The usefulness of detailed information to patients with contact allergy

To find out if patients with contact allergy are helped by computerized information lists, a retrospective study was carried out on 58 patients with contact allergy to lanolin, traced through our local database DALUK. All were sent a questionnaire about their usage of the information list, clearance of their eczema, their education and other details. Clearance of the patient's eczema was found to correlate with use of the information list. It was also found that the effectiveness of the information depended on factors such as education, family circumstances, ethnic background and, most of all, how and where the information list was used.     

How to Effectively Implement an Indicator System to Improve Performance from a Management Perspective: The Case of Taiwan Healthcare Indicator Series (THIS) System

This study uses the Taiwan Healthcare Indicator Series (THIS) system as an example to examine which determinants would improve performance by sharing indicators from a management perspective. This study population included all 227 hospitals participating in the THIS system in 2006. A structured questionnaire was sent to the director who was responsible for the THIS system via electronic mail. A total of 111 responses were returned by February 10, 2006. Questions included current implementation and impacts of the system. Hierarchical regression models were performed to identify which variables were significantly associated with performance improvement, adjusted for hospital characteristics. Four variables significantly associated with implementing the THIS system to improve performance were ‘senior management support,’ ‘benchmarking,’ ‘making departments improve the underperforming indicators and report the improvement results in performance management meetings,’ and ‘integration with the National Health Insurance payment regulations’. This study contributes substantially to the evidence base about what works to improve performance by information sharing. Although information sharing is the basis of efforts to improve performance, senior management support and how to effectively apply the information are the most important determinants of performance enhancement.     

Performance in population models for count data,part II: A new SAEM algorithm

Analysis of count data from clinical trials using mixed effect analysis has recently become widely used. However, algorithms available for the parameter estimation, including LAPLACE and Gaussian quadrature (GQ), are associated with certain limitations, including bias in parameter estimates and the long analysis runtime. The stochastic approximation expectation maximization (SAEM) algorithm has proven to be a very efficient and powerful tool in the analysis of continuous data. The aim of this study was to implement and investigate the performance of a new SAEM algorithm for application to count data. A new SAEM algorithm was implemented in MATLAB for estimation of both, parameters and the Fisher information matrix. Stochastic Monte Carlo simulations followed by re-estimation were performed according to scenarios used in previous studies (part I) to investigate properties of alternative algorithms (Plan et al., 2008, Abstr 1372 []). A single scenario was used to explore six probability distribution models. For parameter estimation, the relative bias was less than 0.92% and 4.13% for fixed and random effects, for all models studied including ones accounting for over- or under-dispersion. Empirical and estimated relative standard errors were similar, with distance between them being <1.7% for all explored scenarios. The longest CPU time was 95 s for parameter estimation and 56 s for SE estimation. The SAEM algorithm was extended for analysis of count data. It provides accurate estimates of both, parameters and standard errors. The estimation is significantly faster compared to LAPLACE and GQ. The algorithm is implemented in Monolix 3.1, (beta-version available in July 2009).     

An investigation into the information obtained by patients undergoing gastroscopy investigations

? The benefits of informing patients before undergoing surgery or other investigative procedures are clearly demonstrated in the literature. ? This study aimed to determine the amount and type of information given to patients before, during and after undergoing gastroscopy investigations. ? A survey approach incorporating structured interviews and structured observation was utilized. ? There were statistically significant differences between the information acquired by younger and older patients prior to, but not during or after, the procedure. ? Nurses appear to be the most important source of information for older patients while the information leaflet was perceived as the most important source of information for younger patients.     

An effect of triazolam on visual attention and information processing

This study explored whether benzodiazepines selectively affect aspects of attention and/or visual information processing, as they do memory. A cued visual-search paradigm was employed, using normal volunteers and a single dose of triazolam. This paradigm provided for a detailed examination of two aspects of visual attention and information processing: 1) controlled versus automatic attention allocation (via central and peripheral cues), and 2) the extent to which processing an item in a non-cued location affects performance (via cue-validity). Triazolam, compared to placebo, significantly increased response time, and Drug Condition interacted with Cue-Validity but not Cue-Type. Based on these data, we argue that triazolam doesnot affect attention allocation butdoes affect attentional disengagement and/or attention switching mechanisms.     

Patients' desire for information about anaesthesia: Danish attitudes

Background : Patients' desire for information about anaesthesia has been examined in a number of Commonwealth countries but not in Scandinavia. A questionnaire was distributed to form a basis for giving Danish patients more appropriate preoperative information.
Methods : 201 preoperative patients in Denmark were asked to complete a questionnaire. The patients were divided into subgroups according to: age, gender, residential origin, ASA group, educational level, type of anaesthesia planned and number of previous anaesthetics.
Results : Patients from a city area required significantly more information than patients from a rural/urban area about pre-medication drugs, drips/catheters, pain/pain relief and complications. Men more than women preferred to know about dangerous complications. Information about pain /pain relief, duration of anaesthesia, and influence of anaesthesia on daily activities such as eating, drinking, mobilisation was given the highest priority, while unpleasant information such as about complications and needles was given the lowest priority. Meeting the anaesthetist and information about alternative methods of anaesthesia and premedication drugs were given only moderate priority. Ranking information in Denmark was significantly correlated with Scotland, Canada and Australia, despite profound differences in priority. More often than Danish patients, Australian patients felt they had right to know, and especially about complications.
Conclusion : Patients from a city area required more information than patients from a rural/urban area. Information about the influence on daily activities was preferred to unpleasant information. Ranking information in Denmark was correlated with a number of Commonwealth countries.     

Using online databases to find peer-reviewed journal articles on injury prevention and safety promotion research: a study of textword queries by SafetyLit users.

OBJECTIVE: To assess the capacity of textword queries to provide a comprehensive listing of articles on injury prevention and safety promotion (IPSP) concepts in a literature database. METHODS: All terms used to search SafetyLit (a database of scholarly literature selected for its relevance to the IPSP field) during the years 2000-2005 were listed and then examined to identify terms that are synonyms for the same concept. Terms were grouped by concept, the number of queries that used terms within each concept category were summed, and the concepts were then ordered by the total number of searches for each concept category. For each textword, the proportion of all articles for that concept that could be found by using it alone was calculated. RESULTS: Each of the 25 most searched-for concepts has 4 to 40 synonyms. Sixteen of the concepts required queries using two or more terms to find 75% of the available articles. Few searchers used a sufficient number of textword synonyms in their queries to return a complete listing of the available material. CONCLUSION: On the basis of this study, queries using only one or two textword terms are insufficiently sensitive to find all relevant journal articles about an IPSP concept.     

Four-Dimensional Computerized Tomography （4D-CT） Reconstruction Based on the Similarity Measure of Spatial Adjacent Images

Objective：To investigate the feasibility of a 4D-CT reconstruction method based on the similarity principle of spatial adjacent images and mutual information measure. Methods：A motor driven sinusoidal motion platform made in house was used to create one-dimensional periodical motion that was along the longitudinal axis of the CT couch. The amplitude of sinusoidal motion was set to an amplitude of ±1 cm. The period of the motion was adjustable and set to 3.5 s. Phantom objects of two eggs were placed in a Styrofoam block, which in turn were placed on the motion platform. These objects were used to simulate volumes of interest Undergoing ideal periodic motion. CT data of static phantom were acquired using a multi-slice general electric （GE） LightSpeed 16-slice CT scanner in an axial mode. And the CT data of periodical motion phantom were acquired in an axial and cine-mode scan. A software program was developed by using VC ＋ ＋ and VTK software tools to resort the CT data and reconstruct the 4D-CT. Then all of the CT data with same phase were sorted by the program into the same series based on the similarity principle of spatial adjacent images and mutual information measure among them, and 3D reconstruction of different phase CT data were completed by using the software. Results：All of the CT data were sorted accurately into different series based on the similarity principle of spatial adjacent images and mutual information measures among them. Compared with the unsorted CT data, the motion artifacts in the 3 D reconstruction of sorted CT data were re- duced significantly, and all of the sorted CT series result in a 4D-CT that reflected the characteristic of the periodical motion phantom. Conclusion：Time-resolved 4D-CT reconstruction can be implemented with any general multi-slice CT scanners based on the similarity principle of spatial adjacent images and mutual information measure. The process of the 4D-CT data acquisition and reconstruction were not restricted to the hardware or software of the C     

交互信息在心脏状态和心率研究中的应用

交互信息是一种检测系统之间相依性的方法 ,它可以同时检测线性和非线性相关。本文介绍了交互信息的计算方法和性质 ,讨论了它在单个时间序列上的应用 ,并将它应用于心脏状态研究上。利用实验动物的数据 ,我们发现了心搏的运动既不是随机的也不是周期的 ;并且 ,不同心脏状态下的交互信息有很大的差别 ,浅麻 ,机控呼吸和开胸状态下交互信息都相对较小 ,心肌损伤后有明显增大 ,提示心搏的交互信息与心脏健康程度有很大关系