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At least 199 records · Page 11Linked to original sources
PubMed2005

Predictors of failed attendances in a multi-specialty outpatient centre using electronic databases.

BACKGROUND: Failure to keep outpatient medical appointments results in inefficiencies and costs. The objective of this study is to show the factors in an existing electronic database that affect failed appointments and to develop a predictive probability model to increase the effectiveness of interventions. METHODS: A retrospective study was conducted on outpatient clinic attendances at Tan Tock Seng Hospital, Singapore from 2000 to 2004. 22864 patients were randomly sampled for analysis. The outcome measure was failed outpatient appointments according to each patient's latest appointment. RESULTS: Failures comprised of 21% of all appointments and 39% when using the patients' latest appointment. Using odds ratios from the mutliple logistic regression analysis, age group (0.75 to 0.84 for groups above 40 years compared to below 20 years), race (1.48 for Malays, 1.61 for Indians compared to Chinese), days from scheduling to appointment (2.38 for more than 21 days compared to less than 7 days), previous failed appointments (1.79 for more than 60% failures and 4.38 for no previous appointments, compared with less than 20% failures), provision of cell phone number (0.10 for providing numbers compared to otherwise) and distance from hospital (1.14 for more than 14 km compared to less than 6 km) were significantly associated with failed appointments. The predicted probability model's diagnostic accuracy to predict failures is more than 80%. CONCLUSION: A few key variables have shown to adequately account for and predict failed appointments using existing electronic databases. These can be used to develop integrative technological solutions in the outpatient clinic.

Adult↗
PubMed2005

Development and implementation of a Clerkship Counseling Hotline.

BACKGROUND: The 3rd year of medical school is stressful, yet students may hesitate to access their school's mental health services. DESCRIPTION: We instituted the Clerkship Counseling Hotline, an anonymous, 24-hour cell phone hotline staffed by an independent counselor. EVALUATION: Hotline calls were logged, and students were surveyed regarding the hotline. Seventeen students called the hotline 25 times during the year. Callers' concerns included disillusionment with medicine, anxiety over performance, and personal problems. The hotline did not reduce overall student stress compared with the 3rd-year classes preceding the hotline. However, 75% said continuing the hotline was important, and 75% found the hotline's availability reassuring. CONCLUSION: A clerkship counseling hotline may enhance medical schools' mental health resources.

Clinical Clerkship↗
PubMed2006

Unfair trade: e-waste in Africa.

Africa is quickly becoming a destination for information technology in the form of tons of used computers, fax machines, cell phones, and other electronics. Although many of these machines can be repaired and resold, up to 75% of the electronics shipped to Africa is junk. This equipment, when dumped, may leach lead, mercury, and cadmium into the environment; when burned, it may release carcinogenic dioxins and polyaromatic hydrocarbons. In the United States, activists are working to limit the flow of e-waste to developing countries through international agreements and voluntary e-waste export reduction efforts.

Africa↗
PubMed2005

Microwaves from GSM mobile telephones affect 53BP1 and gamma-H2AX foci in human lymphocytes from hypersensitive and healthy persons.

The data on biologic effects of nonthermal microwaves (MWs) from mobile telephones are diverse, and these effects are presently ignored by safety standards of the International Commission for Non-Ionizing Radiation Protection (ICNIRP). In the present study, we investigated effects of MWs of Global System for Mobile Communication (GSM) at different carrier frequencies on human lymphocytes from healthy persons and from persons reporting hypersensitivity to electromagnetic fields (EMFs). We measured the changes in chromatin conformation, which are indicative of stress response and genotoxic effects, by the method of anomalous viscosity time dependence, and we analyzed tumor suppressor p53-binding protein 1 (53BP1) and phosphorylated histone H2AX (gamma-H2AX), which have been shown to colocalize in distinct foci with DNA double-strand breaks (DSBs), using immunofluorescence confocal laser microscopy. We found that MWs from GSM mobile telephones affect chromatin conformation and 53BP1/gamma-H2AX foci similar to heat shock. For the first time, we report here that effects of MWs from mobile telephones on human lymphocytes are dependent on carrier frequency. On average, the same response was observed in lymphocytes from hypersensitive and healthy subjects.

Adult↗
PubMed2005

Use of electronic technologies by people with intellectual disabilities.

Today's electronic technologies, including computers, cell phones, Internet, and electronic organizers, hold great promise for individuals with intellectual disabilities, yet little research has been conducted to explore patterns of use among this population. Drawing upon a survey of 83 adults with intellectual disabilities, we examined factors affecting use for three key electronic technologies: computer, Internet, and electronic organizers. Forty-one percent of participants used a computer; 25%, the Internet; and 11%, electronic organizers. Age, work setting, and self-perceived ability to manually copy information affected likelihood of use. Primary barriers reported by participants included lack of access, training and support, and expense of technologies. Interest in using such technologies was high, and participants offered suggestions for improved accessibility.

Adolescent↗
PubMed2002

[Patient monitoring after discharge by teleconsultation].

The Televisite application is a post-stationary consulting method, whose main aim is to reduce the treatment time of inpatients. It provides a high quality home consultation after the patient has been discharged from the hospital. The technical handling and the validity of the new method of caring will be analysed--particularly the human-machine interface. In a prospective study case injured patients were attend using the Televisite. For communications with the consulting doctor they were supplied with a high resolution digital camera and a mobile PC with an integrated HCSCD cell phone. The doctor examined the data transmitted by the patient and remotely consulted the patient using the Televisite. Through a simple self-explaining user interface, a smooth information transfer was guaranteed.

Computer Systems↗
PubMed2004

Government and private insurance medical programs as well as MDVIP, an update.

On November 19,1945, President Truman outlined a Prepaid Medical Insurance Plan for all people through the Social Security System. Because of its comprehensive nature, it was coined "National Health Insurance." On July 30,1965, President Johnson signed the Medicare and Medicaid bill (Title XVII and Title XIX of the Social Security Act). Today, many groups of people are covered by Medicaid. However, there are strict requirements that may vary from state to state. Medicare offers the following types of medical heath care plans to include the original Medicare plan that is a "fee for service" plan. The individual may stay in the original plan unless he/she chooses to join a Medicare+ Choice Plan or a Medigap Plan. Most individuals will receive Medicare Part A when they are 65 without paying a premium because it has been deducted annually through their tax payments before the age of 65. Medicare Part A helps pay for the following: inpatient hospital care, skilled nursing facility, hospice care, and some home health care. Medicare Part B, however, must be paid by the individual through premiums to the Federal government. Medicare Part B medical insurance pays for doctors' services, outpatient services, and some other services that Medicare Part A doesn't cover. In an effort to supplement one's health care coverage, the individual may select either a Medicare+ Choice Plan or a Medigap Policy. The Medicare+ Choice Plan has four different types: Medicare Managed Care Plans, Medicare Private Fee for Service Plan, Medicare Preferred Provider Plans, and Medicare Specialty Plans. If one selects a Medigap policy, one may choose either a Medigap SELECT Policy or the standard Medigap policy. The front of a Medigap Policy must clearly identify it as a "Medicare Supplement Insurance." One must be carefully advised of the selection of the Medigap Policy. The Medicare Part B has a wide range of preventative services, including tests for breast cancer, cervical cancer, vaginal cancer, and colorectal cancer; bone mass measurements; diabetes monitoring and diabetes self-management; flu, pneumonia, Hepatitis B shots, and prostate cancer screening tests. It is important to emphasize that Medicare and Medicare supplemental insurance policies do not pay for home health care, such as durable medical equipment. Because of the enormous complexity of the wide variety of health insurance plans and their billing strategies, many physicians are electing to charge their patients an additional fee for being part of their practice. In return for their annual fee, their patients receive immediate cell phone access to their doctor 24 hours a day, 7 days a week. In addition, they receive same-day appointments and on-time appointments. They also spend as much time with their doctors as they wish. It is not surprising that there is growing evidence that the privately insured patient with a life-threatening illness will live longer than those individuals who have the same disease but have public insurance only. Legislatures are well aware of this crisis in medical care that must be corrected immediately.

Aged↗
PubMed2003

Lack of genotoxic effects (micronucleus induction) in human lymphocytes exposed in vitro to 900 MHz electromagnetic fields.

In the present study, we investigated the induction of genotoxic effects in human peripheral blood lymphocytes after exposure to electromagnetic fields used in mobile communication systems (frequency 900 MHz). For this purpose, the incidence of micronuclei was evaluated by applying the cytokinesis-block micronucleus assay. Cytotoxicity was also investigated using the cytokinesis-block proliferation index. The experiments were performed on peripheral blood from 20 healthy donors, and several conditions were tested by varying the duration of exposure, the specific absorption rate (SAR), and the signal [continuous-wave (CW) or GSM (Global System of Mobile Communication) modulated signal]. The following exposures were carried out: (1) CW intermittent exposure (SAR = 1.6 W/kg) for 6 min followed by a 3-h pause (14 on/off cycles); (2) GSM signal, intermittent exposure as described in (1); (3) GSM signal, intermittent exposure as described in (1) 24 h before stimulation with phytohemagglutinin (8 on/off cycles); (4) GSM signal, intermittent exposure (SAR = 0.2 W/kg) 1 h per day for 3 days. The SARs were estimated numerically. No statistically significant differences were detected in any case in terms of either micronucleus frequency or cell cycle kinetics.

Adult↗
PubMed2003

Effects of in vivo exposure to GSM-modulated 900 MHz radiation on mouse peripheral lymphocytes.

The aim of this study was to evaluate whether daily whole-body exposure to 900 MHz GSM-modulated radiation could affect spleen lymphocytes. C57BL/6 mice were exposed 2 h/day for 1, 2 or 4 weeks in a TEM cell to an SAR of 1 or 2 W/kg. Untreated and sham-exposed groups were also examined. At the end of the exposure, mice were killed humanely and spleen cells were collected. The number of spleen cells, the percentages of B and T cells, and the distribution of T-cell subpopulations (CD4 and CD8) were not altered by the exposure. T and B cells were also stimulated ex vivo using specific monoclonal antibodies or LPS to induce cell proliferation, cytokine production and expression of activation markers. The results did not show relevant differences in either T or B lymphocytes from mice exposed to an SAR of 1 or 2 W/kg and sham-exposed mice with few exceptions. After 1 week of exposure to 1 or 2 W/kg, an increase in IFN-gamma (Ifng) production was observed that was not evident when the exposure was prolonged to 2 or 4 weeks. This suggests that the immune system might have adapted to RF radiation as it does with other stressing agents. All together, our in vivo data indicate that the T- and B-cell compartments were not substantially affected by exposure to RF radiation and that a clinically relevant effect of RF radiation on the immune system is unlikely to occur.

Animals↗
PubMed2004

Measurement of DNA damage and apoptosis in Molt-4 cells after in vitro exposure to radiofrequency radiation.

To determine whether exposure to radiofrequency (RF) radiation can induce DNA damage or apoptosis, Molt-4 T lymphoblastoid cells were exposed with RF fields at frequencies and modulations of the type used by wireless communication devices. Four types of frequency/modulation forms were studied: 847.74 MHz code-division multiple-access (CDMA), 835.62 MHz frequency-division multiple-access (FDMA), 813.56 MHz iDEN(R) (iDEN), and 836.55 MHz time-division multiple-access (TDMA). Exponentially growing cells were exposed to RF radiation for periods up to 24 h using a radial transmission line (RTL) exposure system. The specific absorption rates used were 3.2 W/kg for CDMA and FDMA, 2.4 or 24 mW/kg for iDEN, and 2.6 or 26 mW/kg for TDMA. The temperature in the RTLs was maintained at 37 degrees C +/- 0.3 degrees C. DNA damage was measured using the single-cell gel electrophoresis assay. The annexin V affinity assay was used to detect apoptosis. No statistically significant difference in the level of DNA damage or apoptosis was observed between sham-treated cells and cells exposed to RF radiation for any frequency, modulation or exposure time. Our results show that exposure of Molt-4 cells to CDMA, FDMA, iDEN or TDMA modulated RF radiation does not induce alterations in level of DNA damage or induce apoptosis.

Apoptosis↗
PubMed2005

Expression of the proto-oncogene Fos after exposure to radiofrequency radiation relevant to wireless communications.

In this study the expression levels of the proto-oncogene Fos were measured after exposure to radiofrequency (RF) radiation at two relatively high specific absorption rates (SARs) of 5 and 10 W/kg for three types of modulated signals: 847.74 MHz code division multiple access (CDMA), 835.62 MHz frequency division multiple access (FDMA), and 836.55 MHz time division multiple access (TDMA). This work was undertaken to confirm a previous report by Goswami et al. (Radiat. Res. 151, 300-309, 1999) that CDMA and FDMA radiation caused small but statistically significant increases in Fos levels as cells entered plateau phase during exposure. No effects on Myc or Jun levels were observed in that study. Therefore, in the present study, analyses were restricted to Fos expression during the transition from exponential growth to plateau phase. Fos expression was measured using the real-time polymerase chain reaction (RT-PCR) technique. Serum-stimulated C3H 10T(1/2) cells were used as a positive control for Fos expression. Possible influences of final cell number or pH variability on Fos expression were evaluated. Expression of Fos mRNA in C3H 10T(1/2) cells was not significantly different from that found after sham exposure at either SAR level for any signal modulation. Therefore, the results of Goswami et al. could not be confirmed.

Animals↗
PubMed2006

Effects of GSM-modulated radiofrequency electromagnetic fields on B-cell peripheral differentiation and antibody production.

We examined the effects of in vivo exposure to a GSM-modulated 900 MHz RF field on B-cell peripheral differentiation and antibody production in mice. Our results show that exposure to a whole-body average specific absorption rate (SAR) of 2 W/kg, 2 h/day for 4 consecutive weeks does not affect the frequencies of differentiating transitional 1 (T1) and T2 B cells or those of mature follicular B and marginal zone B cells in the spleen. IgM and IgG serum levels are also not significantly different among exposed, sham-exposed and control mice. B cells from these mice, challenged in vitro with LPS, produce comparable amounts of IgM and IgG. Moreover, exposure of immunized mice to RF fields does not change the antigen-specific antibody serum level. Interestingly, not only the production of antigen-specific IgM but also that of IgG (which requires T-B-cell interaction) is not affected by RF-field exposure. This indicates that the exposure does not alter an ongoing in vivo antigen-specific immune response. In conclusion, our results do not indicate any effects of GSM-modulated RF radiation on the B-cell peripheral compartment and antibody production and thus provide no support for health-threatening effects.

Animals↗
PubMed2003

How adolescents use technology for health information: implications for health professionals from focus group studies.

BACKGROUND: Adolescents present many challenges in providing them effective preventive services and health care. Yet, they are typically the early adopters of new technology (eg, the Internet). This creates important opportunities for engaging youths via eHealth. OBJECTIVE: To describe how adolescents use technology for their health-information needs, identify the challenges they face, and highlight some emerging roles of health professionals regarding eHealth services for adolescents. METHODS: Using an inductive qualitative research design, 27 focus groups were conducted in Ontario, Canada. The 210 participants (55% female, 45% male; median age 16 years) were selected to reflect diversity in age, sex, geographic location, cultural identity, and risk. An 8-person team analyzed and coded the data according to major themes. RESULTS: Study participants most-frequently sought or distributed information related to school (89%), interacting with friends (85%), social concerns (85%), specific medical conditions (67%), body image and nutrition (63%), violence and personal safety (59%), and sexual health (56%). Finding personally-relevant, high-quality information was a pivotal challenge that has ramifications on the depth and types of information that adolescents can find to answer their health questions. Privacy in accessing information technology was a second key challenge. Participants reported using technologies that clustered into 4 domains along a continuum from highly-interactive to fixed information sources: (1) personal communication: telephone, cell phone, and pager; (2) social communication: e-mail, instant messaging, chat, and bulletin boards; (3) interactive environments: Web sites, search engines, and computers; and (4) unidirectional sources: television, radio, and print. Three emerging roles for health professionals in eHealth include: (1) providing an interface for adolescents with technology and assisting them in finding pertinent information sources; (2) enhancing connection to youths by extending ways and times when practitioners are available; and (3) fostering critical appraisal skills among youths for evaluating the quality of health information. CONCLUSIONS: This study helps illuminate adolescent health-information needs, their use of information technologies, and emerging roles for health professionals. The findings can inform the design and more-effective use of eHealth applications for adolescent populations.

Adolescent↗
PubMed1997

Caught in the Web. Combating work stress in the information age.

The computer, the fax, the cell phone, the pager--all the trappings of the information age--cause much stress in the workplace. Mastering these gadgets--knowing how and when to use them and dealing with the barrage of messages generated by them--is essential to maintaining workplace sanity.

Clinical Laboratory Information Systems↗
PubMed1999

[Recent data from the literature on the biological and pathologic effects of electromagnetic radiation, radio waves and stray currents].

Electromagnetic radiation is present in increasing amounts in our environment, and its potential effects on human (and animal) health has been investigated. It remains unclear whether the risk of acute childhood leukemia is associated with cumulative exposure to magnetic fields. An association with brain cancer and colon cancer has been suggested in electrical company workers. The radars used by police departments may increase the incidence of cancer. Electromagnetic radiation may play a role in a number of disorders such as depression and memory loss. It has been established that cell phones interfere with pacemakers only if direct contact occurs and have no effect if held in their normal position. Interferences have been reported between pacemakers and shop-lifting detectors.

Adult↗
PubMed2001

Blirtatiousness: cognitive, behavioral, and physiological consequences of rapid responding.

The Brief Loquaciousness and Interpersonal Responsiveness Test (BLIRT) measures the extent to which people respond to others quickly and effusively. The BLIRT displays desirable psychometric properties and distinguishes people who should theoretically score high (e.g., car salespersons) from those who should score low (e.g., librarians). Scores on the scale predict (a) the amount and rapidity of people's verbal responses in an unstructured interaction, (b) how likable and competent people's classmates perceive them to be early in the semester, (c) how quickly people respond to an obnoxious cell-phone user and how physiologically aroused they become, and (d) how quickly and emphatically people respond to a series of personal insults as well as their degree of physiological arousal. Converging evidence indicates that blirtatiousness is unique in its ability to amplify people's qualities, making these qualities more readily observable to perceivers.

Adolescent↗
PubMed2001

The role of driver distraction in crashes: an analysis of 1995-1999 Crashworthiness Data System Data.

Five years (1995-1999) of national Crashworthiness Data System (CDS) data are analyzed to determine the role of driver distraction in traffic crashes and the specific sources of this distraction. Results show that 8.3 percent of the drivers were distracted at the time of their crash; after adjustment for the large percentage of drivers with unknown distraction status, the percentage rose to 12.9 percent. The most frequently cited sources of driver distraction were persons, objects or events outside the vehicle (29.4% of distracted drivers), adjusting the radio, tape or CD player (11.4%), and other occupants in the vehicle (10.9%). Other specific distractions (moving objects in vehicle, other objects brought into vehicle, adjusting vehicle or climate controls, eating and drinking, cell phones, and smoking) were each cited in only one to four percent of the cases. The likelihood of being distracted and the source of distraction varied by driver age but not by gender. Results are discussed in light of the limitations inherent in the CDS and other crash data, and the need for expanded data collection initiatives.

Accidents, Traffic↗