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Designing a patient care medication and recording system that uses bar code technology.

Bar code technology has been implemented in a variety of health care applications to facilitate computerized data entry. In this report, the author describes the potential application of a patient medication administration and recording system that uses bar code technology for data entry. The need for nursing to collaborate with pharmacy and information systems developers is discussed, and issues for consideration in the design of the medication system are outlined.

Drug Therapy

The evaluation of radioactive microsphere data: remarks on the use of the BMDP and SAS statistical software packages.

We investigated the suitability of BMDP and SAS as an integrated tool for the evaluation of regional blood flow data obtained from the radioactive microsphere technique. Both packages were applied to a recent study on muscle blood flow with a 3-factorial design. The organization of data and files, the strategy of data reduction, and the evaluation by means of statistical and graphical techniques are shown. The method may be applied to any microsphere study design. A considerable amount of time can be saved and data integrity may be improved. The statistical quality of the results may benefit from the broad spectrum of statistical tests available.

Algorithms

LaboImage: a workstation environment for research in image processing and analysis.

Numerous images are produced daily in biomedical research. In order to extract relevant and useful results, various processing and analysis steps are mandatory. The present paper describes a new, powerful and user-friendly image analysis system: LaboImage. In addition to standard image processing modules. LaboImage also contains various specialized tools. These multiple processing modules and tools are first introduced. A one-dimensional gel analysis method is then described. The new concept of 'normalized virtual one-dimensional gel' is introduced, making comparisons between gels particularly easy. This normalized gel is obtained by compensating for the bending of the lanes automatically; no information loss is incurred in the process. Finally, the model of interaction in a multi-window environment is discussed. LaboImage is designed to run in two ways: interactively, using menus and panels; and in batch mode by means of user-defined macros. Examples are given to illustrate the potentialities of the software.

Algorithms

A database of cardiac arrhythmias.

OBJECTIVE: To describe a database of cardiac arrhythmia recordings, useful for the development and testing of ECG rhythm processing or monitoring algorithms and devices. METHODS: The raw data were acquired within the Wisconsin-Dane County emergency medical technician-defibrillation program and contained emergency rhythm recordings of an average length of 30 minutes. The raw data were integrated into a software platform designed for the annotation and visualization of the recordings. RESULTS: Currently the database contains the following arrhythmia episodes: ventricular fibrillation (56), asystole (65), electromechanical dissociation (31), and other arrhythmias (42). The software, resident on personal computers, also can transmit any of the database recordings, through a digital-to-analog converter board, to a device under test. CONCLUSIONS: The database technique described will provide a useful means of objectively assessing electronic devices for their ability to detect arrhythmias. The database is unique in that it contains lengthy episodes of arrhythmias. The database will be extended to include additional cases.

Arrhythmias, Cardiac

Improving perinatal outcome through data management: the design of the small area analysis system.

The decentralization of health management requires that appropriate tools be developed for decision support at the local level. The Improved Pregnancy Outcome Data Management System (IPODM) was designed to enable health managers and physicians with little computer experience to access over 500 variables derived from United States Census and California Vital Statistics sources. Using an interactive format one can create datasets describing the sociodemographic composition and perinatal outcome of individuals residing in individual census tracts (or zip codes) and in aggregates of these basic units such as neighborhoods, health catchment areas, or municipal districts. IPODM allows one to analyze this information in terms of tables, plots, maps, and basic statistical procedures using an interactive format. This paper describes the system designed for the State of California and the principles that guided the design.

Database Management Systems

The design and implementation of a software system for clinical studies: an illustration based on the needs of a comprehensive cancer center.

A computerized system for the management of a clinical research database has been developed with several attractive features. This relational database management system allows for screen-driven data entry, data checking, system security, and report generation in a timely manner. In addition, the system is cost-effective in a number of ways: (1) development time is considerably reduced due to the inherent programming features of the software, (2) once developed the system can be maintained by nontechnical personnel thereby reducing personnel costs, (3) the system can be developed and maintained on a microcomputer system, and (4) the commercial software used in our system is periodically updated thereby assuring the user of state-of-the-art technology. Beyond the initial expenditures for hardware and software, no additional system costs are incurred. While this system, currently adopted by the Yale Comprehensive Cancer Center, represents an effective approach to handling the data-management needs of a large, single-institution cancer research center, the design and programming methodology can be readily adapted to other research settings.

Cancer Care Facilities

A shell program for the design of PCR primers using genetics computer group (GCG) software (7.1) on VAX/VMS systems.

A number of software analysis packages for the design of PCR primers are available for PCs; however, software for users that depend on VAX/VMS operating systems is not available. By treating oligonucleotides as RNA molecules, I have designed an alternative means toward studying oligonucleotide interactions using software that is currently available from The Genetics Computer Group (GCG, Madison, WI). The oligonucleotide interactions with self and non-self are analyzed by the GCG FOLD program, a program which finds a secondary structure of minimum free energy for an RNA molecule. This approach allows the identification of self-priming primer pairs, and the interaction energies provide a guideline for the prediction of optimal PCR primers.

Base Sequence

Mental dysfunction: a clinical pilot project in the elderly.

In recognizing that there will be an increase in the number of individuals with dementing illnesses well into the next century, the authors show how one institution is coping with this problem today. The authors outline an innovative approach to admission and discharge planning and monitoring of patients with irreversible dementias and behavioral problems. Nurses and other team members need a mechanism (ie, a flow chart) to monitor behavior and plot progress within an individualized program designed to meet the needs of dementia patients.

Aged

A model for database design.

Computerized databases can facilitate several types of occupational therapy research. The value and usefulness of any database, however, is dependent on how well it has been designed. In this paper, a systematic, sequential-process model for the development of a computerized database is introduced. Each component of the model is illustrated by examples of its application to the actual design of a database for a community agency that provides occupational therapy services. The model focuses on issues related to the development of the contents of a database rather than on computer hardware and software. The issues addressed by the model include decisions about the purpose of the database, selection of the variables, and identification of the most appropriate measures with which to operationalize these variables. Content-related development issues have been given little attention in the literature, yet their neglect typically results in important limitations on the usefulness of a database. Therefore, this paper provides a set of guidelines for occupational therapists planning to establish a database for facilitating research.

Databases, Factual

Computerized Anesthesia Personnel System.

CAPS, (Computerized Anesthesia Personnel System), is a personnel management system for a large anesthesia department. It is written in BASIC for the IBM PC or IBM-compatible computer using 2 or more 5 1/4 inch disk drives or a hard disk. CAPS is designed to facilitate assignment of up to 30 attending anesthesiologists, 40 residents, 15 CRNAs, 5 interns, 5 anesthesia assistants, and up to 15 medical students to the operating room schedule. The system supports part-time personnel, regular laboratory/office/reading days, and resident rotations inside the operating suite, outside the operating suite, and to secondary hospitals. CAPS generates an availability list each day, listing all persons available for the operating room and the rotations and call days assigned. It then lists all persons not available that day and the reason for the absence. CAPS also tracts vacation, meeting, administrative and compensatory time for all members of the department, and maintains an absence record for each person listing sick times and all other absences. CAPS generates a weekly staffing list showing days each person is available to the operating room and the total number of attendings, residents, CRNAs, and assistants available each day. This article discusses why the program was developed, how it was designed, and how well it has met the objectives of the designers.

Anesthesia Department, Hospital

Fundamentals of computerised data acquisition in the human performance laboratory.

Researchers of the future will depend upon computer technology to address questions that previously could not be answered using traditional methods of data acquisition. Recent advances in computer design and software availability have eliminated many of the limitations previously associated with computer use in the laboratory setting. Although computerisation facilitates the acquisition of laboratory data, identification of errors introduced into the measurement is often more difficult. The laboratory computer is only one component of an automated data acquisition system. A system designed to collect physiological data comprises several primary components, including: (a) sensing element; (b) signal amplification/conditioning circuits; (c) analogue display; (d) computer interface; (e) laboratory computer; and (f) acquisition software. The acquisition and conditioning of analogue signals is accomplished using traditional laboratory procedures familiar to the researcher. Converting this analogue signal into a digital format used by the computer, however, represents new techniques. Fundamentals of computerised data acquisition are discussed. An understanding of how an automated data acquisition system is configured and the techniques used to transform the values will assist the user in identifying sources of error introduced into the measurement. Additionally, familiarization with the methods of computerisation will provide insight into future applications of computer technology in the human performance laboratory.

Analog-Digital Conversion