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The recent fundamental transformation in government policy on the National Health Service has far-reaching implications for all types of health-care information provision and use. This paper highlights the new opportunities, as well as the major issues, these developments have generated.
In this paper we describe the methods used to link birth and infant mortality and morbidity surveillance data sets into sibships using deterministic or multistage probabilistic linkage methods. We describe nine linked data sets: four in the United States (Georgia, Missouri, Utah and Washington State), and four elsewhere (Scotland, Norway, Israel and Western Australia). Norway and Israel use deterministic methods to link births and deaths into sibships. The deterministic linkage is usually dependent on the availability of national identification numbers. In both countries they assign these numbers at birth. Deterministic linkage is usually highly successful, and the major problem is the validation of linkages. In the United States, Western Australia and UK linkage is multistage and probabilistic. This approach is usually dependent on the calculation linkage weights from sociodemographic variables. The success rates of probabilistic methods are above 80%. Maternally-linked perinatal data open new vistas for epidemiological research. Recurrence of poor perinatal outcomes is more appropriately studied using longitudinally-linked data sets. In addition, the emergence of risk factors and the recurrence of risk factors can be studied.
A questionnaire survey was carried out to investigate the competence and attitude of dental students towards computers. The current study presents the findings deriving from 590 questionnaires collected from 16 European dental schools from 9 countries between October 1998 and October 1999. The results suggest that 60% of students use computers for their education, while 72% have access to the Internet. The overall figures, however, disguise major differences between the various universities. Students in Northern and Western Europe seem to rely mostly on university facilities to access the Internet. The same however, is not true for students in Greece and Spain, who appear to depend on home computers. Less than half the students have been exposed to some form of computer literacy education in their universities, with the great majority acquiring their competence in other ways. The Information and Communication Technology (ICT) skills of the average dental student, within this limited sample of dental schools, do not facilitate full use of new media available. In addition, if the observed regional differences are valid, there may be an educational and political problem that could intensify inequalities among professionals in the future. To minimize this potential problem, closer cooperation between academic institutions, with sharing of resources and expertise, is recommended.
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This review discusses the state of neurology and the Internet at the turn of the millennium. First, some basic definitions about the Internet and its component protocols are presented. Next, ways neurologists and patients can use the Internet are enumerated. Internet resources or applications are available or are being created that can aid in the successful fulfillment of a neurologist's core professional activities: clinical care, teaching, research, and practice issues. Currently, the most useful categories of Internet resources for neurologists are electronic communication and access to knowledge bases. They fulfill needs that are not met by traditional, non-electronic media. There are many other types of Internet applications that supplement traditional medical methodologies. Finally, some problems and prospects concerning medical uses of the Internet are discussed: technological infrastructure including usability, security, meaning, validity/quality, value, outcomes, and responsibility. These issues must be successfully addressed if Internet computing is to become truly useful 'just in time' at the point of medical care. Solutions are actively under development today. The prospects are bright for neurology, and medicine in general, on the Internet. The Internet will become an essential medical device in the near future.
Standards, guidelines, and position and consensus statements by themselves do not change practice or improve pain management and care at the end of life. However, if they are used effectively, they support best practices, provide a forum for discussion of current recommendations, and provide nurses with the latest science and information to advocate for effective pain and symptom management.
The development of support for a more research-based approach to care has created the imperative for nursing education to tackle the issue of information literacy. Information literacy means the ability to locate, evaluate and apply information in critical thinking and problem solving. This paper outlines and provides a rationale for a curriculum-integrated information literacy programme, implemented in the pre-registration Bachelor of Nursing course at the University of Wollongong, NSW, Australia. It also describes a multidimensional evaluation process for determining nursing students' growth in cognitive and affective domains. Results of the programme evaluation will be featured in a future paper.
The research project "VICORA - Virtual Institute for Computer-Assisted Radiology", funded by the German Federal Ministry of Education and Research, was initiated in the year 2000. Its virtual organization brings together physical science, engineering, information technology, clinical radiology and the medical technology industry. In the German radiology research domain VICORA serves as a model for interdisciplinary collaboration for the changing radiology paradigm illustrated by a "radiologycube". The project does not only aim at scientific goals but also considers the infrastructure, components and human resource management within a virtual organization. The common rapid prototyping platform ILAB 4 ensures user-friendly and time-efficient software that assists with the routine radiology work-flow including full DICOM functionality. By offering a new work environment and collaborative culture based on telematics and knowledge exchange in radiology research, VICORA overcomes limitations of traditional research organization.
The technology is now available for commercial cloning of farm animals for food production, but is the food safe for consumers? Here, we provide data on >100 parameters that compare the composition of meat and milk from beef and dairy cattle derived from cloning to those of genetic- and breed-matched control animals from conventional reproduction. The cloned animals and the comparators were managed under the same conditions and received the same diet. The composition of the meat and milk from the clones were largely not statistically different from those of matched comparators, and all parameters examined were within the normal industry standards or previously reported values. The data generated from our match-controlled experiments provide science-based information desired by regulatory agencies to address public concerns about the safety of meat and milk from somatic animal clones.
Hazards are threats to people and what they value and risks are measures of hazards. Comparative analyses of the risks and hazards of technology can be dated to Starr's 1969 paper [Starr, C. (1969) Science 165, 1232-1238] but are rooted in recent trends in the evolution of technology, the identification of hazard, the perception of risk, and the activities of society. These trends have spawned an interdisciplinary quasi profession with new terminology, methodology, and literature. A review of 54 English-language monographs and book-length collections, published between 1970 and 1983, identified seven recurring themes: (i) overviews of the field of risk assessment, (ii) efforts to estimate and quantify risk, (iii) discussions of risk acceptability, (iv) perception, (v) analyses of regulation, (vi) case studies of specific technological hazards, and (vii) agenda for research. Within this field, science occupies a unique niche, for many technological hazards transcend the realm of ordinary experience and require expert study. Scientists can make unique contributions to each area of hazard management but their primary contribution is the practice of basic science. Beyond that, science needs to further risk assessment by understanding the more subtle processes of hazard creation and by establishing conventions for estimating risk and for presenting and handling uncertainty. Scientists can enlighten the discussion of tolerable risk by setting risks into comparative contexts, by studying the process of evaluation, and by participating as knowledgeable individuals, but they cannot decide the issue. Science can inform the hazard management process by broadening the range of alternative control actions and modes of implementation and by devising methods to evaluate their effectiveness.
In the last 50 years science has provided new perspectives on the ancient art of herbal medicine. The present article discusses ways in which the evidence base for the professional use of 'Western' herbal medicine, as therapy to treat disease, known as phytotherapy, can be strengthened and developed. The evidence base for phytotherapy is small and lags behind that for the nutritional sciences, mainly because phytochemicals are ingested as complex mixtures that are incompletely characterised and have only relatively recently been subject to scientific scrutiny. While some methodologies developed for the nutritional sciences can inform phytotherapy research, opportunities for observational studies are more limited, although greater use could be made of patient case notes. Randomised clinical trials of single-herb interventions are relatively easy to undertake and increasing numbers of such studies are being published. Indeed, enough data are available on three herbs (ginkgo (Ginkgo biloba), St John's wort (Hypericum perforatum) and saw palmetto (Serenoa repens)) for meta-analyses to have been undertaken. However, phytotherapy is holistic therapy, using lifestyle advice, nutrition and individually-prescribed mixtures of herbs aimed at reinstating homeostasis. While clinical experience shows that this approach is applicable to a wide range of conditions, including chronic disease, evidence of its efficacy is scarce. Strategies for investigating the full holistic approach of phytotherapy and its main elements are discussed and illustrated through the author's studies at the University of Reading.
OBJECTIVE: Consumer education is an important aspect in the adoption of any new technology. The objective of this work was to determine whether consumer's knowledge and attitudes would be influenced by a face-to-face presentation involving food biotechnology. MATERIALS AND METHODS: Participants (576) were requested to complete a pre-test prior to receiving a 45-80 minute presentation, which was then followed by a post-test. Participants included members from a community organization, undergraduate and graduate college students and cooperative extension educators (county agents). RESULTS: Following training, 98% to 99% correctly indicated that fruits and vegetables contain chromosomes and that foods from biotech crops were currently sold in grocery stores. Prior to training, only 31% felt that these crops were properly regulated by federal agencies, and only 25% were confident that bioengineering was unlikely to make an existing food allergenic. Following training, 83% felt that these crops were properly regulated, and 63% believed that biotechnology was unlikely to add new allergens to our food supply. In addition, 90% of those trained would eat or serve genetically-modified foods to their family, and 90% believed that they or their family would benefit from genetically-modified foods within the next five years. CONCLUSIONS: It is apparent from these results that when provided sound, science-based information, participants are more accepting of this technology and the regulatory process.
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This article introduces a discussion on developments in political and strategic thinking on the use of existing and emerging weapons (including Non-lethal Weapons) and their doctrinal operational implications in the context of present trends in international relations. It asserts the need to address both the strategic assumptions and the political implications of choosing military-led solutions to trends in international social conflict. The so-called Revolution in Military Affairs (RMA) must be considered in the light of the current debate on the military application of non-lethal weapons (NLWs) to present or future conflict. The issue is introduced from a politico-strategic perspective, with a critique of the RMA debate as a starting point for discussion of the role of NLWs in conflict. Questions are set out for the politicians and strategists who are asked to formulate policy based on technology to be used in new political/social conflicts. The danger of neglecting other important dimensions of politics and strategy vis-à-vis present conflict is noted.
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Venus and Mars likely had liquid water bodies on their surface early in the Solar System history. The surfaces of Venus and Mars are presently not a suitable habitat for life, but reservoirs of liquid water remain in the atmosphere of Venus and the subsurface of Mars, and with it also the possibility of microbial life. Microbial organisms may have adapted to live in these ecological niches by the evolutionary force of directional selection. Missions to our neighboring planets should therefore be planned to explore these potentially life-containing refuges and return samples for analysis. Sample return missions should also include ice samples from Mercury and the Moon, which may contain information about the biogenic material that catalyzed the early evolution of life on Earth (or elsewhere). To obtain such information, science-driven exploration is necessary through varying degrees of mission operation autonomy. A hierarchical mission design is envisioned that includes spaceborne (orbital), atmosphere (airborne), surface (mobile such as rover and stationary such as lander or sensor), and subsurface (e.g., ground-penetrating radar, drilling, etc.) agents working in concert to allow for sufficient mission safety and redundancy, to perform extensive and challenging reconnaissance, and to lead to a thorough search for evidence of life and habitability.