Constrained least-squares restoration of nuclear medicine images: selecting the coarseness function

Image restoration using the constrained least-squares (CLS) method theoretically adapts to the image being processed. In addition, it only requires knowing the modulation transfer function of the imaging system when applied to nuclear medicine images. Prompted by these observations, a systematic evaluation of the effects of the form of the "coarseness function" [C(f)] used by the CLS method has been conducted. Nine C(f)'s are evaluated using an observer preference and a normalized mean-squared error (NMSE) criterion. This evaluation is conducted for three modulation transfer functions and a wide range of count levels. The results of the subjective studies support using the form of C(f) which has been most widely employed in previous studies, i.e., the form designed to minimize the energy in the second derivative of the restored image. A different form of C(f) is generally found to be optimal by the mean-squared error criterion. The CLS method is then compared to: (1) no processing, (2) count-dependent smoothing, and (3) count-dependent Metz restoration. When evaluated using objective measurements of error and contrast, the CLS method is found to be slightly inferior to the best method, Metz restoration. However, CLS restoration is found to be equal to or better than the other methods when judged by the results of observer preference studies.     

Health expenditure and finance: who gets what?

The methods used in South Africa's first comprehensive review of health finance and expenditure are outlined. Special measures were adopted to make the process acceptable to all concerned during a period of profound political transition. The estimation of indicators of access to public sector resources for districts sorted by per capita income allowed the health care problems of disadvantaged communities to be highlighted.     

CAMs and FGF cause a local submembrane calcium signal promoting axon outgrowth without a rise in bulk calcium concentration

Binding of basic fibroblast growth factor (bFGF) and cell adhesion molecules to the nerve cell membrane promotes axon outgrowth. This response can be blocked by antagonists of voltage-gated calcium channels, yet no change of cytosolic calcium concentration in the growth cone can be detected upon binding of the growth factor bFGF or the cell adhesion molecule L1. Using barium as a charge carrier, we show that bFGF and L1 open a calcium influx pathway in growth cones of rat sensory neurons without changing the membrane voltage. L1 does not activate influx in cells expressing a dominant negative mutant of the fibroblast growth factor receptor (FGFR) tyrosine kinase. FGFR-activated influx is blocked by specific antagonists of L- and N-type voltage-gated calcium channels and by an inhibitor of diacylglycerol lipase. We propose that both L1 and bFGF act via the FGFR to generate polyunsaturated fatty acids which in turn cause calcium channels to flicker open and shut. Short-lived domains of raised calcium at the cytosolic mouth of open channels activate axon outgrowth without raising bulk cytosolic calcium concentration. In confirmation of this model, the rapidly-acting calcium buffer BAPTA is significantly more effective at blocking FGF-induced axon outgrowth when compared with the slower buffer EGTA. Generation of short-lived calcium domains may provide a crucial mechanism for axon guidance during development and for promoting regeneration of damaged axons.     

Factors affecting the level of success of community information systems

The factors that influence the ultimate level of success or failure of systems development projects have received considerable attention in the academic literature. However, previous research has rarely targeted different instances of a common type of system within a homogeneous organisational sector. This paper presents the results of a survey of IM&T managers within Community Trusts to gain insights into the factors affecting the success of Community Information Systems. The results demonstrate that the most successful operational systems were thoroughly tested prior to implementation and enjoyed high levels of user and senior management commitment. Furthermore, it has been shown that there is a relationship between the level of organisational impact and systems success, with the most successful systems engendering changes to the host organisation's culture, level of empowerment and clinical working practices. In addition to being of academic interest, this research provides many important insights for practising IM&T managers.     

Developing a plan for primary health care facilities in Soweto, South Africa. Part I: Guiding principles and methods

The new political era in South Africa offers unique opportunities for the development of more equitable health care policies. However, resource constraints are likely to remain in the foreseeable future, and efficiency therefore remains an important concern. This article describes the guiding principles and methods used to develop a coherent and objective plan for comprehensive primary health care facilities in Soweto. The article begins with an overview of the context within which the research was undertaken. Problems associated with planning in transition are highlighted, and a participatory research approach is recommended as a solution to these problems. The article goes on to describe how the research methods were developed and applied in line with the principles of participatory research. The methods were essentially rapid appraisal techniques which included group discussions, detailed checklists, observation, record reviews and the adaptation of international and local guidelines for service planning. It is suggested that these methods could be applied to other urban areas in South Africa and elsewhere, and that they are particularly appropriate in periods of transition when careful facilitation of dialogue between stakeholders is required in tandem with the generation of rapid results for policy-makers.