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PubMed1997

READS: a radiology-oriented electronic analysis and display station.

READS is a picture archiving and communications system (PACS) display program that is tailored to allow a radiologist to efficiently perform image review tasks. In this study, the image review process was observed and functional patterns were identified. These were used to define a design that was considered to represent the optimal balance of compromises for a low-cost review station that also allowed easy addition of new functionality. As a result, a program was designed and implemented that has been found to be acceptable for image review and for special image processing function development.

Data Display↗
PubMed1998

The role of digital imaging and communications in medicine in an evolving healthcare computing environment: the model is the message.

The decision to use Digital Imaging and Communications in Medicine (DICOM), Health Level 7 (HL7), a common object broker such as the Common Object Request Brokering Architecture (CORBA) or ActiveX (Microsoft Corp, Redmond, WA) or any other protocol for the transfer of DICOM data depends on the requirements of a particular implementation. The selection of protocol is independent of the information model. Our goal as message standards developers is to design a data interchange infrastructure that will faithfully convey the computer-based patient record and make it available to authorized health care providers when and where it is needed for patient care. DICOM accurately and expressively represents the clinically significant properties of images and the semantics of image-related information. The DICOM data model is small and well-defined. The model can be expressed in Standard Generalized Markup Language (SGML) or Object Management Group Interface Definition Language or other common syntax-and can be implemented using any reliable communications protocol. Therefore our opinion is that the DICOM semantic data model should serve as the basis for a logically equivalent set of specifications in HL7, CORBA, ActiveX, and SGML for the interchange of biomedical images and image-related information.

Computer Communication Networks↗
PubMed2004

[Complications of infectious diseases and benefits of immunization].

Significant progress regarding hygiene, nutrition, and antimicrobial treatment as well as immunizations have lead to a significant decline of morbidity and mortality of infectious diseases in the recent past. Furthermore, immunizations are one of the most cost-effective tools for prevention. However, lack of perception of the substantial risks of complications associated with infectious diseases cause doubts about the necessity of immunizations today. This development is highly worrisome and needs to be adequately addressed by informing physicians and the public about the risks of vaccine-preventable diseases, efficiency, safety and benefits of available vaccines, as well as providing convincing arguments justifying current immunization recommendations. These activities are indispensable for successful implementation and continuation of current immunization programs.

Communicable Disease Control↗
PubMed2006

Update and overview of practical epidemiologic aspects of HIV/AIDS among injection drug users in the United States.

In a changing public health landscape in which local, state, and federal agencies must confront threats of bioterrorism, emerging infections, and numerous chronic diseases, transmission of HIV among injection drug users (IDUs) continues to be an important public health issue and one of the driving forces behind the HIV epidemic. Using a computerized MEDLINE search of published articles from January 1981 through October 2005, we conducted a literature review of practical epidemiologic aspects of HIV/AIDS among IDUs in the United States. Although recent trends indicate a decline in the proportion of newly diagnosed HIV infections associated with injection drug use, drug-use behaviors overall still account for 32% of new HIV diagnoses. Factors in addition to syringe sharing contribute to HIV transmission among IDUs: risky sexual behaviors, sharing of drug preparation equipment and drug solutions, and contextual and social factors. Promising approaches for HIV prevention include rapid HIV testing, office-based substance abuse treatment, behavioral interventions, improved communication about syringe exchange programs, and case management. HIV among IDUs continues to be an important public health problem in the 21st century. It is imperative that public health agencies continue to monitor and combat the HIV epidemic among IDUs to ensure that hard-won gains will not be eroded.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Environmental effects on human reproduction: the basis for new efforts in eastern Europe.

Increasing data are becoming available to implicate toxic environmental effects on the reproductive process in animals and man. Political changes in Central and Eastern Europe have provided new opportunities to study reproductive health in an area where environmental effects may be marked. Eastern European health has been affected by environmental transgressions, but other factors, including life style, have played a role in recent changes in life expectancy in the region. While a few programs worldwide are actively pursuing the implications of environmental toxins on reproduction, human data remain sparse. Further research in this field on a global basis is needed. A new center in Copenhagen has begun to pursue such activities, additionally supported by wider World Health Organization (WHO) programs to promote greater communication between eastern and western scientists working in reproductive health.

Environmental Exposure↗
PubMed1989

Improvements in brachytherapy quality assurance.

Quality assurance (QA) for a busy brachytherapy service is a demanding task which requires the involvement of the entire brachytherapy team. This communication describes the QA program for brachytherapy procedures and source identification and inventory which is currently practiced at the Radiation Oncology Center, Mallinckrodt Institute of Radiology.

Brachytherapy↗
PubMed1991

Activities of the International Federation of Pharmaceutical Manufacturers Associations in world health.

The IFPMA represents 51 member associations of national pharmaceutical manufacturers throughout the world. It has developed several programs to interface and communicate with the World Health Organisation (WHO) programmes especially in regard to its activities in developing countries. Examples of collaboration with WHO are the IFPMA Training Scheme in Quality Control run jointly with the Pharmaceuticals Unit of the WHO. The IFPMA has developed a Code of Pharmaceutical Marketing Practices. It contributes to the health of both the developed and developing world through industry research, development and production of new and improved medicines. IFPMA publications provide important technical information for the global pharmaceutical industry and deal with the important issues of rational drug use in the developing world.

Drug Industry↗
PubMed2004

Contact investigation of a case of active tuberculosis.

BACKGROUND: The Veterans Administration (VA), Marion, Illinois, following Public Health and Veterans Affairs guidance has an excellent tuberculosis (TB) control program with all employees included. METHODS: This VA is a low-risk facility for TB, according to the Centers for Disease Control and Prevention guidelines. A patient presented with active TB in January 2002. Follow-up was complicated and enlarged to the community, adjacent state, and notification of Centers for Disease Control and Prevention. The concentric circle approach in identifying highest-risk contacts had to be modified and expanded because of the immunocompromised condition of some of the contacts. RESULTS: After identification of active TB, contacts were identified. Initially 108 employees and 42 patients were reviewed for follow-up at the VA, with 98 employees and 27 patients actually tested. At 3-month follow-up there were 2 conversions. CONCLUSION: Because of excellent participation in the employee tuberculin skin testing program, conversion was readily identified among staff. Contact investigation of a case of TB requires both diligence in the program and prompt, effective communication and action between state and local health departments and hospitals.

Contact Tracing↗
PubMedDate not supplied

Cystic fibrosis screening.

The integration of universal cystic fibrosis screening in women's health has considerably altered the way we care for obstetric patients and likely will be the foundation for incorporating other genetic tests into routine women's health care. Prior to this change in the standard of care, screening for genetic disease was primarily limited to those individuals who had a personal or family history of the genetic condition or who belonged to a particular ethnic or racial group characterized by a high frequency of carrier and affected individuals. However, technological advances have resulted in facile and economic methodologies for detecting an increasing number of genetic mutations and in the realization that screening for common and uncommon disorders will likely be a not-too-distant-future part of routine health care. Programs that permit clinicians to properly implement genetic protocols and allow patients to make informed decisions about genetic screening and diagnostic tests are needed. The implementation of universal cystic fibrosis screening allows clinicians to recognize the benefits and pitfalls of genetic testing of the general population and encourages the development of programs that will effectively communicate genetic information to professionals and laity.

Cystic Fibrosis↗
PubMedDate not supplied

Group e-mentoring: a new approach to recruitment into nursing.

In an effort to interest young people in the nursing profession, a unique approach merging mentoring with electronic communications was developed. This program, Group Electronic Mentoring in Nursing (GEM-Nursing), aims to educate and motivate young people, ages 15-21, to consider the nursing profession as their career choice. It links students with volunteer nurse mentors across the country via e-mail and a Web site (www.gem-nursing.org). This article describes the process of creating and maintaining a virtual community of nurse mentors and potential nurses. Group e-mentoring allows nurse mentors, limited in terms of their time and geographical location, to provide advice, information and support to potential nurses. It reduces the barriers of scheduling and allows mentors to interact with many more students.

Electronic Mail↗
PubMed2006

Social insects: from selfish genes to self organisation and beyond.

Selfish gene and self-organisation approaches have revolutionised the study of social insects and have provided unparalleled insights into the highly sophisticated nature of insect social evolution. Here, we briefly review the core programs and interfaces with communication and recognition studies that characterise these fields today, and offer an interdisciplinary future perspective for the study of social insect evolutionary biology.

Animals↗
PubMed2005

Non-technical constraints to eradication: the Italian experience.

Although technical constraints to eradication of bovine tuberculosis are well-recognised, non-technical constraints can also delay progress towards eradication, leading to inefficiency and increased programme costs. This paper seeks to analyse the main non-technical constraints that can interfere with the successful implementation of tuberculosis eradication plans, based on experiences from an area of high tuberculosis prevalence in Regione Piemonte, Italy. The main social and economic constraints faced in the past 20 years are reviewed, including a social reluctance to recognise the importance of seeking eradication as the goal of disease control, effective communication of technical issues, the training and the organization of veterinary services, the relationship between the regional authority and farmers and their representatives, and data management and epidemiological reporting. The paper analyses and discusses the solutions that were applied in Regione Piemonte and the benefits that were obtained. Tuberculosis eradication plans are one of the most difficult tasks of the Veterinary Animal Health Services, and non-technical constraints must be considered when progress towards eradication is less than expected. Organizational and managerial resources can help to overcome social or economic obstacles, provided the veterinary profession is willing to address technical, but also non-technical, constraints to eradication.

Animal Husbandry↗
PubMed2003

Reliability of the electronic early treatment diabetic retinopathy study testing protocol in children 7 to <13 years old.

PURPOSE: To assess the test-retest reliability of the electronic Early Treatment Diabetic Retinopathy Study (E-ETDRS) visual acuity algorithm using the computerized Electronic Visual Acuity (EVA) tester in children 7 to <13 years old. DESIGN: Test-retest reliability study. METHODS: This multicenter study involved 245 subjects at four clinical sites. As the main outcome measure, visual acuity was measured twice using the E-ETDRS testing protocol on the EVA system, which uses a programmed handheld device to communicate with a personal computer and a 17-inch monitor at a 3-m test distance. RESULTS: Test-retest reliability was high (r =.94 for right eyes and 0.96 for left eyes) and for both right and left eyes, 89% of retest scores were within 0.1 logarithm of the minimal angle of resolution (logMAR) (five letters) of the initial test score and 99% of retests were within 0.2 logMAR (10 letters). Reliability was high across the age range of 7 to <13 years. Based on 95% confidence level estimates, a change in visual acuity of 0.2 logMAR (10 letters) from a previous acuity measure is unlikely to result from measurement variability. CONCLUSIONS: The E-ETDRS protocol using the EVA has high test-retest reliability in children 7 to <13 years of age. Potential advantages include better standardization across multiple sites, the ability to directly capture data electronically with an automatic acuity score calculation, the reduction of potential bias by limiting the tester's role, and the requirement of only a single testing distance for measurements from 20/800 to 20/12. This computerized testing method should be considered when visual acuity is used as an outcome measure in eye research involving children 7 to <13 years old.

Adolescent↗
PubMed1996

Benchmarking patient satisfaction at academic health centers.

BACKGROUND: In 1991 the University HealthSystem Consortium (UHC), an alliance of 70 academic health centers, began its patient satisfaction benchmarking project. The survey, adapted from the Picker Institute survey, was pilot tested in 1992 and has been in use since 1993. Each year the project's steering committee refines the survey on the basis of member needs and survey item performance. KEY FINDINGS: Findings have shown that the survey can document the effects of specific quality improvement efforts, that patients from different medical services report different levels of satisfaction with their care, and that physician and nursing care have had the greatest impact on overall satisfaction. USING THE RESULTS: Each participating organization receives concise narrative reports of the survey results, with priorities for improvement efforts clearly highlighted. A five-to six-page Executive Summary provides the organization's executive team with a quick overview of the results, as well as a summary of the areas where quality improvements are most needed. A longer Managers' Report provides a more detailed analysis of the findings for quality managers and department heads. Sections for each major area of care can be copied and distributed as "stand alone" reports to the appropriate decision makers. For example, the section on nursing care can be distributed to the chief nursing officer and nurse managers. For each key aspect of the patient's experience, best practices for maintaining patient satisfaction are identified from across the hospitals and compiled into a catalogue. LESSONS LEARNED: The UHC patient satisfaction benchmarking program has created ongoing communication among the participating hospitals, whose staff members have been willing to share problems encountered and possible solutions.

Academic Medical Centers↗
PubMed1989

Anesthesia for liver transplantation.

A successful liver transplant program needs cooperation and communication from the surgical, blood banking, pathology, primary care, and anesthesia services. Rapid availability of laboratory data, efficient blood banking services, ability to infuse blood products rapidly, coagulation management capability, and plentiful manpower are essential.

Adolescent↗
PubMed1991

Emergency management of blunt trauma in children.

Apart from the trend to nonoperative treatment of blunt abdominal injuries, based on accurate CT diagnosis, most of the recent and anticipated changes in pediatric trauma are organizational. They include resuscitation and triage before hospitalization, the use of designated trauma centers, resuscitation by trauma teams, noninvasive diagnosis and monitoring, comprehensive pediatric intensive care, the use of objective measures of outcome, and improved rehabilitation programs (Templeton JM: personal communication). The treatment of individual cases is based on simple but well-established principles. The key steps in management are to recognize children with life-threatening injuries (on the basis of the mechanism of injury or a Pediatric Trauma Score less than or equal to 8 or a Revised Trauma Score less than or equal to 11), to support the function of vital organs by establishing and maintaining adequate respiratory gas exchange and circulation, and to identify all important injuries by thorough and ongoing assessment.

Child↗