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排序方式: 共有565条查询结果,搜索用时 15 毫秒
21.
The Kampung Improvement Project in Indonesia and slum improvement projects in Lusaka, Zambia and in Calcutta, Hyderabad, Indore, Visakhapatnam, and Vijayawada, India are examples of multidisciplinary projects that emphasize primary health care (PHC) and are designed to meet the needs of low income people. A case study of such a project in a developing country city reveals that each health center had filed 7770 pieces of data each month from 105 slums yet no one had analyzed the data. Health managers believed computers were needed to evaluate the health information system but the problems were greater than just the lack of computers. They included the considerable time taken to complete forms, unreliable accuracy of data, and not using the data to make decisions at the local or municipal level. So consultants set up a rationalization of indicators system to guide health managers on what type of data to include and exclude into the health information system. The 1st step involved reviewing each proposed indicator using 5 steps for decision making purposes. For example, they advised exclusion of number of households with latrines and vague and complicated variables such as number of 1-year old children who were fully immunized and whose mothers had had all prenatal immunizations. The next step was ranking the indicators based on ease of collection, accuracy, and value to managers. The final step was eliminating unsuitable indicators (low scoring ones). Decentralization of management of the slums into 4 regions also occurred which resulted in monthly meetings with health workers to review activities and increased morale. A computer programmer became responsible for data entry into the new system. This case study demonstrated the difficulty of a health information system steered by data instead of the need for data to use for decision-making purposes. 相似文献
22.
Weise R Fricke H Kammeier A Lindner O Burchert W 《Zeitschrift für medizinische Physik》2005,15(4):274-278
A dynamic heart phantom for the quality control of tomographic systems used in nuclear cardiology imaging was developed, built, and tested. The heart phantom anatomically simulates the left ventricle of the heart. The variable parameters are represented by the volume of the left ventricle, the temporal course of the filling event, and the frequency of the filling of the left ventricle. These parameters can reliably simulate the wall motion, wall thickening, ejection fraction, and stroke volume of the left ventricle. 相似文献
23.
Nina?HeinrichsEmail author Heike?Bertram Annett?Kuschel Kurt?Hahlweg 《Prevention science》2005,6(4):275-286
Despite the potential of parent training as a prevention and behavioral family intervention strategy, there are a number of important issues related to implementation (e.g., recruitment and retention of families). This paper presents recruitment and retention data from families enrolling in a randomized controlled universal prevention trial for child behavior problems conducted in Germany. The recruitment rate averaged 31% (general project participation), with families of lower socioeconomic status (SES) participating at a lower rate. Project-declining families most often reported intrusion of privacy as their primary concern. In contrast, once parents were enrolled in the project, participation among those randomized to the parent training group averaged 77% (program/intervention participation); non-participation was mostly due to logistical issues. Parents accepting the offer of parent training were more likely to report child behavior problems than did declining parents. Although parents from more disadvantaged areas had a lower overall level of participation in the project once recruited, parents with children having higher levels of behavior problems indeed were more likely to participate in the intervention. Different recruitment methods may be required to engage high-risk families from socioeconomically disadvantaged areas to further improve community-level impact on child mental health. 相似文献
24.
R. K. Annett 《Canadian family physician Médecin de famille canadien》1974,20(11):76-79
Hypertension is a very common and important finding. The family physician is ideally suited to manage this problem on a long term basis. To do so, he must have an adequate practical plan of diagnosis and management. This article describes one approach to the problem. 相似文献
25.
26.
Weipert J Noebauer C Schreiber C Kostolny M Zrenner B Wacker A Hess J Lange R 《The Journal of thoracic and cardiovascular surgery》2004,127(2):457-464
OBJECTIVES: In patients after the Fontan operation, we determined risk factors for late failure and for intra-atrial re-entrant tachycardia at 15 to 20 years' follow-up. Midterm results after electrophysiologic ablation therapy for these tachycardias were also evaluated. METHODS: Current follow-up was available in 162 patients (2005 patient-years) with a wide range of underlying diagnoses operated on between February 1978 and May 1995. Risk factor analysis included patient-related and procedure-related variables, with late failure and the incidence of re-entrant tachycardia as outcome parameters. RESULTS: Forty late failures were observed (2.0 per 100 patient-years). At 15 years, Kaplan-Meier estimated survival was significantly (P =.007) better for patients with tricuspid atresia (93%) compared with that for patients with complex congenital malformation (71%). The sole multivariable risk factor for Fontan failure was the type of underlying diagnosis. At 20 years' follow-up, overall freedom from tachycardia was estimated to be 46% +/- 12%. Acute success of electrophysiologic ablation was seen in 25 (83%) of 30 patients, and Kaplan-Meier estimated freedom from recurrent tachycardia was 81% +/- 10% at 3 years. Multivariate analysis identified duration of Fontan circulation as the sole risk factor for re-entrant tachycardias. CONCLUSION: After the modified Fontan operation, long-term survival in patients with tricuspid atresia was significantly better compared with that in patients with complex congenital malformations. As first-choice therapy for atrial re-entrant tachycardias, we recommend electrophysiologic ablation therapy. 相似文献
27.
28.
A technical triade for proteomic identification and characterization of cancer biomarkers 总被引:7,自引:0,他引:7
Melle C Ernst G Schimmel B Bleul A Koscielny S Wiesner A Bogumil R Möller U Osterloh D Halbhuber KJ von Eggeling F 《Cancer research》2004,64(12):4099-4104
Biomarkers are needed to elucidate the biological background and to improve the detection of cancer. Therefore, we have analyzed laser-microdissected cryostat sections from head and neck tumors and adjacent mucosa on ProteinChip arrays. Two differentially expressed proteins (P = 3.34 x 10(-5) and 4.6 x 10(-5)) were isolated by two-dimensional gel electrophoresis and identified as S100A8 (calgranulin A) and S100A9 (calgranulin B) by in-gel proteolytic digestion, peptide mapping, tandem mass spectrometry analysis, and immunodepletion assay. The relevance of these single marker proteins was evaluated by immunohistochemistry. Positive tissue areas were reanalyzed on ProteinChip arrays to confirm the identity of these proteins. As a control, a peak with low P was identified as calgizzarin (S100A11) and characterized in the same way. This technical triade of tissue microdissection, ProteinChip technology, and immunohistochemistry opens up the possibility to find, identify, and characterize tumor relevant biomarkers, which will allow the movement toward the clonal heterogeneity of malignant tumors. Taking this approach, proteins were identified that might be responsible for invasion and metastasis. 相似文献
29.
Trefzer U Herberth G Wohlan K Milling A Thiemann M Sherev T Sparbier K Sterry W Walden P 《International journal of cancer. Journal international du cancer》2004,110(5):730-740
Hybrid cell vaccination was developed as therapeutic approach that aims at stimulating tumor-specific cytotoxic T-cell responses in cancer patients using hybrids of autologous tumor and allogeneic dendritic cells. We tested this concept and the efficacy of the vaccines in inducing clinical and immunologic responses in a clinical trial with melanoma stage III and IV patients. Of the 17 patients evaluated, 1 experienced a complete response, 1 a partial response and 6 stable disease with remarkably long survival times. In 11 of 14 patients analyzed, high-frequency T-cell responses to various tumor-associated T-cell epitope were induced and detectable in the peripheral blood. These immune responses were detected in clinical response patients as well as nonresponders. Failures of clinical responses in all the cases investigated correlated with loss of antigen expression and presentation. Hybrid cell vaccination thus proves effective in inducing tumor-specific T-cell responses in cancer patients. 相似文献
30.
Sommerer F Vieth M Markwarth A Röhrich K Vomschloss S May A Ell C Stolte M Hengge UR Wittekind C Tannapfel A 《Oncogene》2004,23(2):554-558
Activation of the Raf/MEK/ERK (MAPK) signal transduction cascade by RAS mutations has been found in a variety of human cancers. Mutations of BRAF provide an alternative route for activation of this signalling pathway. To determine the role of mutations in BRAF and KRAS2 in the neoplastic progression of Barrett's adenocarcinoma, we analysed both genes for common mutations. After microdissection, DNA of 19 Barrett's adenocarcinomas, 56 Barrett's intraepithelial neoplasias (n=29 low-grade intraepithelial neoplasia (LGIN) and n=27 high-grade intraepithelial neoplasia (HGIN)), 30 Barrett's mucosa without neoplasia and normal squamous, as well as gastric epithelium, were analysed for BRAF and KRAS2 mutation. Activating BRAF mutations were identified in 2/19 Barrett's adenocarcinomas (11%) and in 1/27 HGIN (4%). KRAS2 mutations were found in four out of 19 (21%) Barrett's adenocarcinomas examined and in three cases of HGIN (11%). In LGIN as well as in normal gastric or oesophageal mucosa, neither BRAF nor KRAS2 mutations were detected. All lesions with KRAS2 mutations had an intact BRAF gene. The status of mismatch-repair proteins was neither related to BRAF nor KRAS2 mutations. These data indicate that RAS or BRAF mutations are detected in about 32% of all Barrett's adenocarcinomas. We conclude that the disruption of the Raf/MEK/ERK (MAPK) kinase pathway is a frequent but also early event in the development of Barrett's adenocarcinoma. 相似文献