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PubMed2004

Concept-oriented indexing of video databases: toward semantic sensitive retrieval and browsing.

Digital video now plays an important role in medical education, health care, telemedicine and other medical applications. Several content-based video retrieval (CBVR) systems have been proposed in the past, but they still suffer from the following challenging problems: semantic gap, semantic video concept modeling, semantic video classification, and concept-oriented video database indexing and access. In this paper, we propose a novel framework to make some advances toward the final goal to solve these problems. Specifically, the framework includes: 1) a semantic-sensitive video content representation framework by using principal video shots to enhance the quality of features; 2) semantic video concept interpretation by using flexible mixture model to bridge the semantic gap; 3) a novel semantic video-classifier training framework by integrating feature selection, parameter estimation, and model selection seamlessly in a single algorithm; and 4) a concept-oriented video database organization technique through a certain domain-dependent concept hierarchy to enable semantic-sensitive video retrieval and browsing.

Abstracting and Indexing↗
PubMed2005

Epidemiology of vestibular vertigo: a neurotologic survey of the general population.

OBJECTIVE: The purpose of this study was to determine the prevalence and incidence of vestibular vertigo in the general population and to describe its clinical characteristics and associated factors. METHODS: The neurotologic survey had a two-stage general population sampling design: nationwide modified random digit dialing sampling for participation in the German National Telephone Health Interview Survey 2003 (response rate 52%) with screening of a random sample of 4,869 participants for moderate or severe dizziness or vertigo, followed by detailed neurotologic interviews developed through piloting and validation (n = 1,003, response rate 87%). Diagnostic criteria for vestibular vertigo were rotational vertigo, positional vertigo, or recurrent dizziness with nausea and oscillopsia or imbalance. Vestibular vertigo was detected by our interview with a specificity of 94% and a sensitivity of 84[corrected]% in a concurrent validation study using neurotology clinic diagnoses as an accepted standard (n = 61). RESULTS: The lifetime prevalence of vestibular vertigo was 7.4[corrected]%, the 1-year prevalence was 4.9[corrected]%, and the incidence was 1.4[corrected]%. In 80% of affected individuals, vertigo resulted in a medical consultation, interruption of daily activities, or sick leave. Female sex, age, lower educational level, and various comorbid conditions, including tinnitus, depression, and several cardiovascular diseases and risk factors, were associated with vestibular vertigo in the past year in univariate analysis. In multivariable analysis, only female sex, self-reported depression, tinnitus, hypertension, and dyslipidemia had an independent effect on vestibular vertigo. CONCLUSIONS: Vestibular vertigo is common in the general population, affecting [corrected] 5% of adults in 1 year. The frequency and health care impact of vestibular symptoms at the population level have been underestimated.

Activities of Daily Living↗
PubMed2004

Gender composition of occupation and industry and working women's alcohol consumption.

OBJECTIVE: This article examines the impact of the gender compositions of occupation and industry on women workers' consumption of alcoholic beverages. METHOD: A sample of 11,783 currently working women, aged 21 to 65, was obtained from the 1990 National Health Interview Survey (NHIS). The gender compositions of three-digit occupational and industrial categories were calculated based on a 1% sample of the 1990 census and attached to the NHIS sample. A set of regression analyses tests the relationship between gender composition of occupation or industry and drinking behavior, such as the likelihood of being a drinker and the level of alcohol consumption among the drinkers, and reported levels of stress. RESULTS: When the demographic background variables are controlled for, the percentage of men within each occupational classification is positively correlated with stress levels. Curvilinear relationships were found between percentage of men in both industry and occupation and the likelihood of drinking in the past year. CONCLUSIONS: These findings suggest that the women working in gender-balanced rather than gender-typed, jobs were more likely to drink due to increased interaction between genders. The results also suggest that male dominance of an occupation may be a source of stress, which may increase alcohol consumption among women workers.

Adult↗
PubMed1998

Determination of acceptability of flavored oat bran frankfurters by older adults.

The US population is aging rapidly and, within the next 25 years, 20-25% will be over age 60. This creates a vast new market for age-specific products and increases the responsibility of food scientists and nutritionists to provide appropriate foods for older adults. Many older individuals are energy deficient and need to be encouraged to consume more food in order to maintain body weight and health, but need to decrease the calories from fat in their diets. Many of these older individuals are not inclined to eat foods that they enjoy for fear that these foods may be detrimental to their health (de Castro, 1993), or they have lost their gustational abilities to the degree that these foods are no longer enjoyable. This research looks at a possible solution to both problems by replacing fat in a favorite food of older adults and adjusting the flavor levels of this product. Frankfurters were made from mechanically deboned poultry meat in which standard commercial formulation was compared to three flavoring treatments using oat bran as a fat replacer (6% oat bran, 30% H2O). Mixed spices (traditional saucisson) were added to two of these treatments in standard and double proportions. Participants were 71 individuals over the age of 65 in varying levels of health from four regional care facilities. Seven gram, three-digit-coded samples were evaluated at 60 degrees C, and scored on a nine-point hedonic scale. A significant (alpha = 0.0004) preference was shown for the double-spiced frank. No differences by sex or race were found. Research concluded that addition of flavoring aids in the increased acceptability of products by older adults.

Aged↗
PubMed2000

Property rights and privacy principles.

Healthcare consumers own their medical information. As paper medical folders become digital, protection of this private and confidential information falls to information specialists rather than the traditional care givers. On the basis of a nationwide market assessment study, the authors identify the key issues regarding protecting this personal digital property and outline the federal requirements stemming from the Health Insurance Portability and Accountability Act (HIPAA). Consumer informed consent over the use of specific medical data is a basic requirement, and is a concept supported by physicians and care givers who rely on consent to approve surgeries and treatment. The article concludes with a solution outline that places the patient in control of his or her personal information, meets security and privacy concerns, and facilitates the critical exchange of patient information among care givers.

Computer Security↗
PubMed2003

Current status of outcome measure development for clinical trials in systemic sclerosis. Report from OMERACT 6.

Systemic sclerosis (SSc), also known as scleroderma, is a complex, multisystem disease that results in severe morbidity, disability, and life-threatening complications. The wide range of biological systems clinically involved, and the large spectrum of disease activity and damage that occurs in this disease have limited clinical investigation of SSc, especially therapeutic trials. The OMERACT 6 Workshop on Systemic Sclerosis was conceived as a starting point for the process of assessing the current state of the science in outcome assessment in SSc and then setting a realistic research agenda and priorities for future work in this area This article reviews the current status of assessment tools for research in SSc within the main fundamental domains of illness in SSc, including problems related to skin, pulmonary, cardiac, peripheral vascular (Raynaud's phenomenon and digital ulceration), renal, and musculoskeletal systems as well as health-related quality of life and physical functioning. The current level of validation of outcome measures in SSc is assessed according to the guidelines set forth by prior OMERACT meetings.

Clinical Trials as Topic↗
PubMed2003

Correlation between preoperative magnetic resonance spectroscopic data on high grade gliomas and morphology of Ki-67-positive tumor cell nuclei.

OBJECTIVE: To investigate possible statistical correlations between metabolic data from preoperative proton magnetic resonance spectroscopy (1HMRS) and morphology of proliferating tumor cell nuclei in anaplastic gliomas and glioblastomas. STUDY DESIGN: Ki-67-positive tumor cell nuclei in paraffin sections of surgical specimens from 36 patients (7 anaplastic gliomas, World Health Organization grade 3; 29 glioblastomas, World Health Organization grade 4) were investigated by means of a digital image analysis system. Stringent inclusion criteria were formulated for all cases with respect to histologic quality and spectroscopic examination. As morphometric variables, nuclear area, shape variables (roundness factor, size-invariate Fourier amplitudes) and density of Ki-67-positive tumor cell nuclei per reference area were determined. RESULTS: Correlation analysis according to Spearman revealed a significant positive correlation between the total creatine (TCR) peak and nuclear area (P = .005). This correlation was also found within the glioblastoma group (P = .019). There was also a significant negative correlation of nuclear area with the ratio between choline and TCR in all cases (P = .014) and within the glioblastoma group (P = .046). No significant correlation of spectroscopic data was found with nuclear shape or density of Ki-67-positive tumor cell nuclei. CONCLUSION: The results demonstrate a correlation between spectroscopic data and morphology of proliferating tumor cell nuclei (nuclear size) in high grade gliomas. This study is part of a detailed investigation of the interrelationship between preoperative 1HMRS and quantitative histomorphology of gliomas.

Biomarkers, Tumor↗
PubMed2006

Assessing human movement with accelerometry.

The methods for measuring and evaluating human movement have advanced rapidly over the past 2 decades. The use of smaller, lighter, more powerful personal computers, digital video cameras and miniature, portable accelerometers have allowed the health professional, engineer, sports coach and scientist to very precisely record and quantify human movements on the sports field, in the business office, industrial setting and in the home. Most human motion analysis systems have evolved to meet the particular needs of the user. One such system that has developed over the past ten years in the Sport Science Laboratory at Dalhousie University is the Padlog series of accelerometer systems. This paper will discuss the development the Padlog systems at Dalhousie.

Acceleration↗
PubMed1994

[Quality criteria of digital subtraction angiography of the trunk of the body].

The presently valid quality criteria of digital subtraction angiography in the body trunk area are described. The indications for intravenous and intraarterial examinations are explained; these are closely connected with the respective demands. The problem levels are analysed and update technical and methodical solutions are offered.

Angiography, Digital Subtraction↗
PubMed2006

Knowledge of colon cancer screening in a national probability sample in the United States.

This study examined colon cancer screening knowledge and potential covariates (demographic, health, health care, and cancer information seeking) among adults of at least 45 years of age. Data were analyzed from the 2003 National Cancer Institute's (NCI's) Health Information National Trends Survey (HINTS 2003), a U.S. random-digit dial study. Our sample consisted of 3,131 adults (53.6% female, 77.9% White). The colon cancer screening knowledge questions assessed whether participants had heard of the fecal occult blood test (FOBT; 73.7%), knew the recommended start age (26.1%), knew the frequency of FOBT (39.5%), had heard of flexible sigmoidoscopy or colonoscopy (84.3%), knew the start age (39.6%), and knew the frequency with which to test (12.8%). Factors associated with lower knowledge (all equal to p < .05 in a multivariate analysis) included being younger (45 to 49 years old) or older (70 years old or more), African American or non-Hispanic other, unmarried; had lower educational attainment; had not visited a health care provider in the past year; had not previously undergone FOBT; and had never looked for cancer information. This study documents low rates of colon cancer screening knowledge in the general population, and identifies subgroups where health communication interventions are most warranted.

Adult↗
PubMed2004

Satisfaction with health care for young children.

OBJECTIVES: The aims of this study are to 1) assess parent satisfaction with well-child care for their young child and 2) identify how global satisfaction ratings and parent reports on the processes of care vary with child and family characteristics, health care received, and health system factors. METHODS: The National Survey of Early Childhood Health is a telephone survey that used a stratified random-digit-dial sampling design to achieve a nationally representative sample of 2068 children and 4 to 35 months. Parents provided global ratings of satisfaction with their child's well-child visits (range 0-100) and reported their satisfaction with information provided and the time spent with the provider. A subsample of parents whose child has a particular provider for well-child care (n = 930) also reported their likelihood of recommending their provider. RESULTS: The mean global satisfaction rating is 86.9 (standard error: 6.1). Approximately 94% of parents of young children reported information satisfaction, 88% reported time satisfaction, and 79% would recommend their child's provider. Bivariate analysis shows lower satisfaction for uninsured children but few differences associated with insurance type or health care setting. In multivariate analyses including child and family factors and health system factors, Hispanic, Spanish-speaking mothers of young children have lower odds than non-Hispanic white mothers of reporting information (odds ratio [OR]: 0.32; 95% confidence interval [CI]: 0.13-0.79) and time satisfaction (OR: 0.44; 95% CI: 0.21-0.90). Parents of children who experienced missed or delayed care have lower odds of time satisfaction (OR: 0.27; 95% CI: 0.16-0.46) and have lower global satisfaction. Greater length of well-child visits is consistently associated with greater satisfaction on all 4 measures. CONCLUSION: Although most parents reported relatively high levels of satisfaction with well-child care, shorter length of well-child visits and experiencing missed or delayed care are the 2 factors consistently associated with lower satisfaction using each of the measures. Efforts to improve satisfaction ratings might focus on improving the delivery of well-child care and ensuring that parents get the time they need.

Analysis of Variance↗
PubMedDate not supplied

Consumer attitudes about health care-acquired infections and hand hygiene.

Mandatory reporting and disclosure of health care-acquired infections have resulted in controversy over the perceived notion that consumers will not understand how to interpret data and that such information may negatively influence utilization of hospitals. The objective was to determine consumers' attitudes about health care-acquired infections, hand hygiene practices, and patient empowerment. A telephone survey based on a random digit dialing sample of all households in the United States was conducted. Consumers were asked about choosing a hospital, hand hygiene practices, and health care-acquired infections. Some 94% of respondents rated environmental cleanliness as very important. Hospital infection rates would influence decision making for 93% of consumers. Four in 5 consumers said they would ask their health care worker to wash and sanitize his or her hands. Our findings strongly suggest that (1) consumers will use infection data in selecting and/or leaving a hospital system and (2) consumers are ready to be empowered with information to ensure a positive outcome.

Cross Infection↗
PubMed2004

Depression, anxiety, and physical impairments and quality of life in the U.S. noninstitutionalized population.

OBJECTIVE: The objective of this study was to examine health-related quality of life and health behaviors among persons reporting a primary mental health impairment compared with those reporting a primary physical health impairment and those reporting no impairment. METHODS: Data were obtained from the Behavioral Risk Factor Surveillance System, an ongoing state-based, random-digit telephone survey of the noninstitutionalized U.S. population aged 18 years or older. In 2001-2002, health-related quality-of-life measures were administered in 23 states and the District of Columbia. RESULTS: An estimated 5.1 percent of U.S. adults reporting a primary health impairment indicated that a mental health problem was the primary cause. Those with a primary mental health impairment were more likely than those with a primary physical health impairment to report infrequent vitality (less than 14 days in the previous 30 days) and frequent occurrences of mental distress, depressive symptoms, and anxiety (at least 14 days in the previous 30 days). Relative to those who reported no impairment, persons who reported a mental health impairment were more likely to indicate that they experienced frequent physical distress and frequent pain. Persons with a primary mental health impairment were more likely than those with a primary physical health impairment to smoke and drink heavily. No significant difference was found in self-reported frequent sleeplessness or fair-to-poor general health between persons with a primary mental health impairment and those with a physical health impairment. CONCLUSIONS: Mental health impairment is strongly associated with reduced health-related quality of life and health behaviors, frequently at levels equal to or exceeding those of physical health impairments.

Adolescent↗
PubMed1995

[The validity and reliability of arterial pressure measurement in a health center].

OBJECTIVE: To evaluate the validity of blood pressure measurement by studying the presence of preference bias in last digits and also of the bias which tends to situate measurements below the established limit. To evaluate the interobserver (doctor-nurse) reliability of the measurements. DESIGN: A cross-sectional [correction of crossover] observation study with descriptive and analytic components. SETTING: A nursing station in the Health Centre. PATIENTS: The patients who attended the nursing station by appointment during the months of September and October 1993. MEASUREMENTS AND MAIN RESULTS: The patients who attended the nursing station by appointment had their blood pressure measured by a doctor or nurse in a random fashion. We detected a preference in last digits, which was very significant for both systolic and diastolic pressure (p < 0.0001). The tendency to reduce diastolic figures to below the preestablished limit of pressure was also very significant (p < 0.05). The nurse found lower figures than the doctor, with a very significant difference for diastolic pressure (p < 0.001). The index of kappa concordance between nurse and doctor on evaluating whether pressure was high or not was 0.4864, with a C.I. of 95%, from 0.3530 to 0.6198. CONCLUSIONS: The existence of two important biases in the measurements of pressure questions their validity. Additionally the significant difference between the pressure averages and the low concordance poses a serious question over the interobserver reliability and should make us restate blood pressure measurement and the treatment of patients suffering Hypertension.

Adolescent↗
PubMed2006

Measuring dissimilarity in online health search activities.

There is growing evidence of the use of the Internet to obtain critical health information as well as increased diversity of user groups. While users of web-based information often report their reliance on healthcare providers for validation of information, it has yet to be determined if this is universally true across all types of information or user groups. In some cases consumers may aggregate in places where they trust web information (relative to provider-based information), such as areas of unsettled diagnostic methods or ambiguous treatment protocols. To date little research has been done to identify and differentiate clusters of health consumers and their similarities related to type of information sought. Data from a study of consumer Web search activity in a post-intervention era serves as a natural experiment, and can identify whether clusters of "digitally underserved groups" persist in the US, following national efforts to eliminate barriers to health information access. This exploratory technology assessment study seeks to differentiate and delineate specific information behaviors, across targeted healthcare subgroups. Doing so allows the design of more effective strategies to promote the use of the Web as a health education and health promotion tool, under the envisioned shared decisionmaking, consumer-centric health information model, critical to the proposed US national health information infrastructure.

Attitude to Computers↗
PubMed1996

Income, social stratification, class, and private health insurance: a study of the Baltimore metropolitan area.

Most studies of inequalities and access to health care have used income as the sole indicator of social stratification. Despite the significance of social theory in health insurance research, there are no empirical studies comparing the ability of different models of social stratification to predict health insurance coverage. The aim of this study is to provide a comparative analysis using a variety of theory-driven indicators of social stratification and assess the relative strength of the association between these indicators and private health insurance. Data were collected in a 1993 telephone interview of a random digit dialing sample of the white population in the Baltimore Metropolitan Statistical Area. Indicators of social stratification included employment status, full-time work, education, occupation, industry, household income, firm size, and three types of assets: ownership, organizational, and skill/credential. The association between social stratification and private health insurance was strongest for those having higher household incomes, having attained at least a bachelor's degree, and working in a firm with more than 50 employees, followed by being an owner or manager, and by being employed. The addition of education and firm size improved the prediction of the household income model. The authors conclude that studies of inequalities in health insurance coverage can benefit from the inclusion of theory-driven indicators of social stratification such as human capital, labor market segmentation, and control over productive assets.

Adult↗
PubMed2001

Impact of health care system on physicians' discontent.

This study was designed to investigate the impact of physicians' perceptions of the health care system on their discontent with their profession. By using a random digit dialing technique, a structured telephone interview was conducted with 401 generalist physicians (343 men, 56 women) who were practicing medicine at least for five years and were younger than 65 years. Physicians' willingness to choose medicine again was correlated with their perceptions of different aspects of the health care system. Of the total participants, 288 (72 percent) indicated that they would choose medicine again, 91 (23 percent) would not choose medicine, and 22 (5 percent) were not sure. Results of the step-wise logistic regression showed that after adjustment for physicians' gender and age, those who would not choose medicine again were more than twice as likely as other physicians who would choose medicine to believe that the health care environment will deteriorate more in the future (odds ratio = 2.1, p < .01), were less than half as likely to believe that physicians nowadays share more responsibilities with other health care professionals (odds ratio = .42, p < .01), and were less than half as likely to confirm that patients understand their health insurance better than before (odds ratio = .46, p < .01). Findings suggest that physicians' discontent can be predicted by their negative perceptions of the health care environment. Findings have implications for improving the quality of professional and personal life of the physician, thus improving the quality of care and satisfaction of the patient.

Adult↗