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PubMed2004

Medical modernization, scientific research fields and the epistemic politics of health social movements.

As health social movements (HSMs) and complementary and alternative medicine (CAM) professions increasingly mount challenges to the authority of medical knowledge, the tendency for the medical research community and medical profession to dismiss such epistemic challenges (termed here 'paternalistic progressivism') and the corresponding response from challengers that medicine is corrupt (termed here 'medical devolution') has given way to a process of incorporation of challenges under the rubric of evidence-based research (termed here the epistemic dimension of 'medical modernization'). Under conditions of medical modernization the distinction between lay/alternative knowledge and scientific knowledge, upon which the epistemic authority of medicine rested, is submerged in a more complex field of competing scientific networks and research programmes. Furthermore, the older policy of transmitting science to an illiterate public and suppressing dissidents is replaced by an emerging system of the 'public shaping of science', in which there is both greater agency of social movement/lay advocacy organisations and greater recognition of the legitimacy of that agency. Indirect and direct forms of the public shaping of science are discussed, as are emergent problems of co-optation. Understanding the emergent epistemic politics that are characterised here as medical modernization requires an ongoing theoretical integration of medical sociology and the sociology of science.

Attitude of Health Personnel↗
PubMed1994

Internet tools in the medical classroom.

The Internet contains a vast amount of medically relevant information. In order to access this information, however, many networks require one to master applications written in UNIX, an operating system considered by many not to be user friendly. Although these tools may be available on campus, it is difficult to teach their use unless there is some immediate benefit to the already busy user. From that standpoint, it is important for instructors to realize that common UNIX applications can be utilized as classroom tools to significantly enhance the learning experience by facilitating teacher/student communication. Also, whilst the student enjoys greater communication with the instructor (and with other students) he/she is also becoming adept at using information management tools.

Computer Communication Networks↗
PubMed1995

Wired or wary?

Explore the source record for details and available documents.

Computer Communication Networks↗
PubMed2003

Medical research networks--an international comparison.

Medical research networks (MRN) are described as a new approach in fostering science for health. It is described that this approach can be found in several countries and global business companies. MRNs try to maximise use of information technology (IT) for speeding up the long research and transfer process from basic science to patient care. Despite the fact that several countries have funding schemes for this approach, nomenclatures and frameworks vary due to different national conditions. Nevertheless there is a general expectation that MRNs are necessary. However, there long-term impact and efficiency has still to be evaluated. The results of this report are based on a benchmarking study currently underway in Germany.

Benchmarking↗
PubMed1996

Remaking health care in America.

Academic medical centers, vulnerable populations, rural health. Each represents the fragmentation of the current health care delivery system. Not surprisingly, the challenge of achieving cost-effective integrated delivery raises complex issues for each. These issues are explored in Remaking Health Care in America, based on research by Stephen Shortell, Ph.D., and his colleagues at Northwestern University, in partnership with KPMG's National Health Care & Life Sciences practice and 11 integrated health care systems. Hospitals & Health Networks presents an exclusive preview of the book.

Academic Medical Centers↗
PubMed2005

The SUCOZOMA program: results and challenges.

The research program Sustainable Coastal Zone Management (SUCOZOMA), which was started in 1996 by the Swedish Foundation of Strategic Environmental Research, was motivated by the recognition of increasingly severe global, regional and national coastal problems. The program approached the complex issues of coastal eutrophication, fishing practices, and overexploited coastal resources, with a concerted effort involving multidisciplinarity, stakeholder cooperation, and a focus on the problems perceived as most serious by the public and decision-makers. As the program was concluded in 2004 it had resulted in the completion or near-completion of 22 doctoral dissertations and approximately one hundred publications. More than 40 scientists were involved in the program. Göteborg University was the host university, but important research teams have also been located at Stockholm University, the Beijer Institute, and the Kristineberg Marine Research Station of the Royal Swedish Academy of Sciences, and within the National Board of Fisheries. During the program, networks of stakeholders were established and SUCOZOMA had contributed to numerous political and administrative processes relevant for integrated coastal zone management (ICZM). SUCOZOMA program results can be grouped into different categories. Many of the projects in the two phases of the program produced results which can be defined as technical or practical and available for direct implementation in, e.g. mussel cultivation, restoration and safeguarding of spawning areas, seal-safe fishing gear or sustainable fishing of underexploited species. Other results can be characterized as policy oriented, and the impact of these can only be fairly evaluated as new policies are put into effect. SUCOZOMA resulted in important new knowledge regarding coastal science and management, but also concerning the organization required to conduct an end-user oriented multidisciplinary program effectively.

Animals↗
PubMed2005

Applying organizational network analysis techniques to study information use in a public health agency.

We are applying organizational network analysis to explore information use in a public health department. The technique is grounded in social science theory, and employs calculations derived from graph theory to generate statistical and graphical models from relational data matrices. For this pilot we will develop network models to characterize how information use in routine work contributes to the agency's performance goals. This is the first step in ongoing work that will extend network analysis with computational methods, to predict the potential effects that improving information use has on the agency's performance.

Humans↗
PubMed1995

The rural and global medical informatics consortium and network for radiology services.

Telemedicine systems that provide health delivery services to rural clinics and hospitals are being demonstrated in clinical settings. This paper summarizes the research and consortia projects at the University of Arizona Medical Center. The paper describes the Rural and Global Picture Archiving and Communications (PACS) environment developed under a National Science Foundation grant. The Rural and Global PACS environment includes many workstations, database, and networking components and is treated as a large distributed system. These components are described in this paper. The multimedia services for radiology provided by the Rural and Global PACS are described and their performance is measured. Finally, the current research work using the Open Software Foundation's distributed computing environment (OSF DCE) services is described. An OSF DCE testbed for the Rural and Global PACS is described and the rationale of using OSF DCE in the project is presented.

Arizona↗
PubMed1996

Networking consumer health information: bringing the patient into the medical information loop.

The Library of the Health Sciences at the University of Illinois at Chicago obtained a grant from the Illinois State Library to implement a statewide demonstration project that would provide consumer health information (CHI) using InfoTrac's Health Reference Center CD-ROM database. The goals of the project were to cooperate with targeted public libraries and clinics in providing CHI at the earliest point of need; to provide access to the database via a dial-up network server and a toll-free telephone number; and to work with targeted sites on database training, core CHI reference sources, and referral procedures. This paper provides background information about the project; describes the major systems and technical issues encountered; and discusses the outcomes, impact, and envisioned enhancements.

CD-ROM↗
PubMed2002

Interpreting small quantities of DNA: the hierarchy of propositions and the use of Bayesian networks.

The dramatic increase in the sensitivity of DNA profiling systems that has occurred over recent years has led to the need to address a wider range of interpretational problems in forensic science. The issues surrounding questions of the kind "whose DNA is this?" have been the subject of considerable controversy but now it is clear that the emphasis is shifting to questions of the kind "how did this DNA get here?" Such issues are discussed in this paper and new insights are provided by two particular recent developments. First, the notion of the "hierarchy of propositions" that has arisen from a project called Case Assessment and Interpretation (CAI) that has been running in the British Forensic Science Service (FSS). Second, a technique for drawing inferences in the face of many interacting considerations, known as "Bayesian networks"--or "Bayes' nets" for short--that has been the subject of an earlier paper in this journal (1). The discussion is carried out by means of case studies, based on actual cases. It is clear that, whereas the inference in relation to the source of the DNA in a crime sample might be overwhelmingly strong, the inference in relation to the propositions that a jury must consider relating to the identity of the actual offender may be much more tentative.

Bayes Theorem↗
PubMed1993

DNA ploidy, S-phase, and steroid receptors in more than 127,000 breast cancer patients.

Several potential prognostic factors are available today for patients with breast cancer, and many more are being identified and studied. To evaluate the clinical utility of these factors, it will be necessary to measure them on a large number of patients, and then follow these patients so that multivariate survival analyses can be performed. The Oncology Research Network was established in 1986 by the University of Texas Health Science Center at San Antonio and Nichols Institute Reference Laboratories in order to evaluate the clinical utility of new prognostic factors for patients with primary breast cancer. The first generation of prognostic factors included steroid receptors, along with DNA ploidy and S-phase fraction determined by flow cytometry. Currently, laboratory results have been obtained from more than 127,000 patients, and follow-up information is available on a subset of more than 25,000 of these patients. S-phase fraction was related to the ploidy status of the tumor. An increased incidence of aneuploidy and higher S-phase fractions were found in estrogen and progesterone receptor negative tumors, tumors from patients with positive axillary lymph nodes, tumors greater than 2 cm in diameter, and patients younger than 35 years of age. Preliminary survival analyses suggest that S-phase fraction and DNA ploidy, in combination with other prognostic factors, are powerful predictors of early disease relapse. The Oncology Research Network provides an important resource for examining the clinical significance of new laboratory assays and for expediting improvements in existing laboratory techniques.

Breast Neoplasms↗
PubMed1995

The EUROLEISH network: an exercise in partnership.

The EUROLEISH network arose in 1989 as a spontaneous initiative from contract holders funded by the health component of the Science and Technology for Development programme of the European Commission (EC). Leishmaniasis projects from other programmes (International Scientific Co-operation and Avicenna) joined the network later on. The network has three central objectives: to improve interactions between laboratory and field scientists; to rank the queries raised by health services in order of importance for research; and to develop partnerships between European countries and between these and developing countries. The EUROLEISH network is run consensually by the contract-holders and meets yearly, the subject of each meeting alternating between biology (in Europe) and epidemiology (in an endemic country). Presently, the network comprises 66 contract-holders from 18 projects in 28 countries, with a research budget of 4.6 million ecus during the Third EC Framework Programme (1990-1994). The next main issue to be addressed by the network will probably be the strengthening of thematic research, by promoting 'bridge building' between projects at regional level.

Forecasting↗
PubMed1987

Beyond the online catalog: developing an academic information system in the sciences.

The online public access catalog consists essentially of a machine-readable database with network capabilities. Like other computer-based information systems, it may be continuously enhanced by the addition of new capabilities and databases. It may also become a gateway to other information networks. This paper reports the evolution of the Bibliographic Access and Control System (BACS) of Washington University in end-user searching, current awareness services, information management, and administrative functions. Ongoing research and development and the future of the online catalog are also discussed.

Catalogs, Library↗
PubMed1975

Planning serials cancellations and cooperative collection development in the health sciences: methodology and background information.

In an era of steady-state budgets many research and academic libraries must cancel a significant number of current serials to maintain acquisitions of monographs. Thus paper reviews several techniques that have been used or that are of potential use in a rational selection of titles for cancellation. The context of the proposed methodology involves a network of libraries rather than an individual library. The methodology was tested with specific health sciences serial titles held by University of California libraries and resource libraries in NLM Region XI. As a test for the proposed methodology, background data were collected on 600 current foreign language serial titles included in SERLINE and held by at least one of the libraries in the networks of interest. Price, major secondary service coverage with productivity/impact factors, extent of holdings, and average number of recorded circulations per year in several of the libraries were recorded for each title. With the use of several different rules, estimates were made of the subscription savings that might be realized. It seems feasible to extend the same methodology to other groups of serial titles.

Abstracting and Indexing↗
PubMed2006

Consequences of chain networks on thermodynamic, dielectric and structural properties for liquid water.

A vast array of experimental data on water provides a global view of the liquid that implicates its tetrahedral hydrogen-bonding network as the unifying molecular connection to its observed structural, thermodynamic, and dielectric property trends with temperature. Recently the classification of water as a tetrahedral liquid has been challenged based on X-ray absorption (XAS) experiments on liquid water (Ph. Wernet et al., Science, 2004, 304, 995), which have been interpreted to show a hydrogen-bonding network that replaces tetrahedral structure with chains or large rings of water molecules. We examine the consequences of tetrahedral vs. chain networks using three different modified water models that exhibit a local hydrogen bonding environment of two hydrogen bonds (2HB) and therefore networks of chains. Using these very differently parameterized models we evaluate their bulk densities, enthalpies of vaporization, heat capacities, isothermal compressibilities, thermal expansion coefficients, and dielectric constants, over the temperature range of 235-323 K. We also evaluate the entropy of the 2HB models at room temperature and whether such models support an ice I(h) structure. All show poor agreement with experimentally measured thermodynamic and dielectric properties over the same temperature range, and behave similarly in most respects to normal liquids.

Journal Article↗
PubMed2002

Using a neural network with flow cytometry histograms to recognize cell surface protein binding patterns.

Flow cytometric systems are being used increasingly in all branches of biological science including medicine. To develop analytic tools for identifying unknown molecules such as the antibodies that recognize different structure in the identical antigens, we explored use of a neural network in flow cytometry data comparison. Peak locations were extracted from flow cytometry histograms and we used the Marquardt backpropagation neural networks to recognize identical or similar binding patterns between antibodies and antigens based on the peak locations. The neural network showed 93.8% to 99.6% correct classification rates for identical or similar molecules. This suggests that the neural network technique can be useful in flow cytometry histogram data analysis.

Antibodies, Monoclonal↗