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At least 379 records · Page 21Linked to original sources
PubMed2005

Database application of digital medical X-rays and labs: computerization, storage, retrieval, interpretation, and distribution.

Stenter lets the health care worker order an X-ray that is produced as a computer image rather than on flat film. The health care provider can be in any location with the correct equipment, and view the digital image. The dimensions of this discussion are extensive. The cost savings because of reduced media and storage cost is substantial. Health care quality can be improved because of the ability to obtain consultation via telemedicine and the enhanced ability to track medical problems over time via trends. The major downside is the limited cost imbursement system to pay for technology. Unfortunately, this may impact on the improved quality of care. In simple terms someone needs to pay for the technology and the quality of health care needs to be maintained or improved. The real cost to the health care systems needs to be correctly calculated and inappropriate charging kept to a minimum. Specific costs need to be kept in mind and the first is the cost for new staff or staff training. The number of health care providers that are able to read the X-ray can be enlarged remembering that only American Board Certified Radiologists are allowed to give the final recommendation. How do we view the cost of missing something? It could be argued that this risk will be reduced because of improved technology for obtaining the digital X-ray and improved enhancement software. One way to view this situation is to include technology, management, and organization. The cost and benefits occur through the interplay of all three dimensions. The development of digital imaging hardware and artificial intelligence software will demand change in the management and organization. The organization will require changes in its design to accommodate the technology as to support and resources. Management will evolve to include methods for control and monitoring this technology. Business processes and standard operating procedures will change to integrate the technology into the organization in the most effective and efficient manner.

Database Management Systems↗
PubMed2003

Web-based PDA downloads for clinical practice guidelines and decision support tools.

The extraordinary volume of health-related information made available on the Internet comes at a high cost for effectively storing and accessing clinical information resources. Additionally, the ability to use critical patient care information is limited to the availability of computer access. Physicians and other health care professionals have readily adopted personal digital assistants (PDAs), also known as handheld computers, because the devices provide succinct critical patient care information at the point of need. Clinical practice guidelines available through the Internet for use with PDAs present health professionals, who have little time, with powerful information already formatted for point-of-care devices. This paper will review several strategies for finding and accessing point-of-care clinical information.

Computers, Handheld↗
PubMed1990

Use of Medicare-covered home health agency services, 1988.

From 1974 through 1983, Medicare-covered home health visits and expenditures increased at double digit rates (18.4 and 29.0 percent annually, respectively). During the period from 1984 through 1987, intensified bill review by fiscal intermediaries and increased denial rates led to a decline in the number of home health visits. New reimbursement policies led to a markedly reduced rate of increase in the payments for home health services. By 1988, the use of and expenditures for home health services resumed rising. In this article, the trends in home health service use and expenditures are presented and the changes in legislation and policies that affected them are discussed.

Data Collection↗
PubMed2002

Electronic patient records for dental school clinics: more than paperless systems.

The Electronic Patient Record (EPR) or "computer-based medical record" is defined by the Patient Record Institute as "a repository for patient information with one health-care enterprise that is supported by digital computer input and integrated with other information sources." The information technology revolution coupled with everyday use of computers in clinical dentistry has created new demand for electronic patient records. Ultimately, the EPR should improve health care quality. The major short-term disadvantage is cost, including software, equipment, training, and personnel time involved in the associated business process re-engineering. An internal review committee with expertise in information technology and/or database management evaluated commercially available software in light of the unique needs of academic dental facilities. This paper discusses their deficiencies and suggests areas for improvement. The dental profession should develop a more common record with standard diagnostic codes and clinical outcome measures to make the EPR more useful for clinical research and improve the quality of care.

Computer Communication Networks↗
PubMed1997

Reliability of an electrophoretic and image processing analysis of human skeletal muscle taken from m. vastus lateralis.

The relative content of myosin heavy chain (MHC) isoforms IIb, IIa and I in human skeletal muscle taken from the m. vastus lateralis of 30 healthy male subjects was analysed using mini-gel electrophoresis. Repeated electrophoretic gels utilizing the same methods were produced for all subjects and the determination of MHC protein bands was performed using a digital scanner and National Institutes of Health (NIH) Image software and laser densitometry. A comparison between the NIH Image processing technique and laser densitometry revealed differences of 6.47%, 6.35% and 6.84% between these measurement techniques for MHC-IIb, -IIa and -I isoforms, respectively. The percentage technical error of measurement (TEM%) between electrophoretic gels was shown to be 19.1%, 17.8% and 14.2%, with regard to percentage of occurrence of MHC-IIb, -IIa and -I isoforms respectively. The variation in electrophoretic gel analyses was shown to be 5.7%, 7.3% and 5.5%, with regard to the percentage of MHC-IIb, -IIa and -I isoforms respectively. Intra-class correlations comparing NIH Image and laser densitometry produced r values in the range 0.38-0.63. Comparisons between and within gel analyses produced r values in the range 0.59-0.94 and 0.93-0.98, respectively. Analyses of variance revealed no significant differences (P < 0.05) between analysis techniques, between gels or within gels for the measurement of MHC-IIb, -IIa and -I isoforms. The inter-gel error between fibre subgroups was moderate for the two type-II MHC populations and less for type-I MHC; the intra-individual error in the measuring technique used for classifying the MHC-IIb, -IIa and -I protein bands was small. The results obtained in this investigation showed consistent trends which may reflect a false classification of the type-II MHC populations for the inter-gel and intra-individual analyses. The NIH Image software and digitizing process was shown to be a valid and reliable method for distinguishing between MHC protein bands of human skeletal tissue as separated by mini-gel electrophoretic techniques.

Adult↗
PubMed1998

An update on dental imaging.

This paper reviews recent advances and current trends in dental radiology. Developments in the design of dental x-ray equipment which improve both radiation hygiene and image quality are described. Also discussed are new features which broaden the scope of intra-oral and panoramic radiological diagnosis in the general dental practice setting. The article concludes with the main recommendations from the latest guidelines on quality standards for radiography, selection criteria and quality assurance in general practice.

Equipment Design↗
PubMed1991

Transrectal ultrasound, digital rectal examination, and prostate-specific antigen: preliminary results of an early detection program for prostate cancer.

Three hundred and ninety eight self-referred men with no histories of prostate problems were followed once each year for up to four years to determine the feasibility of early prostate cancer detection by digital rectal examination, transrectal ultrasound, and prostate-specific antigen. Evaluation of prostate-specific antigen was based on a polyclonal level of normal of 2.6 nanograms per milliliter by the Yang assay. Biopsies were performed when indicated by either transrectal ultrasound or digital rectal examination. The overall cancer detection rate for the four year period was 6.3 percent. A 3:1 cancer detection advantage of transrectal ultrasound over digital rectal examination was shown. Transrectal ultrasound and prostate-specific antigen each detected 92 percent of the proven cancers, and were complementary when either test was normal, together detecting 100 percent of the cancers. Thirty two percent (8/25) of all cancers were detected by digital examination, with digital exam having no predictive power after two study years. Prostate-specific antigen as an initial screening test for early prostate cancer may identify a suspicious group, whom may further be evaluated by transrectal ultrasound and digital exam. Results of this study lend credibility to the large scale randomized screening study proposed by the U.S. National Institutes of Health in which prostate-specific antigen and digital rectal examination are to be used as initial tests for prostate cancer detection.

Aged↗
PubMed2005

Taking a tougher stance on lifestyle factors.

With health care costs continuing to rise at double-digit rates, many payers have decided to hold participants responsible for unhealthy behaviors by actually hiking their health care premiums. Proponents of the approach maintain that it gets peoples' attention in ways that most other strategies have utterly failed. However, opponents argue that such penalties risk an employee/participant backlash that could cause more harm than good. Experts weigh in on both sides of the debate.

Cost Control↗
PubMed1999

A time-motion study of digital radiography at implementation.

With increasing budgetary restraints on the health system, it is apparent that the main contribution that radiology departments can make to significant cost reduction in hospitals is to decrease the length of time between requesting an X-ray examination and receiving the report (and images). Digital radiography (DR) was introduced into the Radiology Department at the Royal Adelaide Hospital as a pilot project to research the cost-benefits and efficiency of the system, and to determine future directions for planning a digital department. The business plan developed prior to implementation of this pilot project predicted a saving of one bed-day per inpatient when a fully digital department with a picture archiving and communication system (PACS) is installed. This initial study comparing DR and conventional radiography (convR) provides baseline data and shows encouraging results for more rapid transmission of reports to clinicians.

Cost-Benefit Analysis↗
PubMed2001

Digital toxicology education tools: education, training, case studies, and tutorials.

This review presents a brief and non-comprehensive overview of a representative sampling of some of the broad array of toxicology-related learning, tutorial and information resources now becoming widely available to educators, health professionals, students and the general public in digital media and/or via the Internet. A broad variety of useful learning and reference resources in the general fields of toxicology and the environmental health sciences is provided to introduce the reader to the diverse types of information currently available. The sources and Internet links contained in this review will hopefully constitute a useful resource of basic toxicology information that should be readily accessible to most if not all readers.

Humans↗
PubMed1999

The relationship between diet and breast cancer in men (United States).

OBJECTIVES: The purpose of this paper was to investigate the relationship between food and beverage consumption and the development of breast cancer in men. METHODS: Possible relationships of dietary factors to risk of breast cancer in men were assessed in a case-control study conducted between 1983 and 1986. Cases (N = 220) were ascertained from ten population-based cancer registries. Controls (N = 291) were selected by random-digit dialing (< age 65) and from Health Care Financing Administration Medicare beneficiary lists (> or = age 65). RESULTS: No trends in risk were observed with increasing intakes of specific foods, except for an increase in risk with citrus fruits. No increase in risk with increasing amounts of specific fats, vitamins, or minerals or with amounts of protein, fiber, carbohydrate, starches, nitrites, or alcohol consumed was observed, except for an increase in risk with dietary vitamin C consumption. A decreasing trend in risk with dietary niacin and with coffee and an increasing trend in risk with tea consumption were observed. No associations were found with use of any dietary supplements, including vitamin C. CONCLUSIONS: The observed associations are not consistent with findings from studies of breast cancer in women and probably do not represent causal relationships. Dietary factors are unlikely to be strong determinants of breast cancer in men.

Adult↗
PubMed2001

An overview of the Tenth International Conference on Cancer Gene Therapy.

Dr. Scanlon, the new president (2001-2002) of the International Society of Cancer Gene Therapy, gave the conference summary and an overview of gene therapy in the new millennium. The conference reflected the progress made in the development of new promoters and improved delivery systems for gene therapy. Many presentations and posters focused on the progress in these areas. These scientific findings in the field of gene therapy may ultimately be exploited in the future developments of stem cell research. Conversely, challenges still remain before gene therapy will significantly impact cancer. The basic science of the cancer model systems lacked the ability to reflect the clinical reality of patient treatment. This places the burden on the physicians to be more vigilant to subtle changes in patient response that were not observed in the preclinical models. The bystander effect has yet to be fully understood and needs further clinical validation. Systemic delivery needs to be further addressed before a marketable product can be developed. The delivery systems discussed at the conference lack the ability to achieve pharmacological doses of therapeutic genes in the target tissue. Until these challenges are addressed, gene therapy will remain on the sidelines as a cancer modality. Yet, the field should be optimistic with the current progress. The future influences of the digital and genomic revolution in the health care industry will certainly impact the design of products for gene therapy. Dr. Scanlon concluded that the education of scientists would cross over into diverse disciplines so that novel observations will be exploited for new therapies. This gene therapy series will continue with the International Conference on the Gene Therapy of Cancer, scheduled for December 13-15, 2001, in San Diego, CA.

Animals↗
PubMedDate not supplied

Household hazardous waste in Massachusetts.

Household wastes, when disposed of improperly, are hazardous to health. This paper reports a random digit dial telephone survey of Massachusetts households concerning household hazardous waste (HHW) disposal with a 54% response. Of the automotive oil disposed of by 33% of survey households, 57% was deposited in the ground, sewer, or landfill. Annually by household oil disposal in Massachusetts is estimated to be 8.8 million quarts. Four percent of hazardous waste generated in Massachusetts is from households. Improper disposal makes it a major environmental contaminant. More households (41.5%) in smaller communities disposed of oil compared with 26% of households in larger communities. Paint and pesticides were disposed of by 10% of the households, but were dumped on the ground sewer or landfills more than 90% of the time.

Household Products↗
PubMed2005

Changes in the prevalence of US adults with arthritis who meet physical activity recommendations, 2001-2003.

CONTEXT: Increased physical activity is recommended for adults with arthritis. OBJECTIVE: The objective of this study was to update and compare recent physical activity prevalence estimates of US adults with self-reported doctor-diagnosed arthritis. DESIGN: The authors studied the 2001 and 2003 Behavioral Risk Factor Surveillance Survey (BRFSS), an annual random-digit telephone survey conducted by state health departments. SETTING: The authors conducted a population-based sample from 50 states and the District of Columbia. PARTICIPANTS: The study included a total of 52,311 adults, 18 years or older, reporting doctor-diagnosed arthritis in 2001, and 82,839 reporting doctor-diagnosed arthritis in 2003. MAIN OUTCOME MEASURES: Reported level of physical activity was classified into 3 categories: physically inactive, insufficiently active, and meeting public health recommendations. RESULTS: Between 2001 and 2003, the prevalence of physical inactivity decreased by 1.1% (23.8% versus 22.7%), the prevalence of insufficient levels of physical activity increased by 0.2% (38% versus 38.2%), and the prevalence of meeting physical activity recommendations increased by 0.9% (38.3% versus 39.2%). Compared with 2001 estimates, the prevalence of meeting physical activity recommendations increased by 6.2% (54.8% versus 61%) among those aged 18 to 24 years, 3.5% (36.4% versus 39.9%) among never smokers, 3% (49.4% versus 52.4%) among those aged 25 to 34 years, 2.4% (29.9% versus 32.3%) among obese adults, and among those aged 55 to 64 years (36.9% versus 39.3). Prevalence of inactivity increased by 3.2% among Hispanics (30.4% versus 33.6%) and 2.9% among those with 8 or fewer years of education (47.6% versus 50.5%). CONCLUSIONS: Prevalence estimates of the 3 levels of physical activity among adults with arthritis changed very little. Given the established benefits of physical activity for arthritis, public health efforts to promote increased activity should continue to be developed and refined.

Adolescent↗
PubMedDate not supplied

Two interpolating filters for scatter estimation.

We have previously reported on a dual-measurement sample-and-estimate technique for scatter correction. In this paper, we present a scatter-correction technique that uses the previous sampling scheme but a different method of estimation. To provide samples of the scatter directly, an array of small, uniformly spaced lead disks is placed immediately before the object during only the first measurement. Interpolating from these samples we form an estimate of the scatter. We subtract this estimate from the second measurement to form a scatter-corrected image. Previously, we used least-squares interpolation to estimate the scatter. Because the samples are uniformly spaced, classical sampling theory motivated the investigation of interpolating filters for scatter estimation. To form the scatter image, we convolved the sample set with two different interpolating filters--a sinc function from classical sampling theory and a jinc function because the scatter function is radially symmetric. Using phantoms as objects, we applied both filters for scatter correction in vessel imaging and energy-subtraction imaging. Initial corrected images contained an artifact attributed to aliasing. We modified the filter widths to reduce the aliasing. Although improvements in image quality were measured and the artifact was less pronounced, the artifact was still present. We present the phantom results obtained with this class of filters and discuss methods for its improved performance.

Algorithms↗
PubMedDate not supplied

Solutions to challenges facing a university digital library and press.

During the creation of a university digital library and press intended to serve as a medical reference and education tool for health care providers and their patients, six distinct and complex digital publishing challenges were encountered. Over nine years, through a multidisciplinary approach, solutions were devised to the challenges of digital content ownership, management, mirroring, translation, interactions with users, and archiving. The result is a unique, author-owned, internationally mirrored, university digital library and press that serves as an authoritative medical reference and education tool for users around the world. The purpose of this paper is to share the valuable digital publishing lessons learned and outline the challenges facing university digital libraries and presses.

Hospitals↗