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PubMed2004

Monitoring mortality in general practice in Grampian, Scotland.

Information on the distribution of mortality and morbidity in general practice is scarce, and not easily accessible either by health authorities or individual general practices. Although the assessment of population mortality is a standard public health measure, colleagues in public health, information sciences and general practice rarely undertake such activity related to general practice populations. Mortality information can be used for various purposes. Examples are providing background data for clinical audits or alerting practitioners to quality issues in the healthcare industry or even suggesting environmental hazards. We measured the experience of mortality in all generally practices in Grampian in the years 1991 to 1999. All practices were notified of their actual and expected mortality over this period of time and asked for comment. Only three general practices had excess mortality experience in both the periods 1991 to 1995 and 1996 to 1999. Only a minority of practices commented on the results. It appears that a high presence of nursing homes in a practice might skew the results; this phenomenon will be central to further inquiry. Future methodology for recording death in general practice should take account of this, as well as providing an account of the qualitative aspects of patients' need for a dignified satisfactory death.

Adolescent↗

PubMed1999

Theories for practitioners: two frameworks for studying consumer health information-seeking behavior.

Consumer health information studies in library and information science (LIS) are typically not grounded within a theoretical framework. This article explains the importance of theory to LIS research in general, and the specific value of using theories from other disciplines to study consumers' health information-seeking behavior. The argument is supported with two examples: Miller's psychological theory of blunting and monitoring behavior and Granovetter's sociological theory of the strength of weak ties. These theories can be applied by practitioner-researchers to investigate a variety of research problems.

Adaptation, Psychological↗

PubMed1998

Innovative informatics education: aligning theory and practice through strategic partnership.

The University of Victoria School of Health Information Science (HINF) and The Toronto Hospital (TTH) have formed a strategic partnership to align current information management theory with practical experience. The fourth year undergraduate course in Information Management and Technology was redesigned to include a joint research project with TTH. Staff from TTH were paired with groups of 2-3 students to explore current information management issues. Technology such as electronic mail and conference calls enabled timely communication. Final results were presented via video conference at the end of the term and jointly graded by the professor and hospital staff. Over the three years, a variety of projects have been undertaken and the approach has been refined. Each year offered new insight to both students and staff. Findings include several key success factors: senior level support, early planning, timely communication, access to technology, and opportunity for staff and student feedback. This partnership offers strategic advantages to both organizations in innovation, mutual learning, recruiting, and partnership. Next steps include expansion of the project to a regional model and seminars on current information management topics for TTH staff.

Canada↗

PubMed2002

Low level laser therapy for treating tuberculosis.

BACKGROUND: The main treatment for tuberculosis is antituberculous drugs. Low energy laser therapy is used as an adjunct to antituberculous drugs, predominantly in the former Soviet Union and India. OBJECTIVES: To assess the benefits and harms of low level laser therapy for treating tuberculosis in randomized and quasi-randomized controlled trials. To seek information about potential benefits or harms from observational studies. SEARCH STRATEGY: We searched the Cochrane Infectious Diseases Group specialized trials register (up to June 2001), the Cochrane Controlled Trials Register (Issue 1, 2001), MEDLINE (1966 to December 2001), EMBASE (1988 to December 2001), CINAHL (up to November 2001), PEDro (up to November 2001), the Science Citation Index (up to December 2001), National Centre for Science Information at the Indian Institute of Science (15 April 2002), electronic catalogue of the Central Medical Library (Moscow; 1988 to January 2002), the internet using 'Google' (21 January 2002), and reference lists of articles. We contacted relevant organizations and researchers. SELECTION CRITERIA: (1) Randomized and quasi-randomized controlled trials comparing low level laser therapy with no low level laser therapy in people with tuberculosis. We also conducted a subsidiary analysis of of the potential benefits and harms from observational studies. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. We contacted study authors for additional information. Adverse event information was collected from the studies. MAIN RESULTS: No randomized or quasi-randomized controlled trials met the inclusion criteria for the review. The potential benefits and harms from 29 observational studies involving over 3500 people are described. REVIEWER'S CONCLUSIONS: We have not identified any well designed trials using low level laser therapy (LLLT) to treat tuberculosis. Therefore, the use of LLLT to treat tuberculosis is not supported by reliable evidence.

Humans↗

PubMed2025

A content analysis of health-related epigenetic information in YouTube videos.

PURPOSE: This study aimed to explore how health-related epigenetic concepts are depicted in YouTube videos, a widely accessed platform for informal science education. As epigenetics becomes increasingly relevant to medical therapeutics, it is essential to understand what information is being disseminated in the public sphere. METHODS: We conducted a content analysis of 296 YouTube videos about epigenetics that were under 10 minutes in length. We transcribed and analyzed the videos using an iteratively developed codebook and then categorized relevant codes as categories. RESULTS: We identified 7 categories: (1) defining epigenetics, (2) causes of epigenetic changes, (3) effects of epigenetic change, (4) epigenetic inheritability, (5) application of epigenetics, (6) personal control, and (7) epigenetic mysticism. Although the content about the molecular epigenetic mechanisms mostly aligned with the latest scientific findings, there were numerous unsubstantiated and exaggerated claims about effects of epigenetics on human health, especially disease outcomes. CONCLUSION: We identified several scientific concepts described on YouTube regarding epigenetics. Our findings also reveal what information about epigenetics is widely shared in the public sphere, helping to identify key misconceptions to address and guiding the development of strategies for accurate scientific communication.

Humans↗

PubMedDate not supplied

An evaluation of the Postgraduate Diploma of Applied Science in Health Information Management.

Thirty-six students have graduated with a Graduate Diploma of Applied Science (Health Information Management) from the University of Sydney since the course was introduced in 1992. A survey of graduates was conducted to examine the extent to which they believed the course had provided them with sufficient knowledge and skills to become effective health information management practitioners. Options for changes to the course were also explored in the questionnaire. The results demonstrated that graduates strongly supported the existing curriculum. Increased opportunities for practical experience were suggested by many respondents. There was not strong support for an option to increase the length of the course. However, the option to commence study in January and undertake some classes in the inter-semester break was viewed positively by 68% of the graduates.

Attitude of Health Personnel↗

PubMedDate not supplied

Trends in computational biology: a summary based on a RECOMB plenary lecture, 1999.

Computational biology, a term coined from analogy to the role of computing in the physical sciences, is now coming into its own as a major element of contemporary biological and biomedical research. Information science and computational science provide essential tools for next generation biological science efforts, from focusing the direction of experimental studies to providing knowledge and insight that can not otherwise be obtained. Going beyond the revolution in biology reflected in the successes of the genome project and driven by the power of molecular biology techniques, computational approaches will provide an underpinning for the integration of broad disciplines for development of a quantitative systems approach to understanding the mechanisms in the life of the cell.

Cell Physiological Phenomena↗

PubMed1989

The medical information needs of internists and pediatricians at an academic medical center.

Medical information needs were examined in a survey of sixty-seven physicians selected from the faculty and housestaff at Johns Hopkins Hospital. A standardized questionnaire was administered personally by a medical informatics physician to collect data on information needs, attitudes, and previous experience with computers. The types of information most frequently required by both faculty and housestaff were treatment recommendations and differential diagnosis. The sources of reference information most commonly used were textbooks and colleagues. The information needs of housestaff differed significantly in several categories from those of faculty physicians. Housestaff more frequently needed information for patient care (P less than 0.05), and preferred the use of textbooks (P less than 0.01) and handbooks (P less than 0.001) as information sources. Faculty more frequently needed information for activities unrelated to patient care (P less than 0.01) and placed greater importance on basic science information (P less than 0.01). When asked to suggest references for online access, the respondents named 143 journals and textbooks, with journals overwhelmingly preferred over textbooks. Only one reference, the New England Journal of Medicine, was requested by a majority of the respondents. The importance of a broad understanding of physician information needs through improved data-collection techniques is discussed as a means of increasing the use of medical information systems.

Academic Medical Centers↗

PubMed1978

Health information for patients: The hospital library's role.

Libraries today, including most hospital-based patients' libraries, are involved only peripherally in providing patient health science information. Hospital libraries should collaborate with health professionals in getting health information to patients--along with the library's more traditional roles of providing recreational reading for patients and serving the informational needs of the physician and medical staff. The library should act as the center for educational materials and programs within the hospital. Many health agencies, health educators, physicians, and librarians have been discussing the need for patient health education, but there are few effectively organized or established education centers. This paper discusses an overview of patient health education and intellectural freedom, proposes a new role for the existing hospital library in patient health education, and suggests guidelines for establishing a patient education center.

Health Education↗

PubMed1991

Accuracy of telephone reference service in health sciences libraries.

Six factual queries were unobtrusively telephoned to fifty-one U.S. academic health sciences and hospital libraries. The majority of the queries (63.4%) were answered accurately. Referrals to another library or information source were made for 25.2% of the queries. Eleven answers (3.6%) were inaccurate, and no answer was provided for 7.8% of the queries. There was a correlation between the number of accurate answers provided and the presence of at least one staff member with a master's degree in library and information science. The correlation between employing a librarian certified by the Medical Library Association (MLA) and providing accurate answers was significant. The majority of referrals were to specific sources. If these "helpful referrals" are counted with accurate answers as correct responses, they total 76.8% of the answers. In a follow-up survey, five libraries stated that they did not provide accurate answers because they did not own an appropriate source. Staff-related problems were given as reasons for other than accurate answers by two of the libraries, while eight indicated that library policy prevented them from providing answers to the public.

Follow-Up Studies↗

PubMed1987

Using the computer to optimize human performance in health care delivery. The pathologist as medical information specialist.

The demands for information retrieval, processing, and synthesis placed on all providers of health care have increased dramatically in the last several decades. Although systems have been developed to capture charge-related data in support of cost reimbursement, there has been a conspicuous lack of attention paid to information tools to directly enhance the delivery of patient care. The termination of cost reimbursement, together with an increasing recognition of the problems inherent in current manual record-keeping systems, is creating a significant new focus on medical information. This change in focus requires a shift in systems orientation away from financial and departmentally centered systems and toward patient-centered approaches. There is thus increasing recognition of the need for a physician-level medical information specialist to serve as an institution's chief information officer, assuming responsibility for the collection, manipulation, and availability of all patient care-related data. By virtue of training, typical experience, hospital presence, and a noncompetitive position with the hospital's medical staff, the pathologist is uniquely suited for this position. To effectively perform this role, a variety of new specialized data management tools are becoming available. Integrated information systems, patient care management by exception, decision support tools, and, in the future, "artificial intelligence" assists can all be expected to become staples of pathology practice, especially impacting those pathologists who choose to be responsive to the new practice milieu of medical information science.

Artificial Intelligence↗

PubMed1993

Uses of diagnostic expert systems in clinical care.

The development and testing of computerized systems to assist in the diagnostic process is a time honored research activity in medical information science. The focus of the majority of the applications produced is on providing accurate diagnostic suggestions when appropriate clinical information is entered. We believe that diagnostic knowledge has a much wider range of uses than that of simply assigning diagnostic labels. Below we describe three applications which illustrate alternate uses for diagnostic systems. Applications that assist in data collection, assess the quality of medical reports, and extract relevant clinical data from natural language x-ray reports are discussed. We believe that more effort should be directed toward studying the use of diagnostic knowledge bases in processes that help plan diagnostic strategies, in quality assurance applications, and in processes that facilitate all aspects of medical communication.

Clinical Medicine↗

PubMed1993

What does the American Board of Surgery In-Training/Surgical Basic Science Examination tell us about graduate surgical education?

BACKGROUND: This research sought to identify the strengths and weakness in residents' basic science knowledge and, second, to determine whether they progressively improve in their abilities to recall basic science information and clinical management facts, to analyze cause-effect relationships, and to solve clinical problems. METHODS AND RESULTS: Basic science knowledge was assessed by means of the results of the January 1990 American Board of Surgery's In-Training/Surgical Basic Science Exam (IT/SBSE). Postgraduate year (PGY) 1 residents' scores were compared with those of PGY5 residents. Content related to a question was considered "known" if 67% or more of the residents in each of the two groups answered it correctly. Findings showed 44% of the content tested by the basic science questions were unknown by new and graduating residents. The second research question required the 250 IT/SBSE questions to be classified into one of three levels of thinking abilities: recall, analysis, and inferential thinking. Profile analysis (split-plot analysis of variance) for each pair of resident levels indicated significant (P < 0.001) differences in performance on questions requiring factual recall, analysis, and inference between all levels except for PGY3s and PGY4s. CONCLUSIONS: The results of this research enable program directors to evaluate strengths and weaknesses in residency training curricula and the cognitive development of residents.

Analysis of Variance↗

PubMed1987

A strategy for responding to information demands in occupational health.

The explosion in scientific information has created serious difficulties for data retrieval and utilization in occupational health. Ready access to pertinent, intelligible and useful information represents one of the most pressing problems in the field, not only for professionals but also for the clientele they serve. Effective information management is required for professionals to respond speedily and appropriately to requests for data and advice in occupational health. This paper describes a response strategy involving the collection, evaluation, presentation and dissemination of occupational health information and outlines the contribution and importance of information technology and information science to the area of occupational health.

Canada↗

PubMed1968

Implications of planning for regional libraries: our underlying philosophy.

The National Library of Medicine Extramural Program in administering the Medical Library Assistance Act of 1965 has developed the following specific program objectives: provide financial assistance for improving biomedical libraries; encourage and assist the establishment and functioning of a responsive national biomedical information network by strengthening present biomedical libraries and their interlibrary relationships; and assure that the biomedical library network is linked to related science information systems. The ultimate goal is to develop the role of the library as a full learning resource center for education, research, and service. The regional library program aims to augment present capability of existing medical libraries so that information can be made available more extensively and more rapidly. Comprehensive and thorough advanced planning is a basic element in the development of regional medical libraries.

Libraries, Medical↗

PubMed1978

Drug information: an overview and prospect for the future.

The need and demand for improved adverse drug reaction reporting; literature access, control and dissemination; and student-literature exposure has been evident for many years. Drug information attempts to manage these perplexities by performing specific functions (i.e., by the communication of information, designing improved retrieval systems and offering individualized services). The drug information specialist is clinically-oriented and endeavors to surmount long-existing barriers to information transmission (e.g., the "invisible college" or colleague consultation). As a documentalist he is concerned with bibliographic control and systems improvement and design. Both functions require specialized education which is obtainable in schools of graduate pharmacy and in schools of library and information science. The properties of such programs are presented.

Drug Information Services↗

PubMed2002

1.4 Research and the dental student.

There has been significant concern that the dental curriculum and system of clinical education, in particular, is not designed to take advantage of the explosion in knowledge in biomedical science and its application to the health of the public. Although there are some examples of innovations in dental education on a global scale that have the capacity to increase the assimilation of basic and clinical knowledge, most of the dental education models are mired in the traditional '2 + 2' approach to education. This can be seen in North America and the European '2 + 3' model or the stomatological '4 + 2' approach. In each of these systems, the basic and behavioural science courses continue to be perceived as hurdles over which students must leap in order to reach the clinical programmes where there is little opportunity to use basic science information to advance patient care and treatment. Examples of issues that are not well represented include: innovations in imaging; diagnosis; bio-materials; science-based approaches to clinical practice; novel approaches to therapeutics; interactions between the oral, dental and craniofacial complex and systemic health and disorders; the role of oral infections and systemic disease; the increasing appreciation of chronic diseases and disorders such as osteoporosis and diabetes that affect oral tissues; the promise of bioengineering, tissue engineering and biomimetics; the potential use of saliva as a diagnostic tool; the understanding of oral complications of cancer treatment; the treatments of HIV/AIDS diseases and hepatitis; the use of dental and dental hygiene staff on health-care teams to deal with issues such as birth defects, orofacial trauma, head and neck cancer, chronic pain management and so on. There seems to be an excessive emphasis on restorative dentistry and, to a lesser extent, on the more biological approaches to diagnosis, prevention and therapeutics. This continued lack of integration of basic and clinical sciences in the curriculum continues to foster a dental workforce that is highly technically competent to provide specific clinical services but poorly equipped to evaluate and implement new biological approaches to diagnosis, therapeutics and intervention. Unfortunately, after many attempts by organized dental symposia aimed at the integration of basic and clinical sciences, there has been little discernible curricular change. It appears that there is an opportunity through this global congress to identify the best practices in the various global curricula that could change this paradigm in dental education and lead us toward the education of a more scientifically orientated practitioner-one who can take advantage of innovations in new and emerging technologies in their application to patient care. It is the challenge of this section to try to ascertain the best method or methods by which dental education promotes research to the dental student and what research represents in terms of critical thinking and evidence-based approaches to dental education and clinical practice.

Competency-Based Education↗

PubMed2003

The digital code of DNA.

The discovery of the structure of DNA transformed biology profoundly, catalysing the sequencing of the human genome and engendering a new view of biology as an information science. Two features of DNA structure account for much of its remarkable impact on science: its digital nature and its complementarity, whereby one strand of the helix binds perfectly with its partner. DNA has two types of digital information--the genes that encode proteins, which are the molecular machines of life, and the gene regulatory networks that specify the behaviour of the genes.

Animals↗