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Computer control of mechanical ventilation.

Computer control of mechanical ventilators includes the operator-ventilator interface and the ventilator-patient interface. New ventilation modes represent the evolution of engineering control schemes. The various ventilation control strategies behind the modes have an underlying organization, and understanding that organization improves the clinician's appreciation of the capabilities of various ventilation modes and gives an idea of what we can and should expect for the future. The operator-ventilator interface has received little attention in the literature, despite the fact that there is a whole science of human-computer interaction. This report suggests a methodology for the study of ventilator interfaces.

Artificial Intelligence↗

A software solution for the control of visual behavioral experimentation.

Psychophysical and neurophysiological research requires precise control of experimental devices for the purpose of delivering stimuli and monitoring behavioral and neural responses. This has previously been accomplished by complex, often proprietary, programmable systems, interfacing with a limited range of hardware. We have developed a software solution entirely within the Matlab environment that can achieve high-speed control of experimental and behavioral variables. We make this Wake-Forest Visual Experimentation (WaVE) software freely available under the GNU public license, and demonstrate how to customize it to individual laboratory needs. WaVE takes advantage of existing Matlab libraries and toolboxes to present visual stimuli, collect experimental data, update behavioral variables, and communicate with other computers. Although we have developed it for use in a Windows-based Personal Computer, the portability of the Matlab code makes possible its customization for use in a variety of other systems. We present simulation results showing sub-millisecond sampling rate and updating precision, running on single-processor, desktop PCs. The WaVE software offers a simple, flexible and powerful solution that compares favorably with many of its costly alternatives.

Animals↗

Using behavioral theory in computer-based health promotion and appraisal.

This article explores how behavioral theory can facilitate the development, implementation, and evaluation of health promotion software packages intended to influence personal health practices and/or assess health risks. Current behavioral theories and models are reviewed, and their relevance to developing health promotion software is discussed. A series of six steps is suggested for developing and evaluating health promotion and appraisal software within a behavioral theory framework. These steps should help to facilitate direct application of the theory-based process to health promotion software development.

Behavioral Sciences↗

Nursing informatics: the trend of the future.

Nursing informatics is a combination of computer, information, and nursing sciences. This new and expanding field addresses the efficient and effective use of information for nurses. Preparing nurses for computerization is essential to confront an explosion of sophisticated computerized technology in the workplace. It is critical in a competitive health care market for preparing nurses to use the most cost-effective methods. A model is presented that identifies six essential factors for preparing nurses for computerization. Strong leadership, effective communication, organized training sessions, established time frames, planned change, and tailored software are the essential factors to consider for development of a successful educational program.

Computer User Training↗

A Web-accessible tutorial for PsyScope based on classic experiments in human cognition.

PsyScope is a graphically oriented, script-based program for the control of experiments on Macintosh computers that has been made freely available to the psychology community by its developers (Cohen, MacWhinney, Flatt, & Provost, 1993) at Carnegie Mellon University. We describe a graduated tutorial that was written for new users of PsyScope (instructors or students); the text and scripts can be retrieved from a website at Hamilton College (http:/(/)cogito.hamilton.edu/tutorial/). The tutorial examples may be used as classroom demonstrations or as pedagogical aids in teaching students how to use PsyScope in their own research projects. The four examples include a Stroop test, simple and choice reaction time, and a sentence-verification task.

Cognition↗

Comparing properties of brains and computers.

The criterion that pure natural science can only investigate objective phenomena which can be observed by independent observers sets certain limits to pure natural scientific understanding of brain functions. It excludes consciousness and feelings since these are only subjectively accessible and alternatives cannot be decided objectively. The limitations of brain research are discussed by comparing the properties of brains and computers. At least for the time being we do not know of any natural scientific--i.e. physical or chemical--method which allows the objective measurement of consciousness, sensations, and emotions. In addition it is discussed how and in how far our brain understands its surrounding nature.

Animals↗

National services provided by the Health Sciences Resource Centre of Canada.

The Health Sciences Resource Centre forms part of the National Science Library of Canada, whose collections and services are described. The new Centre coordinates activities of the various provincial medical libraries. Its creation began with increased collections of medical journals, and plans are underway to print out a union list of medical journals from the Union List of Scientific Serials tapes. The first product of the Centre is a medical "proceedings index" to proceedings held by the National Science Library; this is computer-produced, and will appear annually. An analysis was made of the medical items requested for borrowing from the National Science Library according to type of material, service provided, type of user, and geographical location. The results are given.A description is given of the SDI service currently provided by the National Science Library, based on Chemical Titles, Chemical Abstracts Condensates, INSPEC, and the ISI tapes. It is hoped to expand this data base with MEDLARS tapes.

Canada↗

Tell me, what did you see? The stimulus on computers.

Most psychology experiments start with a stimulus, and, for an increasing number of studies, the stimulus is presented on a computer monitor. Usually, that monitor is a CRT, although other technologies are becoming available. The monitor is a sampling device; the sampling occurs in four dimensions: spatial, temporal, luminance, and chromatic. This paper reviews some of the important issues in each of these sampling dimensions and gives some recommendations for how to use the monitor effectively to present the stimulus. In general, the position is taken that to understand what the stimulus actually is requires a clear specification of the physical properties of the stimulus, since the actual experience of the stimulus is determined both by the physical variables and by the psychophysical variables of how the stimulus is handled by our sensory systems.

Behavioral Sciences↗

The InterCon network: a program for education partnerships at the University of Texas-Houston Health Science Center.

The University of Texas-Houston Health Science Center (UT-Houston) has created programs and activities to address the state's pressing needs in minority education. Through InterCon, a network of universities and K-12 schools, UT-Houston works with its partners to identify competitive candidates in the current pool of minority graduates with bachelor's degrees and to help them--along with their non-minority counterparts--progress in their education. Another objective is to expand the pool of minorities underrepresented in medicine who complete high school and go to college. In 1994 UT-Houston and Prairie View A&M University created a collaborative venture to provide new educational opportunities at UT-Houston for Prairie View's predominantly African American students. A three-track summer internship program--a result of that collaboration--has since been expanded to partnerships with other minority and majority universities throughout Texas. In 1998, for example, 108 undergraduate students from these universities (and 40 other universities nationwide) participated in research, professional, and administrative summer internships at UT-Houston. The InterCon network also has partnerships with K-12 schools. UT-Houston works with inner-city, suburban, and rural school districts to develop education models that can be transferred throughout the state. The partnerships deal with helping to teach basic academic skills and computer literacy, improve science-related instruction, meet demands for health promotion materials and information for school-initiated health and wellness programs, and develop distance-learning paradigms. UT-Houston views InterCon as a program helping Texas institutions to engage and adapt to the socioeconomic factors, demographic changes, and technology explosion that currently challenge public education.

Community-Institutional Relations↗

A life scientist's gateway to distributed data management and computing: the PathPort/ToolBus framework.

The emergent needs of the bioinformatics community challenge current information systems. The pace of biological data generation far outstrips Moore's Law. Therefore, a gap continues to widen between the capabilities to produce biological (molecular and cell) data sets and the capability to manage and analyze these data sets. As a result, Federal investments in large data set generation produces diminishing returns in terms of the community's capabilities of understanding biology and leveraging that understanding to make scientific and technological advances that improve society. We are building an open framework to address various data management issues including data and tool interoperability, nomenclature and data communication standardization, and database integration. PathPort, short for Pathogen Portal, employs a generic, web-services based framework to deal with some of the problems identified by the bioinformatics community. The motivating research goal of a scalable system to provide data management and analysis for key pathosystems, especially relating to molecular data, has resulted in a generic framework using two major components. On the server-side, we employ web-services. On the client-side, a Java application called ToolBus acts as a client-side "bus" for contacting data and tools and viewing results through a single, consistent user interface.

Biological Science Disciplines↗

Recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, Computer-based Patient Record Institute, Medical Library Association, Association of Academic Health Science Libraries, American Health Information Management Association, American Nurses Association.

In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record Institute, the Medical Library Association, the Association of Academic Health Sciences Libraries, the American Health Information Management Association, the American Nurses Association, the Center for Healthcare Information Management, and the American College of Physicians. The consortium proposes four categories of clinical system risks and four classes of measured monitoring and regulatory actions that can be applied strategically based on the level of risk in a given setting. The consortium recommends local oversight of clinical software systems, and adoption by healthcare information system developers of a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively. FDA regulation should exempt most clinical software systems and focus on those systems posing highest clinical risk, with limited opportunities for competent human intervention.

Clinical Medicine↗

Grounding a new information technology implementation framework in behavioral science: a systematic analysis of the literature on IT use.

Many interventions to improve the success of information technology (IT) implementations are grounded in behavioral science, using theories, and models to identify conditions and determinants of successful use. However, each model in the IT literature has evolved to address specific theoretical problems of particular disciplinary concerns, and each model has been tested and has evolved using, in most cases, a more or less restricted set of IT implementation procedures. Functionally, this limits the perspective for taking into account the multiple factors at the individual, group, and organizational levels that influence use behavior. While a rich body of literature has emerged, employing prominent models such as the Technology Adoption Model, Social-Cognitive Theory, and Diffusion of Innovation Theory, the complexity of defining a suitable multi-level intervention has largely been overlooked. A gap exists between the implementation of IT and the integration of theories and models that can be utilized to develop multi-level approaches to identify factors that impede usage behavior. We present a novel framework that is intended to guide synthesis of more than one theoretical perspective for the purpose of planning multi-level interventions to enhance IT use. This integrative framework is adapted from PRECEDE/PROCEDE, a conceptual framework used by health planners in hundreds of published studies to direct interventions that account for the multiple determinants of behavior. Since we claim that the literature on IT use behavior does not now include a multi-level approach, we undertook a systematic literature analysis to confirm this assertion. Our framework facilitated organizing this literature synthesis and our analysis was aimed at determining if the IT implementation approaches in the published literature were characterized by an approach that considered at least two levels of IT usage determinants. We found that while 61% of studies mentioned or referred to theory, none considered two or more levels. In other words, although the researchers employ behavioral theory, they omit two fundamental propositions: (1) IT usage is influenced by multiple factors and (2) interventions must be multi-dimensional. Our literature synthesis may provide additional insight into the reason for high failure rates associated with underutilized systems, and underscores the need to move beyond the current dominant approach that employs a single model to guide IT implementation plans that aim to address factors associated with IT acceptance and subsequent positive use behavior.

Attitude to Computers↗

Pharmacokinetic software for the health sciences: choosing the right package for teaching purposes.

Computer assisted learning has an important role in the teaching of pharmacokinetics to health sciences students because it transfers the emphasis from the purely mathematical domain to an 'experiential' domain in which graphical and symbolic representations of actions and their consequences form the major focus for learning. Basic pharmacokinetic concepts can be taught by experimenting with the interplay between dose and dosage interval with drug absorption (e.g. absorption rate, bioavailability), drug distribution (e.g. volume of distribution, protein binding) and drug elimination (e.g. clearance) on drug concentrations using library ('canned') pharmacokinetic models. Such 'what if' approaches are found in calculator-simulators such as PharmaCalc, Practical Pharmacokinetics and PK Solutions. Others such as SAAM II, ModelMaker, and Stella represent the 'systems dynamics' genre, which requires the user to conceptualise a problem and formulate the model on-screen using symbols, icons, and directional arrows. The choice of software should be determined by the aims of the subject/course, the experience and background of the students in pharmacokinetics, and institutional factors including price and networking capabilities of the package(s). Enhanced learning may result if the computer teaching of pharmacokinetics is supported by tutorials, especially where the techniques are applied to solving problems in which the link with healthcare practices is clearly established.

Computer Simulation↗

The effect of a multiple literature database search--a numerical evaluation in the domain of Japanese life science.

In literature database searching, we show that it is necessary to use plural databases for a more improved search. We also compare the results of a single database search with that of multiple database search in the domain of Japanese life sciences. We searched the MEDLINE and EMBASE using the same search terms. There were some differences in the results, owing to differences in the journals and recording methods. We herein show some of the differences in the journals contained in both databases. Furthermore, we show the differences in the number of papers derived from the same journal. Next, as an example of a practical search, we selected some universities in Japan, searched both databases regarding papers published from these universities and then merged the results by hand. According to our results, only 63% of all papers were common to both databases.

Biological Science Disciplines↗

Organizational change techniques: their present, their future.

To help carry out their responsibility of managing rapid and often unexpected change, managers have an available set of techniques: organizational behavior modification, management by objectives, management development, organization development, management auditing, and a control cycle of planning, implementation, and control. Each of these has a format that species the procedures to be followed to bring about organizational change. Michael emphasizes that such formats are preferable to a haphazard, trial-and-error approach that may produce unanticipated results. In part because some techniques are newer than others, data from a research project of planning and control that Michael conducted show different rates of usage by a sample of Fortune 500 companies. The control cycle is the most widely used; organizational behavior modification the least widely used. The use of these techniques of organizational change is likely to vary in some ways and experience may bring about changes in the techniques. Michael concludes that the newer breed of managers who are versed in the social sciences, mathematics, and the computer are likely to spread new techniques in the organizational world.

Behavior Therapy↗