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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 793 records · Page 44Linked to original sources
PubMed2005

Rapid health assessment in Aceh Jaya District, Indonesia, following the December 26 tsunami.

OBJECTIVES: To rapidly determine the public health impact of the Asian tsunami on the population of three communities in Aceh Jaya District, Indonesia, and to prioritize health interventions. METHODS: Rapid health assessment, utilizing direct observations, interviews with key informants, a single focus group discussion, town mapping, a review of medical records and a systematic random sample of the entire town of Calang, capital of Aceh Jaya District, Indonesia. RESULTS: Almost 100% of dwellings were destroyed in all three communities. For the town of Calang: only 18.2% of the pre-tsunami population remained 2 weeks following the disaster, with an estimated 70% of the population having died at the time of impact; government estimates of the remaining population were inflated by approximately 250%; mortality rates were not elevated post-tsunami; 100% of the population lacked access to sanitation and clean water; 85% of children under 5 years reported diarrhoea over the preceding 2 week period; 95% of individuals with a medical complaint reported satisfactory access to clinical care; acute malnutrition was not a significant problem; and over one-fifth of households were hosting an orphan. For the villages of Rigah and Sayeung: approximately 46.2 and 86.0% of the population survived the tsunami impact, respectively; mortality rates were not elevated post tsunami; 100% of the population lacked access to sanitation and clean water; diarrhoea was the main cause of morbidity; primary care services were available only in Rigah; and only Rigah had received external assistance. CONCLUSIONS: Almost two-thirds of the population of the three communities died as a result of the tsunami's impact. Although mortality rates were not elevated post tsunami, significant threats to public health persisted, especially water-borne diseases. Priority activities included emergent environmental health interventions, mobile clinics to the two villages and a more detailed assessment of the needs of orphans. Data were shared with agencies better placed to address needs in the areas of shelter and food aid.

Adolescent↗
PubMed2002

A critical assessment of the neurodestructive and neuroprotective effects of nitric oxide.

Whether nitric oxide is cytodestructive or cytoprotective is of obvious clinical importance. The debate on this subject in the past decade has generated much "heat and light". This paper focuses on the actions of NO on the nervous system and reexamines the controversial issue and the contribution of the authors and their colleagues in the light of recent findings. We also report new findings, critically assesses previous experimental data, and share perspectives on this important subject.

Animals↗
PubMed1978

Toward assuring confidentiality of records in large-scale assessment programs.

EPSDT, or any similar national health program, will spawn multiple records on millions of children and adults. Multiple providers will need to share more data to provide quality care. Maintaining privacy of child/parent records, avoiding the dangers of labeling, controlling the life of records and insuring their appropriate demise exacerbate record maintenance problems. Principles of record-keeping confidentiality are proposed.

Attitude of Health Personnel↗
PubMedDate not supplied

Standards for medical identifiers, codes, and messages needed to create an efficient computer-stored medical record. American Medical Informatics Association.

A major obstacle to establishing a computer-stored medical record is the lack of "standards" that would permit government, care providers, insurance companies, and medical computer system developers to share patient data easily. In this position paper, the Board of Directors of the American Medical Informatics Association recommends specific approaches to standardization in the areas of patient, provider, and site of care identifiers; computerized health care message exchange; medical record content and structure, and medical codes and terminologies. The key concept developed in this position paper is that developers and users of computer-stored medical records must embrace existing and tested approaches, despite their imperfections, to progress quickly. This approach to standardization is being coordinated with the American National Standards Institute's Health Informatics Standards Planning Panel. The development of standards is a long-term process involving continued refinement. The proposed standards are an important step toward the goal of better and more efficient health care.

Association↗
PubMed2005

Expanding the use of magnetic resonance in the assessment of tumor response to therapy: workshop report.

Although dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and magnetic resonance spectroscopy (MRS) have great potential to provide routine assessment of cancer treatment response, their widespread application has been hampered by a lack of standards for use. Thus, the National Cancer Institute convened a workshop to assess developments and applications of these methods, develop standards for methodology, and engage relevant partners (drug and device industries, researchers, clinicians, and government) to encourage sharing of data and methodologies. Consensus recommendations were reached for DCE-MRI methodologies and the focus for initial multicenter trials of MRS. In this meeting report, we outline the presentations, the topics discussed, the ongoing challenges identified, and the recommendations made by workshop participants for the use of DCE-MRI and 1H MRS in the clinical assessment of antitumor therapies.

Humans↗
PubMed2000

Independent inheritance of serum immunoglobulin E concentrations and airway responsiveness.

Elevated serum Immunoglobulin E (IgE) levels and increased airway responsiveness (AR) are correlated traits that are characteristic of asthma. It is not known to what extent these traits arise from distinct or shared genetic determinants. We investigated the genetic and environmental components of variance of serum total and specific IgE levels and AR in an Australian population-based sample of 232 Caucasian nuclear families. The inter-relationships of the genetic determinants of these traits were also investigated. Log(e) total serum IgE levels had a narrow-sense heritability (h(2)(N)) of 47.3% (SE = 10.0%). Specific serum IgE levels against house dust mite and timothy grass, measured as a RAST Index, ad a h(2)(N) of 33.8% (SE = 7.3%). AR, quantified by the log(e) dose-response slope to methacholine (DRS), had a h(2)(N) of 30.0% (SE = 12.3%). Extended modeling demonstrated an approximate 70% overlap in the genetic determinants of total and specific serum IgE levels. The genetic determinants of serum IgE levels and AR exhibited less than 30% sharing. These data are consistent with the existence of multiple genetic determinants of the pathophysiologic traits associated with asthma, and suggest that AR is genetically distinct from atopy. These results have implications for gene discovery programs.

Adolescent↗
PubMed1986

When interpretation masquerades as explanation.

The principal goal of the clinical interpretation (and of the larger clinical narrative) is to bring about insight and change in the patient, and not to present a reasoned argument that relies on public data and shared rules of evidence and logic. When the clinical account is transposed to the public domain and presented as a form of explanation, it is no longer designed for the benefit of one individual but must now be accessible to all. We are still under the shadow of Freud's five famous cases which are literary landmarks of exposition and persuasion. As a result, we are less sensitive to what happens when interpretations are substituted for explanations. The time has come to develop a new genre and a new mode of clinical reporting that would allow the reader to participate in the argument, allow him to evaluate the proposed links between evidence and conclusion (instead of relying on the authority of the analyst-author), and open up the clinical report to the possibilities of refutation, disconfirmation, and falsification.

Austria↗
PubMed1992

Cost-sharing and the future of fees for service for frail elders in state programs.

Although Congress has rejected the concept of mandatory cost-sharing under the Older Americans Act, many states already use client fee systems under state-funded home and community-based services programs. This research included a survey of actual state experiences and a review of earlier studies. States are compared on issues concerning policy and experience with fee systems, including income verification, fee schedules, termination policies, and costs of administration. Although policy and practice differ markedly across states, certain states are close to operationalizing comprehensive policies in this area. The author concludes that there is a need to conduct additional state-level demonstrations that address policy issues identified in the research. Evaluation research is needed to determine program effectiveness and efficiency, particularly concerning whether cost-sharing increases the amount of services available and ensures a high level of services to minorities.

Aged↗
PubMed2006

Design aspects of a distributed clinical trials information system.

BACKGROUND: Clinical trials informatics has evolved through the development of multiple applications addressing distinct parts of the clinical trials cycle. This setting creates difficulties in the transport and sharing of data among applications that serve a common functionality. PURPOSE: We present an alternative approach for the design of clinical trials information systems consisting of loosely coupled components standing on a comprehensive model of the global clinical trial process. METHODS: We describe how such a structure is able to support the development and implementation of complex knowledge-driven modules, such as automated database query systems, reporting systems and intelligent data-analysis tools, and how currently available internet technologies may be used to support the independent development of applications and collaboration between researchers. RESULTS: These principles were applied to the development of a fully functional system that has been in production for eight years in a diversity of pharmaceutical and academic drug trials. Marked time savings in database set-up and statistical reporting have been documented, as well as good reliability in the selection of appropriate statistical methods to clinical trial data analysis. CONCLUSIONS: In order to meet the expected functionality and to avoid the proliferation of databases and software applications, clinical trials information systems need to be based on a generic model of clinical trials and on a distributed architecture.

Clinical Trials as Topic↗
PubMed2006

Inference of ancestry: constructing hierarchical reference populations and assigning unknown individuals.

The ability to infer personal genetic ancestry is being increasingly utilised in certain medical and forensic situations. Herein, the unsupervised Bayesian clustering algorithms structure, is employed to analyse 377 autosomal short tandem repeats typed on 1,056 individuals from the Centre d'Etude du Polymorphisme Humain Human Diversity Panel. Individuals of known geographical origin were hierarchically classified into a framework of increasingly homogeneous clusters to serve as reference populations into which individuals of unknown ancestry can be assigned. The groupings were characterised by the geographical affinities of cluster members and the accuracy of these procedures was verified using several genetic indices. Fine-scale substructure was detectable beyond the broad population level classifications that previously have been explored in this dataset. Metrics indicated that within certain lines, the strongest structuring signals were detected at the leaves of the hierarchy where lineage-specific groupings were identified. The accuracy of unknown assignment was assessed at each level of the hierarchy using a 'leave one out' strategy in which each individual was stripped of cluster membership and then re-assigned using the supervised Bayesian clustering algorithm implemented in GeneClass2. Although most clusters at all levels of resolution experienced highly accurate assignment, a decline was observed in the finer levels due to the mixed membership characteristics of some individuals. The parameters defined by this study allowed for assignment of unknown individuals to genetically defined clusters with measured likelihood. Shared ancestry data can then be inferred for the unknown individual.

Algorithms↗
PubMed2004

Gene Ontology: looking backwards and forwards.

The Gene Ontology consortium began six years ago with a group of scientists who decided to connect our data by sharing the same language for describing it. Its most significant achievement lies in uniting many independent biological database efforts into a cooperative force.

Animals↗
PubMed2006

The importance of participation in support groups for women with ovarian cancer.

PURPOSE/OBJECTIVES: To explore the experience of participation in support groups for women recently diagnosed with ovarian cancer. RESEARCH APPROACH: Exploratory, qualitative. SETTING: Oncology department in a hospital in western Sweden. PARTICIPANTS: 10 Swedish women, aged 42-76, who recently had been diagnosed with ovarian cancer and had participated in support groups. METHODOLOGIC APPROACH: Data were collected by semistructured interviews and analyzed using grounded theory. MAIN RESEARCH VARIABLES: Ovarian cancer, support group experience. FINDINGS: Three categories emerged from the data analysis: sharing experiences and emotions, exchanging informational support, and exchanging emotional support. The core category was the experience of being in the same boat. Trust, openness, and willingness to create space for each other were experienced. CONCLUSIONS: Support groups offer an opportunity to share experiences and emotions as well as exchange information. They are also a possible source of emotional support and therefore can contribute to quality of life of patients with ovarian cancer. INTERPRETATION: Knowing that others had similar symptoms and reactions, and that those experiences are normal, was very important for support group participants. Nurses can reduce patients' fears and uncertainties by confirming normality. Oncology nurses need to be aware that cancer support groups offer a unique opportunity to interact with others in a similar situation. Participation in support groups can be an important source of emotional and informational support for patients. The support program in this study may be used as a model when planning for extended emotional and informational support.

Adult↗
PubMed2006

The clinical document architecture and the continuity of care record: a critical analysis.

Health care provides many opportunities in which the sharing of data between independent sites is highly desirable. Several standards are required to produce the functional and semantic interoperability necessary to support the exchange of such data: a common reference information model, a common set of data elements, a common terminology, common data structures, and a common transport standard. This paper addresses one component of that set of standards: the ability to create a document that supports the exchange of structured data components. Unfortunately, two different standards development organizations have produced similar standards for that purpose based on different information models: Health Level 7 (HL7)'s Clinical Document Architecture (CDA) and The American Society for Testing and Materials (ASTM International) Continuity of Care Record (CCR). The coexistence of both standards might require mapping from one standard to the other, which could be accompanied by a loss of information and functionality. This paper examines and compares the two standards, emphasizes the strengths and weaknesses of each, and proposes a strategy of harmonization to enhance future progress. While some of the authors are members of HL7 and/or ASTM International, the authors stress that the viewpoints represented in this paper are those of the authors and do not represent the official viewpoints of either HL7 or of ASTM International.

Computer Communication Networks↗
PubMed2003

Insulin-lowering agents in the management of polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a medical condition that has brought multiple specialists together. Gynecologists, endocrinologists, cardiologists, pediatricians, and dermatologists are all concerned with PCOS patients and share research data and design clinical trials to learn more about the syndrome. Insulin resistance is a common feature of PCOS and is more marked in obese women, suggesting that PCOS and obesity have a synergistic effect on the magnitude of the insulin disorder. Hyperinsulinemia associated with insulin resistance has been causally linked to all features of the syndrome, such as hyperandrogenism, reproductive disorders, acne, hirsutism, and metabolic disturbances. Women with PCOS should be evaluated for cardiovascular risk factors, such as lipid profile and blood pressure. Modification of diet and lifestyle should be suggested to those who are obese. Several insulin-lowering agents have been tested in the management of PCOS. In particular, metformin is the only drug currently in widespread clinical use for treatment of PCOS. In a high percentage of patients, treatment with metformin is followed by regularization of menstrual cycle, reduction in hyperandrogenism and in cardiovascular risk factors, and improvement in response to therapies for induction of ovulation.

Female↗
PubMed2026

A guide to selecting high-performing renewable antibodies for KIF5A (Q12840) across western blot, immunoprecipitation, and immunofluorescence.

Kinesin Family Member 5A (KIF5A) is an important protein for anterograde cellular transport. We characterized ten commercially available research antibodies against KIF5A for use in western blot, immunoprecipitation, and immunofluorescence using a standardized workflow. Antibody performance was assessed by comparing signal in a wild-type cell line and its corresponding knockout derivative. This work is part of a broader collaborative public-good initiative to improve biomedical research by systematically evaluating commercial antibodies against human proteins and openly sharing the data as a resource for the scientific community. We encourage readers to use this report as a guide for selecting antibodies best suited to their specific applications.

Kinesins↗
PubMed1992

Employer-sponsored health insurance in 1991.

Since 1987 the Health Insurance Association of America (HIAA) has documented features of employer-sponsored group health insurance through detailed surveys of over 3,000 U.S. firms. The 1991 employer survey reveals several noteworthy developments. The percentage of small firms (100 employees and under) that offer health insurance to their employees has declined since 1989. With a significant increase in health maintenance organization (HMO) market share, more than half (54 percent) of employees in employer-sponsored plans are now covered by managed care plans. Premiums increased 14 percent in 1991, showing identical increases for conventional, HMO, and preferred provider organization (PPO) plans. The percentage of employees in self-insured health plans decreased from 45 percent in 1990 to 40 percent in 1991.

Cost Control↗