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PubMed1997

Bacterial diversity of a Carolina bay as determined by 16S rRNA gene analysis: confirmation of novel taxa.

Carolina bays are naturally occurring shallow elliptical depressions largely fed by rain and shallow ground water. To identify members of the domain Bacteria which inhibit such an environment, we used PCR to construct a library of 16S rRNA genes (16S rDNAs) cloned from DNA extracted from the sediments of Rainbow bay, located on the Savannah River Site, near Aiken, S.C. Oligonucleotides complementary to conserved regions of 16S rDNA were used as primers for PCR, and gel-purified PCR products were cloned into vector pGEM-T. Partial sequencing of the cloned 16S rDNAs revealed an extensive amount of phylogenetic diversity within this system. Of the 35 clones sequenced, 32 were affiliated with five bacterial groups: 11 clustered with the Proteobacteria division (including members of the alpha, beta, and delta subdivisions), 8 clustered with the Acidobacterium subdivision of the Fibrobacter division (as categorized by the Ribosomal Database Project's taxonomic scheme, version 5.0), 7 clustered with the Verrucomicrobium subdivision of the Planctomyces division, 3 clustered with the gram-positive bacteria (Clostridium and relatives subdivision), and 3 clustered with the green nonsulfur bacteria. One sequence branched very deeply from the Bacteria and was found not to be associated with any of the major divisions when phylogenetic trees were constructed. Two clones did not consistently cluster with specific groups and may be chimeric sequences. None of the clones exhibited an exact match to any of the 16S rDNA sequences deposited in the databases, suggesting that most of the bacteria in Rainbow Bay are novel species. In particular, the clones related to the Acidobacterium subdivision and the Verrucomicrobium subdivision confirm the presence of novel taxa discovered previously in other molecular surveys of this type.

Bacteria↗

PubMed2005

Symptom-based outcome measures for dyspepsia and GERD trials: a systematic review.

BACKGROUND: Symptom assessment using questionnaires has been recommended as the primary outcome measure in clinical gastroesophageal reflux and dyspepsia trials. Questionnaires should have proven reliability, validity, and responsiveness, and may assess the frequency and/or severity of dyspepsia symptoms. Although a number of measures have been developed, it remains unclear which of these should be used in new trials. OBJECTIVE: To describe existing questionnaire outcome measures that assess symptoms of gastroesophageal reflux dyspepsia for use in clinical trials. METHODS: Studies were identified from Medline, Embase, the Cochrane library, and reference lists. The inclusion criterion was that the study assessed a questionnaire, which measured the frequency or severity of dyspepsia or gastroesophageal reflux symptoms, in a sample of patients. RESULTS: No direct comparison between questionnaires was possible due to methodological heterogeneity. Thirty-seven studies describing 26 questionnaires met the inclusion criteria. Twelve were unidimensional (assessed symptoms only) and 14 were multidimensional (also assessed quality of life). Eleven questionnaires assessed both frequency and severity of dyspepsia, and 10 had proven reliability, validity, and responsiveness. No studies compared different questionnaires. CONCLUSIONS: Future gastroesophageal reflux and dyspepsia clinical trials should use unidimensional or multidimensional outcome measures that assess both the frequency and severity of symptoms, and have proven reliability, validity, and responsiveness. Further research is necessary to compare existing outcome measures to determine which are the most reliable, valid, and responsive instruments.

Clinical Trials as Topic↗

PubMed2000

Urban girls, internet use, and accessing health information

Background: With the burgeoning growth of the Internet, many have raised concerns over whether and how underserved populations might be included in the Information Revolution. This study examines how urban adolescent girls access the Internet and whether it is a viable source for health information.Methods: During Fall 1999 in New York City, 176 girls completed an anonymous survey where half were from a private high school (N = 86) and the other half were patients at a health clinic serving ethnically diverse and disadvantaged youth (N = 90). Data were analyzed to provide information on how urban girls use the Internet.Results: Internet use was widespread; 99% of the high school and 83% of the clinic girls said they used this medium (p <.001). On frequency, 32% of high school girls compared to 13% of the clinic girls used the Internet 6-7 days/wk (p <.001). Among the high school girls, 30% indicated that they used the Internet less than 30 min/wk and another 18% reported using the Internet more than 5 hrs/wk. Among clinic girls, 51% used the Internet less than 30 min/wk while 9% reported more than 5 hrs/wk. Comfort levels differed with 20% of the high school compared to 10% of the clinic girls reporting "extreme" comfort using the Internet (p <.001).Urban girls accessed the Web from multiple locales. Almost all (98%) of the high school girls compared to 45% of the clinic girls reported that they used the Internet from home (p <.001). Most high school girls (82%) used the Internet at school compared to 63% of the clinic girls currently in school (p <.05). More clinic girls used the Internet at another family member's house (28% vs. 14%, p <.05). Similar percentages of high school and clinic girls used the Internet at a friend's house (46%), the library (31%), or a community center (3%).With similar rates among high school and clinic girls, 44% reported that they had tried to get health information from the Web. Of these (N = 74), 50% said that they got information on different diseases, 43% on diet/nutrition, 34% on fitness/exercise, 26% on sex, 24% on alcohol/drug abuse, 20% on mental health, 14% on medicines, 12% on violence among peers, 10% on parenting, 8% on violence among dating partners, 7% on tobacco and smoking, 7% on emotional or physical abuse, 3% on sexual abuse, and 1% on illness support groups. Clinic girls were more likely to have tried to get information on sex (p <. 001) and parenting (p <.001) from the Web. Many girls (59%) indicated that it was "very" or "extremely" worthwhile to have general health information on the Web, with no significant differences between high school and clinic girls. As well, 71% and 62% said it was "very" or "extremely" worthwhile to have access to contraceptive and diet/nutrition information, respectively. Conclusions. High school girls, as anticipated, were technologically savvy. Somewhat surprising, however, were the clinic girls' high levels of Internet use and access. Significant differences revealed that the high school girls were more on-line than clinic girls, but clinic girls were still using the Web frequently. A considerable number or urban girls had tried to get a range of health information from the Internet. This study offers promising statistics on how urban adolescent girls are accessing and using the Internet, especially for health information.

Journal Article↗

PubMed1995

A unique repeated DNA sequence in the cyclosporin-producing strain of Tolypocladium inflatum (ATCC 34921).

Recombinant lambda clones containing repeated DNA sequences were isolated from the cyclosporin A-producing fungus Tolypocladium inflatum (ATCC 34921) by differential hybridization with total fungal DNA and rDNA probes. From this survey 1% of the lambda clones appeared to contain repeated sequences. Subsequent analysis led to the identification of a dispersed repetitive DNA element. It was named CPA element (cyclosporin production associated) and appears to be strain specific, since it is absent from other related strains or fungi. Hybridization with chromosomal restriction fragments indicates an equal distribution of the CPA element in the genome. The copy number was estimated to be between 20 and 30 per haploid genome. Sequence analysis of a 0.9-kb XhoI fragment from three copies of the CPA element revealed strong conservation of this sequence among all copies. A 200-bp region exhibits similarities to a repeated sequence from Zea diploperennis. The use of this DNA sequence as a molecular marker for identification of this cyclosporin-producing strain ATCC 34921 is discussed as is the relevance of repeated DNA sequences for rearrangements of fungal karyotypes.

Base Sequence↗

PubMed2006

Colorectal cancer screening awareness in European primary care.

BACKGROUND: Adjustment for stage at diagnosis markedly reduces USA versus European colorectal cancer survival differences and a screening bias was therefore suspected. Moreover, little is known about colorectal cancer screening habits in European primary care and the history of guidelines implementation. The purpose of the study was to index the overall colorectal cancer screening attitudes of European physicians involved in primary care activities. METHODS: A systematic literature-search was performed in three major medical libraries: PubMed/MEDLINE, ISI web of science, and COCHRANE. RESULTS: We found only five eligible studies, but valuable data were presented only in four. Colorectal cancer screening was recommended by 65-95% of physicians, but the major part of them implemented it only among high-risk individuals; stool occult blood testing was advised by 42-83% and prescription of screening endoscopic modalities was inconsistent. Most European reports found were not eligible and were mainly focused on diagnostic delay in symptomatic subjects rather than on screening procedures among asymptomatic individuals. CONCLUSION: In comparison with European practice, colorectal cancer screening habits of American physicians are to a greater extent rational, evidence-based and well monitored and have a longer tradition in medical care thus allowing better prevention services for asymptomatic individuals.

Colorectal Neoplasms↗

PubMed2006

Methods of consumer involvement in developing healthcare policy and research, clinical practice guidelines and patient information material.

BACKGROUND: The importance of consumer involvement in health care is widely recognised. Consumers can be involved in developing healthcare policy and research, clinical practice guidelines and patient information material, through consultations to elicit their views or through collaborative processes. Consultations can be single events, or repeated events, large or small scale. They can involve individuals or groups of consumers to allow debate; the groups may be convened especially for the consultation or be established consumer organisations. They can be organised in different forums and through different media. We anticipated finding few comparative evaluations that reliably evaluated the effects of consumer involvement. OBJECTIVES: To assess the effects of consumer involvement and compare different methods of involvement in developing healthcare policy and research, clinical practice guidelines, and patient information material. SEARCH STRATEGY: We searched: the Cochrane Consumers and Communication Review Group's Specialised Register (4 May 2006); the Cochrane Controlled Trials Register (CENTRAL) (The Cochrane Library, Issue 1 2006), MEDLINE (1966 to January Week 2 2006); EMBASE (1980 to Week 03 2006); CINAHL (1982 to December Week 2 2005), PsycINFO (1806 to January Week 3 2006); Sociological Abstracts (1952 to 24 January 2006); and SIGLE (System for Information on Grey Literature in Europe) (1980 to 2003/1). We scanned reference lists from relevant articles and contacted authors. SELECTION CRITERIA: Randomised and quasi-randomised trials, interrupted time series analyses, and controlled before-after studies assessing methods for involving consumers in developing healthcare policy and research, clinical practice guidelines or patient information material. The outcome measures were: participation or response rates of consumers; consumer views elicited; consumer influence on decisions, healthcare outcomes or resource utilisation; consumers' or professionals' satisfaction with the involvement process or resulting products; impact on the participating consumers; costs. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials for inclusion, assessed their quality and extracted data. We contacted study authors for clarification and to seek missing data. We presented results in a narrative summary and pooled data as appropriate. MAIN RESULTS: Five randomised controlled trials of moderate or low methodological quality involving 1031 participants were included. There is moderate quality evidence that involving consumers in the development of patient information material results in material that is more relevant, readable and understandable to patients, without affecting their anxiety. This 'consumer-informed' material can also improve patients' knowledge. There is low quality evidence that using consumer interviewers instead of staff interviewers in satisfaction surveys can have a small influence on the survey results. There is very low quality evidence of telephone discussions and face-to-face group meetings engaging consumers better than mailed surveys in order to set priorities for community health goals, and resulting in different priorities being set for these goals. AUTHORS' CONCLUSIONS: There is little evidence from comparative studies of the effects of consumer involvement in healthcare decisions at the population level. The studies included in this review demonstrate that randomised controlled trials are feasible for providing evidence about the effects of consulting consumers to inform these decisions.

Community Participation↗

PubMed1998

Comparative genomic hybridization of esophageal and gastroesophageal adenocarcinomas shows consensus areas of DNA gain and loss.

Relatively little is known about the genetic changes that occur in esophageal and gastroesophageal adenocarcinomas. To provide a survey of relative DNA gains and losses in these cancers, we microdissected 15 primary human esophageal and gastroesophageal adenocarcinomas to enrich for cancer cells and subsequently performed comparative genomic hybridization. Eighteen regions of high-level amplification were detected in 11 tumors, with 8p23, 17q21, and 18p11 showing four, three, and two such events, respectively. The most common minimal regions of gain were 8q24 (8/15), 20q (7/15), 17q21 (7/15), and 7p 1-15 (7/15 ). The most common minimal regions of loss were 5q 12-21 (8/15), 4q10-24 (5/15), 4p (5/15), and 18q (3/15). These results implicate the well-characterized oncogenes MYC (8q24) and ERBB2 (17q21), and they predict the involvement of additional oncogenes on 8p23, 20q, and chromosome 7 in the pathogenesis of these cancers. Chromosomes 4 and 5 are frequent targets of deletion in these tumors and may harbor novel tumor suppressor genes.

Adenocarcinoma↗

PubMed1998

Novel division level bacterial diversity in a Yellowstone hot spring.

A culture-independent molecular phylogenetic survey was carried out for the bacterial community in Obsidian Pool (OP), a Yellowstone National Park hot spring previously shown to contain remarkable archaeal diversity (S. M. Barns, R. E. Fundyga, M. W. Jeffries, and N. R. Page, Proc. Natl. Acad. Sci. USA 91:1609-1613, 1994). Small-subunit rRNA genes (rDNA) were amplified directly from OP sediment DNA by PCR with universally conserved or Bacteria-specific rDNA primers and cloned. Unique rDNA types among > 300 clones were identified by restriction fragment length polymorphism, and 122 representative rDNA sequences were determined. These were found to represent 54 distinct bacterial sequence types or clusters (> or = 98% identity) of sequences. A majority (70%) of the sequence types were affiliated with 14 previously recognized bacterial divisions (main phyla; kingdoms); 30% were unaffiliated with recognized bacterial divisions. The unaffiliated sequence types (represented by 38 sequences) nominally comprise 12 novel, division level lineages termed candidate divisions. Several OP sequences were nearly identical to those of cultivated chemolithotrophic thermophiles, including the hydrogen-oxidizing Calderobacterium and the sulfate reducers Thermodesulfovibrio and Thermodesulfobacterium, or belonged to monophyletic assemblages recognized for a particular type of metabolism, such as the hydrogen-oxidizing Aquificales and the sulfate-reducing delta-Proteobacteria. The occurrence of such organisms is consistent with the chemical composition of OP (high in reduced iron and sulfur) and suggests a lithotrophic base for primary productivity in this hot spring, through hydrogen oxidation and sulfate reduction. Unexpectedly, no archaeal sequences were encountered in OP clone libraries made with universal primers. Hybridization analysis of amplified OP DNA with domain-specific probes confirmed that the analyzed community rDNA from OP sediment was predominantly bacterial. These results expand substantially our knowledge of the extent of bacterial diversity and call into question the commonly held notion that Archaea dominate hydrothermal environments. Finally, the currently known extent of division level bacterial phylogenetic diversity is collated and summarized.

Bacteria↗

PubMed2000

A survey of genes expressed in adults of the human hookworm, Necator americanus.

Hookworms are gut-dwelling, blood-feeding nematodes that infect hundreds of millions of people, particularly in the tropics. As part of a program aiming to define novel drug targets and vaccine candidates for human parasitic nematodes, genes expressed in adults of the human hookworm Necator americanus were surveyed by the expressed sequence tag approach. In total 161 new hookworm genes were identified. For the majority of these, a function could be assigned by homology. The dataset includes proteases, protease inhibitors, a lipid binding protein, C-type lectins, an anti-bacterial factor, globins and other genes of interest from a drug or vaccine development viewpoint. Three different classes of small, secreted proteins were identified that may be involved in the host-parasite interaction, including potential potassium channel blocking peptides. One third of the genes were novel. These included highly expressed, secreted (glyco)proteins which may be part of the excretory-secretory products of these important pathogens. Of particular interest are a family of 9 genes with similarity to the immunomodulatory protein, neutrophil inhibitory factor, that may play a role in establishing an immunocompromised niche for this successful parasite.

Amino Acid Sequence↗

PubMed1990

Genomic organization and physical mapping of the transfer RNA genes in Escherichia coli K12.

By using a set of 476 ordered DNA clones (in lambda phage vector) that covers the entire chromosome of Escherichia coli K12, we have made an exhaustive survey of tRNA genes in the E. coli genome. Ultraviolet-irradiated bacteria were separately infected with each of the 476 clones and the RNA molecules produced upon infection were labeled with 32P. The labeled tRNAs were separated by gel electrophoresis and then characterized by fingerprinting analysis. Fifty-nine of the 476 clones produced tRNAs, including adjacent overlapping ones that share the same tRNA genes. The products of all the previously mapped tRNA genes (about 60, to date) were detected according to their expected positions, and 19 more tRNA genes were newly elucidated. These new tRNA genes were identified by sequencing the DNA from relevant regions of the clones; the DNA sequences were scanned for the stretches that could be folded into the familiar cloverleaf structure and the transcription units were deduced by predicting the promoters and terminators. The total complement of the tRNA genes in E. coli K12 was 78 for 45 tRNA (or 41 anticodon) species, distributed in 40 different transcription units throughout the chromosome. In addition, a gene for selenocysteine tRNA was detected by hybridization and mapped to a specific DNA segment. A comprehensive tRNA gene map of E. coli was constructed, including the selenocysteine tRNA gene. All the tRNA genes encode the 3' CCA, and in several cases the terminal 19 nucleotides (including the 3' CCA) of a tRNA gene is repeated several times. Finally, in the present study the sites for a long inversion (approx. 800 x 10(3) base-pairs, around the oriC region) in Kohara's library was determined to be within the 23 S-5 S regions in rrnD and rrnE, revealing the exchange of combinations of spacer and distal tRNA genes between these two ribosomal RNA operons.

Base Sequence↗

PubMed2002

Assessing health status and quality-of-life instruments: attributes and review criteria.

The field of health status and quality of life (QoL) measurement - as a formal discipline with a cohesive theoretical framework, accepted methods, and diverse applications--has been evolving for the better part of 30 years. To identify health status and QoL instruments and review them against rigorous criteria as a precursor to creating an instrument library for later dissemination, the Medical Outcomes Trust in 1994 created an independently functioning Scientific Advisory Committee (SAC). In the mid-1990s, the SAC defined a set of attributes and criteria to carry out instrument assessments; 5 years later, it updated and revised these materials to take account of the expanding theories and technologies upon which such instruments were being developed. This paper offers the SAC's current conceptualization of eight key attributes of health status and QoL instruments (i.e., conceptual and measurement model; reliability; validity; responsiveness; interpretability; respondent and administrative burden; alternate forms; and cultural and language adaptations) and the criteria by which instruments would be reviewed on each of those attributes. These are suggested guidelines for the field to consider and debate; as measurement techniques become both more familiar and more sophisticated, we expect that experts will wish to update and refine these criteria accordingly.

Health Services Research↗

PubMed2004

Soybean bacterial artificial chromosome contigs anchored with RFLPs: insights into genome duplication and gene clustering.

Surveying the soybean genome with 683 bacterial artificial chromosome (BAC) contiguous groups (contigs) anchored by restriction fragment length polymorphisms (RFLPs) enabled us to explore microsyntenic relationships among duplicated regions and also to examine the physical organization of hypomethylated (and presumably gene-rich) genomic regions. Numerous cases where nonhomologous RFLPs hybridized to common BAC clones indicated that RFLPs were physically clustered in soybean, apparently in less than 25% of the genome. By extension, we speculate that most of the genes are clustered in less than 275 M of the soybean genome. Approximately 40%-45% of this gene-rich portion is associated with the RFLP-anchored contigs described in this study. Similarities in genome organization among BAC contigs from duplicate genomic regions were also examined. Homoeologous BAC contigs often exhibited extensive microsynteny. Furthermore, paralogs recovered from duplicate contigs shared 86%-100% sequence identity.

Chromosomes, Artificial, Bacterial↗

PubMed2006

[Complementary and alternative therapies for climacteric symptoms].

OBJECTIVE: Review on complementary and alternative therapies for climacteric symptoms. METHODS: Search for publications about complementary or alternative treatments for climacteric symptoms based on Cochrane Library and Medline (1966-2006) including the references from the identified clinical trials and reviews. RESULTS: Cimicifuga may influence climacteric symptoms, especially hot flushes. Results for phytoestrogens, hop and Salvia seem promising but are less convincing. St. John's wort is an option for the treatment of moderate depressive symptoms. Phytoestrogens seem to have some potential for the prevention of osteoporosis and cardiovascular diseases. Results for the influence of lifestyle on hot flushes are conflicting, but interventions have demonstrated their use for the prevention of osteoporosis and cardiovascular diseases. CONCLUSIONS: Lifestyle modifications, Cimicifuga and phytoestrogens may relieve climacteric symptoms. Phytoestrogens and Cimicifuga should not be given to breast cancer survivors.

Acupuncture↗

PubMed2000

[Development of bioethics. Analysis of practices in 20 hospital departments].

OBJECTIVE: In order to analyze the constitution and management of DNA banks and the limitations on procedures currently used in France, we conducted a study in a sample of French hospital units. A DNA bank was defined as any facility where individual samples of DNA, irrespective of the form, are stored for ongoing or future gene studies. The aim of this work was to focus attention on the need for in-depth thought on the ethical issues involved in storing and using DNA as part of everyday clinical practice and research and to provide elements for a debate on the interest and limitations of the French bioethics laws whose revision is currently being considered. METHODS: A questionnaire was sent to the heads of departments in two university hospitals. Five areas were retained for evaluation: the nature and degree of DNA storage activities, procedures followed for reporting the DNA bank, procedures used to protect confidentiality, information given to patients and procedures used for informed consent, and finally, internal rules governing the bank's operation. The answers to the questionnaires were analyzed anonymously. RESULTS: Among 20 hospital units collecting DNA samples, 70% also stored other samples (DNA, blood, tissue, cell lines) including a large proportion of tissue samples. These samples were collected for purposes of fundamental research and clinical practice. The number of samples stored was quite variable, ranging from a few dozen samples to more than 40,000. Only 55% of the units had reported the facility to a control body, in compliance with current law. Seventy percent maintained computerized data bases but only 50% used an anonymous code. Seventy-five percent obtained written consent but patients were not always informed of the site of the storage or the transfer of their DNA. In addition, the validity of the consent over time, the duration of storage and the types of studies that could be conducted on the DNA were poorly detailed. Internal rules governing the bank's activities were not implemented by most of the units (65%). CONCLUSION: The responses to our questionnaire survey show that there is currently a gap between everyday practice and regulatory procedures concerning DNA banks in France. Further analysis of current practices would appear to be necessary so professionals could become more aware of the human and social issues involved with the use of DNA banks. These data on everyday practices should be made available to health care workers, public officials and law makers in order to promote ethical practices that, as has been observed, are not dictated solely by legislation which often lags behind everyday activities. All those involved in the management of DNA banks must be aware of their responsibilities in protecting patients' rights within the framework of a system based on information, consent, and over-the-board trustworthiness regularly submitted to short and long term assessments. A correct response to ethical issues is the only means of developing a real process of social interaction which cannot be achieved by revision of the bioethics laws alone.

Confidentiality↗

PubMed2005

Effective e-learning for health professionals and students--barriers and their solutions. A systematic review of the literature--findings from the HeXL project.

INTRODUCTION: In 2003/4 the Information Management Research Institute, Northumbria University, conducted a research project to identify the barriers to e-learning for health professionals and students. The project also established possible ways to overcome these barriers. The North of England Workforce Development Confederation funded the project. METHODOLOGY: The project comprised a systematic review of the literature on barriers to and solutions/critical success factors for e-learning in the health field. Fifty-seven references were suitable for analysis. This review was supplemented by a questionnaire survey of learners and an interview study of learning providers to ensure that data identified from the literature were grounded in reality. RESULTS: The main barriers are: requirement for change; costs; poorly designed packages; inadequate technology; lack of skills; need for a component of face-to-face teaching; time intensive nature of e-learning; computer anxiety. A range of solutions can solve these barriers. The main solutions are: standardization; strategies; funding; integration of e-learning into the curriculum; blended teaching; user friendly packages; access to technology; skills training; support; employers paying e-learning costs; dedicated work time for e-learning. CONCLUSIONS: The authors argue that librarians can play an important role in e-learning: providing support and support materials; teaching information skills; managing and providing access to online information resources; producing their own e-learning packages; assisting in the development of other packages.

Communication Barriers↗

PubMed2000

Design and evaluation of a software prototype for participatory planning of environmental adaptations.

A software prototype to support the planning process for adapting home and work environments for people with physical disabilities was designed and later evaluated. The prototype exploits low-cost three-dimensional (3-D) graphics products in the home computer market. The essential features of the prototype are: interactive rendering with optional hardware acceleration, interactive walk-throughs, direct manipulation tools for moving objects and measuring distances, and import of 3-D-objects from a library. A usability study was conducted, consisting of two test sessions (three weeks apart) and a final interview. The prototype was then tested and evaluated by representatives of future users: five occupational therapist students, and four persons with physical disability, with no previous experience of the prototype. Emphasis in the usability study was placed on the prototype's efficiency and learnability. We found that it is possible to realise a planning tool for environmental adaptations, both regarding usability and technical efficiency. The usability evaluation confirms our findings from previous case studies, regarding the relevance and positive attitude towards this kind of planning tool. Although the prototype was found to be satisfactorily efficient for the basic tasks, the paper presents several suggestions for improvement of future prototype versions.

Activities of Daily Living↗

PubMed2005

Chromosomal inversion polymorphism leads to extensive genetic structure: a multilocus survey in Drosophila subobscura.

The adaptive character of inversion polymorphism in Drosophila subobscura is well established. The O(ST) and O(3+4) chromosomal arrangements of this species differ by two overlapping inversions that arose independently on O(3) chromosomes. Nucleotide variation in eight gene regions distributed along inversion O(3) was analyzed in 14 O(ST) and 14 O(3+4) lines. Levels of variation within arrangements were quite similar along the inversion. In addition, we detected (i) extensive genetic differentiation between arrangements in all regions, regardless of their distance to the inversion breakpoints; (ii) strong association between nucleotide variants and chromosomal arrangements; and (iii) high levels of linkage disequilibrium in intralocus and also in interlocus comparisons, extending over distances as great as approximately 4 Mb. These results are not consistent with the higher genetic exchange between chromosomal arrangements expected in the central part of an inversion from double-crossover events. Hence, double crossovers were not produced or, alternatively, recombinant chromosomes were eliminated by natural selection to maintain coadapted gene complexes. If the strong genetic differentiation detected along O(3) extends to other inversions, nucleotide variation would be highly structured not only in D. subobscura, but also in the genome of other species with a rich chromosomal polymorphism.

Animals↗

PubMedDate not supplied

Information needs of health care professionals in an AIDS outpatient clinic as determined by chart review.

OBJECTIVE: To examine the information needs of health care professionals in HIV-related clinical encounters, and to determine the suitability of existing information sources to address those needs. SETTING: HIV outpatient clinic. PARTICIPANTS: Seven health care professionals with diverse training and patient care involvement. METHODS: Based on patient charts describing 120 patient encounters, participants generated 266 clinical questions. Printed and on-line information sources were used to answer questions in two phases: using commonly available sources and using all available medical library sources. MEASUREMENTS: The questions were divided into 16 categories by subject. The number of questions answered, their categories, the information source(s) providing answers, and the time required to answer questions were recorded for each phase. RESULTS: Each participant generated an average of 3.8 clinical questions per chart. Five categories accounted for almost 75% of all questions; the treatment protocols/regimens category was most frequent (24%). A total of 245 questions (92%) were answered, requiring an average of 15 minutes per question. Most (87%) of the questions were answered via electronic sources, even though paper sources were consulted first. CONCLUSIONS: The participating professionals showed considerable information needs. A combination of on-line and paper sources was necessary to provide the answers. The study suggests that present-day information sources are not entirely satisfactory for answering clinical questions generated by examining charts of HIV-infected patients.

Ambulatory Care↗