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At least 595 records · Page 33Linked to original sources
PubMed1988

Information management through integration of distributed resources.

Duke University Medical Center conducted a strategic planning process focused on information management needs beginning in 1983 and ending in 1985. That effort concluded that the institution was ready to establish an Integrated Academic Information Management System (IAIMS). A model was proposed in which information management was to be achieved through integrated distributed resources. The elements of the IAIMS model are ongoing policy development and planning; communications; an electronic library or resource inventory; coordination of the development or selection of the end-user function; user support; and ongoing evaluation. This model is being tested to determine its effectiveness in meeting the administrative, patient care, research, and educational needs of a basic science department and a clinical science department at Duke University.

Academic Medical Centers↗
PubMed2005

Integrating child health information systems.

The Health Resources and Services Administration and All Kids Count (a national technical assistance center fostering development of integrated child health information systems) have been working together to foster development of integrated child health information systems. Activities have included: identification of key elements for successful integration of systems; development of principles and core functions for the systems; a survey of state and local integration efforts; and a conference to develop a common vision for child health information systems to meet medical care and public health needs. We provide 1 state (Utah) as an example that is well on the way to development of integrated child health information systems.

Child↗
PubMed2004

Underlying principles of visual shape selectivity in posterior inferotemporal cortex.

Object perception depends on shape processing in the ventral visual pathway, which in monkeys culminates in inferotemporal cortex (IT). Here we provide a description of fundamental quantitative principles governing neural selectivity for complex shape in IT. By measuring responses to large, parametric sets of two-dimensional (2D) silhouette shapes, we found that neurons in posterior IT (Brodmann's areas TEO and posterior TE) integrate information about multiple contour elements (straight and curved edge fragments of the type represented in lower-level areas) using both linear and nonlinear mechanisms. This results in complex, distributed response patterns that cannot be characterized solely in terms of example stimuli. We explained these response patterns with tuning functions in multidimensional shape space and accurately predicted neural responses to the widely varying shapes in our stimulus set. Integration of contour element information in earlier stages of IT represents an important step in the transformation from low-level shape signals to complex object representation.

Action Potentials↗
PubMed2006

Multisensory integration for timing engages different brain networks.

How does the brain integrate information from different senses into a unitary percept? What factors influence such multisensory integration? Using a rhythmic behavioral paradigm and functional magnetic resonance imaging, we identified networks of brain regions for perceptions of physically synchronous and asynchronous auditory-visual events. Measures of behavioral performance revealed the existence of three distinct perceptual states. Perception of asynchrony activated a network of the primary sensory, prefrontal, and inferior parietal cortices, perception of synchrony disengaged the inferior parietal cortex and further recruited the superior colliculus, and when no clear percept was established, only the residual areas comprised of prefrontal and sensory areas were active. These results indicate that distinct percepts arise within specific brain sub-networks, the components of which are differentially engaged and disengaged depending on the timing of environmental signals.

Acoustic Stimulation↗
PubMed2003

Robotics and neurosurgery.

Ultimately, neurosurgery performed via a robotic interface will serve to improve the standard of a neurosurgeon's skills, thus making a good surgeon a better surgeon. In fact, computer and robotic instrumentation will become allies to the neurosurgeon through the use of these technologies in training, diagnostic, and surgical events. Nonetheless, these technologies are still in an early stage of development, and each device developed will entail its own set of challenges and limitations for use in clinical settings. The future operating room should be regarded as an integrated information system incorporating robotic surgical navigators and telecontrolled micromanipulators, with the capabilities of all principal neurosurgical concepts, sharing information, and under the control of a single person, the neurosurgeon. The eventual integration of robotic technology into mainstream clinical neurosurgery offers the promise of a future of safer, more accurate, and less invasive surgery that will result in improved patient outcome.

Clinical Competence↗
PubMed2004

[The interview with the relatives of the neurosurgical patient].

INTRODUCTION: Information of diagnosis, therapeutic managements and inabilities are a very difficult task for neurosurgeons and very important for relatives. The interview is the best instrument that the neurosurgeon has to inform integrally; but many young physicians are not well prepared to deal with medical information and the educational work to achieve it still is insufficient. OBJECTIVE: To provide some general, organized and practical experiences on how to develop the interview with the relatives of the neurosurgical patient. DEVELOPMENT: The importance of the interview demands of: a) knowledge of the patient's data, b) reaching a specific diagnosis and appropriate therapy, c) accurate selection of the participants in the interview and d) specify when and where we will met the relatives. Most families prefer a physician that maintains an attitude of trust and sincerity and expresses clearly and slowly his thought. The explanations should be direct and simple. Repeated interviews can be concerted and we will perform a similar interview in emergent cases. CONCLUSIONS: The interview should be carried out as soon as possible and as soon as results of the medical investigations were available. The pessimism should be avoided and support will be given, without losing the contact with the reality. Information, which is sacrificed frequently in the art of the Medicine to give more importance to the science, indeed germinates much of the criticism to neurosurgeons and neurosurgical centers in the last two or three decades. We should not conform with the signature of an elementary and insufficient informed consent.

Humans↗
PubMed2003

Information technology, the internet, and the future of neurology.

BACKGROUND: This review addresses the impact of information technology and the Internet on the current and future practice of neurology. Information technology is influencing medical practice in ways that could be both beneficial and harmful. Scenarios are presented to depict some of the ways in which the practice of neurology is being influenced by the growth of technology. REVIEW SUMMARY: First, the advantages and disadvantages of e-mail as a means of doctor-patient communication are presented. Some of the ethical and legal issues arising in this context are discussed.Second, the Internet is changing neurologists' relationships to other professionals in the health care industry. Geographical isolation is less problematic than in the past. Telemedicine, including remote consulting via the Web, has special implications for neurologists in several areas, including stroke management, movement disorders, and epilepsy.Third, the growing availability of large databases, powerful search engines, and online full-text journals is discussed. Skill in navigating and managing these resources will become increasingly important. New computer-assisted decision support systems will continue to be implemented. Applications exist or are being developed for use by clinicians for many specific neurologic disorders.Finally, some of the problematic issues concerning medical use of the Internet are discussed, including availability, portability, security, quality, and outcomes. CONCLUSIONS: Medical information systems, with their attendant advantages and limitations, will become increasingly significant in the practice of neurology. Despite overall improvement in access to information, major barriers still exist to the proper implementation and utilization of truly integrated information systems.

Access to Information↗
PubMed2004

Area-selective neuronal activity in the dorsolateral prefrontal cortex for information retrieval and action planning.

We compared how neurons in the dorsal and ventral regions of the dorsolateral prefrontal cortex (dl-PFC) participate in processing 2 sets of sensory signals, given at intervals, to generate plans for future actions. For the first set of visual signals, neurons in the ventral region of dl-PFC responded preferentially to the visuospatial properties of the signal, whereas neurons in the dorsal region of dl-PFC were involved primarily in retrieving information from the signal, such as the location of the target or which arm to use. For the second set of visual signals, most ventral dl-PFC neurons reflected either the sensory properties of the signals or the information retrieved from each signal. By contrast, dorsal neurons were involved more in integrating information about the target location and which arm to use to reach the target, thereby generating information that could be used to plan future actions. Thus sensorimotor transformations in the dorsolateral PFC appear to be time-variant and region-selective.

Animals↗
PubMed1998

The role of pharmacoeconomic evaluations in disease management.

Disease management is a systematic approach to a health condition or a healthcare intervention that organises preventative, interventional and care approaches throughout the continuum of care and which measures outcomes in terms of populations, not individuals. Disease management's advantage over the current component system is that it stresses prevention over acute treatment of a chronic disease. Patients with better control of their chronic diseases will likely have a decrease in the use of emergency room and inpatient hospitalisation services, thereby improving clinical outcomes of patients. To achieve these goals, disease management uses pharmacoeconomic evaluations and outcomes measures to provide information that helps build formularies and clinical practice guidelines. Several problems exist in integrating pharmacoeconomic studies in disease management models, such as the need for more integrated information systems, standardisation and who should perform these evaluations. Some possible solutions will be addressed in this article. With greater emphasis being placed on controlling costs, the need for pharmacoeconomic evaluations in the design of disease management models will continue to increase in the future.

Cost Control↗
PubMed1997

Facilitating linkage through universal patient identifiers: a difficult endeavor.

The article discusses the creation and use of universal patient identifiers to facilitate the linkage of patient records from all the components of the health care delivery system. The benefits and disadvantages of using a national health identifier that uses the Social Security number are discussed. A number of universal patient identifier proposals are presented to illustrate the complexity of the issue. The article concludes with a discussion of what health information managers can currently do in their own facilities to facilitate access to integrated information.

Community Networks↗
PubMedDate not supplied

Strengthening the public health system.

Although the American public health system has made major contributions to life expectancy for residents of this country over the past century, the system now faces more complex health problems that require comprehensive approaches and increased capacity, particularly in local and State public health agencies. To strengthen the public health system, concerted action is needed to meet these five critical needs: First, the knowledge base of public health workers needs to be supplemented through on-the-job training and continuing education programs. To this end, self-study courses will be expanded, and a network of regional training centers will be established throughout the country. Second, communities need dynamic leadership from public health officials and their agencies. To enhance leadership skills and expand the leadership role of public health agencies, focused personal leadership development activities, including a Public Health Leadership Institute, and national conferences will provide a vision of the future role of public health agencies. Third, local and State public health agencies need access to data on the current health status of the people in their communities and guidance from the nation's public health experts. To improve access to information resources, state-of-the-art technologies will be deployed to create integrated information and communication systems linking all components of the public health system. Fourth, local and State agencies need disease prevention and health promotion plans that target problems and develop strategies and the capacity to address them. To provide communities with structured approaches to this process, planning tools have been developed and distributed, and technical assistance will be provided to local and State health agencies to involve each community in planning,priority setting, and constituency building.Finally, public health agencies need adequate resources to fund prevention programs. To improve the use of existing Federal support and enhance the availability of new community resources, grant programs will be modified, and innovative approaches to local resource enhancement will be developed and shared.Activities in these five key areas are designed to improve the infrastructure of the public health system and its capacity to carry out effectively the core functions of public health assessment, policy development, and assurance of the availability of the benefits of public health. If the nation is to achieve the health objectives for the year 2000, the public health system-the individuals and institutions that, when working effectively together, promote and protect the health of the people-must be strengthened.

Computer Communication Networks↗
PubMed1997

Patients' rights in laboratory examinations: do they realize?

This article discusses the rights of patients who are attending hospital for the most common laboratory examinations and who may also be taking part in research studies. A distinction is made between five kinds of rights to: protection of privacy, physical integrity, mental integrity, information and self-determination. The data were collected (n = 204) by means of a structured questionnaire specifically developed for this study in the clinical chemistry, haematological, physiological and neurophysiological laboratories of one randomly selected university hospital in Finland. The analysis of the data was statistical. On the whole, patients' rights were realized reasonably well. This was most particularly the case with protection of privacy, as well as with the rights of physical and mental integrity. The rights to information and self-determination were less well realized. There are various steps that health care professionals and organizations can take to make sure that patients can enjoy their full rights, by counselling the patient, by giving opportunities to plan the examinations in advance, and by arranging a sufficient number of small examination rooms.

Adolescent↗
PubMed2004

Attention and cognitive control as emergent properties of information representation in working memory.

A hallmark of primate, and particularly human, behavior is cognitive control, the ability to integrate information from a multitude of sources and use that information to flexibly guide behavior in order to achieve an infinite number of goals. The neural mechanisms of cognitive control have yet to be fully elucidated, although the prefrontal cortex is known to play a critical role. Here, I review evidence suggesting that a unifying principle regarding the role of various portions of the prefrontal cortex in a wide range of cognitive tasks is the active maintenance in working memory of different types of currently relevant information-from specific stimulus features, to instructional cues, to motivational goals and contexts. I argue that the key to demonstrating the existence of this domain-dependent organization lies in a better understanding of the nature of the representation of this information and the ways in which this information itself controls cognition and behavior.

Attention↗
PubMed2000

DataFoundry: information management for scientific data.

Data warehouses and data marts have been successfully applied to a multitude of commercial business applications. They have proven to be invaluable tools by integrating information from distributed, heterogeneous sources and summarizing this data for use throughout the enterprise. Although the need for information dissemination is as vital in science as in business, working warehouses in this community are scarce because traditional warehousing techniques do not transfer to scientific environments. There are two primary reasons for this difficulty. First, schema integration is more difficult for scientific databases than for business sources, because of the complexity of the concepts and the associated relationships. While this difference has not yet been fully explored, it is an important consideration when determining how to integrate autonomous sources. Second, scientific data sources have highly dynamic data representations (schemata). When a data source participating in a warehouse changes its schema, both the mediator transferring data to the warehouse and the warehouse itself need to be updated to reflect these modifications. The cost of repeatedly performing these updates in a traditional warehouse, as is required in a dynamic environment, is prohibitive. This paper discusses these issues within the context of the DataFoundry project, an ongoing research effort at Lawrence Livermore National Laboratory. DataFoundry utilizes a unique integration strategy to identify corresponding instances while maintaining differences between data from different sources, and a novel architecture and an extensive meta-data infrastructure, which reduce the cost of maintaining a warehouse.

Computer Systems↗
PubMed2001

Impact of an electronic information system on physician workflow and data collection in the intensive care unit.

OBJECTIVE: To test the hypotheses that: (1) integrating information processing tasks using an electronic clinical information system (ECIS) decreases time to complete these tasks by hand; and (2) structured data entry encourages generation of more detailed records and capture of specific data elements even when entry is voluntary. DESIGN: Prospective observational time analysis during medical documentation tasks. Retrospective analysis of clinical documentation completed by hand or electronically. SETTING: Eleven bed pediatric intensive care unit within an academic medical center. PARTICIPANTS: Five pediatric intensive care medicine attending physicians. MEASUREMENTS: Compared handwritten and electronic documentation to determine: (1) time spent entering data or composing notes; (2) number of descriptors documenting patients' physical exams; (3) users' preferences for structured or unstructured data entry; (4) frequency of documenting specific data elements related to nutritional support. RESULTS: Documentation time varied by user but not charting method: it took 13 % less time to document using the ECIS but this was not significant. Electronic documents were more detailed than handwritten containing 50 % more descriptors (17.8 +/- 1.4 vs 11.6 +/- 1.4) overall and some data elements that were not handwritten: information related to nutritional supplementation was recorded in 13 % of electronic documents but in none of 89 handwritten documents. CONCLUSIONS: Electronic and handwritten documentation consumed equal amounts of time. Structured entry, compared to handwriting, may encourage recording of specific or otherwise unincorporated data elements resulting in a more detailed record. This suggests that user interfaces and decision support components may influence both the types and complexity of clinical data recorded by caregivers.

Analysis of Variance↗
PubMed2000

Mouse-human comparative map resources on the Web.

Comparative maps have been a valuable resource for extrapolating biological information among organisms. The relationship between mouse and human maps provides a framework for integrating information from each species and thereby increasing the utility of all available data such as gene location, structure and function. This review describes the various public resources, both databases and web sites, containing genome-wide mouse-human comparative map information available through the World-Wide Web. We will focus on the use and applicability of these resources in their current form and consider future potential directions.

Animals↗
PubMed2003

Mother-lamb acoustic recognition in sheep: a frequency coding.

Ewes of the domestic sheep ( Ovis aries ) display selective maternal investment by restricting care to their own offspring and rejecting alien young. This trait relies on individual recognition processes between ewes and lambs. Whereas identification at the udder is only olfactory, distance recognition is performed through visual and acoustic cues. We studied the effectiveness and modalities of mutual acoustic recognition between ewes and lambs by spectrographic analysis of their vocal signatures and by playbacks of modified calls in the field. Our results show that ewes and their lambs can recognize each other based solely on their calls. The coding of identity within the vocal signatures, previously unknown in sheep, is similar in lamb and ewe: it uses the mean frequency and the spectral energy distribution of the call, namely the timbre of the call. These results point out a simple signature system in sheep that uses only the frequency domain. This engenders a signal with low information content, as opposed to some highly social birds and mammal species that may integrate information both in the temporal and spectral domains. The simplicity of this system is linked to the roles played by vision and olfaction that corroborate the information brought by the vocal signature.

Animals↗
PubMedDate not supplied

The functional relationship of monkey infra parietal cortex (IPL) to behavior in the extrapersonal space.

Lesions of the posterior parietal system in humans and of the presumably homologous area 7 of the monkey cause impairment in high-order manipulative behavior. A specific "misreaching" observed prompted the outlook of dysfunction constrained to the perceptual, the comand/motor aspects excluded. To clarify the nature of normal functioning in this domain, a study was done by microelectrode recording from area 7 of the monkey of neural firing in relation to hand reaching to targets. The data obtained show that an area 7 neuron fires in relation to simple stimuli, such as a square of white light, and to composite stimuli, such as hand reaching by the monkey or by the trainer in the monkey's extrapersonal space, the response to complex stimuli characteristically multiduty. The firing patterns were presumably relatable to encoding of stimulus components with superposed situation variance. Selectivity of the stimulus was maintained along specific invariance, such as to hand used, to direction of outgoing reaching, to direction from which the rewarding hand of the trainer reached. It is proposed that functional linkage of cognate features, a consequent modular category encoding and "packaging" of information relevant for praxis schema, is thus achieved by area 7 cells specialized for integrating information in the time and space domains visual, tactile, proprioceptive/kinaesthetic, and other for the sake of behavior in extrapersonal space. Generalization without jeopardizing of differentiating is presumably enabled through the multiduty cell entity.

Animals↗