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The PACRAT system: an extensible WWW-based system for correlated sequence retrieval, storage and analysis.

With PACRAT (Patterns, Analyses, Correlations. Remote Archive Testbed) we present an online database solution to the problem of accessing high-confidence sequences with specific relationships to classes of genes, such as upstream intergenic regions attached to tRNA genes. In addition the software contains a data warehousing and analysis-facilitating suite to streamline the process of analyzing the collected data. An unexpected additional benefit of the system is that it also provides easy access to sequences of lower confidence, and may be of assistance in such things as resolving ORF-call conflicts in genomic annotation projects.

Computational Biology↗

GABAagent: a system for integrating data on GABA receptors.

MOTIVATION: Scientific data pertaining to GABA receptors, which are of medical importance, are widely scattered throughout numerous heterogeneous Internet resources. This situation has made the integrated acquisition of such data difficult and substantially time consuming even for researchers who are Internet aficionados. Thus, there exists a genuine need for the development of Internet applications, such as GABAagent, which provide efficient and timely access to concise and integrated information. RESULTS: We report here the establishment of a novel server (GABAagent) which has been written in Perl script, and which is freely accessible through the Internet. GABAagent is designed to assist researchers in retrieving focused and integrated information related to GABA receptors from various public domain databases. GABAagent relies on server-side flat-file databases that have been created through data mining from Internet sources such as the PubMed, DDBJ, SWISS-PROT and TrEMBL, in addition to the many World Wide Web (Web) sites which are accessible through Excite (E-Web). These warehouse databases are regularly updated and contain among other things, information concerning: (i) GABA receptor publications, (ii) DNA and protein sequences and (iii) the contents of related E-Web sites along with their addresses. Our system also provides hard links to the above-mentioned Web sites and E-Web sites; the feature which adds to it the character of virtual federation type of database. The current version of GABAagent provides two user-friendly services. The first is a search engine possessing intelligent query reformulation support (GABAengine), the second an elaborate email alert service was designed into the system (GABAalert). The GABAengine allows the user to search server-side databases exclusively for GABA receptor-related queries. Whereas, GABAalert allows the user, by means of subscription, to receive immediate and/or monthly updates automatically. AVAILABILITY: GABAagent is freely accessible at the following Web address http://www.ust.hk/gaba.

Databases, Factual↗

Health care's 100 most wired.

They're wired all right, and America's 100 most techno-savvy hospitals and health systems share one more thing: a commitment to using technology to link with employees, patients, suppliers, and insurers. "We want to be a health care travel agency for our community," says one chief information officer. "And we see Internet technology as a key."

Benchmarking↗

Health websites in Italy: use, classification and international policy.

In this paper, we discuss international policy in relation to the use of health websites and we describe the results obtained from application of a search engine to the recognition and classification of health websites in Italy. We then compare the results with health websites in other countries. Effective use of technology has led to medical advances that have not only extended life expectancy, but also fuelled an increasingly well-informed public to expect more and more from today's healthcare providers. As a consequence of the Web's rapid, chaotic growth, the resulting network of information lacks organization and structure and the quest for a method of quickly finding relevant and reliable information is spawning the growth of Internet portal sites. The US and the European Union and now Italy, have established the importance of rules to check the quality of health sites both for the non-professional users (citizens), mainly for privacy and security (for example, of medical records); and for health operators (physicians and others), where the most important thing is to evaluate the quality of content. In June 2001, the search engine used here found 2627 Italian health sites, of which only 46 exhibited the HON Code, and they can be classified into: 1% personal medical sites, 17% health portals, 18%, metasites, 27% documental sites and 37% information sites for health operators and/or for citizens.

Community Participation↗

Quality improvement to guide the new health system.

While there are many areas, such as intensive care treatment and pain management, where great gains in quality improvement can be made, the greatest strides will come as the leaders and trustees in health care organizations begin to create "the industrial revolution" in their organizations by creating cultures of quality. Stephen Shortell recommends the following list of things board members can do to improve quality in their organizations.

Benchmarking↗

Perceived barriers to and benefits of attending a stop smoking course during pregnancy.

OBJECTIVE: During pregnancy, the uptake of smoking cessation courses is very low. We assessed perceived barriers to and benefits of attending a cessation course during pregnancy. METHODS: A decisional-balance questionnaire was devised, including 10 statements reflecting benefits of attending a cessation course and 10 statements of barriers to attendance. The questionnaire was delivered via the Internet and targeted pregnant smokers/recent ex-smokers. Participants completed the questionnaire on a single occasion, indicating their agreement with each statement. RESULTS: Among 443 respondents, the most frequently endorsed barriers were 'Being afraid of disappointing myself if I failed' (54%) and not tending to seek help for this sort of thing (41%). The most frequently endorsed benefits were advice about cigarette cravings (74%) and praise and encouragement with quitting (71%). A greater interest in receiving help with quitting from a counselor was significantly associated with: being older, lower income, husband/partner advising cessation and less confidence in quitting. CONCLUSION: Pregnant smokers perceive many benefits of smoking cessation courses. However, these women also perceive many barriers to attendance and studies are needed to evaluate interventions for overcoming such barriers. PRACTICE IMPLICATIONS: Smoking cessation services need to address the perceived barriers to attending stop smoking courses during pregnancy, to publicise the benefits of these courses and to target women who feel that they cannot quit without this type of support.

Adolescent↗

Do you need an ASP ASAP?

Is your organization looking at the possibility of using an application service provider (ASP)? If so, here are some things you should know about making that decision, selecting a provider, and negotiating a contract.

Cost Control↗

Health care futures, Part 1. The emergence of the new health care consumer. Panel discussion.

In Part 1 of this second annual panel discussion, six experts examine the new health care consumer. The whole concept of the patient as consumer still makes people uneasy when it's applied to health care. Whether you prefer consumer, customer, purchaser, end-user, ultimate buyer, or beneficiary, one thing's for sure: Many of us are as different from the bygone patient as an HMO is from the general practitioner who made house calls. One of the reasons for many Americans' new interest, knowledge, attitudes, and expectations about health and health care is the Internet, the second topic in this discussion. In Part 2, physician executives from the three leading physician practice management companies (PPMCs) join Jeff Goldsmith, Barbara LeTourneau, and Uwe Reinhardt for a spirited exchange about this burgeoning new industry in the American health care sector. They will tackle questions such as: Are PPMCs delivering what they promise? What will separate successful PPMCs from the rest? Can PPMCs meet Wall Street's earnings expectations and also help physicians deliver better care? When PPMCs win, who loses? And, what roles will physician executives play in PPMCs?

Attitude to Health↗

Nutrition-related information-seeking behaviours before and throughout the course of pregnancy: consequences for nutrition communication.

BACKGROUND: Research has shown that especially pregnant women, and also women with a wish for a child, have increased nutrition awareness. Seeking nutrition information seemed to be an important determinant for nutrition awareness. However, little research has been carried out about nutrition-related information-seeking behaviours before and during pregnancy. OBJECTIVE: This study aimed to explore nutrition-related information sources, nutrition information-seeking behaviours and motives for seeking nutrition information before and throughout the course of pregnancy. DESIGN: Data were collected by means of retrospective in-depth face-to-face interviews of 1 h with five groups of 12 women: women with a child wish, women in their first, second and third trimester of the first pregnancy and women in their first trimester of the second pregnancy. Women were mainly selected via midwifery practices. The interviews took place at conference rooms or at the respondent's home. Qualitative data were analysed with the software program NUD(*)IST (QSR, Melbourne). This was based on the research objectives and relevant text segments of transcripts. RESULTS: Women with a child wish generally sought little nutrition information because they were not pregnant yet. Information sources were the Internet (anonymous) and the social environment (models). In relation to the manifestation of nutrition-related information-seeking behaviours during first-time pregnancies, three groups of women could be distinguished: (1) women who feel like a mother from the moment they know that they are pregnant, (2) women who feel like a mother later in pregnancy and (3) women who do not feel like a mother yet. Each group had its own specific information-seeking behaviour. Important information sources of the first group were the Internet (anonymous and up to date), books (extended) and midwives (expert) during the first trimester; the 9-month calendar (fun and tips), friends (experienced) in the second trimester; and friends (information on breastfeeding) in the third trimester. Information sources of the second group of women were mainly brochures provided by the midwife and the midwife herself. The third group of women mainly relied on their own common sense. Second-time pregnant women mainly relied on their experience, the midwife and books for specific questions. CONCLUSIONS: Pregnant women perceive pregnancy-specific nutrition information as important because it is one of the few things that they can apply in their daily lives to protect the health of the fetus. Nutrition-related information-seeking behaviours mainly were pregnancy specific in character, rather than directed to general nutrition information.

Adult↗

"To me, it's my life": medical communication, trust, and activism in cyberspace.

This paper studies the conversations and activities of an online support group for breast cancer sufferers and survivors and their supporters. Using communications medium theory and social capital theory, it examines the mundane and profound exchanges, the poignant self-disclosures, the creative expressions of solidarity, and the minor but not-insignificant political actions of people--initially strangers--who come together as a 'virtuous circle,' not only to assist with medical issues but also to meet emotional and even material needs. Sponsored by the Canadian nonprofit organization Breast Cancer Action Nova Scotia (BCANS), this virtual community has logged over a half million messages since 1996. Not every BCANS participant is an activist--many are just trying to grapple with their disease--but some find ways to shatter the professional "information monopoly," and to press for healthcare improvements. The study illustrates the scope, passion, and complexity of peer-to-peer medical communication in a virtual environment that promotes "thick trust". BCANS participants discuss with candor, warmth and even humor such painful topics as death and dying and the crises in intimate relationships brought about by a terminal illness. The sharing of confidences and fears enables participants to pool their 'collective intelligence' about many things, from how to cope with swelling, to how to think about end-of-life issues, to how to improve social policy.

Adolescent↗

Consumer Health Informatics--integrating patients, providers, and professionals online.

Consumer Health Informatics (CHI) means different things to patients, health professionals, and health care systems. A broader perspective on this new and rapidly developing field will enable us to understand and better apply its advances. This article provides an overview of CHI discussing its evolution and driving forces, along with advanced applications such as Personal Health Records, Internet transmission of personal health data, clinical e-mail, online pharmacies, and shared decision-making tools. Consumer Health Informatics will become integrated with medical care, electronic medical records, and patient education to impact the whole process and business of health care.

Access to Information↗

Automated graphic image generation system for effective representation of infectious disease surveillance data.

Infectious disease surveillance schemes have been established to detect infectious disease outbreak in the early stages, to identify the causative viral strains, and to rapidly assess related morbidity and mortality. To make a scheme function well, two things are required. Firstly, it must have sufficient sensitivity and be timely to guarantee as short a delay as possible from collection to redistribution of information. Secondly, it must provide a good representation of the results of the surveillance. To do this, we have developed a database system that can redistribute the information via the Internet. The feature of this system is to automatically generate the graphic images based on the numerical data stored in the database by using Hypertext Preprocessor (PHP) script and Graphics Drawing (GD) library. It dynamically displays the information as a map or bar chart as well as a numerical impression according to the real time demand of the users. This system will be a useful tool for medical personnel and researchers working on infectious disease problems and will save significant time in the redistribution of information.

Automation↗

The virtual terrorism response academy: training for high-risk, low-frequency threats.

The Virtual Terrorism Response Academy is a reusable virtual learning environment to prepare emergency responders to deal with high-risk, low-frequency events in general, terrorist attacks in particular. The principal learning strategy is a traditional one: apprenticeship. Trainees enter the Academy and travel through its halls, selecting different learning experiences under the guidance of instructors who are simultaneously master practitioners and master trainers. The mentors are real individuals who have been videotaped according to courseware designs; they are subsequently available at any time or location via broadband Internet or CD-ROM. The Academy features a Simulation Area where trainees are briefed on a given scenario, select appropriate resources (e.g., protective equipment and hazmat instruments), then enter a 3-dimensional space where they must deal with various situations. Simulations are done under the guidance of a master trainer who functions as a coach, asking questions, pointing out things, explaining his reasoning at various points in the simulation. This is followed by a debriefing and discussion of lessons that could be learned from the simulation and the trainee's decisions.

Computer Simulation↗

Characteristics of men who have sex with men on the internet but identify as heterosexual, compared with heterosexually identified men who have sex with women.

We compared men who have sex with other men on the Internet with the remainder of the sample of men who reported only sex with women on the Internet, in a sample of 1,846 Swedish men recruited from a major Swedish portal. We report on the self-identified heterosexual men in the sample who reported engaging in cybersex in the past year, and for whom there was complete data on sexual identity and the gender of cybersexual partners. Of the 244 cases with full data, 76% were heterosexual in both identity and behavior, 16% were gay or bisexual in identity and reported both male and female cybersexual contacts on the Internet, and 8% indicated their sexual preference was heterosexual but also reported at least one male sexual partner on the Internet. Thus, 11% of self-identified heterosexual men had sex with other men online. Comparing the two groups, the men who had sex with men (MSM) who did not identify (MSM-NI) spent significantly more time per week online, although a similar amount of time on sexual pursuits, as the heterosexual men. The MSM-NI were significantly more likely to agree that their online sexuality had affected their sexuality in a positive way, to have bought sex from prostitutes, to agree that they do things online that they would not do offline, have cybersex more often, use a web-camera and microphone more often, flirt and visit contact sites more often, and agree more often that sexual thoughts and behaviors are causing problems, desire to have sex creates problems, and sometimes fail to meet commitments due to their sexual behavior. These data taken together suggest that MSM-NI online are not uncommon and are characterized by the extent of their cybersexual involvement that sometimes extends to other men. Such men may rationalize this cybersex with other men as not, or minimally, sexual in much the same way as Humphreys characterized MSMs in public restrooms.

Adolescent↗

World Health Day is a day for safer motherhood.

Every year, April 7 is kept as World Health Day. This year [1998] marks the 50th anniversary of the foundation of WHO. However, the day has a double significance because the theme of this year's World Health Day is safe motherhood. All around the world people will mark this day and remind communities and leaders that there is still much work to be done to make pregnancy and childbirth safer. World leaders in Washington will be doing their part on this day, for without high-level political commitment it is hard to get things done. However, this effort is not just for a day. The whole year is dedicated to the theme of safe motherhood. Please let us know about the initiatives taking place in your country, and do send photographs] We can all do something this year to make things better for women and their newborns. Please send your stories and photos to the Editor, Safe Motherhood (address on back page). As well as the 10 action messages that were developed at the technical consultation to mark the 10th anniversary of the Safe Motherhood Initiative, fact sheets and slides are also available either by writing to WHO or on the Internet.

Health↗

Zoology www guide.

In almost every branch of zoology the internet is now a vital place for posting up-to-date status reports on all kind of animal groups and research areas. Many websites not only provide the latest on taxonomy, ecology and distribution, but also include valuable background information and details of experimental procedures as well as discussion forums. For the zoologist the online world seems to hold everything from acarology to otoliths. To show what impressive things can be done in communicating and facilitating research in zoology, given a little initiative and perseverance, we will introduce websites that find fresh ways to approach their subjects and that may, in some way or another, inspire zoologists. Readers are welcome to join in this process for future editions of Zoology www guides and should send their website suggestions to tbosch@zoologie.uni-kiel.de. In this issue the focus is on molluscs.

Journal Article↗