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At least 1,603 records · Page 89Linked to original sources

PubMed1996

Reducing the lifetime risk of cancer from spinal radiographs among people with adolescent idiopathic scoliosis.

STUDY DESIGN: Data from a retrospective cohort study of people with adolescent idiopathic scoliosis were combined with information on full-spinal radiographs to estimate contemporary x-ray doses and lifetime risks for development of cancer. OBJECTIVES: To project the lifetime risk for development of cancer from diagnostic radiographs for people with adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Although a twofold excess risk for breast cancer has been reported for women treated for scoliosis between 1925 and 1965, information on the cancer risks associated with scoliosis management today is sparse. Specifically, there is a lack of up-to-date information on the number of spinal radiographs taken, the organ-specific x-ray doses from current radiographic techniques, and the projected cancer risks. METHODS: The cohort consisted of subjects with adolescent idiopathic scoliosis who were referred to the scoliosis clinic of a large pediatric hospital between 1965 and 1979 in Montreal, Quebec, Canada. Based on radiographic equipment and practices implemented in 1982, organ-specific x-ray doses to the thyroid gland, female breast, respiratory organs, digestive organs, and bone marrow were calculated using Monte Carlo methods. These doses were incorporated into a life table procedure to calculate theoretic lifetime cancer risks. For all organs except the thyroid gland, dose-response models from the United States National Academy of Sciences Fifth Committee on the Biological Effects of ionizing Radiation were used. For thyroid cancer, a risk model was derived from a study of thyroid cancer incidence after x-ray treatment for tinea capitis. RESULTS: The average number of spinal radiographs was 12 for women (80% anteroposterior or posteroanterior) and 10 for men (78% anteroposterior or posteroanterior). Cumulative x-ray doses were in general higher in adolescents who were referred as younger teenagers than at later ages, and doses increased with the size of the spinal curve. Depending on the age at referral and curve size, the total excess lifetime cancer risks were calculated to range from 42 to 238 cases per 100,000 women and 14 to 79 cases per 100,000 men. For subjects who underwent surgery (those exposed to the highest doses), the lifetime number of cancer cases over and above background was almost as great as the number of thyroid cancers that would occur in the absence of radiation exposure. If the anteroposterior view was replaced by the posteroanterior view, a three- to sevenfold reduction in cumulative doses to the thyroid gland and the female breast would be achieved, yielding three- to fourfold reductions in the lifetime risk of breast cancer and a halving of the lifetime risk of thyroid cancer. CONCLUSIONS: The cancer risks from full-spinal radiographs for scoliosis are not negligible and can be reduced from one half to three quarters if the anteroposterior view is replaced with the posteroanterior view.

Adolescent↗

PubMed2005

Combating child homicide: preventive policing for the new millennium.

High-profile media coverage of crimes against children has heightened public awareness of critical child safety needs and issues. However, numerous research studies in the area of child homicide have illustrated the importance of the power of science to correct false perceptions and misinformation, improving how to best serve and protect our children. Age-based analyses of childhood crime patterns have vastly improved how law enforcement and social service practitioners identify, investigate, and resolve child victimization cases. Future protective efforts must involve multiagency and multidisciplinary collaboration. Law enforcement, social service clinicians, educators, and academicians should jointly develop and implement pragmatic and effective prevention, detection, and resolution programs and policies.

Child↗

PubMedDate not supplied

Women in science, engineering and technology (SET): a report on the Indonesian experience.

This paper presents the preliminary results of a study by the Gender Working Group, Indonesian Institute of Sciences, on women's contribution to, and benefits to women from, science, engineering and technology (SET), specifically the benefits accruing to disadvantaged women in urban and rural areas in Indonesia. Previous studies on the participation of women in SET have shown the under-representation of women in all SET activities, including decision-making and advisory positions. However, some studies have shown that if gender perspectives are included in the design and implementation of development activities, disadvantaged women in urban and rural areas could greatly benefit from SET in development projects. The two case studies in North Sulawesi and Central Lombok provinces show that the projects have enabled the expansion of employment opportunities for women and thus increased their technical skills and income. In addition, the projects have also contributed to enhancing women's self-confidence, self-reliance and communication skills.

Asia↗

PubMed2005

Ethics in the trenches: a multifaceted analysis of the stem cell debate.

The increasing understanding of stem cell biology has opened up the possibility of using cell transplantation to treat a large variety of diseases. The medical need to identify optimal therapies is being challenged, however, by some members of society who seek to impose on this scientific quest their views--generally associated with particular religious beliefs--of what constitutes allowable research. This conflict mirrors earlier battles, extending over 150 years, between those implementing inoculation and vaccination to protect against smallpox and those who felt this to be unethical for religious reasons. For the many individuals who might benefit from the potential of stem cell medicine, such prolonged debate is unacceptable. In this review, conflicts in this debate are examined by holding opponents of embryonic stem cell (ESC) research to the standards applied to the science. The challenge of identifying optimal cells for tissue repair is juxtaposed with misrepresentations of stem cell science by those opposed to ESC research. Absolutist views on ethics are juxtaposed with examples of the bad science and unethical acts that occur when dogmatic religious filters and definitions of human-ness are forced upon scientific discussions. Finally, after considering how opponents of ESC research may, ironically, enhance commercial demand for cells derived from fetuses aborted for personal reasons of the mother, 10 proposals are offered that would--if followed by all participants in this debate--produce more ethically balanced discussions and a more comprehensive body of data from which evidence-based conclusions can be drawn.

Bioethical Issues↗

PubMed1988

Setting AIDS priorities: the need for a closer alliance of public health and clinical approaches toward the control of AIDS.

The approach to the acquired immune deficiency syndrome (AIDS) taken by public health departments and clinicians varies. Public health programs often neglect the human side of AIDS while clinicians often overlook public health issues. Current research on AIDS has failed to address many fundamental questions including: the biology of the human immunodeficiency virus (HIV) in semen; whether present antiretroviral therapy has any effect on sexual infectivity; and whether adequate counseling was given to persons in HIV discordant partner studies. These unanswered basic questions highlight how research efforts framed from clinical, basic science, or public health viewpoints may have too narrow a focus. Three suggestions are made: 1) additional studies about the biology of HIV in the genital tract need to be conducted; 2) clinical trials studying drug therapy of HIV infection need to assess effect on HIV in the genital tract; 3) clinicians involved in studies and care of HIV infection need to implement educational strategies minimizing transmission of HIV from their patients. More interaction between public health and clinical approaches toward AIDS is needed.

Acquired Immunodeficiency Syndrome↗

PubMed2002

Psychological distress of cancer and clinical trial participation: a review of the literature.

The House of Commons Select Committee on Science and Technology 2000 state that currently less than 5% of adult patients with solid tumours are entered into clinical trials. They recommend that increasing the number of adult cancer patients entering clinical trials must become a high priority. Health-care providers need to prepare themselves for this proposed increase in trial participants by assessing the current status of care and implementing changes within the current infrastructure to provide optimal holistic care. Cancer can change a patient's life either for better or for worse. At one extreme, having cancer leads to enhanced appreciation of life and closer bonds with others. However, at the other extreme, cancer combined with its treatment is viewed as an event that evokes distress and emotional anguish taxing the individual's ability to cope. In the last 25 years, owing to the advent of clinical trials, progress has been made in cancer treatment. Clinical trials may be hailed as the saviour to many therapeutic dilemmas. Treatments are now available which can offer patients hope of cure. Nevertheless, many participants may fear, for the purpose of research, that they may be assigned to less than optimal therapy or that their care will be carried out in a sterile scientific atmosphere devoid of humane and personal consideration. These and other reasons may cause unacceptable personal distress that overrides the potential therapeutic gain. Cancer diagnosis coupled with the ramifications of clinical trial involvement can have significant psychological implications. They may trigger the onset of a mood disorder or exacerbate a present symptom. This article will identify mood disorders in the cancer population, focus on the participants' needs in the clinical trial arena and investigate the influence trial participation has on psychological status.

Anxiety↗

PubMed1997

Common ground: the HealthWeb project as a model for Internet collaboration.

The establishment of the HealthWeb project by twelve health sciences libraries provides a collaborative means of organizing and enhancing access to Internet resources for the international health sciences community. The project is based on the idea that the Internet is common ground for all libraries and that through collaboration a more comprehensive, robust, and long-lasting information product can be maintained. The participants include more than seventy librarians from the health sciences libraries of the Committee on Institutional Cooperation (CIC), an academic consortium of twelve major research universities. The Greater Midwest Region of the National Network of Libraries of Medicine serves as a cosponsor. HealthWeb is an information resource that provides access to evaluated, annotated Internet resources via the World Wide Web. The project vision as well as the progress reported on its implementation may serve as a model for other collaborative Internet projects.

Computer Communication Networks↗

PubMed1996

WHO program on emerging virus diseases.

Infectious diseases, and especially viral diseases, are important, evolving complex public health problems. Their ultimate prevention and control will increasingly require sophisticated interaction between epidemiologic resources, molecular expertise, and application of modern statistical tools. The integration of epidemiologic and laboratory sciences is central to the success of a coordinated approach to new, emerging and re-emerging infectious diseases, and the WHO is attempting to facilitate and strengthen these resources internationally by focusing on improved surveillance, infrastructure building, applied research, and improved prevention and control strategies. Reference virus laboratories, especially those that deal with exotic virus diseases, will play a key role in implementation of the program, since these laboratories are likely to be called upon to assist in the identification of new, emerging, or re-emerging diseases. Thus, ensuring that these laboratories are well prepared to perform their critical tasks is essential to the ultimate success of the program.

Biometry↗

PubMed2003

Effectiveness of a TEOAE-based screening program. Can a patient-tracking system effectively be organized using modern information technology and central data management?

It has been shown that detecting and treating children with hearing loss at an early age will improve their speech and language development. The implementation of universal hearing screening programs is therefore one of the major goals in pediatric audiology. One problem of present screening programs is high lost to follow-up rates. The aim of this paper was to evaluate the effectiveness of a patient tracking system based on central data management and data transmission via the internet. The screening program was organized as a TEOAE (transitory evoked otoacoustic emissions)-based three-stage procedure and covered a complete German federal state (Saarland). The measurements of the first stage took place in well-baby nurseries (WBNs) as well as neonatal intensive care units (NICUs). Measurements of the second stage were performed by pediatricians and ENT physicians on an outpatient basis. The third stage comprised diagnostic ABR (auditory brainstem response) measurements performed by pediatric audiologists. Using a central data management system we were able to identify and follow every child not screened or with negative results. The overall coverage in the first stage was 93% of all newborns. A screening result of the second stage could be obtained for 90% of the children. Four out of 3,830 children screened turned out to have a relevant hearing loss and were fitted with hearing aids. A TEOAE-based newborn hearing screening system can be organized effectively. Central data management as well as interdisciplinary organization of the follow-up are important prerequisites for the success of a hearing screening program. A follow-up system as proposed in this paper can also be implemented in AABR (automated auditory brainstem response)-based programs.

Database Management Systems↗

PubMed2006

Does federal policy support the use of scientific evidence in school-based prevention programs?

Since 1998, federal policy has explicitly required the use of "evidence-based" prevention programs in schools. We review how this policy has been implemented through state recipients of the Safe and Drug Free Schools (SDFS) Program, and how other federal and private agencies have supported the policy by providing guidance about the scientific evidence for specific programs' effectiveness. We report data from a survey of SDFS state office directors, and we compare and contrast the most popular lists of effective programs. State offices supply the infrastructure for administering the SDFS Program, providing technical assistance to local school districts, monitoring the implementation of federal policy at the local level, and determining funding eligibility based on compliance. We found that states rely heavily on federal lists to determine whether school districts are meeting federal policy requirements, particularly the National Registry of Effective Programs and Practices (NREPP). Both SDFS and NREPP are changing, however, and the changes do not bode well for the transfer of prevention science to schools. Conclusions and recommendations are presented.

Data Collection↗

PubMed2005

Re-engineering the process of medical imaging physics and technology education and training.

The extensive availability of digital technology provides an opportunity for enhancing both the effectiveness and efficiency of virtually all functions in the process of medical imaging physics and technology education and training. This includes degree granting academic programs within institutions and a wide spectrum of continuing education lifelong learning activities. Full achievement of the advantages of technology-enhanced education (e-learning, etc.) requires an analysis of specific educational activities with respect to desired outcomes and learning objectives. This is followed by the development of strategies and resources that are based on established educational principles. The impact of contemporary technology comes from its ability to place learners into enriched learning environments. The full advantage of a re-engineered and implemented educational process involves changing attitudes and functions of learning facilitators (teachers) and resource allocation and sharing both within and among institutions.

Biomedical Engineering↗

PubMed2005

Phase contrast and DIC illumination for AFM hybrids.

High-resolution optical microscopy is an essential pre-requisite for life science force microscopy, particularly for applications in cell biology and medicine. Identification and validation of cells is typically established with techniques like phase contrast microscopy or differential interference contrast microscopy. The option to select or monitor individual cells online with such light microscopy techniques while performing atomic force microscopy (AFM) measurements is therefore extremely beneficial. Here, we report two conceptually different strategies to implement these light microscopy techniques in a fully functional AFM head at the ultimate resolution of the Abbe diffraction limit.

Epithelial Cells↗

PubMed2002

[The SGB IX, book 9 of the German social code, in the development of social security law].

The SGB IX is the legal basis of rehabilitation in Germany since 2001. It is embedded in the codification of the German social code, the Sozialgesetzbuch (SGB). There it has an intermediate function between the general social law and the special laws of the social insurance and social security institutions. Rehabilitation in Germany is working in a system of several different institutions with different legal roots. In special these are compensation of damages caused by employment accident and war and the avoidance of disability benefits by rehabilitation and activation. Inequality of treatment of disabled people according to the cause of their disability and to their employment status are accepted less; common principles of rehabilitation are being searched. Important reforms of rehabilitation law have taken place in 1974 and 1975. Since then problems have become visible in implementation and in the coordination of the complex system. SGB IX is a new effort for a general rehabilitation law. Open questions remain in handling the relations between rehabilitation and sickness treatment, long term care and prevention. Important are the newly defined terms for participation (Teilhabe) and disability (Behinderung), which build the linkage of SGB IX with constitutional law and with the health sciences. A weak point is still the relation of disability and age. Political attempts for unequal benefits in health insurance endanger the now reached level of rehabilitation law.

Disability Evaluation↗

PubMed1992

Industrial ecology: concepts and approaches.

Industrial ecology is a new approach to the industrial design of products and processes and the implementation of sustainable manufacturing strategies. It is a concept in which an industrial system is viewed not in isolation from its surrounding systems but in concert with them. Industrial ecology seeks to optimize the total materials cycle from virgin material to finished material, to component, to product, to waste product, and to ultimate disposal. To better characterize the topic, the National Academy of Sciences convened a colloquium from which were derived a number of salient contributions. This paper sets the stage for the contributions that follow and discusses how each fits into the framework of industrial ecology.

Journal Article↗

PubMed2003

Patient information letters on nutrition: development and implementation.

BACKGROUND: In 1998 the Dutch College of General Practitioners (NHG) began developing patient information letters (PILs), based on the practice guidelines for family physicians (FPs) (NHG standards). Five nutritional guidance letters have since been developed with the Dutch Nutrition Center. METHODS: In August-September 2001 a survey was done among a random sample of 200 FPs who subscribe to the PILs. They received a questionnaire about the use and implementation of the PILs in general, and about the nutrition letters specifically. RESULTS: Responses were received from 133 FPs (67%). Of these FPs, 89% use the PILs in their practice. Only 5% of FPs say that they use the PILs on nutrition sufficiently; 32% think they should use them a bit more, whereas 63% make much too little use of the nutrition letters. The most important barriers for using the letters are that FPs do not think about them at the right moment (66%), do not know the content enough (32%), find that using them is too time-consuming (29%), have computer problems (17%), and have too little knowledge about nutritional advice (11%); only 6% do not see dietary advice as an FP's task. The most important reason for not using the nutrition letters is the fact that the letters are not integrated into their FP information system (23%). CONCLUSIONS: Implementation of PILs takes time, and there are great advantages to integrating them into the existing Family Practice Information Systems.

Cholesterol↗

PubMed2001

From strategy to reality: 25 years of planning and progress in occupational injury research.

Injury as a major public health problem, although noted as early as the 1930s, was not widely accepted by the public health community until the 1980s. Over recent decades, there have been a number of strategic plans developed to prevent and control occupational injuries. These plans have been remarkably consistent in that many of the same recommendations surfaced despite different planners from different eras. The recommendations also generally align with the steps in the public health approach. Although recognition of the relevance of the public health approach to traumatic occupational injury came decades ago, significant barriers have inhibited its full implementation. Today, these barriers are being overcome, due to improved surveillance, increased collaborations among disciplines, increasing partnerships with industry, improved prevention evaluation methods, cost analysis models, and increasing funding. Of course, many of the experiences in the United States are paralleled in other countries in the Western world, and even in some developing countries. Substantial progress has been made in recent years in identifying problems and developing solutions, in addressing the recommendations of decades of planning, and of building the scientific foundation necessary to guide prevention. As a result, traumatic occupational injury research must begin to increase focus on bringing the public health process full circle, including the implementation and evaluation of preventive strategies and interventions. Now, the final steps of the process need our attention-evaluating the effectiveness of these solutions and then getting knowledge and products onto the shop floor, the construction site, and the farm, the convenience store, and the delivery truck; getting effective prevention into the workplace. Now is the time to close the loop, from science to prevention.

Humans↗

PubMed2003

A method of moments technique for fitting interaction effects in structural equation models.

The desire to fit structural equation models containing an interaction term has received much methodological attention in the social science literature. This paper presents a technique for the cross-product structural model that utilizes factor score estimates and results in closed-form moments-type estimators. The technique, which does not require normality for the underlying factors, was originally introduced in a very general form by Wall and Amemiya (2000) for any polynomial structural model. In this paper, the practical implementation of this method, including standard error estimation, is presented specifically for the cross-product model. The procedure is applied to an example from social/behavioural epidemiology where the flexibility of the cross-product model provides a useful description of the underlying theory. A simulation study is also presented comparing the method of moments for the cross-product model with three other procedures.

Humans↗

PubMed1998

Information science for the future: an innovative nursing informatics curriculum.

Health care is increasingly driven by information, and consequently, patient care will demand effective management of information. The report of the Priority Expert Panel E: Nursing Informatics and Enhancing Clinical Care Through Nursing Informatics challenges faculty to produce baccalaureate graduates who use information technologies to improve the patient care process and change health care. The challenge is to construct an evolving nursing informatics curriculum to provide nursing professionals with the foundation for affecting health care delivery. This article discusses the design, implementation, and evaluation of an innovative nursing informatics curriculum incorporated into a baccalaureate nursing program. The basic components of the curriculum framework are information, technology, and clinical care process. The presented integrated curriculum is effective in familiarizing students with informatics and encouraging them to think critically about using informatics in practice. The two groups of students who completed the four-course sequence will be discussed.

Computer Systems↗