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PubMed1994

Dental informatics for Australia.

Dentistry is undergoing significant changes with need for the dentist to manage a larger body of knowledge and information. There will be increasing reliance on electronic information systems in education, research, and dental practice. Dental informatics is concerned with computer and information science and technology and communications. Goals, that could be adopted for Australia, were proposed in the USA in 1989. Specific action steps that could meet those goals are proposed for Australia.

Australia↗
PubMed2006

Application of micro- and nano-electromechanical devices to drug delivery.

Micro- and nano-electromechanical systems (MEMS and NEMS)-based drug delivery devices have become commercially-feasible due to converging technologies and regulatory accommodation. The FDA Office of Combination Products coordinates review of innovative medical therapies that join elements from multiple established categories: drugs, devices, and biologics. Combination products constructed using MEMS or NEMS technology offer revolutionary opportunities to address unmet medical needs related to dosing. These products have the potential to completely control drug release, meeting requirements for on-demand pulsatile or adjustable continuous administration for extended periods. MEMS or NEMS technologies, materials science, data management, and biological science have all significantly developed in recent years, providing a multidisciplinary foundation for developing integrated therapeutic systems. If small-scale biosensor and drug reservoir units are combined and implanted, a wireless integrated system can regulate drug release, receive sensor feedback, and transmit updates. For example, an "artificial pancreas" implementation of an integrated therapeutic system would improve diabetes management. The tools of microfabrication technology, information science, and systems biology are being combined to design increasingly sophisticated drug delivery systems that promise to significantly improve medical care.

Administration, Cutaneous↗
PubMed1984

Needs for computing facilities in anesthesiology.

The use of computers in the practice of anesthesiology appears to be very promising--therefore the time has come to reflect on ways to utilize the possibilities of computers in this field. The anesthesiologist is faced with an existing "medical information science" and system developments and must now address these questions: How do computers fit in these systems? What is the kind of support and help one can expect from the use of computers? Next one attempts to define the needs for computer support, taking into account the specific working conditions of various anesthesia teams. A description is made of how a system for medical information is automatized--and by way of an example--how such a computer system for anesthesiologists is linked to a larger regional facility. Advantages and disadvantages of such a system are discussed.

Anesthesia Department, Hospital↗
PubMedDate not supplied

Electronic medical records: are physicians ready?

The use of electronic medical records (EMR) in healthcare organizations will require substantial changes in the way physicians and their staff provide patient care. This study is the first part of a larger study assessing factors that influence successful implementation of EMR in ambulatory care settings. The purposes of this study were to identify specific attitudes or factors that should be targeted before implementating an EMR project, and demonstrate empirical support for a model of perceived usefulness of EMR. We found that computer experience, computer anxiety, and perceptions of organizational support predict the degree to which physicians and mid-level practitioners view the EMR effort positively. Strategies for the successful management of EMR implementation include engaging the physicians and practitioners in computer activities prior to implementation and providing strong organizational support before and during the redesign effort. Acceptance of EMR by physicians and their support staff is essential if computerization is to be successful, yet anecdotal reports of resistance and negative attitudes are frequently reported. Empirical studies indicate that physicians have not yet embraced this technology. As part of strategic planning and deployment of a computerized patient record, attitudes of end-users must be assessed. Using an integrative framework from the job design literature and management information sciences, we propose that multiple factors influence attitudes toward EMR, offer a conceptual model of end-user acceptance, and present findings from an empirical test of our model.

Age Factors↗
PubMed1993

Probabilistic constraint satisfaction with structural models: application to organ modeling by radial contours.

One of the key challenges within medical information sciences is the development of useful models for biological structure and its variability. Many biomedical problems involve the elucidation of structure (for example, from experimental data or from imaging studies), and structural models can often drive the process of inferring precise structure from data. Ideally, model-driven data interpretation combines knowledge about the generic features of a class of biological structures (as contained within a model) with data that provide specific information (often noisy) about a particular instance of the class. In this paper we briefly discuss model-driven determination of biological structure as an example of a structural constraint satisfaction problem. We describe a probabilistic implementation of structural constraint satisfaction, and show that our formulation of a particular organ modeling technology (Radial Contour Models) exhibits promising performance. Our results demonstrate the utility of probabilistic models for the solution of structural constraint satisfaction problems.

Computer Simulation↗
PubMed1993

Necrotizing enterocolitis: research agenda for a disease of unknown etiology and pathogenesis.

Necrotizing enterocolitis (NEC) is a significant neonatal public health problem that affects low-birth weight infants in neonatal intensive care units throughout the country. As the survival rate of low-birth weight infants continues to increase and as the number of low-birth weight births remains unchanged, we can anticipate that NEC will continue to be a cause of significant morbidity and mortality in the future. Despite many reports about NEC that describe demographic risk factors and short-term or long-term outcome, there is a paucity of basic science information about neonatal gastrointestinal physiology and pathophysiology in human preterm and even full-term infants. It has become increasingly evident that we need a much better understanding about the developmental aspects of gastrointestinal function in health and disease before we can achieve further advances in our understanding of and thus rational therapy for and prevention of NEC. The purpose of the National Institute of Child Health and Human Development conference "Necrotizing Enterocolitis: Basic Science Approaches to Gut Maturation and Pathogenesis" was to bring together basic science investigators, clinical epidemiologists, and clinical scientists to identify important areas of research that need to be applied to the problem of NEC. The concept of applying the "bench to bedside" type of collaborative research was emphasized and encouraged because many clinical neonatologists may have little scientific interaction with basic scientists. In addition, many basic scientists may be unaware of NEC and the implications for targeted research related to this disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Digestive System↗
PubMed1994

Service providers and users discover the Internet.

Although the Internet has evolved over more than twenty years, resources useful to health information professionals have become available on the Internet only recently. A survey conducted by the Regional Medical Libraries of the National Network of Libraries of Medicine in the fall of 1993 indicates that libraries at academic institutions are much more likely to have access to the Internet (72%) than are libraries in hospital environments (24%). Health information professionals who take on the challenge and exploit the Internet's resources find rewards for themselves and their clients. The basic electronic mail capability of the Internet allows colleagues to collaborate, communicate, and participate in daily continuing education. Internet terminal and file-transfer capabilities provide improved access to traditional resources and first-time access to new electronic resources. Through the Internet, online catalogs are available worldwide, and document delivery is faster, cheaper, and more reliable than ever before. Institutions can make organizational, full-text, online, and publication information available through Internet tools such as direct file-transfer protocol (FTP), menu-based Gopher, and hypertext-based Mosaic. The National Library of Medicine (NLM) is among organizations finding new ways to provide service through the Internet. NLM now uses electronic mail to communicate with users, FTP service to distribute publications, and tools such as Gopher and Mosaic to distribute publications and graphics and connect users to online services. The Internet allows service providers and health sciences information professionals to work in a rich, new medium whose potential is just beginning to be explored. At the same time, its characteristics--including lack of formal organization, standards, quality control, and permanence--pose a challenge.

Computer Communication Networks↗
PubMed1997

Medical computing in Mississippi.

As our society enters the information age, physicians are finding an ever growing role for computers in the practice of medicine. Computers are used for education, research, medical record keeping, communications and as a powerful reference resource. They have even served as electronic consultants to assist in diagnosis and medical decision making. Mississippians have been pioneers in the use of computers in research and education and have taken a very progressive view of the future of medical computing in our state. Resources such as the Mississippi Health Sciences Information Network have served to connect rural health practitioners to academic centers and other informational resources and improve the quality of patient care throughout the state. Internet users will find that there are many Mississippi medical institutions that have home pages on the world wide web that also connects us to the global medical community. Computers are rapidly becoming one of the most important new tools in the black bag of the modern physician.

Computer Communication Networks↗
PubMed2004

Research on the value of medical library services: does it make an impact in the health care literature?

OBJECTIVE: To evaluate the impact in the health care literature of research articles that provided evidence of the value of library services (including MEDLINE) as an element of quality health care. DATA SOURCES/SELECTION: Four research articles on the relationship between use of library services and quality health care were selected as "primary articles" from a MEDLINE search using appropriate Medical Subject Heading. Primary articles met the following criteria: written in English, reported research, related to clinical care, and published before 1995. DATA EXTRACTION: The technique of citation analysis was used to measure the impact of the primary articles on the subsequent literature. The number, authorship, type, and publication venue of articles citing the primary articles were determined using ISI Web of Science, MEDLINE, other electronic resources, and the citing articles themselves. For the 146 English-language citing articles, the article type (i.e., advocacy, instructional, research) was noted; and, for those that reported research, the use to which the author put the cited material was determined. RESULTS: The primary articles were cited more often than the average articles published that year in the same journals. At the time of the study each article had been cited almost every year since publication. Of the 146 citing articles written in English, 43% were written by librarians, 38% by physicians, 12% by librarians with physicians. The majority were published in medical journals, followed in order of decreasing frequency by the Bulletin of the Medical Library Association, information science journals, and health administration journals. CONCLUSIONS: The results of this study demonstrate that published research on the value of medical library services has an impact on the literature. These articles are read and cited and continue to be of value.

Authorship↗
PubMed1992

Coordinated delivery of clinical care: the "re-integration" of the medical group practice.

This paper suggests that for medical knowledge to be effective, it must be reliably translated into a series of synchronized activities, both clinical and operational. The goal of medical information science must be not only to identify the best course of care, but also through the use of systems for the ordering, scheduling, and deployment of staff and resources to assure that the planned course of care is reliably and efficiently delivered in actual practice settings. We present a brief history of several innovations in patient care coordination and logistics at Mayo Clinic to provide background for the main concepts presented. The principle of patient care coordination underlying this history of innovation is shown to have evolved into a new need for information systems capable of proactively effecting the delivery of care through patient, staff and resource deployment and monitoring.

Delivery of Health Care↗
PubMed2002

[Time resolution spectrum measurements of the process of photon acting on the silver halide materials].

The silver halide material is a very important optical information material. Silver halide material plays a very imperative role in the development of the information science and technology. The time characters of the photon action process determine the quality of the silver halide material to a great degree. We adopt the microwave absorption technology to measure the time characters of the process of the photon acting on silver halide material. A sample of the silver halide material is inserted into a microwave resonant cavity. With the excitation of excimer laser, photogenerated charge carriers are created in the silver halide material. The generation of the photogenerated charge carriers changes the dielectric function of the silver halide material. Therefore, the change of the dielectric function embodies the information of the time characters of the photogenerated change carries. At the same time, the change of the dielectric function results in an alteration of the cavity quality factor. This change leads to a reflected microwave. The reflected microwave contains the information of the time characters of the photon action process. Through the measurement of the reflected microwave, we can obtain the time resolution spectrum of the process of the photon acting on the silver halide material and study the time characters of the photon action process. The time resolution spectra of the process of the photon acting on various silver halide materials were obtained in our experiments. We analyzed the time characters of photon acting on the black-and-white film, color film and X-ray film.

Absorption↗
PubMed2006

Informational landscapes in art, science, and evolution.

An informational landscape refers to an array of information related to a particular theme or function. The Internet is an example of an informational landscape designed by humans for purposes of communication. Once it exists, however, any informational landscape may be exploited to serve a new purpose. Listening Post is the name of a dynamic multimedia work of art that exploits the informational landscape of the Internet to produce a visual and auditory environment. Here, I use Listening Post as a prototypic example for considering the creative role of informational landscapes in the processes that beget evolution and science.

Art↗
PubMed2000

Design and use of clinical ontologies: curricular goals for the education of health-telematics professionals.

In computer science, the notion of a domain ontology--a formal specification of the concepts and of the relationships among concepts that characterize an application are a--has received considerable attention. In human-computer interaction, ontologies play a key role in defining the terms with which users and computer systems communicate. Such ontologies either implicitly or explicitly drive all dialogs between the computer and the user. In the construction of health-telematics applications, professionals need to understand how to design and apply domain ontologies to ensure effective communication with end-users. We currently are revising our training program in Medical Information Sciences at Stanford University to teach professional students in health telematics how to develop effective domain ontologies. Instruction concerning the construction and application of clinical domain ontologies should become an integral component of all health telematics curricula.

Attitude to Computers↗
PubMed2006

Knowledge translation versus knowledge integration: a "funder's" perspective.

Each year, billions of US tax dollars are spent on basic discovery, intervention development, and efficacy research, while hundreds of billions of US tax dollars are also spent on health service delivery programs. However, little is spent on or known about how best to ensure that the lessons learned from science inform and improve the quality of health services and the availability of evidence-based approaches. To close this discovery-delivery gap, researchers and their funding agencies not only must recognize the gap between basic discovery and intervention development, addressed in part through translational research investments, but they must also work together with practitioners and their funding agencies to recognize the growing gap between innovative interventions developed through research and what is actually delivered to reduce the burden of chronic disease within the United States. From a funding-agency perspective, the complexity of the challenges of translating lessons learned from science to public health, primary care, or disease specialty service settings requires a multifaceted partnership approach to accelerate the translation of research into practice. This essay reviews the background and challenges of closing the development-to-delivery gap and some exemplar strategies that have been used by funding agencies to address these challenges to date.

Education, Continuing↗
PubMedDate not supplied

Planning for PACS at Osaka University Hospital.

We have a plan to adopt PACS as a medical image information system in the new hospital. In order to construct PACS suitable for our hospital, a preliminary survey was carried out to determine how PACS should be introduced and what are the physicians requirements for a new medical image system. The most important requirement of the physicians was a good quality workstation. Our plan of a new medical image information system is as follows. A primary database will be constructed according to each of modalities in the Department of Radiology. In the Department of Medical Information Science, we will make a secondary database according to the patient. Although it may be difficult for us to obtain a sufficient budget digitalizing all medical images by our move to the new hospital, our goal is to establish total PACS throughout the new hospital in 1995.

Computer Communication Networks↗
PubMed2001

Dental informatics. A cornerstone of dental practice.

BACKGROUND: Dental informatics is a relatively new field that has significant potential for supporting clinical care. Most dentists are unaware of what dental informatics is, what its goals are, what it has achieved and how they can get involved in it. METHODS: The authors conducted a literature review and several round-table discussions with dental informatics experts to discuss the preceding issues surrounding dental informatics. RESULTS: Dental informatics is the application of computer and information sciences to improve dental practice, research, education and management. Numerous applications that support clinical care, education and research have been developed. Dental informatics is beginning to exhibit the characteristics of a discipline: core literature, trained specialists and educational programs. CONCLUSIONS: Dental informatics presents possible solutions to many long-standing problems in dentistry, but it also faces significant obstacles and challenges. Its maturation will depend as much on the efforts of people as on the collective efforts of the profession. PRACTICE IMPLICATIONS: Dental informatics will produce an increasing number of applications and tools for clinical practice. Dentists must keep up with these developments to make informed choices.

Delivery of Health Care↗
PubMedDate not supplied

[Inequities in access to information and inequities in health].

This piece presents evidence that inequities in information are an important determinant of health inequities and that eliminating these inequities in access to information, especially by using new information and communication technologies (ICTs), could represent a significant advance in terms of guaranteeing the right to health for all. The piece reviews the most important international scientific research findings on the determinants of the health of populations, emphasizing the role of socioeconomic inequities and of deteriorating social capital as factors that worsen health conditions. It is noteworthy that Latin America has both socioeconomic inequities and major sectors of the population living in poverty. Among the fundamental strategies for overcoming the inequalities and the poverty are greater participation by the poor in civic life and the strengthening of social capital. The contribution that the new ICTs could make to these strategies is analyzed, and the Virtual Health Library (VHL) is discussed. Coordinated by the Latin American and Caribbean Center on Health Sciences Information (BIREME), the VHL is a contribution by the Pan American Health Organization that takes advantage of the potential of ICTs to democratize information and knowledge and consequently promote equity in health. The "digital gap" is discussed as something that can produce inequity itself and also increase other inequities, including ones in health. Prospects are discussed for overcoming this gap, emphasizing the role that governments and international organizations should play in order to expand access to the global public good that information for social development is.

Caribbean Region↗
PubMed2005

Urban asthma and the neighbourhood environment in New York City.

Asthma is now the leading cause of emergency room visits, hospitalizations, and missed school days in New York City's poorest neighbourhoods. While most research focuses on the influence of the indoor environment on asthma, this study examines the neighbourhood effects on childhood asthma, such as housing and ambient environmental hazards. Using Geographic Information Science (GI Science) we identify neighbourhoods with elevated concentrations of childhood asthma hospitalizations between 1997 and 2000 in US census tracts, analyze the sociodemographic, housing characteristics, and air pollution burdens from stationary, land use and mobile sources in these areas. The paper reveals the importance of distinguishing the specific and often different combinations of poor housing conditions, outdoor air pollution and noxious land uses that contribute to the high incidence of asthma in impoverished urban neighbourhoods.

Adolescent↗