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PubMed1994

[Quality development at an emergency unit--an intervention study based on consumer satisfaction].

A study among the users of an emergency department was carried out to assess user satisfaction, based upon a questionnaire. The study was split into two periods, before and after a change in procedure in the emergency department, namely that a nurse was to give information about waiting time, make coordinations and fix an order of priority of patients (triage) in the waiting room. Fourteen hundred and twenty-six answers were received, 794 before and 632 after the change. The users questioned after this change of procedure felt that they had been better received, that they had waited for a shorter time and described a better general experience as compared to the users questioned before the change, these differences were significant. There were no difference between the two groups concerning opinions on information about diagnosis, treatment and outcome, whether there was enough time for examination, treatment and information, whether the staff were obliging or whether their expectations had been fulfilled. It is concluded that such changes in procedure in the emergency department are to be recommended.

Denmark↗

PubMed1999

CAFASP-1: critical assessment of fully automated structure prediction methods.

The results of the first Critical Assessment of Fully Automated Structure Prediction (CAFASP-1) are presented. The objective was to evaluate the success rates of fully automatic web servers for fold recognition which are available to the community. This study was based on the targets used in the third meeting on the Critical Assessment of Techniques for Protein Structure Prediction (CASP-3). However, unlike CASP-3, the study was not a blind trial, as it was held after the structures of the targets were known. The aim was to assess the performance of methods without the user intervention that several groups used in their CASP-3 submissions. Although it is clear that "human plus machine" predictions are superior to automated ones, this CAFASP-1 experiment is extremely valuable for users of our methods; it provides an indication of the performance of the methods alone, and not of the "human plus machine" performance assessed in CASP. This information may aid users in choosing which programs they wish to use and in evaluating the reliability of the programs when applied to their specific prediction targets. In addition, evaluation of fully automated methods is particularly important to assess their applicability at genomic scales. For each target, groups submitted the top-ranking folds generated from their servers. In CAFASP-1 we concentrated on fold-recognition web servers only and evaluated only recognition of the correct fold, and not, as in CASP-3, alignment accuracy. Although some performance differences appeared within each of the four target categories used here, overall, no single server has proved markedly superior to the others. The results showed that current fully automated fold recognition servers can often identify remote similarities when pairwise sequence search methods fail. Nevertheless, in only a few cases outside the family-level targets has the score of the top-ranking fold been significant enough to allow for a confident fully automated prediction. Because the goals, rules, and procedures of CAFASP-1 were different from those used at CASP-3, the results reported here are not comparable with those reported in CASP-3. Nevertheless, it is clear that current automated fold recognition methods can not yet compete with "human-expert plus machine" predictions. Finally, CAFASP-1 has been useful in identifying the requirements for a future blind trial of automated served-based protein structure prediction.

Algorithms↗

PubMedDate not supplied

[Abuse of licit and illicit psychoactive substances in children and teenagers in the PACA Region (Southeastern France)].

INTRODUCTION: The abuse of licit and illicit psychoactive substances in children and teenagers represents a public health problem. MATERIALS AND METHODS: The aim of this study was to evaluate the extent of this phenomenon and its growth in the PACA (Provence-Alpes-Côte d'Azur) region (Southeastern France). The cases identified during the 10-year period 1992-2002 by the CEIP (Centre d'Evaluation et d'Information sur la Pharmacodépendance) were studied retrospectively. RESULTS: One hundred and ninety-one cases were identified. In most instances, abuse involved a first experience or was sporadic. The users were often boys (70%). The substances were solvents (48.7%) used collectively (33%) during recreational activities (74%). Illicit drugs accounted for 28.2% of the cases involving a first experience (89%), with polyconsumption accounting for 50%, cannabis 57.6%, ecstasy 25.9%, and LSD (lysergic acid diethylamide) 12.1% of cases. Medicines were also used (16%), the most frequent being benzodiazepines (51.6%). CONCLUSION: The study confirms the abuse of licit and illicit psychoactive substances in children and teenagers and provides information regarding the substances available in this region of France.

Adolescent↗

PubMed2005

If I didn't have HIV, I'd be dead now: illness narratives of drug users living with HIV/AIDS.

The purpose of this study is to illuminate the experiences of lower income, urban, HIV-positive drug users. The authors asked 60 participants about HIV risk behaviors, the impact of HIV on their lives, religious beliefs, life plans, relationships, and work-related issues both prior to and since diagnosis. They developed a theoretical framework based on illness narratives and ambiguous loss theories. Themes pertaining to both physical and emotional or spiritual dimensions were located within Benefit, Loss, or Status Quo orientations. The findings contribute to researchers' understanding of the HIV/AIDS illness experiences among the very marginalized and have important implications for physical and mental health care professionals working with HIV-positive drug users.

Acquired Immunodeficiency Syndrome↗

PubMed1990

A protein assay program for Lotus 1-2-3.

Protein assays have become a widespread procedure not only in biochemistry but in many disciplines. This paper describes a program that takes advantage of the capacity of a spreadsheet program such as Lotus 1-2-3 to produce a graph and perform the calculations necessary for such assays. Its simplicity allows users with little or no experience with Lotus 1-2-3 to run it once installed.

Mathematical Computing↗

PubMed1990

Mortality in a cohort of long-term users of hormone replacement therapy: an updated analysis.

OBJECTIVE: To reexamine the mortality experience of a cohort of long-term users of hormone replacement therapy (HRT) in comparison with that reported previously for the same cohort of women, paying particular attention to cardiovascular mortality, deaths from breast and endometrial cancer, and deaths attributed to suicide or suspected suicide. DESIGN: Longitudinal cohort of 4544 long-term users of HRT amongst whom mortality is being monitored prospectively in comparison with expected rates in the female population of England and Wales (taking account of age and calendar period). SUBJECTS: 4544 women, all of whom were recruited from specialist menopause clinics around Britain and had taken at least one year's continuous HRT at the time of recruitment to the study. MAIN OUTCOME MEASURES: All cause mortality, cardiovascular mortality, deaths from female cancers, deaths attributed to suicide or suspected suicide. RESULTS: Overall mortality (based on 236 deaths over the entire study period from recruitment to December 1988) remained significantly lower than expected on the basis of national rates (relative risk (RR) 0.56, 95% confidence limits (CL) 0.47-0.66). When specific causes were considered, the only mortality ratios greater than unity were for injury, poisoning and violence (1.54, 95% CL 1.02-2.06), and for suicide and suspected suicide ('suicide') (2.40, 95% CL 1.68-3.11). Comparison of the ratios for the 112 additional deaths with those obtained in our previous analysis revealed that one of the few ratios to show any increase was that for breast cancer mortality. This rose from a significant deficit of 0.55 (95% CL 0.28-0.96) in the earlier period to 1.00 (95% CL 0.55-1.45) in the later period. There was also a suggestion of an increase in breast cancer risk with increasing duration since first use of HRT. Most of the other cause-specific ratios were very similar over the two periods. The ratio of death from all circulatory diseases was notably lower in the later analysis (RR 0.37, 95% CL 0.15-0.58) than in the earlier analysis (0.51, 95% CL 0.36-0.69), as were all of the subcategories of cardiovascular death. The mortality ratio for cancer of the ovary and uterine adnexa fell from 1.12 in the previous analysis to 0.63 (95% CL 0-1.41). The mortality ratio for 'suicide' also decreased, but was only slightly lower in the later period. As before, however, there was evidence of a relatively high prevalence of prior psychiatric problems amongst the recent 'suicide' deaths, suggesting that the excess of deaths from 'suicide' may be a manifestation of selection. CONCLUSION: These data are consistent with a beneficial effect of HRT on cardiovascular diseases, although updated information comparing progestogen-opposed and -unopposed treatment is not available. The increase in breast cancer mortality contrasts with the pattern for all other specific causes examined; taken together with the suggestion of an increase in breast cancer mortality with increasing interval since first exposure to HRT, this finding is somewhat worrying.

Breast Neoplasms↗

PubMed2005

MicroGen: a MIAME compliant web system for microarray experiment information and workflow management.

BACKGROUND: Improvements of bio-nano-technologies and biomolecular techniques have led to increasing production of high-throughput experimental data. Spotted cDNA microarray is one of the most diffuse technologies, used in single research laboratories and in biotechnology service facilities. Although they are routinely performed, spotted microarray experiments are complex procedures entailing several experimental steps and actors with different technical skills and roles. During an experiment, involved actors, who can also be located in a distance, need to access and share specific experiment information according to their roles. Furthermore, complete information describing all experimental steps must be orderly collected to allow subsequent correct interpretation of experimental results. RESULTS: We developed MicroGen, a web system for managing information and workflow in the production pipeline of spotted microarray experiments. It is constituted of a core multi-database system able to store all data completely characterizing different spotted microarray experiments according to the Minimum Information About Microarray Experiments (MIAME) standard, and of an intuitive and user-friendly web interface able to support the collaborative work required among multidisciplinary actors and roles involved in spotted microarray experiment production. MicroGen supports six types of user roles: the researcher who designs and requests the experiment, the spotting operator, the hybridisation operator, the image processing operator, the system administrator, and the generic public user who can access the unrestricted part of the system to get information about MicroGen services. CONCLUSION: MicroGen represents a MIAME compliant information system that enables managing workflow and supporting collaborative work in spotted microarray experiment production.

Computational Biology↗

PubMed1996

Psychological morbidity and route of administration among amphetamine users in Sydney, Australia.

A sample of 301 amphetamine users were interviewed about their experiences of psychological symptoms prior to, and subsequent to, their initiation of amphetamine use. Psychological morbidity was common, with 44% scoring greater than a conservative cut-off of 8 on the General Health Questionnaire. The most commonly reported symptoms subsequent to the onset of amphetamine use were depression (79%), anxiety (76%), paranoia (52%), hallucinations (46%) and violent behaviour (44%). All these symptoms increased in prevalence after the onset of amphetamine use. Route and frequency of amphetamine administration were significant independent predictors of overall psychological morbidity, while route of administration was related to the experience of hallucinations, violent behaviour and paranoia. The avoidance of injection as a route of administration and the use of amphetamines less than weekly are recommended as steps that users can take to reduce the psychological sequelae of amphetamine use.

Adult↗

PubMed1991

Hearing instruments for the elderly hearing impaired. A comparison of in-the-canal and behind-the-ear hearing instruments in first-time users.

The purpose of this investigation was to compare negative and positive experiences between two matched groups of elderly first-time users of hearing instruments (HI). One group had been supplied with behind-the-ear hearing instruments (BTE), the other with in-the-canal hearing instruments (ITC). There were 20 persons in each group. All were visited in their homes. Those who needed extra help were offered follow-up at the Hearing Centre. ITC were found to be superior to BTE as regards time-of-use, operational difficulties and undesirable sound experiences. ITC were also used in more difficult listening situations. Successful instruction and follow-up was more easily achieved with ITC users than with BTE users. ITC are recommended as the preferred instrument for elderly first-time HI users, at least for hearing losses not exceeding 60 dB PTA, provided the subject's dexterity and anatomical conditions permit fitting of ITC.

Acoustic Stimulation↗

PubMed1986

Caffeine consumption during pregnancy and association with late spontaneous abortion.

In a prospective cohort study, 3135 pregnant women were followed to evaluate the association of caffeine consumption during pregnancy with late first- and second-trimester spontaneous abortion. Almost 80% of pregnant women used some caffeine; among users the average daily intake was 99.3 mg from all sources. Sources of caffeine were nonherbal tea (used by 49.4% of women), coffee (41.2%), colas (35.0%), and drugs (6.6%). In all, 28% of pregnant women consumed greater than or equal to 151 mg of caffeine daily, and these "moderate-to-heavy" caffeine users were significantly more likely to experience late first- or second-trimester spontaneous abortion when compared with nonusers and light users (0 to 150 mg). Demographic characteristics, reproductive and medical history, contraceptive use, and smoking and drinking habits were taken into consideration. The adjusted relative risk of miscarriage after moderate-to-heavy caffeine consumption was 1.73 (p = 0.03). Light caffeine use (1 to 150 mg daily) was associated with increased risk for spontaneous abortion only among women who aborted in their last pregnancy (RR = 4.18, p = 0.04). Replicative studies are necessary before the association of caffeine with spontaneous abortion can be confirmed.

Abortion, Spontaneous↗

PubMed2006

Survey of handheld computing among medical students.

The purpose of this study was to identify trends in the utilization and acceptance of handheld computers (personal digital assistants) among medical students during preclinical and clinical training. We surveyed 366 medical students and collected information on computer expertise, current handheld computer use, predicted future use, and user acceptance. Handheld computers were primarily used for personal applications by students during their preclinical training and as drug references and clinical calculators during their clinical training. In the future, all participants predicted they would use handheld computers at significantly higher rates and on a broader range of medical applications. The adoption of handheld computing was independent of user satisfaction. Those with more clinical experience were less satisfied with handheld computers, suggesting that the expectations of the more experienced users were not met. The lack of institutional support was seen as a key limitation.

Attitude to Computers↗

PubMed1985

The active medicine user.

The purpose of the study is to analyse medicine behaviour seen from the user's point of view. The study intends to generate ideas to specify topics of problems and to try out a combination of qualitative research methods. The practitioners and four asthmatic patients attached to a health centre in Billund, Denmark, were interviewed. The patients kept a diary based on topics, the notes of which were elaborated by weekly telephone interviews. In a final interview all participants evaluated the course of the study. The combination of qualitative methods has been very suitable to provide the perspective of the user. The results of the study question the ideal picture of the patient as a passive user of medicine. The main trends show that: the users develop different strategies to evaluate medication therapy; it has negative consequences to the patient when medication is changed regardless of patient experience; the therapy improves when the doctor draws on the experience of the patient. The study contributes to the present, sparse knowledge about the consciously acting user of medicine and indicates the importance of incorporating the user's experience and life situation in the health care system's handling of health problems.

Child↗

PubMed1987

Accident- and injury-related health-care utilization among benzodiazepine users and nonusers.

Benzodiazepine tranquilizers have been found to cause psychomotor and cognitive impairment, and there is evidence of an increased rate of automobile accidents among users of these drugs. To determine whether benzodiazepine users are more likely than nonusers to experience accidental injury requiring medical attention, we examined health-care utilization among 7,271 such users and an age- and sex-matched sample of 65,439 nonusers, all of whom were enrolled in an "HMO-like" health insurance plan. Benzodiazepine users and nonusers were identified through a review of 4 months' prescription drug claims. Six months' health-care claims for each user and nonuser subsequent to the first observed claim for a benzodiazepine or nonbenzodiazepine agent, respectively, were compiled. Claims related to accidents were identified on the basis of physician-recorded diagnoses. Our results indicate that benzodiazepine users were significantly (p less than .01) more likely than nonusers to experience (1) at least one accident-related episode of care; (2) a greater number of accident-related hospital admissions; and (3) a greater number of accident-related inpatient days. Accident-related utilization was also significantly higher when users had recently filled a prescription for a benzodiazepine agent. Benzodiazepine users, however, also utilized significantly more non-accident-related health-care services than nonusers. The nature of the association between benzodiazepine use and a higher accident-related utilization is thus unclear. A pretest-posttest study is now being undertaken to ascertain the significance of these findings.

Accidents↗

PubMed2006

Integrated software for macromolecular crystallography synchrotron beamlines II: revision, robots and a database.

This manuscript chronicles the evolution of software used originally to control a diffractometer at a macromolecular crystallography beamline. The system has been augmented and rewritten. A modular and carefully organized suite of programs now handles the whole experimental environment from a single vantage point. It provides automatic logging of the experiment and communication with the user, all the way from an initial proposal to perform the work to the end of data collection. This has included construction of a relational database to organize all details of the experiment and incorporation of a robotic specimen changer to provide automation for high-throughput applications.

Crystallography↗

PubMedDate not supplied

Long-acting hormonal contraception: assessing impact on bone density, weight, and mood.

The decline in unintended pregnancies and abortions in the United States has been attributed largely to increased use of two highly effective, hormonal contraceptive methods, depot medroxyprogesterone acetate injection (DMPA) and levonorgestrel implants (Norplant). Despite the efficacy and increasing acceptability of these long-term methods, some clinicians and women are reluctant to use them because of concerns regarding reduction in bone density with DMPA, and depressive symptoms and body weight issues with both injectables and implants. Recent multicenter experience showed no increase in depressive symptoms after 1 year's DMPA use and 2 years' Norplant use, even among users with the highest mean depressive symptom scores pre-therapy. Observational studies indicate that, as with other hormonal contraceptives and hormone replacement, DMPA does not cause significant weight gain, even during long-term use. Multicenter experience with the new soft-tubing Norplant product found an average annual pregnancy rate of <1% and a cumulative 5-year pregnancy rate of 4.2% in women weighing 70 kg or more--substantially lower than failure rates cited in the product labeling. Trends in bone density seen with DMPA appear similar to those during lactation. Subgroups of long-term DMPA users may experience a decrease in spinal bone density that appears to be reversible following discontinuation. A once-a-month injectable contraceptive combining 25 mg medroxyprogesterone acetate and 5 mg estradiol cypionate (Cyclo-Provera, Cyclofem or Lunelle), a 2-rod levonorgestrel system, and a single-rod 3-ketodesogestrel implant system may become available in the United States. Large-scale trials have established the safety, efficacy, and acceptability of Cyclo-Provera. In contrast to DMPA, users of Cyclo-Provera experience predictable, regular monthly bleeding, fewer discontinue due to bleeding-related problems. Fertility returns rapidly following discontinuation. A U.S. multicenter study is currently nearing completion.

Affect↗

PubMed2004

Intregrated analysis of the human cardiac transcriptome, proteome and phosphoproteome.

Altered expression of different classes of genes has been shown to differentiate between failing and nonfailing human hearts. However, characterization of proteins and the post-translational modifications that regulate their functions is required for understanding both the physiology of cardiac muscle and the mechanisms leading to pathological states associated with cardiac diseases. We present in this paper, an analysis of the human cardiac transcriptome, proteome and phosphoproteome. Data from two sources (i) experiments performed in our laboratory and (ii) bioinformatics searches of public databases (SWISS-PROT, NCBI, Cardiac Gene Expression Knowledge Base, Gene Ontology Consortium and Affymetrix) are reported in a relational database that allows user-designed specific queries. Microarray experiments were performed with Affymetrix Hu95Av2. Cardiac proteins were digested with trypsin. An 11 step cation exchange procedure produced fractions for analysis in separate reversed phase high-performance liquid chromatography-tandem mass spectrometry (MS/MS) experiments. Immobilized metal affinity chromatography was used to select the phosphopeptides from the same tryptic peptide mixture. They were then further investigated by MS/MS. Gel-free approaches were used to detect 267 proteins and 47 phosphopeptides. Our human cardiac database contains 447 entries. We propose the use of this platform, built with data derived from nonfailing hearts, as a template for initiating the effort to characterize the human cardiac proteome and its associated post-translational modifications.

Chromatography, Affinity↗

PubMedDate not supplied

Comments on an experimental end-user training course.

The MEDLINE training course organized for users was based on the experience acquired by IMA from problem encountered in the user/system concerning: (a) The understanding of a computerized documentation system and its capabilitiesd. (b) The role of the computer, often over-estimated. (c) The user-search analyst interface, i.e. the role of the analyst, the necessity for the user to explain his question clearly and his real need for information. All these problems were discussed concretely with the help of specific searches presented by each of the participants.

France↗

PubMed2006

Self-report outcome in new hearing-aid users: Longitudinal trends and relationships between subjective measures of benefit and satisfaction.

This study focussed on self-report outcome in new hearing-aid users. The objectives of the experiment were changes in self-report outcome over time, and relationships between different subjective measures of benefit and satisfaction. Four outcome inventories and a questionnaire on auditory lifestyle were administered to 25 hearing-aid users repeatedly after hearing-aid fitting, and assessments took place one week, four weeks, and 13 weeks after hearing-aid provision. The results showed that, for first-time users who used their hearing aids more than four hours per day, self-reported outcome increased over 13 weeks in some scales, although there was no change in amplification during this time. Furthermore, it was found that, for data collected immediately post-fitting, some subscales were much less face valid than for data collected later. This result indicates that the way in which hearing-aid users assess outcome changes over time. The practical consequence of the results is that early self-report outcome assessment may be misleading for some self-report outcome schemes.

Analysis of Variance↗