Search PubMed⌕ Search

Biomedical subjects

R Beuscart

Publications and source records attributed to R Beuscart.

At least 37 records · Page 2Linked to original sources
PubMed1999

The RITHME inter-mediation platform for data exchanges between healthcare professionals.

Data Exchanges between Healthcare Professionals are always limited to paper. For letters, reports, results, the physicians and hospitals are yet using the classical post-office mailing system. With the growing development of Medical Informatics within the Hospital Information Systems and the GPs offices, the way to exchange medical data will be more and more oriented towards the Telematics procedures. If Tele-consultation, video-conferencing applications appear as routine procedures, a safe, protected, and rapid transmission of medical data and records through electronic mailing systems is not yet really available. The Rithme Intermediation Platform is an experimental product, tested in the town of Armentières (in the City of Lille) in the North of France to allow a better, safer, more rapid electronic communication between all the professionals of a geographical sector. One of the mail component of this platform is the "Events Server" which collects and displays all the available information concerning a dedicated patient to the medical authorized correspondents. To realise this task the Rithme Platform takes charge of 4 main functions: formatting the messages, assuring the security, managing the directories, notifying emergencies. Currently experienced with success in the City of Lille, this Platform will be soon customised and commercialized.

Computer Communication Networks↗
PubMed1999

QUALIDIAB: implementation of the Diabcare project in the French-speaking environment: regional, national and international issues. Qualidiab Group.

Diabcare is an international Project devoted to the evaluation of the Quality of Care [1] in the population of diabetic patients. As Diabetes is one of the most frequent chronic illnesses, the management of its treatment has a strong impact on the public health policy both regional and national [2]. Funded by the European Commission, initiated by WHO and the International Diabetes Federation (IDF), this Project is now recognised as a Pilot Project throughout the world as an example of a large international collaboration for the surveillance of quality of care in a typical chronic disease.

Computer Security↗
PubMed1998

A regional university hospital in the framework of a regional information network: the experience of Lille.

Information is essential for the taking care of the patients and is also a guarantee for the quality of cares. In this objective, the University Hospital of Lille has developed for 10 years a politic based on information and communication divided in 3 phases: 1. The University Hospital has developed a HIS based on the communication between hospitals and medical centers for a better sharing of data concerning the patient. 2. The second phase consisted in the integration of external platforms to the HIS with a middleware. 3. The actual phase consists in the opening of the HIS to the external environment of the hospital and especially to the GPs through a Regional Medical Information System.

Computer Communication Networks↗
PubMed1998

Dynamic workflow model for complex activity in intensive care unit.

Cooperation is very important in Medical care, especially in the Intensive Care Unit (ICU) where the difficulties increase which is due to the urgency of the work. Workflow systems are considered as well adapted to modelize productive work in business process. We aim at introducing this approach in the Health Care domain. We have proposed a conversation-based Workflow in order to modelize the therapeutics plan in the ICU [1]. But in such a complex field, the flexibility of the workflow system is essential for the system to be usable. In this paper, we focus on the main points used to increase the dynamicity. We report on affecting roles, highlighting information, and controlling the system We propose some solutions and describe our prototype in the ICU.

Humans↗
PubMed1998

Activity modelling for assessing the usability of telematics applications in healthcare.

With the development of Telematics Applications in Healthcare, it becomes obvious that the success of these services is tightly linked with their usability and their acceptance by users. That is why Users Requirements Analysis appears as an essential step before implementation of new computer services. In many cases, particularly when doctors are directly involved in the management of information, there is a strong interaction between their usual activity and the new tasks implied by the computer. In those cases, Activity Modelling can be useful to describe the way people are working, the motivations that underlie this activity, the place of information management in this activity. Moreover, these models can help to forecast possible difficulties or reasons for failure of the data management when computerised. Obviously, these models are highly depending on the healthcare organisation but some basic lines can be transferable. In this paper we illustrate the Activity Modelling Methodology by examples from Telematics exchanges between GPs and Hospitals.

Delivery of Health Care↗
PubMed1997

The future is no longer what it used to be. Managing health telematics projects.

Future used to mean global progress and convergence of science and technology and society. Today, we observe the decoupling of the two poles of knowledge formation and application (i.e. science and technology, and culture and society, respectively) and also fierce confrontation between them. The key issue to reconcile the two poles is to re-invent the link between them. The new future lies in the development of mental and technical capacities for change and the creation of new forms of solidarity. We propose, as a general attitude, to reactivate and develop the four principles of efficacy-effectiveness-efficiency, hospitality, responsibility and pertinence. Translated into driving forces for the development of health care telematic projects, they amount to the acceptance of and capacity for enterprise-wide solutions, hospitality and capacity to acquire outside knowledge, self-managed, multi-functional team work spirit, reengineering mentality to achieve pertinent technico-cultural solutions.

Attitude↗
PubMed1997

Cognitive evaluation: how to assess the usability of information technology in healthcare.

As the adoption of information technology has increased, so too has the demands that these systems become more adapted to the physicians and nurses environments, to make access and management of information easier. The developers of information systems in Healthcare must use quality management techniques to ensure that their product will satisfy given requirements. This underlines the importance of the preliminary phase where Users Requirements are elicited. Some methodologies, such as KAVAS (E.M.S. Van Gennip, F. Grémy, Med. Inform. 18, 1993, 179) chose to use a continuous assessment protocol as a key strategy for quality management. At each stage of the conception and development of a prototype, the assessment checks that it conforms to the expectation of the users' requirements. The methodology of evaluation is then seen as a dynamic process which is able to improve the design and development of a dedicated system. The purpose of this paper is to demonstrate the necessity to include a cognitive evaluation phase in the process of evaluation by: (1) evaluating the integration (usability) of the I.T. in the activity of the users; and (2) understanding the motives underlying their management of information. This will help the necessary integration of information management in the workload of the healthcare professionals and the compatibility of the prototypes with the daily activity of the users.

Cognition↗
PubMed1997

An asynchronous co-operative model for co-ordinating medical unit activities.

CSCW is devoted to the analysis of interactions among human beings when performing their work together (Ellis et al., Commun. ACM 1 (34) (1991) 38-58). The main fields of application are work organisation, healthcare, education and training. Our main goal is to study the co-operative models allowing task co-ordination and conflict management between actors within a distributed environment, particularly in medical units. We do not aim to produce a practical system suitable for near-term deployment in the intensive care units (ICU), but rather an experimental system that performs and co-ordinates a range of intelligent planning tasks in ICU activities. The emphasis will be put especially on asynchronous co-operation. We apply the Workflow approach to ICU organisation through the analysis and the proposal of a co-operative model.

Computer Simulation↗
PubMed1997

Epidemiologic study of sleep quality and troubles in French secondary school adolescents.

BACKGROUND: The purpose of the study was to assess the prevalence and correlates of sleep problems in adolescents. METHODS: A total of 763 students chosen at random among the 15 secondary schools of a French département were given a self-report questionnaire. RESULTS: As much as 40.8% reported at least one of the five sleep disturbances we studied including difficulties falling asleep and staying asleep, a need for more sleep, early awakenings, and chronic sleeping pill intake. These sleep problems were highly related to various personal and family disorders. Discriminant analysis for categorical data pointed to a consistent but not significant descriptive profile accounting for sleep problems in these students. Suicide, weight concerns, and stimulant abuse were the most informative personal correlates as parts of this profile. CONCLUSION: These findings suggest that the complaint of poor sleep should be regarded with special care in adolescents as a possibly meaningful and sensitive sign of severe family or personal disruption.

Adolescent↗
PubMed1996

[Microprocessor cards and portable medical record].

The smart cards are considered as "intermittently connected devices" ensuring the security and the confidentiality of the data. This technique can be used in the healthcare domain for 2 types of applications: 1. patient cards for administrative functions (Social Security card, identification card) or medical purposes (general medical record or "niche" cards); 2. healthcare professionals cards for identification, authentification of the bearers. Electronic signature and cryptography algorithms reinforce the security of the transactions in medical informatics and telematics. In every case, the smart card must be considered as a mobile tool, intermittently connected with a larger, not limited information system.

Confidentiality↗
PubMed1995

PLACO: a cooperative architecture for managing workflow in CCU.

Computer-Supported Cooperative Work (CSCW) is a multi-disciplinary research theme involving software developers, computer scientists, as well as psychologists and sociologists. CSCW is devoted to the analysis of interactions among humans when performing their work in a collaborative way. The main application fields are work organization, healthcare, education and training. The term of Groupware, as defined by C.A. Ellis, refers to software that assists groups of people in communicating, in collaborating and in coordinating their activities. Our objective is to study software architectures allowing task coordination and conflict management between participants within a distributed environment, in particular medical units. We do not aim to produce a practical system suitable for near-term deployment in the Critical Care Unit (CCU), but rather a "proof of concept", an experimental system that performs and coordinates a range of intelligent planning tasks in CCU activities. The emphasis will be put especially on asynchronous cooperation since the work of physicians and nurses is discontinuous.

Communication↗
PubMed1995

Integration architecture: the ISAR project.

ISAR (Integration System Architecture) will integrate six AIM Projects on the HIS platform at the University Hospital (CHRU) of LILLE. These Projects were elicited from six European consortiums that provided prototypes or pre-competitive products. These consortia are: ESTEEM (storage and analysis of electromyograms), EURIPACS (picture archiving and communication system), MENELAS (analysis of the natural language for medical applications), OEDIPE (storage and serial analysis of electrocardiograms), OPADE (help with drug prescription), and TANIT (mobile system for anaesthesia). When introducing an information system to a medical department and running it, two issues arise. First, how can the Information system be anchored to the Clinical processes in order to support them in an effective and efficient way, and, second, how can the Information system adapt to the changes in the Clinical processes?

Computer Communication Networks↗
PubMed1995

Workflow: a new modeling concept in critical care units.

The term Groupware concerns computer-based systems that support groups of people engaged in a common task (goal) and that provide an interface to a shared environment [1]. The absence of a common tool for exchanges between physicians and nurses causes a multiplication of paper supports for the recording of information. Our objective is to study software architectures in particular medical units that allow task coordination and managing conflicts between participants within a distributed environment. The final goal of this research is to propose a computer solution that could answer the user requirements in Critical Care Units (CCUs). This paper describes the Workflow management approach [5] for supporting group work in health care field. The emphasis is especially on asynchronous cooperation. This approach was applied to CCUs through the analysis and the proposal of a new architecture [6]. We shall limit ourselves to explaining control board and analyzing the message management we support.

Critical Care↗
PubMed1993

Interrelationship between ultrasonography and biology in the diagnosis of polycystic ovarian syndrome.

In order to compare the diagnostic significance of hormonal and ultrasonic criteria of polycystic ovarian syndrome (PCOS), the presence or the absence of ultrasonographic and hormonal features of PCOS were recorded in a heterogeneous population of 90 women presenting with hyperandrogenism and/or menstrual disorders. On clinical and hormonal grounds exclusively, these patients could be separated into five diagnostic subgroups: presumed cases of PCOS (n = 21), idiopathic hirsutism (IH) (n = 26), hypothalamic anovulation (HA) (n = 11), hyperprolactinemia (HPRL) (n = 9), and miscellaneous or undetermined diagnosis (n = 23). By the means of a computed automatic classification of patients (cluster analysis) using five hormonal and ultrasonic criteria of PCOS, four homogeneous clusters of patients were obtained. Cluster #1 (25 patients) had the most characteristic profile of PCOS. It included 15 cases of PCOS and 7 cases of IH. Cluster #4 (47 patients) had the less characteristic profile of PCOS. It included the majority of patients with HA and HPRL and the half of the patients with IH. Cluster #2 included only two hyperandrogenic patients, who were massively obese and in whom ultrasonography may have failed to detect PCOS. Cluster #3 (16 patients) included patients from each diagnostic group, who were gathered together because ultrasonographic and hormonal features were, respectively, present and absent in nearly all of them. With the same analysis, the criteria of PCOS could be graded according to their grouping potential. The presence of an abnormal ovarian stroma by ultrasonography appeared as the most potent criterion. Elevated serum testosterone and androstenedione levels and the polyfollicular pattern of ovaries gave intermediate results, while elevated basal LH level was a much weaker grouping parameter. In conclusion, the automatic classification of patients by cluster analysis using both hormonal and ultrasonographic criteria revealed that the classical diagnostic classification, relying upon hormonal data exclusively, may arbitrarily separate patients having the same disease; and that ultrasonography affords pertinent information that should help provide a better diagnostic definition of PCOS.

Adolescent↗
PubMed1993

Platelet serotonin levels in alcoholic patients: changes related to physiological and pathological factors.

This study investigated platelet serotonin (5-hydroxytryptamine; 5-HT) levels and the effects of different physiological and pathological factors in 108 alcoholic patients (alcohol abuse, n = 49; alcohol dependence, n = 59) and 32 healthy control subjects. Platelet 5-HT levels were determined by a fluorescent-ortho-phthalaldehyde assay. In patients, platelet 5-HT levels during withdrawal from alcohol and after 2 weeks of abstinence were significantly lower than in control subjects. Among patients, this decrease was enhanced both in alcohol-dependent patients and in patients who were depressed during the withdrawal phase, whereas lifetime impulse control disorders (mostly found in alcohol abusers) were associated with comparatively high platelet 5-HT levels (i.e., close to control subjects' values). These results, which reflect the likely biphasic effect of alcohol ingestion upon 5-HT functioning, are consistent with the dimensional 5-HT hypothesis in psychiatric disorders.

Adolescent↗
PubMed1993

[Children and alcohol. A study in the school milieu].

Epidemiologic studies have consistently found that use of alcohol is increasing among teenagers and that children who have their first drink before the age of ten years are at increased risk for alcohol use during adolescence. In this study, a questionnaire was completed by 351 children (185 boys and 166 girls) aged 7 to 11 years in eight different schools in the Lille area (northern France). Most respondents (70.8%) reported previous experience with alcoholic beverages. Regular use of alcohol was reported by 8.7% of respondents and at least one episode of acute over-drinking by 23.6%. Attitudes towards alcohol and reasons for alcohol use varied across age groups. Use of alcohol produced guilt in the youngest children but was viewed as normal in the older age groups. Although some awareness of alcohol-related hazards was found, misconceptions were common. Use of alcohol was related to age and awareness: among the younger children, the level of awareness was significantly higher in regular users than in non-users, whereas the opposite was true in the older respondents. A positive correlation was found between current alcohol use and the children's predictions of future use. These data highlight the value of epidemiologic surveys for developing strategies aimed at preventing alcohol use in youngsters.

Alcohol Drinking↗
PubMed1992

Effects of beta-blocking drugs in alcohol withdrawal: a double-blind comparative study with propranolol and diazepam.

Alcohol withdrawal is associated with a decrease in gamma-aminobutyric acid neurotransmission. This explains the efficacy of benzodiazepines. However, an increase in adrenergic activity may also play a part in alcohol withdrawal symptoms, suggesting a potential efficacy of beta-blocking drugs. A double-blind comparative study of propranolol and diazepam was carried out in 28 patients suffering from moderate uncomplicated alcohol withdrawal. Patients were treated for 15 days with either 75 mg of propranolol or 30 mg of diazepam. The results show that both drugs at the dosages used are equipotent in reducing physical withdrawal symptoms and anxiety symptoms. This suggests that most likely the central as well as the peripheral effects determine the clinical usefulness of propranolol in the management of alcohol withdrawal. However, propranolol is ineffective in preventing major motor seizures, suggesting that different neurobiological mechanisms underlie the alcohol withdrawal symptoms.

Adrenergic beta-Antagonists↗