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PubMed1989

Information technology and the future of health services delivery.

This article examines the dramatic ways that information technology will influence clinical care, strategic management, and organization of the health care delivery system in the years ahead. Advancements in microprocessors, telecommunications, mass storage of data and images, and input-output devices will be accompanied by increased use of health-related software packages. Standardized patient record formats and coding systems will facilitate system integration and networking of computers. Clinical decision support systems will assist physicians in medical diagnosis and treatment. Computer-enhanced medical imaging and other noninvasive procedures will reduce surgery, patient pain and discomfort, and lower costs. Automation will get closer to the patient. Management information and decision support systems will be central to effective management in a highly competitive environment. Information systems will support strategic planning, cost control, productivity enhancement, quality improvement, and evaluation of products and services.

Delivery of Health Care↗
PubMedDate not supplied

[Comparative evaluation of 2 epidemiologic surveillance systems of hepatitis A].

Epidemiological surveillance represents an important tool for the prevention of hepatitis A. In Italy, the surveillance of hepatitis A is based on the routine notification system of infectious diseases (from 1996 it was replaced by SIMI, Computerised System of Infectious Diseases) and on SEIEVA (Epidemiological Integrated System of Acute Viral Hepatitis). From 1997 to 2000 the two surveillance systems have been compared in Puglia region to evaluate match rate, completeness and sensitivity. A total of 7.018 records from SIMI and 4.413 from SEIEVA have been analyzed. During this period, the 37.0% of cases notified to SIMI match SEIEVA records whereas the 58.8% of cases reported to SEIEVA match cases notified to SIMI. Therefore, the match rate between the two systems was 29.0%. The sensitivity of SIMI and SEIEVA resulted 79.4% and 49.9% respectively. The comparison of the two surveillance systems allowed to recognise problems in local organisation. Therefore, a more adequate training should be supplied to workers involved in the surveillance activities.

Hepatitis A↗
PubMed1986

Strategies in Doppler ultrasound.

A computer based system integrating a continuous wave 10 MHz Doppler ultrasound system with a standardising electrocardiographic record has been developed and tested. Data storage and duplication are intrinsic elements in the system which also includes on line analysis of the data. The electrocardiograph permits exact timing and standardisation of the pulse wave forms. The results can be displayed and printed. The controlled data provides a valid basis for comparison. Data obtained from patients suffering from amaurosis fugax are presented and discussed.

Blindness↗
PubMed1981

[Morphofunctional equivalents of the pituitary-adrenal system in disruptions of the integrity of the cardiorespiratory systems].

Desintegration of the cardio-respiratory apparatus activity was modelled in 8 dogs using an individually dosed loading (running in the treadmill) up to V stage according to the original technique (control--10 dogs). By means of morphometric, histological, histochemical and electron microscopic analysis, morpho-functional equivalents of the reaction of the hypophysis-adrenals system were studied at a repeated desintegration in the activity of the cardio-respiratory apparatus. It was demonstrated that certain elements of the hypophysis-adrenals system were completely involved into the adaptive reactions. The greatest functional activity was detected in chromophobic and basophilic adrenocytes and in cells of the glomerular zone. In cells of the fascicular zone and in the medullar substance of the adrenals peculiar signs of the functional activity appeared. It is not expedient to calculate training regimes basing on the loading which determines the state of desintegration in the cardio-respiratory apparatus activity.

Adaptation, Physiological↗
PubMed1996

Database and knowledge base integration in decision support systems.

Since decision support systems (DSS) in medicine often are linked to clinical databases it is important to find methods that facilitate the work for DSS developers to implement database queries in the knowledge base (KB). This paper presents a method for linking clinical databases to a KB with Arden Syntax modules. The method is based on a query meta database including templates for SQL queries. During knowledge module authoring the medical expert only refers to a code in the query meta database. Our method uses standard tools so it can be implemented on different platforms and linked to different clinical databases.

Artificial Intelligence↗
PubMed2003

A personalized and automated dbSNP surveillance system.

The development of high throughput techniques and large-scale studies in the biological sciences has given rise to an explosive growth in both the volume and types of data available to researchers. A surveillance system that monitors data repositories and reports changes helps manage the data overload. We developed a dbSNP surveillance system (URL: http://www.pharmgkb.org/do/serve?id=tools.surveillance.dbsnp) that performs surveillance on the dbSNP database and alerts users to new information. The system is notable because it is personalized and fully automated. Each registered user has a list of genes to follow and receives notification of new entries concerning these genes. The system integrates data from dbSNP, LocusLink, PharmGKB, and Genbank to position SNPs on reference sequences and classify SNPs into categories such as synonymous and non-synonymous SNPs. The system uses data warehousing, object model-based data integration, object-oriented programming, and a platform-neutral data access mechanism.

DNA↗
PubMed2002

A multiscale conceptual framework for integrated ecogeomorphological research to support stream naturalization in the agricultural Midwest.

The complexity of fluvial systems necessitates interdisciplinary research in fluvial geomorphology and aquatic ecology to develop a fundamental understanding of interconnections among biotic and abiotic aspects of these systems. Integrated knowledge of this type is vital for environmental management of streams in human-dominated environments. A conceptual framework is presented for integrating geomorphological and ecological research on streams in East Central Illinois, USA, a glaciated low-relief agricultural landscape. The framework embodies a multiscale perspective in which a geomorphological conception of the fluvial system is used to define a hierarchy of characteristic spatial scales for exploring important linkages between stream geomorphology and aquatic ecology. The focus ecologically is on fish, because a rich body of historical information exists on fisheries in East Central Illinois and because past work has suggested that availability of physical habitat is a major factor influencing the community characteristics of fish in this human-altered environment. The hierarchy embodied in the framework includes the network, link, planform, bar unit, bar element, and bedform/grain scales. Background knowledge from past research is drawn upon to identify potential linkages between geomorphological and ecological conditions at each of these scales. The conceptual framework is useful for guiding integrated ecogeomorphological research at specific scales and across different scales. It also is helpful for illustrating how widespread human modification of streams has catastrophically altered the scalar structure of fluvial systems in East Central Illinois. Knowledge emerging from the integrated research provides a basis for environmental-management schemes directed toward stream naturalization.

Agriculture↗
PubMed1978

[Present situation and future prospects for epidemiological surveillance within the framework of Quebec new health system (author's transl)].

Epidemiological surveillance in Quebec is part of the integral system of this activity throughout the whole of Canada and the United States. Since surveillance is aimed mainly at the ecosystem of the disease rather than just the cases, the activities are insured from the horizontal point of view by several organisations, aided by various Ministeries (health, agriculture, industry and commerce). The vertical structure (besides the Center for Disease Control in Atlanta as coordinator) includes the federal Laboratory Centre for Disease Control, its epidemiology and surveillance bureaus, as well as its territorial epidemiologists, provincial epidemiologists and their teams. Quebec has recently been given a new health structure, introduced in conjunction with the traditional organisations by the new Departments of Community Health, and the Social Centres of Community Services. This structure which is new to North America is characterised mostly by its close integration with community health. Moreover, it represents an excellent opportunity for developing an epidemiological surveillance complementary to local problems and for heightening their responsibility.

Communicable Disease Control↗
PubMed1987

Integrated communication/environmental controller system for the physically disabled.

A wireless integrated communication/environmental controller system (ICECS) is described, which offers total communication as well as environmental control for the disabled person. The system is flexible and simple enough to be used from the wheelchair by patients with spinal cord injuries. The system has three parts: the mobile unit, the base unit, and a set of remote-control receiver modules. The mobile unit and the base unit are linked together by radio, while the base unit and the remote receiver modules communicate over a power line carrier. The telephone mode allows telephone calls to be placed and received. Different electrical devices are controlled by the environmental control mode. The intercom mode permits two-way communication with an attendant or the nursing station. The modes can be switched simply by pressing a button on the mobile unit. Sixteen soft-touch switches arranged in a 4 X 4 matrix allow operation by hand or mouthstick.

Communication Devices for People with Disabilities↗
PubMed2000

An integrated data warehouse system: development, implementation, and early outcomes.

This paper describes a generic vision of global information flow and the development of an integrated data warehouse system, using clinical data on all patient encounters and administrative data on all operating transactions as part of an integrated health care system. This new integrated data warehouse system has been successfully used for multiple purposes, including patient care, health services research, resource utilization and feasibility studies. During 1999, core analyses included the electronic abstraction, aggregation, and analysis of data on over 400,000 patients. This approach to building a centralized data system comprised of multiple repositories efficiently meets a variety of individual and aggregate information needs, while reducing the need to create duplicate databases.

Database Management Systems↗
PubMed2006

Constant contour integration in peripheral vision for stimuli with good Gestalt properties.

The visual system integrates discrete but aligned local stimuli to form percept of global contours. Previous experiments using "snake" contours showed that contour integration was mainly present in foveal vision but absent or greatly weakened in peripheral vision. In this study, we demonstrated that, for contour stimuli such as circles and ellipses, which bore good Gestalt properties, contour integration for shape detection and discrimination was nearly constant from the fovea to up to 35 degrees visual periphery! Contour integration was impaired by local orientation and position jitters of contour elements, indicating that the same local contour linking mechanisms revealed with snake contour stimuli also played critical roles in integration of our good Gestalt stimuli. Contour integration was also unaffected by global position jittering up to 20% of the contour size and by dramatic shape jittering, which excluded non-contour integration processes such as detection of various local cues and template matching as alternative mechanisms for uncompromised peripheral perception of good Gestalt stimuli. Peripheral contour integration also presented an interesting upper-lower visual field symmetry after asymmetries of contrast sensitivity and shape discrimination were discounted. The constant peripheral performance might benefit from easy detection of good Gestalt stimuli, which popped out from background noise, from a boost of local contour linking by top-down influences and/or from multielement contour linking by long-range interactions.

Contrast Sensitivity↗
PubMed2004

Automated high throughput ADME assays for metabolic stability and cytochrome P450 inhibition profiling of combinatorial libraries.

Early determinations of pharmaceutical properties can serve as predictors of a compound's likely development success. Our laboratory has implemented high throughput in vitro absorption, distribution, metabolism and excretion (ADME) assays which address absorption, metabolism, and physico-chemical properties in an effort to identify potential development liabilities early, thereby minimizing discovery to market attrition. In response to the throughput demands of parallel synthesis, we have incorporated a SAGIAN core robotics system for the determination of both metabolic stability in human liver microsomes (HLMs) and cytochrome P450 (CYP450) inhibition. This automated solution has led to an increase in capacity, throughput and reliability for both in vitro assays. The SAGIAN core robotics system integrates devices such as liquid handlers, plate hotels and incubators through the use of an ORCA robotic arm. The HLM stability assay utilizes a Multimek 96-channel pipettor for liquid handling. The incubation plates are transferred off-line for final semi-quantitative analysis using high throughput parallel LC/MS. The CYP inhibition method combines both liquid handlers and an integrated fluorescence plate reader to perform single concentration percent inhibition assays for 88 compounds. Cytochrome P450 inhibition is measured for both CYP3A4 and CYP2D6 isozymes. This system represents a fully integrated approach to high throughput ADME evaluation in support of drug discovery. The core system concept creates a plug-and-play approach, which combines a series of modular stations to build a robotic platform, which is flexible, upgradable, and easily reconfigured when assays change or are newly developed. The application of these strategies as a means of assessing metabolic stability and CYP inhibition of synthetic libraries is discussed.

Combinatorial Chemistry Techniques↗
PubMed2003

Breaks in continuity of care and the rural senior transferred for medical care under regionalisation.

Continuity of care, defined as the patient experiencing coherent care over time and place, is challenged when a rural senior with multiple medical problems is transferred to a regional hospital for acute care. From an illustrative case of an older patient with pneumonia and atrial fibrillation, we catalogue potential breaks in continuity of care. Optimal continuity of care is characterised not only by regular contact with the providers who establish collaboration with patients and their caregivers, but also by communication, co-ordination, contingency, convenience, and consistency. Because it is not possible to have the same providers continuously available (relational continuity), for continuity of care, there is a need for integrative system approaches, such as: (1) policy and standards, disease management programs, integrated clinical pathways (management continuity), (2) electronic health information systems and telecommunications technology (communication continuity). The evaluation of these approaches requires measures that account for the multi-faceted nature of continuity of care.

Journal Article↗
PubMed2006

[Application of global positioning system and geographic information system in surveillance of schistosomiasis].

OBJECTIVE: To use the snail survey data of Yugan, Jiangxi Province as an example to evaluate the effects and advantages of global positioning system integrated with digital maps and remote sensing data in order to manage and analyze the whole country's surveillance data of schistosomiasis by using geographic information system. METHODS: The data of geographic information and snail information of 20 marshlands in Yugan, Jiangxi Province were collected, and by the correction of remote sensing images based on the digital maps and index extraction, the snail current situation and trend were analyzed and expressed. RESULTS: A series of specific procedure images of these 20 marshlands was established and the effects of Yugan surveillance platform based on geographic information system were validated. CONCLUSION: The whole country's surveillance data of schistosomiasis might be successfully integrated with geographic information system by global positioning system and be managed and expressed, which supplies a successful platform in using the surveillance data effectively.

Animals↗