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Teledermatology and teledermatopathology.

Teledermatology is in essence an application of clinical telemedicine that deals with the practice of dermatology via the latest communication and information technology. As with other telemedicine applications, the goal is to provide the highest quality of dermatologic care more efficiently by moving patient information rather than the patient. Teledermatopathology, on the other hand, is a nonclinical telemedicine application specifically relating to diagnosis of cutaneous histologic specimens. There are numerous articles evaluating diagnostic concordance of teledermatology. However, because of a lack of a "true" gold standard, most published studies have compared diagnostic capabilities of teledermatology to our traditional face-to-face evaluations. Although the diagnostic correlation varies from study to study, most experts agree that Store and Forward and real-time video teleconferencing teledermatology is as clinically effective as a face-to-face consultation, which is less than 100% accurate. Teledermatopathology is showing similar potential, but because of the limitations on sampling error and the high cost of the alternative, robotic remote telepathology units, its acceptance into our daily practice has been delayed. This article focuses mainly on Store and Forward Teledermatology given its significant advantage and reviews the literature on teledermatology and teledermatopathology's diagnostic concordance and acceptance.

Attitude of Health Personnel↗

Cyberinfrastructure: empowering a "third way" in biomedical research.

Biomedicine has experienced explosive growth, fueled in parts by the substantial increase of government support, continued development of the biotechnology industry, and the increasing adoption of molecular-based medicine. At its core, it is composed of fiercely independent, innovative, entrepreneurial individuals, organizations, and institutions. The field has developed unprecedented capacity to characterize biologic systems at their most fundamental levels with the use of tools and technologies almost unimaginable a generation ago. Biomedicine is at the precipice of unlocking the very essence of biologic life and enabling a new generation of medicine. Development and deployment of cyberinfrastructure may prove to be on the critical path to obtaining these goals.

Biomedical Research↗

Hospice care and patients' pain: communication between patients, relatives, nurses and doctors.

This article describes a study that sought to assess how patients, relatives, doctors and nurses in a palliative care unit viewed pain and pain management, and how standards and expectations for pain relief can be raised by upholding statements of care and agreed partnership values. The results showed that research-based pain management enables the provision of pain control that is acceptable to patients, relatives, doctors and nurses. By valuing patient-centred care, where assessment tools assist communication and information sharing, a partnership of care is established in which patient and professional autonomy are recognized and respected, international recommendations for pain relief are practised and professional codes of conduct upheld. Good pain management requires accurate assessment that is best achieved by open and honest discussion in a supportive environment. Hospices provide specialist symptom control aimed at improving quality of life for patients with advanced disease. They are not only an ideal setting to provide evidence for practice, but also a learning environment for specialist understanding of symptom control and a resource base for other professionals.

Attitude of Health Personnel↗

School of nursing sponsorship of a school-based health center: challenges and barriers.

School-based health centers (SBHCs) are a growing phenomenon in the United States and appear to be an ideal fit for school of nursing (SON) sponsorship. However, nationally only about 6% of existing SBHCs are sponsored by either an SON or a school of medicine. Sponsorship of health care in schools is consistent with the mission of university-based SONs, but also presents many challenges. Despite these challenges, the authors believe that the benefit to nursing students, faculty, and the profession far outweigh constraints. This article describes the many benefits that can occur when SONs create and maintain a SBHC in their own community. Extensive practical suggestions for how to overcome the barriers that constrain university faculty from developing service-oriented programs in the community are also emphasized.

Adolescent↗

Interface management: effective communication to improve process safety.

Failure to successfully communicate maintenance activities, abnormal conditions, emergency response procedures, process hazards, and hundreds of other items of critical information can lead to disaster, regardless of the thoroughness of the process safety management system. Therefore, a well-functioning process safety program depends on maintaining successful communication interfaces between each involved employee or stakeholder and the many other employees or stakeholders that person must interact with. The authors discuss a process to identify the critical "Interfaces" between the many participants in a process safety management system, and then to establish a protocol for each critical interface.

Chemical Industry↗

Bridging the gap between molecular epidemiologists and evolutionists.

Molecular epidemiology designates the various molecular methods that aim to identify the relevant units of analysis of pathogens involved in transmissible diseases: species, subspecies, strains, clones and genes of interest. It is frequently based on an empirical approach. I advocate that evolutionary concepts enrich this discipline considerably and should be considered as an integral part. In turn, the experience and questioning of field experts are crucial to evolutionists who use transmissible diseases as models. A molecular epidemiology aim gives evolutionary studies a practical goal, putting a stop to approaches that are overly speculative.

Animals↗

CSCW-based system development methodology for health-care information systems.

Health-care organizations are now moving toward integrated delivery systems to provide high-quality care, as they are being held to an ever-increasing scope of accountabilities. Distributed applications such as telemedicine and electronic patient records (EPR) are seen as key requirements for the future to deliver cost effective and high-quality health-care services. This initiative would provide dynamic environments for health professionals to access patient information and thereby increase the decision-making capacities on patient care procedures. Although telemedicine applications and EPR contribute to the improvement of healthcare services, poor communication mechanisms and practices negatively impact on quality of service (QoS) in teamwork environments of patient care. Awareness and responsiveness are becoming important factors in dynamic group collaborative work environments in healthcare facilities. This paper reports on a detailed case study of group communication patterns in a patient service environment. Further, an ethnographic approach that addresses group communications patterns, identifies tools and techniques in light of Computer-Supported Collaborative Work (CSCW), which requires the application of a number of disciplines including sociology, organizational science, psychology, and computer science. In cooperative work environments, it is important to understand the activities of others for human interaction and communication in general. This is very important for future development of CSCW-based distributed architectures that focus on the challenges of improving QoS in healthcare environments.

Computer Communication Networks↗