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The use of video display terminals (VDTs) has increased dramatically in the past 10 years and is projected to increase. Particular concerns related to the use of VDTs include vision, radiation, reproduction, dermatitis, stress and ergonomics. This article summarizes the current literature related to possible effects of VDT use and health.
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The evaluation and management of hypertension is based on indirect blood pressures obtained in the office (COBPs) using the mercury sphygmomanometer. The usefulness of COBPs is limited by factors such as observer bias, which confound the ability to discern the true blood pressure value. Automated portable monitors have been marketed, which also measure blood pressure (ABP) indirectly throughout 24 hours, but without human intervention. Acceptance of a new device that indirectly records blood pressure depends largely on its the agreement with the established method of blood pressure measurement. This review compares the variability of blood pressures collected indirectly by standard mercury sphygmomanometer and by an auscultatory automated portable blood pressure monitor. The results indicate that blood pressure, when measured indirectly in a hypertensive patient, is quite variable. Automated blood pressures were lower and demonstrated less within-subject variability during repeated measures than COBPs. The agreement between ABPs and COBPs was better than the agreement between COBPs alone on successive visits. In addition, the mean hourly blood pressure profiles recorded throughout 24 hours by automated and manual methods from ten hypertensive patients were nearly identical. These data suggest that blood pressures measured by auscultatory automated methods are similar to and representative of those obtained manually.
Simultaneous ACCESS to and DISSEMINATION of electronically available PROFESSIONAL KNOWLEDGE, in a productive, Cost-of-Ownership effective, and affordable manner are now achievable. Emerging MANAGEMENT-OF-INFORMATION and SYSTEMS-INTEGRATION disciplines are essential contributing factors to devising and implementing NEW STRATEGIES for ONLINE REFERENCE LIBRARIES. Bringing integrated information closer to the ultimate user and RESHAPING the electronic databases and full-text management systems MARKETPLACE are the most significant outcomes. Key technology attributes are advancements in CD-ROM, Networking, and office automation. We have proven this concept by developing an INTERFACE between MEDLINE from COMPACT CAMBRIDGE and ALL-IN-1 from DIGITAL EQUIPMENT CORPORATION. Saved search results are automatically routed to the individual's ALL-IN-1 account where further DOCUMENT MANAGEMENT and electronic mail functions may be performed. A 486Ware system from Logicraft and a five-members VAX-Cluster (respectively), are linked in a DECNet environment that is the foundation of Children's Integrated Hospital Information System. In phase one of the project up to 8 SIMULTANEOUS USERS may access the 8 RECENT YEARS, from any one of 1500 ACCESS POINTS (local and remote), and utilize any one of 150 NETWORKED PRINTERS. Opportunities are now within reach to expand the electronic library services while utilizing progressive methods and taking advantage of the best available technologies.
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If you can set aside the intense marketing and the appealing gadgetry that surround computer systems, you will still be left with a complex and challenging set of choices. Investigate the hardware and software carefully, certainly, but pay especially close attention to the quality of the people involved, from the consultants to the vendors. Be as skeptical and cautious as any good customer, and make your decisions as though the future of your practice depended on it.
The Genetics Office Automation System (GOAS) is a database management system for the collection and reporting of medical genetics data. We have previously reported on its implementation in a single university center [1,2]. We report here on its implementation in a coordinated data collection effort for the State of Missouri. We discuss the current status of the data collection activities and procedures to share data collected at an individual center with state, regional, and national data collection efforts.
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Blood pressure is a cardiovascular measurement with dynamic characteristics that can be influenced by a number of internal and external factors. The preferred blood pressure determination method would be one that reduces variability between measurements and that reflects the true blood pressure level. In this article, we present the variability of, and agreement between, the blood pressures collected by two indirect methods on the same patients during a hypertensive research project. Data obtained on patients in a typical clinical setting are also provided. Twenty-four-hour diastolic pressures obtained by the automated method demonstrated no regression to a lower mean, while blood pressures obtained casually in the office exhibited such regression. The 95% confidence interval of repeated measures for casual office blood pressure on a patient in a research setting (35/17 mm Hg) or in typical clinic practice (26/19 mm Hg) were similar, while the range of the mean 24-hour automated blood pressure monitoring (21/11 mm Hg) was smaller and demonstrated less variability. The magnitudes of the differences in blood pressures obtained on separate occasions in the same subjects were significantly lower with automated vs casual blood pressure determination methods (7.9/4.6 vs 13.7/7.4 mm Hg for both systolic and diastolic pressures). The agreement (95% confidence interval) between blood pressures obtained by the two methods (19/12 mm Hg) was found to be similar to the repeatability of automated blood pressure monitoring alone, and superior to that for data recorded casually in the office (35/17 mm Hg). Thus, the variability in mean 24-hour automated blood pressures is less than that for casual office blood pressures. The clinician should understand that the variability of blood pressures measured on an individual may be much greater than that reported for populations of hypertensive patients, and must be considered when applying epidemiologic group data to a specific patient. Moreover, any methodology of indirect blood pressure measurement that may reduce the variability and improve repeatability of casual office blood pressures deserves further consideration.
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More than one half of the Dutch dentists uses a p.c., but many of them just for invoicing. Efficiency and quality in daily practice will increase by utilizing all possibilities of the p.c. In this article the advantages of networks are described and a more 'integrated' use of this powerful instrument, for instance by coupling with expert systems, is encouraged.
Most universities and major research institutions in North America, Western Europe and around the Pacific are connected via computer communication networks. The authors have used these networks' accessible, low cost, electronic mail system to develop a network of public health researchers and teachers. Current and potential uses of this network are discussed. These networks can not only facilitate international cooperation within public health; they also make it possible to conduct international collaborative research projects that would be too cumbersome and time consuming to initialize and conduct without this communication facility. One participant from Hungary has been able to participate in the network by using telefax. This has some drawbacks compared to electronic mail. In this era of rapid change in Eastern Europe, we urge that electronic communication be made freely available to colleagues in Eastern Europe.
The Cleveland Clinic Foundation has developed a physician to physician communication network designed to meet the needs of their affiliate physicians--physicians who do not have admitting privileges at the Cleveland Clinic Hospital. This paper provides an overview of the CompreLink network as it exists today, as well as a glimpse into some of their plans for network expansion and development.
The University of Nebraska Medical Center maintains the Synapse Health Information Network to provide timely clinical and library resource information to health professionals across Nebraska and surrounding regions. The system is in over 115 sites across Nebraska and surrounding regions and maintains over 320 network users.