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PubMed2000

A study of well-being among a population of Swedish workers using a job-related criterion-referenced multidimensional vocational assessment.

OBJECTIVES: This study involved Swedish workers (n = 106) who perform jobs categorized into four occupational groups from Jist's Enhanced Dictionary of Occupational Titles (DOT) (Technical, Clerical, Service and Miscellaneous occupations) [1]. The workers capacity for work were investigated according to the Criterion Referenced Multidimensional Vocational Assessment (CMVA) comprising four aspects (described below), which were assessed in 14 different ways using 465 items. METHOD: The participants were interviewed [2], observed during performance of simulated work tasks [3], and answered mailed questionnaires [4,5,6,7,8,9,10,11,12,13,14,15]. The collected data were statistically analyzed using descriptive statistics and the tests of Cronbach's alpha coefficient, ANOVA, Chi-square, linear regression and Pearson's correlation coefficient. RESULTS: The participants' work contained different level of occupationally substantive complexity showing that the work demands were different for the four work groups. For some of the participants ill-health were detected; The workers' work skills, e.g., the demands (VALPAR work samples) [3] the jobs required of the worker was higher than 14 of the workers' capacity for work. It was remarkable that many of the workers (34%) estimated themselves in need for rehabilitative measures (Functional Status Questionnaire) [12,13]. The results suggested that there was a negative discrepancy of what the workers' valued and strived for in connection to what they had attained in their work-lives [15,16]. The psychosocial work environment influenced the worker both positively and negatively. Participants (about 17%) who are performing their usual work for at least 20 hours a week had risks for ill-health [6]. In several components of CMVA there were significant differences between male and female workers, probably showing that the female workers had a greater burden to perform all the myriad of daily occupations (Self-Assessed Capabilities to Perform Daily Occupations) [7] including salaried work.

Journal Article↗
PubMed2002

Towards elicitation of users requirements for hospital information system: from a care process modelling technique to a web based collaborative tool.

Growing attention is being given to the use of process modeling methodology for user requirements elicitation. In the analysis phase of hospital information systems, the usefulness of care-process models has been investigated to evaluate the conceptual applicability and practical understandability by clinical staff and members of users teams. Nevertheless, there still remains a gap between users and analysts in their mutual ability to share conceptual views and vocabulary, keeping the meaning of clinical context while providing elements for analysis. One of the solutions for filling this gap is to consider the process model itself in the role of a hub as a centralized means of facilitating communication between team members. Starting with a robust and descriptive technique for process modeling called IDEF0/SADT, we refined the basic data model by extracting concepts from ISO 9000 process analysis and from enterprise ontology. We defined a web-based architecture to serve as a collaborative tool and implemented it using an object-oriented database. The prospects of such a tool are discussed notably regarding to its ability to generate data dictionaries and to be used as a navigation tool through the medium of hospital-wide documentation.

Health Personnel↗
PubMed2002

Facts about artefacts in diagnostic pathology.

Literal meaning of artefact given by 'Oxford Advanced Learner Dictionary' is 'a thing made by people'. In medical science 'the fact' is not true; but we observe routinely is called artefact. We face various types of artefacts in daily reporting of pathology specimen. Many times artefacts hinder the actual diagnosis. The artefacts i. e. fixation artefact, processing artefact, staining artefact, mounting artefact, air bubbles etc. can cause difficulty in diagnosis and a pathologist should be trained to identify those artefacts.

Artifacts↗
PubMed2003

Analysis of neural coding through quantization with an information-based distortion measure.

We discuss an analytical approach through which the neural symbols and corresponding stimulus space of a neuron or neural ensemble can be discovered simultaneously and quantitatively, making few assumptions about the nature of the code or relevant features. The basis for this approach is to conceptualize a neural coding scheme as a collection of stimulus-response classes akin to a dictionary or 'codebook', with each class corresponding to a spike pattern 'codeword' and its corresponding stimulus feature in the codebook. The neural codebook is derived by quantizing the neural responses into a small reproduction set, and optimizing the quantization to minimize an information-based distortion function. We apply this approach to the analysis of coding in sensory interneurons of a simple invertebrate sensory system. For a simple sensory characteristic (tuning curve), we demonstrate a case for which the classical definition of tuning does not describe adequately the performance of the cell studied. Considering a more involved sensory operation (sensory discrimination), we also show that, for some cells in this system, a significant amount of information is encoded in patterns of spikes that would not be discovered through analyses based on linear stimulus-response measures.

Air↗
PubMed1976

Banality reinvestigated: A computer-based content analysis of suicidal and forced death documents.

Suicide and simulated notes and forced-death documents were processed on the Harvard III Psycho-Sociological Dictionary. For each text, frequencies of related words were generated; these were contrasted with each other and with baseline data using z scores. The results indicated that the suicidal groups were more "deviant." Other findings are concreteness and constriction of focus for suicides--a pattern suggesting denial just prior to the deed. The forced-death group seemed to be more meaningfully in contact with life and aware of responsibility. The stimulated group appeared to be fabricating a popular stereotype rather than exhibiting empathy. Implications were discussed.

Adult↗
PubMed2003

Arthroscopic acromioplasty: a comparison between workers' compensation and non-workers' compensation populations.

BACKGROUND: The purpose of the present prospective study was to analyze a consecutive series of patients with subacromial impingement syndrome who were managed with arthroscopic acromioplasty by a single surgeon. METHODS: A consecutive series of 106 patients (106 shoulders) with a mean age of 44.7 years (range, twenty to seventy years) was analyzed after a mean duration of follow-up of thirty-two months. The Workers' Compensation group included forty patients (twenty-five men and fifteen women) with a mean age of 41.7 years. The non-Workers' Compensation group included sixty-six patients (thirty-two men and thirty-four women) with a mean age of 46.5 years. The work-demand level was categorized according to the Dictionary of Occupational Titles from the United States Department of Labor. Previously unrecognized intra-articular pathological changes were categorized with use of consistent criteria. Workers' Compensation status, the work-demand level, and the presence of associated intra-articular pathological changes were analyzed for their effect on outcome scores and time to return to full-duty work. RESULTS: The mean outcome scores for the entire population showed significant improvement when the preoperative values were compared with the postoperative values; specifically, the American Shoulder and Elbow Surgeons (ASES) score improved from 41.8 to 86.9, the Simple Shoulder Test (SST) score improved from 5.1 to 10.0, and the visual analog scale (VAS) for pain improved from 6.0 to 1.1 (p < 0.05). Postoperatively, there was no significant difference in the mean outcome scores between the Workers' Compensation and non-Workers' Compensation groups or between different work-demand levels. There was, however, a significant difference in the average time to return to full-duty work (13.7 weeks in the Workers' Compensation group compared with 9.1 weeks in the non-Workers' Compensation group; p = 0.0001), with the Workers' Compensation group having relatively heavier work-demand levels. Intra-articular pathological findings did not affect the outcome scores, but pathological findings that changed treatment were associated with a longer time to return to work (p = 0.04). CONCLUSION: Arthroscopic acromioplasty consistently provided a good surgical outcome and the ability to return to work in both the Workers' Compensation and non-Workers' Compensation populations. The work-demand level had a direct effect on the time to return to full duty, regardless of Workers' Compensation status. Patients, physicians, therapists, and employers may benefit from the knowledge of these expected outcomes and realistic time-frames for return to work.

Acromion↗
PubMed2003

Reducing medication errors and increasing patient safety: case studies in clinical pharmacology.

Today, reducing medication errors and improving patient safety have become common topics of discussion for the president of the United States, federal and state legislators, the insurance industry, pharmaceutical companies, health care professionals, and patients. But this is not news to clinical pharmacologists. Improving the judicious use of medications and minimizing adverse drug reactions have always been key areas of research and study for those working in clinical pharmacology. However, added to the older terms of adverse drug reactions and rational therapeutics, the now politically correct expression of medication error has emerged. Focusing on the word error has drawn attention to "prevention" and what can be done to minimize mistakes and improve patient safety. Webster's New Collegiate Dictionary has several definitions of error, but the one that seems to be most appropriate in the context of medication errors is "an act that through ingnorance, deficiency, or accident departs from or fails to achieve what should be done." What should be done is generally known as "the five rights": the right drug, right dose, right route, right time, and right patient. One can make an error of omission (failure to act correctly) or an error of commission (acted incorrectly). This article now summarizes what is currently known about medication errors and translates the information into case studies illustrating common scenarios leading to medication errors. Each case is analyzed to provide insight into how the medication error could have been prevented. "System errors" are described, and the application of failure mode effect analysis (FMEA) is presented to determine the part of the "safety net" that failed. Examples of reengineering the system to make it more "error proof" are presented. An error can be prevented. However, the practice of medicine, pharmacy, and nursing in the hospital setting is very complicated, and so many steps occur from "pen to patient" that there is a lot to analyze. Implementing safer practices requires developing safer systems. Many errors occur as a result of poor oral or written communications. Enhanced communication skills and better interactions among members of the health care team and the patient are essential. The informed consent process should be used as a patient safety tool, and the patient should be warned about material and foreseeable serious side effects and be told what signs and symptoms should be immediately reported to the physician before the patient is forced to go to the emergency department for urgent or emergency care. Last, reducing medication errors is an ongoing process of quality improvement. Faculty systems must be redesigned, and seamless, computerized integrated medication delivery must be instituted by health care professionals adequately trained to use such technological advances. Sloppy handwritten prescriptions should be replaced by computerized physician order entry, a very effective technique for reducing prescribing/ordering errors, but another far less expensive yet effective change would involve writing all drug orders in plain English, rather than continuing to use the elitists' arcane Latin words and shorthand abbreviations that are subject to misinterpretation. After all, effective communication is best accomplished when it is clear and simple.

Adult↗
PubMed2003

[A brief research on the life of Li Lian, the author of Yi shi (Medical history) of the Ming dynasty, and his works].

The dates of birth and death of Li Lian, a medical historian and literati of the Ming dynasty and the writing of Yi shi (Medical History) are studied. Based on the Ming scholar Chen Bo's epitaph and Li Lian's own essays and poets, Li's date of birth is settled as 1488, that of his death, 1566. Thus, the mistakes and missing of these dates of the entry "Li Lian" appeared in three biographical dictionaries are corrected. The family background of Li Lian, a descendant of the "Jin Zhong Li", a family pediatrician of over 200 years, are studied. Comprehensive analysis is made on the date of compilation of Li Lian's Medical History based on the prefaces, epitaphs of Yang Lian and Wang Ao, both Ming officials, and inferred to be around 1529 - 1530.

China↗
PubMed2003

[Analysis of generic drug supply in France].

BACKGROUND: The list of generic medicines (LGM), published since 1997 by the Agence Française de Sécurité Sanitaire des Produits de Santé (AFFSSaPS), the French Medicine Agency, concerns a special part of the medicines reimbursed by the National Health Insurance (Social Security). The objectives of the present study were: i) to describe the components of this list, based on pharmaceutical, economical and therapeutic characteristics, ii) to study differences between generic and reference products (formulations, excipients, prices, etc.), iii) to analyze information on excipients provided to health care professionals. METHODS: The 21st version of the LGM (April 2001) was used. Therapeutic value was retrieved from the 2001 AFSSaPS report on the therapeutic value of 4490 reimbursed medicines. Information on excipients in the LGM and the Vidal dictionary (reference prescription book in France) was compared. RESULTS: The products included in the LGM represent 20% of all reimbursed medicines. The mean price differences between generics and their reference products vary between 30 and 50% for more than two thirds of the generic groups. The therapeutic value of the products of the LGM was judged important in 71% of cases (vs 63% for the 4409 assessed medicines) and insufficient in 13% of cases (vs 19%). Information on excipients is often missing and sometimes erroneous. CONCLUSION: Although the LGM is regularly revised and thus the generic market in perpetual change, the 2001 cross description of this pharmaceutical market provides much informations and raises some concern.

Chemistry, Pharmaceutical↗
PubMed1992

Obstetric care and cesarean birth rates: a program to monitor quality of care.

OBJECTIVE: To study the quality of obstetric care in relation to rising cesarean rates, a Task Force was formed in New York state by the Department of Health and ACOG District II. The Task Force also included the Organization of Obstetric, Gynecologic, and Neonatal Nurses and the Hospital Association of New York State. The goals were to enhance hospitals' in-house review processes, standardize terminology, and improve the quality of care. A premise of the program was that if quality of care improved, cesarean rates would fall. METHODS: A Dictionary of Terms was developed to standardize clinical and diagnostic terminology. A two-tiered review process was instituted, using internal and external hospital reviews. A format for in-house review of obstetric care was developed and recommended to hospitals. External reviews were conducted at 24 hospitals during 1989-1990. Review teams, composed of obstetrician-gynecologists and obstetric nurses in active obstetric practice, assessed obstetric facilities, staffing, medical care, and the in-house review process. Contacts continued with the hospitals after site visits to follow up on implementation of recommendations. General recommendations to improve care, based on the overall program experience, were distributed to hospitals and physicians as part of educational efforts to improve quality of care. RESULTS: The state cesarean rate reversed. Statistics for 1989 and 1990 showed a stronger downward trend in reviewed hospitals than in non-reviewed hospitals. A survey of reviewed hospitals reported a positive response to the review process. CONCLUSION: A successful quality assurance program can be jointly developed by a state regulatory agency and a medical specialty society.

Cesarean Section↗
PubMed2001

[On the etymology and the semantics of the medical term: Istiska'].

This article deals with the etymology and semantics of the term istiska' which was interpreted as cirrhosis in some studies. The meaning of the term in the old medical texts and dictionaries was studied by quoting examples from original sources. It is concluded that istiska was used for dropsy, that is, an abnormal accumulation of serous fluid in tissue or in a cavity of a body, such as the abdomen, pleura, thorax, peritoneum etc.; and in the 19th and 20th centuries it meant hydrax and, was used as the prefix hydr- or hydro-. The text also describes the various forms of istiska' found in the Turkish terminology.

Edema↗
PubMed2003

Mapping care processes within a hospital: a web-based proposal merging enterprise modelling and ISO normative principles.

Today, the economic and regulatory environment are pressuring hospitals and healthcare professionals to account for their results and methods of care delivery. The evaluation of the quality and the safety of care, the traceability of the acts performed and the evaluation of practices are some of the reasons underpinning current interest in clinical and hospital information systems. The structured collection of users' needs and system requirements is fundamental when installing such systems. This stage takes time and is generally misconstrued by caregivers and is of limited efficacy to analysis. We used a modelling technique designed for manufacturing processes (SADT: Structured Analysis and Design Technique). We enhanced the initial model of activity of this method and programmed a web-based tool in an object-oriented environment. This tool makes it possible to extract the data dictionary from the description of a given process and to locate documents (procedures, recommendations, instructions). Aimed at structuring needs and storing information provided by teams directly involved regarding the workings of an institution (or at least part of it), the process mapping approach has an important contribution to make in the analysis of clinical information systems.

Critical Pathways↗
PubMed2003

DicoSE--a Web-interface based on XML for visualizing and searching the topology of the data structure defined by the DICOM 3 standard.

To adequately visualize and interpret the data fields of DICOM 3 datasets the data structure defined in the DICOM 3 standard has to be applied. The DICOM 3 data structure is very extensive and therefore costly to implement. We are working on an open source system which provides the data structure via a Java-programming interface. The data is held in a freely available XML-database. As a spin-off we are providing the web-based Dicom Search Engine (DicoSE) which will be available via internet soon. DicoSE allows for searching the DICOM standard data dictionary for defined data fields and visualizes the topology of the data which is present in DICOM datasets acquired by various types of modalities. Thus, the interpretation of the meaning of data fields is supported. For maintaining the data stored in the database a web-based administration interface is provided.

Database Management Systems↗
PubMed2003

A prototype natural language interface to a large complex knowledge base, the Foundational Model of Anatomy.

We describe a constrained natural language interface to a large knowledge base, the Foundational Model of Anatomy (FMA). The interface, called GAPP, handles simple or nested questions that can be parsed to the form, subject-relation-object, where subject or object is unknown. With the aid of domain-specific dictionaries the parsed sentence is converted to queries in the StruQL graph-searching query language, then sent to a server we developed, called OQAFMA, that queries the FMA and returns output as XML. Preliminary evaluation shows that GAPP has the potential to be used in the evaluation of the FMA by domain experts in anatomy.

Anatomy↗
PubMed2003

Extracting diagnosis from Japanese radiological report.

This study is aimed at extracting diagnosis with positive or negative assertion from radiological report written in Japanese Natural Language. We get frequency of verb patterns that indicate pos/neg assertion, and extract a rule in order of the occurrence. We made customized dictionary of 36,152 terms relating to disease names or radiological findings, and tried to extract pairs of (pos/neg, disease and verb pattern ) by using rules according to the most frequent pattern from 1,524/5,000 CT reports (each report consists of 15.1 words on the average). We tried only a few rules so far, and continue to find other rules.

Diagnosis↗
PubMed2004

Translating medical journals into Arabic. JAMA Middle East as an example.

JAMA Middle East has distributed monthly 25,000 issues into 14 Arab countries since 1991. Translating the original articles into Arabic was considered as the license permits translation. The number of Arab physicians exceeds 250,000, but those who studied medicine in Arabic are very few. Adequate translators and other publishing staff are lacking. Advertisers will not invest in journals without readership. The other 13 international editions of JAMA publish in their national languages, so do their medical schools. Teaching medicine in a foreign language did not bring leadership to Arab medicine. It is just another indicator of Arab underdevelopment. There is growing support to shift the language of medical teaching into Arabic, but the only practical step has been the Unified Medical Dictionary.

American Medical Association↗
PubMedDate not supplied

Computer use among medical students in an institution in southern India.

BACKGROUND: This cross-sectional, descriptive study was conducted in Pondicherry from May to October 2002 to assess computer and internet use among medical students. METHODS: The participants were four batches of undergraduate students, one batch of interns and two batches of postgraduate students. A pre-tested questionnaire was used to collect data from 394 subjects. Written informed consent was obtained from all the participants. RESULTS: Computer knowledge was found to be higher among postgraduates (93.3%) compared to undergraduates (84.5%). Students learnt computers by self-learning, attending classes and using manuals. Writing letters was the most common use of the computer (postgraduates [100%] and undergraduates [87.5%]). Seventy-one per cent of the postgraduates and 43% of the undergraduates used English language dictionaries. About 61% of the undergraduates used computers for playing games. Students also used computer for watching movies. MS Office was the most commonly used software (postgraduates [100%] and undergraduates [72.2%]). The use of software for visual designing and drawing was low. Undergraduates used audio players more often than postgraduates. Most students used the internet for e-mail (postgraduates [100%] and undergraduates [97.3%]). Undergraduate students used the internet for chatting and entertainment. Online banking was also used to some extent. Most of the students were willing to undergo training. All the groups unanimously felt that the institute should provide free training in medical informatics. CONCLUSION: This study revealed high computer use among medical students in an institution with good computer facilities. The majority expressed their willingness to undergo further training.

Computer Literacy↗