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Extending the VA CPRS electronic patient record order entry system using natural language processing techniques.

An automated practitioner order entry system was recently implemented at the VA Puget Sound Health Care System. Since the introduction of this system, we have experienced various problems, among them an increase in time required for practitioners to enter orders. In order to improve usability and acceptance of the order entry, an alternate pathway was built within CPRS that allows direct natural language based order entry. Implementation of the extension in CPRS has been made possible because of the three layers CPRS architecture and its strong object oriented models. This paper discusses the advantages and needs for a natural language based order entry system and its implementation within an existing order entry system.

Humans↗

Ambulation and self-care are goals of rehabilitation after stroke.

Successful rehabilitation of the elderly hemiplegic patient means achievement of ambulation of self-care. The patient's potential for reaching this goal can be determined shortly after the stroke by the stand-up test. Delay of an adequate rehabilitation program, often caused by administrative obstacles to proper care, decreases the potential. Rehabilitation of the elderly hemiplegic also is often hampered by impairment of communication. However, with correction of organic abnormalities causing mental disturbance and with use of simple techniques to facilitate communication, it is possible to achieve ambulation even in patients with marginal ability to communicate.

Activities of Daily Living↗

[The cochlear implant in childhood. Possibilities, limits and perspectives of management].

Therapeutic experiences with cochlear implants in late adult deafness have become so large that implants now belong to the accepted methods of therapy for profoundly deaf patients. Affected patients often recognize speech through simple auditory means. In the last 5 years increased numbers of children with congenital or infantile deafness have also been successfully treated with cochlear implants. Some reports have already been published about clinical experiences and rates of success. In this paper some positive results are shown, but the limitations of treatment and the necessity for accurate preoperative diagnosis must be understood. The further development of treatment for deaf implants requires refinements in phoniatric and pedaudiological techniques.

Adolescent↗

[Communication disorders in the practice of Department of Phoniatrics ad Audiology in Poznań].

The relations between audiology and phoniatrics which formed the base for the present name of Poznań Department of Phoniatrics and Audiology are presented. It is specific for this Department to include the olfacto-gustometry into clinical evaluation of sensory organs. The periodic "Informacje Foniatryczne" which were published in 1966-1972 in our Department were exception in the history of Polish phoniatrics. The communications disorders should be inspected by rehabilitation team: phoniatrician, psychologist and logopedist, but the leading role is left for the physician. The prevention, prophylaxis and rehabilitation of professional voice disorders is one of the main social goals for audiology and phoniatrics.

Academic Medical Centers↗

[Treatment and rehabilitation in juvenile hearing disorders].

The early fitting of a hearing aid to a child with a proven hearing disorder is decisive for the further development of the child. Depending upon the age of the child, the fitting of a hearing aid requires a variety of strategies, and differs considerably from aid fitting in adulthood. It is more difficult, requires more time, and needs a lot of patience and experience. The individual steps and procedures for fitting an aid are described, and the possibilities of rehabilitation of a child with such a hearing impairment are discussed. Apart from the optimal provision of a hearing aid, the child requires intensive early and long-term aftercare to ensure normal speech and normal development.

Child↗