If not, these were calculated from study data. RESULTS: Pre-notification of survey recipients, personalizing the survey mailout package, and nonmonetary incentives were not associated with increased response rates. Monetary incentives, the use of stamps on both outgoing and return envelopes, and short questionnaires did increase response rates. Few differences were reported in response rates of phone surveys compared with mail surveys and between the demographics and practice characteristics of early survey respondents and late respondents. CONCLUSIONS: We report some simple approaches that may significantly increase response rates of mail surveys. Surprisingly, the response rates of mail surveys of physicians compared favorably with those from telephone and personal interview surveys. Nonresponse bias may be of less concern in physician surveys than in surveys of the general public. Future research steps include specifically testing the more compelling results to allow for better control of confounders.

Adult↗

PubMed1999

[Theoretical bases of semiology in pediatric psychiatry. I. Theoretical models].

This paper is the first part of a study on the theoretic concepts used in child psychiatry and their functioning during the first consultations with a child and his family. These models have different origins (medicine, psychology, education) and contribute to the true specificity of child psychiatry, which must take into account both the developmental aspect as in pediatrics, and the peculiarity of the human psyche. This gives a special stamp to child psychopathology and some usual ways of thinking (like normality, comparability) are quickly inoperative. The five main theoretic models available in child psychiatry are recalled: the model of the medical semiology which describes symptoms and gives them value, the clinical-anatomical model which tries to set up relationships between structure and function, the developmental and cognitive model which emphasizes the psychomotor and intellectual abilities of the child, the affective model (psychoanalysis and attachment) which studies his/her emotional development, and the environmental model which set the child in his/her conditions of growth. These models only support the thoughts of the consultant who must keep in mind the psychic development as a whole and try to aggregate all his findings in the various fields to extract the main features underlying the child's difficulties.

Affect↗

PubMed2003

Temporal abstraction and inductive logic programming for arrhythmia recognition from electrocardiograms.

This paper proposes a novel approach to cardiac arrhythmia recognition from electrocardiograms (ECGs). ECGs record the electrical activity of the heart and are used to diagnose many heart disorders. The numerical ECG is first temporally abstracted into series of time-stamped events. Temporal abstraction makes use of artificial neural networks to extract interesting waves and their features from the input signals. A temporal reasoner called a chronicle recogniser processes such series in order to discover temporal patterns called chronicles which can be related to cardiac arrhythmias. Generally, it is difficult to elicit an accurate set of chronicles from a doctor. Thus, we propose to learn automatically from symbolic ECG examples the chronicles discriminating the arrhythmias belonging to some specific subset. Since temporal relationships are of major importance, inductive logic programming (ILP) is the tool of choice as it enables first-order relational learning. The approach has been evaluated on real ECGs taken from the MIT-BIH database. The performance of the different modules as well as the efficiency of the whole system is presented. The results are rather good and demonstrate that integrating numerical techniques for low level perception and symbolic techniques for high level classification is very valuable.

Algorithms↗

PubMed1999

Abstraction on clinical data sequences: an object-oriented data model and a query language based on the event calculus.

In this work, we deal with temporal abstraction of clinical data. Abstractions are, for example, blood pressure state (e.g. normal, high, low) and trend (e.g. increasing, decreasing and stationary) over time intervals. The goal of our work is to provide clinicians with automatic tools to extract high-level, concise, important features of available collections of time-stamped clinical data. This capability is especially important when the available collections constantly increase in size, as in long-term clinical follow-up, leading to information overload. The approach we propose exploits the integration of the deductive and object-oriented approaches in clinical databases. The main result of this work is an object-oriented data model based on the event calculus to support temporal abstraction. The proposed approach has been validated building the CARDIOTABS system for the abstraction of clinical data collected during echocardiographic tests.

Databases, Factual↗

PubMed2003

Influence of form structure on the anesthesia preoperative evaluation.

STUDY OBJECTIVE: To determine the impact of changes in form design on the capture of administrative and clinical data elements. DESIGN: Randomized retrospective chart review. SETTING: Academic health center. PATIENTS: Patients undergoing surgical procedures in the operating rooms at Medical College Hospital. INTERVENTION: The principal intervention was the implementation of a newly designed anesthesiology preoperative evaluation form with the intent to improve data capture. MEASUREMENTS: Charts were reviewed for the presence or absence of the following indicators: Addressograph Stamp, Proposed Surgery, Current Medications, Medication Doses/Frequency, Allergies, ASA Physical Status, Anesthesia Plan, Attending Note, and fasting (NPO) Status. MAIN RESULTS: Completion of Proposed Surgery and ASA Physical Status was lower for the structured form. Completion of Attending Notes was higher with the new form. Medication Doses were more often completed, but they remained below desired levels on the new form. CONCLUSIONS: Design of a form can have a significant impact on the completion rate of form elements. Visual cues such as a labeled space for medication doses may improve the completion of these elements. Design layout can also have an influence on completion. In this case, changes to the layout may have impeded the completion rate for ASA Physical Status.

Anesthesia↗

PubMed1998

Evaluation of an electronic hand-held spirometer in patients with asthma.

In this pilot study we assessed patient compliance and acceptability of data recorded in the home environment by asthmatics using a Vitalograph 2110 spirometer which measures peak expiratory flow rate (PEFR) and forced expiratory volume in 1 s (FEV1). This meter automatically time and date stamps all measurements and can also assess the technical acceptability of results. Data are uploaded to a personal computer for review and analysis. We recruited 30 patients (10 male and 20 female, age range 21-72 years) from the chest clinic at Guy's Hospital (n = 20) and from a GP clinic (n = 10). Patients were asked to record spirometry data using the meter at set times (8.00 a.m. and 8.00 p.m.) for 2 weeks. The spirometer incorporated an alarm to remind patients to take measurements. All patients completed the study. Mean (SD) compliance with spirometer use was 100.8% (49.9%). Nineteen patients had a compliance rate of between 80% and 120% of expected use. Timing of recordings was compared with the scheduled times of 8.00 a.m. and 8.00 p.m. Values recorded with +/- 2 h were judged as acceptable. For morning recordings 67.4% of all values and for evening recordings 71.7% of all values met this criterion. Technical acceptability of spirometry data was also assessed by using quality assurance criteria recorded by the spirometer. Valid tests were performed for 75.2% of all recordings. Twenty-two patients performed valid tests for 80-100% of the time. We suggest that the use of an electronic meter in the home environment is practical and is likely to generate more accurate and reliable data.

Adult↗

PubMed1995

Defining vascular nursing: a survey of vascular nurses.

For the purpose of defining the specialty of vascular nursing, a survey was sent to the nursing membership of the Society for Vascular Nursing. Nurses in all geographic locations were included, and the survey was accompanied by a self-addressed, stamped return envelope. A total of 873 nurses were surveyed. Respondents were encouraged to give the survey to other vascular nurses who were not members of the Society for Vascular Nursing. The initial mailing resulted in 276 responses. A second mailing provided an additional 224 responses for a total response of 500. Fifty-six of the 500 respondents (11.2%) were nonmembers. Response rate of members was 50.9% (444 of 873). Demographic information was obtained regarding age, years in nursing and vascular nursing, sex, employment type, and location. In addition to demographic information, the survey asked the respondent to identify a definition or definitions of vascular nursing. There was no restriction on space or content. In a small pilot study, "defining the specialty" was the only question asked. However, on the basis of responses to the pilot, the form was refined to request a description of the skills necessary to be a vascular nurse. A total of 73 definitions were identified on the basis of coded responses. The range in number of definitions given on any survey was 0 to 13. Essential skills listed by any one respondent ranged in number from 0 to 14. A total of 90 skills were identified. The purpose of this study is to identify the definitions of vascular nursing given by vascular nurses. In addition, the skills identified as necessary will be elaborated on.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1999

PROQUAD: accreditation program of the Brazilian society for clinical densitometry.

In 1996, the Brazilian Society for Clinical Densitometry (SBDens) developed an accreditation program to be applied to all densitometry centers, under the supervision of the certified physicians from SBDens. This program is named Programa Nacional de Qualidade em Densitometria (PROQUAD) and was developed to verify at least three aspects of the bone densitometry practice: the functioning of equipment, the methods used by technicians in performing the scans, and how the physicians are analyzing the scans and interpreting the results. From the 360 certified physicians who are members of SBDens, nearly one-third are participating in this program. The final purpose of PROQUAD is to provide approved centers with a seal, to be stamped on their examinations. The seal will signify to referring physicians, and the community, which centers are working under high standards of quality. It has been 2 yr since PROQUAD was established, and the data obtained confirm the improvement of quality in the practice of densitometry in Brazil. Any input from other societies that could improve PROQUAD is welcomed. Ensuring good densitometry practices is a goal for which all densitometry societies must strive.

Absorptiometry, Photon↗

PubMed2002

[Chemoradiotherapy in the adjuvant treatment of gastric adenocarcinomas: real progress?].

Frequency of local and distant failures after gastrectomy has led to extended lymph nodes dissection to obtain a better locoregional control. However, five year survival rates were not significantly different between patients undergoing D2 and D1 lymphadenectomy, and higher morbidity and post operative deaths were reported in large randomised trials (respectively 25% vs 48% and 4 vs 13%). Additionally, several metanalysis failed to demonstrate a significant survival advantage with adjuvant chemotherapy. The results of the first trial demonstrating one advantage to adjuvant post-operative chemoradiotherapy should modify the standard care. Disease free and overall survival after surgery alone and after surgery and concurrent chemoradiotherapy were respectively 31% vs 48% and 41% vs 50%. The intergroup trial demonstrate that better local control improve survival if radiation fields include stamps, tumour bed, proximal nodal chains and nodes corresponding to D2 extended lymph nodes dissection. Treatment was feasible with few severe toxic effects (1%). Of the 281 patients, 17% stopped treatment because toxic effects. Technical modalities of radiotherapy and post-operative nutrition support, which are critical points of interest for this treatment, are also discussed.

Adenocarcinoma↗

PubMed2003

Neural stem cell transplantation in cold lesion: a novel approach for the investigation of brain trauma and repair.

We developed a new neural transplantation protocol for the investigation of the repair of brain trauma. Cortical lesion was induced by touching a cold (-60 degrees C) metal stamp to the dura over the forelimb motor cortex of adult rats. The procedure caused a localized lesion and the animals developed a significant motor deficit, which was monitored throughout the protocol. Six days later the animals received embryonic neural stem cells in the penumbra of the lesion. The donor cells were freshly isolated from E14 rat embryos, had a high viability, and expressed the stem cell marker nestin. A further 6 days later the survival and differentiation of the grafted cells were investigated by immunohistochemistry. The majority of the surviving grafted cells were found in the lesion and they did not express lineage-specific markers. Only 10% of all surviving transplanted cells were located in the penumbra. These cells had an astrocytic phenotype and expressed glial fibrillary acidic protein. A few cells expressed neural or oligodendrocytic markers. In conclusion, we established a novel neural transplantation protocol, which focuses on cortical brain trauma. The model is a combination of surgical, neurological and histological approaches, all adapted to each other to make a reliable and reproducible experimental model.

Acridine Orange↗

PubMed2003

Temporal query of attribute-value patient data: utilizing the constraints of clinical studies.

We describe an interface and architecture for ad hoc temporal query of TrialDB, a clinical study data management system (CSDMS). A clinical study focuses primarily on the effect of therapy on a group of patients, who have individually enrolled in a study at different times. Relative times (chronological offsets from the time of enrollment) are therefore more useful than absolute times when collectively describing therapeutic or adverse events. For logistic reasons, study parameter values are typically recorded at fixed relative times ('study events'), which serve as time-stamps and can be used by CSDMS temporal query algorithms to simplify temporal computations. The entity-attribute-value model of clinical data storage, used by both CSDMSs and clinical patient record systems, complicates temporal query. To apply temporal operators, data for parameters of interest must first be transiently converted into conventional relational form, with one column per parameter.

Academic Medical Centers↗

PubMed2003

European data format 'plus' (EDF+), an EDF alike standard format for the exchange of physiological data.

The European data format (EDF) is a widely accepted standard for exchange of electroencephalogram and polysomnogram data between different equipment and labs. But it hardly accommodates other investigations. EDF+ is a more flexible but still simple format which is compatible to EDF except that an EDF+ file may contain interrupted recordings. Also, EDF+ supports time-stamped annotations for the storage of events such as text annotations, stimuli, averaged signals, electrocardiogram parameters, apnoeas and so on. When compared to EDF, EDF+ can not only store annotations but also electromyography, evoked potentials, electroneurography, electrocardiography and many more types of investigations. Further improvements over EDF include the use of standard electrode names. EDF+ is so much like EDF that existing EDF viewers still display the signals in EDF+ files. Software development is limited mainly to implementing the annotations. EDF+ offers a format for a wide range of neurophysiological investigations which can become a standard within a few years.

Data Interpretation, Statistical↗

PubMed2001

Food shopping practices are associated with dietary quality in low-income households.

ABSTRACT Nutrition education for low-income audiences often focuses on building skills in food shopping and food resource management to help families receive the best nutrition from the resources they have available. However, empirical evidence for the effect of food shopping practice on dietary quality has been limited. This article presents new analyses from two studies that found an association between food shopping practices and diet quality. Logistic regression of data from 957 respondents from the 1996 National Food Stamp Program Survey found that food shopping practices were significantly (p </= .05) associated with the availability of nutrients in the food the households used during a week. Similarly, analysis of baseline data from 5159 women from selected counties of states who participated in the Expanded Food and Nutrition Education Program found that food shopping practices were significantly (p </= .05) associated with increased consumption of nutrients as measured through a single 24-hour recall. These findings suggest that food shopping practices are an important area for nutrition education with low-income audiences.

Diet↗

PubMedDate not supplied

Consumption and perceptions of soy among low-income adults.

OBJECTIVE: To assess the consumption and perceptions of soy among low-income adults. DESIGN: A survey, which included demographic items, Likert scales for items on perceived benefits and barriers to soy consumption and factors that may increase soy consumption, and a soy food consumption frequency questionnaire. SUBJECTS/SETTING: A convenience sample of 353 adults enrolled in either the Pennsylvania Expanded Food and Nutrition Education Program or the Pennsylvania Food Stamp Nutrition Education Program. STATISTICAL ANALYSES: Descriptive statistics. RESULTS: Few participants (13%; n = 44) reported currently consuming soy foods. The percentage of respondents recognizing potential health benefits of soy ranged from 53% to 57%. The major barriers to soy consumption were a lack of knowledge on how to use soy (87%), cost (55%), and unavailability (45%). Participants indicated that education on how to use and incorporate soy into the diet (88%) and addition of soy into familiar foods (82%) may increase their soy consumption. APPLICATIONS/CONCLUSIONS: The findings suggest that this population would benefit from exposure to soy foods and instruction on preparing low-cost soy foods that can easily be included in their diet, in addition to education on the potential health benefits of soy foods. The results may provide direction for the development of curricula that educate this population on the potential benefits and uses of soy.

Cooking↗

PubMedDate not supplied

Development of a tool to assess psychosocial indicators of fruit and vegetable intake for 2 federal programs.

OBJECTIVE: Development of an evaluation tool of psychosocial constructs for use by participants in 2 federal programs, Food Stamp Nutrition Education and the Expanded Food and Nutrition Education Program. DESIGN: Cross-sectional data from a longitudinal study. PARTICIPANTS: Limited-resource women (n = 111) living in low-income communities. MEASURES: Test-retest reliability, internal consistency, ethnic differences, convergent validity. ANALYSIS: Spearman rank order correlation, analysis of variance, principal components analysis. RESULTS: Reliability coefficients ranged from a low of r = .18 (not significant) to r = .74 (P < .0001). Two items were deleted for not meeting criteria for reliability and 2 for redundancy. Ethnic differences at baseline were significant for 1 item. Domain constructs loaded on 4 to 5 factors for the biopsychosocial framework. Estimates of convergent validity of 9 constructs led to the deletion of 3 (ie, perceived barriers, social support, and perceived norms), with retention of perceived benefits, perceived control, self-efficacy, readiness to eat more fruit, readiness to eat more vegetables, and perceived diet quality. As an estimate of convergent validity, the final version of the tool with 6 constructs remaining showed significant correlations with indicators of diet quality: serum carotenoid values (r = .38, P < .001); hypothesized nutrients calculated from the mean of 3 24-hour dietary recalls (vitamin C, r = .47, P < .0001; vitamin A, r = .39, P < .0001; folate, r = .37, P < .0001; beta-carotene, r =.31, P < .001; and fiber, r = .46, P < .0001); fruit and vegetable servings (r = 0.55, P < .0001); Healthy Eating Index (r = .27, P < .05); and a fruit and vegetable behavioral scale (r = .60, P < .0001). CONCLUSION AND IMPLICATIONS: This systematic process yielded a fruit and vegetable evaluation tool useful for practitioners and researchers. This is the first validation study of this type to estimate convergent validity with 5 indicators of diet quality, including a biomarker.

Adult↗

PubMedDate not supplied

A logic model framework for community nutrition education.

Logic models are a practical method for systematically collecting impact data for community nutrition efforts, such as the Food Stamp Nutrition Education program. This report describes the process used to develop and test the Community Nutrition Education Logic Model and the results of a pilot study to determine whether national evaluation data could be captured without losing flexibility of programming and evaluation at the state level. The objectives were to develop an evaluation framework based on the Logic Model to include dietary quality, food safety, food security, and shopping behavior/food resource management and to develop a training mechanism for use. The portability feature of the model should allow application to a variety of community education programs.

Consumer Product Safety↗