Respiratory quotient evolution during normal pregnancy: what nutritional or clinical information can we get out of it?

Food intake increases to a varying extent during pregnancy to provide extra energy for the growing fetus. Measuring the respiratory quotient (RQ) during the course of pregnancy (by quantifying O2 consumption and CO2 production with indirect calorimetry) could be potentially useful since it gives an insight into the evolution of the proportion of carbohydrate vs. fat oxidized during pregnancy and thus allows recommendations on macronutrients for achieving a balanced (or slightly positive) substrate intake. A systematic search of the literature for papers reporting RQ changes during normal pregnancy identified 10 papers reporting original research. The existing evidence supports an increased RQ of varying magnitude in the third trimester of pregnancy, while the discrepant results reported for the first and second trimesters (i.e. no increase in RQ), explained by limited statistical power (small sample size) or fragmentary data, preclude safe conclusions about the evolution of RQ during early pregnancy. From a clinical point of view, measuring RQ during pregnancy requires not only sophisticated and costly indirect calorimeters but appears of limited value outside pure research projects, because of several confounding variables: (1) spontaneous changes in food intake and food composition during the course of pregnancy (which influence RQ); (2) inter-individual differences in weight gain and composition of tissue growth; (3) technical factors, notwithstanding the relatively small contribution of fetal metabolism per se (RQ close to 1.0) to overall metabolism of the pregnant mother.

Medical and legal professionals' attitudes towards confidentiality and disclosure of clinical information in forensic settings: a survey using case vignettes.

OBJECTIVE: When potentially dangerous patients reveal criminal fantasies to their therapists, the latter must decide whether this information has to be transmitted to a third person in order to protect potential victims. We were interested in how medical and legal professionals handle such situations in the context of prison medicine and forensic evaluations. We aimed to explore the motives behind their actions and to compare these professional groups. METHOD: A mail survey was conducted among medical and legal professionals using five fictitious case vignettes. For each vignette, participants were asked to answer questions exploring what the professional should do in the situation and to explain their justification for the chosen response. RESULTS: A total of 147 questionnaires were analysed. Agreement between participants varied from one scenario to another. Overall, legal professionals tended to disclose information to a third party more easily than medical professionals, the latter tending to privilege confidentiality and patient autonomy over security. Perception of potential danger in a given situation was not consistently associated with actions. CONCLUSION: Professionals' opinions and attitudes regarding the confidentiality of potentially dangerous patients differ widely and appear to be subjectively determined. Shared discussions about clinical situations could enhance knowledge and competencies and reduce differences between professional groups.

Limitations and information needs for engineered nanomaterial-specific exposure estimation and scenarios: recommendations for improved reporting practices

The aim of this paper is to describe the process and challenges in building exposure scenarios for engineered nanomaterials (ENM), using an exposure scenario format similar to that used for the European Chemicals regulation (REACH). Over 60 exposure scenarios were developed based on information from publicly available sources (literature, books, and reports), publicly available exposure estimation models, occupational sampling campaign data from partnering institutions, and industrial partners regarding their own facilities. The primary focus was on carbon-based nanomaterials, nano-silver (nano-Ag) and nano-titanium dioxide (nano-TiO2), and included occupational and consumer uses of these materials with consideration of the associated environmental release. The process of building exposure scenarios illustrated the availability and limitations of existing information and exposure assessment tools for characterizing exposure to ENM, particularly as it relates to risk assessment. This article describes the gaps in the information reviewed, recommends future areas of ENM exposure research, and proposes types of information that should, at a minimum, be included when reporting the results of such research, so that the information is useful in a wider context.

Immediate Decision-Making and Information Needs in Intensive Care Coordination

The aim of this study was to develop a theoretical model for information integration to support the deci¬sion making of intensive care charge nurses, and physicians in charge – that is, ICU shift leaders. The study focused on the ad hoc decision-making and immediate information needs of shift leaders during the management of an intensive care unit’s (ICU) daily activities. The term ‘ad hoc decision-making’ was defined as critical judgements that are needed for a specific purpose at a precise moment with the goal of ensuring instant and adequate patient care and a fluent flow of ICU activities. Data collection and research analysis methods were tested in the identification of ICU shift leaders’ ad hoc decision-making. Decision-making of ICU charge nurses (n = 12) and physicians in charge (n = 8) was observed using a think-aloud technique in two university-affiliated Finnish ICUs for adults. The ad hoc decisions of ICU shift leaders were identified using an application of protocol analysis. In the next phase, a structured online question¬naire was developed to evaluate the immediate information needs of ICU shift leaders. A national survey was conducted in all Finnish, university-affiliated hospital ICUs for adults (n = 17). The questionnaire was sent to all charge nurses (n = 515) and physicians in charge (n = 223). Altogether, 257 charge nurses (50%) and 96 physicians in charge (43%) responded to the survey. The survey was also tested internationally in 16 Greek ICUs. From Greece, 50 charge nurses out of 240 (21%) responded to the survey. A think-aloud technique and protocol analysis were found to be applicable for the identification of the ad hoc decision-making of ICU shift leaders. During one day shift leaders made over 200 ad hoc decisions. Ad hoc decisions were made horizontally, related to the whole intensive care process, and vertically, concerning single intensive care incidents. Most of the ICU shift leaders’ ad hoc decisions were related to human resources and know-how, patient information and vital signs, and special treatments. Commonly, this ad hoc decision-making involved several multiprofessional decisions that constituted a bundle of immediate decisions and various information needs. Some of these immediate information needs were shared between the charge nurses and the physicians in charge. The majority of which concerned patient admission, the organisation and management of work, and staff allocation. In general, the information needs of charge nurses were more varied than those of physicians. It was found that many ad hoc deci-sions made by the physicians in charge produced several information needs for ICU charge nurses. This meant that before the task at hand was completed, various kinds of information was sought by the charge nurses to support the decision-making process. Most of the immediate information needs of charge nurses were related to the organisation and management of work and human resources, whereas the information needs of the physicians in charge mainly concerned direct patient care. Thus, information needs differ between professionals even if the goal of decision-making is the same. The results of the international survey confirmed these study results for charge nurses. Both in Finland and in Greece the information needs of charge nurses focused on the organisation and management of work and human resources. Many of the most crucial information needs of Finnish and Greek ICU charge nurses were common. In conclusion, it was found that ICU shift leaders make hundreds of ad hoc decisions during the course of a day related to the allocation of resources and organisation of patient care. The ad hoc decision-making of ICU shift leaders is a complex multi-professional process, which requires a lot of immediate information. Real-time support for information related to patient admission, the organisation and man¬agement of work, and allocation of staff resources is especially needed. The preliminary information integration model can be applied when real-time enterprise resource planning systems are developed for intensive care daily management

Forest inventory information needs in Northwest Russia

This thesis applies the customer value hierarchy model to forestry in order to determine strategic options to enhance the value of LiDAR technology in Russian forestry. The study is conducted as a qualitative case study with semi-structured interviews as a main source of the primary data. The customer value hierarchy model constitutes a theoretical base for the research. Secondary data incorporates information on forest resource management, LiDAR technology and Russian forestry. The model is operationalised using forestry literature and forms a basis for analyses of primary data. Analyses of primary data coupled with comprehension of Russian forest inventory system and knowledge on global forest inventory have led to conclusions on the forest inventory methods selection criteria and the organizations that would benefit the most from LiDAR technology use. The thesis recommends strategic options for LiDAR technology’s value enhancement in Russian forestry.

Forest inventory information needs in Northwest Russia

This research report applies the customer value hierarchy model to forestry in order to determine strategic options to enhance the value of LiDAR technology in Russian forestry. The study is conducted as a qualitative case study with semi-structured interviews as a main source of the primary data. The customer value hierarchy model constitutes a theoretical base for the research. Secondary data incorporates information on forest resource management, LiDAR technology and Russian forestry. The model is operationalised using forestry literature and forms a basis for analyses of primary data. Analyses of primary data coupled with comprehension of Russian forest inventory system and knowledge on global forest inventory have led to conclusions on the forest inventory methods selection criteria and the organizations that would benefit the most from LiDAR technology use. The report recommends strategic options for LiDAR technology’s value enhancement in Russian forestry. This work has been conducted as a part of the project ‘Finnish-Russian Forest Academy 2 - Exploiting and Piloting’, which has been supported financially by the South-East Finland- Russia ENPI CBC 2007-2014 Programme.

Information needs for a purchase of fairtrade coffee

This research investigates what information German Fairtrade coffee consumers search for during pre-purchase information seeking and to what extent information is retrieved. Furthermore, the sequence of the information search as well as the degree of cognitive involvement is highlighted. The role of labeling, the importance of additional ethical information and its quality in terms of concreteness as well as the importance of product price and organic origin are addressed. A set of information relevant to Fairtrade consumers was tested by means of the Information Display Matrix (IDM) method with 389 Fairtrade consumers. Results show that prior to purchase, information on product packages plays an important role and is retrieved rather extensively, but search strategies that reduce the information processing effort are applied as well. Furthermore, general information is preferred over specific information. Results of two regression analyses indicate that purchase decisions are related to search behavior variables rather than to socio-demographic variables and purchase motives. In order to match product information with consumers’ needs, marketers should offer information that is reduced to the central aspects of Fairtrade.

Adaptación cultural del cuestionario LINQ (Lung Information Needs Questionnaire) en pacientes con enfermedad respiratoria crónica en un programa de rehabilitación pulmonar en Cali, Colombia

Objetivo: Adaptar culturalmente el cuestionario LINQ (Lung Information Needs Questionnaire) en pacientes con enfermedad pulmonar crónica. Métodos: Estudio descriptivo, después de la traducción del cuestionario por traductor certificado y de la adaptación cultural, se aplicó en ocho pacientes para identificar las dificultades y dudas relacionadas con el entendimiento de las preguntas, la terminología y para evaluar no solo la calidad de la traducción, sino también para verificar aspectos prácticos de su aplicación. Posteriormente, se realizó una segunda traducción al idioma inglés la cual fue enviada a los autores para asegurar el contenido original del cuestionario y conseguir el aval para su uso. Resultados: La muestra en la fase de adaptación cultural fue constituida por 6 hombres y 2 mujeres con una edad promedio de 61 años. La versión en españo ldel LINQ y la adaptación cultural fue comprensible y fácil de usar y no presentó discrepancias con la versión original durante el proceso de retratraducción. Conclusiones: La traducción al español y la adaptacion del LINQ fue adecuada pues los pacientes no manifestaron dificultades para entender y responder las preguntas. Esto podrá facilitar la realización de futuros estudios que evalúen el componente educativo en los programas de rehabiltación pulmonar.

Support and information needs of older and disabled older people in the UK

The aim of this study was to determine the support and information needs of older and disabled older people in the UK. Following an initial literature survey, an examination of data on enquiries made by older people to information providers, and a series of focus groups, a questionnaire was developed for a nationwide survey. Over 1630 questionnaires were completed by disabled older clients of Day Care Centres and less frail older members of social clubs. Findings showed that there is a serious shortfall in the number of older people getting the practical support that they need, and the information that enables access to this support, compared to the number that actually need help. Substantial percentages of the survey respondents experienced difficulty with everyday tasks and with accessing the information they needed. Implications for formal sources of support and information are discussed.

Community College Student and Faculty Information Needs and Information Seeking: an Ethnographic Study

This presentation was offered as part of the CUNY Library Assessment Conference, Reinventing Libraries: Reinventing Assessment, held at the City University of New York in June 2014.

[The importance of clinical information in diagnostic imaging in the febrile patient]

From conventional radiography to cross-sectional imaging methods, modern radiology offers a wide range of diagnostic tools for investigating patients with fever. To achieve the best results and to yield a correct diagnosis, the radiologist must tailor the diagnostic protocol individually for every patient. The decision on the most suitable imaging method, and the type and timing of contrast media strongly depends on the suspected diagnosis. Based on patient history and laboratory data, some modalities may be contraindicated or the patient may need a premedication. The authors give a short overview of diagnostic strategies in evaluating the most important causes of fever and point to the need of discussion and co-operation between clinicians and radiologists.

Analysis of postprandial lipemia as a Cardiovascular Disease risk factor using genetic and clinical information: an Artificial Neural Network perspective

Clinical studies indicate that exaggerated postprandial lipemia is linked to the progression of atherosclerosis, leading cause of Cardiovascular Diseases (CVD). CVD is a multi-factorial disease with complex etiology and according to the literature postprandial Triglycerides (TG) can be used as an independent CVD risk factor. Aim of the current study is to construct an Artificial Neural Network (ANN) based system for the identification of the most important gene-gene and/or gene-environmental interactions that contribute to a fast or slow postprandial metabolism of TG in blood and consequently to investigate the causality of postprandial TG response. The design and development of the system is based on a dataset of 213 subjects who underwent a two meals fatty prandial protocol. For each of the subjects a total of 30 input variables corresponding to genetic variations, sex, age and fasting levels of clinical measurements were known. Those variables provide input to the system, which is based on the combined use of Parameter Decreasing Method (PDM) and an ANN. The system was able to identify the ten (10) most informative variables and achieve a mean accuracy equal to 85.21%.

Categorizing Developer Information Needs in Software Ecosystems

We present the results of an investigation into the nature of the information needs of software developers who work in projects that are part of larger ecosystems. In an open- question survey we asked framework and library developers about their information needs with respect to both their upstream and downstream projects. We investigated what kind of information is required, why is it necessary, and how the developers obtain this information. The results show that the downstream needs are grouped into three categories roughly corresponding to the different stages in their relation with an upstream: selection, adop- tion, and co-evolution. The less numerous upstream needs are grouped into two categories: project statistics and code usage. The current practices part of the study shows that to sat- isfy many of these needs developers use non-specific tools and ad hoc methods. We believe that this is a largely unexplored area of research.

A Quantitative Analysis of Developer Information Needs in Software Ecosystems

We present the results of an investigation into the nature of information needs of software developers who work in projects that are part of larger ecosystems. This work is based on a quantitative survey of 75 professional software developers. We corroborate the results identified in the sur- vey with needs and motivations proposed in a previous sur- vey and discover that tool support for developers working in an ecosystem context is even more meager than we thought: mailing lists and internet search are the most popular tools developers use to satisfy their ecosystem-related information needs.