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PubMed1987

Applications of the marketing perspective in nutrition education.

The marketing paradigm is based on the premise of exchange of value, that is, value received for value given. The role of the nutrition educator as a marketer is to facilitate exchanges of value with consumers. To carry out this role, a strong orientation to the consumer, what she or he wants and needs and is willing to "pay," guides the development of the nutrition education mission, objectives, and strategies. The marketing paradigm calls for a marketing information system that includes internal record keeping, marketing intelligence gathering, and marketing research. The information is used in the marketing audit, which identifies organizational strengths and weaknesses and marketplace opportunities and barriers. Marketing objectives are formulated, and strategies for segmenting, positioning, and developing the marketing mix follow. These are translated in the marketing plan to an action plan, a budget, and profit and loss projections. Use of the marketing paradigm in nutrition education is not a panacea for organizational ills and marketplace problems. Instead, the paradigm raises issues to which nutrition educators must bring their expertise, commitment, ingenuity, and creativity.

Marketing of Health Services↗
PubMed1984

Sound signal processing.

In the CHORIMAC-12, the French device, the whole speech information despite its redundancy is transmitted to the few cochlear nerve fibers that are still present. Only loud speech intensities between 40 db and 100 db are introduced in a filter battery which gives out the frequency information in 12 channels including the 100-6000 Hz. This 60 db intensity scale is transmitted in a compression rate of about 6 db. The time sampling is 3 msec. A 12 electrode bearer or 12 separate electrodes (in case of ossified cochlea) transmit the electrical information. The electrical stimulus is a square wave: its frequency is equal or inferior to 300 Hz; its voltage may vary between 2.5 and 6.5 volts; its duration may vary between 0 and 200 mu sec. The performances of the system is demonstrated by means of a system of computerized psychophysic tests and speech intelligibility tests.

Cochlear Implants↗
PubMed1994

Adaptive signal analysis and interpretation for real-time intelligent patient monitoring.

On-line intelligent monitoring, diagnosis, and control of dynamic systems such as patients in intensive care units necessitates the context-dependent acquisition, processing, analysis, and interpretation of large amounts of possibly noisy and incomplete data. The dynamic nature of the process also requires a continuous evaluation and adaptation of the monitoring strategy to respond to changes both in the monitored patient and in the monitoring equipment. Moreover, real-time constraints may imply data losses, the importance of which has to be minimized. This paper presents a computer architecture designed to accomplish these tasks. Its main components are a model and a data abstraction module. The model provides the system with a monitoring context related to the patient status. The data abstraction module relies on that information to adapt the monitoring strategy and provide the model with the necessary information. This paper focuses on the data abstraction module and its interaction with the model.

Algorithms↗
PubMed1995

Curriculum of medical informatics and medical technology in the medical faculty.

1. CURRICULUM DESCRIPTION. Twenty years ago, our faculty organized several lessons in a physiology course to inform students about computers. Recently, new courses in informatics were established. In their first year, students take a compulsory course (15 hours=h) of basic computer science (computers databases, networking, and basic non-medical computer software). A special elective course in medical informatics (30h) can be taken in the 4th year (about 20% of students pass tis course). This course includes the following lessons: computers in medicine (2h), scientific information (4h), classification in medicine (2h- including ICD, SNOMED etc.), computer support of clinical decision (2h-calculation principles with demonstration), artificial intelligence (2h), statistical software (2h), hospital information systems (2h), software for practitioners (2h), biosignal and image analysis (4th), computers in pharmacology (2h), computer simulation (2h), support of metabolic care (2h-consultations, risk calculations), and laboratory information systems (2h). The same course, though slightly differences, is used for paramedical students (occupational therapy, health education, and nursing). Medical technology was established in a three year curriculum courses in the 1st year include common courses in electronic devices (60 h), computers and programming (120 h), biophysics (90 h), biomechanics (30 h), and different medical courses (500 h). For the 2nd and 3rd year, 75% of the courses (700 h per year) are technical e.g., medical devices, information systems, signal and picture analysis, laboratory technique, and data protection. 2. CONCLUSION AND PERSPECTIVES. Students of medicine, and some paramedical studies, are able to use computer in their profession after having taken these courses. Bachelors of medical technology find application in biomedical research, hospitals, and medical technology firms.

Curriculum↗
PubMed1991

Automatic generation of plans for biomedical image interpretation.

This paper presents a new object-centered, goal-driven planning approach to biomedical image interpretation. We describe here a prototype system which takes advantage of spatial and detectability constraints from an expert-derived model of expected anatomical structures to automatically generate plans for the interpretation of multimodality images.

Artificial Intelligence↗
PubMed1996

Intellectual evaluations of children using human figure drawings: an empirical investigation of two methods.

This study evaluated the scoring systems of Goodenough and Harris (1963) and Koppitz (1968) for using human figure drawings to assess the intellectual abilities of children. Drawing scores of 125 children, aged 5 to 15, were compared to their performance on the Wechsler Intelligence Scale for Children-Revised (WISC-R), while the drawing scores of a separate group of 74 children, aged 5 to 12, were compared to their performance on the Stanford-Binet Intelligence Scale, Form L-M. While Both drawing systems correlated significantly with the WISC-R as well as the Stanford-Binet, the longer and more detailed Goodenough-Harris had a significantly higher correlation with Performance IQ on the WISC-R than did the Koppitz. Neither drawing system had a pattern of significantly different validity coefficients for children of varying ages or IQ levels.

Adolescent↗
PubMed2005

A framework for intelligent visualization of multiple time-oriented medical records.

Management of patients, especially chronic patients, requires presentation and processing of very large amounts of time-oriented clinical data. Using regular means such as text or tables is often ineffective, thus we propose to use the visual presentation of the information in decision support, especially in the medical domain. Displaying only raw data is not sufficient, because it still requires the user to derive meaningful conclusions from large amount of data. In order to support the computation process, we provide automated mechanisms for temporal abstraction. These mechanisms perform derivation of context-specific, interval-based abstract concepts from raw time-stamped clinical data, by using a domain-specific knowledge base. Then, these abstractions can be visualized and explored. In addition, in many cases (e.g. when comparing the effect of new drugs on various groups of patients) a view of multiple records is more effective than a view of each indi-vidual record separately. We have designed and implemented a system called VISITORS (VisualizatIon of Time-Oriented RecordS) which includes several tools for intelligent visualization and exploration of raw data and abstracted concepts for multiple patient records.

Abstracting and Indexing↗
PubMed1994

Case-based reasoning and imaging procedure selection.

RATIONALE AND OBJECTIVES: Case-based reasoning, an artificial intelligence technique for learning and reasoning from experience, has shown great potential for use in decision support systems. The authors developed and tested a prototype case-based decision support system to explore the applicability of this technique to the selection of diagnostic imaging procedures. METHODS: A case-based system, ProtoISIS, was developed based on the Protos learning apprentice. ProtoISIS learned the domain of ultrasonography and body computed tomography by reviewing 200 consecutive cases of actual requests for imaging procedures. ProtoISIS was tested by using it to classify four sets of 25 cases of actual imaging procedure requests. RESULTS: ProtoISIS correctly classified 72% of the imaging-procedure requests. Its performance improved as it gained experience: in the last two test series, it correctly classified 84% of the cases presented. CONCLUSIONS: Case-based reasoning can be applied successfully to the selection of diagnostic imaging procedures and holds potential for use in clinical decision support aids. Further work is necessary to realize a clinically useful system.

Artificial Intelligence↗
PubMedDate not supplied

Real-time Raman system for in vivo disease diagnosis.

Raman spectroscopy has been well established as a powerful in vitro method for studying biological tissue and diagnosing disease. The recent development of efficient, high-throughput, low-background optical fiber Raman probes provides, for the first time, the opportunity to obtain real-time performance in the clinic. We present an instrument for in vivo tissue analysis which is capable of collecting and processing Raman spectra in less than 2 s. This is the first demonstration that data acquisition, analysis, and diagnostics can be performed in clinically relevant times. The instrument is designed to work with the new Raman probes and includes custom written LabVIEW and Matlab programs to provide accurate spectral calibration, analysis, and diagnosis along with important safety features related to laser exposure. The real-time capabilities of the system were demonstrated in vivo during femoral bypass and breast lumpectomy surgeries. Such a system will greatly facilitate the adoption of Raman spectroscopy into clinical research and practice.

Algorithms↗
PubMed1998

The LabFlow system for workflow management in large scale biology research laboratories.

LabFlow is a workflow management system designed for large scale biology research laboratories. It provides a workflow model in which objects flow from task to task under programmatic control. The model supports parallelism, meaning that an object can flow down several paths simultaneously, and sub-workflows which can be invoked subroutine-style from a task. The system allocates tasks to Unix processes to achieve requisite levels of multiprocessing. The system uses the LabBase data management system to store workflow-state and laboratory results. LabFlow provides a Per15 object-oriented framework for defining workflows, and an engine for executing these. The software is freely available.

Artificial Intelligence↗
PubMed1992

VALAB: expert system for validation of biochemical data.

In large laboratories that use "high-throughput" equipment, it is now possible to use artificial intelligence techniques to aid decision making and validation of data. This paper describes an artificial intelligence project, VALAB, that has been carried out in our laboratory. VALAB, an expert system that permits real-time validation of data, is designed to be equivalent to validation by the laboratory director. The decision produced by the expert system is based on several factors, including correlation between repeated laboratory results, physiological association between different variables, the hospital department from which the test was ordered, and the patient's age and sex. In 200 abnormal chemistry profiles randomly selected, VALAB's ability to detect abnormal cases (i.e., sensitivity = 0.75) was exceeded by only one of seven laboratory experts. However, all seven experts outperformed VALAB's measured specificity of 0.63. The VALAB system incorporates greater than 4000 rules. Operational since November 1988, it has validated greater than 50,000 medical patients' reports in real time.

Artificial Intelligence↗
PubMed1992

The role of computer based techniques in patient monitoring: technical note.

In this paper the requirements of Neurophysiology and Neurotraumatology monitoring are analyzed. As a result a set of designated systems were developed by the authors a short description of which is given in the paper. Finally the future perspectives and problems to be faced are briefly described.

Artificial Intelligence↗
PubMed2005

A user-centered framework for redesigning health care interfaces.

Numerous health care systems are designed without consideration of user-centered design guidelines. Consequently, systems are created ad hoc, users are dissatisfied and often systems are abandoned. This is not only a waste of human resources, but economic resources as well. In order to salvage such systems, we have combined different methods from the area of computer science, cognitive science, psychology, and human-computer interaction to formulate a framework for guiding the redesign process. The paper provides a review of the different methods involved in this process and presents a life cycle of our redesign approach. Following the description of the methods, we present a case study, which shows a successfully applied example of the use of this framework. A comparison between the original and redesigned interfaces showed improvements in system usefulness, information quality, and interface quality.

Artificial Intelligence↗
PubMed2003

Falls prevention within the Australian general practice data model: methodology, information model, and terminology issues.

The iterative development of the Falls Risk Assessment and Management System (FRAMS) drew upon research evidence and early consumer and clinician input through focus groups, interviews, direct observations, and an online questionnaire. Clinical vignettes were used to validate the clinical model and program logic, input, and output. The information model was developed within the Australian General Practice Data Model (GPDM) framework. The online FRAMS implementation used available Internet (TCP/IP), messaging (HL7, XML), knowledge representation (Arden Syntax), and classification (ICD10-AM, ICPC2) standards. Although it could accommodate most of the falls prevention information elements, the GPDM required extension for prevention and prescribing risk management. Existing classifications could not classify all falls prevention concepts. The lack of explicit rules for terminology and data definitions allowed multiple concept representations across the terminology-architecture interface. Patients were more enthusiastic than clinicians. A usable standards-based online-distributed decision support system for falls prevention can be implemented within the GPDM, but a comprehensive terminology is required. The conceptual interface between terminology and architecture requires standardization, preferably within a reference information model. Developments in electronic decision support must be guided by evidence-based clinical and information models and knowledge ontologies. The safety and quality of knowledge-based decision support systems must be monitored. Further examination of falls and other clinical domains within the GPDM is needed.

Accidental Falls↗
PubMed1994

Multichannel spatial auditory display for speech communications.

A spatial auditory display for multiple speech communications was developed at NASA/Ames Research Center. Input is spatialized by the use of simplified head-related transfer functions, adapted for FIR filtering on Motorola 56001 digital signal processors. Hardware and firmware design implementations are overviewed for the initial prototype developed for NASA-Kennedy Space Center. An adaptive staircase method was used to determine intelligibility levels of four-letter call signs used by launch personnel at NASA against diotic speech babble. Spatial positions at 30 degrees azimuth increments were evaluated. The results from eight subjects showed a maximum intelligibility improvement of about 6-7 dB when the signal was spatialized to 60 or 90 degrees azimuth positions.

Auditory Perception↗
PubMed1997

Knowledge based functions for routine use at a German university hospital setting: the issue of fine tuning.

In this paper we present the introduction of knowledge based functions into clinical routine at Giessen University Hospital. For this purpose a therapy planning module at the medical intensive care unit has been extensively redesigned in order to support the structured documentation of drug prescriptions. After introduction of this new HIS component in January 1996 research has been initiated to establish a basic drug therapy knowledge base. The main components of a knowledge based system have been fully incorporated into the hospital information system WING and are in routine use since December 1996. During a pre-production phase warnings of reminder functions were logged and reviewed by an interdisciplinary team in order to adapt the system to the actual clinical environment. The paper describes experiences during this fine tuning and adaptation process which was necessary to bring a small set of knowledge modules into clinical routine.

Artificial Intelligence↗