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Observations on health information in developing countries.

Based on personal experiences, observations are offered on health information in developing countries, ways in which information systems can be strengthened, and opportunities for health-information science graduates. Although data collection consumes a significant portion of the health worker's day, information systems are often a low priority in developing countries. Health-information systems can be strengthened by focusing on local solutions, by building skills in health workers, by utilizing appropriate technology, and by integrating information systems into health programs. Health-information science graduates can assist in improving systems in developing countries, but this will require a broad and flexible definition of health information science, which is much more than computing technology; it is supporting health workers to define, manage, and apply the information they need.

Developing Countries↗

Database access and problem solving in the basic sciences.

This study examined the potential contribution that access to a database of biomedical information may offer in support of problem-solving exercises when personal knowledge is inadequate. Thirty-six medical students were assessed over four occasions and three domains in the basic sciences: bacteriology, pharmacology, and toxicology. Each assessment consisted of a two-pass protocol in which students were first assessed for their personal knowledge of a domain with a short-answer problem set. Then, for a sample of problems they had missed, they were asked to use a database, INQUIRER, to respond to questions which they had been unable to address with their personal knowledge. Results indicate that for a domain in which the database is well-integrated in course activities, useful retrieval of information which augmented personal knowledge increased over three assessment occasions, even continuing to increase several months after course exposure and experience with the database. For all domains, even at assessments prior to course exposure, students were able to moderately extend their ability to solve problems through access to the INQUIRER database.

Bacteriology↗

Rehabilitation of partial laryngectomy patients.

Rehabilitation and function following three anatomically discrete forms of partial laryngectomy (hemilaryngectomy, subtotal supraglottic laryngectomy, and partial laryngopharyngectomy) were studied in 68 patients. Study parameters included posttreatment respiration, deglutition, taste, smell, and hearing function; articulation and voice analysis; and social, communicative, and vocational adjustment. The major portion of the study involved specific testing of posttreatment voice quality and articulation. Recorded word lists and sentences were evaluated by independent observers regarding breathiness, hoarseness, harshness, pitch, loudness, and intelligibility. These data were analyzed employing a Statistical Package for the Social Sciences (SPSS) through the Washington University computer facilities.

Carcinoma, Squamous Cell↗

Computer utilization trends in biomedical illustration.

A national study was designed to determine computer utilization trends in biomedical art and illustration in North America. In the fall of 1991, 453 surveys were mailed to the Association of Medical Illustrators and the Association of Biomedical Communications Directors; 112 (25%) completed survey forms were returned. The survey compares similarities and differences between the groups with regard to the impact (e.g., staffing, time, cost, and quality control) of computer technology (e.g., hardware, software) on biomedical artwork in the health sciences.

Administrative Personnel↗

Interactive multimedia patient simulations in dental and continuing dental education.

Transfer of knowledge from the basic biopsychosocial sciences to patient care is a major task for dental students during their education. Computer-based interactive patient simulations can help students affect this transfer because simulations allow students to develop and practice problem solving and decision-making skills interactively within the context of patient problems. A program for authoring computer-based interactive simulations is described. Patient simulations can effectively integrate basic science relevance, preparation for clinical problem solving, teaching new clinical content and several other necessary elements into curriculum infrastructure. Case simulations also can contribute to evolving educational standards set out by accrediting bodies.

Accreditation↗

Promise and challenge of high-performance computing, with examples from molecular modelling.

Computational modelling is one of the most significant developments in the practice of scientific inquiry in the 20th century. During the past decade, advances in computing technologies have increased the speed of computers by a factor of 100; an increase of a factor of 1000 can be expected in the next decade. These advances have, however, come at a price, namely, radical change(s) in computer architecture. Will computational scientists and engineers be able to harness the power offered by these high-performance computers to solve the most critical problems in science and engineering? In this paper, we discuss the challenges that must be addressed if we are to realize the benefits offered by high-performance computing. The task will not be easy; it will require revision or replacement of much of the software developed for vector supercomputers as well as advances in a number of key theoretical areas. Because of the pace of computing advances, these challenges must be met by close collaboration between computational scientists, computer scientists and applied mathematicians. The effectiveness of such a multidisciplinary approach is illustrated in a brief review of NWCHEM, a general-purpose computational chemistry code designed for parallel supercomputers.

Algorithms↗

Grid computing and biomolecular simulation.

Biomolecular computer simulations are now widely used not only in an academic setting to understand the fundamental role of molecular dynamics on biological function, but also in the industrial context to assist in drug design. In this paper, two applications of Grid computing to this area will be outlined. The first, involving the coupling of distributed computing resources to dedicated Beowulf clusters, is targeted at simulating protein conformational change using the Replica Exchange methodology. In the second, the rationale and design of a database of biomolecular simulation trajectories is described. Both applications illustrate the increasingly important role modern computational methods are playing in the life sciences.

Biopolymers↗

Technique for neurosurgically relevant CT image transfers using inexpensive video digital technology.

OBJECTIVE: To examine and document neurosurgically relevant CT image transfers using inexpensive video digital technology. METHODS: Thirty abnormal CT scans were evaluated on a personal computer monitor following their digital image creation and transfer by electronic mail (e-mail). These were compared with the radiologist's interpretation of a hard copy of the CT scan originals. Any change in diagnosis based on the CT scan or e-mail image was assessed after completion of the comparison. RESULTS: A total of 30 CT scans were successfully transferred and reviewed. On only one image was there disagreement between the neurosurgeon's and the radiologist's interpretations of the image. This resulted in a change in the radiologist's diagnosis after digital image transfer occurred and the neurosurgeon diagnosed an isodense subdural hematoma, which was later confirmed at the time of surgical decompression. CONCLUSIONS: A hand-held, inexpensive digital camera may serve neurosurgeons as a helpful alternative to expensive, labor-intensive teleradiology systems. It should be considered as an adjunctive option for small community-based hospitals unable to financially support more sophisticated teleradiology techniques, which have been shown to provide a significant benefit in the management and outcome of head trauma patients.

Humans↗

Telecommunication discussion groups for health services and medical research.

International university and research institute telecommunication links provide free or low-cost access to several computer networks (commercial and non-commercial). Previously used by science researchers, such networks are now used in clinical and social medicine. University affiliation, a personal computer, and a modern and software are needed. A host-computer, at a local computing centre, operates server software that automatically distributes information to subscribers. The server stores all messages in a monthly logbook that can be edited to produce an electronic magazine. The magazine can also be accessed by non-subscribers. The software gives convenient, fast, single-key processing of messages and files and also allows on-line conferences. Discussion groups on several medical specialties and data bases for AIDS and other communicable diseases are already operating.

Computer Communication Networks↗

Towards performance control on the Grid.

Advances in computational Grid technologies are enabling the development of simulations of complex biological and physical systems. Such simulations can be assembled from separate components--separately deployable computation units of well-defined functionality. Such an assemblage can represent an application composed of interacting simulations or might comprise multiple instances of a simulation executing together, each running with different simulation parameters. However, such assemblages need the ability to cope with heterogeneous and dynamically changing execution environments, particularly where such changes can affect performance. This paper describes the design and implementation of a prototype performance control system (PerCo), which is capable of monitoring the progress of simulations and redeploying them so as to optimize performance. The ability to control performance by redeployment is demonstrated using an assemblage of lattice Boltzmann simulations running with and without control policies. The cost of using PerCo is evaluated and it is shown that PerCo is able to reduce overall execution time.

Benchmarking↗

WEDS: a Web services-based environment for distributed simulation.

Web services have the potential to radically enhance the ability of researchers to make use of distributed computing resources, but jargon and a plethora of standards make their use almost impossible for the scientist without prior experience of the necessary technologies. A powerful and simple WSRF-based middleware scheme is presented, designed to let scientists remotely deploy single or multiple instances of a pre-existing code across multiple resources, and giving steering, visualization and workflow functionality with only simple modifications to program code. It is hoped that the development and implementation of such a toolkit will be relevant not only to the problem of deploying workstation-class codes in real time, but also the move towards more tractable alternatives to the Globus toolkit for deployment of processes in a high-performance computing environment.

Computer Simulation↗

Connecting the health sciences community to the Internet: the NLM/NSF grant program.

In 1992, as part of its high-performance computing and communications initiative, the National Library of Medicine decided to provide health sciences institutions with Internet connection grants similar to those offered to universities by the National Science Foundation. Although library involvement is not required, librarian and library uses have been the most common category in the applications received.

Computer Communication Networks↗