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At least 1,531 records · Page 85Linked to original sources
PubMed2006

Health-related quality of life, work productivity, and health care resource utilization of subjects with irritable bowel syndrome: baseline results from LOGIC (Longitudinal Outcomes Study of Gastrointestinal Symptoms in Canada), a naturalistic study.

BACKGROUND: Abdominal pain/discomfort, bloating, and constipation are gastrointestinal dysmotility and sensory symptoms associated with irritable bowel syndrome (IBS). No studies have followed patients with IBS symptoms for 1 year under conditions of routine clinical practice to assess prospectively the impact of treatments on health outcomes. OBJECTIVE: The objective of this ongoing, naturalistic study is to assess the long-term impact of IBS treatments on quality of life (QOL), work productivity, and resource utilization. This report describes the baseline characteristics and patterns of care of the patients enrolled in this study. METHODS: Patients with physician-diagnosed IBS symptoms were enrolled from 147 physician sites across Canada between May 4, 2004, and March 31, 2005. Clinical data were collected at baseline and at the end of the 12-month follow-up (patients were followed for 1 year between May 4, 2005, and March 31, 2006). Patient-reported outcomes were collected at baseline and at months 1, 2, 6, 9, and 12. Health-related QOL, health status, and work productivity were assessed with the IBS-QOL, a 5-item EuroQol descriptive system, and Work Productivity and Activity Impairment questionnaires, respectively. A resource utilization questionnaire elicited information on physician; visits, treatments, and procedures. Baseline data are reported here. RESULTS: Data were obtained from 1555 patients; 85.1% (1320/1552) were women. Patients had a mean (SD) age of 45.8 (15.0) years and mean (SD) duration of IBS symptoms of 11.4 (11.5) years. Self-reported bowel patterns were predominantly constipation (41.0%, 587/1433) and constipation alternating with diarrhea (39.4%, 564/1433); 60.3% (938/1555) of subjects used > or =3 IBS treatments in the previous 4 weeks. Approximately 50% of all patients reported distress "quite a bit or "extremely" for abdominal pain, gas, bloating, and constipation. The mean overall IBS-QOL score (0-100 scale, with 0 indicating poor QOL) was 66.3; food avoidance (51.8) and health worry (59.3) were the most serious concerns. Patients reported 5.6% work absenteeism, 31.4% presenteeism, and 34.6% overall work productivity loss, equivalent to 13.8 hours lost productivity per 40-hour workweek. CONCLUSIONS: The baseline data from this ongoing, prospective, naturalistic study are consistent with previous findings that suggested significant use of health care resources with concomitant low QOL and decreased work productivity in patients with IBS symptoms.

Adult↗
PubMed2005

Non-biodegradable biopolymers from renewable resources: perspectives and impacts.

In recent years the biotechnological production of bulk biopolymers has focused on the synthesis of biodegradable polymers to replace their non-biodegradable counterparts derived from fossil resources. Examples include polyhydroxyalkanoates and polylactic acid, which act as substitutes for polyolefins. By contrast, the biotechnological production of non-biodegradable polymers from renewable resources has so far been scarcely considered, probably because this idea contradicts the paradigm that all natural compounds are biodegradable. Polythioesters, which were recently described as new biopolymers, do not follow this paradigm because although they are produced by bacteria, they are persistent to microbial degradation. Mankind has a need for both non-biodegradable and biodegradable polymers and methods to produce them from renewable resources will be of great value.

Bacteria↗
PubMed2005

[On a density-dependent model of competition for one resource].

We use the concept of steady-state characteristic of a population using a single limiting resource, in order to discuss the issue of the competition of many species for the same resource. The steady-state characteristic is a curve that is associated to each species, likely to be determined empirically. Once one knows the steady-state characteristics and the dynamic of the renewal of the resource, it is possible to predict to some extent the issue of the competition and to give sufficient conditions for coexistence.

Algorithms↗
PubMed2005

Alcoholism: Illness beliefs and resource allocation preferences of the public.

BACKGROUND: Alcohol-dependent patients are at risk of being denied necessary care because of their diagnosis. We sought to find out whether public illness beliefs influence resource allocation decisions of the public, thus putting alcohol-dependent patients at a disadvantage compared to those suffering from other medical and mental disorders. METHOD: A telephone survey involving the adult German population was conducted in 2004 (n = 1012). Participants were asked to name three out of nine conditions for which they would prefer resources not to be cut should general cutbacks within the health care budget be necessary. For all conditions we asked about personal attitudes and illness beliefs. RESULTS: Schizophrenia and alcoholism were chosen least frequently when it was a question of being spared from budget reductions. Compared to other diseases, alcoholism was considered to be particularly self-inflicted and evoked a high desire for social distance. The perceived severity of the disease, the perceived own risk of becoming alcohol dependent, and the notion that alcoholics are themselves responsible for their illness were associated with resource allocation decisions. CONCLUSION: Alcohol-dependent patients are at risk of being structurally discriminated within the health care system.

Adolescent↗
PubMed2004

The public's preferences concerning the allocation of financial resources to health care: results from a representative population survey in Germany.

OBJECTIVE: The aim of the study is to examine to what extent the public is willing to allocate financial resources to the care of people with mental disorders. METHODS: In 2001, a representative survey was conducted among the adult population of Germany (n = 5025). The respondents were asked to select three out of nine conditions for which available resources should on no account be shortened. For data analysis, multiple unidimensional unfolding was used. RESULTS: Compared with medical diseases, the respondents were far less willing to allocate financial resources to the care of people with psychiatric disorders, making a clear distinction between the two types of diseases. While familiarity with mental illness had the effect of decreasing the reluctance to spend money for psychiatric patients, the endorsement of traditional values increased it. CONCLUSION: Our findings point to both the chances and the limitations of efforts aimed at reducing the structural discrimination of people with mental illness.

Adolescent↗
PubMed2025

Toward an integrated resource for pharmacogenomics (PGx): Survey findings from the genomic medicine communities.

PURPOSE: Pharmacogenomics (PGx) is a critical component of precision health care that aims to improve drug efficacy and reduce adverse events. Terminologies and standards have not always aligned between PGx and broader genomic medicine communities, which is a barrier to PGx implementation. An updated assessment of community barriers, needs, and perspectives is critical to enable more standardized terminologies and interpretation frameworks. METHODS: The Clinical Genome Resource's PGx Interpretation Committee (PGxIC, formerly referred to as the PGx Working Group, PGxWG) conducted 2 surveys targeting the PGx and genomic medicine communities (n = 508) to evaluate perspectives on PGx clinical validity and actionability frameworks, as well as other barriers to PGx implementation. Surveys were tailored toward self-reported familiarity with PGx. Data primarily consisted of free text, which were analyzed using qualitative content analysis methods. RESULTS: Survey responses indicated conflation of terminology across disciplines, including confusion around differing definitions of terms in PGx and non-PGx contexts. Data also indicated broad support for leveraging existing PGx guidelines and framework structures alongside the standardization of approaches and centralization of resources. CONCLUSION: These novel survey results demonstrate broad consensus on the importance of integrating PGx into clinical practice, including support for development of gene-drug response clinical validity and actionability frameworks aligned with Clinical Genome Resource's frameworks for gene-disease relationships.

Humans↗
PubMed2004

Resource allocation equity in northeastern Mexico.

Currently, the population health needs are unlimited, but allocation of financial resources is not in accordance with these needs, probably due to the lack of specific information. In this work, we propose a new approach to allocate resources with equity as a tool for decision-making in planning. The grade of equity in resource allocation in decentralized management medical areas (DMMAs (AMGD, for its initials in Spanish)) was determined; these are limited geographical areas of a social security institution in three states of the northeastern region of Mexico. The areas with more health needs in the global index were DMMA no. 12 in Tamaulipas with a Z-score (ZS) of -5; area no. 3 in Coahuila with -4; and area no. 9 in Nuevo Leon, no. 16 and no. 17 in Tamaulipas with -2. Equity was measured according to the degree of concordance between the health needs index and the per capita health expenditure of each area: (r = 0.19, P > 0.05). Low concordance was found between these variables in the studied medical areas.

Health Care Rationing↗
PubMed2004

Health care resource allocation and individuals' health care needs: examining the degree of fit.

Previous studies examine associations between health system resources and an individual's use of health services, yet the importance of these resources in meeting an individual's health care needs is unclear. This paper examines the relationship between health care system characteristics, other social and economic characteristics of counties in a mid-western U.S. state and an individual's ability to meet health care needs over a 12-month period. We conclude that policy interventions are needed that look beyond health resource allocation to address problems in health care access that contribute to inequities in health.

Adolescent↗
PubMed2005

Indexing method of digital audiovisual medical resources with semantic Web integration.

Digitalization of audiovisual resources and network capability offer many possibilities which are the subject of intensive work in scientific and industrial sectors. Indexing such resources is a major challenge. Recently, the Motion Pictures Expert Group (MPEG) has developed MPEG-7, a standard for describing multimedia content. The goal of this standard is to develop a rich set of standardized tools to enable efficient retrieval from digital archives or the filtering of audiovisual broadcasts on the Internet. How could this kind of technology be used in the medical context? In this paper, we propose a simpler indexing system, based on the Dublin Core standard and compliant to MPEG-7. We use MeSH and the UMLS to introduce conceptual navigation. We also present a video-platform which enables encoding and gives access to audiovisual resources in streaming mode.

Abstracting and Indexing↗
PubMed2006

Recurrent changes in the work environment, job resources and distress among nurses: a comparative cross-sectional survey.

BACKGROUND AND OBJECTIVES: Occupational stress in nursing has frequently been considered in nursing literature. The operationalization of job demands in different work settings and its relation to distress have been discussed to identify significant interactions with job resources. In this study, job demands were defined as recurrent changes in the work environment of nurses (i.e. changing colleagues, supervisors, workplaces, working hours and tasks). In particular, we focused on the 'negative appraisal' (i.e. 'threat') of these changes. The interaction between 'threat' and job resources (i.e. timing control, method control and supervisor support) and its relation to distress among Registered Nurses was examined. METHODS: The study was part of a larger cross-sectional survey among 7863 (response rate 51%) employees belonging to 10 general hospitals in Belgium. The results are based on self-administered questionnaires of 1094 Registered Nurses employed in intensive care units (ICU) (n = 416) and surgery/medical wards (non-ICU) (n = 678). General Linear Modelling was used to test the moderating effects. RESULTS: In both study samples, 'threat' was positively associated with distress (P < 0.001). However, in contrast with non-ICU nurses, ICU nurses only considered 'supervisor support' as a significant moderator in the positive relationship between 'threat' and distress (P = 0.023). 'Timing and method control', instead of supervisor support, moderated this relation among non-ICU nurses (P = < 0.001 and 0.018, respectively). CONCLUSION: These findings provide additional evidence to consider negative appraisal of recurrent changes as occupational specific stressor in nursing. Moreover, the buffering effects which were found between 'threat' and the measured job resources in relation to distress, and the difference of these interactions in ICU and non-ICU health care settings, confirmed the suggestion to consider particular job characteristics in job stress research. Finally, the findings of our study may be of importance for nursing administrators who are dealing with distress among nurses.

Belgium↗
PubMed2005

Towards new information resources for public health--from WordNet to MedicalWordNet.

In the last two decades, WordNet has evolved as the most comprehensive computational lexicon of general English. In this article, we discuss its potential for supporting the creation of an entirely new kind of information resource for public health, viz. MedicalWordNet. This resource is not to be conceived merely as a lexical extension of the original WordNet to medical terminology; indeed, there is already a considerable degree of overlap between WordNet and the vocabulary of medicine. Instead, we propose a new type of repository, consisting of three large collections of (1) medically relevant word forms, structured along the lines of the existing Princeton WordNet; (2) medically validated propositions, referred to here as medical facts, which will constitute what we shall call MedicalFactNet; and (3) propositions reflecting laypersons' medical beliefs, which will constitute what we shall call the MedicalBeliefNet. We introduce a methodology for setting up the MedicalWordNet. We then turn to the discussion of research challenges that have to be met to build this new type of information resource. We build a database of sentences relevant to the medical domain. The sentences are generated from WordNet via its relations as well as from medical statements broken down into elementary propositions. Two subcorpora of sentences are distinguished, MedicalBeliefNet and MedicalFactNet. The former is rated for assent by laypersons; the latter for correctness by medical experts. The sentence corpora will be valuable for a variety of applications in information retrieval as well as in research in linguistics and psychology with respect to the study of expert and non-expert beliefs and their linguistic expressions. Our work has to meet several considerable challenges. These include accounting for the distinction between medical experts and laypersons, the social issues of expert-layperson communication in different media, the linguistic aspects of encoding medical knowledge, and the reliability, volume, and emergence of medical knowledge. The work described here has been tested in a small pilot experiment and awaits large-scale implementation.

Computational Biology↗
PubMed2003

PhysioNet: an NIH research resource for complex signals.

The Research Resource for Complex Physiologic Signals, supported by the National Institutes of Health (NIH), is intended to promote and facilitate investigations in the study of cardiovascular and other complex biomedical signals. The resource website (www.physionet.org) has 3 interdependent components: 1) PhysioBank is an archive of well-characterized digital recordings of physiologic signals and related data, including databases of electrocardiogram and heart rate time series from patients with heart failure, coronary disease, sleep apnea syndromes, and cardiac arrhythmias; 2) PhysioToolkit is a library of open-source software for physiologic signal processing and analysis; and 3) PhysioNet, for which the resource is named, is an on-line forum for dissemination and exchange of recorded biomedical signals and open-source software for analyzing them. PhysioNet, in cooperation with the annual Computers in Cardiology conference, hosts a series of challenges inviting participants to tackle clinically interesting problems that are either unsolved or not well solved. PhysioNet invites contributions of databases and software from the biomedical community.

Atrial Fibrillation↗
PubMed2006

Vegetation and carbon sequestration and their relation to water resources in an inland river basin of Northwest China.

In the Heihe River Basin in the arid inland area of northwest China, the distribution of water resources in vegetation landscape zones controls the ecosystems. The carbon sequestration capacity of vegetation is analyzed in relation to water resources and vegetation growing conditions. During the last 20 years, the vegetation ecosystems have degenerated in the Heihe River Basin. Simulation using the C-FIX model indicates that, at present, the total amount of NPP of vegetation accounts for about 18.16 TgC, and the average value is 106 gC/m(2)/yr over the whole basin. NPP has generally the highest value in the upperstream mountain area, middlestream artificial oases area, downstream river bank area, alluvial fan and the terminal lake depression where vegetation grows relatively well. The lowest value is found in the vast downstream desert and Gobi area. Protection of vegetation ecosystems and enhancement of carbon sequestration require such inland river basins as the Heihe River Basin to be brought under management in a comprehensive way, taking water as a key, to carry out a rational and efficient allocation and utilization of water resources.

Altitude↗
PubMed2006

Resource allocation to reproduction and soma in Drosophila: a stable isotope analysis of carbon from dietary sugar.

Metabolic resources in adults of holometabolous insects may derive either from larval or adult feeding. In Drosophila melanogaster, reproduction and lifespan are differently affected by larval vs. adult resource availability, and it is unknown how larval vs. adult acquired nutrients are differentially allocated to somatic and reproductive function. Here we describe the allocation of carbon derived from dietary sugar in aging female D. melanogaster. Larval and adult flies were fed diets contrasting in sucrose (13)C/(12)C, from which we determined the extent to which carbon acquired at each stage contributed to adult somatic tissue and to egg manufacture. Dietary sugar is very important in egg provisioning; at every age, roughly one half of the carbon in eggs was derived from sugar, which turned over from predominantly larval to entirely adult dietary sources. Sucrose provided approximately 40% of total somatic carbon, of which adult dietary sucrose came to supply approximately 75%. Unlike in eggs, however, adult acquired sucrose did not entirely replace the somatic carbon from larvally acquired sucrose. Because carbon from larval sucrose appears to be fairly "replaceable", larval sucrose cannot be a limiting substrate in resource allocation between reproduction and lifespan.

Animals↗
PubMed2005

Spatial self-organization in a cyclic resource-species model.

Biological communities are remarkable in their ability to form cooperative ensembles that lead to coexistence through various types of niche partitioning, usually intimately tied to spatial structure. This is especially true in microbial settings where differential expression and regulation of genes allows members of a given species to alter their lifestyle so as to fill a functional role within the community. The resulting species interactions can involve feedback, as in the case of some bacterial consortia that participate in the cooperative degradation of a given resource in a succession of steps and in such a way that certain "later" species provide catalytic support for the primary degrader. We seek to capture the essential features of such spatially extended biological systems by introducing a lattice-based stochastic spatial model (interacting particle system) with cyclic local dynamics. Here, a given site progresses through a sequence of resource and species states in a prescribed order. Furthermore, this succession of states (at a site) is assumed to form a cyclic pattern due to a natural feedback mechanism. We explore conditions under which all the species are able to coexist and consider the extent to which this coexistence requires the development of spatio-temporal patterns, including spiral waves. This self-organization, if it occurs, results when synchronization of the dynamics at the microscopic level leads to macroscopic patterns. These patterns result in consumer-driven resource fluctuations that generate a form of spatio-temporal niche partitioning. As with most models of this complexity, we employ a mixture of mathematical analysis and simulations to develop an understanding of the resulting dynamics.

Adaptation, Biological↗
PubMed2006

Inferring resource distributions from Atlantic bluefin tuna movements: an analysis based on net displacement and length of track.

We use observed movement tracks of Atlantic bluefin tuna in the Gulf of Maine and mathematical modeling of this movement to identify possible resource patches. We infer bounds on the overall sizes and distribution of such patches, even though they are difficult to quantify by direct observation in situ. To do so, we segment individual fish tracks into intervals of distinct motion types based on the ratio of net displacement to length of track (DeltaD/DeltaL) over a time window Deltat. To find the best segmentation, we optimize the fit of a random-walk movement model to each motion type. We compare results from two distinct movement models: biased turning and biased speed, to check the model-dependence of our inferences, and find that uncertainty in choice of movement model dominates the uncertainties of our conclusions. We find that our data are best described using two motion types: "localized" (DeltaD/DeltaL small) and "long-ranged" (DeltaD/DeltaL large). The biased turning model leads to significantly better resolution of localized movement intervals than the biased speed model. We hypothesize that localized movement corresponds to exploitation of resource patches. Comparison with visual behavior observations made during tracking suggests that many inferred intervals of localized motion do indeed correspond to feeding activity. From our analysis, we estimate that, on average, bluefin tuna in the Gulf of Maine encounter a resource patch every 2h, that those patches have an average radius of 0.7-1.2 km, and that, overall, there are at most 5-9 such patches per 100 km(2) in the region studied.

Animals↗
PubMed2005

Score in the Palmore's Aging Quiz, knowledge of community resources and working preferences of undergraduate nursing students toward the elderly in Hong Kong.

Health care professionals are the gate-keepers for elderly health information. Unfavorable attitude to the elderly posts an obstacle to health information delivery. Therefore, it is vital to identify the knowledge and attitude of nursing students toward working with the elderly. The present study aimed to examine the knowledge and working preferences toward the elderly among undergraduate nursing students in Hong Kong. Two hundred and sixty-nine students completed a questionnaire that incorporated 70 questions in the Palmore's Aging Quiz and 10 questions reflecting the knowledge on local community resources for the elderly. The results revealed that nursing students generally have a neutral to positive working preferences toward the elderly. 83% of them gained a mean Palmore's score of 40.90 out of 70 (SD=5.02) and good knowledge of the community resources (mean score=8.49, SD=1.85). Those who disliked working with the elderly had a significantly lower mean Palmore's score (F=7.73, p=0.001). Though the level of study had a positive correlation with the knowledge of community resources, it did not increase with Palmore's score. Further research on the study results and more detail examination of geriatric education for nursing students to refine their attitude toward the elderly are recommended.

Adult↗
PubMed2005

A community-based randomised controlled trial of three different educational resources for men about prostate cancer screening.

Randomised evaluations of resources to facilitate informed decisions about prostate cancer screening are rarely conducted. In this study, 421 men recruited from the community were randomly allocated to receive a leaflet (n = 140) or one of two resources meeting criteria for a decision-aid: a video (n = 141) or an evidence-based booklet, developed by the authors (n = 140). Men in all three groups demonstrated significant increases in knowledge scores from pre to post-test. Scores were significantly higher at post-test amongst those who had received our evidence-based booklet compared with men who received the leaflet or video (P < 0.001). Scores were significantly modified by men's preferences for decisional control (P = 0.002). Decisional conflict was significantly lower amongst men receiving the evidence-based booklet (P = 0.038). Men receiving the evidence-based booklet also were less likely to accept a recommendation by a GP to undergo prostate-specific-antigen (PSA) screening (P = 0.003). Men require detailed information about the pros and cons of PSA screening in order to make an informed decision. Resources are not equivalent in achieving these outcomes.

Aged↗