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Biomedical subjects

James G Anderson

Publications and source records attributed to James G Anderson.

At least 19 recordsLinked to original sources
PubMed2006

Ultrasensitive near-infrared integrated cavity output spectroscopy technique for detection of CO at 1.57 microm: new sensitivity limits for absorption measurements in passive optical cavities.

A robust absorption spectrometer using the off-axis integrated cavity output spectroscopy (ICOS) technique in a passive cavity is presented. The observed sensitivity, conceptually the detection threshold for the absorption cross section (cm2) multiplied by the concentration (cm(-3)) and normalized by the averaging time, is measured to be 1.9 x 10(-12) (1/cm square root of Hz). This high sensitivity arises from using the optical cavity to amplify the observed path length in the spectrometer while avoiding cavity resonances by careful design of the spot pattern within the cavity. The instrument is ideally suited for routine monitoring of trace gases in the near-infrared region. A spectrum showing ambient carbon monoxide at 1.57 microm is presented.

Journal Article↗
PubMed2006

Social, ethical and legal barriers to e-health.

BACKGROUND AND PURPOSE: Information technology such as electronic medical records (EMRs), electronic prescribing and decision support systems are recognized as essential tools in Europe, the U.S., Canada, Australia, and New Zealand. But significant barriers impede wide-scale adoption of these tools, especially EMR systems. OBJECTIVES: The objectives of this study were to investigate the present status of information technology in health care, the perceived benefits and barriers by primary care physicians. METHODS: Literature analysis and survey data from primary care physicians on adoption of information technology are reviewed. RESULTS: The U.S. trails European countries as well as Canada, Australia and New Zealand in the use of information technology in primary care. The results of the study indicate that physicians in general perceive benefits to information technology, but also cite major barriers to its implementation in their practices. These barriers include lack of access to capital by health care providers, complex systems and lack of data standards that permit exchange of clinical data, privacy concerns and legal barriers. CONCLUSIONS: Overcoming these barriers will require subsidies and performance incentives by payers and government; certification and standardization of vendor applications that permit clinical data exchange; removal of legal barriers; and greater security of medical data to convince practitioners and patients of the value of EMRs.

Computer Communication Networks↗
PubMed2006

The need for organizational change in patient safety initiatives.

OBJECTIVES: This study describes a computer simulation model that has been developed to explore organizational changes required to improve patient safety based on a medication error reporting system. METHODS: Model parameters for the simulation model were estimated from data submitted to the MEDMARX medication error reporting system from 570 healthcare facilities in the U.S. The model's results were validated with data from the Pittsburgh Regional Healthcare Initiative consisting of 44 hospitals in Pennsylvania that have adopted the MEDMARX medication error reporting system. The model was used to examine the effects of organizational changes in response to the error reporting system. Four interventions were simulated involving the implementation of computerized physician order entry, decision support systems and a clinical pharmacist on hospital rounds. CONCLUSIONS: Results of the analysis indicate that improved patient safety requires more than clinical initiatives and voluntary reporting of errors. Organizational change is essential for significant improvements in patient safety. In order to be successful, these initiatives must be designed and implemented through organizational support structures and institutionalized through enhanced education, training, and implementation of information technology that improves work flow capabilities.

Adverse Drug Reaction Reporting Systems↗
PubMed2006

Changes in the stability of dietary patterns in a study of middle-aged Swedish women.

Dietary patterns reflecting food habits may be associated with chronic diseases, yet little is known about the stability of these patterns. The objective of this study was to observe over time the stability of dietary patterns measured with exploratory and confirmatory factor analysis. Four random subsamples of 1000 women between 49 and 70 y old were chosen from >60,000 women included in the Swedish Mammography Cohort. Subjects in these subsamples were administered a FFQ 4, 5, 6, or 7 y after the baseline questionnaire; 3607 of the women responded (90% response rate). The stability of dietary patterns was evaluated with Spearman correlation coefficients between pattern scores at baseline and follow-ups and by a test of internal stability, which evaluated the significance of changes within patterns between baseline and follow-up. We found 3 major dietary patterns: a healthy pattern, a Western pattern, and an alcohol pattern. Correlations between explored dietary pattern scores at baseline and at follow-up decreased from 0.59 (P < 0.01) after 4 y to 0.50 (P < 0.01) after 7 y for the healthy pattern, from 0.47 (P < 0.01) to 0.39 (P < 0.01) for the Western pattern and from 0.54 (P < 0.01) to 0.46 (P < 0.01) for the alcohol pattern. After 4 and 5 y, there was no evidence for internal instability in any of the 3 patterns. The Western pattern became internally unstable after 6 and 7 y and the alcohol pattern was unstable after 7 y. Our findings for this specific population suggest that in longitudinal studies, dietary exposures should be updated after at least 7 y.

Aged↗
PubMed2005

Rotationally resolved absorption cross sections of formaldehyde in the 28100-28500 cm(-1) (351-356 nm) spectral region: implications for in situ LIF measurements.

The rotationally resolved ultraviolet absorption cross sections for the 2(0)(0)4(1)(0) vibrational band of the A(1)A(2)-X(1)A(1) electronic transition of formaldehyde (HCHO) at an apodized resolution of 0.027 cm(-1) (approximately 0.0003 nm at 352 nm) over the spectral range 28100-28500 cm(-1) (351-356 nm) at 298 and 220 K, using Fourier transform spectroscopy, are first reported here. Accurate rotationally resolved cross sections are important for the development of in situ HCHO laser-induced fluorescence (LIF) instruments and for atmospheric monitoring. Pressure dependence of the cross sections between 75 and 400 Torr at 298 K was explored, and an average pressure broadening coefficient in dry air of 1.8 x 10(-4) cm(-1) Torr(-1) for several isolated lines is reported. Gaseous HCHO was quantitatively introduced into a flow cell by evaporating micron-sized droplets of HCHO solution, using a novel microinjector technique. The condensed-phase concentrations of HCHO were determined by iodometric titrations to an accuracy of <1%. Accuracy of the measured absorption cross sections is estimated to be better than +/-5%. Integrated and differential cross sections over the entire band at low resolution (approximately 1 cm(-1)) obtained with our calibration technique are in excellent agreement with previous measurements. A maximum differential cross section of 5.7 x 10(-19) cm(2) molecule(-1) was observed at high resolution-almost an order of magnitude greater than any previously reported data at low resolution.

Journal Article↗
PubMed2004

The role of ethics in information technology decisions: a case-based approach to biomedical informatics education.

The purpose of this paper is to propose a case-based approach to instruction regarding ethical issues raised by the use of information technology (IT) in healthcare. These issues are rarely addressed in graduate degree and continuing professional education programs in health informatics. There are important reasons why ethical issues need to be addressed in informatics training. Ethical issues raised by the introduction of information technology affect practice and are ubiquitous. These issues are frequently among the most challenging to young practitioners who are ill prepared to deal with them in practice. First, the paper provides an overview of methods of moral reasoning that can be used to identify and analyze ethical problems in health informatics. Second, we provide a framework for defining cases that involve ethical issues and outline major issues raised by the use of information technology. Specific cases are used as examples of new dilemmas that are posed by the introduction of information technology in healthcare. These cases are used to illustrate how ethics can be integrated with the other elements of informatics training. The cases discussed here reflect day-to-day situations that arise in health settings that require decisions. Third, an approach that can be used to teach ethics in health informatics programs is outlined and illustrated.

Curriculum↗
PubMed2004

A daily diary analysis of vaginal bleeding and coitus among adolescent women.

OBJECTIVE: To evaluate the effect of vaginal bleeding on the likelihood of coitus among adolescent women. METHODS: Participants were 191 sexually active women aged 14 to 21 years enrolled from a sexually transmitted disease clinic and three primary care adolescent clinics. Data were collected from diaries maintained for up to 7 months. Subjects recorded each occurrence of coitus, partner initials, condom use, and vaginal bleeding. Multivariable logistic regression was used for the analyses. Generalized estimating equations approach was used to adjust the estimated parameters for within-subject correlation. RESULTS: Subjects reported a total 21334 diary days, with 2684 days with coitus (12.6% of diary days) and 1433 days with bleeding (6.7% of diary days). Only 65/2684 (2.4%) coital events were associated with vaginal bleeding. Multivariable analysis showed that absence of bleeding was associated with increased likelihood (odds ratio = 4.2) of coitus, independent of age, race, and usual coital frequency. Younger age and higher coital frequency were associated with increased likelihood of any coitus during vaginal bleeding. CONCLUSIONS: For most sexually active adolescent women, bleeding is associated with avoidance of coitus.

Adolescent↗
PubMed2004

Information technology for detecting medication errors and adverse drug events.

It is estimated that over three-quarters of a million people are injured or die in hospitals each year from adverse drug events (ADEs). The majority of medical errors result from poorly designed healthcare systems rather than from negligence on the part of healthcare providers. In general, healthcare systems rely on voluntary reporting, which seriously underestimates the number of medication errors and ADEs by as much as 90%. This paper reviews the causes and impact of medication errors and ADEs. It also reports studies that have used information technology (IT) to detect and prevent medication errors and ADEs. Significant reduction of medication errors and ADEs requires systemic implementation of IT, improvements in the reporting of errors, and integration of the components of the healthcare systems' information systems. At the present time, most healthcare systems should be able to use IT to detect and prevent ADEs.

Adverse Drug Reaction Reporting Systems↗
PubMed2003

The impact of CyberHealthcare on the physician-patient relationship.

It is estimated that 70 million Americans have used the Internet to acquire health-related information. Multiple factors provide the driving force behind this demand for online health information. Information technology is beginning to change the exclusive focus of medicine from curing disease to prevention of disease and enhancing health status. A critical feature of this change is the development of information and services that assist consumers to assume more responsibility for their own health and to actively participate in health care decisions. At the same time, physicians remain skeptical about the advantages of using the Internet for patient education. Some of the issues that this paper addresses include the following: What are the major factors that are leading to the increased use of the Internet by consumers to obtain health-related information? How do physicians view the use of the Internet by patients to obtain health-related information and services? How is the use of the Internet by consumers affecting physician-patient communications? What are the implications of the Internet for the future of physician-patient relationships?

Attitude of Health Personnel↗
PubMed2003

A framework for considering business models.

Information technology (IT) such as computerized physician order entry, computer-based decision support and alerting systems, and electronic prescribing can reduce medical errors and improve the quality of health care. However, the business value of these systems is frequently questioned. At present a number of barriers exist to realizing the potential of IT to improve quality of care. Some of these barriers are: the ineffectiveness of existing error reporting systems, low investment in IT infrastructure, legal impediments to reforms, and the difficulty in demonstrating a sufficient return on investment to justify expenditures for quality improvement. This paper provides an overview of these issues, a framework for considering business models, and examples of successful implementations of IT to improve quality of patient care.

Information Management↗
PubMed2003

A systems approach to preventing adverse drug events.

It is estimated that over three-quarters of a million people are injured or die in hospitals each year from adverse drug events. The majority of medical errors result from poorly designed health care systems rather than from negligence on the part of health care providers. While there is considerable evidence that information technology can be used to significantly reduce medication errors and adverse events, information technology, to be effective, must be implemented using a systems approach. This paper reviews three studies that have used a systems approach to investigate the causes of medication errors and the effectiveness of information technology in preventing adverse drug events. Significant reduction of medication errors and adverse drug events requires systemic implementation of information technology, improvements in the reporting of errors, and integration with other systems designed to detect and prevent errors.

Adverse Drug Reaction Reporting Systems↗
PubMed2002

Gas-phase ozonolysis of alkenes: formation of OH from anti carbonyl oxides.

Gas-phase ozone-alkene reactions are known to produce the hydroxyl radical (OH) in high yields. Most mechanistic studies to date have focused on the role of syn carbonyl oxides; however, OH production from ethene ozonolysis indicates a second, poorly understood OH-forming channel, which may contribute to OH production in the ozonolysis of substituted alkenes as well. Using laser-induced fluorescence, we have measured OH and OD yields from the ozonolysis of two partially deuterated alkenes, cis- and trans-3-hexene-3,4-d2. OD is formed from both alkenes, indicating a pathway of hydroxyl-radical formation involving vinylic hydrogens, accounting for one-third of total OH formation from cis-3-hexene. The lack of a significant kinetic isotope effect suggests this pathway is the "hot acid" channel, arising from rearrangement of anti carbonyl oxides. Measured yields also allow for the estimation of syn:anti carbonyl oxide ratios, approximately 50:50 for trans-3-hexene and approximately 20:80 for cis-3-hexene, qualitatively consistent with our understanding of ozonide decomposition pathways.

Journal Article↗
PubMed2002

Evaluation in health informatics: computer simulation.

The evaluation of complex medical informatics applications involves not only the information system, but also its impact on the organizational environment in which it is implemented. In instances where these applications cannot be evaluated with traditional experimental methods, computer simulation provides a flexible approach to evaluation. The construction of a computer simulation model involves the development of a model that represents important aspects of the system under evaluation. Once validated, the model can be used to study the effects of variation in system inputs, differences in initial conditions and changes in the structure of the system. Three examples are discussed, namely, a wide-area health care network, physician order entry into a hospital information system, and the use of an information system designed to prevent medical errors that lead to adverse drug events in hospitals.

Computer Simulation↗
PubMed2002

Evaluation in health informatics: social network analysis.

Social network analysis comprises a set of research methods that can be used to analyze the relationships among entities such as people, departments, and organizations. The purpose of the analysis is to discover patterns of relationships that affect both individual and organizational attitudes and behavior such as the adoption, diffusion, and use of new medical informatics applications. This paper presents an introduction to the concepts and methods of social network analysis. Several applications to health informatics are described.

Attitude↗
PubMed2002

Modeling the costs and outcomes of cardiovascular surgery.

Coronary artery bypass graft (CABG) operations consume more health care resources than any other single procedure. The objective of this study was to develop a computer simulation model that can be used to predict costs and patient outcomes of CABG surgery. The analysis is based on a systems dynamic model developed using STELLA software. Two sets of data from Medicare patients who underwent CABG operations at Methodist Hospital of Indiana were used to construct and validate the model. The model predictions of length of hospital stay, use of specialists in caring for patients, costs and postoperative functional status are reasonably close to actual data on patients who underwent CABG surgery. The analysis indicates the most important factors affecting costs and outcomes are gender, age, whether or not the surgery is a reoperation and whether the patient experiences postoperative complications. The model can be used to predict costs and outcomes for a patient population from a small set of preoperative characteristics (i.e., age, gender, DRG, whether the surgery is a reoperation, and the patient's operative status). A second potential use of the model is to answer clinical questions such as do the costs and risks of CABG operations outweigh the benefits for patients with certain risk factors.

Aged↗
PubMed2002

E-medicine and health care consumers: recognizing current problems and possible resolutions for a safer environment.

Millions of Americans access the Internet for health information, which is changing the way patients seek information about, and often treat, certain medical conditions. It is estimated that there may be as many as 100,000 health-related Web sites. The availability of so much health information permits consumers to assume more responsibility for their own health care. At the same time, it raises a number of issues that need to be addressed. The health information available to Internet users may be inaccurate or out-of-date. Potential conflicts of interest result from the blurring of the distinction between advertising and professional health information. Also, potential threats to privacy may result from data mining. Health care consumers need to be able to evaluate the quality of the information provided on the Internet. Various evaluative mechanisms such as codes of ethics, rating systems, and seals of approval have been developed to aid in this process. The effectiveness of these solutions is evaluated in this paper. Finally, the paper addresses the importance of including patients in developing standardized quality assurance systems for online health information.

Conflict of Interest↗