The Press-Dispatch
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The Press-Dispatch A-11 Wednesday, April 17, 2013 Sharing individual health information could improve care By Elizabeth Gardner and Cindy Fox Aisen Information collected from individual patients at doctor's office and hospital visits could be used to improve health care and reduce costs on a national scale, according to a report released by the Institute of Medicine. As health care records move to electronic systems, there is an opportunity to compile information taken from individuals and use it to conduct large studies that advance the entire health care system, said Michael D. Murray, the Regenstrief Institute investigator and Purdue University professor who led the team of experts that wrote the report. "Every health care encounter provides not only an opportunity to improve the health of the individual patient, but also to help improve the care of others," said Murray, who is the executive director of the Regenstrief Center for Healthcare Effectiveness Research at the Regenstrief Institute, Inc. "Currently, the information col- lected like blood pressure, weight, medications used, disease diagnoses and medical history are used only to inform decisions for that individual patient. We are missing a tremendous opportunity to turn our health care system into one that learns from each care experience and leads to better and more affordable care for all." Such information could be used to better monitor diseases and outbreaks, target medical services where they are most helpful, reduce unnecessary testing and treatments, prevent medical errors, and accelerate medical research and delivery of new treatments, he said. "Patient and provider engagement in sharing data is the key to realizing this potential," said Murray, who also is a distinguished professor of pharmacy practice and endowed chair of medication safety at Purdue. "We want the public to know that this can be done in a very secure way that maintains their privacy. We hope that a better understanding of what could be achieved leads to a greater number of people approving the use of their data for research and health care improvement." There are laws that set standards for the use of clinical data for research and measures like the removal of names, addresses and other identifying information to protect a patient's confidentiality. Still, surveys show the privacy and security of electronic data are among patients' top concerns about data sharing. In addition to raising awareness of the benefits of secure data sharing, better integration of data and more trained professionals to analyze large data sets are needed, he said. The report, "Making the Case for Continuous Learning from Routinely Collected Data," details the various sources of clinical data available and case studies of how this information can be used. The authors were participants in the Clinical Effectiveness Research Innovation Collaborative of the Institute of Medicine Roundtable on Value & Science-Driven Health Care. Nitrogen key to uptake of other corn nutrients, study shows By Brian Wallheimer A historical analysis of corn research shows that new hybrids are taking up more nitrogen than older plant varieties after the crucial flowering stage, a clue as to how plant scientists will need to adapt plants to increase yields. Tony Vyn, a professor of agronomy, and Ignacio Ciampitti, a postdoctoral research associate, are studying the timing of nutrient uptake in corn and how that process affects yield. They found that modern hybrids (post-1990) took up 27 percent more total nitrogen from the soil after flowering than pre-1990 corn plants. In fact, nitrogen uptake after flowering in post-1990 hybrids averaged 56 percent of the total grain nitrogen at the end of the season. Primarily, more grain nitrogen came from new nitrogen uptake from soil during grain filling, as opposed to nitrogen being remobilized from plant leaves and stems. The higher amount and duration of nitrogen uptake contributed to superior grain yields even as actual grain nitrogen concentrations declined. The timing of nitrogen uptake is also important in understanding how other plant nutrients are affected. Vyn said optimum nitrogen levels increased plants' abilities to absorb phosphorus, potassium and sulfur. Part of the corn plant's response to receiving adequate nitrogen is that progressively higher percentages of total plant phosphorus, potassium and sulfur end up in the grain fraction at harvest. "You need to think in terms of nutrient balance. If you have a plant with more biomass and more yield, it will be taking up more nutrients in a balanced manner that shifts with plant needs and growth stages," Ciampitti said. Post-1990 corn hybrids use nitrogen more efficiently, so less is necessary per unit of yield. But as those plants increase nitrogen utilization, they increase their uptake of other nutrients, which affects how much of those nutrients growers need to use and when they need to apply them. "At some point, they'll need to increase the amount of these other nutrients applied to their fields as yields continue to increase," Vyn said. Vyn and Ciampitti also found that the timing of nutrient uptake is important for predicting yield and nutrient efficiencies. Vyn said it would be economically beneficial to identify simple, early-stage plant traits that could be measured to predict final yield, but the earliest they could predict yield with even 50 percent certainty was at flowering, much later than hoped. "It's desirable to estimate yield and nutrient efficiency of new genotypes at an early stage, but you have to wait until flowering time," Vyn said. "You need to wait until flowering stage for most of the total potassium uptake to be present in the plant and recognize that proportionally more phosphorus than nitrogen uptake can occur later in modern corn hybrids. But all nutrient uptake rates are dependent on the specific interactions of hybrids with their environment and management factors like plant density and soil nutrient availability." Ciampitti said biomass and nutrients were measured for two weeks before, at and two weeks after, flowering in an effort to predict yield. Those periods were crucial because it is the time in which most corn biomass is made in modern hybrids when water is not limiting. The results of the studies were reported in two journal articles. The review of nitrogen source changes was published in Crop Science. Nutrient accumulation and partitioning results were published in Agronomy Journal. Hoosier Harvest Market food hub sets meeting for farmers By Keith Robinson Hoosier Harvest Market Inc., formerly known as Central Indiana Food Hub, will have a meeting April 23 in Greenfield for farmers interested in becoming vendors in the online market for their products. The meeting will be from 7-9 p.m. EDT at the Hancock County Purdue Extension office, 802 N. Apple St., just north of the county fairgrounds. Hoosier Harvest Market is a system that coordinates, through online marketing, the weekly sale and collection of local farm products for delivery to customer delivery points across the region. " The Hoosier Harvest Market is organized with both the farmer and the consumer in mind as a means of conveniently connecting the Indiana shopper with the very best that Indiana farmers can produce," said Roy Ballard, Purdue Extension agricultural and natural resources educator in Hancock County. "All products that you might expect to see at a traditional farmers market will be included in the offerings of the Hoosier Harvest Market." Because of the approaching growing season, farmers interested in selling through the market this year should attend the meeting to learn more about the logistics of the market and what they can expect if they participate, Ballard said. Farmers will receive an information packet and a member agreement for their consideration and will have the opportunity to ask questions and voice any concerns. Like other food hubs, Hoosier Harvest Market seeks to increase consumer access to fresh and healthy locally produced foods, including those in underserved areas while at the same time provide wider access to institutional and retail markets for small to mid-sized producers. The market will provide another access point for shoppers who want to support local farmers and buy the freshest local products from farmers they know and trust but are currently limited to the traditional choices such as roadside markets and community farmers' markets. Farmers who sell through Hoosier Harvest Market will be able to provide their inventory and prices online weekly. Shoppers, including consumers buying for their families and perhaps restaurants seeking locally grown products for their menus, will be able to shop among all of the listed farmers for an array of products. Shoppers will pay for the products online. At the end of each marketing cycle, farmers who sold products will deliver them to an aggregation point where the products will be sorted into customer market baskets and delivered to their selected drop-off point. For more information or to register for the meeting, producers can contact their county Extension educator or Roy Ballard at 317462-1113 or by email at rballard@purdue.edu. Farmers and growers who are unable to attend the meeting but want to learn more about Hoosier Harvest Market can get information on the market's website at www.hoosierharvestmarket.com or look for updates on the Hoosier Harvest Market Facebook page. Shoppers who would like to receive information about the opportunity to buy products through the market can inquire by email at info@ hoosierharvestmarket.com. netedition It's the paper. Just digital. PressDispatch.net/Subscribe TIME TO ADVERTISE FOR THE MAY 11TH CITY-WIDE YARD SALE Hurry in! Deadline is Noon • Tuesday, May 7, 2013. CALL 354-8500 FAX 354-2014 EMAIL classifieds@ pressdispatch.net COME IN: 820 E. Poplar, Petersburg We Accept CASH CHECK MAIL-IN or FAX CLASSIFIED AD ORDER Write your classified ad on the lines below, one word per line. 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