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A gridified protein structure prediction system "Rokky-G" and its implementation issues.

In recent years, simulation using computer systems has been of increasing importance in the life sciences. We have developed a system called "Rokky-G" that facilitates a protein structure prediction strategy called "Rokky" on Grid systems. Rokky-G provides the framework of protein structure prediction on the Grid. In this paper we discuss the architecture of Rokky-G and implementation issues identified in order to obtain highly reliable results.

Algorithms↗

The paradox of guideline implementation: how AHCPR's depression guideline was adapted at Kaiser Permanente Northwest Region.

BACKGROUND: To ensure implementation, the Agency for Health Care Policy and Research's (AHCPR) Guideline for the Treatment of Depression in Primary Care was recently translated into a local document by a large health maintenance organization (HMO). The guideline revision process was studied on the basis of interviews with members of the guideline revision committee and others, observation of meetings, and documents and correspondence. WHY THE GUIDELINE WAS CHANGED: The HMO changed the AHCPR guideline for reasons of convenience, credibility, audience, purpose, and context. For example, in their roles as representative consumers, committee members perceived that the AHCPR guideline, although addressed to primary care clinicians, was actually written from a psychiatric perspective and based on a psychiatric literature not relevant to primary care. COMPARISON OF THE GUIDELINES: Although the guidelines differ dramatically in length and format, coverage, emphasis, and organizing principle, substantive conflict between the two guidelines' recommendations is minimal. For example, the emphasis on medication is greater in the adaptation, which adds considerable original material of a practical nature on drugs and drug use. In addition, the original guideline has a "research literature orientation." In contrast, the adaptation is described as "clinical decision oriented", identifying the key actions and decisions that a practicing clinician must make to treat depression. DISCUSSION AND IMPLICATION: Translation of science-oriented national guidelines into user-oriented documents tailored to local audiences and settings can add great value to the guideline development process without sacrificing science-derived integrity-and is probably essential to successful implementation.

Depressive Disorder↗

Evaluation of communication surrounding the implementation of the resident assessment instrument.

Two outcomes of the introduction of the Resident Assessment Instrument at Sunnybrook Health Sciences Centre in 1996 were (1) a communication plan and (2) patient unit RAI communication centres. This article describes a survey that was used to evaluate the effectiveness of the plan and centres in implementing the RAI Staff identified the InfoRAInbow Newsletter as the most useful communication strategy. Satisfaction with communication about the RAI implementation was only 57 percent. Further investigation of this level of satisfaction is required. This result may be attributed to the "choices" staff make as to whether or not to read information, or to environmental factors that occurred at the time of the survey's completion. Future directions for improving the RAI Communication Plan should focus on environmental factors that may impede communication of information, especially information that affects integration of the RAI into the clinical care system.

Canada↗

Staff compliance with infection control practices: application of behavioural sciences.

Microbiology and epidemiology have made significant contributions to the field of Infection Control. Most nosocomial infections which can be prevented are related to inappropriate patient care practices. However, it is extremely difficult to implement new infection control policies. To achieve staff compliance, infection control should learn from the behavioural sciences. Three related fields have been shown to be helpful in this respect: social psychology, consumer behaviour and organizational behaviour. Basic concepts from all three fields can be applied to the work of infection control for achieving staff compliance; the use of social power and the reasoned action model from the field of social psychology; the use of participatory decision-making from organizational behaviour; and the opinion leaders from consumer behaviour.

Behavioral Sciences↗

Designing systematic conservation assessments that promote effective implementation: best practice from South Africa.

Systematic conservation assessment and conservation planning are two distinct fields of conservation science often confused as one and the same. Systematic conservation assessment is the technical, often computer-based, identification of priority areas for conservation. Conservation planning is composed of a systematic conservation assessment coupled with processes for development of an implementation strategy and stakeholder collaboration. The peer-reviewed conservation biology literature abounds with studies analyzing the performance of assessments (e.g., area-selection techniques). This information alone, however can never deliver effective conservation action; it informs conservation planning. Examples of how to translate systematic assessment outputs into knowledge and then use them for "doing" conservation are rare. South Africa has received generous international and domestic funding for regional conservation planning since the mid-1990s. We reviewed eight South African conservation planning processes and identified key ingredients of best practice for undertaking systematic conservation assessments in a way that facilitates implementing conservation action. These key ingredients include the design of conservation planning processes, skills for conservation assessment teams, collaboration with stakeholders, and interpretation and mainstreaming of products (e.g., maps) for stakeholders. Social learning institutions are critical to the successful operationalization of assessments within broader conservation planning processes and should include not only conservation planners but also diverse interest groups, including rural landowners, politicians, and government employees.

Conservation of Natural Resources↗

Building a digital library for the health sciences: information space complementing information place.

In 1990, the University of California, San Francisco, dedicated a new library to serve the faculty, staff, and students and to meet their academic information needs for several decades to come. Major environmental changes present new and additional information management challenges, which can effectively be handled only through the widespread use of computing and computing technologies. Over the next five years, a three-pronged strategy will be followed. We are refining the current physical, paper-based library through the continuous application of technology for modernization and functional improvement. At the same time, we have begun the planning, design, and implementation of a "free-standing" Digital Library of the Health Sciences, focusing on the innovative application of technology. To ensure complementarity and product integrity where the two libraries interface, we will look to technology to transform these separate entities into an eventual, integral whole.

Computer Communication Networks↗

Targeting the proteome/epitome, implementation of subtractive immunization.

Monoclonal antibody technology has generated invaluable tools for both the analytical and clinical sciences. However, standard immunization approaches frequently fail to provide monoclonal antibodies with the desired specificity. Subtractive immunization provides a powerful alternative to standard immunization and allows for the production of truly unique antibodies. With the intent of targeting specific epitopes within the proteome, subtractive immunization has been broadly and successfully implemented for the production of monoclonal antibodies otherwise unobtainable by standard immunization. Subtractive immunization utilizes a distinct immune tolerization approach that can substantially enhance the generation of monoclonal antibodies to desired antigens. The approach is based on tolerizing the host animal to immunodominant or otherwise undesired antigen(s) (tolerogen) that may be structurally or functionally related to the antigen of interest. Tolerization of the host animal can be achieved through one of three methods: High Zone, Neonatal, or Drug-induced tolerization. The tolerized animal is then inoculated with the desired antigen (immunogen) and antibodies generated by the subsequent immune response are screened for the desired antigenic reactivity. Over the past 15 years a large number of investigators have used the subtractive approach with cleverly chosen tolerogen-immunogen combinations and successfully generated uniquely reactive antibodies which are often neutralizing or function-blocking. This review will focus on the implementation of subtractive immunization for the production of antibodies otherwise unobtainable by standard immunization.

Animals↗

A quality assurance process in health sciences libraries.

A goal of libraries is to assure the improvement of library services. Many organizations have attempted to use standards as a method to assure quality services, but often standards have failed through a lack of individual commitment to those standards and to the methodology used in establishing the standards. Many segments of the health care field have adopted the concept of quality assurance and are applying it to the service and care they provide. This process has the potential to raise or assure quality of service in health sciences libraries. The process involves: selecting a subject for review; developing measurable criteria; ratifying the criteria; evaluating existing services using the criteria; identifying problems; analyzing problems; developing solutions; implementing solutions; and reevaluating services. Two pilot quality assurance studies conducted in the Midwest Health Science Library Network during 1978 are described. Plans are under way to use this process on a regional basis.

Libraries, Medical↗

Reconciling science and policy in setting federal drinking water standards--four states' perspectives.

After almost 20 years of experience with implementing the Safe Drinking Water Act and eight with Amendments to the Act, the individual states within the United States have gained valuable experience while trying to reconcile the legal mandates provided by the statutes with the science underlying them. This paper presents four different topics illustrating the problems of reconciling these two issues in the regulation of toxic chemicals in drinking waters. It presents these from the perspectives of the states of Massachusetts, Rhode Island, Connecticut, and New Jersey and offers suggestions for improved program efficiency based on considerations of comparative human health risks. The approach and schedule for controlling toxic chemicals used through 1994 are first examined and a recommendation is made for more flexibility in the rate at which chemicals are regulated. Recent U.S. EPA proposals to more stringently control radon in drinking waters are presented in the context of all sources of radon exposures, illustrating the intersection of science, laws, and economic consequences of regulatory initiatives. Inhalation and dermal exposures as a result of using chemically contaminated drinking waters are then discussed with the suggestion of the possible underprotectiveness of some present standards. Finally, the difficulty faced by the states and federal government in the control of naturally occurring arsenic exposures through drinking water is also presented and an argument is made for more local flexibility in the application of health-based standards.

Administration, Cutaneous↗

The state of the science of health care epidemiology, infection control, and patient safety, 2004.

Being aware and implementing the latest and best scientific evidence in infection control and health care epidemiology is critical to enhancing patient outcomes. In this review, the latest published scientific data in health care epidemiology and patient safety were reviewed for the period May 2003-May 2004. Medline reviews and reviews of infection control and infectious diseases journals were used for this period. The latest guidelines and publications on antimicrobial resistance, nursing or infection control professional staffing, West Nile virus, and Severe Acute Respiratory Syndrome (SARS) are included. Awareness of these and other important infection control publications is essential if the latest measures are to be implemented to prevent and control health care-associated infections.

Anti-Bacterial Agents↗

Informed consent in epidemiologic research before the implementation of ethical guidelines.

On June 17, 2002, the Ministry of Education, Culture, Sports, Science and Technology, together with the Ministry of Health, Labour and Welfare, introduced the Ethical Guidelines for Epidemiological Research. Although studies begun before the adoption of the Guidelines are not necessarily required to conform to them, some studies have been reviewed anew by ethics review committees. In this article for the Young Investigator Award of the Japan Epidemiological Association, therefore, the author would like to offer an overview of informed consent in epidemiologic researches conducted before the introduction of the Guidelines. It is hoped that this may serve as a reference as to the contents and status of ethical considerations in these studies, for use in examinations of research that was already in progress when the Guidelines were introduced.

Epidemiology↗

Roles for learning sciences and learning technologies in biomedical engineering education: a review of recent advances.

Education in biomedical engineering offers a number of challenges to all constituents of the educational process-faculty, students, and employers of graduates. Although biomedical engineering educational systems have been under development for 40 years, interest in and the pace of development of these programs has accelerated in recent years. New advances in the learning sciences have provided a framework for the reexamination of instructional paradigms in biomedical engineering. This work shows that learning environments should be learner centered, knowledge centered, assessment centered, and community centered. In addition, learning technologies offer the potential to achieve this environment with efficiency. Biomedical engineering educators are in a position to design and implement new learning systems that can take advantage of advances in learning science, learning technology, and reform in engineering education.

Biomedical Engineering↗

[Current responsibility of information processing in gynecology].

Rapid development and innovative research in medical computer science influences physicians work. Not only new hardware but also network implementation changed the way of decision making techniques in medicine. The main reason for acceptance and distribution of the internet is the possibility to present information in a reasonable and contemporary way. A self-labeling of medical information by web authors and systematic critical appraisal of health-related internet information by third parties may help to filter harmful health information and to positively identify and select high quality information. The German Work Group for Information Technologies in Gynecology and Obstetrics (AIG) informs physicians about health care issues related to computer science.

Computer Systems↗

The ontology of the questionnaire: Max Weber on measurement and mass investigation.

Although contemporary sociologists of science have sometimes claimed Max Weber as a methodological precursor, they have not examined Weber's own writings about science. Between 1908 and 1912 Weber published a series of critical studies of the extension of scientific authority into public life. The most notable of these concerned attempts to implement the experimental psychology or psycho-physics laboratory in factories and other real-world settings. Weber's critique centered on the problem of social measurement. He emphasized the discontinuities between the space of the laboratory and that of the factory, showing how several qualitative and historically conditioned differences between the two settings rendered the transfer of instruments and methods between them highly problematic. Weber's critical arguments prepared the ground for his greatest foray into empirical sociology, a survey he directed for the Verein für Sozialpolitik investigating the conditions and attitudes affecting the lives and performance of industrial workers. Using a different measuring instrument - the questionnaire - Weber tried to implement a concept of social measurement which implied a different ontology, drawn not from natural sciences but from the historical sciences.

Historiography↗

MELVYL MEDLINE: reference service implications of an end-user search system.

The implementation of MELVYL MEDLINE, a successful online end-user system in the University of California (UC) health sciences libraries greatly enhanced the capabilities of reference desk service by providing immediate access to current medical literature from the MEDLINE database. With these enhancements, the extent of the impact on the delivery of reference service was not anticipated. Concurrent with providing traditional reference service requests, there was a constant need for individualized end-user instruction by MELVYL MEDLINE users, and continual maintenance of workstation equipment and supplies. This paper describes the experiences at the UC Irvine (UCI) Biomedical Library and compares these experiences with other UC health sciences libraries. The purpose of this paper is to discuss some of the issues which must be considered when planning for the implementation of an end-user system within the reference service function.

California↗

Behavioral and social sciences theories and models: are they used in unintentional injury prevention research?

Behavioral and social sciences theories and models have the potential to enhance efforts to reduce unintentional injuries. The authors reviewed the published literature on behavioral and social science theory applications to unintentional injury problems to enumerate and categorize the ways different theories and models are used in injury prevention research. The authors conducted a systematic review to evaluate the published literature from 1980 to 2001 on behavioral and social science theory applications to unintentional injury prevention and control. Electronic database searches in PubMed and PsycINFO identified articles that combined behavioral and social sciences theories and models and injury causes. The authors identified some articles that examined behavioral and social science theories and models and unintentional injury topics, but found that several important theories have never been applied to unintentional injury prevention. Among the articles identified, the PRECEDE PROCEED Model was cited most frequently, followed by the Theory of Reasoned Action/Theory of Planned Behavior and Health Belief Model. When behavioral and social sciences theories and models were applied to unintentional injury topics, they were most frequently used to guide program design, implementation or develop evaluation measures; few examples of theory testing were found. Results suggest that the use of behavioral and social sciences theories and models in unintentional injury prevention research is only marginally represented in the mainstream, peer-reviewed literature. Both the fields of injury prevention and behavioral and social sciences could benefit from greater collaborative research to enhance behavioral approaches to injury control.

Accident Prevention↗

Effects of an alternate dissection schedule on gross anatomy laboratory practical performance.

The current medical curricula reform that is taking place in many medical schools throughout the world has resulted in less time for gross anatomy laboratory instruction. In response, anatomists are using a variety of approaches (e.g., peer teaching, prosections, plastinated anatomical models, etc.) to adapt to these changes. To accommodate recent curricular reform at the University of Health Sciences College of Osteopathic Medicine, an alternating dissection schedule was implemented. The purpose of this study is to examine the effects of the alternating schedule on gross anatomy laboratory practical performance. Using a Mann-Whitney Rank Sum test, back and upper limb (back-upper limb), and lower extremity laboratory practical performance for students who dissected in every laboratory (EL group; n = 227) is compared to students who dissected in every other laboratory (EOL group; n = 254). For the back-upper limb part of the anatomy laboratory practical, the mean percentage scores for the EL and EOL groups were 74.5% and 68.1%, respectively (P < 0.001). The mean percentage scores for the EL and EOL groups on the lower limb portion of the anatomy lab practical were 75.9% and 75.6%, respectively (P = 0.994). These data suggest that the use of an alternating dissection schedule had an equivocal effect on the students' gross anatomy laboratory practical performance for these two sections. The reasons for these conflicting results may have been related to regional complexity or volume of information, and the sequence in which the regions were taught.

Anatomy↗

The potential use of expert systems to enable physicians to order more cost-effective diagnostic imaging examinations.

Educating physicians to order diagnostic imaging examinations more cost-effectively is a difficult and time consuming task, which may be assisted significantly by the use of an expert system. This report is based on a study undertaken at the Health Sciences Centre in Winnipeg, Manitoba, to determine the feasibility of implementing an expert system to aid physicians in selecting appropriate imaging studies. The report reviews the potential benefits, requirements, and limitations of expert systems under development, and highlights the major issues to be considered in choosing such a system for implementation. An extensive literature search was done and is included to aid the reader interested in pursuing this opportunity for improving the cost-effective utilization of expensive diagnostic imaging resources.

Computer-Assisted Instruction↗