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PubMed2004

The Breast Cancer Family Registry: an infrastructure for cooperative multinational, interdisciplinary and translational studies of the genetic epidemiology of breast cancer.

INTRODUCTION: The etiology of familial breast cancer is complex and involves genetic and environmental factors such as hormonal and lifestyle factors. Understanding familial aggregation is a key to understanding the causes of breast cancer and to facilitating the development of effective prevention and therapy. To address urgent research questions and to expedite the translation of research results to the clinical setting, the National Cancer Institute (USA) supported in 1995 the establishment of a novel research infrastructure, the Breast Cancer Family Registry, a collaboration of six academic and research institutions and their medical affiliates in the USA, Canada, and Australia. METHODS: The sites have developed core family history and epidemiology questionnaires, data dictionaries, and common protocols for biospecimen collection and processing and pathology review. An Informatics Center has been established to collate, manage, and distribute core data. RESULTS: As of September 2003, 9116 population-based and 2834 clinic-based families have been enrolled, including 2346 families from minority populations. Epidemiology questionnaire data are available for 6779 affected probands (with a personal history of breast cancer), 4116 unaffected probands, and 16,526 relatives with or without a personal history of breast or ovarian cancer. The biospecimen repository contains blood or mouthwash samples for 6316 affected probands, 2966 unaffected probands, and 10,763 relatives, and tumor tissue samples for 4293 individuals. CONCLUSION: This resource is available to internal and external researchers for collaborative, interdisciplinary, and translational studies of the genetic epidemiology of breast cancer. Detailed information can be found at the URL http://www.cfr.epi.uci.edu/.

Age Distribution↗
PubMed2004

Information technology principles for management, reporting, and research.

Information technology holds the promise to enhance the ability of individuals and organizations to manage emergency departments, improve data sharing and reporting, and facilitate research. The Society for Academic Emergency Medicine (SAEM) Consensus Committee has identified nine principles to outline a path of optimal features and designs for current and future information technology systems. The principles roughly summarized include the following: utilize open database standards with clear data dictionaries, provide administrative access to necessary data, appoint and recognize individuals with emergency department informatics expertise, allow automated alert and proper identification for enrollment of cases into research, provide visual and statistical tools and training to analyze data, embed automated configurable alarm functionality for clinical and nonclinical systems, allow multiexport standard and format configurable reporting, strategically acquire mission-critical equipment that is networked and capable of automated feedback regarding functional status and location, and dedicate resources toward informatics research and development. The SAEM Consensus Committee concludes that the diligent application of these principles will enhance emergency department management, reporting, and research and ultimately improve the quality of delivered health care.

Emergency Medicine↗
PubMed2004

An evaluation of the current state of genomic data privacy protection technology and a roadmap for the future.

The incorporation of genomic data into personal medical records poses many challenges to patient privacy. In response, various systems for preserving patient privacy in shared genomic data have been developed and deployed. Although these systems de-identify the data by removing explicit identifiers (e.g., name, address, or Social Security number) and incorporate sound security design principles, they suffer from a lack of formal modeling of inferences learnable from shared data. This report evaluates the extent to which current protection systems are capable of withstanding a range of re-identification methods, including genotype-phenotype inferences, location-visit patterns, family structures, and dictionary attacks. For a comparative re-identification analysis, the systems are mapped to a common formalism. Although there is variation in susceptibility, each system is deficient in its protection capacity. The author discovers patterns of protection failure and discusses several of the reasons why these systems are susceptible. The analyses and discussion within provide guideposts for the development of next-generation protection methods amenable to formal proofs.

Computer Security↗
PubMed2005

ALICE: an algorithm to extract abbreviations from MEDLINE.

OBJECTIVE: To help biomedical researchers recognize dynamically introduced abbreviations in biomedical literature, such as gene and protein names, we have constructed a support system called ALICE (Abbreviation LIfter using Corpus-based Extraction). ALICE aims to extract all types of abbreviations with their expansions from a target paper on the fly. METHODS: ALICE extracts an abbreviation and its expansion from the literature by using heuristic pattern-matching rules. This system consists of three phases and potentially identifies valid 320 abbreviation-expansion patterns as combinations of the rules. RESULTS: It achieved 95% recall and 97% precision on randomly selected titles and abstracts from the MEDLINE database. CONCLUSION: ALICE extracted abbreviations and their expansions from the literature efficiently. The subtly compiled heuristics enabled it to extract abbreviations with high recall without significantly reducing precision. ALICE does not only facilitate recognition of an undefined abbreviation in a paper by constructing an abbreviation database or dictionary, but also makes biomedical literature retrieval more accurate. This system is freely available at http://uvdb3.hgc.jp/ALICE/ALICE_index.html.

Abbreviations as Topic↗
PubMed1983

Marijuana-induced primary process content in the TAT.

Seventy-two normal adult male subjects wrote TAT stories under baseline and either placebo- or marijuana-ingestion conditions. Marijuana subjects received 20 mg. doses of delta-9 tetrahydrocannabinol. The stories were keypunched and content analyzed with the Regressive Imagery Dictionary, which yields a score for primary process content. Results indicate that marijuana, relative to placebo, caused subjects to write stories with a higher proportion of primary process content than they had included in baseline stories.

Adult↗
PubMed1992

Comparison of TAT and free speech techniques for eliciting source material in computerized content analysis.

We compared the free speech samples and Thematic Apperception Test (TAT) responses of 95 community-residing volunteers by using the General Inquirer content analysis computer program and the Harvard III Psychosociological Dictionary (Stone, Dunphy, Smith, & Ogitvie, 1966). Comparability was assessed by computing mean differences and correlations among techniques. The techniques were evaluated by assessing the ability of data derived from each to predict individual differences in developmental level, gender, depressive symptomatology, and personality. Results show highly discriminable profiles and low reliability among techniques. TAT data were superior in predicting individual, differences. We suggest that structured techniques like the TAT are preferable to standard free speech instructions for eliciting data in content analytic studies and discuss the possibility of computerized content analysis as a method of scoring the TAT.

Journal Article↗
PubMed2002

Emotions as wishes and beliefs.

Emotions can be assessed by means of different diagnostic methods, for example, by self-report instruments, ratings of facial expressions, or by projective techniques. This study presents an alternative approach: a computerized investigation of verbally expressed emotions by means of the Affective Dictionary Ulm (ADU; Dahl, Hölzer, & Berry, 1992), which was applied to responses in the Holtzman Inkblot Technique (HIT; Holtzman, 1988; Holtzman, Thorpe, Swartz, & Herron, 1961). A normal group (n = 30), patients with neurotic disorders (n = 30), borderline patients (n = 30), acute schizophrenics (n = 25), and chronic schizophrenics (n = 25) were compared in regard to verbally expressed emotions. According to the results, patients with neurotic disorders did not differ from the normal group in regard to verbally expressed emotions. Borderline patients expressed fear and emotions in general significantly more frequently than all other diagnostic groups. Furthermore, borderline patients differed in regard to specific emotions from patients with neurotic disorders, acute schizophrenics, and chronic schizophrenics. Acute schizophrenics did not differ from the normal group in regard to the expression of emotions, whereas chronic schizophrenics expressed anger, fear, anxiety, and emotions in general significantly less frequently than normals. By a discriminant analysis using verbally expressed emotions as predictors of the diagnosis, hit rates between 87% and 100% could be achieved. Furthermore, hypotheses about correlations between emotions on the one hand and internalized primitive object relations and bizarre-idiosyncratic thinking were tested empirically. Significant correlations could be demonstrated. These results support the validity of assessing emotions through a lexical content analysis of the HIT by use of the ADU.

Adult↗
PubMed2004

"Profession": a working definition for medical educators.

PURPOSE: To provide a working definition of professionalism for medical educators. SUMMARY: Thus far, the literature has not provided a concise and inclusive definition of the word profession. There appears to be a need for one as a basis for teaching the cognitive aspects of the subject and for evaluating behaviors characteristic of professionals. Furthermore, a knowledge of the meaning of the word is important as it serves as the basis of the contract between medicine and society, and hence, of the obligations required of medicine to sustain the contract. A definition is proposed based on the Oxford English Dictionary and the literature on the subject. It is suggested that this can be useful to medical educators with responsibilities for teaching about the professions, professional responsibilities, and professional behavior. CONCLUSIONS: The proposed definition is as follows: Profession: An occupation whose core element is work based upon the mastery of a complex body of knowledge and skills. It is a vocation in which knowledge of some department of science or learning or the practice of an art founded upon it is used in the service of others. Its members are governed by codes of ethics and profess a commitment to competence, integrity and morality, altruism, and the promotion of the public good within their domain. These commitments form the basis of a social contract between a profession and society, which in return grants the profession a monopoly over the use of its knowledge base, the right to considerable autonomy in practice and the privilege of self-regulation. Professions and their members are accountable to those served and to society.

Canada↗
PubMed2003

Computer-assisted generation of a protein-interaction database for nuclear receptors.

With the increasing amount of biological data available, automated methods for information retrieval become necessary. We employed computer-assisted text mining to retrieve all protein-protein interactions for nuclear receptors from MEDLINE in a systematic way. A dictionary of protein names and of terms denoting interactions was generated, and trioccurrences of two protein names and one interaction term in one sentence were retrieved. Abstracts containing at least one such trioccurrence were manually checked by biologists to select the relevant interactions out of the automatically extracted data. In total, 4360 abstracts were retrieved containing data on protein interactions for nuclear receptors. The resulting database contains all reported protein interactions involving nuclear receptors from 1966 to September 2001. Remarkably, the annual increase in number of reported interactors for nuclear receptors has been following an exponential growth curve in the years 1991 to 2001. Apparent in the data set is the high complexity of protein interactions for nuclear receptors. The number of interactions correlates with the number of published papers for a given receptor, suggesting that the number of reported interactors is a reflection of the intensity of research dedicated to a given receptor. Indeed, comparison of the retrieved data to a systematic yeast two-hybrid-based interaction analysis suggests that most NRs are similar with respect to the number of interacting proteins. The data set obtained serves as a source for information on NR interactions, as well as a reference data set for the improvement of advanced text-mining methods.

Computers↗
PubMed1995

Relationship between lifetime occupation and parietal flow: implications for a reserve against Alzheimer's disease pathology.

We previously reported an inverse relation between parietal cerebral blood flow and years of education in Alzheimer's disease (AD) patients matched for clinical severity. This suggested that the clinical manifestation of advancing AD pathology is delayed in patients with higher educational attainment. Other aspects of life experience may also provide a reserve against the clinical expression of AD. To test this hypothesis, we classified the primary life-time occupations of 51 AD patients using the Dictionary of Occupational Titles, published by the US Department of Labor, and derived six factor scores describing intellectual, interpersonal, and physical job demands. Regional cerebral blood flow was measured using the xenon-133 inhalation method. After controlling for age, clinical dementia severity, and education, there was less relative perfusion in the parietal region in subjects whose occupations were associated with higher interpersonal skills and physical demands factor scores. We conclude that independent of education, aspects of occupational experience may provide a reserve that delays the clinical manifestation of AD.

Administration, Inhalation↗
PubMed1999

Psychiatric adverse events during vigabatrin therapy.

OBJECTIVE: To determine the incidence of psychiatric adverse events associated with vigabatrin therapy, we reviewed data from US and non-US double-blind, placebo-controlled trials of vigabatrin as add-on therapy for treatment-refractory partial epilepsy. METHODS: "Verbatim" terms from investigators' reports had been translated into standard "preferred" terms using an adverse event dictionary. Terms for psychiatric events were then combined into categories for analysis of rates during vigabatrin versus placebo treatment. RESULTS: Compared with placebo, vigabatrin subjects had a higher incidence of events coded as depression (12.1% versus 3.5%, p < 0.001) and psychosis (2.5% versus 0.3%, p = 0.028); there were no significant differences between treatment groups for aggressive reaction, manic symptoms, agitation, emotional lability, anxiety, or suicide attempt. Although depression and psychosis were typically observed during the first 3 months, most studies were 12 to 18 weeks long, so that definitive conclusions could not be reached about timing of events. Psychosis was generally transient and reported to be responsive to reduction or discontinuation of vigabatrin or to neuroleptic treatment. Depression was typically mild. Serious depression, defined as discontinued from the study, hospitalized, or suicide attempt, or coded as psychotic depression, occurred in only 9 of the 49 vigabatrin-treated patients with depression. CONCLUSIONS: Vigabatrin use in treatment-refractory partial epilepsy is associated with increased occurrence of depression and of psychosis, although the frequency of psychosis is apparently lower than previously reported. Clinical experience suggests that these adverse events respond to reduction of vigabatrin dose or to counteractive psychotropic treatment.

Anticonvulsants↗
PubMed2004

Retaining and transferring nursing knowledge through a hospital internship program.

In healthcare, organizations recognize that human capital is their most valuable asset. The importance of investing in knowledge workers is imperative given the current and future shortage of health professionals. Knowledge acquisition occurs through continuous learning and the transfer of information from those who are highly experienced to those who are less qualified. At St. Michael's Hospital, two innovative and unique programs were created for the transfer of knowledge. The first was a nurse fellowship program that enabled experienced nurses to spend two to three months learning new skills to advance clinical practice. The second was a nurse internship program in which new graduates spend three to four months in their area of hire to enhance clinical practice through skill development and prioritization of patient care needs. This paper describes both programs and presents an evaluation of the new-graduate internship program as an opportunity for professional development and career enhancement For nurse interns, the program promotes self-esteem and professional confidence, improves job satisfaction and rewards nurses for their contribution. For nurse preceptors, the program provides job enrichment, experience in teaching and recognition by the organization and peers that they are knowledge experts. In healthcare, organizations have come to acknowledge that their most valuable asset is human capital, in particular, knowledge workers (Horibe 1999). Knowledge workers contribute a composite of information, intellectual property and experience (Horibe 1999), acquired by study, investigation, observation or practice (Webster's Dictionary 1989). Investing in knowledge workers is investing in the future. In this regard, organizations have implemented recruitment and retention strategies to attract, retain and advance the highest calibre of health professional. Knowledge workers contribute to an organization through their ideas, analyses of complex situations and sound judgment in decision-making (Horibe 1999). They further develop these skills over the course of their career through continuous learning. This paper will focus on the importance of investing in nurses as knowledge workers. In particular, given the shortage of nurses and the reality that 25% of today's nurses can retire over the next 10 years (CNA 2001), it is imperative that knowledge transfer occur from highly experienced to less experienced nurses.

Attitude of Health Personnel↗
PubMedDate not supplied

Parastomal hernia: an exploration of the risk factors and the implications.

Risk may be defined as 'the chance that something may happen to cause loss or an adverse effect' (Concise Oxford Medical Dictionary, 2003). Patients undergoing stoma formation are at risk of developing a wide range of complications following surgery. A parastomal hernia is an adverse effect that can contribute to postoperative morbidity. The risk of developing a parastomal hernia is dependent upon a number of variables, and stoma care nurses need to be aware of these to plan the appropriate care for patients undergoing stoma formation. This article discusses the issues surrounding the development of parastomal hernias and also looks at ways in which the risk factors associated with the development of a parastomal hernia may be minimized.

Colostomy↗
PubMed2005

Where love flies free: women, home, and writing in Cook County Jail.

Several definitions of "home," drawn from dozens provided by the Oxford Dictionary of the English Language, underscore how a large urban county jail becomes many forms of home for the women detainees there. Drawing on the women's poetry and the mechanics of creative writing workshops facilitated by the author for the last seven years at Cook County Jail, this essay describes some of the realities of the criminal (in)justice system and how the women's writing becomes a way of writing against the grain of official discourse, thus altering certain definitions of this "home."

Attitude↗
PubMed1986

Health and health care of employed adults: occupation and gender.

This paper reports on a study of health and health care of employed women and men that used the National Health Interview Survey of 1975-1977 as the data source. Materials from the Dictionary of Occupational Titles and other government sources were used to develop scales for psychosocial and physical health features of individual occupations. Multiple regressions were then used to study the relation of occupational factors and gender along with family factors, to health status, chronic limitations, and use of physician and hospital services. The study shows a correlation of the jobs that are more complex and challenging and offer more autonomy with better health status. The current job structure shows more variation in psychological level of occupations than in physical healthiness; women are concentrated in the less desirable occupations. The study also examines gender differences in illness-day measures and health care utilization in 36 occupations with substantial employment of both sexes, and finds considerable variability among occupations in the extent of gender differences.

Absenteeism↗
PubMed2004

Evaluation of a deidentification (De-Id) software engine to share pathology reports and clinical documents for research.

We evaluated a comprehensive deidentification engine at the University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, that uses a complex set of rules, dictionaries, pattern-matching algorithms, and the Unified Medical Language System to identify and replace identifying text in clinical reports while preserving medical information for sharing in research. In our initial data set of 967 surgical pathology reports, the software did not suppress outside (103), UPMC (47), and non-UPMC (56) accession numbers; dates (7); names (9) or initials (25) of case pathologists; or hospital or laboratory names (46). In 150 reports, some clinical information was suppressed inadvertently (overmarking). The engine retained eponymic patient names, eg, Barrett and Gleason. In the second evaluation (1,000 reports), the software did not suppress outside (90) or UPMC (6) accession numbers or names (4) or initials (2) of case pathologists. In the third evaluation, the software removed names of patients, hospitals (297/300), pathologists (297/300), transcriptionists, residents and physicians, dates of procedures, and accession numbers (298/300). By the end of the evaluation, the system was reliably and specifically removing safe-harbor identifiers and producing highly readable deidentified text without removing important clinical information. Collaboration between pathology domain experts and system developers and continuous quality assurance are needed to optimize ongoing deidentification processes.

Confidentiality↗
PubMed1999

Linking verbal and non-verbal representations: computer analysis of referential activity.

The objective of this study was to develop a computer assisted procedure to model the Referencial Activity scales as scored by raters. Referential Activity is defined as the function of connecting non-verbal experience with language. Using a large text corpus that had been rated by experienced and reliable judges, extreme samples from both ends of the Referential Activity Scales were selected. The Characteristic Vocabularies for each of these corpora, words that were significantly more frequent in each corpus as compared to the other, were then identified. A small set of 181 frequent words was derived that accounted for half of all words in the text corpora. These words were used as dictionaries for a Computerized Referential Activity measure based on computer assisted content analysis techniques. The new measure showed a correlation with judge-scored Referential Activity of around .50 across both the development and test corpora.

Artificial Intelligence↗
PubMed2003

Achieving women and declining sex ratios.

Professionally written biographies of 353 women selected for inclusion in two volumes of a dictionary of biography were analyzed separately for data on family structure, occupation, and personality characteristics. Findings from Volume 4 (1921-1940) were similar to those from Volume 5 (1941-1960). Results showed that 55.2% of women biographees had no children. They were either unmarried or, if married, childless. Of those who did have children, biographees had a significantly high ratio of sons to daughters compared with the norm (0.514) (Vol. 4: males = 106, females = 76; Vol. 5: males = 115, females = 80; totals: males = 221, females = 156; chi2 = 7.87; p = 0.005). These data, interpreted according to the maternal dominance hypothesis (Grant 1998) and set in the context of increased workforce participation by women and declining fertility, suggest another possible explanation for the contemporary decline in the secondary sex ratio.

Achievement↗