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PubMed1992

In search of a perfect partnership.

There's no question that our partnership is a natural, given the technological emphasis in modern medicine. My comments are not intended as criticism, but offered in the spirit of broadening our mutual understanding. I believe that open communication will enhance our continued collaboration in this interdisciplinary effort and yield significant advances in medical science.

Algorithms↗
PubMed1998

Dental public health for the 21st century: implications for specialty education and practice.

A panel of public health practitioners sponsored by the Health Resources and Services Administration met December 6-8, 1994, to examine current roles and responsibilities for dental public health workers and to recommend changes in education and training to meet challenges posed by an evolving health care system. Overall, at least the same number, if not more, dental public health personnel will be needed in the future. While some new roles were identified, the panel felt that only small numbers of personnel will be needed to fill these new roles. Not all of these roles necessarily require a dental degree. The panel felt that a need exists for more academicians for dental schools, schools of public health, dental public health residencies, and dental hygiene programs; oral epidemiologists and health services researchers; health educators; and specialists in utilization review/outcomes assessment, dental informatics, nutrition, program evaluation, and prevention. To meet these personnel needs: (1) dental public health residency programs should be structured to meet the educational needs of working public health dentists with MPH degrees through on-the-job residency programs; (2) the standards for advanced specialty education programs in dental public health should be made sufficiently flexible to include dentists who have advanced education and the requisite core public health courses; (3) flexible MPH degree programs must be available because of the rising debt of dental students and the decreased numbers of graduating dentists; (4) loan repayment should be available for dentists who have pursued public health training and are working in state or local health departments; and (5) standards for advanced education in dental public health should be developed for dental hygienists.

Certification↗
PubMed2000

NHSnet in Scottish primary care: lessons for the future.

OBJECTIVE: To evaluate the primary care communications initiative, which introduced NHSnet to primary care in Scotland. DESIGN: Semi-structured telephone interviews, postal questionnaire. SETTING: All 15 Scottish health boards, random sample of 1 in 3 of all Scottish general practices. PARTICIPANTS: Information management and technology managers of health boards, 355 practice managers in the general practices. MAIN OUTCOME MEASURES: Variations between health boards in styles of project management, means of connection to NHSnet, costs to general practices, and training provided. Practices' levels of participation in initiative, initial use of NHSnet, and factors acting as incentives and disincentives to use of NHSnet. RESULTS: 99% of Scottish general practices agreed to participate in initiative. Health boards varied significantly in project management styles (from minimal to total control), the nature of the networks they established (intranets or direct connections), costs to practices (from nothing to pound125 per general practitioner per year), and training provided (from none to an extensive programme). In 56% of practices someone accessed NHSnet at least once a week. Practices varied considerably in amount of internet training received and staff groups targeted and in the intention to provide desktop access to NHSnet through a practice network. CONCLUSION: The initiative has successfully introduced a network that links Scottish general practices, health boards, and hospital trusts. However local variation in this "national" initiative may affect its use in primary care. Health authorities and general practices in England and Wales may wish to note these findings in order to avoid unhelpful variation.

Computer Communication Networks↗
PubMed1989

Fully automated computer analysis of intracolonic pressures.

A fully automated (PC compatible) software and hardware analysis system has been designed and developed to analyse colonic pressure records quickly and objectively. Eight hours of colonic pressure trace was analysed in 48 10 minute epochs manually and by computer for the variables of mean amplitude, % duration of activity, motility index, number of peaks and activity index. Agreement between methods was good for mean amplitude: (bias -0.5 mmHg; (36.8) (2 SD, limits of agreement); -5.8 to 4.8, 95% CI of bias; 0-289, average range of values by both methods), % duration of activity: (-0.9; (13.4); -2.9 to 0.9; 0-100), motility index: (-55; (2072); -356 to 245; 0-26,220), number of peaks: (-20; (91); -44 to 3.5; 1-211), and activity index bias -5.2 mmHg. min; (127.3); -23.7, to 13.2; 0-2159. The time taken for manual analysis was 889 minutes compared with 14 minutes for the automated system. Fully automated analysis of colonic pressure records is fast, objective, and shows good agreement with labour intensive manual analysis. Previously acquired data can be reanalysed using new definitions and criteria. Widespread use of the technique could introduce uniformity in colonic pressure record analysis. In addition this wave form analysis system can be adapted to record and analyse pressure data from other regions of the gastrointestinal tract.

Colon↗