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Predicting small area health-related behaviour: a comparison of multilevel synthetic estimation and local survey data.

A recent paper in Social Science and Medicine (Twigg et al. 50 (2000) 1109) outlined an approach to the estimation of prevalences of small-area health-related behaviour using multilevel models. This paper compares results from the application of the multilevel approach with those derived using the more traditional strategy of the local 'lifestyle' survey. Estimations of smoking prevalence and high alcohol consumption are examined and critical assessments made of both estimation approaches. It is concluded that the alternative method is more suited towards the prediction of smoking rates as opposed to unsafe alcohol consumption.

Alcohol Drinking↗

Data modeling and data communication in GenomEUtwin.

Database infrastructure has become a critical component for competitive life sciences research and discovery. The explosion of data requires that the data are properly loaded, accessed, managed, queried, analyzed, and shared with others. The key purpose of the population-based twin cohorts housed at different institutions in Europe is to gather an extremely large quantity of information from their twin populations, and share it. Longitudinal research over a long period of time, hopefully generations, demands completely new methods and systems to handle the gathering of information and storing. These cohorts bring to the fore problems concerning the need for a standardization of research data and a computer and storage strategy. In the following we describe the preliminary strategy being implemented in the Database Core of GenomEUtwin.

Database Management Systems↗

Mental tools for thinking about DNA technologies in new ways.

OBJECTIVE: To investigate the nature of creative thinking in biomedical science with specific applications to molecular pathologies and DNA technologies. DATA SOURCES: Accounts of breakthroughs and inventions contained in autobiographies, biographies, interviews, and archival sources. STUDY SELECTION: Discoveries that have altered, or may yet alter, basic textbook accounts of biomedical sciences for which appropriate data sources exist. DATA EXTRACTION: Approximately 1000 data sources were analyzed, both within appropriate sciences and in other creative fields, such as the arts. DATA SYNTHESIS: The current analysis is based on a framework described in our previous book, Sparks of Genius, which outlines a general approach to understanding creative thinking. CONCLUSIONS: Creative thinking in all disciplines depends on a common mental "toolkit" that consists of 13 fundamental tools: observing, imaging, abstracting, pattern recognition, pattern forming, analogizing, body thinking, empathizing, dimensional thinking, modeling, playing, transforming, and synthesizing. Scientists recognize and solve problems by observing data that break the patterns established by theories; exploring a system by creating an abstract model with which they can play; and transforming data into feelings, sounds, and other forms that create surprising analogies to already-understood principles. The result of such personal thinking is knowledge combined with sensation and emotion--feeling and understanding synthesized into complete awareness. We illustrate some of these modes of thinking with reference to recent breakthroughs in DNA-related areas and suggest ways in which the use of "tools for thinking" can increase the probability of making further discoveries in the biomedical sciences.

Biotechnology↗

The Shivplot: a graphical display for trend elucidation and exploratory analysis of microarray data.

BACKGROUND: High-throughput systems are powerful tools for the life science research community. The complexity and volume of data from these systems, however, demand special treatment. Graphical tools are needed to evaluate many aspects of the data throughout the analysis process because plots can provide quality assessments for thousands of values simultaneously. The utility of a plot, in turn, is contingent on both its interpretability and its efficiency. RESULTS: The shivplot, a graphical technique motivated by microarrays but applicable to any replicated high-throughput data set, is described. The plot capitalizes on the strengths of three well-established plotting graphics--a boxplot, a distribution density plot, and a variability vs intensity plot--by effectively combining them into a single representation. CONCLUSION: The utility of the new display is illustrated with microarray data sets. The proposed graph, retaining all the information of its precursors, conserves space and minimizes redundancy, but also highlights features of the data that would be difficult to appreciate from the individual display components. We recommend the use of the shivplot both for exploratory data analysis and for the communication of experimental data in publications.

Journal Article↗

Census survey for a primary health care programme.

OBJECTIVE: To describe the process of gathering information from a census survey as a preliminary step for supporting the working of a primary health care center. It also presents briefly the results of the survey and its broader implications on the health needs of the local population. METHODS: A questionnaire was used to obtain basic information regarding the ethnicity/area of origin, number of household members and their breakdown according to gender, age and marital status. The medical students of different batches were involved in the data collection process, as part of their Survey Methodology course of Community Health Sciences (CHS) in first year. RESULTS: Data was obtained from 2,033 houses, having a total population of 16,118 persons. Fifty three per cent of the population was under fifteen years, 42% were between 15-49 and 5% were over 50 years of age. The overall percentage of males was 52% and females 48%. Approximately 79 percent people were Pushto speaking. CONCLUSION: Sikanderabad is a typical slum settlement, with an emigrant population being mostly of Pathan and Afghan refugees. The fertility rate in Sikanderabad is much higher than that of Karachi. This highlights the need for education and availability of family planning facilities. At the same time, due to the fact that there is a major portion of the population aged under five years, so facility for treating children must be appropriately provided. The Primary Health Care center established in Sikanderabad is based on the above information. The emphasis is on maternal and childcare, including antenatal and postnatal care; family planning and nutritional counseling.

Adolescent↗

Communicating science-based food and nutrition information.

Science evolves. Ongoing research, review and debate generate novel ideas and provide new insights to current scientific understanding. However, science is frequently reported to the public without context, which creates confusion. One study seemingly contradicts another, leaving consumers to doubt both scientific experts and science. This paper highlights quantitative and qualitative data to illustrate consumer confusion, frustration and apathy toward nutrition science and health information. Further, this paper shows how science communications and health advice can be tailored for specific audiences and, importantly, how scientists themselves can help the media understand and position research to minimize consumer confusion.

Food↗

Confidentiality and spatially explicit data: concerns and challenges.

Recent theoretical, methodological, and technological advances in the spatial sciences create an opportunity for social scientists to address questions about the reciprocal relationship between context (spatial organization, environment, etc.) and individual behavior. This emerging research community has yet to adequately address the new threats to the confidentiality of respondent data in spatially explicit social survey or census data files, however. This paper presents four sometimes conflicting principles for the conduct of ethical and high-quality science using such data: protection of confidentiality, the social-spatial linkage, data sharing, and data preservation. The conflict among these four principles is particularly evident in the display of spatially explicit data through maps combined with the sharing of tabular data files. This paper reviews these two research activities and shows how current practices favor one of the principles over the others and do not satisfactorily resolve the conflict among them. Maps are indispensable for the display of results but also reveal information on the location of respondents and sampling clusters that can then be used in combination with shared data files to identify respondents. The current practice of sharing modified or incomplete data sets or using data enclaves is not ideal for either the advancement of science or the protection of confidentiality. Further basic research and open debate are needed to advance both understanding of and solutions to this dilemma.

Confidentiality↗

Contribution of basic sciences to academic success in nursing education.

The present study set out to examine the contribution of basic sciences to academic success in nursing education. A number of regression analysis models were used to analyze the relationships among predictor and criterion variables. Data analyses showed that basic sciences and grade point average of nursing courses in year 3 and 4 contributed significantly to student success in the program (p < 0.001). The cumulative grade point average was the only significant predictor of the licensure examination success. These results suggested that the content in science courses may have unique relevance to nursing and, therefore, may have a factor in their predictive value.

Achievement↗

Pulmonary diffusing capacity and pulmonary capillary blood volume during parabolic flights.

Data from the Spacelab Life Sciences-1 (SLS-1) mission have shown sustained but moderate increase in pulmonary diffusing capacity (DL). Because of the occupational constraints of the mission, data were only obtained after 24 h of exposure to microgravity. Parabolic flights are often used to study some effects of microgravity, and we measured changes in DL occurring at the very onset of weightlessness. Measurements of DL, membrane diffusing capacity, and pulmonary capillary blood volume were made in 10 male subjects during the 20-s 0-G phases of parabolic flights performed by the "zero-G" Caravelle aircraft. Using the standardized single-breath technique, we measured DL for CO and nitric oxide simultaneously. We found significant increases in DL for CO (62%), in membrane diffusing capacity for CO (47%), in DL for nitric oxide (47%), and in pulmonary capillary blood volume (71%). We conclude that major changes in the alveolar membrane gas transfers and in the pulmonary capillary bed occur at the very onset of microgravity. Because these changes are much greater than those reported during sustained microgravity, the effects of rapid transition from hypergravity to microgravity during parabolic flights remain questionable.

Acceleration↗

Factors influencing research productivity among health sciences librarians.

Secondary analysis was performed of data collected in 1989 from a random sample of members of the Medical Library Association. Results show that about half the sample had at least one publication; academic health sciences librarians were much more likely than hospital librarians to have published. Almost half the sample had taken formal courses in research, but only a small percentage had taken continuing education (CE) courses in research. Institutional support services for research were most available in academic settings. The combination of institutional support, CE training, and research courses explained 31.1% of the variation in research productivity among academic librarians; these factors were less important in hospitals and other institutional settings. The authors suggest that health sciences librarians working outside academia should seek support for research from sources outside the employing institution.

Humans↗

Computational intelligence in earth sciences and environmental applications: issues and challenges.

This paper introduces a generic theoretical framework for predictive learning, and relates it to data-driven and learning applications in earth and environmental sciences. The issues of data quality, selection of the error function, incorporation of the predictive learning methods into the existing modeling frameworks, expert knowledge, model uncertainty, and other application-domain specific problems are discussed. A brief overview of the papers in the Special Issue is provided, followed by discussion of open issues and directions for future research.

Artificial Intelligence↗

Systems theory and the ethics of human enhancement: a framework for NBIC convergence.

Representatives from government and the private sector recommend a major, cooperative initiative directed toward using NBIC (nano-, bio-, info-, and cogno-) technologies for human enhancement. By appropriately seeding the convergence of NBIC domains, they believe that the rate of development can be both accelerated and simultaneously channeled to avoid adverse risk and advance human good. However, to accomplish these goals, leaders of the convergence efforts identified as a major intellectual barrier the "development of a hierarchical architecture for integrating science across many scales, disciplines, and data modalities." Such a holistic framework requires a radical rethinking of the nature of science and engineering, and, beyond this, is also necessary for addressing their normative ethical and societal implications. In the first part of this essay, I consider the claim that a new view of science and engineering is needed. After reviewing the central features of a classical view of science, I consider aspects of the nano-revolution, showing why the classical conception is inappropriate and how a systems-oriented perspective is responsive to the character of this new science. I then consider how both science and engineering are transformed, calling into question older dichotomies between pure and applied domains. With the reworking of this distinction comes opportunities for rethinking the relation between science and the humanities more generally, which is necessary if we are to more appropriately address normative ethical aspects of the convergence initiative. After providing this groundwork for the needed hierarchical architecture, I consider a useful example of how a systems perspective might guide NBIC convergence. In the 1960s-1990s George Engel advocated a systems-theoretic model as an alternative to a more reductionistic "biomedical model" in medicine, and he did it for the exact same reasons as those advocated by the leaders of the NBIC convergence; namely, it embodies a more appropriate notion of science and enables one to address ethical aspects of medicine that were insufficiently addressed in the older model. By reviewing Engel's "biopsychosocial model" we can learn important lessons for developing the needed NBIC framework. I close by extending Engel's model so that it addresses all areas of enhancement envisioned as a part of NBIC convergence, and then identify areas where future research is still needed.

Biomedical Enhancement↗

Link between monthly rates of four subtypes of acute myocardial infarction and their corresponding cosmophysical activity parameters.

UNLABELLED: The aim of this study was (1) to examine the relation between the monthly rate of acute myocardial infarction (AMI) and three cosmophysical activity parameters: solar activity (SA), geomagnetic activity (GMA), and cosmic rays activity (CRA) levels; (2) to study whether different subtypes of AMI: ST-elevation MI (STEMI), non-ST-elevation (NSTEMI), Q-wave (Q-waveMI) and non-Q-wave (NQ-wave MI) are linked with monthly cosmophysical indices or with the daily level (I degrees-IV degrees) of GMA. METHODS: For the first question, we studied for 204 consecutive months (1983-1999) 16,683 patients (including 10405 males) with AMI who were included in the Kaunas Registry and for the second, 3824 AMI patients (2342 males), 72-month data. Cosmophysical data were obtained from the Apatity Neutron Monitoring Station of the Russian Academy of Science. RESULTS: According to neutron monitoring data, total AMI and all its subtypes significantly correlated with monthly levels of CRA and inversely correlated with SA and GMA indices (r = 0.32-0.45; p = 0.0007-0.0001). No significant correlation was found between AMI subtypes and the daily level (I degrees-IV degrees) of GMA. All cosmophysical parameters were stronger in female patients. CONCLUSION: The monthly rates of all subtypes of AMI were significantly correlated with CRA and inversely correlated with SA and GMA, more strongly in female patients. We presume that the environmental factors studied here affect the general patho-physiological components of AMI, and that different subtypes are a consequence of the localization and extent of the process.

Adult↗

[Report on obstetrical activity during the triennium 1985-1987. 4th Obstetrics and Gynecology Clinic, University of Milan, Institute of Biomedical Sciences, S. Gerardo Hospital, Monza].

The data of three years of activity (1985-1987) at the 4th Obstetrics and Gynecology Department of the University of Milan, S. Gerardo Hospital in Monza, for a total of 5595 deliveries and 5672 new-borns are reviewed. Each case of perinatal death has been evaluated for gestational age, weight, way of delivery and preexisting or pregnancy-induced maternal diseases, trying to single out the primary causes of death. In order to compare these data with the ones of the previous three years the results have been divided, following the gestational age, in two groups (less or more and equal than 28 weeks). Late perinatal death rate (including all the babies older than 24 weeks of gestational age, still-born or live-born and dead within the 28th day of life) has been 1.8%, compared to the 2.1% in the previous 3 years. Obstetrical procedures and neonatal outcomes are analyzed in depth. Puerperium was pathological in 8.9% of patients. Only 4.2% of women decided not to breast-fed their babies.

Adult↗

Outpatient planning: still more art than science?

A general lack of comprehensive data on ambulatory care isn't preventing hospitals from engaging in high-quality planning in that area. "A good forecast" for future ambulatory care demand depends mainly on a "thoughtful determination of what needs to be forecasted and why," says Andrew McCulloch, chief operating officer at Harborview Medical Center, Seattle. The rapid pace of outpatient development has led some hospitals to invest a great deal of time and money to develop improved information systems. Those hospitals are heeding the statistical trends: Outpatient revenue grew far faster than inpatient did in 1990.

Ambulatory Surgical Procedures↗

Clinical implications of the biology of grafts: conclusions of the 2005 IUGA Grafts Roundtable.

With few exceptions, the current expansion of graft utilization in pelvic reconstructive surgery is not a product of evidence-based medicine. Abdominal sacrocolpopexy and suburethral sling procedures are two situations under which synthetic graft utilization is indicated, based on randomized prospective trials and reported clinical outcomes. Otherwise, indications and contraindications for graft utilization are unclear. Current published data on the biology of synthetic and biologic grafts are limited and overall not very helpful to the reconstructive surgeon who is faced with the selection of a graft for use during a reconstructive procedure. This Roundtable presented the opportunity for a series of basic science researchers to present their data to a group of reconstructive surgeons and provide publishable background information on the various currently available grafts. The occurrence of healing abnormalities after graft implantation is becoming increasingly recognized as a potentially serious problem. To date, definitions and a classification system for healing abnormalities do not exist. Based on the input from basic scientists and experienced surgeons, a simple classification is suggested based on the site of healing abnormality, timing relative to graft implantation, presence of inflammatory changes, and the viscera into which the graft is exposed. Many opportunities for clinical and basic science research exist. As the use of grafts in reconstructive surgery is expanded, surgeons are encouraged to familiarize themselves with currently published data, and determine whether a graft should, or should not be, utilized during a reconstructive procedure, and if so, the type of graft best indicated in each specific clinical situation.

Animals↗