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Intellectual property: the control of scientific information.

Control of scientific information is increasingly at the center of legal and administrative disputes, raising questions of sovereignty and secrecy, of proprietary rights over research. Disputes originate from efforts to extend the right of access to data at an early stage of research, from demands for information that threaten confidentiality, from proprietary interests in competitive areas of research, and from government restrictions on the free exchange of scientific ideas. They reflect policy changes with respect to information disclosure, university-industry collaboration, patent rights, and national security. A review of diverse situations that have led to disputes and of efforts to negotiate principles for controlling intellectual property suggests the problems of establishing such principles in the context of the changing role of science.

Confidentiality↗

Science and ethics in epidemiology.

This article is the summary of my Special Lecture at the 14th Annual Scientific Meeting of the Japan Epidemiological Association in 2004. Epidemiology is defined as the "science of investigating the distribution of diseases in human populations and their determinants." Recent advances in study methodology, especially a widespread conduct of randomized controlled trials (RCTs), have strengthened the scientific basis of epidemiology. When a highly scientific method of investigation is applied to humans, the ethical aspects of the study also become an issue. However, it would also be unethical to use new drugs and vaccines without scientific evidence. The ethical aspects and the scientific aspects of epidemiologic research are thus both very important, but conflict with each other, often causing dilemmas. I would discuss how we could solve these dilemmas and thus contribute ourselves to health promotion and disease prevention of human populations. Finally, I would propose the new paradigm of changing epidemiology into a "neotype science" and transformation of EKIGAKU (epidemiology) into EKIGAKU (beneficial science).

Bias↗

[Biostatistics contribution to the development of biomedical sciences].

Biostatistics can be defined as the science of data reduction methods, variability and populations, in the field of medicine and biomedical science. Its origins trace back to the work of Quetelet (1796-1874) and more recently of Fisher (1890-1962). Following the technological advances in biomedical sciences during the 20th century, modern biostatistics is facing the formidable challenge of translating information into knowledge. Biostatistics has significantly contributed to the development of biomedical sciences in many areas: laboratory medicine (reference values and quality control), randomized clinical trials (RCT), clinical decision-making, new drugs development. The explosion of scientific research over the past decades, however, has led to misuse and abuse of statistical methods. Common sense should therefore always prevail. In sum, biostatistics, an amalgalm of mathematics, logic and judgment, has given the quantitative and factual dimension that the evolution of biomedical sciences required.

Biomedical Technology↗

Awareness of oral cancer and precancer among patients attending a hospital in Sri Lanka.

OBJECTIVE: To assess awareness about oral cancer and precancer among patients attending for dental treatment at a University Dental hospital. METHODS AND MATERIALS: A self-administered questionnaire was used to collect information from 410 randomly selected outpatients attended the Dental Hospital (teaching), Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. The questionnaire included questions to ascertain information on socio-demographic parameters, awareness of oral cancer and precancer, habits of betel chewing, smoking and alcohol consumption. RESULTS: Ninety five percent of the respondents were aware of the possibility of occurrence of cancer in the mouth while only 44.9% (n=184) were aware about precancer. Of the 390 individuals who were aware of the existence of oral cancer, 80.7% were knowledgeable about the causal relationship between betel chewing habit and oral cancer. Forty-seven and 17 percent were aware of links with tobacco smoking and alcohol consumption, respectively. However, out of those who had knowledge of oral cancer, 18 % (n=69) were not knowledgeable about associations with habits. CONCLUSIONS: This survey revealed that the patients attending the hospital were well informed about oral cancer. However, awareness about precancer was relatively low. Knowledge about the causal relationships with tobacco smoking and use of alcohol was low compared to that for betel chewing.

Adolescent↗

Evidence-based nursing Web sites: finding the best resources.

Evidence-based nursing is becoming an increasingly widespread phenomenon in the nursing profession. As the evidence-based nursing movement grows, the Internet/World Wide Web has become a vital information link for keeping pace with current science and medical advancements. This article describes Internet resources currently available to support evidence-based nursing practice, presents practical search methods for locating these resources, and suggests criteria for evaluating the "evidence" available on the Internet. Results of an Internet search for Web sites that met the proposed criteria for support of an evidence-based nursing practice located only three sites. The sites are described and evaluated for their usefulness. The authors demonstrate that although many Internet resources are available to nurses, few sites provide information or evidence supported by valid research.

Evidence-Based Medicine↗

Sources of information for HIV prevention program managers: a national survey.

This study's objective was to find out if HIV prevention program planners seek out science in designing interventions, and if not, where they turn for prevention information. Researchers conducted a survey of 284 program managers of AIDS prevention programs across the United States. Respondents' three most important sources of information were peers and colleagues, departments of public health (DPH) and the centers for Disease Control (CDC). The four least important sources included scientific publications and government reports. We find that most program managers do not turn to research, nor do they perceive it as an important source of information. They turn to each other, their DPH, and the CDC. The authors have made suggestions for researchers, community-based organizations, state DPHs, and the CDC to close the gap between HIV prevention science and prevention practice. We must ensure that our efforts will not be wasted, and we can make a difference in the fight against HIV.

Community Health Services↗

Computational biology: toward deciphering gene regulatory information in mammalian genomes.

Computational biology is a rapidly evolving area where methodologies from computer science, mathematics, and statistics are applied to address fundamental problems in biology. The study of gene regulatory information is a central problem in current computational biology. This article reviews recent development of statistical methods related to this field. Starting from microarray gene selection, we examine methods for finding transcription factor binding motifs and cis-regulatory modules in coregulated genes, and methods for utilizing information from cross-species comparisons and ChIP-chip experiments. The ultimate understanding of cis-regulatory logic in mammalian genomes may require the integration of information collected from all these steps.

Animals↗

Cognitive sciences and psychoanalysis: a possible convergence.

This paper compares the psychoanalytic description of inner experience with that of the cognitive sciences, which see it in terms of information processing. The two observational standpoints relate to the same mental events. The author considers the possibility of bringing the two descriptions into line with each other and of their mutual translation. The "information" processed in the deep, unconscious, affective, internal experience of a relational context must be identified. This may be possible if a general theory of mental functioning that allows for the data of psychoanalytic observation in terms of semantics, memory, and communication can be formulated. The author examines the theoretical tradition of psychoanalysis, and draws attention to the uncertainties to which Freud's metapsychology gives rise. The energy/drive theory was not only descriptive and clinical in nature, but also had explanatory value, which put psychoanalysis in contact with the other mental sciences of the time. This explanatory value is no longer valid today, and psychoanalytic theories since Freud seem to have disregarded the aspect of "explanation," leaving a theoretical void that has isolated psychoanalysis from the other sciences of the mind. The author contends that object theories may be an appropriate starting point for the exploration of experience in terms of learning processes and of memory traces, and suggests a psychoanalytic cognitivism, coupled with a personal theory to explain the development of the mind.

Cognitive Science↗

Principles for effective surveys of hunger and malnutrition in the United States.

To be effective, the information derived from a survey must be used to make decisions that affect policies and programs. This paper discusses why scientifically sound surveys may not be effective and vice versa. Effectiveness depends on the information being relevant to the decision-maker's understanding of the problem to be solved. To the extent that science contributes to both understanding the problem and providing the information for a decision, the survey will be scientific and effective. The measurement of malnutrition and barriers to communication are not at present the major obstacles to effective scientific surveys relative to hunger and malnutrition in the United States. Rather, the obstacles seem to be poor scientific conceptualization and measurement of hunger, on the one hand, and poor sampling techniques for malnutrition, on the other hand. These frontiers of knowledge have implications for science and policy beyond surveys. The challenge for the American Institute of Nutrition is to recruit the scientific skills need to understand hunger and identify pockets of malnutrition and their causes--scientific skills that go beyond those traditionally associated with nutrition research.

Epidemiologic Methods↗

Chemistry in bioinformatics.

Chemical information is now seen as critical for most areas of life sciences. But unlike Bioinformatics, where data is openly available and freely re-usable, most chemical information is closed and cannot be re-distributed without permission. This has led to a failure to adopt modern informatics and software techniques and therefore paucity of chemistry in bioinformatics. New technology, however, offers the hope of making chemical data (compounds and properties) free during the authoring process. We argue that the technology is already available; we require a collective agreement to enhance publication protocols.

Access to Information↗

A strategy for curriculum integration of information skills instruction.

The ever increasing need of health professionals for information and the inclusion of active learning experiences in the medical school curriculum require that students learn the effective use of health information tools. Curriculum integration is gaining acceptance as an effective approach to teaching information skills in this setting. At the University of Miami School of Medicine, information skills components taught by library faculty are integrated into the Freshman Orientation Program and two sophomore curriculum courses. Beginning with a core set of skills and basic information management tools, more complex and subject-specific skills are introduced sequentially throughout the basic sciences curriculum. During the first two years, a wide range of information skills are taught, and students receive many opportunities to seek and identify information using both printed sources and computerized bibliographic databases. This paper describes how curriculum integration of information skills instruction was achieved and the many benefits of this approach. Included are a description of the information skills components, evaluation data, and future plans.

Computer Systems↗

Specific issues related to developing, disseminating, and implementing pediatric practice guidelines for physicians, patients, families, and other stakeholders.

OBJECTIVE: To describe ways in which medical information should be developed and disseminated, focusing on pediatric practice guidelines as an example of one type of information. PRINCIPAL FINDINGS: The methodology of guideline development is well known and has been previously reviewed. Guideline development poses problems for many medical specialties, but particularly for pediatrics, because (1) few diseases are prevalent, (2) only limited randomized controlled trials have been conducted with respect to specific diagnostic and therapeutic options, and (3) clinicians often are dealing with patient surrogates--parents--rather than with the actual patient. Patient and family involvement in guideline development and dissemination has been limited and may affect the likelihood that guidelines will be adopted and subsequently improve child health outcomes. The science of dissemination, including guidelines and other information, is poorly developed. Little is known about the most effective ways to ensure that guidelines reach clinicians and are adopted. Finally, the effect of guidelines on child health outcomes is itself uncertain. RECOMMENDATIONS: (1) Research efforts should focus on guideline dissemination and adoption. (2) The effect of guideline implementation on health outcomes needs to be better understood. (3) Parents should be more involved in guideline dissemination and adoption.

Acute Disease↗

Making medical research clinically friendly: a communication-based conceptual framework.

CONTEXT: It often takes a long time before the results of medical research are actually used by health care practitioners in day-to-day clinical settings. This problem, referred to as "the evidence-to-practice gap", has significant implications for patient health care. Practitioners have difficulty keeping up with the latest information in part because it is reported in hundreds of journals that may not be easily accessed and understood. APPROACH: This essay conceptualizes the evidence-to-practice gap as a communication problem and suggests how academic research can be translated into messages that are easier for practitioners to access, comprehend and incorporate into their medical practice. A "translation framework" shows the importance of targeting messages to specific audiences and provides a communication-based conceptual approach for summarizing research for clinicians. PRACTICAL IMPLICATIONS: Targeting the results of academic research to practitioners will decrease the time it takes for patients to benefit from the latest medical evidence. Translation guidelines can help health researchers write more effectively for both academic and practitioner audiences. Since the evidence-to-practice gap is a systemic problem that begins with how we train our health researchers, educators should consider addressing this topic in the health professions classroom. The framework presented here can serve as the basis for an instructional unit on interpreting and reporting research findings. Finally, information technology can play a much larger role in the communication process because of the enormous advantages of quick access and data organization that computers and the Internet provide. Practitioner-targeted research summaries could be made available on government or not-for-profit sponsored websites as well as by journals themselves. Funding opportunities exist for research that focuses on how technology can help improve health care, and so the time is right for health researchers to investigate ways of making their studies more accessible and quickly usable via web-based distribution. The potential of medical science should not be limited by an information delivery system that we have the knowledge, expertise and resources to improve.

Biomedical Research↗

Life-science applications of the Cambridge Structural Database.

Several studies show that the molecular geometries and intermolecular interactions observed in small-molecule crystal structures are relevant to the modelling of in vivo situations, although the influence of crystal packing is sometimes important and should always be borne in mind. Torsional distributions derived from the Cambridge Structural Database (CSD) can be used to map out potential-energy surfaces and thereby help identify experimentally validated conformational minima of molecules with several rotatable bonds. The use of crystallographic data in this way is complementary to in vacuo theoretical calculations since it gives insights into conformational preferences in condensed-phase situations. Crystallographic data also underpin many molecular-fragment libraries and programs for generating three-dimensional models from two-dimensional chemical structures. The modelling of ligand binding to metalloenzymes is assisted by information in the CSD on preferred coordination numbers and geometries. CSD data on intermolecular interactions are useful in structure-based inhibitor design both in indicating how probable a protein-ligand interaction is and what its geometry is likely to be. They can also be used to guide searches for bioisosteric replacements. Crystallographically derived information has contributed to many life-science software applications, including programs for locating binding 'hot spots' on proteins, docking ligands into enzyme active sites, de novo ligand design, molecular superposition and three-dimensional QSAR. Overall, crystallographic data in general, and the CSD in particular, are very significant tools for the rational design of biologically active molecules.

Crystallography, X-Ray↗

Sharing the science on human milk feedings with mothers of very-low-birth-weight infants.

Mother's milk provides protection from serious and costly morbidity for very-low-birth-weight infants (<1500 g), including enteral feeding intolerance, nosocomial infection, and necrotizing enterocolitis. However, NICU and maternity nurses may be hesitant to encourage mothers to initiate lactation because of a reluctance to make mothers feel guilty or coerced. This article reviews the evidence for the health outcomes of mothers' milk feeding in very-low-birth-weight infants and provides examples of ways to share this science with mothers so that they can make an informed feeding decision.

Breast Feeding↗