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The role of standards in a dynamic area.

It proves difficult to achieve a good measure of security in medical informatics applications. A number of reasons for this are analyzed. It is argued, that standardisation will help in solving this problem to a certain extent, but a more complete solution is possible when this is used in close conjunction with legal instruments (e.g. EU directives) and advice of a less strict nature, like guidelines. On the whole, a pragmatic step-by-step approach is needed, although there are signs that the general environment for these developments is improving.

Computer Literacy↗

The development of an approach to evaluate NHS manager's competence in medical informatics.

This paper describes the research and development of Checkpoint, a self-assessment instrument. It outlines how the instrument has helped managers in the NHS identify their strengths and weaknesses with respect to their management and use of informatics. The paper presents trends and feedback from the use of Checkpoint and the implications for future education and training of managers in the NHS.

Administrative Personnel↗

Preferences for different sources of information about cancer.

A wide range of cancer information resources is available to patients and their relatives, who are increasingly acting as independent learners. In order to examine preferences for different types of information and to establish the appropriateness of providing a Web-based cancer information resource (CancerHelp UK) a questionnaire survey was undertaken. Of 258 questionnaires distributed to patients attending for oncology outpatient or general practice appointments, 205 (80%) were suitable for analysis. 74% (95% confidence interval 68% to 80%) of participants wanted as much information as possible. All participants cited people most frequently as a future source of cancer information. All participants frequently cited television as a source of both general and cancer-specific information. Despite a lack of computer experience patients were significantly more likely than other groups to say that they would like to use the Web-based resource. It is suggested that such resources are likely to be increasingly well used, particularly by cancer patients, given the growth in health information on the Web and developments in delivery of digital information into the home via television.

Adult↗

Internet oncology: increased benefit and risk for patients and oncologists.

Whether the benefits will outweigh the risks of electronic health care remains to be seen, and to a large extent the question is moot; consumers, providers, and interested third parties have ensured its existence. One can surmise, or at least hope, that all interested parties will become increasingly sophisticated in both the delivery and consumption of e-health information, and that ultimately consumer, advocate, and physician demands will help shape the industry into a self-regulated entity that balances the need for high-grade information with a commitment to the principles of privacy and autonomy.

Computer Literacy↗

Computers and the pediatric surgeon: a primer.

Computers have become an integral part of surgical practice. To use and maintain computers effectively, the surgeon must have a basic knowledge of the inner workings of the computer. It also is helpful to understand how the systems have evolved. Medical computing started in the financial department of large hospitals. From there it expanded to clinical data systems. Coincident with the development of clinical data systems was the introduction of the IBM personal computer in 1981 and the development of the Internet. All these events led to the use of the personal computer as a communication tool. This will shape much of how we use computers in the coming millennium. The computer is made up of several component parts. The brain of the computer is the central processing unit (CPU), which performs all of the calculations in the computer. The CPU works in concert with the random access memory (RAM) and hardware peripherals to perform tasks as directed by a program. To use this increasingly complex tool effectively, the pediatric surgeon must have a basic knowledge of information systems. It is through this knowledge that information systems may be used to enhance the efficiency of pediatric surgical practice.

Child↗

Computer and information technology: hardware.

Computers open the door to an ever-expanding arena of knowledge and technology. Most nurses practicing in perianesthesia setting were educated before the computer era, and many fear computers and the associated technology. Frequently, the greatest difficulty is finding the resources and knowing what questions to ask. The following is the first in a series of articles on computers and information technology. This article discusses computer hardware to get the novice started or the experienced user upgraded to access new technologies and the Internet. Future articles will discuss start up and usual software applications, getting up to speed on the information superhighway, and other technologies that will broaden our knowledge and expand our personal and professional world.

Computer Communication Networks↗

Taming the silicon dragon.

This article is an introduction to how computers work. Although many can begin to use this tool without any formal knowledge of its components or how they work together, only a functional understanding of these aspects can really unleash the power and capabilities available and allow you to proceed without fear that some mysterious force will come up and "eat the data" or somehow cause some other damage to the system. Through an inspection of the terminology, anatomical dissection, and physiology of our imagined "silicon dragon," we can appreciate the qualities of the beast, dispell our fears, and take real control of this potentially awesome tool. Although the basic information is perforce, quite technical in nature, the article is meant both to be readable and also provide a reference for terms and concepts mentioned both elsewhere in this issue, as well as generally. It is especially useful to be refreshed on these terms and concepts when considering an initial purchase or upgrade of computer equipment.

Computer Literacy↗

Overview of computerized dietary assessment programs for research and practice in nutrition education.

Computerized dietary assessment programs are often used for nutrition education research and practice. This article provides an informal overview of 29 dietary assessment programs mentioned in the literature covered by MEDLINE from 1996 to 2003, along with the components and capabilities of these programs derived from additional sources as needed. According to the literature, the advantages of using computers for dietary assessment include standardization of the questioning sequence, fast and easy processing, immediate results, and increased flexibility. The disadvantages include the need for typing skills and computer literacy, as well as potential bias in the responses if an interviewer is required.

Diet↗

Information technology in ENT: are we ready to be 'Connected For Health'?

The NHS Connecting for Health agency continues to implement the national programme for information technology within the National Health Service (NHS). In preparation, NHS employees are being encouraged to develop their information technology skills via the European computer driving licence training course. A postal survey of British Association of Otorhinolaryngologists members was undertaken to evaluate their levels of information technology training, competency and knowledge. Three hundred and thirty-six surgeons responded. Most respondents had received no formal information technology training. Only 3.9 per cent had taken the European computer driving licence course. Most surgeons felt comfortable using word processing and presentation software but were less comfortable with other applications. Junior surgeons were more confident in all areas of information technology application than senior surgeons. Seventy-two per cent of surgeons wanted more information technology training. Most felt that such training should be routine at undergraduate and postgraduate level. With the national programme committed to improving information technology infrastructure within the NHS, more formal training should be provided to ensure a basic standard of information technology competency amongst ENT surgeons.

Adult↗

Support needed to create psychiatric advance directives.

Psychiatric advance directives (PADs) inform treatment during periods of compromised decision-making. We report consumer desire and need for support to create PADs among 106 adult outpatients with severe and persistent mental illness. PADs were completed using computer software and flexible peer support. All participants were able to complete PADs. However, nearly all participants needed support using the software, or clarification of PAD information. Types of support needed may vary depending on PAD creation methods. While one-third of participants wanted support from case managers to complete PADs, the appropriate level of clinician support is not clear-cut, and should be at consumers' discretion.

Adult↗

Internet experts' planning of explanations for laypersons: a Web experimental approach in the Internet domain.

How flexible are Internet experts in taking the perspective of laypersons? A Web experimental approach is presented that examines the Internet experts' perspective taking in planning explanations for laypersons. The Internet was the topic to be communicated and it also provided the means to implement the experimental method. Participants rated how extensively they would treat some specific concepts when explaining a topic such as the WWW. Independent variables were the addressee's intention, their level of domain knowledge, and the importance of the concepts to be evaluated. The results show that the experts preferred planning strategies that integrated all three types of information. Though their planning decisions were mainly guided by conceptual constraints, the Internet experts also took into account information about the addressee's intention and prior knowledge.

Adult↗

Computing facilities available to final-year students at 3 UK dental schools in 1997/8: their use, and students' attitudes to information technology.

OBJECTIVE: To identify computer facilities available in 3 dental schools where 3 different approaches to the use of technology-based learning material have been adopted and assess dental students' perception of their own computer skills and their attitudes towards information technology. DESIGN: Multicentre cross sectional by questionnaire. SUBJECTS: All 181 dental students in their final year of study (1997-8). RESULTS: The overall participation rate was 80%. There were no differences between schools in the students' self assessment of their IT skills but only 1/3 regarded themselves as competent in basic skills and nearly 50% of students in all 3 schools felt that insufficient IT training had been provided to enable them to follow their course without difficulty. There were significant differences between schools in most of the other areas examined which reflect the different ways in which IT can be used to support the dental course. CONCLUSIONS: 1. Students value IT as an educational tool. 2. Their awareness of the relevance of a knowledge of information technology for their future careers remains generally low. 3. There is a need to provide effective instruction in IT skills for those dental students who do not acquire these during secondary education.

Attitude↗

Information and communication technology among undergraduate dental students in Finland.

Use of information and communication technology (ICT) is rapidly increasing in medical and dental education. The aim of the present study was to determine the knowledge, skills and opinions of dental undergraduate students regarding ICT and to analyze possible shifts in the acquisition of these resources. For these purposes a survey of all undergraduate dental students at the University of Oulu, Finland, was conducted during the spring term 2000. All the students in the 5 years of study (n = 140) were asked to answer a questionnaire presented during a lecture or demonstration. An overall response rate of 95% was achieved. The frequencies and percentage distributions of the items were analyzed separately for each year (1-5). All the students in the faculty are provided with personal e-mail addresses at the beginning of their studies and special emphasis has been laid on the utilization of their ICT knowledge and skills. An overwhelming majority of the students, more than 95%, judged themselves to have good or satisfactory skills in word processing, but only a slight majority considered that they could manage some advanced operating system functions. Use of ICT services was high, as about 60% of the students used e-mail and one-third WWW services daily. Literature retrieval was widely employed, so that almost 80% of the students had used literature databases (including Ovid Medline and collections of electronic full-text articles), which were introduced and provided by the Medical Library when the students were in their second year. More than 50% had received educational material in electronic form often or sometimes, and almost 80% had communicated by e-mail with a faculty teacher. A clear trend (P < 0.05) was found for the younger students to use ICT services in general and for educational purposes more often than the older ones. In conclusion, e-mail and WWW have been widely adopted for both private and educational purposes by dental students in Finland and are employed together with WWW-based medical and dental publication databases. The younger students have more interest in ICT and better skills, which presents a challenge for dental education in the future.

Computer Literacy↗

Individual differences in spatial learning from computer-simulated environments.

A multivariate study examined relationships between the following factors: paper-and-pencil assessments of verbal and spatial ability, ability to form an accurate spatial representation of a large real-world environment, gender, computer attitudes and experience, proficiency with the navigational interface of a virtual environment (VE), and the ability to acquire and transfer spatial knowledge from a VE. Psychometrically assessed spatial ability and proficiency with the navigational interface were found to make substantial contributions to individual differences in the ability to acquire spatial information from a VE. Gender influenced many VE-related tasks, primarily through its relationship with interface proficiency and spatial ability. Measures of spatial knowledge of a VE maze were highly predictive of subsequent performance in a similar real-world maze, suggesting that VEs can be useful for training people about real-world spaces.

Adult↗