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At least 1,315 records · Page 73Linked to original sources
PubMed2005

User acceptance of the Web-based distribution of radiology services in regional and remote centres of Western Australia.

A large-scale, Web browser-based radiological information system integrated with a picture archiving and communication system (RIS/PACS) has been installed in regional and remote radiology centres of Western Australia. This provides patients in rural areas with local access to advanced medical imaging. User attitudes to the changes were surveyed in a six-week period starting in March 2005. A total of 53 people completed the survey (62% response rate). Respondents were eight radiologists, 21 medical imaging technologists, 10 administration officers and 14 reception staff. All groups gave average ratings of the system's quality. All staff rated the information quality of the system as good. On-site information technology support was judged to be reliable, professional and empathic towards user concerns. There was a broad range of opinion between groups, but on average they were satisfied. The lack of a modern network, comparable to what is available in the metropolitan areas, has impeded the full potential of RIS/PACS in the smaller rural centres.

Attitude of Health Personnel↗
PubMed2005

Integration demonstration. The CMS' latest pay-for-performance initiative will test the power of integrated delivery systems to alter doc practice patterns.

Linda Magno of the CMS says the Medicare Health Care Quality Demonstration project is one of the agency's boldest initiatives yet. She says the project is a chance for providers to "redesign the healthcare system." The project will feature "a lot of latitude" in payment and waivers of Medicare provisions. And the CMS needs a few good volunteer providers to participate.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1995

Assessment of basic medical sciences in an integrated systems-based curriculum.

Basic medical sciences at Sultan Qaboos University (SQU) are taught in a systems-based curriculum. During the development of the courses different formats have been used for the written examinations and also different types of questions. This paper compares students' performance in relation to examination format and to types of questions used. The formats were non-coordinated (NCAs), each discipline having a separate paper; coordinated (CAs), questions from various disciplines being given in the same paper but with separate sections for each discipline; and integrated assessments (IAs), questions being grouped under structure, function, and problem-based integrated long essays. The types of questions used were multiple choice (MCQs), short essays (SEQs), and structured integrated long essays (SILEQs). Students performed better in SEQs than in MCQs. Our analyses also show that SILEQs measure skills similar to those of MCQs and SEQs combined. Students performed best in NCAs. In CAs, students concentrated on those disciplines carrying most weight in the final grade. Currently we use IAs consisting of two parts: part I, comprising MCQs and SEQs, and part II, comprising SILEQs. To date, students are performing better in part II than in part I. We suggest that it is prudent to use different types of questions to measure students' knowledge and skills when IAs are used for systems-based courses.

Analysis of Variance↗
PubMed1986

Reconstitution of an operon from overlapping fragments: use of the lambda SV2 integrative cloning system.

We have used the lambda SV2 system [Howard and Gottesman. In Gluzman (Ed.), Eukaryotic Viral Vectors. Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, 1982, pp. 211-216; in Inouye, M. (Ed.) Experimental Manipulations of Gene Expression. Academic Press, New York, 1983, pp. 137-153] to reconstitute the Salmonella typhimurium his operon from overlapping fragments. lambda SV2 can be propagated as an autonomously replicating plasmid or as a prophage integrated in the Escherichia coli chromosome at the lambda attachment site; our reconstitution was accomplished in the integrated state. We first inserted a portion of the his operon into lambda SV2 and integrated the resulting plasmid by site-specific recombination into the E. coli chromosome. This was achieved by brief induction of a resident prophage. The lysogen was then transformed with DNA from a lambda SV2 clone carrying the remainder of the his operon on an overlapping DNA fragment. The second plasmid was forced to integrate into the first by homologous recombination. When this recombination occurs at the his overlap, a lysogen carrying two lambda SV2 prophages is produced. One prophage carries the entire his operon and the other carries the his overlap region. The latter is removed by site-specific recombination, permitting further contiguous sequences to be sequentially added to the remaining prophage. This method should be applicable for the reconstitution and maintenance of large genes or gene clusters in the E. coli genome.

Alleles↗
PubMed2002

Integration of polyaniline/poly(acrylic acid) films and redox enzymes on electrode supports: an in situ electrochemical/surface plasmon resonance study of the bioelectrocatalyzed oxidation of glucose or lactate in the integrated bioelectrocatalytic systems.

Electropolymerization of aniline in the presence of poly(acrylic acid) on Au electrodes yields a polyaniline/poly(acrylic acid) composite film, exhibiting reversible redox functions in aqueous solutions at pH = 7.0. In situ electrochemical-SPR measurements are used to identify the dynamics of swelling and shrinking of the polymer film upon the oxidation of the polyaniline (PAn) to its oxidized state (PAn(2+)) and the reduction of the oxidized polymer (PAn(2+)) back to its reduced state (PAn), respectively. Covalent attachment of N(6)-(2-aminoethyl)-flavin adenin dinucleotide (amino-FAD, 1) to the carboxylic groups of the composite polyaniline/poly(acrylic acid) film followed by the reconstitution of apoglucose oxidase on the functional polymer yields an electrically contacted glucose oxidase of unprecedented electrical communication efficiency with the electrode: electron-transfer turnover rate approximately 1000 s(-1) at 30 degrees C. In situ electrochemical-SPR analyses are used to characterize the bioelectrocatalytic functions of the biomaterial-polymer interface. The current responses of the bioelectrocatalytic system increase as the glucose concentrations are elevated. Similarly, the SPR spectra of the system are controlled by the concentration of glucose. The glucose concentration controls the steady-state concentration ratio of PAn/PAn(2+) in the film composition. Therefore, the SPR spectrum of the film measured upon its electrochemical oxidation is shifted from the spectrum typical for the oxidized PAn(2+) at low glucose concentration to the spectrum characteristic of the reduced PAn at high glucose concentration. Similarly, the polyaniline/poly(acrylic acid) film acts as an electrocatalyst for the oxidation of NADH. Accordingly, an integrated bioelectrocatalytic assembly was constructed on the electrode by the covalent attachment of N(6)-(2-aminoethyl)-beta-nicotinamide adenine dinucleotide (amino-NAD(+), 2) to the polymer film, and the two-dimensional cross-linking of an affinity complex formed between lactate dehydrogenase and the NAD(+)-cofactor units associated with the polymer using glutaric dialdehyde as a cross-linker. In situ electrochemical-SPR measurements are used to characterize the bioelectrocatalytic functions of the system. The amperometric responses of the system increase as the concentrations of lactate are elevated, and an electron-transfer turnover rate of 350 s(-1) between the biocatalyst and the electrode is estimated. As the PAn(2+) oxidizes the NADH units generated by the biocatalyzed oxidation of lactate, the PAn/PAn(2+) steady-state ratio in the film is controlled by the concentration of lactate. Accordingly, the SPR spectrum measured upon electrochemical oxidation of the film is similar to the spectrum of PAn(2+) at low lactate concentration, whereas the SPR spectrum resembles that of PAn at high concentrations of lactate.

Acrylic Resins↗
PubMed1983

The buddy system. An integral school health care plan.

The education for all Handicapped Children Act (Public Law 94-142) is both an education and civil rights law. As a result of the civil rights perspective of the law, students with chronic illnesses and disabilities are demanding access to public education. These students often require multiple services designed to meet their special health needs. It has become the responsibility of school personnel to assess these students and determine the best type of school health plan for them. This article is about the creation of a Buddy System used in an urban, middle school in grades six-eight for students ages 10-13.

Adolescent↗
PubMed1999

The management of endodontically treated teeth using a Computer-Aided Design and Computer-Assisted Manufacturing/Computer-Aided Design and Computer-Integrated Manufacturing system.

This article introduces a new approach for restoring endodontically treated posterior teeth. Significantly reduced natural tooth structure often remains not only because of previous restorative measures but also because of endodontic procedures. Cast restorations for these teeth are almost universally recommended. The exception to this is the rare instance in which only conservative endodontic access openings exist in teeth presenting with no former existing restorations. Typically, multiple clinical appointments are required to complete the final cast restoration. This article presents Computer-Aided Design and Computer-Assisted Manufacturing/Computer-Aided Design and Computer-Integrated Manufacturing applications for restorative dentistry that provide the necessary care in an expeditious manner.

Ceramics↗
PubMed1989

Effect of uncertainty and diagnosticity on classification of multidimensional data with integral and separable displays of system status.

Integrative, objectlike displays have been advocated for presenting multidimensional system data. In this research two experiments assess the effect of uncertainty on the processing of integral and separable displays. In each experiment 30 subjects were trained to classify instances of system state into one of four state categories using a configural display, a bar graph display, or a digital display. In Experiment 1 the range of instances from the state categories was uniform; in Experiment 2 the distribution was biased toward those instances of highly uncertain state category membership. After training, subjects received extended practice classifying system data. In both experiments uncertainty was found to have the greatest effect on classification performance. In Experiment 1 the bar graph display was consistently superior; the configural display was superior to the digital display only under conditions of low uncertainty. In Experiment 2 the superiority of the bar graph display diminished, producing results equivalent to those of the digital display, with the configural display producing the worst performance. The effect of uncertainty on classification performance is discussed, with specific attention paid to the apparent configural and separable properties of the bar graph display.

Adolescent↗
PubMedDate not supplied

Elucidating endometrial function in the post-genomic era.

The post-genomic era has now arrived, and science and biology are on the threshold of a transition from understanding functions of single molecules and pathways in cells, tissues and whole organisms to understanding integrative systems. The endometrium is a dynamic tissue that responds to multiple stimuli, depending on physiological and environmental conditions, including steroid hormones, an implanting conceptus, withdrawal of steroid hormones, contraceptive steroids, selective steroid hormone receptor modulators, infection, transient cell populations, and metaplastic and neoplastic agents. High throughput technologies with regard to DNA, RNA and proteins are well positioned to enable a thorough understanding of the dynamic changes and integrative systems involved in endometrial maturation, desquamation, receptivity to implantation, infertility, pregnancy maintenance and failure, inflammation and infection, and malignant transformation. This monograph reviews some of the salient features of the new technologies and summarizes current information on endometrial biology derived from these approaches.

Embryo Implantation↗
PubMed1991

An Integrated International Aerospace Medical Information System.

An Integrated International Aerospace Medical Information System (IIASMIS) is proposed. Such a system is needed to allow all appropriate resources to be brought to bear on the medical problems that must be solved for safe extended manned missions. Existing medical data bases are reviewed. The suggested approach involves the formation of an international working group that would determine the scope of the problem, identify the real needs, and design the top-level architecture of the system. Participants would develop national data bases independently. A prototype system would be developed and evaluated; upon satisfactory operation, it would be expanded to include all active partners.

Aerospace Medicine↗
PubMed2005

Impact of local guidelines and an integrated dispensing system on antibiotic prophylaxis quality in a surgical centre.

Surgical antibiotic prophylaxis is effective in preventing postoperative wound infections. Guidelines are designed to optimize antimicrobial use in this setting. The aim of this study was to assess antibiotic use in surgical prophylaxis in a surgical hospital before and after the implementation of both local antibiotic prophylaxis guidelines and a specific medication set for various surgical procedures. The appropriateness of surgical antibiotic prophylaxis increased from 50.9% in the pre-implementation stage to 94.9% in the postimplementation stage (P<0.001). The implementation of a multidisciplinary protocol and design of medication sets helped to improve the practice of surgical antibiotic prophylaxis.

Antibiotic Prophylaxis↗
PubMed2006

A new integrated ultrasound system for shockwave lithotripsy.

BACKGROUND AND PURPOSE: Inline ultrasound monitoring requires good image quality for accurate stone localization, as well as low shockwave shadowing and a robust transducer. In general, conventional transducers designed for another purpose, such as abdominal scanning, are employed. The distance between the transducer and the SWL focus can be varied by a mechanical drive. The drawback is reduced fragmentation at short distances and poor imaging at long distances. This paper introduces a new approach using a specially designed transducer without a mechanical drive. MATERIALS AND METHODS: A transducer prototype with optimized beam focusing (B-K Medical, Herlev, Denmark) was integrated into a modified Compact Delta II therapy head (Dornier MedTech, Wessling, Germany). Image quality was tested at two clinical sites, where 40 kidney and 14 ureteral stones were treated. The shockwave was characterized by model stone tests and fiberoptic hydrophone measurements. RESULTS: Both kidney and ureteral stone treatments could be monitored reliably. Despite the long distance to the SWL focus, the transducer could be operated with relatively high frequencies (3.5-6 MHz), so that high image resolution was obtained. Model stone tests yielded the same fragmentation as the standard Compact Delta II without a transducer. CONCLUSIONS: This study shows that the concept of an integrated transducer distant from the shockwave focus is feasible. Transducer elevation, which is accompanied by shockwave shadowing and early transducer failure, is avoided by employing a dedicated transducer design.

Humans↗
PubMed2001

An integrated approach for genome-wide gene expression analysis.

Since efficient and relatively cheap methods were developed for determining biosequences, a lot of biosequence data has been generated. As the main problem in molecular biology is the analysis of the data instead of the data acquisition, part of the study of computational biology is to extract all kinds of meaningful information from the sequences. Computer-assisted methods have become very important in analyzing biosequence data. However, most of the current computer-assisted methods are limited to finding motifs. Genes can be regulated in many ways, including combinations of regulatory elements. This research is aimed at developing a new integrated system for genome-wide gene expression analysis. This research begins with a new motif-finding method, using a new objective function combining multiple well defined components and an improved stochastic iterative sampling strategy. Combinatorial motif analysis is accomplished by constructive induction that analyzes potential motif combinations. We then apply standard inductive learning algorithms to generate hypotheses for different gene behaviors. A genome-wide gene expression analysis demonstrated the value of this novel integrated system.

Algorithms↗
PubMed2000

Nursing future search. Building a community of nurses in an integrated healthcare system.

Many models and approaches are available to manage change and plan for the future. Large group intervention is one approach to tapping the collective wisdom of a nursing system facing formidable adaptive challenges. Large group interventions involve many people, and they include open sharing of information, group problem-solving, participation, and sharing of power to create a shared future. One model for creating a vision for the future is called "Future Search". In this article, we describe the methodology of Future Search as a model to plan for change. A case study illustrates the use of a Nursing Future Search by an integrated, not-for-profit healthcare organization in northern Virginia. Results and the outcomes of a 6-month follow-up conference reveal nine planning groups that are moving a community of nurses to action.

Delivery of Health Care, Integrated↗
PubMed1998

Case management in an integrated delivery system.

A case management program is designed so that the nurses could work with any client within the health system, regardless of the diagnosis of provider. A variety of challenges surfaced: maintaining visibility within a large health care system; working with varied approaches to client care issues; and being clinically knowledgeable in the variety of chronic illnesses. Hospital admissions, physician and emergency department visits and costs are measured after establishing a nurse case management program.

Case Management↗
PubMed2001

Integrated health systems: success or failure?

There continues to be an increasing number of healthcare delivery systems as a result of marketplace changes that include declining reimbursement and increasing costs for healthcare. However, the majority of these systems fail. Failures are a consequence of poor management, lack of a common mission and business rationale, individual's interests that outweigh the entity's interests, and the conflict of cultures. Incremental changes will continue, but the healthcare environment will remain unstable for the foreseeable future.

Delivery of Health Care, Integrated↗