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PubMedDate not supplied

Preventive health pamphlets in the emergency department.

We conducted a prospective clinical trial to determine the effectiveness of an emergency department informational pamphlet in improving patients' compliance with recommendations that they receive Pap smears, mammograms, and a pneumococcal vaccination. Informational pamphlets were distributed to 1,000 consecutive patients who presented to a university-affiliated emergency department (ED). The pamphlet contained information stating the indications for obtaining routine Pap smears, mammograms, and a pneumococcal vaccination. Target individuals were women 18 years and older and men 65 years and older. Target patients were called approximately 2 months after their ED visits to obtain follow-up data. There were 464 target patients obtained from the 1,000 pamphlets distributed (409 female/55 male), and 68% (316) of the 464 were contacted by telephone for follow-up data. Significantly more women than men had read the pamphlet (62% vs. 8%). Of the women contacted (279), 31.9% (89) were not up to date (UTD) with Pap smears, and 11.2% (10) stated that they had scheduled an appointment for a Pap smear; 14.5% (11) of the women were not UTD with mammograms, and none had scheduled an appointment to receive care. Of the patients over age 65, 67% were not UTD with a pneumococcal vaccination, and no appointments were scheduled to obtain one. We conclude that a significant number of patients who present to this ED are in need of preventive health care. Emergency department informational pamphlets may have a role in improving Pap smear compliance. Women may be more likely then men to read informational pamphlets distributed in the ED.

Adult↗
PubMed2005

Using social judgement theory to model nurses' use of clinical information in critical care education.

Understanding the learning needs of students is a vital step in planning the delivery of effective education. Evaluating the impact of such interventions is not always easy and many methods rely on self-reported behaviour or simple changes in knowledge--whose relationship to action is not always clear. Using conjoint analysis, within the theoretical framework of social judgement theory, this study illustrates a novel means of examining nurses' use of clinical information when diagnosing hypovolemic shock in a series of simulated cases presented via computer. The study examines changes in information usage before and after a traditional lecture. The results show that nurses' information use is not linear and the utility for decision judgement derived from clinical information is not distributed equally. The study also suggests that some clinical information (for example, the Glasgow Coma Score) is not well understood and incorporated into clinical judgement. The study has implications for those designing and evaluating educational interventions and those studying information use, clinical judgement and decision making.

Adult↗
PubMed1995

Assessment of extracellular glucose distribution and glucose transport activity in conscious rats.

The effects of insulin on extracellular glucose distribution and cellular glucose transport activity were studied by simultaneously analyzing the plasma kinetics of L-[1-14C]glucose and 3-O-[3H]methylglucose after an intravenous injection during saline or insulin infusion (euglycemic glucose clamp) in conscious rats (n = 7 for each). The time profiles of plasma L-glucose were almost superimposable in the two protocols, and compartmental analysis showed that neither distribution volumes nor distribution rate constants were affected with insulin (P > 0.05 for all), suggesting that glucose distribution within the extracellular space was not influenced with insulin. In contrast, the time profile of plasma 3-O-methylglucose (3-MG) was markedly altered with insulin; the initial decrease was much faster during insulin infusion than during saline infusion, indicating stimulation of 3-MG transport into intracellular spaces with insulin. The 3-MG data were analyzed using a comprehensive model separately describing extracellular distribution and cellular transport of 3-MG by incorporating information on extracellular distribution kinetics obtained from L-glucose data. The combined L-glucose and 3-MG kinetic analysis precisely estimated insulin's effect in vivo to stimulate glucose transport into and out of intracellular spaces. We conclude that 1) insulin does not affect extracellular glucose distribution kinetics or volumes in conscious rats and 2) insulin's effects on cellular glucose transport in vivo can be assessed by simultaneous analysis of plasma L-glucose and 3-MG kinetics.

3-O-Methylglucose↗
PubMed2003

Air pollution and the elderly: oxidant/antioxidant issues worth consideration.

The elderly are frequently classified as being particularly susceptible to air pollution. The basis of this increased sensitivity is not known but it is likely that it is linked to age-related impaired function of the lung. However, given this uncertainty and increased impact of air pollution of this section of the community there is a need to explore the mechanisms involved. Gaseous air pollutants such as ozone and nitrogen dioxide, or many of the components adsorbed onto the surface of respirable particles, are either powerful oxidants or capable of generating free radicals. If unabated, oxidants can cause injury to the delicate cells that line the respiratory tract. Small molecular weight antioxidant defences present in respiratory tract lining fluid (RTLF) represent the first line of defence against a range of oxidants that enter the lung. The quantity and quality of the RTLF airways antioxidant network are, therefore, likely to be important determinants of the impact of the oxidant challenge on the underlying respiratory epithelium. As yet, comprehensive information on the distribution and variability of respiratory tract lining fluid antioxidant defences is only available in young, mainly healthy volunteers. Studies undertaken in patients with a range of respiratory diseases suggest that marked changes in the distribution of respiratory tract lining fluid antioxidants can occur. Information is not currently available on the impact of ageing on the respiratory tract lining fluid antioxidant defence network. As several respiratory tract lining fluid antioxidants are of dietary origin, the elderly, who often have different dietary patterns to younger individuals, may have decreased availability of important antioxidants. Given these possibilities, a better understanding of respiratory tract lining fluid antioxidant defences in the aged lung is warranted.

Aged↗
PubMed2006

Cone beam computerized tomography-based dental imaging for implant planning and surgical guidance, Part 1: Single implant in the mandibular molar region.

Computerized tomography (CT)-based dental imaging for implant planning and surgical guidance carries both restorative information for implant positioning, as far as trajectory and distribution, and radiographic information, as far as depth and proximity to critical anatomic landmarks such as the mandibular canal, maxillary sinus, and adjacent teeth. This case report describes a systematic approach to the planning and surgical placement of a single implant-supported crown, utilizing CT-based dental imaging for implant planning and surgical guidance. The simple steps result in the accurate transfer of critical radiographic information to the surgical site.

Adult↗
PubMed1998

Validity of self-reported fat distribution in young adults: the CARDIA Study. Coronary Artery Risk Development in Young Adults.

To determine the validity of self-reported information on body fat distribution, relationships between reported location of weight gain and measured waist-to-hip ratio (WHR), high density lipoprotein cholesterol (HDL-C), and fasting insulin were analyzed in 5115 black and white men and women aged 18-30 years. In black men, WHR adjusted for age and body mass index (BMI) ranged from 0.833 among those reporting upper and central weight gain to 0.812 among those reporting lower body weight gain (trend across five reported fat distribution categories, P = 0.0004). Corresponding values were, for white men, 0.852 to 0.831; for black women, 0.777 to 0.721; and for white women, 0.772 to 0.701 (each P < 0.0001). Reported fat distribution was associated with HDL-C in women, but not in men, and with fasting insulin in all groups. While these associations were somewhat weaker than with measured WHR, self-reported fat distribution does provide valid information about body fat distribution in young adults, particularly women.

Adult↗
PubMed2004

An information system for drug prescription and distribution in a public hospital.

With 773 beds and 3696 employees, the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP)-Universidade de São Paulo, is one of the largest medical institutions in Latin America. The complete process of prescribing and distributing medication at HCFMRP involves the following stages: prescribing (physicians); ordering (infirmary); separating and dispensing (main drugstore); verifying and administering (infirmary). This was a manual process, normally taking place in the morning. Bottlenecks were inevitable and the risk of errors was elevated. An information system (IS) was devised and implemented with a view to controlling such problems. This article addresses the construction of this system and reports on a survey in which different groups of users have evaluated the project.

Brazil↗
PubMed1986

The effects of changes in bite pressure and mucosal stimulation on the perception of mandibular position in man.

In edentulous subjects, the mandibular position (MP) was altered by adjustable hydraulic jacks attached to the denture base. The MP which they began to perceive as high (HMP) was shifted toward the closed position when the bite pressure against the incisal region was increased. Thus the perception of MP may be modulated by information concerning the distribution of bite pressure. The HMP also shifted toward the closed position when the incisal palatal region of the denture-supporting mucosa was subjected to increased mechanical stimulation, the distribution of the bite force being constant. Therefore, mechanoreceptors in the mucosa may be involved in the perception of MP by providing precise information as to the distribution of bite pressure.

Aged↗
PubMed2000

Tissue distribution and persistence in mice of plasmid DNA encapsulated in a PLGA-based microsphere delivery vehicle.

Information regarding the distribution and persistence of DNA encapsulated in poly-(lactide co-glycolide) microspheres was collected to provide additional information regarding the safety of DNA vaccines and to support the clinical testing of this new delivery system for DNA. Plasmid DNA was encapsulated in poly(lactide co-glycolide) microspheres and the distribution and persistence of plasmid in murine tissues resulting from parenteral administration were examined by a sensitive PCR assay. Encapsulated DNA delivered by intramuscular or subcutaneous injection can be detected for 100 days post-injection and is distributed primarily at the site of injection and the lymphoid organs. Intravenous administration results in more widespread dissemination with long term persistence limited to the lymphoid organs and those of the reticuloendothelial system. Specific cellular uptake of DNA by professional antigen presenting cells (APCs) following injection suggests the utility of microspheres as DNA delivery agents. Distribution and persistence studies support the safety of encapsulated DNA and the specific cellular uptake of DNA by professional APCs following injection suggests the utility of microspheres as DNA delivery agents.

Animals↗
PubMed2004

Design of a patient-centered, multi-institutional healthcare information network using peer-to-peer communication in a highly distributed architecture.

OBJECTIVE: to design a community healthcare information network for all 450,000 citizen in the State of Geneva, Switzerland, connecting public and private healthcare professionals. Requirements include the decentralized storage of information at the source of its production, the creation of a virtual patient record at the time of the consultation, the control by the patient of the access rights to the information, and the interoperability with other similar networks at the national and european level. METHODS: a participative approach and real-world pilot projects are used to design, test and validate key components of the network, including its technical architecture and the strategy for the management of access rights by the patients. RESULTS: a distributed architecture using peer-to-peer communication of information mediators can implement the various requirements while limiting to an absolute minimum the amount of centralized information. Access control can be managed by the patient with the help of a medical information mediator, the physician of trust.

Community Networks↗
PubMedDate not supplied

Distributional regularity and phonotactic constraints are useful for segmentation.

In order to acquire a lexicon, young children must segment speech into words, even though most words are unfamiliar to them. This is a non-trivial task because speech lacks any acoustic analog of the blank spaces between printed words. Two sources of information that might be useful for this task are distributional regularity and phonotactic constraints. Informally, distributional regularity refers to the intuition that sound sequences that occur frequently and in a variety of contexts are better candidates for the lexicon than those that occur rarely or in few contexts. We express that intuition formally by a class of functions called DR functions. We then put forth three hypotheses: First, that children segment using DR functions. Second, that they exploit phonotactic constraints on the possible pronunciations of words in their language. Specifically, they exploit both the requirement that every word must have a vowel and the constraints that languages impose on word-initial and word-final consonant clusters. Third, that children learn which word-boundary clusters are permitted in their language by assuming that all permissible word-boundary clusters will eventually occur at utterance boundaries. Using computational simulation, we investigate the effectiveness of these strategies for segmenting broad phonetic transcripts of child-directed English. The results show that DR functions and phonotactic constraints can be used to significantly improve segmentation. Further, the contributions of DR functions and phonotactic constraints are largely independent, so using both yields better segmentation than using either one alone. Finally, learning the permissible word-boundary clusters from utterance boundaries does not degrade segmentation performance.

Adult↗
PubMed1998

A hospital information system based on Common Object Request Broker Architecture (CORBA) for exchanging distributed medical objects--an approach to future environment of sharing healthcare information.

Tightly related subsystems in a HIS have to exchange medical data flexibly by the data object rather than by the battery of the data. We developed a CPR subsystem based on Common Object Request Broker Architecture (CORBA) that retrieves and stores clinical information in the object-oriented database via Internet Intra-ORB Protocol (IIOP). The system is hybridized with the legacy HIS applications on the client terminals. We believe that our solution and the experiences will contribute to the future CORBA-based environment in which computerized patient information is shared among hospitals, clinics, and tightly related systems.

Computer Communication Networks↗
PubMed1992

Effect of the signal-to-noise ratio on the quality of linear estimation reconstructions of distributed current sources.

Currently, linear estimation reconstruction is the only feasible method for extracting information about spatially distributed current sources from measurements of neural magnetic fields. We present the results of a systematic study of the effect of the signal-to-noise ratio on the imaging quality of one such algorithm in over-as well as undetermined circumstances. In particular, we will discuss the necessary trade-off between the contradictory goals of a minimum norm of the reconstructed current density distribution and of a minimal deviation of the reconstructed fields from the measured fields. As an example, we show the reconstruction of a simple arrangement of two nearly parallel dipoles in two different depths inside a spherical volume conductor, discussing the differences between the computer simulation without noise and simulation with a realistic noise level.

Algorithms↗
PubMed1999

Development of a mathematical model for the water distribution in freeze-dried solids.

PURPOSE: Development of a mathematical model to provide information about the amount of water associated with a protein and an excipient in a lyophilized product. METHODS: The moisture content of the product and the mass fraction of each component were used to derive a model for the calculation of the mass of water associating with each component. The model was applied to lyophilized formulations of rhDNase containing various amounts of mannitol or lactose. The total water content was investigated by thermogravimetry, crystalline properties by X-ray powder diffraction and water uptake behaviour using a moisture microbalance system. RESULTS: Calculations based on the model suggest that in a lyophilized rhDNase-mannitol formulation where the sugar is crystalline, most of the water is taken up by the protein. However, in the lyophilized rhDNase-lactose formulation where the sugar is amorphous, water is taken up by both the sugar and protein to a comparative extent. At high relative humidities when the amorphous sugar undergoes crystallization, the model can accommodate such a change by allowing for the formation of an additional crystalline phase. CONCLUSIONS: The rhDNase-sugar formulations show excellent conformity to the model which provides quantitative information about the distribution of water in the lyophilized binary protein-excipient products.

Crystallography, X-Ray↗
PubMed1977

Distribution of 14C-lindane in Japanese quail using autoradiography of whole body sections.

Information on the distribution of lindane in Japanese quails was obtained by autoradiography of whole body sections. The most part of lindane was found in fatty tissues of the animals and the distribution in the other parts of the organism was equal. A single dose of 14C-lindane is found in the organism of Japanese quails mainly in the gastro-intestinal tract and is excreted within 72 hours after the application.

Animals↗
PubMed1998

Experimental study on distribution of serotypes and antimicrobial patterns of group B streptococcus strains.

OBJECTIVE: To obtain information on the distribution of serotypes and antimicrobial agent susceptibilities to group B streptococcus (GBS) strains isolated in Beijing area from 1991 to 1996. METHODS: Bacterial isolates of GBS were obtained from vaginal and cervical tract of pregnant and nonpregnant women in Beijing Tian Tan Hospital by culture. A total of 76 GBS strains were identified finally by coagglutination. Serotyping was determined by Standard Lancefield method. Susceptibility to test agents was assessed by determining the minimal inhibitory concentrations (MICs) with agar dilution method that was established by the National Committee for Clinical Laboratory Standards (NCCLS). RESULTS: Seven serotypes were identified among 76 GBS strains isolates. Types II (33%), III (23%) and I a (16%) were the predominant serotypes in pregnant and nonpregnant women. MICs of penicillin G and ampicillin were < or = 0.06 microgram/ml. MICs of cephazolin, cefuroxime and cefoperozone were 0.003 microgram/ml-0.06 microgram/ml. MICs of erythromycin were 0.003 microgram/ml-0.03 microgram/ml. MICs of gentamycin were 1 microgram/ml-32 micrograms/ml. MICs of amikacin were 4 micrograms/ml- > or = 64 micrograms/ml, nearly 12.8% and 40.4% of the strains were resistant to gentamycin and amikacin, respectively. CONCLUSIONS: Our study provides useful epidemiologic data for preparation of GBS type-specific vaccines which can prevent GBS infections and antimicrobial agents susceptibility patterns in China. Routine reports on GBS susceptibilities by clinical laboratories and continuous surveillance for changes in the susceptibility are of considerable clinical importance.

Adult↗
PubMed1989

Application of method of moments analysis to fluorescence decay lifetime distributions.

In fluorescence decay work, distributions of exponential decay lifetimes are anticipated where complex systems are examined. We describe here methods of gaining information on such distributions using the method of moments analysis approach. The information obtained may be as simple as the average and deviation of the lifetime distribution, quantities which we show may be estimated directly from the results of a multiexponential analysis. An approximation to the actual distribution shape may also be obtained using a procedure we call the variable filter analysis (VFA) method without making any assumptions about the shape of the distribution. Tests of VFA using both simulated and experimental data are described. Limitations of this method and of distribution analysis methods in general are discussed. Results of analyses on experimental decays for ethidium intercalated in core particles and in free DNA are reported.

Kinetics↗
PubMed2001

Putting background information about relative risks into conjugate prior distributions.

In Bayesian and empirical Bayes analyses of epidemiologic data, the most easily implemented prior specifications use a multivariate normal distribution for the log relative risks or a conjugate distribution for the discrete response vector. This article describes problems in translating background information about relative risks into conjugate priors and a solution. Traditionally, conjugate priors have been specified through flattening constants, an approach that leads to conflicts with the true prior covariance structure for the log relative risks. One can, however, derive a conjugate prior consistent with that structure by using a data-augmentation approximation to the true log relative-risk prior, although a rescaling step is needed to ensure the accuracy of the approximation. These points are illustrated with a logistic regression analysis of neonatal-death risk.

Bayes Theorem↗