Information Discovery on Electronic Health Records Using Authority Flow Techniques

Background As the use of electronic health records (EHRs) becomes more widespread, so does the need to search and provide effective information discovery within them. Querying by keyword has emerged as one of the most effective paradigms for searching. Most work in this area is based on traditional Information Retrieval (IR) techniques, where each document is compared individually against the query. We compare the effectiveness of two fundamentally different techniques for keyword search of EHRs. Methods We built two ranking systems. The traditional BM25 system exploits the EHRs' content without regard to association among entities within. The Clinical ObjectRank (CO) system exploits the entities' associations in EHRs using an authority-flow algorithm to discover the most relevant entities. BM25 and CO were deployed on an EHR dataset of the cardiovascular division of Miami Children's Hospital. Using sequences of keywords as queries, sensitivity and specificity were measured by two physicians for a set of 11 queries related to congenital cardiac disease. Results Our pilot evaluation showed that CO outperforms BM25 in terms of sensitivity (65% vs. 38%) by 71% on average, while maintaining the specificity (64% vs. 61%). The evaluation was done by two physicians. Conclusions Authority-flow techniques can greatly improve the detection of relevant information in EHRs and hence deserve further study.

Dimensions of gender relations and reproductive health inequity perceived by female undergraduate students in the Mekong Delta of Vietnam: a qualitative exploration

Introduction Increasing evidence indicates that gender equity has a significant influence on women’s health; yet few culturally specific indicators of gender relations exist which are applicable to health. This study explores dimensions of gender relations perceived by female undergraduate students in southern Vietnamese culture, and qualitatively examines how this perceived gender inequity may influence females’ sexual or reproductive health. Methods Sixty-two female undergraduate students from two universities participated in eight focus group discussions to talk about their perspectives regarding national and local gender equity issues. Results Although overall gender gaps in the Mekong Delta were perceived to have decreased in comparison to previous times, several specific dimensions of gender relations were emergent in students’ discussions. Perceived dimensions of gender relations were comparable to theoretical structures of the Theory of Gender and Power, and to findings from several reports describing the actual inferiority of women. Allocation of housework and social paid work represented salient dimensions of labor. The most salient dimension of power related to women in positions of authority. Salient dimensions of cathexis related to son preference, women’s vulnerability to blame or criticism, and double standards or expectations. Findings also suggested that gender inequity potentially influenced women’s sexual and reproductive health as regards to health information seeking, gynecological care access, contraceptive use responsibility, and child bearing. Conclusion Further investigations of the associations between gender relations and different women’s sexual and reproductive health outcomes in this region are needed. It may be important to address gender relations as a distal determinant in health interventions in order to promote gender-based equity in sexual and reproductive health.

Middle school teachers' intentions to refer eating disorder students for professional counseling

Eating disorders can lead to a negative impact on students' academic growth, nutrition and can cause death (Claude-Pierre, 1997; Manley, Rickson, & Standeven, 2000; Romeo, 1996). Early intervention by referring students to professional counseling might help counter these negative consequences. The teacher is in the position to assist students by providing health information, identifying those with problems, and intervening for a variety of dysfunctions that may include the eating disorders called anorexia nervosa and bulimia nervosa (Myers-Clark & Christopher, 2000). However teachers are in a difficult position to know when to address student concerns and judge what action to take (Ransley, 1999). Teachers' engagement seems crucial (Smolak, Harris, Levine, & Shisslak, 2001) since eating disorders are being identified in younger children. The purpose of this study was to examine (a) the relationships of the theoretical constructs, attitude, subjective norm, and perceived behavioral control of the theory of planned behavior as predictors of behavioral intention (Ajzen & Fishbein, 1980) of middle school teachers to identify and refer suspected anorexia nervosa (AN) and/or bulimia nervosa (BN) students for professional help; and (b) the actual behavior of middle school teachers who reported having ever referred a student suspected of having AN and BN and those teachers who reported not having made such a referral. One hundred fourteen middle school teachers in Broward County, Florida volunteered to participate in the ex post facto research. Data were collected from a questionnaire. Multiple regression analysis revealed that the constructs of subjective norm (perception of what others think about one's performance of behavior combined with motivation to comply) and perceived behavioral control (perception regarding the extent of the difficulty of performing the behavior) were predictive of teachers' intent (likelihood of engaging in a behavior) to refer. However, the analysis revealed that attitude (overall positive or negative feeling with respect to performing the behavior) was not predictive of teachers' intent. Discriminant function analysis revealed that both intent and perceived behavioral control were predictive of group membership, either having referred a student suspected of having an eating disorder for counseling or not having made such a referral. Attitude and subjective norm were not predictive of group membership.

Better primer design for metagenomics applications by increasing taxonomic distinguishability

Current methods of understanding microbiome composition and structure rely on accurately estimating the number of distinct species and their relative abundance. Most of these methods require an efficient PCR whose forward and reverse primers bind well to the same, large number of identifiable species, and produce amplicons that are unique. It is therefore not surprising that currently used universal primers designed many years ago are not as efficient and fail to bind to recently cataloged species. We propose an automated general method of designing PCR primer pairs that abide by primer design rules and uses current sequence database as input. Since the method is automated, primers can be designed for targeted microbial species or updated as species are added or deleted from the database. In silico experiments and laboratory experiments confirm the efficacy of the newly designed primers for metagenomics applications.

A content analysis of food and nutrition television advertisements

Television (TV) reaches more people than any other medium which makes it an important source of health information. Since TV ads often offer information obliquely, this study investigated implied health messages found in food and nutrition TV ads. The goals were to determine the proportion of food and nutrition ads among all TV advertising and to use content analysis to identify their implied messages and health claims. A randomly selected sample of TV ads were collected over a 28-day period beginning May 8, 1987. The sample contained 3547 ads; 725 (20%) were food-related. All were analyzed. About 10% of food-related TV ads contained a health claim. Twenty-five representative ads of the 725 food ads were also reviewed by 10 dietitians to test the reliability of the instrument. Although the dietitians agreed upon whether a health claim existed in a televised food ad, their agreement was poor when evaluating the accuracy of the claim. The number of food-related ads dropped significantly on Saturday, but the number of alcohol ads rose sharply on Saturday and Sunday. Snack ads were shown more often on Thursday, but snack commercials were also numerous on Saturday morning and afternoon, as were cereal ads. Ads for snack foods accounted for the greatest proportion of ads (20%) while fast food accounted for only 7%. Alcohol constituted about 9% of all food and nutrition ads.

Navigating health sources on the Internet: A mixed-methods examination of online consumer reviews and expert text on psychotropic drugs

Purpose. The Internet has provided an unprecedented opportunity for psychotropic medication consumers, a traditionally silenced group in clinical trial research, to have voice by contributing to the construction of drug knowledge in an immediate, direct manner. Currently, there are no systematic appraisals of the potential of online consumer drug reviews to contribute to drug knowledge. The purpose of this research was to explore the content of drug information on various websites representing themselves as consumer- and expert-constructed, and as a practical consideration, to examine how each source may help and hinder treatment decision-making.^ Methodology. A mixed-methods research strategy utilizing a grounded theory approach was used to analyze drug information on 5 exemplar websites (3 consumer- and 2 expertconstructed) for 2 popularly prescribed psychotropic drugs (escitalopram and quetiapine). A stratified simple random sample was used to select 1,080 consumer reviews from the websites (N=7,114) through February 2009. Text was coded using QDA Miner 3.2 software by Provalis Research. A combination of frequency tables, descriptive excerpts from text, and chi-square tests for association were used throughout analyses.^ Findings. The most frequently mentioned effects by consumers taking either drug were related to psychological/behavioral symptoms and sleep. Consumers reported many of the same effects as found on expert health sites, but provided more descriptive language and situational examples. Expert labels of less serious on certain effects were not congruent with the sometimes tremendous burden described by consumers. Consumers mentioned more than double the themes mentioned in expert text, and demonstrated a diversity and range of discourses around those themes.^ Conclusions. Drug effects from each source were complete relative to the information provided in the other, but each also offered distinct advantages. Expert health sites provided concise summaries of medications’ effects, while consumer reviews had the added advantage of concrete descriptions and greater context. In short, consumer reviews better prepared potential consumers for what it’s like to take psychotropic drugs. Both sources of information benefit clinicians and consumers in making informed treatment-related decisions. Social work practitioners are encouraged to thoughtfully utilize online consumer drug reviews as a legitimate additional source for assisting clients in learning about treatment options.^

3D TerraFly: Quality of service management for online interactive 3D geographic information system

3D geographic information system (GIS) is data and computation intensive in nature. Internet users are usually equipped with low-end personal computers and network connections of limited bandwidth. Data reduction and performance optimization techniques are of critical importance in quality of service (QoS) management for online 3D GIS. In this research, QoS management issues regarding distributed 3D GIS presentation were studied to develop 3D TerraFly, an interactive 3D GIS that supports high quality online terrain visualization and navigation. ^ To tackle the QoS management challenges, multi-resolution rendering model, adaptive level of detail (LOD) control and mesh simplification algorithms were proposed to effectively reduce the terrain model complexity. The rendering model is adaptively decomposed into sub-regions of up-to-three detail levels according to viewing distance and other dynamic quality measurements. The mesh simplification algorithm was designed as a hybrid algorithm that combines edge straightening and quad-tree compression to reduce the mesh complexity by removing geometrically redundant vertices. The main advantage of this mesh simplification algorithm is that grid mesh can be directly processed in parallel without triangulation overhead. Algorithms facilitating remote accessing and distributed processing of volumetric GIS data, such as data replication, directory service, request scheduling, predictive data retrieving and caching were also proposed. ^ A prototype of the proposed 3D TerraFly implemented in this research demonstrates the effectiveness of our proposed QoS management framework in handling interactive online 3D GIS. The system implementation details and future directions of this research are also addressed in this thesis. ^

Cuba’s Role in Venezuela’s Control of the Internet and Online Social Networks

The arrival of Cuba’s Information Technology (IT) and Communications Minister Ramiro Valdés to Venezuela in the Spring of 2010 to serve as a ‘consultant’ to the Venezuelan government awakened a new reality in that country. Rampant with deep economic troubles, escalating crime, a murder rate that has doubled since Chávez took over in 1999, and an opposition movement led by university students and other activists who use the Internet as their primary weapon, Venezuela has resorted to Cuba for help. In a country where in large part traditional media outlets have been censored or are government-controlled, the Internet and its online social networks have become the place to obtain, as well as disseminate, unfiltered information. As such, Internet growth and use of its social networks has skyrocketed in Venezuela, making it one of Latin America’s highest Web users. Because of its increased use to spark political debate among Venezuelans and publish information that differs with the official government line, Chávez has embarked on an initiative to bring the Internet to the poor and others who would otherwise not have access, by establishing government-sponsored Internet Info Centers throughout the country, to disseminate information to his followers. With the help of Cuban advisors, who for years have been a part of Venezuela’s defense, education, and health care initiatives, Chávez has apparently taken to adapting Cuba’s methodology for the control of information. He has begun to take special steps toward also controlling the type of information flowing through the country’s online social networks, considering the implementation of a government-controlled single Internet access point in Venezuela. Simultaneously, in adapting to Venezuela’s Internet reality, Chávez has engaged online by creating his own Twitter account in an attempt to influence public opinion, primarily of those who browse the Web. With a rapidly growing following that may soon reach one million subscribers, Chávez claims to have set up his own online trench to wage cyber space battle.