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PubMed2005

How the national healthcare quality and disparities reports can catalyze quality improvement.

BACKGROUND: The purpose of the National Reports on Healthcare Quality and Disparities is to enhance awareness of quality and health care disparities, track progress, understand variations, and catalyze improvements in health care. OBJECTIVES: The objective of this paper is to propose a model that will facilitate a user's progression from knowledge to action and to show how the reports, its data warehouse, associated products, and Agency for Healthcare Research and Quality resources are integrated and focused on a comprehensive campaign to improve health care quality. DESIGN: The design of the paper is to present a conceptual model and to show how implementation strategies for the reports fit the model. FINDINGS: The authors propose a quality improvement supply chain model to help elucidate the links of the process, corresponding developmental stages that potential users need to master and progress through, and "just-in-time" supply chain inputs at each of the corresponding stages, and populate the model with examples. CONCLUSION: The traditional ways of disseminating knowledge derived from science through reports and conferences are inadequate to the humbling need for vast improvements in the US health care system. Our model suggests the need for a wide variety of information, packaged in a diverse ways, and delivered just in time and on demand. It encourages the alignment of decision makers and researchers, along with information intermediaries and innovation brokers, to make the information production cycle more efficient and effective. Future iterations of the reports will improve relevance, meaning, and distribution of information to facilitate its uptake by potential users.

Adolescent↗

PubMed2005

Using the Internet? The experiences of parents of disabled children.

BACKGROUND: Research has offered consistent evidence that the provision of crucial information to parents of disabled children, at a time when they need it and in a form that they can use, is an intractable problem. This makes it important to develop new and effective approaches to information presentation, distribution and delivery. The Internet has been put forward as a medium through which families' needs for information and services can be met. This paper looks at parents of disabled children's experience of using it. METHODS: A cross-sectional survey of 3014 adult carers, of which 788 were carers of disabled children aged 0-17. Data were collected using a postal questionnaire. RESULTS: A high proportion (75%) had previously used the Internet. Of these, 63% were frequent users and 91% were using it at home. Popular uses were emailing, obtaining information about caring, ordering equipment and shopping online. Despite positive benefits, users experienced problems relating to technical issues and equipment and system design. Lack of time owing to caring and other circumstances was an issue for over half of all users. Never users were more likely to be living in rented accommodation, be unemployed and not have a PC at home. Reasons for not using the Internet included lack of access to equipment, cost and lack of skill. CONCLUSIONS: For some parents the Internet is a viable and flexible medium for accessing useful information and services. However, caution about the extent to which it becomes the primary means for delivering information is needed. Technical problems and lack of time can make it difficult to search for complex information. The 'digital divide' between users and non-users makes it crucial that issues of cost, lack of equipment and skill be addressed. Information needs to be made available in other forms to ensure that those who cannot or do not wish to use the Internet are not socially excluded.

Adolescent↗

PubMed1987

Temporal encoding of two-dimensional patterns by single units in primate inferior temporal cortex. III. Information theoretic analysis.

Ablation and single-unit studies in primates have shown that inferior temporal (IT) cortex is important for pattern discrimination. The first paper in this series suggested that single units in IT cortex of alert monkeys respond to a set of two-dimensional patterns with complex temporal modulation of their spike trains. The second paper quantified the waveform of the modulated responses of IT neurons with principal components and demonstrated that the coefficients of two to four of the principal components were stimulus dependent. Although the coefficients of the principal components are uncorrelated, it is possible that they are not statistically independent. That is, several coefficients could be determined by the same feature of the stimulus, and thus could be conveying the same information. The final part of this study examined this issue by comparing the amount of information about the stimulus that can be conveyed by two codes: a temporal waveform code derived from the coefficients of the first three principal components and a mean rate code derived from the spike count. We considered the neuron to be an information channel conveying messages about stimulus parameters. Previous applications of information theory to neurophysiology have dealt either with the theoretical capacity of neuronal channels or the temporal distribution of information within the spike train. This previous work usually used a general binary code to represent the spike train of a neuron's response. Such a general approach yields no indication of the nature of the neuron's intrinsic coding scheme because it depends only on the timing of spikes in the response. In particular, it is independent of any statistical properties of the responses. Our approach uses the principal components of the response waveform to derive a code for representing information about the stimuli. We regard this code as an indication of the neuron's intrinsic coding scheme, because it is based on the statistical properties of the neuronal responses. We measured how much information about the stimulus was present in the neuron's responses. This transmitted information was calculated for codes based on either the spike count or on the first three principal components of the response waveform. The information transmitted by each of the first three principal components was largely independent of that transmitted by the others. It was found that the average amount of information transmitted by the principal components was about twice as large as that transmitted by the spike count.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed2002

The Nucleic Acid Database.

The Nucleic Acid Database was established in 1991 as a resource to assemble and distribute structural information about nucleic acids. Over the years, the NDB has developed generalized software for processing, archiving, querying and distributing structural data for nucleic acid-containing structures. The architecture and capabilities of the Nucleic Acid Database, as well as some of the research enabled by this resource, are presented in this article.

Computer Graphics↗

PubMed2006

The mahogany family "out-of-Africa": divergence time estimation, global biogeographic patterns inferred from plastid rbcL DNA sequences, extant, and fossil distribution of diversity.

With information on fossils and extant distribution of diversity/endemism in the mahogany family, we perform a global biogeographic study of Meliaceae using plastid rbcL data for all subfamilies, tribes and nearly all genera. Our study indicates that: (1) Meliaceae are of western Gondwanan origin; (2) dispersal played an important role for the current distribution of mahogany biota; and (3) the direction of dispersal was most likely an "out-of-Africa" scenario with important dispersal routes across Eurasia and between Eurasia and North America provided by Beringia and the North Atlantic land bridge and North America and South America via island chains and/or direct land connections. Populations in North America, Europe, and East Asia were presumably eliminated as tropical climates disappeared from these areas during the Miocene. Extensive Meliaceae fossil findings confirm that the entry of megathermal (frost-intolerant) angiosperms into southern continents from Oligocene to Pliocene must be considered as an important means of establishing pantropical distribution patterns.

Africa↗

PubMed1986

Information content of binding sites on nucleotide sequences.

Repressors, polymerases, ribosomes and other macromolecules bind to specific nucleic acid sequences. They can find a binding site only if the sequence has a recognizable pattern. We define a measure of the information (R sequence) in the sequence patterns at binding sites. It allows one to investigate how information is distributed across the sites and to compare one site to another. One can also calculate the amount of information (R frequency) that would be required to locate the sites, given that they occur with some frequency in the genome. Several Escherichia coli binding sites were analyzed using these two independent empirical measurements. The two amounts of information are similar for most of the sites we analyzed. In contrast, bacteriophage T7 RNA polymerase binding sites contain about twice as much information as is necessary for recognition by the T7 polymerase, suggesting that a second protein may bind at T7 promoters. The extra information can be accounted for by a strong symmetry element found at the T7 promoters. This element may be an operator. If this model is correct, these promoters and operators do not share much information. The comparisons between R sequence and R frequency suggest that the information at binding sites is just sufficient for the sites to be distinguished from the rest of the genome.

Bacterial Proteins↗

PubMed2003

A theory for classification of health care organizations in the new economy.

Most of the available studies into information technology (IT) have been limited to investigating specific issues, such as how IT can support decision makers distributing the information throughout health care organization, or how technology impacts organizational performance. In this study, for use in the planning of information system development projects, a theoretical model for the classification of health care organizations is proposed. We try to reflect the development in the contemporary digital economy by theoretically classifying health care organizations into three types, namely traditional, developing, and flexible. We describe traditional health care organizations as organizations with a centralized system for management and control. In developing health care organizations, IT is spread over the horizontal dimension and is used for coordinating the different parties throughout the organization. Finally, flexible health care organizations are those which work actively with the design of new health care organizational structure while they are designing the information system.

Decision Making, Computer-Assisted↗

PubMed1997

Information needs among Italian abortion patients.

Controversy still surrounds abortion and abortion care in many countries. Information for women who seek abortion is not always as objective and complete as desired. In Italy abortion has been legal for the last decades. The overall purpose of this study was to investigate general information needs among patients in a hospital in Rome. A questionnaire concerning information needs, opinions on information to include in a booklet, and methods of information was distributed among 212 women in a public hospital in Rome. Women answered the questionnaire very differently, and general information needs were not shown to be as essential as expected; their present needs seemed especially underestimated. However, a booklet with information as objective and complete as possible is suggested as a way of giving information to abortion patients.

Abortion, Induced↗

PubMed2004

Information on ancestry from genetic markers.

It is possible to estimate the proportionate contributions of ancestral populations to admixed individuals or populations using genetic markers, but different loci and alleles vary considerably in the amount of information that they provide. Conventionally, the allele frequency difference between parental populations (delta) has been used as the criterion to select informative markers. However, it is unclear how to use delta for multiallelic loci, or populations formed by the mixture of more than two groups. Moreover, several other factors, including the actual ancestral proportions and the relative genetic diversities of the parental populations, affect the information provided by genetic markers. We demonstrate here that using delta as the sole criterion for marker selection is inadequate, and we propose, instead, to use Fisher's information, which is the inverse of the variance of the estimated ancestral contributions. This measure is superior because it is directly related to the precision of ancestry estimates. Although delta is related to Fisher's information, the relationship is neither linear nor simple, and the information can vary widely for markers with identical deltas. Fortunately, Fisher's information is easily computed and formally extends to the situation of multiple alleles and/or parental populations. We examined the distribution of information for SNP and microsatellite loci available in the public domain for a variety of model admixed populations. The information, on average, is higher for microsatellite loci, but exceptional SNPs exceed the best microsatellites. Despite the large number of genetic markers that have been identified for admixture analysis, it appears that information for estimating admixture proportions is limited, and estimates will typically have wide confidence intervals.

Black People↗

PubMed1992

Features of spliceosome evolution and function inferred from an analysis of the information at human splice sites.

An information analysis of the 5' (donor) and 3' (acceptor) sequences spanning the ends of nearly 1800 human introns has provided evidence for structural features of splice sites that bear upon spliceosome evolution and function: (1) 82% of the sequence information (i.e. sequence conservation) at donor junctions and 97% of the sequence information at acceptor junctions is confined to the introns, allowing codon choices throughout exons to be largely unrestricted. The distribution of information at intron-exon junctions is also described in detail and compared with footprints. (2) Acceptor sites are found to possess enough information to be located in the transcribed portion of the human genome, whereas donor sites possess about one bit less than the information needed to locate them independently. This difference suggests that acceptor sites are located first in humans and, having been located, reduce by a factor of two the number of alternative sites available as donors. Direct experimental evidence exists to support this conclusion. (3) The sequences of donor and acceptor splice sites exhibit a striking similarity. This suggests that the two junctions derive from a common ancestor and that during evolution the information of both sites shifted onto the intron. If so, the protein and RNA components that are found in contemporary spliceosomes, and which are responsible for recognizing donor and acceptor sequences, should also be related. This conclusion is supported by the common structures found in different parts of the spliceosome.

Base Sequence↗

PubMed2002

An interactive database of cocaine-responsive gene expression.

The postgenomic era of large-scale gene expression studies is inundating drug abuse researchers and many other scientists with findings related to gene expression. This information is distributed across many different journals, and requires laborious literature searches. Here, we present an interactive database that combines existing information related to cocaine-mediated changes in gene expression in an easy-to-use format. The database is limited to statistically significant changes in mRNA or protein expression after cocaine administration. The Flash-based program is integrated into a Web page, and organizes changes in gene expression based on neuroanatomical region, general function, and gene name. Accompanying each gene is a description of the gene, links to the original publications, and a link to the appropriate OMIM (Online Mendelian Inheritance in Man) entry. The nature of this review allows for timely modifications and rapid inclusion of new publications, and should help researchers build second-generation hypotheses on the role of gene expression changes in the physiology and behavior of cocaine abuse. Furthermore, this method of organizing large volumes of scientific information can easily be adapted to assist researchers in fields outside of drug abuse.

Animals↗

PubMed1985

Cumulative causation and selectivity in labour market oriented migration caused by imperfect information.

This paper is concerned with the implications of job search models for migration. In contrast to earlier models, the model described here does not assume perfect information about the wage offer distribution. "In this model information about the wage offer distribution is imperfect and accumulated through the search process. When based on this search model, the migration model is largely enriched and also more realistic. Strategies, which are suboptimal or even absurd with perfect information about the wage offer distribution, such as purchase of information, can be preferable in a migration model, when imperfect information is assumed." The author suggests that the model can explain many phenomena utilized in the argumentation of polarization theory. Consideration is also given to selectivity with respect to age, educational status, and risk preference, as well as the cumulative effects caused by past migration flows and the size of regions. (summary in FRE, GER)

Age Factors↗

PubMed2006

Monte Carlo sampling and principal component analysis of flux distributions yield topological and modular information on metabolic networks.

The work presented here uses Monte Carlo random sampling combined with flux balance analysis and linear programming to analyse the steady-state flux distributions on the surface of the glucose-ammonia phenotypic phase plane of an Escherichia coli system grown on glucose-minimal medium. The distribution of allowable glucose and ammonia uptake rates showed a triangular shape, the apex corresponding to maximum growth rate. The exact shape, e.g. the diagonal boundary is determined by the relative amounts of nutrients required for growth. The logarithm of flux values has a normal distribution, e.g. there is a log normal distribution, and most of the reactions have an order of magnitude between 10(-1) and 1. The increase in the number of blocked reactions as growth switched from aerobic to micro-aerobic phase and the presence of alternate networks for a single optimal solution were both reflections of the variability of pathway utilization for survival and growth. Principal component analysis (PCA) provided us with significant clues on the correlations between individual reactions and correlations between sets of reactions. Furthermore, PCA identified the most influential reactions of the system. The PCA score plots clearly distinguish two different growth phases, micro-aerobic and aerobic. The loading plots for each growth phase showed both the impact of the reactions on the model and the clustering of reactions that are highly correlated. These results have proved that PCA is a promising way to analyse correlations in high-dimensional solution spaces and to detect modular patterns among reactions in a network.

Ammonia↗

PubMed1984

What should the public be told about primary prevention of CHD?

There is an increasing demand from the general public for medical information. In his analysis of ongoing and prospective tendencies in Megatrends, Naisbitt foresees a change from an industrial era to a society based on the creation and distribution of information, and 'from a society run by short-term considerations and rewards in favour of dealing with things in much longer-term frames'. And with regard to medical care: 'The new emphasis on the human angle shows up in three major trends behind the move from institution help to self-help'. These aspects include among others our responsibility for health, self-care and preventive medicine. The medical profession has to meet this demand for information with appropriate answers. So far we have failed in several respects. One source of confusion is the rapid distribution to the general public of research results which have not had time to be put into an overall health prospective. Some of the issues which seem to be confusing with respect to coronary heart disease (CHD) prevention are: what risk factors are really of importance, what can be achieved by screening examinations versus more general health measures, and whether our diet really matters.

Coronary Disease↗

PubMedDate not supplied

Should drug information be an integral part of health care?

The fact that the effects of drugs are incompletely known makes special demands on drug information for the public. Much of this information is marred by poor content, choosing target groups by likely sales, and giving drug-centred rather than health-centred information. These problems arise from the imbalance between the relative quantities of commercial and independent drug information, the separation of drug information from health education, and strong commercial and professional interests. Suggested solutions include setting standards, integration, and using pharmacists to distribute drug information. Such actions may, however, create new problems. It might be necessary or desirable to regulate the quantity, forms and sources of commercial drug information aimed at consumers. Drug information should be regarded as an integral part of health care and treated accordingly. Furthermore, the widening range of substances used to influence health, shrinking prescription requirements, biased reporting in mass media, and national industrial priorities are changing the drug information scene and demand new solutions.

Drug Information Services↗

PubMed1996

Ixodes (Ixodes) scapularis (Acari:Ixodidae): redescription of all active stages, distribution, hosts, geographical variation, and medical and veterinary importance.

The blacklegged tick, Ixodes (Ixodes) scapularis Say, 1821, is redescribed, based on laboratory reared specimens originating in Bulloch County, Georgia. Information on distribution, host associations, morphological variation, and medical/veterinary importance is also presented. A great deal of recent work has focused on this species because it is the principal vector of the agent of Lyme disease (Borrelia burgdorferi Johnson, Schmidt, Hyde, Steigerwaldt & Brenner) in eastern North America. Its distribution appears to be expanding, and includes the state of Florida in the southeastern United States north to the provinces of Nova Scotia and Prince Edward Island, Canada, west to North and South Dakota, United States, and south to the state of Coahuila, Mexico. Although I. scapularis feeds on at least 125 species of North American vertebrates (54 mammalian, 57 avian, and 14 lizard species), analysis of the U.S. National Tick Collection holdings show that white-tailed deer, Odocoileus virginianus (Zimmermann), cattle, Bos taurus L., dogs, Canis lupus L., and other medium-to-large sized mammals are important hosts for adults as are native mice and other small mammals, certain ground-frequenting birds, skinks, and glass lizards for nymphs and larvae. This tick is a polytypic species exhibiting north-south and east-west morphological clines. Analysis of variance and Student-Newman-Keuls multiple comparisons revealed significant interpopulational variation that is expressed most significantly in the nymphal stage. Nymphs from northern (Minnesota, Massachusetts, Maryland) populations had relatively larger basis capituli with shorter cornua (except Maryland) than southern (North Carolina, Georgia) populations. Midwestern populations (Minnesota, Missouri) differed from eastern populations (Massachusetts, Maryland, North Carolina, Georgia) in idiosomal characters (broader scuta, larger coxae III, and IV). In addition to Lyme disease, this tick is also a primary vector of the agent of human and rodent babesiosis, Babesia microti Franca. Under laboratory conditions it has transmitted the agents of deer babesiosis, Babesia odocoilei Emerson & Wright, tularemia, Francisella tularensis McCoy & Chapin, and anaplasmosis, Anaplasma marginale Theiler. Moreover, I. scapularis can reach pest proportions on livestock, and females can cause tick paralysis in dogs.

Animals↗

PubMed2004

Distributed representation of sound intensity in the rat auditory cortex.

We epipially mapped tone-burst-evoked potentials over the rat auditory cortex, and investigated the representation of intensity information. The experiments were designed to elucidate how the auditory cortex represents a steady-state plateau sound pressure level (SPL) and dynamic onset temporal structure, i.e., the rate of pressure change (in Pa/s), and how the representations differ across the auditory fields. The anterior and ventral fields have spatial axes of the rate of pressure change. Characteristic frequency (CF) locations mainly handle the dynamic state, while off-CF locations have the potential to code the steady state. Each field represents the intensity information differently, particularly at the off-CF locations. These results suggest that intensity information is distributed in various aspects in the multiple auditory fields.

Acoustic Stimulation↗

PubMedDate not supplied

The function of sentence accents and given/new information in speech processing: different strategies for normal-hearing and hearing-impaired listeners?

Two experiments were carried out to investigate how the correspondence between sentence accentuation and distribution of information is used in human word processing. A forced-choice task with target words embedded in sentences was employed for this purpose. Target words provided either 'given' or 'new' information, and were either accented or unaccented. The subjects had to choose between two words that differed in the last consonant by one phonetic feature (e.g., mouth/mouse). The first experiment involved both normal-hearing and hearing-impaired listeners. A fixed amount of noise was used to reduce the quality of speech for normal-hearing listeners, in order to enable a comparison between the two listener groups. The results of the first experiment showed different processing patterns for normal-hearing and hearing-impaired listeners. The hearing-impaired listeners were more accurate with words that were properly accented for their information value, whereas the normal-hearing subjects were more accurate with accented than unaccented words regardless of their information value. A new group of normal-hearing subjects was tested in a second experiment with speech of more severely reduced quality. The results indicated that, under these circumstances, the normal-hearing listeners changed their strategy and also showed an interaction between information value and accent. It seems that, as speech becomes less intelligible, listeners depend increasingly on linguistic expectations stemming from the correlation between information value and accentuation.

Adult↗