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Information technology infusion model for health sector in a developing country: Nigeria as a case.

To date, information technology (IT) has not been widely adopted in the health sector in the developing countries. Information Technology may bring an improvement on health care delivery systems. It is one of the prime movers of globalization. Information technology infusion is the degree to which a different information technology tools are integrated into organizational activities. This study aimed to know the degree and the extent of incorporation of Information Technology in the Nigerian health sector and derive an IT infusion models for popular IT indicators that are in use in Nigeria (Personal computers, Mobile phones, and the Internet) and subsequently investigates their impacts on the health care delivery system in Nigerian teaching hospitals. In this study, data were collected through the use of questionnaires. Also, oral interviews were conducted and subsequently, the data gathered were analyzed. The results of the analysis revealed that out of the three IT indicators considered, mobile phones are spreading fastest. It also revealed that computers and mobile phones are in use in all the teaching hospitals. Finally in this research, IT infusion models were developed for health sector in Nigeria from the data gathered through the questionnaire and oral interview.

Cell Phone↗

The fusion of gerontology and technology in nursing education: History and demonstration of the Gerontological Informatics Reasoning Project--GRIP.

Phase I of our Gerontological Reasoning Informatics Project (GRIP) began in the summer of 2002 when all 37 senior undergraduate nursing students in our accelerated BSN nursing program were given PDAs. These students were oriented to use a digitalized geriatric nursing assessment tool embedded into their PDA in a variety of geriatric clinical agencies. This informatics project was developed to make geriatric nursing more technology oriented and focused on seven modules of geriatric assessment: intellect (I), nutrition (N), self-concept (S), physical activity (P), interpersonal functioning (I), restful sleep (R), and elimination (E)--INSPIRE. Through phase II and now phase III, the GRIP Project has become a major collaboration between the College of Nursing & Health Professions and College of Information Science and Technology at Drexel University. The digitalized geriatric nursing health assessment tool has undergone a second round of reliability and validity testing and is now used to conduct a 20 minute comprehensive geriatric health assessment on the PDA, making our undergraduate gerontology course the most high tech clinical course in our nursing curriculum.

Aged↗

[The applications of informatics in ophthalmology].

The paper reports on the applications of information science in Romania in ophthalmology, and mainly in glaucoma, in the diagnosis of: degenerative affections of the fundus oculi, uveitis, strabismus, in functional exploration of the chromatic sense, ergo-ophthalmology, pupillary reflex and forms of the pupil, etc. The Romanian made computers Felix, Independent, Coral, Cobra, etc. were used.

Diagnosis, Computer-Assisted↗

New media in medical education.

In 1984 the American Association of Medical Colleges' Panel on the General Professional Education of the Physician challenged the medical community to take a leadership position in the effective application of information science and computer technology to medical education. The medical education community has risen to that challenge through the use of microcomputer technology and optical disc media including the recently developed fully integrated Hypermedia environment to enhance the learning environment.

Audiovisual Aids↗

Operations upon the biliary tract during transplantation of the liver.

Operation upon the biliary tract is a discipline within transplantation of the liver. There exists a background of basic science information concerning anatomy and physiology, an historical evolution of surgical techniques, a divergence of contemporary opinion regarding preferred approaches and a body of well described complications. The complication rate, once more than one-half with substantial contribution to mortality rates, now ranges from approximately 15 to 25 per cent. Current practice in most institutions is to use choledochocholedochostomy with T-tube stent when a recipient duct is present and Roux-en-Y choledochojejunostomy with internal stent when a suitable recipient duct is absent. Hepatic arterial thrombosis is an important cause of complications of the biliary tract. The overlap of symptoms and signs of rejection with those of biliary sepsis and other complications of the biliary tract underscores the need for algorithmic use of diagnostic modalities in the post-transplant period.

Biliary Tract Surgical Procedures↗

User attitudes toward end-user literature searching.

A survey to determine attitudes toward end-user searching was made at Loyola University's Medical Center Library using MEDIS, an online full-text and bibliographic medical retrieval system. One hundred forty-one completed questionnaires were analyzed for this report. Information was collected on user familiarity with computers, end-user training, system use, mechanics of searching, and attitudes toward future use. Computer familiarity was highest among the faculty users. Ninety percent of the respondents saw librarians as a crucial agent in training and in providing end-user assistance. Respondents identified five major reasons for using the system: helpfulness, convenience, time savings, rapid feedback, and presentation of needed information. Searching the MEDLINE database rather than the full-text database was the search method of choice. Continued use of both mediated and end-user searching was intended by most of the respondents. Survey results support a perceived need for end-user searching and confirmed recommendations of the Association of American Medical Colleges on medical information science skills.

Attitude of Health Personnel↗

A perspective on the role of decision analysis in clinical practice.

The upsurge in interest in clinical decision support techniques is not accidental. Clinical decision situations are more and more characterized by complexity and uncertainty, due to increasing diagnostic and therapeutic possibilities, the fast growth of medical knowledge, the increasing quality demands by the public, and the pressure towards cost-conscious decision making. On the other hand, information science is increasingly able to provide the tools for building decision-support systems. There are several approaches to the development of decision aids. The present paper is mainly concerned with one potentially very powerful method: decision analysis. Basically, decision analysis is a method for explicitating, structuring and analysing clinical decision situations for individual patients. Suggestions for therapy choice, and diagnostic and prognostic statements are obtained by integrating the probability and value judgments made during the analysis. A clinical decision analysis can conveniently be divided into four stages: defining and structuring the clinical problem, assessing the relevant probabilities and utilities, calculation of the preferred course of action, including sensitivity analysis, and formulation of the results of the analysis in a clinically useful way. An optimistic scenario of the future role of decision analysis in clinical medicine would describe--among others--decision-consultation departments, decision-oriented clinical data-bases and medical knowledge bases, research groups for development, testing, and updating of clinical strategies, decision-analysis courses in all levels of medical education, and decision-oriented clinical textbooks. Moreover, decision analysis will help in setting priorities in clinical research, in quality control and peer review, and in development of protocols for use by the paramedical personal. Some illustrations from applied decision analysis are given.

Decision Making, Computer-Assisted↗

Goals, objectives, and competencies for reference service: a training program at the UCLA Biomedical Library.

The UCLA Biomedical Library, in cooperation with the UCLA Graduate School of Library and Information Science, offers a medical library internship program for second-year library school students. Goals, objectives, competencies, and training guidelines have been developed for the reference services section of the internship, including reference desk experience, online searching, group discussions, assigned readings, and training new staff members, allows flexibility in meeting the differing interests, needs, and abilities of trainees.

Competency-Based Education↗

Biocomputational methodology an adjunct to theory and applications.

The role of "methodology", as distinguished from "theory" and "application", is discussed and illustrated. It is argued that research in the biomedical sciences is moving towards a degree of complexity different in both kind and extent from that usually encountered in other disciplines. Certain biocomputational methodology can be viewed as a bridge between the data forms commonly encountered in biomedicine, and the statistical and computational machinery which had previously been developed to deal with physical science information. Examples are given of three promising research subareas, all of which concern methods for dealing with highly complex forms of health and medical data.

Computers↗

Model-driven visualization of coronary arteries.

In a joint project between the Department of Computer and Information Sciences and the Department of Radiology, we are applying techniques of artificial intelligence to improve clinical performance in coronary arteries. Specifically, we are investigating how images from intravenous digital subtraction angiography (DSA) can be enhanced so that their efficacy for lesion detection and quantitation becomes comparable with that of the more dangerous procedure of selective coronary arteriography. The enhancement techniques (which include algorithms for 3-dimensional vessel detection, reconstruction and display, as well as for accurate lumen-size estimation) are based on models of (i) the 3-dimensional topological structure of the coronary arterial tree, (ii) myocardial dynamics, and (iii) the X-ray imaging process involved in producing digital subtraction angiograms. The evaluation of these model-driven visualization techniques is done by the standard psychophysical method of Receiver Operating Characteristic (ROC) analysis applied to observer performance tests on images from an animal coronary atherosclerosis model.

Analog-Digital Conversion↗

Biomedical resources on Usenet.

Usenet offers efficient access to health sciences information resources. The software for reading and searching Usenet includes filters that can eliminate irrelevant messages, sorts related items by topic, and allows users to reply to either the group or an individual. Usenet has more than 2,000 news groups on topics from back rubs to radiological imaging, and it provides information in various ways, including discussion groups and software distribution.

Computer Communication Networks↗

Incongruence of existing practice management curricula content and actual medical practice need.

BACKGROUND AND OBJECTIVES: Practice management is an important, but often overlooked, element of medical training, especially for physicians in primary care. The objective of this study was to evaluate our program's practice management curriculum to determine if it meets the needs of its graduates. METHODS: A questionnaire, developed and sent to 1986-1991 graduates of the residency program (n = 76), determined their perceptions of how well the practice management curriculum prepared them to operate a practice. Fifty (65.8%) usable surveys were returned. RESULTS: The respondents perceived deficits in areas of preparing for office management, starting and building a practice, using professional services (especially in the areas of financial decisions and use of professionals), and reimbursement procedures. CONCLUSIONS: Physicians need an understanding of business fundamentals such as economics, organization management, contract evaluation, negotiation and mediation skills, methods of allocation of limited resources, information science, and consumerism. This article offers a process through which other family practice residency programs can begin evaluating and restructuring their practice management curricula to meet these needs.

Curriculum↗

[Biological versus artificial intelligence: a critical approach].

After brief considerations about intelligence, a comparative study between biologic and artificial intelligence is made. The specialists in Artificial Intelligence found that intelligence is purely a matter of physical symbol manipulation. The enterprise of Artificial Intelligence aims to understand what we might call Brain Intelligence in terms of concepts and techniques of engineering. However the philosophers believed that computer-machine can have syntax, but can never have semantics. In other words, that they can follow rules, such as those of arithmetic or grammar, but not understand what to us are meanings of symbols, such as words. In the present paper it is stressed that brain/mind complex constitutes a monolithic systemic that functions with emergent properties at several levels of hierarchical organization. These hierarchical levels are non-reducible to one another. They are at least three (neuronal, functional, and semantic), and they function within an interactional plan. The brain/mind complex, which transform informations in meanings, deals with problems by means of both logical and non-logical mechanisms; while logic allows the mind to arrange the elements for reasoning, the non-logical mechanisms (fuzzy logic, heuristics, insights) allows the mind to develop strategies to find solutions. The model for construction of the "intelligent machine" is the operating way of the brain/mind complex, which does not always use logical processes. The role of information science in Artificial Intelligence is to search for knowledge itself (virtual knowledge), rather than to simply attempt a logico-mathematical formalization of knowledge.

Artificial Intelligence↗

NLM Medical Library Resource Improvement Grant Program: an evaluation.

The Extramural Programs, NLM, undertook a staff study to evaluate the Medical Library Resource Improvement Grant Program in order to determine impact on hospital library development and to assess factors significant to regional medical library (RML) network development. Initiated in fiscal year 1971, the improvement grant program provides one-year, one-time grant awards of a maximum of $3,000 to assist in establishing a basic collection of books, journals, and other health science information resources for community hospitals and comparable health facilities. Applicants who received grant awards were compared to applicants who did not receive awards and to nonapplicants, using nine dependent variables, four independent variables, and responses to an RML questionnaire. Results show that the applicants who received awards outperformed the other groups, and that the improvement grant program has been successful in stimulating library development. As a result of this study, the improvement grant program will be modified to support consortium arrangements as well as individual institutions, and to extend the period of grant support to two years. Future grant support will be a maximum of $4,000 in the first year, and up to $3,000 with a provision of $1,000 in matching funds from the grantee in the second year.

Economics, Hospital↗