Ontology driven integration platform for clinical and translational research

Semantic Web technologies offer a promising framework for integration of disparate biomedical data. In this paper we present the semantic information integration platform under development at the Center for Clinical and Translational Sciences (CCTS) at the University of Texas Health Science Center at Houston (UTHSC-H) as part of our Clinical and Translational Science Award (CTSA) program. We utilize the Semantic Web technologies not only for integrating, repurposing and classification of multi-source clinical data, but also to construct a distributed environment for information sharing, and collaboration online. Service Oriented Architecture (SOA) is used to modularize and distribute reusable services in a dynamic and distributed environment. Components of the semantic solution and its overall architecture are described.

PANEL DISCUSSION: "Medical Ethics, Eugenics, and the Holocaust"

A panel discussion moderated by Dr. Thomas R. Cole, McGovern Chair in Medical Humanities and Director of the John P. McGovern Center for Humanities and Ethics at the University of Texas Health Science Center in Houston. Panelists include: Rabbi Samuel E. Karff, Rabbi Emeritus of Congregation Beth Israel and Associate Director of the John P. McGovern Center for Humanities and Ethics and Visiting Professor in the Department of Family Medicine at the University of Texas Health Science Center at the Texas Medical Center. Cardinal DiNardo, the second Archbishop of the Archdiocese of Galveston-Houston and the first cardinal archbishop from a diocese in the Southern United States. Dr. Sheldon Rubenfeld, Clinical Professor of Medicine at Baylor College of Medicine. He is Board Certified in Internal Medicine and in Endocrinology, Diabetes, and Metabolism, and is a Fellow in both the American College of Physicians and the American College of Endocrinology. Dr. Rubenfeld has taught "Healing by Killing: Medicine During the Third Reich" for three years and "Jewish Medical Ethics" for seven years at Baylor College of Medicine. He created a six-month program about Medicine and the Holocaust at Holocaust Museum Houston, including an exhibit entitled How Healing Becomes Killing: Eugenics, Euthanasia, Extermination and a series of lectures by distinguished speakers entitled "The Michael E. DeBakey Medical Ethics Lecture Series".

Caring Minds

Honoring a Leader 25th Anniversary Symposium Four Investments in Innovation --Accelerated Ph.D. Campaign --House Bill 4471 Aids Nursing --“Pacesetter” Model --John S. Dunn Research Foundation Gift Fabulous from the Start PARTNERS Luncheon Robert Wood Johnson Foundation Executive Nurse Fellow Alumni News Faculty Scholarship

Caring Minds

DEAN’S MESSAGE CELEBRATING 35 YEARS AKERS SCHOLARSHIP ENDOWMENT NANCY B. WILLERSON ENDOWED PROFESSORSHIP PARTNERS LUNCHEON UT PARTNERS WITH ALDINE ISD THE FUTURE IS HERE RETIRED PHYSICIANS SHARE YEARS OF KNOWLEDGE CARING FOR BABIES RESEARCH STARS CENTER ON AGING VIDEOS/ALUMNI NEWS FACULTY SCHOLARSHIP

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Greetings from Dean Patricia Starck New DNP program explores new frontiers of nursing Profile Joanne V. Hickey, PhD, APRN, BC, ACNP, FAAN, FCCM With assistance from PARTNERS scholarship, Family Practice Nurse pursues her dream through new DNP program School of Nursing offers training in geriatrics for nurses PARTNERS organization endows first professorship University of Texas Health Services planning to expand number of clinics Caring Leaders The Engine of Innovation: School of Nursing researchers part of $36 million NIH grant to spur innovation Johnson and Johnson gala spotlights nurses Chad and Heath LePray UT School of Nursing and Memorial Hermann Hospital create partnership with Chief of Advanced Practice position A Tribute to Frank Cole Faculty Scholarship Endowed Faculty Positions

Caring Minds

Welcome from Dean Patricia Starck The Face of Health Care Leading Technology School of Nursing Collaborates to Initiate Texas Medical Center’s First Digital Repository Nursing Research, A Growing Field Nursing in the Wake of the Storm Profile: Huaping Liu, RN, PhD, Dean and Associate Professor, School of Nursing at Peking Union Medical College Newsbrief: Planning for the Future with a New Doctor of Nursing Practice Program in Fall 2006 Newsbrief: Fast Track Nursing Program Gives Students a Speedy Start Profile: Susan Bankston, RN, BSN, Psychiatric Nursing, Currently enrolled in the MSN to DSN track Newsbrief: University of Texas Health Services Reports Outstanding Achievements in FY’05 Student Grants Newsbrief: New Degree Program Develops Leadership and Business Skills for Today’s Nurses Profile: Pamela Klauer Triolo, PhD, RN, FAAN Clinical Professor of Nursing Director, Nursing Leadership and Administration in Health Systems Newsbrief: Successful Luncheon Completes $1 Million Endowment UT School of Nursing Building Recognized as Blending Form and Function Faculty Scholarship Endowed Faculty Positions

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Greetings Biobank and Centers model collaboration – Enable work of young researchers AccPhD Scholars Find First Year Exciting, Challenging Event Salutes AccPhD Donors Fay named to UT System’s Academy of Health Science Education PARTNERS Luncheon – Opera star hails nurses as “Beautiful Angels” at 2011 PARTNERS Spring Luncheon Hodges Voted School’s 2011 McGovern Outstanding Teacher Graduates soar– Steady growth and success of DNP program follows being first in Texas Reception honors Freds “Best Graduate Schools” – Guide ranks UTHealth tops in Texas/Newsbriefs Faculty Publications Faculty Research Endowed Faculty Positions

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Greeting Consortium on Aging Biobank at School of Nursing PARTNERS Luncheon/ "Ralph Thomas knows the value of investing in the future..." UTHealth, HCC Partnering for more Bachelor's Degree Nurses in Texas/ New Pacesetters Program Fast-Track PhD Program/ AccPhD scholars took many routes to same commitment Profiles and Newsbriefs McCombs School's MBA Program/ Keeping in Touch with Alumni Faculty Publications Faculty Research Endowed Faculty Positions

The effects of exercise on self-rated sleep among adults with chronic sleep complaints

Purpose The purpose of this study was to evaluate whether and to what extent the observed effects on self-rated sleep in a previous study using a combined treatment program with physical exercise and sleep education can be attributed by the physical activity (PA) component. Methods The present study reports supplementary analysis of an already described and published study. Data were provided by a nonclinical sample of 98 normal-active adults with chronic initiating and the maintaining of sleep complaints. The additional analysis included sleep log, exercise log, and daily pedometer data which were collected during a baseline week and 6-week of a combined intervention. Results The results indicate that the number of steps (p = 0.02) and the duration of PA (p = 0.01) is significantly related to the improvement in subjective sleep measures and therefore reveal an independent effect within this combined sleep program. Sleep diary data (recuperation of sleep, number of awakenings after sleep onset, and wake time after sleep onset time) improved significant (all p < 0.01) over the intervention program. About 50% of the participants stated that the PA had an effect on their improvement. Conclusion Improvements on subjective sleep quality after a combined intervention cannot be attributed to the cognitive component alone, but PA has an independent effect. Adults with chronic sleep complaints benefit from exercise. Therefore structured PA should be implemented in any sleep management programs.

Assessing residents' readiness to screen for domestic violence: Utilizing the transtheoretical model - stages of change, decisional balance and self-efficacy

Domestic violence is a major public health problem, yet most physicians do not effectively identify patients at risk. Medical students and residents are not routinely educated on this topic and little is known about the factors that influence their decisions to include screening for domestic violence in their subsequent practice. In order to assess the readiness of primary care residents to screen all patients for domestic violence, this study utilized a survey incorporating constructs from the Transtheoretical Model, including Stages of Change, Decisional Balance (Pros and Cons) and Self-Efficacy. The survey was distributed to residents at the University of Texas Health Science Center Medical School in Houston in: Internal Medicine, Medicine/Pediatrics, Pediatrics, Family Medicine, and Obstetrics and Gynecology. Data from the survey was analyzed to test the hypothesis that residents in the earlier Stages of Change report more costs and fewer benefits with regards to screening for domestic violence, and that those in the later stages exhibit higher Self-Efficacy scores. The findings from this study were consistent with the model in that benefits to screening (Pros) and Self-Efficacy were correlated with later Stages of Change, however reporting fewer costs (Cons) was not. Very few residents were ready to screen all of their patients.^

An assessment of differences in pediatric dental services provided for a Medicaid population when compared to a federally subsidized (military) clinic

Reimbursement for dental services performed for children receiving Medicaid is reimbursed per service while dental treatment for military dependents provided at a military installation is neither directly reimbursable to those providing the care nor billed to those receiving the care. The purpose of this study was to compare pediatric dental services provided for a Medicaid population to a federally subsidized military facility to compare treatment choices and subsequent costs of care. It was hypothesized that differences in dental procedures for Medicaid and military dependent children would exist based upon treatment philosophy and payment method. A total of 240 records were reviewed for this study, consisting of 120 Medicaid patients at the University of Texas Health Science Center at San Antonio (UTHSCSA) and 120 military dependents at Wilford Hall Medical Center (WHMC), Lackland Air Force Base, San Antonio. Demographic data and treatment information were abstracted for children receiving dental treatment under general anesthesia between 2002 and 2006. Data was analyzed using the Wilcoxon rank sum test, Kruskal-Wallis test, and Fisher's exact test. The Medicaid recipients treated at UTHSCSA were younger than patients at WHMC (40.2 vs. 49.8 months, p<.001). The university also treated significantly more Hispanic children than WHMC (78.3% vs. 30.0%, p<.001). Children at UTHSCSA had a mean of 9.5 decayed teeth and were treated with 2.3 composite fillings, 0 amalgam fillings, 5.6 stainless steel crowns, 1.1 pulp therapies, 1.6 extractions, and 1.0 sealant. Children at WHMC had a mean of 8.7 decayed teeth and were treated with 1.4 composite fillings, 0.9 amalgam fillings, 5.6 stainless steel crowns, 1.7 pulp therapies, 0.9 extractions, and 2.1 sealants. The means of decayed teeth, total fillings, and stainless steel crowns were not statistically different. UTHSCSA provided more composite fillings (p<.001), fewer amalgam fillings (p<.001), fewer pulp therapies (p <.001), more extractions (p=.01), and fewer sealants (p<.001) when compared to WHMC. Age and gender did not effect decay rates, but those of Hispanic ethnicity did experience more decay than non-Hispanics (9.5 vs. 8.6, p=.02). Based upon Texas Medicaid reimbursement rates from 2006, the cost for dental treatment at both sites was approximately $650 per child. The results of this study do not support the hypothesis that Medicaid providers provide less conservative therapies, which would be more costly, care when compared to a military treatment center. ^