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PubMed2002

[Contribution of anesthesia to workflow operation].

The changes in our health care system caused by the introduction of DRGs make it necessary for us to abandon departmental process structures in favour of total hospital orientated process structures. An interdisciplinary approach is crucial to enable the most effective use of personnel and material resources. Future orientated information technology and organisational structures will enable us to process our patients effectively and efficiently from pre-admission to discharge. Anaesthesia has to be integrated into a patient management system for in- and out-patients. The essential matters for consideration are anaesthesia consulting hours, the common establishment of process structures for preoperative care, operation room management and postoperative patient care. Routine controls and analysis of the required teamwork reveal improvement potential and enable us to use the necessary control elements effectively.

Anesthesia Department, Hospital↗
PubMed2005

Linear analysis of carbon-13 chemical shift differences and its application to the detection and correction of errors in referencing and spin system identifications.

Statistical analysis reveals that the set of differences between the secondary shifts of the alpha- and beta-carbons for residues i of a protein (Deltadelta13C(alpha)i - Deltadelta13C(beta)i) provides the means to detect and correct referencing errors for 1H and 13C nuclei within a given dataset. In a correctly referenced protein dataset, linear regression plots of Deltadelta13C(alpha)i, Deltadelta13C(beta)i, or Deltadelta1H(alpha)i vs. (Deltadelta13C(alpha)i - Deltadelta13C(beta)i) pass through the origin from two directions, the helix-to-coil and strand-to-coil directions. Thus, linear analysis of chemical shifts (LACS) can be used to detect referencing errors and to recalibrate the 1H and 13C chemical shift scales if needed. The analysis requires only that the signals be identified with distinct residue types (intra-residue spin systems). LACS allows errors in calibration to be detected and corrected in advance of sequence-specific assignments and secondary structure determinations. Signals that do not fit the linear model (outliers) deserve scrutiny since they could represent errors in identifying signals with a particular residue, or interesting features such as a cis-peptide bond. LACS provides the basis for the automated detection of such features and for testing reassignment hypotheses. Early detection and correction of errors in referencing and spin system identifications can improve the speed and accuracy of chemical shift assignments and secondary structure determinations. We have used LACS to create a database of offset-corrected chemical shifts corresponding to nearly 1800 BMRB entries: 300 with and 1500 without corresponding three-dimensional (3D) structures. This database can serve as a resource for future analysis of the effects of amino acid sequence and protein secondary and tertiary structure on NMR chemical shifts.

Amino Acid Sequence↗
PubMed2000

An allelic series for the chalcone synthase locus in Arabidopsis.

Five new alleles of the Arabidopsis chalcone synthase (CHS) locus, tt4, have been characterized at the gene, protein, and end product levels as a genetic approach to understanding structure-function relationships in a key enzyme of plant secondary metabolism. Together with two previously described mutants, these tt4 lines represent one of the first allelic series for a central enzyme of the flavonoid pathway and include both null alleles and alleles with leaky, apparently temperature-sensitive, phenotypes. A variety of effects on accumulation of CHS protein and flavonoid glycosides were observed among these lines, including alterations in the apparent stability and activity of the enzyme. Assembly of the CHS homodimer also appeared to be impacted in several cases. A three-dimensional model of the Arabidopsis CHS protein, based on the recently determined structure for alfalfa CHS, predicts significant effects on protein structure or folding for several of the mutations. This allelic series should provide a useful genetic resource for ongoing studies of flavonoid enzyme structure, function, and subcellular organization.

Acyltransferases↗
PubMed2005

Information resource preferences by general pediatricians in office settings: a qualitative study.

BACKGROUND: Information needs and resource preferences of office-based general pediatricians have not been well characterized. METHODS: Data collected from a sample of twenty office-based urban/suburban general pediatricians consisted of: (a) a demographic survey about participants' practice and computer use, (b) semi-structured interviews on their use of different types of information resources and (c) semi-structured interviews on perceptions of information needs and resource preferences in response to clinical vignettes representing cases in Genetics and Infectious Diseases. Content analysis of interviews provided participants' perceived use of resources and their perceived questions and preferred resources in response to vignettes. RESULTS: Participants' average time in practice was 15.4 years (2-28 years). All had in-office online access. Participants identified specialist/generalist colleagues, general/specialty pediatric texts, drug formularies, federal government/professional organization Websites and medical portals (when available) as preferred information sources. They did not identify decision-making texts, evidence-based reviews, journal abstracts, medical librarians or consumer health information for routine office use.In response to clinical vignettes in Genetics and Infectious Diseases, participants identified Question Types about patient-specific (diagnosis, history and findings) and general medical (diagnostic, therapeutic and referral guidelines) information. They identified specialists and specialty textbooks, history and physical examination, colleagues and general pediatric textbooks, and federal and professional organizational Websites as information sources. Participants with access to portals identified them as information resources in lieu of texts. For Genetics vignettes, participants identified questions about prenatal history, disease etiology and treatment guidelines. For Genetics vignettes, they identified patient history, specialists, general pediatric texts, Web search engines and colleagues as information sources. For Infectious Diseases (ID) vignettes, participants identified questions about patients' clinical status at presentation and questions about disease classification, diagnosis/therapy/referral guidelines and sources of patient education. For ID vignettes, they identified history, laboratory results, colleagues, specialists and personal experience as information sources. CONCLUSION: Content analysis of office-based general pediatricians' responses to clinical vignettes provided a qualitative description of their perceptions of information needs and preferences for information resource for cases in Genetics and Infectious Diseases. This approach may provide complementary information for discovering practitioner's information needs and resource preferences in different contexts.

Adolescent↗
PubMed1984

New library buildings: the University of Michigan Medical Library and Learning Resource Center.

The University of Michigan opened a new medical library in July 1980. The five-story structure combines the library with a learning-resources center. Overall, the building has operated smoothly and has been well accepted. The combining of two facilities designed to support the teaching and learning objectives of the health sciences curriculum will ensure long-term cooperation between them.

Audiovisual Aids↗
PubMed1999

EFFECTS OF PLANTS ON NEMATODE COMMUNITY STRUCTURE.

Plant-related inputs provide the resources for nematode communities. Sampling of nematode communities must be on appropriate temporal and spatial scales. Size, feeding types, food or host specificity, and chronology allow over 200 nematode species to coexist in a district. Relationships between nematode functional groups and ecological processes regulating decomposition processes have been found in field experiments. Pulse-labeling experiments have shown root-feeding nematodes to increase the flow of carbon from roots to soil microbial biomass. Soil texture is related to suitability for cropping and affects nematode communities through crop-specific infestations. Nematode diversity tends to be greatest in ecosystems with least disturbance, and bacterial-feeding nematodes make the greatest contribution to the decomposer food web in more intensively managed ecosystems. Indices of the nematode fauna reflect changes in the nematode community; these changes reflect soil and ecological processes. Understanding the role of nematodes in these processes is the key to understanding of the relationship between plants and soil nematode communities.

Journal Article↗
PubMed1994

The changing role of academic health care centers in generalist education and practice support.

Academic medical centers have been more compatible with the training and support of specialist and subspecialist physicians than that of their generalist colleagues. To meet the increasing demand for well-prepared generalist physicians, academic centers must change the manner in which they discharge their traditional missions of patient care, education, and training. This will require alteration of their organizational structures, changes in the allocation of resources, and an evolution of the culture of academic medicine toward one that is supportive of generalist education and practice. This paper discusses 1) the present organizational, structural, and cultural elements of the academic health care center that are inadequate for that goal; 2) a model for reorganizing academic health care centers to best achieve that goal; and 3) educational programs and technologies that promise to address the continuing educational needs of generalists.

Academic Medical Centers↗
PubMed2005

A tale of two hospitals: assessing cultural landscapes and compositions.

Clinical directorate service structures (CDs) have been widely implemented in acute settings in the belief that they will enhance efficiency and patient care by bringing teams together and involving clinicians in management. We argue that the achievement of such goals depends not only on changing its formalized structural arrangements but also the culture of the organisation concerned. We conducted comparative observational studies and questionnaire surveys of two large Australian teaching hospitals similar in size, role and CD structure. Martin's conceptualization of culture in terms of integration, differentiation and fragmentation was applied in the analysis of the data. The ethnographic work revealed that compared to Metropolitan Hospital, Royal Hospital was better supported and more favourably viewed by its staff across six categories identified in both settings: leadership, structure, communication, change, finance and human resource management. Royal staff were more optimistic about their organisation's ability to meet future challenges. The surveys revealed that both staff groups preferred CD to traditional structures and shared some favourable and critical views of them. However Royal staff were significantly more positive, reporting many more benefits from CDs e.g. improved working relations, greater accountability and efficiency, better cost management, more devolvement of management to clinicians and a hospital more strategically placed and patient focused. Metropolitan staff were more likely to claim that CDs failed to solve problems and created a range of others including disunity and poor working relationships. There was greater consensus of views among Royal staff and more fragmentation at Metropolitan where both intensely held and uncertain attitudes were more common. The outcomes of implementing CDs in these two similar organisations differed considerably indicating the need to address cultural issues when introducing structural change. Martin's framework provides a useful antidote to researchers' tendency to focus at only one level of culture.

Anthropology, Cultural↗
PubMed2003

Hypobaric biology: Arabidopsis gene expression at low atmospheric pressure.

As a step in developing an understanding of plant adaptation to low atmospheric pressures, we have identified genes central to the initial response of Arabidopsis to hypobaria. Exposure of plants to an atmosphere of 10 kPa compared with the sea-level pressure of 101 kPa resulted in the significant differential expression of more than 200 genes between the two treatments. Less than one-half of the genes induced by hypobaria are similarly affected by hypoxia, suggesting that response to hypobaria is unique and is more complex than an adaptation to the reduced partial pressure of oxygen inherent to hypobaric environments. In addition, the suites of genes induced by hypobaria confirm that water movement is a paramount issue at low atmospheric pressures, because many of gene products intersect abscisic acid-related, drought-induced pathways. A motivational constituent of these experiments is the need to address the National Aeronautics and Space Administration's plans to include plants as integral components of advanced life support systems. The design of bioregenerative life support systems seeks to maximize productivity within structures engineered to minimize mass and resource consumption. Currently, there are severe limitations to producing Earth-orbital, lunar, or Martian plant growth facilities that contain Earth-normal atmospheric pressures within light, transparent structures. However, some engineering limitations can be offset by growing plants in reduced atmospheric pressures. Characterization of the hypobaric response can therefore provide data to guide systems engineering development for bioregenerative life support, as well as lead to fundamental insights into aspects of desiccation metabolism and the means by which plants monitor water relations.

Adaptation, Physiological↗
PubMed2001

Perceptions of mission-critical organizational resources: a survey of substance prevention and treatment agencies in the southwest.

This article explores administrator and staff perceptions of mission-critical agency capacity in a predominantly Hispanic region that has a high degree of acculturation and elevated use of alcohol, tobacco, and other drugs. The domains explored are financial resources, proposal development, agency policies, organizational structure, communication, leadership, planning, and networking capabilities. Although significant differences were found among all eight domains, both staff and administrators concurred regarding the two areas of least capacity--financial resources and proposal development--and the two areas of greatest capacity--planning and networking capabilities. The authors suggest that agreement about the ranking of the domains is the most important finding rather than the differences between administrators and staff. A discussion of the practice and educational implications concludes the article.

Administrative Personnel↗
PubMed2006

Policing stabilizes construction of social niches in primates.

All organisms interact with their environment, and in doing so shape it, modifying resource availability. Termed niche construction, this process has been studied primarily at the ecological level with an emphasis on the consequences of construction across generations. We focus on the behavioural process of construction within a single generation, identifying the role a robustness mechanism--conflict management--has in promoting interactions that build social resource networks or social niches. Using 'knockout' experiments on a large, captive group of pigtailed macaques (Macaca nemestrina), we show that a policing function, performed infrequently by a small subset of individuals, significantly contributes to maintaining stable resource networks in the face of chronic perturbations that arise through conflict. When policing is absent, social niches destabilize, with group members building smaller, less diverse, and less integrated grooming, play, proximity and contact-sitting networks. Instability is quantified in terms of reduced mean degree, increased clustering, reduced reach, and increased assortativity. Policing not only controls conflict, we find it significantly influences the structure of networks that constitute essential social resources in gregarious primate societies. The structure of such networks plays a critical role in infant survivorship, emergence and spread of cooperative behaviour, social learning and cultural traditions.

Animals↗
PubMed1987

Attention, autonomic arousal, and personality in behaviorally disordered children.

This study assessed the construct validity of the Revised Behavior Problem Checklist (RBPC) by measuring attention, autonomic arousal, and personality in 40 behaviorally disordered children aged 7 to 15 years. Conduct Disorder and Socialized Aggression subscales were characterized by high Psychoticism, Impulsivity, and Lie personality scores, by lower heart rate levels, and by more errors on a continuous performance reaction-time task. Conversely, Attention Problems, Anxiety Withdrawal, and Motor Excess were characterized by greater variability in reaction times. Conduct Disorder alone was related to an external locus of control, while only Attention Problems was characterized by low scores on the WISC Freedom from Distraction factor. These differential relationships suggest (a) support for the construct validity of the RBPC, (b) that antisocial behavior and hyperactivity/attention deficits are dissociated disorders, and (c) that hyperactivity/attention deficits may be characterized by fluctuations in the allocation of attentional resources rather than a core structural deficit in attention.

Adolescent↗
PubMed2003

[German physicians' access to professional knowledge. Acceptance, quality and availability of professional information with special reference to electronic information media].

BACKGROUND AND PURPOSE: The growing relevance of continuous medical education is evident. Also information retrieval helping to solve clinical problems yet at the patient's bedside becomes more and more important. This study challenges common and coming methods of information retrieval applied by German physicians. It helps answering the question which advantage or disadvantage due to the chosen method of information acquisition may arise. It also shows which practical relevance and which grade of quality the information seeking doctor may anticipate. METHODS: A questionnaire was sent out to all registered clinicians in hospital and practice in Germany. Not only traditional means of information retrieval were analyzed. Also, a lot of the questions posed focused on the acceptance and use of new media in the professional context. About 16,000 colleagues answered by filling in the complete form therewith allowing a deep insight into their informational needs and habits. RESULTS: While traditional media like books and scientific papers enjoy wide public confidence, the acceptance and estimated reliability of virtual sources of information today still remain restrained. The lack of transparency of the virtual sources and ways of information within the web according to often imprecise rules for quality assurance lead to major complaint. Information offered directly by the industry has a very low rate of acceptance. CONCLUSION: To gain higher confidence in electronic media presenting professional knowledge and advanced medical training, the development of technological advantages today seems to be less relevant. Work on the transparency of the informational structures including clear definition of resources and clear indication of possible conflicts of interest are just as important as a comprehensible quality of forthcoming medical content.

Adult↗
PubMed2005

Construction and characterization of a Coffea canephora BAC library to study the organization of sucrose biosynthesis genes.

The first bacterial artificial chromosome (BAC) library of Robusta coffee (Coffea canephora) was constructed, with the aim of developing molecular resources to study the genome structure and evolution of this perennial crop. Clone 126, which is highly productive and confers good technological and organoleptic qualities of beverage, was chosen for development of this library. The BAC library contains 55,296 clones, with an average insert size of 135 Kb per plasmid, therefore representing theoretically nine haploid genome equivalents of C. canephora. Its validation was achieved with a set of 13 genetically anchored single-copy and 4 duplicated RFLP probes and yielded on average 9 BAC clones per probe. Screening of this BAC library was also carried out with partial cDNA probes coding for enzymes of sugar metabolism like invertases and sucrose synthase, with the aim of characterizing the organization and promoter structure of this important class of genes. It was shown that genes for both cell wall and vacuolar forms of invertases were probably unique in the Robusta genome whereas sucrose synthase was encoded by at least two genes. One of them (CcSUS1) was cloned and sequenced, showing that our BAC library is a valuable tool to rapidly identify genes of agronomic interest or linked to cup quality in C. canephora.

Amino Acid Sequence↗
PubMed2006

TUGAI: An integrated simulation tool for ecological assessment of alternative water management strategies in a degraded river delta.

The development of ecologically sound water allocation strategies that account for the needs of riverine ecosystems is a pressing issue, especially in semiarid river basins. In the Aral Sea Basin, a search for strategies to mitigate ecological and socioeconomic deterioration has been in process since the early 1990s. The Geographic Information System-based simulation tool TUGAI has been developed to support the policy determination process by providing a simple, problem-oriented method to assess ecological effects of alternative water management strategies for the Amudarya River. It combines a multiobjective water allocation model with simple, spatially explicit statistical and rule-based models of landscape dynamics. Changes in environmental conditions are evaluated by a fuzzy habitat suitability index for Populus euphratica, which is the dominant species of the characteristic riverine Tugai forests. Water management scenarios can be developed by altering spatiotemporal water distribution in the delta area or the amount of water inflow into the delta. Outcomes of scenario analysis are qualitative comparisons of the ecological effects of different options for a time period of up to 28 years. The given approach utilizes different types of knowledge, from quantitative hydrological data to qualitative local expert knowledge. The main purpose of the tool is to integrate the knowledge in a comprehensive way to make it available for discussions on alternative policies in moderated workshops with stakeholders. In this article, the modules of the tool, their integration, and three hypothetical scenarios are presented. Based on the experience gained when developing the TUGAI tool, we propose that the general framework can be transferred to other areas where tradeoffs in water allocation between the environment and other water users are of major concern. The potential for a simulation tool to structure and inform a complex resource management situation by involving local experts and stakeholders in the development of possible future scenarios will become increasingly valuable for transparent and participatory resource management.

Conservation of Natural Resources↗
PubMed1993

The Oncology Nursing Society: commitment and activities promoting cancer pain relief.

The primary mission of the ONS is promoting excellence in oncology nursing. In its efforts to accomplish this mission, the undertreatment of cancer pain has emerged as a significant issue for clinicians, educators, researchers, and administrators involved in the care of people with cancer. In an effort to promote cancer pain relief, the ONS contributes human, administrative, and financial resources from its existing organizational structure, personnel, and volunteers in the variety of ways described above. The structure of the ONS enables it to support the goal of cancer pain relief from the broadest of policy-making activities nationally to the provision of care by a nurse to a patient and family. The ONS Position Paper on Cancer Pain, other position papers and statements, adopted resolutions, and the strategic planning process will continue to guide the ONS's commitment and contributions to promoting cancer pain relief.

Health Promotion↗
PubMed2004

GLIF3: a representation format for sharable computer-interpretable clinical practice guidelines.

The Guideline Interchange Format (GLIF) is a model for representation of sharable computer-interpretable guidelines. The current version of GLIF (GLIF3) is a substantial update and enhancement of the model since the previous version (GLIF2). GLIF3 enables encoding of a guideline at three levels: a conceptual flowchart, a computable specification that can be verified for logical consistency and completeness, and an implementable specification that is intended to be incorporated into particular institutional information systems. The representation has been tested on a wide variety of guidelines that are typical of the range of guidelines in clinical use. It builds upon GLIF2 by adding several constructs that enable interpretation of encoded guidelines in computer-based decision-support systems. GLIF3 leverages standards being developed in Health Level 7 in order to allow integration of guidelines with clinical information systems. The GLIF3 specification consists of an extensible object-oriented model and a structured syntax based on the resource description framework (RDF). Empirical validation of the ability to generate appropriate recommendations using GLIF3 has been tested by executing encoded guidelines against actual patient data. GLIF3 is accordingly ready for broader experimentation and prototype use by organizations that wish to evaluate its ability to capture the logic of clinical guidelines, to implement them in clinical systems, and thereby to provide integrated decision support to assist clinicians.

Artificial Intelligence↗
PubMed2006

The MitoDrome database annotates and compares the OXPHOS nuclear genes of Drosophila melanogaster, Drosophila pseudoobscura and Anopheles gambiae.

The oxidative phosphorylation (OXPHOS) is the primary energy-producing process of all aerobic organisms and the only cellular function under the dual control of both the mitochondrial and the nuclear genomes. Functional characterization and evolutionary study of the OXPHOS system is of great importance for the understanding of many as yet unclear aspects of nucleus-mitochondrion genomic co-evolution and co-regulation gene networks. The MitoDrome database is a web-based database which provides genomic annotations about nuclear genes of Drosophila melanogaster encoding for mitochondrial proteins. Recently, MitoDrome has included a new section annotating genomic information about OXPHOS genes in Drosophila pseudoobscura and Anopheles gambiae and their comparative analysis with their Drosophila melanogaster and human counterparts. The introduction of this new comparative annotation section into MitoDrome is expected to be a useful resource for both functional and structural genomics related to the OXPHOS system.

Animals↗