Establishing a research informatics program in a public healthcare system: a case report with model documents.

While much is known about governance models for research informatics programs in academic medical centers and similarly situated cancer centers, community and public health systems have been less well-characterized. As part of implementing an enterprise research governance framework, leaders in the Los Angeles County Department of Health Services established a research informatics program, including research data warehousing. The strategy is focused on high-priority, patient-centered research that leverages the investment in health IT and an efficient, sustained contribution from 2 affiliated Clinical Translational Sciences Institutes.

Velocity-specific fatigue: quantifying fatigue during variable velocity cycling.

Unlabelled: Previous investigators have quantified fatigue during short maximal cycling trials ( approximately 30 s) by calculating a fatigue index. Other investigators have reported a curvilinear power-pedaling rate relationship during short fatigue-free maximal cycling trials (<6 s). During maximal trials, pedaling rates may change with fatigue.

Effect of catheter design on tracheal pressures during tracheal gas insufflation.

Background And Objective: This study investigated the distribution of pressures within a model trachea, produced by five different tracheal gas insufflation devices. The aim was to suggest a suitable design of a tracheal gas insufflation device for clinical use.

Methods: Each device was tested using insufflation flow rates of 5 and 10 L min(-1).

Chlamydia trachomatis in older Los Angeles County residents, 1991-1998: implications and recommendations for the detection of sexually transmitted infections in older age groups.

Objectives: This study examined the incidence and implications of reported chlamydia cases in Los Angeles County residents aged 50 and older.

Design: Observational study of passive surveillance data submitted to the Los Angeles County Sexually Transmitted Disease Program.

Settings: Private and public health facilities in Los Angeles County.

Cognitive behavioural group anger management for out-patients: a retrospective study.

This study proposes that anger as the "forgotten emotion" (DiGiuseppe 1994), can cause distress and hardship for the individual who experiences dysfunctional anger in the form of high levels of intensity, duration and rapid onset as well as causing distress to those who observe or are victims of the behavioural responses to anger It is very difficult to calculate the cost of dysfunctional anger to an individuals physical well being and relationships, or to society in general. The author suggests the costs are immense. With this in mind anger management training has gradually emerged in differing forms and from different psychotherapeutic alliances.

Acoustically derived ice-fracture velocity in central Arctic pack ice.

Sounds radiated by fractures in Arctic ice (called acoustic events) are used to estimate fracture velocity. Both speed and orientation are obtained by measuring Doppler shifts induced by source motion. Data from the SIMI experiment of 1994 in the central Arctic are used in the frequency window 10 to 350 Hz.

Research into visitor needs using Molter's tool--time to move on.

Modern research into the needs of intensive care unit visitors was pioneered by Molter in 1979. Much of the published research does not build on the methodology developed by Molter but simply repeats her work with minor modifications. Repetition does not always provide new information and may simply replicate methodological shortcomings.

Antibiotic resistance in bacterial urinary tract infections, 1991 to 1997.

This study assessed changing patterns of antibiotic resistance in Escherichia coli urinary tract infections at a university student health center during three periods: the first 6 months each of 1991, 1994, and 1997. Urine culture and sensitivity results were taken from available medical records of female patients having urine cultures during the three periods (1991, n = 739; 1994, n = 938; 1997, n = 863); age and ethnicity were also noted. In E.

Etiology of genital ulcers and prevalence of human immunodeficiency virus coinfection in 10 US cities. The Genital Ulcer Disease Surveillance Group.

To determine the etiology of genital ulcers and to assess the prevalence of human immunodeficiency virus (HIV) infection in ulcer patients in 10 US cities, ulcer and serum specimens were collected from approximately 50 ulcer patients at a sexually transmitted disease clinic in each city. Ulcer specimens were tested using a multiplex polymerase chain reaction assay to detect Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus (HSV); sera were tested for antibody to HIV. H.

The significance of statistical significance.

Currently, much nursing practice is based on limited evidence, for example, small-scale research, case studies and clinical experience. In a mature science this would be undesirable, but nursing is in the early stages of development as a science, and many of its practices depend on relatively informal knowledge. To encourage the spread of potentially valuable ideas, nurses must be willing to share their clinical experience and journal editors should consider publishing this information.

The significance of statistical significance.

Currently, much nursing practice is based on limited evidence, for example, small-scale research, case studies and clinical experience. In a mature science this would be undesirable, but nursing is in the early stages of development as a science, and many of its practices depend on relatively informal knowledge. To encourage the spread of potentially valuable ideas, nurses must be willing to share their clinical experience and journal editors should consider publishing this information.

Comparisons of cost and accuracy of DNA probe test and culture for the detection of Neisseria gonorrhoeae in patients attending public sexually transmitted disease clinics in Los Angeles County.

Background: Strict handling and transport requirements for the successful use of culture in the detection of Neisseria gonorrhoeae warrant investigation of accurate and cost-effective test alternatives such as the Gen-Probe PACE 2 DNA probe assay (Gen-Probe, Inc., San Diego, CA).

Study Design: The Gen-Probe PACE 2 DNA probe assay for N.

Preventing the ITU syndrome or how not to torture an ITU patient! Part 2.

Admission to an intensive therapy unit (ITU) has been described as a 'necessary evil' (Barrie-Shevlin 1987), and some of the 'tortures' described in Part I of this article (Dyer 1995) may be an inevitable result of ITU care. This does not mean that the development of the ITU syndrome should be regarded as inevitable. Many potential causes of the syndrome can be avoided or at least ameliorated.

Preventing the ITU syndrome or how not to torture an ITU patient! Part I.

Staff working in intensive therapy units (ITUs) have known about the 'ITU syndrome' for many years. In spite of this the syndrome continues to occur. It is suggested that one of the reasons for this continued occurrence is that ITU staff place a lower priority on psychological care than they do on physical care.

Breaking the news: informing visitors that a patient has died.

Most nurses working in critical care areas for any length of time will be involved in informing visitors that a patient has died. This paper describes some of the methods which may be used to give this news and some of the means of providing support to visitors at this time.

Meeting the needs of visitors--a practical approach.

Large amounts of research have been carried out into the needs of visitors to intensive therapy units and these needs are now well established. These needs may be categorised as emotional, personal and cognitive. What is now required is a quick and easy means by which individual intensive care units can judge their success (or failure) in meeting these needs and a knowledge of strategies to deal with any failures.

How to pass a nasogastric tube.

The passage of a nasogastric tube may be met with some difficulty. The indications and contraindications for, and the method of insertion of, the tube are described, as are the difficulties that may be encountered, their solutions, and the complications that may result from the procedure.

Structure of 3'-azido-3'-deoxythymidine, AZT.

C10H13N5O4, Mr = 267.2, monoclinic, P2(1), a = 5.716 (3), b = 11.

Ocean dynamics and acoustic fluctuations in the fram strait marginal ice zone.

Acoustic waves transmitted over a 100-kilometer path in the Fram Strait marginal ice zone undergo Doppler shifts and fluctuations around these shifts, the former due to quasi-steady motion of both acoustic source and receiver and the latter to unsteady motions of the water column and ice cover. Internal waves and differential Doppler shift usually account for such fluctuations in the deep temperate ocean but only partially explain the results obtained in the marginal ice zone. There the fluctuations are more energetic and may be caused alternatively or additionally by comparably energetic fluctuations in ice-edge eddies or other mesoscale motions.