Medical Field (medical + field)

Distribution by Scientific Domains


Selected Abstracts


Increasing practice nurse access to alcohol training

DRUG AND ALCOHOL REVIEW, Issue 3 2002
ANN DEEHAN
Abstract Policy makers have repeatedly placed emphasis on the role of primary care in screening for at-risk alcohol consumption and delivering public health messages to the general population. Research has pointed to primary care staff holding negative attitudes towards alcohol misusing patients. Training has traditionally been seen as the key to increasing the capacity of the medical field to engage with alcohol misusing patients but little work has been undertaken to examine the potential barriers to training take up. Consequently, the aim of this study was to explore the willingness of practice nurses to be trained in alcohol screening and brief intervention, and whether identifiable barriers to training exist and how they may be overcome. All practice nurses (n = 82) in an outer London (UK) Health Authority Area were twice mailed an invitation to an alcohol training seminar and a telephone invitation was made to all of those who did not reply to the mailings. Those who did not attend (n = 66) were contacted to take part in a short structured telephone interview ,89% (59/66) were contacted successfully and interviewed. Respondents were experienced in primary care and viewed health promotional activity as a valid part of their role. Few had undertaken previous alcohol training and as a group they were highly active in attending training events with training undertaken tending to be related directly to perceived practice needs and priorities: thus this group could not be characterized as unwilling to be trained. Barriers to training at alcohol events were found to be either personal or work-related, with most nurses interested in receiving further training or information. These data imply that the ways in which training is organized and delivered require sensitivity to identifiable barriers if it is to reach and effect changing practice among practice nurses successfully. A range of possibilities are identified as alternative approaches to the provision of elective training events which may be more acceptable to the target population of health-care staff. [source]


Trends in the literature on eating disorders over 36 years (1965-2000): terminology, interpretation and treatment,

EUROPEAN EATING DISORDERS REVIEW, Issue 1 2004
Sten S. Theander
Abstract A database with more than 14,700 references to articles on ED during 1965,2000 was analysed with the aim of identifying long-term and short-term trends in the literature. The main data of the analysis are the percentages of references per 6-year period or per year for the most recent 6 years, that contain certain words or phrases. The use of words in references should reflect changes in the content of the scientific papers. Trends over time have been noted in the use of terms on diagnostics, personality, comorbidity, psychotherapy, epidemiology, biology and course of illness. The use of words on psychoanalysis has diminished, while the use of biological words has increased. The discussion concerns the use of bibliographic methods and especially the general problems of using data from digital databases as a research tool in the search for trends in the development of a medical field. Copyright © 2004 John Wiley & Sons, Ltd and Eating Disorders Association. [source]


Metallocene based polyolefin: a potential candidate for the replacement of flexible poly (vinyl chloride) in the medical field

POLYMERS FOR ADVANCED TECHNOLOGIES, Issue 9 2010
M. C. Sunny
Abstract A comparative assessment of the performance properties of metallocene polyolefin (m-PO) with those of plasticized poly (vinyl chloride) (pPVC) and ethylene vinyl acetate (EVA) copolymer having 18% vinyl acetate content (EVA-18), the two common polymers used for flexible medical products, is carried out. The preliminary evaluation of the processability, mechanical properties, and thermal stability of the new material, m-PO is described. The processability parameters like mixing torque and melt viscosity of m-PO are found to be comparable with those of pPVC and EVA-18. Mechanical properties such as tensile strength, elongation at break, and tear strength (TS) of m-PO are much higher than that of pPVC and EVA-18. Thermo gravimetric analysis (TGA) indicates that the thermal degradation of m-PO takes place only at temperatures above 340°C and can be processed at 170°C without much damage. Oxygen and carbon dioxide permeabilities of m-PO at three different temperatures (10, 25, and 40°C) are evaluated and compared with those of pPVC and EVA-18. It could be seen that the permeabilities of both the gases for m-PO at three temperatures were lower than those of pPVC and EVA. Biological evaluation of m-PO is carried out by assessing its cytotoxicity, hemolytic property, and blood clotting initiation. The cytotoxicity studies indicate that m-PO is non-toxic to the monolayer of L929 mammalian fibroblast cell lines on direct contact or the exposure of its extract. Non-hemolytic property of m-PO by direct contact as well as test on extract is revealed both in static and in dynamic conditions. Blood clotting time experiments indicate that the initiation of blood clotting due to m-PO is faster than that of pPVC and EVA-18. Copyright © 2009 John Wiley & Sons, Ltd. [source]


Technical note: Morphometric maps of long bone shafts and dental roots for imaging topographic thickness variation

AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 2 2010
Luca Bondioli
Abstract Qualitative and quantitative characterization through functional imaging of mineralized tissues is of potential value in the study of the odontoskeletal remains. This technique, widely developed in the medical field, allows the bi-dimensional, planar representation of some local morphometric properties, i.e., topographic thickness variation, of a three-dimensional object, such as a long bone shaft. Nonetheless, the use of morphometric maps is still limited in (paleo)anthropology, and their feasibility has not been adequately tested on fossil specimens. Using high-resolution microtomographic images, here we apply bi-dimensional virtual "unrolling" and synthetic thickness mapping techniques to compare cortical bone topographic variation across the shaft in a modern and a fossil human adult femur (the Magdalenian from Chancelade). We also test, for the first time, the possibility to virtually unroll and assess for dentine thickness variation in modern and fossil (the Neanderthal child from Roc de Marsal) human deciduous tooth roots. The analyses demonstrate the feasibility of using two-dimensional morphometric maps for the synthetic functional imaging and comparative biomechanical interpretation of cortical bone thickness variation in extant and fossil specimens and show the interest of using this technique also for the subtle characterization of root architecture and dentine topography. More specifically, our preliminary results support the use of virtual cartography as a tool for assessing to what extent internal root morphology is capable of responding to loading and directional stresses and strains in a predictable way. Am J Phys Anthropol, 2010. © 2010 Wiley-Liss, Inc. [source]


Use of Transgenic Animals to Improve Human Health and Animal Production

REPRODUCTION IN DOMESTIC ANIMALS, Issue 4 2005
L-M Houdebine
Contents Transgenic animals are more widely used for various purposes. Applications of animal transgenesis may be divided into three major categories: (i) to obtain information on gene function and regulation as well as on human diseases, (ii) to obtain high value products (recombinant pharmaceutical proteins and xeno-organs for humans) to be used for human therapy, and (iii) to improve animal products for human consumption. All these applications are directly or not related to human health. Animal transgenesis started in 1980. Important improvement of the methods has been made and are still being achieved to reduce cost as well as killing of animals and to improve the relevance of the models. This includes gene transfer and design of reliable vectors for transgene expression. This review describes the state of the art of animal transgenesis from a technical point of view. It also reports some of the applications in the medical field based on the use of transgenic animal models. The advance in the generation of pigs to be used as the source of organs for patients and in the preparation of pharmaceutical proteins from milk and other possible biological fluids from transgenic animals is described. The projects in course aiming at improving animal production by transgenesis are also depicted. Some the specific biosafety and bioethical problems raised by the different applications of transgenesis, including consumption of transgenic animal products are discussed. [source]


Defining Systems Expertise: Effective Simulation at the Organizational Level,Implications for Patient Safety, Disaster Surge Capacity, and Facilitating the Systems Interface

ACADEMIC EMERGENCY MEDICINE, Issue 11 2008
Amy H. Kaji MD
Abstract The Institute of Medicine's report "To Err is Human" identified simulation as a means to enhance safety in the medical field, just as flight simulation is used to improve the aviation industry. Yet, while there is evidence that simulation may improve task performance, there is little evidence that simulation actually improves patient outcome. Similarly, simulation is currently used to model teamwork-communication skills for disaster management and critical events, but little research or evidence exists to show that simulation improves disaster response or facilitates intersystem or interagency communication. Simulation ranges from the use of standardized patient encounters to robot-mannequins to computerized virtual environments. As such, the field of simulation covers a broad range of interactions, from patient,physician encounters to that of the interfaces between larger systems and agencies. As part of the 2008 Academic Emergency Medicine Consensus Conference on the Science of Simulation, our group sought to identify key research questions that would inform our understanding of simulation's impact at the organizational level. We combined an online discussion group of emergency physicians, an extensive review of the literature, and a "public hearing" of the questions at the Consensus Conference to establish recommendations. The authors identified the following six research questions: 1) what objective methods and measures may be used to demonstrate that simulator training actually improves patient safety? 2) How can we effectively feedback information from error reporting systems into simulation training and thereby improve patient safety? 3) How can simulator training be used to identify disaster risk and improve disaster response? 4) How can simulation be used to assess and enhance hospital surge capacity? 5) What methods and outcome measures should be used to demonstrate that teamwork simulation training improves disaster response? and 6) How can the interface of systems be simulated? We believe that exploring these key research questions will improve our understanding of how simulation affects patient safety, disaster surge capacity, and intersystem and interagency communication. [source]


The alcohol industry and public interest science

ADDICTION, Issue 2 2010
Kerstin Stenius
ABSTRACT Aims This report argues that the growing involvement of the alcohol industry in scientific research needs to be acknowledged and addressed. It suggests a set of principles to guide ethical decision-making in the future. Methods We review relevant issues with regard to relationships between the alcohol industry and the international academic community, especially alcohol research scientists. The guiding principles proposed are modelled after expert committee statements, and describe the responsibilities of governmental agencies, the alcohol industry, journal editors and the academic community. These are followed by recommendations designed to inform individuals and institutions about current ,best practices' that are consistent with the principles. Findings and conclusions Growing evidence from the tobacco, pharmaceutical and medical fields suggests that financial interests of researchers may compromise their professional judgement and lead to research results that are biased in favour of commercial interests. It is recommended that the integrity of alcohol science is best served if all financial relationships with the alcoholic beverage industry are avoided. In cases where research funding, consulting, writing assignments and other activities are initiated, institutions, individuals and the alcoholic beverage industry itself are urged to follow appropriate guidelines that will increase the transparency and ethicality of such relationships. [source]


Shaping the future of Scandinavian anaesthesiology: a position paper by the SSAI

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2010
E. SØREIDE
Traditionally, Scandinavian anaesthesiologists have had a very broad scope of practice, involving intensive care, pain and emergency medicine. European changes in the different medical fields and the constant reorganising of health care may alter this. Therefore, the Board of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) decided to produce a Position Paper on the future of the speciality in Scandinavia. The training in the various Scandinavian countries is very similar and provides a stable foundation for the speciality. The Scandinavian practice in anaesthesia and intensive care is based on a team model where the anaesthesiologists work together with highly educated nurses and should remain like this. However, SSAI thinks that the role of the anaesthesiologists as perioperative physicians is not fully developed. There is an obvious need and desire for further training of specialists. The SSAI advanced educational programmes for specialists should be expanded and include formal assessment leading to a particular medical competency as defined by the European Union of Medical Specialists (UEMS). In this way, Scandinavian anaesthesiologists will remain leaders in perioperative, intensive care, pain and critical emergency medicine. [source]


Evidence-based meta-analysis of pharmacotherapy for benign prostatic hypertrophy

INTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2002
Osamu Ishizuka
Abstract Evidence-based diagnosis and treatment have been proposed recently in various medical fields. Evidence-based diagnostic and therapeutic guidelines for benign prostatic hypertrophy (BPH), one of the most common urological diseases, have been proposed in foreign countries. This paper examines common therapeutic drugs for BPH in Japan from the viewpoint of evidence-based medicine (EBM). The term ,BPH' and drugs indicated for BPH were used as key words to search related articles in the PubMed website. A total of 813 articles extracted as of October 2001 were examined. The articles were ranked in levels ranging from I,V, where Level I indicated a large randomized controlled trial and Level V indicated a non-controlled case accumulation study. Among the 813 articles extracted, 132 clinical articles were suitable for evaluation. There were many reliable articles on the effectiveness of ,-blockers. However, it seemed necessary to examine further how to choose the optimum ,-blocker for each clinical case and the combination of antiandrogen drugs with ,-blockers. It was also considered necessary to evaluate the effectiveness of drugs, such as eviprostat and hachimi-jio-gan, that are available only in Japan. The present study evaluated the effectiveness of commonly available therapeutic drugs for BPH in Japan from a viewpoint of EBM. [source]


In vivo, in vitro and in silico methods for small molecule transfer across the BBB

JOURNAL OF PHARMACEUTICAL SCIENCES, Issue 12 2009
Jurgen Mensch
Abstract The inability of molecules to permeate the BBB is a significant source of attrition in Central Nervous System (CNS) drug discovery. Given the increasing medical drivers for new and improved CNS drugs, small molecule transfer across the BBB is attracting a heightened awareness within pharmaceutical industry and medical fields. In order to assess the potential for small CNS molecules to permeate the BBB, a variety of methods and models, from in silico to in vivo going through in vitro models are developed as predictive tools in drug discovery. This review gives a comprehensive overview of different approaches currently considered in drug discovery to circumvent the lack of small molecule transfer through the BBB, together with their inherent advantages and disadvantages. Particularly, special attention is drawn to in silico models, with a detailed and contemporary point of view on prediction tools and guidelines for rational design. © 2009 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 98:4429,4468, 2009 [source]


Nerve regeneration along bioengineered scaffolds

MICROSURGERY, Issue 5 2007
S. Geuna M.D.
Tissue engineering has recently seen great advancements in many medical fields, including peripheral nerve reconstruction. In the rat median nerve model, we investigated nerve repair by means of bioengineered tissue scaffolds (muscle-vein-combined tubes) focusing on changes in the neuregulin-1/ErbB-receptor system which represents one of the main regulatory systems of axo-glial interaction in peripheral nerves. Repaired nerves were withdrawn at 5, 15, and 30 days postoperative and processed for morphological and retro-transcriptase polymerase chain reaction (RT-PCR) analysis. Results revealed an early and progressive increase in the expression of NRG1, isoform only, while the appearance of the , isoform of NRG1, which is normally present in peripheral nerves, was delayed. In regards to ErbB2 and ErbB3 receptors, their expression increased progressively inside the muscle-vein-combined scaffolds, though with different kinetics. Taken together, these results suggest that variations in neuregulin-1/ErbB system activation play a key role in peripheral nerve regeneration along bioengineered muscle-vein-combined scaffolds. Since similar variations are also detectable in denervated skeletal muscles, it can be hypothesized that the existence of a NRG1's autocrine/paracrine trophic loop shared by both glial and muscle fibers could be responsible for the effectiveness of muscle-vein-combined conduits for repairing nerve defects. © 2007 Wiley-Liss, Inc. Microsurgery, 2007. [source]


5-Aminolevulinic Acid Derivatives in Photomedicine: Characteristics, Application and Perspectives

PHOTOCHEMISTRY & PHOTOBIOLOGY, Issue 4 2006
Nicolas Fotinos
ABSTRACT The introduction of lipophilic derivatives of the naturally occurring heme precursor 5-aminolevulinic acid (5-ALA) into photomedicine has led to a true revival of this research area. 5-ALA-mediated photodynamic therapy (PDT) and fluorescence photodetection (FD) of neoplastic disease is probably one of the most selective cancer treatments currently known in oncology. To date, this method has been assessed experimentally for the treatment of various medical indications. However, the limited local bioavailability of 5-ALA has widely prevented its use in daily clinical practice. Although researchers were already aware of this drawback early during the development of 5-ALA-mediated PDT, only recently have well-established concepts in pharmaceutical science been adapted to investigate ways to overcome this drawback. Recently, two derivatives of 5-ALA, methylaminolevulinate (MAL) and hexylaminolevulinate (HAL), gained marketing authorization from the regulatory offices in Europe and Australia. MAL is marketed under the trade name Metvix for the treatment of actinic keratosis and difficult-to-treat basal cell carcinoma. HAL has recently been launched under the trade name Hexvix to improve the detection of superficial bladder cancer in Europe. This review will first present the fundamental concepts underlying the use of 5-ALA derivatives in PDT and FD from a chemical, biochemical and pharmaceutical point of view. Experimental evidences from preclinical data on the improvements and limits observed with 5-ALA derivatives will then be introduced. The state-of-the-art from clinical studies with 5-ALA esters will be discussed, with special emphasis placed on the process that led to the development of MAL in dermatology and to HAL in urology. Finally, we will discuss promising medical fields in which use of 5-ALA derivatives might potentially lead to further use of this methodology in photomedicine. [source]