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PubMed1991

Prevention of stroke--a report from collaboration project between Zagreb and Barcelona.

Cerebrovascular disease (CVD) is the main killer in the modern society and the most frequent cause of death and disability. According to the experiences of highly developed Western countries, especially of the U.S.A., the incidence of stroke can be reduced by the development and introduction of preventive actions and change of life style. Incidence of cerebrovascular disease is high in Croatia as well as in Spain (46% in the 46-59 age range) with an increasing tendency in younger population. As prevention is the only way of CVD incidence reduction, it is indispensable to organize an integral preventive neurologic network. Within the W.H.O. project "Health for All by the Year 2000 and the project "Zagreb"--Healthy City" a preventive action under the slogan 'With perfect brain and veins--enjoy the healthy days', has been organized with the aim to reduce the incidence of stroke for 20% during the following 10-year period. A standardized work of preventive network in Zagreb has also been established in Barcelona as a joint work. Using the interdisciplinary counselling approach, medical teams are still making examinations. In Zagreb Center for Neurological Sciences and Brain Research, data of risk factor distributions and trends of stroke incidence changes have been collected and the results have been analyzed. The Zagreb Center has also become a center for continuous evaluation and further planning. In this article functions of preventive centers, the preventive standardized protocol and structural and functional preventive network are introduced. The results of preventive action in Zagreb are also briefly presented.

Aged↗
PubMedDate not supplied

Fracture mechanics principles applied to implant medical devices--a review.

Historically, the fatigue behavior of materials and structures, including biomaterials and implant devices, was analyzed using stress-life (S-N) techniques, i.e. by determining the number of cycles to failure at a calculated peak stress. The development of fracture mechanics technology has made the crack-growth aspect of fatigue analysis a more exact science, providing more precise data on the properties of materials, incorporating more geometric and metallurgical information from the structure, and, in some cases, providing for updated in-service lifetime predictions. Over the past decade, the medical implant industry and researchers have adopted this analytical tool to varying degrees. The result has been the development of some improved materials, operative procedures, and devices, based on a more exact knowledge of the properties most critical to assuring the long-term durability of devices. Examples of the application of fracture mechanics technology to orthopedic and cardiovascular devices and the potential for further applications are reviewed.

Biomechanical Phenomena↗
PubMed1987

Homicide by insulin administration.

This report describes a case of homicide by insulin administration and a study of the effects of storage conditions on insulin in serum. The study revealed insulin to be remarkably stable at refrigerator temperatures. Therefore, for forensic science purposes, insulin immunoassay data are interpretable even when serum is not stored by the standard laboratory method of freezing.

C-Peptide↗
PubMed1987

A comparison of three allied health manpower projection methodologies.

Three manpower projection methodologies most often employed in the allied health sciences were compared: population ratio, occupational matrix, and regression analysis. Comparisons were made among the methodologies themselves, their strengths, and their weaknesses. These methodologies were then applied to the largest allied health discipline - clinical laboratory sciences - using Kentucky statewide data. The resultant projections were then compared with actual data (F.J. Morris, PhD, unpublished data, 1985). The most appropriate methodology to be used by the administrator should be determined by his/her specific needs and goals in relation to the specific strengths and weaknesses of the individual methodology.

Allied Health Personnel↗
PubMed1979

Searching the MEDLARS file on NLM and BRS a comparative study.

A comparison of the MEDLARS data base as it is currently available from the National Library of Medicine and Bibliographic Retrieval Services (BRS), Inc., is presented in chart format, and some major capability differences between the two systems are highlighted. The information inlcuded justifies the dual availability of the data base in health sciences libraries. This paper is intended for searchers and others familiar with one or both systems. Administrators considering the acquisition of the BRS system may find the study useful.

MEDLARS↗
PubMedDate not supplied

Behavioral science in family medicine residencies: Part I. Teachers and curricula. The STFM Task Force on Behavioral Science.

A survey was conducted of all members of the Society of Teachers of Family Medicine to describe teachers, curricula, and teacher satisfaction in family medicine residency behavioral science education. The response rate was approximately 60% of eligible individuals. Family medicine teachers divide themselves into behavioral scientists, family physicians, both, program directors, and other faculty members. Behavioral scientists are most often psychologists or social workers, have been teaching family medicine a relatively short time, and are more likely to be female than the other groups. Behavioral science curricula emphasize counseling, interviewing, and family dynamics. Satisfaction with behavioral curricula is high.

Behavioral Sciences↗
PubMedDate not supplied

Behavioral science in family medicine residencies: Part II. Teacher roles, relationships, and rewards. The STFM Task Force on Behavioral Science.

A survey of members of the Society of Teachers of Family Medicine provided information about roles, relationships, and rewards for teachers involved in family medicine residency behavioral science education. Family physicians and behavioral scientists perceive their own roles in behavioral teaching and patient care as greater than is perceived by the other group. All groups of respondents see a continued need for collaborative behavioral teaching, patient care, and research. Interpersonal rewards reported emphasize family physicians learning from behavioral scientists. Frustrations reflect personal style, use of jargon, and a sense that the other group does not understand important aspects of one's work. Income is markedly greater for family physicians than behavioral scientists. Most behavioral scientists responding plan to remain in family medicine teaching.

Behavioral Sciences↗
PubMed1973

MEDLARS II: a review.

The MEDLARS II effort, as it was developed until June 1971, is reviewed in terms of the overall planning process. How MEDLARS I was approached by NLM is discussed first and its objectives used for comparison. Certain technical, managerial, and intellectual aspects are outlined as types of problems encountered in designing MEDLARS II. While improvement upon the MEDLARS I seemed to be the main reason for planning a MEDLARS II, objectives became blurred and divergent as the project went along. The complexities of creating a central computerized data base of health sciences bibliographic information and library functional activities for nationwide use were underappreciated and remain a challenge to NLM.

Computers↗
PubMed1984

The participant-observer approach to research in mental retardation.

Participant-observation, which calls for long-term immersion in the world of the persons being studied yet disciplined detachment from that world, has long been utilized in various social sciences. This method of data collection was seldom used in the study of mentally retarded people until recent years; however, it has now been employed in the study of many aspects of the lives of these people and their families. Although this method of research is expensive and time consuming, it has the advantage of allowing investigators to learn how people actually behave in a variety of contexts and to grasp the meaning these activities have for them.

Activities of Daily Living↗
PubMed1992

Factors influencing research productivity among health sciences librarians.

Secondary analysis was performed of data collected in 1989 from a random sample of members of the Medical Library Association. Results show that about half the sample had at least one publication; academic health sciences librarians were much more likely than hospital librarians to have published. Almost half the sample had taken formal courses in research, but only a small percentage had taken continuing education (CE) courses in research. Institutional support services for research were most available in academic settings. The combination of institutional support, CE training, and research courses explained 31.1% of the variation in research productivity among academic librarians; these factors were less important in hospitals and other institutional settings. The authors suggest that health sciences librarians working outside academia should seek support for research from sources outside the employing institution.

Humans↗
PubMedDate not supplied

[Report on obstetrical activity during the triennium 1985-1987. 4th Obstetrics and Gynecology Clinic, University of Milan, Institute of Biomedical Sciences, S. Gerardo Hospital, Monza].

The data of three years of activity (1985-1987) at the 4th Obstetrics and Gynecology Department of the University of Milan, S. Gerardo Hospital in Monza, for a total of 5595 deliveries and 5672 new-borns are reviewed. Each case of perinatal death has been evaluated for gestational age, weight, way of delivery and preexisting or pregnancy-induced maternal diseases, trying to single out the primary causes of death. In order to compare these data with the ones of the previous three years the results have been divided, following the gestational age, in two groups (less or more and equal than 28 weeks). Late perinatal death rate (including all the babies older than 24 weeks of gestational age, still-born or live-born and dead within the 28th day of life) has been 1.8%, compared to the 2.1% in the previous 3 years. Obstetrical procedures and neonatal outcomes are analyzed in depth. Puerperium was pathological in 8.9% of patients. Only 4.2% of women decided not to breast-fed their babies.

Adult↗
PubMed1990

Outpatient planning: still more art than science?

A general lack of comprehensive data on ambulatory care isn't preventing hospitals from engaging in high-quality planning in that area. "A good forecast" for future ambulatory care demand depends mainly on a "thoughtful determination of what needs to be forecasted and why," says Andrew McCulloch, chief operating officer at Harborview Medical Center, Seattle. The rapid pace of outpatient development has led some hospitals to invest a great deal of time and money to develop improved information systems. Those hospitals are heeding the statistical trends: Outpatient revenue grew far faster than inpatient did in 1990.

Ambulatory Surgical Procedures↗
PubMed1990

Setting human-health-based groundwater protection standards when toxicological data are inadequate.

Toxicological data are not adequate to assess fully the health effects of many of the pesticides that currently contaminate or have the potential to contaminate groundwater. The National Academy of Sciences estimated in 1984 that data to conduct a complete health hazard assessment exist for only 10% of the pesticides currently on the market. Many pesticides have not been tested for their ability to cause cancer, genetic mutation, or birth defects. There are significant gaps in the toxicological data base for the majority of pesticides for which the Environmental Protection Agency proposed health advisories in 1987. To help assure that groundwater standards are adequately protective of human health when toxicological data are not adequate, additional uncertainty factors can be incorporated into such standards. Alternatively, standards can be set at the level of detection. This should be the approach when no data exist to assess major potential health effects. For example, the detection limit could be the standard if no adequate oncogenicity studies have been conducted. In addition, generic standards may be employed when data are inadequate to set chemical-specific standards. New York State has recently taken this innovative generic standard approach.

Databases, Factual↗
PubMed1992

Reporting of highly individual genetic typing results: a practical approach.

This paper considers the interpretation of serological typing data as a problem in forensic science, as opposed to a problem in population genetics or statistics. Controversies arising in this area are partly due to an overly narrow perspective that ignores basic forensic science principles. After an initial discussion of the special problem that deoxyribonucleic acid (DNA) blood typing poses to forensic science, the three difficulties common to all the proposed interpretive methods are discussed. These are: predicting genotype incidence from allele frequencies, predicting frequencies for the joint occurrence of genotypes in a number of different genetic marker systems, and determining the appropriate population to use to measure the frequencies. The inability to test assumptions that are inherent in our routine methods is noted. This is a procedural weakness that unnecessarily limits the admissibility of DNA typing evidence in court. A practical solution to this problem is offered that begins with minimal assumptions. Initially a statement is made based on (1) how many reference samples the laboratory has typed and (2) how many of these samples show genotypes corresponding to the case samples. The second stage of the presentation begins with a statement that additional assumptions are necessary to fully interpret the evidence and that although these assumptions are scientifically very reasonable, they cannot be absolutely proven. The presentation can then proceed, if desired, to consideration of the specific assumptions and frequency estimates of any of the methods that have been proposed to date. To follow this approach population data must be kept in a form that allows the simple first-stage statement to be made. This means that each individual's record would include typing results in each genetic marker system. Although this method of data storage differs from that used in most forensic science laboratories, it is exceptionally versatile, and allows great flexibility in data analysis.

Alleles↗
PubMed1992

Oxygen toxicity.

OBJECTIVE: The objective of this article is to provide an overview of the biochemistry of oxygen metabolism, including the formation of free radicals and the role of endogenous antioxidants. Pathophysiologic correlates underlying the clinical manifestations of oxygen toxicity are reviewed and management strategies are outlined. DATA SOURCES: References from basic science and clinical journals were selected from the authors' files and from a search of a computerized database of the biomedical literature. STUDY SELECTION: Articles selected for review included both historical and current literature concerning the biochemistry and pathophysiology of oxygen toxicity in animals and humans. DATA SYNTHESIS: The benefits of oxygen therapy have been known for many years; however, its potential toxicity has not been recognized until the last two decades. The lungs, the eyes, and, under certain conditions, the central nervous system are the organs most affected by prolonged exposure to hyperoxic environments. Free radical formation during cellular metabolism under hyperoxic conditions is recognized as the biochemical basis of oxygen injury to cells and organs. Endogenous antioxidants are a primary means of detoxifying reactive oxygen species and preventing hyperoxia-induced cellular damage. When this defense fails or is overwhelmed by the excessive production of hyperoxia-induced free-radical species, distinctive morphologic changes occur at the cellular level. The amount of hyperoxia required to cause cellular damage and the time course of these changes vary from species to species and from individual to individual within the same species. Age, nutritional status, presence of underlying diseases, and certain drugs may influence the development of oxygen toxicity. CONCLUSIONS: There is currently no reliably effective drug for preventing or delaying the development of oxygen toxicity in humans. Use of the lowest effective oxygen concentration, the avoidance of certain drugs, and attention to nutritional and metabolic factors remain the best means currently available to avoid or minimize oxygen toxicity. Research is continuing into more effective ways to prevent, diagnose, and treat this disorder.

Animals↗