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PubMed2006

The National Health Survey 2001: usefulness to inform a discussion on access to and use of quality primary health care using type 2 diabetes mellitus as an example.

INTRODUCTION: This paper explores the usefulness of the 2001 Australian Bureau of Statistics National Health Survey (2001 NHS) for examining access to and use of quality primary health care (PHC) in Australia, using diabetes as an example. METHODS: Potential indicators of access to and use of quality diabetes care were investigated (diagnosis, preventive pharmacotherapy, complication screening, multidisciplinary care and hospitalisation), and their association with various factors including socioeconomic and diabetes-related health status was assessed. RESULTS: Older Australian-born females were more likely to receive preventive pharmacotherapy, whereas complication screening was associated with duration of disease. Multidisciplinary care was associated with recent hospitalisation and not health need assessed by presence of comorbidity. CONCLUSIONS: This novel use of the 2001 NHS provided information on patterns of access to and use of diabetes-related PHC that were consistent with previous research. It suggests a new role for survey data in monitoring access to and use of PHC over time and complementing other population health data collections in this area.

Aged↗

PubMed1994

Integrated software tools for the evaluation of radiotherapy treatment plans.

PURPOSE: This article announces the availability of a convenient and useful software environment for the evaluation of three-dimensional (3D) radiotherapy treatment plans. MATERIALS AND METHODS: Using standards such as American National Standards for Information Systems C and the X Window System allowed us to bring the computation and display of dose-volume histograms, dose statistics, tumor control probabilities, normal tissue complication probabilities, and a figure of merit together under one user interface. These plan evaluation tools are not stand alone, but must interact with a 3D radiation therapy planning system to obtain the required dose matrices and patient anatomical contours. Installation of the software involves a programmer who writes a software bridge between the radiation therapy planning system and the tools, thereby providing access to local data files. This design strategy confines portability issues to one area of the software. RESULTS: Access to the other tools is through the Graphical Plan Evaluation Tool (GPET). GPET coordinates the use of each of the tools and provides graphical facilities for display of their results. Importantly, GPET assures that the displayed results of each tool have been computed with the same input specifications for all treatment plans being compared. For added convenience, the user can rearrange the resultant data to be reviewed in various ways on the video screen. The software design also allows incorporation of customized algorithms and input data for computing tumor control probability and normal tissue complication probabilities, since those currently available are controversial. CONCLUSION: The Graphical Plan Evaluation Tool unifies the simultaneous computation for several analytical tools and graphical display of their results. Within the constraints of the X Window System environment, this assemblage of software tools provides a portable, flexible, and convenient method for the quantitative evaluation of several radiotherapy treatment plans.

Dose-Response Relationship, Radiation↗

PubMed1998

WWW accessible system for national/regional registries of clinical results of cord blood transplants: a tool to facilitate cooperative clinical research.

A system, accessible via internet, has been developed to support the Spanish Registry of Cord Blood Transplants (RETSCU). The system includes a database of clinical results directly accessible by transplant centers (TCs) and cord blood banks (CBBs) (restricted to own cases regarding primary data and unrestricted regarding statistics derived from validated data) and gives open access to Web pages containing results approved for publication. It also includes internal mail for two-way and broadcast messages. Patients' data are essentially those included in Eurocord forms. Additional features of the system are: confidentiality; inalterability of validated primary data; identifiability of data sources. The Unix central computer is accessible via the WWW. For security, data transmission is encrypted and passwords are required for access. Copies are regularly updated. Data can be loaded from CBBs and TCs. The procedure for creating and updating records is user-friendly, with the possibility of errors being minimized by extensive automated checks. Validation of patients' records by a manager is required before making data available for general statistical analysis. TCs and CBBs may retrieve data on their own cases, regardless of validation, as individual records or in tables directly transferable to common statistical programs. Statistical analysis may be done on validated data from all the patients in the Registry or from groups selected according to HLA compatibility and disease, type of transplant (related/unrelated), or protocol. Several similarly designed and managed national/regional Registries might be networked and their data integrated into a multinational Registry. Our system would require some additional developments to be used in this way.

Hematopoietic Stem Cell Transplantation↗

PubMed1998

Access control and system audit based on "patient-doctor relation and clinical situation" model.

Both confidentiality of privacy and the data sharing between healthcare practitioners are required in hospital information systems. A new access control method has been designed by the "patient-doctor relation and clinical situation at the point-of-care" model in addition to the traditional "account and password" mechanism. This method can; (I) allow flexible data access in need, (2) afford accurate access audit, (3) suppress inappropriate access.

Computer Security↗

PubMed2005

Lessons learned: geographic information systems and farmworkers in the Lake States.

Agencies serving the estimated 42,000 to 137,000 migrant and seasonal farmworkers in the Lake States (Wisconsin, Michigan, and Minnesota) face distinct challenges, including inadequate access to farmworker data to address their needs. This project developed and evaluated a geographical information system (GIS) database for compiling and displaying existing farmworker data in the Lake States. A three-step study was conducted in the Lake States: (1) a preliminary resource and needs assessment was conducted among agencies serving farmworkers, (2) a GIS product was created using data available from state agencies, and (3) the GIS product was evaluated by an advisory board of qualified occupational health and safety representatives for appropriateness, applications, and ease of use. Agencies participated by sharing their available farmworker data. The GIS product consisted of a CD-ROM with data displayed in a graphic format and downloadable spreadsheet files consolidated by county demographic, crop, housing, and migrant health clinic information. Evaluators of the GIS product found it to be an accessible, unique clearinghouse for farmworker-related data. The GIS product can become a valuable tool for agencies serving farmworkers and those researching farmworker-related issues. Agencies and health professionals require useful and comprehensive databases to track and serve farmworkers, and a multi-agency partnership using GIS technology could provide this capability. Further research is required with improved definitions and resources to apply the GIS product.

Agricultural Workers' Diseases↗

PubMed2005

Electronic clinical path system based on semistructured data model using personal digital assistant for onsite access.

Clinical Paths (Paths) have been introduced by different hospitals for patient care management. An Electronic Clinical Path (ECP) with onsite access provision seems to improve the efficiency of medical staffs because they can share vast medical information about patients at a time and also can reuse accumulated data easily, which is impossible with paper-based Path. Data model is the basis for implementing ECP. However, there is no established model for ECP. The purpose of this study is to introduce a model for ECP and implement an ECP with onsite access system. We introduced a Semistructured Data Model (SSDM) for ECP, and implemented a Web application system based on this model using Personal Digital Assistant (PDA) as inputting device. Our system functioned as expected with wireless LAN, and users handled the data on bedside using PDA. By introducing SSDM, we showed the correspondence between schema of Paths and implementation of ECP.

Access to Information↗

PubMed1997

Homogeneous two-site immunometric assay kinetics as a theoretical tool for data analysis.

The easily accessible kinetics of a new homogeneous two-site fluorometric immunoassay for prolactin was studied, in order to determine its usefulness for assay data reduction and optimization. The combined use of a simple descriptive model fitted to experimental data and a mechanistic model to simulate the kinetics revealed that (i) the kinetics curve presented an early inflexion point. Its time of occurrence was constant as long as the antigen concentration was below the smallest antibody concentration and decreased to zero for higher concentrations. It may therefore be used as an indicator of hooked samples. (ii) The kinetics steepest slope was correlated with antigen concentration. Its use as a dose-response curve variable would allow higher concentrations to be assayed than with the classical end-point dose-response curve. The results suggest that control and exploitation of kinetic parameters could help to improve the rapidity, analytical range, and reliability of homogeneous two-site immunometric assays.

Animals↗

PubMed2007

Race and mental health diagnosis are risk factors for highly active antiretroviral therapy failure in a military cohort despite equal access to care.

BACKGROUND: Data suggest that African Americans have lower rates of virologic suppression using highly active antiretroviral therapy (HAART), possibly because of socioeconomic status and access to care. In a US Military clinic, where beneficiaries have ready access to no-cost health care, the impact of several variables (including race) on HIV virologic suppression were examined. METHODS: Retrospective analysis of antiretroviral-naive patients who began HAART between 1997 and 2003. Demographics, viral loads, CD4 cell counts, and mental health diagnoses were analyzed. RESULTS: The charts of 129 individuals who initiated their first antiretroviral regimen during the period of observation were evaluated. The overall efficacy of reaching viral suppression was 71% at 12 months and 56% at 24 months. HIV suppression was achieved at 12 months by 63% of African Americans and 92% of whites (P = 0.001). Mental health diagnosis was associated with failure at 24 months (38 vs. 61%; P = 0.034). Being white (odds ratio = 3.5, 95% confidence interval [CI]: 1.2 to 10.3; P = 0.022) and lacking a mental health diagnosis (odds ratio = 8.7, 95% CI: 2.4 to 32.1; P = 0.001) were both associated with increased efficacy at 24 months by multivariate analysis. CONCLUSIONS: African-American race and the presence of a mental health diagnoses were independently associated with antiretroviral failure. Equal access to care yields high efficacy rates with HAART but does not fully equilibrate racial differences in virologic failure.

Adult↗

PubMed2006

IntNetDB v1.0: an integrated protein-protein interaction network database generated by a probabilistic model.

BACKGROUND: Although protein-protein interaction (PPI) networks have been explored by various experimental methods, the maps so built are still limited in coverage and accuracy. To further expand the PPI network and to extract more accurate information from existing maps, studies have been carried out to integrate various types of functional relationship data. A frequently updated database of computationally analyzed potential PPIs to provide biological researchers with rapid and easy access to analyze original data as a biological network is still lacking. RESULTS: By applying a probabilistic model, we integrated 27 heterogeneous genomic, proteomic and functional annotation datasets to predict PPI networks in human. In addition to previously studied data types, we show that phenotypic distances and genetic interactions can also be integrated to predict PPIs. We further built an easy-to-use, updatable integrated PPI database, the Integrated Network Database (IntNetDB) online, to provide automatic prediction and visualization of PPI network among genes of interest. The networks can be visualized in SVG (Scalable Vector Graphics) format for zooming in or out. IntNetDB also provides a tool to extract topologically highly connected network neighborhoods from a specific network for further exploration and research. Using the MCODE (Molecular Complex Detections) algorithm, 190 such neighborhoods were detected among all the predicted interactions. The predicted PPIs can also be mapped to worm, fly and mouse interologs. CONCLUSION: IntNetDB includes 180,010 predicted protein-protein interactions among 9,901 human proteins and represents a useful resource for the research community. Our study has increased prediction coverage by five-fold. IntNetDB also provides easy-to-use network visualization and analysis tools that allow biological researchers unfamiliar with computational biology to access and analyze data over the internet. The web interface of IntNetDB is freely accessible at http://hanlab.genetics.ac.cn/IntNetDB.htm. Visualization requires Mozilla version 1.8 (or higher) or Internet Explorer with installation of SVGviewer.

Algorithms↗

PubMed1990

Species differences in carcinogenicity: the role of metabolism in human risk evaluation.

The assessment of human risk from exposure to chemicals is frequently confounded by differences in response to those chemicals in laboratory animals. In many cases, the basis of the species differences is differences in metabolism and pharmacokinetics. Since metabolic and pharmacokinetic data are readily accessible in both laboratory animals and humans, risk assessments can be significantly improved if these data are incorporated into the process. Several chlorinated solvents, perchloroethylene, trichloroethylene, and methylene chloride, have been investigated, and the species differences in carcinogenicity have been shown to be the result of pharmacokinetic differences between the species. The rates of metabolism of these chemicals have been measured in rats and mice in vivo, and the species differences observed have been reproduced in vitro using tissue fractions and hepatocytes. Identical experiments have been carried out using human tissues. The results of these studies together with species-specific physiological parameters have been used in a mathematical model to predict human cancer risk over a wide range of exposures. This approach provides both an explanation for the species differences in response to these chemicals and also a more rational approach to human risk assessment.

Animals↗

PubMedDate not supplied

The national exposure research laboratory's consolidated human activity database.

EPA's National Exposure Research Laboratory (NERL) has combined data from 12 U.S. studies related to human activities into one comprehensive data system that can be accessed via the Internet. The data system is called the Consolidated Human Activity Database (CHAD) and is available at http:// www.epa.gov/nerl/. CHAD contains 22,968 person days of activity and is designed to assist exposure assessors and modelers in constructing population "cohorts" of people with specified characteristics that are suitable for subsequent analysis or modeling. This paper describes the studies comprising CHAD and the various intellectual foundations that underlay the gathering of human activity pattern data. Next, it provides a brief overview of the Internet version of CHAD, and discusses how the program was formulated. Emphasis is placed on how activity-specific energy expenditure estimates were developed. Finally, the paper recommends steps that should be taken to improve the collection of activity data that would improve energy expenditure estimates and related information needed for physiologically based exposure dose modeling efforts.

Activities of Daily Living↗

PubMed2003

Modular data logger system for physical workload measurements.

Direct technical measurements of physical workload have advantages in studies of work-related musculoskeletal disorders. A data logger has been developed, based on 20 and 40 Mbyte PCMCIA (Personal Computer Memory Card International Association) flash memory cards, for electromyography (EMG), inclinometry and goniometry. They are provided with an input for marking of events that can be used for synchronization with other loggers and with video recordings. To make the data easier to access by the preceeding analysis software, application software has also been developed that reorganizes the data. The loggers are easy to operate and enable whole-day ambulatory field recordings without any need for reduction or compression of the data.

Electronic Data Processing↗

PubMedDate not supplied

Racism and health care access: a dialogue with childbearing women.

The rates of low birth weight and preterm delivery are twice as high for African Americans as they are for Whites in the United States. Racism and health care access may be factors in this twofold disparity. To investigate this possibility, we conducted a qualitative study with African American prenatal and postpartum women (N = 14). In 1- to 2-hr interviews, we asked the participants to describe their ability to access health care and their experiences of racism. We then independently and collectively coded the data until consensus (95%) was obtained. Data categories included access to care, treatment, differences in care, stereotypes, and racism. Three themes emerged from the interviews: (a) the pervasiveness of the stereotype of pregnant African American women; (b) a care that is indifferent, inaccessible, and undignified; and (c) the totality of racism. These themes encompass social, political, and economic factors affecting the experiences of childbearing African American families and mandate the need for further investigation and intervention.

Adolescent↗

PubMed2004

GermOnline, a cross-species community knowledgebase on germ cell differentiation.

GermOnline provides information and microarray expression data for genes involved in mitosis and meiosis, gamete formation and germ line development across species. The database has been developed, and is being curated and updated, by life scientists in cooperation with bioinformaticists. Information is contributed through an online form using free text, images and the controlled vocabulary developed by the GeneOntology Consortium. Authors provide up to three references in support of their contribution. The database is governed by an international board of scientists to ensure a standardized data format and the highest quality of GermOnline's information content. Release 2.0 provides exclusive access to microarray expression data from Saccharomyces cerevisiae and Rattus norvegicus, as well as curated information on approximately 700 genes from various organisms. The locus report pages include links to external databases that contain relevant annotation, microarray expression and proteome data. Conversely, the Saccharomyces Genome Database (SGD), S.cerevisiae GeneDB and Swiss-Prot link to the budding yeast section of GermOnline from their respective locus pages. GermOnline, a fully operational prototype subject-oriented knowledgebase designed for community annotation and array data visualization, is accessible at http://www.germonline.org. The target audience includes researchers who work on mitotic cell division, meiosis, gametogenesis, germ line development, human reproductive health and comparative genomics.

Animals↗

PubMed1976

An NIH/Columbia University information system interface.

The National Institutes of Health (NIH) and the Health Sciences of Columbia University have developed an information system interface whereby sponsored research information is routinely forwarded, in machine-readable form, from the NIH to Columbia University. For Columbia University the interface system has materially reduced data input costs, made information available on a more timely basis, improved the quality of its system by the adoption of existing standardized data definitions, and allowed flexible access to NIH's broad data base. For NIH the system permits an improvement in its data base through high-quality and fast feedback from the grantee institution. The promotion of future systems development is enhanced through the adoption of standardized data element designations and definitions.

Humans↗

PubMed1996

Geographic structure of insect populations: gene flow, phylogeography, and their uses.

Geographic structure of populations is a fundamental component of ecology and evolution that combines both demographic and genetic processes, such as gene flow and migration, genetic drift, selection, and population extinction. Recent advances in both molecular biology and theory have revolutionized the field and have not only expanded the availability of data but also facilitated the accessibility and interpretation of current data. These new techniques allow analysis of genetic similarity among populations to be coupled with phylogeography and the distribution of genotypes within and among populations relative to the history of those genotypes. The numerous case studies described herein illustrate the growing impact of geographic structure on insect science, as well as the importance of insect model systems for understanding general concepts in ecology and evolution.

Journal Article↗

PubMed2000

[Development and evaluation of a local area network system to make drug information paper for inpatient--adaptation to characteristics of diseases, and expansibility to other hospitals and the Internet].

We developed and evaluated a local area network system to make drug information papers. Because pharmacists should explain drug information both orally and using papers to patients in response to their understanding and characteristics of their diseases. The merit of this system is as follows: pharmacists can use it without any education for its operation; most data can be inputted by selection from the lists and automatic reference; the data are adjustable for individuals; different contents are available for different wards; multiple users can access the same data file. Input data in this system are available for making explanation papers on the medical examination of outpatients, and making a plan for pharmaceutical care and guidance services. This system is also available in other hospitals, and on the internet. First, we surveyed the time required for preparing drug information papers. Making a hand written paper for typical patient takes 395 sec. for manuscript, 160 sec. with the system using text data only, and 178 sec. with the system using text and picture data. Next, we surveyed 27 patients' views on the addition of drug pictures to drug information papers, and with the result that 19 patients thought it very good. Last, we surveyed 13 ward pharmacists about their usage of this system. We found that 8 pharmacists used frequently this system, and 3 pharmacists used the same file in the same hours at the maximum.

Aged↗

PubMed1993

Operating system components--Part II.

To summarize this discussion, let us look at a prototype, a capsule scenario in an OS. You make a process creation request on your local timeshare system. The long-term scheduler queues up this request, and eventually creates the corresponding process. Your process takes its turns executing, scheduled by the short-term scheduler. You request a tape drive to retrieve some archived data you need, and thus invoke the resource manager. You use the file manager to access the archived data. You use the I/O system to interact with the application program and to print the reports. The memory manager is swapping pages of your data and program between main memory and secondary memory. The dispatcher in the kernel is loading your process context into the CPU when your process is next on the execute list. The interrupt handler in the kernel is servicing interrupt requests, such as those made when you do I/O to the tape. The concurrency control in the kernel is coordinating your updating and spooled printing activities. So, your process is invoking activities throughout the various layers of the OS. Most of the time, you are unaware of these many varied activities.

Computer Systems↗